San Pedro College

School of Medical Laboratory Science

Internship Program

Equivalency Program

Rubrics for Competency Assessment

Name of Intern: REQUERME, SHAYKA DANIELLE S. Date of Assessment: OCTOBER 2022

Clinical Rotation: ISBB Agency: KMSCI

Rubrics Competent Needs Improvement Remarks or Comments

Preparation of laboratory The materials and equipment COMPETENT

materials and equipment The intern prepared all the
necessary materials and
equipment needed for the
performance of the procedures
and did not require the
guidance of the CI/preceptor
for the preparation
prepared by the intern needed
for the performance of the
procedure was incomplete, and
the intern requires the
guidance of the CI/Preceptor
for the preparation

Specimen Accessioning The intern shows the highest
competence in specimen
accessioning. He/She is able
to examine the specimen for
its criteria of acceptance or
rejection without the guidance
of the CI/preceptor.
The intern shows a limited COMPETENT
degree of competence in
specimen accessioning. As
such, he/she requires the
guidance of the CI/preceptor in
examining the specimen for its
criteria of acceptance or
rejection.

Execution of the The intern performs the
competency laboratory procedure with the
highest level of competence
and does not require the
guidance of the CI/preceptor.
The intern performs the COMPETENT
laboratory procedure with
limited degree of competence
and requires the guidance of
CI/preceptor in some parts of
the procedure.

Analyses and The intern shows the highest
interpretation competence in the analyses and
interpretation of the findings of
the procedures, in such, he/she
is able to determine whether
the results generated is valid
and can be recorded in the
result form, or the results
indicate possible problems and
requires corrective actions after
being validated by the
CI/Preceptor.
The intern performs the COMPETENT
laboratory procedure with
limited degree of competence
in the analyses and
interpretation of the findings
of the procedures, in such,
he/she requires the constant
guidance of the CI/Preceptor
to interpret whether the results
are valid or not.

Execution of biosafety The intern shows only a certain COMPETENT

degree of competence in the
The intern shows the highest execution of biosafety practices
competence in the execution of such as proper donning and
biosafety practices such as doffing of complete PPEs,
proper donning and doffing of biosafety considerations in the
complete PPEs, biosafety pre-analytical, analytical, and
considerations in the post-analytical phases of the
preanalytical, analytical, and procedure, including
postanalytical phases of the disinfection and/or sterilization,
procedure, including and proper disposal of sharps,
disinfection and/or sterilization, infectious wastes, and others
and proper disposal of sharps, wastes. In these, the intern
infectious wastes, and others require the guidance of the
wastes. In these, the intern does preceptor or the C.I on how to
not require the guidance of the execute some of these biosafety
preceptor or the staff in the practices.
execution of these biosafety
practices.

ARIAN MAE MARIE S. TAN, RMT

Name and signature of the evaluator
 San Pedro College
School of Medical Laboratory Science
Internship Program

Equivalency Program

Rubrics for Competency Assessment

Name of Intern: REQUERME, SHAYKA DANIELLE S. Date of Assessment: NOVEMBER 2022

Clinical Rotation: HEMATOLOGY Agency: KMSCI

Rubrics Competent Needs Improvement Remarks or Comments

Preparation of laboratory The materials and equipment COMPETENT

materials and equipment The intern prepared all the
necessary materials and
equipment needed for the
performance of the procedures
and did not require the
guidance of the CI/preceptor
for the preparation
prepared by the intern needed
for the performance of the
procedure was incomplete, and
the intern requires the
guidance of the CI/Preceptor
for the preparation

Specimen Accessioning The intern shows the highest
competence in specimen
accessioning. He/She is able
to examine the specimen for
its criteria of acceptance or
rejection without the guidance
of the CI/preceptor.
The intern shows a limited COMPETENT
degree of competence in
specimen accessioning. As
such, he/she requires the
guidance of the CI/preceptor in
examining the specimen for its
criteria of acceptance or
rejection.

Execution of the The intern performs the
competency laboratory procedure with the
highest level of competence
and does not require the
guidance of the CI/preceptor.
The intern performs the COMPETENT
laboratory procedure with
limited degree of competence
and requires the guidance of
CI/preceptor in some parts of
the procedure.

Analyses and The intern shows the highest
interpretation competence in the analyses and
interpretation of the findings of
the procedures, in such, he/she
is able to determine whether
the results generated is valid
and can be recorded in the
result form, or the results
indicate possible problems and
requires corrective actions after
being validated by the
CI/Preceptor.
The intern performs the COMPETENT
laboratory procedure with
limited degree of competence
in the analyses and
interpretation of the findings
of the procedures, in such,
he/she requires the constant
guidance of the CI/Preceptor
to interpret whether the results
are valid or not.

Execution of biosafety The intern shows only a certain COMPETENT

degree of competence in the
The intern shows the highest execution of biosafety practices
competence in the execution of such as proper donning and
biosafety practices such as doffing of complete PPEs,
proper donning and doffing of biosafety considerations in the
complete PPEs, biosafety pre-analytical, analytical, and
considerations in the post-analytical phases of the
preanalytical, analytical, and procedure, including
postanalytical phases of the disinfection and/or sterilization,
procedure, including and proper disposal of sharps,
disinfection and/or sterilization, infectious wastes, and others
and proper disposal of sharps, wastes. In these, the intern
infectious wastes, and others require the guidance of the
wastes. In these, the intern does preceptor or the C.I on how to
not require the guidance of the execute some of these biosafety
preceptor or the staff in the practices.
execution of these biosafety
practices.

ARIAN MAE MARIE S. TAN, RMT

Name and signature of the evaluator
 San Pedro College
School of Medical Laboratory Science
Internship Program

Equivalency Program

Rubrics for Competency Assessment

Name of Intern: REQUERME, SHAYKA DANIELLE S. Date of Assessment: DECEMBER 2022

Clinical Rotation: CLINICAL CHEMISTRY Agency: KMSCI

Rubrics Competent Needs Improvement Remarks or Comments

Preparation of laboratory The materials and equipment COMPETENT

materials and equipment The intern prepared all the
necessary materials and
equipment needed for the
performance of the procedures
and did not require the
guidance of the CI/preceptor
for the preparation
prepared by the intern needed
for the performance of the
procedure was incomplete, and
the intern requires the
guidance of the CI/Preceptor
for the preparation

Specimen Accessioning The intern shows the highest
competence in specimen
accessioning. He/She is able
to examine the specimen for
its criteria of acceptance or
rejection without the guidance
of the CI/preceptor.
The intern shows a limited COMPETENT
degree of competence in
specimen accessioning. As
such, he/she requires the
guidance of the CI/preceptor in
examining the specimen for its
criteria of acceptance or
rejection.

Execution of the The intern performs the
competency laboratory procedure with the
highest level of competence
and does not require the
guidance of the CI/preceptor.
The intern performs the COMPETENT
laboratory procedure with
limited degree of competence
and requires the guidance of
CI/preceptor in some parts of
the procedure.

Analyses and The intern shows the highest
interpretation competence in the analyses and
interpretation of the findings of
the procedures, in such, he/she
is able to determine whether
the results generated is valid
and can be recorded in the
result form, or the results
indicate possible problems and
requires corrective actions after
being validated by the
CI/Preceptor.
The intern performs the COMPETENT
laboratory procedure with
limited degree of competence
in the analyses and
interpretation of the findings
of the procedures, in such,
he/she requires the constant
guidance of the CI/Preceptor
to interpret whether the results
are valid or not.

Execution of biosafety The intern shows only a certain COMPETENT

degree of competence in the
The intern shows the highest execution of biosafety practices
competence in the execution of such as proper donning and
biosafety practices such as doffing of complete PPEs,
proper donning and doffing of biosafety considerations in the
complete PPEs, biosafety pre-analytical, analytical, and
considerations in the post-analytical phases of the
preanalytical, analytical, and procedure, including
postanalytical phases of the disinfection and/or sterilization,
procedure, including and proper disposal of sharps,
disinfection and/or sterilization, infectious wastes, and others
and proper disposal of sharps, wastes. In these, the intern
infectious wastes, and others require the guidance of the
wastes. In these, the intern does preceptor or the C.I on how to
not require the guidance of the execute some of these biosafety
preceptor or the staff in the practices.
execution of these biosafety
practices.

ARIAN MAE MARIE S. TAN, RMT

Name and signature of the evaluator