186 lines
5.3 KiB
Markdown
186 lines
5.3 KiB
Markdown
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# Administrator Training Record
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| Form ID | FRM-TRN-001 |
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| Form Title | Administrator Training Record |
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| Version | 1.0 |
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| Effective Date | [DATE] |
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---
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## Trainee Information
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| Field | Information |
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|-------|-------------|
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| Name | |
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| Employee/Study ID | |
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| Department/Site | |
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| Job Title/Role | |
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| Education Level | |
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| Clinical Credentials (if applicable) | |
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## Training Session Information
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| Field | Information |
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|-------|-------------|
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| Measure Name | |
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| Measure Version | |
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| Measure Type | ☐ PRO ☐ ClinRO ☐ ObsRO ☐ PerfO |
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| Training Date | |
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| Training Duration | |
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| Training Location | ☐ In-Person ☐ Virtual ☐ Self-Study |
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| Training Materials Version | |
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## Trainer Information
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| Field | Information |
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| Trainer Name | |
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| Trainer Qualifications | |
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| Trainer Certification (if required) | |
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## Training Content Covered
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### General Training Topics
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☐ PRO/ClinRO/ObsRO/PerfO concepts and definitions
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☐ FDA PRO Guidance principles
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☐ Standardized administration techniques
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☐ Avoiding interviewer bias and response influence
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☐ Handling participant questions appropriately
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☐ Missing data minimization strategies
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☐ Data quality and integrity requirements
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☐ Good Clinical Practice (GCP) principles
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☐ Informed consent and research ethics
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☐ Privacy and confidentiality (HIPAA)
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### Measure-Specific Topics
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☐ Measure purpose and theoretical construct
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☐ Target population and intended use
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☐ Item content and response format
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☐ Recall period specification
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☐ Administration instructions (verbatim)
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☐ Timing and scheduling requirements
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☐ Scoring procedures and calculations
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☐ Score interpretation and clinical meaning
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☐ Handling incomplete responses
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☐ Common administration errors to avoid
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☐ Special considerations for this measure
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### Additional Training (check all that apply)
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☐ Electronic administration (eCOA platform training)
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☐ Paper backup procedures
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☐ Translation and language-specific considerations
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☐ Cultural adaptation considerations
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☐ Safety procedures (for PerfO)
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☐ Equipment operation (for PerfO)
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☐ Inter-rater reliability procedures (for ClinRO)
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## Practical Components Completed
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☐ Review of measure items and instructions
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☐ Observation of demonstration administration
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☐ Mock administration with standardized participant
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☐ Role-play practice with feedback
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☐ Video review of administration technique
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☐ Inter-rater reliability exercise (for ClinRO)
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☐ Scoring practice with sample data
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☐ eCOA system navigation practice
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## Knowledge Assessment
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### Written Test
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Test Version: __________
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Number of Questions: __________
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Score: __________ / __________ Percentage: __________%
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☐ Pass (≥80%) ☐ Fail (<80%)
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If failed: Remediation plan and retest date: _________________________
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### Practical Assessment
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☐ Pass - Demonstrated competent administration
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☐ Fail - Additional training needed
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Specific areas needing improvement: _________________________________
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________________________________________________________________
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________________________________________________________________
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## Competency Determination
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☐ **COMPETENT** - May administer measure independently
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☐ **NOT YET COMPETENT** - Additional training/supervision required
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Competency achieved on: __________
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Specific limitations or supervision requirements: _____________________
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________________________________________________________________
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## Copyright Holder Certification (if applicable)
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Certification Required: ☐ Yes ☐ No
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If Yes:
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Certification Program: ___________________________________________
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Certification Number: ___________________________________________
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Certification Date: __________
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Expiration Date: __________
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Certificate on file: ☐ Yes ☐ No
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## Study/Protocol Assignment
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This training qualifies the administrator for the following studies/protocols:
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| Protocol Number | Protocol Title | Principal Investigator |
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|----------------|----------------|----------------------|
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## Signatures
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**I certify that I have completed the training described above and understand the requirements for administering this outcome measure. I will follow all procedures as trained and seek guidance when uncertain.**
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Trainee Signature: ______________________ Date: __________
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**I certify that the trainee named above has successfully completed training and demonstrated competence in administering this outcome measure.**
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Trainer Signature: ______________________ Date: __________
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**I approve this individual to independently administer this outcome measure in the assigned studies/protocols.**
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Supervisor Signature: ______________________ Date: __________
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## Retraining/Recertification Record
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| Date | Reason for Retraining | Trainer | Result |
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| | ☐ Measure update ☐ Performance issue ☐ Extended absence ☐ Certification renewal ☐ Other: _____ | | ☐ Pass ☐ Fail |
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## Distribution
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Original: Personnel Training File
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Copy: Study File
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Copy: Training Database
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**Record Retention:** Duration of employment + 3 years minimum; per study protocol requirements
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---
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**Related Documents:**
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- SOP-GEN-002: Training and Competence for Measure Administration
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- SOP-ADM-001: Clinical Outcome Measure Administration
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- FRM-TRN-002: Competency Assessment Form
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