Training Form Instructions

INDIVIDUAL ANIMAL TRAINING RECORD - IACUC
First Name / Last Name / Degree(s)
Position Title / Department / Lab (PI name)
Work Phone / Email
Yes / No
I. WEB-MODULES: I have completed the relevant CITI courses
II. GENERAL: I have received in-lab training on the following topics:
Animal bites or other injuries and how to report such.
My responsibility to contact my supervisor for training/ before I attempt a task for which I am not trained.
Personal hygiene in the workplace & required PPE
Basic safe animal handling, restraint and husbandry.
Identifying pain & distress in the species with which I work.
Proper animal transport, carcass disposal and cage return.
Animal record keeping and monitoring.
Potential zoonotic diseases.
The emergency action/evacuation plan for my work area.
Identification of Chemicals in the lab & use of the Material Safety Data Sheets.
Location of the emergency shower & eyewash.
How to report concerns about the use of animals at RFUMS
Other topics (LIST):
III. SPECIALIZED TRAINING
Instructions: List the species in each column. Place an (X) under each species that you have had adequate training and/or experience to independently perform the procedure listed. Place an (X) for those techniques on which you are still receiving hands-on training and supervision from the PI or designate (and will NOT be performing independently until considered adequately trained, with updates to the IACUC). Write “n/a” (not applicable) for procedures that are not relevant to the protocol.
Species 1: / Species 2:
Adequately Trained / In
Training / Adequately Trained / In
Training
Euthanasia:
Cervical Dislocation
Decapitation
CO2
Injectable agents
Other:
Anesthesia/Analgesia:
Injectables
Inhalational
Regional (local)
Safe handling & scavenging of anesthetic gases
Controlled drug records & DEA requirements
Recognizing pain & distress
Injections:
Subcutaneous (SQ)
Intramuscular (IM)
Intraperitoneal (IP)
Intravenous (IV)
Submandibular
Retro-orbital
Gavage
Other:
Aseptic Surgery (Rodents and lower species)
Instrument sterilization procedures
Aseptic technique
Anesthesia monitoring
Surgical record keeping
Sterile Surgery (higher mammals)
Sterile surgical technique
USDA requirements for
pre-, peri- and post-surgical monitoring and record keeping.
Other procedures – list below:
VERFICATION OF TRAINING AND/OR EXPERIENCE
In the space below, describe any training and/or experience you have received prior to RFUMS relevant to your duties that supports the experience noted on this form (attach verification if relevant and additional pages if needed). If you have no previous experience, please enter N/A.
SIGNATURES
Individual ______Date______
Principal Investigator ______Date______

Training Form Instructions:

Each individual’s Training Summary Form must be completed and available in a binder in the laboratory for inspections, or upon request by a program veterinarian or IACUC. The training folders will be examined during semi-annual IACUC inspections.

If an individual is checked as “training complete” on an IACUC protocol, the PI is assuring the IACUC that this individual has been trained to proficiency and can work independently with animals.

On the Training Summary Form, place an “X” in the “Adequately Trained” column for each procedure for which the individual has had previous training and experience with, and is deemed proficient by the PI. For example, if someone has been well trained to use injectable anesthetics, then place an “X” in the “Adequately Trained” column across from ‘injectable’ under the heading of ‘Anesthesia’.
Put “n/a” for procedures that are not applicable to the protocol(s) the individual will be working on.

b. If an individual is a new member of the research team and still requires training to become proficient in specialized procedures, they must also be listed on the IACUC protocol. In that case, their status should be indicated as “In Training”. Such individuals are permitted to observe, help and receive training with procedures under the close supervision of the PI or his/her designate (but not work independently).

On the Training Summary Form, indicate this by placing an “X” in the “In Training” column for those procedures for which the individual is still gathering skills.
When training is complete to proficiency, the PI must update the Training Summary Form, checking “Adequately Trained”, initialing and dating the form.
Finally, whenever an individual who was in training has finished training in specialized procedures, an email must be sent to the IACUC coordinator notifying the IACUC that this person is now fully trained for their responsibilities on the protocol(s).

NOTE: The veterinarians or the IACUC can request demonstration of an individual’s proficiency with any specialized technique (as well as provide training in some areas if requested).

Questions?

Contact the IACUC Coordinator: 847-578-8543

email: or

IACUC Chair: 847-578-3440

email:

Updated 5-17-17