The United States of America has always been a country comprised of many different cultures and identities. According to the US census bureau, no single ethnic group will be in the majority by the year 2044. In addition to the changes in racial and ethnic identities, US demographics are also rapidly changing related to age, gender identity, and other social constructs. With evolving demographics, it is essential that all healthcare practitioners are able to adapt to the needs of patients and families, colleagues, and beyond. A patient's background and culture can impact how they view health, disease, treatments, and their interactions with healthcare systems; likewise, diversity among colleagues can impact the working environment. Working with colleagues in a constructive manner and valuing the patient's needs above our own biases promotes an environment for optimal health care delivery. ABBREVIATIONS: LGBT - Lesbian, Gay, Bisexual, Transexual
{"title":"Critical Conversations: Cultural Awareness, Sensitivity, and Competency","authors":"Janice M. Conway-Klaassen, L. Maness","doi":"10.29074/ASCLS.30.1.34","DOIUrl":"https://doi.org/10.29074/ASCLS.30.1.34","url":null,"abstract":"The United States of America has always been a country comprised of many different cultures and identities. According to the US census bureau, no single ethnic group will be in the majority by the year 2044. In addition to the changes in racial and ethnic identities, US demographics are also rapidly changing related to age, gender identity, and other social constructs. With evolving demographics, it is essential that all healthcare practitioners are able to adapt to the needs of patients and families, colleagues, and beyond. A patient's background and culture can impact how they view health, disease, treatments, and their interactions with healthcare systems; likewise, diversity among colleagues can impact the working environment. Working with colleagues in a constructive manner and valuing the patient's needs above our own biases promotes an environment for optimal health care delivery. ABBREVIATIONS: LGBT - Lesbian, Gay, Bisexual, Transexual","PeriodicalId":263458,"journal":{"name":"American Society for Clinical Laboratory Science","volume":"25 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131681787","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
OBJECTIVE: This review describes consensus guidelines and laboratory methods for diagnosing a lupus anticoagulant (LAC). BACKGROUND: A prolonged APTT due to the presence of a LAC is a frequent finding in the clinical laboratory in patients referred for preadmission testing. Accurate detection of the LAC can often be very challenging for the laboratory. While no single assay is specific for diagnosing a LAC, there is a combination of assays that can be used to improve laboratory diagnosis. METHOD: This review describes several assays used to detect a LAC; reviews consensus guidelines that influence the choice of assays by laboratories; and associated preanalytical variables that may lead to a missed diagnosis. CONCLUSION: A thorough understanding of the principles involved in LAC testing and preanalytical variables may lead to a more accurate diagnosis of the LAC. ABBREVIATIONS: aB2GPI - anti-B2 glycoprotein I, aCL - anti-cardiolipin, APLAs - antiphospholipid antibodies, BCSH - British Committee for Standards in Haematology, CLSI - Clinical and Laboratory Standards Institute, DOAC - direct oral anticoagulant, dRVVT - dilute Russell's viper venom time, ISTH-SSC - International Society for Thrombosis and Haemostasis – Scientific Standardization Committee, LAC - lupus anticoagulant, VKA - vitamin K antagonist, SCT - silica clotting time.
{"title":"Laboratory Diagnosis of the Lupus Anticoagulant","authors":"Larry J. Smith","doi":"10.29074/ascls.30.1.7","DOIUrl":"https://doi.org/10.29074/ascls.30.1.7","url":null,"abstract":"OBJECTIVE: This review describes consensus guidelines and laboratory methods for diagnosing a lupus anticoagulant (LAC). BACKGROUND: A prolonged APTT due to the presence of a LAC is a frequent finding in the clinical laboratory in patients referred for preadmission testing. Accurate detection of the LAC can often be very challenging for the laboratory. While no single assay is specific for diagnosing a LAC, there is a combination of assays that can be used to improve laboratory diagnosis. METHOD: This review describes several assays used to detect a LAC; reviews consensus guidelines that influence the choice of assays by laboratories; and associated preanalytical variables that may lead to a missed diagnosis. CONCLUSION: A thorough understanding of the principles involved in LAC testing and preanalytical variables may lead to a more accurate diagnosis of the LAC. ABBREVIATIONS: aB2GPI - anti-B2 glycoprotein I, aCL - anti-cardiolipin, APLAs - antiphospholipid antibodies, BCSH - British Committee for Standards in Haematology, CLSI - Clinical and Laboratory Standards Institute, DOAC - direct oral anticoagulant, dRVVT - dilute Russell's viper venom time, ISTH-SSC - International Society for Thrombosis and Haemostasis – Scientific Standardization Committee, LAC - lupus anticoagulant, VKA - vitamin K antagonist, SCT - silica clotting time.","PeriodicalId":263458,"journal":{"name":"American Society for Clinical Laboratory Science","volume":"99 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130504701","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Each of us holds preconceived assumptions about the things around us including the ideas, judgments, and values that have been developed from our personal experiences in life. Cultural identity is based on a set of beliefs and behaviors that guide a person's understanding of how things routinely work. But as we become a more global society we must understand that all cultures have a set of acceptable guidelines, some of which, may be very different from our own. Although many schools and companies require employees to attend seminars about developing cultural sensitivity, awareness, and competence, our implicit biases may interfere with the application of culturally competent behaviors in real life. The vast majority of health care practitioners are genuinely focused on the well-being of patients and the quality of medical practice. However, many are not aware of their implicit practices of bias that can cause as much harm as explicit prejudice. To find that we hold implicit or unexamined biases can be disturbing but at the same time it is a requisite first step to developing a culturally competent person. This article explores two models of cultural competence as well as a model for constructive communication in culturally diverse environments. Finally, examples of harmful and biased statements experienced by laboratory students and employees are also discussed with suggestions and guidance for constructive management and resolution. ABBREVIATIONS: LGBT - Lesbian, Gay, Bisexual, Transexual, EEOC - Equal Employment Opportunity Commission, IDI® - Intercultural Development Inventory®, NCCC - National Center of Cultural Competence
{"title":"Developing Cultural Competency in Laboratory Practice","authors":"Janice M. Conway-Klaassen, L. Maness","doi":"10.29074/ASCLS.30.1.43","DOIUrl":"https://doi.org/10.29074/ASCLS.30.1.43","url":null,"abstract":"Each of us holds preconceived assumptions about the things around us including the ideas, judgments, and values that have been developed from our personal experiences in life. Cultural identity is based on a set of beliefs and behaviors that guide a person's understanding of how things routinely work. But as we become a more global society we must understand that all cultures have a set of acceptable guidelines, some of which, may be very different from our own. Although many schools and companies require employees to attend seminars about developing cultural sensitivity, awareness, and competence, our implicit biases may interfere with the application of culturally competent behaviors in real life. The vast majority of health care practitioners are genuinely focused on the well-being of patients and the quality of medical practice. However, many are not aware of their implicit practices of bias that can cause as much harm as explicit prejudice. To find that we hold implicit or unexamined biases can be disturbing but at the same time it is a requisite first step to developing a culturally competent person. This article explores two models of cultural competence as well as a model for constructive communication in culturally diverse environments. Finally, examples of harmful and biased statements experienced by laboratory students and employees are also discussed with suggestions and guidance for constructive management and resolution. ABBREVIATIONS: LGBT - Lesbian, Gay, Bisexual, Transexual, EEOC - Equal Employment Opportunity Commission, IDI® - Intercultural Development Inventory®, NCCC - National Center of Cultural Competence","PeriodicalId":263458,"journal":{"name":"American Society for Clinical Laboratory Science","volume":"41 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122740471","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Traditionally, anticoagulant therapy has been conducted through the administration of vitamin K antagonists (VKAs) and parenteral alternatives. Direct Oral Anticoagulants (DOACs) such as apixaban, rivaroxaban and edoxaban provide the convenience of the VKA in that they are administered orally yet they lack many of the disadvantages associated with VKA therapy. Unlike VKAs, measuring DOAC levels is usually unnecessary. However, there are instances with plasma concentrations should be determined. The chromogenic anti-Xa assay is the best linear quantitative assay that is easily accessible to most clinical laboratories for this purpose. However, since the calibrators and controls for apixaban, rivaroxaban and edoxaban are awaiting Federal Drug Administration (FDA) clearance, measurement may have to be performed using the Prothrombin Time assay that lacks the sensitivity of the chromogenic anti-Xa. Results should be periodically verified using liquid chromatography in tandem with mass spectrometry which is the reference method for measuring DOAC levels in plasma. ABBREVIATIONS: AF-atrial fibrillation, DOAC – direct oral anticoagulant, DVT – deep vein thrombosis, FDA – Food and Drug Administration, HPLC – high performance liquid chromatography, LMWH – low molecular weight heparin, PE – pulmonary embolism, PT – prothrombin time, UFH – unfractionated heparin, UPLC – ultra-performance liquid chromatography, VKA – vitamin K antagonist, VTE – venous thromboembolism
{"title":"The Direct Oral Anticoagulants Apixaban, Rivaroxaban, and Edoxaban","authors":"Keith Alan DeHaas","doi":"10.29074/ascls.30.1.2","DOIUrl":"https://doi.org/10.29074/ascls.30.1.2","url":null,"abstract":"Traditionally, anticoagulant therapy has been conducted through the administration of vitamin K antagonists (VKAs) and parenteral alternatives. Direct Oral Anticoagulants (DOACs) such as apixaban, rivaroxaban and edoxaban provide the convenience of the VKA in that they are administered orally yet they lack many of the disadvantages associated with VKA therapy. Unlike VKAs, measuring DOAC levels is usually unnecessary. However, there are instances with plasma concentrations should be determined. The chromogenic anti-Xa assay is the best linear quantitative assay that is easily accessible to most clinical laboratories for this purpose. However, since the calibrators and controls for apixaban, rivaroxaban and edoxaban are awaiting Federal Drug Administration (FDA) clearance, measurement may have to be performed using the Prothrombin Time assay that lacks the sensitivity of the chromogenic anti-Xa. Results should be periodically verified using liquid chromatography in tandem with mass spectrometry which is the reference method for measuring DOAC levels in plasma. ABBREVIATIONS: AF-atrial fibrillation, DOAC – direct oral anticoagulant, DVT – deep vein thrombosis, FDA – Food and Drug Administration, HPLC – high performance liquid chromatography, LMWH – low molecular weight heparin, PE – pulmonary embolism, PT – prothrombin time, UFH – unfractionated heparin, UPLC – ultra-performance liquid chromatography, VKA – vitamin K antagonist, VTE – venous thromboembolism","PeriodicalId":263458,"journal":{"name":"American Society for Clinical Laboratory Science","volume":"32 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125188439","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The clinical appropriateness of blood transfusion rests with physicians having the correct knowledge when making decisions concerning the selection and transfusion of blood and blood components. Transfusion medicine knowledge (TMK) is typically acquired during medical school, as on-the-job training during residency or fellowship, and through continuing education (e.g., online, seminars, workshops) in practice. To obtain a baseline of TMK in physicians at Augusta University Medical Center (AUMC) (formerly Georgia Regents University Medical Center), a multiple-choice survey questionnaire was designed and validated using input from individuals with expertise in the field of transfusion medicine. The survey was then deployed to physicians at AUMC. Analysis of survey response data showed that there were significant knowledge gaps among physicians that varied among specialty groups as well as with the number of formal education hours that physicians received as part of their medical training and in practice. The purpose of this research study was to establish the baseline TMK level of physicians at AUMC. ABBREVIATIONS: TMK - Transfusion Medicine Knowledge, AUMC - Augusta University Medical Center -, ARC - American Red Cross, CMS – Centers for Medicare & Medicaid Services, CFR - Code of Federal Regulations, ASCP - American Society for Clinical Pathology, BEST - Biomedical Excellence for Safer Transfusion, TJC - The Joint Commission, PBM - Patient Blood Management
{"title":"Design and Validation of a Survey Questionnaire for the Assessment of Physician Transfusion Medicine Knowledge","authors":"Ibsa Abdi, Lauren E. Gagnon, S. Wise, G. Passmore","doi":"10.29074/ascls.30.1.28","DOIUrl":"https://doi.org/10.29074/ascls.30.1.28","url":null,"abstract":"The clinical appropriateness of blood transfusion rests with physicians having the correct knowledge when making decisions concerning the selection and transfusion of blood and blood components. Transfusion medicine knowledge (TMK) is typically acquired during medical school, as on-the-job training during residency or fellowship, and through continuing education (e.g., online, seminars, workshops) in practice. To obtain a baseline of TMK in physicians at Augusta University Medical Center (AUMC) (formerly Georgia Regents University Medical Center), a multiple-choice survey questionnaire was designed and validated using input from individuals with expertise in the field of transfusion medicine. The survey was then deployed to physicians at AUMC. Analysis of survey response data showed that there were significant knowledge gaps among physicians that varied among specialty groups as well as with the number of formal education hours that physicians received as part of their medical training and in practice. The purpose of this research study was to establish the baseline TMK level of physicians at AUMC. ABBREVIATIONS: TMK - Transfusion Medicine Knowledge, AUMC - Augusta University Medical Center -, ARC - American Red Cross, CMS – Centers for Medicare & Medicaid Services, CFR - Code of Federal Regulations, ASCP - American Society for Clinical Pathology, BEST - Biomedical Excellence for Safer Transfusion, TJC - The Joint Commission, PBM - Patient Blood Management","PeriodicalId":263458,"journal":{"name":"American Society for Clinical Laboratory Science","volume":"216 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124269832","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A 25-year-old Caucasian female with a history of irritable bowel syndrome, presented to the emergency room with worsening upper bilateral abdominal pain and fatigue that began two days before arrival. The patient described having mild intermittent lower back pain and worsening bilateral edema of her ankles that began several months prior. Blood and urine specimens were tested, with results indicating the presence of systemic inflammation and nephrotic syndrome. The patient was admitted to the hospital for further testing and observation. An ultrasound of the kidneys was negative for renal calculus. A gallium scan indicated localization of leukocytes in the kidneys, liver and spleen. A CT urogram indicated renal damage and a SAP scan indicated amyloid deposits in the kidneys, liver and spleen. The patient was diagnosed with amyloidosis and nephrotic syndrome. Corticosteroids were prescribed and testing to determine the underlining cause of amyloidosis was initiated. ABBREVIATIONS: BUN - blood urea nitrogen, CBC - complete blood count, CRP - C-reactive protein, ECM - extracellular matrix, ESR - erythrocyte sedimentation rate, HLA - human leukocyte antigen, RBC - red blood cell, SAA - serum amyloid A, SAP - serum amyloid P, TNF - tumor necrosis factor, WBC - white blood cell
{"title":"Secondary (AA) Amyloidosis with Development of Nephrotic Syndrome","authors":"C. Larrimore, E. Fox","doi":"10.29074/ascls.30.1.23","DOIUrl":"https://doi.org/10.29074/ascls.30.1.23","url":null,"abstract":"A 25-year-old Caucasian female with a history of irritable bowel syndrome, presented to the emergency room with worsening upper bilateral abdominal pain and fatigue that began two days before arrival. The patient described having mild intermittent lower back pain and worsening bilateral edema of her ankles that began several months prior. Blood and urine specimens were tested, with results indicating the presence of systemic inflammation and nephrotic syndrome. The patient was admitted to the hospital for further testing and observation. An ultrasound of the kidneys was negative for renal calculus. A gallium scan indicated localization of leukocytes in the kidneys, liver and spleen. A CT urogram indicated renal damage and a SAP scan indicated amyloid deposits in the kidneys, liver and spleen. The patient was diagnosed with amyloidosis and nephrotic syndrome. Corticosteroids were prescribed and testing to determine the underlining cause of amyloidosis was initiated. ABBREVIATIONS: BUN - blood urea nitrogen, CBC - complete blood count, CRP - C-reactive protein, ECM - extracellular matrix, ESR - erythrocyte sedimentation rate, HLA - human leukocyte antigen, RBC - red blood cell, SAA - serum amyloid A, SAP - serum amyloid P, TNF - tumor necrosis factor, WBC - white blood cell","PeriodicalId":263458,"journal":{"name":"American Society for Clinical Laboratory Science","volume":"49 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128329531","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Although a diverse working environment can produce an efficient workflow, employees are not always treated fairly based on these diversities. Laws were established in 1963 to protect workers from unfair treatment by employers and coworkers. Since that time, laws have been added and amended to parallel changes in society and technology, from equal pay and equality based on sex, race, and religion, to genetic nondiscrimination. The Equal Employment Opportunity Commission supports these laws and can sue employers when the complaints of diverse workers do not solve problems they face in the workplace. It is vital that employees understand their rights and that employers strictly follow these laws that require them to treat workers with fairness. ABBREVIATIONS: EEOC - Equal Employment Opportunity Commission, UPS - United Parcel Service, ADEA - Age Discrimination in Employment Act, IRCA - Immigration Reform and Control Act of 1986, GINA - Genetic Information Nondiscrimination Act of 2008
{"title":"Laws to Protect Diverse Employees","authors":"L. Maness, Janice M. Conway-Klaassen","doi":"10.29074/ASCLS.30.1.38","DOIUrl":"https://doi.org/10.29074/ASCLS.30.1.38","url":null,"abstract":"Although a diverse working environment can produce an efficient workflow, employees are not always treated fairly based on these diversities. Laws were established in 1963 to protect workers from unfair treatment by employers and coworkers. Since that time, laws have been added and amended to parallel changes in society and technology, from equal pay and equality based on sex, race, and religion, to genetic nondiscrimination. The Equal Employment Opportunity Commission supports these laws and can sue employers when the complaints of diverse workers do not solve problems they face in the workplace. It is vital that employees understand their rights and that employers strictly follow these laws that require them to treat workers with fairness. ABBREVIATIONS: EEOC - Equal Employment Opportunity Commission, UPS - United Parcel Service, ADEA - Age Discrimination in Employment Act, IRCA - Immigration Reform and Control Act of 1986, GINA - Genetic Information Nondiscrimination Act of 2008","PeriodicalId":263458,"journal":{"name":"American Society for Clinical Laboratory Science","volume":"135 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131527682","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The medical laboratory science profession has faced more than twenty-years of a workforce shortage. One component that plays a role in the workforce shortage is the attrition of early career medical laboratory scientists shortly after graduation from an accredited medical laboratory science educational program. This study seeks to identify factors that contribute to the professional socialization of early career clinical laboratory scientists. In this study early career medical laboratory scientists' express high levels of professional behaviors and attitudes coupled with a strong professional identity necessary to remain in the medical laboratory science profession. In addition, this study identified the presence of a theory-practice transition gap that may contribute to retention and attrition of new professional's as they transition from the classroom into the medical laboratory workforce. ABBREVIATIONS: MLS - Medical Laboratory Science, RG - Recent Graduate, NAACLS – National Accrediting Agency for Clinical Laboratory Science, ASCLS – American Society for Clinical Laboratory Science
{"title":"The Professional Socialization of Early Career Medical Laboratory Scientists","authors":"J. Schill","doi":"10.29074/ascls.30.1.15","DOIUrl":"https://doi.org/10.29074/ascls.30.1.15","url":null,"abstract":"The medical laboratory science profession has faced more than twenty-years of a workforce shortage. One component that plays a role in the workforce shortage is the attrition of early career medical laboratory scientists shortly after graduation from an accredited medical laboratory science educational program. This study seeks to identify factors that contribute to the professional socialization of early career clinical laboratory scientists. In this study early career medical laboratory scientists' express high levels of professional behaviors and attitudes coupled with a strong professional identity necessary to remain in the medical laboratory science profession. In addition, this study identified the presence of a theory-practice transition gap that may contribute to retention and attrition of new professional's as they transition from the classroom into the medical laboratory workforce. ABBREVIATIONS: MLS - Medical Laboratory Science, RG - Recent Graduate, NAACLS – National Accrediting Agency for Clinical Laboratory Science, ASCLS – American Society for Clinical Laboratory Science","PeriodicalId":263458,"journal":{"name":"American Society for Clinical Laboratory Science","volume":"21 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114226027","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Michelle R. Brown, Kristopher R. Maday, John B Hurt
INTRODUCTION In the report, Health Professions Education: A Bridge to Quality, the Institutes of Medicine (IOM) has detailed a vision for preparing healthcare professionals.1 A focal point within this vision is teaching students to work in interdisciplinary teams. In a separate report, Measuring the Impact of Interprofessional Education on Collaborative Practice and Patient Outcomes, the IOM calls for an alignment of education and healthcare delivery systems.2 The Clinical Laboratory Science (CLS) education community needs to readily embrace the IOMs vision and enthusiastically answer the call with innovative educational methods such as interprofessional simulation (IP). Some CLS programs are already considering interprofessional simulation, but may not have an existing simulation infrastructure or financial support from administration. Other programs have a laboratory with instrumentation, but have not yet made the leap from simulating a “day in the lab” with CLS students to including students from professions outside the laboratory to provide comprehensive situations that more closely mimic working in a healthcare environment. This manuscript offers small scale, low resource options to help a CLS program include IP simulation as an innovative educational method to teach interprofessional communication and teamwork. Getting Started: Know the Fundamentals While high fidelity mannequins, patient rooms, and instrumentation provide an authentic environment, they are not required to offer a quality IP experience. There are, however, fundamentals that remain the same whether designing intricate scenarios for students from several professional programs or simple scenarios with students from only two professions. This includes the alignment of content knowledge between students… ABBREVIATIONS: IOM – Institutes of Medicine, CLS – Clinical laboratory scientist, IP - Interprofessional, SBAR – Situation, Background, Assessment, Recommendation/request, Team STEPPS - Team Strategies and Tools to Enhance Performance and Patient Safety, APP – Advanced practice provider, WHO – World Health Organization, CUS – Concerned, Uncomfortable, Safety issue, SP – Simulated patient, PA – Physician assistant, UAB – University of Alabama at Birmingham
{"title":"Small Scale, Low Resource Options for Introducing Clinical Laboratory Science Students to Interprofessional Simulation","authors":"Michelle R. Brown, Kristopher R. Maday, John B Hurt","doi":"10.29074/ASCLS.29.4.252","DOIUrl":"https://doi.org/10.29074/ASCLS.29.4.252","url":null,"abstract":"INTRODUCTION In the report, Health Professions Education: A Bridge to Quality, the Institutes of Medicine (IOM) has detailed a vision for preparing healthcare professionals.1 A focal point within this vision is teaching students to work in interdisciplinary teams. In a separate report, Measuring the Impact of Interprofessional Education on Collaborative Practice and Patient Outcomes, the IOM calls for an alignment of education and healthcare delivery systems.2 The Clinical Laboratory Science (CLS) education community needs to readily embrace the IOMs vision and enthusiastically answer the call with innovative educational methods such as interprofessional simulation (IP). Some CLS programs are already considering interprofessional simulation, but may not have an existing simulation infrastructure or financial support from administration. Other programs have a laboratory with instrumentation, but have not yet made the leap from simulating a “day in the lab” with CLS students to including students from professions outside the laboratory to provide comprehensive situations that more closely mimic working in a healthcare environment. This manuscript offers small scale, low resource options to help a CLS program include IP simulation as an innovative educational method to teach interprofessional communication and teamwork. Getting Started: Know the Fundamentals While high fidelity mannequins, patient rooms, and instrumentation provide an authentic environment, they are not required to offer a quality IP experience. There are, however, fundamentals that remain the same whether designing intricate scenarios for students from several professional programs or simple scenarios with students from only two professions. This includes the alignment of content knowledge between students… ABBREVIATIONS: IOM – Institutes of Medicine, CLS – Clinical laboratory scientist, IP - Interprofessional, SBAR – Situation, Background, Assessment, Recommendation/request, Team STEPPS - Team Strategies and Tools to Enhance Performance and Patient Safety, APP – Advanced practice provider, WHO – World Health Organization, CUS – Concerned, Uncomfortable, Safety issue, SP – Simulated patient, PA – Physician assistant, UAB – University of Alabama at Birmingham","PeriodicalId":263458,"journal":{"name":"American Society for Clinical Laboratory Science","volume":"29 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129661640","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Interprofessional (IP) simulation is an effective way to teach teamwork, communication, and utilization of resources.1,2 While traditional classroom learning for health professionals rarely involves application of skills, simulation affords opportunities for practicing communication and collaboration. It allows students and/or practitioners to come together in a safe environment to learn clinical skills and practice communication strategies while serving as a means for clarifying roles on a healthcare team. Laboratory professionals are often described as being behind the scenes. Simulation allows laboratory practitioners to participate on the team and elucidate the importance of the lab during debriefing. In order for laboratory science students and practitioners to participate in medical simulation, there must first be a fundamental understanding of the organization and terminology. Defining Simulation Within healthcare education, experiential learning has become a central aspect of training our future healthcare providers. Simulation is defined as a technique providing experiences that represent or mimic a real life event or situation allowing learners to apply skills and knowledge to providing care during a simulated clinical event.3 During a simulation, there are no real patients, thereby allowing learners to test and try their hand at synthesizing pieces of information into clinical situations without the potential for harm (Figure1). For example, a simulation may involve learners being placed in a simulated environment with a mannequin, or standardized patient that needs an intravenous line started and requiring a blood transfusion. The learners must interact together while obtaining blood and administer it to the patient. Benefits of Simulation Simulation… ABBREVIATIONS: INACSL - Nursing Association for Clinical Simulation and Learning, IP – Interprofessional
{"title":"Primer on Interprofessional Simulation for Clinical Laboratory Science Programs: A Practical Guide to Structure and Terminology","authors":"Michelle R. Brown, P. Watts","doi":"10.29074/ASCLS.29.4.241","DOIUrl":"https://doi.org/10.29074/ASCLS.29.4.241","url":null,"abstract":"Interprofessional (IP) simulation is an effective way to teach teamwork, communication, and utilization of resources.1,2 While traditional classroom learning for health professionals rarely involves application of skills, simulation affords opportunities for practicing communication and collaboration. It allows students and/or practitioners to come together in a safe environment to learn clinical skills and practice communication strategies while serving as a means for clarifying roles on a healthcare team. Laboratory professionals are often described as being behind the scenes. Simulation allows laboratory practitioners to participate on the team and elucidate the importance of the lab during debriefing. In order for laboratory science students and practitioners to participate in medical simulation, there must first be a fundamental understanding of the organization and terminology. Defining Simulation Within healthcare education, experiential learning has become a central aspect of training our future healthcare providers. Simulation is defined as a technique providing experiences that represent or mimic a real life event or situation allowing learners to apply skills and knowledge to providing care during a simulated clinical event.3 During a simulation, there are no real patients, thereby allowing learners to test and try their hand at synthesizing pieces of information into clinical situations without the potential for harm (Figure1). For example, a simulation may involve learners being placed in a simulated environment with a mannequin, or standardized patient that needs an intravenous line started and requiring a blood transfusion. The learners must interact together while obtaining blood and administer it to the patient. Benefits of Simulation Simulation… ABBREVIATIONS: INACSL - Nursing Association for Clinical Simulation and Learning, IP – Interprofessional","PeriodicalId":263458,"journal":{"name":"American Society for Clinical Laboratory Science","volume":"17 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124863472","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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