Clinical laboratory science : journal of the American Society for Medical Technology最新文献

An entire series could be dedicated to the topic of ethics in personalized medicine. Due to the advancements in NGS and genetic testing, personalized medicine is no longer something that will occur in the future, the reality is upon us now. Sequencing an individual's genome can have a substantial impact on the patient's treatment and overall quality of life. However, this can open "Pandora's box" especially if an individual does not want to know the information obtained. In addition, will insurance companies require genetic testing in order to pay for a targeted treatment? If the patient refuses to have the genetic testing, will they have to pay for their treatment out of pocket? In the human interest story presented, the researcher and his team discovered over activity of the FTL3 protein through RNA sequencing which resulted in rapid proliferation of his leukemic cells. He identified a drug marketed for advanced kidney cancer which was a FTL3 inhibitor. However, his insurance company refused to pay for the drug because it was not a known treatment for his condition of ALL. He incurred numerous out of pocket expenses in order to go into remission. Was it unethical for the insurance company to not pay for a treatment that ultimately worked but was not marketed or FDA cleared for his type of leukemia? There are so many questions and concerns when personalized medicine is implemented. Only time will tell the effects next generation sequencing and its role in personalized medicine will have in the future.

A review of professional literature was conducted to examine the history of the education of medical laboratory practitioners. This comprehensive review included historical educational milestones from the birth of medical technology to the advent of World War II. During this time period standards were developed by clinical pathologists for laboratory personnel and training programs. In addition, a formal educational model began to form and by the 1940's two years of college was required for matriculation into a medical technology program. Intertwined within the educational milestones are imprints of the evolution of critical thinking requirements and skills within the profession. For the first laboratory practitioners, critical thinking was not developed, discussed, or encouraged as duties were primarily repetitive promoting psychomotor skills.

Next generation sequencing platforms and the applications that are offered have revolutionized the way a physician will treat and monitor a patient based on the individual's own genetic make-up. Whether whole genome sequencing, exome sequencing, or targeted sequencing is performed, the information generated must be analyzed, interpreted, and reported correctly. Since the various platforms and application panels are not FDA cleared (with the exception of the Illumina MiSeqDx Cystic Fibrosis Clinical Sequencing Assay and the Illumina MiSeqDx Cystic Fibrosis 139-Variant Assay) clinical laboratorians are faced with the challenge of standardizing and validating the various panels and platforms for appropriate quality management. Therefore, the American College of Medical Genetics and Genomics published guidelines for ordering, test development, validation and reporting of genetic information. These guidelines should be followed by all laboratorians performing NGS to ensure quality results and to provide proper interpretation of all genomic variants identified.

Good communication and critical thinking are essential skills for all successful professionals, including Clinical Laboratory Science/Medical Laboratory Science (CLS/MLS) practitioners. Professional programs can incorporate writing assignments into their curricula to improve student written communication and critical thinking skills. Clearly defined, scenario-focused writing assignments provide student practice in clearly articulating responses to proposed problems or situations, researching and utilizing informational resources, and applying and synthesizing relevant information. Assessment rubrics, structured feedback, and revision writing methodologies help guide students through the writing process. This article describes how a CLS Program in a public academic medical center, located in the central United States (US) serving five centrally-located US states has incorporated writing intensive assignments into an existing 11-month academic year using formal, informal and reflective writing to improve student written communication and critical thinking skills. Faculty members and employers of graduates assert that incorporating writing intensive requirements have better prepared students for their professional role to effectively communicate and think critically.

A survey of members of the American Society for Clinical Laboratory Science (ASCLS) was taken in May, 2012 to study workplace incentives and personal factors that could encourage clinical laboratory professionals (CLP) to continue working past retirement eligibility. Benefits, compensation, and opportunity for part-time work were key retention incentives identified by CLP in all age and job function groups. Career stage was shown to play a significant role in how CLP rated the importance of several retirement incentives, suggesting that age differences exist in workplace factors and personal motivators for continuing to work. There are also differences among practitioners, administrators, and educators in how they view incentives for working past retirement eligibility. Results of the study may help laboratory administrators advocate for workplace changes important to retaining staff of varying age and job function.