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

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.

Erythrocyte Sedimentation Rate (ESR) is a laboratory test of historical significance and broad applicability. Its current role in medical diagnostics, however, is often debated due to a lack of specificity in the results and the emergence of more up-to-date alternatives. This case study, however, illustrates a clinical scenario where the ESR was utilized on more than one occasion to significantly aid the diagnostic process and ultimately, improve patient care.

Objective: Hemoglobin Alc (HbAlc) is the standard measurement of glycemic control, and the HbAlc value can be used to estimate average glucose using a formula. Several studies suggest that the relationship between average glucose and HbAlc may be different for Blacks. This project enrolled non-Hispanic black and white individuals with type 2 diabetes and evaluated the relationship between HbAlc and blood glucose.

Method: 22 black and 29 white adults with type 2 diabetes were included in the analysis. Approximately 42 measurements (fasting and postprandial glucose) were collected over three months and compared to HbAl1 of the third month. The effect of race was evaluated by ANCOVA and X2 analysis testing the slope and intercepts simultaneously for HbA1c and its relationship to fasting glucose and to postprandial glucose.

Results: The relationship between HbAlc and glucose was not statistically significantly different between Blacks and Whites (ANCOVA: P = 0.968 for fasting glucose, P = 0.428 for postprandial glucose), allowing us to calculate estimated fasting and postprandial glucose disregarding race. For fasting glucose, the linear regression is FGmgiadl = (18.939 X HbAlc%) - 1.864, R2 = 0.586, P < 0.0001. For postprandial glucose, the linear regression is In(PPG mg,dl) (1.261 X In(HbA1c%)) + 2.555, R2 = 0.614, P < 0.0001. Predicted values for postprandial glucose based on HbA1c were similar to estimated average glucose values reported by ADAG.

Conclusion: This study reinforces the A1c-Derived Average Glucose (ADAG) group finding that the relationship between HbA1c and glucose is similar in non-Hispanic black and white adults with type 2 diabetes.

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.