MLSCI 330 CLINICAL HEMATOLOGY OVERVIEW / GENERAL INFORMATION

1
MLSCI 330 CLINICAL HEMATOLOGY
OVERVIEW / GENERAL INFORMATION
The MLSCI 330 (Clinical Hematology) course is a continuation of the theory and technique
introduced in MLSCI 230 and 235 in Phase I. This Phase II course will provide the student with
technical experience in both a training lab setting and in regional hospital laboratories. In
addition, the theory related to Hematology and Coagulation will be reviewed in this course. This
technical training and theory review will prepare the student for employment as a Medical
Laboratory Technologist/Scientist after graduation, and to write the CSMLS national certification
examinations.
Further course information is found in eClass:
-Access eClass from the University of Alberta webpage (www.ualberta.ca).
-Log into eClass with your ccid and password and choose MLSCI 330A
-Learning modules and links to practice exams on Brainspan© are found here, as well as
study guides for each of the tutorial exams
-Course evaluation questions (covering the student lab weeks, tutorials, exams, etc.) are
also found on eClass.
Evaluation questions regarding the clincial training weeks are available through google docs
and the URLs will be e-mailed to you at the end of your clinical training weeks.
Course Coordinator / Instructor
Valentin Villatoro
Assistant Professor & Clinical Instructor
Office: 2C30.3 EGH
Phone: 780-342-8908
e-mail: valentin@ualberta.ca
University Office:
Phone:
5-376 ECHA
780-492-3277
AHS Hematology Instructors:
Edee O’Brien Smith
Clinical Instructor
Office: 2C30.3 EGH
Phone: 780-342-8925
e-mail: Edee.O’Brien-Smith@albertahealthservices.ca
Allen Keeping
Clinical Instructor
Office: 2C30.1 EGH
Phone: 780-342-8971
e-mail: Allen.Keeping@albertahealthservices.ca
E-mail policy
Communication with the course instructor when the student is at the clinical training site will
usually be done by e-mail. Check your ualberta e-mail frequently so that important messages
are not missed. The instructor will check for e-mails from students Monday to Friday during work
hours.
2
COURSE / LEARNING OBJECTIVES
By the end of the rotation the student will demonstrate mastery in the following areas:
1) Knowledge and Comprehension of Facts, Principles, and Methods
The student will expand their understanding of Hematology theory and be able to:
a) define hematology terms
b) explain the principle of manual and automated hematology tests, coagulation assays,
and special hematology procedures
c) describe the structure and characteristics of both normal and abnormal hemoglobins
d) describe the expected peripheral smear and bone marrow findings in hematological
disorders (anemias and white cell abnormalities)
e) describe the expected lab test results for these disorders
f) explain the normal hemostatic process and mechanisms to keep both clotting and
fibrinolysis under control
g) describe the abnormality and the expected lab test results for coagulation disorders
2) Reasoning Ability (Application, Analysis and Evaluation)
The student will be able to apply their knowledge of hematology to:
a) calculate RBC indices, correct WBC counts for nRBC, calculate relative and absolute
reticulocyte counts, calculate absolute WBC values, and calculate bone marrow M:E
ratios
b) perform calculations required for manual reticulocyte counts, CSF and fluid cell counts
c) analyze hematology and coagulation test results as to their accuracy and reliability, and
suggest appropriate follow up for abnormal results
d) correlate abnormal peripheral smear and bone marrow pictures with possible clinical
conditions
3) Technical Skills
The student will be able to perform the following procedures with accuracy and precision:
a)
b)
c)
d)
e)
f)
manual hematology procedures
WBC and PLT estimates, WBC differentials and RBC morphologies
analysis of specimens on automated hematology analyzers
coagulation procedures
special hematology procedures
organize work and perform tests in volume
4) Attitudes
a)
b)
c)
d)
e)
f)
g)
h)
adhere to all laboratory safety protocols and practices
follow established procedures (SOPs) and show concern for quality of work done
perform clerical checks correctly and report results without errors
respect the patient’s right to confidentiality
arrive to work on time
demonstrate self-motivation and initiative
cooperate with coworkers and trainers
demonstrate good communication skills by writing legibly, speaking clearly and
concisely, listening carefully, and asking for clarification when needed
3
METHODS OF INSTRUCTION
Technical training will initially occur in the training laboratory at EGH under the supervision of
the course instructor. This training will allow the student to re-familiarize themselves with
hematology techniques and gain confidence before entering the regional hematology
laboratories for clinical experience. Theory review will also occur during the training lab weeks
and may extend into the clinical lab weeks of the course. Tutorials with the instructor will help
the student learn the material before examinations are written. Independent review of some
material is also required.
Training will then continue in the hematology department at the clinical training sites.
Completion of Competency-Based Objectives (CBOs) will occur during these 4 weeks. Over the
nine weeks of the rotation the student will gain experience in hematology procedures and
instrumentation, and must attain minimum levels of competency as expected of an entry-level
technologist.
There are six CBOs to be completed in Hematology:
1.
2.
3.
4.
5.
6.
Differentials and Morphology
Manual Counts/Miscellaneous Tests
Multi-parameter Cell Counters
Coagulation
Special Hematology
Professionalism
The Differential and Professionalism CBOs will be signed off by the course instructor at the end
of the rotation, while the technical skills portion of the remaining four CBOs will be signed off by
the facilitators at the clinical training sites. The course instructor is responsible for signing off the
Knowledge Component of all six CBOs, based on the student’s performance on related tutorial
exams and a take-home assignment for the Professionalism CBO.
EVALUATION
1. Competency evaluation by the department
While in the Hematology Department at your training sites, you will be supervised by
technologists who will evaluate your performance according to criteria outlined in the
competency-based objectives. Read the CBOs carefully before beginning each bench in the
department so that you are familiar with the skills that you will be expected to learn. It is the
student’s responsibility to ensure that all skills are completed. Although no marks are assigned
for CBOs, the student must achieve an “Acceptable” level of competence on all six terminal
competencies in order to successfully complete the rotation.
If the student does not pass a CBO, he/she will be required to repeat time on that bench until an
acceptable level of competence is achieved. A “performance improvement plan” (see next page)
will be completed, and a copy given to the student, indicating the problem areas and remedial
action to be taken. If the student is unable to complete all six CBOs within the 9-week
Hematology rotation, it will be considered a failure of the rotation.
2. Theory evaluation by the instructor
The student will write 5 theory exams and complete 3 practical exams throughout the
Hematology rotation. These exams will be used to determine the final course mark, and for
assessment of the Theory component of each CBO. In addition, each student will research a
hematology topic and present their findings to the group. A detailed description of the course
mark breakdown is given in the next section.
4
IMPORTANT*
In order to successfully complete the course, the student must attain each of the following:
1) an overall final course mark of 60% or better
2) a mark of at least 60% on the final exam
3) an “Acceptable” level of competence on all CBOs
If an overall final course mark of at least 60% is not achieved, remedial work such as
assignments and additional exams will be given to the student. This remedial work must be
completed within two weeks of finishing the Hematology rotation. Once the work has been
completed satisfactorily, the final mark assigned for the course will be adjusted to the minimum
pass mark of 60%. If the remedial work is not completed satisfactorily, a grade of F will be given
for the course.
If a mark of less than 60% is achieved on the final exam, an exam re-write will be given. This rewrite must be done within two weeks of failing the final exam. If the re-write is successfully
passed, the mark assigned for the final exam will be adjusted to the minimum pass mark (60%).
If the re-write is failed, a grade of F will be given for the course.
If all the CBOs are not completed with an “Acceptable” rating by the time the 9 week rotation is
over, then the student will be required to do remedial training and re-challenge the CBO/CBOs
at a later time. This extension of training time is dependent on accommodation by the clinical
site and will occur at the convenience of the schedule and the training site. This may mean that
entry into Phase III of the program is delayed.
Supplemental exams and remedial training will only be allowed in one course during
Phase II.
Remedial course work, final exam re-writes, and extension of the training time to
complete CBOs will not be allowed for MLS students entering Phase II on probation.
5
6
DISTRIBUTION OF MARKS AND EXAMINATION SCHEDULE
The following components will be used to determine the final course mark:
1. Theory Exams (worth 40% of the course mark)
Five written exams will be used to assess the theory component of the Differential and
Morphology, Manual Counts, Multi-parameter Cell Counter, Coagulation and Special
Hematology CBOs. These exams will be based on information covered in tutorials and
student lab weeks. Exam study guides provided on e-class will include more specific
information about each exam.
2. Differential, Manual Counts and Special Hematology Practical Exams (worth 20% of the
course mark)
These three practical exams will be used in assessment of the skills components of the
Differential and Morphology, Manual Counts and Special Hematology CBOs.
3. Presentation (worth 5% of the course mark)
Each student will choose a hematology topic to be researched and presented to the
group during the last week of the rotation. The student will create at least four learning
objectives, and using various sources such as textbooks, journal articles, and internet
web-sites will research information on that topic. During the final week of the rotation
each student will summarize their findings using a PowerPoint presentation and will
communicate this information to the rest of the group in a 10 - 15 minute talk.
4. Instructor Evaluation (worth 5% of the course mark)
The instructor will evaluate the student’s performance during the four weeks of student
lab using the criteria described on the next page. This feedback should be used by the
student to target areas for improvement. No marks will be assigned to the evaluations
done during student lab weeks. A percentage mark will be assigned to the instructor
evaluation at the end of the rotation, based on the student lab weeks as well as
comments provided by trainers at the clinical sites on the daily assessment feedback
forms.
5. Final Examination (worth 30% of the course mark)
(60% pass mark is compulsory)
The final exam is a comprehensive written examination covering all aspects of
Hematology.
The exam schedule will be supplied by the instructor at the beginning of the course, however, in
general: Exams #1, 2, and 3 are written during the student lab weeks. Exams #4 and 5 are
written during exam week. The Final Exam is written on the last day of the course.
If a student is absent from an examination, he/she must contact the instructor as soon as
possible with regard to the circumstances and request an excused absence. Missed exams
must be written at a later date as decided by the instructor.
According to University policy the following are examples of unacceptable reasons for
requesting an excused absence: vacations, weddings or travel arrangements. Instructors may
request supporting documentation for an excused absence or can ask students to sign a
Statutory Declaration to outline the reasons for the absence.
7
Criteria for Instructor Evaluation of Student Progress
A percentage mark will be given at the end of the rotation, which will count toward the final
course mark. The instructor will consider the following criteria when providing weekly feedback
to the student during the four weeks of student lab and when assessing a mark at the end. A
rubric is provided in Appendix D which describes each criterion in detail.
Professional values:
 Punctuality
 Preparation
 Motivation/Attitude towards learning
 Initiative
 Respect in the work environment
Teamwork:
 Participation
 Cooperation
Safety:
 PPE and workspace
Aptitude and Ability to Learn:
 Student lab procedures
Organizational Ability:
Comprehension of Theory:
 Tutorials and exams
Application of Theory:
Communication Skills:
 Written
 Verbal/Non-verbal
Technical Ability:
 Technical skills
 Clerical skills
8
ATTENDANCE
Daily attendance is compulsory. If absences occur for any reason, the student may be required
to make up the missed time. However, as soon as 5 absences have occurred during the clinical
year, any further absences must automatically be made up. If an extension of training time
beyond the end of the clinical year is necessary, this will be dependent on availability of a
training place and will be at the convenience of the clinical site and the schedule. Extension of
the clinical year may therefore mean postponement of entry into Phase III of the program.
Arriving late will also mean that time has to be made up. Appointments should be scheduled,
whenever possible, at the end of the day so as not to interfere with training time. However, in
circumstances where it is necessary to miss part of the day for an appointment, the student
must complete a “Schedule Change/Vacation/Leave of Absence Form” (see Appendix E) and
bring it to the instructor for approval and signature. This form will then be forwarded to the
training site.
If sick, absent for another reason, or arriving late, telephone the instructor’s office (780-3428908) before 0800 h and leave a detailed message or send an e-mail to valentin@ualberta.ca.
When working at the clinical site, also phone the Hematology laboratory and leave a message
according to the site protocol:
Site
DynaLIFEDx
200-10150-102 St
Edmonton, AB
Phone Numbers
Assistant Manager
(780) 451-8499 ext 3213
STAT Bench
(780) 451-8499 ext 8211
John Wilson
(780) 451-3702 ext 3207
John.Wilson@dynalifedx.com
GNH
1100 Youville Dr.
Edmonton, AB
MIS
106940-87 Ave
Edmonton, AB
Core Lab
(780) 735-7088
Arlene Garchinski, Tech II
(780) 735-9642
Core Lab
(780) 735-9308
Carol Austen, Manager
(780) 735-2473
Student Directions
1. Report your absence or lateness to the
Assistant Manager. Leave a voicemail if no
answer, and call the STAT Bench to talk to
someone in person.
2. Report your absence or lateness to John
Wilson.
1. Report your absence or lateness to Core
Lab and let them know you are scheduled
for hematology.
2. Report your absence or lateness to Arlene
Garchinski, leaving a voicemail if
necessary.
1. Report your absence or lateness to Core
Lab and let them know you are scheduled
for hematology.
2. Ask to be transferred to Carol Austen (or
her voicemail) to report to her why you are
away or late.
9
RAH
Core Lab
10240 Kingsway
Ave
Edmonton, AB
(780) 735-4378
Cross Cancer
Institute
(780) 432-8598 and leave a
message, or e-mail:
Room 1466
11560- University
Ave
Edmonton, AB
Elaine.kurtzhardowa@albertahealthservices.ca
UAH,
Routine
Hematology
(780) 407-7096
1. Report your absence or lateness to the
tech that answers the phone.
(780) 407-7096
1. Report your absence or lateness to the
person that answers the phone and let
them that you are scheduled for Special
Hematology.
8440-112 St
Edmonton, AB
UAH,
Special
Hematology
8440-112 St
Edmonton, AB
1. Report your absence or lateness to Core
Lab. The person who answers will record
information on the call-in form.
2. The supervisor will call the student back to
determine when the student will return to
work.
1. Report your absence or lateness to Elaine
Kurtz-Hardowa.
OR
Trina.smith2@albertahealthservice
s.ca
The special hematology techs do
not arrive until 0800, so report
your absence to the technologists
in core Hem, who will pass on the
message.
BOOKLIST / REFERENCES
The following books are good references to use in addition to your notes from Phase I to make
study notes for tutorials:
1) Hematology Clinical Principles and Applications, 4th edition, 2012
Rodak, Fritsma, Doig
2) Clinical Hematology and Fundamentals of Hemostasis, 5th edition, 2009
Harmening
3) WHO Classification of Tumours of Haematopoietic and Lymphoid Tissues, 4th edition, 2008
WHO
4) Atlas of Hematology, 2003
Anderson and Poulsen
5) Clinical Hematology Atlas, 3rd edition, 2009 or 4th edition, 2013
Carr and Rodak
10
SCHEDULE
Time required to complete the rotation is 9 weeks.
The rotation will consist of:
1.
Orientation to Hematology – 3 weeks
Students will spend three weeks in the training laboratory at EGH learning to perform both
routine and special hematology procedures. Students will perform differentials and red cell
morphologies on peripheral blood smears, perform manual cell counts, perform bone marrow
differentials and calculate M:E ratios, and perform various special hematology procedures.
During the training lab weeks students will do a differential practical exam which will be used for
assessment of the Differential CBO (CBO #1). The mark for this exam will comprise part of the
hematology final mark.
2.
Automated Counts – 2 weeks
Each student will spend one week in the hematology department at their training site learning to
process patient specimens and controls through an automated multiparameter cell counter
(Coulter LH-750 at UAH and DL, Coulter DxH 800 at RAH, GNH and MIS). The student’s
progress will be evaluated using CBO #3.
3.
Routine Coagulation – 1 week
Each student will spend one week on the coagulation bench in the hematology department at
their training site learning to process patient specimens and controls for routine coagulation
testing (APTT, PT, quantitative D-Dimer assay, and Fibrinogen assay). The student’s progress
will be evaluated using CBO #4.
4.
Manual Counts/Miscellaneous Tests– 1 week
Each student will spend one week in the hematology department at their training site practicing
manual cell counts such as CSF and fluid cell counts, cytospin differentials, ESRs, monospot
tests and any miscellaneous procedures that the site may perform. The student will also
observe the Bleeding Time procedure if possible (at UAH only), and learn to make buffy coat
smears. The student’s progress will be evaluated with CBO #2.
Towards the end of the week the student will do a practical exam to assess the skills component
of the CBO. The exam will be marked by the clinical instructor and this mark will comprise part
of the hematology final course mark.
Students may also spend time this week practicing differentials if time permits. Students may
look at peripheral blood smears or bone marrow smears previously counted by the technologists
in the department. In order to give the student more experience with time pressure the lab may
set a time limit, or set an expected number of slides to be accomplished per day,
5.
Special Hematology/Special Coagulation – 1 week (4 days at UAH and 1 day at CCI)
In the Special Hematology Department at UAH the student will learn to assist with bone marrow
aspirations and to make direct and particle smears. The student will also perform as many
special hematology procedures as possible, and will observe special coagulation tests and
possibly the flow cytometer. The student’s progress will be evaluated using CBO #5.
11
On Wednesday or Thursday of this week the student will spend the day in the laboratory at the
Cross Cancer Institute. Students will learn about the flow cytometer, may assist on bone marrow
collections, and will help with the routine hematology testing.
6.
Exam Week – 4 or 5 days
At the beginning of the week students will come to the training lab at EGH to review case study
and bone marrow slides in preparation for the Special Hematology practical exam, and may also
review written tutorial exams in preparation for the Final.
Later in the week students will be given the Special Hematology practical exam consisting of
peripheral smear and bone marrow slides similar to the case studies seen in student lab, they
will write Exam #5, present their research topic to the group (see description on page 6) and
write the final exam on the last day.
12
Policy about course outlines can be found in §23.4(2) of the University Calendar.
The University of Alberta is committed to the highest standards of academic integrity and
honesty. Students are expected to be familiar with these standards regarding academic honesty
and to uphold the policies of the University in this respect. Students are particularly urged to
familiarize themselves with the provisions of the Code of Student Behaviour (online
at www.governance.ualberta.ca) and avoid any behaviour which could potentially result in
suspicions of cheating, plagiarism, misrepresentation of facts and/or participation in an offence.
Academic dishonesty is a serious offence and can result in suspension or expulsion from the
University.
Audio or video recording of lectures, labs, seminars or any other teaching environment by
students is allowed only with the prior written consent of the instructor or as a part of an
approved accommodation plan. Recorded material is to be used solely for personal study, and
is not to be used or distributed for any other purpose without prior written consent from the
instructor.
Excerpt from Code of Student Behaviour –
30.3.2 Inappropriate Academic Behaviour
30.3.2(1)
Plagiarism
No Student shall submit the words, ideas, images or data of another person as the Student’s
own in any academic writing, essay, thesis, project, assignment, presentation or poster in a
course or program of study.
30.3.2(2)
Cheating
30.3.2(2) a
No Student shall in the course of an examination or other similar activity, obtain
or attempt to obtain information from another Student or other unauthorized source, give or
attempt to give information to another Student, or use, attempt to use or possess for the
purposes of use any unauthorized material.
30.3.2(2) b
No Student shall represent or attempt to represent him or herself as another or
have or attempt to have himself or herself represented by another in the taking of an
examination, preparation of a paper or other similar activity. See also misrepresentation in
30.3.6 (4).
30.3.2(2) c
No Student shall represent another’s substantial editorial or compositional
assistance on an assignment as the Student’s own work.
30.3.2(2) d
No Student shall submit in any course or program of study, without the written
approval of the course Instructor, all or a substantial portion of any academic writing, essay,
thesis, research report, project, assignment, presentation or poster for which credit has
previously been obtained by the Student or which has been or is being submitted by the Student
in another course or program of study in the University or elsewhere.
30.3.2(2) e
No Student shall submit in any course or program of study any academic writing,
essay, thesis, report, project, assignment, presentation or poster containing a statement of fact
known by the Student to be false or a reference to a source the Student knows to contain
fabricated claims (unless acknowledged by the Student), or a fabricated reference to a source.
30.3.2(3)
Misuse of Confidential Materials
No Student shall procure, distribute, or receive any confidential academic material such as
pending examinations, laboratory results or the contents thereof from any source without prior
and express consent of the Instructor.
13
30.3.2(4)
Research and Scholarship Misconduct
30.3.2(4) a
No Student shall violate the University of Alberta Research and Scholarship
Integrity Policy, as set out in § 96.2 of the GFC Policy Manual or any other University regulation
concerning academic matters.
30.3.2(4) b
Where a Student is charged with the academic offence of research and
scholarship misconduct, the special requirements for communication and documentation
imposed by § 96.2 of the GFC Policy Manual shall constitute part of the procedures outlined
below.
14
CSMLS 2010 Competencies
LEGEND:
OL =
SL =
T =
D =
A
O
C
E
=
=
=
=
On-line Learning (Traccess/e-class)
Student Lab
Tutorial
Department
Assignment
Observation
CBO
Exam
CATEGORY 1
SAFE WORK PRACTICES
NUMBER
COMPETENCY
INSTRUCTION
PRACTICE
ASSESSMENT
The medical laboratory technologist conducts professional practice according to established protocols,
safety guidelines, and existing legislation.
1.01
Applies the principles of standard precautions
OL
SL, D
C,O,E
1.02
Uses personal protective equipment, e.g., gloves, gowns, mask, face shields, aprons
OL,SL
SL, D
C,O,E
1.03
Applies appropriate laboratory hygiene and infection control practices
OL,SL
SL, D
C,O,E
1.04
Minimizes possible dangers from biological specimens, laboratory supplies,
radioactive material, and equipment
OL
SL, D
C,O,E
1.05
Utilizes laboratory safety devices in a correct manner, e.g., biological safety
cabinets, fume hoods, laminar flow cabinets, safety pipetting devices, safety
containers and carriers, safety showers, eye washes
OL,SL
SL, D
C,O,E
1.06
Labels, dates, handles, stores, and disposes of chemicals, dyes, reagents, and
solutions according to WHMIS and existing legislation
OL,SL
SL, D
C,O,E
1.07
Handles and disposes of "sharps" according to institutional policy
OL,SL
SL, D
C,O,E
1.08
Stores, handles, transports and disposes of biological, toxic, and radioactive
material according to existing legislation
OL,SL
SL, D
C,O,E
1.09
Selects and utilizes the appropriate method for items to be disinfected/sterilized
OL,SL
SL, D
C,O,E
1.10
Minimizes the potential hazards related to disinfection/sterilization methods
OL
SL, D
C,O,E
1.11
Applies first-aid measures in response to incidents, e.g., chemical injury, traumatic
injury, electrical shock, burns, radioisotope contamination
OL
SL, D
C,O,E
1.12
Applies spill containment and clean up procedures for infectious materials and
dangerous chemicals according to institutional policy
OL,SL
SL, D
C,O,E
1.13
Responds appropriately to fire emergencies
O,SL
SL, D
C,O,E
1.14
Reports incidents related to safety and personal injury (e.g., needle stick injuries),
in a timely manner
OL
SL, D
C,O,E
15
CATEGORY 2
DATA COLLECTION AND SPECIMEN PROCUREMENT/RECEIPT
2.01
Ensures relevant information is on the requisition received with the test request
2.02
Procures and labels blood and other specimens according to specific requirements,
in a variety of conditions
(bone marrow collections)
2.03
Performs venipuncture and capillary blood collection to obtain appropriate
samples for laboratory analysis
2.03.01
Confirms the identity of the patient
2.03.02
Establishes a professional relationship with the patient
2.03.03
Provides the necessary information for the patient to understand the specimen
collection procedure
2.03.04
Obtains agreement from the patient to proceed with specimen collection
ASSESSMENT
COMPETENCY
PRACTICE
NUMBER
INSTRUCTION
The medical laboratory technologist verifies relevant data and ensures that appropriate specimens are
procured according to established protocols.
SL
D
C
SL
2.04
Observes established protocol for procurement of specimens with legal
implications, e.g., blood alcohol
2.05
Collects, labels and delivers specimens in a safe and timely manner taking into
account priority and specimen stability
2.06
Verifies specimen suitability including adequate amount/volume and integrity
T
D
C, E
2.07
Validates documentation to ensure that it corresponds with the specimen
SL
SL,D
C
2.08
Registers specimens into laboratory information system, e.g., logbook, computers
D
D
C
2.09
Complies with existing guidelines for specimen retention, storage and disposal
D
D
2.10
Takes corrective action when errors in specimen procurement are identified
T, D
SL,D
16
CATEGORY 3
ANALYSIS OF SPECIMENS AND VALIDATION OF RESULTS
NUMBER
COMPETENCY
INSTRUCTION
PRACTICE
ASSESSMENT
The medical laboratory technologist analyzes specimens and validates results using established
protocols.
3.01
Prepares specimens for analysis, e.g., centrifuging, aliquoting, preserving
D
D
C
3.02
Ensures appropriate storage of specimens
T, D
D
C
3.03
Prioritizes analyses, e.g., stat, urgent, routine, sample stability
D
D
C
3.04
Maximizes efficient use of resources, e.g., time, equipment, personnel
SL, D
SL, D
C
3.05
Prepares and uses calibrators, standards, quality control materials
T, D
D
C,E
3.06
Organizes specimens from worklists, log books and computerized work documents
SL, D
D
C
3.07
Performs analyses within acceptable limits of error
SL, D
SL, D
C
3.08
Verifies test results using calibration and quality control data
T,D
D
C
3.09
Recognizes possible specimen/analytical deficiencies and takes appropriate action
T, SL,
D
D
C, E
3.10
Identifies implausible results and takes appropriate action
T, SL,
D
D
C
3.11
Verifies that specimen identification is traceable throughout the analysis
D
D
3.12
Verifies that all ordered analyses have been completed
D
D
C
17
CATEGORY 4
ANALYTICAL TECHNIQUES
4.01
Applies the principles of microscopy to laboratory analyses
OL
4.01.01
Uses and maintains the compound light microscope
4.01.02
Selects the appropriate application of the following modifications of the light
microscope:
 phase contrast
 fluorescence
 dark field
 polarizing
 inverted
4.02
4.02.01
4.03
4.03.01
4.03.02
4.04
Applies the physical and chemical principles of staining to laboratory analyses:
Identifies staining problems and initiates corrective action
Operates and maintains common instruments using:
 absorption spectrophotometry
 emission spectrophotometry
 reflectometry
 turbidimetry
Identifies sources of interference and initiates corrective action as applicable
Applies principles of electrochemical systems to laboratory analyses
Operates and maintains common instruments using:
 ion selective electrodes
 conductance electrodes
4.04.02
Identifies sources of interference and initiates corrective action as applicable
Applies principles of electrophoresis and chromatography to laboratory analyses
4.05.01
Operates and maintains common instruments
4.05.02
Identifies sources of interference and initiates corrective action as applicable
4.06
4.06.01
E
OL, SL
SL, D
SL, C
SL
SL, D
E, C
SL
SL
E, C
SL, D
E, C
Applies principles of light measuring systems to laboratory analyses:
4.04.01
4.05
ASSESSMENT
COMPETENCY
PRACTICE
NUMBER
INSTRUCTION
The medical laboratory technologist understands the principles and performs analytical techniques on
specimens that originate from a variety of sources.
Applies principles of osmometry to laboratory analyses
Operates and maintains common instruments
T, SL
T
4.07
T
D
C, E
T, D
D
C, E
Identifies sources of interference and initiates corrective action as applicable
Applies principles of immunoassays to laboratory analyses
(monotest, flow cytometry)
4.07.01
Operates and maintains common instruments
4.07.02
Identifies sources of interference and initiates corrective action as applicable
4.08
ASSESSMENT
4.06.02
COMPETENCY
PRACTICE
NUMBER
INSTRUCTION
18
Applies principles of particle counting systems to laboratory analyses
4.08.01
Operates and maintains common instruments used to evaluate blood cells
T, D
D
C
4.08.02
Identifies sources of interference and initiates corrective action as applicable
T, D
D
C, E
4.08.03
Assesses results to initiate follow-up testing
T, D
D
C
4.08.04
Performs manual counting procedures as appropriate
SL, D
SL, D
C, E
T, D
D
C, E
T, D
D
C, E
SL
SL, D
C, E
4.09
4.09.01
4.10
4.10.01
Performs analyses to assess and monitor hemostasis
Identifies the need for follow-up action
Performs qualitative and quantitative biochemical analyses (G6PD screen)
Assesses results to initiate follow-up testing
4.11
Prepares blood, body fluids and other clinical specimens for microscopic
examination
SL, D
SL, D
C, E
4.12
Identifies and evaluates the morphology of cellular and non-cellular elements in
microscopic preparations
T, SL, D
SL, D
C, E
T, SL, D
SL, D
C,E
SL, D
D
C, E
4.12.01
Differentiates between clinically significant and insignificant findings
4.12.02
Initiates follow-up action as applicable
4.13
Applies principles of immunology to the detection of antigens and antibodies
4.14
Identifies common red blood cell antigens and antibodies
4.14.01
Operates and maintains common instruments/ equipment
4.14.02
Interprets results to determine phenotype/genotype
4.14.03
Differentiates between clinically significant and insignificant antibodies
4.14.04
Performs compatibility analyses
4.14.05
4.15
Assesses results and initiates follow-up action as necessary
Prepares and issues blood products
4.15.01
Assesses suitability of donor/product
4.15.02
Ensures proper storage of blood products
4.15.03
Evaluates the quality of blood products
4.15.04
Evaluates the appropriateness of the blood product for the patient's clinical
situation
4.16
Recognizes and investigates the adverse effects of transfusion according to
established protocol and initiates follow-up action as required
4.17
Performs analyses to detect and identify bacteria and clinically significant yeastlike fungi
4.17.01
Selects appropriate media and environment for the isolation of common
clinically significant organisms from all body sites
4.17.02
Recognizes common clinically significant organisms according to body site
4.17.03
Confirms identification using staining techniques, biochemical and/or
serological tests
4.17.04
Applies the principles of instrumentation to the detection and identification of
organisms
4.18
4.18.01
4.19
Performs appropriate antimicrobial susceptibility analyses according to CLSI
(NCCLS) guidelines
Identifies sources of error and initiates corrective action
Applies molecular diagnostic principles to identify nucleic acid sequences
4.19.01
Operates and maintains common instruments/equipment
4.19.02
Identifies sources of interference and initiates corrective action as applicable
4.19.03
Assesses results and initiates follow-up action as necessary
4.20
Performs tissue preparation techniques to produce paraffin and frozen sections for
microscopic examination
4.20.01
Operates and maintains common instruments/ equipment
4.20.02
Assesses the quality of the preparation and initiates corrective action as
required
ASSESSMENT
COMPETENCY
PRACTICE
NUMBER
INSTRUCTION
19
4.21
Performs techniques to demonstrate cellular and non-cellular components in tissue
and body fluids
4.21.01
Operates and maintains common instruments/equipment
4.21.02
Assesses quality of staining and initiates corrective action as required
4.22
ASSESSMENT
COMPETENCY
PRACTICE
NUMBER
INSTRUCTION
20
Operates and maintains standard laboratory equipment/instruments
CATEGORY 5
INTERPRETATION AND REPORTING OF RESULTS
PRACTICE
ASSESSMENT
INSTRUCTION
The medical laboratory technologist, using scientific knowledge as the basis, interprets, communicates
and documents confidential data.
SL, D
C, E
D
C
T, SL,
D
D
C
Investigates unusual findings prior to reporting
T, SL,
D
D
C
5.05
Recognizes critical values and responds appropriately
T, SL,
D
D
C, E
5.06
Communicates information regarding laboratory analyses to clients in an
appropriate manner
D
C
5.07
Ensures that laboratory results are accurately documented and retained in
accordance with existing legislation
SL, D
C
5.08
Uses a computer for data entry, storage and retrieval
D
C
5.09
Recognizes the implications of laboratory findings and identifies further testing
D
C
NUMBER
COMPETENCY
5.01
Recognizes the relationship between analyses, diagnoses, clinical information and
treatment by assessing results on the basis of:
 reference values
 critical values
 method limitations, e.g. dynamic ranges, interferences, specificity,
sensitivity
 patient delta checks
 recognition of implausible results
 relationship to clinical conditions
 relationship to other laboratory findings
5.02
Releases results of laboratory analyses that meet internal quality control criteria to
the appropriate client in a timely and efficient manner
5.03
Recognizes when results of patient analyses are outside expected findings and
responds appropriately
5.04
T, SL,
D
T
21
CATEGORY 6
QUALITY MANAGEMENT
NUMBER
COMPETENCY
INSTRUCTION
PRACTICE
ASSESSMENT
The medical laboratory technologist practices and promotes the principles of quality management and
the efficient utilization of resources.
6.01
Follows established protocols as defined in policy and procedure manuals
SL
SL, D
C
6.02
Determines the need for calibration of instruments and manual methods
T, D
D
C
6.03
Performs and assesses quality control (internal and external)
T, SL,
D
D
C, E
6.04
Utilizes statistics and indicators to monitor the acceptability of results based on
established quality control ranges
T, SL,
D
D
C, E
6.05
Maintains appropriate documentation, e.g., document laboratory reporting errors
and corrective measures taken
T, SL,
D
SL, D
C
6.06
Utilizes responsible practices which contribute to the cost-effective use of health
care resources
SL, D
D
C
6.07
Follows established preventive maintenance programs & maintains instrument logs
D
D
C
6.08
Recognizes malfunctions in equipment/instruments and initiates appropriate
corrective action.
D
D
C
6.09
Addresses equipment/instrument malfunction according to established protocol
D
D
C
6.10
Applies continuous quality improvement techniques and risk management
processes to ensure quality clinical laboratory services, including point-of-care
testing.
D
D
C
22
CATEGORY 7
CRITICAL THINKING
7.01
Demonstrates an open inquiring mind and self-directed learning processes in
resolving analytical, workplace and career challenges
7.02
Demonstrates the ability to adapt to rapidly changing situations, e.g.: responds
appropriately to critical situations; retains composure in stressful situations; applies
existing skills to new situations
7.03
Demonstrates knowledge of the health care system and professional laboratory
organizations and responsibilities
7.04
Demonstrates knowledge of the determinants of health and their implications for
the laboratory system
7.05
Recognizes that change initiated in one area will impact on other areas of health
care services
ASSESSMENT
COMPETENCY
PRACTICE
NUMBER
INSTRUCTION
The medical laboratory technologist applies critical thinking skills to constructively solve problems.
SL
SL, D
O
D
O
CATEGORY 8
APPLIED INVESTIGATION
8.01
Demonstrates analysis and synthesis skills to resolve workplace challenges
8.01.1
Effectively analyzes and interprets data to arrive at a conclusion or solve a
problem.
8.01.2
Develops recommendations based on conclusions
8.02
Develops implementation strategies that integrate timelines, resource management
and communication
8.03
Demonstrates research skills that further inquiry in laboratory and health care
settings
8.03.1
Develops protocols to investigate problems or evaluate procedures
8.03.2
Seeks out sources of information necessary for problem solving.
8.03.3
Effectively communicates research findings
ASSESSMENT
COMPETENCY
PRACTICE
NUMBER
INSTRUCTION
The medical laboratory technologist demonstrates research skills to investigate, evaluate or problemsolve in the health care setting.
23
CATEGORY 9
RESOURCE MANAGEMENT
9.01
Applies human resources skills to interactions with laboratory colleagues and other
health professionals
9.01.1
Recognizes signs of individual and group stress
9.01.2
Demonstrates empathy in assisting colleagues to deal with stress
9.01.3
Identifies the potential for conflict and uses negotiation skills to manage
conflicts
9.02
ASSESSMENT
COMPETENCY
PRACTICE
NUMBER
INSTRUCTION
The medical laboratory technologist addresses workplace challenges by applying skills involving human
resources as well as skills in change management, materials management, financial management and
information management.
SL, D
SL, D
C, O
D
O
D
C
Applies change management strategies
9.02.1
Demonstrates acceptance of the need for change
9.02.2
Anticipates, contributes to, responds to, and effectively works in a changing
environment
9.03
Demonstrates effective time management
9.04
Demonstrates information management skills
9.04.1
Uses information to make informed decisions
9.04.2
Uses computers, laboratory information systems and related technology in
specimen tracking and data management
OL, D
24
CATEGORY 10
COMMUNICATION AND INTERACTION
NUMBER
COMPETENCY
PRACTICE
ASSESSMENT
INSTRUCTION
The medical laboratory technologist interacts in a professional and competent manner, using effective
listening, verbal and written communication in dealings with laboratory colleagues, patients, students,
clients, and other health professionals. The medical laboratory professional projects a professional
image and follows generally accepted practices regarding interactions with clients, patients and
colleagues.
10.01
Practices effective communication with colleagues, patients, students, clients, and
other health professionals while maintaining a professional attitude
SL, D
A, C
10.02
Demonstrates effective communication skills
SL, T,
D
A, C
T, SL
A, SL
10.02.1
Seeks out and listens to colleagues, patients, students, clients and other health
professionals
10.02.2
Uses effective verbal communication strategies
10.02.3
Uses technology appropriately to facilitate communication
10.02.4
Writes clearly and concisely
10.02.5
Uses effective written communication strategies
10.02.6
Identifies barriers to effective communication
10.02.7
Recognizes forms of non-verbal communication
10.03
Implements interdisciplinary learning in personal practices to develop teamwork
skills in dealings with colleagues, patients, students, clients and other health
professionals
10.04
Promotes interdisciplinary collaboration in dealings with other health professionals
10.05
Demonstrates basic patient care skills relevant to the laboratory professional
10.05.1
Recognizes common indicators of patient stress
10.05.2
Initiates follow-up procedures where necessary for patient well-being
10.05.3
Demonstrates adaptive skills in dealing with patients with varying levels of
acuity
A
SL
A, SL
A, SL
25
CATEGORY 11
PROFESSIONALISM
INSTRUCTION
PRACTICE
ASSESSMENT
The medical laboratory technologist meets the legal and ethical requirements of practice and protects the
patient’s right to a reasonable standard of care. Professional responsibility encompasses scope of
practice, accountability, and professional development.
OL
D
C
NUMBER
COMPETENCY
11.01
Provides for the health care needs of the public, keeping the welfare and
confidentiality of the patient paramount at all times, and respecting the dignity,
values, privacy and beliefs of the individual
11.02
Complies with legislation governing medical laboratory technology and applies
these to the practice of the profession
11.03
Seeks help and guidance when asked to perform beyond competence
11.04
Discusses procedure in order to facilitate informed consent and respects a patient’s
right to refuse treatment
11.05
Exercises a judicious approach to the right to refuse to participate in potentially
dangerous situations
11.06
Takes responsibility and is accountable for professional actions
11.07
Identifies learning needs and participates in continuing education and training
A
A
11.08
Keeps abreast of laboratory techniques and research and shares new knowledge
with colleagues
A
A
11.09
Promotes the image and status of the profession of medical laboratory science as
members of the health care team by maintaining high standards in practice
D
C
11.10
Promotes an awareness and understanding of the contribution the medical
laboratory technologist provides to the consumer and public
11.11
Recognizes how ethical issues in the health care environment affect the medical
laboratory technologist
A, E
D
C