CACMLE—Continuing Education at the

CACMLE—Continuing Education
at the "Grass-Roots" Level
Special
Feature:
Continuing
Education
by Charlene L. Backe, MT(ASCP)
Introduction
The Colorado Association for Continuing Medical
Laboratory Education, Inc. (CACMLE) is a unique
organization that exists strictly to keep its members
and other interested individuals abreast of the latest
developments in the clinical laboratory sciences, an
educational outreach that has been going on for
more than 15 years.
As a nonprofit corporation, CACMLE's purpose, as
stated in its Articles of Incorporation, is to " p r o m o t e
the improvement of clinical laboratory techniques
and practices in the public interest; to promote the
exchange of ideas for the advancement of education
and science; to spread the results of scientific
research by providing lectures, tutorials, seminars
and workshops; to encourage greater understanding
and cooperation between medical technologists and
practicing physicians; and to instruct and train individuals in new laboratory techniques so as to
ultimately create higher standards of medical skills
and better patient care."
Organizational Development
The clinical laboratory personnel in Colorado have
a long history of active participation in and support
of continuing education efforts, by and large using
local resources. During the late 1950s and early
1960s, annual clinical laboratory continuing educaCharlene L. Backe, MT(ASCP), is Administrative
Colorado Association for Continuing
Medical
Colorado.
tion in Denver,
Coordinator
Laboratory
of the
Educa-
tion seminars, known as Post-Craduate Conferences,
were cosponsored by the University of Colorado
School of Medicine and the Colorado Society of
Medical Technologists (now the Colorado Society for
Medical Technology). These conferences, consisting
of series of lectures, seminars and workshops
presented by local as well as national experts,
soon gained national repute.
During 1964, in response to a growing demand for
year-round programming arising from the need to
keep abreast of the rapid changes occurring in the
clinical laboratory field, a cooperative continuing
education committee was established by the Colorado
Society of Medical Technologists and the Colorado
Society of Clinical Pathologists. This Joint Education
Committee, composed of six pathologists and six
medical technologists appointed from the two
societies, developed and presented continuing
education tutorials using instructors selected from
the staffs of local clinical laboratories.
The number of programs increased each year
until, by the early 1970s, more than 50 tutorials,
seminars and workshops were presented annually.
It became difficult for the volunteer administrative staff to maintain the pace of this growing
schedule of programs, which still was not meeting
local needs.
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The Colorado Association for Continuing Medical Laboratory Education, Inc. (CACMLE), located in Denver, is an
organization that has been developing and presenting continuing education programs for clinical laboratory personnel
for more than 15 years. CACMLE's history, goals, development, organizational structure, current programs and projects
are discussed so that they may serve as models for other
groups that may wish to initiate or expand local programs of
their own. (Key words: CACMLE; Continuing education.)
In 1973, CACMLE was incorporated as a nonprofit,
tax-exempt continuing education organization with
the primary goal of meeting the increasing demands
for continuing laboratory education within the
medical community of Colorado. A small paid staff
was established and a combination office/classroom
facility was leased.
Current Programs
Denver Metro Program
Currently, more than 100 courses and workshops
are presented annually through CACMLE, covering
0007-5027/81/0100/031 $00.70 © American Society of Clinical Pathologists
31
a variety of subjects related to the clinical laboratory. Approximately 1500 participants register for
more than 3000 course positions each year. These
courses consist of seminars, tutorials and workshops
designed at basic to advanced levels. Programming
aimed at a local audience allows great flexibility in
scheduling, from short, one-evening programs to
workshops that extend for one or more days.
CACMLE courses are presented by a volunteer
faculty drawn from a pool of more than 200 local
pathologists, medical technologists and other instructors, in addition to a number of out-of-state
experts w h o are invited to participate in specific
programs. The courses are held in classrooms available in the South Building of Mercy Medical Center
and at various medical and educational facilities
throughout the state. Course registrants come from
all over the United States and from Canada.
In order to meet this expressed need for "handso n " laboratory experience, CACMLE applied for and
received in 1975 a three-year Allied Health Professions Special Project grant from the Health Resources Administration of the U.S. Public Health
Service to continue its rural-laboratory upgrading
program. Through this project, a series of "Learning Activity Packages" (LAPs) were developed which
are used by the participants for self-instruction and
laboratory in-service training. Each LAP was designed
to provide " h a n d s - o n " experience with many clinical
laboratory procedures within the framework of
problem-solving and specimen-oriented exercises.
These LAPs were initially supplemented with oneday workshops that were presented every three to
four months at several regional sites through the
state. Twenty-six LAPs were produced under this
grant, covering topics in microbiology, hematology,
coagulation, blood banking and clinical chemistry.
This model project at its peak of activity encompassed 148 rural hospitals and more than 500 clinical
laboratory personnel in C o l o r a d o , W y o m i n g ,
Montana, South Dakota and Utah.
The rural outreach project has spawned two current major endeavors: CACMLE's Self-Study Program
and Teledialogs.
Rural Outreach
Colorado is a large, primarily rural, state with
104 hospitals. Long distances and mountain ranges
separate the rural communities in which a large percentage of the hospitals are located. Travel constraints and staff shortages are problems experienced
by most rural institutions; thus, it is difficult, if not
impossible, for many rural Colorado laboratory personnel to participate in the continuing education
programs offered in Denver.
Recognizing this p r o b l e m , CACMLE applied for
and received in 1974 a one-year contract through the
Manpower Development and Training Act (MDTA)
and the C o l o r a d o - W y o m i n g Regional Medical
Program (RMP) to provide on-site continuing education for laboratory workers in rural Colorado. During
the tenure of this grant, instructors from Denver,
Colorado Springs and Pueblo held three-hour review
sessions on basic laboratory techniques on alternate
32
LABORATORY MEDICINE • VOL. 12, NO. 1, JANUARY 1981
Self-Study Program
The Self-Study Program is designed to serve as
a basic review of various current topics in laboratory medicine for those clinical laboratory personnel w h o have limited local access to continuing
education courses. This program has been useful
also as a training and in-service education tool.
Each program consists of three Learning Activity
Packages, each of which includes a didactic overview of the subject being presented and a series of
photomicrographs and " w e t " specimen exercises.
The " w e t " specimens may consist of lyophilized
serum samples, microorganisms, peripheral blood
smears or other materials that require analysis in the
participant's laboratory. The LAPs are sent out on
approximately a monthly schedule for individual
study. After three LAPs have been studied, partici-
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The educational resources available through the
Denver Metro Program also have been used to develop training programs for Peace Corps volunteers
assigned for service as clinical laboratory workers
in underdeveloped countries. Other extensions of
the Denver Metro Program include CACMLE's Annual Summer Post-Graduate Conference and traveling workshops; both of these projects were initiated
in response to requests from laboratory personnel in
neighboring states w h o wished to participate in
CACMLE's efforts. The Summer Post-Graduate Conference is a four-day program, during which several
courses selected primarily from CACMLE's previous
offerings are repeated. CACMLE has also worked
with other professional groups to provide select
CACMLE programs, known as traveling workshops,
in other states. These cooperative efforts may be
arranged on a contractual or cosponsored basis.
weeks at 17 rural locations throughout Colorado.
Approximately 140 rural medical technologists participated in these review programs. The instruction
was based on the Listen, Look and Learn audiovisual
series produced by the National Committee for
Careers in the Medical Laboratory under a contract
from the U.S. Department of Labor. This initial rural
outreach was most successful, falling short only in an
expressed need on the part of the participants for
" w e t " laboratory instruction in addition to the
didactic review sessions.
pants receive a self-assessment examination, on
which a score of 80% must be achieved to receive
CEU credits for each three-part course. As of
CACMLE's Spring 1980 semester, more than 1600
registrants have participated in the 11 self-study
courses offered.
Telephone Conferencing (TeJediaJogsJ
Organizational Administration
CACMLE is incorporated as a nonprofit, taxexempt educational association of members. Direction is provided by a 20-member, voluntary Board
of Directors which meets monthly. The Board of
Directors is made up of three categories of members: physicians, medical technologists and other
nonphysician laboratory personnel, and nonlaboratory personnel, in a ratio of 2 : 2 : 1 . Each Board
member servesathree-yearterm. In addition, several
individuals are appointed annually to serve as advisors to the Board. A series of standing and ad hoc
committees serve specific functions, such as curriculum development and long-range planning for
the Board of Directors.
CACMLE's staff has grown from an initial 1.5 fulltime equivalent (FTE) staff members to its present
staff of seven FTEs. Included is an executive director,
administrative coordinator, administrative assistant,
bookkeeper, three secretaries, and technical coordinators for special projects as needed. The staff
administers all programs and projects, aids in curriculum development and performs all recordkeeping and financial functions for the organization.
Accreditation
In developing a policy for the awarding of continuing education units (CEUs) for CACMLE programs and courses, the Board of Directors elected
to follow the recommendations issued in 1974 by
Financial Base
CACMLE is a private corporation and receives no
state funding. The majority of CACMLE's financial
support is garnered from the tuition received from
various courses and programs. Because courses are
aimed at all levels of personnel in the clinical laboratory, both the Board of Directors and the CACMLE
staff are committed to maintaining tuition fees at as
low a level as possible. It is an organizational aim to
provide continuing education that is affordable to all
w h o wish to participate.
A small membership fee provides additional financial support. Members are entitled to the following
benefits: they can attend courses at a lower tuition
rate; they may receive a free transcript of course
attendance annually; they are allowed use of
CACMLE's audiovisual library; and they elect the
Board of Directors. Nonmembers can participate in
CACMLE courses but do not receive the benefits
listed above without additional charge. Whenever
possible, CACMLE attempts to gain supplemental
f u n d i n g , such as governmental or foundation support, for the development of new projects.
Facility
CACMLE has been fortunate since its incorporation
to lease office and classroom space from Mercy
Medical Center in Denver. These facilities were made
available in 1973 with the closing of the Mercy
Medical Center Diploma School of Nursing. For
workshops that require the use of extensive laboratory facilities, arrangements are made to hold the
program at the University of Colorado Health
Sciences Center or at one of the local community
colleges.
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Another mechanism that has been successfully
implemented by CACMLE as part of its rural outreach effort is the use of the telephone to deliver
continuing education courses. Under a 1978 contract
from the Center for Disease Control, CACMLE has
developed, tested and evaluated a complete review
course in clinical bacteriology that was delivered to
rural laboratory personnel via a telephone conference network. At the completion of this contract,
CACMLE had established 24 telenet receiving sites in
Colorado, involving42 hospitals and clinics and more
than 200 clinical laboratory personnel. These Teledialog programs are now part of CACMLE's ongoing curriculum and are available to laboratory
personnel in any health-care facility where sending
and receiving equipment for telephone conferencing
has been installed.
the National Task Force on the Continuing Education Unit. 1 CACMLE has cosponsored some programs
with the American Society of Clinical Pathologists
(ASCP) and has received P.A.C.E. accreditation f r o m
the American Society for Medical Technology (ASMT)
for individual courses. In 1979, CACMLE received
accreditation from the American Medical Association
(AMA) for Physician Category I credit for its course
offerings.
Factors Contributing to CACMLE's Success
Individuals and circumstances too numerous to
discuss here have contributed greatly to CACMLE's
unique success. However, certain factors created a
climate in which such success was possible. These
factors include:
1. A large medical community
that is geographically separated from other large medical centers. A survey conducted by CACMLE in 1975
LABORATORY MEDICINE • VOL. 12, NO. 1, JANUARY 1981
33
identified 313 clinical laboratory facilities in
Colorado with a total of 2,948 clinical laboratory
workers. 2 Approximately two thirds of these
laboratories and personnel are located in the
so-called " f r o n t range" area of the state, an
area extending from Fort Collins in the north to
Pueblo in the south, including the Denver
metropolitan area.
3. Flexibility due to small size. CACMLE has always
been able to plan and implement programs
quickly because it is not inhibited by layers of
administrative control that often exist in larger
organizations.
4. A commitment to continuing education on the
part of laboratory personnel and hospital administrators in the area. In addition to survey
data that indicate a high level of interest in
continuing education in Colorado, many local
clinical laboratory personnel actively volunteer
their time for CACMLE to plan and develop curricula and to serve as faculty for its programs.
Most of the hospitals pay for at least a portion
of the course tuition for staff personnel and
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THE
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LABORATORY MEDICINE • VOL. 12, NO. 1, JANUARY 1981
5. A cooperative relationship between
Colorado
pathologists
and medical technologists
that
evolved through the years in the area of continuing
education.
As m e n t i o n e d above,
CACMLE's roots were formulated by a cooperative effort of the state technologist and
pathologist societies. CACMLE's administration
and staff have been careful to nurture this relationship, yet remain independent of either
group. The support of both the technologists
and the pathologists has been vital to CACMLE's
success.
CACMLE has been successful in the Rocky M o u n tain region and could serve as a model for other
groups that wish to develop local continuing education activities. However, the importance of the
previously discussed success factors as well as the
efforts of a nucleus of dedicated individuals cannot
be underrated in that achievement. Groups that wish
to emulate CACMLE's experience are cautioned to
analyze carefully the needs and resources in their
area and to remember that CACMLE's development
took a number of years and a great deal of trial
and effort.
References
1. National Task Force on the Continuing Education Unit, 1974, The Continuing Education Unit: Criteria and Guidelines. Washington. D C .
National University Extension Service.
2. Laboratory Manpower Survey, 1975. Conducted by the Colorado Association for Continuing Medical Laboratory Education, Inc., in cooperation with the Colorado-Wyoming Regional Medical Program, Department of Health, Education, and Welfare.
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2. Extensive local resources for curriculum
and
faculty development.
Denver serves as the
major medical center for much of the Rocky
Mountain region. Many large governmental and
private medical facilities are located there,
including Fitzsimons Army Medical Center, the
University of Colorado Health Sciences Center,
National Jewish Hospital and Asthma Research
Center, and Denver General Hospital. Such
research and teaching facilities provide a wealth
of knowledge and educational capability to any
medical community if properly utilized.
allow paid time off to participate in CACMLE
programs.