author: schum mer, diane m. - uw-stoutof the career. the title clinical laboratory scientist (cls),...

Author: Schum mer, Diane M. Title: An Assessment of Sacred Heart Hospital School of Medical Technology

Curriculum Relative to Certification Examination Content The accompanying research report is submitted to the University of Wisconsin-Stout, Graduate School in partial

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Graduate Degree/ Major: MS in Education

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2

Schummer, Diane M. An Assessment of Sacred Heart Hospital School of Medical

Technology Curriculum Relative to Certification Examination Content

Abstract

The purpose of this evaluation was to identify the strengths and weaknesses of the

Medical Technology program at Sacred Heart Hospital. More specifically, it strived to

determine the extent to which the program prepared candidates for the American Society for

Clinical Pathology Board of Certification Exam in the areas of blood bank, chemistry,

hematology, immunology, laboratory operations, microbiology and urinalysis and other body

fluids. Data regarding certification examination performance, class of 2010 and 2011 graduate

feedback, and current program objectives were collected, collated, and compared to identify the

strengths or weaknesses that can be attributed to program’s curriculum and instruction.

Based on graduates’ ASCP BOC examination scores, Sacred Heart Hospital School of

Medical Technology is adequately preparing its students for professional certification. However,

analysis sub-content scores, graduate feedback and assessment of objectives and competencies

uncovered opportunities for improving the program’s curriculum and instruction. Exam

performance on body fluid sub-content in the urinalysis and other body fluids subtest was

particularly low. The scores also were generally lower in 2011 than 2010 in chemistry,

laboratory operations and microbiology subtests. Graduate feedback indicated both the lecture

component and bench activities provided by the program were helpful or very helpful in

preparation for the certification exam. Lastly, all of the respondents to the survey indicated that

they would recommend Sacred Heart Hospital School of Medical Technology to others.

3

Acknowledgements

I would like to extend my heartfelt thanks to my gracious adviser on this project, Dr.

Kenneth Welty. His patience, guidance and ability to “rein me in” and bring clarity and

understanding to this topic was truly exceptional. It was no easy task for him to save me from

myself so that I was able to complete this project!

Thank you to Mike for your patience, Jonathan and Jessica for your technical help and

expertise, and Mom for your encouragement throughout the entire process of completing my

degree and this project. Thanks also to Jim for challenging me to pursue this degree in the first

place. I must also recognize the support and encouragement from Karen and Sheila in achieving

this goal and as well as the goals that I have reached as a result of completing this degree. Thank

you all!

4

Table of Contents

………………………………………………………………….…………………… Page

Abstract ……………………………………………………………………………… 2

List of Tables ………………………………………………….…………………… 6

Chapter I: Introduction ………………………………………………………………. 7

Background ……………………………………………………..…………….. 7

Education ………………………………………………..……………………. 8

Licensure and Certification ……………………………..…………………….. 8

Purpose of the Study ………………………………………………………….. 10

Key Questions ………………………………………………………………… 11

Definition of Terms …………………………………………………………… 11

Limitations ……………………………………………………………………. 13

Chapter II: Literature Review ……………………….……………………………… 14

Medical Laboratory Science Curriculum ……………………………………... 14

ASCP BOC Certification Examination ……………………………………….. 17

Chapter III: Methodology ………………………………………………………….. 21

Certification Exam Performance ……………………………………………… 21

Graduate Perceptions …………………………………………………………. 23

Curriculum Audit ……………………………………………………………... 26

Summary ……………………………………………………………………… 27

Chapter IV: Results ………………………………………………………………… 28

Information Sources ………………………………………………………….. 28

Blood Bank …………………………………………………………………… 29

5

Chemistry ……………………………………………………………………... 34

Hematology …………………………………………………………………… 38

Immunology …………………………………………………………………... 43

Laboratory Operations ………………………………………………………... 46

Microbiology ………………………………………………………………….. 49

Urinalysis/Other Body Fluids ………………………………………………… 53

Chapter V: Discussion ……………………………………………………………... 57

Limitations ……………………………………………………………………. 58

Blood Bank …………………………………………………………………… 58

Chemistry ……………………………………………………………………... 59

Hematology …………………………………………………………………… 60

Immunology …………………………………………………………………... 60

Laboratory Operations ………………………………………………………... 61

Microbiology …………………………………………………………………. 61

Urinalysis/Other Body Fluids ………………………………………………… 62

Conclusions …………………………………………………………………… 63

Recommendations …………………………………………………………….. 63

References ………………………………………………………………………….. 66

Appendix: Sacred Heart Hospital School of Medical Technology Survey ……..…… 68

6

List of Tables

Table 1: Test Performance – Blood Bank ………………………………………….. 29

Table 2: Test Performance – Blood Bank Sub-content ……………………………… 30

Table 3: Graduate Feedback – Blood Bank …………………………………………. 31

Table 4: Test Performance – Chemistry …………………………………………… 34

Table 5: Test Performance – Chemistry Sub-content ……………………………… 35

Table 6: Graduate Feedback – Chemistry …………………………………………. 36

Table 7: Test Performance – Hematology …………………………………………. 39

Table 8: Test Performance – Hematology Sub-content ……………………………. 39

Table 9: Graduate Feedback – Hematology ………………………………………... 41

Table 10: Test Performance – Immunology ……………………………………….. 43

Table 11: Test Performance – Immunology Sub-content ………………………….. 44

Table 12: Graduate Feedback – Immunology ……………………………………… 45

Table 13: Test Performance – Laboratory Operations ……………………………... 47

Table 14: Graduate Feedback – Laboratory Operations …………………………… 47

Table 15: Test Performance – Microbiology ………………………………………. 49

Table 16: Test Performance – Microbiology Sub-content …………………………. 50

Table 17: Graduate Feedback – Microbiology …………………………………….. 51

Table 18: Test Performance – Urinalysis/other Body Fluids ………………………. 54

Table 19: Test Performance – Urinalysis/other Body Fluids Sub-content ………… 54

Table 20: Graduate Feedback – Urinalysis/other Body Fluids …………………….. 55

7

Chapter I: Introduction

Background

Perhaps the least recognized healthcare professional is the Medical Laboratory Scientist

(MLS). If surveyed, a majority of those polled would not know this person’s role on a healthcare

team. A similar title, Medical Technologist, evokes a wide range of guesses regarding the nature

of the career. The title Clinical Laboratory Scientist (CLS), while slightly more descriptive, is

still likely to confuse the average person. Although terminology may vary, the career path,

education and responsibilities have adapted within the ever-changing scientific and medical

community.

A professional Medical Laboratory Scientist must earn a baccalaureate degree and have

an extensive theoretical knowledge in a variety of biology and chemistry disciplines. Medical

Laboratory Scientists analyze and test tissues, blood and other body fluids to help detect,

diagnose and treat disease. They collect patient specimens, inoculate and evaluate cultures, and

operate complex instrumentation in order to provide a wide range of test results. To ensure

accuracy, they carefully monitor quality control, evaluate and interpret data and troubleshoot

unusual or unexpected results. As experts in the laboratory science field, they often educate and

consult with other healthcare professionals and develop new test methods. The work involves

the use of microscopes, chemicals, computers and sophisticated electronic instruments. By the

conclusion of their training, Medical Laboratory Scientists have learned entry-level skills in all

of the clinical laboratory disciplines including chemistry, hematology, immunology,

immunohematology (blood bank), microbiology and molecular biology. They function as a

generalist in the clinical laboratory by utilizing manual dexterity and visual acuity to perform

accurate macroscopic and microscopic analysis of specimens. Reasoning skills and functioning

8

independently with confidence and efficiency while maintaining team unity are vital to success

in this field (American Society for Clinical Laboratory Science, 2011).

Education

To become a MLS, a bachelor’s degree in medical technology or another life science is

mandatory. The degree program includes courses in chemistry, biology, microbiology and

statistics as well as specialized courses related to clinical laboratory knowledge and expertise.

These courses are generally offered through a hospital-based program affiliated with the

university offering the baccalaureate degree. Within this structure, called the clinical practicum,

the student’s entire senior year is spent at an affiliated hospital laboratory rather than at the

university. Alternatively, larger universities, particularly those associated with academic

medical centers, may provide the specialized clinical courses and a shorter on-site clinical

experience of five to six months. Yet another route to becoming a MLS involves attaining a

baccalaureate degree in one of the life sciences followed with completion of a hospital-based

clinical program. The National Accrediting Agency for Clinical Laboratory Sciences

(NAACLS) is the primary agency responsible for accreditation of university and hospital-based

MLS programs as well as other laboratory science related programs (American Society for

Clinical Pathology, 2011).

Licensure and Certification

Licensure of laboratory professionals is required in some states and typically requires a

bachelor’s degree and successful completion of a state licensing examination. Certification may

not be required in order to work as a MLS, however, most employers insist on certification by a

recognized professional association. Agencies offering certification include the American

Medical Technologists (AMT), The Board of Registry of the American Association of

9

Bioanalysts (AAB), and the Board of Registry of the American Society for Clinical Pathology

(ASCP) (Occupational Outlook Handbook, 2010-2011 Edition, Clinical Laboratory

Technologists and Technicians). Prior to 2009, the National Credentialing Agency for

Laboratory Personnel (NCA) also offered certification. In 2009 the ASCP Board of Registry

(ASCP BOR) and the NCA agreed to merge into a single certification agency called the ASCP

Board of Certification (ASCP BOC). With the implementation of this agreement, NCA was

dissolved as a corporation and current, active NCA certifications were transferred to the ASCP

BOC with no examination requirement. The ASCP title of Medical Technologist (MT) and

NCA title of Clinical Laboratory Scientist (CLS) were replaced with the designation Medical

Laboratory Scientist (MLS) (American Society for Clinical Pathology, 2009). These three titles

are often used interchangeably in the clinical laboratory setting.

The ASCP BOC is the primary organization offering certification of laboratory

professionals in the United States. The society was formed in 1928 and is currently accredited

by the American National Standards Institute (ANSI) for Medical Laboratory Scientist (MLS),

Medical Laboratory Technician (MLT) and Phlebotomy Technician (PBT) certification

categories. Eligibility for MLS certification may be achieved by four routes, however, the scope

of this paper is limited to applicant eligibility by Route 1 defined as “A baccalaureate degree

from a regionally accredited college/university including courses in biological science, chemistry

and mathematics AND successful completion of a NAACLS accredited Medical Laboratory

Science program within the last 5 years”(American Society for Clinical Pathology).

Sacred Heart Hospital’s School of Medical Technology was established in 1959 in Eau

Claire, Wisconsin. This program provides the necessary professional education, including

didactic and clinical laboratory experiences, for Medical Laboratory Science students to become

10

vital members of the hospital and healthcare community. The program has formal affiliation

with the University of Wisconsin-LaCrosse (UW-LaX), the University of Wisconsin-Oshkosh

(UW-O), the University of Wisconsin-Stevens Point (UW-SP) and Michigan Technological

University (MTU). Students from non-affiliated universities may be accepted only if they have

earned a baccalaureate degree prior to admission. Depending upon the availability of qualified

candidates, up to four students may be accepted annually, with preference given to qualified

students from affiliates. The NAACLS accredited program at Sacred Heart Hospital provides the

necessary clinical training requirement of the ASCP BOC and must supply evidence of

successful completion to the ASCP in order for a graduate to be eligible for the MLS

certification exam.

Changes in the clinical laboratory at Sacred Heart Hospital over the last several years

have directly or indirectly impacted the School of Medical Technology. Examples include

elimination of lectures by pathologists, changes in directorship of the laboratory and MLS

program, shorter program length, new lecturers in some laboratory disciplines, reduced overall

laboratory staffing and, most recently, a change to a lean lab configuration.

Purpose of the Study

Because of changes in the program and laboratory operations, this study examined the

extent to which Sacred Heart Hospital School of Medical Technology prepares graduates for

ASCP certification. The assessment reviews certification examination performance, graduate

feedback and curriculum in all sub-disciplines of the clinical laboratory as categorized on the

ASCP-BOC certification examination. The categories are blood bank, chemistry, hematology,

immunology, laboratory operations, microbiology, and urinalysis/other body fluids. This

11

assessment is intended to uncover inadequacies, gaps or weaknesses, as well as identify assets

and strengths in the program providing information relevant to enhancement of the program.

Key Questions

To fulfill the purpose of the evaluation, the following questions were addressed.

1. What are the strengths and weaknesses of the Medical Technology program in terms

of the competencies associated with Blood Bank?


of the competencies associated with Chemistry?


of the competencies associated with Hematology?


of the competencies associated with Immunology?


of the competencies associated with Laboratory Operations?


of the competencies associated with Microbiology?


of the competencies associated with Urinalysis and other Body Fluids?

Definition of Terms

For the purpose of this investigation, the following definitions of terms were adopted.

MT: Medical Technologist

CLS: Clinical Laboratory Scientist

MLS: Medical Laboratory Scientist

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The above terms are current or former titles awarded by accrediting agencies to personnel

who have attained a baccalaureate degree in Medical Technology or Clinical Laboratory Science

and have successfully completed a certification examination allowing them to work in a clinical

laboratory. Medical Laboratory Scientist (MLS) is the most current; however, all three titles are

often used interchangeably.

ASCP: American Society for Clinical Pathology; the most widely recognized

certification agency for laboratory personnel in the United States. The organization also

provides education and advocacy on behalf of patients, pathologists and laboratory professionals

(About ASCP, 2011).

ASCP BOC: American Society for Clinical Pathology Board of Certification; the branch

of the ASCP which administers and oversees certification of clinical laboratory personnel.

NAACLS: National Accrediting Agency for Clinical Laboratory Personnel; international

agency for accreditation and approval of educational programs in the clinical laboratory sciences

and related health professions (Guide to Accreditation, 2003).

Clinical laboratory: Laboratory that tests human specimens such as blood or body fluids

to aid in diagnosis, treatment and monitoring of disease in patients. Clinical laboratories are

most often associated with hospitals and clinics.

Hematology: Section of the clinical laboratory that performs tests that identify diseases

associated with blood and blood-forming tissues such as anemia and leukemia (McCall &

Tankersley, 2008, p. 27).

Chemistry: Section of the clinical laboratory that performs tests to evaluate the function

of a specific organ or body system such as respiratory, endocrine, renal, etc. (McCall &


13

Immunology: Section of the clinical laboratory that performs testing related to

autoimmune disorders and the body’s immune response to infectious agents (McCall &


Urinalysis/Other Body Fluids: Section of the clinical laboratory that evaluates physical

and chemical properties of urine to assess kidney function and look for the presence of infection

(McCall & Tankersley, 2008, p. 32). Analysis of other body fluids such as joint, cerebrospinal,

amniotic etc. is performed to determine causes of disease.

Microbiology: Section of the laboratory that analyzes body fluids and tissues for the

presence of infection caused by a wide variety of microorganisms (McCall & Tankersley, 2008,

p. 34).

Blood Bank or Immunohematology: Section of the laboratory that prepares blood and

other blood products for transfusion (McCall & Tankersley, 2008, p. 35).

Laboratory Operations: Portion of the ASCP BOC Examination that deals with

laboratory management and quality topics such as competency of personnel, accreditation,

compliance, financial management etc. throughout the clinical laboratory.

Limitations

This evaluation encompasses Sacred Heart Hospital School of Medical Technology

graduate performance on the ASCP BOC examination along with a review and comparison of

course objectives to the ASCP BOC Content Outline for the Medical Laboratory Scientist

certification examination. Graduate feedback related to curriculum and instruction has been

solicited in an effort to compare data from a variety of sources. The information obtained in this

evaluation applies uniquely to Sacred Heart Hospital School of Medical Technology and cannot

be further generalized.

15

Chapter II: Literature Review

The purpose of this evaluation was to identify the strengths and weaknesses of the

Medical Technology program at Sacred Heart Hospital to inform refinements to its curriculum

and instruction. More specifically, it strived to assess the extent to which the program

adequately prepared candidates for the ASCP BOC Certification Examination in the areas of

blood bank, chemistry, hematology, immunology, laboratory operations, microbiology and

urinalysis and other body fluids. A review of relevant literature was conducted to inform the

evaluation process. The following narrative reports the results of that literature review. More

specifically, it will address the curricular requirements of NAACS-accredited MLS programs and

structure and content of the ASCP BOC Certification Examination.

Medical Laboratory Science Curriculum

Curriculum is a term that may have a variety of definitions depending upon its context. In

the most general sense, curriculum refers to all courses offered at a particular school. A more

narrow definition may refer to a prescribed set of courses that must be successfully completed in

order to attain a certain level of education or receive a diploma or degree (Conjecture

Corporation, 2002-2011).

Studies related to clinical laboratory science education and attributes of a quality clinical

practicum curriculum are nearly non-existent. Searches of multiple scientific and health-related

databases revealed a plethora of studies addressing nurse and physician clinical education, a

small number related to diagnostic radiology, but almost none associated with the clinical

laboratory.

The “signature pedagogy” of clinical laboratory science education involves participation

in a professional practice experience. The most common terms used to describe this are

16

internship or clinical practicum and it requires spending time in the clinical laboratory learning

from experienced professionals often in a one-on-one situation. A number of NAACLS-

accredited university MLS program professional practice sites in Illinois were surveyed in order

to learn more about the specific components of each program. Results showed wide variation in

program structure or curriculum and content delivery; however, four common characteristics of

the practicum experience were identified. These were categorized using the words develop,

nurture, incorporate and invest. Those teaching at the laboratory bench provide a model for

helping students to develop appropriate behaviors and habits. Laboratory staff not involved in

bench instruction, as well as other employees throughout the institution nurture students as role

models in ethics and professionalism. Incorporation of students into the laboratory dynamics and

making them comfortable helps them feel a sense of belonging and role as contributing members

of the organization (Woeste & Barham, 2006).

The above study did not discuss specifics of curriculum, but rather provided a summary

of the structure and content delivery methods of the schools surveyed. The fact that all were

NAACLS-accredited implies that the curriculum meets the requirements of forth by the

accrediting organization.

Specific curricular requirements are outlined in the NAACLS Unique Standards and

Documentation Required for Accredited CLS/MT Programs. Standard 22, titled Curricular

Requirements, describes mandates for structure, instructional areas, learning experiences and

evaluations. The curricular structure must contain written goals and objectives for each course

offered. Content must include “all the major subject areas currently offered in the contemporary

clinical laboratory” (Guide to Accreditation, 2003, p. 5).

17

Subheading B of NAACLS Standard 22 is tiled Instructional Areas and utilizes a

numbered list of nine topics to describe required curriculum content. According to the standard,

the curriculum must include:

Scientific content including anatomy/physiology, immunology, genetics/molecular

biology, microbiology, organic/biochemistry and statistics.

Pre-analytical, analytical and post-analytical components of laboratory services in all

areas of laboratory testing including phlebotomy. This should encompass principles

and methodologies, assay performance, troubleshooting, interpretation, data

evaluation and assessment of laboratory services.

Principles of quality assurance and quality improvement in all components of

laboratory services.

Application of safety and government regulations in terms of laboratory practice.

Principles of communication and team-building.

Principles of ethics and professionalism.

Education techniques adequate to train or educate users of laboratory services.

Knowledge of research design/practice adequate to evaluate published studies.

Concepts and principles of laboratory operations to include:

Critical pathways and clinical decision-making

Performance improvement

Healthcare delivery systems as related to laboratory service

Human resource management

Financial management (Guide to Accreditation, 2003, pp. 5-6)

18

Eligibility for ASCP Certification via Route 1 requires a baccalaureate degree and

completion of a NAACLS-accredited MLS program. Sacred Heart Hospital School of Medical

Technology is a NAACLS-accredited program designed to prepare students for certification by

this route. Curricular components of the program therefore are determined according to the

NAACLS standard described above, as well as certification examination content as outlined by

the ASCP BOC.

ASCP BOC Certification Examination

The ASCP BOC criterion-referenced examination model involves three components.

The first is a listing of competency statements describing tasks that Medical Laboratory

Scientists should be capable of performing. These competencies apply to all areas of the

laboratory and involve application of theories and principles, appropriate selection and

processing of controls, reagents and instrumentation, calculation and correlation of lab results,

and evaluation of data to determine actions to be taken.

The second component of the examination model is the content outline describing the

subtest areas of the certification exam. Competency statements and examination content are

listed in the ASCP BOC MLS Examination Content Guideline. The outline describes items

assessed in each subtest: blood bank, urinalysis and other body fluids, chemistry, hematology,

immunology, microbiology and laboratory operations.

The third component describes taxonomy levels and the cognitive skills required to

answer a variety of test questions. Level 1 questions involve the ability to recall previously

learned facts or theories. Level 2 builds on recall ability and incorporates data interpretation.

Level 3 questions evaluate the ability to utilize both recall and interpretation in order to resolve a

19

problem and make an appropriate decision related to that problem (Examination Content

Guideline).

The ASCP BOC examination is computerized and preliminary results (pass or fail)

appear on the computer screen upon completion of the test. An official report is mailed to the

examinee soon after they have taken the test and includes pass/fail status. Examinees who have

failed the test are provided with scale scores for each subtest so that they can identify areas of

weakness in preparation for repeat examination.

MLS Program Directors are able to access a Board of Certification Program Performance

Report Summary that includes a variety of statistics and comparisons of various aspects of the

certification exam results. Reports are generated on a quarterly basis allowing program directors

to gauge student performance and make comparisons with similar programs and nationwide

statistics.

Examination scores are reported as a scaled score statistically derived from the raw score

and difficulty level of the questions. Each examinee takes a different form of the exam;

therefore, scaled scores are used so that test results may be compared. The minimum passing

score is 400 and highest attainable score 999. The Program Performance Report Summary

details each students overall score on the certification exam as well as a score for each subtest.

Additionally, each subtest is further dissected into sub-content scores as categorized in the MLS

Examination Content Outline. Listed below are the seven subtests along with the percentage of

the exam each comprises and the sub-content evaluated for each.

1. Blood Bank 17%

a. ABO and Rh

b. Antibody screen and identification

20

c. Crossmatch and special tests

d. Blood donation, transfusion therapy, transfusion reactions and

hemolytic disease of the newborn (HDN)

2. Chemistry 21%

a. Carbohydrate/Acid base/Electrolytes

b. Proteins and other nitrogen containing compounds

c. Enzymes/Lipids/Lipoproteins

d. Special chemistry

3. Hematology 20%

a. Erythrocytes and leukocytes

b. Other tests

c. Morphology and differential

d. Platetlets and hemostasis

4. Immunology 8%

a. Immunity

b. Infectious diseases

5. Microbiology 20%

a. General bacteriology and aerobic gram-positive cocci

b. Aerobic gram-negative bacilli

c. Gram negative cocci, gram-positive bacilli and anerobes

d. Fungus, viruses mycobacteria and parasites

6. Urinalysis and other body fluids 8%

a. Urinalysis

21

b. Other body fluids

7. Laboratory operations (no separate sub-content listings) 6%

Mean scaled scores for each sub-content area are generated for graduates of the program

on a quarterly basis. The minimum scaled score is 100 and maximum is 999. The report

cautions interpretation of scores in the high and low ranges since they may be based on small

numbers of questions and students (Sacred Heart’s program has a maximum of four students).

The scaled score of 400 is recommended to be used as a criterion for assessing overall program

performance (Board of Certification Program Performance Report Summary, 2010).

22

Chapter III: Methodology

This evaluation was intended to identify the strengths and weaknesses of the Medical

Technology program at Sacred Heart Hospital. More specifically, it has strived to assess the

extent to which the program prepared candidates for the ASCP BOC Certification Examination.

The evaluation used an expertise/connoisseur-oriented approach to address the key questions.

Graduate performance on the certification exam was reviewed and evaluated relative to ASCP

BOC standards, feedback from students and curricular components of the program. Graduates

from the past two years were surveyed to ascertain their perceptions of the extent to which they

were prepared for successful completion of the certification exam. Finally, the information

obtained from these two lines of inquiry were compared with competencies and objectives

contained in the Sacred Heart Hospital School of Medical Technology curriculum along with

ASCP BOC Content Outline for Medical Laboratory Scientist certification looking for

correlation, disparity or redundancy.

Certification Exam Performance

Data on test performance was taken from the Board of Certification Program

Performance Report Summary. The overall score on the certification exam along with individual

student scores for each subtest were provided in the report. In addition, mean scaled scores for

graduates of Sacred Heart’s program were provided for each sub-content area of each subtest.

The content outline is divided according to each subtest included on the certification

examination: blood bank, chemistry, hematology, immunology, laboratory operations,

microbiology, and urinalysis and other body fluids. Subtest content is further detailed as

follows:

I. Blood Bank

23

1. ABO and Rh

2. Antibody screen and identification

3. Crossmatch and special tests

4. Blood donation, transfusion therapy, transfusion reactions and

hemolytic disease of the newborn (HDN)

II. Chemistry

1. Carbohydrate/Acid base/Electrolytes

2. Proteins and other nitrogen containing compounds

3. Enzymes/Lipids/Lipoproteins

4. Special chemistry

III. Hematology

1. Erythrocytes and leukocytes

2. Other tests

3. Morphology and differential

4. Platetlets and hemostasis

IV. Immunology

1. Immunity

2. Infectious diseases

V. Microbiology

1. General bacteriology and aerobic gram-positive cocci

2. Aerobic gram-negative bacilli

3. Gram negative cocci, gram-positive bacilli and anerobes

4. Fungus, viruses mycobacteria and parasites

24

VI. Urinalysis and other body fluids

1. Urinalysis

2. Other body fluids

VII. Laboratory operations (no separate sub-content listings)

Both subtest and sub-content scores were reviewed for students who completed the

Sacred Heart program and took the certification examination during the April/May/June testing

cycle in 2010 and 2011. All graduates of the program for the respective years took the exam

during this time frame both years. Subtest and sub-content scores for 2010 and 2011 graduates

were reviewed and compared between the two graduating classes as well against the mean scaled

score of 400 used as a standard for assessing overall program performance.

Graduate Perceptions

Subject selection and description. Graduates who completed the program over the past

two years (2010 and 2011) were queried regarding the degree to which lecture and bench

activities were helpful to them in terms of preparation for the certification exam. Eight graduates

of the program from this time frame received an email requesting feedback with a link to an

online survey. Names of participants were not included in any documents associated with this

evaluation and survey responses were anonymously submitted. The project was submitted to the

UW-Stout Institutional Review Board for the Protection of Human Subjects and found to be

exempt under Category 2 of the Federal Exempt Guidelines.

Instrumentation. The instrument used in this evaluation was developed specifically by

the author and was designed and distributed as on online survey using the website

Surveyspro.com. The survey consisted of nine sections with the bulk of the questions centered

on specific sub-content items within each subtest of the ASCP BOC certification examination.

25

The first section consisted of a short introduction. Text of the introduction indicated the survey

had been reviewed the UW-Stout IRB as required by federal code, that the survey would be

confidential and anonymous, participation would be completely voluntary, and that completion

of the survey implied consent to participate in the project.

Sections two through eight centered on questions specific to each subtest of the

certification exam. The Program Performance Summary Report compiled by the ASCP BOC

contains sub-content scores for each subtest, therefore; questions were designed specifically to

reflect these sub-content topics. A four-point Likert scale prompted respondents to categorize

the extent to which lecture content and bench activities were helpful in preparation for the

certification examination. Response choices were very helpful, helpful, somewhat helpful, and

not at all helpful, respectively.

Each section presented the respondent with two identical questions; the first dealt with

lecture content and the second with bench activities. Section 2 addressed Blood Bank sub-

content and queried the degree of helpfulness of lecture and bench activities related to:

1. ABO and Rh

2. Antibody screen and identification

3. Crossmatch and special tests

4. Blood donation, transfusion therapy, transfusion reactions and hemolytic disease of

the newborn (HDN)

Section 3 addressed Chemistry sub-content and queried the degree of helpfulness of

lecture and bench activities related to:

1. Carbohydrate/Acid base/Electrolytes

2. Proteins and other nitrogen containing compounds

26

3. Enzymes/Lipids/Lipoproteins

4. Special chemistry

Section 4 addressed Hematology sub-content and queried the degree of helpfulness of


1. Erythrocytes and leukocytes

2. Other tests

3. Morphology and differential

4. Platelets and hemostasis

Section 5 addressed Immunology sub-content and queried the degree of helpfulness of


1. Immunity

2. Infectious diseases

Section 6 addressed Microbiology sub-content and queried the degree of helpfulness of


1. General bacteriology and aerobic gram-positive cocci

2. Aerobic gram-negative bacilli

3. Gram negative cocci, gram-positive bacilli and anaerobes

4. Fungus, viruses, mycobacteria and parasites

Section 7 addressed Urinalysis and other Body Fluids and queried the degree of

helpfulness of lecture and bench activities related to these two areas individually.

Section 8 addressed Laboratory Operations as a whole and did not specify any sub-

content related to that subtest. Additionally, only lecture content was included since there is no

specific laboratory bench rotation in laboratory operations.

27

Section 9, titled miscellaneous, asked three general questions. The first requested

comment on any perceived strengths or weaknesses of the program and allowed for a free-text

response. Completion of this question was optional. The second asked whether or not the

respondent would recommend the program and allowed for a response of yes or no. Finally, the

third asked the year the respondent graduated from the program. A copy of this survey can be

found in Appendix A of this paper.

Data collection. The online survey provided a result summary. Each response was

reported as both a percentage and raw number for each choice. Individual respondent answers

could also be ascertained and associated with the corresponding subtest score, but not specific

sub-content items. This allowed not only for comparison of responses with individual sub-

content scores, but also with performance for each class involved in the evaluation.

Data analysis. The survey questions mirrored sub-content for each subtest of the ASCP

BOC certification examination. The answers graduates provided related to sub-content

preparation as a result of both lecture and bench activities were compared with corresponding

subtest performance on the exam.

Curriculum Audit

Five different staff technologists teach six courses in the core laboratory areas of blood

bank, chemistry, hematology, immunology, microbiology, and urinalysis and other body fluids.

Instruction related to laboratory operations is divided between the Director of Laboratory

Services, the same group of technologists who teach the remainder of the disciplines listed

above, and self-study materials. The last step in the evaluation process was to determine the

extent to which the goals and objectives of the curriculum address the competencies required for

ASCP certification in the various laboratory subtests as well as sub-content specific to each

28

subtest. This appraisal involved examining scores and graduate feedback and seeking a

relationship to curricular content. More specifically, subtopics for which graduates scored

particularly high or low (i.e., close to or below the score of 400 used as a criterion for program

performance) were carefully examined in an effort to describe strengths or weaknesses that may

be attributed to curriculum and instruction.

Summary

Information gleaned from the three lines of inquiry; certification examination performance,

graduate feedback, and curriculum were collated and compared in an effort to determine

correlations and/or discrepancies between the data. Certification exam subtest and sub-content

scores were compared with student perceptions about their level of preparation. Curricular

objectives and competencies were also examined in light of scores and preparation perceptions in

an effort to describe strengths or weaknesses that may be attributed to curriculum and

instruction.

29

Chapter IV: Results

The purpose of this evaluation was to identify strengths and weaknesses of Sacred Heart

Hospital School of Medical Technology in preparing its graduates for ASCP certification. To

achieve this goal the evaluator reviewed graduates’ performance on the ASCP certification

exam, their perceptions regarding the role the program played in preparing them for the ASCP

certification exam, and how the program’s objectives align with those measured by the ASCP

certification exam. All of three lines of inquiry addressed competencies in the areas of blood

bank, chemistry, hematology, immunology, microbiology, urinalysis/body fluids and laboratory

operations.

Information Sources

The evaluation focused on 2010 and 2011 program graduates that responded to the

Sacred Heart Hospital School of Medical Technology survey. Eight students graduated from the

program during this time period and they were all were invited to participate in the evaluation.

Six of the eight graduates responded to the survey, which rendered a response rate of 75 percent.

Of those who responded to the survey, three graduated in May of 2010 and three graduated in

May of 2011. The pool of respondents included 5 females and 1 male.

Data regarding the graduates’ performance on the ASCP certification exam was derived

from the ASCP BOC Program Performance Report Summary. Examination results are reported

as a scaled score statistically derived from the raw score and difficulty level of the questions.

Each graduate takes a different form of the test; therefore, scaled scores are used so that tests can

be compared. In addition to providing composite score for each graduate, the report summary

provides a score for each of the sub-test within exam (i.e., blood bank, chemistry, hematology,

immunology, microbiology, urinalysis/body fluids and laboratory operations). The minimum

30

passing score is 400 and highest attainable score 999 (Board of Certification Program

Performance Report Summary, 2010).

The data needed to gauge the relationship between the ASCP certification exam and the

program’s curriculum and instruction came from the most current objectives from the seven

courses that comprise the program curriculum and were reviewed in relation to the MLS

certification examination content outline associated with the ASCP BOC certification exam. The

results of this review were triangulated with the graduates’ performance on the ASCP

certification exam and the results of the Sacred Heart Hospital School of Medical Technology

survey.

Blood Bank

The first key question called for identifying the strengths and weakness of the Medical

Technology program in terms of the competencies associated with Blood Bank. The first step in

this process involved reviewing program graduate test scores for the section of the exam that

addresses blood bank competencies (see table 1). It also involved examining the performance of

program participants across the sub-content topics for this section of the exam (see table 2).

Table 1

Test Performance – Blood Bank

Program Graduates

1 2 3 4 5 6

Sub-test Score 514 536 467 620 555 547

Program graduates 1, 2 and 3 completed the program and certification exam in the spring

of 2010. Graduates 4, 5 and 6 completed the program in the spring of 2011. Overall, scores of

31

the 2011 graduates were better than those of 2010; however, all were well above the minimum

score of 400, which is recommended as a criterion for assessing overall performance.

Table 2

Test Performance on Blood Bank Sub-content

Subtopics 2010 Scores 2011 Scores

ABO and Rh 509 743

Antibody screen and identification 344 431

Crossmatch and special tests 588 500

Blood donation, transfusion therapy, transfusion

reactions, and hemolytic disease of the newborn (HDN)

464 481

Program scores overall for the various subtopics were better in 2011 as would be expected

based on individual scores. The most noteworthy difference could be attributed to the ABO/Rh

subtopic since 2011 graduates performed far better in this section than those from the previous

year. Perhaps one peculiarity is that the latter group scored lower than the previous in the

crossmatch and special tests section. The similarity between scores of the two groups is that the

highest score for both is in the ABO/Rh subtopic and the lowest for both is antibody screen and

identification. In fact, the 2011score for the antibody screen and identification subtopic is below

the score of 400 used in assessing overall program performance.

The second step in the process was to determine the extent to which the program addressed

content in the blood bank section of the exam from the perspective of those who completed the

program in the spring of 2010 and 2011. This assessment involved evaluating graduate feedback

regarding the degree of helpfulness provided by lecture content and bench activities in

preparation for the certification exam (see table 3). Consistent with data presented in table 1,

32

Table 3

Graduate Feedback – Blood Bank

Perceived contribution to registry exam preparation

Lecture Component Bench Activities

Program

Graduate

Sub-Test

Score ABO/Rh

Antibody

Screen

Crossmatch

Special

Tests

Blood

Donation,

Transfusion,

HDN ABO/Rh

Antibody

Screen

Crossmatch

Special

Tests

Blood

Donation,

Transfusion,

HDN

1 514 SH H VH VH VH VH H SH

2 536 SH SH SH H H VH VH VH

3 467 H H H H H H H H

4 620 VH VH VH VH H H H H

5 555 VH VH H VH VH VH VH VH

6 547 VH VH VH H VH VH VH VH

VH = Very helpful H = Helpful SH = Somewhat helpful NH = Not at all helpful

33

graduates 1, 2 and 3 completed the program and in the spring of 2010 and graduates 4, 5 and 6 in

the spring of 2011.

Graduates from 2011 gave considerably more very helpful ratings related to the ABO/Rh

subtopic than 2010 graduates and also scored much higher in that portion of the certification

exam. The same 2011 graduates gave slightly higher ratings regarding their preparation for

crossmatch and special tests compared with those of 2010, but did not do as well on the exam.

This rating difference was not as noteworthy as that for the ABO/Rh subtopic and the gap in

scores between the two groups was not nearly as great.

The survey also shows that 2010 graduates felt that bench activities were more helpful than

the lecture component in their preparation for certification. The 2011graduates ranked lecture as

slightly more helpful but the difference between lecture and bench activities was not as great as

that of the previous class.

The last step in the process was to determine the extent to which the goals and objectives of

the curriculum address the competencies required for ASCP certification in the area of blood

bank. This appraisal involved examining scores and graduate feedback for the four subtopics

and seeking a relationship to curricular content. More specifically, subtopics for which

graduates scored particularly high or low (i.e., close to or below the score of 400 used as a

criterion for program performance) were carefully examined in an effort to describe strengths or

weaknesses that may be attributed to curriculum and instruction.

Scores for the ABO/Rh subtopic were highest for both graduating classes, although the

score for the class of 2011 was appreciably higher (743 compared with 509 in 2010). The

objectives and competencies for the ABO/Rh portion of the blood bank course are quite detailed,

concise and complete. In addition, ABO and Rh blood grouping forms the very foundation of

34

blood banking and this testing is performed virtually every day at the laboratory bench on every

patient that has blood bank testing ordered. Therefore, concepts taught in the lecture portion of

the course are continually reinforced at the bench. These factors would appear to account for the

good performance on the certification exam for this subtopic.

Scores for the antibody screen and identification subtopic were lowest for both 2010 and

2011. Additionally, the 2010 score of 344 actually fell below the 400 level considered to be

acceptable or good performance. The 2011 subtopic score of 431, although higher, is

considerably lower than the other three blood bank subtopics for the same group of test-takers.

Upon review, blood bank curriculum related to antibody screen and identification appeared to be

somewhat disjointed and contained no specific mention of the Duffy, Ii, Kell, Kidd, MNS, or P

blood group systems or discussion of multiple antibodies as listed in the ASCP BOC content

outline. The Rh blood group system and its antibodies were covered in the ABO/Rh section.

Specific objectives and competencies related to the Lewis system were also identified.

Additional objectives reflected information and topics related to antibody formation, structure

and characteristics in a generalized manner, but contained no specifics related to the groups

listed previously. According to the blood bank instructor, since the Lewis blood group system

has very different and unique characteristics from the others, it is singled out for more in-depth

discussion.

One final observation may serve to tie together the three components of examination

scores, perceived contributions of lecture and bench activities, and curriculum and instruction

related to blood bank. Overall, graduate feedback indicated that the degree of helpfulness of

bench activities in blood bank was quite comparable between 2010 and 2011 students. However,

2011 students felt that the lecture component was more helpful than bench activities, while 2010

35

respondents indicated the opposite. This may be indicative that the lecture content and theory

component delivered is more important in certification exam performance than hands-on bench

testing activities. Additionally, a new instructor taught the blood bank lecture course in 2011.

The bench activities remained essentially the same with a variety of staff technologists

participating in student instruction. Student perception of lecture instruction quality may

influence perception of helpfulness in exam preparation; however, quality of instruction is

beyond the scope of this evaluation.

Chemistry

The second key question called for identifying strengths and weaknesses of the Medical

Technology program in terms of chemistry competencies. Program graduate scores for the

chemistry portion of the certification exam were reviewed (see table 4). It also involved

examining the performance of program participants across the sub-content topics for this section

of the exam (table 5).

Table 4

Test Performance – Chemistry

Program Graduates

1 2 3 4 5 6

Sub-test Score 632 587 621 553 662 406


of 2010 and 4, 5 and 6 in the spring of 2011. Nearly all of the students performed very well on

the chemistry subtest with fairly comparable scores between the two years. The one exception

barely scored above the 400 mark used as a standard for assessing performance.

36

Table 5

Test Performance - Chemistry Sub-content


Carbohydrate/acid base/electrolytes 690 434

Proteins and other nitrogen containing compounds 709 557

Enzymes/lipids/lipoproteins 768 454

Special chemistry 537 511

Program scores were considerably better in 2010 than in 2011. There was a large

difference in scores for all sub-content topics except for special chemistry. The score spread

ranged from a difference of 152 for proteins and other nitrogen containing compounds sub-

content to 314 for enzymes, lipids and lipoproteins.

The second step in the process was to determine the extent to which the program

addressed content in the chemistry section of the exam from the perspective of those who

completed the program in the spring of 2010 and 2011. This assessment involved evaluating

graduate feedback regarding the degree of helpfulness provided by lecture content and bench

activities in preparation for the certification exam (see table 6). Consistent with data presented in

table 4, graduates 1, 2 and 3 completed the program in the spring of 2010 and graduates 4, 5 and

6 in the spring of 2011.

37

Table 6

Graduate Feedback – Chemistry



Program

Graduate

Sub-Test

Score

Carbs

Acid/Base

Electrolytes Proteins

Enzymes

Lipids

Special

Chem

Carbs

Acid/Base

Electrolytes Proteins

Enzymes

Lipids

Special

Chem

1 632 VH VH VH VH SH SH SH SH

2 587 SH SH SH H H H H H

3 621 H H H H SH SH SH SH


5 662 SH H H SH NH NH NH NH

6 406 H H H H H H H H


38

Although there was a large spread between the two classes in chemistry sub-content

scores, there was not a notable difference in terms of perceived preparation for the certification

exam provided by the program. As a whole, both groups rated bench activities slightly less

helpful than the lecture component. The ratings indicated that overall the bench activities were

only somewhat helpful in preparation and the lecture component was helpful.

Interestingly, the 2011 graduate who scored the highest in the chemistry subtest rated

sub-content topics for the lecture component as merely helpful or somewhat helpful and all bench

activities as not at all helpful. This is the only place in the survey where any not at all helpful

ratings appeared. In contrast, the 2010 graduate who scored highest on the chemistry subtest

rated all lecture sub-content topics as very helpful and all bench activities as only somewhat

helpful consistent with the overall feedback from the entire group.


the curriculum address the competencies required for ASCP certification in the area of

chemistry. This appraisal involved examining scores and graduate feedback for the four

subtopics and seeking a relationship to curricular content. More specifically, subtopics for which




Upon review of the chemistry objectives and competencies, there did not appear to be

any gaps or missing topics in terms of the sub-content listing for the chemistry subtest of the

certification exam. There were no obvious changes in terms of curriculum per se between 2010

and 2011 that would influence student preparation and performance.

39

Perhaps the difference between the two years lies in the area of instruction. Although the

same instructor taught the chemistry lecture course for both groups, changes in laboratory

operations, staffing and additional responsibilities assigned to this person could easily have been

a factor in the effectiveness of instruction. This person not only had primary responsibility for

the medical technology school, but was also supervisor of the hematology and chemistry sections

and the evening and night shift staff of the laboratory. Additionally, in late 2010 the laboratory

was reconfigured toward a lean design and workflow. The same individual had significant

involvement and responsibility for planning, implementation and training of staff to accomplish

this transformation. With such myriad demands on time, it would be extremely difficult for

anyone to attend to so many responsibilities with the ideal level of attention at all times.

Various staff technologists provide bench teaching in chemistry, as in the other areas of

the laboratory. During the conversion to a new and very different workflow model, these

technologists were learning new tasks and adjusting to major changes in their work environment.

Subsequently, they may not have had adequate time, resources or knowledge of certain topics to

provide effective instruction and assistance to students at the laboratory bench. This may

provide some explanation for students overall perception that bench activities were only

somewhat helpful in preparation for the certification exam. Although reasonable conclusions

may be drawn, the impact of these changes is beyond the scope of this evaluation and may

warrant further investigation.

Hematology

Key question number three called for identifying the strengths and weakness of the

Medical Technology program in terms of the competencies associated with hematology. The

first step in this process involved reviewing program graduate test scores for the section of the

40

exam that addresses hematology competencies (see table 7). It also involved examining the

performance of program participants across the sub-content topics for this section of the exam

(see table 8).

Table 7

Test Performance – Hematology

Program Graduates

1 2 3 4 5 6

Sub-test Score 683 531 473 472 740 560


of 2010. Graduates 4, 5 and 6 completed the program in the spring of 2011. Individual graduate

scores were fairly comparable between the two years. In each class, one student scored

considerably higher than the other two; however, all scored safely above the minimum 400

recommended as a criterion for assessing overall performance.

Table 8

Test Performance - Hematology Sub-content


Erythrocytes and leukocytes 585 659

Other tests 568 532

Morphology and differential 629 637

Platelets and hemostasis 580 513

Program scores on hematology sub-content were fairly comparable between 2010 and

2011 graduates. All were well above the minimum score of 400. Strongest performance for the

41

two groups was in the area of erythrocytes and leukocytes. For the remainder of the sub-content,

scores between the two classes varied both ways with relatively small differences between them.


addressed content in the hematology section of the exam from the perspective of those who



activities in preparation for the certification exam (see table 9). Consistent with data presented in

table 1, graduates 1, 2 and 3 completed the program and in the spring of 2010 and graduates 4, 5

and 6 in the spring of 2011.

In terms of perceived contribution to registry exam preparation, graduates from 2011

gave more very helpful ratings for the lecture component than those from 2010. Ratings related

to bench activities were about equal across the two groups. According to feedback from both

classes, bench activities appeared to be somewhat more helpful than the lecture component

overall in their preparation for certification testing. The morphology and differential sub-content

topic stood out in this regard; all students but one rated the bench activities related to this as very

helpful. In the same manner as other laboratory sections, various staff technologists provide

bench instruction in hematology. It is noteworthy that in spite of changes in laboratory design,

workflow and overall environment in 2011, student perceptions of helpfulness of bench activities

did not change appreciably.

The last step in the process was to determine the extent to which the goals and objectives

of the curriculum address the competencies required for ASCP certification in the area of

hematology. This appraisal involved examining scores and graduate feedback for the four

42

Table 9

Graduate Feedback – Hematology



Program

Graduate

Sub-Test

Score

Erythrocytes

Leukocytes

Other

tests

Morphology

Differential

Platelets

Hemostasis

Erythrocytes

Leukocytes

Other

tests

Morphology

Differential

Platelets

Hemostasis

1 683 H H SH H H H VH H

2 531 H H H H VH VH VH VH


4 472 VH H VH VH H H VH H

5 740 H H H H H H VH H

6 560 VH VH VH VH VH VH VH VH


43





Sub-content scores overall were quite good and did not show appreciable variation

between the two classes. In 2010 and 2011, erythrocytes/ leukocytes and

morphology/differential sub-content displayed higher scores. Similarly, other tests and

platelets/hemostasis showed only somewhat lower scores. Examination of the hematology

curriculum indicated that the competencies and objectives included all of the components listed

in the hematology section of the MLS certification examination content outline. Hematology

curriculum addressing topics related to bone marrow and its role in blood cell formation

appeared to be quite rich in comparison with a brief mention of bone marrow on the MLS

certification exam content outline. More in-depth background on this concept may contribute to

a better understanding of erythrocyte and leukocyte formation and function leading to better

scores on that portion of the exam.

Graduates also performed well on morphology/differential sub-content of the certification

examination. They also rated bench activities as being quite helpful in their preparation for

testing. The bench rotations through hematology emphasize both normal and abnormal

differential results. Evaluation of cellular morphology is a part of performing a differential and

students spend the bulk of their time in hematology reviewing slides and completing tests

associated with differentials and morphology. This emphasis is likely reflected in the registry

exam sub-content scores.

44

Hematology objectives and competencies related to platelets and hemostasis, and

coagulation topics overall, is a relatively small portion of the course curriculum, even though all

concepts indicated on the MLS certification exam content outline are included. This may

account for the slightly lower scores in that sub-content area, although student performance was

still quite good.

Another observation that may be notable in terms of hematology instruction is that the

technologist responsible for the lecture component in 2011was new and different from the person

in 2010. This change did not seem to have an impact on student performance as evidenced by

scores on the certification exam and relatively small differences in performance between the two

classes.

Immunology

The fourth key question called for identifying the strengths and weakness of the Medical

Technology program in terms of the competencies associated with immunology. The first step in

this process involved reviewing program graduate test scores for the section of the exam that

addresses immunology competencies (see table 10). It also involved examining the performance

of program participants in the two sub-content topics for this section of the exam (see table 11).

Table 10

Test Performance – Immunology

Program Graduates

1 2 3 4 5 6

Sub-test Score 583 560 548 580 654 425


of 2010. Graduates 4, 5 and 6 completed the program in the spring of 2011. Graduate scores

45

were fairly consistent between the 2010 graduates, however; the range was much greater

between those who completed the program in 2011. For the two-year time frame, all but one

scored well above the minimum 400 recommended as a criterion for assessing overall

performance.

Table 11

Test Performance - Immunology Sub-content


Immunity 504 608

Infectious diseases 618 512

Sub-content scores for the two immunology subtopics were interestingly reversed

between the two groups of graduates. Graduates in 2010 scored just over 100 points lower than

2011 graduates on immunity sub-content. Conversely, the same group scored higher by roughly

the same spread on infectious disease sub-content.

Although certification exam performance was reversed for the immunology sub-content

topics between the two groups, both classes reported roughly equal perceptions of the extent to

which both lecture content and bench activities were helpful in preparation for the exam. Both

indicated that lecture was slightly more helpful than bench activities for both immunity and

infectious disease sub-content. The lecture component received three ratings of very helpful (two

from the same student). There were no ratings of very helpful related to bench activities. Neither

lecture nor bench received any not at all helpful ratings.

46

Table 12

Graduate Feedback – Immunology



Program

Graduate

Sub-Test

Score Immunity

Infectious

Diseases Immunity

Infectious

Diseases

1 583 VH VH SH SH

2 560 H H H H

3 548 H SH H H

4 580 H H H H

5 654 SH H SH H

6 425 VH H H H




immunology. This appraisal involved examining scores and graduate feedback for the two sub-

content topics and seeking a relationship to curricular content. More specifically, subtopics for

which graduates scored particularly high or low (i. e. close to or below the score of 400 used as a



Immunology subtest performance overall was quite good for both groups of graduates.

Sub-content scores did not reveal any particular pattern. In addition to these sub-content scores,

the ASCP Program Performance Report Summary gives an overall immunology subtest program

47

score. When this score was compared between the two classes, graduates in 2010 performed

somewhat better than those in 2011 with program scores of 564 and 527 respectively. This is not

a large gap and does not indicate any pattern or notable difference between the two groups.

Review of immunology objectives and competencies did not reveal any gaps when

compared with the ASCP BOC MLS certification exam content outline. Immunology course

objectives addressed all topics listed on the outline; there were no apparent gaps nor were there

additional unnecessary or redundant objectives or competencies. In terms of the lecture portion

of the immunology course, the same person provided instruction in 2010 and 2011. The changes

in laboratory design and workflow did not impact immunology bench instruction as greatly as

chemistry and hematology. This area of testing did not fall into the lean lab concept and the core

staff technologists performing testing and providing bench instruction remained largely the same

for both terms.

Laboratory Operations

The fifth key question called for identifying the strengths and weakness of the Medical

Technology program in terms of the competencies associated with laboratory operations. The

first step in this process involved reviewing program graduate test scores for the section of the

exam that addresses laboratory operations competencies (see table 13). The laboratory

operations subtest of the certification exam comprises only six percent of the test and is not

further divided into sub-content areas.


of 2010. Graduates 4, 5 and 6 completed the program in the spring of 2011. Graduates in 2010

performed well on the laboratory operations portion of the certification exam with quite

48

consistent scores. Performance in 2011, although still quite good, was lesser than the previous

year except for one student whose score was much higher than any of the others.

Table 13

Test Performance – Laboratory Operations

Program Graduates

1 2 3 4 5 6

Sub-test Score 626 654 640 513 571 769


addressed content in the laboratory operations section of the exam from the perspective of those

who completed the program in 2010 and 2011. This assessment involved evaluating graduate

feedback regarding the degree of helpfulness provided by lecture content in preparation for the

certification exam (see table 14).

Table 14

Graduate Feedback – Laboratory Operations


Program

Graduate

Sub-Test

Score Lecture Component

1 626 H

2 654 SH

3 640 SH

4 513 SH

5 571 H

6 769 H


49

The laboratory operations portion of the curriculum does not include a specific bench

component. Perceptions of the extent to which laboratory operations lectures aided in

preparation for the exam were evenly split between helpful and somewhat helpful. Within the

class of 2010, the person who scored lowest on this subtest rated the lecture as being helpful

while the two who scored higher gave a rating of only somewhat helpful. This difference may

not be meaningful since the scores were so similar. In 2011 the reverse occurred. As may be

expected, the graduate with the lowest score gave a rating of somewhat helpful and those with

higher scores a rating of helpful. The one graduate who scored considerably higher in this

subtest did not perceive that the laboratory operations lectures were any more helpful than those

who scored approximately 200 points lower.



laboratory operations. Even though the laboratory operations subtest is not broken down

according to sub-content topics, the MLS certification examination content outline associated

with the ASCP BOC certification exam does list seven sub-content items under laboratory

operations. The list consists of quality assessment, safety, management, laboratory mathematics,

instrumentation and analytical techniques, education and communication, and laboratory

information systems. The question graduates were asked on the survey read, “To what extent did

lecture content contribute to your preparation for registry exam questions related to laboratory

operations including quality assessment, safety, management, education and laboratory

information systems?” Curriculum review revealed that a majority of the objectives and

competencies related to laboratory operations are spread throughout the curriculum and

embedded in nearly all of the courses. Laboratory information systems was the only topic for

50

which no specific objectives or competencies were found anywhere in the curricular content of

the program. Instructors provide lectures on management and education; laboratory mathematics

is covered through a self-study unit. The remainder of the topics involving quality, safety and

analytical techniques are addressed in lectures as it specifically relates to each course in the

curriculum. For this reason it may have been rather difficult for graduates to specifically

attribute their level of preparation for this portion of the exam to a specific component of the

curriculum (e. g. laboratory operations lectures). Based on graduate scores on this subtest, the

program appears to cover these topics adequately despite the somewhat disjointed presentation of

the material.

Microbiology

Key question six called for identifying the strengths and weakness of the Medical

Technology program in terms of the competencies associated with microbiology. The first step

in this process involved reviewing program graduate test scores for the section of the exam that

addresses microbiology competencies (see table 15). It also involved examining the

performance of program participants across the sub-content topics for this section of the exam

(see table16).

Table 15

Test Performance – Microbiology

Program Graduates

1 2 3 4 5 6

Sub-test Score 674 645 644 567 897 479

51

Table 16

Test Performance - Microbiology Sub-content


General bacteriology and aerobic gram-positive cocci 469 439

Aerobic gram-negative bacilli 687 618

Gram negative cocci, gram-positive bacilli, anaerobes 699 633

Fungus, viruses, mycobacteria and parasites 689 646


of 2010. Graduates 4, 5 and 6 completed the program in the spring of 2011. Graduates in 2010

performed very well on the microbiology portion of the certification exam with quite consistent

scores. Performance in 2011, although still quite good, was lesser than the previous year except

for one student whose score was much higher than any of the others.

All sub-content scores for 2011 graduates were lower than those for 2010. In both cases,

general bacteriology and aerobic gram-positive cocci sub-content received an appreciably lower

score. In both cases scores on the rest of the sub-content were quite consistent.


content in the microbiology section of the exam from the perspective of those who completed the

program in the spring of 2010 and 2011. This assessment involved evaluating graduate feedback

regarding the degree of helpfulness provided by lecture content and bench activities in

preparation for the certification exam (see table 17). Consistent with data presented in table 15,

graduates 1, 2 and 3 completed the program and in the spring of 2010 and graduates 4, 5 and 6 in

the spring of 2011.

52

Table 17

Graduate Feedback – Microbiology



Program

Graduate

Sub-

Test

Score

Gen Bacti

Gram +

cocci

Aerobic

Gram

neg

bacilli

Gram neg

cocci Gram

+ bacilli

Anaerobes

Fungus

Viruses

Mycobacteria

Parasites

Gen Bacti

Gram +

cocci

Aerobic

Gram neg

bacilli

Gram neg

cocci Gram

+ bacilli

Anaerobes

Fungus

Viruses

Mycobacteria

Parasites

1 674 VH VH VH H VH VH H H

2 645 H H H H VH VH VH SH

3 644 H H H H H H H H

4 567 VH H H H VH VH VH SH

5 897 VH VH VH H VH VH VH H

6 479 VH H VH H VH VH VH VH


53

Graduates in 2011 indicated that both lecture and bench activities were more helpful to

them in preparation for the registry exam than did graduates in 2010, even though they scored

lower in each sub-content area. Both classes appeared to agree that bench activities were slightly

more helpful than the lecture component. Student performance was lowest in the general

bacteriology and gram-positive cocci sub-content area, yet the perceived degree of helpfulness

was not any less than for sub-content items where performance was better. The fungus, viruses,

mycobacteria and parasites sub-content received the lowest overall ratings although the majority

of them were helpful with only two ratings of somewhat helpful. Fungus and parasites are both

covered by self-study units. Viruses and mycobacteria are very short sections in the lecture

component and are only briefly discussed at the laboratory bench. These factors may account for

the lower ratings.


the curriculum address the competencies required for ASCP certification in the area of

microbiology. This appraisal involved examining scores and graduate feedback for the four





All students performed lowest in general bacteriology and aerobic gram-positive cocci

sub-content. Performance on the other three sub-content topics was consistent between the two

classes and notably better for both. According to the ASCP BOC MLS certification exam

content outline, general microbiology includes pre-analytical and susceptibility testing. Review

of microbiology curriculum revealed a number of objectives and competencies addressing these

54

topics. Even though the lecture component of the microbiology curriculum addresses

susceptibility testing, this is perhaps the most complex aspect of microbiology and is subject to

frequent change based on ever-emerging bacterial mutations and drug resistance patterns. The

most serious and most commonly encountered resistance and susceptibility patterns are touched

on at the bench as well, but not necessarily covered in detail. The aerobic gram-positive cocci

portion of the sub-content lists organisms belonging to this group, which are pathogens, as well

as those that are generally considered non-pathogenic. Although it is important to distinguish

between the two, more time is spent teaching identification of pathogenic organisms. Because of

this, students may not be as familiar with characteristics of non-pathogens and may not be well

equipped to answer test questions related to these organisms. Since appropriate objectives and

competencies seem to be in place, inappropriate or suboptimal content delivery may provide a

reasonable explanation for student performance for this sub-content on the certification exam.

However, this line of inquiry would require further investigation and is beyond the scope of this

evaluation.

Urinalysis and Other Body Fluids

The final key question called for identifying the strengths and weakness of the Medical

Technology program in terms of the competencies associated with urinalysis and other body

fluids. The first step in this process involved reviewing program graduate test scores for the

section of the exam that addresses urinalysis and other body fluids competencies (see table 18).

It also involved examining the performance of program participants across the sub-content topics

for this section of the exam (see table 19).

55

Table 18

Test Performance – Urinalysis and Other Body Fluids

Program Graduates

1 2 3 4 5 6

Sub-test Score 490 286 567 406 668 625


of 2010. Graduates 4, 5 and 6 completed the program in the spring of 2011. Performance on this

subtest was better in 2011, although one 2010 graduate scored significantly lower than the

others; barely above the minimum score of 400. In addition, one of the 2010 graduates scored

considerable lower than the 400 mark with a score of 286.

Table 19

Test Performance – Urinalysis and other Body Fluids Sub-content


Urinalysis 505 527

Other body fluids 100 336

Based on the above sub-content scores, it would appear graduates are notably lacking in

knowledge associated with the body fluid sub-content area of this subtest. Not only did both

groups score below the 400 level used as a criterion for assessing overall performance, the 2011

graduates were much lower than that with a program score of only 100.


content in the urinalysis/other body fluids section of the exam from the perspective of those who


56


activities in preparation for the certification exam (see table 20). Consistent with data presented

in table 15, graduates 1, 2 and 3 completed the program and in the spring of 2010 and graduates

4, 5 and 6 in the spring of 2011.

Table 20

Graduate Feedback – Urinalysis/other body fluids



Program

Graduate

Sub-Test

Score Urinalysis

Other Body

Fluids Urinalysis

Other Body

Fluids

1 490 VH H H SH

2 286 H H VH VH

3 567 SH SH H SH

4 406 H H H H

5 668 VH VH VH H

6 625 VH H VH H


According to survey responses, graduates in 2010 perceived both the lecture component

and bench activities as being slightly less helpful in their certification exam preparation than did

2011 graduates. They also did not perform as well on this subtest. Both classes indicated that

both the lecture component and bench activities for urinalysis were more helpful than those

related to body fluids. The student who scored highest for this subtest rated both the lecture

component and bench activities for urinalysis and the lecture component for other body fluids as

57

very helpful while the bench activities for other body fluids were rated as being helpful. The

graduate with the lowest score indicated that both urinalysis and other body fluids lecture

components were helpful and the corresponding bench activities as very helpful.


the curriculum address the competencies required for ASCP certification in the area of urinalysis

and other body fluids. This appraisal involved examining scores and graduate feedback for the

four subtopics and seeking a relationship to curricular content. More specifically, subtopics for

which graduates scored particularly high or low (i.e., close to or below the score of 400 used as a



Performance of program graduates on the body fluids sub-content portion of the

certification exam was markedly lower than any other section. Program scores were well below

the 400 mark for both of the years examined in this evaluation. The review of curricular content

revealed gaps in urinalysis/body fluids course objectives and competencies relative to the ASCP

BOC content outline for the MLS certification exam. The objectives address cerebrospinal fluid,

amniotic, synovial, serous body fluids and feces; however, there is no mention of gastric fluid,

sweat or semen as indicated on the content outline. Although students perceived that the

preparation provided by the program for this portion of the exam was helpful, it would appear

that missing content could well be impacting performance.

58

Chapter V: Discussion

The Sacred Heart Hospital School of Medical Technology has undergone a variety of

changes over the last several years. These changes included the elimination of lectures by

pathologists, changes in the directorship of the laboratory and MLS program, shortening the

length of the program, new lecturers in some laboratory disciplines, reductions in laboratory

staffing, and most recently, the adoption of a lean lab configuration. In light of these changes,

the purpose of this evaluation was to identify strengths and weaknesses of Sacred Heart Hospital

School of Medical Technology in preparing its graduates for ASCP certification. More

specifically, it aspired to address the following key questions.


of the competencies associated with Blood Bank?


of the competencies associated with Chemistry?


of the competencies associated with Hematology?


of the competencies associated with Immunology?


of the competencies associated with Laboratory Operations?


of the competencies associated with Microbiology?


of the competencies associated with Urinalysis and other Body Fluids?

59

To address these questions the evaluator reviewed graduates’ performance on the ASCP

certification exam, their perceptions regarding the role the program played in preparing them for

the ASCP certification exam, and how the program’s objectives align with those measured by the

ASCP certification exam. This assessment was intended to uncover inadequacies, gaps or

weaknesses, as well as identify assets and strengths in the program providing information

relevant to enhancement of the program.

Limitations

This evaluation encompasses Sacred Heart Hospital School of Medical Technology

graduate performance on the ASCP BOC examination along with a review and comparison of

course objectives to the ASCP BOC Content Outline for the Medical Laboratory Scientist

certification examination. Graduate feedback related to curriculum and instruction has been

solicited in an effort to compare data from a variety of sources. The information obtained in this

evaluation applies uniquely to Sacred Heart Hospital School of Medical Technology and cannot

be further generalized.

Blood Bank

Performance on the ASCP BOC certification exam on the blood bank subtest was very

good in both 2010 and 2011. Another strength of the blood bank portion of the program is the

continuity and effective instruction evidenced by the fact that performance on the exam did not

change appreciably under a new instructor. In fact, graduates perceived that overall both the

lecture component and bench activities in blood bank were very helpful in their preparation for

the test with 2011 graduates indicating the lecture component was more helpful than those in

2010.

60

Program completers scored lowest in the antibody screen and identification sub-content

section of the blood bank subtest. In terms of curriculum and instruction, this area was not as

rich as the other sub-content areas. Revision of lecture competencies to more thoroughly address

the different blood group systems as well as additional activities at the bench involving antibody

identification may serve to increase understanding and improve performance in this area of the

certification exam.

Chemistry

Scores on the chemistry subtest of the ASCP BOC certification exam were quite good

and fell above the minimum score of 400 used in assessing overall program performance.

However, there was a notable decrease in scores between 2010 and 2011. Review of the

competencies and objectives for the chemistry portion of the curriculum did not reveal any gaps

in content as compared with the content outline for the MLS certification exam. However,

graduate perceptions indicated that both the lecture component and bench activities were less

helpful in exam preparation than for the other subtests. Bench activities received the lowest

helpfulness ratings; this is the only area of the survey where a respondent gave a not at all

helpful rating. Working to directly tie together theory and concepts taught in the lecture portion

of the course with specific bench activities may serve to improve student comprehension and

consequently, preparation for the certification exam.

The drop in scores between the class of 2010 and 2011 may be attributed to restructuring

of laboratory workflow and the numerous responsibilities of the program director/chemistry

instructor. This may simply be a one-time variance in scores; however, investigation and

possible realignment of staff responsibilities to provide for more effective teaching in chemistry

may be warranted.

61

Hematology

Performance on the ASCP BOC certification exam on the hematology subtest was very

good in both 2010 and 2011. Additionally, consistency between the subtest and sub-content

scores did not reveal any obvious weaknesses in a particular topic. Another apparent strength of

the hematology portion of the program is the continuity and effective instruction indicated by the

fact that performance on the exam did not change appreciably under a new instructor. Despite

drastic changes in workflow of the laboratory, as well as a new instructor, graduates perceived

that their level of preparation for the registry exam as a result of hematology lectures and bench

activities was helpful or very helpful. Continued diligence in content delivery and instruction

should lead to continued strong performance of graduates on the certification exam.

Immunology

Performance on the ASCP BOC certification exam on the immunology subtest was very

good in both 2010 and 2011. There was inconsistency between scores for the two groups in

terms of the sub-content areas of immunity and infectious diseases. Since both classes indicated

approximately the same degree of helpfulness of lecture content and bench activities in their

preparation for the exam, and since this evaluation only encompasses two sequential years of the

program, it is difficult to pinpoint a reason for the inconsistent scores.

Based on certification exam scores and student feedback, instruction in the area of

immunology appears to be adequate for good performance on the exam. Overall, students

indicated that lecture and bench activities were helpful in preparation and review of immunology

objectives and competencies did not reveal and gaps in terms of the ASCP BOC MLS

certification exam content outline. Results of this line of inquiry do not lead to any specific

recommendations for changes to this portion of the program.

62

Laboratory operations

Performance on the ASCP BOC certification exam on the laboratory operations subtest

was very good in both 2010 and 2011. Since this is such a small portion of the exam, it is not

divided into separate sub-content topics making it difficult to identify any specific areas of

strength or weaknesses in terms of graduate performance. Feedback from program completers

indicated that the lecture component of laboratory operations was only helpful or somewhat

helpful. This may be due to the presentation of the content across many other subtest areas

included in the exam. Students may not have recognized it specifically as laboratory operations

information. Because of this rather fragmented nature of the content, careful examination of the

curriculum may be warranted to assure that all topics are covered appropriately. For example,

there were no objectives related to laboratory information systems included anywhere in the

curriculum although the topic was listed on the ASCP BOC MLS certification exam content

outline under the laboratory operations subtest.

Microbiology

Performance on the ASCP BOC certification exam on the microbiology subtest was very

good in both 2010 and 2011. Survey responses from graduates of the program indicated that

overall the lecture component and bench activities related to microbiology were very helpful or

helpful in terms of their preparation for the exam. Graduates scored considerably lower on the

general bacteriology and aerobic gram-positive cocci sub-content topic. Review of the

curriculum did not reveal any gaps in competencies or objectives related to this topic; therefore,

the amount of time and emphasis spent on it with students may not have been adequate.

Additional time, exercises, and evaluative activities related to this sub-content, particularly

63

susceptibility testing and characteristics of non-pathogenic organisms may serve to enhance

understanding and improve performance in this area of the certification exam.

Although performance was good on the certification exam, program completers indicated

that the activities associated with the microbiology sub-content topic of fungus, viruses,

mycobacteria and parasites was only helpful or somewhat helpful in preparation for the exam.

Viruses and mycobacteria are very small portions of the overall microbiology course. Both

fungus and parasitology are self-study units and contain numerous in-depth objectives and

competencies. Interaction with and direct instruction of students in these two topics is minimal

and only takes place as requested by a student who may have questions. Implementation of a

student/instructor interactive component to these self-study units may be helpful in terms of

student comfort level with the topic and perceived degree of preparation for the certification

exam.

Urinalysis and other body fluids

Performance on the ASCP BOC certification exam for the urinalysis and other body

fluids subtest overall was very good in both 2010 and 2011; however, the score on other body

fluids sub-content was considerably lower than the 400 score used to assess overall program

performance for both groups. Graduate feedback indicated that lecture and bench activities

related to other body fluids were less helpful than those related to urinalysis in terms of

preparation for the certification exam. Review of the curriculum in these areas relative to the

ASCP BOC MLS certification exam content outline revealed gaps in some body fluids topics.

No objectives or competencies related to gastric fluid, sweat or semen were found.

In order to improve knowledge and exam performance, curriculum related to these topics

should be developed and incorporated. Additionally, an overall assessment of instruction and

64

bench activities should be done to determine any other potential gaps in the curriculum. Since

hematology involves a body fluid analysis component, collaboration between instructors in these

two areas may serve to better assure that all content is covered adequately and appropriately.

Conclusions

Based on graduates’ ASCP BOC examination scores, Sacred Heart Hospital School of

Medical Technology is satisfactorily preparing its students for professional certification.

However, room for improvement in curriculum and instruction was found when data from sub-

content scores, graduate feedback and assessment of objectives and competencies for the

program were put side by side. Exam performance on body fluid sub-content in the urinalysis

and other body fluids subtest was particularly low and should be addressed. The scores also

were generally lower in 2011 than 2010 in chemistry, laboratory operations and microbiology

subtests. Further investigation would be necessary to determine whether this is part of a trend.

Graduate feedback indicated both the lecture component and bench activities provided by the

program were helpful or very helpful in preparation for the certification exam. In fact, all of the

respondents to the survey indicated that they would recommend Sacred Heart Hospital School of

Medical Technology to others.

Recommendations

Based on the findings and conclusions of this assessment, the following

recommendations for improving curriculum and instruction in the areas of blood bank,

chemistry, laboratory operations, microbiology and urinalysis/other body fluids were made.

Revise objectives and competencies for the lecture portion of the blood bank course

to include more specific information on antibody identification for blood group

systems other than the Rh and Lewis systems.

65

Incorporate bench activities specifically requiring students to perform antibody

identification in order to increase knowledge and experience related to this topic

Develop specific connections between lecture content and bench activities to enhance

understanding and knowledge of chemistry concepts.

Review ASCP BOC MLS certification exam content outline and NAACLS

curriculum requirements and compare with Sacred Heart School of Medical

Technology objectives and competencies to a assure instruction in all topics in this

subtest is provided.

Examine objectives and competencies related to general microbiology, preanalytical

and aerobic gram-positive cocci; develop exercises and evaluative activities to better

ensure and assess student mastery of concepts.

Incorporate a defined instructor/student interactive component into fungus and

parasitology self-study units.

Develop competencies and objectives related to gastric fluid, sweat and semen

analysis.

Assess instructional practices in the area of body fluids and collaborate with

hematology to ensure provision of complete and appropriate instruction in this sub-

content area.

Results of this evaluation revealed additional questions regarding variables that may be

related to the effectiveness of curriculum and instruction at Sacred Heart Hospital School of

Medical Technology. These include, but are not limited to, instructor effectiveness,

responsibilities of instructional staff in addition to teaching, preparatory background of students

from different universities, and feedback from graduates regarding specific reasons various

66

aspects of the program were or were not effective. It is clear that many factors impact the

effectiveness of any program and these are some that may warrant further investigation.

67

References

About ASCP. (2011). Retrieved July 13, 2011, from American Society for Clinical Pathology:

http://www.ascp.org/MainMenu/AboutASCP.aspx

American Society for Clinical Laboratory Science. (2011). Career Center. Retrieved April 12,

2011, from ASCLS: http://ascls.site-ym.com/?page=Career_Toolkit

American Society for Clinical Pathology. (2009, July 22). ASCP BOR and NCA Form Single

Certification Agency. Retrieved April 19, 2011, from ASCP:

http://www.ascp.org/FunctionalNavigation/certification/ASCP-BOR-and-NCA-Form-

Single-Certification-Agency.aspx

American Society for Clinical Pathology. (n.d.). Certification: ASCP Board of Certification.

Retrieved April 12, 2011, from ASCP:

http://www.ascp.org/FunctionalNavigation/certification.aspx

American Society for Clinical Pathology. (2011). Get Certified. Retrieved April 12, 2011, from

ASCP: www.ascp.org/Functional/Navigation/certification.aspx

Board of Certification Program Performance Report Summary. (2010). Retrieved May 3, 2011,

from American Society for Clinical Pathology:

https://www.chicago.ascp.org/Certification/ForProgramDirectors/ppr/data/ppr_yc_retmt.a

sp

Conjecture Corporation. (2002-2011). What is Curriculum. Retrieved July 7, 2011, from

Wisegeek.com: http://www.wisegeek.com/what-is-curriculum.htm

Examination Content Guideline. (n.d.). Retrieved April 12, 2011, from American Society for

Clinical Pathology: http://www.ascp.org/pdf/BOR-

PDFs/Guidelines/ExaminationContentGuidelineMT.aspx

68

Guide to Accreditation. (2003). Retrieved May 2011, from NAACLS:

http://www.naacls.org/accreditation/newguide_accreditation.asp

McCall, R. E., & Tankersley, C. M. (2008). Phlebotomy Essentials. Baltimore: Lippincott

Williams & Wilkins.

Occupational Outlook Handbook, 2010-2011 Edition, Clinical Laboratory Technologists and

Technicians. (n. d.). Retrieved April 12, 2011, from Bureau of Labor Statistics, U. S.

Department of Labor: www.bls.gov/coc/ocos.096.htm

Woeste, L. A., & Barham, B. J. (2006). The signature pedagogy of clinical laboratory science

education: the professional practice experience. Labmedicine, 591-592.

69

Appendix

Sacred Heart Hospital School of Medical Technology Survey

1. INTRODUCTION

This project has been reviewed by the UW-Stout IRB as required by the Code of Federal

Regulations Title 45 Part 46.

Confidentiality:

Your name will not be included on any documents or in any part of this evaluation

process. All survey responses are anonymously submitted. We do not believe that you

can be identified from any of this information.

Right to Withdraw:

Your participation in this study is entirely voluntary. You may choose not to participate

without any adverse consequences to you. You have the right to stop the survey at any

time. However, should you choose to participate and later wish to withdraw from the

study, there is no way to identify your anonymous survey once it has been submitted. If

you are participating in an anonymous online survey, once you submit your response, the

data cannot be linked to you and cannot be withdrawn.

Statement of Consent:

By completing the online survey, you agree to participate in the project entitled, An

Assessment of Sacred Heart Hospital School of Medical Technology Curriculum Relative

to Certification Examination Content.

70

2. BLOOD BANK

To what extent did lecture content contribute to your preparation for registry exam questions

related to:

Very

helpful

Helpful Somewhat

helpful

Not at all

helpful

ABO and Rh

Antibody screen and identification

Crossmatch and special tests such as

elution/adsorption, antibody titer,

prewarm technique

Blood donation, transfusion therapy,

transfusion reactions and hemolytic

disease of the newborn (HDN)

To what extent did bench activities contribute to your preparation for registry exam questions

related to:

Very

helpful

Helpful Somewhat

helpful

Not at all

helpful

ABO and Rh

Antibody screen and identification

Crossmatch and special tests such as

elution/adsorption, antibody titer,

prewarm technique

Blood donation, transfusion therapy,

transfusion reactions and hemolytic

disease of the newborn (HDN)

71

3. CHEMISTRY


related to:

Very

helpful

Helpful Somewhat

helpful

Not at all

helpful

Carbohydrate/Acid Base/Electrolytes

such as glucose, glycosolated hemoglobin,

other carbohydrates such as lactate, pH,

pCO2, pO2, base excess

Proteins and other nitrogen containing

compounds such as total protein,

albumin, globulins, ferritin, Iron/TIBC,

ammonia, BUN/creatinine, troponin,

bilirubin

Enzymes/Lipids/Lipoproteins such as

amylase, lipase, AST, ALT, CK, LD,

cholesterol, triglycerides

Special chemistry such as hormones,

tumor markers, therapeutic drug

monitoring and toxicology


related to:

Very

helpful

Helpful Somewhat

helpful

Not at all

helpful

Carbohydrate/Acid Base/Electrolytes

such as glucose, glycosolated hemoglobin,

other carbohydrates such as lactate, pH,

pCO2, pO2, base excess

Proteins and other nitrogen containing

compounds such as total protein,

albumin, globulins, ferritin, Iron/TIBC,

ammonia, BUN/creatinine, troponin,

bilirubin

Enzymes/Lipids/Lipoproteins such as

amylase, lipase, AST, ALT, CK, LD,

cholesterol, triglycerides

Special chemistry such as hormones,

tumor markers, therapeutic drug

monitoring and toxicology

72

4. HEMATOLOGY


related to:

Very

helpful

Helpful Somewhat

helpful

Not at all

helpful

Erythrocytes and leukocytes

Other tests such as reticulocyte count,

ESR, tests for hemoglobin defects

Morphology and differential

Platelets and hemostasis


related to:

Very

helpful

Helpful Somewhat

helpful

Not at all

helpful

Erythrocytes and leukocytes

Other tests such as reticulocyte count,

ESR, tests for hemoglobin defects

Morphology and differential

Platelets and hemostasis

73

5. IMMUNOLOGY


related to:

Very

helpful

Helpful Somewhat

helpful

Not at all

helpful

Immunity such as ANA, Anti-DNA,

CRP/RF, thyroid antibiodies, other

autoimmunes and preanalytical techniques

Infectious diseases such as EBV,

hepatitis, HIV and other viruses; cold

agglutinins, syphilis, other

microorganisms


related to:

Very

helpful

Helpful Somewhat

helpful

Not at all

helpful

Immunity such as ANA, Anti-DNA,

CRP/RF, thyroid antibiodies, other

autoimmunes and preanalytical techniques

Infectious diseases such as EBV,

hepatitis, HIV and other viruses; cold

agglutinins, syphilis, other

microorganisms

74

6. MICROBIOLOGY

To what extent did Microbiology lecture content contribute to your preparation for registry exam

questions related to:

Very

helpful

Helpful Somewhat

helpful

Not at all

helpful

General bacteriology and aerobic gram

positive cocci

Aerobic gram negative bacilli

Gram negative cocci, gram positive bacilli

and anaerobes

Fungus, viruses, mycobacteria and

parasites

To what extent did Microbiology bench activities contribute to your preparation for registry

exam questions related to:

Very

helpful

Helpful Somewhat

helpful

Not at all

helpful

General bacteriology and aerobic gram

positive cocci

Aerobic gram negative bacilli

Gram negative cocci, gram positive bacilli

and anaerobes

Fungus, viruses, mycobacteria and

parasites

7. URINALYSIS / BODY FLUIDS

To what extent did Urinalysis lecture content contribute to your preparation for registry exam

questions related to urinalysis?

___Very helpful ___Helpful ___Somewhat helpful ___Not at all helpful

To what extent did Urinalysis bench activities contribute to your preparation for registry exam

questions related to Urinalysis?


75

To what extent did lecture content on other body fluids contribute to your preparation for registry

exam questions related to other body fluids?



related to other body fluids?


8. LABORATORY OPERATIONS


related to laboratory operations including quality assessment, safety, management, education and

laboratory information systems?


9. MISCELLANEOUS

Please comment on your perceptions of significant strengths and/or weaknesses of the Medical

Technology program at Sacred Heart Hospital.

Would you recommend Sacred Heart Hospital School of Medical Technology to others?

Yes

No

What year did you graduate from Sacred Heart Hospital School of Medical Technology?

2009

2010

2011

author: schum mer, diane m. - uw-stoutof the career. the title clinical laboratory scientist (cls),...

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