Re: HT Practical question

From:Lee & Peggy Wenk

I believe the answer to both is no - the person does not have to gross or
process the tissues themselves.

And I believe that this is because, in most labs, the histotechs "take over"
the tissues at the processing stage (which is done on machine), and
definitely get involved with the hands-on aspect of the tissue at the
embedding stage.

A few more thoughts on both parts of the question:

1. The registry tissue can be processed along with the day's run. It does
not have to be on a totally separate run.

However, the candidate (person taking the exam) is still ultimately
responsible for the quality of the processing. In other words, if the tissue
is under or over processed (which can be seen when viewed with the
microscope), points will be deducted during the grading process. The
candidate is responsible for making certain that the OPTIMAL fixative,
fixation time, processing schedule and decalcification solution and time is
used for each tissue. Even if it means that different fixatives or
processing schedules are used for different tissues. Even if it means that
the tissue has to be handled different than that labs normal routine. The
candidate cannot say - "But we always use this fixative/processing
schedule/whatever for all our tissues."

The Registry wants each candidate to demonstrate that they know how to
produce high quality tissues/sections/stains, since the candidates are given
3-5 months to work on just 9 slides.

2. The tissue could be grossed by someone else, such as a pathologist or PA.

However, again, the candidate is ultimately responsible for the quality of
the tissue. I have had people complain to me that, since it was their
pathologist who grossed the tissue for them, they (the candidate) shouldn't
have been marked off because their tissues were not what the Registry asked
for, such as:
- too small (not long enough, not a large enough square)
- wrong tissue (such as large intestine instead of small intestine)
- not include the requirements (such as kidney that contained only medulla,
not cortex and medulla as required)
- wrong orientation (such as a length of artery, instead of a cross-section
- poor quality of tissue (such as totally autolyzed GI, instead of all
layers being there)

The candidate is ultimately responsible to make certain that their tissues
are the correct size, correct tissue, and meet all other requirements of
orientation, components and quality. Knowledge of tissue histology and
ability to follow directions are necessary qualities in a good histotech.

(BTW - I'm not knocking the pathologists or PA's. Often, it is the candidate
who gives incomplete information. The Registry may be requesting small
intestine, with all layers, to include epithelium, no autolysis, whose size
after processing must be 2 cm. But the candidate only tells the
pathologist/PA - "I need a piece of intestine 2 cm long." . So the person
grossing cuts a 2 cm long sample necrotic large intestine, which will shrink
after processing to 1.5 cm, and be without epithelium, and of course be
partially autolyzed to boot, due to not opening the intestine to allow
immediate fixation.)

So, I agree with Gayle, it is best if the person does it themselves. Doing
it yourself is a great learning tool and the candidates have no one to blame
but themselves if something wasn't done correctly. But the tissue can be
grossed by someone else, and the tissue processed with all the other

Peggy A. Wenk, HTL(ASCP)SLS
Schools of Histotechnology
William Beaumont Hospital
Royal Oak, MI 48073

----- Original Message -----
From: "Renee Hoyle-Thacker" 
Sent: Thursday, August 01, 2002 9:06 AM
Subject: HT Practical question

> For the HT practical I know that the blocks must be sectioned and stained
> by the examinee, but does that person also need to process the tissue
> and/or gross trim the tissue?
> Renee Hoyle-Thacker
> CIIT Centers for Health Research
> 6 Davis Dr.
> Research Triangle Park NC 27709
> Voice: (919) 558-1322

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