OK - Real quick competency
We'll skip the requirements of - what is in your
job description, and what have you come up with in your task analysis and how
have you defined HOW competent someone must be at each task.
Two main concern to be covered by CAP and
A. There are three areas you need to test
1. Psychomotor - can
someone DO the task - staining, using a pH meter, sectioning, changing
solutions on the tissue processor, etc.
2. Cognitive - what does
someone KNOW about the task.
3. Affective - what is
their attitude, behavior, values, etc. This is probably something you are
already evaluating them on in their yearly evaluation - showing up on time,
being courteous to everyone, volunteering to help others, etc.
B. Within each area (particularly #1 and #2), you
need to test for the ability to:
1. Troubleshoot (what
2. Problem solve (what
are you going to do to correct it now, or to prevent it in the
Now, first of all - competency assessment doesn't
have to be complicated. But it should be useful to those involved. Find out
what they can do, and what they can't do, and then do retraining for those who
didn't quite meet the mark.
Now, as to some ideas:
Pick 1-3 stains to assess this quarter. Something
your lab has had a few problems with this year. Maybe GMS and Gomori
Trichrome, for example.
Psychomotor - when each person is on specials,
give them a slide for each, and have them do the stain and turn it in to you
(or the pathologist)
Grade them on staining
3 = excellent (perfect - great staining,
2 = good (slightly too dark or too light, but
still a good stain)
1 = poor (too dark/light, excess amount of
background staining/precipitate. In real life, the pathologist MIGHT be able
to make a diagnosis, but would probably like the stain redone.)
0 = really bad (so over or understained, or so
much precipitate, that diagnosis would be impossible)
Make a "2" as competent. Reward "3".
Grade them on labeling, coverslipping,
cleanliness, remaking solutions, whatever - basically they did it right or
Have them look at some slides of these stains
that were NOT stained correctly.
Have them write down one reason why the stain is
looking this why (troubleshoot) and how they would do the stain different next
time (problem solve).
Or use the NSH Self-Assessment booklets on these
stains, and use 3-5 multiple choice questions that they have to answer
correctly. Make sure to include troubleshooting and problem solving
Do something similar for equipment. Pick one
piece of equipment for this quarter - say the tissue processor.
Make up a list of all the steps, in the correct
order, for one/some of the tasks. Make a check list out of this. Yes they did
this step correctly, no they didn't. Yes they did them in the right order,
oops they didn't.
Have the person change the solutions, and/or
start the processor, and/or reprogram one of the modules - whatever is within
their job description.
You can then check off each of the steps, as
proof that they can do the psychomotor.(You get to decide HOW accurate they
have to be. How many "didn't do this step right" you will allow.)
Write a couple of questions (or use the NSH
Self-Assessment booklets) on . . . what does it mean if the machine
does _______________________. How would you take care of
That will take care of the cognitive part and
also include troubleshooting and problem solving.
Future assessments -
- sectioning - how fast, how well
- lab math
As for affective -
As some questions about safety, or personnel
Each quarter, choose different stains, a
different piece of equipment, different tasks.
Hope that helps.
Peggy A. Wenk, HTL(ASCP)SLS
William Beaumont Hospital
Royal Oak, MI 48073
----- Original Message -----
Sent: Monday, October 28, 2002 5:34
Subject: Histology Proficiency
Does anyone out there do
proficiency testing in the histology lab? And if so would you mind
sharing some of your ideas? We currently are not doing proficiency
testing and with CAP coming up my lab manager whats something in place.
I have two weeks from today to "have something in place". Thanks
for your help.