Re: Histology Proficiency Testing

From:Lee & Peggy Wenk

OK - Real quick competency assessment.
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 JCAHO:
A. There are three areas you need to test for:
     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 went wrong)
     2. Problem solve (what are you going to do to correct it now, or to prevent it in the future),
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, contrast, etc.)
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 they didn't.
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 questions.
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 it?_________________
That will take care of the cognitive part and also include troubleshooting and problem solving.
Future assessments -
- sectioning - how fast, how well
- coverslipping
- lab math
- etc.
As for affective -
As some questions about safety, or personnel policies, etc.
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 AM
Subject: Histology Proficiency Testing


      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.


<< Previous Message | Next Message >>