RE: BOR Registry - Clarification

From:"Morken, Tim" <tim9@cdc.gov> (by way of histonet)

Louri wrote,

<<Also, you'll have no better influence over the quality of
the more complicated procedures produced by labs because you'll still have
those who are HT grads or who were grandfathered in performing those
procedures that supposedly require the additional education put forth by the

BOR.>>

Did you know that manicurists and barbers have tougher standards of
pracatice than histotechs? All manicurists and barbers, by law, have to go
through training and take a board exam to do their work. The reason is
because there are a lot of ways a they can injure people through improper
techniques.

Doesn't it seem strange that, in most states, a person can go into a histo
lab in the US with no training at all and be allowed to do the work? There
are multitudes of people that have done just that. In one hospital I worked
in we took a dishwasher and made him a histotech. He learned to do the
cutting and stains and did well. It happened, however, that he had no idea
what he was doing; he just followed the directions and managed to get things
right (about the AFB control he would say "If the red dots are there, it's
OK"). No matter how we worked with him he could not grasp chemistry and
biology. He certainly is not one that you would want training anyone else!

That's certainly a worst case scenario but it is what lab administrators
will do when there are no requirements, as there are none in histology now.
Why not? They save money by paying them less and work gets done. You only
need certain education to be certified, not to get a job or work. There are
thousands of uncertified techs working out there and I've seen many that are
incompetent to work with modern technologies.

Now, just because a person CAN be trained OJT to do these things doesn't
mean we should do it that way. There is certainly no rule that says we owe
it to people to give them a job just because they want one or are interested
in a certain field. And why would we want people who don't want to put out
the effort to meet some minimal standards? We're only cutting our own
throats with that line of thinking.

Quality control is the province of a lab. It has nothing to do with
education reuirements needed to be certified. The fact that most histotechs
are being trained by old-time techs just shows you thow the system has
always worked, which is not to say it is a good system. Yes, many of those
techs are excellent. But many are not. I doubt many of them would say  more
education is worthless!

<<I was only trying to understand the purpose behind the AA
requirement, as I do not see how this "advances our profession" as the
previous arguements have stated.>>

I don't understand why you can't see that taking chemistry, biology,
physiology, anatomy and microbiology courses, to name a few, is good for
histotechs. It would seem to be obvious how these would help a person do a
better job!

Learning any of these subjects outside of a formal course is very difficult,
something only the most dedicated will be able to do. Learning them on the
job will result in an incomplete education because you will only learn what
you need to do the job at hand.

<<...you'll have no better control of the quality of training
received unless you implement strict curriculum guidelines for the
certification.>>

It's true that at some point most histotechs learn the hands-on methods on
the job. What they really learn at that time is dependent on who teaches
them and how they apply themselves. The inconsistency in this part of the
training is all the more reason to require certain formal education levels
outside of the job.

It is certainly true that there are only minimal standards for education
right now. The requirements for college education are spelled out according
to certain credit hours of chemistry, biology and other courses, not whole
programs. That is a concern for the future (you may want to see the last
ASCP Lab Medicine, which has an article which outlines and "ideal" B.S.
program for histotechnology). Right now we need to get people with basic
science education in the lab, not dishwashers!

<<It just appears that the BOR is trying to "advance the profession"
through artificial requirements that in the end do not mean much.>>

Sometimes you have to drag people kicking and screaming into the future!
You'll only know the  "meaning" of all those requirements after you meet
them and use them on the job.

<<Again, I do not feel that an HTL is required to perform those more
complicated procedures - as I know many HT's that are high school grads with

OJT that understand it as fully as those who have a degree.>>

Wouldn't you rather have EVERY tech understand the methods, rather than
"many", or more likely, only a few?

<<I just feel that the AA requirement hurts a lot of very capable people
from
entering the field, and it's going to be even harder to recruit individuals
to work.>.

Again, in most states anyone can enter the field now. The education
requirement is only for certification. If a person is really interesed in
making it a profession the AA degree won't be a big hurdle. As I said
before, I believe the higher requirements will most likely attract more
people to the field.

As to being "hurt", how do you think people will feel when they realize they
are not going to get promoted beyond a basic bench tech position because of
their lack of education? Even if an institution is willing to give them a
job at the most basic entry level it doesn't mean they will pass them up the
ladder just because they can do a certain job. Anybody in any lab can tell
you that education is the key to advancement. My experience is that those
who are willing to get the education they need do the very best work in all
circumstances. In fact, the good techs I know recognize a certain truth: the
more you do in the lab the more you realize how much more education you
need.

Finally, Louri, I was shocked when I first started working in the histolab
and found out that only one person had more than a high-school education.
Out of five techs, one was really good, but he learned histotechnology in
the military. The rest were OJT people and were average or below average in
their histotech work(by my standards). I quickly realized that histology was
the backwater of the lab. Since I had never even heard of the field before
that (I was in EM) I could not even imagine that people working in a
hospital lab would be so uneducated. Even later when we got a couple of
bachelor-level people, they had degrees in things like environmental science
and had little understanding of biochemistry, physiology or anatomy. They
were able to learn much more quickly, however, while the others floundered
with every new technology that came in.

I have done consulting work in many labs to train people for immunochemistry
and ISH. I can tell you that there are many, many labs out there that are
just hangning on by a thread because the people working in them are just
working in the dark. Yes, there is a shortage, but the last thing any
respectable lab wants now days is more uneducated people!

Tim Morken
Atlanta


-----Original Message-----
From: Louri Caldwell [mailto:louri_c@hotmail.com]
Sent: Tuesday, September 12, 2000 8:29 AM
To: histonet@pathology.swmed.edu
Subject: BOR Registry - Clarification


To clarify my opinion as stated in the previous e-mail, I am against the
requirement of an AA for an HT - and I was trained by a graduate of a
technical school (not a histology program or an Associates Degree
Program)who had extensive on-the job training.  She also is the best tech
I've ever worked with.

However, I was only trying to understand the purpose behind the AA
requirement, as I do not see how this "advances our profession" as the
previous arguements have stated.

First of all - you'll have no better control of the quality of training
received unless you implement strict curriculum guidelines for the
certification.   Also, you'll have no better influence over the quality of
the more complicated procedures produced by labs because you'll still have
those who are HT grads or who were grandfathered in performing those
procedures that supposedly require the additional education put forth by the

BOR.  It just appears that the BOR is trying to "advance the profession"
through artificial requirements that in the end do not mean much.

Again, I do not feel that an HTL is required to perform those more
complicated procedures - as I know many HT's that are high school grads with

OJT that understand it as fully as those who have a degree.

I just feel that the AA requirement hurts a lot of very capable people from
entering the field, and it's going to be even harder to recruit individuals
to work.  There are not enough of us out there as it is.

Louri
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