Developing a competency assessment framework for medical laboratory technologists in primary healthcare settings in India.

Medical Laboratory Technologists play a significant role in delivering quality laboratory Services. The competency assessment of MLTs is a critical driver for enhancing primary healthcare performance. While several countries have developed competency frameworks for MLTs in primary care, such frameworks are lacking in the Indian context. This study aimed to create a competency assessment framework to assess the competencies of MLTs (Medical Laboratory Technologists) working in Indian public primary healthcare facilities. The research followed a five-step process, starting with a review of existing literature on MLTs' competencies in primary healthcare. Expert consultations were then conducted to establish a consensus on these competencies. Following this, assessment tools were developed based on the literature review and expert input. Another round of expert consultations was held to ensure agreement on the assessment tools. Finally, the developed tools were tested in a public primary healthcare facility. The literature review identified 86 competencies across 11 domains: safe work practices, data/ sample collection, specimen preparation equipment instruments and regiments, assessment and analysis, recording and reporting, infection control, quality management, critical thinking, communication and interaction, and professional practice. Expert consultations resulted in the consensus on ninety-five competencies in ten domains of MLTs in primary healthcare settings. Competencies for each domain were discussed and agreed upon. A competency assessment tool was finalized after unanimous agreement among experts. The competency assessment tool was later finalized after pre-testing on MLTs in a clinical laboratory part of a public primary health care facility. This study successfully developed a competency assessment framework for in-service MLTs in Indian public primary healthcare settings. The framework encompasses ninety-five competencies covering ten domains of MLT responsibilities. It provides a comprehensive tool for assessing MLT's competencies and identifying competency gaps. The framework can be used to capacitate MLTs, improve their performance in primary healthcare settings, and enhance the delivery of healthcare services in India. It bridges a critical gap in the existing literature and can aid as a valuable resource for policymakers, educators, and healthcare professionals involved in practicing medical laboratory Services in primary healthcare settings.

An improved V-Net lung nodule segmentation model based on pixel threshold separation and attention mechanism.

Accurate labeling of lung nodules in computed tomography (CT) images is crucial in early lung cancer diagnosis and before nodule resection surgery. However, the irregular shape of lung nodules in CT images and the complex lung environment make it much more challenging to segment lung nodules accurately. On this basis, we propose an improved V-Net segmentation method based on pixel threshold separation and attention mechanism for lung nodules. This method first offers a data augment strategy to solve the problem of insufficient samples in 3D medical datasets. In addition, we integrate the feature extraction module based on pixel threshold separation into the model to enhance the feature extraction ability under different thresholds on the one hand. On the other hand, the model introduces channel and spatial attention modules to make the model pay more attention to important semantic information and improve its generalization ability and accuracy. Experiments show that the Dice similarity coefficients of the improved model on the public datasets LUNA16 and LNDb are 94.9% and 81.1% respectively, and the sensitivities reach 92.7% and 76.9% respectively. which is superior to most existing UNet architecture models and comparable to the manual level segmentation results by medical technologists.

A novel internal training program using Kern's 6-step approach to curriculum development for medical laboratory scientists training to be international quality assurance/quality control coordinators.

OBJECTIVE: Patient Safety Monitoring in International Laboratories (pSMILE) is a resource ensuring quality testing in clinical laboratories performing National Institutes of Health-funded HIV research requiring specific staff training. We demonstrate the development of an online asynchronous training model using Kern's 6-step approach to support pSMILE functions. METHODS: An existing curriculum was revamped to incorporate Kern's approach. Metrics for success were described in rubrics with feedback guiding improvements and updates. RESULTS: Curriculum updates took more than a year. Direct observations of skills informed curriculum changes. Module self-evaluations were reviewed to assess performance and the overall curriculum. The content, curriculum, and training documentation were deemed compliant with International Organization for Standardization (ISO) 9001:2015. CONCLUSION: Asynchronous training for highly skilled and self-directed staff is a novel way to deploy training while maintaining productivity of existing staff. Feedback and evaluation allowed for curriculum updates including previously underdeveloped topics. Kern's approach ensured that the needs of the sponsor, management, laboratories, and learners were met.

Continuing professional development (CPD) training needs assessment for medical laboratory professionals in Ethiopia.

BACKGROUND: Continuing professional development (CPD) is required for health workers in practice to update knowledge and skills regularly to match the changing complexity of healthcare needs. The objective of this study was to identify the training needs of Medical Laboratory professionals in Ethiopia. METHODS: A total of 457 medical laboratory professionals from five regions and two city administrations were involved in the study. Data were collected from August 02 to 21, 2021 with structured self-administered online tool with five-point Likert scale. The tool had consent, demography, cross-cutting issues, and main activity area specific to medical laboratory. RESULTS: Majority of the participants were male (80.1%). Participants from Amhara region 110 (24.1%) were the largest groups in the survey followed by Oromia 105 (23%) and Addis Ababa 101 (22.1%). The study participants comprised 54.7% with a bachelor's degree, 31.3% with a diploma (associate degree), and 14% with a master's degree. The participants had varying years of service, ranging from less than one year to over 10 years of experience. Most of the participants work as generalists (24.1%) followed by working in microbiology (17.5%) and parasitology (16%). The majority (96.9%) were working in a public sector or training institutions and the rest were employed in the private sector. Our study showed that the three most important topics selected for training in the cross-cutting health issues were health and emerging technology, computer skills and medico-legal issues. Topics under microbiology, clinical chemistry and molecular diagnostics were selected as the most preferred technical areas for training. Participants have also selected priority topics under research skill and pathophysiology. When the laboratory specific issues were regrouped based on areas of application as technical competence, research skill and pathophysiology, thirteen topics under technical competence, four topics under research skill and three topics under pathophysiology were picked as priority areas. CONCLUSION: In conclusion, our study identified that CPD programs should focus on topics that address technical competence in microbiology, clinical chemistry and molecular diagnostics. Additionally competencies in research skill and updating knowledge in pathophysiology should also receive due attention in designing trainings.

Adaptarnos para sobrevivir. Requerimientos de un nuevo paradigma / Adapting to survive. Requirements for a new paradigm

A lo largo de la historia, el rol del bioquímico en el laboratorio clínico ha ido mutando, adaptándose a nuevos paradigmas, consecuencia del avance de la tecnología1 y la informática, de la presión externa ejercida por las empresas proveedoras de reactivos que reducen el tiempo útil de los equipos, aumentando su tasa de recambio, de una medicina más compleja que impone nuevos desafíos diagnósticos y de los cambios sociales que se ven reflejados en una alteración en el orden de los valores adoptado por las nuevas generaciones de profesionales que conviven con otras, provocando "turbulencia generacional" en los lugares de trabajo. Los laboratorios necesitan hoy someterse a una reingeniería de sus procesos, descartar aquellos que no agreguen valor, que causan fugas innecesarias de insumos, personas y tiempo e intervenir la cultura organizacional de manera integral, para adaptarse a las exigencias que la actualidad requiere, donde la calidad, la seguridad y la sostenibilidad son los principales protagonistas )AU)

Over time, the role of the biochemist in the clinical laboratory has been changing, adapting to new paradigms, as a consequence of the advance of technology and informatics, of the external pressure exerted by the companies supplying reagents that reduce the useful time of the equipment, increasing its replacement rate, of a more complex medicine that imposes new diagnostic challenges, and of social changes that are reflected in an alteration in the values adopted by the new generations of professionals who coexist with others, causing "generational turbulence" in the workplace. Laboratories today need to reengineer their processes, eliminate those that do not add value, that cause unnecessary waste of supplies, people and time, and intervene in the organizational culture in a comprehensive manner, in order to adapt to the demands of today's world, where quality, safety, and sustainability are the main drivers (AU)

Interprofessional Education in NAACLS MLT and MLS Programs: Results of a National Survey.

BACKGROUND: Interprofessional education is essential for students enrolled in health care professional programs. OBJECTIVES: We assessed the attitudes towards and the beliefs about interprofessional education (IPE) among program directors of medical laboratory science (MLS) and medical laboratory technician (MLT) programs accredited by the National Accrediting Agency for Clinical Laboratory Sciences (NAACLS). We also investigated the inclusion of IPE in the curricula of such programs. METHODS: We emailed the link to an anonymous 22-item cross-sectional survey to 468 program directors and tabulated the responses. RESULTS: Program directors who support the need to include IPE within the curricula of MLT and MLS programs showed a generally positive attitude towards IPE. The beliefs about IPE among our respondents were not homogeneous. Program directors who have not yet implemented IPE in the curriculum may not have had an opportunity to experience the practical benefits of IPE. CONCLUSION: Although barriers to IPE implementation exist, half of the respondents reported having already implemented IPE within their curricula.

From Ink Pens to Computers: A Personal Look Back at Landmark Changes during 5 Decades as a Clinical Laboratory Scientist in U.S. Hemostasis Laboratories.

In 2023, Seminars in Thrombosis and Hemostasis will be celebrating its 50th anniversary, and similarly this will also mark my 5th decade of working in, or association with, laboratories that perform hemostasis testing. My career started at a large military medical center, but I also worked at several other facilities, including military dispensaries, community hospitals, and a large academic institution. The difference between each type of hemostasis laboratory was as expected, with larger facilities having better instrumentation and more prolific test menus. However, whether one worked in a large academic center, or a small rural hospital, regulatory changes affected every clinical laboratory to the same degree. Advances in technology also eventually affected every hemostasis laboratory, but these salient changes were more likely to occur earlier at the larger institutions. As Seminars in Thrombosis and Hemostasis celebrates its 50th anniversary, that milestone triggered recollection about those salient events that occurred during my own career in hemostasis testing. As such, I describe (my impression) the top ten landmark changes that altered laboratory practice at the facilities where I worked during the past 5 decades.

A Literature Review on How We Can Address Medical Laboratory Scientist Staffing Shortages.

OBJECTIVE: Laboratories are facing a critical shortage of medical laboratory scientists (MLS) and medical laboratory technicians (MLT) to address an increasing demand for laboratory testing. Training program closures, fewer student applicants, and financial decisions have contributed to staffing shortages. Lack of visibility, low wages, and perceived lack of opportunities for upward career mobility contribute to challenges in recruiting and retaining qualified individuals and students who are unaware of laboratory medicine careers. Our goal was to review the literature to determine the current state and consequences of staffing shortages, and potential solutions to address these shortages. METHODS: Medline/PubMed, PubMed Central, MeSH, Google Scholar, and Marshall Digital Scholar were used as resources. DISCUSSION/CONCLUSIONS: A collaboration of stakeholders is needed to identify staffing challenges, barriers, and solutions and to increase visibility of laboratory professionals. Early recruitment is best started in the middle and high school educational process.

The Importance of Medical Laboratory Scientists and the Number of Doctoral Scientists that Began Their Career by Working on the Front Lines of Laboratory Medicine.

BACKGROUND: Due to dwindling numbers of medical laboratory scientists (MLS), we are faced with staffing issues due to lack of visibility, recognition, low wages, and perceived lack of opportunities for upward career mobility. A brief survey of doctoral-level clinical microbiologists showed a significant number were certified, worked "the bench," and used this experience as a steppingstone to become a laboratory director or consultant. OBJECTIVES: To help dispel the notion working as an MLS is a dead-end job, the authors developed an expanded national survey. METHODS: The survey was sent to 815 board-certified microbiologists and chemists to determine their career path. Results indicated that of 243 respondents, 41.3% were MLS certified, 47.1% had worked "the bench," and 51.9% and 63.5% became laboratory or technical directors, respectively. CONCLUSION: Survey results provide evidence to dispel the notion that MLS and bench working jobs lack upward career mobility and may inspire students for a career in laboratory medicine.

MRTs Speak Up: The Professional Identity Crisis Brought on by COVID-19.

The purpose of this study is to share the lived experience of Canadian medical radiation technologists (MRTs) in relation to their mental health during the pandemic by exploring the causes and impacts of the COVID-19 pandemic on the professional group within the workplace. Data from eight semi-structured interviews and one focus group were conducted between April and June 2021. Audio files were transcribed and uploaded to a qualitative data analysis computer software program (NVivo) where codebook thematic analysis was conducted. Participants identified mental health themes at work within the individual, relationship, organization and policy levels. The pandemic alone did not cause MRTs to burnout, the changing policies combined with individual, familial and organization factors merely highlighted the chronic and increasing mental health concerns that existed pre-pandemic. Understanding this snap shot in time may aid in developing appropriate resources and improve workplace culture and mental health seeking behaviours for MRTs. These findings elucidate the need for more timely and equitable funding/resources to ensure that all healthcare workers are recognized and supported.

Competency for Japanese novice medical laboratory scientists: a Delphi method.

BACKGROUND: Competency is used to channel abilities into successful processes and is employed in the medical field. Globally, several laboratory competencies exist, but the job descriptions of Japanese medical laboratory scientists differ from those of other countries and little evidence-based information on novice medical laboratory scientist competency is available in Japan. This study clarified the competencies of novice medical laboratory scientists based on various expert opinions in Japan. METHODS: The Delphi method was used to achieve an expert consensus on novice medical laboratory scientist competencies. We asked the participants to evaluate the importance of each item using the Likert scale and set 70% as the final consensus rate. RESULTS: We obtained 106/400 (26.5%) and 95/106 (89.6%) responses from participants in rounds 1 and 2, respectively. Their professional experience mean ± standard deviation was 32.4 ± 6.0 years (range: 13-41). The average of each category consensus rate was > 99.1%. Ninety-five expert opinions converged and agreed that the competency comprised 8 categories and 54 items. CONCLUSIONS: The survey results revealed that novice medical laboratory scientists were expected to have relatively higher main laboratory skill competencies in the 'Preparation and analysis' category than in other categories. Nevertheless, competencies in other categories required basic skills. In addition, our competencies contained unique competencies compared with others due to their divergent roles and their environment. Further research is warranted to explore assessment tools by developing a competency scale, thereby helping clarify the differences between ability and correlated factors. The unique competencies scale can help assess the efficacy of educational programmes for Japanese medical laboratory scientists.

Application of the electronic book to promote self-directed learning in medical technologist continuing education: a cross-sectional study.

BACKGROUND: Continuing education (CE) is essential for health professionals to improve competence in clinical practice, yet many medical technologists still experience barriers to learning in complex clinical settings. To better manage CE and address medical technologists' learning needs, we developed a learner-centred electronic book (e-book) to promote self-directed learning for medical technologists. METHODS: A cross-sectional study was conducted to explore the acceptability and learning impacts of the e-book as CE material for medical technologists in two medical centres in Taiwan. We designed the learner-centred context in the e-book based on medical technologists' practice requirements and learning needs. Moreover, we adopted The New World Kirkpatrick Model with four levels (reactions, learning, behaviours and results) to evaluate the e-book's learning impacts on medical technologists. A total of 280 medical technologists were invited to complete a questionnaire and a post-test, providing learning patterns as well as their satisfaction with the e-book and their learning outcomes after using it. RESULTS: Most readers had positive learning experiences and better learning outcomes, including knowledge acquisition and behavioural change, after reading the e-book. The e-book became a new CE activity and reached medical technologists in various types of laboratories. CONCLUSIONS: The low-cost and learner-centred e-book effectively overcame CE learning barriers for medical technologists. The interactivity and flexibility of e-learning particularly helped learners to engage in clinical scenarios in laboratory medicine. This study could pave the way for medical educators to build a high-quality e-learning model in CE.

Adaptation of medical laboratory scientists to workplace hazards - experiences from the COVID-19 pandemic.

The COVID-19 pandemic has dramatically changed healthcare personnel's working environment and sense of security. Medical laboratory scientists were also faced with new occupational challenges. They were tasked with performing novel tests for SARS-CoV-2 without being aware of the associated risks. At the beginning of the pandemic, strict sanitary requirements and the fear of becoming infected with the "new virus" were considerable sources of stress. However, these stress responses abated over time. The aim of this two-stage study was to explore the extent to which this group of medical professionals adapted to new working conditions 1 year after the outbreak of the pandemic. The study was conducted at the beginning of the fourth pandemic wave in Poland, i.e., between 10 September and 31 October 2021. The first stage was a pilot study that involved interviews with 14 medical laboratory scientists. The results were used to perform a survey of 294 laboratory scientists in the second stage. The study investigated the problems and fears faced by this professional group at the beginning of the pandemic, as well as changes in their attitudes during successive waves of COVID-19. The analyzed data demonstrated that most medical laboratory scientists had grown accustomed to the pandemic and workplace changes by the beginning of the fourth wave. The study also indicates that in addition to adequate means of personal protection, health professionals should also be provided with emotional support in times of pandemic.

Nurses' Perceptions of Medical Laboratory Scientists: Mistaken Identity and Misplaced Regard.

INTRODUCTION: The medical laboratory science (MLS) profession is an integral part of the healthcare team, providing diagnostic laboratory results used to determine directives in the treatment and management of disease processes. There is a scarcity of literature describing other healthcare professionals' perceptions of medical laboratory scientists. Research also suggests MLS professionals feel unrecognized for contributions to patient care. PURPOSE: A pilot study to describe intensive care unit (ICU) nurses' perceptions of medical laboratory scientists and their role in healthcare. METHODS: Five ICU nurses were interviewed using open-ended questions. Data were analyzed using phenomenological research inquiry to develop themes. RESULTS: Four themes were identified: professional practice, visibility, professional entry, and interprofessional learning. DISCUSSION: While participants were aware of the medical laboratory, they were unaware of the scope of practice, educational requirements, and professional credentials of medical laboratory scientists. Findings also showed misconceptions of the MLS scope of practice that overlaps with phlebotomists and medical laboratory technicians (MLTs). CONCLUSION: This study found that the intensive care nurse participants demonstrated an overall positive perception of medical laboratory scientists but a low level of knowledge of the MLS profession and expertise. Implications for interdisciplinary education to create a more comprehensive healthcare delivery team were presented.

Human Sustainability in Pathology Medical Laboratory Workforce.

While having a dedicated and productive workforce is the cornerstone of a functioning society, the key is sustainability. Allied health laboratory burnout, characterized by mental exhaustion which negatively affects workplace performance, has worsened during the COVID pandemic. For purposes such as these, the issue must be addressed to ensure that the US will have an adequate workforce to meet the laboratory testing needs of an aging population and any potential future pandemics that may arise. The answer to reducing toxic or challenging workplace environments and improving human workforce sustainability is through transparency and anonymous reporting mandates so the data collected from individual laboratories can be reported as a single "human sustainability" score that reflects the health measure of the laboratory. The 10 laboratories with the highest scores could be listed in the laboratory professional magazine's version of "America's Most Admired Laboratories" and the worst performers in the "Improvements-Needed" listing. Companies are inherently competitive, and this forces laboratories to be more cognizant of workforce well-being and the rate of burnout and work-related chronic conditions. This article outlines how the human sustainability advocacy plan can be implemented using ideas gleaned from Bardach's eight-fold path paradigm.

The Hidden Crisis in the Times of COVID-19: Critical Shortages of Medical Laboratory Professionals in Clinical Microbiology.

The COVID pandemic has put a spotlight on laboratory medicine, showcasing how vital diagnostic testing is for society and the health care system. It has also brought to light and accelerated the critical shortage of trained and experienced laboratory personnel that has been felt for decades. The need for laboratory professionals is expected to grow by 11% between 2020 and 2030, a higher rate of growth than the overall average for all other health care occupations. Here, the background to this workforce shortage is reviewed. Some proposed actions to help address the issue are put forth, including increasing awareness of the medical laboratory science profession along with bolstering training opportunities and awareness of alternate routes to obtaining certification as a medical laboratory scientist. In addition, recent survey data specifically related to the employee shortages in microbiology are presented which demonstrate that 80% of microbiology laboratories have vacant positions and that filling these positions is challenging for a number of reasons, including a lack of qualified applicants.

Reflexiones sobre los valores éticos de la protección radiológica para los profesionales tecnólogos médicos de imagenología / Reflections on the ethical values of radiation protection for the professional medical technologists in imaging

Las radiaciones ionizantes tienen el potencial de generar efectos adversos a la salud de las personas. Para hacer un uso más seguro y eficiente de estas radiaciones, la Comisión Internacional de Protección Radiológica fundamentalmente ha implementado un sistema de protección radiológica (SPR) que se basa en tres principios: justificación, optimización y límites. A su vez, estos principios se sustentan en cuatro valores éticos (beneficencia, prudencia, justicia y dignidad). Se sabe que en Chile el profesional que esta mandatado para realizar la toma de los exámenes que utilizan radiaciones ionizantes es el/la Tecnólogo Médico en Imagenología. Por lo tanto, resulta interesante valorar el grado de conocimiento adquirido y posteriormente aplicado en torno a los valores éticos del SPR por parte de dichos profesionales. De esta manera el objetivo del este artículo de tipo Punto de Vista fue realizar una serie de reflexiones en torno a esta temática. Cuando se realiza un procedimientos médico u odontológico con radiaciones ionizantes, el/la Tecnólogo Médico en Imagenología participa esencialmente en la realización del mismo, por lo que no debería ser su responsabilidad el cautelar que se cumplan los 4 valores éticos descritos dentro del SPR. A juicio nuestro, el principio de optimización, sería el único principio o pilar del SPR donde tiene real obligación de participar, utilizando las restricciones a las exposiciones individuales y los niveles de referencia para diagnóstico para reducir las desigualdades en la distribución de las exposiciones entre los grupos expuestos. Finalmente, resulta vital investigar si en su formación de especialidad se tocan estas temáticas

Ionizing radiation has the potential to generate adverse effects on people's health. To make safer and more efficient use of these radiations, the International Commission on Radiological Protection has fundamentally implemented a radiological protection system (RPS) based on three principles: justification, optimization and limits. In turn, these principles are based on four ethical values (beneficence, prudence, justice and dignity). It is known that in Chile the professional who is mandated to perform the exams that use ionizing radiation is the Medical Imaging Technologist. Therefore, it is interesting to assess the degree of knowledge acquired and subsequently applied around the ethical values of the RPS by these professionals. In this way, the objective of this Point of View article was to make a series of reflections on this subject. When a medical or dental procedure is performed with ionizing radiation, the Medical Imaging Technologist essentially participates in its performance, so it should not be their responsibility to ensure that the 4 ethical values described in the RPS are met. In our opinion, the principle of optimization would be the only principle or pillar of the RPS where it has a real obligation to participate, using the restrictions on individual exposures and the diagnostic reference levels to reduce inequalities in the distribution of exposures between exposed groups. Finally, it is vital to investigate whether these topics are addressed in his specialty training.

More than grit: growing and sustaining physician-scientists in obstetrics and gynecology.

Obstetricians know the statistics-1 out of every 10 babies is born premature; preeclampsia affects 1 in 25 pregnant people; the United States has the highest rate of maternal mortality in the developed world. Yet, physicians and scientists still do not fully understand the biology of normal pregnancy, let alone what causes these complications. Obstetrics and gynecology-trained physician-scientists are uniquely positioned to fill critical knowledge gaps by addressing clinically-relevant problems through fundamental research and interpreting insights from basic and translational studies in the clinical context. Within our specialty, however, physician-scientists are relatively uncommon. Inadequate guidance, lack of support and community, and structural barriers deter fellows and early stage faculty from pursuing the physician-scientist track. One approach to help cultivate the next generation of physician-scientists in obstetrics and gynecology is to demystify the process and address the common barriers that contribute to the attrition of early stage investigators. Here, we review major challenges and propose potential pathways forward in the areas of mentorship, obtaining protected research time and resources, and ensuring diversity, equity, and inclusion, from our perspective as early stage investigators in maternal-fetal medicine. We discuss the roles of early stage investigators and leaders at the institutional and national level in the collective effort to retain and grow our physician-scientist workforce. We aim to provide a framework for early stage investigators initiating their research careers and a starting point for discussion with academic stakeholders. We cannot afford to lose the valuable contributions of talented individuals due to modifiable factors or forfeit our voices as advocates for the issues that impact pregnant populations.