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.

Using hospital auxiliary worker and 24-h TB services as potential tools to overcome in-hospital TB delays: a quasi-experimental study.

BACKGROUND: In-hospital logistic management barriers (LMB) are considered to be important risk factors for delays in TB diagnosis and treatment initiation (TB-dt), which perpetuates TB transmission and the development of TB morbidity and mortality. We assessed the contribution of hospital auxiliary workers (HAWs) and 24-h TB laboratory services using Xpert (24h-Xpert) on the delays in TB-dt and TB mortality at Beira Central Hospital, Mozambique. METHODS: A quasi-experimental design was used. Implementation strategy-HAWs and laboratory technicians were selected and trained, accordingly. Interventions-having trained HAW and TB laboratory technicians as expediters of TB LMB issues and assurer of 24h-Xpert, respectively. Implementation outcomes-time from hospital admission to sputum examination results, time from hospital admission to treatment initiation, proportion of same-day TB cases diagnosed, initiated TB treatment, and TB patient with unfavorable outcome after hospitalization (hospital TB mortality). A nonparametric test was used to test the differences between groups and adjusted OR (95% CI) were computed using multivariate logistic regression. RESULTS: We recruited 522 TB patients. Median (IQR) age was 34 (16) years, and 52% were from intervention site, 58% males, 60% new case of TB, 12% MDR-TB, 72% TB/HIV co-infected, and 43% on HIV treatment at admission. In the intervention hospital, 93% of patients had same-day TB-dt in comparison with a median (IQR) time of 15 (2) days in the control hospital. TB mortality in the intervention hospital was lower than that in the control hospital (13% vs 49%). TB patients admitted to the intervention hospital were nine times more likely to obtain an early laboratory diagnosis of TB, six times more likely to reduce delays in TB treatment initiation, and eight times less likely to die, when compared to those who were admitted to the control hospital, adjusting for other factors. CONCLUSION: In-hospital delays in TB-dt and high TB mortality in Mozambique are common and probably due, in part, to LMB amenable to poor-quality TB care. Task shifting of TB logistic management services to HAWs and lower laboratory technicians, to ensure 24h-Xpert through "on-the-spot strategy," may contribute to timely TB detection, proper treatment, and reduction of TB mortality.

Finnish cytotechnologists' views on the competencies of newly graduated biomedical scientists in clinical cytology.

OBJECTIVE: This study asked 40 cytotechnologists for their views on the competencies of newly graduated biomedical scientists in clinical cytology during the national conference of the Finnish Association of Cytotechnologists in November 2015. METHODS: The questionnaire mainly consisted of statements that were scored on a five-point Likert-scale, where 1 was not important and 5 was very important. It covered five sections of clinical cytology: sampling and techniques, gynaecological screening, non-gynaecological screening, safety and quality management, and miscellaneous. RESULTS: Of the 40 delegates approached to complete the questionnaire, 37 (92.5%) agreed. Respondents felt that important sampling and technique competencies were specimen fixation, with a mean score of 4.9 out of 5.0, types of specimens (4.7), Papanicolaou smear collection (4.7), Papanicolaou smear request information (4.7) and evaluation of specimen sufficiency (4.6). Less important competencies were examining FNAs (2.0) and nasopharyngeal specimens (2.2). The respondents had many expectations about how education in cytology could be developed, for example more theoretical lessons, more practice in microscope use, and consistent criteria for training and cooperation between cytology laboratories and universities of applied sciences. CONCLUSIONS: The cytotechnologists who took part in our survey expected newly graduated biomedical scientists to have basic competencies in cytology. These were sampling and techniques, laboratory safety and quality management, specimen adequacy and identifying normal cells taken during gynaecological screening. They were also keen to develop education in cytology.

[Workshop -A New Era of Specialists in Clinical Laboratory Medicine].

Here, we briefly report on the workshop entitled "A new era of specialists in clinical laboratory medicine." The following items were presented in the poster session on "work-life balance among specialists in clinical laboratory medicine": routine work, troublesom issues at work, networking, and career development. Re- garding the topic of "lifelong education," participants in groups discussed the joy they derive from working in the field of clinical laboratory medicine. Many participants mentioned that they had been attracted to this field because of the wide range of academic disciplines available and the relative freedom in choosing special- ties. We believe that this workshop facilitates the sharing of information about routine work and viewpoints regarding the specialty of clinical laboratory medicine, as well as personnel networking on a nationwide level.

[Viewpoint: Skill Certifications for Japanese Medical Technologists].

With the development of medicine, the field of clinical laboratory medicine evolves rapidly, and it will be more specialized in the near future. Medical technologists are required to hone their skills and knowledge, in order to keep up with the evolution. In recent years, board certifications by several medical societies are considered to indicate the skills of medical technologists. The number of board-certified medical technologists in populated areas such as Tokyo, Kanagawa, Osaka, and Fukuoka is greater than in less populated areas such as Kyusyu and Tohoku. The rate of certified medical technologists among prefectures is the highest in Mie (10.1%), followed by Nagasaki (8.8%). Tokyo, Ishikawa, Kyoto, and Osaka have acquisition rates greater than 7%. In contrast, prefectures of Miyazaki, Kumamoto, Yamanashi, and Akita have low acquisition rates of less than 4%. Being certified is not only an opportunity for personal career advancement, but also a chance to improve the laboratory. More technologists are being certified in our laboratory, and we are encouraging a future increase in their number. However, there are some problems to be overcome. Assignment of competent staff and long-term and premeditated rotation are considered to be important for staff to find the work rewarding, and the laboratory to be trusted by physicians.

[Qualification System for BLS -Domestically and Internationally-].

The scope of the biomedical laboratory scientist (BLS) differs in the world. The qualification systems for BLS are also different. Even the name of our profession is not standardized, like "BLS", "Medical Technologist (MT) ", "Medical Laboratory Scientist (MLS) ", "Medical Technician", and so on. We have only the "BLS" license, which is recognized by the Ministry of Health, Labour and Welfare in Japan. Many Asian countries have a qualification system similar to Japan. In the USA, BLSs are qualified by certain scientific organizations, and they are called "MT", "BLS", or "Specialist" in consideration of their education level. The International Association of Medical Laboratory Technologists (IAMLT) was founded by Ms. Elizabeth Pletscher and her Swiss colleagues in order to cooperate with international BLSs in 1954. Since the BLS education system has been improved, chief delegates from the world decided that we should call ourselves "BLS", and IAMLT was revised to the "International Federation of Biomedical Laboratory Science (IFBLS) " at the general assembly in 2002. IFBLS has tried to spread our name and occupation to the public though our international cooperation using the same name "BLS". IFBLS shares the core competence, but does not provide certification. The International Academy of Clinical Cytology (IAC) has provided international certification for cytolo- gists and cytotechnologists. The American Society of Clinical Pathology (ASCP) has certified overseas BLSs (ASCPi), and they are able to work in the USA as BLSs after passing the examination. These certifi- cations will be valid in limited areas. As the current situation, if someone would like to work in another country as a BLS, he/she will have to pass the domestic BLS examination. [Review].

[What Medical Laboratory Testing/Technicians Can and Should Do in Emergency Medicine].

Technology used in clinical laboratory tests has made marked progress in the field of emergency medicine, which has developed simultaneously. Emergency tests have expanded to the bedside as a system called point-of-care testing, and it is now essential for emergency room, critical care unit, and prehospital settings. The favorable relationship between them will continue if we are able to use new testing techniques effective- ly both now and in the future. However, taking the best advantage of them is challenging. This problem will be resolved by the efforts of SHELL Model and Crew resource management (CRM). The SHELL Mod- el offers an important suggestion that a major inhibitor of their effective use is liveware. It is difficult to use liveware resources as efficiently as possible in the numerous emergency medical centers. Referencing CRM, I propose concrete actions to make it possible to: 1) promote 2-way-comunication; 2) share a common language, information, and goals; 3) take the initiative in solving patient problems; 4) establish a trusting rela- tionship between medical staff; 5) eliminate discrepancies at any time and at any center. In these ways, in- tervening actively in care, technologists are closely associated with the patient-centered emergency service, understating not what they have done for patients, but what has become of patients. In addition, they can learn from doctors, other staff, and patients, and vice versa. We, doctors and technologists, can fully interact with each other with emergency testing, and promote healing power that computers cannot harness. [Review].

[Training of Medical Technologists Who Will Be Able to Contribute to Emergency Medical Care].

Although health care is provided by many different medical professionals, medical technologists are usually not present in emergency care settings. Kameda Medical Center has established and been implementing a system of in-house certification as emergency medical care examiners. Medical technologists who have undergone seven-month-or-longer in-house and emergency medical care training and passed the final screening are certified as emergency medical care examiners, and their presence in critical care centers for 24 hours a day has improved the quality and safety of medicine. [Review].

[Current Situation and Tasks for International Activities of BLS -Presentation for International Congress or Study Abroad-].

Nowadays, global consciousness is important for the human race. Many Japanese businesspersons and even students try to improve their foreign language skills, and try to get a chance to join international activities. International Activities of BLSs are as follows: 1. Apply for the Japan International Cooperation Agency (JICA) business for supporting developing countries as a technical expert. Since JICA activity is supported by the Japanese Government, it must be worthwhile and will complete large-scale business. After the completion, it might be difficult to find a good work place to utilize JICA ex- perience. 2. Study abroad such as joining an exchange program, or working as a researcher or trainee. Some Japanese institutes provide systems for studying abroad for BLSs. We should study language and improve our professional skills. An employer might give permission for a short stay easily. Support from a supervisor is important. 3. Overseas occupation. We will need certification or a license when we work abroad. Study or work abroad is a precious experience. We should be clear on the purpose and select a suitable place with a long-term plan. Among international activities, it is easy to be a presenter at the World Congress. There are many inter- national congresses for BLSs such as the IFBLS World Congress, AAMLS Congress, or Scientific Congress for each special filed. We should learn not only language, but also different cultures and international man- ners when we participate in international activities. Supervisors can help to improve the global perspective of young BLSs. [Review].

[Efforts and Prospects for the Globalization of the Japanese Association of Medical Technologists (JAMT)].

The Japanese Association of Medical Technologists (JAMT) has joined the International Federation of Bi- omedical Laboratory Science (IFBLS) and Asia Association of Medical Laboratory Scientists (AAMLS). JAMT has concluded an agreement with the Korean Association of Medical Technologists (KAMT) and coop- erates with the Japan International Medical Technology Foundation (JIMTEF). In addition, JAMT is prepar- ing for the 32nd World Congress of Biomedical Laboratory Science. JAMT founded an international section for globalization, and started the foundation of an overseas short- term program for studying abroad, exchange with the Taiwanese Association of Medical Technologists (TAMT), and support for developing countries. From an academic aspect, we placed the "Japanese Journal of Medical Technology" on the J-STAGE. JAMT nurtures global medical technologists through international exchanges and support from developing countries. [Review].

[Certifying Examination System in College of Laboratory Medicine of Japan].

The three types of certifying examinations provided by the College of Laboratory Medicine of Japan are introduced. They are the Technologist in Laboratory, Specialist in Laboratory, and Technologist in Emer- gency Laboratory. Both the Technologist in Laboratory and Specialist in Laboratory examinations focus on eight areas: microbiology, pathology, chemistry, hematology, immunology, cardiology, neurology, and respi- rology. The Technologist in Laboratory examination started in 1954, and, as of today, it has been passed by 34,646 people. The Specialist in Laboratory examination started in 1956, and due to its level of difficulty, it has been passed by only 232 people. Meanwhile, the Technologist in Emergency Laboratory examination start- ed in 1992, and it has been passed by 5,047 people. These certificates prove that their holders have acquired a certain level of knowledge and technical aptitude, and that they represent the caliber of personnel necessary for clinical laboratories to obtain facility authentication from organizations such as the International Organiza- tion for Standardization (ISO) and the College of American Pathologists (CAP). Therefore, the significance and value of acquiring these qualifications are marked. [Review].

[Strategies to Cope with the Shortage of Technologists: Facing the Mass-Retirement of the 'Baby-Boomer' Generation].

In Japan, the primary 'baby-boomer' generation, born between 1947 and 1949, is now in its retirement. This has caused a marked shortage of human resources nationwide. Clinical laboratory technologists are no exception, and many clinical laboratories in Japanese healthcare facilities are struggling with management because the number of new graduates, i.e., newly licensed technologists, is mostly fixed and, therefore, their recruitment is becoming more and more competitive. Our laboratory is now facing a wave of mass-retirement associated with our history. In addition, in the early 2000s, there was almost no position for new graduates replacing those retiring because of the change in the social healthcare system as well as our hospital's policy. This resulted in uneven numbers of technologists in generations, and it seemed to be getting worse. Fortunately, five years ago, the direction of social health care was changed and lots of positions became available as a result. We have been trying to recruit new graduates and experienced technologists as well, and were able to hire 18 people. Among them, 8 were non-freshmen. The generation gap has been mostly resolved. We will continue to make our laboratory more attractive not just to new graduates but also to experienced technologists, especially those who wish to return to work after a several-year absence to raise their children. We believe that this will energize our laboratory.

Continuing professional development training needs of medical laboratory personnel in Botswana.

BACKGROUND: Laboratory professionals are expected to maintain their knowledge on the most recent advances in laboratory testing and continuing professional development (CPD) programs can address this expectation. In developing countries, accessing CPD programs is a major challenge for laboratory personnel, partly due to their limited availability. An assessment was conducted among clinical laboratory workforce in Botswana to identify and prioritize CPD training needs as well as preferred modes of CPD delivery. METHODS: A self-administered questionnaire was disseminated to medical laboratory scientists and technicians registered with the Botswana Health Professions Council. Questions were organized into domains of competency related to (i) quality management systems, (ii) technical competence, (iii) laboratory management, leadership, and coaching, and (iv) pathophysiology, data interpretation, and research. Participants were asked to rank their self-perceived training needs using a 3-point scale in order of importance (most, moderate, and least). Furthermore, participants were asked to select any three preferences for delivery formats for the CPD. RESULTS: Out of 350 questionnaires that were distributed, 275 were completed and returned giving an overall response rate of 79%. The most frequently selected topics for training in rank order according to key themes were (mean, range) (i) quality management systems, most important (79%, 74-84%); (ii) pathophysiology, data interpretation, and research (68%, 52-78%); (iii) technical competence (65%, 44-73%); and (iv) laboratory management, leadership, and coaching (60%, 37-77%). The top three topics selected by the participants were (i) quality systems essentials for medical laboratory, (ii) implementing a quality management system, and (iii) techniques to identify and control sources of error in laboratory procedures. The top three preferred CPD delivery modes, in rank order, were training workshops, hands-on workshops, and internet-based learning. Journal clubs at the workplace was the least preferred method of delivery of CPD credits. CONCLUSIONS: CPD programs to be developed should focus on topics that address quality management systems, case studies, competence assessment, and customer care. The findings from this survey can also inform medical laboratory pre-service education curriculum.

[Japanese Association of Clinical Laborato Physicians--What We Are Doing Now and How We Should Develop in the Future as Competent Members of Team Medicine].

No clinical laboratory would admit they do not practice team medicine, at least conceptually. However, true team medicine is more than an aspiration--it is an intentional care structure built, led, and delivered by a diverse, multidisciplinary team of physicians, medical technologists, nurses, pharmacists, and dozens of other professionals. We clinical laboratory physicians are able to fulfill an important role as competent members of the team medicine. Because we can look at the results of clinical examinations of patients earlier than anyone else, we can interpret the patient's condition by analyzing that results, and provide useful information to facilitate team medicine. I have conducted a questionnaire survey on team medicine targeting clinical laboratory physicians to clarify the tasks we are performing. In this paper, I describe what clinical laboratory physicians are currently doing, and how should we develop in the future.

Factors affecting job satisfaction and retention of medical laboratory professionals in seven countries of Sub-Saharan Africa.

Effective implementation and sustainability of quality laboratory programmes in Sub-Saharan Africa relies on the development of appropriate staff retention strategies. Assessing the factors responsible for job satisfaction and retention is key for tailoring specific interventions aiming at improving the overall impact of health programmes. A survey was developed to assess these factors among 224 laboratorians working in the laboratory programme the University of Maryland implemented in seven Sub-Saharan African countries. Lack of professional development was the major reason for leaving the previous job for 28% of interviewees who changed jobs in the past five years. Professional development/training opportunities was indicated by almost 90% (195/224) of total interviewees as the most important or a very important factor for satisfaction at their current job. Similarly, regular professional development/opportunities for training was the highest rated incentive to remain at their current job by 80% (179/224). Laboratory professionals employed in the private sector were more likely to change jobs than those working in the public sector (P = 0.002). The findings were used for developing specific strategies for human resources management, in particular targeting professional development, aiming at improving laboratory professionals within the University of Maryland laboratory programme and hence its long-term sustainability.

Preservice laboratory education strengthening enhances sustainable laboratory workforce in Ethiopia.

BACKGROUND: There is a severe healthcare workforce shortage in sub Saharan Africa, which threatens achieving the Millennium Development Goals and attaining an AIDS-free generation. The strength of a healthcare system depends on the skills, competencies, values and availability of its workforce. A well-trained and competent laboratory technologist ensures accurate and reliable results for use in prevention, diagnosis, care and treatment of diseases. METHODS: An assessment of existing preservice education of five medical laboratory schools, followed by remedial intervention and monitoring was conducted. The remedial interventions included 1) standardizing curriculum and implementation; 2) training faculty staff on pedagogical methods and quality management systems; 3) providing teaching materials; and 4) procuring equipment for teaching laboratories to provide practical skills to complement didactic education. RESULTS: A total of 2,230 undergraduate students from the five universities benefitted from the standardized curriculum. University of Gondar accounted for 252 of 2,230 (11.3%) of the students, Addis Ababa University for 663 (29.7%), Jimma University for 649 (29.1%), Haramaya University for 429 (19.2%) and Hawassa University for 237 (10.6%) of the students. Together the universities graduated 388 and 312 laboratory technologists in 2010/2011 and 2011/2012 academic year, respectively. Practical hands-on training and experience with well-equipped laboratories enhanced and ensured skilled, confident and competent laboratory technologists upon graduation. CONCLUSIONS: Strengthening preservice laboratory education is feasible in resource-limited settings, and emphasizing its merits (ample local capacity, country ownership and sustainability) provides a valuable source of competent laboratory technologists to relieve an overstretched healthcare system.