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A lab conference that works.

A lab conference that works

Brief CE presentations over doughnuts and coffee provide a popular weekly forum for exchanging clinical information.

When I joined our 900-bed university hospital's laboratory staff in 1976, the clinical pathology conference was in a slump.

Aimed primarily at pathology residents and faculty heads of laboratory sections, the conference had problems attracting interest and an audience. Every year a new format would be tried, putting the burden of a lengthy presentation on the faculty or residents or a combination of both.

An initial wave of enthusiasm would greet each new format; then participation would sink to a low level again until the following year's introduction of the next new format. Part of the problem was that the time picked for the conference invariably conflicted with teaching commitments or patient-related clinical work.

Then, in 1982, the director of laboratories came up with a format that raised attendance and has stood the test of time. The format could easily be adapted to any type of institution and audience.

The laboratory conference is held every Friday at 7:30 a.m. The starting time doesn't conflict with any other hospital meetings, and residents are able to get back to their laboratory sections before test results are ready for review and interpretation. Although a few bench technologists attend, most are in the middle of their morning work rush at the time of the conference.

Because the pathology department provides doughnuts and coffee, the meeting is known around the halls as the Doughnut Conference. When a faculty member suggested we eat healthy fruit instead, the sugary baked goods once gave way to apples, bananas, and oranges. At the end of that conference, doughnuts were voted back in by a 10-to-1 margin.

The meeting, which lasts for one hour, consists largely of 10-minute presentations, mostly by residents who draw on subjects from the pathology services through which they are rotating. Hearing from chemistry, hematology, immunopathology, the transfusion service, microbiology, and the laboratory at our hospital's teaching affiliate, the Veterans Administration Medical Center, guarantees diversity while helping to unify the various areas. Since residents spend three concentrated months on each rotation, they welcome the opportunity to interact.

The speakers usually prepare a handout consisting of a single typewritten sheet containing pertinent laboratory values, graphs, or figures, as well as a few key references. A microscope and a projector are used to view slides and transparencies. Occasionally, a culture plate or serum protein electro-phoretogram is passed around.

There never seems to be a shortage of interesting material. Residents keep an eye out for unusual specimens, and section heads serve as a sounding board for prospective CE topics. We tell upcoming speakers not to attempt extremely complicated presentations in their 10 minutes but rather to make a single point worth remembering. In the chemistry section, we even hold a dress rehearsal, which gives the resident a chance to practice and the staff a quick opportunity to obtain continuing education.

The residents are quite inventive. In a single Friday morning session, we may examine an interesting culture, discuss a bone marrow biopsy, and learn how a drug affects lab results. One resident in hematology, inspired by a TV news show's designation of a Person of the Week, presented a series of Cells of the Week based on blood smears and bone marrow biopsies he had photographed. I began looking forward every Friday morning to seeing the cells he had chosen.

Success depends on maintaining a brisk pace. The director of laboratories chairs the conference. His "We have to move along" has become a familiar refrain. A resident once turned the tables on him, uttering the same phrase just as the director was about to make a point of his own. Luckily for the resident, the director has a sense of humor.

Sometimes we use wordplay to lighten a grim situation. One case involved an unfortunate couple named Kenneth and Barbara who had become violently ill while eating seafood at a local restaurant. They both suffered from nausea; Barbara actually passed out into her bouillabaisse. The emergency room physician made a tentative diagnosis of paralytic shellfish poisoning. Soon the couple recovered and were released. The title of our presentation the following Friday was "Barbie and Ken on Mussel Beach."

Occasionally we devote an entire conference to a single complicated case, for which each resident presents his or her laboratory section's experience. Understanding the ways in which disperate elements of lab work done for a particular patient are linked helps audience members appreciate how the labs collaborate. Our interchanges also reinforce a more global view of laboratory science than the narrower outlook one can easily develop when working in the same area day after day.

At other times we invite a guest speaker. For example, a physician from the bone marrow transplant service discussed the procedure as it relates to the blood bank and to the hematology and immunopathology services.

The conference's format is flexible enough for use in other settings, although in many laboratories it might work better on a bi-weekly basis. All you need is a group of professionals interested in sharing knowledge. Keep the presentations simple, put someone in charge who will keep the conference on schedule, and provide appealing snacks. It's a great way to fulfill continuing education requirements, too.

I have to move along now.

The author is associate professor of pathology and director of the core clinical chemistry laboratory at the University of Iowa Hospital in Iowa City, Iowa.
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Title Annotation:continuing education presentations over doughnuts & coffee
Author:Feld, Ronald D.
Publication:Medical Laboratory Observer
Date:Nov 1, 1989
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