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Resources and strategies for a successful CE program.

Thereare plenty of continuing education opportunities available for both large and small labs if you know where to look and are committed to offering a regular CE program.

The author is chief technologist in hematology and microscopy al University Hospital Pennsyvania State University, in Hershey.

The Joint Commission on Accreditation of Healthcare Organizations (JCAHO) requires inservice education programs for laboratorians. Yet during a recent lecture I presented, only 3 of the 20 people in the audience said their labs offered regular continuing education for the staff.

I doubt many people would argue the need for CE. Certainly in a field as dynamic as laboratory medicine, we cannot allow technologists' undergraduate training to cap the learning process for their entire career.

The major stumbling blocks seem to be commitment, time, money, and, perhaps most important, assuming responsibility for continuing education. A successful CE program entails a significant commitment, something that no one else can make for you. Time invested in maintaining the program need not be excessive, and special funding is not necessary. What is crucial, though, is assigning responsibility for ongoing CE.

Even if your lab is fortunate enough to have an in-service coordinator, no one person can deliver regular CE meetings for all lab sections. Work schedules, staff interests, and workload peaks are far too varied for one person to develop CE programs that will appeal to all personnel in a mediumto large-size lab. However, an inservice coordinator is an excellent resource person and should not be overlooked. Pathologists and laboratory managers should also be considered as potential resources but not as primary providers of an unlimited supply of CE material.

Who then must shoulder the responsibility for continuing education'? Since it is unlikely that a full schedule of CE meetings will magically appear, section supervisors and their staff members must take charge. Once you identify the primary providers of continuing education, you can begin to explore the following CE possibilities:

* Outside meetings. Professional meetings are probably the first CE resource that comes to mind. The most obvious disadvantage is the cost. Our annual hematology budget for outside meetings is about $1,000 for all 18 employees-a very limited sum when you consider the cost and availability of meetings. The 1988 Pennsylvania Society for Medical Technology (PSMT) convention, held in Harrisburg, was a bargain-$50 per person for a full day of meetings. Even on my budget, I could afford to send the entire staff for one day. While this is a fine educational opportunity, it certainly cannot be construed as continuing education.

The next most economical outside option is probably the oneday professional programs that focus on assorted management topics. These sessions generally cost $50 to $200 per person and may or may not include lunch. After that, it's all uphill. Registration fees for a two- or three-day technical seminar run at least $200 to $300. Add on meals and lodging, and you will rapidly consume all but the most lavish CE budget for just a few staff members. If the trip requires air fare, my section's entire CE budget would probably cover only one or two employees. This brings us to another critical issue: Who should attend'? Selecting prospective travelers poses very real problems. Should outside meetings be limited to supervisors? Should we send our weaker laboratorians, those who need further training to meet standards? Or do we reward the top-notch technologists for their excellent performance? There are no easy answers, and I think all would agree that while outside CE meetings are an excellent resource, they are expensive and do not meet the goal of providing continuing education for all staff members.

* In-house meetings. In-house CE, however, can provide a continuing program for the entire staff. Some programs must be purchased, but many are available free of charge. Those for sale include the teleconferences available from the American Society of Clinical Pathologists (2100 W. Harrison St., Chicago, Ill. 60612; phone 800/621-4142; in Illinois, 312/738-4890) or, in Pennsylvania, from the Coordinating Council for Continuing Education at Penn State University. One drawback, apart from the cost, is that you must coordinate your meeting time with the time of the presentation. Although teleconferences can be taped for later use, the original broadcast-featuring the "live" question-and-answer period-usually provides a superior educational opportunity.

Another excellent source of CE material is the film series of the Network for Continuing Medical Education (I Harmon Plaza, Secaucus, N.J. 07094; phone 201/867-3550). Films in this subscription series cover a wide variety of medical topics. Programs can also be purchased separately in either the VHS or Beta format.

Our hematology and microscopy sections offer two types of CE programs. The first type is directly related to our technical work and may feature lectures on iron deficiency anemia or thrombotic thrombocytopenia for hematology or on renal function or parasitology for microscopy.

I call the other type "general info meetings." Such programs broaden our understanding of our hospital and its service--or of health care in general-and might include a presentation on the role of the hospital's social services department.

*Professional tapes and videocassettes. These are usually available on loan. Scout the advertisements in lab journals, read the hospital newsletter, and ask sales reps for suggestions. For example, we screened "The Penn State Heart" and "Hospital Risk Management" at CE meetings. Both videocassettes were produced by our hospital and were available to any department, The hospital's department of safety and security provided "Hospital Hazards" and "Flashover," and nursing loaned us "CPR." We borrowed "Blood Gas Analyzers-An Overview" from a major manufacturer of lab instruments and reagents. Another vendor gave us "The Yellow IRIS," a videocassette on automated urinalysis produced as a sales tool.

* Instrument demonstrations. Any time you're interested in a new instrument, ask the sales rep for an in-house demonstration and use it for CE. Instrument demos are both educational and a great way to take a look at equipment before you decide to buy. Plus you get firsthand input from the staffers who will be operating the instrument. Ask to have the demonstration presented more than once so that laboratorians from other shifts can attend. Chances are the vendors will be eager to showcase their product. Our CE demonstrations have featured the Sonoclot, a platelet function instrument; the Clinitek 10 and Clinitek 200 urine chemistry analyzers (this demo helped us decide between the two models); the Advanced Instruments Model 3MO osmometer; Wescor Model 5500 vapor pressure osmometer; CellDyn 1600, a blood cell analyzer; and the Coulter S Plus STKR hematology system.

* Hospitalwide meetings and lectures. Watch bulletin boards and the hospital newsletter for announcements. If something sounds interesting, find out who is in charge and ask if you can send your staff. We've sent our laboratorians to employee health meetings, medical student lectures, medical staff conferences, grand rounds, and hematology patient rounds.

*Hospital open houses. These get-togethers may be held as new services are added or as current service areas expand, move, or are remodeled. We go to them all and find these get-acquainted sessions very enlightening. We've made CE visits to the hospital's new lithotripsy service, the emergency care department, and the helicopter facility. Open houses usually include a guided tour and a detailed discussion of the service provided. The sessions are very interesting, and most serve refreshments.

*Tours of other hospital departments. My staff loves this type of CE exercise. They like to get out of the lab, see how the rest of the hospital operates, meet other hospital employees, make new contacts, and learn more about the specialized services offered here. Most of the departments are happy to host tours-many seem pleased that we asked. Try to send the staff in small groups to keep the tour manageable. Over the last few years, we have toured the pharmacy, hospital food services, autopsy service, apheresis area, poison control center, critical care complex, vascular lab, and the medical graphics and biophotography department. Incidentally, if you'd like to take a tour but don't know what you want to see, scan the hospital phone directory for ideas.

* Guest speakers. You might invite speakers from other hospital services, the medical staff, clinical pathology faculty and residents, or technologists from other lab sections. Don't be afraid to ask anyone to speak to your staff; our chief heart transplant surgeon said "yes" without a moment's hesitation. Consider inviting your favorite physicians to give a lecture, and approach the doctors who drop by the lab regularly. Be specific about the topic and the length of the presentation. The few times we've been turned down, it has usually been because we couldn't pin down the topic. If the person seems hesitant about the topic you propose, ask him or her for suggestions.

Try to be flexible to accommodate the speaker's schedule. Ask permission to tape the meeting for those laboratorians unable to attend. Call the day before the presentation to confirm the time and place, and send a thank-you note afterward. Our guest speakers in hematology have included the director of the hospital's volunteer service; the transplant service coordinator; a nurse from the division of infectious disease; and a registered dietitian from the nutritional care department. The focus of these meetings was on services provided by the speaker's department, with a special emphasis on that group's role as part of the health care team.

We particularly enjoyed hearing a staff psychiatrist talk about the psychological problems of hemophiliacs. He chose the topic, using a lecture he had presented elsewhere. A few months ago, the hospital epidemiologist discussed the timely topic of universal precautions against AIDS. Our pathologists and clinical pathology residents have presented the following lectures"Acute Lymphocytic Leukemia, L2 Variant," "Premenstrual Syndrome," "Chronic Myelogenous Leukemia-Aggressive Phase," and "Transfusion Reactions." Technologists from other sections have presented "How to Calibrate an Automatic Pipet," "Lab Statistics-A Review," "Blood Bank Computer Programs," and "HLA Update."

*Section speakers. Staff members who present lectures benefit both themselves and their coworkers. Teaching others is the best way to learn. During performance appraisals, we ask senior staff members to consider presenting one or more lectures as an objective for their own professional development.

Reviewing a new or updated test procedure, for example, provides a practical educational experience . I can think of no better way to insure that all staff members have reviewed a new procedure and understand the changes. Staff members might also demonstrate a new piece of equipment or a new maintenance or troubleshooting procedure. Presentations from those who have attended a professional meeting keep the other staff members up to date and stress the privilege and responsibility of being allowed to travel.

There are many other possibilities for sectional programs. For example, lab trivia quizzes allow the staff to have some fun while learning. There is a commercial lab trivia game available, but developing questions based on your own lab's procedures might be even more useful. My group really enjoyed a quiz session in which we chose teams and competed against each other. I plan to continue collecting trivia questions so that we can have more of these contests.

Staff meetings may or may not provide an educational opportunity. A meeting that fosters problem-solving discussions is much more educational than complaint sessions.

Reviewing College of American Pathologists (CAP) proficiency survey materials is probably the single most valuable-and underutilized-educational resource. These materials are "free" in that they are already on hand. Most of the CAP survey modules work extremely well as CE presentations, particularly for hematology and microscopy. Unfortunately, the chemistry, syphihis serology, and immunology modules do not, since the CAP report in these areas consists mostly of comparative method data.

It is best to reorganize the survey data. For example, CAP provides clinical histories for the hematology and microscopy slides, identification lists, our reported results, and a breakdown of participant and referee results (plus discussion) on separate pages. This is unwieldy. I compressed the format so that the clinical history and master 1D list appear on the first page, with all the reported results and discussion on another (see Figure I). This is more convenient for both the presentation and for subsequent self-testing. I often supplement the CAP discussion with research of my own or use the discussion to emphasize our policy or reporting format for a particular cell or urine sediment structure.

It takes 20 to 30 minutes to present one survey, so I usually do them in pairs. Once I do the basic homework, I can give the same presentation several times. Thus a large number of technologists benefit from minimal preparation time. I currently give seven presentations of each CAP survey-two for the day shift, three for the evening staff, and two for the night crew.

The staff has voted the CAP slide presentations our most beneficial CE program because it pertains directly to our day-to-day lab work and relates that work to the patient (via the patient history).

With all these resources available, you might think setting up an in-house CE program is a snap. It's not, but if you have made the commitment to developing and maintaining a continuing education program, here are several tips that will enhance your chances of success:

Appoint a CE coordinator to be responsible for arranging the section's meetings. This person might be a senior staff member who is willing (or eager) to take on this special management responsibility.

Decide on the frequency of meetings. Start conservatively-meeting once a month or every other month-but make a commitment and keep it. You can always expand the program later. (We hold weekly CE meetings from September through May.)

Set a regular meeting time and location. Choose a time that fits your section's workload, and only consider lunchtime meetings if absolutely necessary. Hold meetings away from the bench to minimize distractions.

Decide how the section will be covered during the meeting. Schedule a minimum number of staff members to cover the section and carefully rotate the coverage so that all staff members are able to participate. Keep a record of rotation. Remind the staff that some sacrifices will probably be required, such as working a little harder to catch up or possibly pulling occasional overtime.

Try to schedule two sessions of each meeting, preferably on different days so that the maximum number of staff members can attend each program. If the speaker is someone from your own section, this shouldn't be a problem; and guest speakers will usually allow you to tape their talk.

Be flexible. Reschedule meetings if absolutely necessary due to reduced staffing or instrument problems, but don't cancel.

Keep the meetings manageable. Begin promptly, and if an hour is too much time away from the bench, try 30 or 45 minutes.

Keep accurate attendance records and make certain that laboratorians who present programs have their participation documented as well.

Consider making the program mandatory. I don't think this is unreasonable, as long as time away from the bench is provided and not taken from meal breaks or as mandatory overtime. After all, should we allow a medical technologist to discontinue his or her professional growth'? I require each staff member to log at least 20 in-house CE hours from the 35 to 40 one-hour meetings we offer annually.

Take advantage of these regular sessions to handle such administrative emergencies as last-minute staff meetings or reviewing a new policy or computer update.

Develop a meeting mentality. Train yourself to be on the lookout for CE possibilities. Read the bulletin boards as you walk down the halls. Be alert to staff questions or an unusual diagnosis that might be a great topic for a meeting. Let the lab director-and others-know of your interest in CE opportunities.

Once your CE program is running smoothly for the day shift, think about the other shifts. Not surprisingly, CE opportunities are most lacking on the second and third shifts. It's hard to line up speakers for these shifts, so I usually do the programs myself-at my convenience. For example, 7 p.m. meetings work well on the evening shift. I come in at 6:30 a.m. to meet with the midnight to 8 staff.

It is difficult to assess the benefits derived from an in-house CE, but I'm certain that our program has sparked the staff's interest in learning. I know this is true because of the problems I have encountered in deciding who will stay behind to cover the section. Staff members now place a very high priority on our meetings and usually accumulate well over the required 20 hours a year.

One sure sign that the benefits to my staff are significant is the fact that the technologists routinely suggest meeting topics. They realize that presenting a CE program is a golden opportunity to fill in the void when they encounter a technical problem, note an interesting diagnosis, or have questions about new procedures or methodologies.
COPYRIGHT 1989 Nelson Publishing
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Copyright 1989 Gale, Cengage Learning. All rights reserved.

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Title Annotation:continuing education for laboratorians
Author:Yapit, Martha K.
Publication:Medical Laboratory Observer
Date:Apr 1, 1989
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