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Training technologists for the late shifts.

Written evaluations of technologists after day-shift orientation

tell the late-shift supervisor where to start the fine-tuned portion of training.

Even though they had been oriented on the day shift of our 524-bed hospital laboratory, newly hired technologists used to arrive for their late-shift assignments as somewhat unknown quantities.

We were never sure how ready an employee was to assume duties on the shifts we supervised. True, we interviewed and hired every member of the evening and night staff. But we met with the day supervisors only at irregular intervals to discuss the progress of newcomers during orientation. There were no written evaluations and no laboratorywide performance standards for trainees.

Ours is a full-service laboratory, staffed 24 hours a day. Stat work is provided around the clock. The bulk of the routine testing is performed during the day, preop work and some routine tests are done during the evening shift, and the night shift concentrates on Stat work with limited routine testing.

Technologists on the two late shifts rotate through chemistry, hematology, and the blood bank.

They keep up on the latest developments in all three areas via log books, frequent meetings and conferences, and bulletins.

The evening shift, which has 12 full-time equivalents compared with seven for the night shift, sends one person to primary training whenever the lab acquires a new instrument. Since the evening staff possesses this expertise, it handles some orientation of its new employees.

For night employees, much more of the orientation takes place during the day. In the past, new employees would often join the night shift shortly before a three month evaluation was due at the personnel department. The night supervisor had scant opportunity to observe how well the employees worked.

We felt we needed a consistent approach, with all three day-shift sections, and evening and night instructors, using the same standards to evaluate new employees. We wanted a fair and accurate evaluation in writing at the time training was finished in a particular section.

Because technologists come to us with varying experience, they are at different stages of ability to perform on the bench even after the day-shift orientation. Written evaluations would help the lateshift supervisors determine where to start fine-tuned training of new employees. The evaluations would also be reviewed with employees, to make sure they knew where they stood concerning progress in each section, and incorporated into their records.

Hematology, chemistry, and the blood bank could not be judged in exactly the same way. We set about to create separate but similar evaluation forms. For example, instrumentation would be emphasized in judging work in our fully automated chemistry section but not in the blood bank.

No matter where the evaluation took place, however, we wanted to know about the employee's ability to work unaided and to meet peak demands for testing. Criteria covering attendance, initiative, and computer operation would also be the same for all three sections.

The chemistry evaluation we developed runs through every major instrument in the section (see Figure 1). Using this form, the chemistry supervisor or a designated evaluator may note that a trainee is ready to run the ACA alone and can troubleshoot that instrument but needs direct supervision on the Ektachem. And so on down the line with every instrument in the section.

Is the trainee familiar with our quality control and panic value procedures? Does he or she recognize malfunctions on an instrument? Are test results produced in a timely manner? How much supervision, if any, is needed? The chemistry evaluation was designed to answer these and other questions.

The hematology evaluation covers the instruments used in that section, manual and automated differentials, coagulation tests, and special procedures. Again, we want to know how the new trainee handles panic values, QC problems, and instrument malfunctions, how much supervision is needed, and if there is any problem coping with a large workload.

In the blood bank, we look for how well the trainee understands the theory, since he or she may work alone in the section. The questions about ability to work without supervision and handling a large workload are also pertinent here. Can the trainee do a good job on crossmatches and antibody identification? What about performance with non-cellular blood products? How familiar is the trainee with the many forms, log books, and work sheets that must be completed?

After the final criteria for assessing initiative, attendance, and computer operation, the evaluation form ends with a space for additional comments.

The form is given to the day supervisor at the time the new employee reports to a section. We feel day-shift orientation can be accomplished in a maximum of six weeks-one andone-half weeks in chemistry and hematology, and three weeks in the blood bank. Experienced technologists may not need that much time to master the basics, and some new graduates may need more.

Day and late-shift supervisors discuss the employee's progress throughout the orientation period, and they meet at the end to review the evaluation. Then the late-shift supervisor discusses the evaluation with the employee. From there, a plan of action is developed to help the employee improve performance in any deficient areas.

The supervisors and assistant supervisors on the late shifts conduct further training, as do senior evening technologists. To be chosen as trainers, technologists must have demonstrated thorough knowledge in the area of instruction and have a temperament suited to teaching.

We expect at least mid-range performance-the middle block of the performance standards in Figure 1-after someone has been on the job six months. That means, for example, that the employee should operate an instrument with minimal supervision. The highest performance rating, "thorough knowledge in all areas of operation," would probably be obtained only if someone had prior, extensive experience on the instrument.

Evaluation forms are not scored; the standards met by the trainee are simply checked off. We explaiin to trainers and trainees that the purpose is to help the supervisor determine the employee's level of expertise and the need for additional training.

We started using the evaluation forms last year. They were entered into a word processor, and we have updated and improved them several times since the original first drafts. Day supervisors and other trainers have suggested valuable changes.

For example, the performance standards had required a minimum of some troubleshooting ability along with basic knowledge of instruments. Trainers told us, however, that while all new employees acquire basic instrument knowledge, few learn troubleshooting in just a few weeks. We changed the evaluation forms to reflect this input.

Feedback has been positive. There was some initial reluctance to use yet another form, but now the day supervisors ask for the form if we forget to furnish it on the first day of orientation. This program has helped day and lateshift supervisors, trainers, and most important, our new technologists.
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Author:Lindemann, Alvina; Ramaley, Shirley A.
Publication:Medical Laboratory Observer
Date:May 1, 1988
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