Portland Community College | Portland, Oregon

Classification, laboratory findings and clinical correlation of myeloproliferative and lymphoproliferative disorders, leukemias, myelodysplastic disorders, lymphomas and various other white cell anomalies is presented.  Case studies are used for improving cell identification and differentiation skills and to practice correlating of laboratory results with clinical history and symptoms.  Principles of automated instrumentation are presented with emphasis on interpretation of automated results, histograms and scattergrams.  Introduces basic principle of flow cytometry and its application to clinical hematology.

• Correlate hematological findings with those generated in other areas of the clinical laboratory, patient symptoms and clinical history, to make appropriate and effective on-the-job professional decisions.
• Perform basic hematological laboratory testing, assess laboratory data and report findings according to laboratory protocol.
• Adapt hematology laboratory techniques and procedures when errors and discrepancies in results are obtained to effect resolution in a professional and timely manner.
• Distinguish normal and abnormal hematological laboratory findings to predict the diagnosis of hematological disorders and diseases.
• Recognize laboratory results consistent with leukemia and other white blood cell disorders.

The class is presented by means of lecture/discussion, audio-visual presentations, handouts, demonstrations, web based instructional media and other educationally sound practices. Comprehensive lab work requires demonstration of competency to receive a satisfactory grade. A laboratory manual is provided. The laboratory exercises provide an opportunity for students to employ the testing principles and methodologies discussed and allow for discussion, application and correlation of the concepts presented.  The student is expected to perform all laboratory procedures according to the criteria established by the department. 

Assessment methods may include written and practical examinations, homework assignments and discussion activities. Student knowledge application, laboratory performance, problem solving skills, punctuality and attendance, participation, and communication skills is assessed in each laboratory exercise utilizing an evaluation rubric that includes cognitive, psychomotor and affective learning domains.  

Course Themes:

• Leukocyte Disorders
  • Acute and chronic leukemia
  • WHO classification of acute leukemias and the general morphologic characteristics and other laboratory findings seen in each type of leukemia
  • Myeloproliferative neoplasms disorders and myelodysplastic syndromes
  • Lymphoproliferative disorders
  • Differentiation between Hodgkins and non-Hodgkins lymphoma
  • White blood cell anomalies and the usual clinical and hematologic findings seen in each condition
• Hematology Instrumentation
  • Principles utilized in automated instruments to count and differentiate blood cells
  • Interpretation of automated results including histograms, scattergrams and instrument flags
  • Principles utilized in flow cytometry and its application to hematology
• Correlation
  • General causes of a leukocytosis and leucopenia and correlation of the usual quantitative and qualitative white blood cell changes that occur with various disease states and physiologic conditions
  • Diagnosis prediction of red and white blood cell disorders from the correlation of hematology results with other laboratory findings, patient symptoms and clinical history.

Skills:

Knowledge and Application (Cognitive Skills):

• Cognitive processes, including
  • Explain hematology theory supporting test principles
  • Integrate knowledge and making informed judgments about hematology  test results  in the clinical setting
  • Formulate a clear, answerable question
  • Predict expected results
  • Follow written protocols and verbal instructions
• Analysis skills
  • Collect and organize data in a systematic fashion
  • Present data in an appropriate form
  • Assess the validity of the data (including integrity and significance)
  • Draw appropriate conclusions based on the results
• Troubleshooting and problem solving
  • Recognize errors or discrepancies in results during lab procedures
  • Select corrective actions for problem solving
• Safety skills
  • Recognize safety equipment and laboratory safety measures
• Communication skills
  • Discuss and present lab results or findings in the laboratory
• Interpersonal and citizenry skills
  • Work effectively in teams or groups so that the task, results, and analysis may be shared
  • Effectively manage time and tasks allowing concurrent and/or overlapping tasks to be done simultaneously, by individuals and/or within a group
  • Integrate knowledge and make informed judgments about general safety in everyday life

Performance (Psychomotor Skills):

• Utilize safety measures and equipment
  • Utilize adequate personal protective equipment, sharp container, fume hood and other safety devices
• Use a bright field microscope to view and interpret slides
  • Correctly set up and focus the microscope
  • Proper handle, clean, and store the microscope
  • Record microscopic observations according to laboratory protocol
• Perform differential counts
  • Differentiate white blood cells
  • Evaluate red blood cell morphology
  • Perform platelet and leukocyte estimations
  • Record results according to protocol

Professional (Affective) Skills:

• Demonstrate interest, enthusiasm, and willingness to learn as seen through active participation.
• Show initiative and motivation as demonstrated by independence in performing routine procedures, preparation before class, decreased need for supervision, willingness to go beyond the required assignments, and recognition of opportunities to improve quality and productivity of work.
• Adapt to stressful and/or new situations by maintaining composure and flexibility without compromising individual integrity.
• Exhibit teamwork through cooperation, courtesy, respect, and sensitivity towards others.
• Convey a professional attitude as shown by an appropriate level of confidence and a positive outlook toward work and other people.
• Demonstrate integrity as shown by the admission and documentation of errors, recognition of the potential danger of short cuts, and the maintenance of patient and co-worker confidentiality.
• Act responsibly and reliably as measured by punctuality, attendance, dependability, and quality of work.
• Respond favorably to supervision and feedback.
• Persevere until task is completed satisfactorily.