Portland Community College | Portland, Oregon

Course is designed to allow students to develop the skills, knowledge, and attitude required to function in a professional manner in the clinical laboratory setting.  Includes approximately 320h of clinical practice under a qualified clinical site trainer during 10 consecutive weeks (4 days a week).  Includes basic procedures for safety, specimen processing, laboratory information systems and record keeping, use and maintenance of instruments/equipment, and quality assurance within each subject area of blood bank, chemistry, coagulation, hematology, microbiology, urinalysis, and phlebotomy.  

Upon successful completion of the course students should be able to:

1. Demonstrate routine laboratory tasks and specimen collection accurately, timely, and professionally using laboratory software.
2. Perform specimen testing, quality control and result reporting in accordance with laboratory protocol.
3. Adapt laboratory techniques and procedures when errors and discrepancies in results are obtained to effect resolution in a professional and timely manner.
4. Employ universal precautions relevant to the clinical setting.
5. Demonstrate professionalism, confidentiality, respect and integrity in the clinical setting.  

The course is presented by means of supervised practice in an affiliated clinical laboratory setting, complemented by web based instructional media, handouts, informal discussion, demonstrations, observation of  laboratory procedures.  The laboratory setting allows students to develop their skills under supervision of laboratory personnel to help them get prepared to attain proficiency at career entry level.  Knowledge, technical skills and professionalism are emphasized.

Student knowledge application, laboratory performance, problem solving skills, punctuality and attendance, participation, and communication skills are assessed in each laboratory department utilizing an evaluation rubric that includes cognitive, psychomotor and affective learning levels. In addition, students are required to take online quizzes in each of the departmental areas and to maintain a portfolio of clinical laboratory experience, procedures and instrumentation. The student knowledge application, technical performance and demonstration of personal growth determine competency and grade. The student receives an evaluation from each departmental area and the overall student performance is reviewed and shared with the student by the Clinical Coordinator at the end of the term.

Themes:

• Professional Development
  • Review and comply with major policies and expectations of clinical affiliate and the college.
  • Consistently display the attitude and traits expected of a clinical laboratory professional.
  • Demonstrate competent written, listening and oral, communication skills expected of the clinical laboratory professional.  
• Safety
  • Locate and discuss the proper use of the clinical laboratory safety equipment and devices.
  • Demonstrate understanding of the OSHA blood borne pathogens standard including the purpose, epidemiology, modes of transmission and protective measures against exposure.
  • Discuss actions to be taken in event of fire within the assigned laboratory/hospital.
  • Identify basic guidelines for safe use of chemicals including proper labeling, protective measures, location and use of SDS, and disposal of hazardous chemicals.
  • List guidelines for electrical and mechanical safety.
• General Laboratory Knowledge, Procedures, and Processes
  • Demonstrate proper care and safe use of basic laboratory equipment including the microscope, centrifuge, pipets and glassware.
  • Participate in daily maintenance and other basic laboratory responsibilities.
  • Demonstrate understanding of lab math and calculations including scientific notation, dilutions, conversion factors, standard curve, and formulas.
  • Demonstrate accurate and skillful use of the laboratory information system and other record keeping systems.
  • Define and demonstrate knowledge of QA including QC and Westgard rules.
  • Describe key terms for workload prioritization and adhere to prioritization policies.
• Blood Bank/Transfusion Services
  • Define common terminology and discuss basic theory for primary aspects of the blood bank including antigen, antibody, compliment, agglutination, antiglobulin, ABO-Rh and other common systems, antibody identification, transfusion therapy, transfusion reactions, and hemolytic disease of the newborn.
  • Demonstrate knowledge and skill in procedures and protocol for ABO-Rh, IAT, DAT, transfusion therapy and antibody identification.
  • Identify common sources of error and discrepancies in testing.
• Chemistry
  • Discuss basic theory and principles of common assays.
  • Demonstrate proficient operation of instruments in performing assays.
  • Demonstrate knowledge of instrument maintenance, standardization, QC, and troubleshooting.
  • Identify sources of error in measuring common assays.
  • Discuss critical values, normal ranges, clinical significance and disease states associated with common assays.
  • Compare and contrast automated instruments including major components and principles of operation.  
• Coagulation
  • Discuss theory and principles of hemostasis including synthesis of plasma and tissue factors, extrinsic and intrinsic coagulation, and platelet function.
  • Discuss theory and principles of common coagulation tests including PT, APTT, fibrinogen, and D-dimer.
  • Demonstrate proficient operation of instruments used in coagulation testing and demonstrate understanding of instrument maintenance and QC.
  • Discuss normal ranges, critical values, clinical significance and disease states associated with common coagulation tests.  
• Hematology
  • List abnormal RBC and WBC variations and discuss the clinical significance of each.
  • List the normal ranges/values for all common hematology procedures including differentials, automated cell counts, and red cell parameters and indices.  Discuss the clinical significance of abnormal values of each.
  • Prepare samples for manual cell counts and perform manual cell counts.
  • Prepare and stain differential smears, and perform normal and abnormal differentials.
  • Demonstrate proficient operation of automated hematology instruments, including instrument maintenance and QC.
  • Use automated instrument to determine cell counts, red cell parameters, and leukocyte distribution. 
  • Interpret results of automated instruments including histograms and scattergrams.
  • Perform other common hematology procedures including sedimentation rate, hematocrit (spun), reticulocyte count, and sickle cell screen.  
• Microbiology
  • Describe common normal and abnormal isolates and discuss disease manifestations of each.
  • Describe and perform primary culture set-up from clinical material.
  • Discuss principles, rationale, use and interpretation of media to isolate and identify isolates in routine cultures.  Demonstrate proficient use of routine media.
  • Explain and perform all phases of the Gram stain including smear preparation, stain, evaluation, reading, reporting and interpretation.
  • Describe principle, rationale, uses and interpretation of routine biochemical tests for organism identification.  Demonstrate proficient use of routine biochemical tests.
  • Quantitate, describe and identify colonies growing on routine media. Correlate Gram stain with colonial morphology on culture plates.
  • Read out and report results from genital, urinary, and throat culture plates.
  • Set-up and interpret the antibiotic susceptibility test.
  • Perform other common microbiology tests/procedures.
• Urinalysis
  • Discuss the principle and limitations of each dipstick test for chemical analysis of the urine.
  • State the normal ranges/values for pH, specific gravity, and 24 hr volume of the urine.  Discuss the clinical significance of abnormal values for each.
  • List various cells and formed elements found in the urine and state normal ranges/values for each.  Discuss clinical significance of increased numbers of cells and formed elements.
  • Perform, report and interpret macroscopic examination and chemical analysis of the urine.
  • Perform, report and interpret microscopic examination of the urine sediment.      
• Specimen Collection and Processing
  • Identify components of collection systems and demonstrate their appropriate use.
  • Discuss the role of the phlebotomist and display professional behavior in dealing with patients, their family, and the public.
  • Appropriately and successfully collect blood specimens from venipuncture and skin puncture sites.
  • Prepare, process, and distribute specimens in order of priority, identifying any unacceptable specimens.  

Skills

Knowledge and Application (Cognitive Skills):

• Cognitive processes
  • Explain  theory supporting test principles
  • Integrate knowledge and make informed judgments about 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)
  • Recognize errors
  • 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

Performance (Psychomotor Skills):

• Utilize safety measures and equipment
  • Utilize universal precautions
  • Utilize adequate personal protective equipment, sharp container, fume hood and other safety devices
• Handle samples, reagents, materials and equipment with care and caution
• Dispose of waste in an appropriate manner
• Perform laboratory tasks
  • Monitor, stock and store laboratory reagents and samples
  • Disinfect benches and equipment
  • Perform maintenance of equipment and instruments
• Perform laboratory testing in the areas of coagulation, body fluids, microbiology and  bloodbank
  • Operate equipment and instrumentation correctly
  • Handle specimens, materials and reagents correctly
  • Report results according to laboratory protocol
  • Operate LIS correctly and with ease

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.