[Histonet] RE: CAP Gen.55500

Thu Feb 21 18:14:21 CST 2013

Michelle, The competencies must be keyed to the persons job description. You hired the person with some kind of assurance they could do the work for a particular job. They them must be trained into your system for that job. 

1.       How do you do your training before you start your competency?

A:  The training is driven by a checklist of whatever it is they need to be trained at. You assume they know how to cut sections but you will orient them to the microtome, etc that your lab uses, show them how it works and then have them do it.  Once they demonstrate they can do it, you have completed that portion of training and you can also sign off their competency.  Then you go down the checklist. It may take many months before they complete the entire training if they are expected to be general histotechs rotating to all sections.

2.       How do you differentiate initial training from initial competency? 
A: Training first, then competency. Even if they "know" how to do it, there will be differences in the way your lab does it verses what they have done elsewhere. The key is for them to know how to do it in your lab and what you expect from them.

3A        Is semiannually after the date of hire?  Or after training?  Or not until after initial competency?  
A: They are hired, they are trained and at 6 months you review their competency and give a 6-month evaluation. We keep records of all the cases they do in the first 6 months and use that as evidence of competency. You need to determine if they are done training, need more work, etc. After that they are reviewed annually. (so, initial hire, 6 month competency review, then at 18 months they get their first annual review)

3B And how does that apply to skills that would only be utilized once or twice a year (such as a special stain that you do not perform on a routine basis but still offer)?
A: there will always be some things that are not done very often. We only include "routine" processes in the initial training and competency. They can be trained in rare tests at the time those come in. After they are trained we require people to do at least one of the rare tests per year, even on a control, to maintain competency. If they do not do that they are taken off the list of people who can do that test and must retrain.

4.       How do you train without using actual patients?  Example...accessioning, embedding, processing, etc
A: all LIS have TEST modules that can also be loaded with dummy patients to use as training modules as well.
All other histology training can be done initially on excess tissue saved for that purpose. You can get bx needles and make your own biopsies to train people to embed well. Etc. Make paraffin blocks from excess tissue of various types for initial microtome training. Use controls for special stains. Etc. 

5.       What template do you use to incorporate all six elements that are listed?
A: We have a standard institution-wide template for this. It is up to each area to fill it with the job description that applies and determine how the elements are applied. It is a lot of work initially, but pays off in standardized evaluations later on.

6.       What are you incorporating as your "test system"?

A: The test system is your standard procedures, but no one actually takes part in the entire system 9ie, tissue procurement to reporting). BUT they must know the elements of each part to understand the whole. So, you can educate them about the parts that take place outside the lab, but they are trained on the parts that take place in your lab that they will actually do. I stress that understanding the entire test system and their part in it is very, very valuable to their understanding of their role.

Have "fun!"

Tim Morken
Supervisor, Electron Microscopy/Neuromuscular Special Studies
Department of Pathology
UC San Francisco Medical Center

-----Original Message-----
From: histonet-bounces <@t> lists.utsouthwestern.edu [mailto:histonet-bounces <@t> lists.utsouthwestern.edu] On Behalf Of Michelle Lamphere
Sent: Thursday, February 21, 2013 12:02 PM
To: 'histonet <@t> lists.utsouthwestern.edu'
Subject: [Histonet] CAP Gen.55500

Good afternoon
We were wondering how other labs handle their training/competencies in response to the revised Competency Assessment question in the Gen Lab portion of the checklist. (GEN.55500)

1.       How do you do your training before you start your competency?

2.       How do you differentiate initial training from initial competency?

3.       Is semiannually after the date of hire?  Or after training?  Or not until after initial competency?  And how does that apply to skills that would only be utilized once or twice a year (such as a special stain that you do not perform on a routine basis but still offer)?

4.       How do you train without using actual patients?  Example...accessioning, embedding, processing, etc

5.       What template do you use to incorporate all six elements that are listed?

6.       What are you incorporating as your "test system"?

I really appreciate any insight or advice you can offer.  Thank you!

Michelle M Lamphere, HT (ASCP)
Senior Tech, Histology
Children's Medical Center
1935 Medical District Drive
Dallas, TX  75235
Office :214-456-2798
Histology: 214-456-2318
Fax:  214-456-0779

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