1 Microbiology Clinical Intensive Rotation- Education’s Response to Changes in Industry Karen Peterson, M.S., MLS(ASCP), University of North Dakota Shannon Jongeward, M.S., MLS(ASCP) CM , University of North Dakota 1 Objectives Upon completion of this session, the participant will be able to: • Identify changes in clinical laboratories that are having a direct impact on Medical Laboratory Science programs • Conceptualize a clinical rotation in a student laboratory setting • Demonstrate entry level competence achievement in a non-traditional clinical rotation 2 Healthcare Culture • Healthcare industry is changing • i.e. PAMA, Value-based care models • Healthcare facilities looking at ways to remain financially viable • Forcing laboratories to consolidate or outsource testing Budget Cuts Department Outsourcing Fewer Clinical Sites Fewer Students Workforce Shortage 3 NAACLS Requirements • Standard VIII.A.2 • MLS Curriculum Instructional Requirements • Address Pre-analytical, analytical, post-analytical components for several laboratory services in 7 different scientific areas 4 Impact on Educational Programs • Clinical sites out-sourcing • Microbiology and Blood Bank major departments affected • Responsibility placed back on programs 5 • CLSEDUC discussion list • Northcentral Tech College, WI • Madison Area Tech College, Madison WI • Wayne State University, Detroit • Ivy Tech Community College Southern Indiana • Farmingdale State College, Farmingdale NY • Quincy College, Quincy MA • Brigham Young University, Provo UT • St. Philip’s College, San Antonio TX • Stark State College, North Canton Ohio • York College CUNY • Wenatchee Valley College, WA • Auburn University, Montgomery AL • University of Wisconsin, WI • Austin Peay State University, Clarksville TN • St. Luke's Hospital, Kansas City 6
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Microbiology Clinical Intensive Rotation-
Education’s Response to Changes in Industry
Karen Peterson, M.S., MLS(ASCP), University of North Dakota
Shannon Jongeward, M.S., MLS(ASCP)CM, University of North Dakota
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Objectives
Upon completion of this session, the participant will be able to:
• Identify changes in clinical laboratories that are having a direct impact on Medical Laboratory Science programs
• Conceptualize a clinical rotation in a student laboratory setting
• Demonstrate entry level competence achievement in a non-traditional clinical rotation
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Healthcare Culture• Healthcare industry is changing
• i.e. PAMA, Value-based care models
• Healthcare facilities looking at ways to remain financially viable
• Forcing laboratories to consolidate or outsource testing
Budget Cuts Department Outsourcing
Fewer Clinical
Sites
Fewer Students
Workforce Shortage
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NAACLS Requirements
• Standard VIII.A.2• MLS Curriculum Instructional Requirements
• Address Pre-analytical, analytical, post-analytical components for several laboratory services in 7 different scientific areas
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Impact on Educational Programs• Clinical sites out-sourcing
• Microbiology and Blood Bank major departments affected
• Responsibility placed back on programs
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• CLSEDUC discussion list
• Northcentral Tech College, WI
• Madison Area Tech College, Madison WI
• Wayne State University, Detroit
• Ivy Tech Community College Southern Indiana
• Farmingdale State College, Farmingdale NY
• Quincy College, Quincy MA
• Brigham Young University, Provo UT
• St. Philip’s College, San Antonio TX
• Stark State College, North Canton Ohio
• York College CUNY
• Wenatchee Valley College, WA
• Auburn University, Montgomery AL
• University of Wisconsin, WI
• Austin Peay State University, Clarksville TN
• St. Luke's Hospital, Kansas City
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Impact at UND• Impacting students at UND close to 10
years• MCIR – 4th year
• Currently • 63 total sites, 11 out-sourcing microbiology
• Anticipate additional sites
• Facility size is not a factor7
VA Medical Center-Spokane
Cavalier County Mem Hospital‐Langdon
Sanford Medical Center‐Vermillion
Rainy Lake Medical Center ‐ International Falls
Park Nicollet‐St. Louis Park
Mayo Clinic Health System‐Austin
Other sites that outsource microbiology
Current sites with students
Students able to rotate in separate facility
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Options Examined
• Fewer clinical sites was NOT an option
• Considered asking other sites to take these students• Creates additional complications
• Non-traditional options
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Solution
Microbiology Clinical Intensive Rotation (MCIR)
• Sub-committee formed to plan details
• Requirements: Emulate a clinical rotation
Let the show begin!
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When are we going to teach
it?
Where would we
get samples?
Issues
Incubator space?
What other resources
are needed?
How many cultures? Automation?
Who was going to teach it?
What types of cultures?
How are we going to fund
this?
Serology?
Where are we going to
do this?
How long will the rotation
be?
How many
faculty needed?
How many students?
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Program Overview
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Undergraduate Program
All routes complete the professional program through
UND• On-line course work
• 12 weeks on campus in the summer
• 27 weeks at a clinical site 13
Traditional 2+2 4+1
WCAMLS 3+1 MLT to MLS
Routes
Mayo Cohort
Categorical
Microbiology Courses
All Students:• Summer: MLS 478 Clinical Microbiology I
• Clinical Rotation: MLS 484 Clinical Microbiology II and MLS 495 Clinical Microbiology III
Routes Prior Microbiology Courses
Traditional 2+2 MBIO 202 Intro to Medical Microbiology LectureMLS 394 Medical Microbiology
Traditional 4+1 Undergraduate micro
WCAMLS 3+1 Curriculum aligned microbiology
MLT to MLS Undergraduate microMLS 394 Medical Microbiology
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MLS 478 Clinical Microbiology I• 10 total labs, 3 ½ hours each
• Station based• Perform and interpret identification testing for Staph, Strep, Strep-like, Enterococcus,
• Rubric used to evaluate performance during the microbiology clinical rotation
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The Pilot Episode2015
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MCIR 2015 Pilot EpisodeHow many students? 8
Where are we going to do this? The UND MLS biohazard lab. • Other options were limited and complicated
Who is going to teach or facilitate it?
• Collaborated with Riverview in Crookston, MN• Outside instructor
• Allowed students to get another perspective
• Hired the lab manager to facilitate this course as well as provide samples
• Karen and Shannon co-instructors• Help from other faculty
• Provide individual bench teaching
How many faculty are needed? Aimed for a 1:2 ratio• Faculty sat between 2 students
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MCIR 2015 Pilot EpisodeWhen? Immediately after Summer Session
• August 17 – September 4, 2015
Considerations• Student housing • Department schedule• Outside instructor availability• Student/Faculty/Staff burnout• Other course responsibilities for students
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How long will the rotation be? 3 weeks, 4 hours each day• Students completing other classes on-line prior to
clinicals
Where would we get samples? Contracted with collaborating lab• Smaller lab, limited samplesAltru Health System• “Filled-in” samples
What types of cultures? • Sputum, throat, Beta Strep screen back-up, aerobic wound, anaerobic wound, blood, genital, ear, eye, urine
How many cultures? Aimed for 5 each day.• Dependent on coordinating lab• Each student saw a total of 95 cultures
MCIR 2015 Pilot Episode
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MCIR 2015 Pilot EpisodeAre we going to incorporate automation?
Vitek• Students transported to facility to set up cultures
Other resources needed? Standard Operating Procedures• Provided copies of Riverview SOP’s,
Requisitions and report forms
Is there enough incubator space?
OK this rotation• 2 table top • 1 double door table top
How will we fund this? General department funds
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Execution • Each student has their own workstation