Hereditary hemochromatosis: a case study and review.

Hereditary hemochromatosis (HH) is a disorder of iron regulation that leads to excessive iron absorption. Over time, the resultant iron overload and deposition in tissue leads to various chronic diseases and premature death. Even though it is the most common genetic disorder among Caucasians in the U.S., hereditary hemochromatosis often goes undetected or unrecognized by healthcare providers. Laboratory tests provide effective, inexpensive means of screening for and confirming hereditary hemochromatosis. The clinical laboratory also plays a key role in hereditary hemochromatosis treatment, reduction of iron stores through therapeutic phlebotomy.

Mentoring for retention and advancement in the multigenerational clinical laboratory.

Retention of recent graduates and other laboratory practitioners in the workplace will play a key role in addressing current and projected shortages of clinical laboratory scientists (CLS) and technicians (CLT). In addition, with overrepresentation of the aging Baby Boomer generation in laboratory supervisory and management positions, it is crucial not only to retain younger practitioners, but to prepare them for assuming these important functions in the future. Mentoring, a practice commonly employed in other professions, is widely considered to be useful in employee retention and career advancement. Mentoring has probably been used in the clinical laboratory profession, but has not been well documented. In the clinical laboratory environment, potential mentors are in the Veteran and Baby Boomer generations, and new practitioners who could benefit from mentoring are in Generation X. Generational differences among these groups may present challenges to the use of mentoring. This article will attempt to provide a better understanding of generational differences and show how mentoring can be applied in the setting of the clinical laboratory in order to increase retention and promote career advancement of younger practitioners. A panel of five laboratory managers provided examples of mentoring strategies. Definitions, benefits, and examples of mentoring are addressed in the accompanying article, "Passing the Torch: Mentoring the Next Generation of Laboratory Professionals".

Laboratory managers' perceptions of the impact of teaching on the clinical laboratory.

OBJECTIVE: To determine managers' perceptions of the impact of teaching students on the clinical laboratory, including: productivity, costs, recruitment/new employee orientation, staff morale/attitude, and staff professionalism. Managers' views on responsibility for teaching and reasons for not having students were also determined. DESIGN: Written survey, randomized sampling. PARTICIPANTS: Five hundred laboratory managers certified by the National Credentialing Agency. MAIN OUTCOME MEASURES: Participants completed a forced-choice written survey consisting of demographic information and statements assessing the impact of teaching. RESULTS: Managers agreed with impact statements on professionalism, recruitment, and new employee orientation. They were also in agreement that clinical teaching is essential. Neutral responses were obtained for impact statements related to laboratory productivity, costs, and staff morale and attitude. Over 90% of respondents who presently had students or who had had students at one time indicated that they hired their graduates. CONCLUSIONS: Laboratory managers understand the importance of clinical education and the benefits to recruitment, new employee orientation, and staff professionalism. Managers are undecided about the effects of teaching on laboratory costs and staff productivity.

Characteristics of clinical laboratory technician students and effects on program outcome.

OBJECTIVE: To characterize student attrition in CLT education programs and relate program outcome (graduate, voluntary withdrawal, or academic dismissal) to student characteristics in three clusters of variables: academic, background and demographic characteristics, and environmental factors. DESIGN: Longitudinal, prospective study using a written survey and follow-up data collection. SETTING: Not applicable. PARTICIPANTS: 1527 students from 61 CLT academic-based educational programs located across the U.S. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Participants completed a forced-choice written survey eliciting demographic and background information and measuring variables related to their involvement with the academic program and environmental factors external to the college. Program outcome groups: graduates, voluntary withdrawals, and academic dismissals were compared on each variable. RESULTS: Graduates of CLT programs differ significantly from both academic dismissals and voluntary withdrawals on variables from all three variable clusters. CONCLUSION: Student characteristics exhibited early in CLT programs may help identify those students who are at risk of academic failure or voluntary withdrawal. Knowledge of factors associated with lack of CLT program persistence may help educators design successful intervention programs to enhance retention.

Minority student persistence in clinical laboratory education programs.

The objective of this study was to characterize minority student persistence in clinical laboratory scientist (CLS) and clinical laboratory technician (CLT) education programs and relate persistence to student characteristics and involvement in academic and social dimensions of college programs. A prospective, longitudinal study was done using written survey and follow-up data collection. Participants were 2,426 CLS and CLT students in academic-based educational programs across the United States. The participants completed a forced-choice survey eliciting demographic information and determining their interactions with social and academic dimensions of college and the clinical laboratory education program. Program outcome groups, i.e., graduates, voluntary withdrawals, and academic dismissals, were compared on each of 14 variables. Of the 2,426 participants, 80.7% graduated, 10.8% voluntarily withdrew, and 8.5% were dismissed for academic reasons. The outcome groups differed significantly on seven of eight academic involvement measures and five of six measures of social involvement. Student persistence behaviors varied by ethnic group, with African Americans more likely to leave for academic reasons than others. Graduation rates varied among the five ethnic groups. Differences were found among ethnic groups on five of eight measures of academic involvement and on two of six measures of social involvement. The results suggest that ethnic groups may differ in their levels of involvement in aspects of social and academic programs, thus explaining their different persistence behaviors. Understanding why some students are unsuccessful may form the basis for effective retention efforts.

Clinical laboratory scientists' view of the competencies needed for current practice.

OBJECTIVE: To provide a current description of competent clinical laboratory scientists (CLSs) that can be used as a guide for educators, practitioners, and students. DESIGN: A survey of clinical laboratory science (CLS) practitioners was developed to assess current work settings and important competencies in those settings. The survey also addressed graduate school enrollment and the impact of multi-skilling on current practice. SETTINGS AND PARTICIPANTS: 135 graduates of the Division of Clinical Laboratory Science at the University of North Carolina at Chapel Hill from 1987 to 1996. MAIN OUTCOME MEASURES: Participants' responses to questions about their current job titles, clinical specialty, type of institution, multi-skilling, graduate school enrollment, and the competencies they considered important for their jobs were analyzed to provide a description of current practice. RESULTS: The response rate for the survey was 73%. The majority of the respondents were employed as staff CLSs in medium to large hospitals. Thirteen percent of the respondents indicated that they had graduate degrees and an additional 13% were currently enrolled in a graduate or professional program. Fourteen percent of the respondents reported that they were working in the laboratory profession and were performing some health care skills not included in the CLS program. The graduates described 15 major areas of competence important for current clinical practice. The skill or competency mentioned most frequently by the respondents was interpersonal skills followed by flexibility. Competence in technical and scientific skills was ranked third and problem solving abilities was ranked fourth. CONCLUSION: The results of this study describe a CLS practitioner who is able to communicate well with others as a team member; flexible and open to change in the work environment; technically component; able to solve problems and correlate clinical information; organized; and involved in the management and leadership of the clinical laboratory. This description can help educators design curricula, guide practitioners' self assessment, and inform students who are considering a career in CLS.

Hematologic changes associated with infection.

Hematologic data provide information useful in both the detection of infectious disease and in the monitoring of patients diagnosed with bacterial, viral, fungal, and parasitic infections. Infection, typically accompanied by inflammation, results in changes within the hematopoietic system that can be observed as qualitative and/or quantitative changes in 3 cell lines: Leukocytes, erythrocytes, and thrombocytes. These alterations to hematopoietic cells are mediated via the influence of microbial toxins and cytokines on cellular proliferation, differentiation, and activation.

Themes in student attrition.

OBJECTIVE: To characterize similarities and differences in attrition in clinical laboratory science and clinical laboratory technician education programs by identifying general themes, specific academic and nonacademic reasons, and other relevant data. DESIGN: Mailed, written survey. PARTICIPANTS: Program directors of 208 clinical laboratory science and clinical laboratory technician educational programs. MAIN OUTCOME MEASURE: Responses to a 36-item forced-choice survey eliciting information about program attrition and the importance of reasons for student attrition. DATA SOURCES: Clinical laboratory science and clinical laboratory technician program directors across the United States. RESULTS: Students were found to withdraw from educational programs for both voluntary and nonvoluntary reasons in approximately equal numbers. Academic underpreparedness was a predominant general theme underlying student attrition in both levels of programs. The importance of certain specific reasons cited for student attrition differed significantly by program level. CONCLUSION: To be effective, it may be necessary to design retention programs that address academic concerns, as well as nonacademic concerns, of students. The level of educational program (clinical laboratory technician or clinical laboratory scientist) should be considered, because reasons for attrition vary in degree of importance. ABBREVIATIONS: CLT = clinical laboratory technician; CLS = clinical laboratory scientist; CAHEA = Committee on Allied Health Education and Accreditation. INDEX TERMS: Clinical laboratory technician students; clinical laboratory science students; education; attrition; retention.

Legal aspects associated with dismissal from clinical laboratory education programs.

OBJECTIVE: To review academic dismissals, students' rights in dismissal cases, and several key cases involving academic and disciplinary dismissals. DATA SOURCES: Recent academic literature and legal precedents. STUDY SELECTION: Not applicable. DATA EXTRACTION: Not applicable. DATA SYNTHESIS: Students involved in dismissals are protected under the principles of constitutional law and/or contract law, depending on whether the institution is public or private. The basis for dismissal from educational programs is either academic or disciplinary in nature. In academic dismissals, a student has failed to meet either the cognitive or the noncognitive academic standards of the program. In disciplinary dismissals, a student has violated the institutional rules governing conduct. Policies that affect progress in the program and the dismissal process should be published and distributed to students, as well as reviewed for consistency with institutional policies. CONCLUSION: The amount of documentation needed in the defense of a dismissal decision has not been specified, but, in general, more is better. Procedures are suggested as a guide to dismissals in clinical laboratory programs.

Legal issues relevant to clinical laboratory education program admissions.

OBJECTIVE: To address the basic legal requirements for admissions, admissions standards, student and applicant records, and discrimination in admissions for clinical laboratory science (CLS) and clinical laboratory technician (CLT) educational programs. DATA SOURCES: Recent academic literature and legal precedents. STUDY SELECTION: Not applicable. DATA EXTRACTION: Not applicable. DATA SYNTHESIS: CLS and CLT educational programs typically practice selective admissions. Program directors and faculty need to be aware of the issues relating to student selection that may have legal implications. Admissions practices should be guided by three basic legal requirements: that the selection process not be arbitrary or capricious, that the program adhere to its published admissions standards and honor admissions decisions, and that the program not have admissions policies that discriminate on the basis of race, gender, age, disability, or citizenship. Specific guidelines are offered for applying these legal requirements to the admissions practices typically used by CLS and CLT programs, including published admission policies and standards, application forms, interviews, rating of noncognitive attributes, and communication with applicants. CONCLUSION: Admissions practices in CLS and CLT programs need to be guided by the three basic legal requirements.

Student retention methods in clinical laboratory education programs.

OBJECTIVE: To document the use of student retention methods in clinical laboratory scientist (CLS) and clinical laboratory technician (CLT) education programs sponsored by academic institutions. DESIGN: Mailed survey. SETTING: Not applicable. PARTICIPANTS: Program directors of 182 CLS and CLT education programs. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURE: Responses to a 52-item, forced-choice s survey of retention methods used and program enrollment data provided by survey respondents. RESULTS: All programs are using retention methods, although only 36% of the programs have official retention programs for all students, while 14% have programs targeting minorities. A wide variety of retention methods are used, maintenance-phase activities being used with the greatest frequency. CLS and CLT programs differ in their use of certain retention methods and in some of the phases of the retention process emphasized. CONCLUSION: This study describes the use of a wide variety of retention methods currently employed nationwide. Educators can use the results of this study as a baseline for evaluating their own programs' retention efforts in attempting to address the problem of student attrition.