Examining the role of diversity, equity, and inclusion in mitigating workforce burnout in laboratory medicine.

OBJECTIVES: The clinical laboratory workforce plays a crucial role in health care delivery, yet little is known about the unique pressures and challenges this workforce faces. The objective of this study was to identify factors that contribute to burnout, discrimination, exclusion, and inequity in pathology and laboratory medicine. METHODS: A nationwide survey was conducted in 2 phases. In phase 1, 2391 laboratory professionals were surveyed over a 1-week period about their experiences with burnout, discrimination, and work-related stress. In phase 2, the survey was extended to 1 month and questions were added to elicit more detailed information about diversity, equity, and inclusion (DEI) as well as wellness. RESULTS: Results showed a high prevalence of burnout, discrimination, and stress among laboratory professionals, with significant differences among certain demographic groups. Women, Black, indigenous, or people of color individuals and those with disabilities reported higher rates of discrimination. The study also showed a need for mentorship and resources to address educational barriers. CONCLUSIONS: Findings from this study highlight the urgent need for interventions to address burnout, discrimination, exclusion, and inequity in the laboratory workforce. Initiatives to increase workforce diversity, promote mentorship and diversity training programs, and improve recognition of the laboratory workforce are recommended. The results underscore the pressing need to addressing the challenges and apprehensions laboratory professionals face, including enhancing recognition of their role in patient care, tackling systemic problems related to discrimination and equity, and enhancing the provision of support and resources for managing burnout and fostering well-being.

Using biological constraints to improve prediction in precision oncology.

Many gene signatures have been developed by applying machine learning (ML) on omics profiles, however, their clinical utility is often hindered by limited interpretability and unstable performance. Here, we show the importance of embedding prior biological knowledge in the decision rules yielded by ML approaches to build robust classifiers. We tested this by applying different ML algorithms on gene expression data to predict three difficult cancer phenotypes: bladder cancer progression to muscle-invasive disease, response to neoadjuvant chemotherapy in triple-negative breast cancer, and prostate cancer metastatic progression. We developed two sets of classifiers: mechanistic, by restricting the training to features capturing specific biological mechanisms; and agnostic, in which the training did not use any a priori biological information. Mechanistic models had a similar or better testing performance than their agnostic counterparts, with enhanced interpretability. Our findings support the use of biological constraints to develop robust gene signatures with high translational potential.

Workplace Bullying in Pathology and Laboratory Medicine.

OBJECTIVES: The specific aims of the study are to explore the prevalence of workplace bullying and to understand the impact of bullying on individual wellness in order to facilitate the development of future organizational solutions to mitigate workplace incivility. METHODS: Cross-sectional data were collected via a web-based survey to gather exploratory demographic information and to assess the relationships between intensity of the exposure to the negative acts with laboratory productivity. Associations between laboratories offering resources to employees and their impacts on productivity and professional job fulfillment were also explored. RESULTS: Results of the survey showed that over two-thirds of laboratorians (68.56%) were classified as victims of workplace bullying, and the perpetrator is most likely a peer of the victim (55.3%). The study revealed the intensity of workplace incivility was positively correlated with the number of sick days taken by the laboratory practitioner (F(2, 217) = 24.245, P < .001). Facilities with a supportive work environment were also associated with a reduction in the number of sick mental days taken (P < .001), a proxy for improved work and health outcomes. CONCLUSIONS: The results of this study shed light on the prevalence of incivility at the workplace and offer evidence on the importance of providing a supportive work environment toward reducing workplace bullying.

On Pathology Laboratory Recruitment and Retention.

OBJECTIVES: The specific aims of the study are to analyze relationships between the personality traits of laboratory professionals and choice of profession and preferred work settings. METHODS: Data from practicing laboratory professionals were collected via a web-based survey tool to gather information about personality types, choice of profession, and work setting preferences among medical laboratory professionals. RESULTS: Results of the survey showed that INFJ (Introversion, Intuition, Feeling, Judging) is the most common medical laboratory personality type across the various laboratory work settings and that there are no significant differences between the practitioners' personality type and the choice of profession within pathology. The study revealed laboratorians from higher-volume laboratories were 1.2 times more likely to prefer Judging than lower-volume laboratories, and younger medical laboratory practitioners were 2.3 times more likely to gravitate toward Perceiving than their older counterparts. CONCLUSIONS: The results of this study shed light on how employers can build on the personality preferences of the laboratory workforce to improve personal job satisfaction and laboratory productivity, quality, and work culture. The research implications are useful for laboratory recruitment and retention.

Frontline Workers in the Backrooms of COVID-19.

OBJECTIVES: To review the response to the coronavirus disease 2019 (COVID-19) pandemic in a forensics center that integrates an academic department of pathology with multiple regional county medical examiners' offices. METHODS: Faculty and staff were asked to volunteer stories, data, and photographs describing their activities from March through May 2020. The information was assembled into a narrative summary. RESULTS: Increased deaths challenged capacity limits in a hospital morgue and a large urban medical examiner's office (MEO) successfully managed by forensic teams and monitored by an institutional command center. Autopsies of suspected and proven cases of COVID-19 were performed in both facilities. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) testing of decedents was performed in a MEO serving a large urban area. Scene investigators worked directly with families to meet needs unique to a pandemic. Artful photographs of decedent's hands and/or tattoos were offered to those unable to have in-person viewings. Pathologists and social workers were available to families of the deceased and created novel solutions to facilitate the grieving process. CONCLUSIONS: Forensic pathology is important to successfully navigating emerging diseases like the COVID-19 pandemic. Direct conversations with families are common in forensic pathology and serve as a model for patient- and family-centered care.

The American Society for Clinical Pathology's Job Satisfaction, Well-Being, and Burnout Survey of Laboratory Professionals.

OBJECTIVES: To examine job satisfaction, well-being, job stress, and burnout among laboratory professionals. METHODS: The study utilized a cross-sectional survey design. The survey was administered online via the American Society for Clinical Pathology's survey tool, to elicit information about job satisfaction, well-being, job stress, and burnout among medical laboratory professionals. RESULTS: Although this survey shows high job satisfaction among respondents, overall job-related stress is high and burnout is prevalent. The majority of the respondents rated their work-life balance as "fair." The main contributing factors to job stress, burnout, and work-life balance are quantity of workload and understaffing. CONCLUSIONS: Based on the results of this survey, creating targeted interventions may help improve the quality of well-being programs for laboratory professionals. A comprehensive wellness program developed at the institutional, local, and national levels may improve morale and alleviate the recruitment and retention challenges faced by medical laboratory professionals.

The American Society for Clinical Pathology's Job Satisfaction, Well-Being, and Burnout Survey of Pathologists.

OBJECTIVES: To examine job satisfaction, well-being, job stress, and burnout among pathologists. METHODS: The study utilized a cross-sectional survey design. The survey was administered online via the American Society for Clinical Pathology's (ASCP's) survey tool to elicit information about job satisfaction, well-being, job stress, and burnout among pathologists. RESULTS: Job satisfaction is high and well-being is rated fair to good by most respondents. However, feelings of anxiety or worry about work, high levels of stress, and burnout are prevalent among pathologists. The main contributing factor to job stress, burnout, and work-life balance is quantity of workload. CONCLUSIONS: Creating targeted interventions based on the results of this survey may help improve the type and quality of wellness programs for pathologists. Trust among team members, managers and clinicians, and institutions can help reduce stress and increase collaboration, engagement, and motivation.

Learning Styles in Pathology: A Comparative Analysis and Implications for Learner-Centered Education.

Initiatives like "American Medical Association (AMA)-Reimagining Residency" and "Accreditation Council for Graduate Medical Education (ACGME)-Next Accreditation System" are examples of a paradigm shift toward learner-centered pedagogy in resident education. Such interventions require an understanding of the basics of the learning process itself. This study aimed to identify preferred learning styles in pathology with the intent to use specialty-specific pattern data, if any, to improve pathology training modalities. Kolb's learning tool questionnaire was sent to pathology-inclined medical students, pathology residents, fellows, and faculty in 5 academic programs. Data from 84 respondents (6 students, 37 residents, 12 fellows, 29 attendings) were analyzed. There was remarkable similarity in learning styles of fellows and faculty, revealing a dominance of observational learning styles ("assimilating" and "diverging") that was consistent with pathology being a visual field. In contrast, residents showed dominance of "learn by doing" styles ("converging" and "accommodating"). Residents' stratification by training year showed a scattered distribution with an upward trend toward "learn by doing" behavior. While the difference in styles between residents and faculty/fellows may be due to a generational gap, transition from medical school, or acquisition of technical skills required for grossing specimens, this is an opportunity for adopting blended learning models and active learning processes to cater to residents' different styles and to allow for flexibility to use all styles as and when needed. Based on these findings, we hypothesize that partnering juniors and seniors with similar styles has a potential for successful mentorship and exploration of other psychometrics is recommended for further understanding and improvement of pathology training.