Building competency in clinical labs with MTS training
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This document discusses how to use the Medical Training Solutions (MTS) website for training and competency assessment in clinical laboratories. MTS offers engaging online training modules covering a wide range of laboratory topics, as well as tools to document training and evaluate competency. Laboratories can use MTS to address audit findings, provide initial and ongoing safety training for staff, and act as a reference resource. The presentation teaches users how to access MTS, navigate the training library, create customized competency tests, and utilize reporting features to track training progress. In conclusion, MTS is a valuable free resource that can help laboratories standardize training procedures and maintain compliance.
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Building competency in clinical labs with MTS training
- 1. Authored by Heidi Hanes, MT (ASCP) SH Presented by Arden Bongco, MT (AMT); RT MTS- Refresher 1
- 2. Building Competency in Today’s Clinical Laboratory 2
- 3. MTS -Medical Training Solutions • For those who have not heard of this website, it was developed by the University of Washington - Department of Lab Medicine. • SMILE has had a subscription to this site since August 2008. • All SMILE-supported international labs are offered the opportunity to use this web site for training and competency purposes at no cost. 3
- 4. MTS Training and Competency System features: 1. Engaging video, animation, and high quality digital images. 2. Online access for lab staff and students. 3. Simple test interfaces for Continuing Education credit. 4. Inspection documentation and reports. 5. An extensive library of topics. 6. Automated e-mail notification for participants. 4
- 5. Objectives •At the end of this presentation you should be able to: • Utilize MTS in your lab for safety training. • Understand how to use MTS for training and competency testing. • Use MTS effectively as a resource to assist with Investigation Report follow-up and solving other laboratory problems. • Use MTS as a reference resource. • Utilize MTS documentation system. 5
- 6. Training Library MTS training courses teaches staff and students essential laboratory skills which can be used for: 1. Initial training for staff and students. 2. Continuing Education. 3. Cross training lab personnel. 4. Reference and remediation. 5. Safety training. 6
- 7. Training Library Modules 58 modules including – Orientation Safety Patient Safety Specimen Collection Specimen Transport Specimen Processing Utilization Management Microscopy And…………. Molecular diagnostics Chemistry Hematology Coagulation Microbiology Body Fluids Blood Banking Immunology PPMP Training 7
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- 10. Why should I use MTS 10
- 11. Solutions for Audit Findings 11
- 12. Training •Are assay-specific training records available (or kept on file) for all laboratory personnel involved with testing activities? 12
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- 14. Safety Training •Is there an initial and ongoing safety training program with documented participation of all laboratory personnel? (If “Yes”, list who provides the training, as well as the frequency of training.) 14
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- 18. MTS Training Library is also a great resource for: •Proficiency testing •Resource Library 18
- 19. MTS can assist with Proficiency Testing Investigations: •Investigative Action •Preventative Measures 19
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- 27. Competency Assessment •Is documentation maintained, indicating the laboratory has assessed the competency of each employee to perform his or her assigned duties? (If “Yes”, report the methods utilized to assess competency, as well as the frequency of evaluation, in the “Comments” section.) 27
- 28. Competency Assessment The bi-annual tests include: • 10 Pre-analytical Tests. • 17 Analytical Testing Assessments. • 73 Point of Care (POCT) Waived Testing Assessments. • 9 Provider Performed Microscopy (PPM) Tests. 28
- 29. MTS Competency Assessment Test includes: • High-resolution photos and slide images. • In-depth explanation for remediation. • Summary reports for managers. • The ability to create your own customized test specific to each site’s regulations and practices. 29
- 30. MTS Administrators have reports that can: • Track training progress. • Track competency testing progress. • Print Continuing Education reports. • Receive monthly reports if they desire. 30
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- 34. How to get started 1. First you need to e-mail your SMILE representative to request access to the website. 2. You will need to provide SMILE with at least one person’s name and e-mail address to become the Administrator of the site. 3. This person(s) will then be contacted by MTS with their UserName and password sign-in and instructions on how to use the site. 34
- 35. Weblink • MTS weblink –http://www.medtraining.org • Heidi Hanes mhanes2@jhmi.edu • Arden Bongco abongco@jhmi.edu 35
- 37. Acknowledgement The presenter would like to thank the following: DAIDS -Daniella Livnat and Joe Fitzgibbon MTS – University of Washington Department of Lab Med Johns Hopkins University - SMILE Dr. Lori Sokoll - Principal Investigator Anne Leach- Project Manager Staff- Peggy Coulter, Mark Swartz, Orlinda Maforo, Amy Rada, Afton Dorasamy, Mandana Godard, Arden Bongco, Eunhee Rim, and Bre’Shey Jones 37
Editor's Notes
- Good afternoon. My name is Arden Bongco from the SMILE Team. For those of you who are not familiar with SMILE, our Team monitors the Safety testing of International laboratories involved with DAIDS funded protocols. Today, I will be presenting a talk on MTS- Medical Training Solutions. Their motto is – Building Competency in Today’s Clinical Laboratory. I am hoping that by the end of this presentation, curiosity and excitement will creep up onto you and lead you to check and take full educational advantage offered through this resource website by SMILE. So let’s begin.
- Read the SCREEN Read after title – Offers Online Training and Competency Assessment for the Clinical Lab and Point of Care
- Read the SCREEN – : the following….#1…… 1- (I) welcome you to drop by and join us in the SMILE drop-in room tomorrow afternoon if you wish to have a demo of the videos or animations. 3- via Multiple choice format that’s easy to navigate. 4- through Real time monitoring of test completions and documentation for inspectors. 6- whereby with just One click, a reminder is sent to your staff.
- Read the slide once done click TWICE
- Read intro then click for each ITEM or # to appear…. Click – 1. We are aware how busy it can be in the laboratory particularly during peak hours. In my visits to several labs who offers internship training for students, I have noticed that the staff technologists struggled to manage both lab testing and working with student interns at the same time. With the availability of MTS for training and teaching purposes, the student can be assigned a topic from the training library and left independently as the lab testing is being attended to for completion by the staff technologist. Click – 2. This is another area that can cause hardship for the labs. Sending staff away for training can be restricted or challenging due to unavailability of funds or staff shortage. The advantage of MTS online training is that you have it available on demand right at your fingertips anytime, anywhere with available training topic of your choice for continuing education opportunity. Click – 3. Having enough techs available to work on multiple benches can also be a challenge, MTS may also be used for cross training across different sections or areas of laboratory testing. Click 4. and Click again for 5 –These last two items are included in the succeeding slides and discussed in more detail.
- The training Library consist of 58 modules covering – everything from orientation through PPMP (Provider Performed Microscopy Program) training such as Vaginal wet prep, Basic Microscopy, etc. MTS tries to add at least one or two new trainings per year.
- This is a list of the training modules that are available and may be assigned. The Peripheral Blood under Hematology and Urinalysis under Chemistry Section includes excellent illustrations, images, and videos for blood cell and urine sediment identification. It is a great tool to hone in and enhance staff skills through familiarity with blood and urine microscopic elements.
- The MTS home page will be on display upon initial log with your name on display along with 4 tabs as follows: My Account (for UN and password option) ► Settings (for test retake and specific program assignments) ► and Support (How to videos, FAQ, Administrator instructions) Immediately underneath are the six primary TABS as follows: My Assignments ► Training Library ► Biblioteca de formacion (Training Library available in Spanish language consisting of 41 modules) ► My CE ► Manage Users ► Manage Content (MTS content and JHU-SMILE Content - Home grown program such as the MTS Vaginal Wet Prep and HAIN LPA Programs)
- Read slide I am sure that many of you have participated or experienced an Audit. Right?
- Likewise, many of you are familiar with this document from SMILE, right? Some of your Action Plan items may be resolve with the use of MTS system as a supplementary resource for item resolution. How? Let me show you an example ……..
- Does this question ring a bell? Read the question. Sounds familiar? This is one of the audit questions found under Section II.C.5.- Personnel Records that pertains to staff TRAINING specific to a lab section or specific assay offered through the MTS program. As I have indicated, there are 58 modules available in the Training Library, a few of which corresponds to specific training areas or needs by the staff.
- On display is an example of a report showing the various training modules that has been assigned to one of our team member at SMILE. It shows a list of modules she had taken to include completion dates, scores obtained, and CE credits earned. Wouldn’t this be a nice report and documentation to have in your employee files for the inspectors to see?
- Here’s another audit question found under Section XIII.C.- Personnel Safety that pertains to SAFETY TRAINING and documentation available through MTS Training Library.
- Note that the MTS “SAFETY training library” is broken down specifically into GENERAL SAFETY Concerns (composed and classified further into 10 specific safety areas) and a specific one particularly for PATIENT Safety only.
- Likewise, under the “Competency Assessment” Section, there is an available test for Patient Safety separate from Safety ( subject specific ). As previously shown and noted, reports may be pulled up for evidence to show the auditor both training and competency testing in the safety area.
- Again, an excellent record to have in individual staff folders…. PLUS BONUS points during audit time
- READ TITLE : (Click) - Proficiency Testing as supplementary resource (Click) - as a resource library. ( We can’t have enough reference tools or books with excellent pictures included particularly that of : for blood cells, urine sediment, and/or parasites.
- READ slide and…… It is useful for both the Click-investigative action- click and Click- future preventative measures. Let’s go through an example using the MTS system as a supplementary resource to a CELL ID investigation resolution …
- On display here is an OWA Cell ID survey asking the lab to identify the cell indicated by the two arrows. The history was given….. a 65 year old man with leukocytosis and increased platelet count. Both WBC (24,200) and platelets (899,000) were significantly elevated. The possible answers were: Megakarocyte, Megakarocyte abn, Megakarocyte nucleus, Platelet hypogranular, Platelet, large, and Platelet, normal
- The lab identified the cell as Megakarocyte, which was deemed “unacceptable” or incorrect, the correct response was Platelet, Large. As such, an investigation was carried out with MTS system used as a supplementary resource by assigning the hematology training and competency module to all technologists in the hematology section.
- Investigative Action and Root Cause here I would put down what steps I took to investigate the problem and why we had the incorrect result Future Preventative measures I will enter how I hope to prevent it in the future. So using what I found on the MTS slides I will fill in these two sections. – click The investigation and troubleshooting process then was documented on the SMILE IR form under Investigative Action and Root Cause along with Future Preventative Measures. The digital image of blood cells available in MTS Hematology module helped in the differentiation and correct identification of the cell.
- Let us now go back and examine the slides for the various forms of platelets. The slide to your left shows a megakaryocyte nuclei or fragment. Megakarocytes are usually seen in the bone marrow but in certain disease such as myelodysplastic syndrome they can be seen in the peripheral blood. The usually have the cytoplasmic protrusions. Which are similar on the structure on the OWA slide but you can see that the megakaryocyte nuclei has a distinct nucleus where the OWA cell to you right does not. So this shouldn’t be called a megakaryocyte nucleus. If you would see these megakarocyte nuclei in a blood smear most instruments will count them as WBC just like a nucleated RBC. You should do corrected white blood count to exclude them from the count. In addition to these cells, patients that have a myelodysplastic syndome can have large bizarre platelets that may be counted as RBC. Because of this both a manual WBC and platelet should be performed.
- Slide to your left: Here we see normal platelets. Slide to your right: Normal platelets are also seen here with the “unknown cell” for identification pointed by the arrows – next-click
- Next – slide to your left showing large platelets. Do they look similar to the arrowed cell on the right? Correct. So our correct response should have been large platelet. So now I will go to my SMILE investigation form.
- So for the Investigative Action, you will indicate that you used MTS for your investigation along with additional details or steps taken. For the preventative measures, you will indicate that a refresher training course on Peripheral Blood Training Course was assigned and recommended to all hematology staff. Note that SMILE had actually received an investigation report that do state this as their preventative measure. (So can everyone see how this could be a useful tool for your investigation?)
- Competency test – click – Here’s another audit question found under Section II.C.7.- Personnel Records that refers to COMPETENCY TRAINING
- . The Competency Assessment section on MTS– click - Includes bi-annual testing in the following sections - click 10 pre analytical test, click 17 analytical assessments, click 73 POCT test, click 9 Provider performed microscopy test click
- MTS competency Assessment Tests include click High resolution photos and slide images, click in depth explanation for remediation, click summary reports for manager will show you a few examples of these reports. click and the ability to create your own customized test specific to each site’s regulations and practices.
- With MTS, the administrators have several ways of tracking their users progress. There are available reports that – click - track training progress Click – track competency testing Click print up continuing education reports and Click you can also receive monthly reports that show the progress of all your users. Let me show you a sample of these reports
- Here we have a training course report on Jane Deer- note that she has not completed a single assigned module to her. With this, an e-mail notice through the MTS system can be sent directly to remind her of the pending courses assigned or due.
- Next her competency assessment report I am happy to see she has actually done 3 of her 6 competency assigned to her.
- Lastly, an example of a Continuing Education certificate. You have the title of the course – click the credits- click and when it was completed. Continuing Education Certificates can only be received with scores of 80% or higher. Lower scores must be reset and taken again for credit. CEs are available ONLY for the Pre analytical and Analytical Competency and all the training modules So all these reports can be filed away in your employees records and when an auditor ask for proof of both training and competency testing you can show them to your inspector.
- So hopefully I have everyone in the room saying – How do I get started Click – first you let SMILE representative you want to participate in the program. Click – next need to give us at least one name and email address to act as the administrator. You can have more than one administrators but to start out we need at least one name. We will then send this person’s name and email address to MTS and Click – shortly afterwards, that person will then receive an email from MTS with temporary user name and password. MTS will also send you instructions on using the system. Note that this presentation is also located in the Resource section of the pSMILE website. Just want to emphasized that our international sites can participate through the SMILE subscription. All domestic sites can contact MTS directly to set up their own subscription to the site.
- The MTS weblink is. I also include my e-mail address along with Arden Bongco. We are in charge of the MTS subscription at SMILE. If you have any questions please contact us.
- I would like to acknowledge the following -