CLS 2524 CLINICAL PRACTICUM II
HEMATOLOGY, URINALYSIS AND BODY FLUIDS
ROTATION
SYLLABUS AND INTRODUCTION
Welcome to the world of the clinical laboratory for hematology, urinalysis and
body fluids. You will complete your clinical practicum rotation at one of the
following sites that you have confirmed with the Clinical Coordinator.
American Esoteric Laboratories
Memphis, Tennessee
Arkansas Methodist Medical Center
Paragould, Arkansas
Crittenden Regionial Hospital
West Memphis, Arkansas
Cross Ridge Community Hospital
Wynne, Arkansas
Five Rivers Medical Center
Pocahontas, Arkansas
Forrest City Medical Center
Forrest City, Arkansas
Great River Medical Center
Blytheville, Arkansas
Lawrence Memorial Hospital
Walnut Ridge, Arkansas
Harris Hospital
Newport, Arkansas
Pemiscot Memorial Health Systems Hayti, Missosuri
Piggott Community Hospital
Piggott, Arkansas
Popular Bluff Medical Center
Popular Bluff, Missouri
St. Bernard’s Medical Center
Jonesboro, Arkansas
St. Edwards Mercy Medical Center
Ft. Smith, Arkansas
South Mississippi County Regional
Osceola, Arkansas
Twin Rivers Medical Center
Kennett, Missouri
White County Medical Center
Searcy, Arkansas
White River Medical Center
Batesville, Arkansas
Differentiating between the clinical practicums for the 2-year and 4-year
student.
01 A student enrolled in either the CLS 2524 Clinical
Practicum II or CLS 4184
Clinical Practicum II (during the
same semester) does not train together at
the same bench or in the same
clinical affiliate with another student enrolled
in the other clinical practicum
or from a different program
.
02 The clinical instruction for technical skill development
and learning procedures
for hematology, coagulation,
urinalysis, and body fluid testing will vary some
what between clinical affiliates. The
following are things that you may expect.
A. The student
clinical evaluation form lists two pages of technical
assessment items. The listing of these items are the same for both
the two- and four-year student for the following reasons.
a. The State of Arkansas is a non-licensured state and there
are no
legislative rules that are applicable to the clinical laboratory profession.
b. All laboratories in the state are CLIA approved and are
subjected to
Federal regulations. For this reason, the technical assessment items
that are listed are the same.
c. The clinical laboratory to which you are assigned will
evaluate you
who are enrolled in the CLT Program will evaluate you at the CLT
expectancy level. If you are enrolled in the CLS Program, you will be
evaluated at the CLS expectancy level.
B. The four-year
student evaluation form will have similarities but with
different
standards
from that for the two-year evaluation form.
03 The four-year student complete activities in the areas of
problem solving
and critical thinking
competencies that addresses case studies, higher levels
of clinical testing,
demonstration of understanding clinical disease processes,
management issues, and
educational methodologies. These are NOT
required of the 2-year student.
A. The majority of
these forms are available in the Blackboard system for
downloading at your convenience.
B. All other forms
are available from the faculty instructor who has
responsibility for this clinical rotation.
C. Items that you
must request from the faculty instructor are:
a. glass slides for making the required slides.
b. plastic case for keeping slides.
c. bubble sheets for recording answers to required
questions.
d. special case study packets (to be completed during
the clinical
rotation assignment).
You have from four to five weeks in which to complete 168 contact hours of clinical rotation
experience at your designated site (selected from the above list). Plan on
arriving between 7:00 a.m. and 8:00 a.m. on the first assignment day and ask for
the laboratory manager. This person’s name will be given to you by the Clinical
Coordinator. On the succeeding days, you will arrive at the time assigned by the
laboratory preceptor which is usually between the hours of 6:00 a.m. to 8:00
a.m. You will maintain a daily attendance log, listing the cumulative hours,
which you will complete and the assigned instructor will initial at the end of
the work shift. You will need the following to complete the requirement of this
course.
01 One set of 200 exam questions which may be down
loaded from
Blackboard or obtained from the
instructor if you are unable to down
load the exam.
02 An answer page (red computer bubble sheet) to record
answers for exam.
Be sure to ask the
instructor for this clinical practicum for an answer sheet.
03
The CLS Program Clinical Rotation Handbook and CLS Program Handbook
are available on the Lab_Sci
list serve. Both are available at the beginning
of each semester and upon
request. If you need to download a copy of
either, contact the CLS/RS secretary, room 101 in the Chickasaw Building.
The student handbook contains contain directions on how to get to your
clinical site. The
clinical rotation handbook contains the attendance sheet,
phlebotomy
check sheet, and clinical site evaluation form (to be completed
by the student).
04 There is a dress code. In the clinical rotation, you
are required to wear
hospital 'scrubs' (red shirt
and black pants) with a student ID badge.
It is now required that you will have
attended a review session on campus before participating in the clinical
rotation. This will take approximately 3 hours. If you do not
attend this review session, you will NOT be allowed to participate in the
clinical rotation experience. You will be notified by email as to the time
and place for the review.
The following general schedule will be followed and will be modified by the
Clinical Preceptor.
First day:
Arrival to the clinical site and introducing yourself to the Clinical
Preceptor.
Expect to receive instruction on laboratory safety,
confidentiality, phone
etiquette, and other orientation requirements.
You may be required to being
reading the procedure manual for
that department and be allowed to observe
instrumentation,
quality control, calibration and maintenance activities, as-well-as
other hematology and coagulation lab operations.
Second day:
This may be a characterized by reading assignments, going on the
floor for
phlebotomy experiences, and observations of lab
operations. It is possible that
the lab may begin to work you into
laboratory activities with supervision and
assistance.
Third day:
Begin to function in lab activities with supervision and assistance.
Fourth day
and remaining days of the rotation assignment, you will be expected
to develop
your proficiency and skills in laboratory assignments
with minimal supervisory
oversight.
When you arrive at the clinical site, the laboratory preceptor will provide
direction and instruction as you progress through this segment of the laboratory
experience. As a student laboratorian you will be expected to perform the
clinical laboratory procedures (refer to the laboratory evaluation sheet) using
mock and/or actual patient specimens. All actual patient specimen tests that you
perform MUST be verified by the medical technologist responsible for that
department (or someone designated by the department supervisor.) As a student,
in your assigned clinical site, you are expected to able to:
A. Complete the following goals
(which are derived from the cognitive,
psychomotor, and affective
domain objectives) after receiving
appropriate instruction and practice:
1. list
one source of error for each procedure.
2. list
normal values and where they are applicable.
3. identify
which specimens are unacceptable and state why.
4. describe
the different types of hematology specimens, how they are
collected and
state the testing purpose for each type of specimen.
5. describe
the handling procedures for blood in terms of timing,
preservation
techniques, handling requirements, and temperature
restrictions.
6. briefly state the testing principle so that an understanding of the
basic
concepts of the procedure may be demonstrated.
7. prepare reagents for test procedures as appropriate.
8. list the advantages and disadvantages of each
procedure.
9. perform math calculations to correct test results as necessary
with
with 80% accuracy.
10. correctly transcribe test results in a legible manner from one form to
another.
11.
interpret test results by distinguishing normal results from abnormal.
12. recognize those test results which represent critical (panic) values
and
describe and/or take an appropriate course of action.
B. Demonstrate, while under the supervision of a laboratory preceptor, the
following basic laboratory techniques:
1. handle the specimen and perform the testing procedures according
to the
laboratory standards and policies for safety.
2. process specimens in accordance to the affiliate's laboratory policies.
3. preparation and use of reagents, controls, standards, etc.
4. select and use appropriate laboratory glassware and equipment.
5. correctly preserve any specimen where the testing procedure must
be delayed
for a period of time.
6.
perform designated Q.C. procedures, then correctly and legibly record the
results.
7. demonstrate
correct handling of stained blood smears and microscopic
UA sediment slides, evaluating each with appropriate accuracy.
8. use correct units when reporting results.
9. correctly and legibly report all results in accordance with the
laboratory
policy.
C. Successfully demonstrate the following for those instruments within the
hematology department of the clinical laboratory:
1. briefly describe the principle and/or theory for each instrument used.
2. demonstrate correct use of the instrument.
3. describe and/or demonstrate correct technique in the care and
upkeep of the
instruments.
4. maintain one or more of the following records of each instrument (or
equipment item):
a. calibration
b. temperature
c. quality control
5. describe basic trouble shooting techniques for each
instrument.
UNDERSTANDING THE CLINICAL ROTATION EVALUATION PROCESS
The clinical practicum rotation consists of experiences that utilize your having
satisfactorily met the cognitive, psychomotor, and affective domain objectives for the
following courses:
CLS 1521 Urine and Body Fluid Analysis
CLS 1531 Laboratory for Urine and Body Fluid Analysis
CLS 2521 Laboratory for Basic Concepts of Hematology
CLS 2523 Basic concepts of Hematology
CLS 2552 Hematology Disorders for the
CLT (highly recommended that
you have completed this course before entering the clinical
practicum)
Refer to the respective syllabi for each of the above courses for a listing of these three types of
objectives. Affective domain and behavorial objectives are also listed in
the student handbook.
Your clinical laboratory practicum experience encompasses these four areas:
hematology, coagulation, urinalysis and body fluids. This will be accomplished
by evaluating you, the student, in these four areas (hematology, coagulation,
urinalysis, and body fluid analysis) in the cognitive, psychomotor, and
affective domains.
Review the Affective Domain criteria (Unit IV) presented in the Student
Evaluation Form. The clinical instructors will use these to assess you when you
complete your time commitment in the clinical rotation.
The Psychomotor evaluation will be performed by your assigned clinical
instructors when you have completed your clinical experience. These criteria are
presented in Unit I (Technical Skills), Unit II (Procedures for Hematology and
Coagulation), and Unit III (Procedures for Urinalysis and Body Fluids).
The Affective Domain and Psychomotor evaluations will constitute 45% of your
grade which is designated as the “Clinical Rotation Evaluation II.” This
“Student Evaluation Form” is a form that is used to assist the supervising ASU
faculty member in assigning the grade. As a reminder, you must remember that
each time you complete a clinical practicum in this professional course of
study, you need to carry this information forward into your next courses and
clinical practicum experiences. The “Student Evaluation Form” for the
hematology, coagulation, urinalysis, and body fluid practicum will be evaluated
in the following manner. There are a minimum of 59 evaluation items for the
psychomotor domain designated as I, II, and III. The preceptor will write in an
appraisal number between 0 – 10 for each item used in the evaluation process.
The numbers will be summed and entered into a formula to obtain a score that
will be combined with the formula results obtained for the affective domain
evaluation. There are other factors which will contribute to your overall grade.
You are expected to earn a minimum of 70 percent to satisfactorily complete this
part of the evaluation process. Failure to meet these evaluation items may
result in a failing grade.
The remaining part of the evaluation is designated as the “cognitive evaluation”
and has several components to it. It is designated as “Clinical Rotation
Evaluation I” and will make up 55% of the grade. “Evaluation I” is made up of
several parts. These grades are combined for the final grade.
01 Compiling the grade for “Clinical Rotation Evaluation I” will be
accomplished by that faculty member who was responsible for your campus based
instruction in hematology, coagulation, urinalysis, and body fluids or who was
assigned to evaluate you during this clinical experience. This is accomplished
in part by providing a final clinical rotation exam, to be completed at the end
of the clinical rotation, that will become part of your overall evaluation. This
final test consists of 30 written questions from each of the four areas for a
total of 120 questions. Ten (10) illustrations/ pictures from hematology cell
morphology, and ten (10) illustrations/pictures from urine sediment. A minimal
score of 70% is expected for this part of the evaluation process.
02 There is an exam of 200 study questions that is available to you at the
beginning of the rotation that is to be completed during the clinical rotation
period and turned in at the time you take the final rotation test of 120
questions. This form may be downloaded from Blackboard 6 (Course: CLS 2524 Clinical Practicum II). Contact the instructor for an answer
sheet.
03 Since you have enrolled in
CLS 2524, you are required to complete other
assignments which may be found in Bb6. Go to the "Course Information" section and
scroll down to
COURSE PROJECTS FOR CLS 2524.
Follow the instructions and you will find the
assignments and instructions for completing the part of your course requirement.
These points will be incorporated into the 55% grade.
04
Three sets of stained blood films, each set with a hospital
generated CBC report for each set of slides, are required. Each set is to
contain a minimum of five (5) stained slides. The grade earned from this activity will be
added into the “Evaluation I” grade as part of the grade. Each set is
worth 15 points based upon the quality of the smear and stain. Poorly
prepared and stained slides will be graded "zero."
A. The patient’s name and I.D. number must be deleted from CBC
report, but the
age and gender needs to be indicated, if it is permitted
by the laboratory.
B. To clarify the meaning of the term "set", each set must consist of
five slides appropriate for a stained blood film
evaluation using the
following example.
a. If the patient is John Doe, then make 5 good blood smears and
stain each
slide.
b. Label each slide with an identification number that matches the
CBC report
that is to accompany that set of slides. Do NOT
place a cover glass over the
stained blood film. The instructor
will do this step.
c. Repeat the process by collecting two more sets of slides from
two other
patients.
C.
Five (5) extra bonus points will be credited for an extra set of 5 slides
turned
in. You may turn in extra sets (up to 3), for extra bonus
points for each set. The earned bonus credit points will be added to
compute the final grade.
D. Note: One set of slides may be from a normal
pediatric patient
(preferably less than 5 years old). Include the age and gender
E. The other sets should be from patients diagnosed with a hematology
disorder or are under therapy for an illness or cancer. Examples of
preferred slides, which includes a variety of disorders are listed
as follows:
Infant patients (under 1 y/o)
Young children (1 to 10 y/o)
Cord blood
Iron Deficiency Anemia,
Pernicious Anemia
B12 and/or Folic Acid Deficiency Anemia
Chronic Myelocytic Leukemia
Hairy Cell Leukemia
Polycythemia vera.
Any Acute Leukemia (M1 - M7 and L1 - L3)
Pelger-Huet Anomaly
Alder-Reilly Anomaly
Chemotherapy
Disseminated Intravascular Coagulation.
May-Hegglin Anomaly
Infectious mononucleosis
Appendicitis
Animal or snake bite victims
Patients diagnosed with bacterial or viral infections
Any slide of unusual hematological interest.
Note:
Be sure to ask the instructor for a box of slides to
complete this part of the clinical rotation requirements.
05 You are required to participate in phlebotomy activities
while you are in
your rotation assignment.
A. A minimum
of 35 blood collections must be completed.
B. If you are
asked to collect blood, do not refuse to do so as it will
negatively affect your overall grade.
C. If you are
employed as a phlebotomist in a clinic or hospital, see
the course instructor for additional instructions on this assignment.
06 In summary, your grade for this CLS clinical practium is calculated from
the following
components:
A. “Clinical Rotation Exam I” (55% of the grade)
a. Two Hundred question exam.
b. Final Rotation Exam.
c. Two case studies.
d One journal report.
e. Three sets of stained hematology slides.
f. Special assignments (two one-page reports) by the instructor.
g. Earned bonus points.
B. “Clinical Rotation Exam II” (45% of the grade).
07 You must turn in to faculty the following documents when
you have
completed the clinical rotation.
a. Completed
attendance sheet, properly initialed by the clinical
preceptor.
b. Your evaluation
sheet of the clinical site and experience in the lab.
c. Answer sheet for
the clinical rotation exam II.
d. Completed 200
question exam.
e. Two case studies.
f.
Three sets of slides,
g.
one journal report.
h. The
completed student evaluation sheet by clinical preceptor.
(This
document may given to you be in a sealed
envelope.)
i.
Turn in the stained blood smears with the hospital CBC reports.
j. Completed
phlebotomy form.
k. any special
assignment.
08 Take the
clinical rotation exam B on campus after you
have completed
your required time in the
clinical rotation. See the instructor for a
copy
of the exam and allow yourselves up to two hours to complete
the exam.
ATTENDANCE
AT THE CLINICAL SITE
Attendance is an important part of the evaluation process. ALL ABSENCES MUST BE
MADE UP. Excessive and unexcused absences will result in a failing grade
regardless of the total points earned.
01 Once you have arrived at the
clinical site, you are required to remain until
you have completed the day's
assignments and that is approximately eight
(8) hours. Failure to adhere
to laboratory attendance protocol will result in
disciplinary action.
02 Leaving and returning to the clinical site is not
permitted unless it is an
emergency.
03 Failure to notify the clinical site
and/or the Clinical Laboratory Program
of your not being able to be in
attendance at the clinical practicum site will
result in point reduction
penalties for the affective domain grade.
04 If, after arriving at the laboratory and an interval of
time lapses, the clinical
laboratory then asks you to
leave the lab to go home for the day, YOU ARE
REQUIRED TO NOTIFY THE CLS
PROGRAM OF THIS OCCURRENCE.
05 You are expected to stay at the clinical site for eight (8)
hours. If you leave
the clinical site without
permission and justification, you are subject to
discipline by the CLS faculty.
Failure to notify the clinical site and/or the
Clinical Laboratory Program that you
will not be in attendance at the clinical
practicum site will result in point
reduction penalties for the affective
domain grade.
Notice. If you are enrolled in a
web-based course, you are NOT EXCUSED from your clinical rotation to leave the
hospital site and go work on any web-based assignment. Web based
assignments can be completed at other hours.
OTHER USEFUL INFORMATION
[1] There are no
generalized review / study questions for the 'hematology, coagulation,
urinalysis, and body fluid' rotation experience to study. A two-hundred question
test developed
from CLS 2523 and CLS 1512 courses has replaced the study questions.
A. These have been
put together to help you prepare for the final rotation
examination and to serve as a review for the national certification
examination.
[2] The following information is included to help you plan your study strategy
for one of the national registry examinations.
A. ASCP Board of Registry Study Guide (4th edition) Clinical Laboratory
Certification Examinations. Order #4160. Approximate cost: $50. You may
go to www.ascp.org and order this item.
B. Dictionary of Questions. There are two 8½ × 11 inch booklets of about 45
pages that provides descriptor information of the entire bank of exam
questions
offered by the ASCP Board of Registry. There is a booklet each for
the Medical
Laboratory Technician and the Medical Technologist. Each
booklet will describe:
a. Process of examination development.
b. Examination Content Guidelines.
c. Competency Statements.
d. Exam Content Outline
e. Frequently asked questions.
f. Item descriptors which is an abbreviated explanation of the types of
questions than can be expected on the exam. The following lists four
examples of
descriptors with their explanation.
