Tools, Technologies and Training for Healthcare Laboratories


Education and Training in Analytical Quality Management, Part One: Developing A "Lesson-Base"

The Digital Age has revolutionized countless facets of our society. Dr. Westgard discusses how the Internet it has and will impact our industry: how we can now access education and training over the web at anytime, from anywhere in the world. (If you can read this, you're part of the revolution!). Read this essay to see how workshops, courses, seminars and more will be affected by electronic communication.

An interesting thing happened while we were developing this website. As I experienced the capabilities of this new web medium, I began thinking about education and training in a totally different way. A course or a lesson can now be delivered to laboratory personnel at the times and places that are convenient for each individual, rather than requiring the people to travel from their jobs or to organize their work around the times and places where the lessons are available. This ability to deliver the training when and where it is needed will become increasingly important for maintaining and improving the skills of laboratory analysts.

This is a major change in my thinking from a year ago when I seldom bothered to look at the web. I have to give credit to our webmaster (Sten) for dragging me into the age of electronic communication. I had an interest in developing a newsletter and Sten recognized that the right medium for the future was the web. I may have been resisting this medium before, but now I've become an advocate. I believe the web will have a major impact on training and education in the future, particularly for subjects where data analysis and computer tools are important for both learning the concepts and applying the techniques.

New Educational Technology

Colleges and universities are interested in new "teaching technology." All campuses now have at least one showplace lecture hall and at least one computer multimedia lab that includes video facilities, computers, and projectors that can display whatever is on the computer screen. Course authoring and management software is becoming available and multimedia course materials are available via your personal computer. This new technology is aimed at making the traditional lecture more visual and understandable - and maybe more entertaining. Sometimes the lecture is supplemented by materials available on the World Wide Web, or sometimes the lecture is replaced by interactive lessons and exercises that are automatically graded.

Faculty are somewhat divided about what to do with this new teaching technology and the web. On one hand, if web materials are developed, students may no longer come to the lectures, in which case the faculty may be judged as being unsuccessful teachers. On the other hand, if the faculty don't use the web, they may be seen as not in tune with the new technology and may become an endangered species. The net result is that we often talk about the new technology, but are reluctant to embrace it until we can understand all the potential advantages and disadvantages. One serious disadvantage might be that I am no longer needed to teach a course if I have done a good job of providing course materials on the web. Of course, that same problem could arise if someone else develops those same materials, so it is best that I my act together and get started.

Distance Education

Another interest in colleges and universitities is delivering education and training to students who are not present on campus. While the higher purpose of colleges and universities still remains for undergraduate education (i.e., to get our children out of our hair and give them some time to grow up), advanced training and continuing education are needed by many professionals who want to continue working while obtaining additional knowledge and skills. Clinical laboratory scientists are a good example of professionals who want and need additional education and training, but often can't afford to leave a job and go back to school. The web offers a new way to obtain that education and training. Even laboratory in-service training may be supplemented via the web.

From my early experience as a clinical chemist and director of a clinical chemistry laboratory, I learned that an effective in-service training program was essential to maintain and manage the quality of the laboratory. Standard processes, procedures, policies, and practices are fundamental to any quality system. This standardization is accomplished through the initial in-service training and maintained through ongoing training when implementing new processes, procedures, policies, or practices.

Basic QC instruction is one example where web materials could be used for in-service training. I am hearing from many companies that more and more of their hot line questions are related to QC and that these questions are also at a more basic level today. In addition, a major push for changing quality systems for point-of-care testing comes from the difficulty in training non-laboratory personnel about QC. Manufacturers who are introducing new instrument systems with new QC capabilities are worrying about training operators to understand and utilize those capabilities. Basic QC, which we have taken for granted as an available laboratory skill, is no longer so readily available.

Educational directions with this website

Analytical quality management is a term I use to describe an area of technical management that includes method evaluation, QC selection and design, and routine QC operation. Although laboratory scientists are getting more and more business and financial training, they are seldom getting the advanced technical management training that is needed in the following areas:

  • Defining quality requirements
  • Evaluating method performance characteristics
  • Planning method evaluation experiments
  • Performing data analysis calculations
  • Interpreting statistics
  • Understanding QC performance characteristics
  • Applying QC planning tools
  • Developing TQC strategies
  • Implementing statistical QC procedures
  • Training others in technical quality management

We intend to cover all these topics on this website. Some have already been discussed in our initial focus on QC planning. We then concentrated on Basic QC Practices, followed by materials on Basic Method Validation. As we develop this "lesson-base" of materials on analytical quality management, we are able to organize these materials for use in short courses for continuing education, modules that can be included in more formal academic courses, and specialized courses that can be targeted at specific audiences who have specific needs.

Concept of a "Lesson-base"

The idea of a "lesson-base" isn't new, but this term is useful to create an analogy with a database which is more readily understood. The idea is to be able to access the appropriate educational materials to answer certain questions or to address specific needs. For example, the accompanying figure illustrates how the question "How do you do QC Planning?" might be answered using the current materials available on this website. A "homepage" can be constructed to provides links to various lessons, applications, program downloads, program tutorials, web tools, and FAQs (Frequently Asked Questions).

Given the current materials on this website, they can be organized to support a variety of educational purposes, as illustrated the the following examples:

Academic course: I teach MT 520 at UW-Madison in the second semester each year. This year I used the web to provide some reading materials, to download tutorials for learning a computer program, and to post example test questions. This was just a start and during this next year you will see more extensive web-materials being used in this course. The students seem to like working on computers and especially enjoy having their pictures on the web.

Continuing education course: These same course materials were organized into a continuing education course on "QC Planning for Healthcare Laboratories." This course was offered by the AACC and accredited for 15 ACCENT credits; it will be replaced by the Basic Quality Planning series. A detailed syllabus describes 16 lessons and includes objectives, selected web materials, things to do, and some suggestions for evaluation. This course was originally offered entirely over the web, including downloads of the necessary computer program and tutorials for learning program operation. [Please note: it is no longer available on CD]

Workshop: Support materials for a half-day workshop on "Tools, Technology, and Training for QC Planning" are made available via the web to participants prior to a scheduled program. This allows interested participants to prepare for the workshop and allows those who can't attend the program to still learn about the subject. It provides a customized workshop manual that can be printed by those participants who want hardcopy documentation. [Please note: This course is no longer available]

Seminar: Support materials for a one-hour laboratory medicine seminar on Tools, Technology, and Training in Analytical Quality Management are provided to interested clinical laboratory scientists at the University of Wisconsin Hospital. This seminar is during a busy time of the day, which makes it difficult to attend. However, everyone in the laboratory has access to the web and to the materials linked on this page.

Just-in-time training

The concept of "just-in-time" inventory has been important in today's quality production systems. The idea is to deliver the materials when needed, rather than building an inventory that has to be stored, managed, and distributed. Just-in-time delivery saves money as well as improves quality. The same idea has been applied for training in quality management - provide the training when it is relevant and needed, rather than expect the training to be stored in people's heads until needed.

Providing just-in-time training in technical areas such as analytical quality management may be difficult, however, since knowledge and skills are already in short supply and there is little time available to develop this training in laboratories today. There is a need to package this training so it can be delivered when needed. Videotape programs lend themselves to this use and so do web-based materials. Given a lessonbase of web materials, it would be possible to organize a custom training program in a matter of an hour or two. All that has to be done is to write a homepage for the course, identify the materials and add the links, then post the page on the web.

Developing a "lesson-base"

The limitation, of course, is the development of the appropriate lesson-base or gaining access to an existing lesson-base. It takes a lot of time to develop these web-materials, even though we don't provide animation, video, sound, etc, which are supported in several of the structured learning environments, such as Lotus Learning Space, Asymetrix Toolbook, Macromedia Authorware Interactive Studio, etc. We think the learning curve and startup time are still too long using these advanced courseware development programs, so we are taking a simpler approach in our first pass at course development. We expect to add some bells and whistles as we refine our course materials.

Even with this simple approach where we are converting traditional course materials into web-based materials, startup time is still a problem. Most teachers will need technical help and assistance to get started publishing course materials on the web. I confess that I don't have a clue how these materials get marked up and transfered to the web. I write this essay using a word processer and e-mail it to the webmaster who takes care of the rest. That allows me to be productive in developing the content, rather than spending my time learning the technology. I expect other teachers would take more readily to the web if they had this same level of support. In the future, teachers will have all the skills necessary to produce web materials themselves because they will have grown up with computers and this new educational technology.

Subject matter expertise is still the critical element in developing a useful lesson-base, thus our knowledge and experience as teachers must be incorporated in these web materials. Ideally, lessons should be created by the subject experts in each area or topic, similar to how textbooks are created today in clinical laboratory science, clinical chemistry, and laboratory medicine. The web is still a risky venture, however, and it may be necessary for professional societies to coordinate and support the initial development of lessonbases relevant to the competencies required by each profession. A coordinated effort will reduce duplication in efforts and lead more quickly to the availability of materials that can be broadly shared to improve education and training in laboratory science.

Joomla SEF URLs by Artio