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Objective: To define entry level competencies in flow cytometry for CLS generalists., Design: Flow cytometry practitioners completed an electronic survey. Of 134 respondents, 131 met the desired demographics and were analyzed., Setting: Links to the survey were mailed to 3 listservs (Medlab-L, CLSEduc, Purdue Cytometry) and 2 email groups (ASCLS and AMLI). Participants completed the survey on-line., Participants: The target population was flow cytometry practitioners who had experienced CLS education, earned certification and practiced at least one year in flow. Survey instructions asked participants not to complete the survey if they did not meet the demographic criteria., Main Outcome Measures: A competency was deemed important at entry level if > or = 50% of respondents agreed., Results: There was strong consensus (62-87%) that entry level CLS generalists should be able to 1) perform HIV CD4/CD8 monitoring, 2) gate cell populations using forward/side scatter and CD45/bright/dim markers and 3) evaluate specimen acceptability. Concepts to understand included leukemia immunophenotyping, quality control and instrument principles (61-83%). Most respondents (74%) felt that memorization of the leukemic CD panels was unnecessary. However, survey results indicated that the markers and cell type associations to memorize are CD3, CD4, CD8, CD19/20, CD34, CD45 and light chains. Hands-on experience with instruments was not identified as critical., Conclusion: CLS educational programs can deliver almost all flow cytometry content in the didactic portion of the curriculum and can restrict CD marker memorization to a limited list. At minimum, HIV monitoring via CD4/CD8 counts and concepts of leukemia immunophenotyping should be included.

The Netherlands Health Care Inspectorate's annual report on the state of the nation's healthcare in 2008 is dedicated to the use of medical technology. The subtitle of the report is 'Risks of medical technology underestimated'. Lack of education and training expose patients to an unacceptable risk of injury within both the care and the cure setting. The Inspectorate urgently recommends applying a certification system to physicians to guarantee safe and appropriate use of devices and equipment. The administration of an institution has the primary responsibility for the visible implementation of risk and safety management. Also, the medical professional must become familiar with the principles of engineering and be trained in applying a systematic approach to safety and reliability within medical technology. This annual report provides recommendations on how to incorporate biomedical engineering into medical education.

Competency assessment is critical for laboratory operations and is mandated by the Clinical Laboratory Improvement Amendments of 1988. However, no previous reports describe methods for assessing competency in patient safety. We developed and implemented a Web-based tool to assess performance of 875 laboratory staff from 29 laboratories in patient safety. Question categories included workplace culture, categorizing error, prioritization of patient safety interventions, strength of specific interventions, and general patient safety concepts. The mean score was 85.0%, with individual scores ranging from 56% to 100% and scores by category from 81.3% to 88.6%. Of the most difficult questions (<72% correct), 6 were about intervention strength, 3 about categorizing error, 1 about workplace culture, and 1 about prioritization of interventions. Of the 13 questions about intervention strength, 6 (46%) were in the lowest quartile, suggesting that this may be a difficult topic for laboratory technologists. Computer-based competency assessments help laboratories identify topics for continuing education in patient safety.

A random sample of 500 phlebotomy technicians certified by a national organization was queried regarding perceptions of importance of 53 specific practice-related tasks representative of various departmental areas. The sample was surveyed via a mail questionnaire. Role centrality was assessed by considering mean importance ratings and by applying the Rasch measurement model to assigned importance ratings. Approximately 36% of the questionnaires received by respondents were returned. The results revealed which tasks were fundamental to the phlebotomy technician scope of practice. To assess longitudinal change in core duties, task saliency was considered with respect to similar data collected a decade earlier. Task importance may be considered by agencies that educate, credential, or employ phlebotomy technicians in providing current job function descriptions. The longitudinal methodology employed may be applicable to other job roles for which the assessment of change is of interest.

Aim of the Paper: The aim of this paper is to report a survey of midwives' views on the use of technology in assisting births., Background: The research was designed to provide a deeper understanding of the integration of technology into midwives' practice and to identify and examine aspects of training needs., Methods: Over 400 midwives responded to a questionnaire seeking information on their experiences and perceived competence with labour ward technology, with a particular focus on the use of cardiotocograph machines (CTGs) for electronic foetal monitoring. The survey sought views on the extent to which midwives trust the technology, their perceived levels of training and competence, their awareness of policy relating to technological intervention and the issue of women's choice in whether the progress of their delivery is technologically monitored., Findings: The majority of midwives in this survey trust the use of technology but have concerns about issues of safety in relation to potential faults, and to their perceived lack of training in technology usage. The majority also indicated that they prefer a nontechnological birth although many point to the benefits of technological support when difficulties are encountered. The use of technology is seen as multi-professional and there was much support among the respondents for multi-disciplinary training in the use of technologies in future curricula., Conclusions: If the various findings of this sample survey were to be consolidated for midwives as a whole, they suggest that provisions for continuing professional development may need to address technological awareness and competence in a more focused manner than is discernible at present.

The article describes technologic competence as caring in critical care nursing, a framework grounded in the perspective of nursing as caring. The achievement of technologic competence is an exercise in the process of knowing the wholeness of persons in the moment. Nurturing persons toward well-being is the focus of nursing. Technology, caring, and competence are core concepts that constitute the framework of technologic competence as caring in critical care nursing. Technologic competence epitomizes critical care nursing and assumes an indispensable position in contemporary nursing practice.

For the past three years a team of educational evaluators and health professionals has worked on development of (1) definitions of competence in occupational therapy, clinical dietetics and medical technology, and (2) associated prototype assessment instruments. This study has also involved an effort to develop a research methodology for pursuing similar investigations in other fields. That methodology, the Professional Performance Situation Model, proved appropriate for occupational therapy. A second application with clinical dietetics brough a number of significant modifications which support the view that PPSM is a valid special model for direct patient contact health professions. The third application, with medical technology, is intended to extend PPSM as a general model for competence definition in health professions. This article concentrates on the application of PPSM in clinical dietetics. It is argued that evidence for the feasibility and validity of PPSM is sufficient to justify confidence in the methodology. Completion of the next phase of development promises to support the authors' contention that they have developed a general paradigm for competence definition and assessment in all health professions.

The process of developing a competency-based credentialing examination for career-entry practitioners is described, including a review of pertinent literature. A modified Delphi technique was used to achieve consensus among a panel of experts with respect to Career-Entry Statements of Competence. Items were written which were referenced specifically to one or more of the statements. The resulting genralist examination for the technologist and technician personnel levels is the first such examination to be reported in the field of clinical laboratory sciences which utilized a formal process involving such large numbers of practicing professionals.