Clinical Chemistry Rotation

Clinical Chemistry Goals and Objectives

At the end of training in the Clinical Chemistry rotation in the Anatomic and Clinical Pathology Residency Program, residents will display the following competencies:

Patient Care Regulatory, Testing and Consultation Requirements

  • Apply knowledge of the regulatory requirements for clinical laboratories to ensure the provision of accurate and reliable patient testing
  • Assist technologists in addressing technical, logistical and clinical problems related to testing and reporting of patient results
  • Provide prompt and reliable consultation for clinicians contacting the chemistry laboratory for information

Medical Knowledge of Chemical Analyses

  • Have a working knowledge of chemical analyses such as electrolytes and acid-base balance, calcium and phosphate metabolism, enzyme analyses, lipids and lipoproteins, carbohydrates and liver function, amino acids and proteins, nitrogen metabolites and renal function, gastric, pancreatic, and intestinal function, therapeutic drug monitoring and toxicology, lead/trace metals, maternal/fetal monitoring, tumor markers, viral markers, immunology/serology and anemia/porphyria assays
  • Know the differential diagnosis of a test result and the major clinical or laboratory factors that affect test results
  • Know laboratory operations including management, personnel and regulatory issues
  • Know the usefulness and limitations of assays, including quality control, reference values and predictive value for a given test
  • Understand assay methods, including photometry, fluorometry, nephelometry, turbidimetry, electrophoresis, osmometry, chromatography, immunometric and automated systems, chromatography and mass spectrometry
  • Understand instrumentation, automation and laboratory information systems used in clinical chemistry, their evaluation, selection and use

Practice-Based Learning and Improvement

  • Be able to assist in troubleshooting common laboratory tests
  • Master quality assurance and quality control as it applies to the clinical laboratory by participating in quality assurance and quality control activities
  • Perform quality assurance investigations as necessary to evaluate laboratory errors

Interpersonal and Communication Skills

  • Admit and learn from shortcomings
  • Be prompt and reliable with commitments
  • Maintain a dignified demeanor toward clinicians, patients and laboratory personnel

Professionalism Standards

  • Provide effective instruction and direction to laboratory technical staff
  • Understand clinician concerns to be able to communicate effective consultative information in a timely fashion
  • Understand the resident's role in the clinical laboratory team and the roles and contributions of laboratory administrative and technical staff

Systems-Based Practice Components

  • Become familiar with the use of computer resources including the laboratory, hospital and health system information systems
  • Know laboratory operations including management, personnel and regulatory issues
  • Understand quality and patient safety practices and how to ensure existing practices and develop new practices in collaboration with clinical services
  • Understand the availability, uses and results of "send-out" tests

Duration of Clinical Chemistry Rotation

The Chemistry rotation is completed in three one-month blocks.

Duties and Responsibilities by Year

  • During the three months, rotate through each laboratory bench and observe the performance of each test with a technologist
  • Present one educational topic per month to laboratory staff
  • Respond to telephone calls from clinicians forwarded from the client services desk weekdays and otherwise according to call schedule
  • Review daily send-out list
  • Support technologists and medical directors with system or case-specific troubleshooting

Clinical Chemistry Teaching Staff

Christine Schmotzer, MD, Rotation Director
Jaime Noguez, PhD, DABCC
Clive R. Hamlin, PhD
Tabitha Barker, MLT, Technical Coordinator
Diane Schell, MT (ASCP), Technical Coordinator

Clinical Chemistry Supervision and Evaluation

Residents on the Clinical Chemistry rotation are under the supervision of the laboratory directors for all matters related to clinical consultations. Residents receive didactic training from laboratory directors with assistance from laboratory personnel. Evaluation of competencies is completed by laboratory directors each month.

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