Goals and objectives
On completing the Immunogenetics laboratory rotation(s), the fellow is expected to be able to:
- Describe the genomic structure and nomenclature of the MHC locus, its role in immunity, transplant immunology and autoimmune disorders.
- Understand the technical, interpretive and quality assurance aspects, of tests performed in the immunogenetics laboratory:
- Serological HLA typing tests, flow cytometric (including Luminex) and functional cellular assays.
- Nucleic acid based tests.
- Understand the clinical implications and limitations of these tests - both in the transplant setting, and when testing for disease susceptibility.
- Perform, interpret and report the tests performed in the laboratory to clinicians.
- Integrate all available data, including: clinical information, serological, cellular tests, and nucleic acid testing results, to arrive at a clinically relevant conclusion. When appropriate, communicate the clinical implications and limitations of these tests to the treating physician.
- When these tests are inadequate to answer relevant clinical questions, help the treating physician identify clinically appropriate tests, laboratories performing such tests, and assist the clinician in interpreting these tests.
- Determine haplotypes from family studies, when appropriate.
Practice Based Learning and Improvement
Fellows shall continuously improve their ability to investigate and evaluate their diagnostic and consultative practices, appraise and assimilate scientific evidence, and improve their patient care practices. Specifically, they shall:
- Continuously update their knowledge in sciences and clinical fields related to the tests performed in the Immunogenetics laboratory.
- Demonstrate an understanding of clinical test development and validation procedures. both technical and clinical. This will be done primarily by review of validation of tests already performed in the laboratory.
- Participate actively in educating and instructing others in matters related to Immunogenetics.
- Ask a definable question or questions related to tests being performed in the immunogenetics laboratory, new clinical, technical or biological issues related to Immunogenetics that may arise or have arisen during or before the rotation, search for relevant scientific information, critically appraise the information using the principles of evidence-based medicine, and evaluate the significance of this to the practice of molecular genetic pathology. The fellow shall present this information at departmental conferences (clinical pathology journal club, Pathology Chief of Service conference, clinical genetics conference, laboratory specific conference) and/or at national conference(s).
Interpersonal and Communication Skills
During the rotation, fellows must demonstrate interpersonal and communication skills that result in effective information exchange and teaming with other health care providers, laboratory personnel, patients, and patients' families. Towards this end they shall:
- Develop effective working relationships with professional and technical staff, and outside consultants.
- Demonstrate effective verbal communication skills when communicating results to clinicians, at the appropriate level for the information being transmitted; convey and explain test results clearly, precisely, and concisely to physicians in direct conversations, or at conferences; communicate effectively with technical personnel when troubleshooting assays, or when managing the laboratory.
- Develop excellent written skills for communication of complicated results when issuing reports, for the development and implementation of new laboratory policies and procedures, and for presentation of scientific research data, as appropriate.
- Develop presentation skills that include selection of appropriate presentation materials and visual aids, good oral presentation and mannerisms, and the ability to answer questions effectively.
During the rotation, fellows must demonstrate a commitment to professional responsibilities, adherence to highest ethical standards, and respect for all. Towards this, they shall:
- Demonstrate respect and compassion for the patient and a dedication to patient care.
- Treat each sample as belonging to a patient, and not just a number.
- Show respect for the confidentiality of all patient information.
- Conduct themselves with integrity and honor; If they identify any errors, or any areas where there is a possibility of unreliable results, quickly bring this to the attention of those responsible so errors may be prevented, or corrected immediately.
- Demonstrate reliability in all assigned activities;
- Demonstrate perfect attendance at all laboratory activities;
- Demonstrate completeness in the workup of all cases in the Immunogenetics laboratory.
- Educate other health care professionals in the technical functioning of and clinical implications of the various functions of the immunogenetics laboratory.
Systems Based Practice
Fellows must demonstrate an awareness of and responsiveness to the larger context and system of health care and the ability to call on system resources to provide molecular genetic pathology services that are of optimal value. Towards this they shall, where appropriate:
- Provide guidance to clinicians and counselors to ensure that molecular testing performed in the molecular pathology is used and integrated into patient care in an appropriate and cost-efficient manner.
- Understand the clinical implications and cost-effectiveness of the tests performed in the molecular pathology laboratory and their implications for patient management.
- Provide information on alternative testing approaches that may be used, when appropriate.
- Demonstrate knowledge of scientific, legal, and ethical issues relating to molecular testing. Understand standards and regulations governing laboratory operations including Clinical Laboratory Improvement Amendments (CLIA), and American Society for Human Immunogenetics, and how the organization of laboratory testing complies with these standards.
- Demonstrate knowledge of the impact of laboratory management and activities on the transplantation services of the hospital.
- Practice cost-effective health care and resource allocation that does not compromise quality of care.
- Be an advocate for quality patient care and contribute to clinician education.
- Demonstrate the ability to assess, understand, and use the resources, personnel, and health care systems necessary to provide optimal care.