ASCP Certification: The Standard of Excellence Designing a Job Task Survey: The Value of Direct Observation and Structured Interviews Pamela Frommelt, MS, MT(ASCP) Laura Culver Edgar, MBA, MT(ASCP) Donna Surges Tatum, PhD, CAE Kory Ward-Cook, PhD, MT(ASCP), CAE

ASCP Certification: The Standard of Excellence OBJECTIVE To collect valuable qualitative data for use in designing a job task survey instrument examining laboratory professionals’ practices. The data includes medical technologists (MTs), medical laboratory technicians (MLTs), and phlebotomy technicians (PBTs) in various practice settings.

ASCP Certification: The Standard of Excellence METHODS  Quantitative data was collected via direct observations and structured interviews at different laboratory settings in three different regions of the country. (Table 1)  The length of time spent performing the observations and interviews varied at each sight from one business day up to 16 business days.  Each individual included in the data collection was directly observed and given a structured interview.  Forty interview questions were partially constructed from previously published consensus documents, competency statements and refereed publications. (Table 2)  To ensure consistency in data collection, certified medical technologists on staff at the ASCP-Board of Registry performed the direct observations and interviews.

ASCP Certification: The Standard of Excellence RESULTS u The observations and interviews (n=160) confirmed and/or uncovered the tasks performed by MTs, MLTs and PBTs. u Regional differences in tasks were noted, all of which were included in the survey. Additionally, the combination of data collection methods enhanced the responses from individuals. u Those laboratory professionals who were more technical gave more detailed information on technical tasks, such as specifics involved in completing a toxicology panel. Those in supervisory or management positions provided information dealing with the less scientific aspects of the career, such as communication and management. u The observations and interviews completed at industrial and research sites provided an even broader view of these professionals’ roles and responsibilities. (Table 3) u Data from the observations and interviews led to an ethnographic report. This served as the foundation for the resultant fifteen-page survey instrument. (Table 4) u The practice analysis survey instrument was distributed to more than 17,000 ASCP- BOR certified individuals.

ASCP Certification: The Standard of Excellence CALIFORNIA (TABLE 1a) PLACE CITY KAISER PERMANENTELOS ANGELES CEDARS-SINAI MEDICAL CENTER LOS ANGELES NAVAL MEDICAL CENTERSAN DIEGO QUEST DIAGNOSTICSSAN DIEGO GEN-PROBESAN DIEGO

ASCP Certification: The Standard of Excellence PLACECITY BECKMAN COULTERMIAMI BROWARD GENERAL MEDICAL CENTER FORT LAUDERDALE CELEBRATION HEALTHORLANDO DIABETES AND ENDOCRINE CENTER ORLANDO FLORIDA GULF COAST UNIVERSITY FORT MYERS FLORIDA HOSPITAL ORLANDOORLANDO QUEST DIAGNOSITICSORLANDO FLORIDA (TABLE 1b)

ASCP Certification: The Standard of Excellence PLACECITY BIOSAFE LABORATORIES, INC.CHICAGO BROOKFIELD ZOOBROOKFIELD COOK COUNTY MEDICAL EXAMINER’S OFFICE CHICAGO ILLINOIS DEPARTMENT OF PUBLIC HEALTHCHICAGO INGALLS MEMORIAL HOSPITALHARVEY LIFESOURCE BLOOD SERVICES GLENVIEW NORTHWESTERN MEMORIAL HOSPITALCHICAGO CLINICAL RESEARCH LABORATORY OF NORTHWESTERN MEMORIAL HOSPITAL CHICAGO PERRY MEMORIAL HOSPITALPRINCETON UNIVERSITY OF CHICAGO HOSPITALCHICAGO ILLINOIS (TABLE 1c)

ASCP Certification: The Standard of Excellence TABLE 2: LIST OF INTERVIEW QUESTIONS 1. Collect specimens (i.e. cyto - FNA): 2. Prepare/process specimens: (for the following: CT, HT, EM, IHC, Flow) 3. Routine laboratory procedures performed: 4. Specialized laboratory procedures performed: 5. List of specimens processed: 6. List special stains performed/used: 7. Perform electron microscopy: 8. Perform flow or laser cytometry (i.e. DNA ploidy): 9. Grossing performed? 10. Level of automation: 11. Perform molecular diagnostic testing (i.e. HPV testing, PCR): 12. QA activities performed: 13. Recognize a problem in QC results: 14. Implement new procedures: 15. Evaluate new instruments: 16. Select new instruments/methods: 17. Establish technical procedures: 18. Recommend test selection: 19. Develop laboratory manuals, reports etc.:, 20. Purchase reagents/supplies: 21. Prepare reagents: 22. Perform preventative maintenance: 23. Troubleshoot lab instruments: 24.Use of instrument manufacturer hotlines

25. Evaluate computer data and problems: 26. Communicate technical information to medical persons: 27. Communicate technical information to lay persons: 28. Recognize normal and abnormal values: 29. Correlate abnormal with disease status: 30. Maintain confidentiality of test results: 31. Evaluate the effectiveness of educational programs: 32. Implement safety and waste management procedures: 33. Train laboratory personnel: 34. Prepare and present lectures: 35. Work with legislative activities: 36. Participate in committee activities: ASCP Certification: The Standard of Excellence TABLE 2 (CONT’D) 37. Participate in research activities: 38. Participate in continuing education: 39. Supervise laboratory personnel: 40. Supervise laboratory projects: 41. Perform point-of-care tests: 42. Perform non-lab tests (i.e. x-ray, respiratory): 43. Reflexive testing: 44. Compliance/regulatory: 45. Skill mix: 46. Number of persons per shift: 47. Other:

ASCP Certification: The Standard of Excellence

TABLE 4: PRACTICE ANALYSIS SURVEY >

 This multi-method approach to instrument design proved to be successful. The interview questions gleaned from other studies combined with the direct observation were key elements to the development of the survey instrument.  The observations and responses that were obtained provided valuable information that otherwise would not have been evident.  Direct observation and structured interviews contributed substantially to the development of a meaningful survey instrument. ASCP Certification: The Standard of Excellence CONCLUSION