1. HIV Drug Resistance Training
Module 17
Laboratory Staff Experience and Training
Present: In this module, we’ll talk about a critical element of the quality system—personnel.
Trainer’s Note: Before the module begins, post a flipchart at the front of the room. The flipchart should be titled Personnel Qualifications. It should have a 5 x 4 table on it like the one below.
Facilitate group tally: To begin the module, ask participants to look through the resumes/CVs that they brought to training and tally up the education and years of training of the molecular biology lab employees. They should put tally marks on the flipchart to indicate the range of experience and education. This tallying may be done during a break to minimize the time to transition to the module content.
Years of Experience
<1
1-3 3+
Highest Level of Education
No degree
Certificate
College degree
PhD, masters or similar

2. Objective
Identify strategies for ensuring you have the best people and then preparing those people to do their best.
Present objectives for the module.

3. personnel
What qualifications should lab personnel in a genotyping lab have?
What type of training is recommended for genotyping personnel?
Transition to next section. Note that we will try to answer this question.

4. Personnel Human resource planning Hiring Retention Training
Supervision
Performance
management
Present:
Personnel issues include all six areas shown on this slide.
Four of them (human resource planning, hiring, retention, and performance management) vary greatly from one location to the next and from one country to the next. We will not discuss those areas here; however, they are still important, and we encourage you to consider these factors in determining whether to establish a genotyping lab, which requires a high level of skill. Also, we encourage the measuring of quality indicators for monitoring and motivation.
Let’s focus now on training and supervision.

5. Laboratory Personnel: Qualifications
One year of experience
Training certificate
B.Sc.
Conditions
Applicant pool
Current staffing
Present:
Minimal qualifications must be determined by each lab.
You should strive for the best qualifications possible, balanced with local conditions.
Goal: B.Sc. or equivalent
Minimally: technical training certificate, at least 1 year full time experience
Consider:
Reality of available pool of applicants
Existing personnel and infrastructure (e.g. if highly experienced staff already present, can hire less experienced technicians)

6. Laboratory Personnel: New Staff
Training:
HIV Genotyping
Passing Scores:
All training listed below
Laboratory safety
Bloodborne pathogens
Personal protective equipment
Biohazardous waste management
Site specific biosafety
Present: Newly hired staff should be trained and obtain passing scores in the following areas before they can be trained on HIV genotyping techniques. (The base of the pyramid).
Laboratory safety
Bloodborne pathogens
Personal protective equipment
Bioharzardous waste management
Site specific biosafety walk through

7. Laboratory Personnel: Training/Proficiency
Genotyping Technique Training
Training and proficiency FIRST, then "real" survey samples
Remove operator-sensitivity of assay accuracy and reproducibility
Use panel of well-characterized control samples
Present:
Training and proficiency must be demonstrated and documented before "real" survey samples processed
Goal is to remove operator-sensitivity of assay accuracy and reproducibility
Use panel of well-characterized control samples to assess performance
Emphasize: Rigorous training, followed by rigorous testing, is essential to ensure accurate and precise results.
Discuss: What training and proficiency processes/procedure do you currently have in palce that can serve as a model for the HIVDR testing training?

8. Laboratory Personnel: Training/Proficiency
Annual re-certification recommended for all personnel
Blinded panel of known samples
May be same as EQA proficiency testing
Present information on slide.
Photo:

9. Laboratory Personnel: Supervision
Base-calling involving mixtures – always have second person review edits
In-process controls when results are unclear
Sample identity questions
Assessment of quality indicators (e.g. phylogenetic trees, number of mixtures, etc.)
Present: Complexity of genotyping assay steps sometimes requires consultation with more experienced supervisor, especially when using in-house assays).
Go over the different examples on the slide of how supervisors can add value to help ensure accurate genotyping.
Photo:

10. Where to Get Training/Experience
Workshops
Genotyping kit vendors
Hands-on workshops
Regional and Specialized accredited labs
Parallel testing
Present information on sources of training and learning:
Workshops like this one!
Genotyping kit vendors
Hands-on workshops delete if we can't cite specific examples
Other accredited labs in ResNet--Training is a responsibility of Regional and Specialized accredited labs
For surveys where samples are being sent to a Regional or Specialized lab, perform testing in parallel and compare results

11. Discussion
What qualifications should lab personnel in a genotyping lab have?
What type of training is recommended for genotyping personnel?
Facilitate a group discussion of the questions that were presented at the beginning of the section, as a review and to make sure participants understand the key points.
Discuss: What implication do these points have to you at the national level?

12. Reflection What will our minimum and desired qualification be?
What systems will we put in place to make sure our staff are adequately prepared to do genotyping?
Training
Proficiency testing
Supervision
Discuss these questions.
Ask participants to write their own answers to these questions in the blank space on their handouts.
Ask select participants to summarize, in one or two sentences, the key points they learned in this module.