The Importance of a New Look at Laboratory Management
Education in Pathology Residency Training

The assertion that training in laboratory management is an important component of pathology resident education is not new, but has been a recurring part of consensus documents about pathology resident education. In 1987 the Graduate Medical Education Committee of the Association of Pathology Chairs (APC) met in Park City, Utah, and listed management principles as an important component of resident education. Similarly, the 1993 ASCP Colorado Springs Conference on curriculum reform led to the Graylyn Conference, a combined effort of Academy of Clinical Laboratory Scientistis (ACLPS), the American Society for Clinical Pathology (ASCP), APC, and the College of American Pathologists (CAP), that concluded, among other things, that residents should become capable of managing clinical laboratories. As a result, the large majority of residency programs in the US and Canada have stated that they incorporate laboratory management training into their curricula, although the extent and manner are quite variable. However, despite these longstanding efforts to achieve some degree of competence in the skills required to direct a laboratory, evidence suggests we are falling short of our stated goals. Surveys of pathologists in practice by Horowitz in 1998 and 2005 found dissatisfaction with the management, communication, and interpersonal skills of newly trained pathologists. A survey conducted by APC and CAP in 2009 confirmed that these perceptions persist.

Why Today?

If management, communication and interpersonal skills have been important and lacking for the past few decades, despite efforts of residency program directors to enhance curricula with such training, why does this deserve additional attention now? Every organization that has looked at the future of pathology has reached similar conclusions. Today and in the future, even more than in the past, the profession needs practitioners who can exert their influence beyond the laboratory. The ASCP has conducted two task forces on the future of pathology. Among other things, these task forces have concluded that it is essential for pathologists to change the way in which we relate to patients, physicians, and the wider health care community, establishing ourselves as an indispensable source of information and guidance. In similar language, the CAP’s Transforming Pathologists initiative stresses the importance of repositioning pathologists as the center of the health care team. Clearly, the future of the profession depends on just those skills that pathologists seem to be lacking, at least as they emerge from their graduate medical education.


Workgroup Established to Develop Curriculum

A Workgroup of PRODS members, with staff and volunteer support from the American Pathology Foundation (APF) and ASCP, has developed the following Laboratory Management curriculum, following a workshop conducted by PRODS, APF, and ASCP at the 2009 APC meeting. In addition to the curriculum itself, a number of principles emerged from the discussions at the PRODS meeting and thereafter:

  1. The skills needed to successfully direct a laboratory and move the profession forward include not only knowledge of management content and principles, but also informatics, communication skills, professional work habits, interpersonal skills and “good citizenship” attributes.
  2. Acquisition of laboratory management skills will promote personal career development and advancement for our trainees, distinguishing not only the individual but the program in which he/she trained.
  3. Management training cannot be accomplished based only on didactic presentations, but requires practical, hands-on experience, ideally including long-term projects, junior directorships, and other opportunities for horizontal learning.
  4. Management training applies to all areas of pathology education: clinical pathology, anatomic pathology, and research pathology.
  5. Mentoring has a key role in pathology education, including management education.
  6. A successful laboratory management curriculum depends upon the enthusiastic support of departmental faculty, especially departmental leadership.
  7. Recruitment of experts from outside of pathology departments can significantly enhance management training. Effective resident education in management will require the development of new evaluation tools. Evaluating the effectiveness of the program requires tools to measure outcomes by assessing graduates in their practices.
  8. This curriculum, like any standardized curriculum, is best viewed as a resource for each individual residency program to develop its own unique curriculum, and is not a mandate.

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