Albany State University

Histotechnology IV

Clinical Evaluation

Please evaluate the student in the following 13 areas.

Grading Scale: 0-6 - Failed to demonstrate satisfactory skills to perform task; 7 - Satisfactorily performed task;
8 - Performed task well; 9-10 - Performed task excellent; N/A - Our lab does not perform this task or student was not asked to perform this task.

Final Clinical Evaluation

Receiving, Accessioning, and Grossing

1. Recognizes and receives specimens on arrival or pick up

Select One 0 1 2 3 4 5 6 7 8 9 10 N/A

2. Verifies that the specimen has been placed in appropriate fixative for the requested procedure

Select One 0 1 2 3 4 5 6 7 8 9 10 N/A

3. Verifies that paperwork has all the necessary patient information and follows up on any discrepancies

Select One 0 1 2 3 4 5 6 7 8 9 10 N/A

4. Assists laboratory personnel in accessioning specimens

Select One 0 1 2 3 4 5 6 7 8 9 10 N/A

5. Follows correct patient identification procedures

Select One 0 1 2 3 4 5 6 7 8 9 10 N/A

6. Assist laboratory personnel with grossing

Select One 0 1 2 3 4 5 6 7 8 9 10 N/A

7. Stores remaining wet tissue according to established procedures

Select One 0 1 2 3 4 5 6 7 8 9 10 N/A

Routine Processing

1. Selects correct processing schedules

Select One 0 1 2 3 4 5 6 7 8 9 10 N/A

2. Assist laboratory personnel with cleaning, rotating, and changing solutions

Select One 0 1 2 3 4 5 6 7 8 9 10 N/A

3. Demonstrates knowledge of proper disposal of used processing reagents

Select One 0 1 2 3 4 5 6 7 8 9 10 N/A

4. Records new reagents, rotation of reagents, and oven temperature of processor on QC log

Select One 0 1 2 3 4 5 6 7 8 9 10 N/A

Decalcification

1. Selects appropriate decalcification methods

Select One 0 1 2 3 4 5 6 7 8 9 10 N/A

2. Recognizes appropriate degree of decalcification

Select One 0 1 2 3 4 5 6 7 8 9 10 N/A

Frozen Sections

1. Maintains a set up work area at all times to minimize specimen preparation time

Select One 0 1 2 3 4 5 6 7 8 9 10 N/A

2. Specimens submitted for frozen section are handled without delay

Select One 0 1 2 3 4 5 6 7 8 9 10 N/A

3. Operates and maintains cryostat with correct setting, temperatures, and alignments

Select One 0 1 2 3 4 5 6 7 8 9 10 N/A

4. Cuts representative sections and maintains enough tissue for routine processing

Select One 0 1 2 3 4 5 6 7 8 9 10 N/A

5. Stains, coverslips, and delivers slide within the appropriate turnaround time frame

Select One 0 1 2 3 4 5 6 7 8 9 10 N/A

Tissue Embedding

1. Recognizes specimens that are not processed completely

Select One 0 1 2 3 4 5 6 7 8 9 10 N/A

2. Selects adequate mold size

Select One 0 1 2 3 4 5 6 7 8 9 10 N/A

3. Identifies and orients specimens correctly

Select One 0 1 2 3 4 5 6 7 8 9 10 N/A

4. Avoids the formation of air bubbles or multilayering of paraffin

Select One 0 1 2 3 4 5 6 7 8 9 10 N/A

5. Validates the actual number of cassettes embedded with the accession log and documents/reports discrepancies

Select One 0 1 2 3 4 5 6 7 8 9 10 N/A

6. Measures paraffin temperature and records temperature on QC log

Select One 0 1 2 3 4 5 6 7 8 9 10 N/A

7. Checks paraffin levels and refills paraffin chamber when needed

Select One 0 1 2 3 4 5 6 7 8 9 10 N/A

8. Embeds at an acceptable rate while maintaining quality

Select One 0 1 2 3 4 5 6 7 8 9 10 N/A

Microtomy

1. Verifies slides match corresponding blocks throughout the microtomy process

Select One 0 1 2 3 4 5 6 7 8 9 10 N/A

2. Operates microtome with the correct settings and alignments

Select One 0 1 2 3 4 5 6 7 8 9 10 N/A

3. Identifies incorrectly embedded blocks

Select One 0 1 2 3 4 5 6 7 8 9 10 N/A

4. Determines appropriate amount of facing (trimming)

Select One 0 1 2 3 4 5 6 7 8 9 10 N/A

5. Cuts representative sections without cutting away too much tissue

Select One 0 1 2 3 4 5 6 7 8 9 10 N/A

6. Recognizes and troubleshoots instances in which a specific tissue might require a deviation from the standard procedure in order to insure a diagnostic section is produced

Select One 0 1 2 3 4 5 6 7 8 9 10 N/A

7. Selects quality sections to pick up and mounts to slide without problems

Select One 0 1 2 3 4 5 6 7 8 9 10 N/A

8. Produces an acceptable number of slides per hour while maintaining quality

Select One 0 1 2 3 4 5 6 7 8 9 10 N/A

Routine Staining

1. Selects appropriate reagents to perform H&E staining

Select One 0 1 2 3 4 5 6 7 8 9 10 N/A

2. Can properly prepare reagents, place labels on reagent containers, and select the proper storage for reagents.

Select One 0 1 2 3 4 5 6 7 8 9 10 N/A

3. Chooses adequate methods and times for drying slides

Select One 0 1 2 3 4 5 6 7 8 9 10 N/A

4. Sets up, loads, and monitors the operation of the automated stainer

Select One 0 1 2 3 4 5 6 7 8 9 10 N/A

5. Demonstrates ability to determine acceptable vs. unacceptable H&E staining by identifying tissue structures and their staining characteristics

Select One 0 1 2 3 4 5 6 7 8 9 10 N/A

6. Can troubleshoot and correct staining problems

Select One 0 1 2 3 4 5 6 7 8 9 10 N/A

7. Records new reagents, rotation of reagents, and oven temperature of H&E stainer on QC log

Select One 0 1 2 3 4 5 6 7 8 9 10 N/A

Special Staining

1. Identifies proper control tissues and stains to be used for demonstrating specific tissue constituents or pathogens

Select One 0 1 2 3 4 5 6 7 8 9 10 N/A

2. Can properly prepare reagents, place labels on reagent container, and select the proper storage for reagents

Select One 0 1 2 3 4 5 6 7 8 9 10 N/A

3. Chooses adequate methods for drying slides, rehydrating slides, and dehydrating slides

Select One 0 1 2 3 4 5 6 7 8 9 10 N/A

4. Demonstrates the ability to determine acceptable vs. unacceptable staining by identifying tissue structures and their staining characteristics

Select One 0 1 2 3 4 5 6 7 8 9 10 N/A

5. Can troubleshoot and correct staining problems

Select One 0 1 2 3 4 5 6 7 8 9 10 N/A

6. Sets up, loads, and monitors the operation of the automated special stainer

Select One 0 1 2 3 4 5 6 7 8 9 10 N/A

Coverslipping Procedures

1. Ensures that debris and partial sections are removed from the slide prior to applying coverslip during manual coverslipping and reviews automatic coverslipped slides to ensure that debris and partial sections are not present on slide

Select One 0 1 2 3 4 5 6 7 8 9 10 N/A

2. Applies an appropriate amount of mounting medium during manual coverslipping

Select One 0 1 2 3 4 5 6 7 8 9 10 N/A

3. Sets up, loads, monitors, and unloads the automated coverslipper

Select One 0 1 2 3 4 5 6 7 8 9 10 N/A

4. Compares finished slides to the accessioning log and documents or reports discrepancies

Select One 0 1 2 3 4 5 6 7 8 9 10 N/A

5. Delivers completed slides to the appropriate person/place

Select One 0 1 2 3 4 5 6 7 8 9 10 N/A

6. Manually coverslips at an acceptable rate while maintaining quality

Select One 0 1 2 3 4 5 6 7 8 9 10 N/A

Instrumentation

1. Can maintain or service equipment according to established protocols

Select One 0 1 2 3 4 5 6 7 8 9 10 N/A

2. Can troubleshoot and fix equipment or report problems to appropriate personnel

Select One 0 1 2 3 4 5 6 7 8 9 10 N/A

General Safety Procedures

1. Demonstrates correct safety practices

Select One 0 1 2 3 4 5 6 7 8 9 10 N/A

2. Recognizes and reports dangerous situations

Select One 0 1 2 3 4 5 6 7 8 9 10 N/A

3. Demonstrates the ability to recall safety information or can efficiently utilize reference materials

Select One 0 1 2 3 4 5 6 7 8 9 10 N/A

4. Can locate SDS, fire extinguishers, eyewash stations, emergency showers, and exits

Select One 0 1 2 3 4 5 6 7 8 9 10 N/A

5. Demonstrates good hand hygiene, don appropriate PPE, and treats all specimens with universal precautions

Select One 0 1 2 3 4 5 6 7 8 9 10 N/A

6. Follows chemical hygiene procedures when handling hazardous chemicals and is knowledgeable about chemical storage and disposal

Select One 0 1 2 3 4 5 6 7 8 9 10 N/A

Patient Safety

1. Maintains correct specimen identification through the entire histology process

Select One 0 1 2 3 4 5 6 7 8 9 10 N/A

2. Reports any suspected patient safety issues to appropriate personnel

Select One 0 1 2 3 4 5 6 7 8 9 10 N/A

General

1. Maintains an orderly and hygienic work area

Select One 0 1 2 3 4 5 6 7 8 9 10 N/A

2. Demonstrates good communication skills with personnel

Select One 0 1 2 3 4 5 6 7 8 9 10 N/A

3. Acts in a professional manner at all times

Select One 0 1 2 3 4 5 6 7 8 9 10 N/A

4. Arrives and leaves as scheduled

Select One 0 1 2 3 4 5 6 7 8 9 10 N/A

5. Follows established procedures and verbal orders

Select One 0 1 2 3 4 5 6 7 8 9 10 N/A

Comments:

Student Name:

Clinical Liaison Name:

Facility Name: