‘Morph’ology of Cytotechnology Education Amber Donnelly, PhD, MPH, SCT(ASCP)

Conflict of Interest No conflict or potential conflict of Interest to declare

Definition of Morph

Morphology in Cytology

• Relates to cellular changes: Shape, structure, form, size

Morph

• Change smoothly from one image to another by gradual steps

• To change gradually and completely from one thing into another thing usually in a way that is surprising or seems magical

Challenges

Decrease in Pap Tests

Screening interval recommendations

Computer assisted screening technology

Primary HPV testing

HPV vaccine

More challenges Student recruitment down

Little known profession (recruitment grant)

Degree advancement necessary (Compete with other specialities)

Negative social media because of declining Pap Tests (insecurity)

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1980 2016

CT Programs in U.S.

Active CT Programs

Program closures Risk of too few cytotechs for jobs in near future (Retirements)

Opportunities

ROSE

FISH (Prepare/analyze/Correlate/

give prelim report/select images for sign-out)

Processing

LIS

Admin

Grossing

Frozen sections

Lab safety

Troubleshooting

Digital imaging

Specimen triage

Telecytology

Billing/coding

Histology

Pre-screening of histologic samples

Ordering ancillary tests (Cyto & histo

specimens)

Scoring of IHC intensity and staining

patterns

Molecular signal detection (GC/CT, PCR)

Molecular diagnostic Oncology (EGFR,

ALK, BRAF, KRAS)

Select and mark area of tumor – tissue

Estimate/evaluate for sufficient DNA

quantity for genetic testing

Circulating tumor cells (utilize software,

select images, analyze, give prelim

report

Research / publications

Implementation Challenges

Acceptance

Billing/reimbursement

Financing (faculty, curriculum…)

Scope of practice defined

Certifying exam needed (New exam or new questions)

How to teach new material?

Degree/Certification levels (New degree or advanced)

What are we doing in the US?

Support of many organizations

Committees formed

CPRC

MLPP committee

ASC/ASCP workgroup

ACE

What are we doing at UNMC

Virtual

Immuno virtual

Histo virtual

ROSE

Research opportunities

Grant experience

Telecytology

Simulation center

Distance education

Distance Education UNMC – Virtual teaching methods

Recorded lectures

Recorded Video microscope sessions

Annotated Virtual microscopy slides

12 month program

8 months didactic

3 months clinical rotations

All body sites:

Case Information and reference from Text book

Virtual slides Annotations

Virtual Microscopy Web site- mScope

Written annotations

Virtual Dot – accompanies written annotation

Magnification Tool

Thumbnail of virtual slide

Virtual Microscopy Web site- mScope

E-Module on the FNA procedure: Roles of a Cytotechnologist and Pathologist

E-Module on ROSE

E-Module on Telecytology

Student Research/Grant Projects

Virtual Anatomy –Anatomage Table

Short term goals

Add to curriculum – those who wish can stay in MSIA program

Digital imaging (Scanning, telepathology, archiving)

Enhanced Immuno (ordering, stain intensity, patterns)

ROSE

Research / Publications

Grant writing

IRB

Intro to histology samples (Morphologic cyto-histo correlation)

Long term goals

Master’s degree in Advanced practice

In additional to the previous list:

Increase length - 18-24 month program

Pre-screen histologic samples (prelim. Diagnosis)

Molecular (signal detection & diagnostic oncology)

Specimen triage (ordering ancillary tests)

Grossing / frozen sections

Management of tumor boards, pathology rounds (Digital imaging)

Increased telepathology services (whole slide, real time, via phone)

Time to Morph

Now is the time to take gradual steps toward change

Let’s join together to make the journey surprising and magical