THE NATURE AND EXTENT OF TRAINING ACTIVITIES IN CLINICAL PATHOLOGY REQUIRED FOR EFFECTIVE CONSULTATION ON LABORATORY TEST SELECTION AND INTERPRETATION

Objective.-The goal of this study was to identify the activities in cl inical pathology training and the length of time required in each to e ffectively train residents as consultants on laboratory test selection and interpretation. Methods.-The information needed to address these questions was obtained from a study of 20 residents in clinical pathol ogy at our institution between 1990 and 1996. In the survey participan ts were asked to assess the value of specific training activities in d eveloping their confidence when addressing consultative questions on l aboratory test use and interpretation. Participants were also asked to assess the length of time required to gain confidence in performing t his role. Results.-The results of the study demonstrate that confidenc e in providing advice on clinical laboratory test selection and interp retation is acquired to a significant but not absolute degree after an intense 8-week experience in a single clinical laboratory subspecialt y, during which time no other responsibilities are assigned. The data also indicate that interactions with clinical pathologists and formal lectures provided to the trainees during their rotations are critical components of the consultation service. There was a significant decrea se in the length of time required to provide effective information on test selection and interpretation as the residents progressed through their training. Conclusions.-For all of the major subspecialties in cl inical pathology, the residents gained significant confidence by 4 wee ks of intense training, and by 8 weeks participants were very confiden t in answering consultation questions. Even after 8 weeks, however, fe wer than 10% of the residents felt absolutely confident in their own d ecisions regarding laboratory test use and interpretation prior to dis cussion with senior residents and faculty. Thus, acquisition of expert ise to effectively provide advice on laboratory test selection and int erpretation required up to 8 weeks of focused training in each clinica l laboratory subspecialty. Gaining confidence in multiple areas requir es a significant commitment of full-time training. This study provides an understanding of the type and extent of training required to attai n the skills necessary to effectively provide consultation in clinical pathology.