Web-based Competency Assessment System for Microscopic Urinalysis

Abstract

Under CLIA, clinical laboratories are required to document the competency of all personnel. Competency assessment assures quality laboratory testing through evaluating employees’ competency and providing remedial training to those who need it (1). Competency assessment can ( a ) identify key training areas, ( b ) identify processes that need improvement, ( c ) provide supervisors and managers with data on employee performance, and ( d ) provide evidence to customers, management, and surveyors that the laboratory assures quality with competent staff (2). The most common methods of assessing competency in laboratory personnel are direct observation, review of laboratory test and quality-control results, review of instrument preventive maintenance records, and written testing (1). Computer-based exams have not been widely used as competency assessment tools although they have several potential advantages, including automatic exam scoring and error analysis (3), immediate detailed feedback to exam questions, and the ability to simulate laboratory instrumentation. In this report, we demonstrate Urinalysis-CA (Urinalysis-Competency Assessment, distributed by Medical Training Solutions, Seattle, WA), a web-based competency assessment system for microscopic urinalysis that is a logical and major extension of Urinalysis-ReviewTM, our previous, diskette-based software (4). Urinalysis-CA is a web-based competency assessment program administered twice annually to registered laboratories. The program runs optimally using Internet Explorer 4 (or higher) or Netscape 4.0 (or higher). Content experts at the University of Washington Department of Laboratory Medicine constructed the exams. Three exams were administered during the study, which lasted from March 2000 to September 2001. Each exam consists of 10 image-based, multiple choice questions that test the ability to identify 1 or more of 34 urine sediment structures in five categories: ( a ) cells, ( b ) casts, ( c ) normal crystals, ( d ) abnormal crystals, and ( e ) organisms/artifacts. The images were collected from urine sediments prepared in the clinical laboratories at …