Pathology Assistants Research Articles

Determinants of Safe Behavior among Clinical Pathology Assistants at Dr. Soebandi Regional Hospital Jember, Indonesia

Introduction: Every workplace has potential hazards that can threaten work safety, including clinical pathology laboratories. Work accidents in clinical pathology at Dr. Soebandi Regional Hospital Jember have decreased every year. This study aims to examine the determinants of safety behavior among clinical pathology assistants at Dr. Soebandi Regional Hospital, Jember. Methods: This research was a quantitative descriptive study with a cross-sectional approach. The study's respondents were 32 clinical pathology assistants. We collected data using a questionnaire. We analyzed this research using frequency, crosstab, and logistic regression tests. Results: The majority of clinical pathology assistants were under 40 years old, had completed occupational health and safety training, possessed competencies suitable for their work, maintained a positive attitude, and demonstrated high motivation at work. Almost all respondents stated that supervision was good, they had good knowledge, and their most recent level of education was Diploma-III. Most clinical pathology assistants behave safely. Clinical pathology assistants who are under 40 years old, have completed occupational health and safety training, exhibit competence, a positive attitude, and high motivation, report good supervision, possess good knowledge, and hold the latest Diploma-III education level are more likely to behave safely. Conclusion: Several clinical pathology assistants have demonstrated safe behavior while working in the clinical pathology laboratory. Several factors, including superior supervision and reasonable supervision efforts in the clinical pathology laboratory, contribute to the safe behavior of clinical pathology assistants.

Current gross examination and reporting patterns of post-neoadjuvant chemotherapy cystectomy specimens: Is it time for a standardized approach?

Neoadjuvant chemotherapy (NACT) is recommended for muscle-invasive bladder cancer, and robust treatment response may result in lack of grossly identifiable tumor in the cystectomy specimen. Current gross examination and reporting protocols, however, do not include specific guidance on the approach to these specimens. A Qualtrics survey was disseminated by email and X (formerly Twitter). Responses from pathologists and pathologists' assistants (PAs) were included. The survey interrogated demographics, practice settings, prevalence of NACT use, approach to gross examination, and reporting practices in the setting of both grossly visible tumor or ulcer bed and the complete absence of a gross lesion. Based on 55 respondents' experience, identifying gross tumor occurred less frequently than tumor or ulcer bed (40% vs 71%). Lack of identification of any gross lesions was estimated to occur in 29% of cases. Gross examination practices were relatively consistent in cases with residual gross tumor or gross tumor bed, with agreement that gross tumor should be submitted as 1 block per centimeter (66%), and tumor or ulcer bed should be submitted in its entirety (97%). Gross examination practices appeared more varied when no gross lesions were identified. Overall, most responders stated they "definitely" or "maybe" support a standardized gross examination (89%) and reporting (96%) protocol. With the increased use of NACT, lack of any gross lesion leads to inconsistent gross examination techniques. This study provides insight into the current approach to examination of post-NACT cystectomies and suggests that a desire exists among pathologists and pathologists' assistants for more standardized practice.

The Effects of Practice-Based Coaching on the Implementation of Shared Book Reading Strategies for Speech-Language Pathology Assistants and Paraeducators Working With Children With Language Delays

This study examined the effects of practice-based coaching with scripted supports designed to support paraeducators and speech-language pathology assistants (SLP-As) as they implement evidence-based shared book reading strategies with preschoolers with language delays. A single-case, multiple baseline across behaviors was employed. Five U.S. educators (three SLP-As and two paraeducators) participated in the study. The primary dependent variable was percentage of strategies correctly implemented; the secondary dependent variable was expressive and receptive vocabulary. Results demonstrate that all five educators were able to successfully implement the strategies with high and consistent levels of fidelity during the intervention and maintained similar levels of fidelity even after coaching and scripted supports were faded or removed. All five preschool participants showed gains in both expressive and receptive vocabulary. Social validity results support the feasibility and usefulness of the intervention. Implications for research and practice are provided.

Time Required for Gross Examination of Routine Second and Third Trimester Singleton Placentas by Pathologists' Assistants.

In both Canada and the United States, workload measurement for anatomic pathology is mainly based on complexity and clinical significance of specimens, with gross examination being a considerable contributor. While Pathologists' Assistants (PAs) play an increasing role in gross examination, there is little known regarding the time required for PAs to complete grossing tasks. This information is essential for effective staffing and workload management in pathology laboratories. The objective of our study was to determine the time required for PAs to gross second and third trimester singleton placentas in a large tertiary hospital with a significant perinatal pathology service. For our study, 7 certified PAs each grossed a minimum of 10 second and third trimester singleton placentas using a standard placental grossing protocol, an electronic laboratory information system, and voice recognition dictation software. Placental specimens requiring photography, sampling for ancillary studies, or immediate pathologist's consultation were excluded. We calculated average and standard deviation of grossing times for each PA, overall average grossing time, and 95% confidence interval using a mixed linear regression model. We analyzed the impact of PA job experience, degree obtained, and number of blocks prepared on overall average in a multivariate analysis. The mean grossing times for each PA ranged from 11.0 (standard deviation [sd] = 2.0) to 17.8 (sd = 4.5) minutes. The overall average grossing time was 14.5 minutes, with a 95% confidence interval of 11.7 to 17.3 minutes. In multivariate analysis, an increase in the number of blocks prepared was significantly associated with longer overall average grossing time. If 4 blocks were prepared consistently, the model predicted a slightly lower overall average of 13.3 minutes, with a 95% confidence interval of 10.9 to 15.7 minutes. To our knowledge, our study is the first to objectively report time required for PAs to perform gross examinations of routine second and third trimester singleton placentas. The methodology of our study is replicable and can be applied to other specimen types and laboratory settings. Previously, estimated grossing times for specimens were primarily based on retrospective surveys, which were susceptible to recall errors and subjectivity. However, our study demonstrates objective data collection is achievable. Furthermore, the data collected from this study offer valuable insights into the accuracy of previous and current pathology workload models for second and third trimester singleton placentas.

The effectiveness of using dye models for small tissue biopsies in the surgical pathology laboratory.

Losing of small tissues during tissue preparatory steps may seriously affect pathological diagnostic performance. Using an appropriate tissue marking dye could be an alternative solution. Therefore, the aim of the study was to find a suitable tissue marking dye to enhance the observable ability of various types of small-size tissues during several steps of tissue preparation. Various small-size samples of various organs and tissues (0.2 to 0.3 cm), including breast, endometrial, and cervical tissue, stomach, small and large intestine, lung, and kidney, were marked with different dyes such as merbromin, hematoxylin, eosin, crystal violet, and alcian blue prior to tissue processing step and their colored-observable ability was evaluated by pathology assistants. Moreover, the diagnostic interfering effect of each tissue marking dye was determined by pathologists. Merbromin, hematoxylin, and alcian blue increased the colored-observable ability of small tissue samples. We suggest using hematoxylin as a tissue marking dye over merbromin and alcian blue because of less toxicity and no interference effect in the step of routine pathological slide examination. Hematoxylin could be a suitable tissue marking dye for small-size samples and may improve the preanalytical process of tissue preparation in pathological laboratories.

Burnout and Disengagement in Pathology.

Despite widely prevalent burnout and attendant disengagement in medicine, the specific patterns and drivers within pathology and laboratory medicine are uncommonly studied. To assess the prevalence and drivers of burnout among pathology and laboratory medicine professionals, retrospectively, prior to the COVID-19 pandemic. This was a cross-sectional, mixed-methods study engaging pathology and laboratory medicine professionals as subjects. Of 2363 respondents, 438 identified as pathologists, 111 as pathology assistants, and 911 as pathology and laboratory professionals. The burnout rate was 58.4% (1380 of 2363) across all respondents in pathology and laboratory medicine. Burnout varied by job role (P < .01) and was highest among pathology and laboratory professionals. Disparities in burnout rate were observed by race. Fifty-six percent (1323 of 2363) of respondents felt that they had at least 1 symptom of burnout and were advancing toward a breaking point. Underlying factors ranked highly among all groups included control over workload and loss of meaning in work. Data provided from this cohort may help departments create successful strategies to reduce disengagement and burnout in the laboratory, especially during periods of increased stress as experienced during the COVID-19 pandemic. Further, these data may serve as a baseline comparison for future studies.

Forum Introduction: Promoting Equity in Speech-Language Services With Indigenous Children.

Forum Introduction: Promoting Equity in Speech-Language Services With Indigenous Children.

Real-Time Telepathology Is Substantially Equivalent to In-Person Intraoperative Frozen Section Diagnosis.

Intraoperative diagnosis by frozen section is a mainstay of surgical pathology practice, providing immediate feedback to the surgical team. Despite good accuracy with modern methods, access to intraoperative surgical pathology with an appropriate turnaround time (TAT) has been a limiting factor for small or remote surgical centers, with negative impacts on cost and patient care. Telepathology offers immediate expert anatomic pathology consultation to sites without an in-house or subspecialized pathologist. To assess the utility of live telepathology in frozen section practice. Frozen section diagnoses by telemicroscopy from 2 tertiary care centers with a combined 3 satellite hospitals were queried for anatomic site, TAT per block, pathologist, and concordance with paraffin diagnosis. TAT and concordance were compared to glass diagnoses in the same period. For 748 intraoperative diagnoses by telemicroscopy, 694 had TATs with a mean of 18 minutes 56 seconds ± 8 minutes 45 seconds, which was slower than on glass (14 minutes 25 seconds ± 7 minutes 8 seconds, P < .001). Twenty-two (2.89% of available) were discordant, which was not significantly different from the on-glass rate (P = .44) or categorical distribution (P = .31). Two cases (0.27%) had technical failures. Although in-person diagnoses were statistically faster, the great majority of telemicroscopic diagnoses were returned in less than 20 minutes. This remained true through numerous pathologists, pathology assistants and/or technicians, different hospitals, and during a combined 6 years. The concentration of discordant diagnoses among relatively few pathologists suggests individual comfort with telepathology and/or frozen section diagnosis. In rare cases, technical issues prevented telemicroscopic diagnosis. Overall, this justifies continued use and expansion of telemicroscopic services in primary intraoperative diagnoses.

Creating opportunities for telehealth education, assessment, and care through Hotspotting (CO-TEACH): An interprofessional telehealth delivery curriculum and guide

Telehealth offers a healthcare solution when functional, social, or geographic barriers arise; however, many clinical education curricula are ill-equipped to prepare learners for effective, multidisciplinary telehealth consultations. The COVID-19 pandemic drastically expanded reliance on telehealth in clinical practice and highlighted the urgent need to educate students across health professions in telehealth delivery. To address this educational gap, student and faculty collaborators from Duke University and the University of North Carolina at Chapel Hill utilized a developmental evaluation approach to rapidly design and pilot a compact, five-session, virtual curriculum to train students from a broad range of health professions in telehealth delivery. Through focused readings, large group didactics, and small group discussion, the curriculum provided a general overview of telehealth, addressed specific issues in health equity and access in virtual care both locally and nationally, introduced skills for conducting telehealth visits, and employed a patient simulation for students to practice their newly learned skills. The curriculum was delivered virtually over eight weeks to 36 students from ten health professions programs (occupational therapy, social work, pharmacy, audiology, speech-language pathology, dentistry, medicine, nursing, physical therapy, and physician assistants) across two universities. End-of-course feedback surveys identified that students most valued the opportunity to work with learners from different professions, practical instruction for telehealth, and a standardized patient experience. On post-course surveys students reported high self-efficacy in their telehealth competencies and indicated very positive attitudes toward interprofessional education. Overall, the compact nature of this curriculum facilitates adaptability to other student-led groups.

Treatment of Speech Sound Errors in Cleft Palate: A Tutorial for Speech-Language Pathology Assistants

Cleft palate is one of the most common birth defects in the United States. Most of these children receive speech therapy by preschool and school-based clinicians. The purpose of this article is to provide a comprehensive tutorial for speech-language pathology assistants (SLPAs) regarding treatment techniques and principles for children with cleft palate. It has been reported that 68% of preschoolers with repaired cleft palate received speech therapy. Preschool and school-based speech-language pathologists (SLPs) have reported a strong desire for practical professional development and continuing education resources regarding treatment of children with cleft palate. Thus, it seems likely that SLPAs may feel similarly unequipped to provide effective treatment for children with cleft palate. Obligatory and learned speech errors commonly found in children with cleft palate are described. Elicitation strategies for compensatory articulations are detailed. The implementation of evidence-based articulation and phonological treatment approaches is described in a step-by-step manner. "Red flags" that may arise during treatment and require input from the supervising SLP are highlighted. SLPAs will learn elicitation techniques for compensatory articulations and implement evidence-based treatment approaches to improve the speech accuracy of children with cleft palate. It is important for all school-based clinicians to be familiar with speech therapy for individuals with cleft palate.

Practice-Based Coaching for Speech-Language Pathologists Supporting Paraeducators and Speech-Language Pathology Assistants.

This tutorial is designed for speech-language pathologists who supervise speech-language pathology assistants (SLP-As) and/ or paraeducators. SLP-As and paraeducators often support young children with disabilities within early childhood settings, but do not always have access to professional development to learn and/or enhance their skill set. Practice-based coaching (PBC) provides a collaborative framework under which professionals can effectively implement instructional strategies with fidelity to support preschool children with language delays. In this tutorial, we will share the components of PBC including implementation materials that can be immediately utilized by SLPs. We will also share methods for embedding effective vocabulary instruction into shared book reading sessions to ensure early literacy instruction is more accessible to learners with varying educational needs.

“Getting Back Into School Mode”: Experiences of Former Speech-Language Pathology Assistants in Graduate School

Purpose: The purpose of this article is to describe the speech-language pathology master's program experience for two groups of students: students with former speech-language pathology assistant (SLPA) experience (fSLPA) and students without SLPA experience (nSLPA). Results are relevant to current SLPAs who are considering attending graduate school and university faculty members involved in program design. Method: A survey was distributed electronically to students nationwide. The survey included both Likert-style questions and open-ended responses. A total of 85 student responses were included in data, 43 fSLPAs and 42 nSLPAs. Qualitative and quantitative results were analyzed separately and then synthesized together in a mixed-methods analysis. Results: Although the study was not designed to directly measure stressors, bottom-up qualitative analysis resulted in a framework of internal and external stressors, internal and external supports, and learning and growing. Stressors and supports were described by participants as intertwined, and a given event (e.g., the start of clinical rotations) did not map neatly to stressors or supports for all participants. fSLPAs reported higher perceptions of clinical success, feeling different than their peers, and the perception that fSLPAs were more successful in graduate school. Taken together, these results converged to develop seven findings. For instance, one finding was that, although both groups reported external and internal stressors, the specific stressors somewhat varied by group. Conclusions: Findings are discussed in relation to transformational learning theory and prior works on stress within the field. Implications for program development and prospective speech-language pathology graduate students are discussed.

Workload Measurement in Subspecialty Placental Pathology in Canada.

Workload measurement is important to help determine optimal staffing and workload distribution for pathology laboratories. The Level 4 Equivalent (L4E) System is the most widely used Anatomical Pathology (AP) workload measurement tool in Canada. However, it was initially not developed with subspecialties in mind. In 2016, a Pan-Canadian Pediatric-Perinatal Pathology Workload Committee (PCPPPWC) was organized to adapt the L4E System to assess Pediatric-Perinatal Pathology workload. Four working groups were formed. The Placental Pathology Working Group was tasked to develop a scheme for fair valuation of placental specimens signed out by subspecialists in the context of the L4E System. Previous experience, informal time and motion studies, a survey of Canadian Pediatric-Perinatal Pathologists, and interviews of Pathologists' Assistants (PA) informed the development of such scheme. A workload measurement scheme with average L4E workload values for examination and reporting of singleton and multiple gestation placentas was proposed. The proposal was approved by the Canadian Association of Pathologist - Association canadienne des pathologistes Workload and Human Resources Committee for adoption into the L4E System. The development of a workload measurement model for placental specimens provides an average and fair valuation of these specimen types, enabling its use for resource planning and workload distribution.

Tutorial: Data Collection and Documentation Strategies for Speech-Language Pathologist/Speech-Language Pathology Assistant Teams.

This tutorial outlines an approach for best practices for speech-language pathology assistants (SLPAs) to collect data and document services. The tutorial outlines methods for developing accurate and effective data collection skills and provides instructions and tools for collecting various types of data. The authors discuss the importance of data collection as it relates to the roles and responsibilities of speech-language pathologists (SLPs) and SLPAs. The process of planning for data collection, recording the data, and reporting data to the supervising SLP is outlined. Developing competence with a wide variety of data collection methods, data types, and documentation tools will assist SLPAs to accurately communicate the results of the services they provide, therefore enhancing the SLP's ability to make well-informed clinical decisions for the student. https://doi.org/10.23641/asha.20277726.

What Makes Our Medical Laboratory Workforce Unique?

Abstract Introduction/Objective A career in the medical laboratory requires advanced education and technical training. To assist both employers and employees, several government organizations conduct demographic, education, and wage surveys for the general U.S. labor market. Through its workforce surveys, the American Society of Clinical Pathology (ASCP) does the same for the medical laboratory professions. Our aim was to compare the findings of these surveys and identify similarities and dissimilarities between the general labor pool and the medical laboratory workforce. Methods/Case Report Since the 2021 ASCP Wage survey is currently open, we reviewed the findings described in ASCP’s 2019 Wage Survey of Medical Laboratories in the United States (Am J Clin Pathol 2021;155:649-673) with the publicly available information (for 2019) on demographics, educational attainment, and average hourly earnings available on the websites of U.S. Bureau of Labor Statistics (www.bls.gov) as well as United States Census (www.census.gov). Results (if a Case Study enter NA) In 2019, the male: female ratio was 52.9:47.1 in general labor pool and 19.1:80.9 in the medical laboratory workforce. The average age of a worker in the general labor pool was 41.9 years and was 42 years in the medical laboratory workforce. The average hourly earnings were $27.99/hour in the general labor pool and ranged from $16.64/hour (phlebotomists) to $53.95/hour (pathologists assistants) in the medical laboratory workforce, with the MLS/MT/CLS earning $30.02/hour to $52.53/hour. While 33.1% adults in the U.S. have attained a bachelor’s degree or above, 73.79% have attained this in the medical laboratory workforce. Conclusion Compared to the general labor pool, the medical laboratory workforce is a highly educated workforce and has a higher participation by women. The average worker age and average hourly wage are comparable. We encourage laboratorians to participate in ASCP surveys since such surveys reveal data that can drive better prospects for the medical laboratory workforce.

Genesis of a New Generation of Telepractitioners: The COVID-19 Pandemic and Pediatric Speech-Language Pathology Services.

Purpose In March 2020, the COVID-19 pandemic caused a worldwide shift from in-person care to synchronous videoconferencing or telehealth. Many barriers to remote service delivery were eliminated, effectively creating a new generation of telepractitioners. This study chronicles changes in speech-language pathology clinicians' use and perceptions of telehealth with pediatric populations. Method The Telehealth Services: Pediatric Provider Survey was created in multiple steps and then distributed broadly through social media and professional community sites. Respondents were speech-language pathologists and speech-language pathology assistants in a variety of employment settings from across the country and abroad who were serving primarily pediatric clients (n = 269). Survey questions sought to capture changes in speech-language pathology clinicians' experiences with and perceptions of telehealth before, during, and predictions after the COVID-19 pandemic. Analyses identified factors that influenced the use of telehealth services before and after March 2020 (COVID-19). Results Survey results documented the dramatic increase in telehealth use from before March 2020 to October 2020. The reasons pediatric speech-language pathology clinicians used telehealth during the pandemic were mostly a result of employer mandates or lowering infection risk for both client and clinician; however, over time, pediatric speech-language pathology clinicians increased their telehealth proficiency and discovered the benefits of telehealth. Conclusion The adoption of telehealth and the rapid improvement in proficiency is a testament to the resiliency of providers and has long-term effects on the use of telehealth into the future. Supplemental Material https://doi.org/10.23641/asha.15183690.

Influence of Uniprofesssional versus Interprofessional Team Learning Activities on the Acquisition of Anatomical Knowledge: A Randomized Crossover Study

Interprofessional education (IPE) aims to cultivate collaborative skills especially in health professional students and is implemented by an increasing number of educational programs. IPE is well received by both students and faculty members citing a wide range of benefits including improved learning, positive professional identity, and better patient care. However, the implementation of IPE may have a negative influence on an already overloaded basic and clinical science curriculum or can be impeded by several factors such as course content, time constraints and scheduling conflicts. In this study, we quantitatively evaluated the influence of IPE on students’ ability to learn in a basic science course. A total of 270 professional students from three different programs over two academic years participated in this randomized crossover study measuring anatomical knowledge acquisition during two learning activities where students learned both course content and interprofessional concepts in a neuroscience course. The students were randomized into two teams and participated in two separate small-group learning activities, one in a uniprofessional team and another in an interprofessional team. Each student acted as their own control and took pre- and post-tests for each learning activity. The data was analyzed by a repeated measures ANOVA to assess any differences between learning neuroanatomy concepts in uniprofessional and interprofessional teams. Main effects for the ANOVA included learning group type (uniprofessional vs interprofessional), the order in which students participated in the learning activities, professional program (pathologist assistant, physical therapy, or podiatry), and academic year (2016 vs. 2017). Neither the learning group type nor any of the other main effects were found to significantly affect learning (p > .05). Additionally, none of the two-way interactions between learning group type and the other main effects were significant (p > .05). Overall, the introduction of interprofessional group learning activities did not impact the students’ test scores when compared to uniprofessional group learning activities. With limited IPE opportunities and scheduling constraints, our data suggested that the inclusion or exclusion of IPE during a basic science course does not affect the students’ anatomy learning outcomes. However, IPE in non-clinical courses could provide other benefits in health professional students’ professional development which warrants further investigation.

The impact of pathology grossing protocol measures to improve pathologic nodal staging in lung cancer

ObjectiveAccurate assessment of lymph node (LN) status is essential for proper staging of resected lung cancer specimens. Here, we assessed pathology-centric interventions to increase the number of peribronchial LNs identified and evaluated in anatomic lung cancer resection specimens as part of a quality improvement initiative. Materials and MethodsAll non-small cell lung cancer (NSCLC) anatomic resection specimens from 2017 to 2020 were evaluated, comprising two years pre-intervention and one year post-intervention. We instituted 3 measures to increase peribronchial LN yield: 1) educational grossing sessions for pathology assistants and residents, 2) directions to submit additional peribronchial tissue if no LNs were identified grossly, and 3) a hard-stop prior to sign-out by the attending pathologist if no peribronchial LNs were identified. ResultsOf the total 227 resection specimens for NSCLC, 107/151 (70.9%) of specimens prior to the intervention had peribronchial LNs identified, whereas after the intervention significantly more (66/76, 86.8%, p < 0.01) specimens had peribronchial LNs identified. In addition, the mean number of peribronchial LNs identified significantly increased from 2.7 ± 3.3 pre-intervention to 4.3 ± 4.0 post-intervention (p < 0.001). Further analysis revealed a strong correlation between peribronchial LN metastases with both overall tumor size and invasive component size (for adenocarcinomas), correlation coefficient 0.974, p < 0.0001. ConclusionEstablishing focused grossing measures by pathology led to a significant increase in the number of peribronchial LNs identified and assessed during histopathologic evaluation of anatomic lung cancer resection specimens. Larger tumors are more likely to have occult peribronchial LN metastases, which may warrant more aggressive peribronchial LN assessment for larger tumors.

A Practical Approach to Investigating Cross-Contaminants in the Anatomical Pathology Laboratory

Tissue contaminants in anatomical pathology are not uncommon. While issues related to the presence of extraneous tissue on glass slides are often easily resolved, this is not always the case and several factors may contribute to diagnostic difficulty. Because of this, familiarity with the different steps involved in handling specimens in the anatomical pathology laboratory is essential when troubleshooting possible cross-contaminants. Most commonly, the specimen constituting the source of cross-contamination is handled before the actual contaminated case; however, this is not always so. In this article, we review the steps involved in processing pathology specimens as they pertain to cross-contamination; share an approach covering how to troubleshoot and prevent tissue contaminants in a systematic and practical manner; present some examples from our own experiences; and compare our experience to what is reported in the literature. The information included in this article will be of use to all members of the anatomical pathology team including medical laboratory technologists, laboratory managers and supervisors, pathologist assistants, trainees in pathology, and pathologists.

Lack of Standardization in the Processing and Reporting of Post-Neoadjuvant Breast Cancer Specimens.

The use of neoadjuvant therapy in the management of early-stage invasive breast cancer is increasing. Residual Cancer Burden and other similar tools use pathologic characteristics of post-neoadjuvant therapy breast tumors to determine long-term outcome. However, there are no standardized guidelines for the pathologic evaluation of these specimens in the routine clinical setting. To assess current practices among Canadian pathologists and pathology assistants with regard to the processing and reporting of post-neoadjuvant therapy breast specimens. An electronic survey was distributed to pathologists and pathology assistants across Canada. Sixty-three responses were obtained. A total of 48% (15 of 31) of surveyed pathologists reported familiarity with the Residual Cancer Burden tool. A total of 40% (25 of 63) of respondents reported a lack of routine use of specimen photography, and 35% (22 of 63) reported a lack of routine use of grossing diagrams. There was significant variation with respect to tumor bed sampling; the most common method was to submit 1 block per centimeter of tumor (20 of 63; 32%). There was also significant variation in the method of measuring residual tumor; the most common method was to measure the largest cross-section of residual tumor (16 of 32; 50%). There is a need for standardization of the evaluation of post-neoadjuvant therapy breast specimens in the routine clinical setting in Canada. We recommend the routine use of specimen mapping, submitting the largest cross section of tumor bed in toto, reporting tumor size as per American Joint Committee on Cancer and Residual Cancer Burden guidelines, and routinely including measurements of residual tumor cellularity and in situ disease in the final pathology report as per Residual Cancer Burden guidelines.