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Walden University ScholarWorks Walden Dissertations and Doctoral Studies Walden Dissertations and Doctoral Studies Collection 2001 The orC relation Between the Levels of Education of Clinical Laboratory Personnel and the Accuracy of Peripheral Blood Smear Results Susan J. Leclair Walden University Follow this and additional works at: https://scholarworks.waldenu.edu/dissertations Part of the Equipment and Supplies Commons, Health and Medical Administration Commons, and the Other Analytical, Diagnostic and Therapeutic Techniques and Equipment Commons This Dissertation is brought to you for free and open access by the Walden Dissertations and Doctoral Studies Collection at ScholarWorks. It has been accepted for inclusion in Walden Dissertations and Doctoral Studies by an authorized administrator of ScholarWorks. For more information, please contact [email protected]. INFORMATION TO USERS This manuscript has been reproduced from the microfilm master. UMI films the text directly from the original or copy submitted. Thus, some thesis and dissertation copies are in typewriter face, while others may be from any type of computer printer. The quality of this reproduction is dependent upon the quality of the copy submitted. Broken or indistinct print, colored or poor quality illustrations and photographs, print bleedthrough, substandard margins, and improper alignment can adversely affect reproduction. In the unlikely event that the author did not send UMI a complete manuscript and there are missing pages, these will be noted. Also, if unauthorized copyright material had to be removed, a note will indicate the deletion. Oversize materials (e.g., maps, drawings, charts) are reproduced by sectioning the original, beginning at the upper left-hand comer and continuing from left to right in equal sections with small overlaps. Photographs included in the original manuscript have been reproduced xerographically in this copy. Higher quality 6” x 9" black and white photographic prints are available for any photographs or illustrations appearing in this copy for an additional charge. Contact UMI directly to order. ProQuest Information and Learning 300 North Zeeb Road, Ann Arbor, Ml 48106-1346 USA 800-521-0600 Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. The Correlation Between the Levels of Education of Clinical Laboratory Personnel and the Accuracy of Peripheral Blood Smear Results by Susan J. Leclair M.S., University of Massachusetts Dartmouth, 1977 B.S., Stonehill College, 1968 Submitted in Partial Fulfillment of the Requirement for the Degree of Doctor of Philosophy Health Services Walden University August 2001 Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. UMI Number: 3027925 Copyright 2002 by Leclair, Susan Jean All rights reserved. _ __ ® UMI UMI Microform 3027925 Copyright 2002 by Bell & Howell Information and Learning Company. All rights reserved. This microform edition is protected against unauthorized copying under Title 17, United States Code. Bell & Howell Information and Learning Company 300 North Zeeb Road P.O. Box 1346 Ann Arbor, Ml 48106-1346 Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. DOCTOR OF PHILOSOPHY DISSERTATIO N OF SUSAN J. LECLAIR APPROVED: J. KENT MORRISON PRESIDENT WALDEN UNIVERSITY 2001 Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. Walden University HEALTH SERVICES This is to certify that I have examined the doctoral dissertation by Susan J. Leclair and have found that it is complete and satisfactory in all respects, and that any and all revisions required by the review committee have been made. Dr. Evelyn Ortiz-Cruz, Committee Chair Health Services Faculty Signature Date Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. Walden University HEALTH SERVICES This is to certify that I have examined the doctoral dissertation by Susan J. Leclair and have found that it is complete and satisfactory in all respects. Dr. Talmage Holmes, Committee Member Health Services Faculty & Signature Date Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. Walden University HEALTH SERVICES This is to certify that I have examined the doctoral dissertation by Susan J. Leclair and have found that it is complete and satisfactory in all respects. Dr. Maria A. Irizarry, Committee Member Education Faculty ^KL Q-• signature U Q 1 §«e Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. Walden University HEALTH SERVICES This is to certify that I have examined the doctoral dissertation by Susan J. Leclair and have found that it is complete and satisfactory in all respects. Dr. David H. Bauer, Faculty Representative Professional Psychology Faculty Signature /¥/ 2d* I Date Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. Abstract The Correlation Between the Levels of Education of Clinical Laboratory Personnel and the Accuracy of Peripheral Blood Smear Results by Susan J. Leclair M.S., University of Massachusetts Dartmouth, 1977 B.S., Stonehill College, 1968 Submitted in Partial Fulfillment of the Requirement for the Degree of Doctor of Philosophy Health Services Walden University August 2001 Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. ABSTRACT This study correlated the performance accuracy of peripheral blood differentials evaluated by clinical laboratory scientists and clinical laboratory technicians. Fifty-one senior-year students from four clinical laboratory science baccalaureate programs and 37 second-year students from five clinical laboratory technician programs were given 10 peripheral blood differentials to perform. Results were compared to the values assigned by the Rajamaki method of proficiency testing. There was a significant discrepancy in the levels of accuracy between the two cohorts, suggesting that the results of peripheral blood differentials performed by clinical laboratory technicians is suspect. Facilities wishing to maintain or improve the quality of laboratory services should consider allowing only baccalaureate level clinical laboratory scientists to perform peripheral blood differentials. Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. TABLE OF CONTENTS CHAPTER 1 - INTRODUCTION TO THE STUDY Introduction ........................................ 1 B a c k g r o u n d.......................................... 2 Statement of the P r o b l e m ........................... 7 Purpose of the Study ............................... 9 Significance of the Study .......................... 9 Theoretical Framework .............................. 12 Current Context .................................... 17 Assumptions, Deliminations, and Limitations ...... 22 Definition of Terms ................................ 26 Hypothesis .......................................... 29 Summary ............................................. 30 CHAPTER 2 - LITERATURE REVIEW Introduction ........................................ 31 History of Clinical Laboratory Science in the United States .................................. 32 Entrance of Women into the Scientific Process.. 32 Clinical Laboratories at the Turn of the C e n t u r y .................................... 33 Clinical Laboratory Science: 1930 through 1960. 36 Clinical Laboratory Science: 1960 through the present .................................... 40 Who Performs Proficiency Testing................... 43 CLIA '88 or Son of CLIA '67 ......................... 46 Scope of Proficiency Testing in the Clinical Laboratory...................................... 49 Proficiency Testing in the Clinical Chemistry Laboratory ................................. 50 Proficiency Testing in the Microbiology Laboratory ................................. 52 Proficiency Testing in the Immunology/ Serology Laboratory ................................. 52 Proficiency Testing in the Cytology Laboratory. 54 Proficiency Testing in the Hematology Laboratory .................................. 55 The’Finnish System .......................... 57 Rationale for the study.............................. 58 Introduction .................................... 58 Initial Use of Proficiency Testing .............. 59 Proficiency Testing Goes Formal and National.... 61 End of an Era and the Beginning of Another .... 62 Summary .............................................. 64 ii Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. CHAPTER 3 - RESEARCH METHOD Introduction .......................................... 67 Proficiency Tests .................................... 68 Research Design ....................................... 71 Sample ................................................ 73 Sample Size ....................................... 75 Sample Diversity ................................. 75 Instrumentation .................................. 76 Validity and Reliability of the Report Form. 77 Peripheral Blood Smears ...................... 78 Nature of the Study .................................. 79 Procedure ...........................................

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