Program Competencies

A. Gynecologic Cytology

1. Prior to screening gynecologic cytology specimens, the graduate will review the patient's medical history and gather relevant clinical information.
2. When given conventional and/or liquid-based gynecologic specimens, the graduate will be able to microscopically identify, discriminate and explain the significance of the following entities in the context of a given patient:
   1. specimen adequacy
   2. cellular components within the negative for intraepithelial lesion or malignancy category.
   3. non-neoplastic findings including cellular changes associated with infections/organisms, reactive and reparative changes associated with inflammation, effects of therapy, effects of devices/instrumentation and presence of glandular cells in noteworthy circumstances.
   4. epithelial squamous abnormalities, including atypical squamous cells of undetermined significance, atypical squamous cells cannot exclude HSIL, low grade squamous intraepithelial lesion, high grade squamous intraepithelial lesion, and squamous cell carcinoma
   5. glandular cell abnormalities including atypical glandular cells, endocervical adenocarcinoma-in-situ and endocervical and endometrial adenocarcinoma and their differential diagnoses
   6. other epithelial and non-epithelial malignant neoplasms
   7. extra-uterine malignant neoplasms
3. The graduate will be able to demonstrate ability to use Pap test computer-assisted screening system(s).
4. When given gynecologic cytology specimens, the graduate will be able to detect, select, and appropriately mark the cells most representative of the nature of any pathological process if present.
5. The graduate will be able to perform a morphologic correlation of cytologic findings with relevant (current/prior) histologic material.
6. The graduate will be able to prepare a report using contemporary, reproducible, uniform reporting system of interpretive terminology.
7. The graduate will be able to independently evaluate gynecologic cytology specimens with sufficient competence to issue the final report for negative gynecologic specimens.
8. The graduate will appropriately triage gynecologic cytology specimens for high risk HPV testing.
9. The graduate will be able to evaluate gynecologic cytology specimens with a high level of accuracy as defined by the program

Although paramount, accuracy should be combined with the realization that timely reporting of results also contributes to patient care.

At minimum, the graduate should be able to manually evaluate an average of 7 non-imaged gynecologic slides per hour (or average of full-slide equivalents per hour for computer assisted review).

B. NON-Gynecologic Cytology

1. Prior to screening any non-gynecologic cytology specimen, the graduate will review the patient's medical history and gather relevant clinical information.
2. When given samples from any non-gynecologic cytology specimen, including fine needle aspirations, the graduate will be able to microscopically identify, discriminate and explain the significance of the following entities in the context of a given patient:
   1. specimen adequacy
   2. cellular components within normal limits
   3. microbiologic entities and associated cytomorphology
   4. cellular features of degeneration
   5. benign cellular changes
   6. cellular features of benign neoplasms g. cellular features of malignant neoplasms h. cellular effects of radiation, chemotherapy and other modalities, when available
   7. altered cellular morphology due to collection methods
3. When given any non-gynecologic cytology specimen, the graduate will be able to detect, select, and appropriately mark the cells most representative of the nature of any pathological process if present.
4. The graduate will be able to triage non-gynecologic cytology specimens for ancillary studies (to include when appropriate-microbiology, flow cytometry, cytogenetics, and molecular analysis) using appropriate transport media.
5. On detection of cellular features of disease, the graduate will be able to develop a differential diagnosis based on synthesis of appropriate data from:
   1. corresponding cell block
   2. morphologic correlation with relevant (concurrent/prior) histologic material
   3. routine special stains including interpretation of positive and negative controls
   4. immunohistochemical stains including interpretation of positive and negative controls, scoring of IHC intensity, and staining patterns (cytoplasmic, nuclear, membranous)
6. The graduate will be able to prepare a report using contemporary, reproducible, uniform reporting system of interpretive terminology.
7. The graduate will be able to evaluate cellular preparations with a high level of accuracy as defined by the program.

C. FNA Cytology (includes touch preparations)

1. Prior to on-site adequacy assessment and/or cytologic screening of any FNA specimen, the graduate will review the patient's medical history and gather relevant clinical information.
2. The graduate will be able to explain the principles of FNA performance, including indications and characteristics of different image-guided modalities (e.g., transcutaneous, endoscopic U/S-guided, endobronchial U/S-guided).
3. The graduate will be able to perform on-site adequacy assessment of FNA specimens and communicate results of this assessment.
4. The graduate will demonstrate a working knowledge of telecytology as it applies to on-site adequacy assessment.
5. The graduate will be able to triage FNA cytology specimens for ancillary studies (to include when appropriate-cell block preparation, microbiology, flow cytometry, cytogenetics, and molecular analysis) using appropriate transport media.
6. When given any FNA cytology specimen, the graduate will be able to microscopically identify, discriminate and explain the significance of the following entities in the context of a given patient:
   1. a. specimen adequacy
   2. target specific cellular components within normal limits
   3. microbiologic entities and associated cytomorphology
   4. cellular features of degeneration
   5. benign cellular changes
   6. cellular features of benign neoplasms
   7. cellular features of malignant neoplasms
   8. cellular effects of radiation, chemotherapy and other modalities
   9. altered cellular morphology due to collection methods
7. When given any FNA specimen, the graduate will be able to detect, select, and appropriately mark the cells/entities most representative of the pathological process if present.
8. The graduate will have working knowledge of how to identify FNA cytology specimens for further workup following cytology screening (to include when appropriate-special stains, IHC, molecular analysis).
9. On detection of cellular features, the graduate will be able to develop a differential diagnosis based on the synthesis of appropriate data from:
   1. corresponding cell block
   2. relevant (concurrent/prior) histologic material
   3. routine special stains including interpretation of positive and negative controls
   4. immunohistochemical stains including interpretation of positive and negative controls, scoring of IHC intensity, and staining pattern (cytoplasmic, nuclear, membranous).
10. The graduate will be able to prepare a report using a c contemporary, reproducible, uniform reporting system of interpretive terminology.
11. The graduate will be able to evaluate cellular preparations with a high level of accuracy as defined by the program.

1. Upon presentation of a cytologic specimen to the laboratory, the graduate will be able to:
   1. explain and apply the basic principles for specimen acceptance and rejection
   2. have knowledge of different preparation and staining techniques, their advantages and disadvantages, and the impact of each on cell morphology
   3. select and perform the preparation and staining technique(s) that is most appropriate for a given specimen
   4. identify and apply principles of quality assurance and quality control as they relate to specimen preparation including, but not limited to:
      • accreditation/regulatory requirements
      • equipment performance and maintenance
      • staining methods
      • stain and technical quality of preparation
   5. solve problems in staining and preparation methods
   6. identify errors that can occur during specimen handling and processing including but not limited to, preparation, staining and instrumentation and apply and implement the most effective resolution
2. The graduate will be able to use the microscope or other instruments to properly visualize the specimen for systematic morphologic review and interpretation with knowledge of proper use and care, to include troubleshooting.
3. The graduate will be able to use basic laboratory skills and techniques, including universal precautions, aseptic technique, reagent preparation, sample preparation, filtration, centrifugation, and pipetting and micropipetting

1. The graduate will be able to explain quality control and quality assurance requirements of applicable accrediting/regulatory agencies including, but not limited to requirements related to competency assessment and proficiency testing.
2. The graduate will demonstrate knowledge of the appropriate slide evaluation limits as outlined by regulatory agencies and demonstrate the ability to document daily workload.
3. The graduate will be able to explain the principles and practices defined by HIPAA.
4. The graduate will be able to explain the requirements and provide documentation that supports maintenance of certification/licensure to practice cytology.
5. The graduate will have a basic understanding of informatics and demonstrate the ability to effectively use the laboratory information system (LIS) including but not limited to viewing patient history, entering results and signing out cases.
6. The graduate will be able to comply with laboratory safety measures and regulations.
7. The graduate will have a basic awareness of emergency preparedness as a member of the healthcare workforce.
8. The graduate will be able to explain and use applicable contemporary ICD and CPT codes for cytologic specimens.

1. The graduate will be able to explain the theory, principles and indications of:
   1. flow cytometry
   2. molecular signal detection (GC/CT, PCR)
   3. molecular diagnostic oncology (e.g., EGFR, ALK, BRAF, KRAS)
   4. computer-based image-analysis and its applications in ancillary tests applied to diagnostic cytopathology
2. The graduate will be able to explain the theory, principles, indications, technical aspects and troubleshooting of*:
   1. HPV DNA testing
   2. immunocyto-histochemistry (IHC/ICC)
   3. FISH/CISH (fluorescent and chromogenic in-situ hybridization)
   4. Standard laboratory digital pathology equipment and procedures, such as, but not limited to digital cameras and photography, digital whole slide imaging scanners, image management, web-screen sharing, and slide viewing

*Does not require performance or proficiency

The graduate will be able to demonstrate the ability to critically evaluate medical literature for its pertinence and reliability.

1. The graduate will be able to explain the importance of continuing education for maintenance of on-going competence.
2. The graduate will be able to demonstrate knowledge of the consequences of specimen evaluation on patient management.
3. The graduate will be aware of cytotechnologist opportunities within professional societies and the cytology community at-large (e.g., patient advocacy, volunteerism, education, research).
4. The graduate will be able to demonstrate knowledge of the ethical role and responsibilities of the cytotechnologist by practicing honesty and integrity in professional duties.
5. The graduate will be able to demonstrate knowledge of the ethical role and responsibilities of the cytotechnologist by practicing principles of good professional relationships with patients, peers, staff, faculty and the public.

Histotechnology professionals are qualified by academic and applied science education to provide service and research in histotechnology and related areas in rapidly changing and dynamic healthcare delivery systems. They have diverse and multi-level functions in the areas of analysis and clinical decision-making, information management, regulatory compliance, education, and quality assurance/performance improvement wherever anatomic pathology testing is researched, marketed, developed or performed.

Histotechnology professionals perform, develop, evaluate, correlate and assure accuracy and validity of laboratory testing and procedures; direct and supervise anatomic pathology laboratory resources and operations; and collaborate in the diagnosis and treatment of patients. They possess skills for financial, operations, marketing, and human resource management of the histopathology laboratory.

Histotechnology professionals practice independently and collaboratively, being responsible for their own actions, as defined by the profession. They have the requisite knowledge and skills to educate laboratory professionals, health care professionals, and others in laboratory practice, as well as the public.

The ability to relate to people, a capacity for calm and reasoned judgment, and a demonstration of commitment to the patient are essential qualities. Communication skills extend to consultative interactions with members of the healthcare team, external relations, customer service and patient education. Histotechnology professionals demonstrate ethical and moral attitudes and principles that are necessary for gaining and maintaining the confidence of patients, professional associates, and the community.

At career entry, the Histotechnologist will possess the following entry level competencies:

A. receiving and accessioning tissue specimens;

B. preparing tissue specimens for microscopic examinations, including all routine procedures;

C. performing more complex procedures for processing and staining tissues, including enzymes and immunohistochemistry;

D. assisting with and/or performing gross examination and frozen section procedures in histopathology as well as cytology specimen preparation methods;

E. identifying tissue structures, cell components, and their staining characteristics and relating them to physiological functions;

F. recognizing factors that affect procedures and results, and taking appropriate action within predetermined limits when corrections are indicated;

G. developing, testing, implementing, evaluating, and selecting new techniques, procedures, instruments and methods in terms of their usefulness and practicality within the context of a given laboratory's personnel, equipment, space, and budgetary resources;

H. making decisions concerning the results of quality control and quality assurance measures, and instituting proper procedures to maintain accuracy and precision;

I. confirming abnormal results, verifying quality control procedures, executing quality control procedures, and developing solutions to problems concerning the generation of laboratory data;

J. establishing and performing preventative and corrective maintenance of equipment or instruments, as well as identifying appropriate sources for repair;

K. exercising and applying principles of safety, management and supervision;

L. demonstrating professional conduct and interpersonal communication skills with patients, laboratory personnel, other health care professionals, and with the public;

M. recognizing and acting upon individual needs for continuing education as a function of growth and maintenance of professional competence;

N. recognizing the responsibilities of other laboratory and healthcare professionals and interacting with them with respect for their jobs and patient care;

O. leading supportive personnel and peers in their acquisition of knowledge, skills and attitudes; and providing leadership in educating other health personnel and the community;

P. applying principles of education methodology;

Q. applying principles of current information systems;

R. applying principles of in-situ hybridization, plastic and electron microscopy

At entry level, the Histotechnologist will have the following basic knowledge and skills in:

A. Application of safety and governmental regulations and standards as applied to histotechnology;

B. Principles and practices of professional conduct and the significance of continuing professional development;

C. Communications sufficient to serve the needs of patients, the public and members of the health care team;

D. Principles and practices of administration, supervision, and safety as applied to histotechnology;

E. Education techniques and terminology sufficient to train/educate users and providers of laboratory services.