Johns Hopkins Pathology

Division of Transfusion Medicine

Specialist in Blood Bank Technology Program

 

• Program Overview

  The Johns Hopkins Hospital Specialist in Blood Bank Technology program is a work-study, graduate-level training program for ASCP-certified Medical Technologists with at least 2 years of full-time Blood Bank experience. The student is considered a full-time employee of the Johns Hopkins Hospital and is paid the salary of a Medical Technologist.
  
  The variety of patients, the size, and the general intellectual environment of the hospital provide excellent opportunities for training in Blood Banking. It is a challenging program that will prepare competent and knowledgeable graduates who will be able to effectively apply practical and theoretical skills in a variety of employment settings. Students are exposed to all areas of Transfusion Medicine including Diagnostic Immunology, Histocompatibility and Tissue Typing Labs, paternity testing, bone marrow processing, education, administration, and research.
  
  

• Application Evaluation

  The SBB Admissions Committee will evaluate all completed application packets for possible admission into the JHH SBB Program. The minimum requirements are:
  
  1. Statement of Intent and Expectations
  2. Resume/Curriculum Vitae- must have at least 2 years of Blood Bank experience with continuing education documentation
  3. Professional References (3)
  4. Official College Transcripts- 3.0 GPA preferred, 2.5 GPA accepted
  
  The Admissions Committee evaluates the completed admissions packet and a determination is made as to the need for a personal interview. If an interview has been granted, the Education Coordinator will arrange for a mutually convenient appointment. Following the interview of each applicant, the faculty will rate the candidates according to academic ability, job experience, interview skills, career goals, and potential to complete the SBB program. These ratings will assist in the admissions process.
  
  Those who have been accepted for admission to the SBB program will be phoned to offer the position. Written notification of acceptance will follow. Those not accepted for admission are sent letters of non-acceptance. Letters will not be sent to individuals who have failed to submit a complete informational record and who have been notified previously of an incomplete application.
  Deadline for Applications is November 30 for admission in September of the following year.
  Mail applications to:
  The Education and Development Coordinator
  Transfusion Medicine Division
  Sheikh Zayed Tower
  Room 3100 F
  The Johns Hopkins Hospital
  1800 Orleans Street
  Baltimore, Maryland 21287

• Objectives and Competency Requirements

  Program Objectives*
  *Adapted from CAAHEP Standards and Guidelines
  
  A student admitted into the JHH SBB program will be educated to:
  1. Develop technical and supervisory competencies in immunohematology, blood component manufacturing, and transfusion medicine.
  2. Function as managers, educators, researchers, or technical consultants.
  3. Work as part of the health care team in providing health services to patients.
  
  Program Competency Statements*
  *Adapted from CAAHEP Standards and Guidelines
  
  An individual who seeks to fulfill the role of an SBB must be able to:
  1. Determine and implement the appropriate procedures for recruiting, collecting, processing, labeling, storing, and distributing of allogeneic blood components and special collections, which include autologous, directed, apheresis, therapeutic stem cell, and bone marrow.
  2. Provide safe, pure, potent, and effective blood components.
  3. Select, utilize and evaluate current methodologies for the detection and identification of red cell, platelet, and leukocyte specific antigens and antibodies.
  4. Evaluate laboratory results of hemostatic disorders including comprehensive diagnostic testing for bleeding, thrombotic and fibrinolytic disorders; correlate test results and provide consultation as an aid to physician diagnosis.
  5. Provide guidance and leadership in administrative matters. These matters include billing and business records, purchasing, maintenance of supplies, general business procedures, workload recording, quality management and human resource responsibilities.
  6. Understand and apply guidance and leadership for regulatory licensure and accreditation issues including current Good Manufacturing Practices, safety, and quality assurance.
  7. Demonstrate professional conduct and interpersonal communication skills with patients, laboratory personnel, other health care professionals, and the public.
  8. Understand and apply consultation for patients in need of transfusion regarding the appropriate indications for blood component therapy, handling of various components, and means of monitoring the efficacy of transfusion.
  9. Apply sound principles of scientific research and educational methodology.
  
  

• Student Evaluation Policy

  Students are continually monitored for both their work and academic performance. The Education Coordinator performs an informal evaluation after approximately three months of matriculation. Formal evaluations are conducted after six and twelve months. All SBB program faculty have input into these formal evaluations for both work and academic performance. Students will be evaluated by the instructors from each of the enhancement rotations and have the opportunity to evaluate the efficacy of each enhancement rotations.
  
  The student's academic progress is evaluated formally by written examination and rotational evaluations. A grade of 80% or better on a research project and all written and practical exams should be achieved.
  
  During the year, students are allotted time to perform a research project. This project must be written, using the same publication format as Transfusion, and submitted to the SBB faculty for review before graduation. In addition, the students will be required to present their project finding to their colleagues in the Transfusion Medicine Division. The student must achieve a grade of B or better on this project.
  
  For all exams, the student must correct questions answered erroneously by documenting the source of the correct answer and why it is the correct answer. The Education Coordinator determines the need for a make-up exam after reviewing and discussing the exam with the student. The make-up exam may be for one or more subject areas in which the student has obtained a score of 80% or less, or for a subject area in which the student scored above 80% but does not demonstrate functional understanding of the subject area. A final practical exam will be given to evaluate the student's ability to solve complex serological problems. The number of specimens will be determined, and a score of 90% or better must be achieved. One additional specimen similar to those tested will be provided for a student who scores less than 90% on the practical. The score on this repeat testing must again be 90% or higher. The enhancement rotation technical instructor will evaluate the student during each rotation.
  
  Students are required to complete all the objectives of the rotation as well as receive an overall average rating of no less 3. Students may be required to repeat the rotation at the discretion of the SBB Coordinator and the supervising technologist. The Education Coordinator will address any deficiencies detected in the rotational evaluations with the student.
  
  Informal evaluations of the student's academic progress are monitored throughout the year by the TMD faculty. This is accomplished through observation of the student's daily work performance to include serological problem solving, management of problem situations, performance on the student project, and participation in tutorials, seminars, and journal clubs.
  
  Students are strongly encouraged to discuss any problems they are having with laboratory work, or academic studies with the Education Coordinator. Other SBB faculty members are also available for discussion as well.
  
  Students who successfully complete the SBB program will receive a Certificate of Completion and are expected to sit for the ASCP BOR SBB certification exam. The SBB Program and working environment of the JHH TMD provide a great deal of structure for the student. A successful year will require the student to be well organized on both their work and study time.
  
  

• Didactic Lecture and Practical Requirements for Graduation

  The topics listed below will be addressed in scheduled lectures, journal clubs, case study reviews, lunch tutorials, continuing education conferences, and rotations (see descriptions on next link).
  
  The student must have achieved acceptable grades and evaluation scores, as noted, for the following didactic and practical curricula:
  
  A. Blood Procurement/Product Manufacturing
  1. marketing/recruitment*
  2. suitability*
  3. collection*
  4. reactions
  5. testing - to include confirmatory testing*
  6. donor notification, re-entry and look-back protocols
  7. component preparation including special products*
  8. labeling/storage*
  9. inventory management *
  10. special collections - to include autologous and directed donations*, therapeutic phlebotomy*, hemapheresis*, stem cell*, and bone marrow collections
  
  B. Immunohematology and Specialized Laboratory Testing
  1. genetics
  2. immunology
  3. molecular biology*
  4. blood groups (history, chemistry, genetics, antibodies)
  5. red blood cell testing methodologies*
  6. histocompatibility and tissue typing
  7. platelets and granulocyte testing
  8. hematopoietic progenitor cell processing*
  9. parentage testing
  10. hemostasis and thrombosi
  
  C. Transfusion Medicine Practice
  1. physiology, composition and function of blood
  2. survival of transfused cells
  3. immune mechanisms of red cell destruction
  4. anemias (clinical aspects, laboratory investigation and principles of management)
  5. platelet disorders
  6. leukopoiesis disorders
  7. hemostatic and thrombotic disorders
  8. blood component therapy*
       a. indications
       b. selection
       c. administration
       d. adverse reactions/complications
       e. evaluations
  9. HDN
  10. special transfusion:
       a. open heart surgery, massive, neonatal and pediatric
       b. intraoperative blood salvage
       c. oncological and transplantation support
  11. blood substitutes and growth factors
  12. therapeutic apheresis*
  
  D. Quality Systems/Process Control
  1. audits/assessments*
  2. quality systems/ quality plan*
  3. Current Good Manufacturing Practices (cGMP)*
  4. regulations, standards, licensure and accreditation :AABB, CAP CLIA, FDA, ISHAGE (International Society for Hematopoietic and Graft Engineers), NCCLS, JCAHO, NRC (Nuclear Regulatory Commission),OSHA, and State
  5. SOP and records management*
  6. errors and accidents and risk management
  
  E. Education and Research
  1. competency evaluation*
  2. proficiency testing
  3. technical writing*
  4. independent research*
  5. education and training theory/techniques*
  6. evaluation and outcomes assessment*
  7. literature critique*
  8. presentation skills*
  F. Management and Administration
  
  1. management theory
  2. human resource management
  3. financial management
  4. information systems management
  5. ethics and medical/legal considerations
  6. quality management system
  
  G. Presentations and Project
  1. Present at least three critiques of current transfusion medicine journal articles.
  2. Present at least three continuing education presentations
  3. Research Project
  
  
  CAAHEP Standards and Guidelines for an Accredited SBB Program
  (Rev. 2000) * Supervised practice curriculum
  
  

• Lecture Descriptions

  Didactic Lecture - Tuesday & Thursday, 3pm - 4pm
  TMD faculty members, senior staff of the TMD, and visiting lecturers, provide these lectures. Students are provided objectives as a guide for each topic and are expected to supplement the lecture presentation with additional readings.
  
  Journal Club - Tuesday, 3pm - 4pm
  Students orally present a critique of at least three current transfusion medicine journal articles of their choice. These sessions allow the student to become familiar with library resources, to become familiar with current research in the field of transfusion medicine, to develop the ability to critique and evaluate research, and to establish a basis for development and evaluation of the student research project.
  
  Case Study Review - Wednesday, 3pm - 4pm
  At least once a month, students will discuss the resolution of serologically complex cases. The cases will gradually progress from relatively easy to very difficult. Each student will present a case of his or her choice by the end of the academic year.
  
  Lunch Tutorial Sessions - Monday, 11am - 11:45am
  The Education Coordinator proctors each session and asks each student a few questions based on the assigned readings. As the year progresses, the student will assume the responsibility for asking questions. This forum provides an excellent opportunity for discussion of the topics in an informal manner. Textbooks used during these sessions may include but are not limited to: AABB Technical Manual, AABB Standards, Scientific Basis of Transfusion Medicine Implications for Clinical Practice by Ness and Anderson, Transfusion Reactions, Second Edition by Popovsky, and Ethical Issues in Transfusion Medicine by Macpherson, Domen, and Perlin.
  
  Continuing Education Lectures - Wednesday, 3pm - 4pm
  These lectures are designed to help fulfill continuing education requirements for the entire TMD staff. Lectures may be presented on Blood Bank or related topics by TMD staff, Department of Pathology faculty, or staff members from other departments within the institution. SBB students are required to make at least three presentations in this forum to include: a joint lecture with another SBB student on a topic of mutual interest, an individual lecture on a topic of the student’s choice, and a presentation of their research project.
  
  Research Project
  During the year, students are allotted time to perform a research project. This project must be written, using the same publication format as Transfusion, and submitted to the SBB faculty for review before graduation. Limited time is allowed for this project and should be well planned in advance. A faculty advisor is assigned to work with each student, however, it is the student’s responsibility to determine the amount of time needed, the type and volume of reagents, and other resources needed to complete the project.
  
  Rotations and Outside Activities
  Students will receive schedules and objectives for their rotations to areas outside of the TMD. If a student is unable to attend a scheduled rotation, they notify the Education Coordinator. Students are expected to follow the directions of their instructor and the policies of the area in which they are rotating.
  
  

• Policies

  Attendance Policy
  Students must attend all regularly scheduled classes and enhancement rotations. The student is expected to be punctual and prepared for all lecture sessions. Reading assignments should be completed in advance of each lecture. Excused absence from class is to be avoided if at all possible, more than two will result in a warning notice. The Education Coordinator must be notified in the event of any absence scheduled or not.
  
  Students are considered employees of the Johns Hopkins Hospital and as such work weekends, off-shifts, and holidays as well as accumulate Paid Time Off (PTO) at 6.77 hours per pay period. Time off for weekends worked is scheduled for the Friday before and the Monday after the weekend. The Lead Tech in charge of scheduling and the Education Coordinator MUST approve PTO for vacation time, including compensatory time, and time off for holidays worked. Prior approval must be obtained to be excused from a scheduled lecture or rotation. For all employees, PTO for illness will be used only in time of illness. Abuse of this time is cause for dismissal.
  
  A maximum of ten absences is the allowed during the year, not including scheduled time off for weekend or holiday work. It is suggested that a student use vacation time sparingly in order to save some time for job interviews at the end of the year and to attend local and national professional meetings.
  
  Unexcused absences and unsatisfactory participation are cause for dismissal. If unexpected circumstances should arise, the student is expected to notify the Education Coordinator and make arrangements to make up any missed rotation time.
  
  Student Withdrawal or Dismissal
  A student's matriculation through the JHH SBB Program may be terminated by two means, self-withdrawal and dismissal. Immediately after withdrawal or removal from the program, the AABB National Office will be notified.
  
  Method for Removal of Students from the SBB Program
  
  A. Cause for Removal
  1. Failure to maintain an acceptable grade average as measured by examinations.
  2. Failure to demonstrate understanding of didactic and technical theory evidenced by the student’s inability to resolve serologic problems, select appropriate patient treatment methods, participate in an intellectual exchange or explain concepts that have been previously discussed.
  3. Failure to regularly attend scheduled classes, seminars, meetings, and/ or failure to participate in an acceptable manner as determined by the Education Coordinator. Unexcused absences will not be tolerated.
  4. Failure to follow the established hospital personnel policies and procedures as outlined in the hospital personnel handbook.
  5. Failure to follow the TMD standard operating procedures.
  
  B. Method of Removal
  1. Failure to follow hospital policy under A-4 above can result in immediate dismissal. Since SBB students are employees, the dismissal method will follow the JHH Personnel Procedure. The Education Coordinator will participate in the evaluation of the student for dismissal.
  2. Failure to follow the TMD standard operating procedures under A-5 above will result in a written warning. Since SBB students are employees, subsequent steps for dismissal will follow the JHH Personnel Procedure.
  3. Failure to participate satisfactorily as outlined in A-1, 2, 3 above, can result in a student's removal from the program. Such action will be discussed and decided by the SBB faculty. The Education Coordinator will utilize both verbal and written warnings to notify the student of sub-standard performance. The warning notice will list the specific deficiencies or reasons the student's performance is considered sub-standard. The statement "Failure to demonstrate improvement can result in dismissal from the program." Will be included in the notice. A follow-up evaluation will take place no later than one month after the initial written warning notice. If the student fails to demonstrate improvement, they will be dismissed from the SBB program.
  4. A student dismissed from the program for reasons listed in A-1, 2, 3 above may request to remain as an employee of the TMD. This decision rests with the Medical Director and Laboratory Manager.
  5. A student may voluntarily withdraw from the program. To continue as an employee, the student will require the approval of the Medical Director and Laboratory Manager.
  6. A student dismissed for reasons listed in A-4, 5 above will automatically be dismissed from the SBB program since the employment status is terminated.
  7. Immediately after withdrawal or removal from the program, the AABB National Office will be notified.
  
  C. Appeals Process
  1. Dismissal for failure to follow JHH policy or TMD standard operating procedures may be appealed through the hospital's grievance procedure as outlined in the JHH Human Resources Policy and Procedure Manual.
  2. Students dismissed from the Program for poor academic performance as outlined in A-1, 2, and 3 above will receive both verbal and written notice of dismissal. Students may appeal this decision by submitting in writing the reasons why they believe they should not be dismissed. The SBB Program Faculty will evaluate this appeal.
  
  

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