ASCLS Today Volume 34, Number 4

ASCLSToday Masthead 680

Volume 34, Number 4


George A. Fritsma, MS, MLS(ASCP)CM

In February of 2017, George Fritsma and the late Cindy Johns led a Clinical Laboratory Educators Conference (CLEC) plenary session entitled, “Enhancing Laboratory Communication to Reduce Extra-analytical Errors.” The presenters referred to the American Board of Internal Medicine (ABIM) Foundation’s Choosing Wisely® (CW) initiative, founded with Consumer Reports in 2012. CW “seeks to advance a national dialogue on avoiding unnecessary medical tests, treatments, and procedures.” All CW recommendations, now over 500, begin with the words, “Do not,” or “Avoid.”

Following the CLEC session, the speakers met with then-president Suzanne Campbell and ASCLS Executive Vice President Jim Flanigan to discuss engaging ASCLS members’ technical expertise to develop lab-related CW recommendations. At the August 2017 ASCLS Annual Meeting, the ASCLS Board of Directors agreed to form a CW Task Force, uniting nine ASCLS members representing the medical laboratory science disciplines clinical chemistry, microbiology, immunology, immunohematology, molecular diagnostics, hematology, hemostasis, and laboratory administration.

The task force generated a series of prospective recommendations that several members presented at the February 2018 CLEC. The presentation drew additional recommendations, which the task force formalized and presented to their respective scientific assembly sections at the August 2018 ASCLS Annual Meeting. The task force subsequently presented the first slate of recommendations for review by the ASCLS Board of Directors (BOD) in the Spring of 2019. In the fall of 2019, the ASCLS BOD elevated the task force to standing committee status, and the new committee now has 11 members, [see Table 1] not counting our BOD Liaison Stephanie Mihane, ASCLS President Cindy Johnson, and EVP Jim Flanigan.

As we prepared our recommendations for the ABIM Foundation, the American Society for Clinical Pathology (ASCP) invited us to collaborate with its Committee on Science, Technology, and Policy (CSTP), which has worked with the ABIM Foundation since 2012. The collaboration gave us additional authority and smoothed the submission process. CSTP also incorporates the ASCLS CW Committee into its own recommendation review process and adds the opportunity to review submissions from fellow collaborator American Society for Microbiology (ASM). The ASCLS recommendations went forward to the ABIM Foundation, who submitted them for review to all the agencies that contribute to the CW site. Our ASCLS recommendations were accepted by the ABIM Foundation and published on June 10, 2020, accompanied by a joint press release provided by ASCLS, ASCP, and the ABIM Foundation.

The ASCLS recommendations are:

  • Do not order a factor V Leiden (FVL) mutation assay as the initial test to identify a congenital cause for a thrombotic event. First, order a phenotypic activated protein C resistance (APCR) ratio assay.
  • Do not use herpes simplex virus (HSV) polymerase chain reaction (PCR) testing for genital HSV infection screening in adults and adolescents. Real-time HSV PCR testing should only be used to confirm herpes diagnosis in patients with suspected herpes.
  • Do not transfuse red blood cells as the sole intervention for expansion of circulatory volume unless deemed necessary for patients experiencing severe hemorrhage.
  • Avoid using hemoglobin to evaluate patients for iron deficiency in susceptible populations. Instead use ferritin.
  • Do not order a comprehensive stool ova and parasite (O&P) microscopic exam on patients presenting with diarrhea less than seven days’ duration who have no immunodeficiency or no history of living in or traveling to endemic areas where gastrointestinal parasitic infections are prevalent. If symptoms of infectious diarrhea persist for seven days or longer, start with molecular or antigen testing and next consider a full O&P microscopic exam if other testing is negative.

You can review these recommendations with clarifying discussions and references by visiting

Besides our technical expertise, ASCLS medical laboratory science educators bring a new dimension, as several have developed CW educational modules. These are offered in classrooms and online for undergraduate and graduate MLS students, physician assistant and nurse practitioner programs, entry-level nursing programs, and pathology residents. Entry level concepts typically exert great influence on clinical practice.

While our initial process proceeded, the committee continued to accept and develop new recommendations from the membership. These are now being processed through the scientific assembly sections and will eventually go to the ASCLS BOD for our next submission. You can find these in our ASCLS Connect communities. Meanwhile, we invite you to share your recommendations, remembering that they always begin with “avoid,” or “do not.”

George Fritsma is proprietor of The Fritsma Factor, Your Interactive Hemostasis Resource, and lives near Birmingham, Alabama.

Table 1 ASCLS Choosing Wisely® Committee

Name Credentials Location Specialty
Lisa Cremeans MMDS, MLS(ASCP)CMSMCMMBCM University of North Carolina, Chapel Hill Microbiology, Molecular
Josephine Ebomoyi PhD, MSPH, M(ASCP) Northern Illinois University, DeKalb Microbiology
Muneeza Esani PhD, MPH, MT(ASCP) University of TX Medical Branch, Galveston Clin Chemistry
George Fritsma MS, MLS(ASCP)CM University of Alabama at Birmingham Heme, Coag
Deborah Josko PhD, MT(ASCP),SM Director, MLS Program, Rutgers University Immunology
Brianna Miller MS, MLS(ASCP)CM University of Alabama at Birmingham Heme, Coag, BB
Ryan Mize DCLS Special Coag Manager Mass General Heme, Coag
Rick Panning MBA, MLS(ASCP)CM HealthPartners, Minnesota Lab Management
Dawn Rudnik MT(ASCP),SM University of Michigan Health Services Lab Manager Microbiology, General
Mayukh Sarkar PhD, MLS(ASCP)CM Wisconsin Diagnostic Laboratories Coag
John Smith MS, MLS(ASCP)CM Retired, Kansas Micro, Health Care Usage



Kristen Croom, MLS(ASCP)CM, MB(ASCP), ASCLS Region X Director

I want to start by saying a huge MAHALO to our laboratory teams working to care for our patients during this pandemic. We have seen unprecedented changes to our healthcare system and our entire way of life. Our laboratory family has the opportunity to come together and provide an important voice to the healthcare team. It is during these times that we can rely on our ASCLS family and colleagues to provide a unified voice.

This quote by Marge Kennedy makes me think of our ASCLS family:

In truth a family is what you make it. It is made strong, not by number of heads counted at the dinner table, but by the rituals you help family members create, by the memories you share, by the commitment of time, caring, and love you show to one another, and by the hopes for the future you have as individuals and as a unit.

Ms. Kennedy’s words speak to our shared commitment to each other and our patients. Our family is incredibly lucky to have each and every member. Our family includes the generations that came before us and built the foundation we are now standing on. These individuals play an important part in our rituals and help us ensure we do not forget our past. They also provide insight into our future by reminding us why we are here and what we have done.

“Our family is amazing when we work together. Gathering information from all generations and deciding how to move forward.”

Our family also includes the younger generations that are eager to get started. These individuals are the future of our organization, and we want to help them succeed and keep the family name alive. As with most families, we worry about their futures and how they will help create future generations.

Our family is amazing when we work together. Gathering information from all generations and deciding how to move forward. In the end, we all care for each other and reinforce our commitment to our fellow family members and the ultimate commitment of caring for our patients.

Our ASCLS rituals help keep the family connected and the commitment alive. Our rituals include our family reunions at our various national and local events. They also include passing our knowledge base to the next generation through formal education and informal relationships. As with most families, the rituals should change to meet the needs of the expanding family. ASCLS has changed the face of its rituals strategically over the last few years. We want to maintain our rituals and meet the needs of our family members.

This year has been personally tough, not having our family reunions at the Laboratory Legislative Symposium, the Joint Annual Meeting, and most of our state meetings. We are entering a new world post-COVID-19, and our family will be together to adjust our rituals and expectations. Our overall goals have not changed; we strive to provide the best care for our patients and ensure that future generations of our family are equipped to handle the job.

Kristen Croom is Director of Laboratories, Pathology and Molecular Services, at the Queen’s Medical Center in Honolulu, Hawaii.


Paula Griswold, PhD, MT(ASCP), and Jessica Dolecheck, PhD

Part of soft skills training, ULM College of Health Sciences faculty coordinated professional luncheons where healthcare employers and students interacted for meaningful, social connections.
Photo credit: ULM Photo Services

Preparing students for careers in healthcare requires competencies in technical skills and acquiring an understanding of the field of entry. This is especially true of students pursuing a career in medical laboratory science (MLS). With more demands for better patient care and outcomes, preparing students for entry into the workforce requires not only proficiency in technical skills but also in soft skills.

Often overlooked, soft skills—or personal skills—are quickly becoming a core criterion for many healthcare positions, especially as patients are demanding a better level of service. Soft skills are defined as a collection of personal, positive attributes and competencies that individuals possess, which enhance their relationships, job performance, and value to the market (Loretto, 2018; Khanna, 2015; SkillSurvey Inc, 2019). These soft skills are characterized as personal skills such as meaningful communication, ability to work in teams, adaptability, empathy, and time management.

In today’s workforce, soft skills are considered essential to managing and working with people, customer satisfaction, and forming a positive work environment (Ravindranath, 2016; Taylor, 2016; Thompson, 2017). Soft skills have become exceedingly important for healthcare professionals to demonstrate and improve upon for workplace success. According to Robles (2012), business executives consider soft skills a very important attribute in job applicants because soft skills are critical for productive performance. Furthermore, these executives complain about the lack of soft skills in new employees and emphasize that knowledge alone is not enough to succeed. As healthcare educators, we recognize soft skills need further emphasis in university curricula. We further recognize the value of imbedding interactive, real-life activities for preparing health science students with critical soft skills to fully prepare them for today’s work environment.

How to Teach Soft Skills

Soft skills training requires a different strategy for teaching than other skills. Recommendations from the literature for the teaching and learning of soft skills are (1) engagement of students, (2) active learning, (3) reflection, and (4) exposure to real-world situations that encourage dialog and cooperative work (Taylor, 2016). Hence, the authors designed and implemented a soft skills project with multidisciplinary faculty and students in the College of Health Sciences (CHS) at the University of Louisiana Monroe (ULM) that encompassed active student/faculty engagement, personal reflection, and participation in real-life situations.

“Soft skills have become exceedingly important for healthcare professionals to demonstrate and improve upon for workplace success.”

The faculty collaborated to design and teach a short course in soft skills within their respective courses and coordinated three professional luncheons whereby healthcare employers and students interacted for meaningful, social connections. The intent of the project was to create a collaborative opportunity for various health science student disciplines to interact with community leaders, display positive interactions, and build confidence in transitioning into their health professions career.

For the training part of the project, certain health science faculty and students were paired to train, interact, and learn about soft skills and their respective professions. For example, MLS and health studies faculty/students completed the soft skills training and interactive educational components in a collaborative manner. The soft skills training consisted of three modules covering topics on professionalism, teamwork, work ethic, attitude, professional interactions, etiquette, and professional business attire. These modules were designed to be inter-professional, engaging, and required a significant amount of self-reflection. The soft skills trainings were delivered face-to-face in the classroom and online, through our Moodle platform used for online course delivery at ULM.

A professional luncheon was hosted on campus after students completed the soft skills training. Thirty-three employers from the northeast Louisiana region who hire our CHS graduates attended the luncheon. The primary goal of the luncheon was to provide students a venue to apply what they had learned during soft skills trainings and to offer a “real world professional experience” prior to their graduation. Students practiced networking, meal etiquette, wearing professional attire, and professional business communication. To gather the students’ perceptions on the trainings, a pre- and post-soft skills training survey was administered. In addition, qualitative data was collected from all who participated in the training and luncheon regarding the impact of this event. The authors anticipate publishing the results of the surveys and the qualitative data in the near future.

The employers that attended the professional luncheon, as well as the students, acknowledged the significance of this event. Employers recognized it as a recruitment opportunity for future employees and a means to connect with faculty and the university. Likewise, the luncheon offered a meaningful academic experience for the students with a link to employers and the current job market.

Setting Students up for Success

In conclusion, both technical and soft skills are necessary for the success of today’s health professional graduate, especially the MLS major. By incorporating soft skills trainings into curricula, such as meaningful communication, ability to work in teams, adaptability to changing situations, empathy, and time management, students are provided an opportunity to gain skills necessary for success in the workplace and in life. The significance of this project raised awareness of the importance of soft skills for both students and faculty in health sciences. Furthermore, the findings of this project provided significant evidence that ongoing measures need to be taken to properly educate students in soft skills before they enter the job market.

Many students, faculty, and employers commented on how meaningful the experience was and the lasting impact it had on their learning. This collaborative project was an innovative, student-centered approach that focused on professional student development, which is critical in producing competitive and qualified graduates for the healthcare workforce. The health professions programs within the College of Health Sciences at ULM plans to continue to incorporate this valuable training into their curricula and evaluate its positive impact on career readiness for health science graduates. The success of this project at ULM could serve as a model to be implemented in other higher education institutions as well as healthcare organizations.


  1. Khanna. V. (2015). Soft skills: A Key to Professional Excellence. International Journal of Research in Engineering, Social Sciences, 5(1). ISSN 2249-9482.
  2. Loretto, P. (2018). The Top 12 Soft Skills Employers Seek. The Balance Careers.
  3. Ravindranath, S. (2016). Soft Skills in Project Management: A Review. IUP Journal of Soft Skills, 10(4), 16-25.
  4. Robles, M. (2012). Executive Perceptions of the Top 10 Soft Skills needed in Today’s Workplace. Business Communication Quarterly, 75 (4). 453-465.
  5. SkillsSurvey Inc. (2019). The Hard Truth about Soft Skills Interactive Book.
  6. Taylor, E. (2016). Investigating the Perception of Stakeholders on Soft Skills Development of Students. Interdisciplinary Journal of e-Skills and Lifelong Learning. 12, 1-18.
  7. Thompson, J. (2017). Communication Skills Lacking in Today’s Workforce. Fort Worth Business Press.

Paula Griswold is Associate Professor, Health Studies, and Interim Associate Dean in the College of Health Sciences at the University of Louisiana Monroe. Jessica Dolecheck is Associate Professor, Health Studies, and Health Studies Program Coordinator in the School of Allied Health at the University of Louisiana Monroe.


Beth Warning, MS, MLS(ASCP)CM, AHI(AMT), ASCLS Region IV Director

Linda Gorman befriended author Beth Warning at the 2001 CLEC. Through their friendship, Beth was introduced to more and more opportunities within ASCLS.

At one time or another, you may have been asked why you chose ASCLS as your professional society, considering we have several from which to choose. Indulge me for a moment while I share my story.

In 2001, I was promoted to education coordinator (meaning I was the figure head for our MLS program, until I completed my master’s degree to become program director) at my hospital. I joined ASCLS then to take advantage of the member discount for the Clinical Laboratory Educators Conference (CLEC) in St. Louis. That’s it … no grand revelation, no realization to “make a difference”—just something asked of me by my employer to help in being fiscally responsible to sponsor my attendance at the meeting.

It was at CLEC that I was approached—sought out, really—by educators from the University of Kentucky, specifically, Dr. Linda Gorman. She befriended me and encouraged me to attend a state meeting with the Kentucky Society of Clinical Laboratory Science (KSCLS). As they say, the rest is history!

How I Magically Got Involved in ASCLS

With Linda as a mentor, I became involved at the state level. It was a slow process, as I was rearing a young family and working on a master’s degree. My initial involvement consisted of attending the state meeting and attending CLEC on a regular basis. It wasn’t until 2005 that I attended the ASCLS Annual Meeting in Orlando, where perhaps it was the “Disney magic” that forever changed my ASCLS path.

I was attending as the president elect-elect for KSCLS (that’s Kentucky by the way) and had a room at the conference hotel. My new friend, Linda, had booked a room with a roommate, and unfortunately, their room had only a king bed. Here is where the magic comes into play … I had a room with two double beds that happened to adjoin the room occupied by Linda! So, from there on Linda and I became roomies at ASCLS meetings—CLEC, the Annual Meeting, Legislative Symposium, anywhere, and everywhere.

Through my friendship with Linda, I was introduced to more and more opportunities within ASCLS. The randomness of being a delegate to one Annual Meeting (where I was asked to attend a few committee meetings that might interest me) found me seated in a conference room listening to the activities of the Professional Affairs Committee (now the Promotion of the Profession Committee) led by Suzie Zanto. Within a year, I was a member of the committee under Shirlyn McKenzie, and eventually continued on as chair, and then board liaison for the PPC.

And you are probably asking, how does this tie into my involvement in ASCLS? Easy. This goes to show it only takes one person to talk with another person to encourage and support you on your ASCLS journey. Through all of this, I credit Linda Gorman for taking me under her wing, mentoring me in all things ASCLS—chatting over dinner, introducing me to other ASCLS members, or, most often, late night slumber party-like chats in our hotel room asking questions, learning, and maneuvering through the various committees and board reports in support of our profession.

Colleagues Become Family

Through continued involvement in KSCLS, I met laboratorians and educators throughout the state. We continue to reunite annually at CLEC, the Annual Meeting, or state meetings and pick up our friendship where we left off, never missing a beat to catch up with work, friends, and family. Annual Meetings are like family reunions—there were even times when we visited local attractions at host cities (the Denver Mint, the White House, SeaWorld, and shopping along the Magnificent Mile). There were lunches held at destinations halfway between home and Louisville, and there were dinners together when passing through Lexington. Annual Christmas cards are exchanged, dealing with aging parents discussed, and weddings celebrated. Just recently an event downstate had me bumming a room off Linda for one night, somewhat to save on hotel costs, but mainly just to catch up on life.

I could go on and on about other mentors and friends I have gained through ASCLS, but for fear of omitting someone, I won’t name names, but I hope each of you know the profound impact you have had on my involvement in our Society. I have found that ASCLS is one big family … we all have the commonality of a shared passion for the profession. We all have lives outside of our volunteer positions but make ASCLS a priority when it comes to advocacy and involvement.

The Family Grows

And my ASCLS story doesn’t stop here. Now as Region IV director, I have the opportunity to meet new people, and to mentor and befriend those I may not have engaged with had it not been for state and regional meetings. I value my fellow board members as my extended family; my regional and constituent society members, my “new” extended family within the states of Michigan, Ohio, and Indiana—people I look forward to seeing and catching up with when we have the opportunity to be together. I can say that I have friends and colleagues in most of the 50 states and Puerto Rico. As an educator, I have been fortunate to actively engage my students in the profession by attendance at both state and national meetings and am proud to have had students serve as vice chair for the Developing Professionals Forum and as regional developing professional representatives. This is mentoring at a different level, by enhancing their interest and advocacy for activities sponsored through our professional Society.

That’s my ASCLS story about my ASCLS family. My challenge to you is to consider where you are, where you came from, and what “family” was there to support you. Where do your ASCLS roots originate? How wide are your ASCLS family tree branches? Who are you connected to? Better yet, who have you connected with to be involved in your ASCLS family? My hope is that your story doesn’t end here, and that you continue to foster, nurture, share, and mentor others into the profession, as Linda says, for the cycle to continue.

I found this quote to be spot on in terms of my ASCLS story and hope that you will continue to bring friends, colleagues, and coworkers into our family.

“A story has no beginning or end: arbitrarily one chooses that moment of experience from which to look back or from which to look ahead.”

- Graham Greene

Beth Warning is Assistant Professor in the Medical Laboratory Science Program at the University of Cincinnati-College of Allied Health Sciences.


Aymen Alsaihati

Healthcare and laboratory practices need to implement a high-quality management system to assure patient safety and provide reliable and precise results. This, in turn, will help in providing more accurate diagnoses. “Accreditation is an effective way to demonstrate competence of the laboratory, a tool to recognize laboratories world-wide, is linked to periodical audits to stimulate the maintenance and improvement of the quality, which leads to a high standard of services for clients (patients, health care providers, etc.)” (Zima, 2017, p. 231). “[A]ccreditation is usually a voluntary program in which trained external peer reviewers evaluate a healthcare organization’s compliance and compare it with pre-established performance standards” (Alkhenizan & Shaw, 2011, p. 407). For that reason, prestigious organizations try to have accreditations that give them more value/prestige. Having local and international accreditations lead to more power and recognition in the market in Saudi Arabia. Some local accreditations are mandatory.

“One of the greatest results of the accreditation experience … is the focus on staff training and development, and patient safety.”

Also, some international accreditations are required to enter the global market and grow healthcare organization business activities locally and overseas. Laboratories, like any other organization, work to have their accreditations either as part of the hospital accreditation or as part of a specialty area accreditation. Local and international accreditations active in Saudi Arabia provide healthcare organizations credibility regarding reliability, precision, quality, proficiency, and good, safe practice. In Saudi Arabia, hospitals and laboratories must have a license and permit. Also, there is the accreditation body here, which is the Saudi Central Board for Accreditation of Healthcare Institutions (CBAHI). Examples of international accreditations in Saudi Arabia are the Joint Commission International (JCI) and the College of American Pathologists (CAP). The International Organization for Standardization (ISO) standards are less applied to healthcare and laboratory practice in Saudi Arabia.

The accreditation bodies active in Saudi Arabia have different philosophies and cover various areas of expertise. For example; the Saudi Central Board for Accreditation of Healthcare Institutions (CBAHI) is “the official agency authorized to grant accreditation certificates to all governmental and private healthcare facilities operating today in Saudi Arabia” and “the principal function of CBAHI is to set the healthcare quality and patient safety standards against which all healthcare facilities are evaluated for evidence of compliance” (CBAHI, n.d.). Such accreditations, either local or international, play a role to monitor the medical practice and grant credibility for their medical practice following specific standards.

Accreditation leads to the development of hospital and laboratory policies and procedures that match the accreditation body standards; these standards are updated regularly.

CAP is the main laboratory accreditation body that Saudi medical laboratories are seeking. CAP accreditation provides an educational accreditation experience that leads to continued improvement and development. One of the greatest results of the accreditation experience, especially the CAP accreditation, is the focus on staff training and development, and patient safety.

As a laboratory leader, it would be desirable for other laboratory accreditation agencies to have standards focusing on staff education and development and patient safety. Requiring comprehensive quality assurance programs not only monitoring testing and quality control, but also including patient complaint documentation and review and improving overall laboratory systems would also be advantageous to laboratories.

Accreditation is a worthy goal but must include continuous quality improvement components and monitoring of all laboratory processes.


  1. Alkhenizan, A., & Shaw, C. (2011). Impact of accreditation on the quality of healthcare services: a systematic review of the literature. Annals of Saudi medicine, 31(4), 407–416.
  2. CBAHI. (n.d.). About CBAHI. Retrieved March 4, 2020, from
  3. Zima T. (2017). Accreditation of medical laboratories - system, process, benefits for labs. Journal of medical biochemistry, 36(3), 231–237.

Aymen Alsaihati is a laboratory specialist, professional trainer, and public speaker in Saudi Arabia.