Staff members are critical laboratory assets. Not only are laboratory technicians directly involved in producing test results used for patient diagnoses, but laboratory quality is also highly dependent on their performance.
Just as equipment is continually maintained and calibrated, laboratory technicians too must continually receive training to ensure competence and stay up-to-date on evolving technology. While staff training has always been important for laboratory quality and efficiency, several trends in today’s clinical laboratory industry are causing the need for personnel training to be stronger than ever.
Personnel shortages have plagued clinical laboratories for some time. As fewer students enter medical technology programs at universities, the situation is not likely to improve in the near future. As a result, less-skilled employees are commonly tasked to handle more and more critical projects.
Add to this intensifying concern over regulatory requirements and it is clear why there is a heightened need for laboratory personnel training. All laboratory operations that can contribute error to test results and affect patient care are being scrutinized, including personnel competency.
Pipetting is one of the most common laboratory skills and also one of the most critical as the quality of test results is highly dependent on accurate and precise liquid handling. Operators are one of the greatest sources of pipetting error, yet most laboratory technicians have not received formal training on pipetting. As tests such as molecular diagnostics require expensive reagents handled in smaller and smaller volumes, the costs and likelihood of error increase. In addition, liquid handling technology continues to advance. Modern pipettes can be multichannel and electronic, with a number of functional modes, making the act of pipetting more complex.
Ongoing pipetting technique training can help laboratories reduce the risk of pipetting error and improve overall laboratory quality and efficiency. Adjustments in technique can produce lasting gains in terms of accurate results and compliance. Several tips and techniques can be incorporated into a pipetting technique training course to improve information retention and optimize the learning process.
Given that liquid handling technology continues to advance, it remains important to educate laboratory technicians on the mechanical function and various features of modern pipettes. This information provides perspective on the task at hand and deepens trainee understanding of the pipetting process and potential sources of error.
In addition, pipetting ergonomics is a major issue that needs to be addressed. According to the Bureau of Labor Statistics (2003), cumulative trauma disorders (CTDs) account for more than 50 percent of all occupational illnesses in the US.1 CTDs by definition are injuries of the musculoskeletal and nervous systems, and repetitive tasks, such as pipetting, are prime causes. Education on ergonomic pipetting, including topics such as selecting proper instruments and avoiding awkward postures, can reduce staff injuries, improve employee satisfaction, and diminish laboratory costs.
Pipetting training courses should also focus on selecting the right pipette and pipetting technique to use in a given application. Technicians are confronted with a number of variables, including which pipette brand and type of pipette tip to use as well as technique choices such as whether to use forward or reverse mode and whether or not to pre-wet the pipette tip. Technique should also be adjusted depending on the fluid types being handled based on characteristics such as viscosity, volatility and sample temperature. Using incorrect tools and techniques for given applications can adversely affect the accuracy of the volumes dispensed. Discussion of best practices can solve this challenge.
Possibly more important than the selection of tool and technique is the execution of the selected technique. Pipetting technique training should educate attendees on the “dos” and “don’ts” of pipetting and how minor physical tweaks can drastically change the volume dispensed. Working too quickly and pipetting at an angle are common pipetting errors that can have a significant impact on volume delivery. Live pipetting demonstrations, coaching, and hands-on practice are effective methods to convey this information to pipetting trainees.
Another fundamental aspect of a pipetting technique training program is an objective measurement tool that can provide periodic checks to determine how accurately attendees are pipetting. Pre- and post-training skills assessments can be conducted to illustrate the necessity of pipetting training. Ideally, the measurement tool should rapidly provide feedback so trainees can immediately witness how modifications to pipetting technique affect pipetted volumes.
Below are additional tips to maximize the positive impact of a laboratory pipetting technique training program:
Pipetting technique training should not be a one-time affair but rather an ongoing event to prevent technicians from reverting to old habits and help them stay up-to-date on evolving liquid handling technologies that may require new knowledge or different skill sets. For example, multichannel pipettes are more challenging to use than single-channel pipettes and training is important to prevent misuse. For maximum effectiveness, training should occur at least annually.
By providing refresher courses and continual competency checks, laboratory managers can ensure that the pipetting skill of staff members is maintained over time. Essential components of training updates include pre-training skills assessments, review of important tips on pipetting technique, and coaching, followed by post-training skills assessments. A roundtable discussion on new challenges in pipetting or concerns that may have arisen since the last training can also prove beneficial. To provide a trail of evidence supporting operator proficiency, documentation of competency results is required.
The objectives of any training program are to impart knowledge and ensure that information is retained. Learning opportunities that are fun and team-building are always more memorable.
Since competition often brings out the best in people, creating an interdepartmental challenge is one idea to motivate training course attendees to pay attention and focus on improving their skills. Incentives and rewards can also be used to boost information retention and overall satisfaction with the training course.
In addition, pipetting technique training sessions should engage staff in a non-threatening manner rather than be used as disciplinary punishment. Be careful not to embarrass technicians who have poor technique and be sensitive to egos. Coach, don’t critique.
Lastly, be flexible based on trainee needs and personalities. Adjusting for the individual is important to result in lasting gains. A technician might prefer to pipette in silence so as not to break concentration while another might require hands-on, active coaching. Adapting the teaching style according to attendee preferences is ideal.
Laboratory staff members are directly responsible for the quality of laboratory results. In today’s clinical laboratory environment, personnel training is essential to maintain compliance and test result integrity. Given the large role that pipetting plays in the typical clinical laboratory, pipetting technique training is essential to reduce error and ensure compliance. An effective pipetting technique training program that is fun and team-building and provides measurable improvement will leave a lasting impression with laboratory staff and encourage continuous development of pipetting skills.
1. Bureau of Labor Statistics (2003), “Lost-worktime injuries and illnesses: characteristics and resulting time away from work”, available at:www.bls.gov/news.release/osh2.nr0.htm (accessed October 31, 2008).