NORFOLK STATE UNIVERSITY
MEDICAL TECHNOLOGY
PROGRAM HANDBOOK
2015
Table of Contents
Introduction ...............................................................................................................................1
Program Officials ........................................................................................................................2
Program Goals ………………………………………………………………………………………………………………………….. 3
Program Objective
Technical Standards
Program Support Services
American Society for Clinical Pathologist Generalist Exam ............................................................8
Admission Procedure and Requirements .....................................................................................9
Program Admission Policies
Program Continuation Policies
Academic Policies and Procedures ...............................................................................................11
Program Requirements
Appeal Process
Academic Honesty Policy
Grading Scale
Medical Technology Professional Behavior Expectations
Additional Policies ......................................................................................................................15
Technology Requirement
Policy when Applied Experience Cannot Be Guaranteed
Policies for Service Work
Learning Experiences
Policy for Procedure Performance
Code of Ethics .............................................................................................................................17
Pledge of the Profession
Confidentiality of Patient Information
Curriculum ..................................................................................................................................19
Clinical Education ........................................................................................................................21
Clinical Practicum Sites
Policies and Procedures for the Clinical Education Portion
Biological Exposure and Safety Plan
Emergency Procedures
Appendices .................................................................................................................................28
Appendix I
Appendix II
Appendix III
Appendix IV
Appendix V
Appendix VI
Appendix VII
Appendix VIII
Release of Personal Health Information
General Guidelines for Clinical Practicum
Clinical practicum
Medical Technology Attendance Record
Laboratory Safety Guidelines
Clinical Professional Behavior Evaluation Form
Clinical Presentation Grading Form
Incident Report
INTRODUCTION
Welcome to the Medical Technology Program at Norfolk State University and the beginning of your
professional education. You will be learning theory and technical skills that will enable you to enter a
career whose primary objective is the best possible care of the patient. During the next two years, you
will be introduced to the concepts and skills necessary to become a competent and skilled technologist
in the clinical laboratory setting.
HISTORICAL BACKGROUND
The Medical Technology Program, also referred to as Medical Laboratory Sciences, was established in
1975 guided by Dr. Paul Brown, Dr. Augustine Okonkwo, and Dr. Patricia Ravenell. The Medical
Technology Program is housed in the Allied Health Division of the Department of Nursing and Allied
Health. The Department of Nursing and Allied Health is one of nine departments in the College of
Science Engineering and Technology.
The Medical Technology Program is constructed following the guidelines of the National Accrediting
Agency for Clinical Laboratory Sciences (NAACLS). It is fully accredited by this agency and graduates are
eligible for national certification as Medical Laboratory Scientist generalists. The target pass rate on the
national exam administer by American Society for Clinical Pathologist (ASCP) for the program is 80%.
Currently, the program has a 64% pass rate for students graduating in 2014.
Contact Information for NAACLS is:
5600 North River Road
Suite 720
Rosemont, IL 60018-5119
Phone: 847.939.3597
Email: info@naacls.org
http://www.naacls.org
Norfolk State University does not discriminate against any person on the basis of race, sex,
color, national origin, religion, sexual orientation, gender identity, age, political affiliation, or
against otherwise qualified persons with disabilities in admission to, participation in, or receipt of
the services and benefits under any of its programs and activities, whether carried out directly or
through a third-party, or any other entity, with which Norfolk State University arranges to carry
out its programs and activities.
1
2
PROGRAM OFFICIALS
Program Director:
Pamela B. Lonergan MS MT(ASCP)SC
Education Coordinator: Each clinical Affiliate laboratory has a designated education coordinator
Faculty and Staff

Pamela B. Lonergan MS MT(ASCP)SC, Program Director
Office: James Bowser Building Room 203
Phone: 757.823.9459
Email: pblonergan@nsu.edu

Marie St. Rose, PhD, Allied Health Programs Coordinator
Office: James Bowser Building Room 106
Phone: 757.823.2480
Email: mstrose@nsu.edu

Jessica Parrott PhD, Chairperson Nursing and Allied Health
Office: Brown Memorial Hall Room 250
Phone: 757.823.9015
Email: jmparrott@nsu.edu
3
PROGRAM GOALS
The mission of the Medical Technology Program is to provide students with the best
educational experience through exceptional teaching and diverse laboratory activities. As a result
of the education and instruction provided to the Medical Technology students, they will be
prepared to serve the community as competent and professional laboratory practitioners who
are prepared to meet the future scientific and biomedical advances in the clinical laboratory.
Specifically, the goals of the Norfolk State University Medical Technology Program seek
to:
a.
Provide a program of instruction that integrates theoretical and practical clinical
laboratory science, producing relevantly prepared practitioners.
b.
Provide a curriculum that is broad enough to allow optional career alternatives.
c.
Provide competency-based instruction wherein learning objectives are clearly
defined.
d.
To educate student to be competent in their profession and to possess the skills
that will allow for career mobility.
e.
Provide an opportunity for individuals possessing deficient academic backgrounds
but high aptitude to become health professionals, through academic enrichment
in basic skills prior to the pursuit of a prescribed curriculum.
g.
Prepare students to successfully write the national certification examination for
Medical Technologists.
h.
Maintain an accredited university-integrated program.
4
Program Objectives
At the completion of the program, the graduate should be able to perform the following with entry-level
competence:
1. Develop, establish and carry out collection and processing of human biological specimens for
analysis.
2. Perform simple and complex analysis of blood and body fluids.
3. Establish and monitor systems which verify the accuracy of laboratory results and accept the
responsibility for reporting valid, pertinent and accurate results.
4. Integrate and relate data obtained by various laboratory tests to make judgments regarding
possible discrepancies, confirm abnormal results, and develop solutions to any problems
encountered considering both technical and physiological variables.
5. Perform and evaluate function verification and preventive maintenance on equipment and
instruments used in the clinical laboratory.
6. Utilize principles of electronic acquisition of information utilizing the Laboratory Information
Systems.
7. With consideration for the specific laboratory’s patient needs, personnel, equipment, budget,
facilities, participate in the evaluation of new techniques and procedures.
8. Demonstrate professional conduct and appropriate interpersonal communication skills with
patients, visitors, laboratory personnel, and other health professionals.
9. Describe the basic principles of laboratory management and value the need for a systematic
organization to accomplish the mission of the clinical laboratory.
10. Demonstrate professionalism in laboratory practice as evidenced by compliance with safety
regulations, participating in continuing education, and by practicing discretion, confidentiality,
honesty and integrity.
11. Apply basic knowledge of research design and statistics to method comparison and other
research endeavors applicable to and encountered in the clinical laboratory science practice.
12. Successfully sit for the national certification for Medical Laboratory Scientist Generalist exam.
13. Recognize the role and importance of professional organizations and actively participate in
them.
5
TECHNICAL STANDARDS
Technical standards represent the essential non-academic requirements of the program
that students must master to participate successfully in the program and become employable.
The following is a list of the technical abilities and skills applicants for admission must possess:
1.
Manual Dexterity: Ability to use hand(s) or terminal devices with coordination.
Ability turn dials, press keypad, perform phlebotomy
2.
Fine Motor: Ability to manipulate small objects with fingertips or adaptive devices.
3.
Mobility: Ability to maneuver in the laboratory and around instruments and in
patient-care settings.
4.
Vision: Ability to distinguish red, yellow, and blue colors; distinguish clear from
cloudy, and see through a microscope. Ability to read dials on equipment, read lines
on instruments that are one millimeter apart and differentiate characters/letters on
the computer screen or sample tube that are ~ 1.5mm
5.
Hearing: Ability to adapt with assistive devices (i.e., phone receivers, hearing aid).
6.
Speech: Ability to verbally communicate understandably in English.
7.
Writing: Ability to communicate effectively in the written form in English.
8.
Reading: Ability to read, understand, and follow directions printed in English.
In addition, in order to be placed into the clinical practicums (MDT 306, MDT 395, MDT 396,
MDT 495, MDT 496), the student:





Must present documentation of immunization to include but may not be limited to the
following: Hepatitis B or signed waiver, Tdap, MMR, Varicella, PPD and Influenza
May be required to travel outside of the Norfolk area for internships
Must provide their own transportation to the clinical practicum sites
May be required to participate in practicums that start very early morning and may be required
to participate in evening practicums
Must have a Background Check performed and may not be allowed to continue into the clinical
practicums if they have certain felony or misdemeanor convictions or charges under
investigation.
6
Program Support Services

Spartan Success Center
The office is located in Nursing and General Education Building Suite 100 and Brown Memorial Hall
(BMH), Room B 191.
The Spartan Success Center supports Norfolk State University’s mission of transforming lives
and communities by empowering a culturally diverse student population through a
comprehensive educational plan that addresses academic engagement, educational
commitment, self-efficacy, and campus engagement.
GOAL
To provide a systematic approach designed to improve student achievement, increase
retention, and reduce time to degree completion.
OBJECTIVES
o
Foster an open and responsive environment that encourages faculty and students to
take an active interest and role in student success.
o
Develop in each student the skills, attitudes, and beliefs necessary to foster an
understanding of the process of learning to achieve academic, career and life goals.
o
Work collaboratively with the campus community to promote student persistence and
successful completion of the students' educational goals.
o
Assess the effectiveness of the Success Center and evolve in response to student
needs.
o
To assist students in becoming more independent, self-confident and efficient
learners.
For additional information, contact the Spartan Success Center at 757.823.8507 or
www.nsu.edu/provost/ssc

Science and Technology Academicians on the Road to Success (STARS) Tutoring
Center
The STARS tutoring center is located in the Nursing and General Education Building Room 307
The center offers free one-on-one tutoring or group tutoring for students taking courses in biology,
chemistry, computer science, engineering, nursing, physics, mathematics, and technology. The tutoring
is provided by graduate and undergraduate peer tutors who have been trained in effective tutoring
7
techniques in accordance with College Reading and Learning Association Guidelines (University
Undergraduate Catalog, 2009-2011).
For additional information, contact the STARS Tutoring Center at 757-823-2891.
 Americans with Disabilities Act (ADA)
In accordance with Section 504 of the 1973 Rehabilitation Act and the Americans with
Disabilities Act (ADA) of 1990, if you have a disability or think you have a disability, contact
Supporting Students Through Disability Services (SSDS) for information regarding programs and
services to enhance student success.
Location:
Lyman B. Brooks Library, Room 240
Contact Person:
Disability Services Coordinator
Telephone:
757.823.2014

Career Services
Career Services is responsible for identifying and developing employment opportunities, supporting
students by providing a data base of employers, providing career counseling and advising, and aiding the
students in preparing for the job search by assisting the students in job search strategies, resume
writing, and interview skills development.

Counseling Center
The Counseling Center provides a wide range of counseling services to students at no charge. Services
include individual, group, and crisis counseling related to those issues that affect students such as
depression troubled relationships, and inability to manage stress
8
AMERICAN SOCIETY FOR CLINICAL PATHOLOGIST GENERALIST EXAM
Upon graduation from the Medical Technology Program at Norfolk State University, students are eligible
to take the Medical Laboratory Scientist (MLS) Generalist Exam offered by the American Society for
Clinical Pathologist Board of Certification.
http://www.ascp.org/Functional-Nav/Laboratory-Science-Students
9
ADMISSION PROCEDURE AND REQUIREMNTS
Student wishing to apply for admission to the professional phase of the program for August of the next
academic year:
1.
Must be admitted as a student at Norfolk State University
2.
Students must be able to complete all of the following science pre-requisites prior to the fall
semester of the pre-clinical coursework:
BIO 110, 110L, BIO 165, BIO 165L, BIO 166, BIO 166L, BIO 310, BIO 310L
CHM 221, 221L, 222, 222L
MTH 151, 153
MTH 250 OR SOC 355
3.
Students must have a 2.0 average in these courses as well as an overall 2.5 GPA for full
admission
4.
It is preferable, but not required that all General Education requirements be completed
prior to entry into the professional phase of the curriculum.
For current Norfolk State University students, whose declared major is Medical Technology, all
application packages MUST be received by April 15 of the spring semester prior to starting the fall
professional phase pre-clinical coursework. Transfer students, students reentering the university, or
students changing majors who are eligible to begin the pre-clinical coursework during their first
semester at NSU or in the Medical Technology major must submit their application package no later
than August 15. A completed application package includes the following:
1.
2.
3.
Application Form
One recommendation from a science or mathematics professor.
A statement describing your reasons for entering the profession of Clinical Laboratory
Science
Medical Technology Minors/Second Degree
Students applying to pursue a minor or second degree in Medical Technology should follow the
same procedure as describe above.
10
Program Admission Policies
Students will be notified by mail within three weeks of the application deadline as to their admissions
status. All Students will be admitted under one of the following categories:
1.
2.
3.
Full Admission to the Medical Technology Program
Conditional Admission to the Medical Technology Program—the student will remain is
this category until:
 The student has successfully completed one semester of pre-clinical course work.
Then the student will be granted Full Admission
 The student has successfully completed any prerequisite requirements not
completed at the time of the admissions process. Upon successful completion of the
requirements the student will be granted Full Admission
 Students who are admitted as Conditional and do not complete the pre-requisite
course work prior to the beginning of the Fall semester will automatically be move
to the Deferred admission status until the courses are satisfactorily completed.
Deferred, with the option to reapply during the next application process.
Program Continuation Policies
Once the student has been granted Full Admission into the Medical Technology Program, the
student must earn a “C” in the Medical Technology coursework for continuance in the program at that
level. In the event that the student does not earn a “C” in any of the Medical Technology courses, the
student will be placed in the Provisional Status until the student successfully completes the course work
with a “C”. Students in the Provisional Status will receive a lower priority for clinical practicum
placement and will be unable to enter the clinical practicum in the area where they have not
successfully completed their pre-clinical coursework. Upon successful completion of the course work,
the student will then return to the Full Admission category.
Students who must repeat pre-clinical course(s), resulting in a more than a 12 month delay
between course work and clinical practicum, will be required to demonstrate mastery of the concepts
through successful completion of the final exam for each course as appropriate.
Students whose preclinical course work is more than 3 years old will be required to reapply to
the program and to repeat any preclinical or clinical course work that is more than 3 years old.
11
Academic Policies and Procedures
In addition to the general academic regulations stated in the University Catalog, the policies and procedures
described below apply to students in the Department of Nursing and Allied Health, Medical Technology Program
Program Requirements
1. Any student that fails to make a grade of “C” or better in a Medical Technology Program
course after two attempts will be removed from the program. The student can reapply
for admission to the program the following year. At that time the student will need to
demonstrate mastery of the concepts for all previously passed courses via successful
performance on the final exam for each course as appropriate.
2. Any student that makes a grade of less than a “C” in two or more Medical Technology
Program courses during one semester will be removed from the program. The student
can reapply for admission to the program the following year. At that time the student
will need to demonstrate mastery of the concepts for all previously passed courses via
successful performance on the final exam for each course as appropriate.
3. All students must contract for a “Background Check “prior to entering the clinical
portion of the curriculum. Certain felony and misdemeanor convictions may, as
determined by the specific health care facility, prohibit the student from proceeding to
the clinical portion of the curriculum and therefore continuation in the program.
4. All students must obtain a series of health screen testing, as described in the Clinical
Education portion of this handbook, prior to entering the clinical portion of the
curriculum. Failure to obtain the necessary testing will prohibit the student from
proceeding to the clinical portion of the curriculum and therefore continuation in the
program, until the requirement is met.
5. All students must obtain Accident Insurance, as described in the Clinical Education
portion of this handbook, prior to entering the clinical portion of the curriculum. Failure
to obtain the necessary insurance coverage will prohibit the student from proceeding to
the clinical portion of the curriculum and therefore continuation in the program until
the requirement is met.
6. All students must obtain Liability Insurance, as described in the Clinical Education
portion of this handbook, prior to entering the clinical portion of the curriculum. Failure
to obtain the necessary liability coverage will prohibit the student from proceeding to
the clinical portion of the curriculum and therefore continuation in the program until
the requirement is met.
7. The student’s performance in the clinical coursework (MDT 395, MDT 396, MDT 495,
MDT 496) must meet the standards define in the Clinical Internship Guidelines. Failure
to maintain an academic standard or professional standard of behavior will result in
student being removed from the course and given a failing grade.
8. All students will be required to take a pre-test prior to entry into the appropriate clinical
internship. The student must achieve a grade of 60%. Failure to achieve a grade of 60
will preclude the student from the internship. The student will be place into a low
priority for internship placement in that specific internship.
12
9. Students must successfully complete Medical Technology Seminar (MDT 475) with a
grade of C and must achieve a minimum score of 73 on the Final Comprehensive Exam.
Failure to achieve a minimum score of 73 on the Final Comprehensive Exam after two
attempts will result in a failing grade and the student will be required to repeat the
course.
Appeal Process
1. A student may appeal any grade or any removal from the clinical practicum which
results in a failing grade. The appeal must be made in writing to the Chairperson of
the Department of Nursing and Allied Health
2. The student has the option to follow the appeal process as describe in the University
catalog.
Academic Honesty Policy
1. University Policy
The university policy on Academic Honesty is published in the University Catalog and the
catalog indicates that the University “expects and requires academic honesty from all
members of the University community”.
2. Medical Technology Program – cheating is defined to include, but not limited to:
a. Cheating on an exam—using answers from or comparing answers with another
student’s paper; using aids which are not authorized for use in the exam; writing an exam
for another student; securing an unauthorized copy of the current or old exam or a copy of
the answers before the exam is given.
b. Cheating and plagiarism on homework or laboratory exercises- writing the assignment
by copying another student’s work; combining efforts of several student in completing an
activity unless specifically indicated by the faculty; falsifying laboratory data on lab
assignments; taking another student’s laboratory results and assuming ownership
3. Program Policy
Any assignment for credit in which plagiarism or dishonesty is observed will be given a grade
of zero (0) and subject to the University Judicial Proceedings as appropriate.
Grading Scale
The grading scale is as follows:
94 - 100
90 - 93
87 - 89
83 - 86
A
AB+
B
73 - 76
70 - 72
67 - 69
63 - 66
C
CD+
D
13
80 - 82
77 - 79
BC+
60 - 62
below 60
DF
NOTE: A minimum grade of C (73 - 76) is necessary for the successful completion of any
Medical Technology course.
Medical Technology Professional Behavior Expectations
The following professional behaviors/attitudes should be clearly demonstrated by each candidate for a
professional degree in Clinical Laboratory Science:
Students in the Medical Technology Curriculum should:
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
Attend all scheduled classes on time and remain in class for all learning activities.
Comply with the established dress code policy as outlined in the Medical Technology Handbook,
the Internship Guidelines and the Laboratory Safety Guidelines.
Notify program director and the practicum supervisor when unable to report to the practicum or
to report on time.
Demonstrate the ability to ask relevant questions and to realize the need for assistance, if
needed.
Complete all work assignments according to provide guidelines and criteria.
Recognize the need to communicate effectively and professionally with course instructors,
clinical staff, administrators, and other students.
Accept evaluation of performance and professional behaviors by instructors as constructive, and
willingly seeks to modify the behaviors.
Cooperate as part of a team by maintaining a clean and organized work area, by restocking
laboratory supplies when necessary in the work area.
Demonstrate initiative by seeking additional activities when not busy.
Exhibit self-confidence in the operation of laboratory equipment and in the performance of
laboratory procedures.
Maintain the confidentiality of privileged information.
Cooperate with others to maintain a pleasant and efficient work place.
Realize the need to avoid, within the clinical setting, excessive conversation, extensive
socialization, and use of cell phones for conversation and text messaging.
Comply with instructions that are given either orally or written.
Recognize the need to maintain self-composure, appropriate language, and tone and volume of
voice under stressful conditions.
Recognize and accept one’s own personal strengths and weaknesses.
Practice ethical behavior, and realize the need to engage in professional and scholarly activities
to better promote the image of the clinical laboratory science profession.
14
Students should maintain a respectful attitude toward the professor/instructor and other students at all
times.






Students should not make noise (talk, whisper, eat loudly, rustle paper) nor work on
other assignment during lecture time. If such activity is occurring to a degree that the
professor or other students is/are distracted, the student carrying on such activities will
be ask to discontinue the disruptive behavior/activities and /or to leave the room.
Cell phones and IPods should not be used during lecture or lab. Phones should be
silenced and put away. You should make your family and friends aware of your class
schedule and ask them not to call during that time.
o Cell phones are NOT permitted during any exam, tests, or quiz and during Lab
activities. If your family/friends need to get in contact with you during these
times in case of emergency, you can ask them to call the Allied Health
Department NGE Room 311 /757.823.8389 or the campus police.
Looking at a cell phone during an exam will be construed as cheating and the student
will receive a grade of zero for that assignment and be referred to the University Judicial
Proceedings as appropriate
Students must come to lab appropriately attired and must use the Personal Protective
Equipment (PPE) which is provided to the student or which the student must supply.
o The student must provide:
 a laboratory coat that has full cuffed elastic sleeves, ¾ to full length,
and closes up to the neck
 a pair of safety goggles
o The Program will provide:
 gloves
 laboratory shields, as appropriate
Because of the potential for contamination (spills, splashes etc), students should only
bring what is needed to lab and stow all other books, purses, coats etc.
Students are expected to maintain a clean and orderly lab. Biohazard trash should be
disposed of appropriately. Microscopes should be cleaned after each lab and before
storing.
15
Additional Policies
Technology Requirement
Writing/ Scientific Reasoning/Critical Thinking: Students will be requires to use
scientific knowledge from the classroom and to apply that knowledge to a specific
situation toward decision making within the clinical laboratory.
Information Technology Literacy: Students must be able to utilize the Course
Management Program, Blackboard and should be able to send and receive email.
Quantitative Reasoning: Students will be required to perform calculations using given
and derived data and to draw conclusions regarding the patient clinical conditions.
Policy when Applied Experience Cannot Be Guaranteed
In the event that an extreme situation (e.g., natural disaster, program closure)
causes the Norfolk State University Medical Technology Program to be unable to complete
the students pre-clinical and practicum coursework, every effort will be made to find
alternate sites for the students to complete their training. This will be accomplished by
contacting local schools in Virginia and throughout the country to attempt to place students
in a program. Documentation of course work as well as any clinical training will be
provided to the alternate site to assist in their evaluation of each student.
Policies for Service Work
Working in a clinical laboratory outside of regular academic hours is noncompulsory for
students. Student may seek opportunities for outside employment in a clinical laboratory setting
during weekend and weekdays when not scheduled for a clinical experience. However, students
should accept these opportunities only to the extent that they do not compromise their
satisfactory performance in the educational program.
These opportunities are optional and students who seek employment in a laboratory setting are
considered employees of the institution during their employment hours.
Learning Experiences
Learning Experiences outside of the normally scheduled academic and clinical experience is not
required of the Medical Technology students. Students are encouraged to participate in
community service and volunteer activities. However, no reward is given for participation and no
penalty is incurred due to non-participation.
16
Policy for Procedure Performance
During the clinical experience and after the student has demonstrated proficiency, students may
be permitted to perform procedures under the supervision of a qualified laboratorian. The
decision to allow the student to perform the procedure will be determined by the clinical faculty
at the institution.
17
CODE OF ETHICS
The American Society for Clinical Laboratory Science (ASCLS) has adopted the following code of ethics.
Preamble:
The code of Ethics of the American Society for Clinical Laboratory Science set forth the
principals and standards by which clinical laboratory professionals practice their
profession.
I.
Duty to the Patient:
Clinical Laboratory Professionals are accountable for the quality and integrity of the laboratory
services they provide. This obligation includes maintaining individual competence in judgment
and performance and striving to safeguard the patient from incompetent or illegal practice by
others.
Clinical laboratory professionals maintain high standards of practice. They exercise judgment in
establishing, performing, and evaluating laboratory testing.
Clinical laboratory professionals maintain strict confidentiality of patient information and test
results. They safeguard the dignity and privacy of patients and provide accurate information to
other health care professionals about the services they provide.
II.
Duty to Colleague and the Profession
Clinical laboratory professionals uphold and maintain the dignity and respect of our professions
and strive to maintain a reputation of honesty, integrity and reliability. They contribute to the
advancement of the profession by improving the body of knowledge, adopting scientific advances
that benefit the patient, maintaining high standards of practice and education, and seeking fair
socioeconomic working conditions for members of the profession.
Clinical laboratory professionals actively strive to establish cooperative and respectful working
relationships with other health professionals with the primary purpose of ensuring a high
standard of care for the patients they serve.
III. Duty to the Society
As practitioners of an autonomous profession, clinical laboratory professionals have the
responsibility to contribute from their sphere of professional competence to the general
wellbeing of the community.
Clinical laboratory professionals comply with relevant laws and regulations pertaining to the
practice of clinical laboratory science and actively see, within the dictates of their consciences, to
change those which do not meet the high standard of care and practice to which the profession
is committed.
Pledge of the Profession –
As a clinical laboratory professional, I strive to:
Maintain and promote standards of excellence in performing and advancing the art and science
of my profession; Preserve the dignity and privacy of patients; Uphold and maintain the dignity,
and respect of our profession; Seek to establish cooperative and respectful working relationships
with other health professionals; and, Contribute to the general well being of the community.
18
CONFIDENTIALITY OF PATIENT INFORMATION
Students are expected to maintain the confidentiality of all patient information and patient identifiers.
Toward that end, the students cannot discuss the patient experiences, results, or circumstances with any
family members or persons outside the clinical laboratory setting. Students cannot “Tweet” or post to
Facebook any reference to their clinical experience or patient interactions. Additionally, no reference should
be made of the clinical site in which the student is participating in the clinical experience.
Students will be asked to sign a confidentiality agreement (see Appendix VIII) and any violation of the
confidentiality agreement will result is immediate dismissal from the program.
19
NURSING AND ALLIED HEALTH DEPARTMENT
MEDICAL TECHNOLOGY PROGRAM
Curriculum Leading to the B.S. Degree
2012
Freshman Year
IUL 101
BIO 110/110L
ENG 101
MTH 151
PED 100, 1XX
SOC 1011
BIO 165/165L
CHM 221/221L
ENG 102
MTH 153
Credit Hours
1st 2nd
Total
Intro to University Life
3
3
General Biology/Laboratory
3/1
4
Communication Skills
3
3
College Algebra
3
3
Fund. Fitness for Life
1
1
Social Science
3
3
Human Anatomy & Physiology
3/1
4
General Chemistry/Laboratory
3/1
4
Communication Skills
3
3
College Algebra & Trigonometry
3
3
14
17
31
Sophomore Year
CHM 222/222L
Cultural Perspective
Cultural Perspective
MTH 250
BIO 166/166L
BIO 310/310L
MDT 308
CSC 150
HUM 2104
SCM 285
General Chemistry/Laboratory 3/1
Humanities2
3
3
Social Sciences
3
Elementary Statistics
3
Human Anatomy & Physiology 3/1
General Microbiology/Laboratory
3/1
Urinalysis
2
Computer Concepts & Applications 3
Humanities
3
Principles of Speech
3
17
15
4
3
3
3
4
4
2
3
3
3
32
1or
Select from HIS 101, HIS 103, BUS 175 or ECO 200
from ENG 383 or MUS 234
3Select from HRP 320, HIS 335, HIS 336, HIS 371
4or Select from, ENG 207 or FIA 201
2Select
Summer Session
MDT 306
CHM 312/312l
Phlebotomy
Organic Chemistry
2
4
20
Junior Year
MDT 315
MDT 325
MDT 373
MDT 410
MDT 425
MDT 450
MDT 455
MDT 473
Clinical Hematology I
Clinical Chemistry I
Clinical Microbiology I
Immunology
Clinical Chemistry II
Clinical Hematology II
Immunohematology
Clinical Microbiology II
4
4
5
4
___
7
4
4
5
4
4
4
4
4
33
4
4
4
4
16
Senior Year
MDT 395
MDT 396
MDT 495
MDT 496
MDT 475
MDT 480
Hematology/Coagulation Practicum 4
Immunohematology/Practicum
4
Clinical Microbiology Practicum
Clinical Chemistry/Practicum
Medical Technology Seminar
Clinical Laboratory Administration
2_
10
4
4
1
__
9
4
4
4
4
1
___
19
SUMMARY OF GRADUATION REQUIREMENTS
General Education ........................
Major Requirements ......................
Total
42 Semester Hours
79 Semester Hours
121 Semester Hours
21
Clinical Education
Clinical Practicum Sites
During the senior year, students are required to complete a two-semester clinical affiliation rotating
through the major clinical areas of the affiliated hospitals and clinical laboratories. The current affiliated
laboratories are described below.
Sentara Norfolk General Hospital
Sentara Norfolk General Hospital, a 543-bed facility, is home to the areas only Level I Trauma Center and burn
trauma unit.
600 Gresham Drive
Norfolk, VA 23507
http://www.sentara.com/HospitalsFacilities/Hospitals/NorfolkGeneral/Pages/mapsdirections.aspx
Sentara Leigh Hospital
Sentara Leigh Hospital, located in Norfolk, is a 250-bed facility featuring all private rooms and specializing in
orthopedic, gynecological and urological services.
830 Kempsville Road
Norfolk, VA 23502
http://www.sentara.com/HospitalsFacilities/Hospitals/Leigh/Pages/mapdirections.aspx
Sentara Bayside Hospital
Sentara Bayside Hospital, a 158-bed acute care facility in Virginia Beach, specializes in outpatient diagnostic and
surgical services.
800 Independence Blvd.
Virginia Beach, VA 23455
http://www.sentara.com/HospitalsFacilities/Hospitals/Bayside/Pages/mapdirections.aspx
Sentara Virginia Beach General Hospital
Sentara Virginia Beach General Hospital, a 282-bed acute care facility, offers the perfect combination of life-saving
technology in a healing environment.
1060 First Colonial Road
Virginia Beach, VA 23454
http://www.sentara.com/HospitalsFacilities/Hospitals/BeachGeneral/Pages/mapsdirections.aspx
Sentara Obici Hospital
Sentara Obici Hospital, a 150-bed facility located in Suffolk, offers a wide range of inpatient and outpatient services.
2800 Godwin Boulevard
Suffolk, VA 23434
http://www.sentara.com/HospitalsFacilities/Hospitals/Obici/Pages/mapanddirections.aspx
22
Sentara Williamsburg Hospital
A model of medical innovation, this 145-bed hospital serves the region with the life-saving capabilities of an ultramodern medical center.
100 Sentara Circle
Williamsburg, VA 23188
http://www.sentara.com/HospitalsFacilities/Hospitals/Williamsburg/Pages/mapsdirections.aspx
Sentara Careplex Hospital
Sentara CarePlex Hospital is a technologically advanced acute care 200-bed facility located in Hampton, Virginia with
leading technology including one of the area’s first "smart" operating rooms and a campus-wide fiberoptic backbone
to support transfer of filmless, digital diagnostic images
3000 Coliseum Drive
Hampton, VA 23666
http://www.sentara.com/HospitalsFacilities/Hospitals/CarePlex/Pages/mapsdirections.aspx
Chesapeake Regional Medical Center
As the cornerstone of the Chesapeake Regional Medical Center family of services, Chesapeake General Hospital
has 310 all-private beds, arranged in special nursing units to provide the best possible care for our patients.
The hospital is a major health resource for southeastern Virginia and northeastern North Carolina residents. It has
nearly 600 physicians on staff from every major discipline
736 Battlefield Blvd., North
Chesapeake, VA 23320
http://www.chesapeakeregional.com/patients-visitors/directions-and-maps
Navy Regional Medical Center
The mission of Naval Medical Center Portsmouth is to support the national interests of the United States
by providing professional education and development, providing quality patient care, being responsive and ready for
deployment, and taking care of each other as shipmates.
620 John Paul Jones Circle
Portsmouth, VA 23708
http://www.med.navy.mil/sites/nmcp/localarea/Pages/Driving.aspx
23
Policies and Procedures for the Clinical Education Portion
1.
2.
3.
4.
Internship sites are procured with a diligence and every effort will be made to provide
internships for every student so that they can graduate at the projected time. However, if
circumstances require, then a priority will be given to those student who have completed all of
the requirements for the degree with the exception of the internships.
Internship will be assigned based on the following criteria:
 Students that have completed all general education and pre-clinical course work
with be given first priority
 Students that have general education or CHM 312/312L to complete but have
successfully completed the pre-clinical course work will receive lower priority
for internships
 Students that have pre-clinical coursework to complete will receive the lowest
priority
 As much as is possible, students will be given one internship. Once those, with
priority, have one internship, then assignment will be made to provide the
second internship for those students and continue on until all internships are
provided.
There is no guarantee that internships will be available to everyone when they need them.
However every effort will be made to provide internships so that students can graduate as
close to their expected date of graduation as possible.
Hours for the internships will vary with the site and the discipline. The hours can vary to include,
and not limited to, 6am to 2:30pm, 7am to 3:30pm, 3pm to 11pm depending on site. In addition,
the hours may vary from week to week depending on the analysis to be done e.g. Monday to
Wednesday 2:30pm to 11pm and 6am to 2:30pm on Thursday and Friday.
The holidays that are observed by the university may not mean that the student has those days
off. The holiday off will be determined at each site and by the student progress at the site.
Transportation to and the costs of transportation to the clinical sites will be the responsibility of
the student. Depending on the availability of internships, the student may be required to drive
up to an hour to reach a clinical site.
Any parking fees that are incurred as part of the clinical practicum experience are the
responsibility of the student.
No later than two weeks prior to beginning the clinical portion or internship portion of the
curriculum, all students must obtain and have a copy on file in the program office the following
health screen information:
 Tetanus, diphtheria, and Pertussis (Tdap) within the last 10 years
 Two MMR immunizations or appropriate titer indicating immune status for all three
parameters
 Two Varicella immunizations or appropriate titer indicating immune status
24



5.
5.
6.
7.
8.
9.
10.
Hepatitis vaccination or appropriate titer indicating immune status; Student can choose
to waive this portion by signing the appropriate form that can be obtained at the
Student Health Center
Two negative PPD in the current year. If no PPD in the current year, then a 2-site PPD
must be obtained--the PPD in performed in one arm and then repeated in other arm no
less than two weeks apart; in the case of sero-conversion or previous treatment, the
student should obtain a chest x-ray
Influenza immunization ( except July and August)
Because this information will be sent to the Employee Health Director of the clinical practicum
sites as documentation, students will be asked to sign a waiver indicating the clinical site with
whom the information is sent. The only persons that will have access to the record are the
Medical Technology Program Director, Clinical Coordinator of the site and the Employee Health
Director of the clinical site. (See Appendix I)
Prior to beginning the clinical portion or internship portion of the curriculum, all students must
purchase liability insurance in the amount of $2,000,000 per occurrence/$6,000,000 aggregate.
Documentation must be provided and be on file in the program office.
Prior to beginning the clinical portion or internship portion of the curriculum, all students must
obtain a background check and provide documentation to the Medical Technology Program
Director that the background check has been done.
Prior to beginning the clinical portion or internship portion of the curriculum, all students must
have documentation of accident/health insurance coverage. The clinical affiliates assume NO
responsibility for providing medical care to the Norfolk State University student. Students may
be seen in the Emergency Room of the hospital if injured during the clinical experience, but their
health insurance or the student themselves may be billed.
Prior to entering the clinical portion or internship portion of the curriculum, all students must
review an orientation program specific for that clinical site and successfully complete an
assessment in order to document their knowledge of the HIPPA rules.
Students are expected to adhere to the General Guidelines for the Clinical Practicum, the
Specific Guidelines specific for each individual clinical practicum, and the Laboratory Safety
Guidelines. Refer to Appendix II, Appendix III and Appendix V
Students are expected to adhere to the professional behaviors as outlined in the Professional
Behavior Expectations (see page 13). Ten percent of the clinical practicum grade will be based
on an evaluation of the professional behaviors. Refer to Appendix V and VI.
Students are expected to be in the practicum for each day in which they have a designated
clinical practicum. The hours allotted for the clinical rotations within the clinical laboratories will
be stringently enforced. A student must, therefore, adhere to the hours assigned by the
supervisors in each clinical laboratory. Any student at is more than 10 minutes late for the
clinical practicum more than twice within a two week period, will be removed from the clinical
practicum. Excessive unexcused absences the clinical facilities (10% or more) will result in a
grade of “F” in the specific course. Any student that is absent more than 2 occasions in a 2 week
time period will be removed from the clinical practicum (See attendance recording sheet
Appendix IV). Any student that fails to notify the internship of an absence or to make the clinical
25
11.
12.
site aware of an extended absence will be removed from the clinical practicum.
The student is requested to adhere to the dress code established by the clinical site and to wear
a lab coat when in the clinical environment. While some clinical sites provide a laboratory coat
for the students to use, it is the student’s responsibility to have a laboratory coat available for use
as needed. The general dress code for the clinical practicum is:
a. Shoes must be completely closed. No clogs, sandals, etc. If sport shoes are worn they
must be leather or leatherette not cloth.
b. Trousers, skirts, scrubs are acceptable attire. T-shirts with logos are not deemed
professional attire. Jeans and jean material is not considered acceptable professional
dress. If you wear a skirt, you must also wear stockings or tights.
c. Glittery, frilly, bare back, low cut clothing is not considered professional attire.
d. Pants or trouser waist must sit no more than 3 inches below the waist
e. A minimum of 2 ear piercings is allowed. If you have more, they must be removed.
f. Any nose, lip, eyebrow or tongue piercing must be removed.
g. Perfume, colognes, and scented lotions should be minimally applied.
h. Nails should be trimmed and free of polish.
i. Any tattoos must be covered.
j. All facilities are smoke free, including grounds and break areas.
k. Cell phones are to be used outside of the facility only on breaks.
The Grade for the Clinical Practicum grade is based on the following percentages (See Appendix VI):
Written Tests 45%
Lab Practical 40%
Presentation
5%
Professional Characteristics 10%
 Students will have 2 exams given during the semester on campus covering the
entry level and certification exam concepts specific for that discipline. The
material covers all concepts of the discipline, not just those performed and
observed during the internship experience.
Grading Scale for the Clinical Practicum is:
A
94-100
C
73-76
A90-93
C70-72
B+
87-89
D+
67-69
B
83-86
D
63-66
B80-82
D60-62
C+
77-79
F
< 60
If a student does not achieve at least a 73% average, he/she will receive a failing grade and must repeat
the clinical rotation. Failure to maintain a 73% average overall in the clinical practicum may be cause for
removal from the clinical practicum prior to completion of the experience
Biological Exposure and Safety Plan
It is the intent of the Medical Technology Program to provide students, faculty and staff with the safest
possible working and learning environment. The Department of Nursing and Allied Health/Medical
26
Technology Program abides by the OSHA Blood Borne Pathogens Standard issued in 1991 as described in
the document “Protection of Laboratory Workers from Infectious Disease Transmitted by Blood, Body
Fluids, and Tissue” (CLSI M29T).
1.
ALL samples or specimens will be treated as potentially infectious.
2.
Students will be expected to follow all infection control measures and safe laboratory practices
as described in the Laboratory Safety Guidelines (Appendix IV)
3.
The Blood Borne Pathogen and Safety Practices will be discussed in Clinical Biochemistry I (MDT
325).
4.
Students will be required to wear lab coats, gloves, and safety goggles when handling patient
samples. Lab coast must be laundered whenever they become blood stained or torn. When
using the serofuges, they must wear full face shields. Cuts and abrasions should be covered with
an impervious bandage. If the cut is on the hand, this should be done before putting on gloves.
5.
All biohazard waste will be placed in appropriately labeled containers for commercial pickup.
6.
In the case of broken glassware and spills, the glass and/or spill should be cleaned up
immediately and your lab instructor notified.
7.
Report all accidents or injury to the instructor immediately and complete an incident report
form immediately (Appendix VII)
Emergency Procedures
1.
In the case of emergency, dial University Police at 823.9000 or 911. When calling, stay calm,
carefully explain the problem, and describe the location of the emergency to the University
dispatcher or to the 911 operator. Do not hang up the phone until told to do so
2.
Diagrams are posted throughout the campus buildings that identify both a primary and
secondary routes of evacuation.
3.
In the case of fire alarm or campus emergency:
 All building evacuations will occur immediately when the fire alarm sounds, or upon
notification by the University Police, the Safety Officer, the building Supervisor, or other
designated persons. NO ONE WILL BE ALLOWED TO REMAIN IN THE BUILDING WHEN THE
ALARM SOUNDS!

When the alarm sounds or as instructed, everyone must leave the building by the nearest
exit, and alert others to do the same.

HANDICAPPED PERSONS MUST BE ASSISTED IN EXITING the building and should leave
with the person nearest to him/her at the time of the alarm. Do not use the elevators in
the case of a fire or earthquake. If possible, however, elevators will be reserved for
assisting handicapped persons.
27

Once outside the building, everyone is to proceed to the location designated in your
syllabus as the class meeting place. Keep the streets, fire lanes, hydrant areas and
walkways clear for emergency vehicles and personnel.

NO ONE WILL BE ALLOWED TO RETURN to an evacuated building unless told to do so by
the Safety Officer, the University Police, or an Emergency Response Team member.

The Safety Officer will ensure that everyone is accounted for by going to the assigned
area, speaking with and assisting the supervisor, or building coordinator.
28
Appendices
29
APPENDIX I
Norfolk State University
Medical Technology Program
Release of Personal Health Information
Student ID ______________
Name: _________________________________________________________
Last
First
Middle
Address: _______________________________________________________________________
_______________________________________________________________________
Primary Phone: (_____) ______-___________
Alternate Phone: (_____) ______-___________
Email: _________________________________________________________________________
I hereby authorize the following designated person of the Medical Technology Program at Norfolk State
University to release the following personal information about me:
Designated Person: Pamela B. Lonergan MS MT(ASCP)SC
Information to be released: Results of the following:
Health Physical, Tetanus, PPD, MMR/Rubella, Varicella, Influenza and Hepatitis
This information may be released to the following institution/individual:
 Sentara Healthcare /Employee Health Director
 Chesapeake Regional Medical Center/ Employee Health Director
 Naval Medical Center Portsmouth/ Occupational Health Director
Note: This waiver is in effect for one year from the date of the request.
Signature: _______________________________________ Date: ___________________
Mail, FAX or deliver the completed form to:
Mailing Address:
Pamela B. Lonergan MS, MT(ASCP)SC
Medical Technology Program
Norfolk State University
700 Park Avenue
Norfolk, VA 23504
You may also deliver the completed form to Room 203 Bowser (JBB) or to the Allied Health Office in JBB 106
The personal information collected on this form will be used for the purpose of processing the request by the designated healthcare
organization, indicated above, to share your personal information as part of the criteria for entry into the clinical practicum phase of the
Medical Technology Program. It is collected under the HIPAA guidelines for release of personal health information, and will be protected under
its provisions. If you have any questions about the collection and use of this information, contact the designated person.
30
APPENDIX II
General Guidelines for Clinical Practicum
At the beginning of each clinical rotation, the student will be informed of all evaluation policies
relevant to his/her progression in the clinical rotation.
1. The student must have a complete physical examination by a physician (at the student’s
expense) before entering the clinical phase of the Medical Technology Program. This
examination must be documented on the Medical Technology medical history form.
2. The student must subscribe to liability insurance prior to entering the clinical phase of the
Medical Technology Program. The policy must be maintained throughout the clinical phase
of the program.
3. The student is requested to adhere to the dress code established by the clinical site and to wear
a lab coat when in the clinical environment. While some clinical sites provide a laboratory
coat for the students to use, it is the student’s responsibility to have a laboratory coat available
for use as needed.
4. Smoking, drinking, eating and the use of cell phones are absolutely forbidden in the working
areas of the laboratories and hospital.
5. The hours allotted for the clinical rotations within the clinical laboratories will be stringently
enforced. A student must, therefore, adhere to the hours assigned by the supervisors in each
clinical laboratory. Any student at is more than 10 minutes late for the clinical practicum more
than twice within a two week period, will be removed from the clinical practicum.
6. Students are responsible for all clinical laboratory time missed due to absences and tardiness.
This time must be compensated. All business affairs and/or appointments should be arranged
on weekends or at the end of the daily laboratory time.
7. Any student seeking part-time employment at a clinical affiliate must be in good academic
standing and must notify the Medical Technology faculty before accepting employment.
Students may be employed in a discipline after completion of a rotation in that discipline. The
employment may be in the same facility as the rotation.
8. Students may not participate in off-site service work during regular academic hours. Medical
Technology students cannot participate in any activity as replacements for regular employees.
9. Excessive unexcused absences the clinical facilities (10% or more) will result in a grade of “F”
in the specific course. Any student that is absent more than 2 occasions in a 2 week time period
will be removed from the clinical practicum.
10. The student is expected to exhibit high standards of scholarship, professional conduct, and to
comply with the regulations of the clinical laboratories at all times.
11.
31
12. If a student does not achieve at least a 73% average, he/she must repeat the clinical rotation.
Failure to maintain a 73% average overall in the clinical practicum may be cause for removal
from the clinical practicum prior to completion of the experience. The grading scale for the
clinical practicum is as follows:
A
AB+
B
BC+
94-100
90-93
87-89
83-86
80-82
77-79
C
CD+
D
DF
73-76
70-72
67-69
63-66
60-62
< 60
Students are evaluated by clinical personnel for each laboratory rotation and the
cumulative grade for each rotation is derived from such evaluations.
13. Regular conferences and reviews will be held with students to monitor progress, solve
problems, and enrich learning. When a student has deficiencies, he/she will be encouraged to
utilize individualized instructional materials within the Medical Technology Program.
14. Students are encouraged to attend local regional seminars, workshops, and conferences when
announced.
15. Students are encouraged to participate in student professional organizations.
16. Students are under the direct supervision of the Medical Technology Program Director (Mrs.
Lonergan) during the clinical practicum. Students are also responsible to the supervisory
personnel within the clinical facilities.
17. Students are governed by the policies and the guidelines within the clinical facilities to which
they are assigned.
18. The highest code of medical ethics is expected of the student at all times. Information
concerning patient care, history, and circumstances must be held with strict confidence.
19. Medical insurance is a requirement. The clinical affiliates assume NO responsibility for
providing medical care to the Norfolk State University student. Students may be seen in the
Emergency Room of the hospital if injured on the job, but their health insurance may be billed.
20. Students will be requested to fill out a form authorizing the release of information for
recommendations for future employment.
32
SAMPLE
APPENDIX III
Sentara Norfolk General Hospital
600 Gresham Drive
Norfolk, VA 23507
757.668.1972
Name: _________________________________
Clinical practicum: ___________________________________
Dates of Clinical practicum:
Monday through Friday
1. Three days prior to start date, contact
2. Times for clinical practicum are:
7:00am to 3:30pm
3. The total hours of this clinical practicum is 40 hours. Any missed time must be made up on the weekend,
on holidays or at the end of the clinical practicum. However, since the clinical practicums are often
scheduled back-to-back, missed days can prove problematic.
4. If you are late or will be absent, you must contact __________ prior to your start time. If she is not there,
you must call back and confirm that she received your message. Laboratory personnel are very punctual
professional people; therefore, 7:00 am truly means 7:00 am not 7:01 or 7:04.
5. In the case of a natural disaster, such as a hurricane, ice storm, snow etc. If the university classes are
cancelled, then the clinical practicum days are also cancelled.
6. The following items should be brought to the clinical practicum:
a. Ink pen
b. Paper and/or notebook for taking notes
c. Textbook for reference
7. Dress Code:
a. Shoes must be completely closed. No clogs, sandals, etc. If sport shoes are worn they must be
leather or leatherette not cloth.
b. Trousers, skirts, scrubs are acceptable attire. T-shirts with logos are not deemed professional
attire. Jeans and jean material is not considered acceptable professional dress. If you wear a skirt,
you must also wear stockings or tights.
33
c.
d.
e.
f.
g.
h.
Glittery, frilly, bare back, low cut clothing is not considered professional attire.
A lab coat will be provided for you.
A minimum of 2 ear piercings is allowed. If you have more, they must be removed.
Any nose, lip, eyebrow or tongue piercing must be removed.
Perfume, colognes, and scented lotions should be minimally applied.
All tattoos must be covered.
8. Parking: Parking is provided with in the complex. You must park in the visitor parking and pay a daily fee
for parking. Do not park in areas designated as reserved or handicapped
9. All Cell Phones are to be turned off during you clinical practicum hours. If you need to check your calls or
make a call you must exit the building, during your break or lunch time, prior to making the call.
10. A professional characteristics evaluation will be conducted by the clinical practicum staff and that grade
will be averaged with the chemistry clinical practicum professional characteristic evaluation.
11. Any concerns or problems within the clinical practicum should be brought to the attention of the Norfolk
State University Faculty (Ms. Lonergan) in an effort to resolve the concerns.
34
APPENDIX IV
Medical Technology Attendance Record
Student Name: ______________________________
Clinical practicum:
___ Phlebotomy
___ Clinical Chemistry
___ Hematology
___ Microbiology
___ Transfusion Services
Clinical Site:
___________________
Date
Time In
Time Out
Clinical Supervisor Signature
Comments
35
Appendix V
LABORATORY SAFETY GUIDELINES
Norfolk State University
Medical Technology Program
Please refer to the laboratory safety manual (white notebook with yellow cover) located in the student
laboratory for information on specific safety procedures, material safety data sheets, and specific specimen
handling procedures.
A.
Specimens used at clinical sites are of human origin and those used in the preclinical courses are often of
human origin. Being of human origin these specimens could contain bacteria and/or viruses that could be
a biohazard to those students and faculty handling those specimens. In order to minimize the potential
hazard from these specimens, a list of specimen guidelines have been developed.
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
There should be no eating, drinking or smoking in the laboratory.
There should be no applying makeup or inserting/removing of contacts in the laboratory.
Hands should be washed often during the laboratory sessions and prior to leaving the laboratory.
Avoid putting pencils, pens, fingers, etc. in your mouth while working in the laboratory.
Cell phones are not to be answered or handled in the laboratory. If the call must be taken, it must
be taken outside of the laboratory.
No IPods and ear phones allowed in lab
There will be no mouth pipetting in the laboratory.
Lab coats, goggles and gloves should be worn in all laboratory sessions and appropriate attire as
dictated by the laboratory. Lab coats and gloves must be removed prior to leaving the laboratory.
Lab coats should hung in the lab or be place in a transfer bag for transport. Lab coat must be at
least ¾ length and have long sleeves and banded cuffs.
No open toed shoes, baby-doll shoes, or sandals can be worn in the laboratory. Upper legs must be
covered by a dress/skirt or pants.
No specimens, reagents or media should be taken from the laboratory.
Any spill should be cleaned up immediately and the area washed with disinfectant (1/10 dilution of
Clorox).
Biohazard trash should be disposed of in the appropriate trash receptacles or red biohazard trash
bags. This trash will be packed and removed by an authorized trash removal company.
Any accident in which the skin is penetrated by needle, pipette, capillary tube, etc. should be
reported immediately to the instructor and/or charge person.
Dirty needles should be disposed of immediately after use in the appropriate sharps containers and
should not be recapped by the use of two hands, broken, or bent prior to disposal.
36
B.
Equipment and Supplies
1.
2.
3.
4.
C.
Chemicals and Reagents
1.
2.
D.
Centrifuges should not be opened until they have completely stopped and should not be stopped
by hand.
Hands should be clean and dry prior to working with electrical equipment.
All electrical equipment should be disconnected prior to maintenance and troubleshooting.
Broken and cracked tubes, slides, pipettes, etc. should be discarded and not used. Boxes with
pieces of broken glass should be discarded after carefully removing useable supplies.
All chemical and reagent spills should be cleaned up immediately. Refer to the MSDS for hazardous
material cleanup.
All chemicals and reagents should be inspected for handling precautions and those precautions
followed. Refer to the MSDS for hazardous material usage.
Glove Usage/Face Shields
Gloves are required for all student labs when handling body fluids, performing phlebotomy, and as
otherwise required by the instructor. When opening tubes of blood, students must utilize a face
shield.
E.
Laminar Flow Hood
The laminar flow hood should be used at all times when mycology specimens, which pose potential
contamination to the laboratory, are in use.
1/05/13
37
APPENDIX VI
Norfolk State University
Medical Technology Program
CLINICAL PRACTICUM GRADE SHEET
STUDENT NAME
______________________________________________________
STUDENT ID NUMBER _____________________
DATES OF ROTATION ______________________________________________________
COURSE NAME
______________________________________________________
CLINICAL SITE _____________________________________________________________
WRITTEN TESTS
________________
________________
________________
________________
Test Average: _____________
PRACTICAL TESTS
___________________
___________________
___________________
___________________
Test Average: ____________
Final Grade Computation
Written Test Average
______________
45%
______________________________
Practical/Technical Average ______________
40%
______________________________
______________
5%
______________________________
Professional Characteristics ______________
10%
______________________________
Presentation
Final Grade: ____________
Grading Scale
A
AB+
B
BC+
94 – 100
90-93
87-89
83-86
80-82
77-79
C
CD+
D
DF
73-76* minimum passing score
70-72
67-69
63-66
60-62
Below 60
38
I have read this evaluation and discussed it with the instructor. I feel it is a _____ biased/ _______ unbiased
evaluation.
COMMENT (Student): ___________________________________________________________________
_________________________________________________________________________________________
_________________________________________________________________________________________
_________________________________________________________________________________________
Signature (Student):
______________________________________________________
COMMENTS (Instructor):
_____________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
Signature (Instructor): ______________________________________________________
Date:
_______________________________
39
Medical Technology Professional Characteristics Evaluation Form
Objective
Exceeds
Meets Expectation (1 Fails to Meet
Expectation(2points) point)
Expectation (0 points)
Attended days of
internship on time and
remained for the
entire shift
Complied with
institutional dress code
Always on time and had
no absent days
If late or absent,
notified the internship
Notified prior to the
start of the internship
time
Asked relevant
questions and
recognized the need
for assistance
Notified prior to the
start of the internship
time; called to confirm
message
Asked questions
immediately; did not
proceed when unsure of
the procedures/policy
Communicated
professionally with the
clinical staff
Did not assume an
inappropriate familiarity
with the staff
Sometimes (<2)
occasions used
language that conveyed
a level of familiarity not
appropriate for student
Late 2 times in 2 weeks;
absent 2 on 2 occasions
in 2 weeks; had difficulty
making up time
Was reminded of dress
code on >1 occasion;
needed suggestion
toward improving
grooming
Failed to call prior to the
internship time; called
>1/2 hour after start
time
Rarely asked questions;
did not seemed to
understand concepts;
did not asked for
assistance
On multiple occasions
(>2) used language that
conveyed nonprofessional relationship
with staff
Cooperated with
others and displayed
willingness to act as
part of a team by
helping, cleaning,
restocking,
when necessary.
Noticed when others
needed help; willingly
maintained a clean and
orderly work area
Responded in a positive
fashion when others
needed help; willingly
maintained a clean and
orderly work area
Did not appear eager to
help others when
needed; had to be
reminded to keep work
area orderly
Objective
Exceeds
Expectation(2points)
Meets Expectation (1 Fails to Meet
point)
Expectation (0 points)
Demonstrated
initiative by seeking
additional activities
when not busy.
When not busy, always
asked for additional
activities or tasks
Willingly accepted
other activities or tasks
when not busy
Over the span of the
internship, exhibited
self confidence that is
appropriate to
capabilities
Exhibited self confidence appropriate
to capabilities; did not
exhibit behaviors that
were presumptuous or
arrogant
Demonstrate some lack
of self- confidence; did
not exhibit behaviors
that were
presumptuous or
arrogant
Always complied with
dress code; has good
grooming habits
Rarely(<2) absent;
rarely late (<2); asked
about makeup
immediately on return
Was reminded of dress
code on only one
occasion; has good
grooming habits
Asked questions, but
sometimes waited and
did not seek help
immediately
Score
Comments/S
Score
Comments/S
When not busy, spent
the time in the break
room or talking to
workers or fellow
students
Demonstrated a lack of
self -confidence or was
over confident for skill
level; sometimes appear
arrogant
40
Maintained
confidentiality of
privileged information
Had no incidence of
failure to maintain
confidentiality and
privacy
Had no incidence of
failure to maintain
confidentiality and
privacy
Had to be reminded of
the potential for
violating patient
confidentiality and
privacy
Sometime made
comments that hurt or
embarrass others;
sometimes had conflicts
with others
Cooperated with
others to maintain a
pleasant and efficient
work place.
Avoided comments that
hurt or embarrass
others; no conflicts with
others
Avoided comments
that hurt or embarrass
others; no serious
conflicts with others
Avoided excessive
conversation,
socialization and did
not use a cell phone in
lab.
Conducted no personal
business in clinical
setting; did not check
cell phone for calls or
text messages; did not
utilize time in excessive
conversation
Conducted no personal
business in clinical
setting; checked cell
phone for calls or text
messages on 1
occasion; did not utilize
time in excessive
conversation
Objective
Exceeds
Expectation(2points)
Meets Expectation (1 Fails to Meet
point)
Expectation (0 points)
Complied with
instructions given
orally or written
Readily responded to
instructions; verbal
communications were
clear, concise and
correct
Responded to
instructions; verbal
communications were
correct but sometimes
were not clear
Seemed hesitant to
respond to suggestions;
verbal communications
were unclear and not
correct
Maintained self composure and
appropriate language
in stressful conditions
Maintained composure
under stressful
conditions without
increasing volume of
speech or exhibiting
non- verbal cues
Rarely lost composure
under stressful
conditions as exhibited
by with increasing
volume of speech or
non -verbal cues
Responsive to change
and willingly varies
scheduled activities to
deal with change in
priorities
Increased work pace to
accommodate work
load and eagerly
embraced any new
work setting
Increased work pace to
accommodate work
load when reminded
and willingly accepted
any new work setting
or activity
Accepts accountability
for actions; accepts
suggestions to improve
laboratory
performance or
Always acknowledged
errors and took steps to
correct
Sometime appeared
hesitant to accept
criticism but corrected
errors
Lost composure under
stressful conditions on
>2 occasions as
demonstrated by
increasing volume of
speech or non- verbal
cues
Hesitated to increases
work pace to
accommodate work
load, even when
reminded; resisted any
change in work /
additional duties
Was hesitant to accept
criticism and had to be
reminded to correct
errors
On >1 occasion
conducted personal
business in clinical
setting; checked cell
phone for calls or text
messages >2 occasions;
on multiple occasions
utilize time in excessive
conversation
Score
41
Comments/S
related personal
behavior
42
APPENDIX VII
Presentation Grading Form
Fails to Meet (1)
Somewhat Meets
(2)
Meets (3)
Somewhat
Exceeds (4)
Exc
(5)
Makes a logical Presentation of
Material
Information is not
presented in a logical
and sequenced fashion;
thesis statement is not
stated or is unclear;
bounces from concept
to concept without
covering any concept
fully
Presents the
information in
sequence for part
of the presentation
but failed to
present all of the
concepts in a
logical sequence;
thesis is clear but
unstated
Presents
information in
sequence and
make a logical
presentation;
starts with a
thesis statement
and covers to
some extent the
related concepts
Presents
information in
sequence but
sometimes
goes back to
the same
material; starts
with a thesis
statement
Pre
in a
bas
com
the
hie
sta
and
con
the
full
Presents multiple concepts to support
thesis
Only used one source
and one concept in
presentation
Utilized two to
three sources and
two to three
concepts in the
presentation;
thesis weakly
supported
Utilized at least 4
sources and
concepts in the
presentation;
thesis supported
Utilized >4
sources but
did not expand
on the
concepts and
focused on
only three;
supported
thesis
Uti
and
tho
pro
sup
Presents information that supports
ideas; suggest solutions and rationale
for the concepts presented; includes
own ideas
Presents minimal
information or ideas;
does not suggest
concepts outside of the
information gathered;
own ideas not included
Presents minimal
information or
ideas; briefly
suggest in passing
concepts outside
of the information
gathered; own
ideas not included
Presents
information or
ideas; suggests 12 concepts
outside of the
information
gathered; does
not included
own ideas
related to the
internship
experience
Presents a
varied set of
ideas; suggests
2-3 concepts
outside of the
information
gathered;
includes own
ideas but does
not relate
them to the
Pre
of i
con
the
gat
ow
stro
to
exp
Criteria
Expectations
43
internship
experience
Presents clear, useful and
understandable PowerPoint
Presentation; Free of typos and
grammar errors
Presents slides that are
difficult to read or see;
use images that do not
enhance the concept;
gives no credit for ideas
and images
Presents slides that
can be read but
that minimally aid
in understanding;
gives credit for
only a portion of
the ideas and
images
Presents slides
that aid in
understanding of
the concepts;
contain less than
1 typo; gives
credit for images
and concepts
Presents slides
are clear and
but that are
not be
effective for
understanding;
cites the
source of
information
and images
utilized
Pre
use
ima
und
con
typ
cite
info
ima
Presents material in an articulate
manner; Demonstrates preparation;
Free of syntax errors, does not read
material
Reads verbatim from
the slide; uses incorrect
syntax or
mispronounces
technical jargon and
general words;
Reads verbatim
>75% of the
slide(s); cannot
pronounce
technical words;
does not appear to
have prepared for
the presentation
Reads verbatim
no more than
10% of the slides;
pronounces
correctly the
word utilized
with < 3 stumbles
Does not read
verbatim the
slides;
demonstrates
having
prepared for
the
presentation;
does not
stumble on
words or
technical
jargon; free of
syntax errors
Do
ver
dem
pre
pre
not
or
app
and
com
con
pre
syn
44
APPENDIX VIII
NORFOLK STATE UNIVERSITY
MEDICAL TECHNOLOGY PROGRAM
INCIDENT REPORT
Name: ____________________________________________
Local Address: __________________________________________________________________
Permanent Address : _____________________________________________________________
Local Phone: _________________________ Permanent Phone: _________________________
Date and Time of Incident: ________________________________________________________
Nature of Incident: Please check appropriate box
Blood/body fluid
Infectious Agent
Stick
Splash
Cut
Inhalation
Splash
Scratch
Other
Other
Source
Source
Chemical
Exposure
Inhalation
Splash
Skin
Absorption
Radiation
Exposure
Internal
External
Other
Chemical
Involved
Brief Description of the incident:
45
List protective equipment in use at time of incident :
Was appropriate laboratory safety procedures followed? If not, describe.
Student Signature: __________________________________________________ Date: _____________
Supervisor/Instructor Signature: _________________________________________ Date: ____________
Note: Copy should be retained prior to referral
Referred to: ______________________________________________________
Medical Evaluation:
Results:
Follow up recommended:
Student Health Center/Physician Name: _______________________________________________
Please Print
Student Health Center/Physician Signature: _____________________________________________
NOTE: Please return to:
Medical Technology Program
JBB Room 106
Norfolk State University
700 Park Avenue
Norfolk, VA 23504
757.823.9459
46
APPENDIX VIII
Statement of Confidentiality
It is the obligation of the Norfolk State University Medical Technology program to maintain
confidentiality of all patient information and to protect the patient’s rights to privacy.
Such information may be disclosed to other health care providers involved in the care or
treatment of the patient or if permitted by written and signed authorization from the patient or
guardian or as otherwise allowed by law.
As a Norfolk State University student taking a Medical Technology Program class, I understand
that I am never to discuss or review, for any personal purposes, any information from a
patient’s laboratory data or information related to the patient’s treatment. Additionally, I
understand that it is a violation of confidentiality to Twitter or Facebook any information
regarding my internship site or experience.
I understand that the violation of any portion of this policy will result in termination from the
Norfolk State University Medical Technology Program and/or a failing grade for the course
during which the infraction occurred.
________________________________________
Student Name (Please Print)
________________________________
Student Signature
_________________________________
Date
47