title: A two-year study of microscopic urinalysis competency using the urinalysis-review computer program.
abstract: BACKGROUND
  The microscopic examination of urine sediment is one of the most commonly performed microscope-based laboratory tests, but despite its widespread use, there has been no detailed study of the competency of medical technologists in performing this test. One reason for this is the lack of an effective competency assessment tool that can be applied uniformly across an institution.
  
  
  METHODS
  This study describes the development and implementation of a computer program, Urinalysis-ReviewTM, which periodically tests competency in microscopic urinalysis and then summarizes individual and group test results. In this study, eight Urinalysis-Review exams were administered over 2 years to medical technologists (mean, 58 technologists per exam; range, 44-77) at our academic medical center. The eight exams contained 80 test questions, consisting of 72 structure identification questions and 8 quantification questions. The 72 structure questions required the identification of 134 urine sediment structures consisting of 63 examples of cells, 25 of casts, 18 of normal crystals, 8 of abnormal crystals, and 20 of organisms or artifacts.
  
  
  RESULTS
  Overall, the medical technologists correctly identified 84% of cells, 72% of casts, 79% of normal crystals, 65% of abnormal crystals, and 81% of organisms and artifacts, and correctly answered 89% of the quantification questions. The results are probably a slight underestimate of competency because the images were analyzed without the knowledge of urine chemistry results.
  
  
  CONCLUSIONS
  The study shows the feasibility of using a computer program for competency assessment in the clinical laboratory. In addition, the study establishes baseline measurements of competency that other laboratories can use for comparison, and which we will use in future studies that measure the effect of continuing education efforts in microscopic urinalysis.
authors.affiliation: Departments of Laboratory Medicine and Medical Education, University of Washington School of Medicine, Seattle, WA 98195, USA. mastion@u.washington.edu
authors.forename: M L
authors.initials: ML
authors.lastname: Astion
authors.forename: S
authors.initials: S
authors.lastname: Kim
authors.forename: A
authors.initials: A
authors.lastname: Nelson
authors.forename: P J
authors.initials: PJ
authors.lastname: Henderson
authors.forename: C
authors.initials: C
authors.lastname: Phillips
authors.forename: C
authors.initials: C
authors.lastname: Bien
authors.forename: L
authors.initials: L
authors.lastname: Mandel
authors.forename: A R
authors.initials: AR
authors.lastname: Orkand
authors.forename: J S
authors.initials: JS
authors.lastname: Fine
mesh_terms: D004521:Educational Measurement / Q000379:methods*; D006801:Humans; D008137:Longitudinal Studies; D011361:Professional Competence; D012984:Software; D016482:Urinalysis