Laboratory assistive personnel in Mohs micrographic surgery: a survey of training and laboratory practice.
BACKGROUND
The success of Mohs micrographic surgery (MMS) is contingent on high-quality frozen tissue sections for histologic interpretation. Laboratory assistive personnel (LAP) are central to this process, but their training and tissue processing techniques are neither standardized nor certified for competence.


OBJECTIVE
To evaluate processes used to train and laboratory techniques practiced by LAP. Letters were mailed to Mohs surgeons with a Web link to an online survey for LAP to complete.


RESULTS
Response rate was 24%. Responders primarily received training on the job, but not from the surgeon. On-the-job training from other LAP was perceived to be the most helpful, and textbook to be the least helpful. On average, survey responders felt it took several months to become proficient. Wide variations in laboratory practice were noted for histology laboratory and Mohs tissue processing techniques and for quality assurance. Differences in training and practices were noted between certified and noncertified LAP.


CONCLUSIONS
Patient care may be compromised because of variable practice of laboratory techniques, quality assurance, and quality control. Standardization of LAP training, along with demonstration and maintenance of competency, may be necessary to ensure the integrity of the MMS technique.
Chen
T Minsue
TM
Department of Dermatology, MD Anderson Cancer Center, University of Texas, Houston, Texas, USA.
Wanitphakdeedecha
Rungsima
R
Whittemore
Darren E
DE
Nguyen
Tri H
TH
D003625:Data Collection; D006653:Histology / Q000193:education; D006801:Humans; D007318:Inservice Training; D017056:Medical Laboratory Personnel / Q000193:education* / Q000592:standards; D015580:Mohs Surgery; D011786:Quality Control; D012878:Skin Neoplasms / Q000601:surgery