CHT 103: ICI HISTOLOGY FOR HISTOTECHNOCIANS TRAINING

Consistent and reproducible quality in histopathology in the care of cancer patients in sub-Saharan Africa.

Eldoret, Kenya

Course Director: Prof. Fredrick Chite Asirwa MD

Consultant Physician. Medical Oncologist & Hematologist Executive 

Director/CEO: International Cancer Institute (ICI)

P.O. Box 8088, Code 30100 Eldoret, Kenya

Email: director@intercancer.com Website: www.intercancer.com

Lead Faculty: Dr. Mary Achakolong MD

Consultant Anatomic Pathologist & Head of Pathology Department

International Cancer Institute (ICI)

P.O. Box 8088, Code 30100 Eldoret, Kenya

Email: mary.achakolong@intercancer.com Website: www.intercancer.com

Course Coordination: Dr. Chizi Kiti MD

Head, Office of Education and Training

International Cancer Institute (ICI)

P.O. Box 8088, Code 30100 Eldoret, Kenya

Email: ckiti@intercancer.com Website: www.intercancer.com

This educational activity is provided by International Cancer Institute (ICI)

INTRODUCTION

The public health burden due to cancer is of increasing magnitude with a far-reaching impact on patients, clinicians, diagnosticians, and scientists of interrelated fields. Appropriate cancer diagnosis relies heavily on high-quality histocytopathology which inevitably depends on good histotechnology practices. In an era where quality patient care and precision medicine are at the core of oncological practices, specific attention has to be accorded to accurate diagnostics. 

THE NEED FOR CONTINUOUS HISTOCYTOLOGY TECHNOLOGIST TRAINING

Pathology plays an essential role in cancer diagnostics however; many centers are not sufficiently equipped to deliver timely and accurate cancer diagnosis. (https://doi.org/10.1016/S1470-2045(12)70598-3)

Laboratory efficiency is partly dependent on appropriate histotechnologist human resource and staffing. A shortage of skilled histotechnicians and related accredited training programs has led to deficiencies in diagnostic capacity in several Sub-Saharan states. ( DOI: 10.1200/JGO.17.00122)

Additionally, limited access to highly advanced diagnostic techniques in Low resource settings further compounds these diagnostic challenges. An understanding of the core components of basic histocytological techniques through comprehensive high-level training is critical in improving diagnostic capacity. Several bridging programs and regulatory bodies have been concerned with promoting high standards of histotechnology practices and this program is an effort towards the same outcome. 

PROGRAM OVERVIEW

The histotechnologist program is an intensive two weeks program combining theoretical and practical hands-on learning. At the core of the program is the application of all techniques in the practice of oncology. It is designed to provide an adept education with core competencies in;

1. Accessioning.
2. Fixation.
3. Grossing techniques.
4. Tissue processing. 
5. Embedding.
6. Microtomy. 
7. Appropriate specimen dispatching practices. 
8. Basic microscopy and tissue identification.
9. Basics in cytopathology.
10. Laboratory health and safety. 
11. Continuous quality improvement as applied to the histopathology laboratory.
12. The application and process of performing special techniques including Decalcification of bone, Special stains, Immunohistochemistry and immunofluorescence introduction and molecular/ISH. 

PROGRAM OBJECTIVES

At the end of this educational activity, participants should be able to;

1. Recognize the role of the laboratory and pathology in cancer care.
2. Describe the basic laboratory work flow.
3. Discuss and practically demonstrate where applicable histopathology practices such as tissue fixation, grossing, processing, embedding and microtomy.
4. Demonstrate acceptable knowledge and practical skills in tissue staining, special techniques, basic microscopy and safe laboratory practices.
5. Understand the general operations of the histopathology laboratory.
6. Have a basic understanding of Immunohistochemical and Molecular/In-situ hybridization techniques.
7. Describe aspects of continuous quality improvement. 
8. Have a basic understanding of cytology techniques.

GENERAL TRAINING REQUIREMENTS AND PREREQUISITES

Admission Requirements:

To be eligible to enroll in the Histotechnologists Training Program, the applicant must conform to the ICI application requirements. 

Each candidate must:

• Be a registered laboratory technologist or histotechnologist
• Have a valid practicing license from KMLTTB
• Be prepared to dedicate 10 days on a full-time basis to the course
• Have performed a color blindness test. 

Reference Material/Resources:

• Bancroft, J. D., Layton, C., & Suvarna, S. K. (2013). Bancroft’s theory and practice of histological techniques.

• Journal of histotechnology
• Tutorials
• Internet
• Access to microscopes, tissues and appropriate laboratory equipment.

Policies:

• Code of conduct:

1. 1. 1. Professionalism
      2. Follow procedures set by the institution

• Attendance:

1. 1. 1. Attend a minimum of 100% of all the teaching classes and practical surgical sessions.

• Dress code;

1. 1. 1. Lab coats are a MUST for practical sessions.
      2. No open shoes in the laboratory.

• Academic standards:

1. 1. Attain a minimum grade of 75% in the post test examination, that includes a written and practical assessment.

 *The pre-test does not contribute to overall final grade. 

1. Actively participate in practical and theory sessions.

• Termination/withdrawal;

1. 1. At-will withdrawal at any point. No certificate will be awarded to any participant who withdraws.
   2. Conduct or health as determined by the ICI team.
   3. Violation of policies and procedures.
   4. Attendance requirement is not achieved.

Format and Delivery Mode of Training:

The teaching methods include:

• • Classroom interactive lectures and discussions
  • Daily reading assignments

• Practical sessions on all the learning aspects in the pathology laboratory

Training Timetable

PRACTICAL SESSIONS SCHEDULE