The organisation of an educational program for specialists in clinical chemistry by the Greek Society of Clinical Chemistry-Clinical Biochemistry

 

The Greek Society of Clinical Chemistry-Clinical Biochemistry (GSCC-CB) was founded in 1989 by scientists who were working in the clinical laboratories in the state hospitals of Greece. The Society has been a member of the International Federation of Clinical Chemistry and Laboratory Medicine (IFCC) since 1994 and also a member of the European Federation of Clinical Chemistry and Laboratory Medicine (EFCC) and the European Communities Confederation of Clinical Chemistry and Laboratory Medicine (EC4). Almost 90% of the Society members are of scientific background (chemists, biochemists, biologists), but there are also a 7% of medical doctors, specialized in Biopathology or Clinical Chemistry.

In Greece, the specialty of Clinical Chemistry and Laboratory Medicine is not officially recognized for scientists. Although in 1973 the Greek State passed a law (law 131/1973) that was introducing the Clinical Chemistry specialty for scientists (chemists, biologists, biochemists, pharmacists), this law was never implemented due to the strong opposition of the medical Biopathologists (formerly named Microbiologists) and therefore, officially organized education and training in clinical chemistry for scientists was never introduced in Greece (1,2). The clinical chemistry labs of the public hospitals in Greece are staffed almost exclusively by scientists while medical Biopathologists are working mainly in the microgiology or hematology labs of the hospitals. There are about 180 public hospitals and heath centers of various sizes in Greece. The small size hospitals have usually one central laboratory that is doing microbiology, hematology, biochemistry and immunology while the bigger hospitals have separate specialized laboratories. In the private sector there are more than one thousand diagnostic centers and laboratories, usually of small to very small size.

In 2002, after the encouragement and help by the Registration Commission and the Board of EC4, the Board of the GSCC-CB decided to start a voluntary Register for specialists in clinical chemistry, aimed to accomplish the following goals:

-          to provide high standards of professional education and practice in clinical chemistry in Greece, equivalent to those of the other European countries;

-          to provide the possibility for each member to register in the European Register for Clinical Chemists and thus, facilitate the free movement of scientists within the European Union;

-          to contribute to the improvement of the quality of laboratory results in clinical chemistry and as a consequence to promote the public health services; and

-          to strengthen the efforts towards the recognition of the specialty of clinical chemistry in Greece.

The main problem that the GSCC-CB had to solve in the process of establishing the Register in Greece was the lack of proper and official education and training for scientists that had been working for many years in the State or private clinical laboratories. Many of them had as many as 20 years of service. In order to overcome this situation the Board of the GSCC-CB decided to organize an intensive educational program for all the colleagues, independently of their professional experience.

The educational program comprised of a series of 18 seminars each one dedicated to a different part of the clinical chemistry content as it is described in the EC4 Syllabus (3). The responsibility for the organization of the seminars was assigned to a Scientific and Educational Committee (SEC) appointed by the Board and voted by the general assembly of the Society. The SEC was responsible for choosing a coordinator for each seminar who, in collaboration with the SEC, was liable for the scientific program of the seminar, the choice of the speakers and the examination. The duration of each seminar was about 6 hours and consisted of 6 to 9 lectures (presentations). Each speaker had to provide an extended text of 10 to 15 pages, of his/her lecture. The texts were edited by the coordinator and the SEC and were published in print as a separate volume (book) for each seminar, which was available to all participants on the day of the seminar. The texts were also available on the internet, through the web page of the Society, at least 10 days prior to the date of the seminar. Access to the texts was limited only to those who had confirmed attendance in that particular seminar.

At the end of each seminar there was a voluntary written examination which comprised of 24 multiple choice questions. The questions were proposed by the speakers and the coordinator had the responsibility for the final choice. For each participant, the attendance to the seminar and the performance in the examination were graded up to a maximum grade of 10 points. Successful completion of the Educational program was leading to a Certificate of Competence under the following prerequisites:

-          attendance of at least 14 out of the 18 seminars (78%);

-          total examination score of at least 60% of the possible maximum score (180 points).

Two cycles of the 18 seminars were completed. The first cycle started in October 2003 and ended in December 2005. In March 2005 a second cycle of the same seminars was started and ended in October 2007. The titles of the 18 seminars as well as the titles of the topics presented in each seminar are shown in Appendix A.

The seminars were attended by both, members and non-members of the GSCC-CB. The non-members of the GSCC-CB were holding at least a four years university degree in chemistry, biology or biochemistry. One hundred eighty nine colleagues was the mean attendance per seminar for the seminars of the 1st cycle. One hundred forty six (77%) of them were members of the GSCC-CB and 43 (23%) non-members. The mean attendance per seminar for the seminars of the 2nd cycle was 38 colleagues of whom 19 (50%) were members and 19 (50%) non-members of the GSCC-CB (Table1).

 

The mean participation to the examination for each seminar of the 1st cycle was almost 80% and the vast majority of the participants (98.7%) passed the examination. For the seminars of the 2nd cycle, the mean participation to the examination was lower (67.6%) but with the same high success rate (96%).

Five hundred colleagues (277 members and 223 non-members of the GSCC-CB) attended at least one seminar of the 1st or the 2nd cycle. Eighty nine members of the Society (32.1%), attended almost all the seminars (16-18 seminars) while 169 members (61%) attended at least 10 seminars. The greatest percentage of the non-members (152; 68.2%) attended 1-3 seminars (Table 2).

 

 

The performance of the participants in the written examination is presented in Table 3. According to the number of the correct answers, the performance was characterized as: Fail (less than 12 correct answers), Fair (12-16 correct answers), Good (17-20 correct answers) and Very Good (21-24 correct answers). The members of the Society had a better performance than the non-members in both cycles. More than 90% of the members and more than 80% of the non-members performed “Good” or “Very good” in both cycles.

 

 

One hundred fifty four presentations were given during each cycle of the educational program (about 7 to 9 presentations per seminar) by 109 speakers. Forty eight of them were medical doctors, 55 were of scientific background (chemists, biologists, biochemists, clinical chemists) and 6 were scientists of various specialties. Thirty six of the speakers were holding academic appointments (lecturers, assistant, associate and full professors) while 66 were professionals working in Hospital laboratories.

In each seminar, participants filled in a questionnaire for the evaluation of the seminar. Sixty participants per seminar on average filled in this questionnaire. About 78% of the responders declared Satisfied or Very Satisfied about the content as well as the organization of the Seminars.

 

 

According the presented statistics, the two cycles of the educational seminars of GSCC-CB should be considered very successful. It is estimated that more than 40% of the scientists who practice Clinical Chemistry in our country, participated to some extent to this educational activity. This successful massive educational activity of the Greek Society raised the scientific level of clinical chemistry professionals in our country and had also a positive impact on the level of laboratory medicine services provided in our country. The series of the 18 seminars in a two-year period raised an enthusiasm among the colleagues, since they had the opportunity to cover again most of the discipline of clinical chemistry and their participation strengthened their professional confidence.

This educational activity and the general efforts of GSCC-CB as well, for the establishment and operation of the Greek Register were positively evaluated by the EC4. In its November 2005 meeting in Prague the EC4 Registration Commission decided, after voting among the European countries, that the standards of the Greek Register were equivalent to the standards of the European Register (4,5). Today, the Greek Register has 218 members and more than 80 of them have become members of the European Register.

The educational program is now provided by the GSCC-CB in the form of distance learning. All the educational materials (texts, presentations and additional information) of the seminars are available on-line through the web-site of the Society organized as an e-learning application. Anyone who wants to participate to the program can have access to the application with a password. The written examination is organized twice a year under the responsibility of the Greek National Clinical Chemistry Registration Commission. The GSCC-CB encourages all the young scientists who enter the field of laboratory medicine to follow this educational program and also to follow the on-the-job training according to the log-book provided by the GSCC-CB.

In conclusion, the GSCC-CB has successfully introduced an educational program in clinical chemistry for the first time in Greece, through the organization of two cycles of 18 seminars. This program is now provided as an e-learning application and it is open for all scientists who want to follow the fascinating discipline of laboratory medicine and its sub-disciplines.

 

 

 

Appendix A: Titles of the 18 seminars and titles of the topics presented in each seminar