25 ECTS credits
750 h study time
Offer 1 with catalog number 6021784ENR for all students in the 1st and 2nd semester at a (E) Master - advanced level.
Clinical biology is the domain of medicine that focuses on performing laboratory dissections on biological fluids or cell material for the prediction, prognosis and monitoring of diseases in children and adults. The clinical biologist gives professional scientifically funded advice concerning the responsible use and interpretation of clinical biological tests. He/she vouches for the quality of dissections from the sampling until the reporting to the requesting physician and for the organization and development of the laboratory.
During the education, the ASO in clinical biology will take a lower education in the 3 subdomains (hematology, clinical chemistry and radio-immunology & microbiology), covering the basics in those disciplines. Afterwards, a higher education is followed, either polyvalent or more targeted towards 1 or 2 sub-specialisms, according to the preferences and future perspectives of the ASO.
Apart from the classical diagnostic research, the general clinical biologist plays a role in diagnostic evaluative sciences, analysis of (new) diagnostic and therapeutic strategies, including analysis, cost-efficiency and cost-effectivity, quality analysis, medico-economic analyses, “outcome research”, decisional analyses, new methods and their evaluation.
During the MaNaMa, the ASO acquires the necessary scientific knowledge, skills and attitudes for the future professional career. These are indispensable for professional formation, as legally determined by the accreditation committee. See OO-fiche ‘Skills in Clinical Biology’.
The following knowledge and skills will be dealt with (the source is mentioned between brackets, also see study material):
General
Integral quality assurance
Quality handbook (iProva “Quality handbook medical laboratories and banks MLM”) and “Practical guidelines” (WIV, see link in KHB)
Legal quality requirements (KB 3-12-1999 Accreditation laboratories clinical biology, link in KHB)
Meaning of accreditation and accreditation of a lab (see documents above, ISO15189:2012 norm)
Selection and use of quality control materials (see point 6.4 in Practical guidelines)
Safety within the lab (iProva “Safety instructions: general”)
Waste problems (see point 6.5 in “Practice guideline”)
Microbial contamination (iProva “Safety instructions: Microbiology LMIK”)
Use of radioactivity, solvents, toxic and corrosive products (iProva “GIDS: management of hazardous products”)
Danger indications (iProva “GIDS”: management of hazardous products”)
Selection and evaluation of laboratory methods
Method evaluation (iProva)
International guidelines: recognize and apply sources (CLSI, EUCAST, Clinical Microbiology Procedures Handbook (Leber)…)
Clinical chemistry & radio-immunology during truncus communis (Sources: textbooks including Tietz Textbook of Clinical Chemistry and Molecular Diagnostics; “Know-hows in laboratory diagnosis”, X. Bossuyt). Sidenote: everything marked with a ‘*’ is also applicable for other fields (hematology and microbiology)
Basic principles of analysis
Purity scales of H2O
Unit systems
Concentration calculations
Gravimetry
Volumetry, buffers and pH calculations
Centrifugation
(Pre-/Post-)analytical phase (Sources: lab guide UZ Brussels, textbooks including including Tietz Textbook of Clinical Chemistry and Molecular Diagnostics; “Know-hows in laboratory diagnosis”, Diagnostic samples: from the patient to the laboratory (4th updated edition, Guder WG, Narayanan S, Wisser H, Zawta B, Wiley).
Collection, processing and storage of biological samples* (including possible error sources in (pre-/post-)analytical phase
Recipients
Patient preparation
Sampling
Transport
Processing
Storage
Calibration
(Internal) standard
Law of Lambert-Beer
Calculation of enzyme activities and substrate concentrations
Principles of analytical methods (iProva procedures, textbooks including Tietz Textbook of Clinical Chemistry and Molecular Diagnostics)
Photometry: substrates, enzymes
Nephelometry, turbidimetry
Chromatography
Electrophoresis
Fluorimetry
Osmometry
Immunochemical techniques
Processing the automates for biochemical analysis and used dosing techniques by these automates
Autonomously perform basic tests
Clinical meaning of a laboratory test*
Reproducibility, correctness
Biological variability (Ricos/Westgaard)
Reference values
Diagnostic performance
Clinical use
Biochemical physiopathology of the organs (possible sources: Robbins Basic Pathology”, Kumar, Abbas, Aster (Eds), Elsevier Saunders, 2013, 9th Ed; “Pathophysiology”, Lee-Ellen C. Copstead and Jacquelyn L. Banasik, Elsevier Saunders, 2013, 5th Ed; Pathophysiology. The biologic basis for disease in adults and children. McCance K and Huether S. 7th Edition. Elsevier)
Evaluation of the lung function: blood gasses and oxygen saturation
Acid-base- and electrolyte equilibria and related disorders
Evaluation of the renal function
Evaluation of the cardiac function
Evaluation of the hepatobiliary function
Evaluation of glucose and diabetes
Evaluation of the cholesterol and other fats
Therapeutic drug monitoring and toxicology
Hematology during truncus communis (Pathophysiology textbooks): know the test principles, autonomously perform basic tests, understand the principles of quality control
Recognize problems for redirection (iProva “guideline clinical validation hematology”)
Basic hematology (cell counting and derived measurements) (iProva “education hematology – cell counting and morphological research”; iProva: SOPs cell counting (e.g. “Cell-Dyn Sapphires”) and morphology. Extra reference works: “Practical Haematology” (Dacie and Lewis), “Hoffbrand’s Essential Hematology”, “Blood cells, a Practical Guide” (Barbara J. Bain), “Bone Marrow Pathology” (Barbara J. Bain), “WHO classification of Tumours of Haematopoietic and Lymphoid Tissues”)
Pre-analytical factors
Determination of hemoglobin, number of erythrocytes, leucocytes, platelets and reticulocytes; calculation of hematological indices
Knowledge on existing equipment, theoretical backgrounds, quality control and validation
Morphology
Cytological examination of the blood, bone marrow and bodily fluids
Knowledge on the operation and adjusting of the microscope
Sickle cell test, Kleihauer, cold agglutinins
Hemostasis
Blood collection conditions, sample treatment, storage, interference
Orienting coagulation investigation
Thorough coagulation investigation (iProva: “Education hematology – hemostasis”; iProva: SOPs basal and special coagulation. Extra reference works: “Practical Haematology” (Dacie and Lewis), “Hoffbrand’s Essential Hematology”)
Immunohematology (“Practical Haematology” (Dacie and Lewis), “Hoffbrand’s Essential Hematology”)
Blood type ABO and Rh(D) problems
Detection irregular antibodies
Molecular diagnostics (iProva: “Education hematology – molecular tests”. Extra reference works: “Molecular diagnostics” (Pelt-Verkuil), “A-Z of quantitative PCR” (Bustin S.A.))
Know and understand test principles
Cellular immunologu (iProva: “Education hematology – cellular immunology”. Extra reference work: “Flow cytometric immunophenotyping for hematologic neoplasms” Craig FE, Blood 2008)
Test-principle, interpretation of results
Humoral immunology (iProva: “Education hematology – humoral immunology”)
Test-principle, interpretation of results
Microbiology during truncus communis
Gram coloring and microscopic investigation of bacteriological preparations (iProva: “Microscopic investigation after Gram coloring”, textbooks)
Giemsa coloring microscopic investigation of big droplet preparations within the framework of malaria diagnostics (iProva: “Microscopic investigation after Gram coloring”, textbooks)
Inoculation procedures for bacteriological samples (iProva: “Inoculation and incubation of breeding grounds”, textbooks)
Performing the identification of bacteria and interpretation of the antibiogram (cf. result of the exercice “identification of germs”, textbooks, including Maldi-TOF MS)
Analysis of hemocultures (iProva “Blood culture”, textbooks)
Microscopic investigation of parasites in feces (iProva “Parasitological investigation”, textbooks)
Track antigens of Cryptococcus, Legionella, Aspergillus, Pneumocystis carinii (multiple procedures and textbooks (accent on expected performance))
Differentiate between Candida albicans and non-C albicans isolations (iProva: “Identification of yeasts”, textbooks)
Performing and interpretation of biological serological parameters within the framework of multi-organ donor research
Basic knowledge infectious serology (hepatitis ABC, HIC, CMV, toxoplasma) (Textbooks, accent on interpretation)
Good knowledge on the following micro-organisms: staphylococci, enterobacteriaceae, frequent non-fermenters and vibrionaceae, haemophilus, neisseria, streptococci, B pertussis, legionella (Textbooks, EUCAST)
Cross-tests
WORKING METHODS
The final objectives are met in practice by:
Multidisciplinary staff meetings (1h/week)
Staff meetings in the discipline (1h/week)
Sessions for technical skills
Bench-side and bed-side teaching
Case discussions
Room tour
Supervised consultation or advices (e.g. thrombo tests, blood collection, infectiology)
The ASO is actively involved in laboratory analyses, including control of the pre-analytical phase and validation of produced results (post-analytical phase). The ASO remains critical and complements the practical knowledge by learning background theory from the various information sources that are provided.
OLR 1: Has acquired profound medical knowledge and insights in the specialism (M, W).
OLR 3: Has further enhanced the problem-solving capacity and applies this in practice (M, W).
OLR 6: Knows the possibilities of other health care disciplines and the expertise of others in patient health care (C, M).
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OLR 2: Has acquired the skills, inherent to the specialism, and applies these correctly.
OLR 13: Can participate in the organization of health care and in the policy of the department (Ma).
OLR 15: Takes into account the economic aspects of medicine and uses the available resources accordingly, avoiding under- and overuse (M).
OLR 17: Keeps further developing and improving own skills.
OLR 18: Is capable of introducing “standards of care” and quality requirements with regard to the different aspects of formulating one’s own specialism (M, Ma).
The final grade is composed based on the following categories:
Oral Exam determines 50% of the final mark.
SELF Practical Assignment determines 50% of the final mark.
Within the Oral Exam category, the following assignments need to be completed:
Within the SELF Practical Assignment category, the following assignments need to be completed:
Portfolio with assessment interview (50%).
Exam with questioning by jury of Clinical Biology on documents and SOPs from the quality handbook (50%).
This offer is part of the following study plans:
Master of Specialist Medicine: Clinical Biology (only offered in Dutch)