Conversenews
Autumn 2013
Advisory Body Report
Haematology Advisory Body
Report on Intermediate Level
Morphology Workshops in Cork and Dublin
On Saturday 18th May, 2013, intermediatelevel haematology blood film morphology workshops were held simultaneously at Cork Institute of Technology and at Dublin Institute of Technology.The workshops were coordinated by members of the Haematology Advisory Body (HAB)following from previous workshops held in 2010 to 2012. A high demand for such workshops at this level across Ireland was identified and sothe HAB developed a vision to address this demand by organising three such workshops in 2013. A further workshop will be held inGalwayin November. It is our hope that the workshops will become a regular annual event at each venue.
What does Intermediate level mean?
Training and experience are fundamental to the examination of blood film morphology; such training from beginner level takes time and must be provided in the laboratory by experienced staff. However, local training can be limited by workload and staffing constraints, as well as by the range of clinical cases seen in each hospital. These workshopstherefore aim tobuild on the fundamental skills and expand participants’ experience, with tuition from experts. They are suitable for recently-qualified Medical Scientists or those with some experiencewho would like to enhance their knowledge. They are also very helpful for those participating in multidisciplinary out-of-hours rotas who may not routinely work in the haematology laboratory, as a supplement to training provided at the workplace.
Photo: Workstation for each participant at Cork Institute of Technology.
Details of the Cork Workshop
The workshop was held in the Department of Biological Sciences at Cork Institute of Technology. Medical scientists based in 7 hospitals,(Cork University Hospital, Bantry General Hospital, Bons Secours Hospital Cork, Waterford Regional Hospital, Kerry General Hospital, Nenagh General Hospital, and the Mater Hospital Dublin) attended.
The day was structured into 2 sessions:
The morning sessionwas presented by Ms. Mary Ring, (Chief Medical Scientist, Department of Haematology,CorkUniversityHospital).
Dr. Norma Reidy (Medical Scientist, Haematology CUH) and Mr. Padraig O’Sullivan (Senior Medical Scientist, Blood Transfusion, CUH) were present to assist participants. The session comprised of a general overview of a wide range of normal and abnormal morphological features of red cells white cells, platelets and parasites. This included a very comprehensive powerpoint presentation complimented with practical work where participants assessed blood films. Interaction between participants was encouraged and each case study was discussed. It was emphasised that a consistent systematic approach to blood film examination should always be exercised.
The afternoon sessionwas presented by Dr. Cleona Duggan.
(Consultant Haematologist, Department of Haematology, CorkUniversityHospital)
Dr. Duggan’s session covered acute and chronic leukaemias, Haemolytic Uraemic Syndrome, HbS and HbC, Malaria and the very rare and interesting case of babesiosis was also presented.Real case studies were presented whereby participants were provided with FBC results, and the findings on the blood film.
A CDROM containing each presentation is available to participants.
Photo: Participants Reviewing Blood Film Case Studies at the Cork Morphology workshop.
Details of the Dublin Workshop
The Dublin workshop was once again a collaborative effort jointly presented by Dr Catherine Flynn (Consultant Haematologist, St James’s and the Coombe Women’s’ hospitals), and by Dr Patrick Thornton of (Consultant Haematologist, Beaumont and ConnollyHospital, Blanchardstown). Each in turn presented 12 cases, which the participants first viewed on their own in a microscope laboratory, given background case information, then each presenter reviewed the cases in detail using a multi-headed teaching microscope.The cases presented covered a wide spectrum of morphological abnormalities including complex haemoglobinopathies, haemolytic anaemias, red cell membrane defects, malaria and diverse haematological malignancies. Examples of medical emergencies where blood film information is essential to diagnosis, such as thrombotic thrombocytopenic purpura (TTP), were again included.
Photo: Paticipants at the Dublin workshop with the presenters Dr Thornton and Dr Flynn in the foreground
Photo: Paticipants at the Dublin workshop, with Ms Irene Regan, organise for the HAB, on the right.
Observations
Feedback from previous workshops had indicated that some participants would have preferred more time to view each case. At the Cork workshop, each participant was given time to find features on the blood film, and if difficulty in identifying such features assistance was provided.Participants found this method of teaching very helpful. At the Dublin workshop, most attendees liked the use of the multi-headed teaching microscope to facilitate group discussion and review of each case as all participants view each slide together.
Participants were also made aware of an online digital morphology course available at and also of the UK NEQAS online digital morphology CPD scheme, available at These can both be used to enhance morphology skills online.
Feedback
The overwhelming response at the Cork workshop was that the course was well organised and at an appropriate level and participants also indicated their interest in a follow up course and also courses in the areas of coagulation and developments in haematology. 100% of respondents would highly recommend the workshop to others, and felt it was practically very relevant witha good range of films to review. At the Dublin workshop, feedback was also very positive and the presenters were particularly praised for their in-depth teaching, which encompassed the underlying pathology in each case as well as the resulting morphological features seen.
Acknowledgements
For the Cork workshop, theHaematology Advisory Body is extremely grateful to Ms. Mary Ring and Dr. Cleona Duggan for their time and commitment in preparing and presenting the material and case studieson the day. The collection of a good database of blood films has taken place over the last number of years and continues at CorkUniversityHospital. We would like to thankMs. Sheila Carmody (Medical Scientist) for coordinating the collection of samples. Sincere thanks arealso owed to the Department of Biological Sciences at Cork Institute of Technology, in particular to Dr. Brendan O’Connell (Head of Department), Mr. Michael Healy (Lecturer) and Mr. John Murphy (Senior Technical Officer) for providing laboratory and lecture theatrefacilities. Thanks also to Ms. Geraldine O’Sullivan (Operations Manager, CIT Student Services Co. Ltd.) who provided a buffet lunch. Dr Reidyis deeply appreciative of the support received from Mr. Padraig O’Sullivan (SMS Blood Transfusion Cork and previous Haematology Advisory Body member) and colleagues of the current Haematology Advisory Body,who by sharing their experience of organising previous workshops, greatly contributed to the delivery of another very successful event.
For the Dublin workshop, the advisory body would like to thank Ms Claire Wynne, lecturer in Haematology, who arranged the microscope laboratory, multi-headed teaching microscope facilities, and catering at DIT. We are most grateful to Ms Nora Kinsella who collected the teaching slides used by Dr Flynn from St James’s hospital and similarly to Dr Thornton’s colleagues at Connolly hospital.We also sincerely thankMs Irene Regan of the HAB who organised the workshop registrations and attendance.
The ultimate goal of both workshops was to help medical scientists in Irelandimprove their blood film morphology knowledge and skills and hence enable them to provide a better service for the benefit of patients.
Dr. Norma Reidy.
Haematology Department
CorkUniversityHospital
(Haematology Advisory Body Member).
Richard McCafferty,
Haematology Department
St James’s Hospital, Dublin
(Haematology Advisory Body Chair).