Clinical Rotations

The department has clinical affiliations with a number of area hospitals and hospital systems.

Clinical Rotation assignments are the responsibility of the Medical Laboratory Science Clinical Laboratory Education Coordinator, in coordination with the affiliated sites. Clinical Rotation assignments are based on a number of factors, with a goal to balancing the needs of the students with the opportunities available at the different affiliated clinical hospital rotation sites. In order to best assign students to the various hospitals and clinical laboratories for the rotations, it is important for the Clinical Laboratory Education Coordinator to be aware of any possible conflicts of interest that exist. Students will be asked to disclose information such as:

• Laboratories that the student has worked, or volunteered, at in the past.
• Laboratories that the student has had a military relationship.
• Laboratories that a student has had previous clinical rotation experience at in a different educational degree program or major (such as an AAS MLT, nursing, etc.).
• Relatives or friends who work at affiliated laboratories.

Most affiliated hospital laboratory sections and elective sites request that only one student is assigned per rotation block. Large hospitals can have more than one student during a rotation block, but the students will be in different sections. In the event that two students are assigned to the same hospital, and in different sections, it may be possible for those students to carpool. It should be kept in mind that students may have different hours of starting and stopping, based on the rotation of each student.

Training occurs during normal operational hours for each particular facility. Students are expected to be available between the hours of 6:00 a.m. and 12:00 midnight, Monday through Friday; some sites will schedule 8-hour clinical rotation hours as early as 6:00 a.m., and some rotation sites will place students on “afternoon shifts” which may end as late as 12:00 midnight. Most clinical laboratory rotations are conducted during normal day shift hours, but in some instances, some rotations may be conducted during evening or night shift hours. Students will be informed well in advance of rotations that are conducted during evening or night shifts. Every effort will be made to place students in day shift rotations. Placements on evening or night shifts will be done in a manner that is equitable to all students.

Students may not ask to arrive late or leave early for any reason. Extenuating circumstances (death in family, automobile accident, regional inclement weather that imposes driving bans, etc.) should be communicated immediately to both the Clinical Laboratory Education Coordinator and the hospital rotation site laboratory supervisor. Religious obligations that are known in advance should be made aware to the Clinical Education Coordinator and the clinical rotation site supervisor at least seven (7) calendar days prior to the religious obligation by the student.

Every attempt will be made to distribute the schedules by the end of the Fall semester to allow students to arrange for transportation, parking, housing, work schedules and personal obligations. Students are advised that multiple factors affect the preparation of the rotation schedule and a number of these factors are beyond the control of the BCLS department and the Medical Laboratory Science Clinical Education Coordinator. Once a rotation schedule is assigned for the students, no student may change the rotation schedule. Any conflicts or problems should be discussed with the Medical Laboratory Science Clinical Education Coordinator.

The UB Medical Laboratory Science Program guarantees placement in required clinical assignments to all enrolled program students who have completed the required prerequisite courses. These clinical assignments are normally scheduled during the spring semester of a student’s senior year of study. However, as clearly illustrated by the 2020 Coronavirus pandemic, uncontrollable events may result in the interruption of the delivery of Medical Laboratory Science Program and/or an inability to place students into clinical assignments in a timely manner. Multiple entities (UB Office of the Registrar and NYS Education Department (NYSED) and the NYS Office of the Professions (NYSOP)) count clinical assignments clock hours for degree and professional licensure. It has been NYSED policy that, regardless of clinical assignment cancellations caused by global events, the clinical assignment clock hour requirement must still be satisfied.

Therefore, when the clinical assignments necessary for MT program completion and degree conferral cannot be immediately scheduled, the policy of the UB MT Program will be:

1. To continue existing clinical assignments, as scheduled, whenever and where ever possible.
2. That students who have completed partial clinical assignments at the time of interruption will be required to make up only the missed portions of that clinical assignment, even if it is completed at another clinical site.
3. To reschedule cancelled clinical assignment at the earliest possible time based upon the availability of clinical assignment sites and the current clinical assignment schedule.
4. That existing clinical assignments will not be cancelled in order to make up a cancelled, or potentially cancelled clinical assignment.
5. To schedule clinical assignments up to 7 days a week and on any available shifts provided the clinical site and student are both agreeable and appropriate preceptors are available.
6. To provide an incomplete “I” grade for all student clinical assignments which cannot be completed during the originally scheduled semester. This will allow the student to complete the clinical assignments without additional financial burden including tuition or fees. An “I” grade provides a 15-month window in which to reschedule and complete clinical assignments.
7. To administer departmental proficiency exams for rescheduled clinical assignments on an ad hoc basis at the completion of each student’s individual assignment. Proficiency exam date and time will be established at the outset of the rescheduled clinical assignment.

1. To reschedule a clinical assignment for the most severely affected students first; a student who has lost two clinical assignments will be given priority for a site placement over a student who has lost only one.
2. To promote fairness when there is no clear priority, students will be assigned by lottery as the clinical assignment sites become available.
   

In the worst possible scenario, the MT program and clinical affiliate sites could experience a natural or man-made disaster in which our infrastructure is so damaged that clinical assignments could not be completed at current affiliates within the 15-month time period provided by the above described “I” grade policy.  The University at Buffalo and SUNY policy provide for a teach-out plan which guarantees that students admitted to a program will be allowed to finish.  In this disaster scenario, MT program administrators, in cooperation with the Office of Legal Counsel of the Jacobs School of Medicine and Biomedical Sciences, will seek out and establish new affiliation agreements with accredited clinical laboratories outside the disaster area in order to provide students with the clinical assignment hours required to complete their degree.

Clinical service work is defined as services rendered at a clinical site in excess of that which is required during normal student training.

During clinical rotations, students will be expected to achieve entry level cognitive (mastery of professional body of knowledge), psychomotor (applied laboratory skills) and affective (interpersonal and professional conduct) competencies.  Task repetition may be required to attain acceptable competence.  The supervising clinical faculty member will monitor performance and evaluate the students’ competence in each learning area.  After competence is achieved, students will progress to the next area of training.  Students will not be required to perform routine clinical work normally performed by employees of a laboratory.  Schedules established at, or prior to, the beginning of each rotation insure that ‘‘service work” will not occur.

Each student will participate in two phlebotomy educational experiences during the clinical rotation semester. The assignment for the phlebotomy rotation is during the clinical elective. 

MT 419: Phlebotomy

• Adult phlebotomy: Each student will be assigned for an entire day to an out-patient facility. Each student is expected to demonstrate proficiency in venipuncture techniques by completing a minimum of ten (10) successful blood draws. Students are expect to stay the entire shift and may not leave when the ten successful venipunctures have been completed. 
• Pediatric phlebotomy: Each student will be assigned for a half-day pediatric observation.  Students will spend a half-day at the pediatric site. The pediatric observation is usually scheduled in the morning, and students are required to return to their elective site for the afternoon.

Students who have formal training and/or previous recent experience with phlebotomy may petition to be waived from the phlebotomy course. Students with education credit, national certification, etc. should speak with the BCLS Undergraduate Program Advisor about the possibility of an exemption/waiver.  Please discuss the particular background with the Undergraduate Academic Advisor as certain restrictions apply and there is a form to be filled out. Documentation will be required to verify applicable transfer credit, national certification, etc.  There is a deadline of October 1 of the fall semester preceding the clinical rotation semester. 

Clinical rotations are required in the following areas:

• MT 408 Hospital Chemistry
• MT 410 Hospital Microbiology
• MT 412 Hospital Hematology
• MT 413 Clinical Elective
• MT 414 Hospital Blood Banking
• MT 419 Phlebotomy
  

Students may select their Clinical Elective rotation (MT 413) from a wide range of choices. Some locations are very popular and many students apply for a limited number of accepted clinical rotation positions. Student placement is determined by lottery in those cases. Some recent clinical electives and their locations include:

• Flow Cytometry - Roswell Park Cancer Institute, Buffalo, NY
• Flow Cytometry - Veterans Affairs of WNY Healthcare System, Buffalo, NY
• Immunogenetics –IMMCO Diagnostics, Buffalo NY
• Histopathology - Veterans Affairs of WNY Healthcare System, Buffalo, NY
• Infertility and In Vitro Fertilization Medical Associates, Amherst, NY
• Private physician group laboratory - Buffalo Medical Group, Williamsville, NY
• Erie County Public Health Laboratory, Buffalo, NY
• Tissue Pathology - Buffalo General Hospital, Buffalo, NY
• Virology - Women’s and Children's Hospital, Buffalo, NY
• Pharmacology – NYS Center for Excellence, University at Buffalo: Translational Pharmacology Research Core, Buffalo NY
• Forensic – Erie County Central Police Services (CPS)
  
• Forensic Laboratory, Buffalo, NY (see below)
• Pathology – Roswell Park Cancer Institute, Buffalo, NY
• Pathology – South Buffalo Mercy Hospital, Buffalo, NY

Each clinical rotation is graded in combination with the clinical site supervisor who is a member of the clinical faculty, and a competency exam.  Students should see the Competency Exams section in the table of contents for the full policy. 

At the conclusion of each hospital rotation students are expected to submit an evaluation of that clinical site to the Clinical Education Coordinator.  Evaluation forms will be distributed at the end of each rotation and are also available in the departmental office.  The evaluations are anonymous, in no way influence the grade in the rotation, and are used to monitor the quality and appropriateness of all aspects of the clinical rotation.  In addition to review by the Clinical Education Coordinator, Program Director and Chair, the evaluations are distributed to the relevant clinical faculty after the conclusion of the semester for use in maintaining and improving Program quality.

Any questions or concerns should be raised – no question is considered too small to address!

A student experiencing a laboratory accident while on rotation must immediately inform the supervising technologist.  The personnel accident plan for that institution must be followed if medical evaluation or treatment is required.  The accident must also be reported to the Departmental Safety Officer, and an accident report form must be completed.

Professional and academic issues arising during the clinical rotations should be directed to the Clinical Education Coordinator.  The Clinical Education Coordinator visits each clinically affiliated laboratory during the clinical phase of training and is also available to meet with students each week when they return to the academic campus.  A student experiencing difficulty in a clinical rotation should contact the Clinical Education Coordinator in the Program in Medical Technology as early as possible in the rotation or before the rotation is completed.

1. While in the hospital rotation portion of the program students are governed by the rules and regulations of the laboratory they are assigned to.  The beginning and ending hours of the workday are set by each laboratory and will vary from laboratory to laboratory and hospital to hospital.  Students should incorporate themselves into the individual laboratory routine.  Starting times, coffee breaks and lunch periods are scheduled according to scheduling and staffing needs and constraints.
2. Dress codes for health care professionals are set by the clinical rotation sites.  Students must adhere to individual hospital laboratories’ specific guidelines regarding hair, jewelry or dress.  Generally, dress codes for health care professionals are set for the protection of health and safety of the health care provider, and image of the institution.  Dress codes for health care professionals often help a patient be less stressful during medical tests or treatment by creating a clinical atmosphere of competence, comfort, safety, and respect.  Employees and by extension, students, create and maintain the first impressions of the hospital to clients, patients, visitors and guests. Professional, appropriate attire sends a nonverbal statement to coworkers and patients that you are a member of a competent and professional team and respectful of the responsibilities to which you have been entrusted.
   1. Clothing should cover the body from the shoulder to the knee, as a minimum.
   2. Clothing should be conservative.  Students generally do not have to purchase new clothes for their clinical rotation experiences; students usually find conservative items from the clothing they already have.
   3. Clean white sneakers are generally acceptable.
   4. Long hair should be tied back.
   5. Clothing should not represent products, logos, pictures, lifestyles, or political statements.
   6. Clothing should not be sexually suggestive.
   7. No casual hats, shorts, jeans, sweatpants, open-toed shoes, or sandals are to be worn.
   8. Fragrances should be avoided; patients and coworkers may have allergies or chemical sensitivities.
      
      A clean and neat knee-length laboratory coat is usually the acceptable outerwear in the laboratory. Bring your lab coat to each rotation.  If the laboratory requires a special lab coat or provides one, you will be informed on the first day of the rotation.  Laboratory coats should not be worn outside of the laboratory.
3.  Students should adhere to the individual laboratory policies regarding universal precautions.
4. Students should consistently attend all scheduled experiences on time.  If absence or lateness is unavoidable, the clinical instructor should be contacted by the scheduled starting time.  A listing of names and telephone numbers of clinical instructors will be distributed prior to the hospital rotation semester.  New York State Department of Education requires a minimum number of educational hours be completed to qualify for licensure.  Therefore, any time missed from a rotation must be made up.  The rescheduling of missed laboratory learning activities will be at the convenience of the clinical facility.  In the event of a prolonged absence, the student should notify the teaching supervisor at the clinical site and the MT Program Director.  Every effort will be made to allow the student to graduate at the end of the semester, although some circumstances may delay the graduation date.
5. Students are responsible for their own transportation to clinical sites.  The student should acquire information regarding parking, meeting time, and any professional issues for preparation prior to the first day of the assignment.  The Medical Technology program does not reimburse students for any incidental expenses associated with clinical rotation sites which include, but are not limited to:  meals, parking expenses, tolls, gasoline, mileage, bus, cab fare or lodging. 
   
6. Students should demonstrate professional behavior at all times by:
   1. Refraining from gossiping about, criticizing and/or comparing hospitals, physicians, technologists, faculty, or other students or persons associated with the Program.
   2. Using professional (clean) language at all times.
   3. Limiting non-work related conversation to breaks and lunch time.
   4. Respecting the authority of technologists, physicians, other health care professionals and staff.
   5. Not initiating or engaging in personal or other conversation that is deemed disrespectful or uncomfortable for others.
   6. Refraining from extraneous or boisterous conversation while any procedure is in progress or while in patient areas.
   7. Avoiding the display of emotional reactions (distaste, disgust, surprise) in the presence of patients.
7. The quality of patient-provider interactions has a profound impact on the client’s ability to adhere to
   recommended treatment and thus the quality of their health care.  Patient interactions with the health care providers must be conducted with consideration of and sensitivity to language, culture, race, ethnicity, religion, national origin, gender, sexual orientation, marital status and military or veteran status. Patient interactions are both verbal and non-verbal. Patients receiving medical care are often under stress; health care providers should take extra care to conduct interactions in a professional manner; it may be necessary to educate the patient about the medical purpose of their test or visit.   Students in clinical rotations should demonstrate appropriate patient interactions.  It is appropriate to be patient and display concern and empathy for a patient and their medical tests and conditions.  It is inappropriate to use the hospital tests, interaction time, or any professional communication as a segue into a personal relationship. 
   
8. Prior to the hospital rotation semester, students will be required to attend a mandatory seminar regarding privacy and confidentiality established by the Health Insurance Portability and Accountability Act of 1996 (HIPAA).  Students should comply with these federal regulations by:
   1. Refraining from any discussion concerning the patient with colleagues in patient, family, or public areas and/or in any way which is not pertinent or relevant to the procedure or patient care.
   2. Taking care with any words spoken within the patient's hearing range.
   3. Maintaining confidentiality of patient records and/or any information offered by the patient.
   4. Refraining from discussing one patient with another.
   5. Maintaining computer safeguards that prevent unauthorized access, disclosure, alteration, deletion and transmission of patient health information.
9. Students should demonstrate professional judgment and responsibility by:
   1. Observing the rules and regulations of the laboratory.
   2. Working in an orderly fashion with the assigned clinical instructor.
   3. Considering consequences before acting.
   4. Recognizing which decisions require approval.
   5. Recognizing own limitations and responsibilities in the work situation.
   6. Adjusting the pace to situation requirements.
10. Students should assume some responsibility for one's own learning by:
    1. Utilizing all available resources (e.g., books, journals, charts, health team personnel).
    2. Using unstructured time wisely.
    3. Functioning without prodding.
    4. Showing interest by asking questions and seeking new learning experiences.
    5. Accepting constructive criticism gracefully.
    6. Evaluating one's own performance and checking those perceptions with instructors.