Abstracts S7

Figure 2 ROC analysis of methodologies

PP14

Targeted Next Generation Sequencing (NGS) of Material Obtainedfrom DiffQuik-stained Thyroid Fine Needle Aspiration (FNA) Smears:Parallel Evaluation of Matched Benign and Malignant Cytological andSurgical Specimens

Adele Kraft, MD, Catherine Dumur, PhD, Jorge Almenara, PhD,Narjes Mousavi, CT(ASCP), Celeste Powers, MD, PhD. VirginiaCommonwealth University, Richmond, Virginia

Introduction: Mutational analyses are becoming essential for papillarythyroid carcinoma diagnostic evaluation, further refining the cytologicaldiagnosis and revealing potential therapeutic targets. Most publicationsdescribe the use of NGS in fluid-suspended cells obtained via a dedicatedFNA pass. Lack of cytomorphological correlation may lead to false-negative results.

This study aims to evaluate the performance of a 50-gene panel targetedNGS on routinely collected thyroid FNA material prepared as DiffQuikstained smears.Materials and Methods: We identified archived surgically resected thyroidglands diagnosed as: classical variant papillary thyroid carcinoma; follicularvariant papillary thyroid carcinoma or nodular hyperplasia with FNAperformed up to 6 months before surgery. Nine surgical/cytology pairedslides were selected using these criteria: matching nodule; uniformhistomorphology; at least moderate cellularity, less than 10% contaminatingcells on cytology. Cytology smears underwent digital scanning, 72-hourxylene immersion, coverslip removal, pre-wetting with ATL buffer(Qiagen) and scrapping off the glass slide with sterile scalpel blade.Similarly, tumor areas from deparaffinized unstained slides were scrappedoff for DNA isolation.

After incubating with Proteinase K, DNA was purified using theQIAamp DNA mini Kit. Double-stranded DNA was assessed byfluorometry on the Qubit. Barcoded libraries for each sample weregenerated from 1 or 10 ng of dsDNA using Ion AmpliSeqTM CancerHotspot Panel v2. Combined barcoded libraries were sequenced onIon 316TM chips, run on the PGM instrument. Sequence variantswere identified with variantCaller plugin 4.0 using validated customparameters. Variant annotation was performed by querying COSMIC,dbSNP and ClinVAR databases.Results: Variants in multiple genes were identified including BRAF andHRAS, with excellent correlation between matched surgical/cytology pairs.

Conclusions: Targeted NGS of material obtained from routinely prepared,DiffQuik stained smears is accurate showing equivalent results to thoseobtained on FPPE material with the added advantage of permittingcytomorphological correlation.

EDUCATION/TRAINING/CURRENT TRENDS1

If You Build It Who Will Come? The Cytology Education Learning Lab(CELL) Website

Marilee Means, PhD, SCT(ASCP)1, Liron Pantanowitz, MD2,Deborah Sheldon, BA3. 1ASC, ASCP, ASCT, & CAP, Kansas City, Kansas;2University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania;3American Society of Cytopathology, Wilmington, Delaware

Introduction: In October 2013, 22 new entry-level competencies (ELCs)were added to the cytotechnology student curriculum. Many of these newtopics (e.g. digital imaging) included emerging technologies. However,available resources for cytotechnology student educators to teach theseELCs were scarce, which presented a problem. This challenge served as theimpetus for the ASC, ASCT, ASCP, and CAP to develop a website thatcould function as a repository for such educational resources. The aim ofthis study was to evaluate the success of this Internet tool by analyzing datafrom the registrants.Materials and Methods: A website was established called the CytologyEducation Learning Lab (CELL) (http://cytologyedlab.org). Webpageswere designed to permit contributors to easily upload various files (articles,images, videos, etc.) and for users to download these ELC-related resourcesfrom the CELL database. The website was launched on March 21st, 2014.Registrant data were evaluated by profession and region.Results: One month after the website went live nearly 500 individuals wereregistered. Many people from around the world and individuals not directlyrelated to the education of U.S. cytotechnologists visited the website. Theseincluded cytotechnologists, pathologists, other health professionals, busi-ness representatives, and non-U.S. instructors. File types uploaded includedPDF documents, images (jpeg), powerpoint presentations, audio files (MP3,MP4) and videos, as well as external web links.Conclusions: CELL is a secure, free, file-sharing website that satisfies thedemand to provide modern cytology educational resources within ourcommunity. The website appears to be successful based upon the increasingnumber of individuals that have logged on and uploaded educationalmaterials for cytotechnology programs and their students to use. As theCELL website matures it is anticipated to progressively provide more usefuland relevant ELC-related resources to its users.

2

A Cytotechnologist Mentoring Program Improves the CytotechnologyStudent Experience

Erica Kaplan, MS, CT(ASCP), Amanda Bruening, BS, CT(ASCP),Bridgette Springer, BS, CT(ASCP)CM, Debbie Sabo, BS, CT(ASCP),Dawn Underwood, MS, CT(ASCP), Sandra Dolar, BA, CT(ASCP),Lindsay Shearer, BS, Jennifer Brainard, MD. Cleveland Clinic, Cleveland,Ohio

Introduction: Mentorship is an important part of career development andmay be formal or informal. Cytotechnologist mentors are best able to helpcytotechnology students navigate a complex and evolving career path. Wedescribe our experience establishing a mentoring program for cytotech-nology students.Materials and Methods: The program director solicited volunteer cyto-technologist mentors, paired them with current students and providedprogram oversight. The program was designed to occur over an 8 month

Table 3 Benefits of Mentoring

Cytotechnologist Student Both Cytotechnologist andStudent

Attention to careerdevelopment

Support system foracademic and careerdevelopment

Networking

Satisfying way togive back toprofession

Insider prospective jobsearch and careerplanning

Encourages a new way ofthinking, explaining andworking

Opportunity toexpand currentknowledge

Exposure to different aperspective andexperience

Creates a team mentality andallows open communication

Enhancemanagement andleadership skills

Experience with current,unscreened cases

Allows for problem solving,and helps to improveprocesses

Identify skill gaps Help with review ofmedical recordsGain confidence forentering the workforce

S8 Abstracts

period with students rotating mentors. The students and the mentors eachformally evaluated the program.Results: The mentoring program was piloted with 4 volunteer cytotech-nologist mentors and 3 students. The students spent 1-2 months with eachcytotechnologist mentor. The time commitment is variable but studentsaverage 4-5 hours a month with the mentors. Each new mentoring rotationbegins with an introductory meeting between student and mentor coveringbasic getting acquainted questions and questions to direct the pair onspecific focus areas (Table 1). A central component of each rotation isstudent previewing of current unscreened cases, with review of cases withthe mentor. A record of student diagnoses is maintained. Additionally, thecytotechnologist involves the student in his/her areas of expertise (Table 2).Early feedback shows that the program benefits both students and mentors(Table 3).Conclusions: The mentorship program is a valuable addition to ourcytotechnology school. Providing students with live cases affords a betterunderstanding of a realistic work environment. By introducing neweducators through mentoring, students learn different approaches to makingcorrect diagnoses. The increased interaction between cytotechnologists andstudents reinforce the mentor’s morphologic criteria through case review.Open communication, flexibility in work flow and full commitment from allparties involved are necessary for a successful program. Student and mentorevaluations at the end of this year will provide valuable feedback andopportunites for improvement.

Table 1 Intoductory Meeting Questions

Introductory meeting questions

What body sites do you need to focus on?How did you find out about cytology?Why did you think cytology would be a good career for you?What was the hardest thing for you to get used to when you became a cytotech?What was your school experience like?What’s one good piece of advice going into cytology?Is there anything you dislike about cytology? Can I help fix it?

Table 2 Hot Topics

Hot Topic Content to cover

Procedures �EBUS�EUS�IR�Adequacy assessments

Quality Control �10% random selection�Review of high risk QC,differences at each institution

Board of Certification �application�deadlines�website tutorial

Specimen Troubleshooting(non screening duties)

�recognizing source (voided urinevs bladder wash and vaginal vs cervix)�rejection criteria�Calling in HSIL results�Sign out HPVs

Career Planning �SCT�Supervisor/Manager�Program director�Lab administration�Sales

Organizations and Societies �National organizations�Local societies�Committee�Board member�Contact information

Documentation �Sign and date every change� Daily workload recording�Track time screening�Slide count

FISH �Hands on intro to fish scope�Abnormal cell criteria�Adjust depth of focus�Counting probes

�Use of all 4 filters

3

Utilization of Laboratory Professionals to Enhance Student Training ina Cytotechnology Program

Sandra Dolar, BA, CT(ASCP), Maureen Croyle, BS, CT(ASCP),Ghada Aramouni, BS, CT(ASCP), Gertrude Little, Gail Imondi, CT(ASCP),Julie Shorie, CT(ASCP), Dawn Underwood, MS, CT(ASCP),Maria Lopez, BS, Jennifer Brainard, MD. Cleveland Clinic, Cleveland,Ohio

Introduction: Involvement of experienced laboratory personnel in trainingcytotechnology students benefits both the students and the laboratory. Asour cytotechnology school is relatively new, we decided to look at ways toinclude laboratory professionals in the cytotechnology student curriculum.We also evaluated professional development needs to enhance thelaboratorians’ role as teacher.Materials and Methods: Areas of potential involvement in the school weredetermined by the program director, lab manager and medical director. Theprogram director presented teaching opportunities to the cytotechnologistsand prep personnel. Laboratory personnel were able to volunteer in bothareas of strength and in areas they wanted to develop. Developmentopportunities were offered to laboratory personnel based on their needsassessment.Results: Opportunities to participate in the cytotechnology schoolincluded: lectures, microscope sessions, ROSE training, trouble-shooting, specimen preparation, FISH training, educational slide setdevelopment and laboratory management. All cytotechnologists andprep personnel volunteered for the school in some capacity. Theprogram director worked with volunteers regarding curriculumrequirements, lecture topics and scheduling. Four cytotechnologistslectured students with input from the program director. Fivecytotechnologists participated in microscopic teaching sessions.Training of laboratory personnel included a talk on how to give aneffective lecture and computer classes. Technologist teaching cyto-technology students has shown mutual benefits for students andlaboratory personnel (Table 1).Conclusions: Laboratory professionals are enthusiastic participants incytotechnology student education. Cytotechnology students gain expo-sure to a variety of techniques and viewpoints beyond the scope ofschool faculty. Employees gain the opportunity to review and reinforcecriteria and practices that make them skilled laboratorians. Theincreased interaction between technologists and students enhanceslearning for both. Topics that are difficult to cover in lecture formatmay be more easily addressed in a less formal setting. Employee,graduate and employer surveys will provide important feedbackregarding program effectiveness.