Lab Medicine Rounds: Recent Episodes

Mayo Clinic Laboratories

A Mayo Clinic curated podcast for physicians, laboratory professionals, and students; hosted by Dr. Justin Kreuter (the Bow Tie Bandit of Blood) and featuring trending topics from subject-matter experts.

In this episode of “Lab Medicine Rounds,” guest host Ann Moyer, M.D., Ph.D., speaks with Justin Kreuter, M.D., transfusion medicine pathologist and assistant professor of pathology and laboratory medicine at Mayo Clinic, about common misunderstandings and practical ways to teach the basics of coagulation.

Timestamps:0:00 Intro
00:48 Why is it important for physicians to understand the fundamentals of coagulation?
02:27 In your experience, what are a few of the common misunderstandings that people might have?
08:15 Do you have any thoughts on what we can do better to teach a complicated topic like coagulation?
13:57 Are there any sessions at the upcoming Bleeding and Thrombosing Diseases conference that you are looking forward to in particular?
15:31 Outro

In this episode of “Lab Medicine Rounds,” Justin Kreuter, M.D., speaks with Laura Tafe, M.D., associate professor of pathology and laboratory medicine at Dartmouth-Hitchcock Medical Center and president of the Association of Molecular Pathology, to discuss practicing art and medicine.

Timestamps:
0:00 Intro
01:30 What is your artist origin story?
03:40 What does that relationship of your art practice and medical practice look like?
07:18 How do you navigate the challenge of not having enough time?
08:52 What advice do you have for healthcare professionals, new residents, who have interests in addition to medicine?
12:37 What are your thoughts? Where does your art practice go in the coming months and years?
15:40 What is your interest in Graphic Medicine? (question from Dr. Tafe to Dr. Kreuter)
20:04 Outro

In this episode of “Lab Medicine Rounds,” Justin Kreuter, M.D., sits down with Bradley Erickson, M.D., Ph.D., Director of the Mayo Clinic Artificial Intelligence Lab and professor of radiology at Mayo Clinic, to talk about working with artificial intelligence and how to train on it.

0:00 Intro
00:45 Why are computer-aided diagnoses, artificial intelligence, important for our healthcare?
02:45 Is there one way or maybe one facet of AI that’s the next generation of a checklist?
03:46 What’s important for physicians to understand about working with artificial intelligence?
06:01 As they are getting developed, is there a standard way the community is talking about this confidence in probability? Is that going to be universal for the different tools that are being developed? Or is it each to their own the way they try to convey that?
08:10 Is the thought then that will help us get away from some of the biases in our clinical practices?
09:25 How are you thinking about how we train our trainees, our residents and fellows, how to use artificial intelligence well? What can you share with our audience?
11:20 If I wanted to get my residents and fellows exposed to AI now, is there a recommended textbook on it, or any online tools to get exposure to and appreciate these points you are highlighting for us?
14:09 Have you started to have program directors approach you and your laboratory to facilitate education around AI in their department/division?
15:48 What do you think the future of AI in medical practice looks like?
20:38 Outro

Resources:
Medical Image Deep Learning (MIDeL)

National Imaging Informatics Course - Radiology (NIIC-RAD)

In this episode of “Lab Medicine Rounds,” Justin Kreuter, M.D., sits down with Clarissa Jordan, M.D., chief resident in anatomic and clinical pathology for the Department of Laboratory Medicine and Pathology at Mayo Clinic, to discuss online pathology resources.

Resources:

AACC Learning Lab: https://www.aacc.org/education/learning-lab
Kurt’s Notes: https://schaberg.faculty.ucdavis.edu/
Surgical Pathology Reimagined (textbooks): https://www.acemypath.com/books
https://www.pathcejmd.com

In this episode of “Lab Medicine Rounds,” Justin Kreuter, M.D., sits down with Isabella Holmes, D.O., a first-year pathology resident at the University of Michigan, to discuss her residency training experience.

0:00 Intro

01:01 Let’s start by telling our audience your story – why did you decide to become a pathologist?

03:03 What has this first year been for you, what’s that rotation look like? How has your experience been?

04:49 Do you have any advice for listeners who might be going into pathology residency, as far as how they can set themselves up for success during that, and try to take ownership for things?

07:37 What does your process look like for capturing the learning?

08:53 I want to applaud and highlight this skill you just articulated. You started one thing, writing things down you need to look up. But then you discovered for yourself that you’re writing this stuff down but not capitalizing on it the way you intended? How did you catch yourself?

11:00 How has navigating residency been going? What has the community been like?

14:55 Do you have any advice for people for speaking up or those who are nervous about making mistakes while training?

17:35 What for you has been the biggest surprise of residency training?

19:40 What do you think is going to be your biggest challenge for the year ahead, how are you thinking about being successful? What kind of tactic/approach are you thinking about for that challenge?

21:30 If you find that you struggle with something, speaking up and talking to colleagues, having a support network in your residency I would say is a great piece of advice, does that seem to resonate with you?

23:43 Outro

Timestamps:0:00 Introduction

0:40 Non-traditional education for pathologists

11:17 Getting involved

13:41 Self-learning

16:19 Becoming an expert

18:46 Other interests in practice or life

22:05 Importance of completing projects

23:59 Outro

Timestamps:
0:00 Introduction
1:18 What is the difference between marijuana, hemp, THC, and CBD?
2:58 So, is CBD legal in the United States?
4:08 What are the common products you can find CBD in?
4:25 How can CBD impact our health? Especially since it is not regulated.
5:28 You run our drugs of abuse and forensics lab, is this having any effect on the testing you do there?
10:45 For our laboratory medicine colleagues, what's important for them to understand about CBD and marijuana drug testing?
13:55 What about different industries? How does it affect athletes in recovery for example?
16:50 Are there any other takeaways you want the audience to appreciate from this?
18:31 Outro

In this episode of “Lab Medicine Rounds,” Justin Kreuter, M.D., sits down with Justin Juskewitch, M.D., Ph.D., and Andrew Norgan, M.D., Ph.D., both assistant professors of laboratory medicine and pathology at Mayo Clinic, to talk about informatics for the pathologist.

Timestamps:

0:00 Intro

00:45 Can you start us off by giving an overview of this latest outbreak of Monkeypox? And also if you could contrast that against Covid-19?

03:25 What do you think this increase means for our hospital laboratories?

05:44 How can we provide the greatest value to our clinical colleagues and to our patients?

08:17 I know we sometimes do culture a virus and look at viruses. Is it that testing that some of us have in our laboratories that’s not specific enough, it looks like other viruses, is that why we have other tests that we’re using?

10:00 Do you think that Monkeypox would be similar to Covid-19 where we have home test kits for the virus?

12:21 Outro

Timestamps:

0:00 Intro

01:32 So for residents who have recently started, now that orientation is behind us, where should their focus be?

09:05 Do you have any advice for what step 1 or 2 might look like for a new resident?

13:46 What is a new skill or two that residents should really focus on developing?

18:26 Could you share with the student listeners, what do you recommend to residents when they feel like they aren’t making the progress they would like?

23:54 How do you recommend residents approach those meetings with their program director?

28:05 Outro

Timestamps

0:00 Intro
01:10 Why is social media a tool that our lab medicine and pathology community should consider using?
04:01 How do you reassure or talk to a pathology resident or a medical laboratory technologist, who is just getting started on social media, when a patient reaches out with a question?
07:29 What is your advice about how to use your time wisely on social media?
09:57 How do you think about the social media landscape at this point, realizing things are dynamic and changing? How do you characterize and think about these different platforms?
12:10 How has your social media practice evolved over time? What has your journey been like and how has this affected you?
14:48 What skills do you think that you can walk away from this with, what skills have this been helping with for you?
16:44 What is next for you? What challenges do you want to throw out there for the experienced social media person?
17:42 Outro

Timestamps:

0:00 Intro

01:01 What is a patient-scientist?

01:36 What’s the perspective of value they can bring to the table?

03:57 What has surprised you the most about this experience of being a patient-scientist?

08:05 Since you have shared this, what has been your experience interacting with the research community?

08:57 What are your reflections about how the medical community should understand about developing these relationships, seeking out or welcoming patient scientists in their research, interest or questions?

10:46 What’s been your own experience when you go to patient or research conferences, what is your experience like in those situations given you’re on both sides?

12:34 Outro

Resources:
TEDx: Researching Your Own Disease

Society of Patient Scientists

Timestamps:

0:00 Intro

00:42 What does the tick season look like this year? Is it true that is has been predicted to be a severe tick season?

01:20 What are the different things that influence the tick season?

03:49 What does “severe tick summer” mean for all of us working and learning in the hospital?

05:08 Have you been getting invitations to talk to some of our clinical colleagues about that differential diagnosis?

05:53 There has been a lot of concern over “superbugs”, are tick-borne diseases evolving as well?

07:30 Going forward, is it going to get worse? What are the experts in the community saying?

09:11 You do a lot of research in the field. I was curious if you have a favorite story about those experiences of leading some students and colleagues into the field to do this tick-based research?

11:48 Outro

Resources:The Essentials of Ticks and Tick-Borne Diseases

Timestamps:
0:00 Intro
00:46 Why is 3D imaging and printing important for patient care?
03:18 Can you help our audience understand when should we be using this? When is it not so good?
09:38 How does that conversation go now differently? Now that somebody can hold this, how has that transformed the questions and the understanding that the patient has?
13:05 Can you help us get our arms around what is the value in the scan, what is the print value?
14:01 Technologies for scanning are improving and that’s resulting in better models for you to look at. Is printing of materials being used improving in such a way you can get the same textures?
15:22 How do you see this field really developing?
17:55 Outro

Timestamps:

0:00 Intro

00:53 Why is the medical field interested in saliva?

02:00 What sorts of information could be gleaned from saliva?

03:17 Are there certain limitations of what could come out of saliva testing?

04:56 Can you elaborate what you mean when you say “matrix?”

06:16 How do you approach navigating what could be interferences?

08:16 Would that be considered part of the matrix? Or is the matrix just the specimen itself?

9:29 Could you elaborate those preanalytic variables a clinician may have top of mind, or what might be in their sphere of control, influence, awareness?

11:41 What’s your advice to laboratory professionals about how we can detect when these kinds of things are going awry, or how do you keep your finger on the pulse of how your colleagues on the clinical side are using your tests?

13:34 What do you see as the future for saliva testing like?

14:54 Outro

Resources:

https://www.aacc.org/cln/articles/2022/janfeb/saliva-in-the-spotlight

https://news.mayocliniclabs.com/2022/04/07/darci-block-ph-d-discusses-saliva-testing-in-aaccs-clinical-laboratory-news/

Timestamps:
0:00 Intro
00:51 Could you give us an update about what has been happening regarding convalescent plasma?
03:46 What are some take-home points from this new AABB guidelines that are out?
15:07 Were there challenges discussed or things that you see these guidelines either domestically or internationally?
18:20 Is there an aspect that you would like to see addressed with more robust data as we go forward?
20:12 Outro

Resources:AABB Guidelines

https://www.aabb.org/news-resources/news/article/2022/04/13/aabb-expert-panel-updates-guidelines-for-clinical-ccp-use

Timestamps:

0:00 Intro

01:15 What has your experience been seeing minorities in Biomedical leadership roles?

03:56 At what points so far have you really been most engaged with leadership training, so that you’re set up for great things in the future? What have you found that really engages/resonates with you?

08:07 Is there one or two insights for what is helpful to make it work, and is there a good first and second step for launching something similar (mentorship program) at their place?

10:10 Is there something I should do automatically when I have a mentee come in who comes from an underrepresented minority or from a disadvantaged background? Do you recommend that being part of an initial conversation of, “Would you like me to identify a mentor for you?” from a diversity perspective?

12:27 What advice would you like to share with the underrepresented minority student trainee learners who are listening to this podcast?

14:40 Outro

Timestamps:0:00 Intro

2:00 Coming off a relaxed 4th year, how do you recommend we get back into the study flow for training?

6:45 Once residency starts and we are working all day and studying in the evenings, do you have recommendations on how to ease back into that?

9:30 How do you recommend finding a mentor in residency training? How do you know if it’s a good fit or if you need to figure out how to find another mentor?

13:35 How would you maximize your time on AP rotations? How is this approach different than CP rotations?

21:22 How do you recommend getting involved in research and residency? If you do find a project you are interested in, how do you approach it if they are not doing a lot of research in that area at the time?

28:18 How do you mentor your residents on balancing step 3 studying, with pathology studying, and working?

29:15 What is the role of having research and research experiences and applying to fellowships (posters, etc.) Research Experiences and Fellowships

33:07 Entering residency with a strong idea of what we want to pursue a fellowship in, what advice can you offer to help secure this fellowship? And on the contrary, if you have no idea what you want to do how do you recommend people narrow it down?

46:00 How do we navigate the type of career setting we want to be in?

50:15 What conferences do you recommend residents attend?

55:00 How do you recommend maintaining work/life balance and experiencing burnout?

1:00:50 Outro

Resources:
· Book: Getting Things Done by David Allen

· Book: Make It Stick: The Science of Successful Learning by Peter Brown

· Book: Peak by Anders Ericsson

Timestamps:

00:00 Intro

01:04 Why is molecular information important for you in your practice to integrate into anatomic pathology?

06:22 How did you recognize that molecular information was really a critical competency for you to develop as an anatomic pathologist?

09:51 Do you find yourself going to different sessions when you go to conferences, or are you specifically paying attention to ones that have a molecular thread through them?

11:23 How do you recommend that we all continue to embrace new opportunities in clinical practice?

13:01 We are talking about how molecular has come down the pike and been something new that’s been added on to your practice. Is this importance of channels of communication, how has it changed in recent years?

14:45 Outro

Timestamps:

00:00 Intro

01:30 Why is it important for us to look at our past when planning for our future?

05:37 Sometimes people struggle with celebrating and I think also, maybe some people get nervous about that--taking time to celebrate accomplishments that have been. What’s your take on that?

07:01 What are one or two aspects of pathology and lab medicine’s past that you are thinking about celebrating this year?

11:56 How do you see these aspects that you’re celebrating in forming kind of the future projections of success in our field?

14:18 Do you have thoughts for how we might approach this as a healthcare system--attracting bright students into medical laboratory science?

17:22 Is there something that we’ve done that we shouldn’t continue, that we need to change and discontinue--a certain process or way that our laboratory works?

20:57 Outro

Timestamps:0:00 Introduction
1:00 Why is it important to look at the past when planning for the future?
4:30 Keeping in mind our audience, we've got laboratorians, we've got pathologists, we have other physicians from the health care team listening, what might be a good resource, or what would you recommend to be aware of these larger trends?
6:50 What are one or two aspects of pathology and laboratory medicines past that you are interested in celebrating this lab week?
8:58 How do we use this professional past, and maybe these experiences with the pandemic you've been talking about knowing where we've been to inform where we're going and, learning from this, how do you see this informing this future success?
11:34 Is there a favorite example in history you can think of in laboratory medicine, pathology, our community we've been successful at crossing these silos, some example that might give us inspiration for the future as we kind of go towards more of this coordination among each other?
14:31 From your vantage point and perspective, what do you wish for the future of laboratory medicine and pathology?
22:58 Outro

00:00 Intro

01:02 How did you get started in magic?

03:57 How does this roll into your practice as an Anatomic Pathologist? How do you see this skill translate?

06:29 What is a mentalist?

11:05 How do you approach teaching our residents and fellows about how they might think about and use magic in their practice?

14:20 How can we get better at suspending that belief for our residents without getting caught up in the nitty gritty?

16:15 What would an ACGME milestone on magic in pathology look like?

26:54 Outro

Interested in attending this year's Forensic Science Symposium?
Click here to register: https://news.mayocliniclabs.com/edu-conferences/7th-annual-forensic-science-symposium/

00:00 Intro

00:58 Why are wellness efforts a need-to-have, rather than a want-to-have?

04:18 What are we learning about wellness that is important for our audience to understand?

07:44 What are those first steps that our listeners can take and initiate for their own local practice, what would their initial support look like?

14:23 Are there classic struggles with improving wellness that you can help our listeners navigate if there are some pearls to share in that regard?

22:01 What do you think is in store for us in the future?

23:52 Outro

Timestamps:

00:00 Intro

01:23 Why is health equity important for laboratory medicine and pathology?

03:13 What are we learning about how as a laboratory we may better advocate for health equity?

05:27 What’s the nuance there that we need to grapple with, not just more testing but better testing?

08:30 Are there examples of how we can do this better from other professions that we can learn from?

09:59 Is that something that you feel with your previous experience as a hematopathologist has prepared you for or are these additional skills you’ve picked up along the way?

12:10 What are two or three ways that we are trying to navigate this for increasing health care equity?

14:36 What kind of feedback can a pathologist provide that helps them build a better test?

20:20 What does the future of health equity look like, what does that laboratory support of health equity look like in the coming years?

21:27 Outro

Resources:

The COVID pandemic: Testing and disparities:

https://chs.asu.edu/diagnostics-commons/blog/covid-pandemic-testing-and-disparities

To hear more on this topic from Dr. Morice, register for the 2022 Phlebotomy Conference: https://news.mayocliniclabs.com/edu-conferences/phlebotomy-2022-performance-public-health-people-in-a-post-covid-world/

Timestamps:

00:00 Intro

01:32 From your points of view, why do you think it’s important to start a pathology interest group?

07:24 What are some important elements that you think are important for a successful interest group in your experience?

11:24 Is there one or two activities that really stands out that’s been perceived as the most valuable and best experiences so far?

13:18 Has there been any challenge with some faculty being able to explain or demonstrate their work, or is there any way to coach faculty during a session so they can truly show what is the work that they’re doing?

19:25 Has the pandemic had an impact on how you approached the pathology interest group?

23:07 What are your thoughts for how are you planning to be iterative and try next year, things that you didn’t try this year? What are ways that you’re interested in moving this forward?

26:20 Outro

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Timestamps:

00:00 Intro

01:05 From your perspective, why is interprofessional education an important for us clinicians, lab medicine colleagues, and students?

04:18 What are a few of those key lessons that you’ve learned about how to do this interprofessional education?

07:15 How do you think we make it a meaningful experience for the students?

10:37 What sort of approach do you take to feedback, to get that feedback that’s really going to help you meaningfully iterate in a positive way?

13:47 Do you have any advice for people out there who have difficulty with the less frequent, yet important things, how can we still keep forward movement on those?

15:52 Do you have any broad thoughts about how social media may, or may not, have a role in interprofessional education?

19:28 What would be a good call to action, next step for listeners to look at in the next couple of weeks?

23:03 Outro

Timestamps:

00:00 Intro

02:00 Why is it important to respond with grace while we’re under pressure?

03:36 How do you think you develop this ability to project poise when in stressful situations?

05:33 Was there a mentor, situation, or experience where it gave you pause and made you think, “Wow, that’s somebody that really showed grace under pressure and leadership abilities.” Is there anybody in your life who comes to mind?

07:15 Did you find yourself having some of these mental conversations? How did that go for you?

08:36 Are those two questions (1. Does this make sense? 2. What could possibly go wrong?) that you’ve been using for a number of years, or is this something that has been more recent for you?

10:57 I’m curious about how do you recognize in your own self, how do you notice when you’re getting challenged and keep it on the rails?

14:28 What’s your feedback to the young professionals in our community to collect themselves in their thoughts?

15:45 How do you continue to grow in your professionalism in your ability to be a more effective leader more broadly?

16:29 What does that well mean to you? What does that look like?

19:54 Outro

Resources:

https://domorestories.com/profile.php?handle=jane-hata

Timestamps:

00:00 Intro

01:05 How did you first get interested in supporting organ transplantation?

04:53 What are the organs that we can transplant?

06:00 When we are at the Department of Motor Vehicles, we can register as a donor and make our wishes known to our family, is that right?

07:03 If people are interesting in donating a kidney, for example, do they reach out to their local hospital and let them know they are interested in being a donor?

08:50 How does your work in the Histocompatability laboratory, how does it support transplantation?

10:57 Can you give our audience kind of a flavor of how does this work to do this kind of dance to match donor and recipient and have a successful transplant?

13:11 What’s on the horizon for HLA and histocompatibility in the next couple of years?

18:30 The ability for us to identify a patient, these patients who could not get a transplant are now able to get the transplant because of these improvements in the laboratory.

20:01 Outro

Resources:

National Marrow Donor Program
United Network for Organ Sharing

Successful pig to human transplant articles:

What the successful test of a pig-to-human kidney transplant means | Science News
Kidney Grown in Pig Successfully Transplanted Into Man (webmd.com)
A pig kidney has been transplanted into a human successfully for the first time : NPR
Progress in Xenotransplantation Opens Door to New Supply of Critically Needed Organs | NYU Langone News
Startup looks to begin pig-to-human organ transplants by 2022 - Big Think

Timestamps:

00:00 Intro

01:24 Why does clinical context matter for what test clinicians order?

08:41 What determines what kind of test to order?

13:07 How does the communication happen between the lab and the clinician? How should it happen to provide best care for the patient?

18:21 What do you think about for the future of ordering laboratory tests?

21:59 Outro

Timestamps:

00:00 Intro

00:48 What’s your origin story? How did you get interested in medical school education?

06:18 What are we learning about better ways to educate?

13:42 How can faculty make it a safe environment? How can we get students to give it a try?

16:25 How do you bring about and navigate curricular change?

20:15 Was there something that you did that prepared you for this role? Is there some advice for people who are interested in taking a leadership role in education at their institution?

24:04 Could you share what you think the future of medical education will look like?

28:33 Outro

Timestamps:

00:00 Intro

01:07 Why is it so challenging to ask questions in an interview?

03:19 Can you go over what are a few aspects that somebody can ask about?

04:41 What was your process when you made your list, that cheat sheet, the actual how we’re doing of formulating a question. What was your approach there?

05:54 Are there any interesting questions you’ve gotten from applicants over the years that really stood out to you? Conversely, what are some questions that you think applicants should avoid if they are going through this process?

09:41 From your perspective as an interviewer, what do you think makes for a positive experience?

13:36 How do you think applicants can navigate “red flags” and what can the interviewer do to approach these subjects empathetically?

17:13 Is there a tip you want to convey to all medical students interviewing for pathology residency?

19:11 Outro

Timestamps:

00:00 Intro

01:22 Why is it important for labs to learn from their COVID-19 experiences?

05:34 Did you have any other lessons learned from this experience?

8:31 How are these meetings focused on maintaining a high quality? How did you manage the rest of your workload (developing new tests, etc.)?

12:51 Have some of those lessons from the experience of how those meetings were run, is there anything that you’re taking forward that you hadn’t been doing before COVID?

14:43 What do you think about those relationships between the laboratory and physicians, what have you heard from your clinical colleagues about what they’ve come to appreciate or something that they’ve learned about the laboratory that they are now taking forward in their practice?

18:25 Through this pandemic, what’s been your joy, how have you kept your heart full so that you can continue to work as hard as you have through this pandemic?

20:47 Outro

Timestamps:

00:00 Intro

01:02 What are a few of the potential risks and benefits of using social media as a professional? Why should I be doing this and thinking about it?

03:31 People can adjust their privacy settings on social media, so why is it important for healthcare professionals and students to behave professionally on social media?

06:08 Some might say that there are several shades of gray when it comes to professionalism. So, what do we need to understand about professionalism on social media?

08:44 I understand that you have some things you’ve helped students and faculty navigate social media, can you share a few of those significant challenges with us?

13:15 What are a few tips for people just getting started?

17:38 What’s your view of professional use of social media?

19:58 Outro

In this episode of Lab Medicine Rounds, Chris Hartley, M.D., Assistant Professor of Laboratory Medicine and Pathology at Mayo Clinic, discusses the topic of cytopathology, and what some of the challenges and advancements are.

Disclosure of relevant financial relationship: Dr. Mazepa received honoraria from Sanofi.

Timestamps:

00:00 Intro

00:52 Why is it important for physicians to have some understanding about TTP?

04:26 What’s new in this immune TTP area?

08:57 If you have a new patient show up, you do caplacizumab and plasma exchange together or are there certain patient populations, like certain characteristics who would or would not get this medication?

11:29 I was wondering if you could elaborate a little bit more about these chronic complications?

16:32 Do you think there is a role for repeat testing of ADAMTS13 on these patients in chronic phase, or is that an area that is unknown at this point?

18:53 What do you see on the horizon, what do you think the future looks like for TTP?

21:36 Outro

Resources:

Stroke and TTP (Hopkins group led by Dr. Shruti Chaturvedi): https://ashpublications.org/blood/article/134/13/1037/374919/Reduced-ADAMTS13-activity-during-TTP-remission-is

Cognitive impairment in TTP:

(Ohio State and London TTP group collaboration) https://ashpublications.org/blood/article/134/13/1037/374919/Reduced-ADAMTS13-activity-during-TTP-remission-is

(OK Registry, Dr. James George)

https://onlinelibrary.wiley.com/doi/full/10.1002/ajh.24060

Timestamps:

00:00 Intro

00:43 Why is it important for physicians to understand about the reversal of these direct oral anticoagulants?

03:09 The complications or the bleed rate was a lot less, with these direct oral anticoagulants?

03:57 Although there is less severe bleeding, there was a concern by patients and physicians about, if it is severe, what is the plan?

04:51 What have we learned new? Are we learning more about what patient population to use them in, as well as the plans to reverse them?

06:10 Can you elaborate a little bit about the idea for weekly monitoring for INR, why is it a big deal?

7:44 Could you give us an example of where it wouldn’t be ideal to do home INR monitoring for a given patient?

09:06 Are there updates to what the reversal plans are, and how have they changed recently?

12:34 Are there still some challenges that remain for reversing these direct oral anticoagulants?

19:54 What do you think the future looks like for anticoagulant reversal?

23:47 Outro

Resources:

https://pubmed.ncbi.nlm.nih.gov/30916798/

Timestamps:00:00 Intro

01:10 Why is reference laboratory testing important for physicians and laboratorians to understand?

02:00 No lab does all the testing in their own laboratory. Labs can’t really have a whole panel of laboratory tests; it just doesn’t make sense, right?

04:39 What have we learned in the last couple years about reference laboratories, how we can best support clinical practice?

06:10 Do you have an insight for how that communication goes?

8:46 How might a hospital reach out and partner with their reference laboratory?

11:06 What does the future of reference laboratories look like? What might be in store for us?

15:00 Outro

Register for Leveraging the Laboratory:www.news.mayocliniclabs.com/2021levlab

Timestamps:

00:00 Intro

01:15 Why are external rotations in pathology important from the student perspective?

03:51 Do you get to understand the particulars of a program or maybe what kind of questions you might be asking when you later interview because you do a rotation?

05:03 What is unique from an international perspective?

07:53 Can you compare and contrast the in-person pathology elective, with some of the virtual resources that are available at this point and time?

11:02 Are there any additional resources that you want to point out that are available now in 2021?

12:34 Can you kind of dive in and provide advice for people that are following in your shoes who might be doing later electives this year or in the near future who are looking at applying to pathology in the next cycle?

13:41 Can you dive in and elaborate on what are some of the helpful things when students get onsite for one of these rotations?

17:26 Can you help us understand how you go about cultivating those relationships?

19:36 Are there any kind of parting words of wisdom that you want to leave with future applicants that are checking out this podcast episode?

20:47 Outro

Timestamps:

00:00 Intro

00:44 With this latest outbreak of the Delta variant with COVID-19, are laboratorians still working on new innovations for COVID?

02:23 Could you go into more detail, elaborate for us about this COVID-19 innovation around sequencing?

04:25 Could you help us understand a little bit on what work is being done in those areas?

07:47 Could you help our audience understand what have these conversation been like now that we’re into this pandemic this far, and the way that laboratory medicine testing is moving? I imagine you’re having more conversations with some of your Infectious Disease colleagues and you’re having more conversations with public health these days?

09:35 How do you answer that question?

11:18 Are there one or two COVID-related challenges that have really been running around in your mind the past week?

13:25 How is the Delta variant impacting what we’re thinking about for starting school?

14:38 Outro

Resources:American Academy of Pediatrics

Timestamps:

00:00 Intro

01:05 From your perspective, why is the blood inventory important to a hospital?

04:17 What have you learned about managing a hospital’s blood inventory these past 18 months or so?

08:09 I was wondering if you could give us a specific example on how are they trying to bridge that gap?

08:55 Can you explain who the Dream Team is?

12:34 How does PVM look different on the hospital side? How is that being worked?

16:33 How might physicians, non-pathologists, help their hospital’s blood inventory? What are the practical things that is within their sphere of control that they can help?

20:52 What do you hope that our learners take away from these blood shortage challenges that we’re navigating right now?

23:20 Outro

Timestamps:

00:00 Intro

02:15 Why is it not enough for learners just to focus on the curriculum of their program?

04:30 What are two or three things that learners should pay attention to during their training?

07:19 Paying attention to the habits of our mentors and understanding that those habits are what is reassuring them, that is a key source for their confidence in their clinical practice. What’s another thing?

09:50 Do you have a third one that we should pay attention to?

12:45 How could learners take ownership for their education and get that knowledge that’s inside their mentor’s heads, into their heads? Any strategies that you recommend?

19:56 What are you thinking about explicitly incorporating into your training program with residents and fellows?

25:05 Outro

Timestamps:

00:00 Intro

01:19 Could you help us understand, why should I consider getting an ethics consult? What value could this bring to my clinical practice?

07:49 What should our audience understand in order to really work better with our local med ethics team?

13:58 Could you help us understand about organizational ethics? How does that compare and contrast with that hospital ethics committee that you said everybody has and are most used to turning to?

22:24 What would be your recommendation for how to reach out to who is doing organizational ethics at our institution?

25:00 I was wondering if you would be willing to share one or two predictions for the future of medical ethics to open our mind up to what are the main issues and questions, and how is your field evolving?

30:35 Outro

Timestamps:

00:00 Intro

00:45 Why is it important to perform molecular testing on solid tumors?

02:47 What is the significance of this testing for the patients and physicians?

07:18 Can you share with us, what are some recent examples that have blown this door open about hereditary oncology?

10:28 Can you talk a little bit about the challenge on how do we get the rapid rise in molecular knowledge and testing? What is your perspective?

15:25 Can you elaborate a little bit on how you interact with your clinical colleagues on how to keep people up to date, or how to explore what’s the right thing to bring on to that test menu?

18:11 What’s your secret to leveraging those relationships?

20:00 What does the future of molecular tumor testing look like?

21:48 Outro

Timestamps:

00:00 Intro

01:11 What are frozen sections, and why are they an important part of patient care?

04:50 What are some of the challenges of actually performing a frozen section diagnosis?

07:03 How has frozen section changed in recent years, or over the course of practice? Has it been practiced similarly over the years, and are there differences in frozen section practice in different hospitals?

14:37 Given this uptick in the complexity of cases, how do you mentor people who are trying to find their way, i.e., the students and trainees?

19:14 As a practicing Pathologist, where do you solicit your feedback from, and maybe an example of how you use that feedback to get better?

24:32 Looking at the future in pathology and surgical pathology, there’s so much interest in artificial intelligence and informatics; is that thought to play a role in the future of the frozen section practice?

27:51 Outro

Timestamps:

00:00 Intro

01:00 How does the cardiovascular laboratory support patient care?

01:47 Can you tell us a bit about ceramides? What are they?

04:14 When should ceramides be tested?

06:04 Can you modify someone’s ceramides such that the test can be repeated and monitored, or is it once in a lifetime because ceramides or more static?

08:05 What is the controversary around ceramides?

09:52 Could you give our listeners an introduction to Lipoprotein(a)?

11:45 Who should be tested for Lipoprotein(a)?

13:59 How do we treat elevated Lipoprotein(a)?

17:20 How did your interests in laboratory medicine develop? How has this brought meaning for you in your career professionally?

19:23 Outro

Resources:1. Ceramides and Ceramide Scores: Clinical Applications for Cardiometabolic Risk Stratification. Hilvo M, Vasile VC, Donato LJ, Hurme R, Laaksonen R. Front Endocrinol (Lausanne). 2020 Sep 29;11:570628. doi: 10.3389/fendo.2020.570628. eCollection 2020. PMID: 33133018 Free PMC article. Review.

Measuring the contribution of Lp(a) cholesterol towards LDL-C interpretation. Fatica EM, Meeusen JW, Vasile VC, Jaffe AS, Donato LJ. Clin Biochem. 2020 Dec;86:45-51. doi: 10.1016/j.clinbiochem.2020.09.007. Epub 2020 Sep 28. PMID: 32997972
Ceramides improve atherosclerotic cardiovascular disease risk assessment beyond standard risk factors. Meeusen JW, Donato LJ, Kopecky SL, Vasile VC, Jaffe AS, Laaksonen R. Clin Chim Acta. 2020 Dec;511:138-142. doi: 10.1016/j.cca.2020.10.005. Epub 2020 Oct 12. PMID: 33058843
Ceramide Scores Predict Cardiovascular Risk in the Community. Vasile VC, Meeusen JW, Medina Inojosa JR, Donato LJ, Scott CG, Hyun MS, Vinciguerra M, Rodeheffer RR, Lopez-Jimenez F, Jaffe AS. Arterioscler Thromb Vasc Biol. 2021 Apr;41(4):1558-1569. doi: 10.1161/ATVBAHA.120.315530. Epub 2021 Feb 18. PMID: 33596665
High-Sensitivity Cardiac Troponin for the Diagnosis of Patients with Acute Coronary Syndromes. Vasile VC, Jaffe AS. Curr Cardiol Rep. 2017 Aug 24;19(10):92. doi: 10.1007/s11886-017-0904-4. PMID: 28840515 Review.
Natriuretic Peptides and Analytical Barriers. Vasile VC, Jaffe AS. Clin Chem. 2017 Jan;63(1):50-58. doi: 10.1373/clinchem.2016.254714. Epub 2016 Oct 10. PMID: 28062611 Review.
Diseased skeletal muscle: a noncardiac source of increased circulating concentrations of cardiac troponin T. Jaffe AS, Vasile VC, Milone M, Saenger AK, Olson KN, Apple FS. J Am Coll Cardiol. 2011 Oct 18;58(17):1819-24. doi: 10.1016/j.jacc.2011.08.026. Epub 2011 Sep 29. PMID: 21962825
Elevated cardiac troponin T levels in critically ill patients with sepsis. Vasile VC, Chai HS, Abdeldayem D, Afessa B, Jaffe AS. Am J Med. 2013 Dec;126(12):1114-21. doi: 10.1016/j.amjmed.2013.06.029. Epub 2013 Sep 28. PMID: 24083646

Timestamps:

00:00 Intro

01:00 Can you give us the lay of the land and explain how does the cardiovascular laboratory provide patient care?

03:24 Can you elaborate for us what it looks like when you have clinical chemists, cardiologists, and other professionals with different backgrounds working together?

05:56 Can you talk about bringing these people into the laboratory and developing a test that provides a lot of value to patients? How is that blended and what’s the output?

07:31 Talking about meetings that you guys do -- how is this meeting not some hierarchy of people who come together? How do these meetings work as an interprofessional utopia?

11:21 How do you keep your clinical colleagues educated about laboratory science?

14:25 Are other laboratories adopting this leadership model?

15:42 What have you learned about establishing the culture and getting them to understand what the plan is?

17:59 Turning to medical laboratory scientists, what’s your pitch for why they should go into clinical chemistry?

20:12 Outro

00:00 Intro

01:15 What’s your origin story? How did you become a forensic pathologist?

03:53 What are some of the misconceptions about forensic pathology?

06:15 Is there a big public health component to forensic pathology?

07:29 Covid is a nice example on how you have partnered with public health, can you elaborate more on that?

10:15 What other types of physicians are you interacting with periodically and what are those conversations about?

13:10 Do you approach autopsies differently depending on the case at hand?

17:30 In what ways is the field of forensic pathology continuing to evolve and grow?

20:50 Outro

Timestamps:

00:00 Intro

01:29 Why is it really important for leaders in our practice to really understand quality for clinical practice?

03:13 What are the latest developments in your area of clinical laboratory medicine?

06:01 In recent years, what have we learned about quality and how we do quality in the hospital?

11:19 How do we actually implement this in clinical practice for success, for sustainability? You talked about putting together an interdisciplinary team. What’s the secret sauce for putting that together?

15:36 You talk about recognition for these project successes. How do we do that when maybe the project is a failure, but still keep that motivation high in our community, make sure it’s normalized as sometimes it doesn’t work out, but not something we don’t talk about anymore?

18:12 What have you kind of learned from your experiences for what are ways to make projects successful and sustainable?

20:28 Can we kind of closeout with thoughts on where the future of quality improvement in medicine is headed? What are your thoughts on that?

23:35 Outro

00:00 Intro

00:40 Can you tell us how your roles in these different laboratories support testing for patient care?

03:13 What are the latest developments in your area of clinical laboratory medicine?

07:22 Can you elaborate a little bit about this new approach that you have developed is able to bring both sensitivity and specificity along?

10:55 Putting the interpretation on the form, you are probably experiencing quite a few phone calls with our clinical colleges. Can you talk to us about how those interactions go between the laboratory and clinical professionals?

15:10 How have your clinical consultations changed, based on feedback you’ve gotten from previous conversations?

18:15 You also serve as Vice Chair for Supply Chain Management in the Department of Laboratory Medicine and Pathology. This has been talked about a lot related to the Sars-Cov-2 pandemic. Do you have any reflections about key lessons you have learned as you try to stay ahead of supply chair issues?

22:06 Can you tell us more about resiliency in relation to supply chain management?

24:42 Outro

Timestamps:

00:00 Intro

01:07 Why is transfusion support an especially important component of patient care for patients that are on ECMO support?

03:24 Are there some principles that we can think about that will help us better understand transfusion decisions in these patients?

05:52 Can you take us through some specific situations that might help our listeners get our hands around (DO2 and VO2) from a practical standpoint?

10:31 How can laboratory professionals add value to the clinical care of these patients?

12:35 How can we improve that interaction (between the clinical side and the laboratory side)?

16:41 What are the different devices we need to keep in mind?

17:11 Outro

Timestamps:

00:00 Intro

01:11 As a critical care physician, why is laboratory testing important for your practice?

04:09 What do you wish lab medicine folks understood better about critical care medicine?

08:19 What would be your advice to a laboratory medical professional that’s interested in developing a better understanding of critical care medicine?

14:51 What do you see for the future collaboration between laboratory medicine and critical care practice?

16:44 Outro

00:00 Intro

01:15 From your perspective, why is cellular therapy an important topic for our listeners?

02:55 What is your origin story into this world of cellular therapy?

06:20 Working in such a fast-paced area, what has been a unique challenge you have had to navigate and how have you done that?

08:05 Keeping up with the literature can be a challenge, and once you are out of training you don’t have those deadlines of “have you read your recent articles for the month.” How have you approached keeping up with the literature?

11:53 There is so much potential with cellular therapy. What is one direction you see this field moving towards over the next 5 years?

15:34 Outro

Timestamps:

00:00 Intro

00:58 How is cellular therapy contributing to the COVID effort?

04:42 Can you give us a little bit of an introduction about what’s so important about the cell (mesenchymal stem cell) or where it comes from?

08:19 What sort of work are you and your lab doing for patient care?

11:14 Once you figure out a successful cellular therapy, is there then opportunity for that to get brought to scale for a given patient population, or does cellular therapy need to exist as a very individualized treatment?

13:48 For our listeners who might be students or other clinicians or laboratory medicine folks, how can they get involved in cellular therapy or how do you recommend those first steps to learn more about this field and how they might intersect with it?

15:50 Outro

Resources:

https://stemcellsjournals.onlinelibrary.wiley.com/doi/10.1002/sctm.20-0472

https://www.medrxiv.org/content/10.1101/2020.10.15.20122523v2

00:00 Intro

00:45 Can you let our listeners know what we know about the vaccines at this point (December 2020)?

02:00 With using the mRNA approach, do these vaccines have similar performance characteristics?

03:00 What does this mean for people after they get vaccinated? Hearing this high numbers of efficacy that is protecting me from the virus, what does this mean for how I should be behaving after I get vaccinated?

04:25 What are your thoughts on if there should be post-vaccination serology testing?

07:10 From your standpoint in the laboratory, has the laboratory developed all the tests that are needed? With the vaccines coming out, is laboratory medicine’s job done regarding COVID-19? Or do the folks in research and development still have some things they need to get done in lab medicine?

10:15 Is the fact that we have a couple of variations out there a testament that this was testing that needed to be brought up in the moment, which is why there are a couple of different strategies, and maybe over time we will see a convergence towards one over the other? Or, is there a reason to continue keeping these assays up because it really needs to be a battery in order to be accurate?

11:35 Outro

Timestamps:

00:00 Intro

01:00 As Pathologists, we have a lot of competing priorities. Why is mentoring residents and fellows consistently a high priority for you?

03:27 Often what we are trying to do as educators is not transparent to our learners, for a variety of reasons. What do you wish that all residents, fellows, and learners understood about the process of their training?

05:00 How do you address someone who started out on the right food and then started a slip a little and stopped taking ownership of their cases? How do you readdress that with the learner?

06:25 Lately, there has been a lot of discussion about deliberate practice as the pathway to developing expertise. How are you deliberately becoming a better pathologist?

08:10 If you had one magic medical education wish, what would it be and why?

08:50 Have there been some things that you have done that have helped you be more successful at having that dedicated time for education?

10:00 Last question, what has surprised you most about your professional journey so far?

Timestamps:

00:00 Intro

01:00 What is HIT and why is it important for clinicians to correctly diagnose HIT?

03:30 What do we know about how laboratory testing may help clinicians get the diagnosis right?

07:25 How could the process of diagnosing HIT be updated or made better?

10:45 What does the future hold for HIT testing? In five years’ time what do you think HIT testing is going to look like in this country?

12:45 How has your relationship with your clinical colleagues helped advance your practice of medicine?

15:30 Outro

Related Resources:

Conference: A Case-Based Workshop: Clinical and Laboratory Aspects of Hemophilia and Thrombosis

Article: National Symposium Focuses on Bleeding and Thrombotic Disorders

Timestamps:
00:00 Intro

01:00 Why is it important for medical students to prepare for their residency interviews?

3:00 What do recommend that students do to prepare for those interviews? Is it looking at websites online or going to PubMed?

05:35 Assuming many interviews will be virtual, is it fair game for an applicant to reach out to the program interviewers ahead of time to ask them if they can test out the system if they are unfamiliar with it?

08:45 Do you have any thoughts on how students can manage stress inducing questions if they cannot come up with a response immediately?

11:35 What are your thoughts an applicant’s background during online interviews, should they use virtual backgrounds or not?

15:20 It can be difficult to ask relevant questions of the program and program director. Knowing what you know, what are a few questions or areas that pathology residents may want to consider asking that would be helpful for getting a pulse or feel for that individual program?

Time Stamps

00:00 Podcast Intro

00:35 Now that the EAP is closed, how are doctors getting convalescent plasma for their patients?

08:50 What new information have we learned about convalescent plasma in recent months?

13:28 If we are in a period of shortage and there is only low titer available, is it ideal to transfer two units of convalescent plasma in that context?

15:30 What remaining questions about convalescent plasma are you most curious about?

18:52 How can study design enable or inhibit certain questions to be asked and answered?

21:00 Are there any additional transfusion therapies on the horizon?

23:50 Outro

Time Stamps

00:00 Podcast Intro

00:40 Why is it important for a laboratory to detect or quantify opioids?

02:00 What are the challenges you have had to navigate in the laboratory specific to opioids?

04:47 Is it like a pregnancy test or is it important to quantify as well?

05:19 Can you help us understand how you collaborate with other health care professionals?

07:07 In terms of new or illicit street drugs, are you having to constantly design new tests to detect these things?

07:53 Can you elaborate a little about that collaboration with law enforcement?

09:07 Are you also periodically going to testify in court on cases?

09:35 What do you think the future of opioid testing looks like?

12:25 Outro

Timestamps
00:00 Podcast Intro

00:45 Why is it important for laboratory medicine and pathology to be deliberate about diversity and inclusion?

03:11 How do you recommend we transform the question “will they fit?” or “do I fit?” so that it invites diversity?

05:33 So, it’s not so much of transforming the question but putting it ahead of the interview and thinking about what you are trying to recruit for?

06:22 What information have we recently learned about diversity and inclusion in the newer findings?

10:35 How is it easier and/or harder to move the needle on diversity and inclusion in the laboratory?

13:35 In 5 years, where will Laboratory Medicine and Pathology be with respect to diversity and inclusion?

16:05 Outro

Time Stamps

00:00 Podcast Intro

00:50 Why does this landscape of COVID testing seem so dynamic?

03:47 So it sounds like we have two sort of rapid tests that are on the market now. Can we dive into that so that we can appreciate a little bit of the compare and contrast between those two rapid assays?

07:17 What are these unique challenges with regards to sensitivity and specificity when it comes to these rapidly evolving tests?

11:08 Highlighting the connection between laboratory medicine and the clinical practice as it applies to COVID-19 testing.

12:49 What new struggles have emerged when it comes to testing for COVID?

15:15 What’s a thought process that you recommend for folks to think about when people are trying to think about what should I offer in my lab, or how should I offer COVID testing?

17:25 Dr. Binnicker, if you were king for a day, what would you make happen for COVID testing?

19:09 Outro

Resources:

Centers for Disease Control and Prevention (CDC)

U.S. Food and Drug Administration (FDA)

Time Stamps

00:00 Podcast Intro

00:51 This is a nice time of year for the academic calendar with new trainees starting residency, and new faculty starting their jobs, and people still in their first couple of years of being an academic pathologist. Why is it important for these individuals to be deliberate about how they begin their career?

04:18 When somebody is in training, there is a lot that is decided for them and things are predetermined. In residency that opens up quite a bit. Can you give us some insight into these goals you are talking about? On a smaller scale, how do you set yourself up so you can be consistent in making progress?

07:55 Are you pretty deliberate about revisiting where you are with your goals? How do you check yourself?

10:30 Your success as a resident and as an attending, what advice works in both roles and what advice is good for a resident versus the attending?

13:53 When evaluating trainees there is a component regarding delegating work. The skill is critical to have when coming on staff either in an academic or nonacademic setting. Is there a way that you prepare trainees to develop their skills in delegating?

17:05 Sometimes things take you by surprise, which is a great learning opportunity. You have really navigated the system quiet well. I’m curious, what has been easy about this process and what has really been a challenge?

19:55 If you could do it all over again, what would you do differently this time?

25:22 Getting feedback and developing relationship the way you can be, is that a lost opportunity?

Time Stamps

00:00 Podcast Intro

01:05 Why is it important to explain the laboratory to patients? How important it is to have open/honest communication with patients?

07:05 With your experience in talking with children and their families is your focus on the child and the parents picks up on your efforts? Or are you addressing the child separately from their parents?

11:10 What tips would you have for pathologists as they approach certain situations (approaching the bedside, engaging with patients, answering questions regarding lab tests or biopsies, etc.)

16:26 What are your tips for clinicians on explaining the laboratory to patients?

20:22 For our student listeners, what has been your most impactful lesson learned?

23:17 You started to create a video to show kids and their families what is happening in the lab behind the scenes, where does their samples go, etc. How are you approaching this?

27:00 Do you envision that material will be geared towards grades K-5 and then different content for teenagers? How differentiated does the education get?

00:00 Podcast Intro

00:53 There seems to be a lot of buzz around the need for interprofessional education and interprofessional collaboration. Can you kind of take us through these concepts? How are they the same, or how are they different?

02:37 What’s the why here? Why should health care institutions, us as individuals, why should we prioritize this interprofessional education or collaboration in practice?

05:34 I imagine there are a lot of people listening who have meetings…for example we have medical technologists that are involved in a meeting and pathology residents, pathologists, and so you have people together. Does that mean that intercollaboration is happening, or happening well? Is there some way to understand that?

11:03 What do you think that the challenges are that get in the way of developing this skill of interprofessional collaboration?

16:17 Critical reflection

19:20 What has surprised you most about interprofessional collaboration?

20:42 Underscoring the importance of laboratorians and clinicians having a strong collaboration during the COVID pandemic

21:44 Outro

Resources:

WHO IPE framework: https://www.who.int/hrh/resources/framework_action/en/
University of Toronto Center for IPE: https://ipe.utoronto.ca/
D’Amour, D. & Oandasan, I. (2005). Interprofessionality as the field of interprofessional practice and interprofessional education: An emerging concept. Journal of Interprofessional Care , 19 (Suppl 1): 8-20.

Time Stamps

00:00 Podcast Intro

03:19 How did you choose forensic pathology as a career?

04:30 Where did you train and where were you prior to Mayo?

05:08 Can you discuss in general the practice of forensic pathology, and the difference between hospital and medicolegal autopsies?

06:37 How often do forensic pathology and microbiology intersect?

07:57 What are the challenges of performing microbiology studies in your practice?

08:54 What types of interesting microbiology cases have you seen so far?

13:13 You practiced in Dallas for almost 15 years. Can you tell us about the Ebola scare in 2014? Were you involved in the one fatality?

21:26 Given the information you now have learned regarding the Ebola outbreak in 2014 and the COVID outbreak now, to what level are we prepared for what comes next?

Resources:

https://www.mayoclinic.org/diseases-conditions/coronavirus/symptoms-causes/syc-20479963?_ga=2.125131913.207068228.1583341931-1731071377.1580216385

https://www.cdc.gov/coronavirus/2019-ncov/cases-in-us.html

Time Stamps

00:00 Podcast Intro

00:40 What is COVID-associated coagulopathy and why is it important to recognize this?

02:45 How is this coagulopathy similar to or different from other coagulopathies that we commonly see in clinical practice?

04:30 Is there recommended testing for COVID-associated coagulopathy?

06:30 Can you explain what the soluble fibrin monomer test is?

08:09 How is COVID-associated coagulopathy managed in terms on prophylactic anticoagulation, therapeutic anticoagulation, and prophylactic transfusion?

14:23 What are a few lessons that you have learned during this pandemic so far?

Resources:

F.A. Klok, M.J.H.A. Kruip, N.J.M. van der Meer, et al., Incidence of thrombotic complications in critically ill ICU patients with COVID-19,Thrombosis Research (2020), https://doi.org/10.1016/j.thromres.2020.04.013
doi:10.1111/JTH.14810

Time Stamps

00:00 Podcast Intro

00:39 What is they ‘why’ behind starting up a convalescent plasma program?

04:00 If physicians are taking care of a patient and wanting to get this product how do they go about it?

11:23 With the Expanded Access Protocol and Emergency IND, how many products does that get for the given patient?

13:00 Where should we direct people who are interested in being a donor?

14:51 Can you give us an idea on who would be eligible to donate convalescent plasma?

17:16 What are some lessons learned from your perspective as you have navigated through COVID-19 and the dynamic situation?

Resources:

https://ccpp19.org
https://covidplasma.org
https://uscovidplasma.org

00:00 Podcast Intro

00:56 On a lot of T.V. shows that I’ve watched over the years, I see the surgeons and emergency medicine docs after they see the patient pop back in the lab and perform those critical tests. In reality, is that really what’s going on?

01:42 Myself as a pathologist, I understand for a lot of physicians I’m probably one degree removed from the bedside, so one degree outside of their mind, and maybe the medical technologist is another degree. So for our physicians and clinicians listening to this podcast, can you maybe share some of the biggest misconceptions about laboratory technologists and the value that they are actually contributing behind the scenes to that patient care?

03:05 I know in our day to day we kind of think about those patients or situations where we’ve really been challenged and made a difference for the patient. Can you share one of those stories about where you specifically really played a role behind the scenes that made a difference for patient care?

04:39 It sounds like you guys really are the both the first and last line of defense on making sure that the information that is coming out of the laboratory is as accurate as possible?

05:25 You know that front end is really something to highlight for our listeners about, we all got used to ordering tests based on how we were trained and what was available at the time we are training, and as with all things, medical science continues to advance. I think that’s a critical point to make. That Medical Technologist is really up to date on what is an older test, or what test is best to answer that question the physician has?

06:46 If you could elaborate a little bit for students who are just starting to consider this field and maybe even, are there some thoughts for some people who are just starting in laboratory medicine about what the best path might be for them?

8:05 So you’re saying that if I’m somebody that likes variety in my day, there’s a place for me in laboratory medical science, and if I like being an expert in something, there’s ALSO a place for me in laboratory medical science?

08:35 You’ve had a really interesting and valuable career and you’ve kind of seen this profession from a couple of different angles. I was wondering if you have any words of wisdom for someone who is maybe just getting started in laboratory medical science in those first 3-5 years of practice? Do you have any advice for them as to what should they be focusing on and thinking about from a coaching perspective?

13:43 Are there any plans for sharing laboratory pride this year (for Lab Week)?

14:29 Do you have any kind of messages for how pathologists can work best with their laboratory technologists?

16:38 Can you share how you found this field of laboratory science?

21:26 What qualities make for a good lab tech?

25:00 Outro

Resources:
Career Exploration: https://ascls.org/

Time Stamps

00:00 Podcast Intro

00:50 Why is it important to have a serologic test for COVID-19 when there are already molecular PCR assays for diagnosis?

01:38 How are we going to b using the serologic test in clinical practice?

03:02 When should and when shouldn’t we be ordering the serologic assay?

04:34 Can you elaborate on some of the limitations of this test?

06:05 Should we be listening to their local area is recommending related to COVID-19?

06:49 What are the challenges that you have to navigate with serologic testing for COVID-19?

09:32 This has really been a collaborative effort across the country to implement this test. Would you mind sharing what implementation of this serologic assay looked like?

12:58 What are some lessons learned at this point that you think would be worth sharing to the lab professionals and students that listen to this podcast?

Time Stamps

00:00 Podcast Intro

00:52 Can you start off and give us kind of the status update on where we are on this COVID-19 pandemic?

02:13 When you talk about it has gone from an epidemic to a pandemic, can you highlight for our listeners what the difference between those two are?

03:22 Now to dive into laboratory testing. There have been a couple of tests talked about in the media and I know that you have led a team here at Mayo that has developed a test for COVID-19. Can you help us summarize these different tests that are potentially orderable?

04:00 Molecular Tests

05:10 Serologic Tests

07:14 I’ve been seeing in the news a lot of speculation based on past experiences about low sensitivity of SARS-CoV-2 diagnostic testing. Can you speak to that and help us understand this from the lab medicine professional’s point of view?

11:00 We’ve been hearing a lot about rapid tests, point-of-care tests for SARS-CoV-2. I was wondering if you could help us understand those, and how do they fit with what we’ve discussed so far?

14:37 Can you take us through what are some lessons learned or unexpected challenges for our laboratory professionals that are listening?

18:19 I was wondering if we could reflect with our audience on some lessons learned for our learners to take away from this experience?

22:33 Outro

Resources· https://www.cdc.gov/coronavirus/2019-ncov/index.html

· https://coronavirus.jhu.edu/map.html

Time Stamps

00:00 Podcast Intro

01:26 Why is it important to consider how we're staffing our laboratory during this pandemic?

02:58 What are the different models or what are some different ways people have been talking about running a lab to mitigate this risk of the lab going down?

07:07 I like how you know, you're also talking about these challenges of space and some of the conversations that you're having with infection control at the institution level.

09:05 When you were talking and looking at those different schedules and going to the different shifts, you mentioned that there was a lot of time that was invested in doing that. Do you have any tips for our listeners about lessons learned from that experience about how they can do that and learn from your experience?

12:17 If we could follow that thread a little further, I'm curious about how your communication has been with the clinical practice. I know that you mentioned you actually have three labs that you oversee. I know especially the cellular therapy lab has many connections with the clinical practice, a lot of co-dependence there when we're talking about transplant and cell therapy. What's that communication been like with the clinical practice?

18:03 I think there's lots of gems that you've laid out there for our listeners and really kind of a big part of this is keeping a humble, this inter-professional collaboration, whether it's working with your supervisors for staffing, communicating with clinical colleagues for what they are expecting as far as volumes and maintaining those lines of communication for how things are going to change. With that, is there anything that you want to add that we haven't touched about?

18:57 Outro

Time Stamps

00:00 Podcast Intro

02:20 For those of us that aren’t in the education technology movement can you give us a little bit of that 50,000 foot view and orientate us, and where we should think about starting?

03:15 Quick tips to consider as a starting place for Virtual Learning: 1.) Presence 2.) Communication 3.) Authenticity

05:25 Synchronous vs. asynchronous environments

07:21 What are some ways we can make this virtual environment work for effectiveness?

09:48 Do you have some tips as far as, are there two or three things that come to the forefront of your mind? I think many people haven’t thought about wait time or down time in a virtual domain. Can you give an example or two of where someone might get off the ground trying this?

12:16 What are your thoughts about how we can facilitate, encourage, and coach that engagement in our learners in a virtual environment?

12:52 What is netiquette?

13:47 How does the netiquette feed into this engagement of learners?

16:30 Free collaborative tools available: Google Forms, Google Docs and MindMeister

17:58 Transitioning more to the learner mind and learner perspective, are there any recommendations for someone who hasn’t learned this way historically in the past, to give this virtual learning its best opportunity?

21:04 How could educators monitor this environment to get that valuable feedback?

24:35 A lot of things are changing when we are using a virtual environment. What things are not changing?

27:28 Outro

Additional Resources:
Mayo Clinic:

· https://mayocliniceducatorscentral.blubrry.net/2020/03/17/virtual-class-now-how-to-move-your-education-online-in-a-hurry-ep14/

Twitter:

· @erhall1

· @MayoFacDev

· #HMICommunity

MedEd/HPE:

· https://www.aliem.com/teaching-age-covid-19-wrap-up/

· Flipped Classroom in Medical Education: Engaging Students to Build Competency https://journals.sagepub.com/doi/full/10.4137/JMECD.S23895

Higher Education Resources:

· Association of Colleges and University Educators: https://acue.org/online-teaching-toolkit/

· Chronicle in Higher Education: Going Online in a Hurry

· Recent Learning Scientist.org Blog

· https://teachremotely.harvard.edu/

· https://ai.umich.edu/keep-teaching/
1. Learning to Teach Online: Understanding & Optimizing an Online Learning Experience by Elizabeth Syben King (@elizabethonline) for Medium.

Welcome to ACUE's Online Teaching Toolkit by Association of College and University Educators (@ACUE_HQ)
Uploading lecture videos on YouTube by Dr Megan Sumeracki (@DrSumeracki)
Going Online in a Hurry: What to Do and Where to Start by Michelle D. Miller for the Chronicle Vitae

Additional Episode Notes:

Virtual/Remote Learning – 50,000 Ft View

Start simple when thinking shifting to virtual – even if you have to move fast (identity dissonance)

Facilitator presence is key in virtual environments

Connect: How do connect with learners?

· Synchronously - Shift to a video conferencing platform (Zoom, Blackboard Collaborate, other)

· Asynchronously – Traditional and non-traditional learning management systems, email, Slack

· Be available and accessible: Virtual Office Hours,

Communicate: What do my learners need to know?

· Reduce cognitive load by sharing expectations of learners/ participants – help them understand how to interact in this new context (netiquette – virtual etiquette)

· Audio:

· Video:

· Be Transparent – concise communication key and narrating the flow of the experience (be deliberate)

· Include wait time – not only processing by muting and unmuting technology

Be Authentic: How can I maintain my personal touch?

· Address people by name

· Make eye contact

· Encourage, acknowledge, and reinforce contributions

· Reinforce what supporting each other looks like

· Demonstrate appreciation and gratitude

· Have fun – add humor

· Give people grace – we are all in this together

One you have done these three things we are ready to start thinking about:

Delivery: Now, what do I do once I am connected to my learners?

Engagement Strategies and Tactics –Learners contribute to Community

I want to frame this question on the premise that learning is social by nature and science of learning principles. In other words:

· How are we maximizing techniques in which people learn by engaging with others - active learning techniques to organize new learning and link to previous knowledge - exposure to how others think, think critically

· How do we engage learners in retrieval of information, elaboration of ideas, and using specific examples to understand abstract ideas

· How do we plan for learners to thinking about their thinking - metacognition

It is common to think about content first which is important in order to scaffolding learning. Establishing what direction instruction is necessary –

· Essentially how it can be used to a focal point for designing the experience

· Move from introduction of content > exploration > integration > application/creation

So if moving online quickly you may have no other option than to do a synchronous virtual lecture or didactic session until you have time to explore alternative approaches (repurpose existing content). If this is the situation you find yourself in case consider a microlecture or perhaps chunking your lecture into bite-size consumable segments. This allows for using this valuable time together to engage learners with the content. These short segments promote checking for understanding, asking probing questions, ensuring the voice of the learner are integrated.

Also consider recording the microlectures (use YouTube, Kaltura, or podcasting) for repurposing in the future or for playback if learners were unable to attend.

Exploration: Communication and Information Sharing

Chat/Backchannel

WhatApp, Slack

Discussion: VoiceThread, FlipGrid

Collaborative Inquiry: Integrate, Apply, and Create

Breakout Rooms for problem solving

Whiteboard Annotation

Collaborative Workspaces: Google Docs, Padlet

Concept and Mind Maps: Mindmeister

Ongoing assessment and metacognition

Polling or gestures

Reflection: FlipGrid

iAnnotate PDF
Google Forms

Explain Everything

Socrative

Mentimeter

LEARNERS

· Curating content – Ask them what is ready to go

· Synthesize discussions happening

· Creating technology based content for retrieval practice

Differentiating for various learners – include non-GME/workforce

In regards to the current situation at hand there is new information coming in daily in relation to learners and interactions in the physical learning environment. Those updates are being posted on our Mayo Clinic Education homepage at college.mayo.edu

Non-Clinical:

· Pulling-in learner voice early on

· Frequent formative assessments – science of learning principles – interleaving and spaced practice

Clinical:

· Co-creation of knowledge; verbal walking through thought processes

· Virtual Post-It Pearls

· Narrating the feel of the room and the bedside frequently, creating a lot of in/then scenarios

Workforce:

· Just-in-Time resources

· Application

Monitor, elicit feedback, when take action to respond (Correct tool, monitor how things are going)

Synchronous:

Pause and Post

Use the raise hand features or similar non-verbal features

Do what my colleague calls “pulse checks”

Asynchronous:

Ongoing basis – use Brookfield CIQ

Despite technology, what are fundamentals of good teaching

It is about the pedagogy, andragogy – not the technology

Think about the human side of things

Be deliberate as a practitioner:

· Integrate formative assessments

· Engage in collaborative co –creation of knowledge and problem solving

Learn from and with your learners

Time Stamps

00:00 Podcast Intro

01:00 What exactly do you mean when you say, diversity in blood supply, and why does that matter?

02:15 Are you saying that there might be differences in blood among different ethnic groups?

02:50 If we only issued O- blood to everyone, would we still need diversity in blood supply?

04:25 You mentioned a hemolytic reaction, so if I have a friend or family member going in for a surgery, do I need to call up the blood bank and talking to them and demanding something? Or what should I be looking for to make sure they won’t have one of those reactions?

07:51 Some of the patients that are going to be receiving multiple blood products throughout their lifetime, might be the people that matching is more important for? What types of characteristics do these patients have?

11:11 What happens if one of the patients that needs a special unit of blood comes in from a bad car accidents and we don’t have that blood on the shelf?

14:00 Is there some sort of barrier that needs to be overcome to help encourage more donations from diverse communities?

16:28 Red blood cells seem pretty simple, shouldn’t you be able to manufacture a red blood cell and then the diversity in blood supply wouldn’t be a problem because you can put whatever antigens on them that you wanted, couldn’t you?

20:14 Are there other areas in regards to the diversity of blood supply that will be important to keep in the forefront for the near future?

22:40 Are there any specific key takeaways you want people to take away from this topic?

25:25 Outro

Time Stamps

00:00 Podcast Intro

00:31 Introduction of Matt Binnicker, Ph.D.

01:07 Can you talk about why it’s so important for people to discuss chlamydia and gonorrhea and why healthcare providers and the general public today need to have a good understanding of the causes of these STDs?

02:32 So we just spoke to Dr. Rizza about how over the last five years, STDs have risen each year consecutively. Is there any reason why we have an increased incidence over this timeline with these infections?

03:31 How are these diagnosed in the laboratory? How do we actually figure out if you have this or not?

04:22 Those diagnostic processes, do you think those are going to change at all in the future or evolve, or do you think what we have is good?

06:28 So why is important then to have accurate and rapid laboratory test results for chlamydia and gonorrhea?

07:17 So with regards to the disease itself, if a patient becomes infected how are they managed?

08:50 With drug resistant gonorrhea being in the news so often, the next real concern is how worried should we be about it?

09:58 What should be the big takeaway the audience should get from talking about gonorrhea and chlamydia?

11:45 Outro

Time Stamps

00:00 Podcast Intro

01:08 Introduction of Stacey Rizza, M.D.

01:50 What is the natural course of HIV if left untreated, and what effects would it have on the body?

03:41 So given those numbers then, who should be tested for HIV?

04:32 How should HIV be treated?

05:29 Do people living with HIV then when they are on therapy need any additional, special kind of care?

06:44 So if someone who’s living with HIV is actually receiving the treatment and doing everything they should be doing, will the disease naturally shorten their life?

07:28 Now given that we’re talking about sexually transmitted diseases, is it safe for a person with HIV to have unprotected sex?

09:57 Given those conversations, is that usually how it goes when people ask how HIV can be prevented, or is there more to it?

11:59 Another thing that’s coming out every month or so we hear about the new technological advances towards a cure for HIV, so how are we doing on that? Is HIV curable?

13:35 So one of the things that comes up fairly frequently every few years is the Delta 32 mutation, which is a mutation that it’s my understanding intrinsically confers some level of resistance against HIV infection?

15:50 HIV is a very large global burden and as a result there has been a lot of outreach around the world from many different organizations. Here in American in 2003, President George W. Bush signed PEPFAR, The President's Emergency Plan For AIDS Relief. What are your thoughts on how well it’s been doing?

17:48 To shift gears here, we’re going to shift from viruses to bacteria. One in particular with a tumultuous history is syphilis. What is syphilis and what effects does it have on the body?

21:08 So that being said, with it having an asymptomatic period where it doesn’t look like you have it at all, who should be tested for syphilis?

21:57 How is syphilis treated?

22:36 So if someone is treated for syphilis, can it reoccur?

23:30 What about prevention? Can syphilitic infection be prevented?

24:14 According to the CDC congenital syphilis cases has risen consecutively over the last five years, is there anything we should be doing for increased surveillance?

25:42 What does congenital syphilis look like?

26:23 Is there a vaccine for syphilis?

27:39 Outro

Time Stamps

00:00 Podcast Intro

01:25 What is proficiency testing?

04:10 Proficiency testing insures my lab is actually getting the accurate results?

05:26 What is proficiency testing referral and why is it important for laboratory medical directors, administrators, supervisors and staff to be aware of PT referral rules?

07:54 Why would laboratories refer proficiency testing to another external lab?

12:05 What’s happening at working to reduce this risk for me? Taking Essential Steps for Testing (TEST) Act of 2012

15:23 These are “near-miss” events and definitely something to learn from, discussing how the holes lined up, what occurred, and now here’s your opportunity to patch that hole?

17:04 What new trends in laboratory medicine have increased the risk of sanctions for proficiency testing referral?

19:55 What are the most effective strategies to prevent proficiency testing referral?

22:26 Are there good resources for this education? Or is every lab on their own to create content?

23:17 In your experience, being on committees and doing inspections at hospitals, what has surprised you most about this issue of PT and referral?

26:17 How do you approach training pathology residents and fellows in understanding proficiency testing, what they are responsible for, how do they trouble shoot a proficiency failure? I imagine it’s difficult to introduce that topic.

28:10 Outro

Additional Resources:

CMS Brochure on PT Referrals @ cms.gov

Time Stamps

00:00 Podcast Intro

00:41 What do we know so far about the novel coronavirus?

02:35 How does this novel coronavirus stack up to influenza?

04:35 Is there still value in getting your flu shot now (this year) if you haven’t gotten it yet?

05:08 Where should people go to get the latest and best information related to the novel coronavirus?

06:36 What should the health care provider be looking for related to the novel coronavirus?

08:18 I’m glad you mentioned the incubation period, is that something we know with this novel coronavirus?

09:15 What do the laboratorians need to have in mind and what does this mean for the hospital clinical labs?

10:50 So, people can test positive for the coronavirus without having this specific novel coronavirus strain?

12:02 So if somebody sent a sample down to a clinical lab, and I was truly positive for the novel coronavirus, I could have a negative result?

12:45 Can you elaborate on when a physician should pick up the phone relative to the new novel coronavirus outbreak?

14:43 Is there a risk to laboratory personnel for the infection to spread when they are handling the samples?

15:20 When should we be suspecting this novel coronavirus?

16:03 What should someone do if they suspect their patient has novel coronavirus?

16:33 As this is an evolving outbreak, where should folks go for the latest information?

Additional Resources:

· Center for Disease Control (CDC)

· World Health Organization (WHO)

Time Stamps

00:00 Podcast Intro

00:42 When is a genetic test useful?

02:15 What situations would genetic testing not be helpful for?

03:15 Since pharmacogenomic testing isn’t useful for every drug, how do we know when it is useful?

05:15 I’ve seen commercials for genetic testing. Can you talk about these?

05:55 So, you’re saying that a private citizen could get some genetic testing performed?

06:32 I imagine you have gotten a couple of phone calls from people asking what do to with their results? Do people sometimes call you about this?

07:44 Can you talk about the differences between what you are going to do in your lab when you’re doing pharmacogenomic testing and what might be available to a patient as a direct-to-consumer?

09:32 That makes me curious, does that mean that some of these direct-to-consumer tests are including alleles that are only for the white population? Or, are they including ones that are relevant to Latino, African-American, Asian communities too?

11:00 Is there genetic testing that can talk about what type of diet I should follow and what type of exercise I should be doing?

12:45 Will everyone have their genomes sequences in a few years?

15:18 Can you explain what you mean when you say the test is getting better overtime?

18:00 What is the role of the laboratory in performing a genetic test?

22:58 Outro

Additional Resources:
· CPIC webpage http://cpicgx.org to see guidelines for pharmacogenomics

· Genetic Testing Registry https://www.ncvi.nlm.nih.gov/gtr/

Time Stamps

00:00 Podcast Intro

01:00 How is influenza different from other respiratory infections, such as the common cold?

02:02 Why is influenza such a big deal? Many people think about influenza for different reasons, but how can we hit this home for the everyday person?

04:43 Can we unpack the idea of getting vaccinations, specifically getting vaccinations every year?

06:36 Can you address some of the common misperceptions when it comes to getting the flu vaccine?

11:02 Who should see their doctor when they exhibit flu-like symptoms?

12:36 How is the influenza test changing?

14:45 The idea of point-of-care testing that bridges the patient/clinical practice and the laboratory supporting that practice caring for that patient. Can you discuss what some of the logistics and challenges are that come in to point-of-care testing?

16:02 What does it mean in regards to treatment of influenza with having a more sensitive test that is rapidly available?

17:55 How are we spreading this knowledge to all of our physicians so they can understand how to make the decision of who needs be treated and why?

19:23 Are there any questions or feedback that either of you have gotten from other physicians or nurses on this topic that surprised you?

21:25 Is there a future state on the horizon where you think we may not need to be getting the influenza shot every year?

23:57 This podcast is really centered on building bridges between the clinical world and the lab world. Would you mind sharing a story that highlights where this collaboration has really helped the patient?

26:47 I’m curious, for the trainees in your program, how are they trained/mentored on crossing the boundaries between the clinical and laboratory?

28:59 Is there anything you would like to add that we haven’t talked about so far?

Additional resources:
https://www.cdc.gov/flu/index.htm

Time Stamps

00:00 Podcast Intro

00:30 Introduction of Robin Patel, M.D. the Division Chair of Clinical Microbiology at Mayo Clinic

00:42 What is the 16S Ribosomal RNA gene?

1:28 How is it detected and sequenced in clinical microbiology?

2:33 What does this mean for physicians and their patients now that this is something that can be done in the microbiology lab?

4:23 How has the testing for this gene changed?

5:58 Can you take us through an interesting case you have come across?

9:47 What are the limitations when you’re talking about this kind of testing?

11:15 Where is this headed? Are we headed towards next-gen sequencing for 16S?

11:51 So, that will be helpful when you’re talking about using it directly on a patient sample vs. a pure colony that you’re using the testing on?

12:29 What’s the turnaround time for this kind of test?

14:08 Where does this 16S Ribosomal RNA gene testing fit in the toolbox of who should be ordering this?

15:21 What is it that you wish the medical community knew about the microbiology lab?

16:34 Outro

Resources:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5652441/
https://jcm.asm.org/content/55/9/2599

Time Stamps

00:00 Podcast Intro

00:58 What is clinical decision support? How does that fit in to patient blood management?

02:37 Can you tell us how clinical decision support is similar to education and how it is a little different than straight forward education?

04:53 How do you make clinical decision support successful?

07:11 Can you share how the collaboration between you and IT has gone? How have you navigated to make sure you can come out with the best and most meaningful clinical support?

10:14 What are some of the pitfalls from implementing clinical decision support?

13:55 Will you share your thoughts on evaluating a clinical decision support program?

16:33 It sounds like there is a lot of quantitative measurements, how about qualitative measurements?

17:45 What has surprised you most about patient blood management?

19:39 What does the future look like regarding clinical decision support?

21:33 As a bedside physician, what do you wish the laboratory understood about your practice?

25:01 Can you share a personal story on how reaching out to the lab has made a difference for one of your patients?

Time Stamps

00:00 Podcast Intro

00:37 Introduction of Joaquin Garcia, Vice Chair of Laboratories in the Division of Anatomic Pathology and Medical Director of the Histology Laboratory at Mayo Clinic.

00:57 Can you give us a little background as to how you came in to this world of anatomic pathology and also where did this interest of salivary gland tumors come from?

02:09 What are the things that come to your attention when people are asking about salivary gland tumors?

03:13 When you talk about getting a small biopsy, are we talking about getting a punch biopsy for skin or are we talking about a fine needle aspirate where your just getting cytology?

04:11 Can you get in to a little bit on where this challenge comes from, whether something is benign, malignant, kind of predicting that behavior?

05:46 How do you train up pathologists to make these calls and recognize malignant from benign?

07:04 Can you elaborate on some of the additional testing you’re talking about (immunohistochemical staining and liquid kind of samples)?

08:48 So, in a more targeted way you are able to make a diagnosis. Is that also true for how we are treating these cancers? Are we able to do targeted therapy based on the pathology that we are getting?

09:54 You’ve just recently completed a book “The Atlas of Salivary Gland Pathology.” What surprised you most about what it took to put together this atlas?

10:35 Is it true that head and neck pathology is the most challenging sub-specialty within all of anatomic pathology?

11:02 What sort of things should be features that are concerning, so that when you hear this in the history you really want to do a thorough exam of the patients mouth, face, and neck features?

13:35 Outro

Resources:
Atlas of Salivary Gland Pathology, 2019, Springer Publishing (JJ Garcia)

Time Stamps

00:00 Podcast Intro

00:34 Introduction of William Morice, II, M.D., Ph.D., the Chair of the Department of Laboratory Medicine and Pathology at Mayo Clinic

00:48 When did you first become interested in leadership?

2:15 What surprised you most once you took on a leadership role?

5:32 What advice do you have for the learners (residents, fellows) who may be interested in leadership? What should they be focusing on during training and during their early career?

8:01 What do you think would be your message to clinicians? What do you wish they knew about the laboratory that would really strengthen the relationship at their center?

10:21 How do you approach setting a team up for success?

14:41 Opposing Dynamic: People getting the work done for the business vs. people that are the innovators. Do you see yourself as trying to model how to have a respectful disagreement?

16:59 At this point in your career, what’s the real challenge for you?

20:28 Do you have a practice of reflection or what’s your practice for self-reflection and discovery?

22:39 Do you have any book recommendations for our listeners who are interested in developing their leadership skills?

26:23 Outro

Time Stamps

00:00 Podcast Intro

00:39 Introduction of Bobbi Pritt, M.D.

00:56 What are ticks?

1:42 What diseases can be transmitted by ticks?

2:03 Background on ticks

2:46 What should we be suspicious of for the diseases ticks carry? (Location)

4:03 When should I be really concerned about tick borne disease? (Timing)

4:56 Laboratory Testing

6:15 Links to Resources (Algorithm & CDC website):

https://www.mayocliniclabs.com/it-mmfiles/Acute_Tick-Borne_Disease_Testing_Algorithm.pdf

https://www.cdc.gov/ticks/index.html

6:44 When should I not test?

8:30 How can we protect ourselves from these tick borne diseases?

9:23 ABC’s of Tick Bite Prevention: https://news.mayocliniclabs.com/ticks

11:03 Key Takeaways

12:10 Outro

Time Stamps

00:00 Podcast Intro

00:32 Introduction of Ann Moyer, M.D., Ph.D.

00:49 How did you decide to go into Molecular Genetic Pathology?

2:33 What do you do all day (as a pathologist)?

4:25 Can you take one test and talk us through how you look at a case?

7:32 What’s your favorite part about being a pathologist?

8:28 What’s the worst aspect?

9:18 Is it true that a lot of the tests that are run in your lab didn’t exist five years ago?

10:20 What have you learned on the job that you weren’t exposed to in your training?

11:36 How can clinicians build that bridge of collaboration with their pathologist?

13:11 What would you tell medical students as to why they should consider pathology?

14:39 What are the top five things that medical professionals should know about laboratory medicine?

17:39 Outro

Time Stamps

00:00 Podcast Intro

00:48 Introduction of Elitza Theel, Ph.D.

1:03 What is the deadliest creature in the world?

2:30 How many types of mosquitoes are there?

3:50 Why do mosquitoes bite us?

4:54 What types of infections do they cause?

6:33 What advice do you give students and learners regarding this topic?

7:37 How does somebody make the diagnosis?

7:54 How can you use lab testing to keep on the right track?

10:49 What are some of the frequent calls received as a Laboratory Director?

13:26 Are these mosquito borne diseases treatable?

13:53 Where do you figure out the species?

14:59 What about treatment for mosquito borne viruses?

15:17 What about vaccines for mosquito born viruses?

16:27 What do you see as the future trends in the world of mosquito borne disease?

18:13 What are your recommendations for protecting against mosquitoes?

19:33 Fun fact on how spreading infections may occur

21:31 Outro

Additional Resources:

https://www.cdc.gov/ncezid/dvbd/index.html

Coming Soon: Lab Medicine Rounds, a podcast to help you connect lab medicine and the clinical practice through insightful conversations.