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Transcript
VCUHS HEMATOLOGY/ONCOLOGY FELLOWSHIP CURRICULUM
Stem Cell Collection, Processing, Administration
Description of Rotation or Educational Experience
The Hematology-Oncology fellowship allows the fellow to experience the processes of stem cell collection, processing, and
administration. In the apheresis lab, the fellow will work with physicians, nurses and technicians in stem cell collection. Here
the fellow will interpret the labs obtained during apheresis and learn the indications for different mobilization medications as
well as their mechanism of actions and side effects.
In the stem cell laboratory, the fellow will participate in the processing of stem cells. The fellow will learn to count CD34 cells
and learn techniques of concentrating stem cells for optimal freezing. The fellow will also learn the process of red blood cell
depletion when the blood types are incompatible. Lastly, the fellow will participate in the thawing and administration of the
autologous stem cells in the bone marrow transplant unit.
Location:
VCUHS MCV Hospital Apheresis lab
VCUHS MCV Bone Marrow Transplant Unit
VCUHS Stem Cell lab
Length of Experience:
2-4 weeks
Educational Goals
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Gain experience as a hematologist in the process of stem cell collection
Describe stem cell processing
Administer autologous and allogeneic stem cells in the inpatient bone marrow transplant unit.
Patient Care
Goal – To administer stem cell products for hematopoietic stem cell transplant.
Competencies
Fellows are expected to:
 Gather appropriate clinical information
 Partner with bone marrow transplant mid-levels in the administration of stem cells
 Observe administration of stem cells for reactions to stem cells or preservative
Objectives
Fellows are expected to:
 Develop skills in history/physical examination of the patient
 Integrate clinical data in the formation of a comprehensive care plan
 Thaw and infuse autologous stem cells
 Infuse fresh allogeneic stem cells
 Document the encounter in the medical record in sufficient detail to communicate to other physicians and meet
billing requirements
Medical Knowledge
Goal
As a hematologist to describe the indications for stem cell collection, cell mobilization, processing and
administration.
Competencies
Fellows are expected to demonstrate skills in:
 Acquisition of knowledge
 Analysis of information
 Application of knowledge
Objectives
All fellows are expected to:
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By the end of the rotation the fellow will be able to describe the process of stem cell collection and the labs
monitored by nursing.
By the end of the rotation the fellow will be able interpret CD34 counts and identify which mobilization agent is
indicated and how it works.
By the end of the rotation the fellow will be able to perform CD34 cell counts on stem cells.
By the end of the rotation the fellow will be able to calculate CD34 dose and volume of DMSO required
concentrating the bag for freezing.
By the end of the rotation the fellow will be able to perform red blood cell depletion technique in ABO
incompatible transplants.
By the end of the rotation the fellow will freeze stem cells using liquid nitrogen.
By the end of the rotation the fellow will thaw stem cells in water bath.
By the end of the rotation the fellow will administer an autologous stem cell infusion.
Practice- Based Learning and Improvement
Goal
Fellows must demonstrate the ability to investigate and evaluate their care of patients, to appraise and assimilate scientific
evidence, and to continuously improve patient care based on constant self-evaluation and lifelong learning. The fellow is
expected to present primary scientific and medical evidence to support their conclusions and care plans in the diagnosis,
prognosis, management, and monitoring of the patients on the service. The fellow is expected to recognize their areas of
deficiency. Depending upon the acuity of the care situation, the fellow is expected to be able to effectively utilize their
resources to arrive at necessary information and to apply the information to their patient care. Moreover, the fellow is
expected to recognize conditions and circumstances requiring escalation.
Please refer to overview of the fellowship curriculum for competencies/objectives for practice based learning and
improvement.
Systems Based Practice
Goal
Fellows must demonstrate an awareness of and responsiveness to the larger context and system of health care, as well as the
ability to call effectively on other resources in the system to provide optimal health care. Fellows will work within an
interdisciplinary team of health professionals including midlevel providers, pharmacists, nurses, physical therapists,
occupational therapists, social workers, care coordinator, and pastoral care. This will provide the fellow experience and
feedback in effectively working within an interdisciplinary team of health professionals. Additionally, working within the
context of a broader health system includes the importance and necessity to recognize conditions and circumstances requiring
consultation and/or escalation for the effective and safe delivery of patient-centered medical care.
Please refer to overview of the fellowship curriculum for competencies/objectives for systems based practice.
Professionalism
Goal
Fellows must demonstrate a commitment to carrying out professional responsibilities and an adherence to ethical principles.
The fellow is expected to model professional and courteous behavior in the treatment of the patient and in working with the
entire health care team. The fellow is expected to complete documentation of their patient care, of their communications with
the patient and health care providers, and of their procedures in a timely fashion within the medical record. The fellow is also
expected to recognize the critical importance of their own education and the importance of life-long learning as part of their
professional responsibility. As such, it is the obligation of the fellow to themselves, their profession, and their patients to
attend and complete in a timely fashion all of fellowship training program’s expected educational activities.
Please refer to overview of the fellowship curriculum for competencies/objectives for professionalism.
Interpersonal and Communication Skills
Goal
Fellows must demonstrate interpersonal and communication skills that result in the effective exchange of information and
teaming with patients, their families, and professional associates.
Please refer to overview of the fellowship curriculum for competencies/objectives for interpersonal and communication
skills.
Teaching Methods
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Patient care/clinical experience
Modeling of observed behaviors of attending physicians and other members of the interdisciplinary team
Case-based interactive discussions
Performance feedback
Self-directed learning
Assessment of Fellow Performance
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End-of-rotation evaluation of the fellow by the supervising attending physicians and/or primary supervising
laboratory personnel
Semi-annual self-assessment by the fellow
Assessment of Rotation
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End-of-rotation evaluation of the supervising attending physicians and/or of the primary supervising laboratory
personnel by the fellow
Annual program review
Discussions with fellows during biannual review
Review in-service and ABIM exam results
Level of Supervision
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Indirect supervision with faculty immediately available
Educational Resources
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The EBMT Handbook Hematopoietic Stem Cell Transplantation 6 th Edition