Laboratory Medicine Education at U.S. Medical Schools: A 2014 Status Report

The Need for Laboratory Medicine in the Undergraduate Medical Education Curriculum: A White Paper from the Association of Pathology Chairs

Considering laboratory results are used to make medical decisions, a fundamental understanding of laboratory medicine is paramount to enhance patient care, optimize health care cost containment, and prevent legal repercussions. With increasing laboratory testing complexity, this education is needed now more than ever. This article is a call to action to have medical schools adequately incorporate practical laboratory medicine content into their undergraduate medical education (UME) curricula. The authors discuss the definition of laboratory medicine, what it encompasses, who uses it and why it matters, and propose that a core laboratory medicine curriculum is a necessary part of UME.

Gamified versus non-gamified online educational modules for teaching clinical laboratory medicine to first-year medical students at a large allopathic medical school in the United States

BACKGROUND

Medical educators seek innovative ways to engage learners efficiently and effectively. Gamification has been explored as one way to accomplish this feat; however, questions remain about which contexts gamification would be most useful. Time constraints and student interest present major barriers for teaching laboratory medicine to students. This study aims to compare two versions of an interactive online module, one gamified and one not, for teaching laboratory medicine concepts to pre-clinical medical students.

METHODS

First-year medical students reviewed either a gamified or non-gamified version of an interactive online module in preparation for an in-person flipped classroom session on Laboratory Medicine. Learning theory guided the design of the modules and both contained identical content, objectives, and structure. The "gamified" module included the additional elements of personalization, progress meters, points, badges, and story/role play. After reviewing the module, students completed an anonymous knowledge check and optional survey.

RESULTS

One hundred seventy-one students completed the post module knowledge check as assigned (82 gamified, 89 non-gamified). Knowledge check scores were higher for the students who reviewed the gamified module (p < 0.02), corresponding to an effect size of 0.4 for the gamified module. Eighty-one students completed optional post-module surveys (46 gamified, 35 non-gamified). Instructional efficiency was calculated using task difficulty questions and knowledge check scores, and the resulting instructional efficiency was higher for the gamified module. There was no significant difference in the student-reported time required to complete the modules. Additionally, both versions of the module were well received and led to positive ratings related to motivation and confidence. Finally, examination of open-ended survey results suggested that the addition of game elements added value to the gamified module and enhanced engagement and enjoyment.

CONCLUSIONS

In this setting, the addition of gamification to an interactive online module enhanced learning outcome, instructional efficiency, student engagement and enjoyment. These results should inspire further exploration of gamification for teaching Laboratory Medicine concepts to pre-clinical medical students.

Experiential exposure as the key to recruiting medical students into pathology

Medical student interest and pursuit of a career in pathology have been steadily declining since 2015. We conducted three separate surveys of medical students to better understand these trends. In our first survey, we focused on assessing U.S. allopathic medical students understanding and perceptions of pathology. We later surveyed U.S. osteopathic medical students as a companion to the allopathic medical student survey, in which many similarities were discovered with some key differences. In our final survey, we specifically looked at curriculum differences between the U.S. allopathic medical schools that graduate the most students who enter pathology training programs (Group 1) versus those schools that graduate the fewest future pathologists (Group 2) to determine if the curriculum had an impact on medical student matriculation into pathology. Together, through these surveys, we were able to identify several remarkable recurring trends, presenting areas of targetable action. Here, we summarize themes from the three studies as well as a review of pertinent literature to offer best practices for exposing and engaging medical students to pathology and possibly recruiting students to consider pathology as a career.

Where is laboratory medicine headed in the next decade? Partnership model for efficient integration and adoption of artificial intelligence into medical laboratories

OBJECTIVES

The field of artificial intelligence (AI) has grown in the past 10 years. Despite the crucial role of laboratory diagnostics in clinical decision-making, we found that the majority of AI studies focus on surgery, radiology, and oncology, and there is little attention given to AI integration into laboratory medicine.

METHODS

We dedicated a session at the 3rd annual European Federation of Clinical Chemistry and Laboratory Medicine (EFLM) strategic conference in 2022 to the topic of AI in the laboratory of the future. The speakers collaborated on generating a concise summary of the content that is presented in this paper.

RESULTS

The five key messages are (1) Laboratory specialists and technicians will continue to improve the analytical portfolio, diagnostic quality and laboratory turnaround times; (2) The modularized nature of laboratory processes is amenable to AI solutions; (3) Laboratory sub-specialization continues and from test selection to interpretation, tasks increase in complexity; (4) Expertise in AI implementation and partnerships with industry will emerge as a professional competency and require novel educational strategies for broad implementation; and (5) regulatory frameworks and guidances have to be adopted to new computational paradigms.

CONCLUSIONS

In summary, the speakers opine that the ability to convert the value-proposition of AI in the laboratory will rely heavily on hands-on expertise and well designed quality improvement initiative from within laboratory for improved patient care.

An open-access laboratory medicine course for medical students

The senior author created a 2-week online laboratory medicine course for fourth-year medical students to meet an unmet need at our institution for a brief survey course of clinical pathology in an online format. The course includes online videos, reading assignments, study questions, and a rubric for written assignments that apply the key principles to topics that are customized based on the specialty interests of each student. Anonymous course evaluation surveys were completed by 42 of 60 students (70%), and 92% of respondents stated that they strongly agree with the quality metrics statements in the survey. The complete course materials are shared in this article in the spirit of open access and may be used for medical students, pathology residents, and other learners.

Millennials Medical Students Generation at the Crosswalks: Motivations and Attitudes Towards Study and Future Career - A Mixed-Method Study

BACKGROUND AND OBJECTIVES

The aim of this study was to investigate in the millennium medical student generation the influence of the curriculum (problem-based curriculum [PBC] vs science-based curriculum [SBC]), gender and semester level on medical students' motives to study medicine, their attitudes toward their career and in this regard their view about their study condition in university.

METHODS

Semi-structured qualitative interviews with 28 medical students were performed and analyzed using Mayring's content analysis. Based on these results, a quantitative questionnaire for a nationwide survey was developed using a mixed-method-approach and send to most medical faculties in Germany. Data from n=1053 students entered statistical analysis.

RESULTS

Humanistic ideals prevailed in the choice to enter medical school and to become a physician. PBC students were found to be significantly (p<0.001) more idealistic and patient oriented, and they regard their curriculum more competitive than SBC-students (p<0.001). A balanced work and family life is essential for all students but particularly important for the PBC - group, male and undergraduate students. The majority of students wanted to work with patients and omitted patient-distant line of work. Undergraduate SBC-students saw their studies as old-fashioned citing lack of patient contact (p<0.001 compared to PBC), which eased in the graduate study part.

CONCLUSION

This study found major differences in student's perceptions depending on curriculum type. PBC-students were more idealistic, and humanistic ideals prevailed in comparison to SBC. For both, close patient contact is essential in their training. Particularly for female students, lifestyle factors and a balanced work-life-integration outweigh career ambitiousness. This study offers an important insight to policy makers and educators to understand the motivation and perceptions of the millennial student generation regarding their studies and future career plans, which should be considered in educational policies.

Implementation and Evaluation of Virtual Laboratory Tours for Laboratory Diagnosis of Hematologic Disease

Objectives

There is often limited time allocated to teaching laboratory medicine to medical students. Without adequate time and context, it can be difficult for students to learn appropriate uses and limitations of laboratory tests. Introducing students to the laboratories and test methods may help them learn these concepts, but physical laboratory tours are difficult to organize for large groups, especially during the coronavirus disease 2019 pandemic.

Methods

We created virtual laboratory tours consisting of short video clips and voiceover PowerPoint slides to teach students about the laboratory tests used to diagnose hematologic malignancies. We assessed the impact on student performance on laboratory medicine–themed quiz questions and surveyed the students to determine their attitudes about the activity.

Results

In total, 129 first-year medical students participated in the study. The average score on the preactivity quiz was 59.8%, and the average score on the postactivity quiz was 92.2%. Students were more confident in their ability to answer quiz questions after completing the activity. Postactivity survey data indicated that the students enjoyed the activity and felt it was an effective way to learn the material.

Conclusions

Virtual laboratory tours show promise as a method of incorporating more laboratory medicine content into medical school curricula.

DIAGNOSTIC ERROR IN THE UNITED STATES: A SUMMARY OF THE REPORT OF A NATIONAL ACADEMY OF MEDICINE COMMITTEE

This review article summarizes the conclusions of the National Academy of Medicine committee on diagnostic error. The committee deliberated during five in-person meetings and during numerous conference calls between April 2014 and April 2015. At three of the meetings, the committee invited multiple speakers to inform its deliberations. The 21 members of the committee represented a broad range of expertise related in some way to diagnostic errors, their potential causes, or their consequences. The members' specialized knowledge included patient safety, health care quality and measurement, patient engagement, health policy, health care professional education, cognitive psychology, health disparities, human factors and ergonomics, health information technology, decision analysis, nursing, radiology, anatomic pathology, laboratory medicine (clinical pathology), law, and health economics.

Survey of Institutional Teaching Approaches to Clinical-Year Clinical Pathology Instruction and Comparison with Prior Survey Results

Teaching approaches to veterinary clinical pathology in the final (clinical) year of veterinary school are often different than those for other specialties. Anecdotally, many schools teach these rotations separately from the routine diagnostic service, but minimal published data are available on this topic or on approaches to teaching and assessment in these rotations. An online survey of 69 veterinary institutions around the world was conducted in 2019. A total of 30 completed surveys were received from 10 countries; 22 completed responses were from North American institutions (73.3%). Survey question categories included information on basic rotations, including microscopy format, personnel involved in instruction, and assessment methods; information on advanced rotations; and challenges and successes with clinical pathology instruction. Data were analyzed and, when appropriate, compared with results from a similar survey conducted in 1997. Formats and content varied greatly among institutions. Several shifts in teaching strategies and rotation format over time were found since the 1997 survey, including increased use of projection microscopy and decreased use of multiheaded microscopy in 2019. More teaching by medical technologists and residents, less teaching by faculty, and a significant increase in the number of students per rotation were seen in 2019 compared with 1997. Several free-text comments referred to challenges related to increasing class size. These data and the comparison with the prior survey highlight common challenges and potential solutions to final-year clinical pathology instruction. Creation of specific, measurable objectives for clinical pathology competence may aid future development and refinement of clinical pathology teaching.

Update in Transfusion Medicine Education

Despite the high frequency with which blood transfusions are performed, transfusion medicine education remains variable in the United States and around the world. Educating medical students and nonpathology physicians is critical for safe and evidence-based transfusion. Many innovative curricula have been published to meet the needs of physicians training in a variety of specialties. Learners' knowledge can be assessed using validated knowledge assessment tools and objective structured clinical examinations. In this review, transfusion medicine curricula and assessment tools are reviewed. Strategies for virtual teaching and learning are also introduced.

Measuring the Efficacy of Pathology Career Recruitment Strategies in US Medical Students

CONTEXT.—

Multiple articles and surveys in the literature suggest that medical students find a career in pathology undesirable and believe it is disproportionately focused primarily on the autopsy.

OBJECTIVE.—

To measure the effect of applied interventions on medical student attitudes about the field of pathology.

DESIGN.—

This prospective study involving medical students from first through fourth year was conducted as a pilot study in 2 medical schools in the United States. A 2-part anonymous survey regarding interest in pathology as a career and familiarity with the specialty using a 10-point scale was given to first- and second-year medical students before and after they listened to a 10-minute pathology career presentation. The same survey was given to third- and fourth-year medical students before and after a 4-week pathology elective.

RESULTS.—

A total of 121 and 83 students responded to the survey before and after the intervention, respectively. Of the 121 students who responded to the survey before the intervention, 106 (87.6%) had not spent significant time in a pathology laboratory before the intervention. The majority of responses in interest in career, job responsibilities, and features of pathologists before and after the intervention demonstrated a statistically significant difference (P < .001). We compared survey scores of presentation versus 4-week rotation groups before and after the intervention. Students who experienced the presentation did not differ from students who experienced the rotation in the majority of questions related to interest in career, job responsibilities, and features of pathologists.

CONCLUSIONS.—

Our study suggests that pathology exposure strategies can have a beneficial effect on student perceptions of the field and consideration of a career in pathology. Overall, the presentation intervention on the first- and second-year students seemed to have the greatest effect.

Perception of usefulness of laboratory tests ordering by internal medicine residents in ambulatory setting: A single-center prospective cohort study

The demand for high value health care uncovered a steady trend in laboratory tests ordering and inappropriate testing practices. Residents' training in laboratory ordering practice provides an opportunity for quality improvement. We collected information on demographics, the main reason for the appointment, preexisting medical conditions and presence of co-morbidities from first-visit patients to the internal medicine outpatient service of our university general hospital. We also collected information on all laboratory tests ordered by the attending medical residents. At a follow-up visit, we recorded residents' subjective perception on the usefulness of each ordered laboratory test for the purposes of diagnosis, prognosis, treatment or screening. We observed that 17.3% of all ordered tests had no perceived utility by the attending resident. Tests were usually ordered to exclude differential diagnoses (26.7%) and to help prognosis estimation (19.1%). Age and co-morbidity influenced the chosen category to legitimate usefulness of tests ordering. This study suggests that clinical objectives (diagnosis, prognosis, treatment or prevention) as well as personalization to age and previous health conditions should be considered before test ordering to allow a more appropriate laboratory tests ordering, but further studies are necessary to examine this framework beyond this medical training scenario.

The reproduction of human pathology specimens using three-dimensional (3D) printing technology for teaching purposes

The teaching of medical pathology has undergone significant change in the last 30-40 years, especially in the context of employing bottled specimens or 'pots' in classroom settings. The reduction in post-mortem based teaching in medical training programs has resulted in less focus being placed on the ability of students to describe the gross anatomical pathology of specimens. Financial considerations involved in employing staff to maintain bottled specimens, space constraints and concerns with health and safety of staff and student laboratories have meant that many institutions have decommissioned their pathology collections. This report details how full-colour surface scanning coupled with CT scanning and 3 D printing allows the digital archiving of gross pathological specimens and the production of reproductions or replicas of preserved human anatomical pathology specimens that obviates many of the above issues. With modern UV curable resin printing technology, it is possible to achieve photographic quality accurate replicas comparable to the original specimens in many aspects except haptic quality. Accurate 3 D reproductions of human pathology specimens offer many advantages over traditional bottled specimens including the capacity to generate multiple copies and their use in any educational setting giving access to a broader range of potential learners and users.

Utilization of biological variation data in the interpretation of laboratory test results - survey about clinicians' opinion and knowledge

Introduction

To interpret test results correctly, understanding of the variations that affect test results is essential. The aim of this study is: 1) to evaluate the clinicians’ knowledge and opinion concerning biological variation (BV), and 2) to investigate if clinicians use BV in the interpretation of test results.

Materials and methods

This study uses a questionnaire comprising open-ended and close-ended questions. Questions were selected from the real-life numerical examples of interpretation of test results, the knowledge about main sources of variations in laboratories and the opinion of clinicians on BV. A total of 399 clinicians were interviewed, and the answers were evaluated using a scoring system ranked from A (clinician has the highest level of knowledge and the ability of using BV data) to D (clinician has no knowledge about variations in laboratory). The results were presented as number (N) and percentage (%).

Results

Altogether, 60.4% of clinicians have knowledge of pre-analytical and analytical variations; but only 3.5% of them have knowledge related to BV. The number of clinicians using BV data or reference change value (RCV) to interpret measurements results was zero, while 79.4% of clinicians accepted that the difference between two measurements results located within the reference interval may be significant.

Conclusions

Clinicians do not use BV data or tools derived from BV such as RCV to interpret test results. It is recommended that BV should be included in the medical school curriculum, and clinicians should be encouraged to use BV data for safe and valid interpretation of test results.

Teaching Laboratory Stewardship in the Medical Student Core Clerkships Pathology-Teaches

CONTEXT.—

Current health care spending is unsustainable, and there is a need to teach high-value care principles to future physicians. Pathology-Teaches is an educational intervention designed to teach laboratory stewardship early in clinical training, at the level of the medical student in their core clinical clerkships.

OBJECTIVE.—

To assess the pilot implementation of case-based educational modules in 5 required core clerkships at our institution.

DESIGN.—

The online cases were developed by using a multidisciplinary approach. In the Pathology-Teaches educational module, students make decisions regarding the ordering or interpretation of laboratory testing within the context of a clinical scenario and receive immediate feedback during the case. The intervention was assessed by using pretest and posttest. Student feedback was also collected from end-of-rotation evaluations.

RESULTS.—

A total of 203 students completed the Pathology-Teaches pilot, including 72 in Family Medicine, 72 in Emergency Medicine, 24 in Internal Medicine, 24 in Neurology, and 11 in Obstetrics-Gynecology (OB-GYN). Pathology-Teaches utility was demonstrated by significantly increased improvement between pretest and posttest scores (mean, 63.1% versus 83.5%; P < .001; Hedge g effect size = 0.93). Of the 494 students who completed the Pathology-Teaches questions on the end-of-rotation evaluation, 251 provided specific feedback, with 38.6% (97 of 251) rating the activity as "extremely valuable" or "very valuable," and 41.4% (104 of 251) as "some/moderate value." Qualitative feedback included 17 positive comments with 6 requests to scale up or include more cases, 16 constructive comments for improvement mainly regarding the technical aspects, and 5 negative comments.

CONCLUSIONS.—

Pathology-Teaches effectively teaches stewardship concepts, and most students perceived value in this educational intervention.

Knowledge of Laboratory Medicine in Medical Students: Is It Sufficient?

Background & Objective

Appropriate use of laboratory testing is essential for achieving safe and effective care to patient. Insufficient knowledge could lead to poor case management and increase the health care costs. It is believed that education on laboratory testing for undergraduate medical student is inadequate. This study was designed to evaluate the level of knowledge of 5 and 6 year undergraduate medical students in field of laboratory medicine.

Methods

Totally, 59 questions including 8 basic questions concerning individual assessment of their knowledge and 51 objective questions focusing on various stages of test ordering and interpretation were asked.

Results

Thirty seven undergraduate medical students at the level of internship participated. On average, 47.9% of students evaluated themselves as "weak" in 8 self-assessment questions. There was no significant difference between responders assessment on their own knowledge in various aspects of laboratory testing (P=0.184). In the objective questions regarding various stages of test ordering including pre-analytic, analytic and post analytic phases,45.6%,51.9% and 50% correct answers were reported ,respectively. Comparison of the level of the knowledge of the students regarding various stages of pathology testing did not show significant difference (P=0.638).

Conclusion

Prioritizing an effective teaching method of laboratory medicine to medical students on appropriate time should be considered in medical school curriculum for better clinical decision making and optimal modern medical care.

How to Teach Laboratory Stewardship in the Undergraduate Medical Curriculum?

OBJECTIVES

Promotion of high-quality care at a lower cost requires educational initiatives across the continuum of medical education. A needs assessment was performed to inform the design of an educational tool with the goal of teaching laboratory stewardship to medical students.

METHODS

The needs assessment consisted of semistructured interviews with core clerkship directors and residency program directors at our institution, a national survey to the Undergraduate Medical Educators Section (UMEDS) of the Association of Pathology Chairs, and a review of existing online resources that teach high-value care.

RESULTS

Two major themes emerged regarding opportunities to enhance laboratory stewardship education: appropriate ordering (knowledge of test indications, pretest/posttest probability, appropriateness criteria, recognition of unnecessary testing) and correct interpretation (understanding test specifications, factors that affect the test result, recognizing inaccurate results).

CONCLUSIONS

The online educational tool will focus on the curricular needs identified, using a multidisciplinary approach for development and implementation.

Reducing Diagnostic Errors Worldwide Through Diagnostic Management Teams

A major challenge facing most countries is the growing cost of healthcare. Laboratory testing costs constitute approximately 3% of all clinical costs, while waste of funds due to inappropriate admissions to clinical departments is reported to be as high as 15%. A frequently used approach to save money in healthcare is random reduction of laboratory budgets, focusing on decreasing the number of unnecessary laboratory tests. The World Health Assembly has approached this problem by publishing a list of essential in vitro diagnostic tests, to achieve a global rationalization of the problem. A much more thoughtful strategy to reducing healthcare expenditure is to improve the efficiency of the diagnostic process. Decreasing the time to a correct diagnosis provides considerable financial and clinical benefits. Additionally, reducing both overutilization and underutilization of laboratory tests while achieving the correct diagnosis is of great benefit to challenged healthcare budgets. Examining the situation in the United States and Italy, this review presents an opportunity for reducing diagnostic error and increasing the efficiency of diagnostic testing worldwide. One approach taken to achieve major savings in healthcare in the United States, which can be applied in Italy and other countries, is the creation of “diagnostic management teams,” comprising experts in specialty areas of medicine, primarily based in the clinical laboratory, who can advise physicians on the selection of necessary tests and the interpretation of complex test results.

The Definition and Scope of Diagnostic Error in the US and How Diagnostic Error is Enabled

Background

The quality of healthcare in the US has been progressively addressed by 3 reports from the National Academy of Medicine, the latest of which, entitled “Improving Diagnosis in Health Care,” was issued in 2015 from a 21-member panel (the author of this report was a member). The report is a review of the longstanding problem of diagnostic error. The infrastructure of healthcare delivery in the US has inadvertently made diagnostic error a major contributor to the high cost of care and preventable poor patient outcomes.

Content

This review describes the failures in US healthcare delivery that have led to the overwhelming number of deaths attributable to diagnostic error. Each failure is associated with recommendations to eliminate it. The review begins with a description of the scope of the diagnostic error problem and then discusses each of the issues that need to be addressed to reduce the number of misdiagnoses.

Summary

The problem of diagnostic error in the US is a large one. Some the contributing factors to this large problem can be resolved at a small expense and with modest change; others require a major overhaul of aspects of medical practice. For the first time, Americans have a “to-do list” to reduce our diagnostic error problem and be on par with other developed countries that are recognized as providing less costly care with better patient outcomes.

Pre-Medical Preparation in Microbiology among Applicants and Matriculants in Osteopathic Medical School in the United States

It is recognized that medical school curricula contain significant microbiology-related content as part of the training of future physicians who will be responsible stewards of antimicrobials. Surprisingly, osteopathic and allopathic medical schools do not require pre-medical microbiology coursework, and the extent to which medical students have completed microbiology coursework remains poorly understood. In this report, we show that fewer than 3% of applicants and matriculants to osteopathic medical school (OMS) have completed an undergraduate major or minor in microbiology, and fewer than 17% of applicants and matriculants to OMS have completed one or more microbiology-related courses. These data demonstrate limited pre-medical microbiology-related knowledge among osteopathic medical students, which may be associated with an increase in perceived stress when learning this content or during clinical rotations as well as a potential lack of interest in pursuing a career in infectious diseases.

Bioinformatics Education in Pathology Training: Current Scope and Future Direction

Training anatomic and clinical pathology residents in the principles of bioinformatics is a challenging endeavor. Most residents receive little to no formal exposure to bioinformatics during medical education, and most of the pathology training is spent interpreting histopathology slides using light microscopy or focused on laboratory regulation, management, and interpretation of discrete laboratory data. At a minimum, residents should be familiar with data structure, data pipelines, data manipulation, and data regulations within clinical laboratories. Fellowship-level training should incorporate advanced principles unique to each subspecialty. Barriers to bioinformatics education include the clinical apprenticeship training model, ill-defined educational milestones, inadequate faculty expertise, and limited exposure during medical training. Online educational resources, case-based learning, and incorporation into molecular genomics education could serve as effective educational strategies. Overall, pathology bioinformatics training can be incorporated into pathology resident curricula, provided there is motivation to incorporate, institutional support, educational resources, and adequate faculty expertise.

A Gram Stain Hands-On Workshop Enhances First Year Medical Students' Technique Competency in Comprehension and Memorization

Background

Laboratory diagnostic tests have an essential role in patient care, and the increasing number of medical and health professions schools focusing on teaching laboratory medicine to pre-clinical students reflects this importance. However, data validating the pedagogical methods that best influence students’ comprehension and interpretation of diagnostic tests have not been well described. The Gram stain is a simple yet significant and frequently used diagnostic test in the clinical setting that helps classify bacteria into two major groups, Gram positive and negative, based on their cell wall structure.

Methods and Findings

We used this technique to assess which educational strategies may improve students’ learning and competency in medical diagnostic techniques. Hence, in this randomized controlled study, we compared the effectiveness of several educational strategies (e.g. workshop, discussion, or lecture) in first year medical students’ competency in comprehension and interpretation of the Gram stain procedure. We demonstrated that a hands-on practical workshop significantly enhances students’ competency in memorization and overall comprehension of the technique. Interestingly, most students irrespective of their cohort showed difficulty in answering Gram stain-related analytical questions, suggesting that more emphasis should be allocated by the instructors to clearly explain the interpretation of the diagnostic test results to students in medical and health professional schools.

Conclusion

This proof of principle study highlights the need of practical experiences on laboratory medical techniques during pre-clinical training to facilitate future medical doctors’ and healthcare professionals’ basic understanding and competency in diagnostic testing for better patient care.