The grossing competency evaluation process in a pathology residency program: transitioning from paper to digital

Abstract

Objective: We sought to identify the challenges of paper-based documentation and quantify the benefits of transitioning to a digital platform for resident grossing competency evaluation.

Methods: We conducted a retrospective review of resident grossing competency documentation and administered surveys to assess satisfaction with an established paper-based system. Following implementation of a digital laboratory information system (LIS)-based process, we reassessed resident grossing documentation, with a 1-month crossover comparison of the 2 methods and a 6-month follow-up evaluation of the LIS-based method.

Results: Overall, resident grossing completion was 37% (745 total completed of 2016 total required) with the paper-based system. Residents forgot documentation "sometimes" (7/17 [41.2%]), "often" (4/17 [23.5%]), or "always" (2/17 [11.8%]); experienced delays in obtaining signatures from attending physicians (14/17 [82.4%]); and reported feeling neutral (6/17 [35.3%]) or dissatisfied (6/17 [35.3%]) with the paper-based system. In the 1-month crossover period, the paper-based system generated 21 competency completions with 3 constructive comments compared with 31 competency completions and 10 -constructive comments collected through the LIS-based process. Documentation levels further increased in the 6-month period following the switch to LIS alone, with means of 97 competencies and 14 constructive comments documented per month.

Conclusions: Transition to a LIS-based system led to greater competency completion capture and constructive feedback. The success of the digital LIS-based system was facilitated by using an easy and familiar system with routine clinical workflows.

Keywords: gross ­evaluation; pathology education; quality assurance; specimen.