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Internal Proficiency Program for Wet Mount Microscopy
The Michigan Regional Laboratory Program seeks to evaluate and document proficiency of practitioners in local health departments for the microscopic examination of vaginal discharge specimens (wet mount analysis). The primary vaginal infections identified during wet mount analysis are bacterial vaginosis (caused by a symbiotic overgrowth of Gardnerella vaginalis and Mobiluncas species), yeast infections (primarily caused by Candida albicans), and trichomoniasis (caused by Trichomonas vaginalis).
This proficiency testing program challenges the practitioner with 3 sets of photo-micrographs of cellular elements commonly observed in vaginal discharges specimens and asks the respondent/s to identify three separate elements per set. There are two challenges per year. Practitioners who perform microscopic examination of vaginal discharge specimens are expected to maintain a proficiency score of 80% or better on each challenge.
It is recognized that the clinical diagnosis of vaginal infections is based on multiple signs and symptoms. This proficiency testing program does not require the practitioner to make a diagnosis of disease since they are not provided with clinical information. Instead, each challenge presents a set of microscopic cellular elements and requires the practitioner to identify each element. Thus, the proficiency program is based on object recognition and not clinical diagnosis. The proficiency testing program also contains an ungraded educational component which provides examples of items commonly seen during wet mount analysis which may be confused with clinically relevent cellular elements.
We maintain a library of past and current proficiency challenges at this location. Each challenge is posted on this website in both Powerpoint format and as a Word document. Each challenge is accompanied by a critique which provides the approved interpretation of each challenge micrograph. In addition, we post microphotographs of examples of clinical material for both training and reference. By providing this material, it is our intention that previous challenges serve as training materials for individuals who need to examine and interpret clinical specimens of vaginal discharge.
Since 2006, the proficiency test challenges have been available in Powerpoint (*.ppt) format. To view these challenges, first save the file to your hard drive. You may then open the file in Powerpoint on your computer and view via "Slide Show". Alternatively, you may print any of these documents by opening the file in Microsoft® Word. You will need a photo quality inkjet printer and high quality matte photo paper - anything else will not give sufficient resolution to the documents for interpretation.
All proficiency test challenges and individual images on this website may be used by other individuals or institutions for educational and training purposes. The Michigan Department of Community Health, Bureau of Laboratories maintains and retains all rights to this material. None of these images may be used to generate revenue. Duplication for publication in any form requires the permission of the MDCH Laboratory Director. Please recognize MDCH whenever this material is used in training or education.
We welcome comments and would be pleased to accept micrographs from clinical professionals of clinical specimens of vaginal discharge. Submissions should be in ‘*.jpg' format and will be considered property of MDCH upon receipt; submitters will be recognized by name and institution whenever a micrograph is used. Please email comments and/or micrographs to email@example.com .
Jeffrey P. Massey, Dr.P.H.
CONTROLS FOR WET MOUNTS
The Quality Control Unit within the Michigan Department of Community Health Bureau of Laboratories provides the Regional Laboratories with an inactivated (nonviable) yeast and bacterial suspension for use as a control for Wet Mount preparations. Agencies are limited to one vial of control per testing site per order. Your agency should limit its inventory to one opened vial and one unopened vial of wet mount control per testing site. Controls are provided as part of our partnership in assisting the Regional Laboratories with their ongoing efforts to comply with CLIA '88.
Each vial contains a volume sufficient for 180 days of testing (the open vial expiration date). Once the currently opened vial is depleted or reaches its assigned expiration date, please contact the Quality Assurance Section for a replacement at 517.335.8585 or 517.335.8859 or via internet: firstname.lastname@example.org or millerT28@michigan.gov.
The QA Section is able to supply a replacement within 24 to 48 hours of the request. As a reminder, orders are to be placed only through the QA Section. Do not contact the MDCH Stockroom at (517) 335-9040 to order wet mount controls.
IPT CHALLENGES - THE COLLECTION OF IPT CHALLENGES AND CRITIQUES
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