Vol. 18 Issue 4
22nd Annual Clinical Laboratory Educators'Conference
According to ASCLS, the Clinical Laboratory Educators' Conference (CLEC) is the most important annual event for faculty, administrators, directors, advisors and others in clinical laboratory science (CLS) education.
This year's theme, "A Fiesta of Ideas," captures the spirit of San Antonio and Texas, ASCLS notes. Now the eighth-largest city in the United States, the city has retained its sense of history and tradition, while carefully blending in cosmopolitan progress.
ASCLS reports that the meeting's goal is to examine a number of timely topics and hear from faculty at the forefront of CLS education. The program offers a variety of substantive educational sessions from which to choose.
Exhibits, poster presentations and technology demonstrations will round out the 2006 CLEC program and provide ample opportunities to network with colleagues.
Opening Keynote: The Many American Ways to Die Henry S. Perkins, MD, Professor of Medicine, The University of Texas Health Science Center and Consultant in Bioethics, Ecumenical Center for Religion and Health, San Antonio. "All American health professionals encounter cross-cultural differences in their work. Those differences become exaggerated when patients are dying. Because many health professionals feel ill-prepared for such situations, this keynote address will provide a useful conceptual framework for understanding cultural differences in care for the dying."
Teaching With Your Students' Brains in Mind William Hendricson, MS, University of Texas Health Science Center at San Antonio. "This session provides instructors and supervisors with perspectives on how the thinking and problem solving of novices and experts are different and offers recommendations for instructional best practices that help novice learners move toward expert functioning."
NAACLS Update Shauna Anderson, PhD, CLS(NCA), President, NAACLS Board of Directors. "This update is merely to give the attendees an idea about how many programs are accredited at the present time. It will also provide the latest figures for accredited programs, graduate numbers and program closures. It offers educators a chance to ask questions and NAACLS an opportunity to thank the volunteers."
ASCP Update Patricia J. Ellinger, MSEd, MT(ASCP)SBBCM, Education Consultant, ASCP. "The ASCP Board of Registry (BOR), founded in 1928, is the largest certification agency for clinical laboratory personnel and has certified more than 405,000 laboratorians. I will review the content areas of several exams and point out significant changes in the content or delivery of the exams. My report includes BOR accomplishments of the past year and initiatives for the upcoming year, including the roll-out of our international exams and discussions with the NCA about the possibility of forming a single certification agency. It is a good forum for educators to ask questions about the exams and other activities of the BOR."
NCA Update Kathy Doig, PhD, CLS(NCA), President, NCA Board of Directors. "Recent examination statistics, policy changes and status of discussions with the ASCP-BOR on forming a single certifying body."
Development of Communication Skills in Clinical Laboratory Science Students Jackie Keene, MBA, MT(ASCP), Warm Springs Rehabilitation System. "Clinical laboratory scientists are naturally trained to excel in performance improvement, yet they rarely are recognized for it. As educators, we need to prepare them for an interdisciplinary environment so their gifts will be recognized and used."
Meaningful Mapping Deborah Fox, MA, MT(ASCP), Our Lady of the Lake College, Baton Rouge, LA. "My session is important because it will teach clinical laboratory educators how to construct graphic organizers, such as concept maps and other meaning-making diagrams. Such visual diagrams are critical in enhancing a student's conceptual understanding of both didactic and laboratory information. Participants will learn suggested methods for teaching these skills to others, as well as options for diagram evaluation."
Applications for a Laboratory Information System in a Student Laboratory David M. Falleur, MEd, CLS(NCA), Texas State University-San Marcos. "My presentation will help educators see the benefits and advantages of a laboratory information system in their student laboratory."
Defining the Signature Pedagogy of Clinical Laboratory Science Education: The Professional Practice Experience Beverly Barham, PhD, MT(ASCP), Illinois State University, Normal (top); Lori A. Woeste, EdD, MT(ASCP), Illinois State University, Normal (bottom). Dr. Barham: "This session is a beginning look at the professional practice experience as the signature teaching experience for the CLS professional. Professional practice is truly 'that which makes us unique' and is also what will pave the way for future professionals."
Copyright Issues Gary J. Sertich, PhD, JD, University of Texas Health Science Center at San Antonio. "Copyright law balances the interests of copyright owners with the interests of the general public by providing incentives to the authors to create works and increase knowledge, yet also provide for public access to and use of these works. Now, with the rapid rise of the Internet, not more than a few days pass until another article appears in the newspaper, or even the Sunday comics regarding a copyright issue. The challenge that all educators face is to use others' works responsibly and teach respect for the creative endeavors we are in fact encouraging in our students. Fair use and other users' rights, when properly applied, do not undermine incentive to authors and thus further the goals of copyright."
Faculty Recruitment and Development in University-Based Programs Susan Beck, PhD, CLS(NCA), the University of North Carolina at Chapel Hill. "There is a need for CLS faculty members who can prepare new practitioners and advance the profession. This session will discuss the ways we can develop faculty members to fulfill these important roles."
The Anatomy of an Immunology Course: Has it Evolved? Brenda Bouchard, MS, University of Massachusetts. "Clinical laboratory programs face a continual struggle to add new information into their courses while still supporting the education of basic concepts. How can this be accomplished? Discussion will question whether immunology courses should transition from basic serology concepts to specific molecular diagnostic techniques. Participants will be asked to share the 'anatomy' of their institutions' immunology course offerings and how they have evolved to accommodate advances in serology."
Balancing Your Professional and Personal Life Deborah Brock, MHS, MT(ASCP)SH, Trident Technical College. "Being a clinical laboratory educator is not a 9-5 job, especially when a person first begins teaching. There is a lot of stress involved in trying to be a good spouse, parent, student and teacher all at the same time. Participants will be able to do a self evaluation to determine their stress level and how they handle the stress. We will discuss ways to keep work issues in the workplace and personal issues in the home. We will discuss how the two can sometimes be successfully merged to productively be good in both areas.
"I believe that the importance of this roundtable is to allow professionals just entering clinical lab education to voice their struggles and for experienced professionals to share insights they have learned from experience."
CLT Issues: Program Directors Mona Gleysteen, MS, CLS(NCA), Lake Area Technical Institute. "This will be a wonderful opportunity for lab educators to share and learn from each other. We will discuss challenges we have encountered, encourage and support each other, and forecast the future."
Cases in Molecular Microbiology Nancy Goodyear, PhD, CLS(NCA), University of Washington. "Molecular techniques are increasingly important in CLS, but difficult to incorporate into a very full curriculum. In addition, the interpretation of molecular identification of microorganisms has special considerations that do not apply in other molecular applications. We'll discuss paper-based case studies that can be used to illustrate the advantages and challenges of molecular identification in microbiology."
What's Hot/What's Not in Teaching Immunohematology Michelle S. Kanuth, PhD, CLS(NCA), University of Texas Medical Branch. "The roundtable will be a discussion of newer techniques in the field that may be added to the curriculum, what is no longer being included on the certification examinations and may need to be de-emphasized, and what basic materials still need to be included in the curriculum because they are the basis for all of the technology."
What's Hot/What's Not in Teaching Chemistry Pam Keiffer, MS, CLS(NCA), Rapid City Regional Hospital. "Laboratory testing is consistently changingfor the better. We do fewer laboratory tests to aid in faster and more specific diagnoses for consumers. This session will reveal new guidelines and testing associated with the more common endocrine dysfunctions (especially thyroid), cardiac risk and hyperglycemia."
How Can We Teach TB, When We Don't Test for TB? Sandra Latshaw, MA, SM(ASCP), University of Nebraska Medical Center. "This session will examine alternate, innovative ways to teach required entry level skills when hands-on teaching techniques are not possible. We will discuss the usefulness of simulations, videos, learning objects, case studies and other learning activities that may substitute for performing lab procedures. This subject is of current importance as a growing number of clinical laboratories are sending tests to reference laboratories in an effort to remain cost-effective. Even though the title of the session focuses on tuberculosis, the approaches that will be discussed can be applied to teaching other skills."
What's Hot/What's Not in Teaching Hematology Louann Lawrence, DrPH, CLS(NCA), Louisiana State University Health Sciences Center. Participants will discuss new "hot topics" that should be included in hematology courses. Other topics that have been deleted in recent years will also be noted.
Issues for Hospital-Based CLS/MT Programs Ellen M. Libby, MS, CLS(NCA), EMMC School of Medical Technology. "This roundtable is directed toward those faculty/program directors who work in hospital based CLS/MT programs. There can be unique issues that face this type of program, since it is not based in an academic institution. This roundtable will discuss the challenges of working within today's fragmented healthcare setting where clinical labs, hospitals and pathology services can comprise three different corporations.
"Other issues covered that may or may not be unique to hospital-based programs are: maintaining faculty appointment standards, motivating faculty to use the newest education technology, and expanding clinical slots as the demand for our graduates increases."
Improving Student Comprehension and Communication Cynthia Martine, MEd, (MT)ASCP, University of Texas Medical Branch. "One of the ongoing issues that I have observed over the years is the reticence of some students to ask questions or to become comfortable with asking questions in class or on a one-to-one basis of their faculty. The importance of this roundtable is that it's offered for faculty interested in addressing student issues of communication."
What's Hot/What's Not in Teaching Microbiology Mary Beth Miele, PhD, CLS(NCA), Penn State Milton S. Hershey Medical Center. "The practice of clinical microbiology continues to change to provide rapid identification and susceptibility testing of infectious agents. As educators, it is difficult to keep up with these changes. It is hoped that the roundtable format will allow exchange of ideas and sharing of microbiology-related teaching resources."
Creating a Universal University for CLS Sonja Nehr-Kanet, MS, CLS(NCA), Idaho State University. "I believe that we could enhance and standardize the education for clinical laboratory professionals by better utilizing the educational technology now available. I envision harnessing the expertise from numerous clinical educators and bringing together a series of courses/topics that could serve as a foundation for clinical laboratory education programs in hospitals, colleges, universities; and as continuing education for working lab professionals. There are certainly many obstacles (administrative and financial) that need to be overcome. I wish to explore the possibilities with my colleagues."
I'm Retired, Now What? Anne T. Rodgers, PhD, MT(ASCP), Retired Professor of Medical Technology. "We have all heard of the 'graying of our profession,' and many clinical laboratory scientists will be retiring in the next few years. In the discussion, I hope participants can come to some conclusions on how we can continue to use the 'brainpower' of these retirees so that their wisdom and experience will not be wasted."
Incorporating Clinical Research into the Clinical Laboratory Educational ProgramWill It Become Essential to the Survival of our Profession? Kristy Shanahan, MS, CLS(NCA), Oakton Community College. "Come and learn why affording our students and professionals opportunities to engage in hands-on research could be key to the survival of the university/college-based CLS program and possibly even to the survival of our profession. We need to be aware of our true situation in today's and tomorrow's world to survive and thrive."
Making Management Relevant E. Camellia St. John, MEd, MT(ASCP)SBB, University of Texas Medical Branch. "This session shares practical ideas for students to become involved in real-time managerial projects. These projects are designed to give students a concrete, rather than abstract, view of management activities in the clinical laboratory."
Prospective Students' Preparation for a CLS Program Leonce Thierry, Jr., MS, MT(ASCP), University of Texas Medical Branch. "This roundtable will discuss the results of a 2-year (2004-2005) program that evaluated prospective students' preparation for a CLS program. The study reveals trends in why students will seek to apply for admission to a CLS program as well as explore reasons for their interest."
Strategies to Discourage Academic Dishonesty Sandra Tijerina, MS, MT(ASCP), University of Texas-Pan American. "A growing issue in higher education and CLS is academic dishonesty. Participants will share their experiences with academic dishonesty and how they have addressed those issues. Innovative strategies to discourage cheating will be presented."
Issues for Hospital-Based CLS/MT Programs Beth Warning, MS, CLS(NCA), St. Elizabeth. "I think it is important for all educators to hear what it is like at the clinical end from a clinical person. There are issues and attitudes that students are exposed to in the hospital setting that are unlike those experienced in the classroom or student lab. The overall morale in the hospital may be poor due to low staffing, high productivity expectations, high volume or overall busyness. And those same techs may be questioning the students' choice of profession instead of being the cheerleader and congratulating the student on the chosen career. Educators may have a link with a preceptor or coordinator at the site, but what else do they need to be in touch with?"
Meet the "Wave Generation" in Distance Learning Lori A. Woeste, EdD, MT(ASCP), Illinois State University. "Transitioning from the traditional classroom to a self-paced distance learning format can be challenging for students. Original data regarding students' approach to this format change and the analogy of waves will be presented and discussed."
Student Problems Kathy Doig, PhD, CLS(NCA), Michigan State University. "Sharing of experiences and lessons learned from managing students' problems: academic and interpersonal."
State Licensure David Mello, MS, CLS(NCA), Rhode Island Hospital. It's time to legalize your practice in the clinical laboratory and become a true professional! This session is designed to explore the central issues and attributes of personnel licensure for clinical laboratory practioners. The discussion will focus on how educators can take a leadership role in state licensure activity and motivate laboratory personnel to see the light!
Helping Non-traditional Students to Succeed Karen S. Chandler, MA, CLS(NCA), University of Texas-Pan American. "Many programs have more non-traditional students. These students often face obstacles that can make it more difficult for them to succeed. This roundtable will allow participants to share ideas to help these students be successful in a professional program."
Writing Instructional Learning Objectives Nancy A. Brunzel, MS, CLS(NCA). "Instruction is successful to the degree that it accomplishes what we intend to teach. For this to occur, we must reveal and clearly communicate to learners our instructional intent. Well-written learning objectives do just that and more. They identify specific, measurable outcomes that can be tested or evaluated to determine whether instruction has been successful.
"In addition, useful learning objectives serve to reduce student anxiety because they provide a 'roadmap' for where they should be spending their time and effort in a course of study. This hands-on session is intended to reinvigorate your ability to write useful instructional objectives."
Teaching Professionalism and Leadership to Clinical Laboratory Science Students Paula Garrott, EdM, CLS(NCA), University of Illinois at Springfield (top); Lynn M. Little, PhD, CLS(NCA), University of Texas Southwestern Medical Center at Dallas (bottom). Garrott: "The practice of CLS has experienced unprecedented change as a result of technological advances, legislative and regulatory influences, and the advent of managed care. There is a growing shortage of practitioners and fewer students entering laboratory education programs.
"We desperately need to recruit individuals to our profession. Although opportunities have expanded, there appears to be an eroding sense of professional identity and pride among clinical laboratory professionals. This erosion impacts our ability to recruit and retain practitioners and to promote the profession.
"Professionalism must begin when future practitioners are students and must be reinforced in practice settings. This session will discuss professionalism and strategies that can be used to 'teach' professionalism."
Dr. Little: "Professor Garrott and I recognized that, although many CLS programs teach management skills to our students, few of us teach skills in professionalism and leadership (at least not, formally so).
"The importance of my session is to introduce leadership as a separate topic to be taught to students, so that when they enter the field as professionals and rise to management positions, they will be able to provide the leadership so necessary to the advancement of any organization."
Improving Lines of Communication Between Academic Institutions and Clinical Facilities Hassan Aziz, PhD, CLS(NCA), Armstrong Atlantic State University (top); Lisa M. Anderson, MHSA, MT(ASCP), Armstrong Atlantic State University (middle); Michelle Butina, MS, CLS(NCA), Armstrong Atlantic State University (bottom). Dr. Aziz: "It is imperative for academic institutions and clinical facilities to establish continuous and reciprocal lines of communication to ensure proper delivery of clinical instruction. My colleagues and I will introduce our way of employing new technologies to enhance how information is dispersed to clinical faculty, thus promoting clinical facility participation. This presentation will actively demonstrate the effectiveness and advantages of applying these new technologies into the pedagogy of clinical laboratory education."
Strengthening Programs With Increased Exposure and Liaisons Sheri Gon, MPH, CLS(NCA), University of Hawaii; Marguerite E. Neita, PhD, MT(ASCP), Howard University; Louise McKissick, MT(ASCP), Parkview Medical Center (pictured). McKissick: "I am so proud of what our hospital's approach has been to meet the shortage needs of healthcare professionals in our area. The School to Employment Program (STEP), in partnership with a local school district, has provided high school seniors an opportunity to explore healthcare careers by bringing the students into the hospital setting for a full semester to earn 0.5 credit hour. By tracking the STEP students for the past 4 years, we have identified students who have been admitted and/or near completion of the following healthcare careers: nursing, laboratory, radiology, rehabilitation and respiratory. I am excited to share the STEP success!"
Writing Test Questions Like the Pros Kathy Doig, PhD, CLS(NCA), Michigan State University. "Teachers make decisions about students and their academic progress toward graduation based on examination results. It is analogous to care providers making decisions about patients based on laboratory test results. To make the best decisions, we need the best examinations and tests. High-quality tests are less frustrating for students as they take them, allowing them to better demonstrate what they know. High quality tests provide better feedback to students about their performance and to us about our teaching. Writing test questions well is an important skill for all educators."
Applications of Molecular Biology to Clinical Medicine Jack G. Chirikjian, PhD, Edvotek, Inc., Georgetown University Medical Center; Vasna Nontanovan, MS, MLT(ASCP), Georgetown University School of Medicine. Dr. Chirikjian: "The workshop will introduce core technologies and concepts in the area of biochemistry and molecular biology as it relates to diagnostic tests. The session is designed for educators who wish to integrate various experiments based on PCR, ELISA and Western blot analysis in core and laboratory courses."
Tactics for Preventing Program Closures Donna J. Spannaus-Martin, PhD, CLS(NCA), University of Minnesota. "In the span of a few years, the University of Minnesota's MT/CLS program has gone from threatened closure of the program to becoming one of the top priorities of the University and the State of Minnesota. This session will show what can be accomplished when educators, laboratorians, pathologists and hospital administrators all work together."
Enhancing the Role of the Clinical Laboratory Scientist in Providing Patient Safety Diana Mass, MA, CLS(NCA), Arizona State University School of Life Sciences. "Patient safety has become the new watchword in healthcare and the clinical laboratory has a major part in this process. Many clinical laboratory scientists have not been given the opportunity to use their capabilities to the fullest. The clinical laboratory scientist must increasingly interact and collaborate with physicians and other healthcare providers to enhance medical efficiency and cost-effectiveness of patient care with respect to the use of the laboratory."
Continental Breakfast with Legislative/CCCLW Updates Elissa Passiment, EdM, CLS(NCA), ASCLS (top); Paula Garrott, EdM, CLS(NCA), University of Illinois at Springfield (bottom). Passiment: "This session contains information about federal regulations and policy that will impact how laboratorians practice, and how we teach students entering the profession."
Engaging Students to Improve Critical Thinking Karen S. Chandler, MA, CLS(NCA), University of Texas-Pan American. "Learning is not a spectator sport! Students must be actively involved in the learning process. Unfortunately, many students suffer from 'death by PowerPoint.' Participants who attend my session will learn some easy strategies to actively engage students and help improve critical thinking skills. Let's wake up our students!"
Trident Learning Evaluation Method Farough Nazari, PhD, Dade Behring, Inc. "In today's fast-paced society where educators are asked to do more with less constantly, it is easy to solely rely on simple test scores to evaluate students' performance. Use of Trident evaluation method along with technology offers an alternative educators can use to correctly understand where and possibly why students may need further help in a given course."
Clinical Laboratory Science Graduate Program on a Shoestring Kathleen Spiegel, PhD, MT(ASCP), Idaho State University (top); Sonja Nehr-Kanet, MS, CLS(NCA), Idaho State University (bottom). "The profession itself is at a crossroads in terms of making sure we have educational professionals in master's and doctoral programs. This session is primarily devoted to how universities with limited resources can foster and promote grad programs that emphasize the science."
Sabbaticals for CLS/CLT Faculty Lynne Williams, PhD, CLS(NCA), Oakland University; John Landis, retired, Ferris State University; Mary Beth Miele, PhD, CLS(NCA), Penn State Milton S. Hershey Medical Center (top); Libby Spence, PhD, CLS(NCA), SHRP, University of Mississippi Medical Center (bottom). Dr. Miele: "It's important that everyone realizes the value of taking a break from teaching and taking on the role of student to pursue areas of professional development and scholarly interests to help meet goals that will enrich careers."
Dr. Spence: "The importance of this is to encourage and support other faculty interested in going on sabbatical, as I have, as a means of professional renewal."
Building an Effective Database for Learning Object Dissemination and Evaluation Vicki Freeman, PhD, CLS(NCA), University of Texas Medical Branch (top); Carol Larson, MSEd, UNMC Clinical Laboratory Science Program (bottom). Dr. Freeman: "Because of pressures both in the educational setting and in the clinical enterprise, CLS faculty need to find ways to teach more efficiently while still being effective. Additionally, as automation becomes more complex, it is important that students understand basic principles behind the instruments that they use when performing laboratory testing. Learning objects are a resource that can save faculty time and increase student learning."
Larson: "CLS instructors do not have the time in today's work environment to develop valuable instructional materials in the manner that they desire. Many instructors are turning to online repositories (databases) that contain digital learning objects (small 'chunks' of instruction) that can be downloaded and incorporated into their lessons/courses.
"The development of a database that is able to collect data about the use of these learning objects and serve as the searchable access point for these learning objects will be discussed in this presentation. Examples of learning objects, how to use them, and the preliminary data that has been collected on how CLS faculty have already put these learning objects to use will be provided."
Integrating Molecular Diagnostics Into the Clinical Laboratory Science Curriculum Lynda Britton, PhD, CLS(NCA), LSU Health Sciences Center (pictured); David J. Mello, MS, CLS(NCA), Rhode Island Hospital. Dr. Britton: "My session, given in conjunction with David Mello, will help CLS educators set up a molecular diagnostics rotation in a hospital-based and university-based program. In addition, lecture topics and educational resources will be shared."
Closing the Loop: Managing Change Karen McClure, PhD, CLS(NCA), University of Texas M.D. Anderson Cancer Center. "Today, a wide variety of tools are available to the educator to evaluate the performance of their program. Data is collected from students, employers, alumni and faculty to gauge how well the program is accomplishing its goals. But what happens when the data indicate a need for change? The process of identifying needed change; implementation and outcomes review are the cornerstone of successful change and growth. This program will identify the use of these elements and the role of the advisory committee in helping to implement and evaluate the effectiveness of change."
Creating a Culture of Consumer Advocacy for Our Students Mary Ann McLane, PhD, CLS(NCA), University of Delaware. "My session deals with how our students (and their faculty, too!) must move from an attitude of 'we cannot diagnose' to 'let me explain that lab test result for you.' Consumer advocacy revolves around seeing 1) the patient as a partner in the healthcare process and 2) ourselves as independent professionals qualified to interpret lab test results. We must become recognized as the information experts in this regard rather than nurses, pharmacists, or anyone else ... and do that from day 1 of our training!"
Closing Session: Look What We Did! Linda F. Comeaux, CLS(NCA), Arapahoe Community College (top); Shirlyn McKenzie, PhD, CLS(NCA), University of Texas Health Science Center at San Antonio (bottom). Comeaux: "The importance of our session is it will be completely interactive. During CLEC, prior to the closing session, attendees will be given the opportunity to submit questions they want addressed by the whole group. Our session will facilitate obtaining the answers to some of these pertinent questions and give the attendees one last chance to take home creative and innovative ideas for the real or virtual classroom."
Dr. McKenzie: "The closing session will be a chance for participants to share concerns, problems, solutions to problems, ideas and experiences with their colleagues. Participants will have until Friday evening to submit in writing areas of concern, problems encountered or questions concerning education of laboratory students. A small group will select a number of these areas to present to the entire group of participants in the closing session. A floor microphone will be used to allow participants to provide immediate feedback in the form of solutions and ideas that worked for them. This will be a chance for participants to take home ideas that can be implemented immediately."
At presstime, Joan Polancic, MSEd, CLS(NCA), ASCLS Director of Education and Project Planning, announced that due to a record number of attendees at this year's CLEC meeting, the following eight sessions were added:
What's Hot/What's Not in Teaching Immunohematology
What's Hot/What's Not in Teaching Chemistry
What's Hot/What's Not in Teaching Hematology
Issues for Hospital-based CLS/MT Programs
Improving Student Comprehension and Communication
What's Hot/What's Not in Teaching Microbiology
Making Management Relevant
Strategies to Discourage Academic Dishonesty n
Compiled by Matthew T. Patton. ADVANCE thanks ASCLS for assistance with compiling this information.
Photos courtesy of the San Antonio Convention & Visitors Bureau/Robert W. Bone and Al Rendon.
Association of Public Health Laboratories
Dade Behring, Inc.
Edvotek, Inc.: The Biotechnology Education Company
F.A. Davis Company Publishers
Lippincott, Williams & Wilkins
National Credentialing Agency for Laboratory Personnel
Nikon Instruments, Inc.
Pointe Scientific, Inc.
Houston Community College
Pointe Scientific, Inc.
Tarleton State University Department of Clinical Laboratory Sciences
Texas Tech University Health Science Center
University of Texas Health Science Center at San Antonio