Ординатура / Хирургия / Библиотека им академика М.И. Перельмана / Книга_2617_Библиотеки_им_академика_М_И_Перельмана

The second reason is that this textbook fully recognizes the development of laboratory medi­cine and its evolution over the past decades. Today, laboratory medicine is a highly complex set of medical subdisciplines that span the breadth of diagnostic testing needed to support all health care. It includes clinical biochemistry, hematology and hemopathology, coagulation, medical microbiology and virology, molecular pathology and genetics, and transfusion medicine. More recently, the integration between pathology and laboratory medicine, known by the acronym “PALM”, has been proposed to ensure a holistic approach to diagnostic testing. PALM services, infact, are cross-cutting, intersectoral, and provide the foundation for safe, effective, and equi­table healthcare delivery, population health, and global health security. Until a few years ago, medical education on laboratory testing was found to be inadequate in Italy, as well as in many other countries including the United States. Despite the integral role of laboratory testing in the practice of medicine, formal teaching of laboratory medicine was a relatively neglected compo­nent of the medical school curriculum, and for many years, successive editions of traditional textbooks did not reect the changing paradigm of the discipline. Most textbooks, infact, focused on only the methodological aspects of laboratory tests, omitting fundamental require­ments of the extra-analytical phases. In particular, medical students should be trained to appro­priately request laboratory tests, as well as to correctly interpret and use laboratory information. Infact, physicians, who use clinical laboratory services, need to be familiar with their role in ensuring quality test results through appropriate test selection, interpretation, and clinical action. This should be recognized as a fundamental issue in teaching laboratory medicine in medical schools and this textbook fully recognizes this strategic aspect of medical education in labora­tory medicine. By selecting the appropriate tests and interpreting the results correctly, medical students and physicians using this book should be able to optimize patient outcomes and reduce the cost of achieving a diagnosis. Most chapters begin with a brief description of the disorder/ medical condition followed by a discussion that includes sentences, tables, and gures detailing the laboratory evaluation of specic disorders, and coverage of diagnosis and baseline tests to

The third reason which highlights the value of the textbook is the faculty, as the chapters have been prepared and written by true experts, thus allowing an effective “evidence-based” approach which, in turn, assures an updated, reliable, and accurate handling of the matter. In an interconnected and integrated medicine, laboratory information plays an increasingly dominant role, but medical student knowledge should be improved to allow future physi­cians to manage the high complexity of the current test menu, to more appropriately require laboratory tests, to interpret better and use laboratory information, and to integrate it into the right clinical context. An in-depth knowledge of laboratory medicine principles is vital to all practicing physicians. Great variation exists in the ways that medical students learn the prin­ciples of laboratory medicine: to ensure that important principles are addressed, medical schools should establish goals and objectives specically related to laboratory medicine and experiment with optimal teaching and assessment methods. Medical students should under­stand the differences in interpretation that different settings require and that laboratory tests must be interpreted in conjunction with the entire clinical presentation. They should be able to order not only all of the tests necessary in a particular clinical setting but also only the tests that are medically useful for their patients. They should know their limitations of knowledge in this area and how to seek appropriate consultation from clinical pathologists, clinical scientists, midlevel provider laboratory personnel, and other subspecialists to maxi­mize appropriate patient care. They should understand the scientic underpinnings of labo­ratory medicine, for the purpose of proper use of current testing and also to be able to assess future modalities wisely. They should also understand the therapeutic modalities available from the clinical laboratory, such as the appropriate use of blood products, cell therapy, and other individualized patient treatments, and understand the cost-effective, evidence-based use of the treatments. Structured classroom teaching, even in an era of novel methodologies, still represents an effective approach to transfering knowledge to medical students through the guidance of a mentor who must be an expert, highly skilled in laboratory medicine. However, even the best mentor cannot provide a series of lessons comprehensive of the increasingly complex and huge number of laboratory tests. Medical students, however, should be allowed to know and understand the complexity of current laboratory testing: they need to look up a textbook!