CLSI President Dr. James Nichols on the Importance of Preparing Students for Laboratory Medicine Careers

We are excited to celebrate CLSI Board President Dr. James Nichols, who has been awarded the 2024 Association for Diagnostics & Laboratory Medicine Award “Outstanding Contributions to Education in Clinical Chemistry.” This award is bestowed upon an individual who has dedicated a significant portion of their professional career to advancing the practice and profession of clinical chemistry through education. Dr. Nichols has been selected for this award in recognition of his remarkable and innovative contributions to education in clinical laboratory science as a faculty member and an active community leader on boards, committees, and councils over 30 years.

Dr. Nichols is a Professor of Pathology, Microbiology, and Immunology and Medical Director of Clinical Chemistry and Point-of-Care Testing at the Vanderbilt University School of Medicine in Nashville, Tennessee. He has held many key positions with CLSI, including serving on the Subcommittee on Point-of-Care Testing, as well as Consensus Council, numerous document development committees, and 10 years on CLSI’s Board of Directors. Dr. Nichols has demonstrated exemplary leadership as both vice-chairholder and chairholder of the Consensus Committee on Point-of-Care Testing. He has also served on the Chairholders Council, Consensus Committee on Evaluation Protocols and as Chairholder for the Evaluation Protocols Expert Panel.

CLSI extends our heartfelt congratulations to Dr. Nichols for this well-deserved recognition of his outstanding contributions to education in clinical chemistry. His dedication and expertise continue to shape and elevate the field, making a lasting impact on the practice of clinical laboratory science.
We spoke with Dr. Nichols about the importance of preparing students for their future careers.

• Question: What is the role of education in preparing students for a career in the laboratory?
  Dr. Nichols: Students training in clinical laboratory science, pathology residency, and postdoctoral fellowship programs for laboratory science need to learn laboratory medicine theory, and also acquire the basic skills that will allow them to think independently, write and speak effectively, and understand the federal laws and requirements of good laboratory practice. Jobs in the laboratory are not just in hospitals; there are opportunities in public health, government, veterinary medicine, as well as diagnostic manufacturing. With the development of small, more portable testing devices, point-of-care testing is moving laboratory testing out of the hospital and into the community, closer to the patient at clinics, schools, sporting events, health fairs and other care settings. Our new class of laboratory science students need to be prepared for employment in traditional hospital laboratories and also to interact with and manage the quality of testing conducted by a variety of clinical staff at various education levels that may not have laboratory experience.
• Question: What do you see as some of the most pressing educational and continuing education needs for those in the field of laboratory medicine?
  Dr. Nichols: I like a quote from Albert Einstein, “Learn from yesterday, live for today, and hope for tomorrow. The important thing is not to stop questioning.” As clinical and medical professionals, our education doesn’t stop at graduation. We are embarking on life-long learning, not just professional CME, but also learning through interactions with our mentors and colleagues. The clinical laboratory field is rapidly changing and to stay abreast of these innovations, we should maintain ongoing, life-long, continuing education.
• Question: What would you say are the most important benefits of participating in CLSI committees and standards development for students or recent graduates?
  Dr. Nichols: CLSI provides the opportunity for professional interactions. Participating on document development committees introduces new graduates to the leaders in their specialty. These contacts will be invaluable in the future. As challenges arise in the laboratory, these contacts can be called upon for professional opinions and suggestions. Committee participation also provides a path to leadership development and for gaining experience in team management.
• Question: How would you address the concerns of students or recent graduates who feel they lack the experience to participate on a CLSI committee?
  Dr. Nichols: Students don’t need to be experts in all aspects of laboratory medicine at graduation, but they should have the foundational skills to succeed in whatever career path they choose. Expertise comes with experience. As students work, they will learn the necessary management aspects to succeed in their chosen laboratory medicine career. Students with even basic experience can contribute by commenting on draft CLSI documents during voting stages to ensure the document guidance will apply to their laboratory workflows and operations.
• Question: How can CLSI better help recent graduates assimilate into their new careers?
  Dr. Nichols: CLSI documents provide “best practice” guidance for managing high quality laboratory operations in a cost-effective and clinically impactful manner. The CLSI documents balance professional, industry, and government viewpoints from experts across the globe. Introducing students to the CLSI document library early in their training will provide familiarity with the resources that can help them succeed in their new jobs and throughout their lifetime in laboratory medicine.
• Question: Can you share a training-related story about your own experience as a mentor, or a meaningful continual learning moment you experienced?
  Dr. Nichols: A few years ago, I was responsible for teaching a medical student rotation in clinical toxicology. We used a case-based approach to assist students in learning the material and encouraged them to follow up anytime with questions that arose during their training. A few months after the rotation, our clinical chemistry fellow received a message from one of the students, Didi, regarding a suspected ingestion of isopropanol – a toxic alcohol. The patient’s creatinine was increasing over the first day or two in the hospital, and the clinical team wasn’t sure if the patient was going into renal failure or if the team would have to dialyze the patient to assist with alcohol clearance. Didi remembered that isopropanol is metabolized to acetone. She did some research on creatinine assay interferences, and while isopropanol does not interfere, some methods, including the Jaffe reaction that we used, could show interference with acetone. We pulled the patient’s samples and had them analyzed by a different test methodology, and in addition prepared a set of samples spiked with acetone. Sure enough, acetone was interfering with our assay. This was an unknown interference to the manufacturer of the test, and Didi published a peer-reviewed case report in JALM, November 2019 on this interference. So, paying attention in class pays off, as the knowledge gained may become important to problem-solving in the future.

The Association for Diagnostics & Laboratory Medicine (formerly AACC) recognizes exceptional achievements in the field of medicine through its prestigious annual awards program. The formal acknowledgment of recipients will take place at the Association for Diagnostics & Laboratory Medicine (ADLM) Annual Scientific Meeting, scheduled to take place this year from 28 July through 1 August.

Are you attending the ADLM Annual Meeting? Please come by to congratulate Dr. Nichols in person at the CLSI booth (#3468), where he will be participating in a meet and greet. On July 31 from 7-8:30, Dr. Nichols will also be presenting with CLSI Board member, Dr. Lorin Bachmann, and CLSI subject matter expert, John Yundt-Pacheco, MSCS, at a workshop entitled “Embracing New Quality Specifications: Adjusting Lab Practices - CLIA 2024 and Beyond.” The workshop will cover the implications of changing quality specifications using the new CLIA 2024 Proficiency Testing (PT) limits as an example.

For a list of all CLSI subject matter experts who will be presenting at ADLM, please click here.