MLT - Ii

VOCATIONAL HIGHER SECONDARY
TEACHER’S SOURCEBOOK
MEDICAL LABORATORY TECHNICIAN COURSE
Second Year
GOVERNMENT OF KERALA
GENERAL EDCUATION DEPARTMENT
STATE COUNCIL OF EDUCATIONAL RESEARCH AND TRAINING (SCERT)

Poojappura, Thiruvananthapuram
TEACHER’S SOURCEBOOK
VHSE - Medical Laboratary Technician (MLT)
Course Second Year
Prepared by:
State Council of Educational Research &
Training (SCERT), Vidhyabhavan
Poojappura, Thiruvananthapuram -12
Kerala
E-mail: scertkerala@asianetindia.com
Type setting by:
SCERT Computer Lab.
Printed at:
©
Government of Kerala
Department of Education
SCERT - 2006
Foreword
Dear Teachers,
This Teacher’s Sourcebook on Medical Laboratary Technician course

is introduces the teacher to the main principles and practices of the
revised pedagogy which is activity-based, process-oriented and
learner-centred.
The realisation that learning is not mere storing information in memory

and that real learning is construction of knowledge through
observation, comparison, classification and analysis has led us to give
a new thrust to the teaching-learning process at Vocational Higher
Secondary level to make it more meaningful and learner-friendly.
This sourcebook has been developed primarily for the benefit of teachers
who teach Medical Laboratary Technician course at Vocational Higher
Secondary level. The subject matter has been dealt with utmost care,
in tune with the revised curriculum and pedagogic principles. It is
hoped that this book will enable the teacher to provide suitable learning
activities for effective learning.
The success of the approach depends upon the vision and commitment
of the teacher. They are expected to make use of this sourcebook at all
stages of their teaching process. It is also expected that the teacher
would seek help and guidance from other sources like libraries and
websites.
Hope that this sourcebook will help the teacher to develop the skills
and experience required for effective classroom transaction.
Creative criticism and suggestions for improvement are most welcome.
With regards,
Thiruvananthapuram Dr E. Valsala Kumar

July, 2006 Director
SCERT, Kerala
CONTENTS
Part I
I General Approach ....................................................................... 06
II Learning strategies ....................................................................... 26
III Curriculum objectives .................................................................. 36
IV Syllabus ......................................................................................... 41
V Planning ........................................................................................ 55
VI Evaluation .................................................................................... 60
Part II Unit Wise Analysis

Unit - 1 - Laboratory Ethics and Management
Laboratory Ethics and Management ............................................. 73
Unit - 2 - Haematology
1. Introduction to haematology......................................................... 84
2. Total cell counts ............................................................................ 90
3. Examination of blood smear......................................................... 97
4. Haemoglobin estimation ............................................................. 103
5. Packed cell volume ..................................................................... 107
6. Red cell indices ........................................................................... 111
7. Erythrocyte sedimentation rate ................................................... 114
8. Coagulation studies ..................................................................... 119
9. Special investigations .................................................................. 123
Unit - 3 - Clinical Pathology

1. Introduction to clinical pathology ............................................... 128
2. Urine analysis .............................................................................. 132
3. Stool examination ....................................................................... 138
4. Sputum examination ................................................................... 141
5. Semen analysis ............................................................................ 144
6. CSF examination ......................................................................... 148
Unit - 4 - Immuno Haematology and Blood Banking

1. Introduction to immuno haematology and blood banking .......... 153
2. Blood group systems ................................................................... 155
3. Blood grouping ............................................................................160
4. Coomb’s test ................................................................................166
5. Cross matching ............................................................................169
6. Blood transfusion .........................................................................172
Unit - 5 - Biochemistry
1. Introduction to biochemistry .......................................................177

2. Instruments used in biochemistry ................................................182
3. Estimation of blood glucose ........................................................188
4. Estimation of protein ..................................................................193
5. Estimation of NPN substances ...................................................196
6. Estimation of lipids .....................................................................199
7. Liver function tests ......................................................................203
8. Renal function tests .....................................................................206
9. Automation and quality control ...................................................209
Unit - 6 - Histotechnology and Cytology
1. Introduction to histotechnology ..................................................214

2. Introduction to cytology ..............................................................219
Part III Practical Evaluation ..........................................................................222
Part IV Appendix .............................................................................................223

GENERAL APPROACH
Significance of vocational education

The ultimate aim of education is human refinement. Education should enable the learner
to formulate a positive outlook towards life and to accept a stand which suits the well
being of the society and the individual as well.
The attitude and potential to work has determined the destiny, progress and cultural
development of the human race. As we all are aware, the objective of education is to
form a society and individuals having a positive work culture. The educational process
expected in and outside our formal schools should concentrate upon inculcating concepts,
abilities, attitudes and values in tune with these work culture. Hence vocationalised
education cannot be isolated from the main stream of education. In another sense, every
educational process should be vocationalised. However due to our inability to utilize the
resources wisely, scarcity of job opportunities is a severe issue of the present society. For
overcoming this deep crisis, emergent techniques have to be sorted out and appropriate
researches have to be seriously carried out. It is in this sense that the content and
methodology of Vocational Higher Secondary Education have to be approached. The
need for meaningful linkages between the world of work and world of education is well
recognized. The essence of the recommendations made by various commissions and
committees is that the vocationalisation should be the main feature of the future system
of education at the higher secondary stage, it can be extended to school level also.
Vocational Education is the system of education which intends to prepare students for
identified occupations , opening several areas of activities.
The Vocational Higher Secondary course envisaged as a part of the National Policy on
Education with the noble idea of securing a job along with education. The relevance of
vocational education is very great in this age of unemployment. This education system,
which ensures a job along with higher education stands aloof from other systems of
education.
This education imparts the life skills required by the youth to enter the world of work
and assuming the responsibilities of adulthood. As per the expert meeting report (2001)
of UNESCO, the life skills are grouped under 4 categories. They are
1. skills for personal fulfilment
2. skills for living in society
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3. skills for dealing with changing economies
4. skills for dealing with changing work patterns.
Vocational Education ensures fulfillment of manpower requirement for national
development and for social security for the citizens through self-employment. It also
helps to reduce the migration of rural youth to urban areas and thus helps in rural
development.
The learners of Vocational Education get an opportunity to avail one year apprenticeship
training in industries to improve their practical skill. During the course of study, on the
job training (OJT) for 10 days in a year is arranged to improve the skill and efficiency of
the learner. This education system motivates the attitude towards self –employment
through Production/ Service cum Training Centres. (PTC)
Objectives of vocational education
The National policy on education has accorded very high priority to the program of
vocationalisation of education, considering the following objectives.
1. To fulfill national goals of development and the removal of unemployment and
poverty.
2. To impart education relevant to increased production and productivity, economic
development and individual prosperity.
3. To make available skilled work force at all levels to alleviate the rural unemployment
and for the development of nation.
4. To develop environmental awareness to ensure sustainable development.
5. To develop vocational aptitude, work culture, values and attitudes of the learners
so as to enrich the productivity of the nation.
6. To develop entrepreneurial competencies and skills of learners for self reliance
and to undertake gainful self employment.
7. To facilitate the expansion of higher education and explore future opportunities
through innovative guidance and programmes.
8. To develop vocational competencies, creative thinking in the related areas and
facilitate training.
9. To create awareness on mental, physical and social health.
10. To acquire awareness about different job areas and to provide background for
acquiring higher level training in subjects concerned.
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LEARNING
Learning is construction of knowledge through a continuous mental process. It is an
advancement through adding and correcting in the light of comparing the new issue with
the previously learned concepts. It is an intellectual process rather than the mere
memorization of facts. Learning is a conglomeration of a variety of activities like problem
solving, finding out co-rrelations, prediction, arriving at conclusions, rational as well as
critical thinking, finding applications, grouping for other possibilities and extracting the
crux when opportunities are provided for intellectual processes learning will become
effective and intellectual ability will get strengthened.
Theoretical foundations of learning
Education is the best device that can be adopted for creation of a new society. It should
be democratic in content and process and should acknowledge the rights of the learner.
It should also provide opportunity for better citizenship training. The concept of equality
at all areas should get recognition in theory and practice. There should be conscious
programme of action to develop nationality, humanness and love against the
encroachment of sectarianism of caste and religion. The learner should become cognisant
of the implications of privatisation, liberalisation, globalisation etc.
They should develop a discrimination to use the acquired learning as a liberative weapon.
They should be able to view education and life with the perspective of social well being.
A basic awareness of all the subjects needed for life is essential for all students.
The remnants of perspectives formed in us during the colonial period still influence our
educational philosophy. The solution to the present day perplexities of the society which
approaches education on the basis of competitions and marketisation is only a
comprehensive view of life.
It is high time that education was recognized on the basis of the philosophy of human
education. The human approach to education has to reflect in its content, learning process
and outlook. The perspective of ‘learning to be’ and ‘learning to live’ together as expressed
by the UNESCO and the concepts of existential, intrapersonal and interpersonal
intelligence.
The basis of new approaches on curriculum and teaching- learning process are derived
from the developments tookplace in the east and west of the world.
When we begin to see the learner at the centre of the learning process, the teaching process
has to be changed timely. It is the result of the rapid growth and development of Science
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and Technology and Pedagogy. If we want to undergo the changing process, we have to
imbibe the modern hypothesis regarding learner that they have
1 Great curiosity
2 Good imagination
3 Numerous other qualities and interests
4 Independent individuality
5 Interest in free thinking and working In a fearless atmosphere.
6 Interest in enquiring and questioning.
7 Ability to reach conclusions after logical thinking.
8 Ability for manifest arid establish freely the conclusions arrived at.
9 Interest for recognition in the society.
10 Determination to face the interference of society and make components which
is a part of social life.
When we consider the learning system, the domains to be stressed in education according
to the modern development becomes relevant.
The knowledge domain consists of
1 Facts
2 Ideas
2 Laws
3 The temporary conclusions and principles used presently by scientists.
The learning is a process. The continuous procedures we undergo to reach a particular
goal is process. The skills which are parts of the process to analyze the collected ideas
and proofs and come to a conclusion is called process skills. Some important process
skills are, the skills;
1 To observe
2 To collect data and record
3 To classify
4 To measure and prepare charts
5 To experiment
6 To predict
7 To recognize and control the variables
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8 To raise questions
9 To generalize
10 To form a hypothesis and check.
11 To conclude
12 To communicate
13 To predict and infer
14 To use tools.
In addition to this, consider the skills related to creative domain also, they are skills:
1 To visualize
2 To connect facts and ideas in new ways.
3 To find out new and uncommon uses of objects
4 To fantasize
5 To dream
6 To develop creative isolated thoughts
Again, the following factors consisting in the Attitudinal domain are also important as;
1 Self confidence
2 Love for scientific knowledge
3 Attitude to know and value history
4 Respect human emotions
5 Decide with reasonable present problems
6 Take logical decisions regarding personal values
As regards the application domain the important factors are the ability to:
1 observe in daily life examples of ideas acquired.
2 take the help of scientific process to solve the problems of daily life.
3 choose a scientific life style
4 connect the ideas acquired with other subjects.
5 integrate the subjects with other subjects.
Some basic stands have to be taken on the new scientific knowledge about intelligence
learning and teaching. When such basic concepts are accepted changes are required in the
following factors.
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1 The vision, approach, structure and content of the curriculum.
2 The vision, approach, structure and content of the textbooks.
3 Role of the teacher and the learner.
4 Learner atmosphere, learning materials and learning techniques.
Some scientific perspectives accepted by modem world in Educational Psychology are
given below.
Constructivism
This approach puts forward the concept that the learner constructs knowledge. New
knowledge is constructed when ideas are examined and practiced in new situations relating
them with the previously acquired knowledge and experience. That is assimilated into the
cognitive structure of one’s knowledge. This method which gives priority to critical
thinking and problem solving provides opportunity for self motivated learning.
Social Constructivism
Social constructivism is a branch of constructivism. Knowledge is formed, spread and
imbibed and it becomes relevant in a social environment. Interactive learning, group
learning, co-operative participatory learning, all these are concepts put forward by social
constructivism.
The main propounders of constructivism are Piaget, Vygotsky and Bruner.
Discovery learning and interactive learning have prime importance. Learning takes place
as a part of the attempt for problem solving. The activities of a learner who confronts
cognitive disequilibrium in a learning situation when he tries to overcome it leads to the
renewal of cognitive structure. It is through this process construction of new knowledge,
the assimilation of them takes place. Observation and enquiry are unavoidable factors.
The learner advances towards new areas of acquisition of knowledge where he tries to
compare his new findings with the existing concepts.
Learning is a live mental process. Rather than the ability for memorization of facts cognitive
process has to be given emphasis. The process of problem analysis, elucidation, critical
thinking, rational thinking, finding out correlation, prediction, hypothesis formation,
application, probing for other possibilities, extracting the crux and other processes are
of critical importance in learning.
Constructivism gives greater predominance to co-operative learning. Social and cultural
factors influence learning. Sharing of knowledge and experience among learners, collective
enquiry, assessment and improvement, group activity and collaborative learning by sharing
responsibilities with the objective of public activity, provide opportunity for effective
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learning.
In learning internal motivation is more important than external motivation. The learner
should have interest and initiative in learning. Learning situation should be capable of
forming a sense of ownership in the learner regarding the learning process.
Learning is not a linear process. It progresses in a spiralled way advancing deeper and
wider.
NEW CONCEPTS OF LEARNING
1. Discovery Learning
The teacher has to create a motivating atmosphere for the learner to discover concepts
and facts, instead of listening always. Creating occasion to progress towards discovery is
preferred. Instead of telling everything before and compelling to initiate the models,
situations are to be created to help the children act models as themselves.
2. Learning by discussion
Discussion leads to learning is Burner’s theory. Here discussion is not opposing each
other. It is a sharing on the plane of ideas. New ideas are arrived at by seeking explanations,
by mutual giving and taking of ideas and by problem solving.
3. Problem solving and learning
Only when the learner feels that some thing is a problem to be solved that he takes the
responsibility of learning it. It is an inborn tendency to act to solve a problem that causes
cognitive disequilibrium in a particular area. It is also needed to have confidence that one
is capable of doing it. The problems are to be presented in consideration of the ability
and level of attainment of the learner.
4. Collaborative learning
This is the learning in which the responsibilities are distributed among the members of
the group keeping common learning objectives. The common responsibility of the group
will be successful only if each member discharges his duties. All the members will reach a
stage of sharing the result of learning, equally through the activity with mutual
understanding. The teachers who arrange collaborative learning will have to make clear
the responsibilities to be discharged. This is possible through the discussion with the
learners. Collaborative learning will help to avoid the situations of one person working
for the whole group.
5. Co-operative learning
This is the learning in which the learners help one another. Those who have more
knowledge, experience and competency, will help others. By this exchange of resources
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the learners develop a plane of social system in learning also. As there are no high ups
and low ones according to status among the learners they can ask the fellow students
doubts and for helps without any hesitation or in hesitation. Care should be taken not to
lead this seeking of help to mechanical copying. It should be on the basis of actual needs.
So even while encouraging this exchange of ideas, among the members of the group
cautious acceptance is to be observed as a convention. There should be an understanding
that satisfactory responses should come from each member and that the achievement of
the group will be assessed on the basis of the achievement of all the members
6. Zone of Proximal Development
Vygotsky observes that there is a stage of achievement where a learner can reach by
himself and another higher zone where he can reach with the help of his teachers, peers
and elders. Even though some of them can fulfill the learning activity by themselves there
is the possibility of a higher excellence. If appropriate help is provided every learner can
better himself.
7. Scaffolding
It is natural that the learner may not be able to complete his work if he does not get
support at the proper time. The learner may require the help of the teacher in several
learning activities. Here helping means to make the learner complete the activity taking
responsibility by himself. The teacher has to keep in mind the objective of enabling the
learner to take the responsibility and to make it successful.
8. Learning - An active mental process
Learning being a cognitive process, the teacher needs to know cognitive processes to
facilitate the creation of learning opportunities. Learning can be made effective by
providing learning experiences involving mental processes like
1 Retrieves/recollects/retells information
2 Readily makes connections to new information based on past experiences
and formulates initial ideas /concepts.
3 Detects similarities and differences
4 Classifies/categories/organizes information approximately.
5 Translates/transfer knowledge or understanding and applies them in a new
situation.
6 Establishes cause-effect relationships
7 Makes connections/relates prior knowledge to new information/applies
reasoning and draw inferences
8 Communicates knowledge/understanding through different media.
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9 Imagines/fantasies/designs/predicts based on received information
10 Judges /appraises/evaluates the merits or demerits of an idea/develops own
solutions to a problem.
9. Intrinsic Motivation
Intrinsic motivation is given more importance than extrinsic motivation. The teacher has
to arouse the internal motivation of the learner. A person internally motivated alone can
immerse in learning and own its responsibility.
10. Multiple intelligence
The Theory of Multiple Intelligence put forward by Howard Gardener has created a
turning point in the field of education. The National curriculum documents has
recommended that the curriculum is to be designed taking into consideration of this
theory.
MAIN FACTORS OF THE INTELLECT
1. Verbal/linguistic Intelligence
Ability to read and write, making linguistic creations, ability to lecture competence to
effective communication, all these come under this. This can be developed by engaging
in language games and by teaching others.
2. Logical/mathematical Intelligence
Thinking rationally with causes and effect relation and finding out patterns and relations
come under this area. Finding out relations, explaining things, sequential and arithmetical
calculations etc. are capable of developing this area of intelligence.
3. Visual/spatial Intelligence
In those who are able to visualize models and bringing what is in the imagination into
visual form and in philosophers, designers and sculptors this area of intelligence is
developed. The activities like modeling using clay and pulp, making of art equipments,
sculpture, and giving illustrations to stories can help the development of this ability.
4. Bodily Kinaesthetic Intelligence
The activities using body language come under this. This area of intelligence is more
developed in dancers and actors who are able to express ideas through body movements
and in experts in sports, gymnastics etc.
5. Musical Intelligence
This is an area of intelligence which is highly developed in those who are able to recognize
the different elements of music in musicians and in those who can here and enjoy songs.
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Playing musical instruments, imitating the songs of musicians, listening silently to the
rhythms and activities like this are capable of developing this area of intelligence.
6. Interpersonal Intelligence
Those in whom this area of intelligence is developed show qualities of leadership and
behave with others in a noble manner. They are capable of understanding the thought or
others and carrying on activities like discussion successfully.
7. Intrapersonal Intelligence
This is the ability to understand oneself. These people can recognize their own abilities
and disabilities. Writing diaries truthfully and in an analyzing way and assessing the ideas
and activities of others will help developing this areas of intelligence
8. Naturalistic Intelligence
A great interest in the flora and fauna of the nature, love towards fellow beings interest in
spiritual and natural factors will be capable of developing this area.
9. Existential Intelligence
The ability to see and distinguish our own existence as a part of the universe, ability to
distinguish the meaning and meaninglessness of life, the ability to realize the ultimate
nature of mental and physical existences, all these are the peculiarities of this faculty of
intelligence.
EMOTIONAL QUOTIENT
The concept of emotional intelligence put forward by Daniel Golman is used in framing
the new curriculum. The fact that one’s Emotional Quotient (E.Q) is the greatest factor
affecting success in life is now widely accepted. The teacher who aims to focus on improving
the emotional intelligence of students need to concentrate on the following.
i) Ability to take decisions
Rather than imposing decision on students while planning and executing activities, the
students may be allowed to take part in the decision making process. Taking decisions
through open discussion in the class, inviting students suggestions on common problems
etc. are habits to be cultivated.
ii) Ability to reach consensus
• When different opinions, ideas and positions arise, the students may be given
the responsibility to reach a consensus.
• Imagining what would be the course of action in some situtations, allowing to
intervene in a healthy way in problems between individuals.
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iii) Problem solving
• Developing the idea that there is reason and solution to any problem.
• Training in finding reasons for problems.
• Suggesting solutions through individual or group efforts.
• Discussing social problems.
• Analyzing the shortcomings in methods to solve problems.
Whether plastic can be banned within school premises can be given as a problem. Group
discussion will provide reasons and solutions. Problems, which can influence classroom
learning and for which the learner can actively contribute solution needs to be posed
1 Self criticism, evaluation
2 Ability to face problem-situation in life
3 Thinking what one would do if placed in the situation of others, how one would
respond to certain experiences of others - All these foster the growth of emotional
intelligence.
iv) Life skills
Life skills need to be given a prominent place in education. W.H.O. has listed : skills
required for-success in life.
1 Self awareness
2 Empathy
3 Inter personal relations
4 Communication
5 Critical thinking
6 Creative thinking
7 Decision making
8 Problem solving
9 Coping with emotion
10 Coping with stress
THE NEW CURRICULUM ADDRESSES THESE AREAS.
Knowing the characteristics of the learner, role of the teacher and how to use the teachers
handbook help the teacher to plan and effectively implement learning activities.
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Role of a Teacher
In the earlier approach the teacher was mainly depending on the lecture method for
teaching. But in the new method of education the student centered approach is given
more importance than the teacher centered approach. Under this changed scenario the
teacher has to perform the following roles in the classroom.
The teacher should be

1 A facilitator of learning
2 A guide to the overall development of the student
3 A good observer and motivator
4 Able to consider the activities, needs, special features and age group of students at
higher secondary level.
5 Able to understand the limitations of learner and their learning problems.
6 An instructional material developer
7 A good communicator
8 An innovator
9 Able to raise leadership qualities and self confidence of the learner
10 An authoritarian in the concerned subject
11 Able to arrest and sustain the attention of the learner
12 Able to bring out and encourage the inborn talents.
13 A resource manger to ensure the optimum utilization of resources.
14 A systematic record keeper
15 A controller to issue guidance to the students
16 A person with high level of practical competency
17 Able to correlate area of study with familiar environmental situations
18 A self evaluator and good listener
19 Able to create awareness in social problems
20 A person with democratic and humanitarian approach
21 A professionalist as well as philosopher
22 A good evaluator
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23 A good organizer and a friend.
24 A co-learner as well as co-researcher
25 Able to give assistance and advice in placement needs and self employment by
giving moral and technical support
26 Able to keep moral values
27 A person equipped with skill for using new techniques of learning
28 Optimistic and impartial
Child friendly Class Room Atmosphere
Learning can be effective and enjoyable only when the class atmosphere is
according to the new conception of learning and the characteristics of vocational teacher.
1 Class and seating are arranged in an attractive way
2 Democratic nature is upheld
3 Always active
4 Students interact with teachers without fear
5 Opportunity for a variety of activities
6 Students allowed to involve interesting group activities
7 Learning speed, learning style and different levels of attitudes are considered. Help
is extended whenever needed.
8 Sufficient instructional materials are available
9 There is freedom of expression, students share their ideas and experiences
10 Students are given acceptance and encouragement
11 Healthy atmosphere
12 Needs of each student is given consideration. Happy and energetic atmosphere
13 Teachers work considering the rights of students
14 Prtoblems handled in a patient way
15 Teachers work at all events from the students view point
There will be students of various ability levels in any class because of learning style,
learning speed, varying exposure to language experiences, physical ad psychological
problems and varying socio-cultural background.
The learning experiences provided must help to bring the low activities to an expected
level and extended the breadth and depth of the skills of the high activities.
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By repeating experiences, introducing variations in a learning experience to suit different
levels and if needed, formulating additional experiences the problem of varying ability
levels can be tackled.
Role of Learner
The learner in second year has undergone a learner centered and process oriented learning
experience up to first year. The learner at this age is in awakening stage and he is enthusiastic
about environment. He needs recognition and encouragement from environment and
also recognize as a grown up man. He is adequately competent to select vocational subjects
according to his aptitude and interact and to acquire higher education and profession as
he wishes. The aspirations about future life is framed in this particular age for seeing
national and international job opportunities. Some of the peculiarities of learner at this
stage are
1 Physical, intellectual and emotional plans have intensive changes during the age and
their reflections can be observed
2 Ability to enquire discover and establish cause effect relationship between
phenomena
3 Readiness to undertake challenges
4 Capacity to shoulder leadership roles
5 Attempt to interpret oneself
6 Susceptibility to different pressures
7 Doubts, anxieties and eagerness about sex
8 Imaging for social recognition
Needs of Learner
1 To make acquaintance with a job or self employment through vocational education
2 To acquire more knowledge in the concerned area through higher education
3 To recognize and encourage the peculiar personality of the later adolescent period
4 To enable him to defend against the unfavorable circumstances without any help
Role of learner
1 Active participant in the learning process
2 Act as a researcher
3 Sharer of information
4 Sharer of responsibilities
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5 Collect information
6 Takes leadership
7 Involves in group work
8 Act as a co-participant
9 Observes his environment
10 Experiments and realises
11 Make interpretations and draw inferences
12 Mould himself in to an active contributor for the welfare of the society
Evaluation
In vocational higher secondary education, a new approach to education and evaluation
should be made. Evaluation must be a systematic and continuous process. As the
curriculum is based on vocational stream, capacity building is a most important part and
it should be evaluated accordingly. The technical skills, interest in the particular field,
communication skill, analysis organizing and presentation skills etc have to be evaluated.
The personal and social qualities also have to be evaluated. Therefore, evaluation should
be transparent, continuous and comprehensive.
Supporting System
In learner centered vocational education, a learning methodology has to be organized
and a proper learning atmosphere is to be provided. Many organizations can support the
learning activity. They are:-
1. School Resource Group (SRG)
Comprising all teachers (vocational and non vocational) instructors, and lab assistants
with academic head as the group leader.
2. School Support Group (SSG)
Comprising PTA president, members of local bodies, members of social clubs, subject
experts etc who can contribute guidance /technology /infrastructure /financial assistance
etc.
3. Parent Teacher Association (PTA)
Can provide adequate funds for field trips, production cum training centers (PCTC),
exhibition, On Job training (OJT) etc.
4. Local bodies
Grama Panchayat, District Panchayat and Block Panchayat can provide infrastructure ie,
class rooms, laboratory, library, seminar hall, audiovisual equipments etc.
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5. Subject club
All vocational teachers handling same vocational subjects should form a subject club at
regional level or district level. This will helps to share the knowledge and practical facilities,
production and marketing of materials, service etc.
6. Nodal School
Based on the excellency, district wise nodal schools may be selected to provide
facilities like central library, museums, video conferencing etc.
7. Institution Industry Interaction Project (III P)
This should be implemented in every institution to update knowledge. This also helps for
OJT , PCTC and field visit.
Monitoring system
Education is a sort of journey from darkness to light satisfying the needs and the wants
of the individual and the society. The modernization of education through activity oriented
system enhances free thinking and working in a fearless atmosphere. It is a qualitative
process not a quantitative one. This necessitates a proper monitoring system. The system
of monitoring should have the following features.
1) It must be transparent.
2) It must enrich the ideas of the facilitator through innovative process.
3) It must be time bound and rational.
4) It must motive the facilitator to adopt new strategies.
5) It must be recordable and ensure effective feedback for the effective monitoring of
the system, three levels of the mechanism should be setup.
1. School level monitoring group.
2. Regional level monitoring group.
3. State level monitoring group
Moreover a social auditing system is advisable to achieve the objective effectively.

FEATURES OF LEARNING PROCESS IN THE NEW SYSTEM
OF EDUCATION
In the new system of education the learning process should be modified in such a way as
to enable the learner to construct the knowledge of his own through observation, co-
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operation, problem solving, social interaction etc. The learning process should consider
the nature ability, social setup, inborn talents and subject selected by the learner. Therefore
the learning process should be:
1 A continuous mental process
2 Simple learner must feel that he is able to undertake the task
3 Enable the learner to attain the curriculum objective
4 Interesting
5 Suitable to the age and attitude of the learner
6 Future possibilities
7 Enable group activity
8 Challenging
9 Time bound
10 Constructive and curiosity developing
11 Possibilities for evaluation
12 Capacity to generate independent thinking
13 Ability to enquire discover and establish cause effect relationship between
phenomena.
Learning Aids
To make the teaching and learning process simple and effective , certain learning aids and
necessary use of such aids for transacting a complex idea make the class room live and
students get more and more involved. The advances in science and technology may be
effectively utilized for this purpose. Some of the learning aids listed below.
1 Multimedia
2 Over Head Projector
3 Computer
4 Internet
5 Liquid Crystal display Projector
6 TV, VCD, DVD and tape recorders
7 Working models
8 Charts
9 Slides
10 Video Conferencing facility
22
11 Library
12 Text book
13 Source book
Society
The new educational policy uplifts the social commitment of the learner. Therefore the
society can also give some valuable contributions in this changing situation. The new
system also ensures that the learner can perform certain useful services for the betterment
of society. The social obligations can be illustrated as follows.
1 To enrich social values, aptitude and ability in learner
2 To develop entrepreneurial aptitude and ability which helps social welfare and self
employment
3 New system of education adopts OJT, PTC etc as part of vocational curriculum
which helps to make close contact with the society.
4 The resources available from our society can be positively utilized to convene
seminars, interview etc.
5 Social organizations can help learners to make their education socially committed.
6 The social clubs like NSS, Tourism Club, Eco Club, Energy Club etc functioning in
schools can make direct link with the society.
23
MM
SUBJECT APPROACH
Modern developments in the field of medical science and information technology have
caused a methodological upliftment in medical education. In recent years, the extension
of health and laboratory services into rural areas demand, more laboratory personals.
This has led to the introduction of MLT course at Higher Secondary level. As a result of
this, VHSE-MLT is one of the most sought for courses among the various vocational
courses offered in the state. It makes the learners capable enough to achieve better health
care on the basis of modern medical science, which in turn will be beneficial to the
society.
Medical Laboratory Technology is one of the most developing branches in the field of
modern medicine. Clinical laboratory tests have become a key element in most diagnos-
tic procedures. The innovative methodology and the use of technologically updated
instrumentation have made the field more inevitable. As trained workers comprise most
of the work force in a medical laboratory, the curriculum provided is highly practical
oriented.
The curriculum for second year of the VHSE-MLT course coveres subjects like Labora-
tory Management and ethics, Haemotology, Clinical pathology, Immunohaematology
and blood banking, Biochemistry and Histotechnology and Cytology. The new system
of learner centered approach to transact MLT is found to be most suitable as we came
across the first year of the course. The second year curriculum is also highly practical
oriented and life oriented. So possibility of every learning strategy should be considered
to transact the curriculum. It makes the learner confident to perform routine laboratory
tests and management of a clinical laboratory. Apart from the above objectives, learners
are expectecd to develop positive attitudes and values along with the development of
various skills.
24
COURSE OBJECTIVES
l To have a basic knowledge about the structure and function of the human body in
health and disease.
l To familiarize the important microbial and parasitic diseases and their diagnosis.
l To be able to handle and investigate various clinical specimens properly.
l To be able to operate and take care of various laboratory equipments.
l To develop ability to perform and interpret various diagnostic investigations.
l To understand the duties and responsibilities of a lab technician/lab assistant.
l To study medical ethics and understand the management of a clinical laboratory.
l To acquire the ability to run a diagnostic laboratory as a part of self-employment

or to work as a lab technician as an employee.
l To acquire ability for time bound completion of task.
l To give awareness among the public about various health hazards.
25
LEARNING STRATEGIES
I n the modern era of globalization the introduction of new technologies ensure

only the survival of the fittest. So it becomes a necessity to equip the leaners to face
the growing challenges in the competitive world. Hence the traditional approach to
learning is no more relevant in the present context. The teacher should use instructional
techniques that motivate the students to construct his own knowledge. Now the
learners are not passive listeners, but they are the active participants in the construction
of knowledge. Here the teacher – student interaction should be given much
importance.
In the new instructional strategy while selecting the methods of teaching, the social
and psychological aspects of the learner is to be taken into consideration. The given
activities for learning are only suggested ones. It can be altered according to the
discretion of the teacher.
To obtain the objectives, the new system of education is introduced in the Vocational
Higher Secondary Education for attaining the objectives of the courses in this system,
we can adopt the following strategies.
I. Assignment
Assignment is some specific work assigned to the students as a part of their academic
enrichment. There are learning activities undertaken as a continuation of class room activities to
realize the curriculum objectives to a broader extent . They should be completed in time bound
manner. They help to lead learner to higher level of learning from the present status. Challenging
assignment can motivate the students to involve in group dynamics and achieve fruitful results.
The teachers may at as a guide.
Assignment may be given on individuals or group basis. Assignment includes preparation
of notes, preparation of charts, models, collection of materials from institutions etc. Assignments
develop skills of reference, observation, enquire reporting etc. It ensures the effective utilization
of leisure time of the students.
II. Seminar
Seminar is a learning strategy involving an in-depth analysis of specific topic, preparation of a
paper and presentation . The paper is presented by either one student or a group of students.
After the presentation, there will be a discussion/ interaction in which all the students can participate
. The students get an opportunity to clear their doubts and make clarification. Seminar helps to
develop communication skill and overcome stage fright.
26
Stages
1. Selection of Topic: The topic of seminar should be relevant to the subject of study
2. Assignment of topic to individuals students or team: The topic may be assigned
to one student or to a group of students.
3. Collection of relevant information: Information required for seminar can be
collected from various sources namely books, magazines, internet, institutions, place
and persons.
4. Preparation of draft paper: Based on the information collected the student may
prepare a draft paper and submit it to the teachers for comments. Revise the draft
paper based on the comments of the teachers. The refined draft is submitted for
approval.
5. Program scheduling: The date, time and venue of the seminar is fixed. A seminar
leader may be selected from the students
6. Seminar paper presentation: The student/ students shall present the paper in the
seminar. The teacher may function as the moderator during the initial stages.
7. Discussion / Interaction: A number of respondents from the students make comments
on the topic. This will be followed by a general discussion. All the group members
should actively participate in discussion.
8. Summing up deliberation: The moderator sums up the deliberation
9. Evaluation / Feed back: Both teachers and students evaluate the programme.
10. Preparation of final report: A final seminar report is prepared covering all the
additional points discussed and consolidated.
III. Panel Discussion
It is a learning strategy in which a panel of experts are allowed to discuss a specific subject under
the control and direction of a moderator. Subjects can be divided according to the number of
panel members. Number of panel members are fixed according to subdivision of points in the
subject. Relevant materials and handout may be given in advance to the learners. The monitor or
moderator introduces the subject of discussion and invites a panel member to start the discussion.
Each panel member is invited for discussion afterwards. After briefing by the panel members the
questions are raised from the audience and the panel members give suitable answer to them. A
report should be submitted by each learner to the moderator.
IV. Project
Project is a self-learning strategy which can exert great influence on the overall development of
the learner. Project as learning strategy is to be selected where a problem arises in any part of the
curriculum. The students may be divided into groups and assigned different aspects of the problem.
27
Each group works independently .Specific aspects of the problem such as data collection,
classification, analysis, report preparation and presentation is to be undertaken by each of the
members. Even though the work is divided among the members, it must be ensured that the
execution of each and every activity is done with the active participation of all. After analyzing
data collected from different sources, the learner arrives at a conclusion that can help to solve the
problem. Thereby learner learns the topic though his own activity. The other advantage of this
learning activities is that it helps the learner to scientifically handle any problematic situation. It
helps in the development of scientific thinking and thereby builds up the students aptitude for the
subject.
Stages of the project
1. Selection of a topic
The project selected should be related to the curriculum and it should not be a project for
projects sake. The topic or problem should arise from the curriculum.
2. Planning of the Project
(a) Hypothesizing: Hypothesizing means making assumptions based on the available
primary information.
(b) Methods and Technique : The methods and Technique should be based on the aim
and Hypothesizing of the Project. The nature of the project, suitability of the tools,
and the methods of learning should be related to each other.
3. Collection and Tabulation of Data
The data may be primary, secondary or tertiary. Either census or sampling method can be used
based on the objective of the project. Suitable questionnaires are to be prepared for the
collection of primary data.
The collected data is to be classified and tabulated so as to make it easily understandable.
4. Analysis of data and formulation of conclusion
By analyzing the data, the reliability of the hypothesis can be examined. Preparation of graphs
and diagrams and maps will positively help the analysis. The similarities, relations and differences
gathered from the analyzed information would tell whether the hypothesis should be accepted or
rejected.
5. Preparation of Report
The cover page should have the title of the project, the period of study, name (s) of investigator/
group, and the address of the school. The report should be structured in the following order.
1. Title
2. Preface
28
3. Hypothesis and aim
4. Methodology
5. Sources of data
6. Analysis and conclusion
7. Suggestions (if any)
8. References
9. Appendices (Questionnaire, Observation schedule, check list Etc.)
6. Presentation of the Project
When the project is presented , the learner is being evaluated and accepted. It is through this
presentation that ideas are shared with others in the class and society.
The project methods promotes scientific self learning and makes him capable of solving the
problem arising in real life situations.
V. Debate
Debate is a hot and interesting learning activities. A debate can be organized only on a topic on
which there is difference of opinion. Therefore a topic suitable for debate has to be chosen.
Debate can be on relevant topic that is different and interesting to the students and relevant to
society. Students with different opinions have to be identified for discussion. Those who have
similar opinion should join together to form a side . Those who hold the opposite view with form
the other side. It would be ideal to write down the topic of the debate and displayed in advance.
There should also a person to control debate.
Students should be given opportunity to absorb the ideas obtained from discussion and debate,
develop the idea through reading and study, and to express them through writing or other means
Stage of Debate
1. Topic Selection
2. Selection of panels keeping in balance with intelligence, gender etc.
3. Selection of moderator
4. Collection of information guided by the teacher
5. Conducting the debate under the control of moderator by avoiding any sort of
personal conflicts
6. Conclusion by the moderator expressing his final version or verdict.
29
VI. Case Study
A case may be a person, institution or a community case study is an in-depth analysis of an actual
event or situation. It presents real pictures of situation with facts, objective information or data.
Learners analyses the case to interpret, predict and resolve issues associated with it. The case
study provides the learner an opportunity to analyse and apply concepts, data and theory taught
from the class. Learners can work individually or in groups.
By studying realistic cases in the classroom, students develop new insights into the solution of
specific on – the – job problem and also acquire knowledge of the latest concepts and principles
used in problem solving.
Case may be presented by the teachers or may be provided in print form.
A simple case study may have the following steps
1. Collection of data
2. Conversion of data into information
3. Analysis of the case in groups
4. Presentation of the finding by each group leader.
5. Evaluation
In addition to the above mentioned learning strategy there are many other learning strategies
which can be used in appropriate situations to enrich leaning process such as problem solving,
Role play, brain storming, debate etc.
VII. Brain Storming
This is the best method for solving creative problems. It facilitates generation of ideas quickly.
Rules for conducting Brain storming.
1. No response is wrong. So welcome every response.
2. Welcome as many responses as possible
3. No criticism is allowed
4. Allow to work on others idea
Steps in Brain storming
1. Presentation of the problem
2. Provide relevant information
3. Record the ideas put forth by the participants
4. Combine similar ideas
30
5. Evaluate each idea and solution
6. Selection of the best solution
If brainstorming is used as an instruction strategy, the last step is not essential
VIII. Discussion
Discussion is essential for the student to share new finding, idea and conclusion at each stage of
learning with fellow students and teachers. In general discussion the teachers should guide the
discussion through questioning and summarizing. The major steps involved are
1. Introduction initiated by the teacher
2. Development of discussion by giving lead points and follow up interactions
3. Transaction stage in which the key points are reviewed by the teacher and
4. Summarizing stage in which teacher provides additional support materials to ensure
the achievement of the objectives
IX. Group Discussion
Group discussion is an ideal method to develop cooperation, democratic attitude, friendliness
and compromising attitude which are the ultimate aims of education. During group discussion
the teacher may observe each group and it needed help them to channel the discussion towards
the common objectives. All students may be given opportunity to take part and express their
ideas within a time limit. The conclusion reached may be entered by each student. A group
representative must present this during consolidation in which the teacher may correct or add
informations to ensure that all the relevant ideas have been covered
X. Collection
Collection is a continuous learning activity, which ensures complete participation of students.
The collected item may be materials, pictures, charts, ideas, data etc. Collection provides
direct experience to learn. An exhibition of collected materials will help to strengthen the concept.
XI. Practical works
Experimentation contains the process skill in an integrated way. In the new approach of curriculum
the student forms idea and comes to conclusion through process. The term ‘Practical ‘when
associated with a science subject usually means an experiment. The objective of doing an
experiment is to explore new ideas through investigation only. Its main purpose is to verify
some principles associated with theory. The subjects end here. But this is not the case with
‘Vocational Practical’
The ultimate goal of a Vocational Education is to generate skill through continuous practice
along with investigation and invention. Continuous practice transforms the unskilled to the skilled.
This is the significance and importance of practical in the Vocational stream. Hence it is very
31
crucial that Vocational teachers as well as instructor should understand the importance of vocational
practical and act accordingly.
XII. Quiz
Quiz programmes can be used as an interesting class room tool for transaction of curriculum
objectives as well as to evaluate the effectiveness of transaction and achievement of students.
For conducting a quiz programme a topic should be selected based on the above objective
The students are asked to prepare questions based on the topic individually. The next day / next
hour the students are grouped into 3-4 groups randomly. A question is raised by a particular
team and the other teams to answer them if they can answer the question they get points for that
if all other teams fail to answer the question raised by the 1St team the 1st team answer the
question and explain the background if necessary. All the teams get equal number of chances to
ask the question . Time limit is also prescribed for the conduction of the programme. The team
who scores maximum points wins
All the participants can make notes on the questions asked, answers and their explanations
which help them in learning
XIII. Models
Models are used in learning process. It enhance the leaning experience. This is based on the
‘seeing is believing”. It helps the learner a chance to see feel the model presented . Still models
and working models help the students to understand the structure, working principles, actual
operation etc.
Several steps are involved
1. Locating the problem
2. The teacher should plan the type of model according to co’s
3. Grouping the students
4. Briefing the tasks
l Aim
l Need
l Material required
l Source & Materials
l Cost of materials
l Division of Labour
l Guidance
l Fixing of a time limit
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5. Presentation by each group about
l How the models were prepared
l Details of - Expenses
l Working and principles
l Finally documentation of the process
6. Evaluation
l By the other groups
l Later a consolidation by teachers are to be done.
XIV. Games
Class rooms can be made attractive by introducing different types of games. Games should be
interesting as well as informative. Some of suitable games are
1. Odd man out
2. Cross word puzzles
3. Match the following
4. Aswamedham
5. Link game – Answer using clues.
XV. Survey
This strategy involves collection of data from the group under study (book, person, materials
etc.) It develops the social interaction and communication ability of the learner. It also provides a
scope for discovery learning.
Step involved in survey
1 Objective of survey
2 Selection of area for survey/sampling frame
3 Selection of survey method
Direct method
With help of questionnaire/schedule
1 Tabulation and analysis
2 Consolidation and Presentation
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XVI. Exhibition
It is a learning strategy by which the learner can get a chance to show the skill developed. It
provides the intrinsic motivation and exposure.
Exhibition item can be conducted either individually or as a group task. It can be conducted at
school / Regional/State/National level. Necessary publicity and other arrangements can be
provided. Presentation, documentation, participation and innovative skills of the learner can be
evaluated.
XVII. Interview
Interview is one of the important learning strategies taking the help of a resource person. Interview
is an inner view. It provides opinion and information about a topic.
An interview is conducted by the following steps
1. How to introduce a problem?
2. Invite a resource person
3. Decide the questions by learners
4. Decide the time, place etc.
5. How to discuss?
6. How many students to participate?
7. Implementation of the interview
8. Conclusion (Facilitator)
Items required
1 Interview Schedule
2 List of questions prepared by learners Selection of students, selected names sequence
of question
XVIII. Field Visit
Field visit is an inevitable vocational tool to be implemented in vocational Higher Secondary
Education. This helps the students to familarise with the modern technologies and new situation
in a different atmosphere. It provides learning though viewing. It is based on the principle that
seeing is better than having. It enables the learning to retain the learned information longer and to
make the subject more interesting. It motivates and give more confidence in his/her particular
vocation.
The facilitator should identify suitable center/ institution/site. Get prior permission from the
authorities before conducting the field visit. Give instructions to the learners for collection data/
34
information/materials/specimens. Teacher may assign different duties to learners by working them
different groups.
Each learner should take utmost care and interest during the visit. He/She should observe and
interact at the center/ institution where the field visit is conducted
After the visit, learner should acquire the ability to apply the ideas/concepts in his future carrier.
Each learner should submit a detailed report about the field visit.
XIX. Demonstration
Though demonstration we can present an item/product and emphasis its features very effectively.
Eg:- To understand the functioning of a computer
1. Material/Item/Process
2. Demonstration
3. Venue
4. Additional requirements depending upon the nature of the item
Demonstration Process
1. Introduction about the item/Material
2. Principles – Working
3. Operation
4. Components
5. Merits of the item
XX. Chart display
It is also one of the important teaching aids. It can be used in every activities of a learning
process.
Chart display is a written or pictorial representation of idea or concept. It is abbreviate, brief and
clear. It is prepared by study
Benefits
1. A learner gets clear idea about the concept
2. The leaner can retain the ideas in his mind for longer periods
3. A complicated idea can be simplified though a chart
Cheap method of teaching aid.
35
Curriculum Objectives
Unit I - Laboratory ethics and Management

1. To understand the role of Laboratory in health care, duties , responsibilities and
code of ethics of laboratory technician through discussion, fields visit, role play,
brain storming, demonstration etc., and prepare notes and field visit report.
2. To understand how to plan and organize a routine laboratory and to familarise with
the purchasing of laboratory materials through discussion, project, field visit chart
and model preparation, collection and prepare report/record/file etc.
3. To understand laboratory safety, personal care, handling and storage of chemicals,
laboratory hazards and first aid through discussion, demonstration, seminar, field
visit, assignment and prepare notes/record/report.
Unit 2 - Hematology
1. Introduction to hematology
4. To understand the different methods of blood collection and to develop skill in per-
forming capillary and venous blood collection technique through discussion, dem-
onstration, practical work and prepare record/report.
5. To understand about different anticoagulants for blood collection and to prepare
EDTA anticoagulated bottle through discussion, demonstration, assignment, practi-
cal work, flow chart preparation and prepare notes/record
2. Total Cell Count
6. To understand the different methods of cell counting and to acquire skill to perform
total and absolute blood cell counting by discussion, practical work, demonstration,
field visit and prepare notes/ record.
3. Examination of blood smear
7. To understand and develop skill to perform differential leucocyte count and periph-
eral smear examination through discussion, demonstration/practical work, chart
preparation and prepare notes/record.
4. Haemoglobin estimation
8. To understand and to perform Sahli’s and Cyanmethaemoglobin estimation through
demonstration, practical, survey, discussion and prepare note and record.
5. Packed Cell Volume
9. To understand and to perform PCV through discussion, demonstration and practi-
cal work, prepare notes/record.
36
6. Red Cell Indices
10 . To acquire an idea about red cell indices through discussion comparison, calculation
and prepare notes.
7. Erythrocyte Sedimentation Rate
11. To understand and perform ESR by Westergren’s method through discussion, dem-
onstration, practical work, prepares notes and record.
8. Coagulation studies
12. To understand various coagulation tests like BT, CT, PT and to perform Duke’s or
Ivy’s method, Lee & White method, Capillary tube method through discussion,
demonstration and practical work prepare note/record.
9. Special Investigations
13 To understand about reticulocyte and reticulocyte count through discussion, dem-
onstration and prepares note.
14. To acquire basic idea about Osmotic fragility test (OFT), LE Cell test and Sickling
test through discussion, reference, demonstration etc., and prepare notes.
Unit 3 - Clinical Pathology
1. Introduction to clinical Pathology
15. To have an idea about the importance of Clinical Pathology and types of specimen
used through discussion, demonstration, field visit and prepare report.
2. Urine Analysis
16. To understand collection, normal and abnormal constituents, physical, chemical and
microscopic examination of urine through discussion, quiz, field visit, demonstration,
practical work, comparison, prepare notes, diary, record /report and Assignment.
17. To get an idea about the importance of pregnancy test and to perform the card test
through discussion, demonstration, practical work, prepare notes and record.
3. Stool Examination
18. To understand the importance, sample collection and to perform macroscopic and
chemical examination of stool by discussion, demonstration, practical work, pre-
pares notes, report and assignment.
4. Sputum Examination
19. To understand the importance, collection of sputum and to perform macroscopic
and microscopic examination of sputum through discussion, demonstration, practi-
cal work, prepares note and record.
37
5. Semen Analysis
20. To understand the importance, sample collection and to perform macroscopic, mi-
croscopic and chemical examination of semen through discussion, practical work
prepares record and note.
6 CSF Examination
21. To understand the importance, collection, macroscopic examination and biochemi-
cal examination of CSF through discussion, demonstration, field visit and prepare
notes.
Unit 4 - Immuno Hematology and Blood Banking
1. Introduction to Immuno hematology
22. To acquire basic idea about the antigen antibody and historical aspects of blood
banking through discussion, reference and prepare notes.
2. Blood group system
23. To understand ABO and Rh blood group system and to have basic idea about
Bombay blood group, HDN and blood group inheritance through discussion, refer-
ence, demonstration, assignment, chart preparation, prepare notes.
3. Blood grouping
24. To understand the basic principles of blood grouping - forward and reverse group-
ing and different methods through discussion, demonstration and reference
25. To perform ABO and Rh typing by slide method and tube method through demon-
stration, practical work, camp, prepare record/report.
4. Coomb’s Test
26. To acquire basic idea about the importance and different types of Coomb’s test
through discussion, reference, demonstration, field visit and prepare notes/report.
5. Cross matching
27. To familiarise with importance and different methods of cross matching through dis-
cussion, demonstration, reference, fields visit and prepare note/report.
6. Blood Transfusion
28. To get an idea about the importance of blood transfusion and understand about
screening of donor, anticoagulants, blood collection, procedure and storage through
discussion, reference, field visit, demonstration etc., and prepare note/record and
develops a positive attitude to donate blood to the needy ones.
29. To identify different components used for blood transfusion and transfusion reac-
tions through discussion, reference, field visit etc., and prepare notes/record.
38
Unit 5 - Biochemistry
1. Introduction to biochemistry
30. To acquire an idea of the importance of biochemistry and different types of solutions
and to perform cleaning of glass wares and preparation of chromic acid solution
through discussion, demonstration, practical work prepare notes/record.
2. Instruments used in Biochemistry
31. To acquaint with the use and care of analytical balance, centrifuge and distillation
apparatus through discussion, demonstration and prepare notes/record.
32. To understand the principle, parts, working, use and care of colorimeter and to have
an idea about spectrophotometer, flame photometer and micropipette through dis-
cussion, reference, demonstration, practical work, prepare notes/record.
3. Estimation of Blood Sugar
33 To acquaint with the different types of blood samples, anticoagulants used and dif-
ferent methods for blood sugar estimation through discussion, reference and pre-
pare notes
34 To perform blood sugar estimation by O.Toludine and GOD-POD method through
demonstration practical work prepare record/report.
35. To get an idea about glucose challenge test and glucose tolerance test through dis-
cussion, reference and prepare notes.
4. Estimation of Proteins
36. To acquire idea of plasma proteins and to perform total protein estimation by Biuret
method, Albumin estimation by BCG method through discussion, reference, practi-
cal work etc., prepare record/report.
5. Estimation of NPN Substances
37. To get an idea about the different NPN substances and to perform blood urea
(Berthlot method) and creatinine estimation (Alkaline Picrate Method) through dis-
cussion, reference, demonstration, practical work and record/report.
6. Estimation of Lipids
38. To acquire an idea about different classes of lipoprotein, their clinical significance
and to perform cholesterol estimation (enzymatic method) through discussion, ref-
erence, demonstration, practical work and prepare notes/record.
7. Liver Function Tests
39. To get an idea about the importance of Liver Function Tests, various Liver Function
Tests and able to perform serum bilirubin estimation through discussion, reference,
demonstration prepares note/record.
39
8. Renal Function Test
40. To get an idea about Renal Function tests, various renal function tests, urea and
creatinine clearance test through discussion, reference and prepare notes.
9. Automation and quality Control
41 To understand the term automation and have a general idea about automation in
biochemistry through discussion, reference, field visit and prepare record/report.
42. To understand the need of quality control and method for attaining quality control
through discussion, reference, field visit and prepare record/report.
Unit 6 - Histotechnology and Cytology
1. Introduction of Histotechnology
43. To acquire a basic idea about collection, reception and labeling of specimens in a
histopathology Lab through discussion, demonstration, field visit and prepares note.
44. To get a brief idea about different steps in tissue processing, sectioning, staining,
mounting and automatic tissue processor and prepare notes.
2. Cytology
45. To get a basic idea about the uses of cytology, different types of specimen, methods
of collection, fixation and the commonly used cytological staining through discus-
sion, demonstration, field visit and prepare notes.
40
SYLLABUS
Vocational Higher Secondary Education

MEDICAL LABORATORY TECHNICIAN COURSE
Second year
Unit Name of Unit Theory Practical Field Total
No. hrs. hrs. visit/OJT hrs.
I Laboratory ethics and management 10 hrs. 20 hrs. 10 hrs 40 hrs.

II Haematology 40 hrs. 140 hrs. 20 hrs 200 hrs
III Clinical pathology 25 hrs. 50 hrs. 20 hrs 95 hrs
IV Immuno haematology and blood banking 20 hrs. 10 hrs. 20 hrs. 50 hrs

V Biochemistry 35 hrs. 100 hrs. 20 hrs. 155 hrs
VI Histotechnology and cytology 10 hrs. - 10 hrs 20 hrs
Total 140 hrs. 320 hrs. 100 hrs 560 hrs
41
Second Year
Unit - 1 Laboratory ethics and management
Sl. No. Chapter Name Theory Practical
hrs. hrs.
1. Laboratory ethics and management 10 hrs. 20 hrs.
Field visit - 10 hrs.
Total 10 hrs. 30 hrs.
Unit - 2 Haematology
hrs. hrs.
1. Introduction to haematology 5 hrs. 10 hrs.
2. Total cell counts 7 hrs. 45 hrs.
3. Examination of blood smear 5 hrs. 30 hrs.
4. Haemoglobin estimation 5 hrs. 24 hrs.
5. Packed cell volume 3 hrs. 12 hrs.
6. Red cell indices 2 hrs. -
7. Erythrocyte sedimentation rate 4 hrs. 15 hrs.
8. Coagulation studies 4 hrs. 4 hrs.
9. Special investigations 5 hrs. -
Total 40 hrs. 160 hrs
Unit - 3 Clinical pathology

hrs. hrs.
1. Introduction to clinical pathology 1 hr. -
2. Urine analysis 12 hrs. 30 hrs.
3. Stool examination 5 hrs. 10 hrs.
4. Sputum examination 2 hrs. 5 hrs.
5. Semen analysis 3 hrs. 5 hrs.
6. CSF examination 2 hrs. -
42
Immunohaematology and
Unit - 4 blood banking
hrs. hrs.
1. Introduction to immuno haematology
and blood banking 3 hrs. -
2. Blood group systems 4 hrs. -
3. Blood grouping 4 hrs. 8 hrs.
4. Coomb’s test 3 hrs. -
5. Cross matching 2 hrs. -
6. Blood transfusion 4 hrs. 2 hrs.
Unit - 5 Biochemistry
hrs. hrs.
1. Introduction to biochemistry 2 hrs. 8 hrs.
2. Instruments used in biochemistry 4 hrs. 8 hrs.
3. Estimation of blood glucose 5 hrs. 24 hrs.
4. Estimation of proteins 4 hrs. 12 hrs.
5. Estimation of NPN substances 5 hrs. 24 hrs.
6. Estimation of lipids 4 hrs. 12 hrs.
7. Liver function tests 4 hrs. 12 hrs.
8. Renal function test 4 hrs. -
9. Automation and quality control 3 hrs. -
Field visit - 20 hrs
Unit - 6 Histotechnology and Cytology

hrs. hrs.
1. Introduction to Histotechnolgoy 8 hrs. -
2. Introduction to Cytology 2 hrs. -
Field visit 10 hrs.
Total 10 hrs. 10 hrs.
43
Unit - 1 Laboratory ethics and management
1. Laboratory ethics and management 10 hrs.
- Role of laboratory in health care.
- Duties and responsibilities of lab technicians.
- Code of ethics of laboratory technician.
- Planning and organization of routine lab.
- Lab safety and personal care.
- Handling and storage of chemicals.
- Laboratory hazards
Biohazards, electrical hazards, chemical hazards, cuts and wounds
- First aid practice.
- Method of ordering, purchasing and utilization of supplies.
Unit - 2 Haematology
1. Introduction to haematology 5 hrs.
- Introduction.
- Methods for collection of blood.
- Capillary and venous blood collection.
- procedure and precautions.
- Anti-coagulants and its classification.
- Explain each anticogulant in detail - EDTA, sodiumcitrate, oxalates, Heparin fluoride
oxalate mixture, ACD, CPD, CPD - A
2. Total cell counts 7 hrs.

- Introduction
- Different methods - manual and automated.
- Manual method of cell counting.
- Mention the different - types of counting chambers.
- Explain improved neubauer counting chamber in detail.
- Dilution method - Pipette dilution and bulk diluation.
- RBC pipette, WBC pipetts.
44
- Principle, diluting fluid, procedure, calculation, normal value and interpretation of
- RBC count, WBC count, Platelet count, Absolute eosinophil count.
- Automated technique (Brief only)
3. Examination of blood smear 5 hrs.

- Preparation of blood smear.
- Characteristics of an ideal smear.
- Factors influencing an ideal smear.
- Staining
- Romanowsky stains
- Preparation of Leishman’s stain
- Leishman’s staining procedure
- Differential leucocyte count
- Counting technique
- Normal value and clinical significance
- Peripheral smear examination
- RBC- Normal size, shape, colour
- Hypochromatia, hyperchromatia
- Abnormal RBC
-WBC- Name the abnormal WBCs.
-Platelets - Normal and arrangement.
4. Haemoglobin estimation 5 hrs.

- Name the different methods of Hb estimation.
- Principle, requirments, procedure, advantage, disadvantage and normal value of sahli’s
acid haematin method in detail.
- Principle, requirements, procedure, calculation, normal value, advantage, disadvantage
and interpretation of cyanmeth haemoglobin method - clinical significance.
- Preparation of standard graph of cyanmeth method.
5. Packed cell volume 3 hrs.

- Introduction to packed cell volume.
- Method of doing PCV - macro method and micro method.
- Explain the principle, requirements, procedure, normal value and interpretation of
Wintrobe’s method.
6. Red cell indices 2 hrs.

- Importance, calculation and normal value of MCV, MCH, MCHC and MCD.
45
7. Erythrocyte sedimentation rate 4 hrs.
- Introduction.
- Different methods of ESR determination: Westergren’s method, Wintrobe’s method.
- Describe the principle, requirments, procedure, normal value and interpretation of ESR
by Westergren’s method.
- Stages of ESR.
- Factors affecting ESR.
- Clinical significance.
8. Coagulation studies 4 hrs.

- Review of coagulation.
- Coagulation factors.
- Name the various cogulation tests.
- Explain:
- Bleeding time by Ivy’s method and its interpretation
- Clotting time by Capillary tube method and Lee & White method.
- Prothrombin time by Quick’s one stage method.
9. Special investigations 5 hrs.

- Know about reticulocyte and reticulocyte count.
- Supravital staining, counting, calculation, normal value and interpretation.
- Basic description of osmotic fragility test.
- Basic knowledge of auto immune disease and LE cell test.
Unit - 3 Clinical pathology

1. Introduction to clinical pathology 1 hrs.
- Importance of clinical pathology.
- Different types of samples used.
2. Urine analysis 12 hrs.

- Collection of urine sample - different types of samples.
- Brief description of normal and abnormal constituents of urine.
- Examination of urine.
- Physical examination.
46
- Volume, colour, specific gravity and reaction.
- Chemical examination.
Principle, reagents, procedure and interpretation of common abnormal constituents
such as:
Sugar - By Benedict’s test
Protein - By Heat and acetic acid test
Ketone bodies - By Rothera’s test
Bile Pigment - By Fouchet’s test
Bile salt - By Hay’s test
Urobilinogen - By Ehrlich’s test
Blood - By Benzidine test
- Microscopic examination of urine
- preparation of urine for microscopic examination.
- demonstration of crystals, cells and casts.
- Pregnency test
- Importance of test
- Name different methods
- Procedure of card test
3. Stool examination 5 hrs.

- Importance of stool examination
- Sample collection
- Macroscopic examination
- Consistency, Colour, Mucus and Parasites
- Microscopic examination
- Saline preparation
- Iodine preparation
- Concentration by saline floatation
- Chemical examination
- Occult blood - Benzidine test
- Reducing substances - Benedict’s test
47
4. Sputum examination 2 hrs.
- Importance of sputum examination.
- Sample collection
- Consistency and Colour
- AFB staining
- Gram’s staining
5. Semen analysis 3 hrs.

- Importance of semen analysis
- Sample collection
- Volume, viscosity, colour, reaction and liquefaction time
- Motility
- Total sperm count
- Morphology of spermatozoa
- Other cells
- Chemical examination
- Name the different tests - Fructose, Acid phosphatase
6. CSF examination 2 hrs.

- Importance of CSF examination.
- Mention the method of CSF collection.
- colour, turbidity and appearance
- total count, differential count, Gram’s staining and AFB staining
- Bio-chemical examination
- Name different tests done - sugar, protein and chloride
48
Immuno haematology
Unit - 4 and blood banking
1. Introduction to immuno haematology 3 hrs.
- Mention the different types of antigen and antibody.
- Introduction to blood banking - Historical aspects.
2. Blood group system 4 hrs.
- Mention different blood group system.
- Explain ABO blood group system.
- Brief idea about Bombay blood group.
- Explain Rh system.
- Brief description of HDN.
- Elementary knowledge of inheritance of blood group.
3. Blood grouping 4 hrs.
- Basic principles of blood grouping.
- Brief description of forward and reverse typing.
- Methods for ABO and Rh typing (slide, tube and tile technique)
4. Coomb’s test 3 hrs.
- Importance of Coomb’s test.
- Mention different methods DCT and ICT.
5. Cross matching 2 hrs.
- Clinical importance of cross matching.
- Mention the different method of cross matching (Tube method).
- Saline phase, Albumin phase, AHG phase.
6. Blood transfusion 4 hrs.

- Importance of blood transfusion.
- Criteria for screening of donor.
- Mention the anticoagulant for blood collection.
- Explain blood collection procedure.
- Brief description of blood storage.
- Blood components
- Mention different components used for blood transfusion.
- Whole blood, packed cell, cryoprecipitate, platelet rich plasma and fresh frozen
plasma.
- Transfusion recations
- Name transfusion reactions.
49
Unit - 5 Bio-chemistry
1. Introduction to bio-chemistry 2 hrs.

- Importance of bio-chemistry.
- Brief discussion on different types of solution - Percentage solution, Molar solution,
Normal solution, Standard solution and Saturated solution.
- Cleaning of glassware
- General cleaning.
- Chromic acid solution.
2. Instruments used in biochemistry 4 hrs.

- Use and care of analytical balance, centrifuge and distillation apparatus,
- Explain the principle, parts, working use and care of colorimeter.
- Familiarise with Spectrophotometer, Flame photometer, Micropipettes.
3. Estimation of blood sugar 5 hrs.

- Estimation of blood glucose.
- Collection of blood for sugar estimation.
- Anticoagulant used.
- Familiarise the term FBS, RBS and PPBS.
- Name different method for blood sugar estimation.
- Explain the principle, requirements, procedure, normal value and clinical significance of
blood sugar estimation.
- O-Toludine method
- GODPOD method
- Brief description of
- Glucose challenge test and Glucose tolerance test.
4. Estimation of proteins 4 hrs.
- Introduction to plasma protein.
- Explain the principle, reagents (name only), procedure and calculation of total protein by
Biuret method.
- Explain the principle, reagents (name only), procedure and calculation for the estimation
of albumin by BCG method.
- Normal value and clinical significance of total protein and albumin.
50
5. Estimation of NPN substances 5 hrs.
- Mention the different NPN substances and its importance.
- Mention the different methods of blood urea estimation.
- Explain the principle, procedure and calculation of blood urea estimation by Berthlot
method.
- Normal value and clinical significance of blood urea.
- Mention the different methods of serum creatinine estimation.
- Explain the principle, procedure and calculation of serum creatinine estimation by alkaline
picrate method.
- Mention normal value and clinical significance of serum creatinine.
6. Estimation of Lipids 4 hrs.
- Mention different classes of lipoproteins and their clinical significance.
- Explain the principle, procedure and calculation of serum cholesterol by enzymatic
method. (cholesterol - esterase - dehydrogenase)
- Normal value and clinical significance of serum cholesterol
7. Liver function tests 4 hrs.
- Importance of LFT.
- Name different liver function tests
- Explain Malloy and Evelyn method for Bilirubin estimation.
- Mention its normal value and clinical significance.
8. Renal function test 4 hrs.
- Importance of RFT.
- Name different renal function tests.
- Brief description of urea clearance and creatinine clearance test.
9. Automation and quality control 3 hrs.
- Understand the term automation
- General idea about automation in bio-chemistry.
- Need of quality control
- Method for attaining Q.C.
51
Unit - 6 Histotechnology and Cytology
1. Introduction of Histotechnology 8 hrs.

- Mention the important steps in the preperation of a tissue for microscopic examination
(brief idea only)
- Collection, reception and labelling.
- Fixation (routine formalin fixative only), dehydration, clearing, impregnation, embedding
and section cutting.
- Name the common staining and mounting method.
- Brief description about automatic tissue processor.
2. Introduction to Cytology 2 hrs.

- Mention the uses of cytology, specimens, name the methods of collection and fixation of
a smear.
- Name the commonly used staining method in cytology.
52
Second Year
Sl. Practical hours
No.
I. Laboratory ethics and management
1. Demonstration of common signs and symbols used in clinical laboratory. 8
2. Familiarise with different types of request/report forms and method of 4
reporting.
3. Familiarise with maintenance of stock registers - consumable and 4
nonconsumable.
4. Familiarise with the layout plans of a basic laboratory. 4
Field visit 10
Total 30
II. Haematology
1. Blood collection technique - capillary and venous blood collection 6
2. Preparation of EDTA auticoagulated bottles 4
3. Haemocytometer - familiarise with RBC pipette, WBC pipette, 12
improved neubauer counting chamber
4. Preparation of normal saline 4
5. Preparation of Tuerk’s fluid 4
6. Total RBC count. 6
7. Total WBC count 6
8. Total platelet count. 7
9. Absolute eosinophil count. 6
10. Preparation of blood smear. 7
11. Preparation of Leishman’s stain. 6
12. Differential leucocyte count. 15
13. Demonstration of abnormal blood cells by photographs or slides. 2
14. Haemoglobin estimation - Sahli’s method. 12
15. Hemoglobin estimation - cyanmethaemoglobin method. 12
16. Packed cell volume - Wintrobe’s method. 12
17. Preparation of 3.8% sodium citrate. 3
18. Erythrocyte sedimentation rate - Westergren’s method. 12
19. Bleeding time - Duke’s or Ivy’s method. 2
20. Clotting time - capillary tube method. 2
Field visit 20
Total 160
53
III Clinical Pathology
1. Preparation of 5% acetic acid solution. 2
2. Physical examination of urine. 4
3. Chemical examination of urine. 16
4. Microscopic examination of urine. 6
5. Demonstration of pregnancy test in urine. 2
6. Macroscopic examination of stool 2
7. Microscopic examination of stool 4
8. Chemical examination of stool (occult blood and reducing substances) 4
9. Sputum examination. 5
10. Semen analysis 5
Field visit 20
Total hours 70
IV. Immunohematology and blood banking
1. ABO grouping and Rh typing - slide method. 3
2. ABO grouping and Rh typing - tube method 5
3. Demonstration of blood collection equipments - blood bag. 2
Field visit 20
Total 30
V. Biochemistry
1. Preparation of chromic acid solution. 3
2. Cleaning of glass wares. 5
3. Colurimeter - parts, operation and care. 8
4. Estimation of glucose (O-toluidine method) 12
5. Estimation of glucose (GOD-POD method) 12
6. Estimation of total protein (Biurete method) 6
7. Estimation of albumin (BCG method) 6
8. Estimation of urea (Berthlot method) 12
9. Estimation of serum creatinine (alkaline picrate method) 12
10. Estimation of serum cholesterol (enzymatic method) 12
11. Estimation of serum bilirubin (Malloy - Evelyn method) 12
Field visit 20
Total 120
VI Histotechnology and Cytology
Field visit 10
Total 10
54
PLANNING
YEAR PLAN – II YEAR
Field vist/
Chapter Name Theory Practical Month Planned
OJT
to teach
Unit 1. Laboratory Ethics & Management
1. Laboratory Management & Ethics 10 Hrs 20 Hrs June 10 Hrs
Unit 2. Haematology
1. Haematology 5 Hrs 10 Hrs June
2. Total cell counts 7 Hrs 45 Hrs June
3. Examination of blood smear 5 Hrs 30 Hrs July
4. Haemoglobin estimation 5 Hrs 24 Hrs July
5. Packed cell volume 3 Hrs 12 Hrs July 20 Hrs
6. Red cell indices 2 Hrs - July

7. Erythrocyte sedimentation rate 4 Hrs 15 Hrs August
8. Coagulation studies 4 Hrs 4 Hrs August
9. Special investigations 5 Hrs - September
Unit 3. Clinical Pathology
1. Introduction to Clinical Pathology 1 Hr - September
2. Urine analysis 12 Hrs 30 Hrs September
3. Stool examination 5 Hrs 10 Hrs October
4. Sputum examination 2 Hrs 5 Hrs October 20 Hrs
5. Semen examination 3 Hrs 5 Hrs October

6. CSF examination 2 Hrs - October
Unit 4. Immuno Haematology & Blood Banking
1. Introduction 3 Hrs - October
2. Blood grouping systems 4 Hrs - November
3. Blood grouping 4 Hrs 8 Hrs November
4. Coomb’s test 3 Hrs - November 20 Hrs
5. Cross matching 2 Hrs - November
6. Blood transfusion 4 Hrs 2 Hrs November
Unit 5. Biochemistry
1. Introduction to Biochemistry 2 Hrs 8 Hrs December
2. Instruments used in Biochemistry 4 Hrs 8 Hrs December
3. Estimation of blood glucose 5 Hrs 24 Hrs December
4. Estimation of proteins 4 Hrs 12 Hrs January
5. Estimation of NPN substances 5 Hrs 24 Hrs January 20 Hrs
6. Estimation of Lipids 4 Hrs 12 Hrs January
7 Liver function tests 4 Hrs 12 Hrs January
8 Renal function tests 4 Hrs - January
9 Automation & quality control 3 Hrs - January
Unit 6. Histotechnology & Cytology
1. Introduction to Histotechnology 8 Hrs - February
10 Hrs
2. Introduction to Cytology 2 Hrs - February
55
56
Unit Plan ESTIMATION OF HAEMOGLOBIN
Curriculum Objectives Idea/ Process skill Activities Materils Evaluation Duration

Concepts requried
-Participation of
To understand and to Different methods of Hb -Communication -Discussion -Reference
discussion
perform Sahli’s and estimation Book
-Observation -Demonsration
Cyanmeth Haemoglobin -Distinguishing
- Idea about Hb -Multimedia
Estimation through -Practical skill -Comparison capacity
discussion, - Functions of Hb -Chart 5 hrs.
demonstration,survey and -Practical work -Perfection in
practical work prepare note - Principle,Procedure, -Materials for practical work
Requirements, Merits -Chart preparation practical work
/Record -Perfection in
Demerits and normal value
note preparation
of Sahli’s and Cyanmeth Hb
method
- Clinical significance of Hb
estimation
- Standard graph for Cyanmeth
Hb method
Daily Plan
Name : X Class : VHSE - MLT

Name of School : XX Division : IInd Year
Subject : Haematology Strength : 25
Chapter : Erythrocyte sedimatation rate Average age : 17 + 1
Topic : Erythrocyte sedimatation rate Duration : 4 hours
To understand and perform ESR by Westergren’s method through discussion,demonstration and practical work, prepares note and
record.
Concepts and ideas
l Different methods of ESR determination

l Principle,requirements,preparation of 3.8% Trisodium citrate
l Procedure of doing Westergren’s method
l Normal value and interpretation of Westergren’s method
l Stage and factors affecting ESR
Process skill
Observation, experimentation.
Previous knowledge
Concept of settling of blood cells
Materials required
Westergren’s tube,Westergren’s stand ,3.8%Sodium citrate, blood etc
57
Activity/Strategies Response/Feedback
58
Introduction
l To check the previous knowledge of students about the settling of blood cells, teacher
demonstrates a simple practical in the laboratory.
Demonstration of simple practical l All students actively observed.
l Take anticoagulated blood in a test tube and instruct the students to observe their findings at l Purpose of demonstration attained.
different intervals.
l All students recognised that rate of
settling of red cells are different at
different intervals.
Illustration
l Teacher illustrates that settling of blood cells can be used for prognosis, when it is done at standard
conditions.
l To get a clear idea about this, distribute handout containing the details to four groups of students for
discussion.
Grouping
l Grouping procedure is correct and
l Group the students into four by repeated counting from 1 to 4 periodically. can be repeated.
l Give handout to each group.
l Points for discussion is demonstrated on a chart.
Details about handout
l Idea about the difference between diagnosis and prognosis.
l Importance of ESR test in prognosis.
l Idea about the different methods of ESR determination.
Activity/Strategies Response/Feedback
Points for discussion (Displayed on chart)

l What is prognosis?
l Importance of ESR estimation.
l Different methods of ESR estimation.
Teacher consolidates the discussion
Process l All groups are engaged in group
l Group discussion discussion.
l Group 2 and 4 deviated from topic
and teacher interefeared to focus
on the topic.
l Consolidation points of Group 1 is
Presentation (Five minutes for each group)
more relevant based on the topic.
l Each group consolidate their discussion points.
l Manoj, Group III leader have to
l Any one member from each group presents their points. imporve his presentation.
l After presentation teacher consolidates the points by adding any missed points. l Activity used is sucessful and
response are very good.
l Prepared note is satisfactory.
59
EVALUATION
Evaluation is a systematic process of collecting, analyzing, synthesizing and interpreting evidences

of students’ progress and achievements both in cognitive and non-cognitive areas of learning.
Evaluation has to play significant role in making the learning process more effective. It provides
diverse experiences to the learners, keeping in view the skill to be attained continuously by them.
As the curriculum is based on a particular vocation the selected stream is the most important part
and it should be evaluated accordingly. Technical skills, interest and devotion in the field, com-
munication skills, organizational and presentation skills are to be evaluated. Evaluation of the
personal and social qualities also should be done. So the evaluation should be continuous and
comprehensive.
Terminal or Term End Evaluation (TE)
It is the written form of evaluation aimed at evaluating the facts, concepts and ideas gained by
the learner. The test should not be aimed to evaluate the memory alone. Questions are framed in
such a way that the learners are able to apply different mental process while answering. The
Terminal Evaluation questions give more emphasis on application, analysis and synthesis level.
The maximum scores for TE is 80 and the minimum is 24 (30%). The questions should be
formulated taking into consideration the time required to read, think, understand and write an-
swers. These aspects should be considered while fixing the scores also. To avoid blind guessing,
multiple choice and application level questions may be mixed. The total number of questions may
vary from time to time. All the questions should be based on the curricular objectives. Open
ended questions may be included. Choice questions, if included also should be based on the
same curricular objectives.
Continuous and comprehensive evaluation (CCE)
Our traditional evaluation methods measure only the memory and recollection capacity of the
learner. To eliminate/ overcome the limitation the evaluation should be done on multi dimensional
ways by measuring multiple intellectual capacities of the learner. So it is better to evaluate the
learner in a continuous and comprehensive manner. CCE helps the learner to understand and
develop his own progress and to develop adequate strategies for further improvement.
Merits
1. Assess the all round development of the learner on a continuous basis through a
variety of activities.
2. Effective feed back is possible
3. Remedial diagnostic teaching is possible
4. Process as well as products are assessed.
60
A series of learning activities are grouped into five major thrust areas as follows
Investigative activities
Activities which create a spirit of enquiry, investigation and a mind for research in the learner
belong to this group.
For example.
1. Study project
2. Case study
3. Field study
Interactive activities
Activities which improve the communication skill, activities of sharing ideas, etc.
For example
1. Seminar
2. Panel discussion
3. Debate
4. Group discussion
Assigned task
Activities assigned to the learners to enrich/ strengthen the concept and ideas.
For example
1. Assignment
2. Collections
Performance task (Tests)
Activities related to the achievements of the learner.
For example
1. Class test (oral/ written/ performance test)
2. Quiz
3. Open book examination
4. Interview
5. Group testing
61
Practical based activities
For example
1. Preparation of working model
2. Album
3. Improvisation
From the above five groups of activities, the teacher has the freedom to choose any
three areas for evaluation purpose.
CE Items
1. Study Project
Sl.No. Stages Criteria Score Total Scores

1. Planning Planning Relevance of the study Identification
4/3/2/1
of problem Ability to select aPVppropriate
tools, ability to select suitable bearing method.
2. Data Ability to collect sufficient and relevant data.

4/3/2/1
collection Ability to classify and arrange data for analy-
sis. Reliability and authenticity of the data
collected.
3. Analysis and Ability to analyses the data Systematic ar-

inference rangements. Ability to draw inferences based 4/3/2/1
on analysis. Ability to give suggestions based
on inference.
4. Report Ability to present in logical and sequential

4/3/2/1
Presentation order, authenticity of report, time bound
completion.
5. Viva-Voice Knowledge of content and process.

Ability to analyses data.
4/3/2/1
Ability to justify inference.
Ability to explain.
Strategies and methods adopted.
62
Case Study
Sl.No Criteria Score
1. Identifying the problem 43/2/1
2. Approach to the problem 43/2/1
3. Time bound Action 43/2/1
4. Analysis of the problem 43/2/1
5. Problem solving / Reporting 43/2/1
Field study
1. Attitude and readiness towards the task 4/3/2/1
2. Capacity for Observation 4/3/2/1
3. Data collection 4/3/2/1
4. Application of ideas 4/3/2/1
5. Documentation / Recording 4/3/2/1
Assignment
1. Awareness of the content 4/3/2/1
2. Comprehensiveness of the content 4/3/2/1
3. Systematic and sequential arrangement 4/3/2/1
4. Observation/suggestion/views/judgment/evaluation 4/3/2/1
5. Timely Submission
Seminar
1. Planning and Organization 4/3/2/1
2. Collection and data / content 4/3/2/1
3. Observation / appraisal and clarity 4/3/2/1
4. Content knowledge 4/3/2/1
5. Presentation 4/3/2/1
63
Debate
1. Readiness to participate 4/3/2/1
2. Depth of subject knowledge 4/3/2/1
3. Communication skill 4/3/2/1
4. Ability to justify the stand 4/3/2/1
5. Presentation 4/3/2/1
Group Discussion
1. Readiness to participate 4/3/2/1
2. Depth of subject knowledge 4/3/2/1
4. Ability to justify in a democratic way 4/3/2/1
5. Leadership quality 4/3/2/1
Interview
1. Planning 4/3/2/1
2. Preparation of Questions 4/3/2/1
4. Participation 4/3/2/1
5. Report preparation 4/3/2/1
Practical Evaluation (PE)

The goal of vocational Education is to generate skills through continuous practices along with
investigation and innovations. Continuous and comprehensive practice transforms the unskilled
learner to a skilled one. This is the importance and significance of vocational practicals.
PE is done to evaluate the practical skills achieved by the learner in the concerned vocational
subject Total Scores for PE is 150 and minimum is 60 score ie 40%. Practical Examination is
conducted for a batch of 8 learners having 6 hours duration.
Practical evaluation should be done taking into account the whole practicals included in the
curriculum since learning of practical skills is a continuous process through out the period of
study.
64
Vocational Competency Evaluation (VCE)
Vocational Competency Evaluation is to evaluate the vocational skill and aptitude developed by
the students during the learning process. This is a system to judiciously evaluate the required
value addition and consequent capacity building in the concerned vocational curriculum. The
vocational education is aimed at developing interest, skills and devotion in specific vocational
fields. As other evaluation components like CE. PE and TE cannot assess the vocational
competencies and professional skills, acquired by the students an internship evaluation (IE)
components has been introduced to meet this requirement.
Internship evaluation should be done based on the following components like regularity and
punctuality, value addition and capacity building.
1. Regularity and punctuality
Regularity and punctuality has vital role in vocational education learning continuous process, the
regular presence of the learner is must for attaining maximum efficiency.
2. Value Addition
Value addition is the qualitative measure of the learner’s interest, devotion perseverance and
efficiency. Value addition can be evaluated through conducting field visits/ vocational survey. The
experiences gained through field visit / vocational survey increases the level of intrinsic motivation
and positive attitude towards the vocational field and thereby increase his value as a
semiprofessional.
3. Capacity Building
It gives a quantitative measure of the student’s skill in graded area exposure. Capacity building
can be evaluated through conducting the following activities.
1. OJT / Simulated experiment
2. Performance – camp/exhibition/clinic
3. Performance – PCT/Service cum Training center.
These components help the learner to practise the acquired skills in the real situation and thereby
increasing self-confidence and promoting self reliance.
Vocational Competency Evaluation Indicators
No Items Scores
1. Regularity and punctuality 10
2. Field visit / survey (anyone) vocational project 20
3. OJT/Simulated experiment performance – Camp/exhibition/clinic
Performance – PSCTC (anyone)/Practical skills 20
Total 50
65
1. Regularity and punctuality can be assessed by using attendance of the learner and time
bound completion of tasks. It is evaluated by using 5 point grading system.
Rating sclae
Sl.No. Item 1 2 3 4 5
1. Regularity Never After Equally Most of the time Always
regular regular regular regular
2. Punctuality Never Often Usually Most of the time Always

regular punctual punctual punctual punctual
Item Evaluation indicators Scores Score

Field visit
Value addition 1. Attitude and readiness towards the task 4/3/2/1
2. Capacity for observation 4/3/2/1
4. Application of ideas 4/3/2/1
5. Documentation/recording 4/3/2/1
Or
Survey
1. Planning 4/3/2/1
3. Consolidation of data and analysis 4/3/2/1
4. Drawing inference 4/3/2/1
5. Reporting 4/3/2/1
Capacity OJT/Simulated experiment
Building 1. Involvement/participation 4/3/2/1
2. Skills in doing work/ communication skills 4/3/2/1
3. Time bound action 4/3/2/1
4. Capacity for observation, analysis and innovation 4/3/2/1
5. Documentation, recording and display 4/3/2/1
Or
Performance in camp/exhibition/clinic
1. Ability for planning and organizing 4/3/2/1
2. Mastery of subject 4/3/2/1
3. Ability for communication 4/3/2/1
4. Innovation 4/3/2/1
5. Involvement/social commitment 4/3/2/1
Or
66
Performance in production/service cum
training center (PSCTC)
1. Mastery of vocational skills 4/3/2/1
2. Managerial capacity 4/3/2/1
3. Promoting self confidence 4/3/2/1
4. Innovation approach 4/3/2/1
5. Promoting self reliance 4/3/2/1
Consolidated Statement of VCE

Course : MLT Year:
Class:
Roll No Name of Regularity of Value addition Capacity Total Grade
Pupil Punctuality Building Score
(10) (20) (20) (50)
Consolidated Grade Record of Vocational Subjects
Course : MLT Year:

Class:
Vocational Theory Vocational Practical VCE

Roll. Name of CE TE Total Grade PE Grade IE Grade
No Pupil 20 80 100 150 50
67
LEARNER EVALUATION PROFILE
Course : MLT
Year :
Ist Year II Year
Name of Subjects Term Term Mini. Max

Score Score
I II III I II III
Part I CE
1. English TE
Total
Grade
2. GFC CE
TE
Total
Grade
Part II Voc. Theory CE

TE
Total
Grade
Voc. Practical Total

Grade
VCE IE
Grade
Paper III CE
Paper I Physics TE
PE
Total
Grade
Paper II CE
Chemistry TE
PE
Total
Grade
Paper III CE
Biology TE
PE
Total
Grade
68
Consolidated Statement of CE
Course :
Class :
Sl. No Name CE items Evaluation Indicators Total (20) Total (60) Average
1 2 3 4 5 CE (20)
1.............................
2.............................
3.............................
1.............................
2.............................
3.............................
1.............................
2.............................
3.............................
1.............................
2.............................
3.............................
1.............................
2.............................
3.............................
69
VHSE - MLT - Sourcebook
UNIT WISE ANALYSIS
70
UNIT LABORATORY ETHICS AND

MANAGEMENT
1
INTRODUCTION
Medical Laboratory Tests have become a key element

in most diagnostic procedures. The effectiveness of
laboratory medicine in patient care largely depends on
ethics of the technician. Without the glimpse of ethics
one cannot attain independent professional competency.
This unit enables the learner to get idea about the
duties, laboratory ethics, how to manage a clinical
laboratory and role of medical laboratory in health
care. Through this unit the learner become capable in
safe laboratory practice and to overcome undue situation
if any. An ideal laboratory technician shall consider
his or her profession as one dedicated to the society.
The idea obtained from this unit mould the student as
a perfect laboratory technician in his/her career.
71
UNIT AT A GLANCE Unit I - Laboratory ethics and Management
72
Curriculum objectives Content/Area Activities/ Materials Product/ Evaluation Reference
Experience skill
Chapter - 1: Laboratory ethics and Management
1. To understand the role of Labo- • Role of laboratory in Discussion, field Reference Prepared
ratory in health care, duties , re- health care Notes, report
visit, Demonstration, books notes report

sponsibilities and code of ethics • Duties and responsi- role play, Brain
of laboratory technician through bilities of laboratory storming
discussion, field visit, role play, technician
brain storming, demonstration • Code of ethics of
etc., and prepare notes and field laboratory technician.
visit report.
Prepared Medical
2. To understand how to plan and • Planning and organiz- Discussion, project, Reference Notes Report on
organize a routine laboratory and ing of routine labora- chart and model Book notes, project project Report Laboratory
to familarise with the purchasing tory preparation, collec- Chart report, Technology
on field visit
of laboratory materials through • Purchasing of Labora- tion, Field visit Field visit Vol. I, Kanai
discussion, project, field visit tory materials report L. Mukherjee
chart and model preparation, • Different types of re- Basic Medical
collection and prepare report/ port forms Laboratory
record/file etc. Techniques,
3. To understand laboratory safety, • Laboratory safety Discussion, Dem- Reference by Barbara H.
personal care, handling and stor- • Personal care onstration, Seminar, Book, Prepared Perfection of Estridge
age of chemicals, laboratory • Common symbols Field Visit, Chart Chart chart Semi- chart, Participa-
hazards and first aid through dis- and signs used in a Preparation, As- nar Report tion in discussion,
cussion, demonstration, seminar, laboratory signment Diary perfection of
field visit, assignment and pre- • Handling and storage seminar report,
pare notes/record/report. of chemicals perfection in as-
• Laboratory hazards signment
• First aid
Unit Chapter
LABORATORY ETHICS
1 AND MANAGEMENT 1
1. To understand the role of Laboratory in health care, duties , responsibilities and
code of ethics of laboratory technician through discussion, field visit, role play,
brain storming, demonstration etc., and prepare notes and field visit report.
2. To understand how to plan and organize a routine laboratory and to familarise
with the purchasing of laboratory materials through discussion, project, field visit,
chart and model preparation, collection and prepare report/record/file etc.
3. To understand laboratory safety, personal care, handling and storage of chemi-
cals, laboratory hazards and first aid through discussion, demonstration, semi-
nar, field visit, assignment and prepare notes/record/report.
Syllabus
F Role of laboratory in health care.
F Duties and responsibilities of lab technicians.
F Code of ethics of laboratory technician.
F Planning and organization of routine lab.
F Lab safety and personal care.
F Handling and storage of chemicals.
F Laboratory hazards
F First aid practice.
F Method of ordering, purchasing and utilization of supplies.
Practical
l Demonstration of common signs and symbols used in clinical laboratory.
l Familiarise with different types of request/report forms and method of reporting.
l Familiarise with maintenance of stock registers - consumable and nonconsumable.
l Familiarise with the layout plans of a basic laboratory.
73
Role of Laboratory in Health Care

Students have the previous knowledge about a Medical Laboratory. But he has little
knowledge about the importance of laboratory in health care. Brainstorming will
help to elaborate the above idea.
Learning activity: Brainstorming

Teacher creates a situation for brain storming by asking some questions like
l What are the common diseases you know?
l Do all the disease shows common symptoms?
l Among these which are having common symptoms?
Teacher initiates brainstorming by providing questions like

l Can we identify these diseases by their symptoms?
l Can a doctor diagnose a disease with mere symptoms?
Teacher facilities the brainstorming by stating

Some diseases can be diagnosed by observable symptoms but in many cases it is not
possible. How diagnosis is possible in such cases?
Elicites response. Facilitator consolidates that
l Laboratory is a key element in the diagnostic procedure.
l Without laboratory, proper diagnosis is not possible.
Outcome
The learner attains clear idea about the role of laboratory in health care
Duties and Responsibilities of Laboratory Technician and code of ethics
Learning Activity: Role play and guided discussion

One among the learner is asked to act a role of laboratory technician who has a rough
attitude during blood collection after a proper guidance from the teacher. Then another
learner is asked to act a role of a laboratory technician who approach the patient in a
pleasant way. After the role play the learners compare the behaviour of the two and
asked to select the best among them. Continue the session by pointing the criteria for
a good laboratory technician.
A group discussion follows by giving handouts to three groups- one group is provided
with handout containing duties of laboratory technician, responsibilities to the second
and code of ethics to the third group. One learner among the group presents the
consolidated points. Finally a poster containing the duties and responsibilities and
code of ethics is prepared and demonstrated in the laboratory.
74
Discussion points
l What are the duties of a laboratory technician?
l What are the responsibilities of a laboratory technician?
l Code of ethics.
Consolidation
l Dedication of high standard of performance.
l Commitment towards the profession.
l Central features of a medical laboratory is the technician.
l Considerate during sample collection.
l Honest, reliable, accurate, organizational skill.
Other suggested activities

l Field visit
l Discussion
Outcome
l The learner got idea about the importance of laboratory Ethics.
l Awareness on duties and responsibilities of laboratory technician.
l Poster preparation on duties, responsibilities and code of ethics.
CE
l Participation in group discussion.
l Oral test.
Planning and Organisation of a routine laboratory
Co. 2 To understand how to plan and organize a routine laboratory and to familarise
with the purchasing of laboratory materials through discussion, project, field
visit, chart and model preparation, collection and prepare report/record/file
etc.
Syllabus
l Planning and organisation of routine lab.
l Method of ordering, purchasing and utilisation of supplies.
Practical
l Familarise with different types of request/report forms and methods of
reporting.
l Familarise with maintenance of stock register, consumable and non-
consumable.
l Lay out plans of a basic laboratory.
75
Learning Activity: Project

Project may be a vested strategy to transact this topic. After a general discussion
about planning of a laboratory, students are grouped to four, then give proper
instructions to execute project on planning and organisation of routine clinical
laboratory.
Stages of the Project
1. Identify a problem
2. Defining a probolem
Aim is to prepare a project report on planning a well organized routine
clinical laboratory.
3. Planning - data to be collected
- sources of data
- methodology and tools
- materials
- time
- Duties
4. Execution
- Data collection
- Recording
- Preparation and analysis
5. Project report
6. Project presentation
Field Visit
The basic group of students visit routine laboratories and collect datas like
Planning
(a) Data to be collected
l Space
l Constructional details (arrangement of rooms)
l Ventilation
l Electric supply system
l Fresh water supply
l Waste disposal/drainage
l Equipments
(b) Organization
l Administration
76
l Staff pattern
l Purchase details
l Maintenance
l Communication (written, verbal)
l Quality control
l Publicity
After field visit and reference, tabulate the collected data.
Tabulation of Data
l Invoice format
l Requisition forms
l Report forms
l Sample copy of laboratory records
l Layout plan or form
l Test requisition form
l Stock register
Analysis
Collected data are classified and analysed.
Conclusion
A conclusion is made after the analysis of data.
Project Report
l Title
l Introduction
l Aims/objectives
l Hypothesis
l Method of study
l Data collected
l Analysis
l Conclusion
l Suggestion (if any)
77
l Reference
l Appendix
Project diary can also be evaluated.

l Reference, CD,MM, Model preparation, Chart preparation.
Out come
l Got concrete idea about planning and how to manage a clinical laboratory
l Project report – each learner should have a comprehensive project report
CE
l Project report
l Perfection in collection of report forms
Personal Care
Co. 3 To understand laboratory safety, personal care, handling and storage of chemi-
cals, laboratory hazards and first aid through discussion, demonstration, semi-
nar, field visit, assignment and prepare notes/record/report.
Syllabus
l Lab safety and personal care.
l Handling and storage of chemicals.
l Laboratory hazards
l First aid practice.
Practical
Demonstration of common signs and symbols used in a clinical laboratory.
Learning Activity: Discussion

A general discussion is started by asking a question. Why laboratory personal are
wearing overcoats? Collect responses from the learners about the purpose of doing
so. Discussion is extended to the area of Laboratory safety and personal care.
Discussion points
l What are the hygienic habits?
l Proper arrangement of laboratory glass wares and other materials.
l Proper maintenance of equipments.
78
l Safe and proper laboratory practices.

l Need for vaccination to laboratory personnel.
l General health of laboratory personnel.
Consolidation
l The hygenic habits include washing of hands after work, avoiding mouth
pipetting, cleaning of work benches etc.
l Misplacement and overcrowding of glass wares and other laboratory
materials leads to laboratory accidents
Outcome
l Awareness about personal care
l Identify the common Sign and symbols used in medical laboratory
CE
l Oral test
PE
l Presentation of drawings of common signs and symbols used in medical
laboratory
TE
Here are some signs and symbols commonly used in medical laboratory. Identify the
meanings of these symbols?
Handling and storage of chemicals
Learning Activity - 2 Self experimentation

l Divide the learners into four groups.
l Provide set of reagents including acid, alkali, photosensitive chemicals,
poisonous chemicals, explosive chemicals, hygroscopic substances etc.
l Instruct the learner to arrange them according to their own idea.
79
l Members of the group are allowed to discuss the logic behind their mode
of arrangement.
l Other groups repeat the same procedure.
l The scaffolder along with the learner analyse the merits and demerits of
their methods.
Consolidation Points
l Generally reagents are arranged alphabetically for easy location of reagent.
l Inflammable chemicals should be kept away from fire.
l Corrosive chemicals like strong acids and alkali should be kept on the lowest
part of cupboard.
Out come
l Awareness about handling and storage of chemicals
CE
l Oral test
TE
l A laboratory technician arranged certain chemicals in the following way.
Can you agree with this mode of arrangement. If not, suggest the correct
way of arranging chemicals
a. Alcohols kept on open cupboards.
b. Strong acids are kept in lower shelves.
c. Hygroscopic chemicals are kept in the refrigerator.
d. Leishman stain kept in ordinary glass bottles.
Laboratory Hazards and First Aid
Learning Activity - 3 Seminar

lTeacher introduce a common incident occurring in routine laboratory. For
example, a student doing Benedict’s test in the laboratory. As a part of this
experiment when he heats the boiling tube containing Benedict’s reagent and
urine over a Bunsen burner. It breaks and the leaner gets injury. Teacher asks,
l Suggest the first aid given to the injured learner?
After getting response the teacher illustrates that like this there are many other hazards
taking place in a routine laboratory and which need first aid.
l Why these types of hazards happen in our laboratory?
l What are the precautions to be taken to avoid them?
Through these types of questions, the learners are attracted to the seminar subject.
80
Process
Topic: Laboratory Hazards and First Aid
Sub topic: 1. Biological Hazards and First Aid
2. Electrical Hazards and First Aid
3. Chemical Hazards and First Aid
4. Physical Hazards and First Aid
Planning
Learners are grouped into four. Information may be collected from Reference books
like laboratory manual for tropical countries by Monica Cheesborough. Text Book
of Medical Laboratory Technician by Kanai.L.Mukerji or from inter net etc. Then
prepare rough seminar paper. Teacher correct the seminar paper and instructed to
use chart, transparency, OHP, power point etc.
Then fix a convenient date for seminar invitation and make necessary arrangement for
the seminar.
Presentation
One of the team member from each group will present their subtopics in the seminar.
After presentation a conclusion is made and every learner should prepare seminar
report.
Other suggested activity

Assignment, Role-play
Out come
l Awareness about the seriousness of laboratory hazards to laboratory
personnel.
l Idea about first aid
l Seminar report
CE
l Seminar report
TE
l Laboratory personnel Usually wear white coat and gloves while working.
Give reasons
l Suppose your co-worker fell down unconscious after an electric shock while
using a water bath. Write your immediate action.
81
UNIT HAEMATOLOGY
2
INTRODUCTION
Haematology is an important branch of clinical
medicine. As the changes occurring during diseased
conditions are reflected in the blood, haematological tests
play a major role in the diagnosis of several diseases
and assessing the patient’s progress. Haematological
tests are regularly performed as part of every patients
initial laboratory investigation. Performing accurate
haematological tests however requires repeated practice.
So a student undergoing medical laboratory technician
course should have a thorough knowledge about the
technique and interpretation of various routine
haematological tests. Many of the techniques requires
adequate skill and experience in the use of instruments.
Students have acquired enough knowledge about the
composition of plasma and formed elements in their
course of first year. The content of this unit includes
an understanding of blood collection, routine tests like
DC, Total RBC count, Total WBC count, Absolute
eosinophil count, ESR, PCV, Hb estimation and to
get a basic idea about special investigations like
reticulocyte count, osmotic fragility test, LE cell test,
and sickling test and coagulation studies. In recent years,
especially in advanced laboratories the manual methods
are replacing by automated techniques. So a
familarisation about the automated techniques in
haematology is also included.
After completing this unit the student should acquire
confidence and enough practical skill for doing routine
haematological tests.
82
UNIT AT A GLANCE Unit 2 - Hematology

Experience skill
1. Introduction to haematology •Different methods of Demonstration Reference Prepared Perfection of Medical
4. To understand the different blood collection tech- Practical work Books Laboratory
notes Record note prepara-
methods of blood collection and nique Chart Technology
of practical tion, practical
to develop skill in performing • Capillary and venous Materials for work Vol. I, Kanai
skill, perfection
capillary and venous blood col- blood collection practical L. Mukerjee
of record
lection technique through dis- technique work Basic Medical
cussion, demonstration, practi- • Precautions Laboratory
Techniques, by
cal work and prepare record/ Barbara H.
report. Estridge
Practical
Notes, Practical skill Haematology,
5. To understand about different • Importance of Discussion, Dem- Reference
anticoagulants Record by Dacie
Books record/notes
anticoagulants for blood collec- onstration, Practi-
• Procedure for EDTA cal work, Assign- Materials for Laboratory
tion and to prepare EDTA anti- manual for
anticoagulated bottle ment practical
coagulated bottle through dis- tropical
preparation work
cussion, demonstration, assign- countries, by
ment, practical work, flow chart Monica
Cheesborough,
preparation and prepare notes/ Vol. I
record.
Text Book of
Medical
Laboratory
Technology, by
83
83
Praful B.
Godkar
Unit Chapter
INTRODUCTION TO
2 HAEMATOLOGY 1
Introduction
Blood is an important specimen in which various haematological as well as
biochemical investigations are done. The accuracy of results largely depends
on properly collected specimen and the anticoagulant used. Through this
chapter the learner attains practical skill in capillary and venous blood
collection and understands the precautions to be taken. This chapter also
deals with different anticoagulants and preparation of EDTA anticoagulant
bottle.
1. To understand the different methods of blood collection and to develop skill in
performing capillary and venous blood collection technique through discussion,
demonstration, practical work and prepare record/report.
2. To understand about different anticoagulants for blood collection and to prepare
EDTA anticoagulated bottle through discussion, demonstration, assignment, prac-
tical work, flow chart preparation and prepare notes/record.
Syllabus
F Introduction.
F Methods for collection of blood.
F Capillary and venous blood collection.
- procedure and precautions.
F Anti-coagulants and its classification.
F Explain each anticogulant in detail - EDTA, sodiumcitrate, oxalates, Heparin
fluoride oxalate mixture, ACD, CPD, CPD - A
Practical
l Blood collection technique - capillary and venous blood collection
l Preparation of EDTA anticoagulated bottles
84
Capillary and Venous Blood Collection
Learning Activity: Discussion and practical
Materials
Lancet, syringe, needle, cotton, tourniquet, spirit etc
Process
Blood collection is a live activity done on human body. Learners should not practice
this procedure without a technical supervision. So a live demonstration and discussion
is essential before practising the capillary and venous blood collection.
Divide the learners into five groups. Teacher demonstrates blood collection procedure
infront of each group. Teacher asks some questions to evaluate learners observation
like,
l Sites for capillary blood collection.
l Which vein is selected for blood collection?
l How will you sterilize the area selected for blood collection?
Let the students collect blood each other and allow them to practice. Record the
work done and submit.
Outcome
l Attaines skill to perform venipuncture and capillary puncture
l Submission of the record on work done
PE
l Skill in blood collection
TE
1. While doing venipuncture a tourniquet is applied on the upper arm. Give
reason.
2. A sample of blood collected by a technician was found to be haemolysed.
Write the reasons and its remedy.
Anticoagulants
Co. 2 To understand about different anticoagulants for blood collection and to pre-
pare EDTA anticoagulated bottle through discussion, demonstration, assign-
ment, practical work, flow chart preparation and prepare notes/record.
Syllabus
l Anti-coagulants and its classification.
l Explain each anticogulant in detail - EDTA, sodiumcitrate, oxalates, Heparin, fluoride
oxalate mixture, ACD, CPD, CPD - A
85
85
Practical: Preparation of EDTA anticoagulant bottle

Learning Activity: Dicussion after demonstration
Materials: Test tubes, anticoagulant, blood etc

Instruct the learners to transfer collected fresh blood in two similar test tubes-one
with anticoagulant and other without anticoagulant. Teacher ask a question:
Can you observe any change occurring in these test tubes?
Elicite response.
Consolidation
Certain chemical substances can prevent the process of coagulation.
Learning Activity: Demonstration, assignment and flow chart preparation
Materials
- Reference book
- Textbook of practical haematology by Daicie.
- Wintrobe’s Haematology
- Hand book of Medical Laboratory Technology - CMC Vellore
Process
Teacher demonstrates 2 or 3 available different anticoagulants (dry and wet) and asks
them to enumerate the difference. A preliminary discussion is held.
The points to be discussed.
l Different types of anticoagulants.
l It’s mode of action.
l Application of each.
l Merits and demerits
l Suggests reference materials
l Instruct them to refer relevant books and prepare an assignment report.
l Evaluate the assignment report.
Outcome
• Understand about different anticoagulants
l Classify anticoagulants
l Assignment
86
CE
l Assignment
l Class test
TE
1. Complete the flow chart
Anticoagulant
Artificial
eg. Heparin eg.
2. Complete the following pair

l ESR – sodium citrate ; Glucose estimation ..................................................
l Coagulation studies – sodium citrate ; blood bank ......................................
Preparation of EDTA anticoagulant bottles
Learning Activity - 3: Demonstration and practical
Process
Learners already have an idea about the concentration of EDTA required to prevent
clotting of blood. After recollecting this idea teacher asks a question.
Can you suggest any easy method for taking such a small quantity of anticoagulant in
several bottles?
Teacher elicits response and concludes . Then a demonstration is made on the
preparation of EDTA anticoagulant bottles. Learners practice the same until perfect
skill is attained. Record the work done.
Outcome
l Attained skill in preparing EDTA anticoagulant bottles
l Record of work done.
87
87
88
Experience skill
2. Total Cell Count • Manual and auto- Discussion, Dem- Reference Practical skill Perfection in Medical
6. To understand the different mated methods onstration, Practi- Books, Laboratory
report, record practical work,
methods of cell counting and to • Haemocytometer cal work, Field visit Chart, Technology
Participation in
acquire skill to perform total and • Different types of Materials for Vol. I, Kanai
discussion, Per-
absolute blood cell counting by counting chamber practical L. Mukerjee
fection of record,
discussion, practical work, dem- • INCC Presentation of Basic Medical
note Laboratory
onstration, field visit and prepare • Manual method of cell
Techniques, by
record and note. counting Barbara H.
• Pipette dilution and Estridge
bulk dilution Practical
• Principle, diluting fluid, Haematology,
(Normal Saline, by Dacie
Turke's fluid) proce- Laboratory
dure, calculation, nor- manual for
mal value and interpre- tropical
tation of RBC, countries, by
WBC,Platelet and Monica
Absolute Eosinophil Cheesborough,
count Vol. I
• Automated technique Text Book of
Medical
Laboratory
Technology, by
Praful B.
Godkar
Unit Chapter
TOTAL CELL COUNTS
2 2
Introduction
Enumeration of formed elements of blood has a key role in the diagnosis
of several diseases. Students have previous knowledge about the formed
elements of blood. This chapter deals with the manual method of total cell
counts and gives an idea about automated method of cell counting.
1. To understand the different methods of cell counting and to acquire skill to per-
form total and absolute blood cell counting by discussion, practical work, dem-
onstration, field visit and prepare notes/ record.
Syllabus
F Introduction
F Different methods - manual and automated.
F Manual method of cell counting.
F Mention the different - types of counting chambers.
F Explain improved neubauer counting chamber in detail.
F Dilution method - Pipette dilution and bulk dilution.

- RBC pipette, WBC pipette.
F Principle, diluting fluid, procedure, calculation, normal value and interpretation of

- RBC count, WBC count, Platelet count, Absolute eosinophil count.
F Automated technique (Brief only)
Practical
l Haemocytometer - familiarize with RBC pipette, WBC pipette, Improved
Neubauer counting chamber
l Preparation of normal saline
l Preparation of Tuerk’s fluid
89
89
l Total RBC count

l Total WBC count
l Total platelet count
l Absolute eosinophil count
Counting methods
l Manual
l Automated
Learning Activity - 1: Dicussion

l Learner already have an idea about blood cells.
Teacher initiates a general discussion by asking questions like,
l What is the significance of cell count?
l What are the methods?
l What are the different types of blood cells?
Teacher elicites response
Consolidation
l Importance of blood cell counting in diagnostic field.
l Comparison of manual and automated methods.
Outcome
l Got idea about manual and automated technique of cell counting
CE
l Oral test
Haemocytometer
Learning Activity - 2: Demonstration

Materials
- Counting chambers, (Improved Neubauer Counting chamber) microscope,
chart, reference books
Process
Learners are instructed to focus the haemocytometer under microscope and to note
the details available for them. Provide relevant text books and chart and then have a
general discussion on haemocytometer.
90
Learners are grouped into four and give RBC and WBC pipette. Learners note the
features and compare these two pipette, then prepare a note or chart and submit.
Teacher consolidates the points from four groups and ask to prepare notes.
Discussion points
l Features (surface, ruled area, grooves and ridges)
l Ruled area, RBC, WBC areas
l Different types of counting chambers
l Different types of blood diluting pipettes
l What is the need of blood dilution?
Outcome
l Got thorough understanding about the different components of
haemocytometer
l Prepared notes
CE
l Oral test
PE
l Identification of different components of haemocytometer
TE
Prepare a comparison chart with the help of the following diagram
1. WBC pipette
2. RBC pipette
WBC pipette
RBC pipette
91
91
Consolidation
l Knowledge of different counting chambers.
l Commonly used counting chamber is imporved neubauer counting cheambar.
l Improved Neubauer counting chamber
l Comparison of WBC and RBC pipette
l Counting is easier when the cells are discrete
l Field visit, Reference
Dilution and charging for counting
Learning Activity - 3: Demonstration and practice

Materials
- Haemocytometer , diluting fluids, microscope etc
Process
Bulk dilution and pipette dilution method are demonstrated by the teacher to the
students. The learner acquires skill in dilution and charging by practice. Teacher assures
that students had attained perfection in practical skill and record the work done.
l Field visit, reference CD
Outcome
l Acquires skill in dilution of blood and charging of counting chamber
l Record of work done
PE
l Perfection in practical skill
TE
l Ravi took blood up to the ‘1’ mark and diluting fluid up to ‘11’ mark of a
WBC pipette. Write the dilution of blood he made?
Blood cell counting
Learning Activity - 4: Practical

Materials
- Counting chamber, diluting fluid, microscope etc
92
Process
Teacher tests the previous knowledge of students by asking different questions like,
l What are the different types of blood cells?
l How they are counted?
l What are the methods?
Teacher then leads a general discussion based on following points.
l Purpose of dilution
l Counting chamber
l Ruled area
l Dilution
l Charging
Teacher demonstrates the method of each cell counting before the students. Let the
students practise the different total cell counts. Teacher ensures that the learner has
acquired enough practise. Calculate and report the results, normal value, interpretation
of different cell counts are obtained through reference. After the practical the learner
prepares record and submit.
Outcome
l Capable to do total RBC count, total WBC count, Platelet count, and
eosinophil count.
l Record on work done and reporting of result
CE
l Class test
l Oral test
PE
l Skill in practical work
TE
Match the following
A B C
RBC count Dunger’s fluid 1.5-4.5 lakhs/mm3
WBC count 1% ammonium oxalate 40-440 cells/mm3
Platelet count Daicie’s fluid 4.5-5.5 million/mm3
Absolute eosinophil count Tuerk’s fluid 5000-11000/mm3
93
93

l Reference on multimedia
l Interview with expert
Automated technique
Learning Activity - 4: Field visit

Process
Organize a field visit to an automated laboratory after proper planning. Data collected
during field visit is discussed in the classroom. The consolidated points are enumerated
as note and submitted.
l Demonstration through CD, MM and discussion
94

Experience skill
3. Examination of blood smear • Importance of smear Practical work Charts Practical skill Perfection of Medical
preparation Discussion materials for
7. To understand and develop skill record note practical work Laboratory
Blood smear prepa- Demonstration practical Technology
to perform differential leucocyte •
ration Chart preparation Participation in Vol. I, Kanai
count and peripheral smear ex- work
discussion L. Mukerjee
Character and factors comparison
amination through discussion, • Perfection of
influencing an ideal Basic Medical
demonstration/practical work, record
smear Laboratory
chart preparation and prepare Presentation of Techniques, by
• Romanowsky Stain
notes/record. note Barbara H.
• Preparation of Estridge
Leishman's stain
Practical
• Leishman staining pro- Haematology,
cedure by Dacie
• Differential Leucocyte Laboratory
count manual for
• Peripheral Smear Ex- tropical
amination countries, by
• RBC-Normal size Monica
Cheesborough,
shape, colour
Vol. I
• Name of abnormal
Text Book of
WBC
Medical
• Normal and arrange- Laboratory
ment of platelet
95
Technology, by
95
Praful B.
Godkar
Unit Chapter
EXAMINATION OF
2 BLOOD SMEAR 3
Introduction
Examination of blood smear is probably the most important laboratory
test for the diagnosis of various diseases. A well-made peripheral blood
smear makes the examination easier. Through this chapter the learner
attains perfect skill in smear preparation, staining, and differential leucocyte
count and an idea about abnormal blood cells
7. To understand and develop skill to perform differential leucocyte count and pe-
ripheral smear examination through discussion, demonstration/practical work,
chart preparation and prepare notes/record.
Syllabus
F Preparation of blood smear.
F Characteristics of an ideal smear.
F Factors influencing an ideal smear.
F Staining
- Romanowsky stains
- Preparation of Leishman’s stain
- Leishman’s staining procedure
F Differential leucocyte count
- Counting technique
- Normal value and clinical significance
F Peripheral smear examination
F RBC- Normal size, shape, colour
- Hypochromastia, hyperchromastia
- Abnormal RBC
F WBC- Name the abnormal WBCs.
F Platelets - Normal and arrangement
96
Practical
l Preparation of blood smear
l Preparation of Leishman’s stain
l Differential leucocyte count
l Demonstration of abnormal blood cells - by photographs or slides
Smear preparation
Learning Activity - 1: General discussion

Conduct a general discussion on the importance of smear preparation. Discussion
includes:
l Importance of examination of blood smear
l Thin smear and thick smear
l Uses of blood smear
Consolidate the points obtained through discussion and prepare notes.

Materials
- Slide, spreader, blood etc
Process
Group the learners in to four groups. Demonstrate live practical on smear preparation
before the four groups. Allow the learners to perform the test individually. Teacher
ensures that the learner has acquired enough practical skill on smear preparation.
Record the work done and submit.
l Demonstration of chart of ideal smear.
Staining
Learning Activity - 1: General discussion

Process
Learner have got previous knowledge about the term differential staining and
importance of staining. Recollect and sharpen their idea through general discussion in
classroom. Discussion is continued and conclude as Leishman stain is the most
commonly used stain in the laboratory.
Discussion points
l What is stain?
97
97
l Use of staining
l Examples of differential staining
l Principle of Romanowsky stain
l Examples of Romanowsky stains
l Importance of Leishman stain
Consolidation
l Stains impart colour to cells
l Leishman staining helps in the good performance of differential counting.
Differential counting
Learning Activity - 1: Discussion and Practical Work

Materials
- Materials for Leishman stain, blood smear, microscope etc.
Process
Make a general discussion about the importance of differential count (Preparation of
Leishman stain, staining and counting) Each learner does the practical with different
blood sample. Record the work done / report and submit. Teacher leads a discussion
to make the idea clear
l Group students in to four according to their result obtained in the above
practical
l Give reference book to four groups
l Ask them to interpret their results on normal value and clinical significance.
l Teacher consolidate and students prepare note.
Peripheral smear examination
Learning Activity - 1: Discussion and demonstration

Materials
l Photographs, slides of normal and abnormal blood cells.
Process
l Divide the students in to 5 groups
l Name them as monocyte, lymphocyte, neutrophil, eosinophil and basophil.
l Provide photographs of normal and abnormal blood cells to each group.
Each groups is instructed to compare the difference between normal and
abnormal cells.
98
Discussion Points
l Different types of RBC - Size, Colour
l Abnormal WBC
l Parasites seen in the smear
l Approximate WBC count
l Platelets
Consolidation
l Anisocytosis, Poikilocytosis, hyperchromic and hypochroimc
l Blast cells
l Blood parasites
l
Concrete idea can be obtained through demonstration of stained peripheral smear

l Practical Work, Multimedia, field visit, interview with experts
Outcome
l Skill in ideal smear preparation
l Idea about different haematological stains
l Skill in performing Leishman staining and D.C.
l Record of work done / Report.
l Prepared notes on normal value and clinical significance of D.C.
Evaluation
CE
l Class test
l Oral test
l Quiz
PE
99
99
TE
1. Diagram
Choose the ideal smear from the above three. Justify your answer.
2. Complete the following staining procedure
1. Cover the air dried smear using Leishman’s stain. Keep for 2 - 3 minutes.
2. .........................................................................................................................
3. Mix well and keep for 7-10 minutes
4. .........................................................................................................................
5. Clean the bottom side of the slide.
6. .........................................................................................................................
100

Experience skill
4. Haemoglobin estimation • Name the different Discussion Chart Record Perfection in Medical
8. To understand and to perform methods Demonstration Laboratory
Reference Note practical
Sahli’s and Cyanmetha - • Principle, procedure, Comparison Book Technology
requirments, merits, Practical skill Participation in Vol. I, Kanai
emoglobin estimation through Practical work Materials for discussion
demerits and normal Chart L. Mukerjee
demonstration, practical, survey, Chart preparation practical Distinguishing
values interpretation Basic Medical
discussion and prepare note and of Sahli’s and work capacity Laboratory
record. cyanmethaemoglobin Techniques, by
method Barbara H.
• Preparation of stan- Estridge
dard graph of Practical
cyanmethaemoglobin Haematology,
method by Dacie
Laboratory
manual for
tropical
countries, by
Monica
Cheesborough,
Vol. I
Text Book of
Medical
Laboratory
Technology, by
Praful B.
101
101
Godkar
Unit Chapter
HAEMOGLOBIN
2 ESTIMATION 4
Introduction
Anaemia is a major health problem especially in women. Further haemoglobin
value drops during pregnancy. Monitoring Hb concentration became an
inevitable part of routine haematological tests. At the end of this chapter,
the learners attain practical skill in performing Hb - estimation by Sahli's
method and cyanmethaemoglobin method.
8. To understand and to perform Sahli’s and Cyanmethaemoglobin estimation through
demonstration, practical, survey, discussion and prepare note and record.
Syllabus
F Name the different methods of Hb estimation.
F Principle, requirments, procedure, advantage, disadvantage and normal value of
Sahli’s acid haematin method in detail.
F Principle, requirements, procedure, calculation, normal value, advantage,
disadvantage and interpretation of cyanmethaemoglobin method - clinical
significance.
F Preparation of standard graph of cyanmeth method.
Practical
l Haemoglobin estimation – Sahli’s method
l Haemoglobin estimation – Cyanmethaemoglobin method
Learning Activity - 1: Discussion

While examining patients doctors usually check the eyelid mucosa. Teacher asks
question
l What is the purpose?
l A discussion is made on it. With the previous knowledge of the learners,
teacher direct the discussion about the haemoglobin, its estimation and
importance.
102
Discussion Points
l What is haemoglobin?
l Importance of haemoglobin estimation
l Functions of haemoglobin
l Different methods of haemoglobin estimation
Consolidation
l Haemoglobin is the respiratory pigment in blood.
l Essential to detect anemia.
l Transport of oxygen, colour of blood etc.
l Sahli’s method, Cyanmethaemoglobin method, physical, chemical and
gasometric methods.
Learning Activity - 1: Practical Work

Materials required
- Sahli’s haemoglobinometer, N/10HCl, Drabkin’s solution, colorimeter,
blood etc.
Process
Teacher starts a general discussion about the principle, requirements, procedure, normal
value, calculation and clinical significance of Sahli’s and Cyanmethaemoglobin methods.
Learners are grouped into four groups. Teacher demonstrates the practical before
each groups. Allow the students to repeat the tests individually until they get sufficient
skill. The teacher ensures that the students acquired the skill. The findings are recorded
and submitted
l Teacher asks the students to prepare note on normal value and clinical
significance of haemoglobin estimation by reference.
Survey – Screening of school children for anaemia.
Out come
l Realizes the importance of haemoglobin estimation
l Able to do haemoglobin estimation by Sahli’s method and Cyanmet
haemoglobin methods skillfully.
l Record on work done/ report
l Prepared notes based on normal value and clinical significance.
103
103
Evaluation
CE
l Class test
l Oral test
l Prepared notes
PE
TE
1. A 14 year old girl complaining about fatigue and breathlessness approach
the doctor. Can you guess the most appropriate test the doctor will
recommend? Give the details of performing the test
2. Different methods are available for haemoglobin estimation. Can you suggest
the method recommended by WHO along with its merits and demerits.
104

Experience skill
5. Packed Cell Volume • Different methods of Discussion Reference Practical Skill Participation in Medical
9. To understand and to perform doing PCV micro Demonstration books Laboratory
method and macro Record discussion
PCV through discussion, dem- Practical work Materials for Technology
method Practical Note Perfection of Vol. I, Kanai
onstration and practical work, practical
• Buffy coat work L. Mukerjee
prepare notes/record.
• Principle, Require- Perfection of Basic Medical
ments, procedure, record Laboratory
normal value and in- Note Techniques, by
terpretation of Barbara H.
Wintrobe’s method. Estridge
Practical
Haematology,
by Dacie
Laboratory
manual for
tropical
countries, by
Monica
Cheesborough,
Vol. I
Text Book of
Medical
Laboratory
105
Technology, by
105
Praful B.
Godkar
Unit Chapter
PACKED CELL
2 VOLUME 5
Introduction
Determination of packed cell volume is a simple method of estimating the
red blood cell mass in blood. Students already have an idea about the
different layers formed when anticoagulated blood is centrifuged. Through
this chapter the learner understands about the importance of PCV, clinical
significance and attains skill to perform PCV.
9. To understand and to perform PCV through discussion, demonstration and prac-
tical work, prepare notes/record.
Syllabus
F Introduction to packed cell volume.
F Method of doing PCV - macro method and micro method.
F Explain the principle, requirements, procedure, normal value and interpretation

of Wintrobe’s method.
Practical
l Packed cell volume – Wintrobe’s method
Learning Activity - 1: Practical Work

Materials
l PCV tube
l Blood
l Pasteur pipette
l Centrifuge
Process
Teacher tests previous knowledge about the components of blood. Initiate a general
discussion on
l The formation of different layers when anticoagulated blood is centrifuged
106
l Teacher demonstrates the process

Continue discussion to lead the idea.
l Volume of packed red cells can be calculated if a calibrated tube and standard
centrifugation is used.
Now teacher demonstrates the process of the practical
l Each learner does the practical till he/she attains the perfect skill
l Prepare a report of the practical
Discussion points
l Different layers
l Buffy coat
l Different methods for PCV
Consolidation
l Plasma, buffy coat and RBCs
l Buffy coat consists of white blood cells and platelets
l Micro and macromethods.
Interpretation and normal value of PCV
Learning Activity - 2: Discussion with hand out

Materials
- Hand outs on normal value and interpretation.
Process
Teacher divides the students into 2 groups. Assigns task for each group.
l Group 1 – Those obtained higher values than normal in the above practical
l Group 2 – Those obtained lower values than normal in the above practical
Give hand out to each group. Instruct each group to compare the results they obtained
with the handouts.
l Teacher guides the group discussion on the clinical significance of the PCV
l Groups presents their findings.
l Teacher consolidates
l Each learner prepares a note on the discussion.
Out come
l Got idea about the importance of PCV
107
107
l Able to do PCV by Wintrobe’s method

l Record on work done / report
l Note based on discussion about normal value and clinical significance
Evaluation
CE
l Class test
l Oral test
l Prepared notes.
PE
l Skill in practical
TE
l Haematocrit (PCV) is a commonly performed test in haematology
laboratory having many applications. Enumerate the various applications.
108

Experience skill
6. Red Cell Indices • Importance, calcula- Discussion Reference Note Perfection of Medical
10 . To acquire an idea about red cell tion, Normal value of Comparison books Laboratory
preparation note preper-
indices through discussion, com-
MCV, MCH, MCHC Calculation
ation Technology
and MCD Vol. I, Kanai
parison, calculation and prepare Participation in
L. Mukerjee
notes. discussion
Basic Medical
Perfection of
Laboratory
practical Techniques, by
Barbara H.
Estridge
Practical
Haematology,
by Dacie
Laboratory
manual for
tropical
countries, by
Monica
Cheesborrough,
Vol. I
Text Book of
Medical
Laboratory
Technology, by
109
109
Praful B.
Godkar
Unit Chapter
RED CELL INDICES
2 6
Introduction
Red cell indices is an important aid to the physician in diagnosing various
types of anaemia. Automated electronic counters can give accurate values
on red cell indices. This chapter familiarises with the calculation of red cell
indices from the results obtained by manual procedures.
10 . To acquire an idea about red cell indices through discussion comparison, calcu-
lation and prepare notes.
Syllabus
F Importance, calculation and normal value of MCV, MCH, MCHC and MCD.
Learning Activity - 1: Discussion and reference

Materials
- Reference Books
- Practical Physiology – G.K.Pal, Pravati Pal
- Medical laboratory Technology - Volume I - Mukerjee
Process
Teachers starts a general discussion by recollecting the previous knowledge about
PCV, Haemoglobin estimation and total count. The discussion continue to calculate
the MCH,MCHC, MCV &MCD using reference books. A brief note is prepared and
submitted
Discussion points
l What are the red cell indices?
l Calculation of red cell indices
l Normal value
l Importance of red cell indices
110
Consolidation
l Red cell indices include MCH,MCHC, MCV &MCD
l Formula for calculating the red cell indices
l
Out come
l Got idea about the importance of red cell indices
l Able to calculate red cell indices
l Prepared notes
Evaluation
CE
l Oral test
l Prepared note
TE
l Here is the haematological report of a patient suffering from anemia
Haemoglobin concentration - 9gm%
PCV - 28 %
Red cell count - 3.2 millions/Millimeter3
ESR - 24 millimeter/1st one hour
Calculate MCV and MCH from the above data
111
111
112
Experience skill
7. Erythrocyte sedimentation rate • Different methods of Guided, discussion Reference Practical skill Participation in Medical
ESR determination Practical work books Laboratory
11 . To understand and perform ESR Record, note discussion
by Westergren’s method • Principle, Require- Demonstration Materials for Technology
ments, preparation of Perfection of Vol. I, Kanai
Practical
through discussion, demonstra- practical
3.8% Trisodium cit- work L. Mukerjee

tion, practical work, prepare rate Perfection in Basic Medical
notes and record. • Procedure
observation Laboratory
• Normal value, inter- Techniques, by
Barbara H.
pretation and clinical
Estridge
siginifance of
Westergren's method Practical
Heamatology,
• Stages, factors affect-
by Dacie
ing ESR
Laboratory
manual for
tropical
countries, by
Monica
Cheesborrough,
Vol. I
Text Book of
Medical
Laboratory
Technology, by
Praful B.
Godkar
Unit ERYTHROCYTE Chapter
SEDIMENTATION
2 RATE 7
Introduction
Learners already have the concept of sedimentation. The rate of red cell
sedimentation can give valuable information about the state of health of
the body. This chapter deals with the technique of ESR determination,
stages of ESR, factors affecting ESR and its clinical significance.
11. To understand and perform ESR by Westergren’s method through discussion,
demonstration, practical work, prepares notes and record.
Syllabus
F Introduction.
F Different methods of ESR determination: Westergren’s method, Wintrobe’s
method.
F Describe the principle, requirments, procedure, normal value and interpretation

of ESR by Westergren’s method.
F Stages of ESR.
F Factors affecting ESR.
F Clinical significance.
Practical
l Preparation of 3.8% sodium citrate

l Erythrocyte sedimentation rate – Westestergren’s methods
Learning Activity - 1: Guided discussion with hand out
Materials
Hand outs on importance and clinical significance of ESR
- Divide the students into 4 groups
113
113
- Supply the hand outs to each group

- Teacher can assist the group when ever necessary
- One among the group presents their consolidation points
- Discussion points are consolidated by teacher
- Notes are prepared by each students
-
Discussion points
l What is prognosis?
l Importance of ESR
l What are the different methods for ESR estimation
Consolidation
l Idea about difference between diagnosis and prognosis
l ESR is the test for prognosis
l Idea about different methods of ESR estimation
Other Suggested activities
l Reference
l Interview with experts
Materials required
- ESR tube – Westergren’s
- Anticoagulant (Trisodium citrate 3.8%)
- Blood etc.
Process
l Teacher demonstrates the mixing of blood with anticoagulant and how the
tube is filled and the method of setting on the stand
l Set an alarm clock for one hour
l Ask the learner to observe the changes.
l Teacher ask to note the length of plasma column which is reported as ESR
value
l The learners are allowed to perform the ESR test until practical skill has
attained
l Record the work done and report
114
Other suggested activity – Field visit, OJT

Learning Activity - 3: Discussion with Hand outs
Materials
Handout on factors affecting ESR, stages, normal value and interpretation
- Divide the students into 4 groups
- Supply the handouts to each group
- Teacher facilitates group discussion where ever necessary
- One among the groups presents the points
- Teacher consolidates and learner prepare notes.
Discussion Points
l Physiological factors affecting ESR
l Technical factors
l Stages of ESR
l Normal value
l Interpretation
Consolidation
l Red cell factor and plasma factors
l Temperature, time, anticoagulant used
l Length of ESR tube
l Inclination of the tube
l

l Reference
l CD, MM
Out come
l Got an idea about the importance and significance of ESR
l Acquired skill in performing ESR
l Prepared notes
l Record of work done
115
115
Evaluation
CE
l Class Test
l Prepared note
PE
TE
l “ESR is a prognostic test rather than diagnostic” Explain the above
statement with the help of example
2. ESR test is based on the principle of sedimentation, the process of solid
particles settling to the bottom of a liquid. Several factors affect the ESR.
Enlist the factors affecting the rate of erythrocyte sedimentation in a blood
sample.
116

Experience skill
8. Coagulation studies • Process of coagula- Discussion Materials for Practical skill Perfection in Medical
tion practical NoteRecord Laboratory
12. To understand various coagula- Demonstration practical,
• Coagulation factors Technology
tion tests like BT, CT, PT and to Practical work Reference Participation in
• Name the various co- Vol. I, Kanai
perform Duke’s or Ivy’s books discussion,
agulation tests L. Mukerjee
method, Lee & White method, Perfection in
• Bleeding Time by Ivy's demonstration, Basic Medical
Capillary tube method through Laboratory
or Duke's method and OT
discussion, demonstration and its interpretations Techniques, by
Barbara H.
practical work prepare note/ • Clotting Time by Estridge
record. Capillary tube and
Practical
Lee and White
Haamatology,
method by Dacie
• PT by Quick's
Laboratory
method manual for
tropical
countries, by
Monica
Cheesborough,
Vol. I
Text Book of
Medical
Laboratory
Technology, by
117
117
Praful B.
Godkar
Unit
COAGULATION
Chapter
2 STUDIES 8
Introduction
Learners already have an idea about the coagulation of blood. Patients
prepared for surgery are routinely tested for normal haemostasis and patients
having bleeding disorders are regularly monitored. Through this chapter the
learners realises their role in investigation of bleeding disorders and attains
skill in performing bleeding time test and clotting time test.
12. To understand various coagulation tests like BT, CT, PT and to perform Duke’s
or Ivy’s method, Lee & White method, Capillary tube method through discus-
sion, demonstration and practical work prepare note/record.
Syllabus
F Review of coagulation.
F Coagulation factors.
F Name the various cogulation tests.
F Explain:
- Bleeding time by Ivy’s method and its interpretation
- Clotting time by Capillary tube method and Lee & White method.
- Prothrombin time by Quick’s one stage method.
Practical
l Bleeding time – Duke’s or Ivy’s method

l Clotting time – Capillary tube method
Learning Activity - 1: Discussion and practical

Materials
- Hand out on bleeding time, clotting time and prothrombin time
- Teacher initiates a discussion after recollecting coagulation factors and
coagulation.
118
Process
l Divide the students into 3 groups
l Give handout on bleeding time to first group, clotting time to second and
prothombin time to the third.
l Instruct each group to go through and discuss the hand out
l One student from each group presents their discussion points
l After completing the presentation, teacher consolidates the discussion points
and learner prepares note
Discussion points
l Process of coagulation
l Importance of coagulation studies
l Clotting time test, bleeding time test, prothrombin test
Consolidation
l Blood cells and coagulation factors are involved in coagulation
l Coagulation studies help in the diagnosis of bleeding disorders.
Other Suggested Activities
l Reference , field visit , interview with technical experts

Materials
- Materials for bleeding time test, clotting time test, prothrombin test
Process
Teacher demonstrates the test – bleeding time test, clotting time test, prothrombin
test in front of the learners. The learners are allowed to perform the test after
observation till practical skill has obtained. Record and report the finding
l Field visit, reference
Out come
l Got an idea about process of coagulation and importance of coagulation
l Gained skill for doing bleeding time test and clotting time test
l Prepared note
l Record of practical work
119
119
Evaluation
CE
l Oral test
l Class test
l Prepared note
PE
TE
l If a patient with bleeding disorder approaches you for laboratory
investigation, what are the tests you would perform up on him
120

Experience skill
9. Special Investigations • Reticulocyte Discussion Reference Note Perfection on Medical
13 To understand about reticulocyte • Supra vital staining Demonstration books Laboratory
note prepara-
Reticulocyte count Technology
and reticulocyte count through • tion
Vol. I, Kanai
discussion, demonstration and • Calculation
L. Mukerjee
prepares note. • Normal value
Basic Medical
• Interpretation Laboratory
Techniques, by
Reference Barbara H.
14. To acquire basic idea about Os- • Osmotic fragility test Discussion Note Perfection on
(screening test) books Estridge
motic fragility test (OFT), LE Reference note prepara-
tion Practical
Cell test and Sickling test • Name auto Immune Demonstration
disease Heamatology,
through discussion, reference, by Dacie
• Procedure LE cell
demonstration etc., and prepare Laboratory
test
notes. manual for
• Procedure of Sickling
tropical
test countries, by
Monica
Cheesborough,
Vol. I
Text Book of
Medical
Laboratory
Technology, by
121
121
Praful B.
Godkar
Unit
SPECIAL
Chapter
2 INVESTIGATIONS 9
Introduction
Though not routinely done special investigations has a role in the diagnosis
of haematological disorders. This chapter gives familarisation of important
special haematological tests. It helps to extend the students knowledge about
haematology.
13. To understand about reticulocyte and reticulocyte count through discussion, dem-
onstration and prepares note.
Syllabus
F Know about reticulocyte and reticulocyte count.
F Supravital staining, counting, calculation, normal value and interpretation.
Learning Activity - 1: Discussion after demonstration

l Teacher shows the photographs of reticulocyte and normal red blood
cells
l Teacher asks to compare the two and comment on the difference observed
l Teacher consolidates discussion points
l Discussion continues on the importance of reticulocyte and its count
l Prepare notes
Discussion Points
l Difference between RBC and Reticulocyte
l Reticulocyte count
Consolidation
l Precursor of RBC, non nucleated cell etc.
l Reticulocyte count related to erythropoetic activity
l
122

l Reference, Multimedia
Learning Activity - 2: Demonstration after discussion

Materials
- Hand outs
- Supravital stain
- Blood smear etc.
Process
l Conduct an oral test based on reticulocyte
l Divide the students in to 4 groups according to score obtained
(Each group should contain learners getting high scores and low scores )
l Give the hand out containing adequate information about the method,
calculation, normal value and interpretation of reticulocyte count to each
group
l Teacher guide the discussion
l One among each group presents the consolidated points
l Teacher performs a live demonstration to get a clear idea about reticulocyte
count.
l Record and submit
Discussion points
l Supravital staining
l Procedure of staining
l Technique of counting
l Interpretation
Consolidation
l Staining in a living condition is supravital staining
l
Outcome
l Got an idea about reticulocyte
123
123
l Acquired basic idea about different steps in reticulocyte count

l Prepared note
CE
l Class Test
l Prepared note
TE
l Reticulocyte counting is done mainly to monitor the treatment response of
anemia. Write down the main steps of reticulocyte counting.
Osmotic fragility test, LE cell test and sickling test
C.O. 14 To acquire basic idea about Osmotic fragility test (OFT), LE Cell test and
Sickling test through discussion, reference, demonstration etc., and pre-
pare notes.
Syllabus
F Basic description of osmotic fragility test.
F Basic knowledge of auto immune disease and LE cell test.
Learning Activity - 1: Discussion after giving hand outs

l Teacher divide the students into three groups
l Each group are given handouts containing brief note about Osmotic Fragility
Test, LE Cell test and Sickling Test.
l Students are asked to discuss the matter
l Teacher assists the group during discussion
l One student from each groups present the consolidated points.
l Teacher consolidates the topic with relevant points
l Note is prepared by each student and submit.
Discussion points
l Osmotic Fragility Test
l LE Cell test
l Sickling Test.
Consolidation
l Brief idea about Osmotic Fragility Test, LE Cell test and Sickling Test.
l
124
Outcome
l Got an idea about Osmotic Fragility Test, LE Cell test and Sickling Test.
l Prepared notes
Evaluations
l Class Test
l Oral Test
l Prepared note
TE
Match the following
A B C
1. Osmotic Fragility Test SLE Sodium metabisulphite
2. LE Cell test Spherocytosis ANA
3. Sickling Test Sicklecell anaemia Hypotonic saline
125
125
UNIT CLINICAL PATHOLOGY

3
INTRODUCTION
Examination of body fluids other than blood is included

in clinical pathology. Clinical pathology investigations
like urine analysis, stool examination, sputum
examination etc. are routinely done in clinical
laboratories. Technicians working in clinical pathology
laboratory are required to examine various body fluids
and it primarily focuses on physical examination,
microscopy and chemical examination.
At the end of this unit learner get thorough practical

skill in urine analysis, stool examination, sputum
examination, and semen analysis. Field visit and
OJT help to give an exposure on CSF examination
also.
126
UNIT AT A GLANCE Unit 3 - Clinical Pathology

Experience skill
1. Introduction to clinical • Importance of clinical Discussion Materials for Note Perfection of Medical
Pathology pathology Field visit demonstra- Diary note diary Laboratory
• Different types of tion Technology
15. To have an idea about the im- Demonstration Participation in
specimen Vol. II, Kanai
portance of Clinical Pathology discussion
L. Mukerjee
and types of specimen used
through discussion, demonstra- Basic Medical
tion, field visit and prepare re- Laboratory
port. Techniques, by
Barbara H.
Estridge
Text Book of
Medical
Laboratory
Technology, by
Praful B.
Godkar
127
127
Unit INTRODUCTION Chapter
TO CLINICAL
3 PATHOLOGY 1
15. To have an idea about the importance of Clinical Pathology and types of speci-
men used through discussion, demonstration, field visit and prepare report.
Syllabus
F Importance of clinical pathology.
F Different types of samples used.
Learning Activity - 1 : Field Visit
Materials
l Field Visit Plan
Process
l Plan a field visit to a nearby clinical pathology laboratory for getting
information about the importance of clinical pathology in medicine and
different types of specimen used in a clinical laboratory. A general discussion
is needed to plan the field visit and confirm the full involvement of students.
During which the following things should be noted
Point for planning
l Mode of conveyance
l Permission from the authority and school
l Diary for recording data
l Time and date
l Instruction to students
Consolidation
l After a field visit a general discussion should be done to evaluate and
consolidate the observed things from laboratory and prepare notes.
128
Other suggeted activities

l Reference, CD, discussion
Outcome
l Basic knowledge about the importance of clinical pathology in medical
diagnosis.
CE
l Field visit diary, oral test.
VCE
l Field visit.
129
129
130
Experience skill
2. Urine Analysis • Urine collection Discussion Chart Record Perfection of Medical
16. To understand collection, normal • Types of samples Demonstration Reference Practical Skill note Laboratory
and abnormal constituents, • Preservation Technology
Assignment books Field visit
physical chemical and micro- • Normal and abnor- Record
Materials for Vol. II, Kanai
scopic examination of urine mal constituents Quiz DiaryNote Diary
practicals L. Mukerjee
through discussion, quiz, field • Physical examination Practical Perfection in
visit, demonstration, practical • Chemical examina- Basic Medical
practical
work, comparison, prepare tion Laboratory
notes, diary record /report and Techniques, by
• Microscopic exami-
Assignment. Barbara H.
nation
Estridge
17. To get an idea about the impor- Discussion
• Pregnancy test Reference Text Book of
tance of pregnancy test and to Practical skill Perfection of
• Importance Demonstration books, practical work Medical
perform the card test through record
• Name of different Materials for Perfection of Laboratory
discussion, demonstration, prac- Practical work
methods practical Technology, by
tical work, prepares notes and record work
• Procedure of card Praful B.
record. test Godkar
Unit Chapter
URINE ANALYSIS
3 2
Introduction
Examination of urine is an inevitable procedure for the abnormalities of
kidney function and the urinary tract. It can also give information about
diseases that affects even outside the urinary tract .The easy availability of
the specimen makes urine analysis a basic investigation. The learners should
get a thorough practical skill in analysing a sample of urine and understand
the interpretation of various tests. Practical classes and OJT help to attain
this skill.
16. To understand collection, normal and abnormal constituents, physical chemical
and microscopic examination of urine through discussion, quiz, field visit, dem-
onstration, practical work, comparison, prepare notes, diary record /report and
Assignment.
17. To get an idea about the importance of pregnancy test and to perform the card
test through discussion, demonstration, practical work, prepares notes and record.
Syllabus
F Collection of urine sample - different types of samples.
F Brief description of normal and abnormal constituents of urine.
F Examination of urine.
F Physical examination.
F Volume, colour, specific gravity and reaction.
F Chemical examination.
Principle, reagents, procedure and interpretation of common abnormal constituents
such as:
Sugar - by Benedict’s test
Protein - by Heat and acetic acid test
131
131
Ketone bodies - by Rothera’s test

Bile Pigment - by Fouchet’s test
Bile salt - by Hay’s test
Urobilinogen - by Ehrlich’s test
Blood - by Benzidine test
F Microscopic examination of urine

- preparation of urine for microscopic examination.
- demonstration of crystals, cells and casts.
F Pregnency test
- Importance of test
- Name different methods
- Procedure of card test
Practical
l Preparation of 5% acetic acid solution

l Physical examination of urine
l Chemical examination of urine
l Microscopic examination of urine
Learning Activity - 1 : Discussion
Material
l Reference books
Process
l First recollect the idea about urine from the previous knowledge. by asking
questions. Teacher consolidates that urine is the common sample reaching
clinical pathology laboratory, it has a major role in the diagnosis of different
clinical conditions. Different methods of urine collection, containers used
for collection etc are discussed.
Discussion points
l Importance of urine as a clinical specimen
l Different collection techniques
l Different types of urine sample
l Preservatives used.
132
Consolidation
l Relevance of urine sample as clinical specimens – diagnostic
l Idea about different collection techniques
l Early morning, midstream, clean catch specimen etc.
l Idea about urine preservation and preservatives used.
Learning Activity - 2 : Practical and comparison
Material
l Materials for practical work
Process
l Teacher give a live demonstration of physical, Chemical and microscopic
examination of urine.
l Provide the students with different samples showing variable results
l Ask to perform the practicals until perfection in practical skill is attained
l Arrange a visit to a hospital or well equipped laboratory to extend and
strengthen the idea
Learning Activity - 3 : Assignment on physical, chemical and microscopic
examination of urine
Process
A preliminary discussion including the major points like,
l Physical Examination
l Chemical Examination
l Microscopic Examinations of urine
l Clinical significance of tests
Teacher explains the above point and suggest reference materials like
l Medical Laboratory Technology by Kanai: Mukerjee
l Clinical diagnosis and Management by laboratory methods - Todd and
Sanford
Instruct them to refer the relevant books and ask to prepare assignment report. Teacher
evaluates the assignment report made individually.
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133
Outcome
l Skill to perform routine urine analysis.
l Record/report
l Assignment
CE
l Assignment note
l Class test
l Oral test
PE
l Physical, chemical, microscopic examination of urine.
TE
Match the following
A B C
Sugar Rothera’s test Starvation/fasting
Protein Hay’s test Obstructive joundice
Ketone body Benedict’s test Diabetes mellitus
Bile salt Heat and acetic acid test kidney disease
VCE
l Field visit
Pregnancy Test
CO.17 To get an idea about the importance of pregnancy test and to perform the
card test through discussion, demonstration, practical work, prepares notes
and record.
Practical
l Demonstration of Pregnancy test in urine
Learning Activity - 2 : Discussion and demonstration
Process
Teacher initiates discussion by asking a question.
How will you detect pregnancy in early stage?
134
l Teacher elicits their response and directs the discussion to importance of

urine sample and hormones related to pregnancy.
l The scaffolder illustrate the importance of HCG in pregnancy
l Teachers demonstrates the method of pregnancy test by card test
l Students record the work done and observation and submit
Consolidation
l Pregnancy can be confirmed by detecting HCG in urine in early stages.
l Methods of pregnancy test in urine
l Skill to perform pregnancy (card)
Outcome
l Able to perform pregnanacy test (card)
l Record the procedure
VCE
l Hospital visit.
135
135
136
Experience skill
3. Stool Examination • Importance Discussion Materials for Practical skill Perfection of Medical
18. To understand the importance, • Collection Demonstration practical record Laboratory
practical work
sample collection and to perform • Macroscopic (consis- Practical work work Technology
Perfection of
Vol. II, Kanai
macroscopic and chemical ex- tency, colour, mucus Assignment record work
and parasite) L. Mukerjee
amination of stool by discussion,
Basic Medical
demonstration, practical work, • Microscopic (saline,
iodine technique and Laboratory
prepares notes, report and as- Techniques, by
concentration by sa-
signment. line floatation) Barbara H.
• Chemical examination
Estridge
(occult blood- Text Book of
Benzdine test, reduc- Medical
ing substance Laboratory
Benedict’s test) Technology, by
Praful B.
Godkar
Unit
STOOL Chapter
3 EXAMINATION 3
Introduction
Stool is an important specimen reaching a clinical pathological laboratory.
The examination of faeces often receives a short shrift due to handling the
specimen. This chapter aims at an understanding the importance of stool
examination and attaining practical skill and there by eliminating handling
of the specimen with diffidence.
18. To understand the importance, sample collection and to perform macroscopic,
microscopic and chemical examination of stool by discussion, demonstration,
practical work, prepares notes, report and assignment.
Syllabus
F Importance of stool examination
F Sample collection
F Macroscopic examination
- Consistancy, Colour, Mucus and Parasites
F Microscopic examination
- Saline preparation
- Iodine preparation
- Concentration by saline floatation
F Chemical examination
- Occult blood - Benzidine test
- Reducing substances - Benedict’s test
Practical
l Macroscopic examination of stool
l Microscopic examination of stool
l Chemical examination of stool
(Occult blood and reducing substance)
137
137
Learning Activity - 1 : Demonstration and practical

Materials
l Stool Sample
l Microscopic slides
l Cover slip
l Microscope etc
Process
Teacher starts discussion on importance of stool examination by asking same questions
like
l What is the choice of specimen collected in the cases of disease like diarrhoea,
gastroenteritis, cholera, helminthes, infection etc?
l How can we collect a stool sample?
l Is there any precautions need to be taken during collection?
Teachers elicits response and leads to a conclusion on the
l Importance of stool examination
l Collection of stool sample
l Precautions to be taken during collection
l Teachers demonstrate macroscopic, microscopic examination and
concentration technique by simple floatations technique.
l Students are asked to repeat the same until practical skill is attained
l Record the work done, finding and report
Outcome
l Learners get skill to perform stool examination.
l Record on work done/findings
PE
l Macro, Micro &chemical examination of stool.
TE
l A patient having diarrhoea symptoms is admitted to hospital. Stool sample
is submitted to the laboratory for examination. Suppose you are the lab
technician there.
How will you process the sample for microscopic examination?
VCE
l Field visit /OJT.
138

Experience skill
4. Sputum Examination • Sputum Discussion Reference Record, Perfection of Medical
• Importance of sputum Demonstration Books
19. To understand the importance, Practical skill, record/note Laboratory
• Sample collection
collection of sputum and to per- Materials for note Technology
• Macroscopic exami- Practical work practical Vol. II, Kanai
form macroscopic and micro- nation, consistency,
work L. Mukerjee
scopic examination of sputum colour
• Microscopic exami- Basic Medical
through discussion, demonstra-
nation - AFB, Gram’s Laboratory
tion, practical work, prepares Techniques, by
staining
note and record. Barbara H.
Estridge
Text Book of
Medical
Laboratory
Technology, by
Praful B.
Godkar
139
139
Unit
SPUTUM Chapter
3 EXAMINATION 4
Introduction
Examination of sputum is a valuable means of investigating diseaeses of
the respiratory tract especially pulmonary tuberculosis. Sputum examination
is carried out routinely as a part of eradication of tuberculosis. This chapter
aims to attain practical skill in sputum examination.
19. To understand the importance, collection of sputum and to perform macroscopic
and microscopic examination of sputum through discussion, demonstration, prac-
tical work, prepares note and record.
Syllabus
F Importance of sputum examination.
F Sample collection
- Consistency and Colour
- AFB staining
- Gram’s staining
Practical
l Sputum Examination
Material
l Handout on collection and importance of sputum.
Learning Activity - 1 : Discussion with handouts
Process
l Teacher collects the previous knowledge of the students
l Then group the students into four and give handout on importance and
collection of sputum.
140
l Teacher guides the discussion whenever necessary

l The discussed points are consolidated by the teacher
l Students are asked to prepare notes
Discussion points
l Anatomy of respiratory tract
l Importance of sputum
l Collection of sputum specimen
Consolidation points
l Sputum examination is the confirmatory tests for pulmonary tuberculosis
and early detection of some other diseases.
l Sputum specimens are collected in a wide mouthed screw capped bottles.
Sputum examination
Learning Activity - 1 : Practical after demonstration
Materials
l Sputum sample
l Microscopic slides
l Stains
l Microscope etc.
Process
l Teacher demonstrates macroscopic and microscopic examination of sputum.
l Students then perform the practical until skill is attained
Outcome
l Learner achieved practical skill to perform sputum examination
l Record on work done/finding.
PE
l Sputum examination
TE
l A patient is supposed to have tuberculosis is admitted to the hospital and
sputum sample is reached the laboratory for investigation. Can you suggest
an outline of sputum sample processing in the lab?
VCE
l Hospital visit /OJT.
141
141
142
Experience skill
5. Semen Analysis • Importance Discussion Reference Practical skill Medical
• Sample collection Perfection of
20. To understand the importance, book record Laboratory
• Macroscopic exami- Practical work practical work
sample collection and to perform Materials for Technology
nation (volume, viscos-
practical Vol. II, Kanai

macroscopic, microscopic and ity, colour, reaction and
work L. Mukerjee
chemical examination of semen liquefaction time)
Microscopic examina- Basic Medical
through discussion, practical •
tion (Motility, Total Laboratory
work, prepares record and note. Techniques, by
sperm count, Mor-
phology of spermato- Barbara H.
zoa, other cells) Estridge
• Chemical examination Text Book of
• Name of tests and acid Medical
phosphatse. Laboratory
Technology, by
Praful B.
Godkar
Unit Chapter
SEMEN ANALYSIS
3 5
Introduction
Semen analysis being a relatively simple investigation, it became a routine
procedure of infertility investigation. Through this chapter the learners get
an understanding about the importance of semen analysis and collection of
the specimen. Practical skill is also attained in semen analysis through
practical and OJT.
20. To understand the importance, sample collection and to perform macroscopic,
microscopic and chemical examination of semen through discussion, practical
work, prepares record and note.
Syllabus
F Importance of semen analysis
F Sample collection
- Volume, viscosity, colour, reaction and liquefaction time
- Motility
- Total sperm count
- Morphology of spermatozoa
- Other cells
F Chemical examination
- Name the different tests - fructose, acid phosphatase
Practical
l Semen analysis
143
143
Importance and collection of semen

Learning Activity - 1 : Discussion and practical
Material
l Sample
l Microscopic slide
l Cover slip
l Counting chamber etc.
Process
Teacher tests the previous knowledge by asking certain questions like
l What is the secretion from the male reproductive organs?
l What are the functions of seminal fluid?
l What is the importance of semen analysis?
l Teacher starts discussion based on recollected points.
l Learners are asked to prepare notes
l Teacher demonstrates the method of semen analysis
l Students repeat the same until practical skill is attained
l Record work done/findings and report
Discussion points
l Importance of semen analysis
l Procedure of collection
l Precautions taken during collection
Consolidation
l Investigation of male infertility
l Medico legal cases
l Concrete idea about sample collection.
l Reference
Outcome
l Skill to perform semen analysis
144
l Prepared notes
l Record on work done/finding
CE
l Prepared notes
l Class test/oral test
TE
l A technician instruct the patient to submitt semen samples within 30 minutes
after collection. But he submitted the sample only after one hour. How it
affects the result?
145
145
146
Experience skill
6 CSF Examination • Importance
Discussion Reference Report note/ Medical
• CSF collection Perfection of
21. To understand the importance, • Macroscopic exami- Demonstration Books diary Laboratory
diary note,
collection, macroscopic examination (colour, turbid- Field visit report Technology
ity, appearance) Vol. II, Kanai
nation and biochemical examina-
• Microscopic exami- L. Mukerjee

tion of CSF through discussion, nation(total count, dif-
Basic Medical
demonstration, field visit and ferential count, gram’s
staining, AFB staining) Laboratory
prepare notes. Techniques, by
• Biochemical examina-
tion (name of different Barbara H.
test for sugar, protein Estridge
and chloride) Text Book of
Medical
Laboratory
Technology, by
Praful B.
Godkar
Unit Chapter
CSF EXAMINATION
3 6
Introduction
Cerebrospinal fluid is a vital specimen reaching a clinical laboratory. Because
the specimen is precious, the specimen should be handled carefully. This
chapter gives an understanding of the CSF examination. OJT will help to
attain the practical skill.
21. To understand the importance, collection, macroscopic examination and bio-
chemical examination of CSF through discussion, demonstration, field visit and
prepare notes.
Syllabus
F Importance of CSF examination.
F Mention the method of CSF collection.
- colour, turbidity and appearance
- total count, differential count, Gram’s staining and AFB staining
F Bio-chemical examination
- Name different tests done - sugar, protein and chloride
Learning Activity - 1 : Discussion and Demonstration

Material
l Reference books
Process
l Teachers recollect the previous knowledge about CSF by asking questions
like
l What is CSF?
l What is the importance of doing CSF examination
147
147
l Teacher starts discussion on importance of CSF and its examination after

giving hand out on the above content
l For that the learners are grouped into four
l The scaffolder guide the discussion and consolidates the discussed points
l Students are asked to prepare notes
Discussion points
l Importance of CSF examination
l Collection of CSF
l Macroscopic examination, microscopic examination and biochemical
examination
Consolidation
l CSF examination reveals some diseases affecting the CNS
l Collected by Lumbar puncture
l Methods of macroscopic, microscopic and biochemical examination
l
If possible a demonstration of CSF examination is done in the laboratory. Record

the work done and report
l Field visit and reference
148
IMMUNO
UNIT HAEMATOLOGY AND
4 BLOOD BANKING
INTRODUCTION
In literal terms blood bank is the BANK for BLOOD.
It is a compact unit where blood is accepted from donors,
processed and stored and then issued to recipients in
need as and when required. To fulfill this aim, the
basics of immuno haematology, blood group systems,
important procedures in blood bank, donor selection,
transfusion, blood components and transfusion reactions
are included in this unit.
People in developing countries like India have a false
conception that blood donation is detrimental to health.
At the end of this unit the learner realizes that it is
their prime duty to try and remove these misgivings
and blood donation is a life saving activity. The learners
also get practical skill in blood grouping which is one
of the prime functions of a blood bank. A field visit to
a blood bank will help to give a clear idea about the
various functions of a blood bank.
149
149
UNIT AT A GLANCE Unit 4 - Immuno Hematology and Blood Banking
150
Experience skill
1. Introduction to Immuno hema-
• Antigen and antibody Perfection of Medical
tology Discussion Reference Laboratory
• Blood banking Note prepa- note prepara-
22. To acquire basic idea about the • Historical aspects Reference books ration tion Technology
Vol. I, Kanai
antigen, antibody and historical
L. Mukerjee
aspects of blood banking
through discussion, reference Basic Medical
and prepare notes. Laboratory
Techniques, by
Barbara H.
Estridge
Unit INTRODUCTION Chapter
TO IMMUNO
4 HAEMATOLOGY 1
22. To acquire basic idea about the antigen antibody and historical aspects of blood
banking through discussion, reference and prepare notes.
Syllabus
F Mention the different types of antigen and antibody.
F Introduction to blood banking - Historical aspects.
Learning Activity - 1 : Guided discussion

Materials
- Text Book of MLT –Bohr
- Medical Laboratory Technology, Vol II, III by Kanai . L. Mukerjee
- Hand out containing the history of blood banking prepared by teacher or
from reference book.
Process
·l Teacher tests the previous knowledge related to blood group antigen,
antibodies and basic idea of immunology.
l Supply handout about the history and importance of blood banking to
three random groups of students.
·l Instruct them to discuss and present their consolidation points in chart or
written form.
l Teacher scaffolds the discussion.
Discussion Points
l Importance of Immunohaematology
l Mile stones in Blood Banking
l Other relevant historical aspects.
151
151
Consolidation
l Immunohaematology – Landmark in blood transfusion
l Land Steiner’s law – Corresponding antigen and antibody doesn’t exist in
same blood group.
Out comes
Learner get clear idea about
l Importance of immunohaematology
l Historical aspects of blood banking
l Complied note after guided discussion.

l Assignment, field visit.
CE
l Assignment, note, Oral test
TE
Match the following

1. William Harvey 1. Transfusion from animal to man
2. Lower Richard 2. Discovered ABO system
3. Denis 3. Blood circulation
4. Karl Land Steiner 4. Animal to animal blood transfusion
152

Experience skill
2. Blood group system Discussion Reference Note prepa- Medical
• Name different blood Perfection of
23. To understand ABO and Rh group system Demonstration books ration note prepara- Laboratory
blood group system and to have • ABO Blood group sys- Reference Materials for Assignment tion Technology
basic idea about Bombay blood tem Assignment demonstra- Vol. I, Kanai
Assignmnet
group, HDN and blood group • Rh system tion and chart L. Mukerjee
• Bombay blood group Chart preparation and chart
inheritance through discussion, preparation Basic Medical
reference, demonstration, as- system
• Inheritance of blood Laboratory
signment, chart preparation, pre- group Techniques, by
pare notes. • Hemolytic disease of Barbara H.
new born Estridge
153
153
Unit BLOOD GROUP Chapter
SYSTEM
4 2
Introduction
Discovery of blood groups is a major step for successful blood transfusion.
Out of these different blood groups ABO system is the most important.
Learners have basic idea about ABO & Rh blood groups. Here we elabo-
rate the above idea and familarises about Bombay blood group, HDN and
inheritance of blood group. A thorough knowledge about blood groups will
be helpful to understand the technique of blood grouping.
23. To understand ABO and Rh blood group system and to have basic idea about
Bombay blood group, HDN and blood group inheritance through discussion,
reference, demonstration, assignment, chart preparation, prepare notes.
Syllabus
F Mention different blood group system.
F Explain ABO blood group system.
F Brief idea about Bombay blood group.
F Explain Rh system.
F Brief description of HDN.
F Elementary knowledge of inheritance of blood group.
Learning Activity - 1 : Chart preparation after guided discussion

Material
l Handout prepared by teacher about different blood groups
Process
l Divide the learners into three
l Group I –Distribute handout on ABO groups.
l Group II Description of Rh blood group.
154
l Group III - description of Bombay blood group

l Instruct each group to prepare consolidation points.
l Each group presents their consolidation points.
l Prepare note based on consolidation points.
l Ask to prepare a chart showing different ABO and Rh blood groups with
the possible antigen and antibody.
Discussion points
l Basic idea of human blood group
l Different types of blood groups.
l Importance of ABO, Rh and bombay blood group.
Consolidation
l Basis of human blood group system is the antigenic characters of red cells.
l Presence or absence of A or B antigen determine ABO blood group .
l ABO Blood group system is the most important blood group system .
l Bombay blood group system is the rare ‘O’ blood group,they lack H antigen
and serum contain anti H antibody.
l Rh blood group system divides human population into Rh +ve and Rh-ve
l Knowledge of different blood group system is essential in safe blood
transfusion.
Outcome
l Understand ABO and Rh system.
l Prepared note
l Prepared chart
CE
l Prepared note
l Prepared chart
l CT
Inheritance of Blood Group
Learning Activity - 2 : Assignment

Teacher tests previous knowledge about the basic principles of Genetics through oral
tests.
155
155
Questions
l What is phenotype, Alleles?
l What is genotype?
l Dominent, recessive, equally dominent
l After oral test, teacher illustrates that the basic principles of genetics can be
applied in the inheritence of blood group system.
l Ask to prepare an individual assignment on inheritence of blood group.
Outcome
l Got idea about the inheritene of blood group.
l Assignment
CE
l Assignment
Haemolytic Disease of Newborn
Learning Activity - 3 : Chart demonstration and discussion

Material
- Flow chart showing the possibility of HDN
Father (RH +ve) Mother (Rh -ve)
Ist child (Not affected)
IInd child
Rh +ve (affected) Rh - ve (not affected)
After showing the chart teacher continue a general discussion. Discussion must involve
the following points.
156
l What is HDN
l Importance of HDN
l Erythroblastosis foetalis.
Consolidation
l Destruction of foetal red cells by maternal immune antibodies.
l Care should be taken by Rh-ve mother before pregnancy.
Outcome
l Prepared note on ABO Rh and Bombay blood group.
l Assignment note on inheritance of blood group.
l Acquire basic knowledge about HDN and useful in future situation.
TE
l Gokul a friend of Ram, was seriously injured during an accident and admitted
to a near by hospital, he need blood. The best friend Ram is ready to donate
blood for him. Doctor refused his blood and explained that AB blood group
of Ram is not suitable to O blood group of Gokul. Justify on doctors
comment?
l Blood group of a person is identified as Bombay blood group. Suggest any
two ways of safe transfusion for him in future if needed.
l Blood group of Sivans’s father and mother are A and B respectively. But his
blood group is entirely different from his father and mother and is O.
- Is it possible? Write your opinion.
157
157
158
Experience skill
3. Blood grouping Discussion Reference Note prepa-
24. To understand the basic prin- • Basic principles of Perfection of
Demonstration book ration, note
ciples of blood grouping - for- blood grouping note
Referece Materials for based on prepration
ward and reverse grouping and • Forward grouping
demonstra- observation
different methods through dis- • Reverse grouping
cussion, demonstration and ref- tion
• ABO and Rh typing
erence different methods
Materials for Note prepa-

25. To perform ABO and Rh typing • ABO and Rh typing by Demonstration Report / Medical
slide and tube method demonstra- ration
by slide method and tube record of Laboratory
Practical work tion and
method through demonstration, work done Technology
practical work, camp, prepare practical
Vol. I, Kanai
record/report. work
L. Mukerjee
Basic Medical
Laboratory
Techniques, by
Barbara H.
Estridge
Unit Chapter
BLOOD GROUPING
4 3
Introduction
ABO grouping and RH typing of donor and recipient are the first step of
laboratory procedure in a blood bank. Students already attained the skill
of perform ABO grouping and RH typing by slide method. An under-
standing about the other methods of blood grouping is obtained through
this unit.
24. To understand the basic principles of blood grouping - forward and reverse
grouping and different methods through discussion, demonstration and reference
25. To perform ABO and Rh typing by slide method and tube method through dem-
onstration, practical work, camp, prepare record/report.
Syllabus
F Basic principles of blood grouping.
F Brief description of forward and reverse typing.
F Methods for ABO and Rh typing (slide, tube and tile technique)
Practical
l ABO blood grouping and Rh typing slide method

l ABO blood grouping and Rh typing tube method .
Learning Activity - 3 : General discussion
Process
l Teacher recollects the previous knowledge about antigen and antibody.
l Teacher illustrates the concept that corresponding Ab doesnot co-exist in
the same blood.
l The discussion continues on the basic principles differenr blood grouping
methods.
159
159
Discussion points
l Land steiner’s law
l Different blood grouping methods.
l Principles of forward and reverse blood grouping.
l Difference between forward and reserve blood grouping
l Most common method of blood grouping.
l Reagents for blood grouping.
Consolidation
l According to Land Steiner’s law blood group antigen and its corresponding
antibody does not co-exist in the same blood.
l Blood grouping methods –forward an reserve grouping
Outcome
l Basic idea about grouping.
TE
l When serum grouping is done with patient serum. A cell, B cell and O cell
give agglutination. Identify the group? Write about the importance of that
blood group?
l Rearrange the following table
Reaction Interpretation
Anti A Anti B Group
+ - B
_ + AB
+ + O
- - A
C.O.25 To perform ABO and Rh typing by slide method and tube method through
demonstration, practical work, camp, prepare record/report.
Learning Activity - 1 : Self experimentation
Meterials
- Blood sample
- Antiserum
160
- Microscopic slides, test tubes etc.

Teacher instruct to do blood grouping by slide method as they done the same in first
year.
Tube method
l Teacher demonstrate a chart showing the standard technique of blood
grouping by tube method in the class.
l Students are asked to do the practical themselves.
l Teacher scaffolds the learner wherever necessary.
l Students record the work done and report.
l Students can also prepare a table showing the interpretation of various
observation.
Extended Activity - 1 : Blood group detection camp
Materials
- Notices
- Group recording register.
- Report cards.
- Materials for blood grouping
- Disposible lancet
- Antisera A,B,D
- Microscopic slides
- Microscope etc
Planning
l Form a committee with principal as chairman
l The members include vocational staff, members of local body voluntary
organization, and student respresentatives.
l A convenient date and place are to be fixed.
l Ask the students to circulate notice amoung the locality
l Collect the materials for the camp.
l Work arrangement can be done as follows.
161
161
Registration
Materials – Table, chairs, register
1. Format for register Place: ...................

Date: ...................
Name of school/Voluntary organization: .............................................................
Sl Name & Address for Age Sex Blood Willingness Remarks
No. Communication with Group for donation
Phone No.
2. Issue of identification slip.

Format for identification slip
Serial No : ..................................................................
Name : ..................................................................
Age : ..................................................................
Sex : ..................................................................
Blood group : ..................................................................
The identification slip is transferred to the next. Blood collection group.
3. Collection of blood
Materials: 1. Cotton swab
2.70% alcohol
3.Disposible lancet.
4. Processing
5. Report entering
l Enter the blood group in the identification slip
l Tag the slips serially
6. Issue of report cards
162
The report cards should be verified and signed by the vocational teacher.
Format for report cards
Registration No & Date : ..............................................................
Name : ..............................................................
Address : ..............................................................
Age : ..............................................................
Sex : ..............................................................
Blood group : ..............................................................
Signature of Vocational teacher
7. The result obtained should be entered in the register.

8. A leaflet containing the importance of blood donation and transfusion can
be givern along with the report card
This will help to motivate and give awareness to the society about this life saving
activity.
Teacher should ensure complete participation of students in the above process.
Out come
l Skill to perform blood grouping
l Acquire skill to organize medical camp.
PE
l ABO grouping and Rh typing by slide and tube method.
l Record on work done.
VCE
l Blood group detection camp.
TE
l Local body authority ask you to submit blood group records of the near by
locality. How will you organize a blood group detection camp at your school
for the above purpose?
163
163
164
Experience skill
4. Coomb’s Test • Coomb's test DCT & Discussion
Reference Note prepa- Medical
ICT (Brief description) Note prepara-
26. To acquire basic idea about the Reference books, ration Laboratory
tion Record /
importance and different types of Material's for Assignment Technology
Demonstration report of field
Coomb’s test through discus- demonstra-
visit Vol. I, Kanai

sion, reference, demonstration, Field visit tion L. Mukerjee
field visit and prepare notes/re-
port. Basic Medical
Laboratory
Techniques, by
Barbara H.
Estridge
Unit Chapter
COOMB’S TEST
4 4
Introduction
Students already have an idea about different blood group antibodies.
Coomb’s test is a very useful technique done in a blood bank to detect weak
immunological reactions, compatibility testing and identification of sensitised
red cells. This chapter gives a brief idea about direct and indirect Coomb’s
test. Field visit and OJT helps to strengthen the idea.
26. To acquire basic idea about the importance and different types of Coomb’s test
through discussion, reference, demonstration, field visit and prepare notes/re-
port.
Syllabus
F Importance of Coomb’s test.
F Mention different methods DCT and ICT.
Practical
l ABO blood grouping and Rh typing slide method

l ABO blood grouping and Rh typing tube method .
Process
l Teacher illustrates the importance of coomb’s text
l Students are grouped into two
l Group I- Give hand out on DCT
l Group II- Give hand out on ICT
l Let them discuss.
l Teacher can guide the students during their discussion.
l One among the group presents their discussed points.
l Teacher consolidates and students prepare note.
165
165
Discussion Points
l What is the importance of Coomb’s test?
l Two types of Coomb’s test ?
l Basic idea about DCT & ICT.
Consolidation
l Coomb’s test is used to detect incomplete antibodies.
l Two types of Coomb’s test –DCT & ICT
Other suggested activities – reference, demonstration, field visit.
Outcome
l Basic idea about Comb’s test
l And different types of Coomb’s test.
VCE
l Field visit
166

Experience skill
5. Cross matching • Importance of cross Discussion Reference Note prepa- Medical
matching, different Note prepara-
27. To familiarise with importance Reference books, ration, notes Laboratory
types of cross match- tion
and different methods of cross Materials for based on Technology
matching through discussion, ing Demonstration Record /
demonstra- observation Vol. I, Kanai
demonstration, reference, field • Major and minor Field visit Report of field
tion L. Mukerjee
visit and prepare note/report. methods visit
• Saline phase Basic Medical
• Albumin phase Laboratory
Techniques, by
• AHG phase (Basic
Barbara H.
idea only) Estridge
167
167
Unit Chapter
CROSS MATHCING
4 5
Introduction
One of the most critical tests performed in the blood bank is cross match-
ing. Proper performance of the test avoids risk of incompatible blood trans-
fusion. Through this chapter the learner gets the idea about the importance
and different methods of cross matching.
27. To familiarise with importance and different methods of cross matching through
discussion, demonstration, reference, fields visit and prepare note/report.
Syllabus
F Clinical importance of cross matching.
F Mention the different method of cross matching (Tube method).
- Saline phase, Albumin phase, AHG phase.
Activity - 1 : Demonstration
Material
- Blood samples of different blood group
- Microscopic slides etc
Process
l Divide the students into two groups
l One group is asked to mix blood of two different blood groups on a
microscopic slides
l The other group is asked to mix blood samples of same group.
l Let them observe.
Teacher starts a general discussion on cross matching.
168
Discussion points
l What is cross matching ?
l Importance of cross matching
l Different methods of cross matching
Consolidation
l Testing compatibility between donor’s and recipient’s blood is cross matching.
l Cross matching is essential for safe blood transfusion.
l Major and minor cross matching.
l In major cross matching mix donor’s blood cell with recipients serum.
l In minor cross matching mix donor’s serum with recipient’s blood cells.
Demonstration and practical work
l Scoff older demonstrates the methods of cross matching (Salino major and
minor) before the learner and instruct them to practise the procedure.
Out come
Basic idea about importanance of corss mathcing and different methods.
l Basic idea about cross matching
l Skill in performing cross matching (saline method)
PE
l Practical record. On saline method of cross matching.
l VCE Field visit:-To observe different methods of cross matching in the
blood bank.
TE
l “Before blood transfusion a cross matching is necessary between the blood
of donor and recipient”. Comment on this statement.
l Compare major and minor cross matching?
169
169
170
Experience skill
6. Blood Transfusion • Importance of blood Discussion Materials for Note, record,
transfusion. Note
28. To get an idea about the impor- Reference demonstra- report on
• Screening of donor Record
tion and field visit
tance of blood transfusion and • Anticoagulant Field visit Report
practical
understand about screening of Seminar,

• Blood collection Seminar work Seminar report
report
donor, anticoagulants, blood • Blood storage Reference
collection procedure and storage books
through discussion, reference,
field visit, demonstration etc., Medical
and prepare note/record and Laboratory
develop a positive attitude to Technology
Vol. I, Kanai
donate blood to the needy ones. L. Mukerjee
Basic Medical
Reference Laboratory
29. To identify different components • Different blood com- Reference Note, record, Note
ponents used for books Techniques, by
used for blood transfusion and report on Record
transfusion Field visit Barbara H.
transfusion reactions through dis- field visit Report
- whole blood Estridge
Seminar
cussion, reference, field visit etc., - packed cells
and prepare notes/record. - cryoprecipitate
- platelet rich plasma
- fresh frozen plasma
• Name transfusion re-
actions.
Unit
BLOOD
Chapter
4 TRANSFUSION 6
Introduction
The various laboratory procedures done in the blood bank leads to safe
blood transfusion. Awareness about donor selection, blood storage blood
collection and transfusion reaction enables the students to realise the misgiv-
ings about blood donation is done through this chapter. A seminar on the
above topic will elaborate the idea. A field visit is necessary to familarise
the learner with the ultimate aim of blood bank in real life situation.
28. To get an idea about the importance of blood transfusion and understand about
screening of donor, anticoagulants, blood collection, procedure and storage
through discussion, reference, field visit, demonstration etc., and prepare note/
record and develops a positive attitude to donate blood to the needy ones.
29. To identify different components used for blood transfusion and transfusion re-
actions through discussion, reference, field visit etc., and prepare notes/record.
Syllabus
F Importance of blood transfusion.
F Criteria for screening of donor.
F Mention the anticoagulant for blood collection.
F Explain blood collection procedure.
F Brief description of blood storage.
F Blood components
- Mention different components used for blood transfusion.
- Whole blood, packed cell, cryoprecipitate, platelet rich plasma and fresh frozen
plasma.
F Transfusion recations
- Name transfusion reactions.
171
171
Practical
l Demonstration of blood collection equipments - blood bag.
Extended Activity - 1 : Seminar

l Distribute the following material among four groups of students
l A VHSE MLT Student Ravi, witnessed an accident case with severe blood
loss in a casualty section of a hospital. The doctor advised that the patient
needs immediate blood transfusion. Unfortunatly they cannot find out a
donor. The student rushed to the blood bank and reported his willingness
for blood donation. The blood bank authority asked about his age and
rejected his willingness. They also said that there are some criteria for blood
donation. Desperately he returned home. The next day he approached his
MLT. Teacher and asked his doubts about transfusion.
l Ask the students to point out their doubts about blood transfusion
l To clarify the above doubts, the learners are introduced to a Seminar on
“Blood Transfusion.”
Topic – Blood Transfusion
Subtopics
1) Importance of blood transfusion and donor screening
2) Blood collection and storage
3) Blood transfusion
4) Blood components
5) Transfusion reactions
Planning
l Learners are grouped into 5
l Ask to collect information from reference book
l Prepare a rough seminar paper
l Teacher read the rough seminar paper and make correction if necessary.
l Teacher instructs the learners to use chart, transparency, OHP, Power point
and other materials to present the seminar paper.
l Fix convenint date for seminar, invite all participants and make necessary
arrangement.
l One of the members from each group presents their subtopic in the seminar.
172
l After presentation conduct a discussion

l Every learner should prepare seminar report and submit
l Teacher evaluates the report.
Out come
l Students become aware of social commitment of blood donation
l Basic idea about blood donation procedure.
l Seminar reports
CE
l Seminar presentation and report
TE
l After blood donation donor’s are allowed to wake’ up only after minute?
Give reason?
l Blood transfusion is performed as a safe procedure after grouping and cross
matching. Even though some complications may arise as transfusion reactions.
Enlist the major transfusion reactions.
l Prepare a sample notice promoting and encouraging blood donation.
Assignment, field visit.
173
173
UNIT INTRODUCTION TO
5 BIOCHEMISTRY
INTRODUCTION
Biochemical tests are now an important part of the
diagnostic investigation and management of patients.
When used properly, biochemical tests can contribute
substantially to the overall care of the patient. Through
this unit the learners get a clear idea about the
importance of biochemistry, attains practical skill in
handling and storage of chemicals, use of laboratory
glasswares, equipments and various estimation
procedures.
The advances in clinical biochemistry have led to a

steady increase in the number and range of
investigations, which in turn led to automation. This
unit also gives a basic idea about automation in clinical
biochemistry. A test wrongly done is worst than a test
not done. So Quality Control ensures that the results
from one lab should be comparable to that from any
laboratory in the world provided, that the same method
is employed. Through this unit the learners get an idea
about the need of quality control in biochemical tests.
174
UNIT AT A GLANCE Unit 5 - Biochemistry

Experience skill
1. Introduction to biochemistry • Importance of bio-
Discussion Reference Record, Text book of
chemistry Perfection of
30. To acquire an idea of the impor- books notes Biochemistry
• Different types of so- Demonstration note
tance of biochemistry and differ- lution (Percentage, Practical work Materials for by Harold
ent types of solutions and to per- Practical work
molar, normal, stan- demonstra- Varley
form cleaning of glass wares and dard and saturated so- tion Record
Textbook of
preparation of chromic acid solution) Material for
lution through discussion, dem- • Cleaning of glass - Biochemistry
practical Tietz
onstration, practical work pre- wares work
pare notes/record. • Chromic acid solution Textbook of
Biochemistry
by Sreekumari
and Vasudevan
175
175
Unit Chapter
BIOCHEMISTRY
5 1
Introduction
Students have knowledge about different types of solutions and its
concentrations. An accurate biochemical result largely depends on the reagents
and chemically clean glassware. Students attain practical skill in cleaning of
different types of glasswares.
30. To acquire an idea of the importance of biochemistry and different types of solu-
tions and to perform cleaning of glass wares and preparation of chromic acid
solution through discussion, demonstration, practical work, prepare notes/record.
Syllabus
F Importance of bio-chemistry.
F Brief discussion on different types of solutions - Percentage solution, Molar
solution, Normal solution, Standard solution and Saturated solution.
F Cleaning of glassware
F General cleaning.
F Chromic acid solution.
Practical
l Preparation of chromic acid solution.
l Cleaning of glass wares.
Learning Activity - 1 : Case presentation followed by guided discussion

Materials
- Reference book
- Laboratory Manual for Tropical Countries by Monica Cheesborogh Volume1
- Hand book of MLT - CMC Vellore
176
Process
l Teacher supplies the photocopy of an extract from a medical journal or
written document in the form of journal. the journal narrates an incident
followed by an interview of an VHSE student with a doctor.
One day while waiting at a bus stop, one VHSE student named Raju witnessed
a middle aged, known diabetic patient under insulin treatment fell down
unconcious. He was rushed to a hospital . Raju is very eager to know what
happened to the man . Raju went to a doctor who was his cousin and had an
interview. Their conversation is narrated below.
Raju : Good morning doctor
Doctor : Haa! Raju, morning please come in.
Raju : May I take your valuable time to clear some doubts.
Doctor : Why not? I am so pleased
Raju : Thanks doctor. Yesterday while I was waiting for my bus, I found a man
with known diabetis mellitus on insulin treatment fell down unconcious
and rushed to hospital. Why this happens ?
Doctor : This may happen due to two reasons
1. His blood sugar level may be increased alarmingly due to the diabetes
2. OR his blood sugar level decreased dangerously due to overdosage of
insulin
Raju : OK doctor. Then what is the treatment in such situation ?
doctor : Yes that is a good question. If it is due to increased sugar level , give more
amount of insulin and if it is due to fall of glucose, give glucose
immediately
Raju : How it can be differentiated?
Doctor : Yes, that is the problem. It can be correctly diagnosied only by biochemical
investigation in a biochemistry laboratory.
Raju : Biochemistry? What is it?
Doctor : It is an important branch in clinical investigations which deals with chemical
reactions occuring in body and the investigations of various bodily
parameters.
Raju : I utilised a lot of your valuable time, but now I am leaving with full a mind
. thank you very much doctor.
177
177
Doctor : OK welcome Raju.

Process
l Divide the students into four groups
l Distribute the copies of the above interview to each group
l Let them go through it
l Then ask some questions relating to it like
l What is biochemistry ?
l What is the importance of a biochemistry laboratory ?
l What may be the reason for unconcious state of the man?
Teacher can consolidate the importance of biochemistry through this activity
Out come
l Learners understand the importance of biochemistry
Different types of solutions and cleaning of glasswares
Materials
Handouts on different types of solutions
l Divide the students into five groups.
l Distribute handouts on percentage solution , molar solution , normal solution,
saturated solution, standard solution etc., to each group.
l Allow a guided discussion and teacher consolidates the points and is recorded
by each student.
Discussion points
l Solute, solvent and solution
l Percentage, molar, normal, standard and saturated solutions.
l Solution is a mixture of solvent and dissolved solute
l Percentage solutions → W/W
W/V
V/V
l 1 gm molecular weight of substance of solute dissolved in 1000ml of solvent
in molar solution
178
Learning Activity - 2 : Discussion and practical
Teacher starts a discussion by asking a question

l How will you clean your household utensils?
l Teacher elictes response and divert the method for cleaning of glasswares.
l Teacher demonstate the cleaning technique of used as well as new glass wares.
l Students are asked to prepare chromic acid solution.
l Students practise the method of cleaning of glasswares.
l Record the work done and submit.
Outcome
l Understand different methods of expressing the concentration of solutions.
l Able to prepare chromic acid solution.
l Able to clean new and old glasswares.
l Record of work done on a practical.
Evaluation
CE
l Oral test
179
179
180
Experience skill
2. Instruments used in Biochem- Materials for
• Use and care of ana- Discussion Record Record/note
istry demonstra-
lytical balance, centri- Demonstration based on
31. To acquaint with the use and fuge and distillation tion demonstra-
care of analytical balance, cen- tion
apparatus
trifuge and distillation apparatus Text book of
through discussion, demonstra- Biochemistry
tion and prepare notes/record. by Harold
Varley
Textbook of
32. To understand the principle, Biochemistry
• Principle, parts work- Discussion Reference Note/record
parts, working, use and care of Record/note Tietz
ing, use and care of Demonstration books based on
colorimeter and to have an idea
colorimeter Reference Materials for practical Textbook of
about spectrophotometer, flame
• spectrophotometer demonstra- work obser- Biochemistry
photometer and micropipette
• Flame photometer tion by Sreekumari
through discussion, reference, vation
Material for and Vasudevan
demonstration, practical work, • micropipette
prepare notes/record. practical
work
Unit Chapter
INSTRUMENTS USED
5 IN BIOCHEMISTRY 2
Introduction
Analytical methods in clinical biochemistry are based on instrumental analysis.
Many methods for quantitative analysis of blood and other fluids are based
on the principle of photometry. This chapter gives a thorough knowledge
about the principle, parts, uses and care of colorimeter and familarise with
other important photometric instruments. Use and care skill of analytical
balance, centrifuge and distillation apparatus are also essential to do different
analytical methods.
31. To acquaint with the use and care of analytical balance, centrifuge and distillation
apparatus through discussion, demonstration and prepare notes/record.
32. To understand the principle, parts, working, use and care of colorimeter and to
have an idea about spectrophotometer, flame photometer and micropipette through
discussion, reference, demonstration, practical work, prepare notes/record.
Syllabus
F Use and care of analytical balance, centrifuge and distillation apparatus,
F Explain the principle, parts, working, use and care of colorimeter.
F Familiarise with Spectrophotometer, Flame photometer, Micropipettes.
Practical
l Colurimeter - parts, operation and care.
Learning Activity - 1 : Self identification, practical with handouts about the

instruments.
Process
l Divide the student into three groups.
l Provide first group with handout on parts ,use and care of centrifuge.
181
181
l Give handout on parts use and care of an analytical balance to the second
group
l Give a handout of distillation apparatus to third group.
l Let the students identify the parts and use of the instument themselves
l Teacher guide the learners during the process
l Record the work done and submit
l Inter change the instrument to ensure that all the groups use the three
instruments.
l Teacher consolidates the discussed points on the care of these instruments
and students prepare notes.
Outcome
l Understand the parts and use of centrifuge , analytical balance and distillation
apparatus.
l Attained skill to use the above instruments.
Evaluation
CE
l Record on work done.
l Oral test
Colorimeter
Learning Activity - 1 : Experimentation
Material
- KMn04 solution
- Test tube
Process
l Teacher instruct one among the students to prepare a coloured solution
(KMn 04 solution) in a test tube with a moderate concentration
l A small portion of the prepared solution is taken into another tube and add
more quantity of distilled water to make a dilute solution.
l Samples from each tube is taken in two small identical test tubes
Ask them to read a printed matter through both the solutions. Learners notes the that
it is difficult to read through concentrated solution. Teacher asks a question.
182
l What may be the reason for this?

l Teacher elicites response and concludes that more amount of light is absorbed
by darker solution.
l The experiment may be repeated with same solution taking in two different
sized test tubes.
l They also note that if the distance travelled through the solution increases
absorbance also increases.
l This experiment gives an idea about the principle (Beer’s-Lambert’s law).
l The teacher then illustrate the law to learners.
l Learners are asked to prepare notes.
Consolidation
l Colour of solution depends on the concentration of the coloured solute
l Amount of light absorbed also depend on the intensity of colour and the
length of column of solution through which the light passes.
l Beer-Lambert’s law
Learning Activity - 2: Demonstration of colori meter and preparation of
block diagram
Materials
- Colorimeter
- KMn04 solution prepared in activity one
Process
l Teacher demonstrates the parts and operation of colorimeter to measure
concentration of coloured solution.
l Idea obtained is clarified with the preparation of block diagram.
l Instruct the learners to practise how colorimeter is used skillfully to measure
the intensity of coloured solution.
l Record the work done.
Outcome
l Understands the principle and parts of colorimeter
l Able to use colorimeter.
183
183
l Prepares notes and block diagram

l Record on work done
Evaluation
CE
l Oral test
l Prepared notes and block diagram
PE
l Skill in using colorimeter
TE
Complete the following block diagram
→ Slit → → Sample → → outRead

meter
Learning Activity - 3: Discussion
Materials
- Handouts about spectrophotometer, flame photometer and micro
pipette.
Process
l Instruct the learner to go through the handout containing a brief but clear
idea about the use and application of spectrophotometer, flame photometer,
micropipette.
l Start open discussion based on the handouts.
l Prepare notes based on discussion.
Discussion points
l What is the importance of flame photometer in Biochemistry?
l What is the diffrence between micropipettes and ordinary pipettes?
l Difference between colorimeter and spectrophotometer
l Flame photometer is used to measure the concentration of metal ions.
l Micropipettes are easier and accurate than ordinary pipette, but expensive.
184
Outcome
l Learner understands about spectrophotometer ,flame photometer and
micropipette
l Prepare notes based on discussion
CE
l Oral test
TE
l Enzymatic methods uses very small quantity of serum for estimation of
different constituents. Suggest a device to deliver such a very small amount
of solution.
l Colorimeter and spectrophotometer are used to measure the optical density
of a solution. Give a comparison between the two
185
185
186
Experience skill
3. Estimation of Blood Sugar • Types of blood
Reference Preparation
samples-FBS, RBS, Discussion Perfection of
33 To acquaint with the different Reference books of notes
PPBS notes
types of blood samples, antico-
• Anticoagulants used OT
agulants used and different meth-

• Name of different
ods for Blood sugar estimation Text book of
methods Biochemistry
through discussion, reference
by Harold
and prepare notes Varley
34 To perform blood sugar estima- • Principle, require- Demonstration Materials for Record Textbook of
Record/report
tion by O.Toludine and ments, procedure, Practical work demonstra- Report on Biochemistry
normal value and clini- tion and OT Tietz
GODPOD method through practical
cal significance of practical
demonstration practical work work Textbook of
blood sugar estimation
prepare record/report. Biochemistry
• O - Toludine method
by Sreekumari
• GODPOD method and Vasudevan
Reference Preparation Perfection of

35. To get an idea about Glucose • Glucose challenge test Discussion books of notes notes
challenge test and Glucose tol- • Glucose tolerance test Reference
erance test through discussion, (brief)
reference and prepare notes.
Unit Chapter
ESTIMATION OF
5 BLOOD SUGAR 3
Introduction
Determination of blood sugar is one of the first and most frequently done
investigations in a biochemical laboratory. It is done for the diagnosis and 3
management of diabetes mellitus. This chapter deals with different blood
samples, method of blood sugar estimation, brief description of glucose
challenge test and glucose tolerance test.
33 To acquaint with the different types of blood samples, anticoagulants used and
different methods for Blood sugar estimation through discussion, reference and
prepare notes
34 To perform blood sugar estimation by O.Toludine and GODPOD method through
demonstration practical work prepare record/report.
35. To get an idea about Glucose challenge test and Glucose tolerance test through
discussion, reference and prepare notes.
Syllabus
F Estimation of blood glucose.
F Collection of blood for sugar estimation.
F Anticoagulant used.
F Familiarise the term FBS, RBS and PPBS.
F Name different method for blood sugar estimation.
F Explain the principle, requirements, procedure, normal value and clinical
significance of blood sugar estimation.
F O-Toludine method
F GODPOD method
F Brief description of glucose challenge test and Glucose tolerance test.
187
187
Practical
l Estimation of glucose (O-toluidine method)
l Estimation of glucose (GOD-POD method)
Learning Activity - 1 : Group discussion

Materials
- Reference Book.
Process
l Group the learners in to three and instruct them to refer the book of relevant
topics and consolidate the points.
l First group refers the types of blood samples, second group about the
anticoagulant for sugar estimation and third group different blood samples
available for sugar estimation.
l After discussion one member from each group will present and consolidate
the points.
l Ask the student to prepare notes from the consolidated points.
Discussion points
l What are the different types of blood sample with respect of food intake?
l What are the anticoagulants used to collect blood for sugar estimation?
l What are the different methods available for sugar estimation?
Consolidation
l Blood sample - FBS, PPBS, RBS
l Sodium fluoride oxalate mixture is the best anticoagulant of choice.
l Blood sugar estimations are based on
a) Reducing property of glucose
b) Condensation property
c) Enzymatic activity.
l Reference
Outcome
l Learner achieves basic idea about the blood sample, anticoagulant used and
different methods used for blood sugar estimation.
188
Evaluation
CE
l Oral test
TE
l A man done his blood sugar estimation in a laboratary at early morning
(got value 90 mg%). Due to some doubt he repeated the test at another lab
one or two hours after his food.(value 150mg%). Due to this wide variations
in results he checked the blood sugar value again at another lab (value
115mg%) He blamed all these lab for the incorrect results, as all are errors.
What is your opinion? Whether all labs are wrong? Is any other reason for
these variations. Write your comment.
Estimation of blood sugar 0-Toluidine and GOD POD
Learning Activity - 1: Discussion demonstration and practical work

Materials
- Colorimeter
- Test tubes
- Reagents
- Blood sample
- Water bath at 370C etc
Process
l Distribute the photocopy of relevant pages and ask the learner for a general
discussion about the principle, normal value and clinical significance of blood
sugar estimation and to prepare note.
l Bring the learner in to lab and demonstrate the different steps of blood
sugar estimation procedure
l Ask the learners to repeat the procedure several times until they acquire
practical skill to perform the test confidently and to prepare record.
Out come
l Learners attained skill in doing the practical work of blood sugar estimation.
CE
l Class test.
PE
l Skill in performing practical test.
189
189
TE
l Measuring blood sugar level is one of the most frequently done tests in a lab.
If a known diabetic patient comes to your lab for testing blood sugar level,
write the steps you will perform to find out the value.
Glucose challenge test and glucose tolerance test
Learning Activity - 1: General discussion and preparation of notes

Material
l Reference books - Clinical Biochemistry - Harold Varley, Textbook of
Bichemistry, Tietz.
Process
l Supply reference books and ask the learners to note the points.
l Teacher consolidates the points.
l Ask the learners to prepare note from the consolidated point .
Discussion points
l What is the use of GCT and GTT?
l These tests are use to differentiate mild, moderate and severe diabetes
mellitus and to rule out the possibility of gestational diabetes.
Out come
l Learners know the importance and use of GCT and GTT
Suggested activity
l Field visit
CE
l Oral test
TE
l GCT and GTT are done to assess the carbohydrate metabolism. Give a
comparison between the two.
190

Experience skill
4. Estimation of Proteins • Plasma proteins
Discussion Reference Note prepa- Text book of
Notes
36. To acquire idea of plasma pro- • Normal value and Reference books ration Biochemistry
clinical significance of Practical skill
teins and to perform Total pro- Demonstration Materials for Record/ by Harold
total protein and albu- Record/report
tein estimation by Biuret method, min Practical work demonstra- report on Varley
Albumin estimation by BCG • Principle, reagents tion and work done Textbook of
method through discussion, ref- (name only) proce- practical Biochemistry
erence, practical work etc., pre- dure, calculation of to- work Tietz
pare record/report. tal protein (Biuret Textbook of
method) and albu- Biochemistry
min(BCG method) by Sreekumari
and Vasudevan
191
191
Unit Chapter
ESTIMATION OF
5 PLASMA PROTEINS 4
Introduction
Proteins are the essential constituents of the body and serve as building
blocks. Estimation of serum proteins is useful in the diagnosis of liver
disorders and a number of other diseases. This chapter gives an
understanding of plasma along with the normal value and skill to perform
total protein and albumin estimation.
36. To acquire idea of plasma proteins and to perform Total protein estimation by
Biuret method, Albumin estimation by BCG method through discussion, refer-
ence, practical work, prepare record/report etc.
Syllabus
F Introduction to plasma protein.
F Explain the principle, reagents (name only), procedure and calculation of total
protein by Biuret method.
F Explain the principle, reagents (name only), procedure and calculation for the
estimation of albumin by BCG method.
F Normal value and clinical significance of total protein and albumin.
Learning Activity - 1: Discussion, demonstration and practical work.

Materials
- Hand outs
- Colorimeter
- Testtubes/pipette
- Re-agents etc.
Process
l Instruct the learners for a general discussion after giving the handouts about
plasma proteins, its normal value and clinical; significance and ask them to
prepare note.
192
l Demonstrate the method of total protein estimation (Biuret method) and

albumin estimation (BCG method)
l Ask the learners to repeat the procedure by themselves until they become
skilled and to prepare record.
l Field visit
l Reference
Out come
l Attained skill to perform total protein estimation and albumin estimation
an had an idea about its clinical significance and normal value.
CE
l Class rest
PE
l Practical skill
PE
l The total protein value of 45 yrs old man found as 5 g%. Write down the
conditions you would expect such a value.
193
193
194
Experience skill
5. Estimation of NPN Substances Reference
Discussion Notes based Notes Text book of
•
37. To get an idea about the differ- Different NPN sub- Reference books on discussion Biochemistry
Practical skill
ent NPN substances and to per- stances and its impor- Demonstration Materials for and reference by Harold
tance practical Record Varley
Practical work Record of

Normal value and
form blood urea (Berthlot •
method) and Creatinine estima- work work done Textbook of
clinical significance of
tion (Alkaline Picrate Method) Blood urea and serum Biochemistry
through discussion, reference, creatinine Tietz
demonstration, practical work • Different methods for Textbook of
and record/report. blood urea and serum Biochemistry
creatinine estimation. by Sreekumari
• Blood urea estimation and Vasudevan
(Berth lot method)
• Serum creatinine esti-
mation (alkaline pi-
crate method)
Unit Chapter
ESTIMATION OF NPN
5 SUBSTANCES 5
Introduction
Estimation of NPN substances in blood plays an important role in the
evaluation of kidney function. The major NPN substances estimated are
blood urea and creatinine. At the end of the chapter the student attains
practical skill in its estimation and understands the normal value and the
clinical significance.
37. To get an idea about the different NPN substances and to perform blood urea
(Berthlot method) and Creatinine estimation (Alkaline Picrate Method) through
discussion, reference, demonstration, practical work and record/report.
Syllabus
F Mention the different NPN substances and its importance.
F Mention the different methods of blood urea estimation.
F Explain the principle, procedure and calculation of blood urea estimation by
Berthlot method.
F Normal value and clinical significance of blood urea.
F Mention the different methods of serum creatinine estimation.
F Explain the principle, procedure and calculation of serum creatinine estimation
by alkaline picrate method.
F Mention normal value and clinical significance of serum creatinine.
Learning Activity - 1: Discussion, demonstration and practical work

Materials
- Photocopy of relevant page of reference book.
- Colorimeter
- Test tubes/pipettes
- Water bath at 370C etc
195
195
Process
l General discussion by referring the photocopy about NPN substances, its
importance and clinical significance and to prepare note.
l Demonstrate the method of estimation of blood urea by Berthlot Method
and creatinine (alkaline Picrate method)
l Since the procedure is almost same in all these estimations, learners acquire
skill in practical work.
l Reference
l Field visit
Out come
l Learners had a clear idea about the importance and clinical significance of
NPN substances and acquired the skill to perform the estimation of blood
urea and serum creatinine.
l Prepared note
CE
l Class test
l Oral test
PE
l Skill in performing estimation of blood urea and serum creatinine.
TE
l Usually proteins are organic compounds containing nitrogen. Write down
the nitrogen containing non-protein substances present in blood which are
clinically important.
l Physician suspects that one of his patients is developing renal malfunction.
Name two diagonostic methods which evaluates the functions of kidney.
196

Experience skill
6. Estimation Lipids • Different classes of
Discussion Reference Notes / Text book of
lipo protein, their clini- Notes
38. To acquire an idea about differ- Reference books record of Biochemistry
cal significance OT
ent classes of lip of protein, their • Name different meth- Demonstration materials for work done by Harold
clinical significance and to per- practical Practical skill Varley
ods of cholesterol Practical work
form cholsterol estimation interview work Record /
estimation Textbook of
report
through discussion, reference , • Cholesterol estimation Biochemistry
practical work, interview and (cholestrerol esterase Tietz
prepare notes / record. dehydrogenase Textbook of
method) Biochemistry
• Normal value by Sreekumari
• Clinical significance and Vasudevan
197
197
Unit Chapter
ESTIMATION OF
5 LIPIDS 6
Introduction
Estimation of lipids especially serum cholesterol is considered as the risk
factor in coronary artery disease. It is also very useful in the investigation of
several other diseases. An interview with an expert is included in this
chapter to give the learner a thorough understanding of the various risk
factors involved in heart diseases. The learner attains skills to perform
total cholesterol estimation.
38. To acquire an idea about different classes of lipoprotein their clinical significance
and to perform cholesterol estimation (enzymatic method) through discussion,
reference, demonstration, practical work and prepare notes/record.
Syllabus
F Mention different classes of lipoproteins and their clinical significance.
F Explain the principle, procedure and calculation of serum cholesterol by enzymatic
method. (cholesterol - esterase - dehydrogenase)
F Normal value and clinical significance of serum cholesterol
Classes of lipoproteins and clinical significance
Learning Activity - 1: Interview

Process
l Teacher asks a question. “What are the common diseased condition causing
sudden death”?
l Responses are elicited and consolidates that heart attack is the most common
cause.
l Teacher understood that learners have a lot of doubts regarding cholesterol,
heart attack, life style etc.
l So arranges an interview with an expert (preferably a socially interested
doctor)
l For that group the learners in to four and ask them to prepare the questions
to be asked.
198
Planning
l Invite a resource person
l Decide the questions to be asked.
l Teacher should give guidance
l Fix a convenient date, time and place.
l Decides the students who can participate.
l Implementation of interview
l Conclusion by facilitator.
l Students are asked to prepare notes based on interview

Estimation of Lipids
Learning Activity - 2: Discussion, demonstration and practical work.
Materials
- Photocopy of reference books
- Colorimeter
- Reagents
- Test tubes and pipettes
- water bath at 37o C.
Process
l Teacher leads a general discussion after referring the handouts about different
types of lipoprotein, clinical significance and to prepare notes.
l Demonstrate the method of cholesterol estimation (enzymatic method)
l Ask the learners to practise the procedure by themselves and to record.
l Reference
l Field visit
Outcome
l Learners would get clear idea about the types of lipoproteins, its clinical
significance and normal value.
199
199
l Learners are also able to perform the test of cholesterol estimation skillfully.
l Prepared note
l Prepared note based on interview.
Evaluation
CE
l Class test
l Prepared notes
PE
l Practical skill in cholesterol estimation in the given sample of blood.
TE
l An obese man having family history of heart attack wishes to monitor his
condition. Which risk factor in serum is estimated? How will you perform
the test?
200

Experience skill
7. Liver Function Tests Reference
• Importance of LFT Discussion Notes/record Notes Text book of
39. To get an idea about the impor- Reference books of work done Biochemistry
• Name different Liver OT
tance of Liver Function Tests, Demonstration by Harold
Function Tests Practical skill
various Liver Function Tests and Practical work Varley
• Bilirubin estimation by Record
able to perform serum bilirubin Malloy and Evelyn Textbook of
estimation through discussion, method Biochemistry
reference, demonstration pre- • Normal value Tietz
pares note/record. • Clinical significance Textbook of
Biochemistry
by Sreekumari
and Vasudevan
201
201
Unit Chapter
LIVER FUNCTION
5 TESTS 7
Introduction
Learners already have knowledge about the various functions of the liver.
The study of these functions through different estimations can be done to
access the liver function. This chapter gives a familarisation of different liver
function tests some of them are done in previous chapters. Here the learner
attains skill to perform Bilirubin estimation.
39. To get an idea about the importance of Liver Function Tests, various Liver Func-
tion Tests and able to perform serum bilirubin estimation through discussion,
reference, demonstration, prepare notes/record.
Syllabus
F Importance of LFT.
F Name different liver function tests
F Explain Malloy and Evelyn method for Bilirubin estimation.
F Mention its normal value and clinical significance.
Learning Activity - 1: Reference, demonstration and practical work

Materials
- Reference books
a. Clinical Biochemistry by Haroldvarley
b. Medical Laboratory manual for tropical countries – monica
cheesborygh, Vol. I.
c. Vasudevan’s Biochemistry (Testbook of biochemistry by
Sreemumary & Vasudevan)
- Colorimeter
- Reagents
- Pipettes and Test tubes
Process
l Group the learners into three and allow to refer the books provided
202
l Guide them to collect relavant and information required.

l Within each group an active discussion is made and one member from each
group will present their points
l Teacher consolidates the points and ask learners to prepare note from the
consolidated points
l Demonstrate the method of estimation of serum bilirubin (Malloy and
Evelyn method)
l Ask to record and report
l Reference
l Field visit
Outcome
l Learners have a knowledge about various liver fuction tests, its clinical
sigificance and normal values. Learners also attained practical skill to perform
serum bilirubin estimation.
l Prepared note
l Record and report on bilirubin estimation
CE
l Class test
PE
l Skill in doing the serum bilirubin estimation is evaluated
TE
l Take the odd man out. Justify your answer
(a) Serum Bilurubin
(b) Serum creatinine
(c) SGOT
(d) Protein
203
203
204
Experience skill
8. Renal Function Tests • Importance of RFT
Reference Notes Text book of
• Name different renal Discussion Notes
40. To get an idea about Renal Reference books Biochemistry
function tests OT
Function tests, various Renal by Harold
• Urea and creatinine
function tests, urea and creati- Varley

clearance (brief de-
nine clearance test through dis- scription) Textbook of
cussion, reference and prepare Biochemistry
notes. Tietz
Textbook of
Biochemistry
by Sreekumari
and Vasudevan
Unit Chapter
RENAL FUNCTION
5 TESTS 8
Introduction
Students already have an idea about the various functions of kidney and
some of the tests, which access kidney function in the previous chapter.
Besides these, this chapter also gives brief description of urea and creatinine
clearance test.
40. To get an idea about Renal Function tests, various Renal function tests, urea and
creatinine clearance test through discussion, reference and prepare notes.
Syllabus
F Importance of RFT.
F Name different renal function test.
F Brief description of urea clearance and creatinine clearance test.
Learning Activity - 1: Reference and discussion
Materials
Reference books
- Clinical Biochemsitry, Harold varley
- Medical Laboratoary Manual for Tropical Countries, Vol. I, Monica
Cheseborough
- Textbook of Biochemistry, Choudhari
Process
l Group the learners in to 3 and provide reference book.
l Help learners to refer the relevant pages.
l Conduct group discussion and one member from each group will present
their topic.
l Teachers consolidate the points and ask to prepare note.
205
205

l Field visit
Outcome
l Learners get a clear idea about renal function tests, urea and Creatinine
Clearance test.
CE
l Class test.
l Oral test.
TE
l “Creatinine clearance test and urea clearance tests are used to assess the renal
function”. According to you which test will give more accurate value? Justify
your answer.
206

Experience skill
9. Automation and quality Control Reference
• Term automation Discussion Notes Notes
41 To understand the term automa- books Record/
• Automation in bio- Reference Record Text book of
tion and have a general idea about Field visit report of field
chemistry Report Biochemistry
automation in biochemistry visit by Harold
through discussion, reference, OT
Varley
field visit and prepare record/
Textbook of
report. Biochemistry
Notes Tietz
Discussion Reference
42. To understand the need of qual- Record/ Notes Textbook of
• Need of quality con- Reference books
ity control and method for attain- report of field Record Biochemistry
trol
ing quality control through dis- • Method of attaining Field visit visit Report by Sreekumari
cussion, reference, field visit and and Vasudevan
quality control OT
prepare record/report.
207
207
Unit Chapter
AUTOMATION AND
5 QUALITY CONTROL 9
Introduction
Study of clinical biochemistry will be incomplete without the glimpse of
automation. Quality control is also an inevitable part of it. This chapter
gives a general idea about automation and quality control in a biochemistry
laboratory.
41. To understand the term automation and have a general idea about automation in
biochemistry through discussion, reference, field visit and prepare record/report.
42. To understand the need of quality control and method for attaining quality control
through discussion, reference, field visit and prepare record/report.
Syllabus
F Understand the term automation
F General idea about automation in bio-chemistry.
F Need of quality control

F Method for attaining Q.C.
Learning Activity - 1: Debate
Materials
Reference books
- Clinical Biochemistry - Harold Varley
- MLT - Kanai L. Mukherjee
Process
l Divide the learners in two groups and ask them to collect informations
favouring the manual method by one group and favouring automation by
second group.
l Assist the learners in collecting data.
l Select 4 pannel members from each group.
208
l Choose a convinent date for debate and also select a moderator (moderator
may be teacher or a selected student)
l Moderator briefs the rules of debate and programme starts by panel
members from each group alternatively.
l Moderator notes their points from each group and consolidates (consolidation
must be in favour of automation).
l Asks the students to prepare notes from the consolidated points irrespective
of their arguments in debate and to submit the note.
Other suggested acitivty
l Field visit
Outcome
l Learners understand the need and advantages of automation.
l Note based on debate.
CE
l Oral test
l Prepared note
l Field visit report.
TE
l In present senario mannual methods are replaced by automated method.
What are the advantages?
Quality control
Learning Activity - 1: Simulated experiment
Materials
- Colorimeter
- Reagents for blood sugar estimation.
- Test tubes and pipettes
Process
l Select four learners and instruct them to perform the blood sugar estimation
of the same blood.
l Compare the obtained results and ask them to give their own reasons. Why
different results are obtained?
209
209
l After noting the pointed out reasons, ask two students to repeat the estimation
again taking care of the noted points.
l Two different reslts may be obtained (if accidently same result is produced
also) and we have no surety about the accuracy of results.
l Then ask them what is the solution (remedy) in such a situation?
l The need of automation may arise here and explain them the different
methods of quality control with the help of handouts.
Other suggested acitivties
l Field visit
l Reference
l Power point presentation
l CD
Outcome
l Learners unerstand the need and method of quality control.
CE
l Oral test
TE
l Enumerate the complications which may arise if there is no quality control
measures.
210
UNIT HISTOTECHNOLOGY AND CYTOLOGY

6
INTRODUCTION
Although Histotechnology and Cytology is not a part

of routine laboratory work, it plays an important role
in the diagnosis of diseases. The pathologist responsible
for tissue diagnosis is heavily dependent on the
competence of his histotechnologist. A student
undergoing MLT course at higher secondary level should
have a basic idea about the various steps involved in
the preparation of tissue for microscopic examination.
This will help to develop skill in this field in their
future studies or career. This unit also gives awareness
about automatic tissue processor.
Early detection of cancer and its prompt treatment

widened the scope of cytological examination. This unit
gives a brief idea about the various steps involved in
the preparation of cells for cytological examination.
211
211
UNIT AT A GLANCE Unit 6 - Histotechnology and Cytology
212
Experience skill
1.Introduction to Histotechnology • Collection Reference
• Reception Demonstration Preparation Notes Textbook of
43. To acquire a basic idea about • Labelling Field visit books of note Histopathology
Field visit
collection, reception and label- Hand out discus- Materials for Field visit Bancrofit
report
ing of specimens in a histopathol- sion demonstra- report

tion Textbook of
ogy Lab through discussion, Cytology
demonstration, field visit and
Koss
prepares note.
• Fixation (routine for- Discussion Cellular
Reference Preparation
44. To get a brief idea about malin fixative only) Reference CT Pathology
books of note
different steps in tissue pro- • Dehydration Demonstration Techniques by
Materials for Report on field
cessing, sectioning, staining, • Clearing Field visit Field visit Culling
demonstra- visit
moun-ting and automatic tissue • Impregnation report
tion Notes
processor and prepare notes. • Embedding
• Section cutting
• Staining (name only)
• Automatic tissue pro-
cessor
Unit Chapter
INTRODUCTION TO
6 HISTOTECHNOLOGY 1
43. To acquire a basic idea about collection, reception and labeling of specimens in
a histopathology Lab through discussion, demonstration, field visit and prepares
note.
44. To get a brief idea about different steps in tissue processing, sectioning, staining,
mounting and automatic tissue processor and prepare notes.
Syllabus
F Mention the important steps in the preperation of a tissue for microscopic
examination (brief idea only)
F Collection, reception and labelling.
F Fixation (routine formalin fixative only), dehydration, clearing, impregnation,

embedding and section cutting.
F Name the common staining and mounting method.
F Brief description about automatic tissue processor.

Materials
- Handout containing details about collection, labeling and reception of
histopathological specimens.
Process
l Teacher illustrates the importance of histopathology in the diagnosis of
diseases.
l Divide the learners in to three groups.
l Group I-Handout about the collection of histopathological specimens.
l Group II-Handout on labeling of histopathological specimens.
l Group III-Handout on reception of specimen in a histopathology laboratory.
213
213
l Instruct each group to discuss the hand out and consolidate.
l Teacher facilitates the discussion if needed.
l One member from each group presents their consolidation.
l Instruct all students to prepare note on the above consolidation and submit.
Discussion Points
l Autopsy and biopsy.
l Use of proper fixative/adequate fixative.
l Proper labeling.
l Accompanying requisition form.
l Points to be noted during the reception of specimen.
Consolidation
l Specimens collected after death is autopsy and that collected from a living
body is biopsy.
l Proper and adequate amount of fixative is needed while collection.
l All specimens should be properly labeled with name,IP/OP No,date of

collection ,age ,sex type of specimen etc.
l Reference
l Field visit
Outcome
Students get basic idea about the reception & labeling of specimen reached in the lab
after collection
CE
l Perfection in note preparation
l OT
VCE
l OJT/Hospital visit
214
TE
l Suppose you are working in a Histopathology lab .You are in the charge of
receving the Histopathological specimen. Give the points to be noted while
receving the specimen.
Tissue processing, section cutting and staining
CO.44 To get a brief idea about different steps in tissue processing, sectioning, stain-
ing, mounting and automatic tissue processor and prepare notes.
Syllabus
F Fixation (routine formalin fixative only), dehydration, clearing, impregnation,
embedding and section cutting.
F Name the common staining and mounting method.
F Brief description about automatic tissue processor.
Learning Activity - 1 : Discussion & Field visit

Materials
- Reference books - Cellular Pathological technique by Culling
- Photographs of Instruments during tissue processing and section cutting.
- Field visit plan.
Process
l Teacher illustrate a general idea about different technique in tissue processing,
section cutting, automated technique, staining and mounting.
Planing of field visit
A field visit plan is prepared containing the following points
l Selection of histopathology lab to be visited.
l Date and mode of conveyance.
l Request for permission.
l Get permission from the laboratory authority.
l What are the things to be observed?
l Format for field visit report.
l Details about collection of materials if possible .
Organise a field visit as above to a histopathology laboratory. Evaluate the prepared
report and collections.
215
215
Main Points to be Observed

l What are the steps of tissue processing ?
l Chemicals used in the various steps of tissue processing?
l Impregnating and embedding media used.
l Automatic tissue processor.
l Instrument for section cutting.
l Which is the commonly used staining method in histopathology?
l Assignment, Multimedia, reference
Outcome
l Students got basic idea about different steps in tissue processing.
CE
l Field visit diary
VCE
l OJT/Field visit
TE
l Histotechnology involves complex process with many steps. The collected
specimens are immediately placed in proper fixative which undergoes further
tissue processing. Enlist the steps involved in the method of processing?
216
UNIT AT A GLANCE Unit 6 - Histotechnology and Cytology

Experience skill
2. Cytology Reference
• Application of cytol- Discussion Note Participation in Textbook of
45. To get a basic idea about the uses books
ogy Demonstration Report/ discussion Cytology
of cytology, different types of
• Types of specimen Field visit Materials for record of Koss
specimen, methods of collection, Perfection of
• Method of collection demonstra- field visit note/diary
fixation and the commonly used Cellular
• Fixation of smear tion
cytological staining through dis- Pathology
cussion, demonstration, field visit • Pap staining (name
only) Techniques by
and prepare notes. Culling
217
217
Unit Chapter
INTRODUCTION TO
6 CYTOLOGY 2
45. To get a basic idea about the uses of cytology, different types of specimen, meth-
ods of collection, fixation and the commonly used cytological staining through
discussion, demonstration, field visit and prepare notes.
Syllabus
F Mention the uses of cytology, specimens, name the methods of collection and
fixation of a smear.
F Name the commonly used staining method in cytology.
Learning Activity - 1 : Discussion with hand outs

Materials
- Hand out containing type of cytological specimens ,collection,fixation and
common staining method.
- Reference books.
Process
l Teacher illustrates the application of cytology.
l Divide the students in to three groups.
l Distribute the hand out to each group.
Group I - Different types of specimens used in cytology.
Group II - Different methods of collection and fixation of cytological specimens.
Group III - Common staining method in cytology.
l Instruct to discuss the relevant points in the hand outs.
l Consolidate the points with the help of scaffolder.
l A member from each group presents their consolidation points.
l Students prepare notes based on the consolidation points.
218
Discussion Points
l What are the different types of specimens?
l Methods of collection.
l Which is the fixative used?
l Which is the staining method?
Consolidation
l Different cytological specimens include blood , CSF, urine sputum, scrapings,
other body fluids etc.
Outcome
l Learner get awareness about the importance of cytology & cytological
process done in a cytology lab
CE
l Prepared note
VCE
l OJT/Field visit
TE
l Exfoliative cytology is a study of exfoliated cells from different parts of the
body. Enlist the main sites from which exfoliative cells are collected.
219
219
PRACTICAL EVALUATION
As Medical laboratory Technology is highly practical oriented course, practical work must
be evaluated periodically. A score of 150 is allotted for practical evaluation and the skill
attained for doing the routine tests only need to be considered for evaluation.
Distribution of scores for practical evaluation
1. Spotting/identification 20% 30 marks
2. Record book 10% 15 marks
3. Viva-voce 10% 15 marks
4. Experiment (3 nos) 60% 90 marks

(Haemotology, urine analysis
and biochemistry)
Total 100% 150 marks
Individual break up for experiments
Experiment details Haemotology Urine analysis Biochemistry

(any one (any two (any one
experiment) experiments) experiment)
Procedure writing 5 5 5
Technique 10 10 10
Observation/Interpretation 5 5 5
Result 5 5 5
Practical-oral 5 5 5
TOTAL 30 30 30
220
APPENDIX
Reference Websites
1. www.clinichem.com
2. www.cli-online.com
3. www.labmedics.co.uk
4. www.diagnostics.com
5. www.aacc.org
6. www.bioinstrument.com
7. www.amtl.com
8. www.finddiagnostics.org
9. www.aab.org
10. www.biomolecule.com
11. www.biotech.com
12. www.ascls.org
13. www.labtestonline.org
14. www.bd.com/vacutainer
15. www.medilib.med.utah.edu.webpath
16. www.hoslink.com/haemtul.htm
17. www.pathology.uthsca.edu/clare/haematology/lectures
221
221
FORMAT FOR SUBJECT WISE EVALUATION
Sl. Name TE Total Gra
CCE PE Vocational Competency Evaluation
no (80) (100) de
1 2 3 Total Total 1 2 3 4 5 6 Total Grade Regularity Value Capacity Total Grade
(20) (20) (20) (60) Out of and addition building (50)
20 panchuality (20) (20)
(10)
70
FORMAT FOR SCHOOL WISE SCORE SHEET
Sl.No Name English General Vocational subject Physics Chemistry Biology
Foundation
Course C T VC
PE
E E E
C T T G C T T G C T T G T G T G C T P T G C T P T G C T T G
E E o r E E o r E E o r o r o r E E E o r E E E o r E E o r
t a t a t a t a t a t a t a t a
a d a d a d a d a d a d a d a d
l e l e l e l e l e l e l e l e
71

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VOCATIONAL HIGHER SECONDARY

MEDICAL LABORATORY TECHNICIAN COURSE

STATE COUNCIL OF EDUCATIONAL RESEARCH AND TRAINING (SCERT)

This Teacher’s Sourcebook on Medical Laboratary Technician course

The realisation that learning is not mere storing information in memory

Creative criticism and suggestions for improvement are most welcome.

Thiruvananthapuram Dr E. Valsala Kumar

Part II Unit Wise Analysis

Unit - 3 - Clinical Pathology

Unit - 4 - Immuno Haematology and Blood Banking

1. Introduction to biochemistry .......................................................177

1. Introduction to histotechnology ..................................................214

Part III Practical Evaluation ..........................................................................222

Part IV Appendix .............................................................................................223

Significance of vocational education

The teacher should be

2) It must enrich the ideas of the facilitator through innovative process.

3) It must be time bound and rational.

4) It must motive the facilitator to adopt new strategies.

1. School level monitoring group.

2. Regional level monitoring group.

3. State level monitoring group

Moreover a social auditing system is advisable to achieve the objective effectively.

l To be able to handle and investigate various clinical specimens properly.

l To be able to operate and take care of various laboratory equipments.

l To develop ability to perform and interpret various diagnostic investigations.

l To understand the duties and responsibilities of a lab technician/lab assistant.

l To study medical ethics and understand the management of a clinical laboratory.

l To acquire the ability to run a diagnostic laboratory as a part of self-employment

l To acquire ability for time bound completion of task.

l To give awareness among the public about various health hazards.

I n the modern era of globalization the introduction of new technologies ensure

l How the models were prepared

l Working and principles

l Finally documentation of the process

l By the other groups

l Later a consolidation by teachers are to be done.

2. Cross word puzzles

3. Match the following

5. Link game – Answer using clues.

2 Selection of area for survey/sampling frame

3 Selection of survey method

With help of questionnaire/schedule

1 Tabulation and analysis

2 Consolidation and Presentation

Unit I - Laboratory ethics and Management

Vocational Higher Secondary Education

I Laboratory ethics and management 10 hrs. 20 hrs. 10 hrs 40 hrs.

IV Immuno haematology and blood banking 20 hrs. 10 hrs. 20 hrs. 50 hrs

Total 140 hrs. 320 hrs. 100 hrs 560 hrs

Unit - 3 Clinical pathology

Unit - 6 Histotechnology and Cytology

2. Total cell counts 7 hrs.

3. Examination of blood smear 5 hrs.

4. Haemoglobin estimation 5 hrs.

5. Packed cell volume 3 hrs.

6. Red cell indices 2 hrs.

8. Coagulation studies 4 hrs.

9. Special investigations 5 hrs.

Unit - 3 Clinical pathology

2. Urine analysis 12 hrs.

3. Stool examination 5 hrs.