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Even as a “newbie” medical laboratory scientist in the early 1990s, Grace Leu-Burke, MT(ASCP), felt strongly that research needed to be part of her work. She often wondered why certain laboratory tests were ordered for certain patients, during her work as a bench tech in a hospital laboratory in Kansas.
Her questioning of the efficacy of certain tests was not meant to be disrespectful. And it was long before “test utilization” became a buzzword in the medical profession. Her laboratory supervisors and others in her hospital community appreciated her inquiries.
“My intent was to ensure we were performing the right test for the right patient for the right diagnosis,” Ms. Leu-Burke says.
All those years of emphasizing the importance of research in the work of medical laboratory professionals paid off. In 2016, the University of Alaska in Anchorage (UAA), hired Ms. Leu-Burke to establish a research program as part of its undergraduate program in medical laboratory science.
“There are not a lot of MLS programs out there that are doing abstracts and research,” says Ms. Leu-Burke, who now teaches microbiology and molecular diagnostics in the MLS program at the UAA.
“We are a science-driven field. We generate the data, and we should be presenting the data. Presenting elevates who we are as a profession.”
When she first arrived at UAA, Ms. Leu-Burke’s first goal for the research program was that it be sustainable.
“So much research is required to have a certain grant cycle,” she explains. “I wanted to look at something that could be embedded in the MLS program, and it had to align with student learning outcomes.”
Additionally, she wanted to impart to undergraduate students the idea that research is part of their job as medical laboratory scientists. She began by embedding research into the freshmen curriculum, using the Centers for Disease Control and Prevention’s One Health Model, which embraces the concept that humans and animals are interconnected through their shared environment. The One Health Model fits well with the Alaskan environment, which is teaming with wildlife.
Ms. Leu-Burke developed UAA’s MLS research program so that it focused on the region’s surrounding environment. As a newcomer to Alaska, she observed the region’s abundance of resident moose that walk everywhere in Anchorage. As a result, the moose leave fecal droppings around, something to which residents are accustomed. Ms. Leu-Burke wondered if it posed a public health concern, particularly since Anchorage has a large homeless population. No one had ever studied the issue. Everyone in the region was used to seeing moose scat on the ground and just walked around it. Residents she had talked to about it, including neighbors, thought the moose fecal matter was probably benign.
So, Ms. Leu-Burke decided to develop a research project around studying stool samples from the local moose population. First, she and her students had to figure out how to handle the fecal matter since it had not been researched before and there was not much literature on the topic. Together, she and the students developed protocols to be consistent in their testing of the samples and to align with the stated outcomes of the curriculum.
“We looked at three possible avenues,” explains Ms. Leu-Burke. “In Alaska, people eat moose meat, so wanted to look for possible food poisoning. We also wanted to determine what type of bacteria was in the stool samples. And, since we were collecting samples off the ground, our concern focused on environmental contamination, as opposed to the health of the animals, and the concept of a shared environment between humans and animals and, therefore, a shared microbiology.”
In their research, her MLS students examined the types of bacteria the fecal matter contained and then explored the types of antibiotics to use if this became an organism that infected someone. Ultimately, they have discovered there were more organisms with significant resistance to antibiotics than originally anticipated.
“The information we are gathering in clinical microbiology classes is in direct relationship to exposure of microbes in our environment,” Ms. Leu-Burke explains. “I want students to know that research does not have to mean it’s an R01 grant from the National Institutes of Health. Ours is a relatively low-budget surveillance of a potentially infectious disease. We just happened to stumble upon something that is significant in our environment: microbes. You need to be aware of microbes in the environment as they are the ones that will be colonized on patients who come into the hospital.”
Ms. Leu-Burke’s MLS students have a strong understanding of the needs and vulnerability of the area’s homeless population and are aware that many of them do not have access to clean water. During classroom discussions, the students share their perspectives on equity and healthcare and how that impacts the local homeless population.
“One student said, ‘If we are not taking care of our most vulnerable people, then we are not helping anyone,'" she says.
Another outcome of the research program is that the students are very focused and understand that the results of their work will truly mean something. The program has been creating a database since it began in 2017 and has collected 435 grams of negative bacilli.
“We have that many isolates that we have identified and have their antimicrobial pattern over four different species. We now have a huge database, and we can start looking at resistance patterns and measuring them,” Ms. Leu-Burke says.
Since 2018, the study has analyzed more than 300 moose samples, enough volume to make predictions. Her students presented a poster at the ASCP 2022 Annual Meeting that examined E. coli isolates and how their resistance changed over the time since they began analyzing it.
This research has helped Ms. Leu-Burke’s students recognize the concept of a sample in patient care, and they now recognize the impact that has in public health. “My students realize this because we do poster abstracts—it’s not just what we study, but how we impact the population in our region,” she explains.
Her students have now had plenty of experience presenting their research projects at conferences. Their work is always very well received. “One reason our projects present well is that these are all undergraduate students doing the presentations and they have developed good procedures, and they have good data. So, you have your controls or parameters,” Ms. Leu-Burke explains.
Often, the students will become excited about where their research and data may eventually lead. She reminds them to stay focused on their current work and that, in time, they will have to let others use their testing results to do further research.
“We start each school year with a new crop of students, and I must make sure that our protocols are appropriate for their learning,” she explains. “They do this work very well. It has only added to their expertise in microbiology by the time they graduate. They have grown in their expertise in working with specimens where they don’t yet know the outcomes of their research project. But they have developed the concept that this is something they need to investigate. That realization doesn’t always happen to students in a university setting because oftentimes, the research projects those programs offer are mock-ups for study, not for actual research.”
In addition to the research embedded in the curriculum, Ms. Leu-Burke also oversees a student research team that meets once a week outside of class. All her students are welcome to attend. Some students attend regularly while others drop in when they have time. Those students who can commit to regular participation are offered the opportunity to lead a research project.
“That means they work along with me as a PI and are involved in research, writing abstracts, or presenting. These students may be considering going on to graduate school, medical school, or postgraduate programs and are highly motivated,” Ms. Leu-Burke explains. “What is cool about this weekly project is that, so many times, students do not have the opportunity to participate in projects like this because they are reserved for honors programs. Here, you can be a C student and can still take part in this. We do have a department honors program, but you must pay for those three credits.”
What gives Ms. Leu-Burke the greatest satisfaction about the overall research work that she has established in UAA’s MLS program is that when students graduate from the program, they have taken part in actual research. They have worked with something that is infectious, and they have a sense of themselves as clinical scientists even before they begin clinical rotations.
“I think for the field of medical laboratory science, it makes our profession more visible,” she says.