The influence of perceived professional status on the career progression of CLS graduates.

OBJECTIVE: To determine if the perception of clinical laboratory science (CLS), as a profession, influences career progression. DESIGN: A questionnaire was designed to collect information on job history including salary and positions held, reasons for leaving the field, satisfaction with the field and the perception of the field as a profession or a technical occupation. SETTING: Research facilities at the Graduate School of Public Health, San Diego State University, San Diego, CA. PARTICIPANTS: Graduates from the CLS program of the University of Minnesota Division of Medical Technology, 1923-1996, were sent questionnaires; 1338 (70.2%) responded. MAIN OUTCOME MEASURES: The comparison of career progression for those who perceive CLS to be a profession to those who perceive it to be a technical field. RESULTS: Seventy-seven percent of the respondents perceived the field to be a profession. They were 1.7 times more likely to have progressed in their careers than those who perceived CLS to be a technical field. This was reflected in the percentage achieving higher positions both currently and over the respondents' entire job history. CONCLUSIONS: Those who perceive CLS to be a profession are more likely to progress in their career and remain in the field of CLS.

Scholarly activities among clinical laboratory science faculty.

OBJECTIVES: To describe the research and scholarly productivity of faculty in four-year college and university clinical laboratory science (CLS) programs. To identify meaningful scholarship, to assign values to that scholarship, and to list the top 15 CLS programs according to faculty research productivity. DESIGN: In 1996, a national study involving 127 college and university CLS programs was conducted to determine whether faculty were participating in research. A questionnaire was distributed to 505 faculty members. Data from 286 respondents (57% response) representing 114 of 127 (90%) CLS programs were analyzed. SETTING: The study took place at The Ohio State University with collaboration from the University of Tennessee-Memphis and the University of Minnesota. PARTICIPANTS: All CLS faculty within a four-year university or college sponsoring a CLS program were invited to participate. MAIN OUTCOME MEASURES: To determine whether CLS faculty scholarly activities have been strengthened in the last decade, to quantitate scholarship productivity by point assessment, and to list the top 15 CLS programs according to faculty research productivity. RESULTS: Research productivity included time spent in research, numbers of publications and presentations, and grantsmanship. Data indicate that faculty who possess earned doctorates and are employed by research universities have higher levels of research productivity. While 46% of the CLS faculty hold doctorates and 50% are tenured, 42% of all CLS faculty members have not published a research paper or abstract since 1990. Conversely, faculty in some non-research institutions may not be expected to participate in such scholarly activities. On the other hand, 23% of the faculty responding had published six or more articles or abstracts since 1990, 46% were successful in obtaining external funding, and 15% of faculty members had been awarded grants larger than $100,000. CONCLUSIONS: The top 10% of clinical laboratory science faculty researchers are performing approximately one-half of all scholarly activities. The top fifteen research programs in CLS are identified, and not surprisingly, are located in research universities. In the past decade, and generally speaking, CLS faculty have made progress in scholarship including highest degree obtained, publications, presentations, and grantsmanship.

Scholarship and research of allied health deans and directors.

In 1997, a questionnaire was sent to 141 allied health deans or directors to: 1) determine current research and scholarship, 2) ascertain institutional expectations regarding scholarly activities, 3) characterize the institution's research environment, 4) quantitate scholarship productivity by point assessment, and 5) compare scholarship of administrators from research universities with that of those at non-research four-year colleges and universities. Seventy-three (52%) responded. Measures of research productivity included time spent in research, numbers of publications and presentations, and grantsmanship. While spending two thirds of their time in administrative duties, many deans and directors were actively involved in scholarship. Since 1990, they had, as a group, produced 855 publications, made 1,348 presentations, and been awarded $38.3 million in total funding. They did not differ significantly by employing institution (a research institution or a non-research institution).

Research productivity and activities of clinical laboratory science faculty: a follow-up study.

A national study was conducted in 1996 to compare clinical laboratory science faculty demographics, scholarly activities, and perceptions of the research environment with corresponding data reported in 1988. Faculty have made progress in earning doctorates (46%), achieving higher ranks (49%), and getting tenured (50%). Relatively few faculty are conducting much of the research, with the greater majority serving as teachers. Research productivity, as evaluated via research publications and presentations, showed that in 1996, full professors and those with doctorates published the most articles and abstracts in refereed journals; they also made more presentations than junior faculty. Faculty in research universities were more productive than those in four-year colleges and universities. The faculty surveyed in 1985 and those surveyed in 1996 perceived their research skills and environments to be almost identical. In both 1985 and 1996, the importance of research for promotion and tenure decisions ranked highest as a characteristic of the environment. Financial resources and time available for research ranked lowest.

Clinical laboratory employment and workload patterns.

Determining numbers and types of personnel to staff clinical laboratories is important to employers and educators. At 5-year intervals over the last 25 years, employment patterns among laboratory personnel have been examined in the 5 county Minneapolis-St. Paul (Twin Cities) area that includes 2.2 million persons, almost 50% of Minnesota's population. The 1995 survey was distributed to laboratory administrators of 28 major laboratories. All (100%) responded with information regarding personnel numbers and types. Data from 1995 were compared to that from 1970, 1980, and 1990. In 1970 there were 30 hospitals in the Twin Cities area with over 10,000 hospital beds; there were also 2 blood banks and 4 clinic laboratories. Altogether approximately 1300 laboratorians were employed. In 1980 there were still 10,000 hospital beds among 29 hospitals. However there were 8 other major employers of clinical laboratory personnel, including blood banks, clinics, and a reference laboratory. Between 1970 to 1980, the number of laboratory personnel almost doubled to 2500. The impact of managed care together with the Prospective Payment System, a government initiative of 1983, profoundly affected health care institutions and their personnel. By 1990 hospital mergers and closures reduced the number of Twin Cities hospitals to 20 with a total of 7500 beds. There were 11 blood banks, clinics, reference labs, and HMOs, including 3 reference (independent) laboratories. Laboratory employees increased slightly to 2600. By 1995, hospitals were reduced to 18 and hospital beds to fewer than 7000. The number of all personnel in the 28 laboratories surveyed rose to 2900. Between 1980 and 1995, 10 major hospitals closed or were converted to a different type of facility. Four hospitals merged to form 2 consolidated hospitals. Only 2 small suburban hospitals were built. However, despite the decrease in hospitals, laboratory personnel numbers increased after 1980, due largely to the emergence of 3 independent laboratories, as well as a result of an increase in overall testing volume. Seventy-five percent of the 28 administrators surveyed reported more laboratory testing in 1995 than in 1990. The number of laboratory personnel in the Minneapolis-St. Paul area has more than doubled in the past 25 years, despite the closure of 1/3 of the Twin Cities hospitals and efforts by the government to reduce laboratory testing. One reason for the expanded employment of laboratories and greater testing volume is the expansion of the laboratory itself--into new diagnostic technologies, as well as into new laboratory sites.

Employment patterns and turnover among laboratory personnel: a twenty-year study.

A longitudinal study of employment patterns and turnover of clinical laboratory personnel in the Minneapolis-St. Paul area was conducted for the years 1970, 1980, and 1990. Laboratory staffing patterns for the years studied showed a general plateau in numbers and categories of personnel between 1980 and 1990, following a doubling in those numbers between 1970 and 1980. In 1990, for a geographic area of 2.2 million people, a total of 2,500 laboratory personnel were employed in 31 major laboratories. Fifty-six percent were medical technologists (clinical laboratory scientists), 6% cytotechnologists and histologic technicians, 23% laboratory technicians, 9% phlebotomists, and 7% in "other" categories. The ratio of full- to part-time employees was approximately 3 to 1. Between 1970 and 1990, annual turnover rates for all laboratory personnel declined from 20% to 15%. In 1990, the personnel group experiencing the lowest turnover was in cytotechnology (4%) and the rate for medical technologists was 9%. The turnover for laboratory technicians was 17%, and the rate for histologic technicians was 19%. Highest turnover occurred among phlebotomists (36%) and "others" (39%). While the numbers of laboratory personnel employed leveled off between 1980 and 1990, numbers of new graduate technologists and technicians decreased by approximately one-half. Personnel shortages in laboratory science can therefore be expected to continue.

Allied health applicant pools and employment opportunities--1987.

This study sought information relative to student capacity and enrollment, quality of applicants, numbers in the applicant pool, and program directors' estimates of the job market and salaries, as well as overall impressions of their respective professions in six allied health disciplines: medical technology, physical therapy, radiologic technology, occupational therapy, dietetics/nutrition, and medical record administration. Of 105 four-year colleges and universities surveyed, 252 programmatic responses were received from 83 institutions (79% response rate). Generally, the status of these six allied health professions appeared very good, with a 2 to 1 overall ratio of applicants to graduates, and an almost 6 to 1 ratio in physical therapy. The average GPA for incoming allied health students was 3.01. Job opportunities were considered plentiful, and 93% of program directors rated the overall outlook for their respective professions as good to excellent. However, there were four areas that program officials may wish to examine more closely: excessive length of some professional programs, numbers of minorities in the institutions surveyed, entry-level salaries for several professions, and a somewhat less positive atmosphere in medical technology as compared to the other five disciplines.

Using a coalition arrangement for providing continuing education.

Since 1981, the Minnesota Society for Medical Technology (MSMT) and the Division of Medical Technology, University of Minnesota, have collaborated in "The Coalition for Continuing Education of Laboratorians in Minnesota" to provide high-quality, organized, and ongoing continuing education programs for clinical laboratory personnel in the state. These programs have been half- and full-day workshops, of which 60 percent have been held outside of the Twin Cities metropolitan area. The CE offerings are intended to be practical, relevant, and timely in the practice of laboratory medicine. The history of the Coalition--its goals, objectives, action plan, programs, and progress--is described. Both groups, MSMT and the University, have derived benefits from this cooperative arrangement that others may wish to consider in continuing education program planning.

Determination of passing scores on certification examinations: an unresolved issue.

In the field of clinical laboratory science, certification may be obtained by passing the National Certification Agency for Medical Laboratory Personnel (NCA) examination. This multiple-choice test is competence-based and criterion-referenced, and uses a modified Angoff procedure to establish the passing score. For this study, the NCA examination scores of 1,868 certification applicants (mostly new graduates) and 111 selected laboratory practitioners were compared. Although the NCA examination is designed to define the level of minimum competence, the failure rate of practitioners identified by their supervisors as minimally competent was almost four times greater that that of the certification applicants. Even the most competent group of practitioners scored well below the applicants for certification. These findings suggest that the examination cut-off point may not really define minimal competence and that the method used to determine the passing score might not be appropriate for certification examinations.

A study of job turnover among clinical laboratory personnel.

A study of job turnover in clinical laboratories in the Minneapolis-St. Paul area was conducted in the years 1970, 1975, and 1980. Annual turnover rates for all laboratory personnel were 20%, 19% and 15% respectively. The groups with the lowest turnover were cytotechnologists, histologic technicians and clinical laboratory scientists (medical technologists). The highest turnover occurred among clinical laboratory technicians and "others," primarily supportive personnel such as phlebotomists, assistants, and aides.