Clinical laboratory scientists' view of the competencies needed for current practice.

OBJECTIVE: To provide a current description of competent clinical laboratory scientists (CLSs) that can be used as a guide for educators, practitioners, and students. DESIGN: A survey of clinical laboratory science (CLS) practitioners was developed to assess current work settings and important competencies in those settings. The survey also addressed graduate school enrollment and the impact of multi-skilling on current practice. SETTINGS AND PARTICIPANTS: 135 graduates of the Division of Clinical Laboratory Science at the University of North Carolina at Chapel Hill from 1987 to 1996. MAIN OUTCOME MEASURES: Participants' responses to questions about their current job titles, clinical specialty, type of institution, multi-skilling, graduate school enrollment, and the competencies they considered important for their jobs were analyzed to provide a description of current practice. RESULTS: The response rate for the survey was 73%. The majority of the respondents were employed as staff CLSs in medium to large hospitals. Thirteen percent of the respondents indicated that they had graduate degrees and an additional 13% were currently enrolled in a graduate or professional program. Fourteen percent of the respondents reported that they were working in the laboratory profession and were performing some health care skills not included in the CLS program. The graduates described 15 major areas of competence important for current clinical practice. The skill or competency mentioned most frequently by the respondents was interpersonal skills followed by flexibility. Competence in technical and scientific skills was ranked third and problem solving abilities was ranked fourth. CONCLUSION: The results of this study describe a CLS practitioner who is able to communicate well with others as a team member; flexible and open to change in the work environment; technically component; able to solve problems and correlate clinical information; organized; and involved in the management and leadership of the clinical laboratory. This description can help educators design curricula, guide practitioners' self assessment, and inform students who are considering a career in CLS.

Venipuncture in the medical physiology laboratory.

Medical physiology laboratories, traditionally devoted to animal experimentation, face unprecedented difficulties linked to cost, staffing, instrumentation, and the use of animals. At the same time, laboratory experiences with living creatures play a unique role in medical education. In this article we describe the use of venipuncture and subsequent blood analysis, with medical students serving as both subjects and experimenters, in a sequence of first-year physiology laboratories. These experiments are safe, robust, inexpensive, and time efficient, and they teach the principles of cardiovascular, respiratory, renal, nutritional, and gastrointestinal physiology. In addition, they enhance medical education in several other important dimensions. First, they teach safe venous blood collection and handling, a training appropriate for students at this level. Second, by serving each week as subjects as well as experimenters, students experience aspects of both sides of the doctor-patient relationship. Third, the laboratories can be used to teach fundamentals of research design and analysis. Finally, because blood analysis is central to medicine, and because the student's own blood data are discussed, students are enthusiastic and cooperative, and the clinical relevance of the data is clear.

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.

A cooperative MLT program between a community college and a university.

In 1991 the University of Utah collaborated with Salt Lake Community College to establish a jointly sponsored Medical Laboratory Technician (MLT) program. With documented need for MLTs in Utah and surrounding states, both institutions combined their resources to create an associate degree program that neither institution could offer alone. The first academic year of prerequisite science and liberal education courses are completed at the Community College followed by a second year of professional didactic and laboratory courses taught by faculty of the Medical Technology (MT) Program at the University of Utah, Department of Pathology. Following the second year of professional courses, MLT students complete 15 weeks of clinical rotations in the Salt Lake Metropolitan area. MLT students as well as MT students benefit from their shared experiences in combined courses that are taught on the university campus.

Surfing the wave of clinical laboratory science evolution in Hawai'i.

OBJECTIVE: To describe the steps taken by the Hawaii Society for Clinical Laboratory Science, an affiliate of the American Society for Clinical Laboratory Science, to inform local laboratory professionals of current trends and to prepare for the future. RESULTS: A Strategic Planning workshop was conducted at the 1997 Hawaii Society for Clinical Laboratory Science Annual Meeting where participants reviewed the essential (but non-traditional) functions of clinical laboratory scientists, and described current realities, identified forces and players affecting the changes, and envisioned the future of our profession. CONCLUSION: As the way health care is provided changes in response to economics and advances in technology, the role of clinical laboratory scientists needs to be redefined. The Hawaii Society for Clinical Laboratory Science continues to provide timely support for members, and plans to work collaboratively with the local chapter of the Clinical Laboratory Managers' Association to advance clinical laboratory science to an appropriate place in the health care community.

Learning styles and outcomes in clinical laboratory science.

OBJECTIVE: To compare two learning styles--reflective observation versus active experimentation--in terms of learning outcomes. DESIGN: The independent variable, student learning styles, was generally defined as styles determined by use of the Kolb's Learning Style Inventory. The styles were identified as either active experimentation or reflective observation. The dependent variables were learning outcomes that were determined by two methods: the average score on eight posttests scheduled at periodic intervals and a national certification examination score. SETTING: Clinical laboratory science education program at the University of Nebraska Medical Center in Omaha and at six clinical sites in other cities across Nebraska. PARTICIPANTS: Forty senior clinical laboratory science students enrolled in a baccalaureate degree program. MAIN OUTCOME MEASURES: Data analysis consisted of descriptive statistics, two-way analysis of variance, two-way analysis of covariance, and repeated measures analysis of variance. RESULTS: Results showed no significant difference between the students' examination scores based on learning styles. There was no significant difference in the pattern of the examination scores over the semester of learners who were active experimenters versus reflective observers. CONCLUSION: Results of the study generally did not support the conclusions of the earlier research; students' learning styles did not affect their examination scores. No pattern in the examination scored exists in the learning style groups.

Journey to the millennium: mentoring in the clinical laboratory.

Mentoring is one solution to preparing medical technology students to face the challenges and changes they will confront in the laboratory of the future. As described here, both mentors and protégés benefit from informal mentoring programs.

Tracing our roots: the beginnings of a profession.

OBJECTIVE: To examine the role of the American Society of Clinical Pathology and the Board of Registry in shaping the field of clinical laboratory science during its formative years. DESIGN: A survey of literature on the history of clinical laboratory science was conducted. References consulted include various books and professional journals. CONCLUSION: The Board of Registry played a significant role in the early development of clinical laboratory science. The Board established standards of competence for entry-level practitioners and a mechanism for assessing competence and developed an accreditation process for educational programs.

Chinese CLS sister school relationship.

OBJECTIVE: Establish a relationship with a Chinese CLS Program to foster cross-cultural diversity, provide for student and faculty cross-cultural exchange, scholarship, research, and improve the health care of both communities served by the colleges. DESIGN: Information needed to develop agreement strategy was gathered by literature review, personal interviews, and direct observation in China. Based upon literature review an original list of items for discussion was developed. Discussions were held between administrators of both schools and the teaching hospital. The Chief Laboratory Technologist of the associated Chinese teaching hospital was interviewed to establish the extent of CLS students' experiences. A form for the interview was developed and the results were used during the negotiation of the final agreement. SETTING/PARTICIPANTS: A CLS faculty team member from the U.S. traveled to the Jingmen School of Nursing and Allied Medical Sciences, Jingmen City, China, Hubei Province, P.R. China to establish an agreement. Tours of six cities in China, the School, and Jingmen hospitals provided for a better understanding of the Chinese culture and the Chinese CLS program. RESULTS/CONCLUSION: Three major concerns for success of the relationship (language barriers, communication vehicles, and socialization issues) were determined and addressed in a final agreement. The components of the agreement may provide some insight for others considering such a collaborative venture. Outcomes will be more fully addressed when exchanges begin.

CLS advanced degrees and career enhancement. Part 1--Comparison of career data.

OBJECTIVE: Determine whether recipients of clinical laboratory science (CLS) advanced degrees (MS) experience greater career achievements than their baccalaureate level (BS) colleagues. DESIGN: Two similar questionnaires were used-one for certified or licensed CLS professionals who had earned advanced CLS degrees (MS); the other for matched BS CLS colleagues. SETTING: Five academic programs that conduct both National Accrediting Agency for Clinical Laboratory Sciences accredited CLS education and CLS MS degree programs participated. PARTICIPANTS: The number of survey respondents was 220, 117 with advanced CLS degrees and 103 BS level controls. There were 99 matched pairs, i.e., 198 individuals were matched for gender, residence region, and years of experience. MAIN OUTCOME MEASURES: Careers of BS vs. MS respondents were statistically compared, e.g., fractions with managerial level jobs, relative earnings increases per year, numbers of publications and reports, and other professional contributions. RESULTS: Compared to their BS degree controls, MS degree respondents had more managerial level jobs (62% MS; 36% BS), a higher frequency of job change (once per 4.3 years MS; once per 5.9 years BS), and a higher increase per year of earnings (9.1% MS; 8.1% BS). A greater percentage of the MS degree graduates (77%) than the BS level controls (33%) had authored external publications; the responses related to authorship of institutional reports and procedures were less different-84% MS and 64% BS. Professional contributions to their institutions or profession were cited slightly more frequently by the MS graduates (65%) than by the BS level controls (55%). CONCLUSION: Compared to their matched BS level CLS colleagues, CLS MS degree recipients had greater job mobility, greater management authority, higher salary, and more numerous professional contributions.

The quest for professional recognition.

OBJECTIVES: To assess the progress clinical laboratory science has made toward achieving professional status. DATA SOURCES: Books, professional journals. STUDY SELECTION: Not applicable. DATA EXTRACTION: Survey of literature. DATA SYNTHESIS: Characteristics of clinical laboratory science as a profession were compared to a model of professionalization developed by Houle to assess the extent to which clinical laboratory science has acquired and refined selected attributes of a profession. CONCLUSION: Although clinical laboratory science has attained some of the characteristics associated with a profession, several critical issues must be addressed before it can achieve full professional status and recognition.

CLS advanced degrees and career enhancement. Part 2--A comparison of perceptions.

OBJECTIVE: To determine whether recipients of clinical laboratory science (CLS) advanced degrees (MS) perceive greater career enhancement value related to earning an advanced degree than is perceived by their baccalaureate level (BS) colleagues. DESIGN: Two questionnaires were used-one for certified or licensed CLS professionals who had earned MS CLS degrees; the other for matched BS CLS colleagues. SETTING: Five academic programs that conduct both National Accrediting Agency for Clinical Laboratory Sciences accredited CLS education and CLS MS degree programs participated. PARTICIPANTS: The number of survey respondents was 220 (117-MS; 103-BS level controls). The groups were matched for gender, residence region, and years of experience. MAIN OUTCOME MEASURES: The primary outcome measurements were the perceived benefits of having a CLS MS degree, the reasons for and against obtaining a CLS MS degree, and the overall evaluation of CLS degree programs at both levels. RESULTS: The highest perceived benefit of having a CLS MS degree was the same in both groups, "enhanced self esteem and confidence". The highest priority motivation of MS degree recipients for obtaining a CLS advanced degree was "personal satisfaction". The highest priority reason of the BS group for not obtaining a CLS advanced degree was "family obligation". In both levels of degree programs the subject most commonly cited as needing modification was laboratory management. CONCLUSION: The results indicate that CLS professionals who have CLS MS degrees perceive a greater career enhancement value of advanced CLS degrees than their BS level colleagues.

Clinical laboratory radioimmunoassay usage.

OBJECTIVES: To determine the extent of radioimmunoassay utilization in clinical laboratories in the state of Texas; to ascertain what methods have replaced it as an analytical tool; to identify trends and elicit comments regarding attitudes toward radioimmunoassay; and to ascertain the extent of instruction of radioimmunoassay principles required in clinical laboratory science curricula. DESIGN: Mailed, written survey designed by the authors. PARTICIPANTS: Laboratory managers or directors of 203 clinical pathology laboratories in Texas. MAIN OUTCOME MEASURE: Responses to seven forced-choice items, prompting information regarding laboratory type and size, extent of radioimmunoassay use, benefits or radioimmunoassay, and replacement technologies; a single item that elicited responses and opinions regarding general attitudes about radioimmunoassay and its place in clinical laboratory science curriculum. DATA SOURCE: Clinical laboratory managers or directors in the state of Texas. RESULTS: A total of 203 surveys were mailed within 127 respondents, yielding a response rate of 63%. The majority (77%) of clinical laboratories surveyed no longer use radioimmunoassay as a diagnostic tool with the predominant reason being the availability and affordability of automated enzyme immunoassays. Time-consuming recordkeeping was another common reason for abandoning the technique. Enzyme immunoassays were by far the most common method replacing radioimmunoassay. Comments reflected the general attitude that radioimmunoassay is a technique of the past in the clinical laboratory. A variety of views were elicited regarding the education of the principles of RIA to clinical laboratory science students. CONCLUSION: Radioimmunoassay, although a viable assay in some situations, has been abandoned as an analytical tool in most clinical laboratories in Texas. Current users are unhappy with the amount of paperwork that accompanies use of the technology, while non-users consider non-isotopic assays equivalent in sensitivity to RIA. In regard to information presented to clinical laboratory science students, the advent of molecular diagnostic techniques requires continued instruction in the principles of radioactivity, although not radioimmunoassay.

Educating for collaborative practice.

OBJECTIVE: To describe a baccalaureate-level course which is designed to help allied health professions students develop an understanding of collaborative practice among interdisciplinary components of a health care system and to report on a survey which assessed the effectiveness of the course for clinical laboratory science graduates. SETTING: University of Kentucky, a large (24,000 students) state-assisted institution PRACTICE DESCRIPTION: Baccalaureate clinical laboratory science program PRACTICE INNOVATION: A college-wide course helps students develop an understanding of the linkages of the major components of a health care system and introduces the techniques necessary to function in an interdisciplinary team. MAIN OUTCOMES MEASURE: Perception of benefit from the course by clinical laboratory science graduates. RESULTS: Graduates report that the course helped them develop a larger perspective of health care delivery beyond that of their own discipline and aided in their understanding of group processes and group problem-solving. CONCLUSIONS: Clinical laboratory science curricula can benefit from the inclusion of a college wide course which introduces a broad perspective of health care delivery and group process concepts.

Using clinical laboratory specialists for in-service education: an important aspect of cross training.

Cross training of clinical laboratory professionals is on the rise because of hospital mergers and downsizing. Confusion and uncertainty during mergers, plus the added stress of cross training or learning a new "bench" can be overwhelming. Utilizing clinical laboratory specialists to provide continuing education as support for cross training laboratorians can be beneficial to both the laboratory employee and to management. This manuscript describes a model for continuing education support for laboratory personnel returning to the hematology "bench" after many years away from the high complexity level tests in this area of the clinical laboratory. The article addresses the cross-functioning role of laboratory specialists as educators as well as high-level bench technologists. This model for in-service education may serve several purposes, such as documentation for continuing education and personnel competency testing, while giving other laboratorians support for learning new tasks and enhancing their resume.