Evaluating distance learning in clinical laboratory science.

OBJECTIVE: The purpose of this study was to determine if there were any significant differences in academic performance between distance students and on-campus students in clinical laboratory science. DESIGN: A quantitative causal comparative research design was used. SETTING: The research study was conducted at an academic health sciences university in the eastern United States. PATIENTS OR OTHER PARTICIPANTS: Anecdotal graduate data were collected from students that had graduated from the Clinical Laboratory Science (CLS) program. INTERVENTIONS: The students had either received their CLS education via distance or through the traditional on-campus methods. MAIN OUTCOME MEASURES: Academic performance was the major outcome measured. This was determined by comparing distance students' final grade point average (GPA) scores and certification scores to their on-campus counterparts. RESULTS: The researchers found no significant difference in gender between distance and on-campus students; however, there was a significant difference in age. On average the distance students were older than their on-campus counterparts. There were no significant differences found for mean overall admission GPA, mean math science admission GPA, mean final GPA score, and mean certification score. There were also no differences found in any of the subcategories of the certification exam except for urinalysis. For the urinalysis subcategory the distance students significantly outperformed their on-campus counterparts. Correlation studies showed that there were significant positive correlations between overall admission GPAs, math science admission GPAs, final GPA scores, and certification scores. CONCLUSIONS: The researchers have shown that distance learning CLS graduates are as academically prepared as their on-campus counterparts.     

Attrition in a clinical laboratory technician associate degree program.

OBJECTIVE: To determine the reasons for attrition in a clinical laboratory technician-associate degree program, a retrospective study was done on classes entering from 1987 to 1992. Suggestions are made to increase retention. SETTING: The medical laboratory department at the Community College of Philadelphia in Pennsylvania. PRACTICE DESCRIPTION: There were 43,987 students enrolled for the 1993 to 1994 academic year; 17,846 full time equivalents at the college. Clinical laboratory technician students averaged 26.2 years and were 26% male and 74% female, which closely paralleled the college. The ethnic make-up of the clinical laboratory technician classes was 54% White, 32% African American, 11% Asian, and 3% Latin American, compared to 48% African American, 36% White, 10% Asian, and 6% Latin American students in the college. PRACTICE INNOVATION: A retrospective study was performed to evaluate attrition rates for the classes entering the clinical laboratory technician program at the Community College of Philadelphia from 1987 to 1992. Reasons for this attrition were tabulated and evaluated. RESULTS: One hundred twenty-nine students entered the program and 75 graduated, producing an attrition rate of 42%. There were 6 categories of reasons given for not completing the program: academic difficulties, dislike of the laboratory science field, family problems, financial problems, substance abuse, and other problems not specified. CONCLUSION: Because 80% of the attrition was due to poor academic performance and a dislike of the field, several changes are being made in the Community College of Philadelphia's retention program. An enhanced orientation will be given to all students, and students will be required to visit a hospital laboratory. Early faculty intervention and peer counseling for students with poor academic performance will be instituted.     

Essential requirements for clinical laboratory science.

OBJECTIVE: To present a sample list of essential requirements for clinical laboratory science (CLS) education that support the requirements of the Americans with Disabilities Act (ADA). The essential requirements provide a basis for student admission and academic progress measurement. DATA SOURCES: Over 700 articles have appeared in various professional and trade journals on the impact of the ADA since it was signed in 1990. DATA EXTRACTION: Literature review. DATA SYNTHESIS: The ADA prohibits discrimination against academically qualified program applicants with disabilities, and requires a list of essential requirements, distinct from academic requirements and distinct from essential functions of jobs, for each academic program. Essential requirements, also called technical standards or functional expectations, are task and attribute-based criteria that define their educational program. Applicants and students must possess or be able to achieve the essential requirements directly or through reasonable accommodations. CONCLUSION: By July 1994, all educators must have been prepared with defensible essential and academic requirements that reflect the needs of their programs, and with appropriate processes for managing applications, academic progress, and program completion that promote equal educational opportunity for qualified individuals with disabilities.     

An entry-level MS degree in clinical laboratory science: is it time?

OBJECTIVE: The study was undertaken to address the following questions: 1) Does the scope of practice of the clinical laboratory scientist require an entry-level master's (MS) degree? 2) How would a change to an entry-level MS degree in clinical laboratory science (CLS) affect educational programs, the practice field, and students? and 3) Based on this study, what recommendations can be made to CLS educators? DESIGN: Surveys were developed to assess the opinions of educators, managers, and practitioners on the need for an entry-level MS degree in CLS. Surveys were also sent to students to assess their interest in an entry-level MS degree and their perceptions of the advantages and disadvantages of this type of program. Surveys sent to educators included questions addressing the effect of a change to an entry-level MS degree in CLS on enrollment and program viability. Managers were asked questions concerning job expectations and compensation for graduates with an entry-level MS degree and practitioners were asked about their interest in this type of program. PARTICIPANTS: The sample for the survey included 280 directors of National Accrediting Agency for Clinical Laboratory Sciences (NAACLS) educational programs, 600 managers randomly selected from the Clinical Laboratory Management Association (CLMA) mailing list, 600 practitioners randomly selected from the American Society for Clinical Laboratory Science (ASCLS) mailing list, and 1400 CLS students selected by program directors. MAIN OUTCOME MEASURES: Educators, managers, and practitioners were asked to read 12 statements related to educational preparation for entry into CLS and indicate their level of agreement on a five point scale. Mean responses to these questions were compared for educators, managers, and practitioners, for educators in hospital-based and university-based programs, and for managers with BS and advanced degrees. Responses to demographic and other forced-choice type questions related to entry-level MS programs were counted and reported. RESULTS: Response rates of 58% (educators), 28% (practitioners), 39% (managers), and 40% (students) were obtained. Educators, managers, and practitioners all agreed that the scope of practice of CLS does not require an entry-level MS degree and that the MS degree is appropriate for those practitioners who wish to further their education. There were no major differences in educators', managers', and practitioners' responses to questions on the need for an MS in CLS. Students indicated that they would be interested in an entry-level MS program if the additional education would give them higher salaries and more job opportunities. Students who entered their CLS program with a baccalaureate (BS) degree were more interested in the entry-level MS option than students who entered with an associate degree or high school diploma. Managers indicated that they would not pay a graduate with an entry-level MS degree more than a graduate with a baccalaureate degree. CONCLUSION: There is currently no support for an overall change from the BS degree to the MS degree as the entry-level requirement for CLS practitioners. Entry-level MS programs in CLS may be attractive to students who already have BS degrees.     

Clinical laboratory technician to clinical laboratory scientist articulation and distance learning.

Laboratory workers and educators alike are challenged to support access to education that is current and provides opportunities for career advancement in the work place. The clinical laboratory science (CLS) program at the Medical College of Georgia in Augusta developed a clinical laboratory technician (CLT) to CLS articulation option, expanded it through distance learning, and integrated computer based learning technology into the educational process over a four year period to address technician needs for access to education. Both positive and negative outcomes were realized through these efforts. Twenty-seven students entered the pilot articulation program, graduated, and took a CLS certification examination. Measured in terms of CLS certification, promotions, pay raises, and career advancement, the program described was a success. However, major problems were encountered related to the use of unfamiliar communication technology; administration of the program at distance sites; communication between educational institutions, students, and employers; and competition with CLT programs for internship sites. These problems must be addressed in future efforts to provide a successful distance learning program. Effective methods for meeting educational needs and career ladder expectations of CLTs and their employers are important to the overall quality and appeal of the profession. Educational technology that includes computer-aided instruction, multimedia, and telecommunications can provide powerful tools for education in general and CLT articulation in particular. Careful preparation and vigilant attention to reliable delivery methods as well as students' progress and outcomes is critical for an efficient, economically feasible, and educationally sound program.     

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.     

Using cooperative learning in clinical laboratory science education.

OBJECTIVE: To compare performance of students instructed by cooperative learning (CL) activities with those taught by lecture. A secondary objective was to assess students' perceptions about their ability to work in teams before and after their exposure to these instructional approaches. DESIGN/SETTING/PARTICIPANTS: CL was incorporated into the immunology/serology course of a university-based clinical laboratory science (CLS) program. Twenty-two students participated in a 4-week study and were randomly assigned to one of two study groups. INTERVENTION: One group received the course material by CL activities, and the other group was exposed to the material through lecture. MAIN OUTCOMES MEASURE: Mean examination scores for CL and lecture groups were compared using an independent samples t-test. Teamwork knowledge, skills, and attitude (KSA) assessment rated students' perceptions of their ability to work in a team environment pre and post tests were compared using a 2 x 2 repeated measures ANOVA. RESULTS: No significant difference was found between mean examination scores of students who acquired their knowledge by CL activities (85.09%) and those taught by lecture (82.18%). Teamwork KSA means scores pre and post tests (22.5, 22.6 CL; 22.7, 21.6 lecture) were not significantly different. CONCLUSION: Results suggest that the incorporation of CL activities did not reduce the students' academic performance or self-perceptions of their ability to work in teams. The use of CL in the classroom, student laboratory, or clinical setting may help prepare students for the role they will be expected to perform as laboratory professionals.     

Updating the immunology curriculum in clinical laboratory science.

OBJECTIVE: To determine essential content areas of immunology/serology courses at the clinical laboratory technician (CLT) and clinical laboratory scientist (CLS) levels. DESIGN: A questionnaire was designed which listed all major topics in immunology and serology. Participants were asked to place a check beside each topic covered. For an additional list of serological and immunological laboratory testing, participants were asked to indicate if each test was performed in either the didactic or clinical setting, or not performed at all. SETTING: A national survey of 593 NAACLS approved CLT and CLS programs was conducted by mail under the auspices of ASCLS. PARTICIPANTS: Responses were obtained from 158 programs. Respondents from all across the United States included 60 CLT programs, 48 hospital-based CLS programs, 45 university-based CLS programs, and 5 university-based combined CLT and CLS programs. MAIN OUTCOME MEASURES: The survey was designed to enumerate major topics included in immunology and serology courses by a majority of participants at two distinct educational levels, CLT and CLS. Laboratory testing routinely performed in student laboratories as well as in the clinical setting was also determined for these two levels of practitioners. RESULTS: Certain key topics were common to most immunology and serology courses. There were some notable differences in the depth of courses at the CLT and CLS levels. Laboratory testing associated with these courses also differed at the two levels. Testing requiring more detailed interpretation, such as antinuclear antibody patterns (ANAs), was mainly performed by CLS students only. CONCLUSION: There are certain key topics as well as specific laboratory tests that should be included in immunology/serology courses at each of the two different educational levels to best prepare students for the workplace. Educators can use this information as a guide to plan a curriculum for such courses.     

Tracing our roots: a new era in clinical laboratory science education.

OBJECTIVE: To describe the emergence of laboratory personnel at the technician and assistant levels and discuss educational issues that arose between 1962 and 1977. DESIGN: A survey of literature on the history of clinical laboratory science (CLS) was conducted. References consulted include various books and professional journals. CONCLUSION: Advances in scientific and medical knowledge and the development of new technologies created new roles and responsibilities for medical technologists (MTs) in the areas of education, research, and laboratory management. At the same time, the certified laboratory assistant (CLA) category was established as a means of providing competent personnel to work in physician office laboratories and small community hospitals in lieu of a certified MT. The growth in popularity of two-year colleges and the availability of federal funding for the development of allied health programs led to the establishment of yet another category of laboratory personnel: the medical laboratory technician (MLT). These developments prompted educators to modify their CLS curricula, develop educational programs at the CLA and MLT levels, and provide opportunities to CLAs, and MLTs for upward mobility. Furthermore, once the Board of Registry (BOR) established the baccalaureate degree as the prerequisite for MT certification, educators also began to restructure and more closely integrate the academic and clinical components of MT programs.     

Teaching method validation in the clinical laboratory science curriculum.

With the Clinical Laboratory Improvement Amendment's (CLIA) final rule, the ability of the Clinical Laboratory Scientist (CLS) to perform method validation has become increasingly important. Knowledge of the statistical methods and procedures used in method validation is imperative for clinical laboratory scientists. However, incorporating these concepts in a CLS curriculum can be challenging, especially at a time of limited resources. This paper provides an outline of one approach to addressing these topics in lecture courses and integrating them in the student laboratory and the clinical practicum for direct application.     

Tracing our roots: origins of clinical laboratory science.

OBJECTIVE: To trace the roots of clinical laboratory science by explaining how women initially gained access to scientific work and to describe the emergence of clinical laboratories. DESIGN: A survey of literature on the history of clinical laboratory science was conducted. References consulted include various books and professional journals. CONCLUSION: The origin of the field of clinical laboratory science can be traced to the early 1900s. Between 1890 and 1910, women were able, for the first time, to pursue careers in scientific professions, clinical laboratories became established in hospitals, and the clinical utility of laboratory tests became more widely recognized by physicians.     

Knowledge fields and inner patterns in clinical laboratory science.

OBJECTIVE: The purpose of the study was to clarify the knowledge base of clinical laboratory science (CLS). This research was motivated by questions concerning the knowledge base itself and its abilities to meet the demands of reality. The following questions were therefore asked to achieve the purposes of the study: What are the knowledge fields and inner patterns in CLS? Which research objects could CLS focus on in order to promote development in practice, education, and research? DESIGN: The findings of the study were arrived at by means of hypothetical-deductive approach and inductive, content analytical strategy. The journal Clinical Laboratory Science of the American Society for Clinical Laboratory Science (ASCLS) provides the source material for the analysis. SETTING: Abo Akademi University, Faculty of Social and Caring Sciences. RESULTS: The findings of the study are discussed in the light of starting points of the theory of science and lead to nine hypotheses concerning CLS. CONCLUSION: The purpose of the present study was to create clarity in CLS as a science of its own. This has been achieved by capturing and describing facts and qualities, and thereafter presenting fundamental hypotheses in CLS. The results of this study give a thought structure for continued development and deepening within the theory and practice of CLS.     

University-based clinical laboratory science programs: strategies for survival.

OBJECTIVE: To describe the current status of clinical laboratory science (CLS)/medical technology (MT) programs regarding the impact of budgetary cutbacks and to identify successful strategies for program survival. DESIGN: Mail survey. SETTING: University-based CLS/MT programs accredited by the Committee on Allied Health Education and Accreditation (CAHEA). PARTICIPANTS: All CAHEA-accredited, university-based CLS/MT programs in Ohio and bordering states and all "big-ten" programs as listed in the Allied Health Education Directory 21st edition (n = 19). INTERVENTION: None. OUTCOME MEASURES: Program directors' perceptions of: the potential threat of program closure, the impact of budget cutbacks, and successful strategies to enhance program viability. RESULTS: A total of 13 programs responded, for a response rate of 68%. The majority of the respondents (66%) indicated that they were experiencing budget cutbacks that affected either their operating budgets or their staffing configurations, or both. Although program closure had been discussed in many programs, directors felt that their programs would not be threatened with closure in the next three years. Only one program had intentionally decreased student enrollment. Strategies implemented by program directors fall into one of four categories: curriculum restructure, use of nontraditional instructional staff, revenue generation, and use of innovative teaching strategies. CONCLUSION: CLS/MT programs are experiencing budget cutbacks consistent with the overall trend in institutions of higher education. In light of the trend toward program closures and decreasing entering practitioners, educators must address issues that relate to program viability. CLS/MT program directors are seeking and instituting changes to enhance the status of their programs in their respective institutions. These strategies are similar to those reported by other higher-education administrators. Further research and evaluation are necessary to determine the outcomes of such measures.