From Technical Assistants to Critical Thinkers: The Journey to World War II.

A review of professional literature was conducted to examine the history of the education of medical laboratory practitioners. This comprehensive review included historical educational milestones from the birth of medical technology to the advent of World War II. During this time period standards were developed by clinical pathologists for laboratory personnel and training programs. In addition, a formal educational model began to form and by the 1940's two years of college was required for matriculation into a medical technology program. Intertwined within the educational milestones are imprints of the evolution of critical thinking requirements and skills within the profession. For the first laboratory practitioners, critical thinking was not developed, discussed, or encouraged as duties were primarily repetitive promoting psychomotor skills.

From Technical Assistants to Critical Thinkers: From World War II to 2014.

A review of professional literature was conducted to examine the history of the education of medical laboratory practitioners. This comprehensive review included historical educational milestones from World War II to present day. During this time period the standard of two years of college required for matriculation into a medical technology program increased to four years. Critical thinking skills promoted in the educational model and applied in practice expanded from an analytic and psychomotor orientation to include those requiring extensive situational interpretation and negotiation. By the end of the twentieth century, the clinical laboratory had experienced significant scientific and technologic transformations necessitating greatly expanded roles for the medical laboratory practitioner. Though the educational requirements and education model have changed minimally since the 1970's, the knowledge and skills required for the next generation of medical laboratory practitioners continue to escalate. The second decade of the 21st century portends a transformation in medical laboratory practitioner education commensurate with the rapid advancement of science, technology, communications, and the precepts of evidence-based practice.

Autonomy and Privacy in Clinical Laboratory Science Policy and Practice.

Rapid advancements in diagnostic technologies coupled with growth in testing options and choices mandate the development of evidence-based testing algorithms linked to the care paths of the major chronic diseases and health challenges encountered most frequently. As care paths are evaluated, patient/consumers become partners in healthcare delivery. Clinical laboratory scientists find themselves firmly embedded in both quality improvement and clinical research with an urgent need to translate clinical laboratory information into knowledge required by practitioners and patient/consumers alike. To implement this patient-centered care approach in clinical laboratory science, practitioners must understand their roles in (1) protecting patient/consumer autonomy in the healthcare informed consent process and (2) assuring patient/consumer privacy and confidentiality while blending quality improvement study findings with protected health information. A literature review, describing the current ethical environment, supports a consultative role for clinical laboratory scientists in the clinical decision-making process and suggests guidance for policy and practice regarding the principle of autonomy and its associated operational characteristics: informed consent and privacy.

Grounded theory in medical laboratory science expert practice development.

Grounded theory and methods related to expert practice development in medical laboratory science were described using data from a large national survey of medical laboratory scientists (MLS) overlaid on findings from analysis of expert practice domains reported in nursing literature. An extensive focus group/expert review iterative process followed by a survey of MLS practitioners produced 25 critical thinking (CT) behaviors important in expert practice. Factor analysis was applied to discern common threads or themes linking the CT behaviors. The 25 important CT behaviors were reduced to a 7-factor structure representing constructs underlying the individual, observable CT behaviors. This 7-factor structure in MLS was compared to the 7 practice domains identified in expert nursing practice. The comparison yielded commonality between MLS and nursing in CT behaviors observed in the 7 expert practice domains of both professions: professional techniques, caring communication, growing professionally, setting priorities, practicing with judgment, anticipating/revising, and creating unique meaning. Emergent grounded theory is that (1) critical thinking is a metaprocess that facilitates learning by interlinking the more basic processes associated with different learning orientations: cognitivist, behaviorist, humanist (affective), and situated/contextual learning, (2) CT behaviors are observable events following from the CT metaprocess, and (3) observations of CT behaviors increase as practice advances from novice to expert. Identification and definition of CT behaviors, i.e., practice competencies, along the continuum of novice to expert can serve as the foundation for MLS curriculum and instructional design as well as measurement and evaluation in both formal and continuing education settings.

The doctorate in clinical laboratory science: an executive summary.

This article describes, in informational bullets, the concept of the doctorate in clinical laboratory science. The intent of the article is to support the marketing of these new practitioners and to provide the conceptual frame and links to data for proposals required to implement educational programs for them.

A quality improvement cycle: hemolyzed specimens in the emergency department.

OBJECTIVE: To determine the cause of and possible solution for an excessive number of hemolyzed specimens received from the emergency department (ED) of a large medical center. DESIGN: The clinical laboratory staff collected data on hemolyzed specimens for all departments of the medical center. The clinical laboratory management team and ED management team intervened with training and surveillance of the ED staff to heighten the awareness of the problem. SETTING: The clinical chemistry laboratory of a large medical center. MAIN OUTCOME MEASURE: The number of specimens submitted by inpatient departments and the ED was measured in relationship to the number ofhemolyzed specimens received from the departments. The clinical laboratory measured specimen processing times and turnaround times to determine their role in possibly contributing to the large number of hemolyzed specimens. Direct observation by a certified phlebotomist documented anecdotal evidence of the ED staffs phlebotomy practices. ED and clinical laboratory practitioners communicated realistic impressions of the medical centers problem with hemolyzed specimens. RESULTS: The laboratory processing times were not responsible for the hemolyzed specimens. The collection equipment was not responsible for the hemolyzed specimens. The ED had an excessive number ofhemolyzed specimens when compared to the rest of the medical center. The collection techniques in the ED appeared to be the origin of the problem. CONCLUSION: The intervention of the laboratory manager with the ED chief and nurse manager abated some of the professional arrogance between the departments. The dialogue educated the staffs about specific data that pointed to a possible origin of the problem. The ED chief placed his department on surveillance against problematic draws. Communication was improved between the two departments. However, only a moderate improvement in the number of hemolyzed specimens was noted. More training of medical center departments in phlebotomy and periodic proficiency evaluation of the all staff was indicated as a possible long-term solution.

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.