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Launching a hospital-based 2 + 2 MT program.

B Launching a hospital-based 2+2 MT Program

Academic and clinical coursework are interwoven in this medical technology program jointly designed by one hospital and one college

Operating an accredited medical technology program since 1936, our 600-bed hospital until recent years used the traditional 3 + 1 structure. students completed three years of course work at their college and a fourth year of clinical coursework with us. In 1977 we began pursuing the idea of a nontraditional structure.

The eventual result was our innovative 2 + 2 integrated program with a single academic affiliate-the only one of its king based at a hospital. The program eases medical technology students into the profession. They are exposed to medical technology as early as their freshman year at a local college. In their junior and senior years,, academic and clinical coursework are integrated; this takes the place of swueezing the entire clinical curriculum into a single year.

We help the college recruit students for its comprehensive allied health program, and the college sends the hospital all of its medical technology majors. The hospital's expense in teaching the students is defrayed in part by student tuition.

A similar arrangement had been discussed with some of the hospital's former academic affiliates, but they were not interested. After all, under the old 3 + 1 medical technology program, the hospital bore the entire cost and responnsibility for clinical coursework; students were not charged tuition for thier clinical year. It was an easy and inexpensive way for the colleges to complete the education of medical technology majors. So why change?

In a sense, it would have been easier for our hospital to continue with the old program. After all, we had no trouble filling the 12 slots with students from several colleges, and we consistently produced technically proficient graduates who went on to assume the traditional roles of bench technologists.

But the profession was changing. We believed strongly that we should be preparing our students to handle the increasing demands of the laboratory of the future.

Prospective payment regulations were bound to force laboratories to reevaluate their staffing, placing greater emphasis on diversity. Nearly all medical technology educators agree that graduates will need computer literacy. In addition, many of them cite skills in research, business, marketing, and communication as funecessary for them to do so.

Our MT program officials wanted to provide students with appropriate learning opportunities for optimum job flexibility at the baccalaureate level. They sought to develop a four-year degree program, in cooperation with an academic institution, that would insure strong backgrounds in both liberal arts and science.

In 1981, preliminary discussions concerning a new direction for the hospital's MT program were held with Rockhurst College's medical technology advisor. This small, private institution in Kansas City had always sent our hospital excellent students. The medical technology advisor agreed that a hospital-based MT program with a single academic affiliate would open up opportunities for highly coordinated curriculum planning. Yet there might be several obstacles.

Could the college deliver enough medical technology students to the hospital program? Which institution would bear the ultimate responsibility for decision making? Would the program receive accreditation? Would it cause hard feelings among the other area hospitals with medical technology programs?

For our hospital, the advantages of the proposed program far outweighed the disadvantages. We could look forward to:

Developing goals and a curriculum cooperatively through equal representation on a curriculum committee.

Receiving students with similar, standardized academic preparation from a single college with an excellent reputation for its allied health program. Previous MT classes had included quite a range of students-from some who could qualify as pre-med to some who had never even heard of a parasite.

Setting up reciprocal continuing education programs for the faculty at both institutions.

Receiving tuition reimbursement for the clinical coursework to help offset the hospital's teaching expenses.

Having an early estimate of the total number of students expected to enter the program during the next few years. If not enough freshmen declared as medical technology majors, we could step up recruitment efforts.

Knowing that the college would continue to provide students with housing, financial aid, and health insurance for the full four years.

We could foresee only two disadvantages: First, the students would have to pay full tuition for all four years of study. In the past, no tuition or fees had been charged for the clinical coursework. Many hospitals, however, now do charge tuition (generally $1,000 to $1,500 in our state) to recover some of the money they spend on medical technology education.

The second disadvantage might best be described as a loss of esprit de corps within the hospital laboratory family-a spirit that developed in the 3 + I program because students broke all ties with their academic institutions during their clinical year. Under an integrated approach, students would have academic coursework throughout the four years.

Although this may seem to foster divided loyalties, we have tional experiences as part of a larger whole, not just a means to a degree.

Rockhurst's medical technology advisor recognized several advantages for the college as well in the exclusive arrangement: decrease the uncertainty-which before had lasted till the middle of the junior year-about where, or even if, they would be accepted.

A cooperative recruitment drive would raise the college's number of medical technology majors at a time when MT enrollment was declining nationwide.

On the other hand, the college worried that it might not be able to supply the 12 students a year desired by the hospital. Indeed, Rockhurst had only sent us one or two students a year in the past, but we were confident that combined recruitment efforts would attract a sufficient number.

The college was also concerned that other area hospitals might resent the exclusive arrangement. Since Rockhurst operated a number of allied health programs, it did not want to jeopardize placements in the other disciplines.

Ironically, the shortage of medical technology students worked in our favor. The other hospitals were happy to see us out of the picture among all but one of the colleges that provided them with MT students.

After weighing the advantages and disadvantages, the hospital and college administrations gave a go-ahead to continued discus' sion toward a new arrangement. Philosophical agreement was essential, and we felt we had that.

Rockhurst was well known as a liberal arts college. Its science division was superior, its majors exceeded our requirements for graduation, and they were routinely advised into computer science and statistical methods coursework.

The college and the hospital both preferred that the program retain its hospital-based accreditation status; that clinical contact hours be decreased as little as possible; that clinical instruction be extended over at least two academic years; that all clinical instruction remain in the hospital; that the college introduce supplementary coursework in business, marketing, computer science, research, and communication; and that students interested in a possible career in medical technology be introduced to the profession as early as possible, particularly at area high schools.

Since we agreed on these fundamental issues, neither side felt anxious about losing control or blurring the program's identity. Each institution's role would remain essentially the same-we would merely work together more closely in coordinating our educational efforts.

We drafted and refined a simple affiliation agreement that was easy to read and just a fraction of the size of most of our former agreements with colleges. It covered all the points specified for such an agreement in the guidelines to the "Essentials" published by the National Accrediting Agency for Clinical Laboratory Sciences.

Signed in October 1982, this agreement named Rockhurst College as the degree-granting institution and our hospital as the NAACLS-accredited base for the medical technology program. A four-member curriculum committee, with two representatives from each institution, was established to oversee curriculum development for all four years of coursework. We also created a mechanism for partial tuition reimbursement by the college to the hospital for clinical instruction.

To keep the agreement simple, such details as maximum class size (12 students) are noted in an addendum. It is written so that it can be easily modified as the program evolves and as NAACLS requirements change.

The number of faculty members for our integrated program remains the same as that for the former 3 + 1 program. One fulltime program director is based at the hospital. Six technologists and one phlebotomist serve as parttime clinical faculty members, coordinating the didactic and bench learning in the various disciplines, but all of the medical technologists in our hospital laboratory participate in the program as bench or didactic instructors. Teaching has become a means of self-instruction and continuing education for the entire staff.

First-year and second-year allied health students have ample opportunity to get acquainted with the various hospital disciplines. Those interested in a medical technology major can spend time "shadowing" technologists in the lab. (The prerequisites for admission are shown in Figure 1.) They also are in touch with the medical technology advisor on campus.

Students begin following the clinical medical technology curriculum outlined in Figure 11 as juniors. They spend Tuesdays and Thursdays at the hospital, taking the introductory-level courses. The rest of the week, they are back at the college continuing their elective coursework.

In the summer preceding their senior year, the medical technology students take a three-week phlebotomy course at the hospital. Then, starting in September, they are at the hospital 24 hours per week-two full days and two half-days. They complete their advanced clinical coursework in the spring.

At that point, students move on to the eight-week summer senior practicum. This offers an overview of the laboratory, with an emphasis on how the sections interact. It is as close as we get to the old clinical rotation. We are able to individualize the practicum for each student and concentrate on areas where weaknesses have been identified during the previous two years.

The integrated program was ready to begin by the fall of 1984, but it took two more years to implement it fully. One reason for the delay was the notice of changeover that we had to give our academic affiliates. We also wanted to give the Rockhurst College admissions office time to promote the new program to high school seniors.

Our MT program was reaccredited in 1986 for the maximum period of seven years, so we had no doubts that the steps we took were appropriate.

The 2 + 2 program opened in the fall of 1986, with three juniors. Enrollment rose to seven students last September when four new juniors arrived. Recruitment has been slower than expected, but that's understandable when one considers the nationwide decline in medical technology enrollments. We are adding more students each year and will eventually reach our maximum enrollment of 24 (or 12 per class for the two years of clinical coursework).

We plan to do an extensive evaluation over the next few years. We will be tracking the students' grade point average and performance on certification exams. And we will be taking a look at our recruitment efforts. We are staring to see transfer students, which is an encouraging sign.

A senior seminar has been incorporated into the summer practicum. Students will discuss such topics as budgeting with a hospital financial officer and medical ethics with our chaplain. There will also be an organized review for the certification exams. This will not only help the students but also give the staff a better idea of how well we are doing.

We have learned a great deal during our affiliation, including the fact that a private Jesuit college and a not-for-profit Episcopalian hospital can work together very well.
COPYRIGHT 1988 Nelson Publishing
No portion of this article can be reproduced without the express written permission from the copyright holder.
Copyright 1988 Gale, Cengage Learning. All rights reserved.

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Title Annotation:medical technology; 2 years of coursework at college, 2 years of clinical coursework at the laboratory
Author:Bertrand, Kay C.; O'Kell, Richard T.
Publication:Medical Laboratory Observer
Date:Jul 1, 1988
Previous Article:The new generation of joint ventures.
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