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Research in clinical laboratory science: professionals' educational preparation.

INTRODUCTION

A task force consisting of nine members of the American Society for Clinical Laboratory Science (ASCLS) was created in October 2008 by the ASCLS leadership, including ASCLS president-elect Mary Ann McLane. The task force was charged with studying the state of research in the clinical laboratory science profession. At that time there was a perceived need for increased attention focused on research related to the practice of clinical laboratory science, especially by members of the profession. The ASCLS Research Task Force, consisting of members from various institutions, met for several months through conference telephone calls from 2008 to 2009. In addition to studying research activities, the Research Task Force chose to describe CLS professionals' educational preparation for conducting research.

The Research Task Force developed a three part survey consisting of 42 items. The first section was to be completed by all participants and assessed demographic characteristics of participants, opinions about research, involvement in research, and barriers to conducting research. Section 2 was to be completed only by CLS professionals who were currently doing research or had done research in the past. Results obtained from survey section 1 and 2 are described in a second article which accompanies this one. Survey section 3 was targeted to program directors of CLS undergraduate and graduate programs. A 3-part online survey using the SurveyMonkey[TM] platform was developed. Survey distribution and results analysis were sponsored by ASCLS.

The focus of this part of the project was to determine CLS professionals' educational preparation for conducting research. Not surprisingly, clinical laboratory science curricular requirements for content related to research vary by program educational level. The National Accrediting Agency for Clinical Laboratory Science (NAACLS) accreditation guide states under a description of career entry that, "The Clinical Laboratory Scientist/Medical Technologist will also possess basic knowledge, skills, and relevant experience in research design/practice sufficient to evaluate published studies as an informed consumer." (1) For doctoral programs in clinical laboratory science (DCLS), curricular requirements include, "Capstone experience, applied research, or translational research as required by the degree. Integral components will include research design, statistics, grant writing, protection of human subjects, and research ethics". (2) Because NAACLS has no published standards specific to the curriculum in master's degree level clinical laboratory science programs, there are no curricular guidelines for programs at this level. Research is not included in the curricular requirement in the NAACLS document for Clinical/Medical Laboratory Technicians (CLT/MLT). (3) Because educational programs in clinical laboratory science do not necessarily include research in the curriculum, survey items for this project addressed alternative means of acquiring research skills.

MATERIALS AND METHODS

Instructions and a link to an online 42 item survey developed by the ASCLS Research Task Force were emailed in May 2009 to 7,572 individuals who were either members of the American Society for Clinical Laboratory Science or program directors of NAACLS accredited two-year, four-year, and graduate educational programs. A second email message was sent to the mailing list as a reminder prior to the survey closing. Data from the survey results was collected following closing of survey availability one month later. There was no attempt to collect or retain participant identifiers in this study. The study was approved by the University of Utah Institutional Review Board.

RESULTS

Demographics

Completion of the 19 items in this section was requested of all survey participants. Responses to the online survey were received from 556 persons, or 7% of those surveyed. Females comprised 83% of the sample. Eighty two percent of respondents were working fulltime, 10% were working part-time, and 7% were not currently working. Participants' employment setting included: community hospital 24% of respondents, urban hospital 21%, 4-year college/university 16%, academic medical center 11%, 2-year college 8%, reference laboratory 6%, physicians' office laboratory 4%, industry 4%, and "other" 6%. Participants' job position/title included: technical staff 32% of respondents, educator 32%, supervisor/manager 26%, student 3%, researcher 2%, and "other" 6.0%. Respondents' highest education levels included: associate's degree 6%, bachelor of science (B.S.) 46%, master of science (M.S.) 33%, doctor of philosophy (Ph.D.) 10%, associate's degree 6%, doctor of education (Ed.D) 1%, and "other" 4%.

Participants were asked to identify the sources of their knowledge of research principles and sources of hands-on training experiences, and those results are listed in Table 1. Formal education, including undergraduate and graduate, were most frequently identified as the source of knowledge of research principles and hands-on experience. Almost one-fourth of respondents indicated that they had not learned how to conduct research, and over one-fourth had no hands-on research training.

Participants also identified activities that they perceived would help them improve their research skills. Mentoring by colleagues who are conducting research was listed by 50.9% of respondents, and attending presentations or workshops at professional meetings was cited by 45.7% of respondents. Other activities included reading articles in professional journals (31.3%), taking online credit courses or degree programs (30.2%), enrolling in traditional courses or degree programs (19.4%), and "other" 6.5%. Almost 30% of 464 survey participants indicated they are not interested in conducting research.

Data from Educational Programs

Respondents to items in this section consisted of directors of baccalaureate level programs (57%), associate degree programs (35%), master's degree programs (12%), and doctoral degree programs (1%) (Some respondents directed more than one program level.) A total of 18% of program directors indicated that there was a separate research course in their undergraduate curriculum ranging from 1 to more than 4 credits. Twenty-eight percent of program directors indicated that a hands-on research project is required of their undergraduate students, 9% indicated that a research project is optional, and 63% indicated that research is not required.

Among undergraduate programs in which a research project is included, 36% of programs have 1 to 5 students engaged in research at any given time, 31% have 6 to 10 students, 15% have 11 to 15 students, and 18% have 16 or more students conducting research. The amount of time allowed for undergraduate project completion ranges from 1 to >6 months. Requirements, other curricular aspects, and collaborators for student research projects are contained in Tables 2 and 3, respectively. Perceived barriers to conducting student research are cited in Table 4.

Eight of twelve survey respondents (67%) indicated that a hands-on research project is required of master's level students in clinical laboratory science. Four (33%) indicated that a research project was not required. Project length varied, ranging from 2 to 4 months (31% respondents), 6 to 9 months (15% respondents), and more than 9 months (54% respondents). Requirements, other curricular aspects, and collaborators for students' master's level research projects are listed in Tables 2 and 3, respectively. Barriers to master's level students participating in research projects are cited in Table 4. Insufficient responses were received from doctoral programs to report findings.

DISCUSSION

There are several measures from the survey that suggest that we prepare only a portion of undergraduate students with the skills needed for conducting research. Over three-quarters of undergraduate programs do not include a separate research course in the curriculum, and 63% do not require participation in a research project. Of all survey respondents, 23% stated that they had not learned how to conduct research, and other respondents indicated that their knowledge of research principles came from graduate education, on the job mentoring, or professional development. Undergraduate education was cited by only 39% of respondents as a source of knowledge of research fundamentals and by only 33% of respondents as a source of hands-on research training. The most frequently cited barrier to research participation in undergraduate programs was time limitations imposed by the curriculum. Current NAACLS standards for the Clinical Laboratory Scientist/Medical Technologist limit knowledge of research to that sufficient to "evaluate published studies as an informed consumer" and do not require the ability to conduct research. (1) If as a profession we believe that the ability to conduct research is important for baccalaureate-level practice, then program curricular standards will require adjustment.

Preparation for research involvement is greater in M.S. programs than in undergraduate programs. Two-thirds of programs responding require a hands-on research project, almost double the research involvement in undergraduate programs. It is noteworthy that not all master's degree programs participating in this study require students to conduct research. Time limitations within the curriculum and lack of funds were identified most frequently as barriers to graduate student research participation. Insufficient faculty time to oversee master's degree student projects was cited by 50% of respondents as an additional barrier.

Karni et al evaluated data regarding graduate degree programs in clinical laboratory science and concluded that both the number of advanced degree programs and the number of graduates are small and had decreased between 1990 and 2007. The 2007 Directory of Graduate Programs for Clinical Laboratory Practitioners listed 28 master's level programs and only 5 doctoral programs (Ph.D., Ed.D., or Doctor of Clinical Laboratory Science) in the U.S.A. (4) Because relatively small numbers of clinical laboratory professionals are being educated at the graduate level, one way to increase research participation is to enhance the research skills expected of baccalaureate level students. Whether or not this is feasible or desirable is worthy of debate.

If the clinical laboratory science profession believes it is desirable to increase research involvement of baccalaureate level professionals, it appears that curricular standards may need to be revised. Programs may choose to add research courses and competencies, including hands-on projects. Articles by Rohde et al and Saleh and Hamed in a recent supplement of Clinical Laboratory Science present curricular models for preparing students to be both analytical consumers and producers of research in the profession. (5,6)

The authors recognize the limitations of this study. First, a 7% response rate may appear insignificant and may provide a narrow perspective. Although there was broad representation among survey participants across educational levels, employment settings, and job positions, the number of survey respondents was limited. It is also noteworthy that data analysis described in this paper is at the descriptive level, with no t-tests or ANOVAs performed. Advanced statistical analysis could possibly reveal additional information.

Only ASCLS members and program directors were surveyed for this study. To gain a more complete assessment of research activity among clinical laboratory professionals, the survey could be sent to members of additional organizations, including the American Society for Microbiology, American Association for Clinical Chemistry, American Society for Clinical Pathology, and others. This would target clinical laboratory professionals who are not members of ASCLS but are members of other professional societies and who may engage in research and scholarly activities.

Because less than one-fourth of CLS undergraduate educational programs offer a separate research course in the curriculum and only about one-third require completion of a research project, the formal educational background of many CLS professionals may leave them inadequately prepared for conducting research. Barriers to participation in research identified by this study will require consideration by educators interested in adding research competencies to program curricula. Another approach to facilitating increased research involvement may lie in increasing the number of clinical laboratory professionals educated at the graduate level.

REFERENCES

(1.) NAACLS Guide to Accreditation: Section III for CLS/MT. Unique Standards and Documentation Required for Accredited CLS/MT programs. Rosemont IL. Section 22. Curricular Requirements. Accessed at http://www.naacls.org/docs/Section3_CLS-MT.pdf on 2/17/11

(2.) NAACLS Guide to Accreditation for Doctorate Programs in Clinical Laboratory Science. Rosemont IL;NAACLS Accessed at http://www.naacls.org/docs/guide_dcls.pdf on 2/17/11.

(3.) NAACLS guide to Accreditation: Section III for Accredited CLT/MLT Programs. Rosemont IL Unique Standards and Documentation Required for Accredited CLT/MLT programs. Section 22. Curricular Requirements. Accessed at http://www.naacls.org/docs/Section3_CLS-MT.pdf on 2/17/11

(4.) Karni K, Polancic J, Fenn J, Spannaus-Martin DJ. Graduate education in clinical laboratory science. Is the glass half full or half empty? Clin Lab Sci 2010;23:166-74.

(5.) Rohde RE, Falleur DM, Redwine GD, Patterson TL. Growing our own: Teaching and doing research in CLS. Clin Lab Sci 2010;23 Suppl:3-11-8.

(6.) Saleh SM, Hamed KM. Preparing CLS professionals to be consumers and producers of research. Clin Lab Sci 2010;23 Suppl:3-19-23.

JoAnn P. Fenn, M.S., MT(ASCP), Department of Pathology, University of Utah School of Medicine, Salt Lake City, UT

Vickie Freeman, Ph.D., MLS(ASCP)[CM]SC, FACB, University of Texas Medical Branch,Galveston, TX Carol McCoy, Ph.D., MLS(ASCP)CM, Fairview Health Services. Minneapolis, MN

Mary Ann McLane, Ph.D., MLS(ASCP)[CM], University of Delaware, Newark, DE

Lillian A. Mundt, Ed.D., MLS(ASCP)SH, Adventists Health System Midwest, Hinsdale, IL

Joan Polancic, M.S.Ed., MLS, American Society for Clinical Laboratory Science, Washington, DC

Tim Randolph, Ph.D., MLS(ASCP), Saint Louis University, Saint Louis, MO

Kristy Shanahan, M.S., MLS(ASCP)[CM], Rosalind Franklin University of Medicine and Science, North Chigaco, IL

Address for Correspondence: Rebecca Laudicina, Ph.D., MLS(ASCP)CM, The University of North Carolina at Chapel Hill, 4110 Bondurant Hall, CB# 7145, Chapel Hill, NC 27599-7145, (919) 843-4350, rebecca_laudicina@med.unc.edu
Table 1. Sources of knowledge of research
principles/fundamentals and hands on research
training experiences. (N = 497)

Source                                      Response       Response
                                               %              %

                                          Knowledge of     Hands-on
                                            research       research
                                          principles/     training *
                                         fundamentals *

Undergraduate education                       39.4           32.9

Graduate school                               36.6           29.8

Boss/mentor/colleagues on the job             26.8           31.6

Have NOT learned how to conduct               23.1            NA
research

Never had hands-on research training           NA            28.9

Professional development opportunities        20.1            NA

On my own due to trial and error              16.1           18.2

Other                                         3.4            3.6

* Respondents could check all that apply.

NA = not applicable

Table 2. Aspects of students' research projects.

Activity *               Frequency      %       Frequency      %

                           Under      Under     Master's    Master's
                         graduate    graduate   students    students
                         students    students    N = 13
                          N = 43

Written paper required      33         76.7        12         92.3

Oral presentation           30         69.8        10         76.9
required

Poster required             18         41.9         1         7.7

Paper submission for        17         39.5        10         76.9
publication encouraged

Students work               17         39.5        10         76.9
independently with
mentor

All typical aspects         12         27.9         6         46.2
completed by student
(proposal, budget,
results, etc.)

Students assist in an       11         25.6         4         30.8
existing research
study

Paper submission for        NA          NA          2         15.4
publication required

Other                        2         4.6         --           --

* Respondents could check all that apply.

NA = not applicable

Table 3. Student research project collaborators.

Collaborators          Frequency     % Under-    Frequency      %
                     Undergraduate   graduate    Master's    Master's
                        N = 41                    N = 12

Instructors or            25           61.0          7         58.3
staff at clinical
affiliates

CLS faculty only          19           46.3          9         75.0

Any faculty at            19           46.3         10         83.3
the institution

Fellow students,          14           34.1          2         16.7
in groups

No collaborators,          1            2.4          1         8.3
work done
independently

* Respondents could check all that apply

Table 4. Barriers to research participation for students. (N = 91)

Collaborators           Frequency      % Under    Frequency      %
                       Undergraduate   graduate   Master's    Master's
                          N = 91                   N = 12

Time limitations            81           89.0        10         71.4
in curriculum

Insufficient faculty        54           59.3         7         50.0
time to oversee
research projects

Lack of funds               49           53.8        10         71.4

Lack of supplies,           41           45.1         5         35.7
Equipment

Lack of space               28           30.8         4         28.6

Insufficient faculty        26           28.6         5         35.7
expertise to oversee
research projects

Other                        8           8.8          1         7.7

* Respondents could check all that apply.
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Title Annotation:FOCUS: BUILDING RESEARCH THROUGH MLS CURRICULA
Author:Laudicina, Rebecca; Fenn, Joann; Freeman, Vickie; McCoy, Carol; McLane, Mary Ann; Mundt, Lillian; Po
Publication:Clinical Laboratory Science
Article Type:Report
Geographic Code:1USA
Date:Sep 22, 2011
Words:2600
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