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The disparities in MLT programs; technicians are becoming more important to lab operations, but this survey indicates that MLT schools differ markedly in admission criteria, courses, and tuition.

Judging from their catalogs and brochures, accredited MLT programs across the United States have highly variable admission requirements, curricula, and tuition costs. That's what I found when surveying the programs from the viewpoint of a student applicant.

The technology of clinical laboratory instrumentation and procedures is advancing at a phenomenal rate. Therefore, educators in medical laboratory technician programs must review the contents of their curricula regularly. But they have no national guidelines to follow.

"Essentials" for accredited MLT programs, adopted by the National Accrediting Agency for Clinical Laboratory Agency for Clinical Laboratory Sciences and the Committee on Allied Health Education and Accreditation of the American Medical Association, do not specify admission requirements and curricula. These building blocks depend largely on the aims of each program and on the planners who offer it. The resulting wide disparities are a source of concern because MLTs will soon assume a much larger role in clinical laboratories.

Demand for technicians will outstrip demand for technologists by the end of this decade as a consequence of increasing laboratory automation and the budget limitations imposed by prospective payment. One study predicted a ratio of six technicians to every technologist/supervisor/clinical laboratory scientist by the 1990s. As that comes to pass, MLT programs are bound to bear greater accountability for curriculum design. Insuring a quality education for MLT students will in the long run insure efficient and reliable clinical laboratories.

With this outlook in mind, I independently conducted a study of admission requirements, course work and credit hours, and tuition costs in MLT programs. It was based on the design of earlier studies. Using the American Society for Medical Technology letterhead, by permission, I requested catalogs or brochures from the 229 accredited programs (148 associate degree and 81 certificate programs) in the Allied Health Education Directory. I collected responses for two months beginning in May 1982.

Eighty-four associate programs (57 per cent of those solicited) and 31 certificate programs (38 per cent of those solicited) responded. Five of the certificate programs had been discontinued, leaving 110 usable catalogs and brochures. I analyzed them as a prospective MLT student would--that is, I assumed I was learning about them for the first time.

Figure I shows the admission requirements listed in the publications. Eighty-one per cent of all programs cited a high school diploma or its equivalent. Presumably, all programs have such a requirement, but 12 per cent of certificate programs and 21 per cent of associate degree programs failed to stipulate high school graduation.

Significant percentages of programs noted high school science prerequisites: mathematics (59 per cent), chemistry (57 per cent), and biology (47 per cent). Only 5.5 per cent of the programs said they require additional science courses, usually physics, although not all were specific.

Almost one-third of the respondents listed personal interviews as an admission requirement. The raw data suggest that a much higher percentage of certificate programs require interviews than do associate programs (50 per cent and 26 per cent, respectively), but a chi-square analysis showed no significant statistical difference. I'll discuss this in detail later.

Of course, an admission criterion may exist even if the school's catalog doesn't mention it. In any event, the discrepancies in published admission requirements point at least to uneven communication by MLT programs and perhaps to serious inconsistencies in design.

On the plus side, course and credit hour requirements were explicit in associate program catalogs, eliminating guesswork for potential applicants. Figure II summarizes those requirements.

It's noteworthy that almost half the associate programs required only 8 to 12 credits in chemistry, even though more than half listed high school chemistry as a prerequisite (Figure I). On the other hand, 60 per cent of the associate programs required 18 to 30 credits in biology, even though fewer than half the respondents indicated that high school biology was required.

Most associate programs required seven or less credits in mathematics, English, or electives. Surprisingly, only half showed credits for clinical rotations, although many of them set substantial levels of hours, in the 23-to-30-credit range.

A meager 8 per cent of te certificate programs offered any information about credit hours. The other 92 per cent had subject listings only or absolutely no information on courses. This is one of the most glaring inadequacies uncovered by the study.

If the certificate programs' silence means that their courses don't carry transferabe credit, they do a disservice to students who might later want to pursue a college degree. Students may elect to enter a program that doesn't offer academic credits, but they should know about this limitation right away. Moreover, it's possible that certificate programs vary significantly in offering academic credit.

Only 39.5 per cent of all respondents discussed tuition in their materials (Figure III); 35 per cent said they charged tuition and 4.5 per cent--all of them certificate programs--said they did not. One-third of programs listing tuition had rates of $500 per year of higher. With so many respondents omitting mention of tuition, applicants are generally in the dark about the cost of an MLT education until they make further contact with each school.

Although academic stipends are discouraged by the "Essentials" for MLT programs, one catalog noted their availability.

Looking over my data and constructing the cross-classification tables in Figures I and II, I was struck by the apparent discrepancy between some certificate and associate program admission requirements. To assess possible distortions caused by a larger base of associate respondents, I selected three admission requirements and performed chi-square tests on them.

Results revealed no statistical difference between the two kinds of programs in how often they required algebra (X.sup.2.=0.027), biology (X.sup.2.=2.778), or an interview (X.sup.2.=5.188), at a .01 level of significance. From these results, a glance at the other requirements in Figure I suggests that they, too, did not differ significantly between certificate and associate programs. Among all respondents, however, there was no strong, stated agreement on admission criteria, other than a high school diploma.

My study was constrained by a once-removed examination of MLT programs, through their catalogs rather than a direct exploration. Nevertheless, it's clear that MLT program descriptions lack consistency and completeness. Since this can deter or confuse potential applicants, program directors should strive for improved communication.

The lack of published consensus suggests that MLT programs don't offer similar opportunities. This doesn't imply that the programs are inadequate--only that they lack a common ground for insuring comparable education of their students.

I'm not urging that MLT programs be standardized. But in an age of high accountability to the public by other health care professionals, administrators, and insurance carriers, the clinical laboratory field should be able to demonstrate carefully thought-out guidelines for educating all of its employees. Such planning would help MLT educators keep their curricula as timely and useful as possible.
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Author:Becan-McBride, Kathleen
Publication:Medical Laboratory Observer
Date:Jun 1, 1985
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