CLT and CLS job responsibilities: Current distinctions and updates

Clinical Laboratory Science, Summer 2001 by Doig, Kathy, Beck, Susan J, Kolenc, Koleen

RESEARCH

OBJECTIVE: This study was undertaken to address the following questions:

1. What tasks distinguish the job of a clinical laboratory scientist (CLS) from that of a clinical laboratory technician (CLT)?

2. What changes in role distinctions, have occurred for entry-level CLS and CLT practitioners over the five-year period 1993-98?

3. What tasks have been deleted from the CLT and CLS content outlines because they were not frequently performed or not considered entry-level?

4. What changes in practice are reflected in the current job analyses?

DESIGN: A national job analysis of tasks constituting the job of clinical laboratory scientists (CLSs) and clinical laboratory technicians (CLTs) was conducted in 1998-99 as part of a standard setting process for the certifying examinations of the National Credentialing Agency for Laboratory Personnel (NCA). The job analyses relied upon mail surveys to 1200 individuals for each job level asking respondents to identify tasks significant to effective practice at job entry. The task lists resulting from statistical analysis of those surveys were examined to answer the study questions.

PARTICIPANTS: The sample for each survey included 1200 practitioners, educators and laboratory managers selected at random from membership in professional organizations or from NCA certificant lists. Sampling was stratified to insure adequate practitioner representation.

MAIN OUTCOME MEASURES: The mean rating on a four point scale for each item on the surveys was evaluated for overall significance as well as significance across geographic regions. The tasks meeting specified criteria were retained in the final task lists. Tasks were counted and their content evaluated to compare CLS and CLT job tasks.

RESULTS: The response rates to the surveys were 33% for CLT and 21 % for CLS. Reliability was judged based on average intraclass correlation coefficients of .86 and .82 for the CLT and CLS surveys, respectively. There were 952 tasks retained on the CLS content outline and 725 retained on the CLT content outline of the 1151 tasks on the original survey. Seven hundred and twenty two tasks were found on content outlines of both job levels, representing a 76 % overlap. Tasks found only on the CLS outline included advanced technical tasks, a few management tasks, and more communication tasks.

CONCLUSIONS: The jobs of CLS and CLT practitioners are distinct at job entry level with CLSs performing a broader array of technical and communication tasks as well as some management

tasks. Though CLS staff uses few management skills at job entry, those tasks are performed by CLS staff in the laboratory and curricula must help prepare graduates for these tasks expected of experienced staff. CLTs perform tasks requiring problem solving and high level reasoning. CLT curricula must address the need for CLTs to perform these tasks.

ABBREVIATIONS: ASCLS = American Society for Clinical Laboratory Science; CLMA = Clinical Laboratory Managers Association; CLS = clinical laboratory scientists; CLT = clinical laboratory technicians; NAACLS =National Accrediting Agency for Clinical Laboratory Sciences; NCA = National Credentialing Agency for Laboratory Personnel; SE = standard error of the mean.

INDEX TERMS: clinical laboratory science; job analysis; job description; medical laboratory technician; medical technologist.

Clin Lab Sci 2001;14(3):173

In 1973, the American Society for Clinical Laboratory Science (ASCLS) articulated a model of clinical laboratory practice in which clinical laboratory technicians (CLTs) performed routine tasks and solved problems using preset criteria, while clinical laboratory scientists (CLSs) performed both routine and complex tests and solved problems without preset criteria.1 ASCLS expanded these role definitions in a 1986 ASCLS position paper that described CLS level practitioners as performing both routine and complex tests, supervising CLT level practitioners, and filling roles as educators, researchers, and consultants.2 In spite of these definitions, the distinction between the CLT and CLS practitioner has often blurred in clinical practice. In an attempt to clarify the differences between these two levels of practice, educators have examined curricula in educational programs and tasks performed in the work setting. These studies found significant overlap in curricula and tasks, but identified some distinctions for the CLS practitioner in non-routine tests, communication skills and supervisory responsibilities.3,4 Beck reported that CLT and CLS job responsibilities were distinct at job entry as assessed by a 1993-94 job task analysis of the National Credentialing Agency for Laboratory Personnel (NCA).5 This study was unique because it included the perspectives of educators, practitioners, and employers in an analysis of the tasks performed at career entry. In the years since the 1993 NCA job analysis, CLS educators have continued to discuss the appropriate roles of CLT and CLS practitioners in the work setting and have suggested that the role of the CLS may change to meet the technological and financial challenges of the future.6 In addition to technical skills, the CLS practitioner could have expanded roles in the technical, financial, human resources, and consultative functions of the clinical laboratory.7