The Investment

             Expanding and modifying the clinical practicum educational component is not an easy task.  As this program is a NACCLS accredited program, changes must be made thoughtfully as to maintain our standard of teaching, accreditation and 100% pass rate.  Preparing simulation laboratories and experiential learning scenarios (IPE, University of Washington) for our students will relieve some of the teaching burden associated with clinical practicum experiences.  This strategy would require at least a year of planning prior to implementation.  Furthermore, new hospital affiliations need to be fostered that include clarifying legal as well as educational relationships.  This is time intensive process requiring not only the additional input of current faculty, but also the hiring of a new non-tenure-track professional faculty member.  This new faculty member will be dedicated to this process under the supervision of the MMLS program director and consultation by current MLS faculty.

 (1) Clinical Practicum Expansion

       An ASCP board-certified, non-tenured track faculty member with expertise in all areas of medical laboratory science is required to develop and expand hospital affiliations throughout Montana and in neighboring states.  Opportunities exist with partnering with Wyoming, Idaho, Nevada and Oregon hospitals as well as existing hospitals within the state.  Developing these relationships will require travel time, travel support, MSU administrative legal support for the development of affiliation agreements, and education of new clinical preceptors. 

 (2) On Campus Simulation Laboratory and Interprofesssional Education Expansion

        An ASCP board-certified, non-tenured track faculty member with expertise in all areas of medical laboratory science and interprofessional education (IPE) experience is requested to facilitate clinical teaching expansion and developing IPE training for MLS students.  To provide an experiential learning experience on campus, the faculty member will develop relationships with the MSU Nursing Program to offer simulated hospital experiences that require laboratorians and nurses to work together.  These experiences will encourage team building and efficiency within the healthcare system.  

            The development of this new curriculum will require time during the first year from not only the new hire, but the MLS program director and supporting faculty.  The first phase of the course development will involve coordinating multi-day simulation clinical laboratory exercises on campus in partnership with the MSU student health clinical laboratory facility.  As the current MLS summer schedule of classes is intense, flexibility in class times and reorganization of classes will need to be examined prior to full implementation of the simulation laboratories.  The second phase of the proposed experiential learning education is to team develop relationships with the School of Nursing and invite senior nursing students to interact with MLS students in clinical scenarios.  This type of education termed interprofessional education or IPE originated with the University of Washington and is gaining momentum and success in health care education.  Including this cutting edge approach in the curriculum will enhance clinical education on the campus of MSU.   We are hopeful that the success of these IPE simulations will lead to eventual inclusion of the first year MSU medical students, as building relationships between the physician, nurse, and laboratorian within our student educational framework will lead to strengthening professional teams in the clinical setting.

The goal here is that students will apply all of the skills learned in their didactic classes and labs by managing and prioritizing laboratory procedures when challenged with multiple specimens and other factors that are inherent to the clinical laboratory.  These include ringing phones, emergencies, and physician demands.  This exercise is essentially going "live" with decoded, deidentified human biological samples provided and or simulated prior to the learning session.  The students will proceed with analysis of the samples based on requisition orders from physicians.  In this simulation, preanalytical, analytical and post-analytical concepts of biological measurements will be tested.  Additionally, the ability for students to work with fellow peers, to support each other in the learning process, and practice their skills is essential for their professional development before entering the clinical practicum.

Justification of New Hire and Salary Release for Current MLS Faculty

As per the discussion at the Board of Regents Meeting (November 15, 2012), it is the Board of Regents priority to attract quality faculty and offer competitive wages as Montana currently ranks as one of the lowest in compensation for faculty and staff as compared to national averages.  Current wages for hospital medical laboratorians with professional experience needed for this non-tenured track position ranges from $57,000 to $78,000 (Table 4).   Therefore, a salary of $70,000 is requested for this 12-month position.  In addition to this new hire, non-tenured faculty in the MLS department will be devoting additional time to this effort.  To account for their time, a total of 35% release for the Director of the MLS is requested for year one, and 10% release time for year two and beyond.  Regarding the three other MLS non-tenure track faculty it is requested that 45% of their time is devoted to year one (each has 15% of their time), followed by 15% in the years following (each has 5% of their time). The Tenure-Track faculty member, Keil will have 15% devoted in year one and 5% in the years after. Their participation in curriculum development, interfacing education strategies with additional clinical sites and IPE teaching simulations ensures a team approach to advancing the MLS program.

      In addition to the investment in personnel, travel support to clinical sites of $7,500 will be required. To facilitate the simulation laboratories, $7,500 support is requested to provide consumable items and capital expenditures required in the testing.  Examples of consumables range from biohazard safety wear such as masks and gloves to reagents for assays, equipment, chemistry and hematology reagents, blood banking typing anti-sera, microbiology plates and supplies, and calibration and quality control materials.

Specific Objectives, Personnel Duties, and Expected Outcomes

      The following table outlines the major tasks, personnel required, outcomes anticipated and programmatic monitoring for each year.  It is anticipated that the increased tuition dollars based on doubling the size of the MMLS student enrollment would facilitate, in part, sustainability and growth of the program.  This increase in base budget is in addition to the current budget of $141,000 which includes a base of $115,000 plus lab fees which is now used to train 15 students in the MMLS training program.

Background

       National Need for Medical Laboratory Scientists

       According to the Bureau of Labor and Statistics, Medical Laboratory Scientists (MLS; baccalaureate degree) comprised 167,000 nationwide job vacancies as of 2006 (Table 1). During the period of 2006-2016, a ‘faster than the average’ rate of growth for a biomedical career in MLS is expected with a minimum 14% increase in jobs. Most MLS jobs are in hospitals, physician offices and other diagnostic laboratories. Therefore, with the rapid emergence of new biomedical technologies and clinical testing paradigms, it is critical to provide healthcare professionals that are successfully trained in high complexity diagnostic medicine to include rapid identification of pathogenic agents, drug detection and monitoring, and the implementation of new technologies in molecular medicine.

MLS biomedical scientists may not only obtain immediate professional jobs in hospital laboratories at competitive wages beginning at $40,000+ per year for new hires, but often pursue careers outside the hospital.  Table 2 describes versatility of the MLS profession in many technical and non-technical careers, while Table 3 describes the range in wages.  It is our experience that Baccalaureate Biology or Chemistry graduates are less likely to attain immediate employment or comparable wages upon completion of their degree.  In fact, many of these students switch to MLS programs for advancing into professional healthcare employment.  Consistent with national averages, a recent program survey identified that MSU graduates in MLS are beginning at wages between $50,000 and $60,000.

Table 1.  The following are data obtained from the National Bureau of Labor and Statistics.

Table 2.  The following are data obtained from the National Bureau of Labor and Statistics.  These data demonstrate high starting wages (>$45K/yr) for Baccalaureate-trained MLS professionals.

Table 3.  The following are data obtained from the National Bureau of Labor and Statisticsfor occupational employment and wages for MLS.

      Medical Laboratory Scientist Program at Montana State University

      Due to MSU’s comprehensive preparation through didactic and hands-on training in biomedical sciences, the versatility of a career in MLS provides job opportunities in clinical hospitals, as well as increased eligibility and opportunities for advanced studies in areas of biomedical research, pharmaceutical industries, public health, government research, or as a springboard to professional careers in medicine, dentistry, and law.   All MLS graduates who seek employment find competitively paying Montana jobs (Table 4) within days or months of graduation while some pursue advanced graduate or professional degrees in biomedical sciences. Therefore, the MLS degree provides remarkable job opportunities both in and beyond the biomedical field.

Table 4.  Medical Laboratory Technologist employment estimates obtained from the Bureau of Labor Statistics for Montana:

  Reference:  accessed Nov 15, 2012: http://www.bls.gov/oes/current/oes292011.htm

Montana State University grants a baccalaureate degree in the MLS option and is nationally accredited by National Accreditation Agency for Clinical Laboratory Science (NAACLS). Our program graduates have demonstrated exceptional quality through internal and external assessment reflecting a highly successful education program.  100% of our MLS graduates have obtained a passing rate on national certification exams during our first 4 years of training students, well above the national average of 70%.  Incidentally, there are only four MLS programs in the nation that have achieved this passing rate level.

To facilitate MLS students making the transition from student to clinical practitioner, we coordinate clinical practicums with local affiliated hospital laboratories.  The clinical practicum experience is designed to provide practical clinical application of the didactic coursework.  Clinical practicums also provide the student with the opportunity to assist in patient care as a member of the professional healthcare delivery team.

Clinical learning experiences occur in selected hospital sites within the state of Montana.  The clinical affiliate training is focused on sample processing, multi-tasking, quality control and assurance, and integration of laboratory and hospital services.  Each clinical affiliate provides the facilities and resources for the clinical component of each student's professional curriculum.  Department supervisors and designated clinical preceptors provide students with meaningful educational experiences during their assigned clinical practicums.  Designated clinical preceptors working in each specified department supervise students.  The clinical preceptor and department supervisor will assess the student's knowledge, skills, and attitudes through observation of task performance and behavior. 

       The Problem

      It is critical to expand additional clinical practicum placement opportunities for MSU MLS students. This program is currently advising approximately 85 MLS majors ranging from freshman to seniors.  However, the MMLS program is limited to selecting 15 students into the MLS program.  This bottleneck is due to the availability of clinical practicum sites located in Montana hospitals. Therefore, it is critical to (1) expand hospital training sites for MLS students and (2) modify the current MLS curriculum to provide additional on-campus experiential learning using interprofessional experience or IPE simulation lab formats.  By providing more on campus learning experiences, some modifications of the clinical curriculum will provide more flexibility in student admission numbers. It is anticipated that the number of students accepted into our MLS program can be increased substantially.  The goal is to expand to 30 students within a 3-year period.

It is vital to invest in the MLS program and offer more enrollment opportunities for MLS majors at MSU.  Not only will this fill a national need for this profession, but it will offer the opportunity to retain these students at MSU and within the state of Montana.  Currently, the student retention rate at MSU Bozeman is 77% (Discussion @ Board of Regents Meeting, Nov 17, 2012).  By offering more clinical placement opportunities for MLS students, we can contribute to a greater student retention rate and avoid the loss of MLS students who may apply to other MLS programs out of state.  Once the student leaves the state for this education, there is a reduced probability that the student will return as a qualified health care professional to serve the Montana healthcare system.

Specific Objectives, Personnel Duties, and Expected Outcomes

       The following table outlines the major tasks, personnel required, outcomes anticipated and programmatic monitoring for each year.  It is anticipated that the increased tuition dollars based on doubling the size of the MMLS student enrollment would facilitate, in part, sustainability and growth of the program.  This increase in base budget is in addition to the current budget of $141,000 which includes a base of $115,000 plus lab fees which is now used to train 15 students in the MMLS training program.

The assessment plan is integrated with the timeline above.  This table describes the outcomes anticipated and the monitoring that will occurr during the duration of the grant and beyond.

It is anticipated that we will meet all goals submitted with this proposal.  In the event that clinical practicum sites are more limited than anticipated, we will explore additional sites in Arizona as their MLS programs have closed within the last few years.  These closures are our opportunity.  Personal communication with laboratory directors at teaching hospitals have confirmed the need for trained professionals in MLS.