Program in Clinical Laboratory Sciences
School of Allied Health and Life Sciences
Quality Enhancement Plan
Executive Summary 2007-2008
Swarna Krothapalli, MS, MT(ASCP), Program Director
Submitted by Kristina Jackson Behan, PhD, MT(ASCP)
PREFACE
Clinical Laboratory Sciences (CLS) is a program in the School of Allied
Health and Life Sciences, in the College of Arts and Sciences. It has
two components, a university phase in which the didactic course
material is taught, and a clinical phase, where students intern at
affiliated hospital laboratories. Both phases are under the direction of
the UWF faculty. The Program has a long history of success as
evidenced by its pass rate on the National Board Examination offered
by the American Society for Clinical Pathology (ASCP); the exam
focuses on the content and critical thinking of the CLS discipline. The
CLS Program is accredited by the National Accrediting Agency for
Clinical Laboratory Sciences (NAACLS). In 2007, the Program
completed its accreditation cycle and earned the maximum 7 years
until the next cycle.
The CLS Quality Enhancement Program chose Communication
and Project Management as areas to be improved, by using a thematic
approach of increasing writing and oral presentation of results and
analysis across several courses during the 19 months of the upper
division. This document shares the results of the QEP for the calendar
year 2007. The summary includes the Program’s Academic Learning
Compact (ALC), Curriculum Maps that demonstrate where the
components of the ALC are introduced, reinforced and assessed, the
results of embedded assessments of communication and project
management, the exam results of the 2007 graduates, and the
student assessment of the program and particular assignments.
TABLE OF CONTENTS
Page
Page
Page
Page
Page
Page
3
5
7
13
15
17
Academic Learning Compact
Curriculum Maps
Embedded Assessments and Student Feedback
Board Examination Results
Student Assessment of Learning Gains related to the ALC
Discussion
2
CLINICAL LABORATORY SCIENCES
Mission Statement
The Clinical Laboratory Sciences Program offers a baccalaureate degree of
highest quality in clinical laboratory sciences, enabling the graduates to
develop successful careers in bio-medical technology fields and to pursue
advanced degrees in related fields. The faculty of the program strive to
advance the knowledge, technology, and education methods in clinical
laboratory sciences; to maintain clinical affiliations with local and regional
health care facilities and serve as a source of well qualified personnel to staff
their clinical laboratories; and to promote and enhance the public’s
knowledge regarding the profession of clinical laboratory sciences and the
UWF Clinical Laboratory Sciences Program.
Student Learning Outcomes
UWF Clinical Laboratory Sciences graduates should be able to do the
following:
Content
 Recognize and apply concepts, principles, and theories from the
sciences that underlie clinical lab skills (e.g., biochemistry,
pathophysiology)
 Apply methodological principles from clinical courses
 Recognize and apply principles of quality assurance
 Use medical terminology accurately
 Describe career opportunities available in clinical laboratory science,
including opportunities in independent practice
 Articulate frontiers of knowledge in chosen profession
Critical Thinking
 Distinguish abnormal from normal results
 Interpret and evaluate clinical procedures and results
 Make and confirm sound diagnostic conclusions
 Predict clinical course following diagnosis
 Conduct research using appropriate literature
 Select and apply appropriate statistical procedures to evaluate data
Communication
 Select, operate, and maintain appropriate strategies for recording and
reporting results
3



Communicate effectively with other medical professionals and service
providers
Interact effectively with patients using calm and reasoned judgment
and sensitivity to patient characteristics
Make professional oral presentations of findings
Integrity/Values
 Articulate appropriate professional responsibility for patient’s welfare
 Recognize and adhere to applicable professional regulations, ethical
standards, and program’s code of conduct
 Advocate for effective, timely, accurate, and cost effective service to
demonstrate commitment to patient’s welfare
 Maintain confidentiality of patient information
Project Management
 Correlate results from various procedures with management of
patient’s condition
 Research, develop, and perform new laboratory procedures and
evaluate effectiveness
 Enact principles of best practice for lab management
 Enact principles of best practice for human resource management
Hazard and Risk Management
 Recognize and describe principles and regulations regarding lab safety
 Practice lab safety procedures and protocols
 Identify and prevent medical error or minimize consequences of
medical
error
Job Prospects for Medical Technology Graduates
Staff Medical Technologist: Hematology, Diagnostic Microbiology,
Clinical Chemistry, Bloodbank,
Immunodiagnostics, Molecular Diagnostics,
Toxicology
Clinical Laboratory Section Supervisor
Clinical Laboratory Manager
Laboratory Information Systems Manager
Clinical Laboratory Compliance Officer
Medical Laboratory Outreach Director
Clinical Laboratory Product and Sale Representative
Clinical Laboratory Science Program Faculty
Public Health Laboratory Scientist
Forensic Laboratory Scientist
Pharmaceutical Laboratory Scientist
Medical Laboratory Consultant
Lab Safety Officer
4
Clinical Laboratory Sciences Academic Learning Compacts
2007 Curriculum Map for University based courses
Major (Core)
Courses
MLS4305
Hematology I
Content
Critical
Thinking
Communication
Writing
I,R
I,R
I
I,R
I,R
I,R
I,R
I,R
I,R
I,R
I,R
I,R
R
I,R
I,R,M
I,R
I,R,M
I,R
I,R,M
I,R
I,R
I,R
I,R
MLS4460
Diagnostic
Micro I
MLS4462
Medical
Microbiology
MLS4334
Hemostasis &
Thrombosis
MLS4620
Clinical
Chemistry I
MLS4630
Clinical
Chemistry II
MLS4550
Immunohematology I
MLS4505
Serology
&
MLS4220
UA BF
MLS4705
Special Clinical
Topics
Communication
Speaking
Communication
Computer
Integrity
Ethics
I
I
I
I
I
Project
Management
Hazard & Risk
Management
I
I
I
R
R
R
R
R
R,M
R
R
R
M
R
M
M
R
R
R
M
R
R
R
M
R
R
M
R
M
R
R
R
M
Key: I = Introduces, R = Reinforces, M = Assesses Mastery
Clinical Laboratory Sciences Academic Learning Compacts
2007 Curriculum Map for Hospital based courses
Major (Core)
Courses
MLS4820L
Clinical
Chemistry
III
MLS4821L
Diagnostic
Microbiology
II
MLS4823L
Immunohematology
II
MLS4824L
Special
Clinical
Methods
MLS4825L
Urinalysis/Bo
dy Fluids II
MLS4822L
Hematology
II
Content
Critical
Thinking
Communication
Writing
Communication
Speaking
Communication
Computer
Integrity
Ethics
Project
Management
M
M
R
R
M
M
M
M
M
R
R
M
M
M
M
M
R
R
M
M
M
M
M
M
R
M
M
M
M
M
R
R
M
M
M
M
M
R
R
M
M
M
Key: I = Introduces, R = Reinforces, M = Assesses Mastery
5
Clinical Laboratory Sciences Assessment Plan
for Program Academic Learning Compacts
2007 Curriculum Map for Embedded Assessment of ALC Domains
The Clinical Laboratory Sciences Program has identified these courses as appropriate for direct assessment
of the ALC Domains. Results of the embedded assessments follow.
Clinical
Laboratory
Sciences
Associated Programmatic SLO-area and
Selected Course Assignment to be Utilized for Embedded Assessment
Hazard
Critical
Project
and Risk
Content
Thinking
Communication Management
Management
Mechanism of
Assessment
ASCP Board of
Registry Exam
Board
Examination
Clinical Chemistry 1
Case Study
Clinical Chemistry 2
Journal Club
Presentation
Special Clinical
Topics
Special Clinical
Methods
Student
seminar
Lab Safety
Practical
Immunohematology
The following faculty have been identified for facilitating the implementation of the initial prototype of this
plan:




Immunohematology:
Clinical Chemistry 1 & 2:
Special Clinical Topics
Special Clinical Methods
Mrs. Swarna Krothapalli & Mr. Sherman Bonomelli
Dr. Kristina Behan
Dr. J. Steve Smith
Dr. Kristina Behan and Dr. Steve Smith
In the following sections, the results from embedded assessments are shown, followed by a discussion
section.
6
B.S. Clinical Lab Sciences/ EMBEDDED ASSESSMENT INSTRUMENT:
Clinical Chemistry I 2007
Program:
Course in Capstone Pathway:
Instructor:
Emphasized Programmatic SLOs:
Tangible Course Product to be Evaluated:
B.S. CLS
Clinical Chemistry I
Dr. Kristina Behan
Critical Thinking
Case Study Analysis
Implementation for Embedded Assessment:
Students will identify a patient they believe to be at risk for heart disease from a data base of
200 people, and rationalize the choice. Students will create a case study of that patient and
describe how laboratory results will be altered after a heart attack. They will peer review
another student’s case and suggest improvements. Due to the limited enrollment in this
discipline, all of the students should be included in this assessment. Record the total number
of students, and the number that fell into each category. Grade the assignment as you would
normally; note characteristics contributing to your rating in the comment section below the
rubric:
CRITICAL THINKING BASED SKILLS TO BE
ASSESSED
Total number of students evaluated 14
Fails to
meet
expectations
Student was able to identify the appropriate
diagnostic tests utilized in management
of the disease
Student was able to distinguish normal from
abnormal results, and make sound diagnostic
conclusions.
1
Meets
expectations
Exceeds
expectations
3
11
4
8
General characteristics leading to ratings of FAILS TO MEET, including reflections by instructor
and comparison to course grades for individuals:
One student identified a subject at high risk, but did not develop a good rationalization for the
choice. Reflection: Students had to peer review other students papers, giving them the
opportunity to improve their own work as well as another student. Both students have some
responsibility for this failure.
General characteristics leading to ratings of MEETS EXPECTATIONS, including reflections by
instructor and comparison to course grades for individuals:
In some cases, students selected a individual to discuss based on anthropometric
measurements, but did not put a significant weight on the laboratory analytes. Since this is a
laboratory focus class, the instructor would like to emphasize that these are the most
important considerations. The rubric for the assignment will be changed to alert the student of
the importance of the laboratory issues.
General characteristics leading to ratings of EXCEEDS EXPECTATIONS, including reflections by
instructor and comparison to course grades for individuals:
Students utilized multiple sources do predict changes in laboratory analytes, and all were
successful in this endeavor. Students selected appropriate subjects that were at high risk for
heart disease and gave careful explanations of the risks they found. Some students predicted
the results of alternate tests and integrated demographics and history of the patient into the
case to enhance the strength of the choice.
7
Attach a reflective commentary that will lead to quality enhancement.
This is the second year that this assignment was given. I feel that it is a good way for
students to stretch in new directions, i.e. predicting disease and correlating laboratory results
to risk of disease. Case studies offer a good mechanism to develop critical thinking skills.
Students were uncertain and uncomfortable about how to predict changes in data, but I feel
that the exercise was quite successful. Students were given one paper to peer review, and this
was done anonymously. Furthermore, the first drafts were perused by the instructor prior to
the peer review, and the drafts that were weak were assigned to authors that were strong,
and vice versa. The range of grades in the assignment was 81-100, and the mean was 95 and
the median was 96.5. Furthermore, the grade was the equivalent of an exam, giving them a
strong incentive. I believe another reason for this high level of success is that this is the
second case study the students wrote this term, so they had some familiarity with the process.
Comparison of the first case study to this case study shows a definite improvement – the
range of grades from the first case was 54-99 , with a mean of 86.5 and a median of 88.
The rubric for the assignment will be changed to guide students better in subject selection,
and in formatting a paper. One or two of the best papers will be provided as a guide, with
some of the content of the paper masked, and with the proviso that a different patient must
be chosen for the case.
I asked the students to complete an assessment of learning gains based on this case study
analysis. 92% of the students felt that the aspect of integrating material of the class into a
patient with a disease helped their learning, and 65% percent of the students felt that it
helped a good deal. 85% of the students also felt that evaluating the work of another student
helped their learning.
8
B.S. Clinical Lab Sciences EMBEDDED ASSESSMENT INSTRUMENT:
COMMUNICATION 2007
Program:
Course in Capstone Pathway:
Instructor:
Emphasized Programmatic SLOs:
Tangible Course Product to be Evaluated:
B.S. CLS
Clinical Chemistry 2 2007
Dr. Kristina Behan
Critical Thinking, Communication
Journal Club Presentation
Implementation for Embedded Assessment:
Complete the following rubric and note characteristics contributing to your rating in the comment section
below the rubrics. Use the student form of the grading rubric to guide assessment. Due to the limited
enrollment, all students should be included in this assessment. Record the total number of students, and
the number that fell into each category. Comments below will be used to guide improvements in teaching
and assessment.
COMMUNICATION-BASED SKILLS TO BE ASSESSED
Total number of students evaluated 14
Unsatisfactory
Satisfactory
(D/F)
(C)
Communicates effectively with peers using vocabulary and
analysis appropriate for the audience. Speaks fluidly, is
able to pronounce diseases, medications and tests.
Demonstrates mastery of the jargon
Articulates peer review in a professional and respectful
manner.
Uses PowerPoint as a tool, not a crutch. Entire talk is not
printed on slides. Maintains eye contact with audience
during most of the talk, uses appropriate speaking volume.
Speed of delivery is appropriate for teaching. Respects
minimum and maximum time allotments.
1
9
Very
GoodExcellent
(A/B)
4
12
2
1
8
5
CRITICAL THINKING-BASED SKILLS TO BE ASSESSED
Unsatisfactory
Satisfactory
(D/F)
(C)
9
Very
GoodExcellent
(A/B)
5
6
4
Defines the correct clinical issue of the paper. Gives
insightful analysis of the conclusions of the study with
respect to the Clinical Laboratory Sciences. Requires
minimal instructor input for interpretation.
Discusses tables and figures from the article in appropriate
depth, drawing on alternate sources for background.
Demonstrates skill in discussing the statistics found in the
paper.
4
General characteristics leading to ratings of UNSATISFACTORY:
The transition from the background material to the article being discussed was poor; citations can be
improved. Speaker volume was too low to be heard – perhaps a second practice for students with fear of
speaking would help. Speaker unable to correctly interpret tables presented.
General characteristics leading to ratings of SATISFACTORY: Showed a clear understanding of the article,
was able to explain subject and figures.
General characteristics leading to ratings of VERY GOOD-EXCELLENT: Clearly took time to understand and
teach the crux of the paper. Difficulty level of paper beyond others presented by peers. Gave insightful
peer review. Drew on many sources to understand the problem. Created in depth teaching aids.
Attach a reflective commentary that will lead to quality enhancement.
If more than 1 student is presenting an article from the same journal, they can skip discussing the
attributes of that journal to save time. There is a shortcoming in citations during the talk. Authors of the
article and their affiliations should be discussed. Students should be instructed to use the reference
section of the article to obtain background information.
9
Most students performed very well, and I was pleased with their progress. They were asked to evaluate
this project using the survey at SALG: Student assessment of learning gains, shown next.
Students were given the opportunity to reflect on their learning gains, and answered these statements
which began with “How much has this project helped your skills in the following”, shown in the Figure
below. The qualifiers were: evaluate published studies as an informed consumer, find appropriate
resources to support and explain a claim, read experimental design and understand methods, find trends
in data, critically review articles, design a presentation, and give oral presentations. Nine students
completed the survey.
Figure 1 Student assessment of learning gains
10
B.S. Clinical Lab Sciences EMBEDDED ASSESSMENT INSTRUMENT:
IMMUNOHEMATOLOGY 2007
Program:
Course in Capstone Pathway:
Instructor:
Emphasized Programmatic SLOs:
Tangible Course Product to be Evaluated:
B.S. Clinical Laboratory Sciences
Clinical Chemistry I 2007
Mr. Sherman Bonomelli
Hazard & Risk Management
Lab safety practical/Specimen handling procedures
Suggested Implementation for Embedded Assessment:
Students are required to practice lab safety procedures during regular sessions and during lab practicals.
Due to the limited enrollment, all students should be included in this assessment. Record the total number
of students, and the number that fell into each category. Grade the assignment as you would normally;
note characteristics contributing to your rating in the comment section below the rubric:
HAZARD & RISK MANAGEMENT SKILLS TO BE
ASSESSED
Total number of students evaluated 11
Unsatisfactory
Satisfactory
Student identified and utilized the appropriate PPE
and Engineering controls for a phlebotomy;
student utilized appropriate work practice controls.
14
Student followed accepted protocol in sample
collection, as assessed using the phlebotomy
checklist provided in lab manual.
14
Very
GoodExcellent
General characteristics leading to ratings of SATISFACTORY, including reflections by instructor and
comparison to course grades for individuals:
Students were mindful of the correct procedures and safety precautions. We believe this is due to their
heavy indoctrination, and the practice they receive on a mannequin arm.
Attach a reflective commentary that will lead to quality enhancement.
This exercise was performed using a checklist to verify that students proceeded in the correct manner. It
was done mid way through the year, so that students had sufficient training and experience in sample
collection and safety.
11
B.S. Clinical Lab Sciences EMBEDDED ASSESSMENT INSTRUMENT
SPECIAL CLINICAL METHODS 2007
CLS EMBEDDED ASSESSMENT INSTRUMENT: Special Clinical Methods 2007
Program:
Clinical Laboratory Sciences
Course in Capstone Pathway:
Special Clinical Topics MLS 4824L
Instructor/Evaluator
Dr. Steve Smith/Dr. Kristina Behan
Emphasized Programmatic SLOs:
Project Management & Critical Thinking
Tangible Course Product to be Evaluated:
Seminar Presentation
Implementation for Embedded Assessment:
Complete the following rubric and note characteristics contributing to your rating in the comment section
below the rubrics. Use the student form of the grading rubric to guide assessment. Comments below will
be used to guide improvements in teaching and assessment.
Count the number of students that fall
into each category.
PROJECT MANAGEMENT SKILLS TO BE
Fails to meet
Meets
Exceeds
ASSESSED
expectations
expectations
expectations
Student was able to correlate results from various
procedures with management of patient’s
condition. NA: 2
0
6
4
0
1
4
Fails to meet
expectations
Meets
expectations
Exceeds
expectations
Defines the correct clinical issue of the topic;
Requires minimal instructor input for
interpretation
1
2
9
Discusses tables and figures presented in
appropriate depth, drawing on alternate sources
for background.
0
4
8
Student was able to research new laboratory
procedures and evaluate effectiveness NA: 7
CRITICAL THINKING-BASED SKILLS TO BE
ASSESSED
General characteristics leading to ratings of UNSATISFACTORY:
Some of the material presented seemed store bought or sophisticated beyond the level of one student.
General characteristics leading to ratings of SATISFACTORY:
Students met the expectations described in the rubric. Noticed that international students mostly fall in
this category, probably due to language issues.
General characteristics leading to ratings of VERY GOOD-EXCELLENT:
Excellent explanation of new lab procedure; creates figures to explain procedures; new directions in the
field are discussed using very current literature for background information; actual patient data analyzed
with a thorough background  potential publication; educational thrust to talk, gave tips to remember
information; managed project without instructor input.
DISCUSSION: This is the second year of this assessment since it became the capstone project in the
Research Design and Evaluation component of the curriculum, and the Project management assessment in
the QEP process. At that time, it was observed that student seminars had inconsistent quality and focus.
The goals and mechanism of the improvement plan are discussed elsewhere. In the improvement plan,
these seminars have been preceded by a series of writing, research and communication activities over the
span of one year and 4 courses. This rubric-driven process has led to exceptional success, with 98% of
the results as “meets expectations” or higher and 50% of the results as “exceeds expectations”. Two of
the 12 presentations were of such high quality that they have strong publication potential. Students will
have the opportunity to provide insight into this and all of the assessments leading up to in using the
Student Assessment of Learning Gains survey. An opportunity to enhance communication skills still
remains within this project – students rely very heavily upon written “speeches” within the presentation.
This issue will be addressed in the following year.
12
B.S. Clinical Lab Sciences EMBEDDED ASSESSMENT INSTRUMENT
Board of Registry Examination Data
Of the 13 graduates, 12 took the national board examination from the American Society for Clinical
Pathology, and 11 of them passed. Passing score is 400. Average score was 547.
Mean Scaled Scores by Subtest For First Time Examinees
BBNK CHEM HEMA IMMU LO
MICR UA
Program Mean Scaled Scores:
517
549
548
498
568
578
577
University Based Program Mean
Scaled Scores:
490
490
497
479
501
487
499
This Cycle Mean Scaled Scores:
501
499
506
494
511
495
511
First Time Examinees from the total population this cycle
Program
Universities
National
Number of Examinees
12
572
995
Mean Scaled Score
547
491
500
Standard Deviation
102
93
95
Number Passing (Percent)
11 (92%)
487 (85%)
855 (86%)
Number Failing (Percent)
1 (8%)
85 (15%)
140 (14%)
Minimum Scaled Score
Achieved
347
204
200
Maximum Scaled Score
Achieved
671
842
842
13
Figure 2. 2007 ASCP Board of Registry results, interquartile ranges
14
B.S. Clinical Lab Sciences EMBEDDED ASSESSMENT INSTRUMENT
2007 Graduate Exit Survey Data
Students were asked to evaluate their individual ability to achieve the criteria defined in the domains of
the Academic Learning Compact by using a 1-5 point score. Each of the following domains achieved 100%
in the range of “agree” to “strongly agree”:
 Recognize and apply concepts and principles from the sciences that underlie clinical
laboratory skills.
 Apply methodological principles from clinical courses; recognize and apply principles of
quality assurance.
 Use medical terminology accurately.
 Distinguish normal from abnormal results.
 Interpret and evaluate lab procedures and results.
 Select and apply appropriate statistical procedures.
 Conduct research using appropriate literature.
 Communicate effectively with other medical professionals.
 Make professional oral presentations of findings.
 Recognize and adhere to applicable professional regulations, ethical standards, and the
profession’s code of conduct.
 Research, develop and perform new lab procedures.
 Recognize, describe and practice principles of lab safety.
15
16
DISCUSSION
The Clinical Laboratory Sciences Program has a strong record of academic achievement. In this current
year, students performed well on the ASCP national board of registry exam. Twelve out of 13 students
took the exam, and 11 passed on the first attempt. Our curriculum strives to address the domains of the
academic learning compact in several courses throughout the curriculum. We have limited the assessment
and discussion of the domains to a few of the core courses.
Communication skills are key in many avenues to the CLS, being the written word, the public address
and the interpersonal type. We have used a thematic approach, in that students as juniors must write in
several classes, including lab reports, lab notebooks, and case studies, and then they must analyze and
present cases and articles. We have found that offering comments and allowing revision has improved the
written products. With respect to oral communication, the students were given several opportunities to
speak, and guided with rubrics and peer review prior to the actual presentations. We see a definite
improvement in the capstone seminar product they produce just prior to graduation.
Project management was assessed by the students’ ability to design, research and execute a
professional seminar. The seminar was chosen because the 2004 and 2005 seminars were mediocre to
good to great, and we felt that a progressive emphasis on deadlines, research, communication and peer
review would improve the product. In 2006 more students ranked as excellent than satisfactory. This
trend continued in 2007.
Hazard and Risk Management is a discipline specific domain. All students were assessed during a
laboratory practical, and have met the necessary requirements for safety in the lab.
Critical thinking skills are required for a licensed practicing Clinical Lab Scientist (CLS). One method
that we use to reinforce critical thinking skills is the interpretation of case studies. Another method is in
reading the research of the CLS, and in discussing it in a public presentation. In Clinical Chemistry I,
students are provided access to a database of research results, and they must deduce which subjects are
at the highest risk for diabetes, and argue their case. Students are instructed in the art of peer review,
and help each other make interpretations, and improve their own thinking and writing this way. In Clinical
Chemistry II, students select a journal article to discuss, and are required to interpret graphs and tables
for their audience. Again they peer review each other prior to the presentation. This year we asked the
students to assess increases in their skills, and 80-90% of them agreed that the classes and assignments
helped somewhat or a lot to improve their ability to evaluate research, find resources, read experimental
design, and critically review articles.
Overall, students who graduated in 2007 reported that they were adequately trained in all of the domains
of the ALC, with all of the results ranked as “agree” to “strongly agree”.
Faculty meeting: The faculty from the university met with the education coordinators from the nearest
hospitals to share this information, on December 13, 2007. Student assessments of the program and
suggestions for improvement were reviewed and discussed.
17