Volume 36 Number 5 | October 2022
S. Renee Hodgkins, PhD, MT(ASCP), DCLS Oversight Committee Member
Development of the Doctorate in Clinical Laboratory Science (DCLS) has been a long relay race that has passed through many hands. In the document, “History of the DCLS Task Force and Oversight Committee,” discussions of development of the DCLS started with the Professional Doctorate Task Force (PDTF) in 2005 at the ASCLS Annual Meeting in Orlando, Florida, through a charge directed by the then ASCLS President Susan Morris.1 Through my time of service on the DCLS Oversight Committee, I have heard that discussions for the development of a professional doctorate took place many years (perhaps even a decade) before the PDTF was even formalized.
Working groups were developed with 18 members of the PDTF to identify tasks related to five areas (DCLS needs assessment, curriculum development, DCLS practice, sources of funding, and development of certification).1 The results of these tasks were used to build the DCLS educators’ toolkit. The journey has been arduous, facing AMA resolutions, laboratory community doubts, criticism from pathology and community alike, and continual advocacy to other organizations (ASCP, CLIAC, and others). Not all has been negative, of course, and we celebrated our achievements as well.
“This document is the cornerstone that will be used for certification development, accreditation standard revisions, and for professional recognition. It is a living, breathing document with many revisions to come in its future as the trails are blazed and the profession grows.”
The majority of those in healthcare understand the need for the DCLS if not the application thereof. Just recently, on July 26, 2022, the Federal Register put forth a proposal to officially accept the DCLS as an appropriate doctoral degree for high complexity laboratory testing directors.2
The DCLS Taskforce has faced many transitions in form from a taskforce to a transition committee, to a DCLS ad hoc committee, and then to the DCLS Oversight Committee reporting to the Education Scientific Assembly (ESA) (now the Clinical Laboratory Educators Forum (CLEF)), and finally to the DCLS Oversight Committee that would report directly to the ASCLS Board of Directors (BOD) in 2017.1 The committee numbers fluctuated through the years as the committee transitioned in its form. It started with 18 original members, was reduced to nine, and is now an 11-member committee with many active interested observers dedicated to moving the profession forward. The members are representative of DCLS practitioners, students, and educators, as well as quality and safety, management, and consulting members that have included pathology, nursing, and pharmacy.
In the fall of 2014, the DCLS Oversight Committee (then reporting to the ESA) was tasked to develop the Body of Knowledge (BOK) for the DCLS. A subcommittee was formed in 2015 of educators working in DCLS programs as there were no DCLS graduates at the time. This subcommittee (Elaine Keohane, Elizabeth Leibach, and myself) compiled the resources available: documents created by the PDTF and approved by the NAACLS Graduate Task Force that outlined the DCLS competencies/model courses/objectives; NAACLS standards and guides to accreditation; ASCLS position papers for the DCLS, practice levels, scope of practice, and patient safety; and the sentinel paper, Health Professions Education: A Bridge to Quality.3 The three current programs (Rutgers, University of Kansas Medical Center, and University of Texas Medical Branch Galveston) offered their course syllabi to help with the development. Discussions around the goals of the BOK document itself took place as to the purpose, audience, and defining characteristics (e.g., entry level or knowledge upon graduation vs. experienced or five years post-graduation knowledge).
Taking the available data and creating a framework to place it in was a challenge. Where to start? The information we collected seemed to fall into three major categories: professional practice, advanced scientific content (outside of the laboratory), and advanced clinical laboratory science. The healthcare community at large was exploring the effects of the healthcare system itself on the safety of our patients with an intentional focus placed on interprofessional collaboration and communication: To Err is Human: Building a Safer Health System, Crossing the Quality Chasm: A New Health System for the 21st Century, and Health Professions Education: A Bridge to Quality.3-5
For the Professional Practice Section, the committee chose a framework that mirrored and elaborated on the five Institute of Medicine (now National Academy of Medicine) competencies for healthcare practitioners: Patient Centered Care, Teamwork and Collaboration, Evidence-Based Practice, Quality Improvement, and Informatics.6 These were areas identified in Health Professions Education: A Bridge to Quality that were necessary for restructuring the education of all healthcare professionals.6 This section would be expanded to include objectives in additional areas of professional practice: education, professionalism and ethics, healthcare policy, and laboratory services management.
The Advanced Clinical Laboratory Science Section launched off the already defined MLS body of knowledge for each major section. The advanced scientific content were areas that needed more development apart from the MLS content areas: research, epidemiology, pharmacology, pathophysiology, and health assessment. Ultimately, the advanced CLS content would join with the advanced scientific content to create a Foundational Knowledge Section in the BOK document.
Once the draft was formed and presented to the whole committee (2019), the next few years would be spent on revising the BOK line by line, forming workgroups to work on sections at a time, and then coming together with the whole document again. A painstaking task of converting some very course-oriented objectives into professional objectives and removing duplication. As the timeline continued, our committee now had graduates, students, and residents to help with the review.
Characterizing this professional as it began to blossom was a very energizing task. The DCLS professional had been born out of a need in the healthcare system for direct to laboratorian communication on information that only a laboratorian would know, and the DCLS students, residents, and graduates practicing would now know best. For some content areas, it was surprising to hear the directions the practitioner was now heading, particularly in areas of pharmacology and antimicrobial stewardship. Following in the path of the clinical pharmacist, we demonstrate the utility of the laboratory’s body of knowledge in the same way the pharmacist once had to demonstrate theirs.
As the DCLS gained traction in institutions, the areas of practice were widening. We were able to make some content changes and refocusing based on the feedback from those now practicing in the field. Laboratory stewardship is the new buzz word in healthcare, and the DCLS is well versed in the language. Our interested observers to our committee now became a lifeline to practice as our DCLS practitioner numbers continue to grow.
On June 30, 2022, the ASCLS House of Delegates approved the DCLS BOK. This date shall be carved into the timeline and the history of the profession. This document is the cornerstone that will be used for certification development, accreditation standard revisions, and for professional recognition. It is a living, breathing document with many revisions to come in its future as the trails are blazed and the profession grows. It is a document that should be used within our profession to guide the DCLS forward in practice and for other professionals to understand our role in the healthcare system; as you know, few understand the role of the medical laboratory scientist, even fewer the doctorate in clinical laboratory science.
To get from there to here, we had 19 contributing authors (and many more who provided input) to this body of knowledge for the DCLS, including laboratory practitioners, managers, graduate-level and DCLS educators, DCLS practitioners, and DCLS residents and students. We also had two consulting pathologists who contributed to the content and review. There were many who laid the path and many who will follow. Without each, this document would not exist. Thank you for the hours, the review, the blood, sweat, and tears.
- DCLS Oversight Committee. (2014 revised 2016). “Chapter Two: History of the DCLS Task Force and Oversight Committee,” www.ascls.org/DCLS, accessed July 29, 2022.
- Provisions of the Proposed Regulations for CLIA Requirements for Histocompatibility, Personnel, and Alternative Sanctions for CoW Laboratories (2022) Federal Register, Vol 87, No. 142, July 26, 2022, pg 44910-44911. https://www.govinfo.gov/content/pkg/FR-2022-07-26/pdf/FR-2022-07-26.pdf, accessed July 29, 2022.
- Institute of Medicine (US) Committee on the Health Professions Education Summit, Greiner, A. C., & Knebel, E. (Eds.) (2003). Health Professions Education: A Bridge to Quality. National Academies Press (US).
- Institute of Medicine (US) Committee on Quality of Health Care in America, Kohn, L. T., Corrigan, J. M., & Donaldson, M. S. (Eds.). (2000). To Err is Human: Building a Safer Health System. National Academies Press (US).
- Institute of Medicine (US) Committee on Quality of Health Care in America. (2001). Crossing the Quality Chasm: A New Health System for the 21st Century. National Academies Press (US).
- Institute of Medicine (US) Committee on the Health Professions Education Summit; Greiner AC, Knebel E, editors. Health Professions Education: A Bridge to Quality. Washington (DC): National Academies Press (US); 2003. Chapter 3, The Core Competencies Needed for Health Care Professionals. Available from: https://www.ncbi.nlm.nih.gov/books/NBK221519/ accessed July 29, 2022.
S. Renee Hodgkins is the DCLS Program Director and Clinical Assistant Professor at the University of Kansas Medical Center in Kansas City, Kansas.