Volume 38 Number 4 | August 2024

Jed Doxtater, MS, MLS(ASCPi)CM, ASCLS Today Volunteer Contributor

Charlie P. Cruz, PhD, SM(ASCPi)CM, MLS(ASCPi)CM, RMT, ASCLS Today Volunteer Contributor

Jed DoxtaterCharlie P. CruzAs higher education institutions (HEIs) more readily rely on outcomes-based measures for academic achievement, the cognitive and psychomotor learning domains have become the primary focus in predicting academic success. Limited time or energy has been focused on the affective domain’s receiving, responding, valuing, organizing, and value-characterizing aspects, even though a direct correlation has been demonstrated between affective assessments and overall academic performance. We conducted a study utilizing an institutional affective assessment tool to investigate student affective factors and their roles as success predictors in the American Society for Clinical Pathology (ASCP) Board of Certification (BOC) examination for medical laboratory scientists (MLSs).

The assessment tool examined five subdomains: receiving, responding, valuing, organization, and characterization, as well as environmental variables. The five subdomains evaluated affective factors by measurable outcomes and evaluations in the educational setting, while the environmental variable measured factors outside of the classroom that can impose a net positive or negative influence on affective attributes. Outcomes associated with the subdomains included receiving and respecting the information presented in class, valuing ideas and concepts, compliance with instruction and deadlines, demonstrating courtesy and cooperation with students and instructors, pursuing self-direction, responsibility for individual learning and self-efficacy, and recognizing abilities and limitations to meet objectives and goals. Data for the environmental variables of the study were qualitatively collected during formal in-person mentor meetings, advising meetings, and programmatic exit interviews. These variables included factors relating to stress or eustress due to managing work, family, physical and mental health, and behavioral or psychological characteristics. Although the students’ affective assessment is the primary variable investigated in our research, other factors were studied to assess student certification exam success, namely grade point average (GPA), highest academic degree (HAD) earned, advanced clinical practicum (ACP) routes, years to degree completion, and gender.

“… predictive variables correlated to the certification performance of MLS students, where the affective domain score was identified as a significant standardized examination success indicator.”

The results of our study revealed a statistical significance between students who achieved a high affective score and MLS BOC exam success, indicating that students with high affective assessments, greater self-efficacy, academic compliance, and fewer adverse environmental factors, such as work-related conflicts, family and home stresses, or physical or psychological health challenges, are more likely to pass the BOC examination on the first attempt. Although this novel study is the first of its kind regarding the MLS profession, these results align with other studies investigating the positive effect of self-efficacy and the negative impact of perceived stress on one’s academic performance.

The HAD earned represents the highest college degree achieved before entering the MLS program. Bachelor-level MLS programs are often composed of a diverse population of students, with associate degree holders entering at a junior academic level, bachelor’s degree students completing the MLS program concurrently or receiving a second four-year degree, and master’s degree students completing a second bachelor’s degree. Our study showed a significant correlation between HAD and BOC pass rates, indicating students with a baccalaureate degree and above had a higher passing rate than students with an associate degree. There is inadequate research correlating these variables in health science professions to investigate this significance further, but a likely theory to explain these results is that students with a higher HAD have already developed successful study habits and time management skills and have robust educational backgrounds to minimize the learning curve and struggles that associate-level students may encounter.

Academic advisors play a pivotal role in the success of students’ efficient and successful progress through academic programs. They assist students in connecting their academic, career, and life goals. Academic advisors can customize student course schedules, such as full-time or parttime, depending on academic or work status. The placement of ACP courses in this MLS program can be split between two semesters (split track) or fully contained in the final semester (straight track) of a degree completion plan, contributing to greater flexibility when developing an advising plan, thus, can help accommodate students’ work and family schedules.

We found no statistical significance when correlating these two ACP advising tracks to BOC pass rates. This may be attributed to the placement of a content review course in the MLS curriculum that always occurs during the final semester of the degree program. No current studies were found investigating clinical practicum placement and advising practices in the MLS profession. This is predictable as this advising indicator is absent in traditional programs. These advising tracks do not extend the degree to completion, which has been investigated by one study, indicating a negative correlation between years to degree completion and BOC scores.

Though not novel predictors of BOC exam success, gender, and GPA were included in this study, we found no statistically significant association between gender and BOC success, which differs from the findings of previous studies that included gender and MLS BOC success, but agreed with a study investigating internal medicine (IM) graduate certification exam pass rates. The difference between the two studies could result from the student demographics evaluated in the 2021 publication, with the “high achieving, predominantly male” premedical students in the study.

GPA as a predictor of academic and certification exam success has been well-researched, and it has been suggested that higher preadmission, science, and cumulative GPA directly relate to higher BOC scores. The results of our study agreed with the previous research and identified a statistically significant relationship between the BOC pass rate and students’ cumulative GPA.

In conclusion, predictive variables correlated to the certification performance of MLS students, where the affective domain score was identified as a significant standardized examination success indicator. A more robust affective assessment tool can be developed and institutionalized in MLS programs to understand better students’ strengths and weaknesses, which can be used as a basis for curricular and programmatic interventions. Future researchers can further investigate the impact of the specific components of the affective domain on the MLS BOC success.

Jed Doxtater is Program Director, Medical Laboratory Sciences at the College of Health Sciences, School of Pharmacy at the University of Wyoming in Casper, Wyoming.

Charlie P. Cruz is Associate Lecturer, Medical Laboratory Sciences at the College of Health Sciences, School of Pharmacy at the University of Wyoming in Casper, Wyoming.