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Objectives: With the exception of states that require licensure, there is no uniform requirement for certification or for education from the National Accrediting Agency for Clinical Laboratory Science (NAACLS) accredited laboratory science program for employment in a laboratory, under the Clinical Laboratory Improvement Amendments (CLIA) of 1988. The objective of the Value of Education and Certification (VEC) study was to determine if lack of NAACLS-accredited education and Medical Laboratory Technician (MLT)/Medical Laboratory Scientist (MLS) certification was associated with laboratory errors., Methods: This cross-sectional study used personnel and testing/reporting error data from 739 laboratorians, involving five laboratory partners., Results: MLS-certified individuals were 33% less likely to make errors (p=0.0473) and MLT-certified individuals were 71% less likely to make errors (p=0.0014) compared to those who were not certified. MLS-certified laboratorians were twice as likely to make testing/reporting errors compared to those who were MLT certified, which was significant (p=0.0238). Education level and accredited laboratory education were not associated with testing/reporting errors., Conclusion: Our data suggest that lack of MLS and MLT certification are independently associated with laboratory testing/reporting errors.

A large-scale practice analysis was undertaken by the American Society for Clinical Pathology Board of Registry to help maintain the validity of its certification examinations. The complete data sample of 1152 practicing phlebotomy technicians, medical laboratory technicians, and medical technologists was found to be demographically representative of the overall sample of 3097 respondents. The first study goal was to identify reliable task scales performed by phlebotomy technicians, medical laboratory technicians, and medical technologists. Thirty-eight task scales were initially found. Second, discriminant analysis was used to predict membership in one of these certification groups based on a more parsimonious combination of task scales. Task scale distinctions among phlebotomy technicians, medical laboratory technicians, and medical technologists were found. Study implications and limitations are discussed.

The Japan Society of Blood Transfusion (JSBT) organized a Board for certification of medical doctors in Transfusion Medicine (Board certified medical doctors by the JSBT) and a Board for certification of medical technologists for transfusion medicine (qualified medical technologists in Transfusion Medicine). For certified medical doctors the JSBT co-ordinated with the Japanese Association of Medical Science and with the Japan Medical Association, and for qualified medical technologists the JSBT co-organized with the Japanese Society of Laboratory Medicine, the Japanese Association of Medical Technologist and the College of Clinical Pathology of Japan. By May 2001, 259 of the certified medical doctors and 875 of the qualified medical technologists have been certified and are participating actively to increase the level of transfusion practice at individual facilities.

The EFCS/QUATE aptitude test is an important measure for evaluating quality in cervical cytopathology and for assessing the level of experience and competence in cervical cancer screening. The test, set up in the 1990s by the ECTP/CCS working party, has been performed since 1992 in several European countries: United Kingdom, The Netherlands, Germany, Denmark, Portugal, Slovenia, Hungary and Italy. In Italy, the test has been performed at the Istituto Superiore di Sanità in 1992 and 1993 and in some Italian universities (Padua 1993, Turin 1994, Sassari 1995, Naples 1996, Messina 1998) and in one hospital (Genoa 1997). The minimum passing score is 60/100 (60% in all sections). The aptitude test for cytotechnologists includes: a written test (50 multiple choice questions); a practical test (screening 10 unmarked cervical smears; spot test of 20 slides with a fixed field of view); and an oral test, for borderline candidates when necessary (60%) or for the diploma with 'distinction' (95%). Successful candidates receive the Certificate of Aptitude in Gynecological Cytotechnology and are entitled to use the initials CT (EFCS-GYN) after their names for professional purposes. The aptitude test for anatomopathologists includes an oral test and a practical test (screening 5 unmarked cervical smears, spot test of 20 slides with a fixed field of view, and reading and diagnosing 3 complex cases). Successful candidates receive the certificate of gynecological cytopathology. The first aptitude test for anatomopathologists in Italy, organized and endorsed by the Istituto Superiore di Sanità in collaboration with SIAPEC (Italian Society of Pathological Anatomy and Cytopathology) and in agreement with the European guidelines for cervical cancer screening, was performed on 18 December 1997 in Rome. The total number of aptitude tests carried out in Europe is 15 for cytotechnologists and 4 for anatomopathologists. A total of 317 cytotechnologists and 73 anatomopathologists has taken the test; the success rates are 77% and 70%, respectively.

The purpose of the present analysis was to determine the degree of invariance of the Job Responsibilities Scale from 1993 to 1995. Factor analyses were conducted on both year's data and nearly identical factor patterns were found. Rasch rating scale analyses were conducted and nearly identical pairs of item estimates were found. These results suggest that even though the overall frequency of performance on some medical technology laboratory tasks increased from 1993 to 1995, the relationships among the tasks themselves remained the same (invariant). This conclusion allows for a description of what it means to increase in level of personal job responsibility from year-to-year. In addition, these results suggest that at the conclusion of this prospective study it may be possible to objectively define the typical career mobility pattern of entry level medical technologists.

There was a large volume of feedback and comment on the discussion paper on the future format of RT examinations. Published in the Canadian Journal of Medical Technology, volume 52, #4, 1990. A total of 63 individual submissions was received, of which 12 addressed cytotechnology only and three addressed RT subject examinations. Because many of the responses came from groups, such as faculty liaison committees or instructor groups, some 300 didactic and clinical teaching personnel were involved in the feedback. Submissions were received from 21 of the 31 RT general programs and from six of the nine cytotechnology programs. The responses can therefore be taken as representing a good cross-section of opinion among training program personnel. The feedback was studied recommendation by recommendation, to determine the levels of agreement and disagreement and to summarize the questions, comments and concerns.

The committees involved in developing the new ART process have received many comments from various groups and individuals in the country. There has been little, if any, response from employers, whose comments would be appreciated to determine if those who attempt the new ART will better meet their expectations. It was felt that the technologist with the new ART designation will be a more rounded technologist.

The certification of foreign-trained technologists is a very sensitive issue, and the CSLT must proceed with caution in making changes to the system. The policy cannot afford to be too lenient, lest in this litigation-conscious climate an incident were to occur that could undermine the credibility of the certification process. On the other hand, it must not be protectionist and discriminatory. If the labour market does become undersupplied with medical technologists, employers in non-regulated provinces may choose to replace their ranks with non-CSLT-certified employees. If this were to happen to a significant degree, employers might come to rely less and less on the CSLT's stamp of approval. In either case, the value of the CSLT, and the RT itself, is at risk.

Development of self-directed study skills and problem solving abilities is not nurtured in an environment in which every subject is specified and choices are few. The CSLT would do well to propose fewer requirements and to keep them process-related. It should have more faith in the universities and the candidates. A degree will develop the key skills to be life-long learners. The work environment and CE courses will help keep information current and relevant. The professional body, the CSLT, should produce an ART evaluation instrument that assesses both skills and knowledge at an appropriate level. Submission of a case study and an oral examination based on the case, if properly constituted, can fulfill this role. The Task Force On Future Trends and the ART Working Group are to be congratulated on developing a blueprint for future advanced certification. Their job has been enormous. They deserve our thanks for having the courage to propose major changes that, while not universally popular at the outset, should serve the membership well in the long term. As the new system evolves, it is important for all views to be heard. Members who have something to contribute, should speak up now. The ART process is still unfolding, and we may be able to influence its direction.

In the field of clinical laboratory science, certification may be obtained by passing the National Certification Agency for Medical Laboratory Personnel (NCA) examination. This multiple-choice test is competence-based and criterion-referenced, and uses a modified Angoff procedure to establish the passing score. For this study, the NCA examination scores of 1,868 certification applicants (mostly new graduates) and 111 selected laboratory practitioners were compared. Although the NCA examination is designed to define the level of minimum competence, the failure rate of practitioners identified by their supervisors as minimally competent was almost four times greater that that of the certification applicants. Even the most competent group of practitioners scored well below the applicants for certification. These findings suggest that the examination cut-off point may not really define minimal competence and that the method used to determine the passing score might not be appropriate for certification examinations.

There are essentially two types of credentialing. One recognizes the competence of educational programs to prepare personnel and is generally referred to as accreditation. The second recognizes the competence of individuals to deliver services and includes the processes of certification, licensure, and registration.