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PROSPECTS FOR THE DEVELOPMENT OF
DOCT ORAL PROGRAMS IN
CLINICAL LABORATORY SCIENCE

By
Kathryn Mary Doig

A DISSERTATION

Submitted to
Michigan State University
in partial tuItiIIment oi the requirements
for the degree of

DOCTOR OF PHILOSOPHY

Department of Educational Administration

1991

ABSTRACT
PROSPECTS FOR THE DEVELOPMENT OF
DOCTORAL DEGREE PROGRAMS IN
CLINICAL LABORATORY SCIENCE
BY

Kathryn Mary Doig

Directors and cleans of accredited clinical laboratory science programs
that otter a master’s degree were surveyed to assess the prospects for
development of doctoral degree programs in clinical laboratory science (CLS).
They were asked about their plans to institute doctoral programs. their
perceptions of their institutions’ resources in support of doctoral programs, as
well as information on the actual resources and factors influencing their
decisions to develop a program. Thirty-tour institutions were included in the
population and responses were received from thirty-two. Administrators from
three institutions reported being in some phase of developing a doctoral
program in clinical laboratory science. The deans and directors from the
programs with plans were more optimistic about their resources for supporting
a doctoral program than were their counterparts from institutions that were not
planning a doctoral program. However, the actual resources of the institutions
that were proceeding with plans for doctoral programs were essentially the
same as the resources of the institutions without plans. A diflerence was that
the programs with plans had on average, one more faculty member with an

active research program. The respondents documented the need for

doctorally-prepared clinical laboratory scientists as faculty in CLS programs
since nearly 85% of directors reported difficulty in hiring doctoraliy-prepared
faculty. The likely supply of CLS doctoral students was estimated to be about
13 per year nationwide. An extended consortium model for design of doctoral
programs was recommended. This model proposes multiple university
participation in a consortium which provides shared, electronically-delivered
courses. Doctoral research would be supervised by a research director off-
campus. This model holds good prospects for developmental-grant funding
because it maximizes student access while minimizing the resource

expenditures of individual institutions.

ACKNOWLEDGMENTS

The author wishes to express sincere appreciation to:

Richard Benson, husband and saint, for patience, forbearance, and
support.

James Snoddy, PhD, major professor, for patient guidance through the
eight years and two research proposals it took to finally complete this work.

Guidance committee members, Richard Gardner, PhD; Irvin Lehmann,
PhD; Sharon Zablotney, PhD; and Douglas Estry, PhD, who offered assistance
in the drafting and writing of this dissertation.

Librarians of the Michigan State University Science Library, Social
Science Library, and Government Documents Division who never failed to help
in the retrieval of needed materials.

Judith Barr, DrPH; Mary Lee Seibert, PhD; and Virginia Johnston, PhD,
professional associates who pretested the survey instrument.

Brenta Davis, EdD for sharing her dissertation.

Gerald Davis, PhD, Director of the Medical Technology Program,
Michigan State University for assistance in completing this project.

Michelle Wright, PhD; Sharon Erhmeyer, PhD; Linda Smith, PhD; Karen

Karni, PhD; Connie Mahon, M.S.; and Deanna Klosinski, PhD, professional

ii
associates from around the U.S., who provided the inspiration to persist in this
endeavor.
Lynn Maedel, Carole Hutchinson, Susan McQuiston, Donna Duberg,
Marsha Parrott-Boyle, Sennin Hardesty, George and Dorothy Doig, Harriet and

Robert Benson, for personal support and encouragement.

 

TABLE OF CONTENTS

CHAPTER I: Introduction ..................................... 1

Statement of the Problem ................................ 4

The Research Questions ................................ 5

Definition of Terms ................................... 12

CHAPTER II: Review of the Literature .................... , ....... 15

A Brief History of Graduate Education

in the United States .................. 15

The Pre-history: to 1876 ........................... 16

The University Revolution: 1876-1900 ................. 19

Consolidation and Standardization: 1900-World War I ..... 20

Growth and Diversification: World War I To World War II . . . 22

Revival and Reappraisal: World War II to 1960 .......... 24

Pluralism and Innovation: 1960 to 1990 ................ 25

Summary ..................................... 26

The Development of Doctoral Education in Nursing ............ 27
Research on the Development of Doctoral Programs in

Nursing .................................. 28

Summary ..................................... 32

Doctoral Education for Clinical Laboratory Scientists ........... 33

Development of Education Programs in CLS ............ 34

Graduate Education for Clinical Laboratory Scientists ...... 42

Summary ..................................... 51

CHAPTER III: Methods ..................................... 52

The Study Population .................................. 52

The Survey Instruments ................................ 53

Survey Instrument Administration ......................... 54

Follow-up Procedures ................................. 55

Analysis of Data ..................................... 56

CHAPTER N: Research Findings .............................. 57

Respondent Profiles ................................... 58

iv

Resources for the Development of

Doctoral Programs in Clinical Laboratory Science ............ 62
Plans to Develop Doctoral Programs
in Clinical Laboratory Science .......................... 77
Factors Influencing Decisions to Develop
Doctoral Programs .................................. 79
Demographic and Biographic Data on Respondents ........... 86
CHAPTER V: Discussion and Conclusions ....................... 90
Resources for the Development of
Doctoral Programs in Clinical Laboratory Science ............ 90
Plans to Develop
Doctoral Programs in Clinical Laboratory Science ............ 93
The Need for More Doctorally-Prepared
Clinical Laboratory Scientists ........................... 96
Implications and Recommendations ...................... 101
Summary ......................................... 107
BIBLIOGRAPHY ......................................... 108
APPENDIX A ............................................ 112
APPENDIX B ............................................ 113
APPENDIX C ............................................ 124
APPENDIX D ............................................ 130
APPENDIX E ............................................ 132

APPENDIX F ............................................ 133

LIST OF TABLES

Table 1: Comparison of the histories of the PhD in the United States
~ (PhD in US), doctorates in nursing(Doc in Nurs.), and

doctorates in clinical laboratory science (Doc in CLS) ...... 26
Table 2: Profile of respondents ............................ 59
Table 3: Numbers of respondents holding academic degrees in

various majors .................................. 60
Table 4: Numbers of respondents holding certification and various

earned degrees ....................... , ......... 61
Table 5: Numbers of CLS respondents holding earned degrees in

various majors .................................. 62
Table 6: Profile of non-respondents ......................... 63
Table 7: Means of responses of directors and deans regarding

resource perceptions ............................. 65
Table 8: Means of responses regarding resource perceptions of

deans with and without plans to develop a doctoral

program ...................................... 67
Table 9: Means of responses about resource perceptions of

directors with and without plans to develop a doctoral

program ...................................... 69

Table 10: Means of actual resources for the development of doctoral
programs in CLS from institutions with and without plans . . . 73

Table 11: Numbers of institutions with plans for doctoral programs in
CLS ......................................... 77

Table 12:

Table 13:

Table 14:

Table 15:

Table 16:

Table 17:

Table 18:

Table 19:

Table 20:

vi

Details of plans for doctoral programs for clinical laboratory
scientists ......................................

Planning process for programs devel0ping a doctoral
program for clinical laboratory scientists ...............

Means of items regarding student supply and demand for
doctoral programs in CLS .........................

Means of responses regarding faculty vacancies over the
last 5 years ....................................

Deans perceptions of the disciplines in which recruiting
doctoral faculty is easiest and why ...................

Credentials sought for faculty in CLS programs ..........

Strategies employed when faculty with the desired
credentials could not be recruited ....................

Deans and directors perceptions of the factors contributing
to the problems in hiring doctoral-level faculty in CLS
programs .....................................

Anecdotal comments of respondents and their professional
credentials ....................................

78

79

81

83

84
85

85

86

CHAPTER I

Introduction

Within the profession of clinical laboratory science (CLS), also known as
medical technology (MT), doctoral education for clinical laboratory scientists
(CLSs) gained interest in the 19805 and became a controversial topic at
professional meetings and in the published literature (Day, 1989; Frohman,
1989; Kelly, 1990a; Kelly, 1990b; Kelly, 1990c; Mendelson, 1988; Westgard,
1989). The heightened interest within the profession stemmed from pressure
on individuals to earn doctoral degrees and from moves within the American
Society for Medical Technology (ASMT) directed at advancing the professional
self-determination of CLS.

Just as nurses in the 1970s (Grace, 1978). CLSs holding positions as
academic faculty in colleges and universities have come under individual
pressure to earn doctoral degrees, conduct on-going research, and publish the
results in order to gain tenure, be promoted, and maintain their positions
(Mendelson, 1988). To meet these demands, and because there were only two
doctoral programs for CLSs in the US. until 1990. CLSs have 'borrowed'
doctoral degrees from other disciplines such as education and the basic

sciences, just as nurses did during the 19603 (Matarazzo, 1971).

2
More general interest and controversy over doctoral education for CLSs

were fueled late in the 1980s during discussions on a position paper then being
drafted by the ASMT. The paper, 'Future Directions of Clinical Laboratory
Science Educational Programs' (American Society for Medical Technology
[ASMT]. 1988), discussed faculty qualifications for teaching in academic CLS
programs. Some participants in that discussion recognized that CLS was not
viewed as an academic discipline from outside the profession because there
was not a defined, distinct body of knowledge; there were virtually no doctoral
programs; and most faculty were not doctorally-prepared. This contingency
pressed for the document to state that the doctoral degree was indeed the
terminal degree in the field or profession of CLS. as it is in the commonly
recognized academic disciplines such as chemistry, English, mathematics, or
psychology. These same participants also wanted wording added to support
and encourage more faculty to earn doctoral degrees and to foster the
development of more doctoral programs in the field.

Some university-employed participants without doctoral degrees found
this recommendation to be problematic. They anticipated that their own
promotion and tenure would be thwarted once the professional association
went on record recognizing the doctorate as the terminal degree in 1988.
Therefore, the wording was softened to declare that the doctorate would be

considered the terminal degree by the year 2000.

3
In the same discussions, some participants pressed to have the

doctorate WW recognized as the terminal degree.
SinceatthetimetherewereonlyMOdoctoralprogramsforCLSsintl'ie
country, mostpractitioners hopingtoeamthedoctoratebytheyearzooo
would need to pursue degrees in related areas. Therefore, this
recommendation was also modified to recognize any doctorate, not even
specifying a Doctor of Philosophy (PhD).

Recognition of the doctorate as the terminal degree was a step in the
professional self-determination or professionalization of CLS (Brubacher, 1962;
Greenwood, 1966). Further, such a professional sanction was expected to
bolster proposals for development of doctoral programs specifically designed
for CLSs. However, as with nursing in the 1960s (Murphy, 1981), the issue of
the uniqueness of the body of knowledge in CLS persisted and would hamper
efforts to initiate doctoral programs. Therefore, in 1989, ASMT approved
another position paper, I'Doctoral Education in Clinical Laboratory Science"
(ASMT, 1989). Among the topics discussed in the paper was a unique
curriculum, clinimetrics; distinct from microbiology, chemistry, physiology, or
other sciences. Clinimetrice is the science of laboratory analysis and its
articulation in this document was analogous to nursing’s development of a
theory of nursing, distinct from medicine, physiology, psychology, or
anthropology. It was also a necessary step in the professionalization of CLS
(Greenwood, 1966).

4
WM

Some important components necessary for develdpment of doctoral
programs in CLS seem to be in place. The profession has formally recognized
the doctoral degree and described the unique curriculum content for that
degree. Additionally, there is a body of CLSs with doctoral degrees who
should be able to expand the body of knowledge and act as research mentors
for students. There is anecdotal evidence of a need for doctorally-prepared
CLSs. especially as faculty for academic programs.

In the presence of favorable attitudes, resources will be a limitation to
the immediate development of doctoral programs in CLS. Anecdotal evidence
suggests that few academic programs have the critical mass of doctoral-level
faculty. Further, the other resources available within the profession are
unknown. Therefore, the problem to be investigated is the identification of
institutions with the best resources and the greatest likelihood of being able to
develop and sustain doctoral programs.

It will be valuable to document the availability of resources and the state
of development of doctoral degree programs for CLSs. The results of this
study will provide a snapshot of the state of development of doctoral programs
in CLS in 1990. Data generated by this study will be valuable for administrators
in assessing the relative strength of their institution’s resources as they
contemplate initiation of such programs. The resources available within the

profession as a whole for the development of doctoral degree programs will be

5
assessed and may be of use in planning cooperative ventures. The data may

be of value to funding agencies in supporting developmental projects and the
results may also be useful to prospective students.

W

The research questions to be investigated are these:

(1) Are there institutions that are perceived by their administrators to possess

the resources necessary to develop a doctoral program in CLS?

(2) In 1990, how many CLS programs are in the process of developing
doctoral programs for CLSs and what is the status of their progress?
(a) How was the decision to proceed with development made?
(b) What problems or obstacles to implementation are anticipated?
(c) What types of programs are planned and what are their

requirements?

(3) If the resources to develop a doctoral program in CLS are not currently
available. what are the projected needs and from where are those resources

expected to come?

6
(4) How do programs that are proceeding with the development of a

doctoral program compare to those that are not developing one?

(a) How do their administrators’ Opinions compare in regard to the
resources of their institutions to initiate doctoral programs?

(b) How do these institutions compare in actual resources?

(c) How do they compare on the numbers of inquiries about doctoral
education they have had?

(d) How do they compare in regard to problems with hiring
doctorally-prepared faculty?

(e) How do they compare in regard to the numbers of master's
degrees granted annually?

(f) How do they compare in the number of master’s graduates that

go on to doctoral study?

(5) is there a perceived need among CLS program directors and deans for
more doctorally-prepared CLSs as faculty members and graduate mentors in
CLS programs?
(a) How does this perceived need compare to the need perceived in
other professions for doctorally-prepared faculty?
(b) What problems have been encountered in recruiting doctorally-

prepared, professionally-certified faculty for CLS programs?

7
(c) What accommodations have been made if applicants with the

desired credentials have not been available?

Questions 1, 2, 3, and 5 will be answered with descriptive data Question 4 will
require comparisons that can be analyzed by the use of hypothesis testing.
The operational hypotheses to be tested and the questions that they address
are these:

(4) How do programs that are proceeding with the development of a
doctoral program compare to those that are not developing one?

(a) How do their administrators’ opinions compare on the resources of their

institutions to initiate doctoral programs?

Ho: There is no significant difference between deans and directors in
their opinions about the adequacy of resources at their institution for the

development of a doctoral program in CLS.

Ho: There is no significant difference between deans of programs with
plans to initiate a doctoral program and deans of programs without
plans to initiate a doctoral program in their opinions about the adequacy
of the resources at their institution for the development of a doctoral

program in CLS.

(b)

H,: There is no significant difference between directors of programs with
plans to initiate a doctoral program and directors of programs without
plans to Initiate a doctoral program in their opinions about the the
adequacy of the resources at their institution for the development of a
doctoral program in CLS.

How do these institutions compare in actual resources?

Ho: There is no significant difference between institutions that are
proceeding with a doctoral program and those institutions that are not in

regard to the number of faculty.

Ho: There is no significant difference between institutions that are
proceeding with a doctoral program and those institutions that are not in

regard to the number of doctorally-prepared faculty.

Ho: There is no significant difference between institutions that are
proceeding with a doctoral program and those institutions that are not in

regard to the number of faculty with active research programs.

H,: There is no significant difference between institutions that are
proceeding with a doctoral program and those institutions that are not in

regard to the amount of external funding the programs receive.

Ho: There is no significant difference between institutions that are
proceeding with a doctoral program and those institutions that are not in

regard to hospital availability.

Ho: There is no significant difference between institutions that are
proceeding with a doctoral program and those institutions that are not in
regard to the presence of other doctoral programs within their

administrative unit.

Ho: There is no significant difference between institutions that are
proceeding with a doctoral program and those institutions that are not in

the number of annual faculty publications.

H,: There is no significant difference between institutions that are
proceeding with a doctoral program and those institutions that are not in

the number of annual grant proposals submitted.

10
Ho: There is no significant difference between institutions that are

proceeding with a doctoral program and those institutions that are not in

the average dollar amount of grants received.

H,: There is no significant difference between institutions that are
proceeding with a doctoral program and those institutions that are not in

the average number of students enrolled in the university/college.

Ho: There is no significant difference between institutions that are
proceeding with a doctoral program and those institutions that are not in

the average number of students enrolled in the undergraduate CLSs

program.

Ho: There is no significant difference between institutions that are
proceeding with a doctoral program and those institutions that are not in
the average number of students enrolled in the master of science

program in CLS.

Ho: There is no significant difference between the directors of programs
that are proceeding with a doctoral program and those directors whose
institutions are not, in the perceived level of administrative support for

initiating such a program.

(C)

(d)

(e)

11
How do they compare on the numbers of inquiries about doctoral

education that they have had?

H,: There is no significant difference between institutions that are
proceeding with a doctoral program and those institutions that are not in
the average annual number of inquiries received about doctoral
education.

How do they compare in regard to problems with hiring doctorally-

prepared faculty?

Ho: There is no significant difference between institutions that are
proceeding with a doctoral program and those institutions that are not in
the opinions of their administrators about difficulty in hiring doctorally-

prepared CLS faculty.

How do they compare in regard to the numbers of master’s degrees

granted annually?

Ho: There is no significant difference between institutions that are
proceeding with a doctoral program and those institutions that are not in

the average annual number of masters degree graduates.

12
(f) How do they compare in the number of master’s graduates that go on to

doctoral study?

Ho: There is no significant difference between institutions that are
proceeding with a doctoral program and those institutions that are not in
the average annual number of master’s degree graduates going on to

doctoral study.

fin' ' f

The following operational definitions will be used:

Academic clinical laboratory science program or clinical laboratory science
program: programs sponsored by accredited colleges or universities offering a

bachelor’s degree in clinical laboratory science.

Accredited clinical laboratory science programs: formal programs of study in
clinical laboratory science that are accredited by the Committee on Allied
Health Education and Accreditation (CAHEA) of the American Medical
Association. Students graduating from such programs are eligible for

certification examinations and may earn a professional certificate (credential).

0f

13
Clinical Laboratory Science: used synonymously with medical technology

(MT), medical laboratory science, and medical laboratory technology to refer to
the allied health profession whose scope of practice encompasses the
deveIOpment, performance, and monitoring of chemical, biological, and
physical laboratory analyses performed on blood or other body fluids and used
for the diagnosis, monitoring, and treatment of disease. Practitioners are

known as clinical laboratory scientists (CLSs) or medical technologists (MTs).

Director: used synonymously with program director or chairperson; an
administrator within the CLS academic unit; usually the department chairperson

or the identified chief administrator of the master’s degree program in CLS.

Dean: the administrator immediately superior to the director as defined herein,
and outside the CLS academic unit, to whom any requests to institute a

doctoral program must be sent.

Doctoral degree: encompasses all post-master's degrees conferred by
accredited institutions of higher education including doctor of philosophy
degrees (PhD) and professional doctorates such as the doctor of medicine
(MD), doctor of public health (DrPH), doctor of nursing science (DNSc), doctor

of arts (DA), and doctor of education (EdD).

14
External funding: sources of revenue for CLS programs outside the university

or health science center in which the program is located.

Hospital availability: access to clinical specimens for research purposes by an

affiliation of some sort with a hospital or other diagnostic laboratory.

Professional credential: a certificate or other recognition that an individual has
met the standards of a professional certifying body; eg. MT(ASCP) or
CLS(NCA) for clinical laboratory scientists, RRT for radiographers, RN for
nurses. For the purposes of this study the academic designations MD and
thD will be considered to be professional credentials as well as
professional doctorates. Licenses will not be considered professional
credentials as licensing is a governmental, and not a professional sanction of

an individual’s credentials.

CHAPTER II

Review of the Literature

The review of the literature supporting this research project will encompass
three areas pertinent to doctoral education for clinical laboratory scientists
(CLSs):

1) the history of the development of doctoral education in the United States:
2) the development of doctoral education in nursing; and

3) graduate education in clinical laboratory science (CLS).

The history of graduate education in the United States has been carefully
reviewed and documented by others (Berelson, 1960; Eells & Haswell, 1960;
Prior, 1965; Simpson, 1983; Spurr, 1970; Walters, 1965) who provide the
general references for this summary. it is not the intent here to detail this
history, rather to highlight significant events, persons, and institutions as may
be pertinent to the development of graduate education in the profession of
clinical laboratory science (CLS). This discussion will therefore be only a brief

description of the history of the doctoral degree in the United States (US).

15

16
The development of graduate education in the United States has been

divided into five eras (Berelson, 1960):
(a) The Pro-history: to 1876
(b) The University Revolution: 1876-1900
(c) Consolidation and Standardization: 1900-World War I
(d) Growth and Diversification: World War I to World War II
(a) Revival and Reappraisal: World War ii to 1960
A sixth era apparent since Berelson’s writing, Pluralism and Innovation: 1960

to the present, will also be discussed.

W

The educational system of the early United States was quite naturally
built upon an English model. It consisted of elementary and secondary
schools. The colleges did not have graduate schools, but granted bachelor’s
degrees (BA) in the classical curriculum of the arts. This could be converted to
a master's degree three years after graduation by maintaining acceptable
behavior and paying a fee; thus an unearned degree. The master’s degree
was of value, however, because it conferred upon its holder the right to teach
at the college level.

Walters (1965) cites five reasons for the failure of US. colleges to
develop graduate schools in the early 1800s. At that time the US. was mostly

a rural society with little demand for advanced education and an overt distrust

17
of intellectual pursuits. Since the country was so young, there was no scholarly

tradition. The existing colleges were founded on the English model which
provided a classical curriculum to only a few affluent students. The curriculums
were rigid and designed to prepare only teachers and clerics.

Since advanced education was not available at home during the 19th
century, US. students went abroad. The young country had only recently
earned its freedom from England, so going to Germany was preferred. As
well, the quality of advanced studies in Germany, especially in science,
exceeded what was available in Britain. Research-oriented doctoral degrees
were developed in Germany early in the 18009 under the direction of Wilhelm
von Humbolt. Doctoral degrees were not instituted at British universities until
after World War I.

By 1850, 200 Americans had studied in Germany. The significant efflux
continued throughout the century with 22% (446) of the foreign students in
German schools in 1891 being from the US. (Simpson, 1983). It is estimated
that nearly 10,000 Americans studied in German universities between 1865 and
1910 (Walters, 1965). Though not all such students earned degrees, half of the
10,000 were studying for the PhD; not degrees in medicine, law, or theology.

Some students who had earned PhDs in Germany retumed home to
prominent positions in US. colleges. They brought with them the philosophy
of freedom and the methods of instruction used in the German schools and

sought to create comparable doctoral programs in the US. Among these

18
pioneers were Theodore D. Woolsey, president of Yale from 1846-71; Francis

Wayland, president of Brown University from 1827-55; and Henry Tappan,
president of the University of Michigan from 1852-63. Their efforts were
generally of limited success.

Late in the 1850s, John Porter, a member of the faculty of Yale, led the
first successful effort to institute graduate education in the US. Porter, who
had studied chemistry under Liebig at Giessen in Germany, appealed to the
Yale corporation to create a Doctor of Philosophy degree at the Sheffield
School of Science.

The Faculty further request of the Board that the degree of W

Ehjlgsgphy be instituted and in accordance with the usage of German

Universities be conferred on those students who have successfully

pursued the above-named higher course of scientific study....lts

institution would remove a disadvantage under which our Department of

Philosophy and the Arts labors in comparison with similar departments

of German Universities. The degree which they offer is an inducement

which we do not present. its establishment here would, in the opinion of
the Faculty, enable us to retain in this country many young men, and
especially students of Science, who now resort to German Universities
for advantages of study no greater than we are able to afford. (Eells &

Haswell, 1960, p. 28)

19
The Corporation approved the request and in 1861 three students graduated

with Doctor of Philosophy degrees, the first granted by a US. institution.
Despite this achievement, graduate education in the US. was not fully
accepted. As with master’s degrees, the value of the doctoral degree was
undermined by the granting of unearned doctorates, honorary doctorates and
even bogus doctoral degrees. These problems persisted throughout the

remainder of the 19th century, but in 1876 an important milestone was attained.

Th niv ' l ' n: 1 7 1

In 1876, Johns Hopkins University was founded under the direction of
Daniel Coit Gilman. It was truly innovative and strategically planned to avoid
some of the problems faced by well established institutions in trying to
inaugurate graduate studies. Gilman and the sponsors of Johns Hopkins
sought to establish a university that was independent of the influence of church
and state. Further, to avoid the resistance posed by the vested interests of
undergraduate faculty, they instituted a graduate-only university simultaneously
freeing Johns Hopkins from the influences of the arts and the classical
curriculum. They rode the theme of the times in developing a university
devoted to the application of research to solution of social problems. The
faculty were selected for their research abilities, not teaching abilities. Gilman

also instituted fellowships to attract students of promise and to stem the loss of

[A

20
students to Germany. The result was a graduate school of unequaled stature

setting the standards for graduate education in the US.

Following a similar design, Clark University and the University of Chicago
developed graduate schools without undergraduate colleges. Spurred by these
successes, established institutions such as Columbia, Harvard, and Cornell
were encouraged to continue their developments of a German-style graduate
school atop their English-style undergraduate college. Though the transition
was difficult in all cases, graduate universities took hold in these and other
institutions during the last quarter of the 19th century. The quality of the
programs improved and students began staying home instead of going
abroad.

Still, problems existed for universities seeking to develop doctoral
programs. At the close of the 19th century, most faculty of state colleges were
clergymen who had failed with congregations. They did not teach single
subjects but multiple ones within the traditional classical curriculum. However,
since they did not have a research background, they were not prepared to

teach in the university. Doctorally-prepared faculty were a distinct minority.

i ' n n i ti n' W n W I
In 1900, the graduate programs had become well established in many
institutions, however, there was little consistency among institutions’

requirements for the doctoral degree. Further, there was concern that small

ins
no
we
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bc
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Cl.

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21
institutions seeking to join the growing demand for graduate education could

not provide a high quality program. Lastly, U.S. educated undergraduates
were not being accepted into foreign, especially German, graduate programs.
To address these concerns, the American Association of Universities (AAU) was
born. The presidents of the universities at California, Chicago, Columbia,
Harvard, and Johns Hopkins invited their counterparts at Catholic University.
Clark, Cornell, Michigan, Pennsylvania, Princeton, Stanford, Wisconsin, and
Yale to a meeting to discuss these and other problems of graduate education.
The topics addressed by the AAU in those early years have become
regular topics for subsequent, similar organizations. Their concerns included
'...the nature of the dissertation, the meaning of research, the conditions of
fellowship awards, admission requirements, preparation for college teaching,
the role of the master’s degree and the foreign language requirements'
(Walters, 1965, p. 16-17).
In these years the members also discussed such contemporary topics
as outside remunerative work by professors, the summer school and
graduate work, the relation of academic and professional doctorates, the
organization of research activities, research professorships, cooperation
with industry, and the graduate school’s failure to create a ’society of
scholars’ within itself (Berelson, 1960, p. 19).

The AAU never sought to accredit graduate schools, though it did create a list

22
of I'approved'I undergraduate institutions used by foreign graduate schools in

considering applicants.

Other associations concerned about graduate education developed
during this period. The National Association of State Universities and the
Association of Land-Grant Colleges and Universities sought similar ends as the
AAU but represented institutions where newer disciplines were emerging,
especially the more practical disciplines such as agriculture. The American
Association of University Professors brought faculty, not just deans and
presidents, into the discussion on standards of graduate education.

Another influence on graduate education during this period was from
outside the university community. Philanthropic groups, especially the
Carnegie Foundation, in setting standards for grant recipients, required the
recipient institution to have at least six doctoral-level faculty. The result, of
course, was that the demand for doctorally-prepared faculty increased.
Similarly, accrediting agencies set standards for doctorally-prepared faculty.

So the demand for doctoral graduates as faculty for universities increased.

n ' ' ti ' rl
Following the first world war, the number of students seeking doctoral
education increased dramatically. Simultaneously, the number of institutions
offering the degree also increased. Part of the impetus for students to seek

advanmd education was the broadening demand for doctorally-prepared

fl

SI

nl

pr

pr

researchers. Industry and government had discovered the value of the PhD.
Though most graduates still became faculty members of universities, increasing
numbers of graduates were finding positions in industry and government. The
result was a significant change in the primary site of research in the US. Prior
to 1900, virtually all research, especially basic research, was conducted at
universities. By the 1930s, universities employed the minority of researchers.
The change in the primary employer of PhD graduates affected the look
of the degree since industry and governmental employers had different views of
what graduate work should entail. Where traditional graduate studies
emphasized independent work for the dissertation, industry and government
required employees who could work cooperatively. Similarly, the development
of a specific skill for the dissertation was less important to these new
employers than a thorough understanding of the fundamentals of the science
and creative thinking to apply the science to the solution of new problems.
Also during the period between the wars, the emerging professions
discovered the value of doctoral work. Though some ‘professional" doctorates,
such as the Doctor of Education (EdD). had been developed earlier, the
number of new degrees increased significantly during this era. Typically,
professional doctorates are meant to prepare expert practitioners in a
profession such as business administration (DBA) or public health (DrPH).

They are comparable to the classical doctorates in medicine and law. They are

24

generally granted by the appropriate school or college, not the graduate
school. Thecurriculum differsfromaPhDinthesamefieldinti'latthe
professional degree does not have a language requirement, may require more
course work, and does not require the original research project, though a
substantial project may be required. The latter requirement means that the
catalog descriptions of the PhD and the related professional degree were often
not clearly different. Ashton (1965) considers the professional degrees to meet
a purpose 'parallel and non-competitive with the PhD' (p. 17). To this day, the

PhD designation has been reserved for 'professional" preparation in research;

essentially focussing on process, not content.

 

During the period of remarkable economic expansion in the US.
following World War II (WWII), doctoral education also grew. The impetus here
was money, much of which came from the federal government. It had become
clear during the war that graduate education was a national security issue. The
GI Bill, and graduate fellowships from the National Science Foundation (NSF)
and National Institutes of Health (NIH) fueled the increased interest in graduate
education. Simultaneously the numbers of fields offering a PhD grew, as did

the number of professional areas.

IA

25
W

A review of the agendas for the annual meetings of the Council of
Graduate Schools in the United States from its inception in 1961 to the present
provides insight into the factors affecting graduate schools in the last three
decades. Two facets repeatedly appear in the meeting proceedings: Issues of
pluralism and innovation.

The 1960s brought a decade of social change and unrest to the United
States. The universities were at the center of student protests against racial
injustice and the war in Southeast Asia. The make-up of the student population
in graduate schools began to reflect increasing numbers of African-Americans
as the civil rights movement improved their opportunities in education and
employment Following closely behind was the women’s movement and the
number of female students also increased. U.S. universities became the
universities of choice for international students, in an ironic contrast to the
previous century. Non-traditional and part-time students added to the variety of
peOple entering graduate schools with needs, beliefs, and attitudes that were
different from the traditional full-time, white male students of previous eras.

The most recent decades were also marked by innovation in curriculum
and administration of graduate programs. Residency and foreign language
requirements began to be recognized as anachronistic. Alternate modes of
administering programs led to a new concept of I'campus". Extemal degree

programs, interinstitutional programs, and industry collaborations meant that

suit
The

fha‘

26

students were no longer physically on campus as they had been previously.

The introduction of communication technology such as teleconferencing meant

matsmdentscouldearnadegreewimouteversetfingfootonmeuniversity

campus.

Summer

The history of the development of doctoral degrees in the U.S. is

summarized in Table 1. The evolution of doctoral degrees in the United States

Table 1

Comparison of the histories of the PhD in the United States (PhD in U.S.),
doctorates in nursing (Doc in Nurs.), and doctorates in clinical laboratory

science (Doc in CLS)

Master’s degree-
prepared faculty

Period of borrowed
PhDs

Concern for quality
of doctoral programs

Debate about PhD vs
professional doctorates

Federal support for
doctoral programs

Outside pressures for
doctoral faculty

PhD In
U.S.

Prior to 1850;
predominant
into 1900s
From Germany
until 1876
1900. AAU
founded

since 1900

after WWII

grant agencies

in 19003

Doc In
Nurs.

Prior to 1950;
predominant
into 1970s
From other
disciplines
until 19603

19808

since1960s

after 1960

National
League for
Nursing

Docin
CLS

predominant
Into 1980s

From other
disciplines
into 1990s

27
began with borrowed degrees from Europe. Once doctoral degrees were

established in the U.S., quality was an issue for nearly a quarter of a century.
Demand for doctoral-degree graduates came from outside the universities.
Programs began to flourish only after the U.S. government provided financial
support, seeing the value of doctoral-degree graduates for its own purposes.
Most recently, graduate schools have responded to the needs of an
increasingly diverse student population of minorities, women, and international
students. Graduate programs have become more creative in the methods of

administration in part to meet the needs of these new student populations.

WW9

As will be seen in the following section, doctoral education for clinical
laboratory science (CLS) is barely in its infancy. It is valuable, therefore, to
look to examples outside of CLS, but similar enough to provide insights that
may predict future events in that profession. The literature in nursing was
reviewed and has been selected for this comparison.

As an identifiable health profession, nursing is approximately 80 years
older than CLS. Nursing is usually classed separately from the allied health
professions like clinical laboratory science, physical therapy, and radiology

technology. Yet there are many similarities making the evolution of nursing, as

28

the older profession, an example for the newer ones such as CLS. Nursing is
primarily a profession of women that developed from a practical orientation,
later moved educationally into the academic environment, and still has multiple
educational routes leading to the professional credential. Nursing has
struggled to develop an identity and body of knowledge distinct from the
practice of medicine. In these ways, nursing is very like CLS. Perhaps the
greatest difference between nursing and CLS is that nursing has far more
practitioners. Still, the well documented educational development of the
nursing profession may provide insights into the doctoral development in CLS.
As with the development of the PhD in general, the history of the
developmental changes in education of nurses has been well documented by
others (Grace, 1978; Matarazzo, 1971; Matarazzo 81 Abdellah, 1971; Murphy,
1985). This review of the literature is summarized in Table 1 and will be cited
when applicable to the history of doctoral education in CLS. However, the
literature on the development of doctoral programs for nursing contains several

especially pertinent articles that deserve a detailed review.

r th I m nt f D P N i

An important study was reported by Leininger in 1976. She surveyed 58
nursing schools that offered graduate nursing programs accredited by the
National League for Nursing. She inquired about present and planned doctoral

programs for nurses, the type of degree offered or planned, financial support

29
for doctoral programs and students, projected needs for graduates of such

programs, on—going research to support doctoral study, and faculty preparation
for supervising graduate students. She had an 80% response rate.

Leininger found that there were ten nurse-scientist programs whose
federal support was scheduled to end in 1976. The nurse-scientist programs
were federally-funded, PhD programs in disciplines such as physiology or
microbiology, but especially designed for nurses. She reported 14 other
existing programs at 13 institutions leading variably to a PhD, EdD, or the
professional Doctor of Nursing Science (DNSc) in nursing or nursing
subspecialties. Twenty-two new programs were planned for initiation by 1980.
Only one of these was the conversion of a nurse-scientist PhD into a doctorate
in nursing. The remaining 21 were planned at institutions that did not
previously have doctoral programs. Twelve of the 21 planned to offer a PhD in
nursing, eight would offer a DNSc, one would grant a Doctor of Arts (DA) in
nursing and the remaining one was undecided at the time of the study.

Analyzing Leininger’s data further shows that virtually all respondents not
offering a doctorate in 1976 (n=23) planned to do so by 1980. As noted
above, 20 of the planned 21 new programs were at institutions not offering
doctoral education in 1976. Wrth 21 new programs planned, one program
converted from nurse-scientist, nine nurse-scientist programs closing and 14
programs continuing, Leininger predicted that there would be 35 doctoral

programs for nurses in 1980. As noted by Murphy (1981), 22 programs

30
actuallyexistedin1980. Assumingthattl're14non-nurse-scientistprograms

emblishedprlorto1976didnotclose, only8011he21actuallycameto
fruition. ThisisnotsurprislnginlightofotherresponsestoLeininger’ssmdy.

Eighty-nine percentofrespondentsassertedthatstatefundswerenot
sufficienttosupportanursingdoctoralprograminthelrinsfitution. Deansand
directors estimated a morethanthreetoone probabilitythattheywould not be
abletofindadequatefunding. Respondentswhoaireadyoffereddoctoral
programs estimated direct costs for their programs from as little as $20,000 to
as much as $354,000 for fiscal year 1972-73, and all but two received some
federal funds to support the program.

Thirtyofthe46respondentsdid not beiievetheyhadanadequate level
ofon-going nursing researchintheirinstitutiontosupportdoctoraleducation.
It cannot be discerned from the report which instimtions these were.
Presuming that the 14 programs established prior to 1976 did have adequate
on-going funding, they would not be part of the 30. The 21 institutions with
proposed programs, or at least most of those planning to proceed with
program initiation, apparently did not believe they had adequate on-going
research or funds to support such a program. Hence, it is little wonder that
only 8 of the planned 21 programs were actually initiated by 1980.

As reported by Leininger, the major needs or priorities related to
doctoral education for nurses were, in rank order, (a) well-prepared faculty to

conduct research and to teach in graduate programs, (b) nursing researchers

31
and research, and (c) institutional funds to support doctoral programs in

nursing.

In 1978, the American Association of Colleges of Nursing (AACN)
reported the results of a survey similar to Leininger’s conducted among their
member colleges. They reported 20 programs that would have students
emailed by the end of 1978; 14 of these awarding the PhD; 5, the DNSc; and 1,
the EdD. Twenty-eight schools described being in various stages of approval
or planning for doctoral programs. The AACN predicted from the survey data
that there would be 50 doctoral programs by the end of the century. In 1988,
Downs reported that there were already 45.

Shores (1986a) studied the process used for making a decision to
initiate a doctoral program in nursing. She surveyed 25 of the 27 programs
existing in 1986. Nineteen usable survey instruments were retumed. The
instrument asked respondents to indicate the degree of importance that each
of 21 factors held in the decision to initiate a doctoral program. Shores was
looking for differences between programs that initiated PhD degrees vs
professional doctorates. She found few differences. Perhaps the most
significant was that for programs opting for the professional degree, the
influence on this decision from groups outside the school of nursing was
significant (57% reported this influence), while of those initiating PhD programs,

only 8% reported a significant outside influence on this decision.

32

From the responses, Shores developed a list of 16 recommendations
she felt should be considered in the development of prospective programs.
Among the recommendations were:

1. PhD and professional doctoral programs in other disciplines should

be present on your campus before initiation of a doctoral program.

2. Your school of nursing should be affiliated with a medical center

(hospital with 500 or more beds and several specialties) before doctoral

program initiation.

3. You must be certain of your college/university administration’s support

for the doctoral program.

4. Give first priority to securing an adequate number of highly qualified

faculty... (1986a, p. 29)

The nursing literature is replete with recommendations of this sort,
(Cleland, 1976; Murphy, 1984; Shores, 1986b; Starck, 1980) thoughoften

relying on non-empirical sources.

Summary

The use of nursing as an examme for the development of doctoral
degrees for clinical laboratory scientists is illuminating. It provides
recommendations on resources needed and the decision making process

regarding initiation of doctoral programs. The historical view provided by the

33

literature will provide an interesting comparison to clinical laboratory science as

doctoral programs in the latter profession continue to develop.

IE tinIr lini IL rt

Clinical laboratory science (CLS) is the allied health profession
concerned with diagnostic laboratory testing. The phrase 'clinical laboratory
science" is used interchangeably with “medical technology'. The scope of
practice in CLS extends from fire selection of the test to be ordered on a
patient through the test performance and back to the interpretation of the test
results. It includes collection of an appropriate specimen; proper handling and
preparation of that specimen; development, evaluation, selection,
implementation, monitoring, and performance of assays and methods;
reporting of results and interpretation of same. The role of the medical
technologist extends to the management and administration of laboratory
services and the education and training of practitioners in all levels of practice.

In order to understand the evolution of graduate education in CLS, an
appreciation of the historical development of the profession’s educational
system is valuable. The most complete history of the development of the

profession is available in Williams’ Intrmggign to the Prgffisim gf Mama!
My (Lindberg, Britt & Fisher, 1984), the major source for this summary

34
of the development of educational programs in CLS. Special attention will be

given to the primary literature on graduate and doctoral education.

 

During the latter quarter of the nineteenth century when nursing was first
evolving as a profession and doctoral education in the U.S. was taking hold,
the profession of CLS was just emerging. The science of laboratory medicine,
pathology, was beginning. Though most hospitals did not have laboratories
and few physicians performed laboratory testing, some pioneered in the
development of laboratory tests. As early as 1844, Dr. Douglas was teaching
laboratory examinations to other physicians at the University of Michigan. Dr.
William Welch established a laboratory at Bellevue Hospital in New York in
1878 and at Johns Hopkins University in 1885. By the end of the century,
clinical laboratories were being established in the hospitals and universities of
most large cities.

During this early developmental period, laboratory testing was performed
by physicians and especially medical students and interns. However, some
physicians began to train technicians to assist in the laboratory procedures.
According to Lindberg, et al. (1984), the 1900 U.S. census listed 100
technicians, all male but not all laboratory technicians. Physicians who

35
specialized in laboratory testing were known at this time as ‘specialists' or

'technicians', and may well be those counted in the census.

In 1915, the Pennsylvania legislature enacted a law requiring all hospitals
to have an adequate laboratory and to employ a full time technician, not
necessarily a physician. There were few technicians available to fill this
requirement. As a result, more physicians began to train technicians.
Typically, the nurses and secretaries of the hospital and laboratory were
recruited as students. This pattern spread to other states where hospitals
increasingly demanded that physicians with an interest and knowledge of
laboratory examinations direct the laboratory. They, of course, needed
technicians to perform the assays.

The first formal training program for laboratory technicians was
established in 1916. Dr. John Kolmer of Philadelphia instituted the program to
comply with the Pennsylvania statute. By 1918 there were 75 graduates, all
women.

A formal training program was established at the University of Minnesota
in 1922. A baccalaureate degree was offered in 1923 and by 1926 there were
13 graduates.

Pathologists had formed a professional organization early in the 1920s.
The American Society of Clinical Pathologists (ASCP) addressed the need for
qualified laboratory technicians, probably in part due to Dr. Kolmer’s influence
as president of the organization. In 1928, the ASCP issued a report of its

36
Committee on Registration of Laboratory Technicians detailing a

recommendation for a standardized course of study for medical technicians
and further recommending that a registry be established. Later in that year, the
Registry of Medical Technicians was established to certify individuals meeting
basic training requirements and to register schools providing approved training.

The Registry established two levels of laboratory practitioners. “Medical
technologist“ was the title given to persons possessing a baccalaureate degree
and completing one year of laboratory experience. “Medical technician" was
the title to be used by certificants with a minimum of a high school education
and six months of laboratory experience.

In 1933, the Registry issued its first list of approved schools. The 34
schools listed varied considerably in their admission requirements, however.
Interestingly, the Registry did not require completion of one of these approved
programs in order to be eligible for certification. Still, the Registry did hope to
persuade colleges and universities to include four-year baccalaureate programs
or two-year certificate programs. They proposed a baccalaureate curriculum
including two years of general education and basic science preparation,
essentially a premedical program, followed by one year of basic medical
sciences, with the fourth year spent gaining clinical laboratory experience.
Indeed, this became the model for the design of most CLS programs into the
1960s.

37
Following this model, universities and colleges offering CLS programs

did not have to revise their course offerings to any significant degree. The
courses needed in preparation for the clinical practicum were the general
courses to be offered to students in other majors and provided by the faculties
of those departments. This was so even for the third year courses in medical
sciences such as physiology, biochemistry, and microbiology. The laboratory-
specific education was provided by practitioners and pathologists during the
hospital practicum. As a result, and in distinction to nursing (Lenz & Morton,
1988), no clinical laboratory scientists (CLSs) were needed as part of the
campus faculty. Hence, the profession of CLS did not experience the
pressures to gain advanced education that influenced both academic faculties
in general at the turn of the century, and nursing during the post-war periods.
In 1933, ASCP established the Board of Schools to accredit the
laboratory component of educational programs. Until nearly 1970, the
predominant structure of educational programs remained in the 3+1 format first
proposed in 1928; that is, three years of academic preparation on the college
campus and the fourth year in a clinical laboratory. However, program
designers in the post-war period began to look at this design and propose and
institute alternative formats. Lindberg et al. (1984) wrote that in 1968, the
Board of Schools was encouraging such innovation. Lindberg et al. also note

there was no need for the Board of Schools to accredit graduate programs

38

since, as academic programs, these would be accredited by the appropriate
academic accrediting agencies.

Among the modifications being proposed in the 1960s for the
undergraduate program was integration of the clinical experience into the
academic portion of the curriculum. Some of this could be accomplished by
providing didactic instruction in laboratory sciences on the college campus.
However, to do so would require faculty with laboratory expertise. not typically
found within traditional academic departments. As a result, CLSs were hired by
academic institutions as faculty to teach the clinical laboratory courses. This
trend accelerated in the 1970s and 19803 with more and more so called
“integrated programs“ being developed.

As Williams (1971) noted, 'The need for advanced degrees for medical
technologists has markedly increased as the scope of laboratory medicine
broadens. The opportunities for employment are primarily in the areas of
supervision, teaching, and specialization' (p. 33-34). Heinemann (1969), in
discussing the role of the university in CLS education, listed expectations for
university and college faculty. The list is most significant in that research was
not listed among the activities expected of faculty. Yet, as time went on CLS
faculty found themselves facing the same demands for promotion and tenure
as other academic faculty. In the 1970s it was often adequate in an academic
position to hold a master’s degree, thereby possessing a degree more

advanced than the students were seeking. However, the pressures on CLS

39
programs to compete as academic units with others possessing largely

doctorally-prepared faculty led CLSs to pursue doctoral degrees. Laboratories
also hired increasing numbers of doctorally-prepared scientists, not physicians,
to direct and manage departments within the clinical laboratory, especially
clinical chemistry and clinical microbiology departments.

By 1982, the paucity of doctoralIy-prepared CLSs was a significant
problem for academic institutions. Speaking at a national symposium on CLS
education, Mary Lee Seibert, Dean, College of Allied Health Professions,
Temple University, discussed the problems of finding doctorally-prepared
individuals to be faculty members in academic CLS programs (Seibert, 1985).
As determined by the 1987-88 salary survey conducted by the American
Society of Allied Health Professions (American Society of Allied Health
Professions, 1989), doctoral-level CLS faculty were still a minority with 60%
holding master’s degrees and only 21% holding doctorates.

;. To meet the need for doctorally-prepared faculty, academic CLS
programs have hired non-CLSs, especially in clinical chemistry and clinical
microbiology. It is similar to nursing hiring non-nurses to teach nutrition or
psychology (Lenz and Morton,1988). The difference lies in that nursing used
non-nurses to teach supportive sciences, not nursing courses. CLS has had to
rely on doctorally-prepared, non-CLSs to teach the professional courses.

In 1988, the House of Delegates of the American Society for Medical
Technology (ASMT) approved a position paper, “Future Directions of Clinical

40
Laboratory Science Educational Programs“. (ASMT, 1988) A constituency

within the organization realized that the continued viability of academic
programs depended on the success with which the faculty could achieve
academic promotion, compete for research funds, and publish their works.
Believing that support from the professional organization was important for
these goals, the paper included the following recommendations:

1. Programs should utilize faculty with appropriate levels of education
and experience for the courses they teach...

3. Programs should assure that faculty are cognizant of their function
as role models and encourage activity in research, publication,
consultation and community service...

6. By the year 2000, the terminal degree in the clinical laboratory
science field will be the doctorate. Programs should encourage
and assist all faculty in obtaining doctoral degrees. (p. 6)

The last point was especially controversial. During discussion, It was
suggested that the last statement be a requirement for a PhD or even a PhD in
CLS. The latter was rejected since only two doctoral programs in the
profession existed in the U.S. at that time, so the generic “doctorate“ was
retained as the final recommendation.

In June, 1989, the House of Delegates of ASMT approved another

position paper “Doctoral Education in Clinical Laboratory Science“ (ASMT,

1989). Noting the existence of only two doctoral programs in the profession

41
and comparing that to nursing and physical therapy. the paper states “...there

is an undersupply of advanced programs in clinical laboratory science
particularly at the doctoral level“ (ASMT, 1989, p. 2). The paper also notes the
“borrowing“ of doctorates from other disciplines by CLSs and the problems
related to this.
Graduate education is available in some of the different disciplines and
provides specialists in each of those disciplines. These specialists, once
established in the separate disciplines, may no longer choose to identify
themselves with clinical laboratory science parse, resulting in a loss of

future researchers, educators and leaders. (ASMT, 1989, p. 2)

The paper describes a curriculum outline for doctoral studies.
Analogous to nursing’s search for a “theory of nursing“, the paper recommends
emphasis in “clinimetrics' for doctoral programs that, for institutional reasons,
must distinguish their offerings from the related sciences of microbiology,
biochemistry, etc. The paper describes in general terms the resources
necessary to establish a doctoral program:
Such resources, include, but are not limited to, a faculty that is doctorally
prepared and qualified to teach and supervise doctoral-level research, a
library with all the services and materials necessary to support research
activities of both students and faculty, suitably equipped research space,

42
financial aid for graduate students, and accessible clinical facilities and

materials to support clinical research. (ASMT, 1989. p. 4)

Among the final recommendations of the document is the following
description of the status of doctoral education in 1989:

Given the need for doctoral level clinical laboratory scientists, it is
important to support existing graduate programs in Clinical Laboratory
Science, both at the master’s and doctoral levels.

Because there are only a few available doctoral level graduate
programs in Clinical Laboratory Science, it is essential to support the
development of new graduate programs in those institutions capable of

implementing such programs. (ASMT, 1989, p. 7)

r E ' nf r lini l r t

The reported literature on graduate education for CLSs is sparse. It will
be reviewed chronologically to provide comparison to the previous historical
description.

In 1966, the National Council on Medical Technology Education of the
National Committee for Careers in Medical Technology (Heinemann, 1967)
conducted an informal survey of the graduate study interests of CLSs.
Supported by a grant from the Cancer Control Division; Public Health Service;
Department of Health, Education and Welfare, Heinemann randomly selected

43
223 CLSs who were members of the American Society for Medical Technology.

Half of these subjects were teaching supervisors, presumably in clinical
programs, and the others were non-teaching technologists. An additional 50
surveys were completed by persons attending the conference of the National
Council on Medical Technology Education. The survey inquired about pursuit
of graduate education, major and degree. financial support, preferred area of
study, and satisfaction with graduate studies.

The survey was returned by 73 of the 111 teaching supervisors and 39
of the 112 non-teaching supervisors for a return rate of 66% and 39%,
respectively. Twenty-one responses were received from the 50 conference
attendees.

Twenty-six percent of the teaching supervisors and 13% of the non-
teachers possessed advanced degrees. One teacher and two non-teachers
possessed doctorates. An additional 23% of the teachers and an equivalent
percentage of the non-teachers were working toward graduate degrees. FIVB
teachers and one non-teacher were working toward doctorates.

Heinemann combined those subjects already possessing graduate
degrees with those in process for a total of 36 teaching supervisors and 14
non-teaching subjects. Seventy-seven percent of the teaching supervisors held
or were pursuing graduate degrees in the sciences, such as biology,
chemistry, or microbiology. The remaining degrees were in education (17%)

and management/administration (6%). All of the non-teaching subjects were

44
pursuing or possessed a graduate degree in a science supporting laboratory

medicine, though two of these sought minors in education.

Nearly three-quarters of both teachers and non-teachers reported
satisfaction with the degree program. However, the most frequently cited
deficiency was the lack of a laboratory or medical orientation in the course of
study. The teachers also noted dissatisfaction with graduate programs that did
not prepare them directly for teaching assignments.

Most of the students in both groups attended school on a part-time
basis. Fifty-six percent of the teaching supervisors reported receiving financial
assistance. For more than half of those it was in the form of a faculty
appointment providing special tuition and fee allowances. Nearly one quarter
of the teachers reported part-time employment and 17% reported support from
scholarships and fellowships. More than one third of the non-teaching subjects
reported support from scholarships and fellowships.

Heinemann reported results for all respondents relative to interest in
graduate education, not participation. Interest in majoring in one of the
supportive sciences was preferred, though some interest, mostly from teachers,
was noted in education. Respondents indicated interest in courses taught in
non-traditional formats, such as shortened summer courses. They cited
inability to gain time away from work as the biggest hinderance to graduate

study, with financial concerns and family commitments named secondarily.

45
When asked about the devel0pment of future graduate programs, the

majority of respondents preferred an emphasis in laboratory management or
administration. “There is limited interest in an advanced degree in medical
technology“ (Heinemann, 1967, p. 510). However, combined programs with a
major-minor combination of both sciences and education or sciences with
management were also suggested.

Heinemann’s study is, by her own report, “informal“. The subjects were
selected from a subset of CLSs participating in a professional association. As
such, they are probably not representative of CLSs in general. It is doubtful
whether they are even representative of CLSs who would be interested in
graduate studies. There may be many graduate-education-oriented CLSs,
especially those seeking doctoral preparation as research scientists, who do
not affiliate with the general professional organization. Therefore, generalization
from this data would be risky.

Heinemann’s report is confusing in that it is never clear how the twenty-
one responses from the conference participants were incorporated into the
data, thus creating further lack of trust in the representative nature of the
results. However, it is apparent that by 1966, teaching supervisors were
probably seeking graduate education in higher numbers than non-teaching
CLSs. This is consistent with Williams’ 1971 reference to the career value of

graduate education.

46
Referring to her own 1967 report, Heinemann writes in 1969 “Continuing

education is more than short courses and workshops. It is also graduate study
for advanmd degrees.“ (p. 497) However, she makes no other mention of
graduate study in this report on the role of colleges and universities in CLS
education.

Writing again in 1971, Heinemann reports on continuing education for
CLSs. She cites the 1967 report of ASMT's Education Committee. The report
suggested the development of more graduate programs in CLS. Although
Heinemann continued her review of continuing education for CLSs, no further
reference to graduate education was included except a quote from Ruth French
in an unpublished institutional document where French states, “The purpose of
continuing education activities for the allied health professions personnel...shall
be to:...4. Provide means for individuals to increase their academic attainment
through course work applicable to bachelor’s and/or advanced degrees“
(Heinemann, 1971, p. 151). However, the major emphasis of Heinemann’s
1971 paper was on non-credit educational activities.

In 1982, Rausch, Barlzack, Catchings, Howard, and Pruden (1982)
published the “Report of the Topic Study Group on Graduate Education in
Medical Technology“. This ASMT sponsored group studied ASMT members
possessing graduate degrees and inquired about level of degree, multiple
degrees, majors, reasons for pursuing graduate studies, benefits, and

problems.

47
Rausch, et al. surveyed 20% (461) of 2,305 ASMT members who

indicated that they possessed a graduate degree in 1979. This 20% of subjects
was randomly selected from the total population. Four hundred fifty seven
surveys were successfully mailed and 315 (69%) were retumed.

Ninety-nine percent reported that their first graduate degree was a
master’s degree. Fifteen percent of the respondents held a second degree.
These were nearly equally distributed between doctoral and master’s degrees.
The authors extrapolated to conclude that approximately 1% of active ASMT
members held a doctoral degree in 1979. More than 90% of these doctorates
were granted by graduate, not professional, schools. This probably under-
represents the number of CLSs pursuing graduate professional programs such
as medical school since such students and practitioners are likely to disaffiliate
with the generalist CLS professional association once they have embarked on
their second profession.

The data were analyzed by dividing the group of respondents into two
groups: graduates of the ASMT/Central Michigan University (CMU) external
degree program and graduates of all other programs. About one-fifth of
respondents were graduates of the former program that offers only
management and education majors. Of the non-CMU graduates, 2596 earned
their first degree in an area related to education, while 11% chose
management/administration. The remaining 64% majored in basic and clinical

sciences. The pattern of second degrees paralleled the first.

48
Most respondents pursued advanced education to satisfy a desire for

more knowledge. However, improved employment options and career
advancement ranked high, especially among the non-CMU graduates. The
CMU students may have already attained advanced positions in their
laboratories and chose the extemal degree program in order to continue in
their position while pursuing graduate work. This is consistent with the fact that
non-CMU students attained the tangible benefits of improved salary and
advanced positions more often than did the CMU subset who may already have
attained higher positions.

The factors affecting the selection of a particular program were the major
to be studied and the convenience of the location. The greatest problems
arose due to time constraints and problems of coordinating work and class
schedules. Most of the CMU students were part-time students, consistent with
the extemal design of the program. More than one-half of the non-CMU group
pursued full-time graduate studies. In the discussion, the authors cited the
following as contributing to the high-rate of part-time students:

The relative newness of graduate programs in medical technology, the

difficulties that young faculty members in medical technology have in

attracting research funds which could support graduate students, the
paucity of doctoral degrees held by medical technologists, and the lack
of independence in practice of medical technologists have an influence

on the matter of support for graduate education and students.

49
Institutions contemplating the offering of graduate programs in medical

technology should be sensitive to the needs of students for financial

assistance. (p. 941)

Though the study group was charged to develop recommendations
“...addressing resultant needs, issues and concerns...“ (p. 935) identified by the
study, the paper does not list such recommendations. The problems related to
graduate education are documented as above, but no remedial plans were
suggested and particular issues relative to doctoral education were not
identified.

As with Heinemann’s study (1967), the use of subjects affiliated with a
professional association limits the generalizability of the results. However, the
common notion that most CLSs earned their doctoral degrees in education was
not supported by this study. Further, the education-oriented majors are likely
over-represented in this study group since it is more likely that persons earning
science PhDs would disaffiliate with ASMT than educators who presumably are
teaching CLS even after receiving their advanced degree.

Rausch et al. and Heinemann found, that, into the 1980s, CLSs, like
nurses in previous decades, borrowed PhDs from other disciplines; a finding
that is not surprising since only two doctoral programs in CLS were in
existence.

For a journalistic-style article, Mendelson (1988) interviewed leading

members of ASMT for their opinions on doctoral education for CLSs. The

50
intenriewees reported their anecdotal understanding of the influences on the

development of doctoral programs. Karen Karni, Director, Medical Technology
Program, University of Minnesota. is cited as saying that academic faculty in
MT programs are under increasing pressure to gain grant funding, conduct
research, and publish the results. “Consequently, universities increasingly
expect MT faculty to provide credentials competitive with those of faculty in
other departments“ (p. 328). Kami is quoted later as saying, “If we are to
achieve recognition, power, and esteem - as a profession and as
professionals - we must compete successfully with colleagues. in medicine and
in the basic and applied sciences, who hold doctorates“ (p. 329). The article
also notes that only two doctoral programs in CLS existed in 1988, so most
practitioners pursuing graduate education were forced to earn degrees in other
disciplines. The article then briefly discusses the problems of implementing
new doctoral programs as described in ASMT’s position paper (ASMT, 1989).
Beck and Chamness (1990) report the results of a survey to determine
whether undergraduate CLS students are encouraged to pursue graduate study
and whether current undergraduate programs prepare students adequately.
They surveyed 50 academically-based undergraduate programs and 50
hospital-based programs. They also surveyed 116 graduate programs to
which CLSs might apply, including programs in chemistry, medicine, veterinary
medicine, clinical laboratory science, and microbiology. They had an 86%

return from the undergraduate programs and 76% return from graduate

51
programs. Most (64%) of the undergraduate program administrators report at

least moderate encouragement to students for graduate studies, with no
statistically significant difference between levels of encouragement from
academic vs. hospital-based programs. However, they estimate that less than
10% of their graduates actually go to graduate school.

The graduate programs surveyed were favorable toward admitting
students with the academic preparation of the average undergraduate MT
student, though in some cases, additional course work was requested before

final consideration.

Swat!

On the whole, the literature on graduate education for CLSs is sparse.
That devoted to doctoral education specifically is largely anecdotal with little
empirical support. The literature reviewed describes circumstances parallel to
those reported in the nursing literature and are summarized in Table 1 along
side the nursing summary. If nothing else, the increased interest in doctoral
education for CLSs, initiated by the two ASMT documents, has opened
discussion of the subject to a broader audience than was previously concerned

withit.

CHAPTER III
Methods

To answer the research questions posed in Chapter I, a survey method
was used. The study population, survey instruments, survey instrument

administration, follow-up procedures, and data analysis will be described.

Wm

it was assumed that clinical laboratory science (CLS) programs that
already offer the master's degree would be those most likely to develop the
doctoral degree. Similarly, programs that offer an undergraduate component
leading to the professional credential are expected to be most sensitive to the
professional issues motivating the development of doctoral degree programs.
Therefore, the academic CLS programs of interest are those that offer
undergraduate programs accredited by the Council on Allied Health Education
and Administration (CAHEA) of the American Medical Association and are
included in their directory (American Medical Association [AMA], 1989), and
that also offer a master’s degree for clinical laboratory scientists (CLSs).

The programs of interest were identified in three ways, since no single,
complete listing exists. First, the list of CAHEA-approved undergraduate CLS
programs (AMA, 1989) was cross-referenced with listings of master’s degree

programs for CLSs available from the Petersen’s Guide listing of graduate

52

53
programs (vonVorys, 1989). Second, the resulting list was expanded by

sending an inquiry (Appendix A) to every academically-based, CAHEA-
accredited program asking whether a master’s degree is offered. Third,
telephone calls were made to program officials who did not respond to the
questionnaire but whose programs were suspected of offering a master’s
degree program.

Once the programs were identified, the directors and deans (as
operationally defined) were identified. The mail inquiry used to identify the
master’s degree programs (Appendix A) also inquired about the names of
program administrators. If the mail inquiry was not returned or was not usable,
telephone calls were made to identify the appropriate individuals to whom the
survey materials were sent

Since the population of interest consists of 34 deans and 34 directors,
and this is a small number of subjects, no sample was drawn. Rather the

whole population was surveyed.

W
The survey instrument for directors is appended (Appendix B), as is the

survey instrument for deans (Appendix C). Since no survey instrument existed
to assess the information and Opinions needed, these were developed by the
researcher. The instruments were developed based on recommendations from

the nursing literature on the resources needed to implement a doctoral

54
program (Cleland, 1976; Shores, 1986a; Shores, 1986b). The portion Of the

instruments on opinions about doctoral education for CLSs was developed
based on the issues described in the literature on professionalization
(Greenwood, 1966) and modeled after those of Davis (1985), used to assess
Opinions of a similar population on program accreditation and
professionalization issues. The results Of that Opinion portion will be reported
in other sources and will not be reported here.

The original draft of the director’s survey was piloted with program
directors of CLS programs not Offering graduate programs (and therefore not
part Of the study population) and to former directors Of programs with graduate
programs. The original draft of the dean’s survey was pilot tested with deans
whose colleges do not have CLS programs and with associate and assistant

deans Of CLS programs who were not subjects in the study.

rv In m nt m' ' ’ n
The surveys were sent to the subjects’ business addresses March 1,
1990 by first class mail. The survey and its accompanying documents were
mailed in a 9 1/2 X 12“ envelope, thus eliminating the need to fold documents.
The survey was accompanied by a letter of transmittal and a self-addressed
stamped envelope for return Of the survey. As indicated in the letter of
transmittal, the surveys carried a number code for follow-up purposes.

The letter Of transmittal (Appendix D) was individually addressed and

55
printed by word-processor and laser printer on letterhead of Michigan State

University, College Of Natural Science. The letters were signed individually by
the researchers using a blue, felt-tip pen.

The letters were OO-signed by Dr. Sharon L. Zablotney. Dr. Zablotney
was president Of the American Society for Medical Technology at the time of
the mailing and is nationally-known as a CLS educator and leader. She was
Associate Dean of the Michigan State University, College Of Natural Science,
and has directed CLS programs at several universities in the U.S. Her
endorsement was expected to contribute significant credibility tO the study.

The researcher also signed the letter. She is also known nationally
within the CLS profession. She chaired the ASMT task force that developed a
model undergraduate curriculum and was founding co-editor of the Society’s
journal, WW. She received recognition as Michigan’s
Medical Technology Educator of the Year for 1989. She has held positions at
the national-level within ASMT and at the time of the study was the immediate
past-president of the Michigan Society for Medical Technology.

The letter Of transmittal asked for a response within 14 days Of receipt of

the survey.

l - r r
Seven days after the survey was mailed, a follow-up postcard (Appendix

E) was sent to non-responding subjects to remind those who had set the

56
survey aside that the response deadline was approaching and to encourage

responses.

Threeweeks afterthe initial mailing,whichwastwoweeksafterthe
reminder postcard, a second letter (Appendix F) and copy of the survey with all
enclosures was sent to all non-respondents.

Any subjects who had not responded within two weeks Of the last letter
(i.e. five weeks after the initial mailing) were considered non-respondents. If
the demographic data regarding earned degree, major, etc. could not be
deduced from the mailing address, the subject was telephoned to gain that

information.

marinate
The data were analyzed using the Statistical Package for the Social
Sciences-X (SPSS-X) (SPSS Inc., Chicago, IL). The commands used included
DESCRIPTIVES and FREQUENCIES to calculate means and frequencies,

respectively.

CHAPTER IV

Research Findings

Thirty-four institutions with a CAHEA-accredited undergraduate program
plus a master’s degree program were identified. Survey instruments inquiring
about resources for supporting doctoral programs and plans to initiate a
doctoral program were mailed to the directors and deans of all identified
programs for a total of 68 subjects, 34 in each group. Both the dean and
director of the researcher’s institution declined to participate due to familiarity
with the researcher. Therefore, the total number Of subjects was 66, divided
equally between deans and directors, and the total number of institutions was
33. Upon analyzing the results, one institution was deleted when the
administrator responded that the institution no longer offered a master’s
degree. Therefore, the final total Of institutions and subjects was 32 and 64,
respectively.

The survey materials were successfully mailed to all subjects. None
were returned as undeliverable. One director contacted the researcher
suggesting that she was not the appropriate respondent and recommended
that the survey be forwarded to a colleague. The researcher concurred and the
survey materials were so forwarded.

Forty-nine survey instruments were returned by the due date; 28 from

directors and 21 from deans. In response to the follow-up mailing three weeks

57

58
later,anaddifionalsbisu~eyswerereMmed;MOfromdirectorsandfourflom

deans. Of the 30 directors' instruments, 29 were usable. Twenty-four of the 25
returned deans’ instruments were usable. The final average retum rate was
83% with 91% from directors and 75% from deans. Thirty Of32 institutions
were represented.

W
A profile of the respondents is available in Table 2. Nearly one half Of

respondents who indicated the type or facility in which their program is housed
were from colleges Of allied health. Colleges of medicine or arts/sciences and
health science centers were nearly equally represented.

Forty percent Of respondents were certified laboratory professionals and,
as would be expected, virtually all of those certificants were clinical laboratory
science (CLS) program directors. There was one dean certified as a medical
technologist (MT). Twelve of the MT respondents also held certification as
clinical laboratory scientists (CLSs). Three of the MTs had a laboratory
specialty certification. It is significant that 65% Of deans held no professional
certification despite the fact that many of them direct colleges Of allied health.

Eighty-five percent Of respondents held a doctoral degree in some field.
The doctor of philosophy was the predominant degree and was distributed
nearly equally between directors and deans. Sixty-six percent of directors held

doctorates that predominantly were PhDs. All but one dean held the doctorate.

59

Table 2

Profile of respondents

N
Directors 29
Deans 24
Total 53

Type of facility
Health Science Center
Allied Health College
Arts/Science College
Medicine
Other
Unknown

Certification
MT(ASCP)
with CLS(NCA)
with specialty
RRT/PT/Other allied health
MD/DDS
None
Unknown

Highest earned degree
BS/BA

MS/MA

PhD

EdD

DrPH/DHS
MD/DDS/PharmD
Unknown

Major
Education
Natural science
Medicine/dentistry
Pharmacy/Public health
Social science/Humanities
Unknown

Directors

20

\IN

Deans

N-hUtNr-I

0-D

UTHw-h

HHUIHOt

60
All physicians (MDs) responding were deans, four Of whom were deans in

colleges Of medicine.

Most respondents’ terminal degrees were in science. Education was the
second most common major.

Table 3 displays the nature Of the relationship between terminal degree
and major for all respondents. The majority of respondents holding PhDs
earned their degrees in science, as did the master’s and baccalaureate

respondents.

Table 3

Numbers of respondents holding academic degrees
in various majors

Highest Earned Degree

MAJOR BS/BA MS/MA PhD EdD MD/DDS DrPh/DHS Totals
Education 2 7 5 14
Natural Sci. 1 5 18 l 25
Medicine 5 5
Pharm/Pub

Health 1 1
Social sci/

Humanities l 1
Totals 1 7 26 5 5 2 46

Table 4 presents the respondents’ certifications and earned terminal

degrees. Fifty-four percent of the PhD respondents held no

HIGHEST
DEGREE

BS/BA
MS/MA
PhD

EdD
DrPH/DHS
MO

Totals

61

Table 4
Numbers of respondents holding certification and
various earned degrees
CERTIFICATION

MT(ASCP) RRT/PT/Other
Allied Health

MD/DDS None

7
11 1 14
2 l l
1 1
5
21 2 5 17

Totals

45

professional certification. Eleven Of the 12 remaining PhDs were certified MT s.

Fourteen Of 21 MT-respondents held doctorates, 11 Of which were PhDs.

Table 5 displays the degrees and majors for all CLSs responding.

Among CLSs holding master’s degrees, the majority were in science.

However, doctorates were distributed nearly equally between education and

infience.

Table 5
Numbers of CLS respondents holding
earned degrees in various majors

CLS Respondents

HIGHEST EARNED DEGREE

MAJOR BS/BA MS/MA PhD EdD MD/DDS DrPH/DHS Totals
Education 2 5 2 9
Natural Sci. 5 6 1 12
rotors 7 11 2 1 21

Data profiling non-respondents is shown in Table 6. The profile Of non-
respondents is comparable to respondents in all categories except for a slightly

higher representation of physicians among the non-respondents.

R r frth lmnt

D r r 'n lini l rt

Both deans and directors were queried about their perceptions Of the
adequacy of resources within their institutions for the development of a doctoral
program in CLS. Directors were asked additional questions about the actual

resources Of their institutions.

Profile of non-respondents

N
Directors 3
Deans 8
Total 11

Type Of facility
Health Science Center
Allied Health College
Medical School
Unknown

Certification
MT(ASCP)
MDIDDS
None
Unknown

Highest earned degree
BS/BA
MS/MA
PhD
EdD
MD/DDS/PharmD
Unknown

Major
Natural science
Medicine
Unknown

Table 6

Total

0le0-:

Huh (UNI-i (alt-lab“

b-bw

Directors

1 .

NH

Deans

MUN

wH-b

64
TO analyze the opinion items about resources, the following procedure

was used. First. since effectively the entire population was represented by the
respondents, no inferential statistics were used for data interpretation.
Differences between groups of subjects were interpreted to be real, and the
practical meaning Of the differences was inferred by the researcher.

TO determine whether subgroups Of respondents differed in their
Opinions, the responses of the subgroups were compared. The numerical
value Of the responses were used to calculate mean responses. The mean of
all responses to all eight items from individuals in one subgroup (e.g. deans)
were compared to the mean of all responses to all eight items from individuals
in the comparison group (e.g. directors). Since responses range from 1 to 4, a
mean of all responses above 2.5 would indicate disagreement with the
statements while a mean of all responses below 2.5 would indicate agreement.
The mean value Of all responses of individuals in different subgroups were
compared to determine whether the stated null hypothesis was retained.

For further insight into the respondents’ views on the Opinion items,
individual item means were compared between subgroups.

The first hypothesis proposed regarding resources was:

Ho: There is no significant difference between deans and directors in

their opinions about the adequacy Of resources at their institution for the

development of a doctoral program in CLS.

65

The mean of all responses from directors was 2.58 while the mean of all

responses from deans was 2.70 (Table 7). The null hypothesis was retained.

Both groups held generally pessimistic views of the adequacy of their

resources to support a doctoral program.

Item
no.

18

19
20

21
22
23
24

25

Table 7

Means of responses of directors and deans regarding
resource perceptions

Item Directors Deans
Content
Faculty skills. knowledge 2.07 2.50
and ability
Faculty interest 1.89 2.26
Laboratories. libraries. 2.07 2.08
and other facilities
Funding 3.32 3.25
Time 3.10 3.00
Numbers of faculty 2.79 2.92
Demand from prospective 2.93 2.96
students
Demand from prospective 2.48 2.64

employers of graduates
Mean of all responses 2.58 2.70

The individual resource perceptions Of deans were compared to those

Of directors (Table 7). On the whole, both directors and deans were

pessimistic about funding (item 21), faculty time (item 22), and

66

numbers Of faculty (item 23) to support a doctoral program. Further they did
not perceive a demand from either students (item 24) or employers (item 25)
for doctoral programs in CLS. However, both groups believed that, in their
institution, the facilities needed for a doctoral program (laboratories, libraries,
etc) were adequate (item 20) and that faculty were interested in directing
doctoral students (item 19). However, deans were somewhat skeptical of their
faculty's ability to do so as evidenced by a neutral response to item 18.
Suspecting that administrators with plans to develop a doctoral
program may differ from those without plans, the following hypothesis was
posited:
Ho: There is no significant difference between deans Of programs with
plans to initiate a doctoral program and cleans Of programs without
plans to initiate a doctoral program in their Opinions about the
adequacy of the resources at their institution for the development Of a

doctoral program in CLS.

The null hypothesis was rejected. The deans with plans had a generally
neutral view as evidenced by a mean Of all responses of 2.38 (Table 8). Deans
without plans had a mean Of all responses Of 2.75 (T able 8), a generally

negative view Of their resources.

Item
no.

18

19
20

21
22
23
24

25

Means of responses regarding resource perceptions
of deans with and without plans to
develop a doctoral program

Faculty skills, knowledge.
and ability

Faculty interest

Laboratories. libraries.
and other facilities

Funding

Time

Numbers of faculty

Demand from prospective
students

Demand from prospective
employers of graduates

Mean of all responses

67

Table 8

Deans
with plans

2.00

2.00
2.00

3.00
2.67
2.67
2.33

2.33

2.38

Deans

without plans

2.57

2.30
2.10

3.29
3.05
2.95
3.05

2.68

2.75

When the individual item responses Of deans whose programs are

proceeding with developing a doctoral program (deans with plans) are

compared to those of deans from programs that are not proceeding (deans

without plans), a clear pattern emerges (T able 8). Deans with plans had a

lower mean value (re. more positive attitude) on all eight resource perception
questions as compared to the deans without plans. However, the magnitude of

the difference is generally small. Differences of opinion occurred only on items

18 and 24. Deans with plans believed their faculty have the skills and

68
knowledge to direct doctoral students (item 18) whereas deans without plans

were neutral to the item. Deans with plans were neutral to item 24 about
prospective student interest whereas deans without plans were distinctly
pessimistic about it. Once again, deans from both programs were neutral or
pessimistic about funding (item 21), faculty time (item 22), and faculty numbers
(item 23) to support a doctoral program.

Directors from programs with plans were hypothesized to differ from
their counterparts in institutions without plans as described in the following
hypothesis:

H,: There is no significant difference between directors Of programs with

plans to initiate a doctoral program and directors Of programs without

plans to initiate a doctoral program in their opinions about adequacy of

resources at their institutions to develop a doctoral program in CLS.
The null hypothesis was rejected because the mean of all responses from
directors with plans was an optimistic 2.00 whereas that of directors without
plans was a pessimistic 2.74 (Table 9).

The individual resource perceptions Of directors with and without plans
are compared in Table 9. As with the deans, the directors with plans had a
mean response lower than the directors without plans for all eight resource
perception items (items 18-25). Unlike the deans, the mean responses of the
directors with plans were significantly lower than those Of directors without

plans for 6 Of the 8 items. The directors with plans agreed with all items except

69
item 21 indicating their general Optimism about resources, but also indicating

concern over funding (item 21). The directors without plans disagreed with or
were neutral to 5 of the 8 items. They were optimistic only about faculty ability
(item 18) and interest (item 19) in supervising doctoral students, and about
facilities (item 20).

Table 9

Means of responses about resource perceptions of directors with and
without plans to develop a doctoral program

Item Item Directors TDirectors
no. Content with plans without plans
18 Faculty skills. knowledge, 1.67 2.22

and ability
19 Faculty interest 1.67 2.00
20 Laboratories, libraries. 2.00 2.17
and other facilities
21 Funding 3.00 3.48
22 Time 2.33 3.33
23 Numbers Of faculty 2.00 3.04
24 Demand from prospective 1.67 3.08
students
25 Demand from prospective 1.67 2.62

employers of graduates
Mean of all responses 2.00 2.74

The following hypotheses were proposed regarding actual resources to
support doctoral education.

Ho: There is no significant difference between institutions that are

70
proceeding with a doctoral program and those institutions that are not In

regard to the number of faculty.

H,: There is no significant difference between institutions that are
proceeding with a doctoral program and those institutions that are not in

regard to the number of doctorally-prepared faculty.

H,: There is no significant difference between institutions that are
proceeding with a doctoral program and those institutions that are not in

regard to the number Of faculty with active research programs.

Ho: There is no significant difference between institutions that are
proceeding with a doctoral program and those institutions that are not in

regard to the amount Of external funding the programs receive.

Ho: There is nO significant difference between institutions that are
proceeding with a doctoral program and those institutions that are not in
regard to hospital availability.

Ho: There is no significant difference between institutions that are

proceeding with a doctoral program and those institutions that are not in

71
regard to the presence of other doctoral programs within their

administrative unit

Ho: There is no significant difference between institutions that are
proceeding with a doctoral program and those Institutions that are not in
the number Of annual faculty publications.

Ho: There is no significant difference between institutions that are
proceeding with a doctoral program and those institutions that are not in

the number of annual grant proposals submitted.

Ho: There is no significant difference between institutions that are
proceeding with a doctoral program and those institutions that are not in

the average dollar amount Of grants received.

Ho: There is no significant difference between the directors Of programs
that are proceeding with a doctoral program and those directors whose
institutions are not, in the perceived level Of administrative support for

initiating such a program.

72
H,: There is no significant difference between institutions that are

proceeding with a doctoral program and those institutions that are not in

the average number Of students enrolled in the university/college.

H.: There is no significant difference between institutions that are
proceeding with a doctoral program and those institutions that are not in

the average number Of students enrolled in the undergraduate CLSs

program.

Ho: There is no significant difference between institutions that are

proceeding with a doctoral program and those institutions that are not in

the average number Of students enrolled in the master Of science

program in CLS.

The mean values of the actual resources as reported by directors with
plans were compared to those reported by directors without plans (T able 10).
Based on these findings all the null hypotheses are retained with the exception

of the following:

Ho: There is no significant difference between institutions that are
proceeding with a doctoral program and those institutions that are not in
regard to the presence of other doctoral programs within their

administrative unit.

Table 10

Means Of actual resources for the development Of doctoral programs in
CLS from institutions with and without plans

Item Resource Programs Programs
no. with plans without plans
29 Other doctoral programs in 100% yes 79% yes
the same college 21* no
30 Access to a clinical
laboratory 1008 yes 1004 yes
31 Dean’s support
None 33% 50%
Complete 5*
Tentative 67k 45%
32 Administration support
None 33% 42%
Complete 33* 21k
Tentative 33% 37*
33a Number of faculty with an
. active research program 3.0 1.7
33b Percent of total faculty with
‘ active research program 58 33.3
34 External funding of research 3 30,000 $ 35.000
35 Annual faculty publications
from the unit 4.33 3.7
36 Annual grant requests 2.33 3.2
37 Average amount of funding
requests $200,000 $162,571
Dollars received/grants
requested 3 12.876 3 10.938
54 Number of students at the
institution 16.500 20.630
55a Number of undergraduates in
the MT program 59 50
55b Number of graduate students
in the master’s program 11 9
57a. Number Of faculty
in the MT program 5.7 5.3
57b Percent Of faculty with PhD 42 45
57c Percent of faculty with
with MT certification 76 86
579 Percent of faculty with
tenure 37 45

74
H.: There is no significant difference between the directors Of programs

that are proceeding with a doctoral program and those directors whose
institutions are not, in the perceived level Of administrative support for

initiating such a program.

Ho: There is no significant difference between institutions that are
proceeding with a doctoral program and those institutions that are not in

regard to the number of faculty with active research programs.

As indicated in the perception items, some Of the areas of greatest
concern for administrators were faculty numbers and external funding. On
these items there was no difference between programs with plans and those
without. The two types of programs had, on average, the same number of
faculty (item 57a) and the same percentage of doctoral-level faculty (item 57b).
Though the percentages Of certified faculty (item 57c) and tenured faculty (item
579) may appear to differ, the absolute numbers Of people represented by
these percentages were the same for both groups, so no significant difference
existed.

Programs that are proceeding with the development Of a doctoral
program showed a slightly higher, though not meaningfully different, level Of
extemal funding (item 34) for a comparable number of faculty. However,

programs with plans had a higher percentage of faculty actively involved in

75
research (item 33). Though programs with plans submitted fewer grant

requests (item 36) for more total support (item 37), the differences were not
significant. The grant dollars actually resulting from those requests were
comparable (item 34) as were the ratios of dollars received to grants
requested.

Programs with plans were all situated in colleges that offer other doctoral
programs (item 29) while 21% of the programs without plans were in academic
units without other doctoral programs. All respondents indicate that a clinical
laboratory is available as a source of research specimens (item 30).

Programs with plans differed little from programs without plans in terms
of size Of the institution (item 54), size of the undergraduate CLS student
population (item 55a), and graduate student numbers (item 55b).

Directors in programs without plans appear to have perceived a lower
level of support for a doctoral program from higher administration in their
institutions (item 32) than directors with plans. A single respondent without
plans perceived complete support from his or her immediate superior (item
31). However, on the whole, directors without plans perceived a lower level of
support from their immediate superiors than did directors with plans.

Deans were asked to describe the administrative obstacles to gaining
support for a doctoral program. Funding was the problem cited most often
with space being second most frequently mentioned. No documented demand

or need from students and employers and duplication of other degree content

76
were mentioned. Too few faculty, too few faculty with on-going research, and

too little time were each mentioned once.

Directors were asked to estimate the incremental increase in faculty,
funds, and facilities that would be needed to support a doctoral program. All
directors who responded to this question estimated a need for more faculty.
Sixty-one percent estimated a need for two full-time equivalent (Fl'E) positions,
though others estimated a need for four or five additional Fl'Es.

On average, the directors estimated a need for one-time only start-up
funds of $350,000. However, this figure is slightly inflated by a single estimate
of three million dollars, while all other estimates range from $20,000 to
$300,000. A more realistic average estimate of $121,000 is obtained when the
single high estimate is eliminated.

The estimates of annual recurring expenses range from $10,000 to a
high of $2,000,.000 These high and low figures each seem questionable as the
salary to fund two faculty would obviously exceed $10,000 and the $2,000,000
figure is out of line with other estimates. The more realistic estimates are
$60,000 to $120,000, with an of average $95,000/year in recurring costs
including faculty salaries.

Eighty-six percent of respondents indicated a need for additional
laboratory space (item 28). About half of the respondents indicated a need for
additional office space for faculty and one quarter reported a need for

additional space for graduate students. One respondent indicated a need for a

77

building to accommodate research laboratories, office space, and teaching

facilities.

MW

in lini l

Deans and directors were both asked about their programs’ intentions to
develop a doctoral program. Directors were asked additional questions about
the details of those plans. As shown in Table 11, three deans and their
directors (i.e. three institutions) indicated they were in some stage of
developing a doctoral program. Those three directors’ responses to the
descriptive items about their proposed programs and the planning process are

provided in Tables 12 and 13.

Table 11
Numbers of institutions with plans for doctoral programs in CLS

Numbers of Respondents

Status of Plans Directors Deans
NO plans, no discussion 15 16
Discussed, but no plans 8 5
Proposal submitted 3 2

Plans to implement 1

Question

Type of degree

78

Table 12
Details of plans for doctoral programs for clinical laboratory
scientists
Program
A B C
professional doctorate in PhD
doctorate allied health

to be offered

Rationale for
offering this
degree

Title of the
major

Admission
requirement

Sources of
funding

Financial
support for

Obstacles

with emphasis
in lab science

needs needed in
the field;
institutional
survival
clinical laboratory
science medicine
education

certified MT,

bachelor's degree,

3 years of work
experience,
TOEFL > 565

reallocation of
unit funds,
added permanent
funds,
institutional
and external
start-up funds

assistantships,
external grants

institutional
politics

reallocation of
unit funds,
added permanent
funds, external
start-up

assistantships,
tuition waivers

reluctance to
approve any new
graduate
programs

due to
finances, lack
of other model
programs,
funding,low
undergraduate
enrollment,
competition
from specialty
programs

79

Table 13

Planning process for programs developing a doctoral program for clinical

Question

Hith whom did you
consult?

Hhat forms

of needs
assessment did
you use?

Did you use any
resources from
professional
associations?

laboratory scientists

Program

A C
other doctoral other doctoral
programs in the programs in the
college and college, other
university, doctoral programs
other doctoral in MT, persons
programs in MT, the graduate
persons in the college

graduate college,
external adminis-
trators and faculty

survey local MTs, survey alumni and

unsolicited local MTs,

inquiries contact existing
doctoral programs
in MT, professional
leaders

policy statement no

Infl ' 'i ri t I) l

W

All subjects were questioned about factors that may influence their

decisions to develop a doctoral program. The first set of questions to directors

asked about possible student interest in such a program. Directors and deans

80
were then both queried about problems in hiring doctoral-level faculty,

effectively asking them to respond as prospective employers of doctoral
graduates.

Three hypotheses were proposed about the supply of graduate students
and demand for doctoral programs:

Ho: There is no significant difference between institutions that are

proceeding with a doctoral program and those institutions that are not in

the average annual number of master’s degree graduates.

H,: There is no significant difference between institutions that are
proceeding with a doctoral program and those institutions that are not in
the average annual number of master’s degree graduates going on to

doctoral study.

Ho: There is no significant difference between institutions that are
proceeding with a doctoral program and those institutions that are not in
the average annual number of inquiries received about doctoral

education.

As the results in Table 14 indicate, only the second of these null hypotheses
was retained. Over the last five years, programs with plans have graduated

about 50% more master’s students (item 48a) than programs without plans.

81

Programs proceeding with a doctoral program received about one-third fewer

inquiries (item 49) each year from prospective doctoral students. However.

about the same number of students from each type Of program have gone on

to doctoral studies over the last 5 years (item 48d).

Table 14

Means of items regarding student supply and demand for doctoral programs

Item
no.

48a

48d

49

in CLS

Student Programs Programs
Factor with plans without plans
Numbers of master’s 14.3 9.5

students graduated
in the past 5 years

Numbers of master's 2.5 2.0
graduates going on
to doctoral studies
in the past 5 years

Numbers of inquiries 6 9.3

about doctoral studies
in the past year

Since academic CLS programs are employers of doctorally-prepared

CLSs, the following hypothesis was proposed relating plans for developing a

doctoral program to difficulty in filling faculty vacancies:

Ho: There is no significant difference between institutions that are
proceeding with a doctoral program and those institutions that are not in
the opinions of their administrators about difficulty in hiring doctorally-

prepared CLS faculty.

82
This null hypothesis was retained based on the results presented in Table 15.

Though programs without plans reported twice as many faculty vacancies over
the last 5 years (item 50a), administrators’ responses indicate a similar problem
in filling their vacancies. All programs with plans (N = 3) sought doctorally-
prepared candidates while three-quarters of programs without plans indicated
that they did the same (item 50b). Sixty-seven percent of the programs with
plans sought candidates with both doctorates and professional certification. Of
the 76% of programs without plans that sought doctoral candidates, 81% (Le.
62% of all programs without plans) sought faculty who were also
professionally-certified. All of the programs with plans that sought both
credentials reported being unsuccessful in filling their vacancies. Eighty-three
percent of programs without plans that sought both a doctorate and
professional certification (Le. 51% of all programs without plans) were
unsuccessful in filling their faculty vacancies. Since the number of programs
with plans is so small, the percentage differences between the groups are
meaningless. Essentially, both groups have had difficulty in hiring faculty when
a doctorate is required along with professional certification and the null
hypothesis is retained.

When deans were asked the same basic question about difficulty in
hiring doctoral-level faculty, all of the deans with plans indicated that there were
problems while only 45% of the deans without plans indicated there were

problems (Table 15). The majority of deans felt that the problem of recruiting

83

Table 15

Means of responses regarding faculty vacancies over the last 5 years

Directors' Survey

Item Facul ty
no. Issue

50a Number of faculty
vacancies in the
last five years

50b Here doctorally-
prepared candidates
sought?
No
Yes

50c Has laboratory
certification also
required?
NO
Yes

50d Here you successful
in recruiting candidates
with the required
credentials?
Yes
No

Deans' Surveys

32 Problems in hiring
doctoral-level faculty?
No
Yes

33 Similar problems in other
disciplines?
Same in all health
professions
Horst in MT
Horst in other
disciplines

Programs
with plans

1

100%

33%
67%

100*

100*

67*
33*

Programs
without plans

2.14

24*
76%

19*
81%

17%

55%
45%

57*

33%

doctorally-prepared faculty in CLS is the same as in other health professions
(T able 15). For the few who thought it was easier to recruit in other
professions. their reasons are listed in Table 16.

Table 17 lists the types of credentials that were sought for faculty when

both a doctorate and certification were sought.

Table 16

Deans perceptions of the disciplines in which recruiting doctoral
faculty is easiest and why

Larger pool of candidates in:
nursing
dietetics/nutrition
exercise science
chemistry
biology
health services administration

Faculty salaries are higher in physical therapy

There are fewer programs in health services administration
competing for the available candidates

, Nursing is a more academically mature profession

85

Table 17
Credentials sought for faculty in CLS programs
Credentials Numbers of
respondents
MT certification plus PhD in science/

basic science 6

MT certification plus PhD in science
with expertise in hematology 2

MT certification plus PhD in science
with expertise in immunohematology 2

MT certification plus PhD in science
with expertise in microbiology 1

Table 18 lists the strategies used when candidates meeting the specified
qualifications could not be found. Table 19 describes the specific problems

respondents described as contributing to difficulties in hiring doctoral faculty.

Table 18

Strategies employed when faculty with the desired credentials could not
be recruited

Strategy Number of
Respondents
Hire lecturer for one year and reopen
the search 3
Hire a master's candidate with certification 4

Naive certification requirement but require
clinical experience or post-doctoral
training 3

Reorganize faculty responsibilities and
reopen search for candidates with
different expertise , 1

86

Table 19

Deans and directors perceptions of the factors contributing to the
problems in hiring doctoral-level faculty in CLS programs

Factors Number of
respondents
Low faculty salaries 6
Lack of qualified applicants 10
Lack of tenure-stream position 1
Research-oriented faculty do not want the
service/teaching Obligations in MT program 1
nn r ' n i hi t n

Demographic and biographic data were collected in the last part of each
administrator’s survey. Table 2, previously presented, summarizes this
infixnnafion.

Respondents were offered the opportunity to comment in an open-ended
format as to their opinions about doctoral education for CLSs. Table 20

includes these comments.

87
Table 20

Anecdotal comments of respondents and their professional credentials

DEANS

Encourage CLS faculty to obtain PhD in related science.
DrPh, college of allied health

I believe that doctorates should be In basic sciences rather than in
CLS.
PhD in physiology, college of allied health

I think such a program is badly needed. It would be a disservice to the
students involved and indeed the entire profession if a program were
developed, however, in the absence of a solid, productive faculty
involved in the generation of new knowledge.

EdD in physical education, college of allied health

Tracks in clinical laboratory preparation in basic science PhD
departments would be easiest to push.
Doctor of dentistry, college of allied health

Unneeded, unnecessary. A clinical laboratory scientist should seek a
PhD in a related science department so as to learn research skills with
appropriately trained scientists. A PhD in CLS would be looked on as a
“window dressing“ degree with no real substance to it. Such a thing
therefore detracts from the value of an earned doctorate in a
traditional terminal degree program.

PhD in medical microbiology

DIRECTORS

I think a doctoral program in allied health science would provide a
solution with a greater breadth and use than a PhD in MT. a program
with a core curriculum and specialization in MT/PT or 0T, etc. is at
this time, a better solution.
MS in natural science, MT certification, academic
health science center

In the practice of clinical laboratory sciences there is no need for a
doctoral degree. In academia there is and always will be a need for
doctoral degrees - such degrees should be (in my opinion) in the science
of the CLS area that the faculty member is specializing in. The
doctorate in CLS will become a reality on many university campuses once
the faculty in the CLS departments are primarily scientists (not with

88
Table 20 (cont'd).

education degrees) and are heavy into research. Instituting doctoral
degrees that are not rigorous in science will hinder - not help - our
profession.
DrPh in epidemiology, MT certification, college of
allied health

DO not really believe doctorate in clinical laboratory science is
needed. Need more clinical microbiologists, clinical chemists, etc. -
specialty areas. Issues at undergraduate level more pressing and not
any positions for doctorates except in educational institutions.
PhD in educational administration, MT certification,
college of sciences

Out higggst problem in implementing a PhD in MLS would be our 19;
student FTEs. The PhD in dietetics is currently facing problems at the
university level for this reason. Next problem is lack of professional
identity. We have too many practitioners who regret having gone into
med tech in the first place and who do not feel there are career
opportunities beyond the bachelor' 5 degree.

PhD in biochemistry, MT certification, college of

allied health

In our institution we will probably never hire anyone with less than a
PhD again. Hhile we would prefer future vacancies to be filled by med
techs with doctorates, these individuals are rare. He probably will
fill a retirement in 1/2 years with a PhD clinical chemist since med
techs with research capabilities are very hard to come by. Research
comes first here at U of

Medical technology is part of the department of laboratory
medicine and pathology of the medical school. The department has a PhD
pathobiology program. I’d like to be able to put in a CLS “track“ within
pathobiology, rather than initiate anew PhD program which could be
attacked by other interest groups.

If MT' 5 don’ t pursue doctorates (of any kind) we may find our
faculty filled by PhDs in genetics, molecular bIOIOQY. etc., rather than
with those who come from the CLS background. The “shape“ that doctoral
education takes isn’t important - the graduates are.

PhD in education, MT certification, college of
medicine

I am concerned about advertisements for faculty in medical laboratory
science programs that state “PhD preferred or required“. He all know
what happens to PhDs in academic settings, or most settings. Here, we
are in the School of Medicine. Any PhD is on tenure track and MUST
publish. The amount of teaching required of med laboratory science
faculty does not allow significant amounts of time for research. So
either that person does not succeed in maintaining tenure, or master's

Table 20 (cont'd).

level or BS degree people and up doing the teaching, especially in the
laboratory sessions. I am supportive of PhDs as program directors, but
Ihthink that it is unrealistic to require all faculty members to hold
P Ds.

MS in medical technology, MT certification, college
of medicine

CHAPTER V

Discussion and Conclusions

Three areas of conclusions will be discussed. They are the resources
for the development of doctoral programs in clinical laboratory science (CLS),
plans to develop doctoral programs, and the need for more doctorally-prepared
clinical laboratory scientists (CLSs). Recommendations for the development of

doctoral programs in CLS will also be described.

WW

IP i lini ' n

The following research questions were investigated in regard to the
resources for the development of doctoral programs in CLS:
(1) Are there institutions that are perceived by their administrators to possess

the resources necessary to develop a doctoral program in CLS?
(3) If the resources to develop a doctoral program in CLS are not currently

available, what are the projected needs and from where are those resources

expected to come?

90

91

(4) How do programs that are proceeding with the development of a

doctoral program compare to those that are not developing one?

(a)

(b)
(C)

(d)

(e)

(1)

How do their administrators’ opinions compare in regard
to the resources of their institutions to initiate doctoral
programs?

How do these institutions compare in actual resources?
How do they compare on the numbers of inquiries about
doctoral education they have had?

How do they compare in regard to problems with hiring
doctorally-prepared faculty? (See discussion of The Need
for More Doctorally-prepared CLSs)

How do they compare in regard to the numbers of
master’s degrees granted annually?

How do they compare in the number of master’s

graduates that go on to doctoral study?

As would be expected, administrators developing a doctoral program

perceive their resources more favorably than their counterparts who are not

developing doctoral programs. Directors are even more optimistic than deans

regarding their resources. However, a pessimistic view may in fact be a

realistic assessment of resource adequacy, so the data on actual resources is

important in assessing the perception responses.

92
Institutions developing doctoral programs do not have distinctly greater

resources to support doctoral education as described by the survey instrument
The only meaninng difference is a higher percentage of the faculty in
programs with plans are reported to be involved in active research. However,
in absolute terms this is an average increase of only one individual faculty
member compared to the programs without plans. It would seem that
directors in programs with plans perceive this level of resources to be
adequate while those without plans do not. A survey of the resources of the
two existing doctoral programs would have been useful to provide a standard
of what is an adequate level of resources.

Other institutional factors not surveyed may influence administrators’
perceptions of resource adequacy. Nearly all directors estimate a need for
additional faculty, funds, and facilities to support a doctoral program. It may be
that those institutions with plans legitimately perceive a likelihood ‘of attaining
those additional resources and, equally legitimately, administrators without
plans cannot expect to attain the additional needed resources.

The sources for those new resources were listed only by directors with
plans to develop a program. In both cases, directors anticipated that at least

some funding would need to come from outside the institution.

 

Administrators were queried about their institutions’ plans for developing
a doctoral program in CLS to address the following research questions:
(2) In 1990, how many CLS programs are in the process of developing

doctoral programs for CLSs and what is the status of their progress?

(a) How was the decision to proceed with development
made?

(b) What problems or obstacles to implementation are
anticipated?

(c) What types of programs are planned and what are their
requirements?

Three institutions were described by both their deans and directors as
being in the process of developing a doctoral program for CLSs.

The two programs proceeding with the development of doctoral
programs that provided information on their prospective degree programs
describe two distinctly different degree programs. The first will emphasize
laboratory education and grant a professional doctorate. The other will grant a
PhD in laboratory medicine. The latter type of program is probably more
important to the professionalization of CLS by identifying laboratory medicine

94
as a distinct field Of study. In fact, the existing doctoral programs in CLS are

actually degrees in biomedical science or biology with an emphasis in
laboratory medicine. The director Of Program C (T able 12) may have been
referring to this when she noted there are no model doctoral programs in CLS.
Unfortunately, neither of the responding directors provided any information of
the details of the planned degree program.

Program C's list of obstacles (Table 12) includes several rather
predictable items such as finances and administrators' reluctance to approve
any new graduate programs. Competition from specialty programs may be
interpreted to mean related science disciplines that will compete for students.
Those programs may have some relative advantage since there are few models
Of doctoral programs in laboratory medicine and students may not be
adventurous enough to pursue a doctorate in an unproven discipline.

However, Program C did a more extensive needs assessment than did
program A and presumably found support from potential students. Both
programs reporting on their developmental process reported performing some
level of needs assessment.

In Leininger's 1976 study of prospective nursing programs, she found a
great deal of enthusiasm for developing doctoral programs but significant
pessimism about resources, particularly funding. CLS program administrators
in this study appear to have beliefs about resources similar to those Of earlier

nursing administrators. By 1980 only one third of the projected programs in

95
Leininger’s study actually had come to fruition. If a similar ratio were to apply

as doctoral programs for CLSs begin to develop, only one of the three
proposed programs is likely to emerge by 1993. However, in the nursing
situation there were many programs competing for the available outside
resources such as grant funding so that many of them were likely to fail in their
initial efforts. Since so few programs in CLS are developing doctoral programs
at this time, each will be in a better position to compete for external resources
including funding and students.

Although not included directly within the survey scope, institutional
factors may affect the decision to institute a doctoral program. Several
respondents offered extemporaneous comments that indicated that the
decision to institute a doctoral program may depend on institutional factors,
such as organizational structure, despite the good intentions of administrators
at all levels. For example, one respondent discussed the apparent duplication
that a doctorate in CLS would provide since the CLS program was situated
within the department of pathology in the college of medicine and CLSs were
already eligible for that existing doctoral degree. Therefore, though attitudes
may impede the development of a doctoral program when resources are
adequate and institutional Obstacles are minimal, favorable attitudes even in the
presence of adequate resources may still not be enough to allow for the

development of such programs.

Directors and deans were both questioned about the need for more
doctorally-prepared CLSs in order to address the following research questions:
(5) Is there a perceived need among CLS program directors and deans for

more doctorally-prepared CLSs as faculty members and graduate mentors in

CLS programs?

(a) How does this perceived need compare to the need
perceived in other professions for doctorally-prepared
faculty?

(b) What problems have been encountered in recruiting
doctorally-prepared, professionally-certified faculty for CLS
programs?

(c) What accommodations have been made if applicants with

the desired credentials have not been available?

CLS programs may become producers of doctoral graduates but they
are already employers of them. CLS programs provide faculty positions as one
of the most obvious employment opportunities for graduates of doctoral
programs. Therefore, CLS programs that are having difficulty in recruiting
faculty with doctoral qualifications may decide to try to fill the need for

97

themselves and others. Though none of the program directors from programs
with plans directly addressed this, each of them indicated that they had been
unable to fill faculty vacancies with doctoral faculty.

Respondents to this study have substantiated a previous anecdotal
impression that academic CLS programs have been experiencing difficulty in
identifying and recruiting doctoral-level faculty, especially if certification is also
required. Seventy-seven percent of all respondents have experienced this
within the last five years. Some institutions have apparently maintained their
commitment to build a research-oriented, doctorally-educated faculty by
reopening searches when appropriate candidates could not be found. Other
programs have forsaken the goal of building a doctoral faculty by hiring
master’s degree-prepared people. This may be with stipulations on earning a
doctorate that were not indicated in the survey, but the open-ended format of
the question allowed for that and none was Offered. However, as master’s-
prepared faculty are significantly disadvantaged in the grant funding process,
the prospects for developing a research program are effectively negated and
the program has made a decision that limits its growth as a research unit.

The problem for this profession appears to be no greater than in other
allied health disciplines, in the view of deans. However, it is doubtful whether
development of more doctoral programs, particularly those designed especially
for CLSs, will solve the apparent shortage of doctorally-educated practitioners.

Doctoral programs in related sciences are available around the county and this

98
is an acceptable credential for CLSs in lieu of a doctorate in their own science.

Therefore, the number of available programs and convenience of doctoral
study is not a factor preventing CLSs from pursuing doctoral education.

More importantly, not many certified CLSs are entering doctoral study.
The programs smdied here report that about two master’s graduates go on to
doctoral studies every five years. There were 32 programs in the population,
thus about 64 CLSs enter doctoral study every five years or about 13 every
year. This estimate is low because it is based on graduates of master’s degree
programs associated with CLS programs and does not include CLSs that
pursue graduate programs in other academic departments. However, it is still
a useful figure since students graduating with master’s degrees in other
disciplines would be more likely to pursue doctoral work in the same discipline.
Therefore, this number is probably a conservative but reasonable estimate of
the number of CLSs that would be interested in doctoral studies in CLS
annually in the United States. In the end, this means there are not many CLSs
inclined to pursue doctoral studies. There may be some demand from past
graduates but once satisfied, the annual number of students may be expected
to be modest.

The problem of few CLSs pursuing doctoral studies is compounded
when CLSs enter doctoral programs in other disciplines. The profession
experiences some loss of members as doctoral candidates choose to affiliate

themselves with colleagues in their new doctoral discipline and forsake CLS.

99
The reasons an individual would do this or why an individual would not choose

doctoral study in the first place are the more fundamental issues. Few CLSs
apparently perceive the value of doctoral education for themselves and their
profession. Unlike bachelor’s degree programs in other academic disciplines
that groom undergraduates toward doctoral study, CLS has often failed to do
this. This has been in large part because most professional education
programs were provided within hospitals, not academic settings. The students
were taught by baccalaureateeducated practitioners and by physicians, neither
of whom had an orientation toward research. Today, 70% Of accredited CLS
programs are still provided in the 3+1, hospital-based format so that a
significant proportion of students do not have role models of doctoral-level CLS
researchers and are not mentored toward doctoral study as in typical academic
disciplines and programs.

The data reported by Beck and Chamness (1990) refute this, however,
with hospital-based and academically-based program directors reporting
equivalent levels of encouragement for students in the pursuit of graduate
studies. Since the data were not presented comparing responses of hospital-
based to academically-based administrators, the authors’ conclusion cannot be
validated. They posed the question about encouragement without guidelines
on what “slight“, “moderate“, or “a great deal of encouragement“ were, so the
respondents’ self-reports are not standardized. A respondent actually doing

very little to encourage students may perceive that they are doing a moderate

100

amount of encouraging, while another respondent doing a greater amount in
absolute terms, may perceive that to be only slight encouragement. Further, a
relatively small percentage of hospital-based programs was surveyed and may
not be truly representative Of that group.

The development of university-based CLS programs over the last several
decades provides the foundation for changing this pattern and instilling in
students a sense that the educational continuum within the CLS profession
includes doctoral study. However, the reality is that university-based programs
still face difficulties in this areas. As indicated by the results of this study, more
than 50% of their faculty still do not possess doctoral degrees. Unfortunately,
there is no published data from the past to reveal how this figure may have
changed over the last decade. Anecdotally, the percentage of doctorally-
educated faculty in CLS programs is rising nationwide as evidenced by the
change in credentials described in advertisements for faculty vacancies. Yet,
six programs, nearly 20% of the total, did not require a doctorate when filling
recent faculty vacancies.

Other problems contribute to the failure of CLSs to pursue doctoral
study including the lack of appreciation within the profession for the factors
affecting professional self-determination. Further study is needed to ascertain
the degree to which the general population of professionals is sensitive to
these professionalization issues. However, though CLSs are concerned about

professionalism, as evidenced in the literature, professionalization and Its

101
related issues are rarely discussed. Even when it is mentioned, the fairly

simplistic attributes view is taken and CLS is compared to the classic
characteristics of a profession. The influences of power held by competing

professions is rarely discussed.

I I' l' | B I !°
The implications resulting from this study are most meaningful when

synthesized with other sources of information. These sources include
information on the necessary resources for doctoral programs gleaned from
existing programs in CLS, the literature on adult education, the literature on
graduate education for CLSs in particular, and the projected number of
prospective doctoral students from this study.

In this study, the resources of CLS programs planning doctoral degrees
were comparable to those of the programs that were not proceeding with
developing a doctoral program. However, in the Opinion of most
administrators surveyed, this level of resources is inadequate to support a
doctoral program. Their pessimistic assessment may be accurate it the
existing doctoral programs in CLS are used as a standard against which to
measure the adequacy of resources. The programs at Northeastern University
in Boston and Catholic University in Washington, DC do not rely solely on the

CLS faculty and CLS program resources to support their CLS doctoral

102
programs (Catholic University, 1989; Northeastern University, 1988). At

Northeastern University, the degree is actually a PhD in Biomedical Sciences
with a specialization in Medical Laboratory Science. The PhD program is jointly
supported by several departments including pharmacy, medical laboratory
science, and pharmacology. Similarly, at Catholic University, the doctoral
degree is actually a DA or PhD degree in Biology with an emphasis in Clinical
Laboratory Science and therefore is supported by the resources Of the
relatively larger biology department Further, the program appears to rely
heavily on clinical faculty as research directors. A second factor that cannot be
overlooked in regard to these existing doctoral programs is that each is
geographically situated in an area of high population density, increasing the
number Of prospective students without requiring significant sacrifice on the
student’s part e.g. moving, giving up jobs, disrupting family life.

The literature on CLS graduate education (Heinemann, 1967; Rausch, et
al, 1982), indicates that the population seeking graduate education in CLS is
typical of working adult students. Issues of convenience, such as part-time
attendance and evening classes, are paramount in decisions to pursue
graduate education; a finding that is consistent with the literature in adult
education (Cross, 1981; Knowles, 1980). Graduate programs Often ignore
barriers that prevent working adults from pursuing advanced degrees and
persist in scheduling classes during the day or requiring residency or full-time

status for extended time periods. This is probably not prudent for CLS

103
programs whose likely student population will include a majority of working

adults unless student financial support is substantial. Another factor to be
considered here is geographic location, which is an especially significant
barrier for working adults with other adult obligations and responsibilities, such
as working spouses and children in school.

The fourth item to be synthesized here is the relatively small number of
prospective students nation-wide that will be interested in doctoral studies in
CLS, as projected from this study.

The following recommendations are based on four assumptions: (a)
Programs likely to develop doctoral programs for CLSs have relatively few
faculty with only a modest amount of funded research on-going. (b) These
programs have responsibility for an accredited undergraduate program and a
master’s program with all the teaching and administrative responsibilities
attendant to these. Therefore, they have relatively little time for teaching and
administering a doctoral program. (c) There is likely to be less than one
doctoral student annually and slhe will prefer to be a part-time student because
of adult responsibilities. Hence, his or her program will last at least 4 years
post-master’s degree. (d) Most prospective students will live geographically
distant from the university.

When considered together, these factors suggest that cooperative
programs allowing sharing of resources will be necessary for programs like

those surveyed. Among the programs surveyed this may be planned but this

104
information was not specifically sought. Resource sharing may be within the

institution, as with Northeastern University. However, it may be possible to rely
on the resources Of outside institutions within reasonable geographic distance,
as at Catholic University. For example, researchers in local industries (e.g.
pharmaceutical, chemicals, diagnostics), medical research centers, or public
health agencies may act as research directors for doctoral candidates, thus
easing the academic department’s resource needs both in faculty time and
laboratory supplies, equipment, and space. This model is effectively an
extended, but traditional model of graduate education with all course work
offered on campus. but the research experience offered Off campus.

The extended model may work very effectively for institutions that are
geographically close to other facilities that have on-going research programs.
Since this model presumes the student will be in residence reasonably close to
the academic institution in order to attend classes, the model is probably most
reasonable for academic institutions that are in large population centers and
therefore can expect a more consistent supply of prospective students.

An alternate model may be more appropriate for institutions that do not
have the prospects of resource sharing within a reasonable geographic
distance or those in areas of low population density with uncertain prospects
for a regular supply of students. The alternative is a university-unmout-walls
model and may take one of two forms, centralized or consortium.

The centralized model would suggest that a given institution, e.g.

105
University of X, offers the doctoral program. Courses are presented in formats

that are easily delivered electronically so that students at significant distance
can participate and assignments are handled either through the mail or
electronically. The student’s research is directed by an individual approved by
University of X but geographically near the student and probably working in
facilities like those used in the extended model above. Periodic (e.g. annual)
visits to the university may be required for short-tenn courses and conferences
with supervising faculty. The degree is ultimately granted by the University of
X.

Theoretically, a student in any geographic location with the necessary
research resources available could earn a doctorate from the University of X
and in that sense the centralized university-without-walls model could easily
meet student needs for access. It does ease the resource demand on the
sponsoring institution since the research portion of the student’s degree would
be off-campus as in the extended model above. However, the major
disadvantage of the centralized model is that it does not address all the
institution’s needs. The responsibility for teaching a full array of courses still
resides with the University Of X and may pose a burden to the small faculty.
Further, such a small faculty is necessarily limited in expertise and the breadth
of the degree will be limited.

A consortium model addresses some of the disadvantages of the

centralized model. A consortium of programs currently providing master’s

106
degree programs could be fonned. Each program would seek approval from

its institution to sponsor a doctoral degree by resource sharing with the
consortium. Using electronic modes of delivery, each institution would
contribute a course (or several courses) relying on the expertise of its faculty.
Faculty at each institution would supervise the research Of their own students.

The consortium model addresses the institution’s needs for resource
sharing because each institution would ofier fewer doctoral-level courses than
in the previously discussed models. A degree of shared curriculum planning
would be needed among the participating institutions. However, major
responsibility for supervising research and the attendant expenses of that are
still borne by each institution. By inclUding multiple institutions, the model
extends the geographic area which would be served by doctoral programs but
still requires students to be reasonably close to a participating university.

A fourth model that is a hybrid of the extended and consortium models
could be developed - an extended consortium model. Once the consortium
model is developed, the individual institutions could Offer their students the
option of having their research director be an off-campus researcher at some
geographic distance. The expanded consortium model has the advantages of
minimizing the course teaching obligations of any single institution as well as
minimizing the resource demands for providing research experiences. The
student has maximum access by virtue of being able to participate in the

degree program without moving and could conceivably participate on a part-

107
time basis. This model would seem to hold good prospects for grant funding

by relying on institutional cooperation and maximizing access for prospective
students. These same features may help overcome the concerns of

administrators in regard to faculty numbers, time, funding, and facilities.

airman
The resources within the CLS profession to develop doctoral programs

were surveyed. The resources at institutions proceeding with doctoral studies
and those that are not were generally comparable, therefore other factors affect
the decision to proceed. Those factors may include attitudes of administrators
but may also include institutional factors not studied in this survey such as
institutional structure. Three programs out Of 32 studied reported being in the
planning process for a doctoral program. Nearly all respondents reported
having difficulty identifying and recruiting doctoral-level faculty who are also
professionally certified in CLS, thus substantiating a limited need for graduates
of doctoral programs in laboratory science. An extended consortium model for
a doctoral program is recommended to maximize access for students while

minimizing the demand on institutional resources.

BIBLIOGRAPHY

American Association of Colleges of Nursing. (1978). Survey of doctoral
programs in U.S.A. conducted by AACN. Nursingjesesm 21. 324.

American Medical Association (1989). W
Chicago, IL: Author.

American Society for Medical Technology. (1988). W
Warns. Washington 00: Author

American Society for Medical Technology. (1989). W
Wage. Washington, DC: Author.

American Society of Allied Health Professions. (1989). W

W. Jackson, MS: University of Mississippi Medical
Center.

Ashton, J.W. (1965). Other doctorates. In E. Walters (Ed.) W
Meg. Washington, DC: American Council on Education.

Beck, SJ. and Chamness, MS. (1990). Graduate education for clinical

laboratory scientists. WW 3(1). 49-53.

Brubacher, J.S. (1962). The evolution of professional education. In N.B. Henry
(Ed), Eegeetien fer the professions; The six_ty-first yeemeels ef the Netienel
W (p- 47-67). Chicago: The University of
Chicago Press.

Catholic University. (1989). Ph.D r in ' i l l ' n .
Washington, DC: Author.

Cleland, V. (1976). Developing a doctoral program. W 25(10),
631-635.

Cross, K.P. (1981). Were. San Francisco: Jossey-Bass.

Davis, B.G. (1985). Specialized accreditation: The relationship between
attitudes toward outcome oriented standards and the professionalization of
medical technology. (Doctoral dissertation, Memphis State University, 1985).

W. £97k

108

109

Day, CM. (1989). The other side of the doctoral question. Wm
Science. 2(5). 262.

Downs, ES. (1988). Doctoral education: Our claim to the future. Nursing
murals. 3.60). 18-20.

Frohman, E. M. (1989). The doctoral debate. W 2(3),
134.

Grace, H. K. (1978). The development of doctoral education in nursing: In
historical perspective MW 11(4) ”-27

Greenwood, E. (1966). The elements of professionalization. In H.M. Vollmer &
D.L. Mills (Eds.), W. (p. 9-19). Englewood Cliffs, N..l.:
. Prentice-Hall, Inc.

Heinemann, RI. (1967). Graduate study interests Of medical technologists.
ml fM i IT nl 3(6),505-512.

Heinemann, R I (1969). The college and university in medical technology
education WW 35(8) 491-501

Heinemann, RI. (1971). Continuing education in medical technology. Amefieen
WW 31(4). 147-156.

Kelly, C. K. (19903) MT with first doctorate instills excellence. mm
Wists. 2(28) 1243

Kelly, C. K. (1990b) Northeastern Upgrades Lab Science Program. Meets;
medimuechnclogists. we 12

Kelly, C.K. (1990c) Doctoral program revised to meet current needs. Mme
Wists. 2(28). 13.

Knowles, M. (1980). - ' = -
W. Vlfilton, CT. Association Press.

 

Leininger, M. (1976). Doctoral Programs for nurses: Trends, questions, and
projected plans. dualism 25(3). 201-210.

Lenz, ER. and Morton, PG (1988). Non-nurse faculty in schools of nursing.
Mam 36(4). 182-185.

110
Matarazzo. JR D (1971) Perspective In W

nf r n 1..(pp 49-105). Bethesda.
MD: U.S. Department Of Health, Education and Welfare.

Matarazzo, JD. and Abdellah, F.G. (1971). Doctoral education for nurses in
the United States. W 29(5), 404-414.

Mendelson, MA (1988). The doctoral degree in clinical laboratory science:
Prospects for the future. WW 1(6), 326-331.

Murphy, J.F. (1981). Doctoral education in, of, and for nursing: An historical
analysis. Muslim 29. 645-649.

Murphy, J.F. (1984). Essential resources for developing a doctoral program in
nursing- W 9. 6-10.

Murphy, J.F. (1985). Doctoral education of nurses: Historical development,

programs, and graduates. Ann IR ' N in r 3,171-189.
Northeastern University. (1988). W

metessjens. Boston, MA: Author.

Rausch, V. L, Bartzack, C, Catchings, 8., Howard, B., and Pruden, E. (1982).
Report of the topic study group on graduate education in medical technology.

‘ WEI“) 9135-942

Seibert, ML (1985). The future of clinical laboratory science: A crisis in
education. In G.D. Price and K. Karni (Eds.), Th r f lini

W. Minneapolis, MN: University of Minnesota.

Shores, LS. (1986a). Analysis of decisions to initiate doctoral programs in
nursing- W 1.10). 26-30.

Shores, LS. (1986b). Opening a doctoral program in nursing: Factors to
consider. mm. 31(6), 286-288.

Simpson. R. (1983). Wafer
MW. Guildford, Surrey, England: Society for Research into
Higher Education.

Starck, P. (1980). Practical aspects of conducting a feasibility study for
graduate education in nursing. W 19,, 33.

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vonVorVS. 8 (Ed) (1989) W
W (23rd ed”) Princeton. NJ: Peterson’ s
Guides.

Westgard, J. O. Clinimetrics may be forcus for graduate studies. Qljgieel
mm 15(7). 5 31

Williams, MR. (1971). u ' _
Philadelphia. Lea and Febinger.

 

n r l f r n
Berelson. B. (1960). W New York:

McGraw-Hill Book Company.

Eells WC and Haswell H A (1960) WWW

o:.o.r unf rrs- . in it iconsfhio-h r -d :tio-ninth n'-- 2:1».
Bethesda, MD: U. S. Department of Health Education, and Welfare.

Undberg, D.S., Britt, M.S., and Fisher, PW. (1984). W
W. Philadelphia: Lea and Febinger.

Prior, ME. (1965). The doctor of philosophy degree. In E. Walters (Ed.),
W (30-61). Washington, DC: American Council on
Education.

Simpson R (1983) W
W. Guildford, Surrey, England. Society for Research into
Higher Education.

Spurr, SH. (1970). A mi r r ' Inn v iv .New
York: McGraw-Hill Book Company.

Walters, E. (1965). The rise of graduate education. In E. Walters (Ed.),
W (pp. 1-29). Washington, DC: American Council on

Education.

APPENDIX A

112

MICHIGAN STATE UNIVERSITY

 

wanton. rtcrtrrowov recount am unsure - marrow - «us-rise
rm weiiowtt mitt '
ism iii-rues

FaemedocUdeducefimfannddeogisu.mneedbidmfilyCAHEA
accredited medical technologyprogramsthatalso administer master's degree programs designed
especially for medical technologists. llyoursissuchaprogram. please completetheinformstlon
requested belowand rettrntoKathyDoigattheaddressabovebyJanueryio. 1990. Thankyou.

 

CAHEA accredited program/institution

 

Address

 

 

 

CAHEA program director

 

Graduate programtitle

 

Chief administrator of the graduate program

HempMdefiunmmdaddmudfiufirstukmnediatdy-supefiaadmldemb
Miomrequeststoinstituteadoctoralprograrnmuldbedirected.

 

Administrator/Dean

 

Address

 

 

 

MSU is a Mir-um AW W Inuit-use

APPENDIX B

113

CIJNICAL LABORATORY SCIENCE
DOCTORAL PROGRAM STUDY

Program Administrator’s Survey
Please complete the following survey regarding doctoral education in clinical laboratory science.
For the purposes of this survey the phrases “clinical laboratory science“, “medical technology“,
“medical laboratory science“ and “medical laboratory technology“ will be considered synonymous.
Part I
misfirasquuediomaslsyomopinbnabmndodomlwumfimbrnndimlmdfmbgists.
Indicate the degree to which you agree or disagree with the following statements by circling the
letter representing the opinion which is most like your own: Strongly Agree (SA), Agree (A),
Disagree (D) and Strongly Disagree (SD). Please feel free to comment in the margins.

1. The terminal academic degree in clinical laboratory science in
the U.S. mm is the master’s degree SA A D SD

 

2. The terminal academic degree in clinical laboratory science in
the U.S. M1122 the doctoral degree ....... SA A D SD

 

3. There is a need for more doctorally- prepared clinical
laboratory scientists - SA A D SD

 

4. There is no need for more doctoral programs specifically
designed for clinical laboratory scientists ---SA A D SD

 

5. There is a need for more doctoral programs in clinical
laboratory science SA A D SD

 

6. It is preferable for clinical laboratory scientists to
earn doctoral degrees in clinical laboratory science --.---SA A 0 SD

 

7. Doctoral programs in clinical laboratory science should confer a
professional doctorate, like the Doctor of Nursing Science,
rather than a PhD ---SA A D SD

 

8. There are as employment options for graduates of doctoral
programs in clinical laboratory science - - -- SA A D SD

 

9. The curricular emphasis of doctoral programs for clinical
laboratory scientists should be unique as compared to other disciplines ..... SA A D SD

114

10. Clinical laboratory scientists should preferably earn doctorates
in sciences related to laboratory medicine such as microbiology .................. SA A D SD

11. The curriculum of doctoral programs in clinical laboratory
science should be designed by certified laboratory scientists
who also hold doctoral degrees in education - - - ---SA A D SD

 

12. For a certified laboratory scientist, a doctoral degree in
clinical laboratory science is more professional than a doctorate
in a different discipline SA A D SD

 

13. Development of doctoral programs in clinical laboratory science
will do nething to further the laboratory science profession SA A D SD

 

14. Decisions about instituting doctoral programs in clinical
laboratory sciehce will be made by parties gm the laboratory

 

 

 

 

science profession -......SA A D SD

15. Clinical laboratory science is get a distinct discipline with a

research base adequate to support doctoral education- -..SA A D SD

16. Clinical laboratory scientists are as; capable of developing

doctoral programs and supervising doctoral students - SA A D SD

17. Doctoral programs designed for clinical laboratory scientists

should also admit non-certified individuals SA A D SD
Part II

Thisnmdsddquedmsaslsmopinimsabmfiflmmsourcesofywrdhimlbboratay
Scienceunittoinitiateadoctoralprogram.

18. Our faculty possess the skills, knowledge and ability to supervise
doctoral students in research SA A D SD

 

19. Our faculty possess the interest to supervise doctoral students
in research SA A D SD

 

20. We have the laboratories, libraries and other necessary facilities to
support doctoral students SA A D SD

 

21. We have the funding necessary to support a doctoral program ....... SA A D SD
22. We have the time necessary to supervise doctoral students ............. SA A D SD

23. We have sufficient numbers of faculty to institute
a doctoral program SA A D SD

 

115

24. There is sufficient demand from prospective students
for a doctoral program in clinical laboratory science SA A D SD

 

25. There will be demand from employers for graduates of
a doctoral program in clinical laboratory science SA A D SD

 

If you feel that the faculty, facilities or funds are currently inadequate to support a doctoral
program in your facility, please estimate the incremental increase needed in each of these areas:

26. Faculty

27. Funds
a One time only, start-up costs

b. Recurring, annual expenses

28. Facilities

29. Are there other PhD and/or professional doctoral programs in other disciplines offered
within your college or comparable academic unit?
[1 no
[ ] yes; please list degrees and up to five majors

30. Do you have access to a hospital or other clinical facility as a source of clinical specimens
for research?

lino
lives

31.

32.

37.

116

How much support do you have from the dean of your college or comparable
administrator for development of a doctoral program within your unit?

[1 none
[] complete
[] tentative
[] ldon’t know

Do you have support from the graduate school or college (or comparable administrative
unit) for development of a doctoral program within your unit?

3

l l o

[1 yes, tentative support
[ ] yes, complete support
[ ] I don’t know
How many faculty do you have who have an active research program is. supported by
outside funds or publish regularly in peer-reviewed journals or submit grants for support
Of research or actively conduct research.

number what percentage of your faculty is this?

 

What is the overall level of external funding for support of research in your unit?

On average, how many peer-reviewed manuscripts are published annually by faculty in
your unit?

On average, how many grant requests for support of research are submitted annually by
faculty in your unit?

What is the average dollar amount of the grant proposals submitted from your unit?

117

Part III

ThenmdsdchuesflasaslsabmdmiMmfimsbdevdopadodaaipmgrwnbrnedicd
technolojsts.

Please place an “x“ in the box next to the response which most closely represents your opinion.
Select only one response unless otherwise directed. Please feel free to comment in the margins.

38.

Has your institution/unit considered initiating a doctoral degree program in clinical
laboratory science?

[ 1 no -> go to question 48

[ l we have briefly discussed it but have no plans for developing a program in the
near future -> go to question 48

l l we have seriously discussed it but have rejected the idea; briefly describe your
rationale for this decision then -> go to question 45

we have submitted a proposal to higher administration for consideration
we have approval for implementation and have initiated planning for an
implementation date of

H"
Ha

 

a) What type of degree are you planning to offei?

[ ] Doctor of Philosophy (PhD)

[ ] Doctor of Education (EdD)

[ 1 Doctor of Science (DSc)

[ ] Doctor of Arts (DA)

[ ] professional doctorate ie. Doctor of Clinical LabOratory Science or Doctor of Medical
Technology

[1 other; please specify

 

b) What was the rationale for offering this degree?

What will be the title of the major for the doctoral degree you propose?

41.

42.

I]

ll
_ [] institution-supported fellowships; amount
' ii

[i

[l

118

Summarize, or provide apprOpriate documents, that describe the requirements for the
doctoral degree which you propose eg. admission requirements, number of credits of
course work, numbers of credits of research, major topic areas for course work, language
requirement, residence requirement. etc.

What sources of funding will support the doctoral program you propose? Mark all which
aPP'Y-

reallocation of unit funds

additional permanent institutional funds
institutional start-up funds only

external grant for start-up

other; please specify

HHHHH
HHHHH

 

What sources of financial support will be available for graduate students? Mark all which
aPP'Y-

teaching assistantships; amount
research assistantships; amount

 

 

tuition waivers
external grants and fellowships
other; please specily

 

List the major problems or obstacles you perceive in gaining administrative approval for
a doctoral program.

119

PartN

mmmmmmmmmmmmmmma
notyoumitwouldhstilmeadoctordprogramatthistime.

45.

Regarding your decision relative to developing a doctoral program, with which of the
following did you consult? (Mark all that apply)

other doctoral programs within the college

other doctoral programs within the university

doctoral programs in medical technology programs at other institutions
persons within the graduate school/college on your campus

other; please specify

Hnfinn
“Han“

 

46. Did you conduct a needs assessment for a doctoral program in your unit?

47.

l i no
[ ] yes; please mark all your needs assessment methods

survey alumni
survey prospective employers

survey other medical technology programs

survey current master’s degree students

survey current bachelor’s degree students

survey local medical technologists

collect data on unsolicited inquiries

contact existing doctoral programs in clinical laboratory science
others; please specify

__—__n_——
HHHHHHHH-

 

 

Did you use any resources from professional associations such as the American Society
for Medical Technology or the American Society of Clinical Pathologists in making your
decision about instituting a doctoral program?

[ ] no
[ ] yes: please list any documents or describe any resources used and explain how they
were used

120

Pat V

fliehstsdofquesfimsaslsbrdamgmphicinfonmfimmywrpmgmmdfawfiy.
48. a. How many students have graduated from your master’s degree program in the last 5
years?

b. How many of them completed a thesis?

c. In which areas were theses written? Indicate number of each.
clinical sciences
education

laboratory management
other; please specify

 

d. How many of the graduates of the last five years have entered doctoral programs?

49. How many inquiries regarding doctoral studies have you had in the last year?
50. a. How many tenure-track faculty vacancies have you had within the last 5 years?

b. Have you sought to hire doctorally-prepared candidates for at least some of these
vacancies?

[] no -> go to question 52
[ ] yes: doctorate only in a science related to clinical laboratory science
[ ] yes: doctorate in any area of expertise including education/laboratory management

c. Have you required professional certification in addition to a doctoral degree?

[] no; -> go to question 51

l ] yes; certification as a generalist clinical laboratory scientist

[ ] yes; certification in a laboratory specialty

[ ] yes; certification as a generalist clinical laboratory scientist or in a laboratory specialty

51.

52.

121

d. Have you been successful in recruiting doctorally-prepared. professionally-
certified faculty with the credentials you require?

[ ] yes, in all cases; -> go to question 51
[ ] not in all cases; describe the specific combination(s) of qualifications which you have
not been able to find eg. certified MT with PhD in science and expertise in hematology

e. Describe what you have done when you were unable to find a candidate with the
preferred combination of credentials eg. waive the certification requirement,
reopen search, etc.

Describe any problems not mentioned above that you have had in recruiting doctorally-
prepared faculty.

In which of the following is your unit administratively housed?

academic health science center

college of allied health or pharmacy and allied health
college of arts and/or sciences

college of nursing
college of medicine
other; please specily

HHHHHH

 

Which of the following positions do you hold? Mark all that apply.

[ ] faculty in the clinical laboratory science program

[ ] CAHEA medical technology program director

[ ] chairperson/program director of undergraduate program

[ ] chairperson/program director of master’s degree program

[ ] dean/administrator of college/unit which houses the clinical laboratory sciences
program

[ ] other; please specify

 

122

How many students are there at your university/college?

How many students are there in your clinical laboratory science program?
undergraduates
graduate students

If you would care to offer any additional opinions about doctoral education for clinical
laboratory scientists, please do so here.

CONTINUE ON NEXT PAGE

123

57. Please complete the following chart which describes your faculty. Include yourself as
Number 1. You may distribute it to faculty to facilitate its completion. Make additional
cOpies of this page and attach it necessary

Highest Major/ ‘ Professional Academic Tenure?
degree department certifications rank y or n
earned of degree and agency

 

 

 

 

 

 

 

 

 

 

 

10.

 

 

 

 

 

Thank you taking the time to complete this survey.
Please return the survey en er eefore March is, 13$ in the postage paid envelope
to: Kathy Doig, M.S., CLS

E-37 McDonel Hall

Michigan State University

E. Lansing, MI 48825

(517)353-7800

APPENDIX C

124

CUNICAL LABORATORY SCIENCE
DOCTORAL PROGRAM STUDY

Please complete the following survey regarding doctoral education in clinical laboratory science.
For the purposes of this survey the phrases “clinical laboratory science“, “medical technology“,
“medical laboratory science“ and “medical laboratory technology“ will be considered synonymous.

Part I
Thisfirstsamqucwasaslsywopinbnammdodordedumdmbrnmmiss.
Indicate the degree to which you agree or disagree with the following statements by circling the
letter representing the opinion which is most like your own: Strongly Agree (SA), Agree (A).

Disagree (D) and Strongly Disagree (SD). Please feel free to comment in the margins.

1. The terminal academic degree in clinical laboratory science in
the U.S. mm is the master’s degree .......... SA A D SD

 

2. The terminal academic degree in clinical laboratory science in
the U.S. W the doctoral degree ---_-.-.SA A D SD

 

3. There is a need for more doctorally-prepared clinical
laboratory scientists- - SA A D SD

 

4. There is no need for more doctoral programs specifically
designed for clinical laboratory scientists ..... SA A D SD

 

5. There is a need for more doctoral programs in clinical
laboratory science - - ......................... SA A D SD

 

6. It is preferable for clinical laboratory scientists to
earn doctoral degrees in clinical laboratory science ........................................ SA A D SD

7. Doctoral programs in clinical laboratory science should confer a
professional doctorate, like the Doctor of Nursing Science.
rather than a PhD ........... SA A D SD

 

8. There are as employment Options for graduates of doctoral
programs in clinical laboratory science - ....... SA A D SD

 

9. The curricular emphasis of doctoral programs for clinical
laboratory scientists should be unique as compared to other disciplines ..... SA A D SD

125

10. Clinical laboratory scientists should preferably earn doctorates
in sciences related to laboratory medicine such as microbiology .................. SA A D SD

11. The curriculum of doctoral programs in clinical laboratory
science should be designed by certified laboratory scientists -
who also hold doctoral degrees in education _ ............... SA A D SD

 

12. For a certified laboratory scientist, a doctoral degree in
clinical laboratory science is more professional than a doctorate
in a different discipline .SA A D SD

 

13. Development of doctoral programs in clinical laboratory science
will do nething to further the laboratory science profession - SA A D SD

 

14. Decisions about instituting doctoral programs in clinical
laboratory science will be made by parties outside the laboratory

 

 

 

 

science profession - - ..SA A D SD

15. Clinical laboratory science is n_ot a distinct discipline with a

research base adequate to support doctoral education -- - --SA A D SD

16. Clinical laboratory scientists are 993 capable of developing

doctoral programs and supervising doctoral students .................................... SA A D SD

17. Doctoral programs designed for clinical laboratory scientists

should also admit non-certified individuals ..... - SA A D SD
Part II

Thisnefisaofquesfiommyouropinbnsabommemsoumesofyomamubomow
Scienceunittoinitiateadoctoralprograrn.

18. Our faculty possess the skills, knowledge and ability to supervise

 

doctoral students in research ........ -- - ---SA A D SD
19. Our faculty possess the interest to supervise doctoral students
in research u...-....SA A D SD

 

20. We have the laboratories, libraries and other necessary facilities to
support doctoral students - ----- ---- ---SA A D SD

 

21. We have the funding necessary to support a doctoral program ....... SA A D SD
22. We have the time necessary to supervise doctoral students ............. SA A D SD

23. We have sufficient numbers of faculty to institute
a doctoral program ...................... SA A D SD

 

126

24. There is sufficient demand from prospective students
for a doctoral program in clinical laboratory science - ..SA A D SD

 

25. There will be demand from employers for graduates of
a doctoral program in clinical laboratory science ........ SA A D SD

 

If you feel that the faculty, facilities or funds are currently inadequate to support a doctoral
program in your facility, please estimate the incremental increase needed in each of these areas:

26. Faculty

27. Funds
a. One time only. start-up costs

b. Recurring, annual expenses

28. Facilities

29. If you support the idea of developing a doctoral program, but the resources are
inadequate, how could adequate resources be obtained?

CONTINUE ON NEXT PAGE

127

Part III

flienmdsachuawmsaslsabmnymuhuenfimsmmadodoralpmgmmfunndical
technologists.

30.

31.

32.

Has your institution/unit considered initiating a doctoral degree program in clinical
laboratory science?

[1 no

[I we have briefly discussed it but have no plans for developing a program in the near
future

[ ] we have discussed it seriously but have rejected the idea; briefly describe your

rationale for this decision

[ ] we have submitted a proposal to higher administration for consideration
[ ] we have approval for implementation and have initiated planning for an implementation
date Of

 

What problems or obstacles do you see to gaining administrative approval for a doctoral
program in clinical laboratory science?

Have you experienced difficulty in hiring doctoral-level faculty in your clinical laboratory
science/medical technology program?

i i no
[ ] yes: please describe the types of problems you have had

35.

128

Are there other health-related programs within your college or comparable administrative
unit?

[ ] no
[1 yes, please list all health-related programs in your college/unit

Are there other health-related programs at your institution which are housed in colleges
(or comparable administrative units) other than yours?

I] no
lives

To what degree have you faced problems similar to those you described in question 32
when hiring faculty in fields other than clinical laboratory science?

[ ] The problems are the same in all health professions
[ j The problems are worst in

 

specify profession
[] The problems are worst in medical technology

In which profession have you had least difficulty hiring doctorally-prepared, professionally-
certified faculty members?

Why do you think this has been easier?

PartIV

Tlielastsetofquestionsisondemographicdata.

36.

Which of the following do you administer?

academic health science center
college of allied health

college of arts and/or sciences
college of nursing
college of medicine
other; please specify

nmmnnn
HHHH—H

 

37.

40.

41.

129

What is your highest earned academic degree?

In what major/department did you earn the degree named above?

What professional credentials or certifications such as an RN, CLS, RRT do you hold?

Are you the first administrator who would receive a request for a doctoral program from
the clinical laboratory science/medical technology program?

IIYes
II no

If you would care to offer any additional Opinions about doctoral education for clinical
laboratory scientists, please do so here.

Thank you taking the time to complete this survey.

Please return the survey en er mfere Mmh 15. 1a in the postage paid envelope to:

Kathy Doig, M.S., CLS
Medical Technology Program
E-37 McDonel Hall

Michigan State University

E. Lansing, MI 48825
(517)353-7800

APPENDIX D

130

4 ‘ '5: COLLEGE or NATURAL scrrznc: (5171 3554470

“ ' I HI AN STATE UNIVERSITY 103NofurolScienceBunding
/ M C 6 East Lansing. Michigan 48824-1115

 

February 27, 1990

DearDr.

Doctoral education for clinical laboratory scientists/medical technologists has become an
area of prominent inmost in the past year. We are interested in studying the opinions of
the administrators of medical technology programs as they are critical to the development
of doctoral programs specially designed for medical technologists. The data which we
amass will be useful to you and other administrators in developing, designing and gaining
approval for doctoral programs within your institub‘on. It will include information on the
characteristics of other programs, their status in developing doctoral programs and
prospectsforsuccessaswellasfhemarketforgraduates.

Since the success of doctoral programs lies with the administrators, deans and directors,
youopinionsareMtothestudyweareoonductlng. Aetherearefewlnstitutionswhich
can even consider sponsoring doctoral programs for medical technologists. your response
is especially important. Therefore, we ask you to take a few minutes to participate in this
study. T'hesuivey instrumenthas been pilottested onasample ofyour peersand has
been revised to maximize our data collection while minimizing your time commitment. In
all cases, the time for completion of the instrument was less that 30 minutes. As it is m
opinionsinwhichweareinterested, - - . f .

mt.

Theresults ofthesurveywill beentirely confidential. Thesurveycarriesacodenumberto
be used for follow-up only. In published reports of the results, only aggregate data will be
, reported and your individual responses will not be identifiable. You indicate your voluntary

agreement to participate by completing and retuming the survey.

 

“SCIENCE IS YOUR FUTURE - BEA PART OF IT"

‘Isl .s .m Allunulri'r' Ar tin-r (film) I lunatiiimir Irhtrfiifiiur

131

Page2

Pleaseretumthesurvey by March 15,1990. Shouldyou haveanyquesfions regardingthe
study. please call Ms. Doig collect between Barn-noon and 1pm-5pm (EDT), Monday
through Friday at (517)353-7800. We will be happy to share the executive summary of the
study with you upon its completion in mid-1990.

Your participation is sincerely appreciated.

Yours truly,
Sharon L Zablotney, Ph.D., CLS Kathryn Doig, M.S., CLS
Associate Dean Undergraduate Director

College of Natural Science Medical Technology Program

APPENDIX E

132

Approximately one week ago you should have received a letter from us requesting your
participation in the CLS Doctoral Program Study. If you have already returned your
survey, we would like to thank you for your prompt participation. If you did not receive
our letter, please call Ms. Doig eellect at 517-353-7800 between 8 am and 5 pm EST.

If you have not yet completed your survey, we would like to remind you that it will take
less than 30 minutes of your time. Your participation is critical since there are so few
programs which currently offer graduate study for medical technologists. Without your
response, the data may be inaccurate and misleading. Please complete the survey and
return in before March 15, 1990. Your prompt participation will facilitate completion of the
project and dissemination of the results to you and others. Thank you.

Sharon L Zablotney, PhD, CLS Kathryn Doig, M.S., CLS
Associate Dean Undergraduate Director
College of Natural Science Medical Technology Program
Michigan State University Michigan State University

APPENDIX F

  

133

COLLEGE or NATURAL SCIENCE (51713554470

J p l AT N l V E R S | T Y 103 Natural Selence Budding
2: MIC H l G A N S E U 5051 Lonsmg. Michigan 48824-1115

March 22. 1991

DearDr

Approximately three meks ago you received a request from us for your participation in a
survey regarding doctoral education for clinical laboratory scientists. To date we have not
received your response. If you have completed the survey already, we thank you for your
participation and you can discard this correspondence. If you have misplaced the previous
mailing. we have enclosed another copy of the survey.

Asweexplained inourfirstlettertoyou,weareinbrested instudyingtheopinionsofthe
deans and program chairpersons of medical technology programs as they are critical to the
development of doctoral programs specially designed for medical technologists. The data
which we amass on doctoral programs for medical technologists will be useful to you and
other administrators in developing, designing and gaining approval for doctoral programs
within your institution. It will include information on the characteristics of other programs,
theustatusindevelopingdoctoralprogramsandprospectsforsuccessaswellasthe
market for graduates.

Since the success of doctoral programs lies with the administrators. deans and directors.
your Opinions are emcial to the study we are conducting. As there are few institutions which
can even consider sponsoring doctoral programs for medical technologists. your response
is especially important. Without it, the data may be inaccurate and misleading. We are
awaiting your response to complete the survey results. Therefore, we ask you to take a few
minutes now to participate in this study. The survey instrument has been pilot tested on a
sample of your were and has been revised to maximize our data collection while minimizing
your time commitment. In all cases. the time for completion of the instrument was less that
30 minutes. ‘

The results of the survey will be entirely confidential. The survey carries a code numberto
be used for follow-up only. In published reports of the results, only aggregate data will be
reported and your individual responses will not be identifiable. You indicate your voluntary
agreement to participate by completing and retuming the survey.

"SCIENCE IS YOUR FUTURE — BE A PART OF IT"

‘hi 14...: Allmrmln l‘ 1.1mm (mu? 1 tr {nullr'lllu ’n-Iirriruur

134

Page2

PleaseretumthesuiveybyAprile.1990. Shouldyouhaveanyquestionsregardingthe
study, please call Ms. Doig Quect between Barn-noon and 1pm-5pm (EDT), Monday
through Friday at (517)353-7800. We will be happy to share the eoiecutive summary of the
study with you upon its completion in mid-1990.

Your participation is sincerely appreciated.

Yours truly,
Sharon L Zablotney, Ph.D., CLS Kathryn Doig, M.S., CLS
Associate Dean Undergraduate Director

College of Natural Science Medical Technology Program