CLN Article

The Laboratory Workforce Shortage Demands New Solutions

Kimberly Scott

The shortage of qualified laboratory professionals is not a new story; it is also one that won’t go away. As the aging population and expanded health insurance coverage increase the demand for healthcare services, the need for qualified laboratory professionals is expected to grow. But whether the nation’s clinical laboratory educational programs can meet the anticipated need is far from certain.

In fact, an improving economy—even at its current sluggish pace—is making the shortage more acute, as the unemployment rate falls and older workers feel confident enough to retire. Data released in October show higher vacancy rates as well as higher anticipated retirement rates compared to just 2 years ago (Am J Clin Pathol 2015;144:432–43). By department, chemistry had the highest percentage of employees anticipated to retire in the next 5 years, 23.6%, followed by hematology at 19.51%, microbiology at 19.48%, and blood banks at 19.19%.

While it is clear that the demand for medical laboratory professionals is growing, the number of new students graduating from clinical laboratory programs is still declining, partly as the result of program closures. The nation’s labs need to fill more than 7,000 jobs annually, but U.S. clinical laboratory education programs are producing only about 6,000 qualified laboratory professionals each year, according to the National Accrediting Agency for Clinical Laboratory Sciences (NAACLS).

School closings in the last 15 years have reduced the number of medical laboratory scientists (MLS) and medical laboratory technologists (MLT) being trained annually. Since 1990, the number of laboratory training programs has dropped from 720 to 608, a decrease of more than 15%. Some states, such as Nevada, Vermont, and Wyoming, have only one NAACLS-accredited laboratory educational program, forcing labs in those states to recruit from other states.

Even as the number of laboratory educational programs has declined, many medical laboratory science programs could actually train more students than they are currently, but the difficulty comes in finding clinical placements where the students can complete their training, said program directors interviewed by CLN.

Janice Conway-Klaassen, PhD, director of the Medical Laboratory Sciences program at the University of Minnesota’s Center for Allied Health Programs, said her program has reduced the time MLS students spend on clinicals from 22 weeks to 12 weeks because the healthcare organizations where students are placed don’t have enough staff to devote 22 weeks to training. She is considering dropping clinical rotations even further, to 8 weeks, so that more students can participate.

Currently, the MLS program at the University of Minnesota graduates about 60 students per year. One-third have a job before they finish and the rest typically find employment within 6 months. Conway-Klaassen said the program could easily admit 100 students if it could get commitment from clinical sites to take on more students in rotation.

“There is definitely a shortage,” she said, noting that a lab in a neighboring state recently contacted her because it has a need for 25 laboratory scientists but is unable to fill that need through state programs. “Hospitals and labs don’t understand the return on investment,” Conway-Klaassen said. “Yes, taking a student does take a hit on your productivity, but if you have already pre-trained an employee, that person will require less training in the probationary period and you actually save money in the long run.”

In an effort to bring laboratory education programs and clinical sites together, HealthForce Minnesota recently hosted a laboratory professionals’ workforce summit. The event brought together representatives of several CLS programs and healthcare organizations from throughout the state to discuss the return on investment of serving as a clinical site, and discuss ways to improve how the programs and affiliates work together.

One way of increasing the number of 2-year MLT students that facilities can train is by spacing out the training schedule, suggested Rick Panning, senior administrative director for HealthPartners and Park Nicollet Care Group Laboratories in Minnesota, which is one of the clinical sites for University of Minnesota. HealthPartners’ hospitals provide clinical rotations for eight to 10 MLT students between January and May each year.

“If there were a way to spread this out more so that we could take some students in the fall, we could probably take more,” he noted. “I think Minnesota is situated better than many states in terms of supply and demand, but what I’m really worried about is in five to ten years down the road when a lot of our workforce retires.”

The average age of lab workers at HealthPartners’ hospitals is the late 40s to early 50s. “We have a lot of workers in the last stage of their careers and a lot in the early stage, but not a lot in the middle,” Panning said. “That’s where we are going to struggle. We are going to have to find ways to adapt.”

Conway-Klaassen agreed. “We need to look at a new paradigm for how we educate students,” she said.

The Virtual Laboratory

The National Institutes of Health (NIH) is funding just such an effort, called the eClinic. The project is developing 30 student learning modules featuring computer-based medical laboratory sciences information and uses high-quality 3D animated simulations and virtual laboratories for classroom settings.

The technology, being developed by the Athena Group, in close collaboration with three universities, will use virtual wet labs and advanced, embedded learning strategies to better prepare students for professional practice. The goal is to have the eClinic training modules available nationwide.

Mary Ann McLane, PhD, a professor of medical laboratory sciences at the University of Delaware, is helping to develop five student-focused modules and five faculty-focused modules for the second phase of the project. Also involved in the project are Morgan State University in Baltimore and George Washington University in Washington, D.C.

Noting that it is cost prohibitive for MLS programs to have all instrumentation available for students to practice on, McLane explained that the eClinic student modules will help bridge the gap between student labs and clinical rotations by allowing them to practice on virtual instruments. This experience will allow students to maximize the limited time they will have at clinical sites.

“Ultimately, the goal will be that these modules will help in providing the students with what they need to know regardless of, or in addition to, the training they are getting at their facility,” McLane said. “This should make the time they spend at the clinical affiliate more efficient.”

The University of Delaware MLS program currently graduates 36 students annually, placing students at 25 clinical affiliates in Delaware, Maryland, Pennsylvania, and New Jersey. Students have four clinical rotations, each 4 weeks long for a total of 16 weeks. And like Conway-Klaassen, McLane said the program is limited only by the number of clinical affiliates available for training.

“Demand for qualified lab staff far outpaces supply, but we can only teach as many students as we can place in clinical rotations,” she said. “It is a challenge convincing hospital administrators that training is actually a critical part of their mission.”

Experts agree that meeting the increasing demand for qualified laboratory professionals will require laboratory administrators and staff to make a commitment to provide hands-on clinicals for students. At the same time, laboratory science programs will need to beef up their training so they can shorten the amount of time students must spend in clinicals. “We have to get creative,” Conway-Klaassen said.