A recent water cooler topic in the clinical laboratory science world is the prospective Doctorate in Clinical Laboratory Science (DCLS) degree. Laboratorians have different views on how this degree could change the field and the way it's viewed. Some still have questions: What will one have to do to obtain this degree? What kind of responsibilities will a person holding a DCLS have in the lab? How long until schools start offering DCLS programs?

ADVANCE spoke with DCLS task force and committee members to get the lowdown on this degree and to help answer some of your questions.

The History
Many different people and groups have been discussing the possibility of a doctorate degree for years. Elissa Passiment, EdM, CLS(NCA), executive vice president of the American Society for Clinical Laboratory Science (ASCLS), dates the discussions back to 1987, when ASCLS, then the American Society for Medical Technology (ASMT), produced a position paper on where education for the clinical laboratory science profession should go in the future.

"The paper recognized the ever-changing science and the health policy issues the profession was facing were straining the curriculum at every level," Passiment told ADVANCE. "That paper mentioned a doctorate and what this level of practitioner might do."

Passiment reported after much debate and study, the ASMT House passed a position in 1989 that the terminal degree for the medical laboratory profession should be the doctorate by 2000.

In 1999, Cheryl Caskey, MA, CLS, CLSpIH(NCA), then ASCLS president-elect and chair of the ASCLS Long Range Planning Committee, and her group reviewed ASCLS positions. She posed the question if the doctorate was still a good terminal degree. This led to discussions and the 2005 ASCLS position paper on Advanced Practice.

Around the same time, the National Accreditation Agency for Clinical Laboratory Sciences (NAACLS) held its Futures Conference of stakeholders, according to Randall S. Lambrecht, PhD, FASAHP, MT(ASCP), dean and professor, UW-Milwaukee College of Health Sciences, and chair of the NAACLS Doctoral Review Committee.

"The purpose of the conference was to look into the future and imagine the possible roles laboratory professionals would have," Dr. Lambrecht said. "It was clear clinical laboratory science as a professional discipline needed to emerge as having a significant role as part of the future healthcare team."

After the conference, NAACLS appointed a task force to study the feasibility of advanced graduate professional degrees for the field. Dr. Lambrecht said the task force produced numerous documents on the subject and issued formal updates to stakeholder organizations. After receiving feedback, the NAACLS Board of Directors held a second Futures Conference in 2004.

"There was strong consensus to maintain the current entry level degree for CLS/MT, but there was also general support for considering a clinical or advanced practice doctorate in the field," Dr. Lambrecht recalled.

Later, a multiorganizational task force was formed among members of ASCLS, NAACLS and the American Society for Clinical Pathology (ASCP) to discuss what the doctorate would look like, what the curriculum would be and how to develop and implement the programs in schools.

The Responsibilities
There was one conclusion all the tasks forces and committees agreed on: a position needed to be created to act as a liaison between the laboratory and the rest of the hospital.

"We quickly realized there was a huge gap in the healthcare information continuum, for patients and providers alike who didn't fully understand the implications of laboratory test results," Passiment said.

"What is missing from our field is the keystone degree that would look at the practice from a quality and future standpoint," said Elizabeth Kenimer-Leibach, EdD, MS, CLS(NCA), MT(ASCP), SBB, chairman and associate professor, Department of Biomedical and Radiological Technologies, Medical College of Georgia, Augusta; and chair of the ASCLS DCLS task force. "We need to make sure the services we offer are what the healthcare system needs."

Dr. Kenimer-Leibach added some laboratorians have been stepping up to become the liaison, but without the needed formal training.

"Some of us are filling that role on an informal basis, but with experiential training and not formal training," she said. "What we are setting up to do with the DCLS is to formalize that education, giving them the skills and training they need. They would also be salaried to do this job."

What exactly would a person holding a DCLS do? "A clinical laboratory professional with a DCLS will have the knowledge and stature to develop, implement and oversee protocols for the appropriate ordering of laboratory tests and the use of laboratory information," Dr. Lambrecht explained.

Additionally, this laboratorian will aid in diagnosis and treatment of the patient by providing knowledge to other healthcare practitioners.

Dr. Lambrecht pointed out currently, clinical laboratory scientists do have the knowledge to assess test results, but they do not have access to all the patient information needed to interpret them. A person with a DCLS would have access to this information and be able to look at a patient's whole healthcare picture.

A person holding a DCLS degree would not have to work in a hospital setting. She could also work in a reference laboratory, physician practice, industry, public health agency, government facility, research organization or an academic institution, according to NAACLS.

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