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Canadian Society for Medical Laboratory Science (CSMLS)Future of the Professions: Who has the

Crystal Ball?

Christine Nielsen BHA, MLT, CAE

Bessie Carydis M MSc, BHA, ART

www.csmls.org/www.scslm.org

• Evolving needs in healthcare• Co-dependent nature of lab (subservience)• Setting the standards• Unfinished journey of regulation for MLA• Meeting future patient’s needs – impact of Boomers• Crystal ball

Drivers of Change


• Regulation of MLT (PEI, BC and territories excluded)• Delegation of Controlled Act - phlebotomy• Employer Demand – lazy HR departments• Evolving Technology – lab on a chip? POCT• Aging Demographics• HHR• IPC• Global migration• Starved for clinical placements• Devolution of duties

Dynamic Health Care-Evolving Landscape


• Are we actually in a health human resource crisis?

• Will the boomers ever retire?

• Will MLAs dominate the market place?

• Foreign Qualification recognition – we identify the gaps, WHO helps the clients fill them? Role of higher education

HHR


•CMA approves all CSMLS Competency Profiles for accreditation•MLT - since 1941•MLA - since 2007•Ensure integrity of ALL MLA programs – private and public•Certification exam offered to graduates of CMA accredited MLT and MLA programs, or equivalent through PLA•Certification accepted as entrance to practice for MLT/MLA in all provinces except Quebec•CSMLS Competency Profiles serve as scope of practice for MLT and MLA in Canada

Canadian Medical Association Accreditation


• Creation of National Competency Profiles• Periodic competency profile review- consultative process• Standardization of MLT/MLA Profession• Eligibility Criteria for CSMLS Exam - Additional Eligibility Pathway -

PLA• Competency Profile / blueprint for testing• Creation and delivery of national certification exam – often enough?

National Certification


• Every 5 years or when major change to domain• Taskforce composed of subject matter experts• Consultative process – educators, members, non-members,

practitioners, regulators, employers etc• Market demand - future competencies, emerging technologies• Major themes identified (feedback via survey)• Draft new competency profile• Consultative validation process with all stakeholders• If insufficient support – redrafted, validation cycle repeats• Process takes 12-18 months to complete

Competency Profile Review


Competency Profile Process


•PEI and BC are pursuing regulation of MLT•MLA not regulated in any province•Alberta, Ontario, Newfoundland, Saskatchewan, Manitoba all requested MLA regulation but denied•BC/PEI are pursuing MLT and MLA umbrella regulation•No MLAs in Quebec

Unfinished Journey of Regulation


• Rapid changes in technology (slow uptake in Canada)• Focus on molecular genetics, diagnostics and targeted therapies

• What is funded depends on province – individual willing to pay?

In Pursuit of the “Magic Bullet”


• HPV molecular testing vaccines have made great strides in cervical cancer

• Pap smear screening on a decline – change of screening matrix, change in screening algorithm – less cytotechs needed

• 2014 – Competency Profile review outcome was to expand the scope of practice to include histology, performing molecular techniques, pathology assistant duties and screening of histology slides

Sweeping Changes in Diagnostic Cytology


• MLTs MAY evolve into biomedical specialists – more in line with the rest of the world

1. Core Lab Technologist (hematology, transfusion medicine & microbiology)

2. Pathology Technologist (histology, cytology & pathology assistant)

3. Clinical Genetics technologist (cytogenetic & molecular genetics)

• MLA perform (not interpret) most lab tasks – automation

Crystal Ball - Within 20 years


• Dark Daily – May 12 – Significant Numbers of Primary Care Doctors Are Uncertain About the Correct Clinical Laboratory Tests to Order

• Will the NEW technologist become more involved in schedule of test, referral patterns, advising on appropriateness? Will anyone LISTEN?

• Designer genes, diagnostics and therapies• MLTs all involved in genetics??• Full automation with larger numbers of MLAs • What is the impact of global migration?

Crystal Ball - Within 50 years


• Molecular diagnostics – targeted therapies• Point of Care testing – at patient bedside

and homes – QA crucial• Changing roles – outside of the lab and in

the communities

Champions of Patient-centred Care


Christine Nielsen, [email protected]

Bessie Carydis, Director – Certification and PLA

[email protected]

www.csmls.org

www.csmls.org canadian society for medical laboratory science (csmls) future of the professions: who...

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