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- Department of Laboratory Sciences and Primary Care, Texas Tech University Health Sciences Center, Lubbock TX
- Department of Laboratory Sciences and Primary Care, Texas Tech University Health Sciences Center, Lubbock TX
- Address for Correspondence: Joel Hubbard
, TTUHSC, Dept. of Laboratory Sciences and Primary Care, 3601 4th Street, STOP 6281, Lubbock, TX 79430, 806-743-3256, joel.hubbard{at}ttuhsc.edu
ABSTRACT
A passing score on the American Society for Clinical Pathology Board of Certification (BOC) exam is a metric of a student’s academic success in most Clinical Laboratory Science (CLS)/Medical Laboratory Science programs. It would be ideal if CLS/Medical Laboratory Science programs were able to predict a student’s success when an individual applies for admission to a CLS/Medical Laboratory Science program. This study aimed to demonstrate that there was a positive correlation between admissions scores at the Texas Tech University Health Sciences Center (TTUHSC) School of Health Professions and students’ performance on the BOC exam. Using simple linear regression analysis with Pearson correlation, specific criteria that are part of the application and admissions scoring process were used to determine the relationship. The results of the study indicated moderate positive correlation between certain criteria and BOC exam performance, but they provide enough information to make an admissions decision on students who would have the best chance of success in the TTUHSC CLS program and the profession.
- ASCP - American Society for Clinical Pathology
- BOC - Board of Certification
- CLS - Clinical Laboratory Science
- GPA - grade point average
- MLS - Medical Laboratory Science
- SHP - School of Health Professions
- TTUHSC - Texas Tech University Health Sciences Center
- TAS - Total Admissions Score
INTRODUCTION
Since 1985, the Department of Laboratory Sciences and Primary Care at Texas Tech University Health Sciences Center (TTUHSC) has offered a traditional face-to-face in-classroom two-year Bachelor of Science curriculum in Clinical Laboratory Science (CLS). The traditional CLS program at TTUHSC has had an average class size of 20–30 students per admissions cycle. In the fall of 2008, TTUHSC began to offer an online one-year Bachelor of Science CLS degree program, and a one-year certificate program was added the following year. The online CLS program enrollment averages approximately 50–60 students per cycle. Student enrollment in the traditional program typically consists of a younger group of men and women beginning their junior year in college, whereas the online students comprise a more diverse group of men and women of various ages from different educational and employment backgrounds. These students enter a rigorous 12-month program that includes two weeks of hands-on laboratory training on-site at the TTUHSC campus and a 12-week preceptorship at an accredited clinical site.
In any professional academic program, the admission process is designed to select applicants of the highest caliber to ensure student academic success in that program. Professional programs that include health professions programs, law schools, and dental schools use scores obtained on postgraduation certification or licensing exams to indicate student academic achievement within that program. For a CLS educational program, one key metric of success is student performance on the American Society for Clinical Pathology (ASCP) Board of Certification (BOC) examination.
The purpose of this study was to determine if there is a positive correlation between certain components of TTUHSC CLS student applicants’ admissions assessment and their ASCP BOC exam overall score after completing the program. This study examined the correlation between several elements of the admissions evaluation process, including science grade point average (GPA), nonscience prerequisite GPA, the interview score, and the Total Admissions Score (TAS) with postgraduation BOC exam scores.
Whether a CLS academic program is traditional, online, or hybrid, high pass rates on the BOC exam are the goal of most laboratory science programs, as these scores are indicative of students’ mastery of the curriculum. However, how or whether a program can predict if a student will pass the BOC exam remains a question. Many of the applicants to the TTUHSC CLS online programs seek admission to advance from a medical laboratory technician to a medical laboratory scientist, whereas others with a degree in biology or biochemistry simply look to put their skills to effective use. Undergraduates in the traditional program pursue this direction in their desire to be involved in health care or to find something that will provide them with gainful employment in an area they enjoy. Student goals following graduation vary, but each CLS student’s goal before that event is to attain a degree or certificate from the CLS program and pass the ASCP BOC exam. Because the diverse applicant pool is large, the TTUHSC CLS programs looked for a way to predict student outcome based on information obtained during a student’s application and admissions office review. Since passing the BOC exam is a metric of student academic success, TTUHSC devised a correlation study with the hypothesis that certain parts of the application and admissions evaluation (the independent variables) will positively correlate with a passing score on the BOC exam (the dependent variable).
Similar studies of admission criteria and student success have been performed with other health-related professional programs. Although it is recognized that some of these studies come from different health-related programs and are based on the achievement of different competency skills, the comparison of their admission criteria to students’ passing of their proficiency exams revealed some important associations to this study. In a study of the Doctorate of Veterinary Medicine1 and Doctorate of Physical Therapy programs admissions criteria and postgraduation competency, studies reported low correlations between admissions criteria and outcomes on licensing exams and indicated a need to reevaluate admission criteria as predictors of school success.2,3 In a national study of Physical Therapy students scheduled to graduate in the years 2000 through 2004 from 20 programs, Utzman et al’s3 study provided an in-depth statistical analysis of admission criteria correlated to the National Physical Therapy Exam results and found that the strongest correlation existed between poor verbal Graduate Record Examinations scores and exam failure. However, a study of a dental school admission criteria reported a strong correlation with overall school performance (in which admissions criteria were included) and licensing exam results. This study indicated that the best predictor of success was students’ performance during their enrollment in the program of study.4 Conway-Klaassen5 reported recent studies of an Medical Laboratory Science program’s admission selection criteria compared with postgraduation achievement as measured by passing scores on the ASCP BOC exam. This retrospective analysis demonstrated moderately positive and significant correlations between cumulative GPA, science GPA, and prerequisite GPA and performance on the BOC exam. Another recent study authored by Alaki et al and published in 20166 regarded undergraduate pre–dental school applicants and their interview scores, motives, and ambitions. These authors reported that those aspects of the dental school application were significant positive predictors of student GPA and concluded that the interview score was predictive of future academic performance. The purpose of this study was to determine if there is a positive correlation between certain components of TTUHSC CLS student applicants’ admissions assessment and their ASCP BOC exam overall score after completing the program. This study examined the correlation between several elements of the admissions evaluation process, including science GPA, nonscience prerequisite GPA, the interview score, and the TAS with postgraduation BOC exam scores.
MATERIALS AND METHODS
The TTUHSC traditional face-to-face classroom CLS program’s admissions data from 2010 to 2014 (n = 115) and the TTUHSC online (postbaccalaureate and certificate) CLS program’s admissions data from 2011 to 2014 (n = 117) were used for this study. For each of these years, students’ postgraduation ASCP BOC exam scores (n = 117; the dependent variable) were recorded. Admissions data used as independent variables included the components of the Academic Score (student’s science GPA, nonscience prerequisite GPA, and essay score) and the Student Interview Score. Using simple linear regression and Pearson correlation, data from both traditional and online programs were analyzed to determine if a positive correlation existed between TTUHSC CLS program’s admissions criteria with the national certification exam scores. Institutional review board approval was not required for this study.
ADMISSION PROCESS
Each year in early spring, the School of Health Professions (SHP) Office of Admissions and Student Affairs opens the admissions process to select students that will enter the program in the fall semester of the same year. The SHP Office of Admissions and Student Affairs collects and collates all the applications for each of the CLS programs. This office reviews and evaluates applications for completeness to ensure that all required prerequisite courses are completed with a minimum grade of “C” or higher. Applications include a completed application form, up-to-date official transcripts showing all courses taken from all colleges attended, and the applicant’s written essay. Once assessment for completeness of the applicant’s folder is done, it is sent to the TTUHSC Department of Laboratory Science and Primary Care CLS Admissions Committee to review for admission. Students with the highest TASs are granted admission to the CLS programs.
ADMISSIONS CRITERIA AND ADMISSION SCORE
The TAS is a composite score that represents the two major admissions criteria: academic performance and student interview skills. The TAS consists of the sum of the Academic Score and the Student Interview Score, which are worth 50 points each. The Academic Score is a composite of the student’s science GPA, nonscience prerequisite GPA, and essay score. The science GPA is ranked on a scale of 6–20 possible points (6 points being a GPA of 2.5 and 20 points for a GPA of 4.0). The student’s nonscience prerequisite GPA is ranked on a scale of 6–15 possible points (6 points being a GPA of 2.5 and 15 points for a GPA of 4.0). The student’s essay is worth 15 points, which are achieved if the essay is well-written using correct grammar and spelling, reflects an understanding of the profession, and contains clearly stated personal goals. See Figure 1 for Academic Score Sheet. All applicants with higher-than-average Academic Scores will be invited for an interview with two of the program’s faculty. The remaining 50 points of the TAS are assessed from the applicant’s interview score. Each applicant is asked a standardized set of questions in the areas of study habits and past academic preparation, motivation and interest in the profession, general knowledge about the profession, personal communication, and background and also includes the interviewer’s personal observations. The TAS from each student application is assessed and ranked on a 100-point scale.
Copy of the Academic Score Sheet used for the traditional CLS applicant.
STATISTICAL ANALYSIS
Simple linear regression analysis and Pearson correlation studies to determine coefficients of correlation and determination were performed to assess correlation and significance between components of the TAS and the ASCP BOC exam scores of students in the TTUHSC CLS programs. The Graphpad InStat3 program was used to obtain results. The dependent variable was the BOC exam score, and the independent variables that were correlated to the exam score included the TAS, science GPA, nonscience prerequisite GPA, and the Academic Score. The strength (fair, moderate, good, or excellent) of the correlations was assessed using the basic tenets for evaluating correlation coefficients,7,8 in which a correlation ranging from 0.00 to 0.25 indicates little or no relationship; those from 0.25 to 0.5 suggest a fair degree of relationship; values of 0.50–0.75 are moderate to good; and values above 0.75 are considered good to excellent. Significance indicated how different the regression line was from a line having no slope (flat). Scatterplots were prepared to illustrate these results. Coefficients of determination indicated what percentage of the BOC exam scores could be attributed to the independent variables.
RESULTS
Results of the statistical analyses of the study are summarized in Table 1; scatterplots are shown in Figure 2A–H. The TAS of the traditional classroom students demonstrated a fair positive and significant (p = 0.005) correlation with an r value of 0.321 compared with that of the students in the online programs (p = 0.009; r = 0.239). The association of science GPA and BOC exam scores showed significant moderate and positive correlation. In this case, the traditional CLS students’ and the online students’ science GPAs produced correlation coefficient values equal to 0.329 and 0.261, respectively. When correlated to the BOC exam scores, nonscience prerequisite GPA of the traditional classroom students achieved significance (p = 0.001) with an r value of 0.381, indicating a fair positive correlation between these two measures. The r value of the online students’ nonscience prerequisite GPA compared with the BOC exam score was equal to 0.250, also indicating significance (p = 0.007) with a weak positive correlation. Correlation of the Academic Scores (science GPA, nonscience prerequisite GPA, and the essay score) to the BOC exam score produced an r equal to 0.266 (fair correlation) for the online students but only an r equal to 0.102 for the traditional students. Coefficients of determination (r2), although low in each case, were above 10% for all of the traditional students’ BOC exam correlations, with the nonscience prerequisite GPA being highest (14.5%).
Correlation of TTUHSC CLS program admission criteria with student BOC exam scores
(A) Scatterplot of online students’ TAS correlation to BOC exam score, (B) scatterplot of traditional students’ TAS correlation to BOC exam score, (C) scatterplot of online students’ science GPA correlation with BOC exam scores, (D) scatterplot of traditional students’ science GPA correlation with BOC exam scores, (E) scatterplot of online students’ nonscience GPA correlation with BOC exam scores, (F) scatterplot of traditional students’ nonscience GPA correlation with BOC exam scores, (G) scatterplot of online students’ academic score correlation to BOC exam score, and (H) scatterplot of traditional students’ academic score correlation to BOC exam score.
DISCUSSION
Findings of this study support the hypothesis that criteria in the application and admissions evaluation (the independent variables) positively correlate with a passing score on the BOC exam (the dependent variable). Although it is understood that correlation does not imply causation, the results indicate that there is a positive relationship between the independent and dependent variables and that the relationships are fair to moderate. It is the goal of the TTUHSC CLS programs to generate students who will go on to become successful laboratorians, researchers, or other health care professionals. With this in mind, the TTHUHC CLS admissions committee should focus on the admissions criteria that produced the strongest relationships with the student performance on the BOC exam. The admissions process is important to the TTUHSC CLS program if the data examined here determined that the final admission score might not only predict the student’s academic ability and success in the CLS program but also predict whether the student will pass the BOC exam as well. This information is crucial in keeping program attrition rates low by choosing the best applicants to ensure student academic success. In this study, fair yet significant predictors of student success in three of the four categories (TAS, science GPA, and nonscience prerequisite GPA) indicated that the academically strongest applicants will be the most successful students in the TTUHSC CLS programs. However, with the weak correlation between the traditional students’ Academic Scores and their scores on the BOC exam, it seems that there is little relationship to performance on the BOC exam score no matter how high or low these students score on the Academic Score Sheet. Interestingly for the online students, the Academic Score correlation to the BOC result had the highest r value of the four correlations, as opposed to the very weak and nonsignificant traditional students’ result. This could indicate that these students might be better equipped to navigate the BOC exam than their traditional counterparts because of their maturity, life experiences, and possession of a degree or degrees.
The findings also demonstrate that although these factors may influence some students’ academic success in the TTUHSC CLS programs of study and their eventual BOC scores, they are not absolute. It has been observed in the TTUHSC CLS programs that an entering student with a weak GPA but a high interview score sometimes achieves a high score on the ASCP BOC exam at the end of the program. Factors that this can be attributed are many, including student age, maturity, and previous health-related experiences. Previous studies of student academic and proficiency exam success related to admissions criteria have also indicated this same premise.1⇓⇓-4
The current study was designed to be a preliminary study of the relationships between admissions data and BOC exam scores only. A further analysis utilizing chi-square statistics will specifically compare admissions requirement scores with the BOC exam scores of students who pass the exam and those who fail the exam. This study will include other independent variables, such as sex, age, postbaccalaureate education, time of employment in a clinical laboratory, or university attended. To this extent, it is of general interest to examine the mean values of ASCP BOC exam scores of the online group of CLS students compared with the traditional face-to-face classroom group in addition to comparing the mean values of the science GPAs of the traditional students and the online students using a t-test. A quick analysis of the t-test results did reveal a very significant difference between the means of the two sets (traditional and online CLS students) of BOC exam scores (p = 0.0063) and science GPAs (p = 0.005). These data, once fully gathered, will be reported in a forthcoming manuscript.
CONCLUSION
How well students may perform in a CLS program is based not only on preprogram GPAs but may further depend upon factors that are difficult to measure. For example, individual maturity, novelty of the curricular material, ability to work in groups, and professional aptitude may mold a student’s likelihood of achieving success in any preprofessional academic program. With TTHUSC CLS programs, the predictor of passing the BOC is most likely the student’s performance within a program’s curriculum, something that was not examined in this study. Regardless, based on the findings of this study, the TTHUSC CLS programs can judiciously use the fair correlations to modestly forecast a student’s chance of success in completing the CLS program and successfully passing the BOC exam.
- Received January 8, 2018.
- Accepted May 17, 2018.
American Society for Clinical Laboratory Science
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Keywords
- ASCP - American Society for Clinical Pathology
- BOC - Board of Certification
- CLS - clinical laboratory science
- GPA - grade point average
- MLS - medical laboratory science
- SHP - School of Health Professions
- TTUHSC - Texas Tech University Health Sciences Center
- TAS - Total Admissions Score
- clinical laboratory science
- admissions criteria
- board of certification
- education