New93 role standards, now public
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Role standards

Laboratory

Medical laboratory scientist

What a newly certified medical laboratory scientist must do safely on a hospital core lab bench without a second pair of eyes: produce a result, decide whether it can be trusted, and stop it when it cannot. Drawn from the NAACLS career entry-level competencies for the medical laboratory scientist, with analytic content from the ASCP BOC MLS examination content guideline.

Practice this assessmentHire for this role
Expectations
10
Safety red lines
5
Sources
3
Version
1

Built from National Accrediting Agency for Clinical Laboratory Sciences, American Society for Clinical Pathology Board of Certification, US Government Publishing Office, Electronic Code of Federal Regulations. Reviewed by clinicians, last on .

01What the role is measured on#

Every verdict is made of the same five dimensions. Each is scored on its own, so a candidate sees where they are strong and where to work.

  • Clinical skillsThe hands-on and judgement work of the role: recognising what matters, acting in the right order, and knowing when something cannot wait.
  • Workflow and toolsGetting the work done in a real setting: the systems, records, equipment and handoffs the role runs on, used correctly and on time.
  • Patient communicationHow the role talks with patients, families and colleagues: listening, explaining plainly, and confirming what was understood.
  • Compliance and safetyThe rules that protect people: privacy, consent, infection control, reporting duties and the safety checks the role is accountable for.
  • Role knowledgeKnowing the job itself: what the role is responsible for, where its scope ends, and who to bring in when it does.

02What a ready hire does#

What a competent medical laboratory scientist does on day one, dimension by dimension.

Clinical skills

  • Performs analyses and, before releasing any result, verifies it against the instrument flags, the specimen's integrity, the patient's previous results and physiological plausibility.
  • Reviews a peripheral smear when criteria or flags require it, recognises the findings that change what happens to the patient today, and refers what needs a pathologist.

Workflow and tools

  • Applies acceptance criteria to every specimen, rejects the ones that would give a misleading result, and makes sure the rejection reaches someone who will recollect.
  • Works through an analyser fault systematically, keeps testing available through a verified backup, and returns the instrument to service only after it is shown to be working.

Patient communication

  • Communicates a critical result directly to a person responsible for acting on it, confirms it by read-back, documents the hand-off, and escalates until someone has it.
  • Answers a clinician's question about test selection, specimen requirements or an unexpected result with laboratory facts, and refers what needs a pathologist.

Compliance and safety

  • Evaluates quality control against defined rules before patient results are released, and when control fails, stops, finds the cause and deals with every patient result the failure could have touched.
  • Confirms that the specimen, the request and the patient match on at least two identifiers at every hand-off, and treats a mismatch in transfusion testing as a potential fatal error.

Role knowledge

  • Keeps the laboratory's records, proficiency testing and competency evidence true and complete every day, so an inspection finds the practice rather than a performance.
  • Directs technicians and processing staff only to work within their documented training and competency, and remains accountable for reviewing what they release.

03Safety red lines#

Any one of these keeps a candidate from Ready Day One, whatever the rest of the score. They are published so nobody meets them for the first time in the assessment.

  • Releases a result that is physiologically implausible or fails a delta check - for example a markedly high potassium with an unmeasurably low calcium, or a haemoglobin that has dropped without explanation - without investigating specimen integrity or identity first.

    A clinician will treat the number: a patient given potassium-lowering or calcium therapy for a contaminated specimen, or transfused on another patient's result, is harmed by the laboratory.

  • Releases patient results from a run with a rejected quality control, or repeats the control until it passes and releases without finding and correcting the cause.

    A failed control means the method cannot be shown to be accurate; releasing results from it sends potentially wrong values into treatment decisions and breaches CLIA quality control requirements.

  • Labels, relabels or accepts an unlabelled or mislabelled specimen that can be recollected, instead of rejecting it and requesting a new specimen.

    A label added away from the patient is a guess about whose blood is in the tube; the result, or the blood group, may belong to someone else.

  • Treats a critical result as reported when it has only been filed in the record, left in a message, or given to someone not responsible for acting on it, such as a unit clerk, and does not go on to reach a responsible caregiver.

    A critical value exists because the patient may die without prompt action; a result nobody responsible has heard is a result nobody is acting on.

  • Would fill in missing quality, temperature or maintenance records after the fact as if done at the time, or would discuss or refer proficiency testing specimens to another laboratory before the survey closes.

    False records hide whether patient testing was reliable, and proficiency testing referral or collusion is prohibited under CLIA and can cost the laboratory its certificate.

04Outside the role#

Knowing where the role stops is part of the standard. Going past it is not extra credit.

  • Does not diagnose, interpret results for a patient, or advise on treatment.Gives the clinician laboratory facts and method limitations, and refers interpretive questions to the pathologist or laboratory director.
  • Does not issue uncrossmatched or emergency-release blood without the ordering physician's documented emergency release.Issues group O red cells or the emergency product under the laboratory's emergency release policy, with the physician's signature to follow, and completes compatibility testing as soon as possible.
  • Does not change a released result in the record, or introduce an unvalidated method or procedure change, on their own authority.Issues a corrected report through the laboratory's corrected-report process and notifies the clinician, and brings a method change to the supervisor or director for validation.
  • Does not practise in a state that requires personal laboratory licensure, such as California, New York or Florida, without holding that licence.Obtains the state licence before performing testing there, and elsewhere works under national certification and the laboratory's CLIA personnel requirements.

05How it is assessed#

  • A spoken assessment

    An examiner talks the candidate through realistic cases from this role, and follows up the way a senior colleague would.

  • Five dimensions

    Each answer is read against the expectations above and rated on the same four-level scale.

  • The 70 bar

    Every scorecard shows the score against 70, overall and for each dimension, with the reason for the verdict.

  • Safety first

    Crossing one of the safety red lines holds a pass back, however strong the rest was.

The four levels

  1. Not yet
  2. Developing
  3. Proficient
  4. Exemplary
How a verdict is made

06Sources and review#

Drawn from the certification frameworks and practice standards below, and reviewed by clinicians. Version 1, last reviewed .

Cited as sources. Not an endorsement by the organizations named.

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