Implementing a New Prior Learning Assessment (PLA) Process PLA for MLA s 2012 CAPLA Conference Lorna Zilic, MLT Team Leader Certification & Prior Learning Assessment
Agenda Who is the CSMLS? Eligibility to Exam Why do PLA? Stakeholder Impact Competency Based Testing Prior Learning Assessment (PLA) Credentialing Challenges The PLA Process PLA for MLA Taskforce Accountability
CSMLS Vision
CSMLS Mission Expand CSMLS s Sphere of Influence Transform the Profession Champions for Patient Safety Invest in the Organization
CSMLS Values The CSMLS is committed to high ethical and professional values by promoting excellence in all our endeavors
Who We Are Not for profit association National certifying body for Medical Laboratory Technologists (MLTs) and Medical Laboratory Assistants (MLAs) National professional society for medical laboratory professionals Represents >14,500 members in Canada and around the world! National PLA service for MLTs Located in Hamilton, Ontario Established in 1937
What We Do Set the national standard (Competency Profiles) for certification of Medical Laboratory Technologists (MLTs) and Medical Laboratory Assistants (MLAs) Create and administer competency-based examinations Prior Learning Assessment process for Internationally Educated Medical Laboratory Technologists (IEMLTs)
Additional Services Continuing Education (Distance) Professional Liability Insurance Volunteer Opportunities Advocacy Grants and scholarships National Conference-LABCON Research
The Very First Exam 1938 System has undergone major changes since then!
Four Certifications General MLT clinical chemistry hematology clinical microbiology transfusion science histology/histotechnology Technologist exams are considered high stakes (mandatory for profession) Diagnostic Cytology Gyne & Non-Gyne Clinical Genetics Cytogenetics & Molecular Genetics Medical Laboratory Assistants (MLA)
Eligibility to MLT Exam Option A Option B Graduate of a CMA Accredited MLT program Equivalent through the Prior Learning Assessment process at CSMLS
Eligibility to MLA Exam (Current) Option A Option B Graduate of a MLA program Validated on the job experience
Eligibility to MLA Exam (January 1, 2013) Option A Option B Graduate of a CMA Accredited* MLA program Equivalent through Prior Learning Assessment process at CSMLS * Or scheduled for accreditation
Why do PLA for MLTs? Current MLT shortage need more technologists Assist in the integration of highly skilled internationally educated professions Federal, provincial and territory government priority Allows candidates to be compared on an individual basis (currently there is no reciprocity to any program or country) To provide reasonable access to their profession for newcomers To ensure that Canada benefits fully from the education, training and experience of all skilled MLTs
PLA By the Numbers (MLT) In 2011, there were 190 first time assessments 22 were eligible for exam on first assessment (twice the amount from 2010) 168 were presented with a specific learning plan; those who do not qualify for a specific learning plan are required to complete a full CMA accredited MLT program. ONE structured bridging program Ontario Mohawk College(Hamilton, ON) Approximately 11 spots
Why do PLA for MLAs? Unregulated profession in Canada Some MLA programs have no clinical! Some make students find their own clinical placement Many were not being trained by laboratory professionals CSMLS felt it was time to declare the standard (Competency profile) and move to mimic the well respected MLT process
Why do PLA for MLAs? MLTs want to know the qualifications of people they work with in other words how do I know I can trust you? Facilities are pushing the boundaries of the scope of practice, and there is a need for external validation that competency has been achieved Only those who have been rigorously screened should have access to a certification exam. It is risky to have a low stakes process where anyone can sign up - must move to protect exam integrity.
Credibility CSMLS is an expert in setting standards for the profession (competency profiles) CSMLS has been certifying since 1937, MLAs since 2003 Experts in PLA MLT process is the envy of many professions and the darling of fairness commissioners We know how to do it, we do it well, and we have credibility. The perfect combination for great outcomes
Notice Period CSMLS knew the impact would be BIG Previously unchecked education programs, many collecting BIG tuition payments, would be subject to Canadian Medical Association accreditation if they wanted their students to be eligible to the national examination Some programs, we know, will not make it unless they invest appropriately and that s OK
Response from the Educators Most programs WANT seals of approval they use it as a market differentiator and they WANT to be accredited To date, 35 programs from across Canada have applied for accreditation 6 awarded 6 year accreditation, 2 awarded 2 year accreditation, 25 have registered for accreditation, 1 did not pass initial stage
High Stakes Testing The MLA exam is currently a voluntary exam: however, it is expected to become the entry to practice in some jurisdictions across Canada, and the MLT and Pathologist shortages further impact the field, increasing the need for a well-trained, certified workforce. CSMLS has invested in a high stakes process for the MLAs since 2003. MLA Exam: 2.5 h, offered three times per year Multiple-choice questions (1 right answer, worth 1 mark)
Licensure for MLAs Interest in licensure: ON AB NB BC Part of registration requirements will likely be successful completion of a certification exam. Who will be first? The race is on
The CSMLS Exam All Disciplines The CSMLS examinations are competency-based exams. A competency based exam is designed to determine whether a candidate is competent and safe to practice (at the entry level). Competencies have been clearly defined (competency profile) and weighted (exam blueprint) Its not about what the candidate knows, its how they apply it!
Competency Profiles - See Our Website
The Competency Profile Articulates expectations at an entry level Outcome based, patient centered competencies NOT a list of tasks or skills (old syllabus) Appropriate nationally
Competency Profiles and CSMLS Reviewed every five years or when the domain changes Favored format for health care Stakeholder input is critical Process take approximately 18 months
Exam blueprint outlines areas of importance for the national certification exam It is a welldefined sample of the domain
Credential Recognition at the CSMLS In 1999, the Council on National Certification (CNC) embarked on a move to develop a seamless, more clearly articulated process for assessing credentials of internationally-trained MLTs. Endorsed by all provinces except Quebec
CSMLS Challenges with Credential Recognition Documentation authentication challenges Risk management Skeptics in the profession is a paper-based review enough? Costs best practices, assessments, appeals, supplementary information, fee collection, processing, human resources
Client Challenges with Credential Recognition Original documentation requirement often difficult to obtain Amount of detail required Very high language standard Time (from application to employment)
Client Challenges with Credential Recognition Lack of accurate information prior to immigrating to Canada Cost (documentation, assessment fees, language, courses, programs) Disagree with assessment team report Frustration with process for licensure and certification (feel they should be linked)
Employer Challenges with Credential Recognition Time (from application to employment) Ignorance of PLA/licensing process some jurisdictions actively recruit overseas without understanding the process
PLA Information Handbook Scroll down page The PLA Information Handbook is located in the Examination Information and Resources Section on our website
Prior Learning Assessment Under the mandate of the Council on National Certification (CNC) To establish equivalency to the national competency profile Detailed review of: Education Work experience Certifications Professional development/ce
Prior Learning Assessment CSMLS established a formal prior learning assessment (PLA) process 1999 long history of qualification review since the 60s Single-site access to professional certification This coordinated national PLA service is unique to just two health professions in Canada at this time (others are moving to it)
Prior Learning Assessment The CSMLS & CNC have worked to ensure that the process for IEMLTs is: Transparent Fair Efficient Reduces Barriers
PLA - Top Source Countries (MLT)
PLA - Purpose To establish equivalency with the Canadian standard If equivalent client becomes eligible to challenge the national certification exam Certification is used for licensure in most provinces CSMLS does not grant certification without examination
PLA - Goals Maintain the standards of the profession Ensure a fair and equitable process Transparent process Meeting the needs of the profession, the employer and the public
PLA - Assessment The CSMLS Prior Learning Assessment (PLA) reviews education, training and work experience To qualify to write the Certification Exam, client must be declared eligible through the CSMLS PLA process This means Equivalency to the Canadian Competency Profile and language requirements, which is the standard for Canadian-educated medical laboratory technologists (MLTs) In January 2013 an assessment process is slated to be available to help current MLT PLA clients establish eligibility for the MLA Certification Examination
PLA - Cost The current fee only covers a portion of the total cost of administering and maintaining the PLA process. CSMLS does NOT receive funding from governments or regulatory bodies for providing PLA services. The process is subsidized by CSMLS members through annual dues
PLA - Process Timelines Assessment begins when all documents received at CSMLS (12 months from application) Assessment takes about 4-6 weeks Client has up to 2 years to complete the learning plan outlined in their report Once equivalent - 12 months (3 consecutive attempts) to pass the exam (same as domestic)
The PLA Process SUBMIT DOCUMENTS PRE-ASSESSMENT STAGE I ASSESSMENT = CLB 6 POST ASSESSMENT STAGE II EQUIVALENT = CLB 8 NOT EQUIVALENT EXAM LEARNING PLAN = Language Proficiency Testing (if applicable)
We assess IEMLTs to the Canadian standard as outlined in the Competency Profile: Competencies Expected of an Entry Level Technologist The public has a right to assume certification means quality
PLA: Two Main Stages The period of time that starts when PLA is applied for and ends when we have received all the required documents. We then assess the client s file and make a report. PLA: Stage II The period of time that starts when the PLA report is sent to the client. PLA: Stage I
PLA: Stage I 1. PLA Application & Fee Once the PLA application and fee are received, the client has 12 months to submit all documents 2. Supporting Documents 3. Assessment (Technical Report) When all required documents are received, files are submitted to the assessment team. (average 4-6 week turnaround)
Required Documentation Credential Evaluation MLT Education Work Experience Continuing Education ICES WES Canada Transcripts Course Outlines Clinical Education (internship) Most recent work experience (detailed) Includes continuing education and professional development courses, seminars and workshops related to medical laboratory technology
Required Documentation Language Proficiency Professional Certification Personal Competency Rating Booklet Online Self Assessment Two-Stage Language Proficiency Requirement Technical Review (CLB 6) Equivalent and Eligible to Exam (CLB 8) Professional qualification/licensure in medical laboratory technology Used to rate and compare ones education and training to the Canadian Competency Profile For self identification of knowledge gaps and aids in decision of whether or not to pursue Canadian certification
Language Proficiency Two-Stage Language Proficiency Requirement 1. Technical Review (CLB 6) This language requirement must be meet before the PLA file can be reviewed (technical report) 2. Equivalent and Eligible to Exam (CLB 8) This language requirement must be meet before candidate (client) can become eligible to write the exam Results need to be sent directly to the CSMLS from the testing agencies
Canadian Language Benchmark (CLB) Examples CLB 6 CLB 8 Go to Centre for Canadian Language Benchmarks Can Do checklists at: http://www.language.ca/display_page.asp?page_id=372
Official Documentation We consider a document official only if it is sent to us directly from the appropriate institution by mail; we accept paper documents only Documents sent directly to us by issuing institutions and agencies become the property of the CSMLS We do NOT accept faxes, e-mailed documents or photocopies personally sent to us
PLA: From Stage I to Stage II The Technical Report Once we have received all of the required official documents, files are given to the assessment team (4-6 week turnaround) for evaluation and a technical report is drafted Client will then receive their technical report (good for 24 months) and enter into Stage II PLA Technical Report PLA Technical Report PLA Technical Report
The PLA Technical Report Possible Outcomes: EQUIVALENT Recognition NOT EQUIVALENT Partial Recognition Non-Recognition If Equivalent: Proceed to Examination
The PLA Technical Report and there is Partial Recognition If Not Equivalent: Possible Outcome #1 Refresher Gap(s) Client must successfully complete a learning plan to fulfill the gaps identified in their technical report. A refresher gap is an area or discipline in which the client has not recently been involved. Client must successfully complete a learning plan to fulfill the comprehensive gap identified in their technical report. A comprehensive gap is an area in which the client has little or no education, clinical internship and/or work experience. Possible Outcome #2 Comprehensive Gap (one)
The PLA Technical Report and there is Non - Recognition If Not Equivalent: Possible Outcome #3 Comprehensive Gaps (> one) Non-Equivalent to the competency profile with more than one gap BioTalent Canada Medical Laboratory Assistant Full time CMA accredited MLT Program Possible Alternatives
PLA: Stage II Learning Plan Learning plan outlines how gaps identified in the technical report can be filled. Clients has two (2) years from the date on their report to successfully complete the learning plan Supplemental Documentation Appeal If a Not Equivalent technical report is received, client may submit additional documents within 90 days from the date of the assessment If a Not Equivalent technical report is received and the client believes that the assessment is wrong, they can challenge the result by submitting an appeal within 45 days from the date of the assessment
Eligibility Statement Once declared Equivalent in their technical report, the client will receive an Eligibility Statement Statements are valid for 12 months from the date provided on their statement This allows client three consecutive attempts to pass the exam Exam sessions are held three times per year in February, June and October
PLA for MLA Taskforce A PLA for MLA taskforce was established Face to face meeting in March 2012 Determined which competencies were essential to practice (paper based assessment) Taskforce consisted of: o MLTs and MLAs from across Canada o rural and non rural locations o seasoned professionals and new grads representation o first hand experienced with the PLA process
Taskforce Considerations & Challenges Will they need to do a self assessment? Is there a minimal education requirement (high-school)? Is language proficiency testing needed? Will we accept other certifications? Will we institute the currency factor like MLTs? Will we have an array of outcomes? Who should conduct the assessments? Will we have an appeal and/or supplemental documentation policy? How much missing content constitutes a full time program is required?
A Commitment to Accountability The CSMLS is committed to an evidence-informed research approach for PLA policies to ensure that the process is transparent, objective, fair and impartial, and does not create artificial barriers for IEMLTs
Specific Accountability Measures: 1999 Eliminated requirement for Canadian practice hours 2002 Opened PLA applications to clients in their country of origin 2005 Commissioned an external audit of PLA processes that found no significant barriers and made suggestions for minor refinements 2007 Added a second credential evaluation services (WES Canada) Added IELTS & CanTest to approved language proficiency tests 2008 Converted all PLA documents to plain language Established language benchmarks for certification and the workplace Introduced a two-stage language proficiency standard = Externally-funded projects
Specific Accountability Measures: 2009 Validated cut scores for language proficiency tests Validated an allied health language proficiency test Conducted a business case analysis of bridging programs 2010 Online self-assessment tool for PLA readiness Assessing the competency gaps of IEMLTs Loan libraries for IEMLTs Inter-professional workforce integration Peer support networks for IEMLTS 2011 PROJECTS IN PROCESS Self Directed Bridging Program: Refresher course validation and creation of a guidelines document for clinical placement Exam Preparation Resource for MLT s: Modules to answer common questions posed by IEMLTs = Externally-funded projects
A Consultative Approach CSMLS is leading the health professions in research in the areas of PLA, language proficiency and credentialing for IEHPs Involved in numerous consultative projects federally: including common orientation curriculum development for IEHPs Serve on advisory and stakeholder committees on projects being conducted by other organizations Work with stakeholders and other health professions to expand its relevance and mandate in research and to disseminate evidence-informed resources and data
QUESTIONS