Thank you, Madam Chairman.
I'd like to share with you some concerns today in a key area of health human resources in the area of clinical education.
The medical laboratory has been referred to as the diagnostic engine of the health care system. With over 85% of physician decisions being based on medical lab results, you can be pretty well assured that you need to have a good motor in this engine. I think you would all agree that we need to keep this as a priority, and I hate to inform you, but the “service engine” light has been on for some time.
Canada is facing a nation-wide shortage of medical laboratory technologists. We predict that by 2015, half of Canada's MLTs will be eligible to retire. Since 1998, we've been alerting decision-makers that the number of seats in MLT education programs is not sufficient to produce enough new graduates to replace those who will leave the workforce. Currently there are 27 education programs across Canada, with an estimated 762 students enrolled in those programs.
Provincial governments across Canada have responded to our promptings about the shortages by opening new programs and expanding existing programs. This is a positive development; however, we're still short 120 seats of the recommendations contained in our 2002 HR report.
But there's a bigger problem.
Funding for new and expanding programs has been provided for the classroom portion only of those institutions. Unfortunately, little thought has been given to support for clinical training.
As with most health professions, clinical training is a vital component of medical laboratory science education. Completion of a clinical placement is a mandatory component of a Canadian accredited training program.
In 2002, our organization started to hear anecdotal reports that clinical sites, the vast majority of which are in hospitals, were finding it increasingly difficult to devote resources to educating students. Technologists on the bench simply didn't have the time to educate students, because of staffing shortages. Their first priorities—which they should have been—were patient results.
Our 2004 research study, Clinical Placements for Canadian Medical Laboratory Technologists: Costs, Benefits, and Alternatives, revealed several issues that compromise the ability to deliver the clinical component of MLT programs in the future. Significant issues identified in the study included inadequate funding for clinical education, student training resources seriously impacted by clinical staffing shortages, and a lack of research on best practices in clinical education.
Some people have suggested that clinical simulation would be cheaper, faster, and would relieve the burden on clinical sites. We wanted to put those assumptions to the test, and earlier this year we published the results of a study that found that simulation-based training to be resource intensive in terms of both personnel and equipment. Programs adopting simulation required the very expensive high-tech laboratory equipment that is used in today's hospitals, with very high start-up costs and operational costs—clearly a wasteful duplication of resources. Two colleges that participated in our study indicated that they had already been forced to terminate their simulation programs because of the lack of ongoing government funding.
Our study also revealed that there is a lack of research evidence to support the use of simulation in medical lab technology programs.
And we're not alone. Other health professions are facing similar problems. The pan-Canadian health human resources plan explicitly recognizes the importance of clinical education and sets a specific goal of increasing access to clinical training and clinical education.
Herein lies the rub. UBC's Dr. John Gilbert notes that the responsibility for funding of clinical education at the provincial level lies “in the purgatory of clinical education”, somewhere between the ministries of health and education. Specific funding for clinical education is pretty well non-existent. How can we increase access to clinical training if no one is willing to claim responsibility for providing the necessary resources to support it?
So where are we today? We're in a situation where clinical sites, primary hospital labs, are refusing to accept students because of staffing shortages. It has become a vicious cycle. They can't take students because they're too busy due to staffing shortages, and they're short of staff because there aren't enough new graduates.
We need to break this cycle now. CSMLS is recommending that provincial and federal governments target funds to support on-site clinical education for medical laboratory technologists. Across Canada, we need funding for 140 dedicated clinical preceptors in our labs who can devote the necessary time and attention to support students.
We further recommend that funding also be made available to conduct additional research into the value and effectiveness of clinical simulation. A reinvestment today may help ease the future impact of a shortage of medical laboratory professionals.