by Herb Miller, Ph.D., MT(ASCP)
As the National Accrediting Agency for Clinical Laboratory Science (NAACLS) turns 50, I have been asked to share some of my memories of what it was like when NAACLS started. I was privileged to have Ruth French, a founding leader in the establishment of NAACLS, as a mentor. Ruth was an Associate Professor at the University of Illinois-Chicago and the Medical Technology Program Director from 1966-72. She was Assistant Dean of the College of Associated Health Professions from 1972-1974, and Associate Dean for Academic Affairs from 1974-1984. Ruth served as secretary on the inaugural NAACLS Board of Directors, and later as President of that Board. At the time, several of my colleagues in Chicago and I were enrolled in a Master of Health Science in Education degree program that was competency-based. Ruth made sure that we used our knowledge and experience in the development and review of the NAACLS accreditation guidelines.
Competency-based education was at the forefront of the education arena in the early 70s. It provided a clear and thoughtful relationship between curricular content and educational outcomes. Bloom’s Taxonomy  became a familiar term involving domains and measurable outcome levels. Accreditation essentials (a term previously used for standards) prior to the formation of NAACLS did not require the submission of detailed performance objectives. Emphasis was placed on clinical experiences and not as much on didactic content. Students were told that their job was not to diagnose, but to provide helpful data to aid in diagnosis. A wide variation in curriculum delivery and content existed. NAACLS established its accreditation essentials based on the competency-based educational model.
At the time that NAACLS was established, several categories for laboratory personnel existed: Clinical Laboratory Assistant (CLA), Medical Laboratory Technician (MLT); Medical Technologist (MT); Cytotechnologist (CT) and Histotechnologist (HT). Most “training” programs, now termed “educational” programs, were located in hospitals. Curricular content varied and was dependent on the abilities, availability and knowledge of the laboratory staff of the training institution. Program quality was evaluated on the passing rates for the ASCP certification examinations. Programs were administered by certified Medical Technologists who held the title “Educational Coordinator.” The title of “Program Director” was reserved for a Pathologist. To meet certification standards, hospital-based Medical Technology programs were required to affiliate with a university that awarded a Bachelor of Science degree at program completion. Programs located at university hospitals, who could grant a Bachelor of Science degree, established the 2+2 program model. The goal and mission of NAACLS was to standardize the curricula and accreditation of education programs in clinical laboratory science and related healthcare professions.
The political climate in Medical Technology at the time was quite tumultuous. Many have forgotten, and some do not know, that the formation of NAACLS marked a revolutionary victory for the Medical Laboratory Science profession in its efforts to wrest accreditation control from the American Medical Association (AMA) and American Society of Clinical Pathologists (ASCP).[3,4] Accreditation of allied health programs started in the 1930s, with Medical Technologists participating in an advisory role. The final decisions on essentials were ultimately made by physicians.
In its quest for professional recognition and educational program accreditation control, the American Society for Medical Technology (ASMT), now known as the American Society for Clinical Laboratory Science (ASCLS), brought several lawsuits against the ASCP-BOR for restraint of trade by monopolizing the accreditation and certification of medical laboratory personnel. A 1969 ASMT lawsuit stated that the ASCP-BOR “engaged in conspiracy to monopolize trade”.  Finally in 1973, after collaboration between ASCP and ASMT, NAACLS was established to be an independent accreditation agency.
In 1974, NAACLS held its first workshop to help program officials and faculty understand the new requirements for accreditation at the national ASMT meeting in Washington DC. There were many questions and, of course, captious complaints, but ample time had been allocated for these concerns prior to this meeting and the homologation of the new standards. I remember that I was given the hotel Presidential Suite as I checked into the hotel late, and this was the only room left. The suite had a large conference table which several of us used for group sessions to work on assignments. Attendees received overview instructions on the new accreditation requirements, the preparation of the self-study, paper review and site visit processes. Performance objectives and taxonomy levels were explained. Assignments were given on writing performance objectives and preparing a self-study. Long nights were spent completing these. The meeting content was overwhelming. I found, however, that it did help me prepare my own program self-study on my return to work. NAACLS continues to teach this content for Program Directors and faculty at its workshops.
Our professional education and accreditation procedures have changed greatly since I was a new Education Coordinator in the early 1970s. As a long time paper reviewer and site visitor for NAACLS, I remain confident that the NAACLS accreditation process is exemplary. It has standardized our curricula and is an outstanding model of distinction in accreditation.
- University of Illinois. Meeting minutes Board of Trustees. September 9-10, 1992. p.57.
- Shabatura, Jessica. University of Arkansas. Jul 26, 2022. Using Bloom’s Taxonomy to Write Effective Learning Outcomes | Teaching Innovation and Pedagogical Support (uark.edu)
- Brenta G. Davis, EdD. Edited and updated by Dianne Cearlock & Edward Rotchford. The History and Purpose of NAACLS. 2013. (Org. 1995). NAACLS Document
- Kotlarz, VR. Tracing our Roots: the beginnings of a profession. Tracing our roots: the beginnings of a profession – PubMed (nih.gov)
- Hanenberg, Justin, ASCLS, CM “History of the Medical Laboratory Science Profession ASCLS”. https://ascls.org/history-of-the-medical-laboratory-science-profession/