Evaluating the impact of remote teaching on competency‑based outcomes in clinical laboratory education

We sought to determine whether instructional modality in 2 preclinical, laboratory-intensive courses, clinical laboratory science (CLS) 306 (Immunology and Blood Banking) and CLS 307 (Clinical Hematology), is associated with performance on the American Society for Clinical Pathology Medical Laboratory Scientist (MLS(ASCP)) Board of Certification exam.

We conducted a retrospective, single-institution analysis at California State University, Dominguez Hills (2020-2024 cohorts). The primary outcome was a composite competency index formed by standardizing the Immunology, Blood Banking, and Hematology subscores and averaging them. Secondary outcomes were the total examination score and first-attempt pass or fail. Ordinary least squares models with heteroskedasticity--consistent SEs adjusted for letter grades (A-F mapped to grade point values and mean centered). Multiplicity across secondary contrasts was controlled using the Holm procedure; sensitivity analyses repeated domain models after trimming the lowest and highest 10% and 15% of outcome distributions.

Students with any virtual exposure in CLS 306 or CLS 307 had lower adjusted composite performance, lower adjusted total examination scores, and reduced odds of passing the MLS(ASCP) on the first attempt than students who completed both courses in person, although mean course grades were modestly higher in the virtual sections of both courses. Taken together, these findings suggest that as students complete more coursework online, local grading has become less aligned with external competency benchmarks, such as the ASCP examination.

In this single-institution analysis, our findings suggest that hands-on laboratory teaching is important for maintaining competency-based outcomes. After accounting for course achievement, virtual instruction corresponded to modest reductions in certification performance and first-attempt pass probability.