Developing core competencies to reform medical laboratory scientists’ curricula in Low-Middle-Income Countries (LMIC)

Background: Medical laboratory technologists face challenges related to inconsistent formal education, insufficient post-qualification training opportunities, and limited oversight by a national accreditation body. Objective: The purpose of this study was to obtain consensus from field experts on the exit competencies essential for medical laboratory graduates for developing a competency-based curriculum for an MLT training program. Design: Using the CDC/APHL competency framework developed by the Centers for Disease Control and Prevention (USA) and the Association of Public Health Laboratories, experts from related disciplines selected relevant competencies, followed by a Delphi survey to establish consensus. Responses were collected via a Likert scale, and consensus was defined as ≥ 80% agreement. Data was analyzed using SPSS. Ethical approval was obtained from the AKUH Ethical Review Committee. Results: A total of 11 workshops were conducted in a flipped format to finalize 106 competencies from the source guideline and included in the Delphi questionnaire. Ninety-five competencies achieved ≥ 80% agreement in the 1st round, and three competencies reached agreement in the 2nd round. The competencies spanned core system-level and operational domains such as quality management systems, ethics, leadership, communication, safety, surveillance, and informatics, and were applied across laboratory disciplines, including microbiology, clinical chemistry, hematology and blood banking, bioinformatics, and research. Conclusion: This Delphi study identified 98 competencies for MLSs across 17 domains, providing the first structured, contextually grounded competency framework for a graduate program in MLS education in Pakistan.