Volume 7, Issue 7, July – 2022 International Journal of Innovative Science and Research Technology

ISSN No:-2456-2165

The Effectiveness of Medical Laboratory Trainees’

Internship Programs in Improving Technologists’
Competence and Operational Strategy for the
Healthcare Sector in Kenya
Josephat SUA

Abstract:- The study, anchored on the social learning In the majority of developing countries, training
theory, aimed to establish the effectiveness of clinical facilities for medical laboratory personnel in many training
laboratory trainee attachment programs in improving institutions are under-equipped with both qualified tutors
laboratory technologists’ competence in Kenya. Through and modern laboratory training equipment.
an e-mail survey, structured questionnaires that
targeted senior medical laboratory personnel working in Unlike the majority of other medical professions,
Kenyan medical laboratories were used to gather the clinical laboratory testing is equipment-depended and
data. The findings indicate that most of the study therefore the quality of patients' results released to doctors
participants were moderately allowed to operate depends heavily on the laboratory technologist's ability to
laboratory types of equipment. The lack of staff to guide understand the principles and operations of the types of
during the attachment is cited as a major equipment used in the laboratory.
challenge.Further, the study findings show that most of
As a result, part of the training curriculum for
the study participants believe that the current medical
laboratory attachment programs are not so effective in laboratory technologists includes a prescribed mandatory
providing them with the competence required for practical/ attachment within a hospital/laboratory setup to
gain types of equipment hands-on experience, and increase
employment as medical laboratory technologists.
confidence, and competence before entering the labor
Keywords:- Clinical laboratory, Competence, Healthcare market (Rioki, 2019).
sector and in Kenya, Laboratory Technologist, Trainee
attachment programs. Currently, the opportunities for clinical laboratory
trainee attachment openings before employment are limited
I. INTRODUCTION and faced with several challenges including inadequate
certified centers for attachments, inadequate laboratory staff,
Attaining health objectives in a population depends on and a lack of modern diagnostic types of equipment for
effective, efficient, and accessible services provided by practicals. Consequently, the newly graduated medical
human resources for health. These include doctors, nurses, laboratory technologists enter the labor market with limited
pharmacists, dentists, laboratory technologists, and other practical exposure and hands-on experience.
auxiliary professionals.
Failure to undergo a sufficient structured and standard
In Kenya, the training for human resources for health is attachment/internship program before entry into the labor
controlled by government-funded health regulatory agencies market might compromise the quality of diagnostic
which are mandated with the training and practice by healthcare services offered. This ultimately harms the
ensuring the availability and accessibility of medical operational effectiveness of health care units in Kenya.
professionals (Muthaura et al., 2015). The Kenya Medical
Laboratory Technologists and Technicians Board II. LITERATURE REVIEW
(KMLTTB) is mandated to provide general supervision of
training, employment, and practice of medical laboratory In Kenya, the medical laboratory workforce is grouped
technologists. into several categories depending on the level of their
training. Medical laboratory technicians (MT) are laboratory
Laboratory technologists provide a vital role in health personnel who have undergone a two-year certificate course
care delivery, especially for services that depend on in medical laboratory training while medical laboratory
diagnostic testing for decision making (Rioki, 2019). The technologists (MLT) are professionals who have undergone
demand for quality laboratory tests has been increasing year either a three-year diploma or four-year degree course in
after year due to the increase in the aging population and the medical laboratory training.
emergence of new disease states like COVID-19.
Using sophisticated equipment and technology,
Over the years, there have been three entry levels of laboratory technologists examine and analyze patients’
clinical laboratory personnel in the labor market in Kenya: a samples to guide physicians make correct treatment
two-year certificate course, a three-year diploma program, decisions.
and a four-year bachelor's degree in medical laboratory
sciences.

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Volume 7, Issue 7, July – 2022 International Journal of Innovative Science and Research Technology
ISSN No:-2456-2165
The Kenya Medical Laboratory Technicians and III. METHODOLOGY
Technologists Board (KMLTTB), a government
professional regulating authority, is mandated to regulate the This study applied an exploratory kind of study. The
training and practice of medical laboratory professionals. study targeted senior medical laboratory personnel working
in Kenyan medical laboratories. Structured questionnaires
A medical laboratory attachment is an internship were used to collect the data. The questionnaires were
program in which an unpaid work-based learning experience emailed to the respondents.
brings practical application to learning beyond the
classroom (Miller, 2020). The attachment aims to provide The study involved clarifying research questions and
hands-on experience in a laboratory testing environment objectives, collecting qualitative data through a semi-
while simultaneously creating a high level of awareness of structured questionnaire, and finally analyzing the data to
the challenges confronted by laboratory personnel. establish the relationship of the data.

A. Research Objective The data gathering process began with the

The study aims to establish the effectiveness of medical development and refinement of the questionnaire, which was
laboratory trainee attachment programs in improving then assessed for validity by a sample of medical laboratory
laboratory technologists' competence in Kenya. professionals. After the final questionnaire was designed, it
was administered to a sample of 28 medical laboratories at
B. Research Questions Kenya's Level IV county hospitals, and private and mission
 Which institutions in Kenya provide laboratory hospitals.
internship programs?
Eighteen (18) senior laboratory employees completed
 What are the challenges experienced by the laboratory
the questionnaire, which indicated their training and
trainees during attachment programs?
laboratory attachment history.
 How effective are medical laboratory trainees’
attachment programs in improving laboratory
technologists’ competence in Kenya?

IV. RESULTS

This chapter presents an analysis of the quantitative data collected and the results of the data analysis.

Fig. 1: Institution of First Medical Laboratory Training

Note: Extracted by the Researcher fromSPSS-Statistics data analysis output

According to the findings (Figure 1), 8 of the a similar number had received their first medical laboratory
respondents (44.4%) indicated to have received their first training from private universities.
medical laboratory training from the Ministry of Health
(MOH) medical training college while 4 (22.2%) had These findings indicate that medical laboratory training
received their first medical laboratory training from a in Kenya was mostly conducted by government-sponsored
governmentuniversity. The findings also indicated that 3 institutions such as medical training colleges and public
(16.7%) of the study participants had received their first universities.
medical laboratory training from national polytechnics while

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Volume 7, Issue 7, July – 2022 International Journal of Innovative Science and Research Technology
ISSN No:-2456-2165
A. Institution of Laboratory Practical Attachment
Regarding attachment, the study sought to find out the institution that provided laboratory practical attachment to the study
respondents.

Fig. 2: Institution of Laboratory Practical Attachment

Note: Extracted by the Researcher fromSPSS-Statistics data analysis output

The findings in Figure 2indicate that 12 of the The findings of this study imply that in Kenya, county
respondents (66.7%) had received their practical laboratory referral hospitals were the main providers of practical
attachment from county referral hospitals while 3 (16.7%) laboratory attachment opportunities.
had laboratory practical attachment in mission/faith-based
hospitals. The findings indicated that those who received B. Challenges during Laboratory Attachment
their laboratory practical attachment from the national The study investigated the challenges that the
hospital, sub-county hospitals, and private hospitals were 1 respondents experienced in the process of gaining practical
(5.6%) each. experience during their medical laboratory practical
attachment period.Various probable challenges were listed
and respondents were required to indicate whether those
were serious, minor, or no challenges to them.

Challenge Not a challenge Minor challenge Serious challenge

F % F % F %
Lack of staff to provide guidance - - 5 27.8 13 72.2
Lack of training equipment in the facility - - 6 33.3 12 66.7
lack of time (attachment period) 15 83.3 3 16.7 - -
Table 1: Challenges during Laboratory Attachment

Note: Table provided by the author

The findingssummarized in Table 1 indicate that lack C. Effectiveness of laboratory attachments in major clinical
of time during the attachment period was not a challenge to areas
83.3% (n = 15) of the study participants. However, the The study investigated the opinion of the study
findings show that the lack of staff to guide during the participants regarding the overall effectiveness of the
attachment period was a serious challenge according to attachment towards providing needed skills and competence.
72.2% (n = 13) of the respondents. Moreover, the lack of The areas of competence were assessed according to the
training equipment in the facilities was cited as a serious various medical laboratory departments and included
challenge to 66.7% (n = 12) of the study participants. clinical chemistry, hematology and coagulation,
microbiology, immunohematology, urinalysis and body
These findings imply that the facilities that provided fluids, serology and immunology, and parasitology.
medical laboratory practical attachment lacked adequate
staff to guide interns and also lacked adequate training
equipment. These challenges are consistent with the findings
by Rioki (2019) to be vital since students leave these
facilities with insufficient professional abilities, skills, and
competence.

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Volume 7, Issue 7, July – 2022 International Journal of Innovative Science and Research Technology
ISSN No:-2456-2165
Area of Competence Not effective Moderately effective Highly effective
F % F % F %
Clinical chemistry 13 72.2 4 22.2 1 5.6
Hematology and coagulation 1 5.6 17 94.4 - -
Microbiology 12 66.7 6 33.3 - -
Immunohematology 2 11.1 11 61.1 5 27.8
Urinalysis and body fluids - - 6 33.3 12 66.7
Serology and immunology - - 16 88.9 2 11.1
Parasitology - - 2 11.1 16 88.9
Table 2: Effectiveness of laboratory Attachment in Providing Competence

Note: Table provided by the author

The findingssummarized in Table 2indicate that 94.4% Further, the study sought to find out whether the
(n = 17), 88.9% (N=16), and 61.1% (n = 11) of the attachment provided the participants with the requisite
participants were of the view that the attachment was competence required in professional employment.
moderately effective in providing competence in
hematology,serology, and immunohematologyrespectively.

However, most of the respondents indicated that the

attachment was not effective in providing them with
competence in clinical chemistry (72.2%, n = 13) and
microbiology (66.7%, n = 12).

To determine how the medical laboratory attachment

provided skills and competence to the study respondents,
they were asked whether they were allowed to operate
laboratory equipment during the attachment period.

Fig. 4:The Study Findings

Note: Extracted by the Researcher fromSPSS-Statistics data

analysis output

The study findings displayed in Figure4show that 94%

(n = 17) of the study participants believed that the medical
laboratory attachment was only moderately effective in
providing them with the competence required in
employment.These findings indicate that there are skill gaps
that medical laboratory attachment in Kenya does not
bridge, thus not providing the required transition from
training to employment as indicated in the internship policy
by the Government of Kenya (2020).
Fig. 3: Whether Laboratory Trainees were allowed to
Operate laboratory Equipment V. CONCLUSIONS & RECOMMENDATIONS

Note: Extracted by the Researcher fromSPSS-Statistics data In establishing which institutions offer medical
analysis output laboratory training, the current study showed thata majority
of the sampled participants (44.2%) went through Kenya
The findings displayed in Figure3indicate that 94% of medical training colleges (MTC) while 22.2% went through
the study participants (n = 17) were only not allowed to the government universities.
operate laboratory equipment while 1 (6%) was allowed to
operate equipment. On the second objective, results from the survey
revealed that 66.7% had received their practical laboratory
Though the attachment program enables graduates to attachment from county referral hospitals while 16.7% of
hone their abilities in medical laboratory practice the sampled respondents had their laboratory practical
andexposes the respondents to the field of laboratory attachment in mission/faith-based hospitals.
medicine and modern equipment, Zhao et al. (2021) observe
that the skills and competence acquired may be limited Regarding challenges encountered during attachment,
without adequate practical exposure and interaction with the study concludes that the lack of staff to guide during the
laboratory personnel and equipment. attachment period was a seriouschallenge as demonstrated

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Volume 7, Issue 7, July – 2022 International Journal of Innovative Science and Research Technology
ISSN No:-2456-2165
by 72% of the respondents. Lack of training equipment in [10.] Xia, O., Ye, J., Lin, A., Chen, Y., Guo, W., Fong, T.,
the facilities was also identified to present serious challenges Qian, R., Luo, P., & Zeng, Z. (2019). The efficacy of
experienced by 66.7% of the respondents. The prevalence of the new medical internship management network
these challenges in Kenya has been documented by Rioki system. Medicine, 98(7).
(2019) and the Government of Kenya (2020). https://doi.org/10.1097/MD.0000000000014435
[11.] Zhao, Y., Osano, B., Kiarie, H., Gathara, D., &
The study provides the following recommendations English, M. (2021). Characterizing hospitals ’
based on the findings and conclusions herein. To senior suitability for medical officer internship training in
medical laboratory managers, the study recommends Kenya: Analysis of the Kenya Harmonized Health
ensuring that medical laboratory interns are provided Facility Assessment. Research Square, 1–11.
adequate guidance and opportunities to interact with the
equipment and systems in the laboratory.

To the Government of Kenya, it is recommended that it

should fast track the implementation of the strategies in its
internship policy by enhancing the capacity of
countyreferral hospitals with personnel and equipment to
enable them to provide attachment opportunities for fresh
graduate laboratory technologists.

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