Volume 76 - Fall 2000	Download

Essential Functions by Louis Caruana, PhD, MT(ASCP) CLSPRC Member

The Americans with Disabilities Act of 1990 (ADA) was passed by Congress to protect qualified individuals with disabilities in the workplace. Colleges and universities have been subject to many of the non-discrimination provisions contained in the ADA for a number of years, as the Rehabilitation Act of 1973 prohibits discrimination on the basis of disability by a program receiving federal financial assistance.

Since courts of law have interpreted that public and private institutions of higher education are public accommodations, these two laws cover virtually all educational programs. Therefore, educational programs are mandated to establish means that no person, with or without a disability, is arbitrarily excluded access to the program.

Educational programs should take care that the qualifications for admission do not screen out individuals with disabilities, and if they do, such exclusion should be based upon established standards of practice. In other words, with or without reasonable accommodations, the student should possess certain physical and mental attributes to be able to complete the curriculum of the program.

To ensure compliance, the program should establish in writing what is expected of the student. These outcome expectations are the bases for establishing the "essential functions" of the program. The functional expectations for students must be written and provided to all applicants to the program.

What does this mean in practical terms to clinical laboratory science programs? Programs must take care that all applicants be made aware of the essential functions that are needed to be able to complete the program of study. This necessitates that all programs have written essential functions and they are provided and discussed with each student prior to admission to the program.

It is the responsibility of the program to adequately inform each student the demands and expectations of the program. On the other hand, the student must demonstrate, with or without appropriate academic adjustments or reasonable modification to policies and proactive, the ability to perform the essential functions safely, reliably and efficiently within the framework of the standards of practice of the profession.

The need to establish Essential Functions of the Program is covered in 1995 Essentials under Essential 17:

"There shall be a procedure for determining that the applicant's or student's health will permit them to meet the written essential functions of the program."

The program's "essential function" should be published in the Student Handbook that is provided to each student during orientation to the program as dictated in Essentials 13 & 15. However, it behooves the program to provide essential functions to all program applicants and to ascertain if each applicant understands and can meet the requirements stated. This should be done on an individual basis and each applicant should be assessed to ascertain if a reasonable accommodation will allow the individual to complete the program successfully and in a timely fashion.

Readers note: Refer to the Fall 1997 (Volume 67) issue of the NAACLS NEWS for an earlier article covering this topic or go online to:
http://www.naacls.org/news/naacls-news/archives.asp?article_id=654

What should be included in the Essential Functions of the Program? First, they must be measurable such as behavioral objectives are. They may vary from program to program and are, generally, not dependent upon the type of the program. A CLS/MT and CLT/MLT program may have established very similar sets of "essential functions." They might be called "functional expectations for students."

Essential functions, at the minimum, usually contain the following:

Observation:

The applicant student must be able to accurately observe demonstrations and exercises in which biological fluids are and products are being tested for their biochemical, hematological, immunological, microbiological and histochemical components. The applicant/student should be able to characterize color, ordor, clarity and viscosity of biologicals, reagents or chemical reaction products. These determinations might be made by the aid of simple and complex instruments and microscopes. In summary, the applicant/student must be able to possess functional use of the senses of smell and vision and somatic sensation.

Communication:

Applicants/students must be able to communicate orally and in writing. The ability to read and comprehend written material is essential in order to correctly and independently perform laboratory test procedures. The applicant/student must be able to communicate effectively and efficiently with all members of the healthcare team.

Psychomotor Skills:

Applicants/students must have sufficient motor function to perform all tasks that are normally expected within the scope of practice for the practitioner in the workplace. For example, students must be able to possess the psychomotor skills to collect blood specimens, manipulate instruments that require eye-hand coordination, perform manual laboratory procedures with dexterity and ability to operate computers.

Intellectual and Cognitive Abilities:

Applicants/students must be able to measure, calculate, analyze, synthesize, integrate and apply information. The applicant/student should be able to use sufficient judgement to recognize and correct performance and problem solve unexpected observations or outcomes of laboratory test procedures.

Behavioral and Social Attributes:

Applicant/students must possess the emotional health required to use their intellectual abilities fully, such as exercising sound judgement, promptly completing all responsibilities, being able to work in a changing and stressful environment, displaying flexibility and functioning independently in the face of uncertainties or problems that might arise.

Ethical Standards:

Applicants/students must demonstrate professional demeanor and behavior and must perform in an ethical manner in dealing with peers, faculty, staff and patients.

Academic Performance:

Applicants/students must be able to obtain relevant information from lectures, seminars, laboratory sessions or exercises, clinical laboratory practicums and independent study assignments. The applicants/students must be able to use computers based examinations to assess and improve educational outcomes of the program. The student will be expected to sit for examinations, both written and oral, complete written assignments, deliver presentations, and perform required laboratory practice with and without supervision.

In summary, each program should establish its list of essential functions and they should be presented to the applicant or student in terms that the individual would be fully aware of what is expected to complete the program curriculum of study.

An Internet Bibliography of Related Material on and Examples of Essential Functions

• http://www.abanet.org/lawlink/site-tation.html
• http://www.abanet.org/lawlink/home.html
• http://www.lectlaw.com/rotu.html
• http://www.alllaw.com/
• http://www.eskimo.com/~jlubin/disabled.html
• http://www.disabilities.thelinks.com/
• http://counsel.cua.edu/ADA/jobdesc.htm
• http://counsel.cua.edu/ada/index.htm
• http://www.geni.com/hiringtips/jobfunc.htm
• http://www.swt.edu/cls/cls_essential.html
• http://copland.udel.edu/~scoobie/medtech/essential_functions.html

The internet bibliography on Essential Functions is published on my CLS Internet Resources web site. The URL is:
http://members.tripod.com/~LouCaru/index-5.html

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