Workforce Crisis in Laboratory Medicine: Recruitment, Retention, and Burnout Prevention Strategies: A review of the underlying crisis in the lab workforce and innovative solutions to training
Abstract
Background: The global healthcare system is confronting a silent yet critical crisis within its laboratory medicine workforce. Long-standing challenges in recruitment and retention, compounded by systemic burnout among medical laboratory professionals, have been pushed to a breaking point by the COVID-19 pandemic. This crisis stems from multifaceted issues, including a lack of public visibility, non-competitive compensation, high educational barriers, and relentlessly increasing workloads.
Aim: This review aims to synthesize the current literature to delineate the causes and consequences of the laboratory workforce crisis and to critically evaluate evidence-based and innovative strategies for its revitalization.
Methods: A comprehensive analysis of the extant literature was conducted, drawing on a wide range of scholarly and professional sources to explore the interrelated challenges of recruitment, retention, and burnout. The review systematically examines the evidence supporting various interventions, from outreach and rebranding to organizational change and educational innovation.
Results: The findings reveal severe consequences, including high vacancy and turnover rates, a loss of institutional knowledge, and significant risks to patient safety. Burnout, fueled by chronic understaffing and a lack of support, is identified as a central driver of attrition. The analysis confirms the potential of targeted strategies, such as K-12 STEM outreach and social media branding for recruitment; competitive compensation and agile staffing for retention; and proactive organizational wellness culture and automation to combat burnout. Furthermore, innovative training approaches like competency-based education and simulation are shown to be crucial for building a sustainable future workforce.
Conclusion: A systemic and multi-stakeholder commitment is urgently required to address this crisis. The implementation of comprehensive strategies for recruitment, retention, and burnout prevention is essential to safeguard the foundational pillar of modern healthcare: a robust, resilient, and skilled laboratory medicine workforce.
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References
Al Atiyyah, A. H., Al Mutairi, D. M., Al Johani, K. I., Al Mutairi, M. B., Al Abdaly, H. S., Albreak, I. A., … Alrasheedi, W. A. (2024). Laboratory-Nursing Partnerships in Managing Multi-Drug-Resistant Organisms (MDROs): A Comprehensive Review. Saudi Journal of Medicine and Public Health, *1*(1), 154–164. https://doi.org/10.64483/jmph-73
Bertholf, R. L. (2020). The History of Laboratory Medicine Part 4: 2004–2012; A New Journal for the New Century. Laboratory Medicine, 51(4), 329-335. https://doi.org/10.1093/labmed/lmaa035
Chiou, P. Z. (2021). Exploring staff turnover, burnout, and resilience in cytology reference laboratories: a workforce qualitative study. Cytopathology, 32(6), 738-750. https://doi.org/10.1111/cyt.13024
Cortelyou-Ward, K., Ramirez, B., & Rotarius, T. (2011). The laboratory workforce shortage: a managerial perspective. The Health Care Manager, 30(2), 148-155. DOI: 10.1097/HCM.0b013e318216f5df
Dean, W., Talbot, S., & Dean, A. (2019). Reframing clinician distress: moral injury not burnout. Federal Practitioner, 36(9), 400. https://pubmed.ncbi.nlm.nih.gov/31571807/
de Lima Garcia, C., Bezerra, I. M. P., Ramos, J. L. S., do Valle, J. E. T. M. R., Bezerra de Oliveira, M. L., & Abreu, L. C. D. (2019). Association between culture of patient safety and burnout in pediatric hospitals. PloS one, 14(6), e0218756. https://doi.org/10.1371/journal.pone.0218756
Garcia, E., Kundu, I., Kelly, M., Soles, R., Mulder, L., & Talmon, G. A. (2020). The American Society for Clinical Pathology’s job satisfaction, well-being, and burnout survey of laboratory professionals. American journal of clinical pathology, 153(4), 470-486. https://doi.org/10.1093/ajcp/aqaa008
Garcia, E., Kundu, I., & Fong, K. (2021). American Society for Clinical Pathology’s 2019 wage survey of medical laboratories in the United States. American journal of clinical pathology, 155(5), 649-673. https://doi.org/10.1093/ajcp/aqaa197
Greaves, R., Kricka, L., Gruson, D., Ferrari, M., Martin, H., Loh, T. P., ... & IFCC Emerging Technologies Division. (2023). Toolkit for emerging technologies in laboratory medicine. Clinical Chemistry and Laboratory Medicine (CCLM), 61(12), 2102-2114. https://doi.org/10.1515/cclm-2023-0571
Goulding, M. H., Graham, L., Chorney, D., & Rajendram, R. (2020). The Use of Interprofessional Simulation to Improve Collaboration and Problem Solving Among Undergraduate BHSc Medical Laboratory Science and BScN Nursing Students. Canadian Journal of Medical Laboratory Science, 82(2).
Hallworth, M. J. (2011). The ‘70% claim’: what is the evidence base?. Annals of clinical biochemistry, 48(6), 487-488. https://doi.org/10.1258/acb.2011.011177
Halstead, D. C., & Sautter, R. L. (2023). A literature review on how we can address medical laboratory scientist staffing shortages. Laboratory Medicine, 54(1), e31-e36. https://doi.org/10.1093/labmed/lmac090
Hawkins, R. E., Welcher, C. M., Holmboe, E. S., Kirk, L. M., Norcini, J. J., Simons, K. B., & Skochelak, S. E. (2015). Implementation of competency‐based medical education: are we addressing the concerns and challenges?. Medical education, 49(11), 1086-1102. https://doi.org/10.1111/medu.12831
Lopez, D., Hunt, S. D., Kubala, K., & Schmidt, R. N. (2023). An analysis of the ongoing clinical laboratory science workforce shortages in the US. Journal of Business & Behavioral Sciences, 35(1).
Marinucci, F., Majigo, M., Wattleworth, M., Paterniti, A. D., Hossain, M. B., & Redfield, R. (2013). Factors affecting job satisfaction and retention of medical laboratory professionals in seven countries of Sub-Saharan Africa. Human resources for health, 11(1), 38. https://doi.org/10.1186/1478-4491-11-38
Maslach, C., & Leiter, M. P. (2016). Understanding the burnout experience: recent research and its implications for psychiatry. World psychiatry, 15(2), 103-111. https://doi.org/10.1002/wps.20311
Mewborn, E. K., Fingerhood, M. L., Johanson, L., & Hughes, V. (2023). Examining moral injury in clinical practice: A narrative literature review. Nursing Ethics, 30(7-8), 960-974. https://doi.org/10.1177/09697330231164762
Naugler, C., & Church, D. L. (2019). Automation and artificial intelligence in the clinical laboratory. Critical reviews in clinical laboratory sciences, 56(2), 98-110. https://doi.org/10.1080/10408363.2018.1561640
Odun-Ayo, T., & Obafemi-Ajayi, T. (2017, October). Building the K-12 engineering pipeline: An assessment of where we stand. In 2017 IEEE Frontiers in Education Conference (FIE) (pp. 1-9). IEEE. doi: 10.1109/FIE.2017.8190641.
O’donovan, R., & Mcauliffe, E. (2020). A systematic review of factors that enable psychological safety in healthcare teams. International journal for quality in health care, 32(4), 240-250. https://doi.org/10.1093/intqhc/mzaa025
Patel, R., Hoppman, N. L., Gosse, C. M., Hagen-Moe, D. J., Dunemann, S. K., Kreuter, J. D., ... & Boland, J. M. (2021). Laboratory medicine and pathology education during the COVID-19 pandemic—lessons learned. Academic Pathology, 8, 23742895211020487. https://doi.org/10.1177/23742895211020487
Pearse, C., & Scott, S. (2023). A review of clinical laboratory education, training and progression: historical challenges, the impact of COVID-19 and future considerations. British journal of biomedical science, 80, 11266. https://doi.org/10.3389/bjbs.2023.11266
Pottle, J. (2019). Virtual reality and the transformation of medical education. Future healthcare journal, 6(3), 181-185. https://doi.org/10.7861/fhj.2019-0036
Salvado, M., Marques, D. L., Pires, I. M., & Silva, N. M. (2021, October). Mindfulness-based interventions to reduce burnout in primary healthcare professionals: a systematic review and meta-analysis. In Healthcare (Vol. 9, No. 10, p. 1342). MDPI. https://doi.org/10.3390/healthcare9101342
Salvagioni, D. A. J., Melanda, F. N., Mesas, A. E., González, A. D., Gabani, F. L., & Andrade, S. M. D. (2017). Physical, psychological and occupational consequences of job burnout: A systematic review of prospective studies. PloS one, 12(10), e0185781. https://doi.org/10.1371/journal.pone.0185781
Scott, M. G., Rifai, N., Smith, B., Oellerich, M., Panteghini, M., Apple, F., ... & Young, I. (2015). The changing face of laboratory medicine: a more service and less academically oriented profession?. Clinical chemistry, 61(2), 322-329. https://doi.org/10.1373/clinchem.2014.230300
Smith, S. M., Liauw, D., Dupee, D., Barbieri, A. L., Olson, K., & Parkash, V. (2023). Burnout and disengagement in pathology: A Prepandemic survey of Pathologists and laboratory professionals. Archives of Pathology & Laboratory Medicine, 147(7), 808-816. https://doi.org/10.5858/arpa.2022-0073-OA
Tawfik, D. S., Scheid, A., Profit, J., Shanafelt, T., Trockel, M., Adair, K. C., ... & Ioannidis, J. P. (2019). Evidence relating health care provider burnout and quality of care: a systematic review and meta-analysis. Annals of internal medicine, 171(8), 555-567. https://doi.org/10.7326/M19-1152
VanSpronsen, A. D., Villatoro, V., Zychla, L., Wang, Y., Turley, E., Ohinmaa, A., & Yuan, Y. (2022). A new list for choosing wisely Canada from the “hidden profession” of medical laboratory science. American Journal of Clinical Pathology, 157(1), 40-46. https://doi.org/10.1093/ajcp/aqab094
West, C. P., Dyrbye, L. N., & Shanafelt, T. D. (2018). Physician burnout: contributors, consequences and solutions. Journal of internal medicine, 283(6), 516-529. https://doi.org/10.1111/joim.12752
World Health Organization. (2019). Burn-out an "occupational phenomenon": International Classification of Diseases. https://www.who.int/news/item/28-05-2019-burn-out-an-occupational-phenomenon-international-classification-of-diseases
Authors
Copyright (c) 2024 Majed Shayea Algahtani, Reem Saad AlTalal, Majed Mohammednoor Abunassif, Nahla Suliman Alturairi, Khalid Naif Alotaibi, Saeed Swead Abdullah Alqarni, Awatif Mohammed Abdulla Alattas, Shaima Adel Ibrahem Halawani, Wafa Mohammed Alshehri, Hind Aloumi
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