Date Approved


Degree Type

Open Access Dissertation

Degree Name

Doctor of Philosophy (PhD)

Department or School

Leadership and Counseling

Committee Member

David Anderson

Committee Member

Jaclynn Tracy

Committee Member

Elizabeth Broughton

Committee Member

Peggy Liggit


The clinical laboratory science field requires an abundance of technical knowledge; however, the importance of implicit or tacit knowledge gained through observation and practice is often discounted in this field, even though it is a critical part of reflective thinking, critical thinking, and reflective practice. The “de-skilling” of laboratory practitioners may be a result of limited training opportunities in an overtaxed system. A deeper analysis of the decision-making skills by interviewing practicing medical laboratory scientists in this study may illuminate, for practitioners and the public sector, the complexity of the profession. This study adds to the body of knowledge in clinical laboratory science by specifically observing practitioners for behaviors that reflect the use of specialized technical knowledge in decision-making in the context of the laboratory. In addition, this research provides insight for medicine, nursing, and other allied healthcare disciplines to enhance their processes in the context of clinical training. The study used interview and observation techniques in a phenomenological approach to understand decision-making. A purposeful sample of five medical laboratory science practitioners was obtained. They have an average of 20 years’ experience and varying levels of technical and administrative experience and responsibilities in their current positions. The research question was as follows: How do medical laboratory scientists go about making decisions when confronted with problematic or unique situations in the clinical laboratory? Major findings included balancing the work environment, which contains routine and high-stakes decisions through strategies such as anthropomorphism. The use of anthropomorphism provides a new lens to look at the tension between decision-making as art (as opposed to “science”) for many different “semi-professional” fields. The results provided support that trainers and faculty should allow “gut intuition” to be a legitimate choice for trainees and students. Providing more time in practice for “pause” or reflection, and asking students to listen to their inner voice during problem-solving and express that explicitly in the moment, would build on reflective practice and the motivation to perform during stressful and routine situations.