Developing a competency framework for medical laboratory scientists in Taiwan: a modified Delphi approach

BACKGROUND: Medical Laboratory Scientists (MLS) are essential members of the healthcare team, providing critical information for diagnosis, treatment monitoring, and disease prevention. With rapid advances in laboratory medicine, the scope of MLS practice has expanded, increasing the need for clearly defined competency expectations. Although competency frameworks have been developed in several countries, Taiwan currently lacks a comprehensive framework that is both internationally informed and contextually relevant to local healthcare practice. METHODS: This study was conducted from August 2022 to July 2023, employing a multi-stage mixed-methods approach to develop a competency framework for MLS in Taiwan. A structured literature review and expert focus group discussions were first undertaken to identify preliminary competency domains. A three-round modified Delphi survey involving 39 experts from teaching hospitals across different regions of Taiwan was subsequently conducted to achieve consensus. Iterative modifications were made between each round to refine competency indicators, and the final consensus rate was set at 75%. RESULTS: The final framework comprises five core competencies—Technical Skills, Knowledge Base, Communication, Continuous Professional Development, and Professionalism—and 15 associated sub-competencies. Notably, three competency domain-level revisions were made during the Delphi process to reflect more observable and assessable behaviors. Additionally, six sub-competencies were revised for clarity and alignment with professional practice. CONCLUSION: This study successfully constructed a comprehensive and hierarchically structured competency framework for MLS in Taiwan. The framework is both internationally aligned and deeply localized, providing a robust foundation for curriculum development and competency-based assessments. This framework is expected to significantly support the ongoing modernization of MLS education and enhance the quality of laboratory services in Taiwan.