American Medical Technologists

Certified Medical Laboratory Assistant (CMLA) Certification Competencies

and Examination Specifications

Summary Table

Work Area Number of Items Percentage of Exam

I. Laboratory Safety and Quality 45 22.5%
II. Pre-examination (Preanalytical) 36 18.0%
Considerations
III. Examination (Analytical) Considerations 83 41.5%
IV. Patient Test Management, 36 18.0%
Communications, and Foundations
Total 200 100%

Question Weightings, Work Areas, Task Areas, and Competencies

Number
of items
45 I. LABORATORY SAFETY AND QUALITY (22.5% of exam)

1. SAFETY STANDARDS, INFECTION CONTROL PROCEDURES, AND OSHA

REGULATIONS

A. General knowledge

1. Know terminology related to safety, infection, and OSHA

Standard Precautions aseptic pathogen infection
Universal Precautions airborne exposure SDS
chemical hygiene plan hazard pictogram
transmission-based precautions

B. Practices

1. Know chain of infection

2. Demonstrate knowledge of infection control and safety practices
3. Demonstrate accepted practices for infection control, isolation techniques,
aseptic techniques, and methods of disease prevention

©2020 American Medical Technologists. All rights reserved. Page 1 of 8

 4. Comply with federal, state, and locally-mandated regulations regarding
safety practices
5. Observe the OSHA Bloodborne Pathogens Standard and Needle Safety
Precaution Act
6. Use appropriate practices, as outlined in the OSHA Hazard Communication
Standard, including the correct use of the Safety Data Sheet
7. Understand Globally Harmonized System of Classification and Labeling of
Chemicals (GHS)
8. Employ proper public health reporting for national and state-notifiable diseases
(HCV, HIV, lead)

2. QUALITY ASSESSMENT, QUALITY CONTROL, AND CONFIRMATORY TESTING

A. Quality Assessment and Quality Control

1. Know terminology related to quality control and quality assessment to include:

precision linearity coefficient of variation
reliability mean value standard deviation
shift accuracy trend
2. Know and perform quality control/quality assessment (QC/QA) within the laboratory
assistant’s scope of practice
a. Know and recognize the difference between QC and QA
b. Know the difference between external and internal QC and what is accomplished by
each
c. Know and understand regulations pertaining to proficiency testing within the
laboratory assistant’s scope of practice
d. Perform QC/QA procedures
e. Know daily quality control and use of results
3. Understand the importance of maintaining temperature/humidity logs; Document and
take corrective action for out-of-range temperatures
4. Perform instrument maintenance and calibration within the laboratory assistant’s
scope of practice

B. Deviations from Prescribed Use of Waived Tests

1. Understand that "off-label use" or modified use of a waived test system defaults the
test to high complexity
2. Follow manufacturer’s instructions or package inserts precisely to avoid:
a. performing the test on a population not indicated based on intended use or
limitations
b. not reading the test in an appropriate time frame per manufacturer's
instructions
c. not storing reagents or supplies correctly
d. employing an incorrect specimen type (e.g., whole blood vs. serum; throat vs
np)

©2020 American Medical Technologists. All rights reserved. Page 2 of 8

 C. Confirmatory and Supplemental Testing

1. Follow manufacturer’s instructions regarding the necessity for confirmatory and

supplemental testing
a. confirmatory testing for urine drug screening (GC/MS or LC/MS)
b. confirmatory testing for rapid strep screen (culture or approved confirmatory
molecular test, influenza immunoassay)
c. confirmatory testing for cultures (DFA or approved confirmatory molecular
test)

36 II. PREEXAMINATION (PREANALYTICAL) CONSIDERATIONS (18% of exam)

3. PHLEBOTOMY

A. General knowledge

1. Know terminology related to phlebotomy to include:

tourniquet lancet safety needle evacuated tube
adapter syringe butterfly safety lancet
hematoma petechiae pulse syncope
seizure vein/venous capillary artery/arterial
serum plasma whole blood anticoagulant
preservative transfer device
2. Know the differences between serum, plasma, and whole blood
3. Understand the difference between clotted and anticoagulated blood

B. Practice of phlebotomy
1. Identify correct patient properly
2. Select appropriate containers for specimens and know requirements for container
identification
3. Use proper anticoagulants for each analysis and understand effects of improper
anticoagulant use
4. Know physiological aspects of blood collection
5. Prepare patient for various tests
6. Select proper venipuncture site
7. Perform venipuncture
8. Collect specimens properly
a. observing proper order of draw
b. understanding the effect of short draw
c. preventing hemolysis, understanding the effect of a hemolyzed specimen
d. knowing the limit of time that plasma can set on the cells
9. Perform capillary punctures
10. Perform capillary punctures on infants
11. Provide proper post care of venous puncture sites
12. Handle blood samples to maintain specimen integrity
13. Follow standard operating procedures for labeling, transporting, and processing
specimens, including transporting to reference laboratories
14. Describe and follow the criteria for specimens and test results that will be used as legal
evidence

©2020 American Medical Technologists. All rights reserved. Page 3 of 8

 4. PREEXAMINATION (PREANALYTICAL) PROCESSES AND SPECIMEN COLLECTION

A. Patient Test Management and Specimen Collection

1. Instruct patients in the proper collection and preservation of various urine samples
including:
a. mid-stream
b. random
c. clean-catch
d. timed collections
e. collections for drug screening
2. Recognize the suitability of specimens for urinalysis procedures as relates to:
a. test requested
b. appropriate patient preparation and method of collection
c. time of collection and processing
d. specimen storage
e. specimen rejection criteria
3. Instruct patients in the collection of other specimens (e.g., semen, feces, sputum)
4. Properly collect and handle specimens with time/temperature requirements
5. Handle and preserve body fluids for chemical analysis
a. Know the types and uses of urine preservatives
b. Know how to handle and process all body fluids
6. Prepare and stain slides for further analysis
7. Prepare, store, and dispose of specimens for test analyses according to standard
operating procedure
8. Process specimens for shipping
9. Identify and report potential preexamination (preanalytical) errors that may occur
during specimen collection, labeling, transporting, and processing
10. Recognize patient problems related to syncope (fainting), nausea, and other
complications

83 III. EXAMINATION (ANALYTICAL) CONSIDERATIONS (41.5% of exam)

5. CHEMISTRY

A. General Knowledge

1. Know terminology related to clinical chemistry to include:

hepatic (liver) function tests carbohydrate (glucose) metabolism tests
kidney (renal) function tests general chemistry tests
supernatant endocrinology
decant electrolytes
serum plasma

B. Instrumentation

1. Know use of instrumentation falling within the laboratory assistant’s scope of practice
2. Know cleaning and maintenance of chemistry instrumentation

©2020 American Medical Technologists. All rights reserved. Page 4 of 8

 3. Perform maintenance on chemical analyzers as appropriate
4. Know the operation and principles of commonly-used analyzers

C. Point-of-Care and Waived Testing

1. Know that point-of-care tests are within the laboratory assistant’s scope of practice
2. Perform point-of-care and waived clinical chemistry tests

D. Toxicology

1. Know what toxicology tests are within the laboratory assistant’s scope of practice
2. Perform toxicology tests within the laboratory assistant’s scope of practice

6. HEMATOLOGY

A. General Knowledge

1. Know terminology related to hematology to include:

hematology hemoglobin cells blood
reticulocyte plasma serum mononucleosis
erythrocyte anemia hematocrit complete blood count
thrombocyte (platelet) erythrocyte sedimentation rate
leukocyte (neutrophil, lymphocyte, monocyte, eosinophil, basophil)
2. Know functions of the blood
3. Recognize the functional differences between platelets, erythrocytes, and leukocytes

B. Instrumentation

1. Follow established quality control procedures

2. Maintain and calibrate instruments

C. Coagulation and Hemostasis

1. Know terminology related to coagulation to include: heparin, warfarin, protime, PT, PTT
2. Perform the prothrombin time (PT) test and know what medication it monitors
3. Perform the partial thromboplastin time (PTT) test and know what medication it
monitors
4. Understand the linear range for International Normalized Ratio (INR)

D. Point-of-Care and Waived Testing

1. Perform point-of-care and waived hematological tests

7. IMMUNOLOGY, SEROLOGY, AND IMMUNOHEMATOLOGY

A. General Knowledge

1. Know terminology related to immunology, serology, and immunohematology to include:

©2020 American Medical Technologists. All rights reserved. Page 5 of 8

 antigen hemolysis blood serum plasma Strep A test HIV test
antibody agglutination RPR test RSV test influenza A and B test
heterophile agglutination test (mono test) fibrinogen
rheumatoid arthritis tests (latex agglutination)
qualitative and quantitative pregnancy tests
2. Know the principles of antigen-antibody reaction
3. Know that there are blood types, Rh types, and other antigens

B. Point-of-Care and Waived Testing

1. Perform immunological, serological, and immunohematological procedures

within the laboratory assistant’s scope of practice

8. MICROBIOLOGY

A. General Knowledge

1. Know terminology related to microbiology to include:

bacteria aerobic pathogenic anaerobic virus
yeast fungal culture sensitivity resistance
MIC gram-negative rod agar incubator inoculate
loop gram-positive cocci colony normal flora contaminant
A&P disk alpha, beta, gamma hemolysis candidiasis exudates
organelles agglutination spores Strep culture AFB smear
KOH Gram stain wet prep culture and sensitivity (C&S)
2. Recognize appropriateness of specimen for type of microbiological test ordered

B. Media, Techniques, and Cultures

1. Follow special safety procedures and aseptic techniques required for processing
microbiological specimens
2. Prepare, store, dispose of, and properly transport specimens for microbiological
testing according to standard operating procedure
3. Within scope of practice, recognize appropriateness of microbiological procedure
ordered as relates to:
a. test requested
b. appropriate patient preparation and method of collection
c. time of collection and processing
d. specimen storage
e. specimen rejection criteria
4. Assemble reagents, standards, and controls for microbiological procedures
5. Prepare and stain slides for further analyses

9. URINALYSIS

A. General Knowledge

1. Know terminology related to urinalysis to include:

©2020 American Medical Technologists. All rights reserved. Page 6 of 8

 random midstream clean-catch timed (2, 12, 24-hour, etc.)
crystals casts cells skin contaminant specific gravity
artifact mucus bacteria spermatozoa refractometer
yeast trichomonas pyuria sediment ketones
C&S hematuria glycosuria polyuria proteinuria
chemical analyses confirmatory tests microscopic macroscopic

B. Point-of-care and Waived Urinalysis Procedures

1. Prepare, store, dispose of, and properly transport specimens for urinalysis according
to standard operating procedure
2. Prepare slides for microscopic examination within the laboratory assistant’s scope
3. Perform urinalysis tests within the laboratory assistant’s scope of practice

C. General knowledge of microscopy

1. Know terminology related to microscopy to include:

ocular stage base diaphragm light source immersion oil
condenser objectives lens magnification fine/course adjustment
2. Perform microscopic urinalysis procedures within laboratory assistant’s scope of
practice
3. Perform general cleaning of microscope

10. BASIC ANATOMY AND PHYSIOLOGY

A. Apply basic knowledge of anatomy

B. Apply basic knowledge of physiology

36 IV. PATIENT TEST MANAGEMENT, COMMUNICATIONS, AND FOUNDATIONS (18% of exam)

11. LEGAL, ETHICAL, CONFIDENTIAL, AND PROFESSIONAL CONSIDERATIONS,

HIPAA, AND PATIENT’S BILL OF RIGHTS

A. Principles of liability in the laboratory

1. Know use of consent forms

2. Know use of waiver of liability for Medicare (Advance Beneficiary Notice - ABN)
3. Know regulations for ordering tests
4. Know right of patient to refuse treatment, complying with the American Hospital
Association’s Patient’s Bill of Rights and the Patient’s Bill of Rights from the
workplace
5. Define and use medicolegal terms and discuss policies and protocol designed to
avoid medicolegal problems
6. Know that regulations restrict the performance of provider-performed microscopy
(PPM) to providers only

©2020 American Medical Technologists. All rights reserved. Page 7 of 8

 B. Professional appearance and ethical conduct in the performance of duties

1. Ensure appropriate personal appearance

2. Employ professional mannerisms and behavior in the conduct of duties
3. Employ professionalism and ethicality when engaging in the use of social media

C. The Health Insurance Portability and Accountability Act (HIPAA)

1. Observe tenets of confidentiality

2. Observe tenets of appropriate record release

12. CLERICAL SKILLS, COMMUNICATIONS, AND INTERPERSONAL RELATIONS

A. Chart or file laboratory-generated reports properly

1. Know what constitutes a complete and final report
2. Know reporting and documentation of abnormal results
B. Enter, retrieve, and verify patient collection data and special notations using
health information technology
C. Maintain inventory levels, order and restock supplies
D. Manage supplies appropriately recognizing test kit, QC, or reagent expiration date vs. "open
date" expiration date
E. Employ billing and coding for procedures within the laboratory assistant’s scope of
practice
F. Inform patients of special test requirements
G. Acknowledge, report/notify, and document critical values appropriately, understanding the
significance of critical values
H. Develop and use proper and professional, verbal and non-verbal communication skills with
staff, patients, and families
I. Use proper technique and etiquette for answering the telephone and providing
information
J. Understand the importance of time management as applied to the appropriate use of
technology (cellular phones, Internet, etc.)

Task and Knowledge Inventory Note

The task and knowledge areas included in this inventory are considered by American Medical Technologists to be
representative of the medical laboratory assistant’s role. This document should be considered dynamic, to reflect the
assistant’s current role. Therefore, tasks may be added, removed, or modified on an ongoing basis. The content
category weights should be considered reliable, but approximate.

©2020 American Medical Technologists. All rights reserved. Page 8 of 8