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Volume LVII, Number 2 |

Julie Smith 
Biomedical Laboratory Science, Department of Technology, Faculty of Health, University College Copenhagen, Copenhagen, Denmark

Helen Nordahl Madsen 
Education of Biomedical Laboratory Science and Research Centre for Rehabilitation, VIA University College, Aarhus N, Denmark

Lene Noehr-Jensen 
Biomedical Laboratory Science, Department of Biomedical Laboratory Science, Physiotherapy and Radiography, UCL University College, Odense, Denmark

Steffen Jørgensen 
Biomedical Laboratory Science, Centre for Engineering and Science, University College Absalon, Naestved, Denmark

Leif Kofoed Nielsen 
Biomedical Laboratory Science, Department of Technology, Faculty of Health, University College Copenhagen, Copenhagen, Denmark 

Marianne Ellegaard 
Biomedical Laboratory Science, Department of Technology, Faculty of Health, University College Copenhagen, Copenhagen, Denmark 

Sofie Gry Pristed 
Programme of Biomedical Laboratory Science, University College of Northern Denmark, Hjørring, Denmark

Francisco Mansilla Castaño 
Education of Biomedical Laboratory Science, University College South Denmark, Esbjerg, Denmark

Abstract

University colleges (UCs) in Denmark offer professional bachelor’s degrees and have received government funding to establish research infrastructures since 2013. This was also incorporated into educational legislation, reflecting a priority to strengthen research in practice-oriented professions. For the biomedical laboratory science (BLS) program, research environments had to be built from the ground up at all UCs in Denmark, and we aim to share this national experience.

All six BLS programs in Denmark participated in both qualitative and quantitative research to explore the establishment of research infrastructures from 2013 to 2022. Together, our different approaches made it possible to analyse our data and identify key factors for research productivity.

A decentralised structure, involvement of talented BLS students, and uninterrupted time for a selected group of driven researchers appeared to have positive academic outcomes. Other key aspects discussed include location, size, PhD qualifications, management, collaborations, funding, and research topics.

All UCs contributed to changes in infrastructure and culture with the aim of integrating research into the BLS programs and enhancing the quality of education. Based on our national experience in a new field of research and our analytical approach to identifying key factors influencing academic outcomes, our findings may inspire others seeking to establish or manage research initiatives.

Keywords: Higher education policy; Research integration and development; Faculty support; Research in Curriculum; Health science; National study; New field of research

Introduction

While Denmark boasts a rich history and outstanding traditions in research, exemplified by the University of Copenhagen, research at university colleges (UCs) has a much more recent origin (Bouchrika, 2025). The six Danish UCs offer bachelor’s programs for practice-oriented professions such as nursing, teaching, pedagogy, physiotherapy, and biomedical laboratory science. Historically, and in line with legislative directives, UCs were not allowed to offer education beyond the bachelor’s level, and their primary mandate was teaching rather than research (dfir, 2023; LA 215, 2013). 

This changed in 2012 when the Danish government required all UCs to establish research and development (R&D) infrastructures. Consequently, the Finance Act of 2013 allocated an annual budget of 273 million DKK / 37 million EUR, known as Frascati funding, earmarked for this purpose (UC, 2012). Since 2014, engagement in R&D has been a legal requirement, with a mandated focus on practice-oriented research aimed at solving profession-specific challenges and contributing innovative solutions to the private and public sectors (EVA, 2017; LA 936, 2014). 

Before 2013 there was no culture of research within the profession of biomedical laboratory scientists (BLS) in Denmark. BLS primarily work at hospitals and key laboratory skills especially involve biomarker analyses and the performance of quality assurance procedures. Traditionally in Denmark, research in human biomarkers has been conducted and defined by medical doctors or others with academic university degrees, like molecular biologists. Research in the biomedical laboratory science field includes investigations of diagnostic methods, laboratory technologies, and laboratory workflows with the aim of generating new knowledge or improving clinical laboratory practice. 

In Danish research settings, BLS may have performed laboratory analyses in research projects and been credited in the acknowledgements, but they have usually not participated in academic writing or been credited as authors. To establish their presence in the highly competitive research environment, BLS need to move beyond their traditional roles and become academic partners (Smith et al., 2017).

When R&D became a legal requirement at the Danish UCs, there was no research environment or infrastructure in any of the bachelor’s degree programs (BLS programs). Creating a successful research environment requires specific attributes, including leadership, expertise and skills within research and the prioritization of time for research (Bland & Ruffin, 1992). Establishing R&D infrastructures started from the ground up in 2013 and the process is still ongoing at all our BLS programs. Key influential factors have previously been studied in established settings or single center studies in other parts of the world (Nies et al., 2018; Tofighi et al., 2017). Our aim in this national study is to share our first ten years of experiences from 2013 to 2022 in a Northern European context in a new field of research. With a comprehensive analysis, we aim to identify key factors influencing the research outcome and impact during this start-up period, particularly considering impact on practice, education, and academic outcomes in institutions of varied size and location. This paper thus reports on an innovative, comparative national analysis of factors that can enhance the establishment of a research infrastructure in a new field, using the underrepresented and relatively small research field of biomedical laboratory science as an example.

Methods

A work meeting addressing the status of R&D at the BLS programs took place in Odense in 2022 at UCL University College. All six UCs in Denmark were represented, i.e., University College Copenhagen (Danish: Københavns Professionshøjskole, abbreviated as KP), VIA University College (VIA), UCL University College (UCL), University College South Denmark (UC South), University College Absalon (Absalon), and University College of Northern Denmark (UC North).

Representatives from the UCs decided to collect data to describe and analyse the development of R&D environments over the first 10 years period (2013-22). This national comparative approach was chosen to allow us to identify key elements that were particularly supportive for developing research environments in a new field. The management at each UC selected representatives from their R&D staff to participate in this study and serve as the authors of this paper. The study combined quantitative and qualitative collection methods. 

Quantitative Description of 10 Years Research

In late 2022 and early 2023, a written survey was developed at KP with feedback from fellow co-authors at the other UCs. The survey included 22 questions, which were outlined in a table, so it was possible to fill in answers for the ten years. The main topics were size of the university college and BLS programs, number of students in specialized R&D programs, and number of staff members involved in research, publications affiliated to the UC, direct government (Frascati) funding and external (project) funding. The survey was distributed via e-mail in February 2023 with a deadline in May 2023. Data acquisition was carried out by the authors, supported by information provided by the respective UC administration units.
GraphPad Prism version 10 was applied for statistical analysis of how student involvement correlates with outcome of scientific measures (Spearman correlation coefficient r).

Qualitative Description of 10 Years Research

The authors crafted a qualitative summary on the establishment and development of the R&D environment at their respective UC. The summary tracked the journey from 2013 when R&D at UCs became part of the Finance Act in Denmark and extended over the following 10 years. The choice of content was open-ended with the suggested themes: The challenges, advantages, R&D strategy, management, impact on students' learning environment, student opportunities, impact on student curriculum, new employees, impact on employees' environment, opportunities in employees' work, quality improvement and ongoing development and student experiences from student evaluations. Data acquisition was carried out by the authors, assisted by information from colleagues, management, and the respective UC administration units.

Interpretation of Data

Visual pipelines were created for an organisational description of R&D at the UCs to provide a deeper analysis and insight to influential key factors. Together with our data and the existing literature this also resulted in a comprehensive analysis of three major topics: Impact on practice, impact on education and impact on scientific measures for the BLS programs.

Results

The results section consists of two main parts: “Organisational description” and “Student´s experiences being involved in research projects”.

Organisational Description

This section describes the organisational aspects surrounding the implementation of R&D at the Danish UCs and BLS programs during the first 10 years (2013-2022) including structure, decisions and investments at the UCs. This description will be applied to analyse the impact on practice, education and scientific measures in the discussion including identifying key influential factors.

Maturity and Size

While the development of R&D environments began at most UCs in 2013, the BLS program at UC South was new, with its first students graduating in the same year. Therefore, considerations about how to implement research activities among the only five employed staff members first began in 2015. The BLS program at UC North was also new and welcomed the first students in September 2022, the last year of this study (and with first graduates in 2026). Demographic data encompassing the size of all six UCs and BLS programs are detailed in Table 1, and include number of students, graduates, lecturers and the city of the UCs with population size ranking in Denmark (Gregersen, 2025).

Table 1. Demographic data of the included university colleges and their specific BLS programs.

The number of people is shown for 2022, and from 2013 provided in brackets to indicate the baseline when the implementation of research began.

BLS = biomedical laboratory scientist; n.a.= not applicable
*) Some data from 2013 are n.a. because KP was established in 2018 when Metropol fused with another university college (UC) in Copenhagen.
**) UC North started the BLS education in 2022 in Hjørring (UC North´s main campus is in Aalborg, which has city ranking 4, (Gregersen, 2025)).
***) The manager of the BLS program holds a PhD (co-author), but not any lecturers.
¹ Reference: Gregersen, 2025 

Frascati Funding

The public Frascati funding was distributed to the six Danish UCs according to number of students (dfir, 2023). Each UC decided how the Frascati funding was distributed internally; this is shown as a visual pipeline in Figure 1. All UCs established a centralised R&D support unit and some UCs also used parts of the Frascati funding for other support activities such as their scientific libraries (EVA, 2020). There was, however, a difference in how centralised the Frascati funding were managed and governed. At VIA, UCL and UC South, the Frascati funding was only placed in the centralised R&D units with centralised research areas, hence each researcher from the BLS programs had to apply internally to retrieve funding for projects or apply to participate in the centralised projects/areas (EVA, 2020). Such centralised units included The Research Centre for Health and Welfare Technology at VIA, which was a multidisciplinary unit composed of employees from health professions, e.g., schools of nursing and physiotherapy. At UCL, the Health Sciences Research Centre (HSRC) was established in 2013 to support and develop research at the various health sciences institutions and support interdisciplinary research collaborations. However, at KP and Absalon, Frascati funding was distributed to all the institutes. The funding was hence distributed from the institutes to the individual educational programs, so research was managed locally on the specific educational programs including the BLS programs  (EVA, 2020).

Figure 1. In 2013, the Danish government decided that all educations at university colleges (UCs) should engage in research, thus the public funding (Frascati funding) was introduced. BLS programs had basically no research infrastructure. 

Figure 2 shows approximately how much each BLS program received of Frascati funding during the 10-year period, and Figure 1 shows how it was invested for each BLS program. Figure 3 shows what type of research was supported at the BLS programs by the internal Frascati and/or external funding as a visual pipeline. For example, research in educational development and didactics was supported by Frascati funding at some UCs, but not at others. At UC South, costs of R&D materials and publication costs had to be paid by the educational program, as only actual research hours (salary) were financed by the Frascati funding. These conditions were not feasible for the small UC South BLS program (Table 1), and Figure 2 shows the small Frascati funding allocated (9000 €) the last two years of the first decade, when employees assisted with statistical analyses in two centralised nursing projects, which resulted in two scientific publications.

Figure 2. Approximate received funding in Euro (€) to the BLS programs in Denmark in the first 10 years of implementing research (2013-2022). 

External Funding

Establishing valid projects to receive external funding takes time, and the external funding shown in Figure 2 was mainly received between 2017-2022. Some projects received larger donations than shown in the figure, however, this was not included in the calculations, because the funding was directly awarded to the clinical collaboration partners (Figure 3). For example, at VIA, two grants were received through a partner at the University of Aarhus to cover VIA researchers’ salary and running costs for biomarker analysis as part of two larger projects (110.000 € and 40.000 € as shown in Figure 2).

Figure 3. Visual pipeline of first 10 years of research at six Danish BLS programs.

LEFT: Collaboration partners. RIGHT: Type of research. At the bottom: How external funding has been retrieved in short and authorships. Laboratory Science = Quality Assurance, Validation, Optimization or Development of Biomarkers, or Laboratory Workflows; Medical Biomarker Research =Measurement of biomarkers to get knowledge of e.g. a medical condition; Medical Research =Without the use of biomarkers in the medical study; Registry Research = May include biomarker studies or not; UC = university college; KP = UC Copenhagen; VIA = VIA UC; UCL = UCL UC; UC South = UC South Denmark; Absalon = UC Absalon; UC North = UC of Northern Denmark. BLS programs = Biomedical Laboratory Science bachelor’s degree educational programs; RTO= Danish system of Research and Technology Organisations ("GTS institutes").

Employees with PhD

In 2013, the interest organization for the Danish UCs outlined a strategy where minimum 50% of the employed lecturers at the UCs had to hold a PhD degree by 2022 to make R&D flourish. However, already in 2014 this was considered too ambitious a goal (Erichsen, 2014), so local strategies were developed. For instance at UCL the local goal became 33-35% (UCL, 2015). Despite the strategy being at the UC organisational level, BLS programs at UCL and VIA reached 45% of lecturers holding a PhD in 2022, as shown in Table 1. Table 1 also shows that the majority of BLS programs already had PhDs employed in 2013 for teaching BLS students (like co-author FMC), however, not all got involved in research, because some had intentionally left their research careers behind. Lecturers without a PhD degree had the opportunity to enter a PhD program in collaboration with universities, but this path was difficult for the BLS programs to establish (finding candidates, collaborations, projects and funding), and only one candidate succeeded in entering a PhD program in this first decade (KP). Also new employees with PhD background were employed to contribute to build up the research environment (for coauthors this was in 2013 JS / LKN and later HNM; LNJ; SJ). Despite the ambition to employ PhDs, candidates with a BLS master’s degree have sometimes been prioritized for employment at the BLS programs over PhDs to strengthen BLS professional expertise within the programs. This has also been due to the scarcity of BLS professionals holding a PhD in Denmark. 

Assignment For Becoming Senior Lecturer Must Now Include Research

At all Danish UCs, newly employed assistant lecturers, including PhDs, must write an Assignment for Senior Lecturer within four years of employment to develop theoretical, academic, pedagogical, didactic and profession-oriented competencies (LA 762, 2013). The approval advances assistant lecturer to senior lecturer (also called associate lecturer). Since 2013, the assistant lecturer must not only work with research-related tasks, but also “develop competencies in relation to R&D activities”. This includes one’s own work in research and how to employ research in education to increase the quality of the education (LA 762, 2013). At all BLS programs, apart from UC South, Frascati funding covered this (see Figure 1). For UC South, the allocated Frascati funding shown in Figure 2 was for other projects, not for the research made for the assignments. Scientific publications have not been a requirement for the approval of the assignment; assistant lecturers were, however, encouraged to publish in peer reviewed journals, and additional Frascati funding was possible to allocate in relation to the assignments. At VIA, UCL and UC South this had, however, to be applied for internally in the organization (EVA, 2020). For many lecturers the assignment did not lead to scientific publications, and not at all at UCL, UC South and Absalon, however, most work was presented at relevant scientific conferences. 

Who Drove the Research Forward at the BLS Programs

From 2013, the BLS program at KP allocated Frascati funding to engage a university professor as a consultant to initiate and strengthen the R&D infrastructure (Figure 1). As the KP management were not researchers, the professor promoted a culture of research within the management, supported lecturers in initiating research projects and successfully established a PhD research project for an internal lecturer, to be conducted externally in collaboration with strong partners. In 2016, a docent (may also be called senior associate lecturer) was allocated instead of the professor with the responsibility to continuously drive research forward at the BLS program. At Absalon, a docent also started in 2016. The purpose of the docent positions was to aid the management in formulating research strategies for the BLS program, to identify and initiate collaborations with external partners, drive the research forward and attract external funding. Frascati funding covered the salaries of the docents (Figure 1). At Absalon BLS program, the lecturers worked with specific projects outlined by the docent and management, where this was self-directed for researchers at the KP BLS program with the docent being a more structural support. In 2021, another docent at KP was employed for research in didactics and education to cover three technological educational programs including the BLS program (co-author ME). At the other UCs, docents were employed at the centralised research units, not locally in the BLS programs. 

The initial strategy at Absalon, UC North and later KP was to include all lecturers in research (approximately 10% of the work time for each). This strategy was evaluated to be unsustainable at the UCs; hence the internal funding was given to support only a few researchers with motivation and skills; see Figure 1 (EVA, 2020). So overall, a core of the same few lecturers with PhDs drove the research forward, whereas other lecturers participated intermittently. 

At the rest of the UCs’ BLS programs, the strategies were less specific on an allocated time policy and mostly focused on the Assignment for senior lecturer to drive research forward. At VIA, UCL and UC South, the extent that lecturers could be involved in R&D activities was mostly governed by the centralised research units (EVA, 2020); see Figure 1.   

Collaboration Partners and Type of Research 

To establish valid research projects and find academic collaboration partnerships were challenging for all BLS programs. This included collaborations with BLS, MDs and other professions at universities or hospitals, or with partners in the industry. Generally, BLS management in hospital departments did not allocate time for their BLS staff to conduct research. At times, partners also withdrew from collaborations due to changing priorities or uncertainty about the role that UC lecturers should fulfil. Figure 3 shows that research has been in different areas and not only in laboratory science for most UCs. The range of research at the BLS programs included core biomedical laboratory science, medical science, registry research and educational development. Figure 3 shows the spread of research areas and collaboration partners; the figure includes only areas and partners that resulted in scientific peer-reviewed dissemination. 

R&D in Student Curriculum

Implementation of R&D also affected the curriculum of the BLS programs. Some differences appear between the BLS programs, but the trend was the same that learning objectives for academic skills became more explicit. All BLS students were increasingly taught, trained, and examined in academic methods, like statistics, philosophy of science and especially in their bachelor's project using scientific methods to familiarize students with scholarship. This also included reading and using scientific peer-reviewed articles in journal clubs, literature studies and bachelor projects. The BLS programs also integrated research into education by involving students in R&D projects. These specialized R&D activities did not include all students but were offered to the few who were particularly motivated to develop their academic skills. 

The legal act of 2015 made it possible to add extracurricular activities or to show a distinction on their graduation certificate for the talented students (LA 597, 2015). This option was only effectuated at UCL, where five BLS students accomplished this. At the other UCs, the specialized R&D activities were not specified on the graduation certificates. The R&D student activities were in general with collaboration partners and at their laboratory premises, whilst at VIA some talented students assisted at the campus laboratory facilities with a biomarker research project. Absalon could, from 2018, offer one internal bachelor project yearly, which involved students in research projects at the in-house R&D laboratory (with co-author SJ); see Figure 3. 

At KP, the first real student R&D program started in 2014 with students mentioned in “Acknowledgements” for their work involving optimizing analysis of circulating tumor cells (Frandsen et al., 2015). Since then, students were able to dedicate their 6th and 7th semester in a research group, which included their bachelor project. The KP R&D student programs have since been anchored in a variety of settings, but Figure 3 only shows collaboration partners resulting in scientific peer-reviewed dissemination. KP have had R&D students at: the start-up companies CytoTrack and HEI-therapeutics, the established Novo Nordisk and Radiometer, the public funded RTO Bioneer, Copenhagen University and Copenhagen University Hospitals including the Steno-Diabetes Center. Also, international R&D student programs were pursued mainly with a professor in Australia. Like Absalon and VIA, KP started inhouse research projects from 2022 at “KP Science Lab” and integrated students in the projects. Of all these various R&D collaborations and projects (n=104), only a few resulted in student scientific publications (n=17); see Table 2. By repeating student projects it was possible to achieve data for publication and with the last participating students becoming coauthors (Sejrup et al., 2020; Smith et al., 2019). The student publications in Table 2 also included ordinary bachelor students and not only R&D students (Lynge et al., 2022; Sejrup et al., 2020). From 2020, students could write their bachelor thesis with a manuscript for a peer reviewed scientific journal included, which helped a potential publication process (Lynge et al., 2022). This option also became available at UCL since 2018, but only one group of students took that challenge, and it was unfortunately not published. To explore if the inclusion of R&D student projects at the UCs had a positive effect on scientific outcome, our data in Table 2 were tested with nonparametric Spearman correlation coefficient (r). We found that the number of R&D projects with students and total number of publications with and without students were very strongly correlated r=0,80 but not statistically significant, p=0.13, meaning that the correlation may be based on random chance; and note n=5 only.

Table 2. First decade of research: Publications from 2013 to 2022.

The data represents the total number of publications, and the numbers in brackets represents publications with students as co authors. The last line shows the number of students affiliated with research projects, although only a few of these projects resulted in publications at the six BLS programs at Danish university colleges.

BLS program = Biomedical Laboratory Science bachelor’s degree program at university college (UC) in Denmark¸ 
*UC North started the BLS education August 2022, so no data yet

Students’ Experience Being Involved In R&D Projects

To evaluate the new research infrastructures at the UCs, we investigated students’ experiences of participating in R&D projects. Data was available from KP that also had the highest number of students directly involved in R&D projects (Table 2). From 2019-2022 oral evaluations were completed after the 6th semester (by co-author LKN) with an average of 9 students per semester. From the oral evaluations, the students expressed that they were very pleased to participate in the R&D projects, and the possibility for a deeper immersion into topics. They also expressed that they experienced significant learning outcomes. The students felt professionally challenged and very satisfied with the role of the different supervisors in the process. A few students worked alone and some of them, but not all, indicated that the lack of fellow students led to some social isolation even though the departments tried to include them. Most worked in pairs and very few in groups of three. The impression of the evaluator was that pairs were most optimal, both for social reasons and for professional reasons improving learning outcomes. 

These sentiments were echoed in quantitative data from an anonymous online evaluation, which is shown in Figure 4, where a KP standard online teaching evaluation was possible for the R&D student program in Fall 2021 and based on seven students. At the other UCs there were no systematic evaluations, however, two UCL students stated in an interview that their involvement in a research project was worth all the effort, despite having to work more hours than usual, and that the experience made them dream about working with research in the future. They also expressed that they were happy to be challenged and given more responsibility (UCL, 2022). A student interviewed in connection with an article about the R&D student program at VIA also expressed that the experience had supported their self-efficacy and belief in their own abilities, as well as strengthening general laboratory competencies (Jørgensen & Madsen, 2022).

Figure 4. A quantitative evaluation was conducted to investigate students’ experiences of participating in specialised R&D projects for one year as part of their BLS education. Questions related to the R&D program were added to the standard anonymous online course evaluation at KP (University College Copenhagen). The evaluation of the R&D student program was completed in Fall 2021. All 7 students that participated in an R&D project at that time answered the evaluation (100% participation in questionnaire).

Discussion

This discussion is organized into four sections. The first three examine how the integration of R&D within the BLS programs has influenced professional practice, education, and scientific measures. The final section highlights influential key factors that shaped the development, and with reflections from existing literature.

Impact on Practice

At the BLS programs, we mainly educate graduates for employment in hospitals and the aim of the legal requirements from 2014 was to promote applied research within various practice-oriented professions to create an impact on professional practice (Legal Act 936, 2014). Figure 3 shows our various collaboration partners, and the different types of research conducted, which in some cases may have deviated slightly from the political objectives set in 2014. 

BLS at Hospitals 

Since the BLS programs primarily educate graduates for employment in hospital laboratories, pursuing research collaborations with these laboratories was the natural choice for the UCs. The question of what constitutes R&D within the BLS profession prompted extensive discussion at our UCs—particularly in terms of how BLS-related research differs from research in the medical sciences. Hospital laboratories are equipped with state-of-the-art diagnostic instruments, automation technologies, skilled BLS staff, and access to patients and patient samples. To meet political requirements, research in biomedical laboratory science must therefore encompass the development, optimization, validation, and quality assurance of biomarker analyses; the advancement and further development of clinical laboratories staffed by BLS professionals; initiatives involving patients, including home-based laboratory testing; and the continual improvement of laboratory workflows.

In 2013, the BLS profession had almost no established culture or history of conducting research within its own field, and BLS professionals had not previously been trained in basic research competencies. However, these competencies are fundamental to enabling a research environment to grow and flourish (Smith et al., 2017). The growing number of lecturers with PhDs in the UC BLS programs was therefore intended to provide the necessary academic foundation to build an R&D infrastructure in collaboration with hospital-based BLS units. Because BLS professionals possess detailed knowledge of laboratory workflows as well as essential hands-on expertise, they were expected to play a central role in forming successful research teams and strengthening research environments. Despite these efforts, establishing research collaborations with hospitals proved to be a general challenge across all UCs. These challenges included difficulties in recruiting BLS staff willing to engage in research with the UCs, as well as obtaining sufficient support from hospital management.

A research infrastructure requires management and organizational support including that BLS professionals are given time for research. (Ajjawi et al., 2018; Bland & Ruffin, 1992). Hospital management must recognize and believe that research in biomedical laboratory science is essential and will benefit patients, advance the profession, foster employee development, and retain ambitious and highly skilled BLS in the field. It has previously been shown that development of laboratory staff is beneficial for retention of employees, which are becoming a key factor due to the growing shortage of healthcare workers in our society (Bimpong et al., 2020; Novis et al., 2020). But this shortage may also be a reason why the management finds it hard to include research and make ends meet at their department, and recruiting BLS for the routine clinical setting has already started to become challenging (Lægeforeningen, 2023; UC, 2021). 

Despite the challenges encountered in the first decade, there were also successes with research collaborations with BLS at hospitals and making an impact on practice. With the new R&D paradigm shift in the BLS programs at the UCs from 2013, the culture of BLS in the clinical setting at hospitals also seems to be sparsely adapting, so the impact on practice in the future can grow even more.

Other Partners 

Denmark has a strong tradition of R&D at university hospitals, universities, and within the health industry. The legislation introduced in 2014 for UCs also included a mandate to conduct research for the private sector (LA 936, 2014). Hence, the UCs also pursued partners away from the hospitals, as shown in Figure 3. With other partners, we ensured that our students developed technological and “hands-on skills” in the laboratories and were strengthened academically. With these partnerships, UC researchers also developed their network, competencies and CVs. 

Cases of Research Projects

This section describes examples of research projects that the UCs established with BLS at hospitals or other collaboration partners. KP made efforts to build up research within the actual BLS profession at the hospitals. This mostly was successful by publishing bachelor projects without external funding, for example, testing the performance of an haematological instrument (Sejrup et al., 2020). KP together with BLS from a pathology department managed to receive a grant in 2021 to improve the chemical work environment for BLS (Frandsen et al., 2025). KP also pursued collaborations with start up companies, in which R&D students contributed to the optimization of a commercial instrument designed to detect circulating tumor cells (Smith et al., 2019). 

To be independent of clinical collaboration partners, which were difficult to establish, qualitative research was sought. For instance, two UCs in collaboration investigated the implementation processes of digital pathology (Smith et al., 2022). Registry research was also sought. Denmark has a long tradition of collecting all health data on its citizens linked via the unique personal identification number making it possible to conduct valid population studies, so at Absalon, KP, and UC North, registry research was performed being more clinically oriented than in actual biomedical laboratory science with treatment outcomes and long-term health effects on specific populations (Jacobsen et al., 2017; Westergaard et al., 2020). 

The research strategy for the BLS program at Absalon was initially formulated in 2014 to focus on personalized medicine but changed to pharmacogenetics with a new docent in 2016. Absalon prioritized strongly to develop internal laboratory-based competencies to attract collaboration partners and published six papers in the first decade. Due to limited external funding (Figure 2), the Absalon UC deprioritised the BLS program in 2021 by not appointing a docent anymore and they limited the Frascati funding to a single staff member (co-author SJ). UCL conducted research in quality improvement of a diagnostic test, and diagnostic safety, but unfortunately had no publications in the first decade as shown in Table 2, nonetheless some of the work has been published since.

Some research projects started with threads into other branches like medical research. As an example, VIA contributed with data collection and measurements of biomarkers for Aarhus University in a study investigating psychological and physiological effects of mindfulness and nature-based therapy on stressed young subjects. A similar collaboration created opportunities for spin-off projects in laboratory science with students as co-authors at the VIA campus laboratory facilities (Christensen et al., 2016). 

Establishing collaborations with medical doctors in hospitals and industry also proved challenging for all UCs, as they were already engaged in R&D within their own institutions and often in partnership with universities. The BLS program at UC South suggested that being placed geographically outside the large cities was a challenge. The geographic placement and being a small BLS program made it difficult to find time, resources and relevant collaboration partners to establish research projects in biomedical laboratory science. This made UC South change strategy and contribute to analysing quantitative statistical data in a centralised internal UC project in nursing (Levisen et al., 2017, 2021). 

A good education for our BLS students is also valuable for the profession, so UC South implemented research in didactics and education, in particular evidence-based practice (EBP), where the BLS program could assume a leading role on the research (Figure 3). Likewise, KP started research in didactics and education in the BLS program with the new docent in 2021 (co-author ME) researching in peer-feedback and improving technological literacy.

As shown in Table 2, there were 87 peer-reviewed articles in the first decade, all with a potential for an impact on practice, and despite there being slight deviations in research areas from the political objectives set in 2014, all fed into the political purpose at the end of the day with an impact on biomedical laboratory practice and education.

Impact on Education 

Student evaluations from the BLS programs suggest that being directly involved in R&D projects is extremely positive and beneficial for the student experiences, and the positive student evaluations at KP were mirrored at UCL and VIA. This finding is also comparable to the conclusions in the literature, where previous studies have shown that the effect of having a research based environment increases the students’ commitment, motivation and learning outcome (Al-Maktoumi et al., 2016; Limniou et al., 2019; Wessels et al., 2021). In addition to the impact on students’ direct involvement in R&D projects, we believe that the implementation of research environments to our programs has had significant impact on all students. Bachelor projects, literature studies and journal clubs have inspired other lecturers (not only the lecturers involved in research) to include research and evidence-based knowledge in the BLS program curriculum, to integrate research methods, to match the curriculum with new trends, and to include scientific literature in taught subjects. However, incorporating our own research results into the curriculum for all students—not only those in R&D tracks—was not always straightforward, as the research did not always align with the subjects in their curriculum. Yet, as more knowledge and projects have been generated, this has gradually become easier. Working with students has additionally made researchers broaden their knowledge and opened doors into new potential research opportunities with collaboration partners. Thus, including R&D in the student curriculum and involving students in R&D have improved the quality of our educational BLS programs and a symbiotic relationship between students and lecturers have evolved. The literature supports that integrating research in higher education lifts the overall quality of the education and improves students’ academic skills (Brew, 2010; Malcolm, 2014). Involvement of R&D in education is believed to improve students’ critical analysis and awareness of evidence based knowledge, which is especially crucial in today’s fast-paced, globally connected information landscape (Brew, 2010). 

With the new generation of BLS, some will pursue an academic career and possess the ambitions, skills and ability to advance their profession, and we believe this will be a strength for the field of biomedical laboratory science in Denmark. The new generation may also help to change the culture at the hospital departments and the mindsets of the managements, so that BLS will become natural partners in research to evolve laboratory science and the profession (Smith et al., 2017). There is a need to embrace this new upcoming academic excellence among BLS, but there is a high risk of losing precious employees to the industry and other opportunities if the culture at hospitals does not change. There is already a shift away from the hospitals with every fourth BLS working in the private sector (dbio, 2023).

We also believe that going back to an environment without research will devaluate the BLS education and deflate the positive trends in biomedical laboratory science that we start to see in practice. As stated by Brew: “Once academics begin to see the possibilities for a research-enhanced education for their students, they cannot go back” (Brew, 2010, p.149).

Impact on Scientific Measures

The public Frascati funding was crucial to boost the R&D at the BLS programs from 2013 (UC, 2012). Our research productivity from the first decade of research is shown in Figure 2 and Table 2, where the numbers imply that the UCs with limited financial support also had lower scientific output. A success of a research environment is typically evaluated through scientific measures, especially peer-reviewed publications (Hanssen et al., 2018). Therefore, to remain competitive in research, strong scientific performance is essential. Apart from the scientific measures shown, all the five established UCs participated with abstracts and oral presentations at international and national congresses, particularly the IFBLS World Congress of Biomedical Laboratory Science (data not shown). 

With an analytical approach from our national experiences and organisational descriptions, we have identified key factors that influence research productivity, which are shown in Figure 5 and thoroughly described in the next section.  

Key Factors Shaping the Development of Research Productivity

Insights into key influencing factors are represented in this section and an overview is provided in Figure 5, which is based on analysis of our data and existing literature. From the start, KP may have had some advantages compared to most other UCs. KP´s location in the capital (Copenhagen) probably gave more opportunities for collaborations with hospitals, universities, and companies compared to UCs located in smaller cities or positioned in rural areas. However being a new research environment in a rural area does not necessarily make it impossible to grow (Nies et al., 2018). Being a larger institution, like KP, also will allow more staff and students as a resource, and it seems that the larger institutions showed greater student involvement in R&D (Table 1 compared to Table 2). BLS programs in smaller cities also had fewer students, hence fewer lecturers, so the flexibility was more limited for the management to give lecturers time for research, which is both costly and time consuming (Ajjawi et al., 2018; Bland & Ruffin, 1992). Resources are key for a successful research environment, and a main characteristic resource is uninterrupted time (Ajjawi et al., 2018). This means that uninterrupted time should be allocated for scientific creativity, scientific writing, field research and research applications. It is well known that heavy teaching and /or administrative burdens hinder research outcome (Bland & Ruffin, 1992). This may also be considered from Table 1, where the student/lecturer ratio was 17:1 for KP, while 24:1 for UC South perhaps giving less time for research per lecturer.

Figure 5. Influential key factors for a positive outcome on scientific research measures.

Identified from our analysis of our quantitative and qualitative data.

VIA is situated in the second largest city in Denmark thus with similar opportunities to KP. A probable significant difference is that the governmental Frascati funds at VIA were centralised, and lecturers had to apply internally to The Research Centre for Health and Welfare Technology for receiving Frascati funding. This adds pressure and workload to the individual lecturer. Lack of economic support or funding obviously challenges the allocation of uninterrupted time for the researchers (Bland & Ruffin, 1992). At KP, some of the received Frascati funding was distributed locally into the institutes that had to channel the funding directly into to the educational programs each year. This gave the local management the opportunity to allow staff both to fail and to succeed within a relatively flat, decentralised structure. When UCs centralised and pooled research areas and research projects (at three UCs, Figure 1), the researchers from the BLS programs did not seem to match to the centralised projects and collaborations inside the UC. Even though “collaborations” are generally considered to be productive and beneficial for research outcome and research environment, it may have a negative impact on the scientific outcome if researchers do not have some autonomy when choosing research partners with complementary interests (Gilmour, 2023). Our findings are supported by the literature suggesting that highly productive research environments correlate with a decentralised and flat organizational structure (Bland & Ruffin, 1992). 

In addition to internal funding, external funding is required for a sustainable research infrastructure. To receive external funding to support research in health sciences, normally requires good academic CVs, valid projects of general interest, good collaboration partners, and depending on project, also access to laboratory facilities and patient samples (Ajjawi et al., 2018; Bland & Ruffin, 1992). A solid foundation like this is necessary to become a successful self-sustainable research environment. But this had to be built up at our BLS programs, and all our programs struggled to receive external funding (Figure 2).

To strengthen scientific capacity, the KP BLS program (advised by the consultant professor; see Figure 1) decided from the start in 2013 to build up the researchers’ CVs by immediately writing papers, so newly employed PhDs were supported to complete publications from former employments, meaning that the affiliation from the employees also included KP (Metropol); for example: (Smith et al., 2015). This was not honoured for researchers at UCL nor UC South, so despite researchers completing and publishing papers during their time at the BLS programs, the UCs were not affiliated. This would, however, have been beneficial for the BLS programs as research environments are evaluated on such scientific outcomes (Hanssen et al., 2018). It is noteworthy that 23% (14/60) of all KP peer-reviewed publications in Table 2 were contributed by an Australian KP Honorary Associate, where KP students travelled to Australia to assist a highly ranked professor in his research related to epigenetics; for example: (El-Osta, 2022). Two of the 14 publications included students as co-authors. In this way KP also has managed to outsource research by strong international collaborations.

In recent years, the focus of R&D at KP and UC South expanded to include educational development and didactics, which at KP has only been allowed to be covered by external funding, not Frascati funding.  Broadening the field of type of research from not only focusing on hospital-related biomedical laboratory science, significantly increased the scientific measures. The costs of research varies greatly (Runciman, 2002). This may explain the discrepancy in price per publication among UCs when Table 2 is compared to Figure 2, which may portray that quantitative laboratory investigations with own facilities are more costly (Absalon) compared to qualitative research or being a statistical partner (UC South), which also is emphasized by Runciman, 2002. 

The number of student R&D projects and number of publications were strongly correlated but not statistically significant, and thus more showed a trend (please note that the number of UCs was small (n=5, Table 2)). This trend, however, may not necessarily be causal and may be due to other effects at the UCs. But focusing on having R&D students through the UC program and finding collaboration partners for the students seemed to have an overall beneficial effect on the research culture and scientific measures at the UCs—effects that have previously been described in the literature in relation to a new research environment (Nies et al., 2018).

There are also other suggested key factors in the literature on how to create an effective research environment. Relevant support is necessary—for example, access to software like statistical programs or informational support such as scientific journals (Umbetzhanova et al., 2018). This was an issue the first few years at the UCs, but the issue remained for UC South, where getting good access to relevant scientific literature continuously was a challenge. Also participative governance is important for a fruitful research environment, as management also should be role models in research (Bland & Ruffin, 1992). The only educational manager holding a PhD was at UC North (co-author SGP), but the other managers did not have a background in research, and thus it can be very difficult to understand “the game” of research, which may also have affected the research environments and scientific outcomes. Employment of a specific manager for research, like a docent, may help this issue. A supportive leadership is suggested to be crucial to create a successful research environment by creating a trusting and respectful relationship and belongingness for the researchers (Ajjawi et al., 2018).  However, there is also a lot of personal drive behind achievements and success within research and it is not all related to the environment (Hanssen et al., 2018).  Being a productive researcher has been evaluated by the literature and includes personal motivation, inquisitiveness, and scientific creativity, excellence in research disciplines, like writing, critical thinking, problem solving and project management (Siskind et al., 2015; Toledo-Pereyra, 2012; Bland & Ruffin, 1992). This was evident at our UCs, where holding a PhD was not necessarily the key to success. Not all PhDs were driven and active in research, whereas driven lecturers not holding a PhD also achieved success in research with a few publications at the UCs. Patience, perseverance, and strong collaboration skills are essential when building research from what feels like ground zero, but they are also fundamental qualities for research in general (Siskind et al., 2015; Toledo-Pereyra, 2012). Candidates with a PhD or similar, and with experience in applied research (even in laboratory science), and with a solid research network would be beneficial for employment at the BLS programs. However, working at UCs with research is not as esteemed as working at universities. Besides, teaching at UCs is pivotal. For instance, the assignment to become senior lecturer must include educational development and didactics for 2/3 and only 1/3 research. This focus and the lack of strong research environments at our BLS programs may also reduce the choice of candidates and therefore many PhDs in health sciences still pursue careers at Danish universities that have more than 500 years of research experience (Bouchrika, 2025).

However, it is not only personal skills that determines research outcome (Siskind et al., 2015; Toledo-Pereyra, 2012), but other factors also have a considerable impact like mentors, research training, network of productive colleagues, resources and substantial uninterrupted time. Thus, a productive research outcome also relies on management and strategies (Bland & Ruffin, 1992; Tofighi et al., 2017). As discussed in this section and listed in Figure 5, we believe that, because of our unique position as a newly established infrastructure in a novel field of research within a Northern European context, this study provides new insights and evidence on the key factors influencing research productivity.

Conclusions

Research in biomedical laboratory science is essential for ensuring timely and high-quality results that optimize and safeguard patient diagnosis, treatment, and prognosis. Integrating research into BLS programs will continuously ensure high-quality education and contribute to improve biomedical laboratory practice. Therefore, we believe it is essential that our new research infrastructures and environments continue to evolve beyond the first decade, also ensuring ongoing academic excellence in the UC programs for BLS students.

Our comparative method in this national study enabled us to identify both similarities and discrepancies, and to discuss their implications for establishing research infrastructures in the first decade at BLS programs in Denmark—from ground zero. The establishment of a thriving research environment in a new field is a gradual process that requires creating an infrastructure, collaborations, active engagement of students, and the generation of research outputs and fundable projects. Our research into impact on practice, education and scientific measures allowed an analytical approach to identify key factors having an influential positive impact on research productivity—such as location, decentralizing research infrastructure and allocating time to a few highly dedicated individuals. Anyone who is administering and managing research infrastructures in both new and established research fields may find our experiences and analyses useful to support their own student and faculty research.

Authors' Note

Julie Smith* 
Biomedical Laboratory Science, Department of Technology, Faculty of Health, University College Copenhagen, Copenhagen, Denmark

Helen Nordahl Madsen 
Education of Biomedical Laboratory Science and Research Centre for Rehabilitation, VIA University College, Aarhus N, Denmark

Lene Noehr-Jensen 
Biomedical Laboratory Science, Department of Biomedical Laboratory Science, Physiotherapy and Radiography, UCL University College, Odense, Denmark

Steffen Jørgensen 
Biomedical Laboratory Science, Centre for Engineering and Science, University College Absalon, Naestved, Denmark

Leif Kofoed Nielsen 
Biomedical Laboratory Science, Department of Technology, Faculty of Health, University College Copenhagen, Copenhagen, Denmark 

Marianne Ellegaard 
Biomedical Laboratory Science, Department of Technology, Faculty of Health, University College Copenhagen, Copenhagen, Denmark 

Sofie Gry Pristed 
Programme of Biomedical Laboratory Science, University College of Northern Denmark, Hjørring, Denmark

Francisco Mansilla Castaño 
Education of Biomedical Laboratory Science, University College South Denmark, Esbjerg, Denmark

Corresponding Author

Senior Lecturer Julie Smith, PhD. Department of Technology, Faculty of Health, University College Copenhagen, Sigurdsgade 26, 2200 Copenhagen, Denmark. E-mail address: jusi@kp.dk; Telephone: +45 51 63 28 12

Competing Interests and Funding

The author declares that there are no conflicts of interest regarding the publication of this paper, and we received no funding.

Author Contributions

Study conception, study design, material preparation and data analysis were performed by Julie Smith. Data collections were performed by all authors for their respective university colleges. The first draft of the manuscript was written by Julie Smith. All authors commented on versions of the manuscript. All authors read and approved the final manuscript.

ORCID

Julie Smith: https://orcid.org/0000-0003-1135-1191 
Helen Nordahl Madsen: https://orcid.org/0000-0001-7103-538
Lene Noehr-Jensen: https://orcid.org/0000-0001-5176-819X
Steffen Jørgensen: https://orcid.org/0000-0002-7529-490X
Leif Kofoed Nielsen: https://orcid.org/0000-0002-6956-1821
Marianne Ellegaard: https://orcid.org/0000-0002-6032-3376
Francisco Mansilla Castaño: https://orcid.org/0000-0001-7440-7071

References