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CT Operation Gap Analysis
Hybrid imaging equipment is changing practice in medical radiation technology. Computed tomography (CT) units are being used for diagnostic CT, PET/CT and CT simulation for radiation treatment planning. The use and operation of CT units has crossed the medical radiation technology disciplines of radiological technology, nuclear medicine technology and radiation therapy. This has opened discussion about who should operate these units and what education is required to optimally operated CT units safely and efficiently.
This discussion led the Canadian Association of Medical Radiation Technologists (CAMRT) to establish the 'CT-Operation Gap Analysis Workgroup'. The group was tasked with identifying the gaps in knowledge, skills and judgment that exists across the three disciplines for technologists/therapist in each of these disciplines to operate a CT unit both within the context of their existing practice and crossing into another discipline's current scope of practice.
An inter-professional group consisting of 6 experienced professionals - two radiological technologists, two nuclear medicine technologists and two radiation therapists - was brought together. In each discipline pair, there was an educator and clinical practitioner.
The group recognized that although each discipline operates a CT scanner in their practice, the purpose for the acquired image and the operational approach of the user varies greatly across the disciplines. Therefore the method taken to identify the gaps looked at what knowledge, skills and judgment are required for the operation of each imaging modality.
In order to begin this analysis there was a need to establish a baseline. Rather than base the analysis on individual clinical sites practice, the group decided to use the 2006 CAMRT revised competency profiles and curriculum guidelines which will be used for certification exam development beginning in Sept 2011. These are the most current competency documents for entry-to-practice.
Using these documents, the workgroup identified where gaps exist at the point of entry-to-practice for each discipline. The concept of safe, effective and competent delivery of care in the operation of diagnostic CT, CT Simulator and PET/CT units by technologists/therapists was a guiding principle.
The following questions were used as guidelines:
- If the radiological technologist wishes to practice in diagnostic CT, CT simulator and PET/CT what are the gaps in the RTR competency profile?
- If the radiation therapist wishes to practice in diagnostic CT, CT simulator and PET/CT what are the gaps in the RTT competency profile?
- If the nuclear medicine technologist wishes to practice in diagnostic CT, CT simulator and PET/CT what are the gaps in the RTNM competency profile?
Gap analysis for operation of a CT diagnostic unit
Gap analysis for operation of a CT Simulator
Gap analysis for operation of a PET/CT unit
In moving forward, it is recognized that technologists/therapists who have the clinical experience of operating CT units in their discipline-specific practice, have not only acquired a discipline-specific competency in the operation of a CT, but also some level of competency related to the use of CT units in other disciplines. It is also recognized that there will be a need to take into account the continuing professional development that technologists/therapists have completed in the operation of CT, both within their existing discipline and across others.
As well, during the process of identifying the gaps across the disciplines, the group identified gaps within each specific discipline for the operation of CT as related to that discipline. This information will be used in the next validation of the entry-to-practice competency profiles to determine the competencies that should be considered entry-to-practice and the competencies that should be acquired through continuing professional development.
Having developed these gap analysis documents, CAMRT's next goal is to facilitate the development of processes that will result in a means for technologists/therapists to achieve competency in the areas currently identified as gaps. These will require a variety of approaches in recognition that many technologists/therapists have already achieved various levels of competency.
The next steps for the CAMRT will be to:
- Distribute the gap analysis documents to CAMRT members and other stakeholders
- Conduct a market study in the fall of 2009 to establish an evidence base for development of future educational experiences that would include both theory and clinical components
- Investigate potential program delivery methods, which would include prior learning assessment recognition
- Invite educational institutions to consider developing the required programming and delivery methods
- Determine the process that will verify an individual's competency to perform CT procedures in disciplines other than the one in which they were originally certified and,
- Conduct another validation survey of the 2006 competency profiles to ensure they reflect the required competency at entry-to-practice. CT has been added or enhanced in 2006 profiles, however, given changes in technology and practice, it will be necessary to identify the additional competencies that should be added for entry-to-practice in the future.
The Gap Analysis Report would not have been possible without the dedication and expertise of the working group who took on this task. The CAMRT would like to thank the following individuals for their work which will be the foundation for moving forward with this key issue facing the profession:
Susan Crowley, BAppSc(MI), MRT(R) M.A. (Ed)
Rob Gamberg, BAppSc, CTIC (R), ACR, RTR
Tammie Currie, BSc.,CTIC (T), ACT, RTT
Renate Bradley, RTT
Julie Avery, BSc., RTNM
Annette Fraser, RTNM
The CAMRT hopes that this report will prove to be useful to individual technologists/therapists as they build their careers and to managers in medical imaging and radiation therapy departments. The CAMRT looks forward to working with members and other stakeholders to develop programs that will help technologists/therapists address the identified competency gaps. It also looks forward to on-going collaboration to respond to the many changes in the dynamic field of medical radiation technology.