Biomedical Technicians Research Articles

Women in engineering, science and technology in sub-Saharan Africa: cultural attitudes, challenges, and gaps affecting clinical engineering and medical devices maintenance practices

PurposeFrom previous studies, we had observed that the number of biomedical engineers and technicians (BMETs) skilled in the maintenance of medical devices (MDs) were limited in sub-Saharan Africa (SSA) and that a likely parallelism existed between BME maintenance-related tasks and house chores mainly carried out by women in daily life. Our objective in carrying out this study was to understand underlying local cultural and social factors and domestic traditions interfering with the inclusion of women in the field of clinical and biomedical engineering (BME), and to identify existing gaps in opportunities for women in Engineering, Science and Technology (EST) in this region.MethodsWe carried out an online survey involving 51 respondents (70.6% women, 29.4% men), to investigate gender-biased and cultural perceptions of maintenance-related tasks among engineers/technologists/technicians in BME and other allied professions in SSA​. The survey was refined through focus groups and pilot tests to assess its validity, and then shared among specific associations of women in engineering and other bodies in EST, as well as some hospital communities and institutions.ResultsThe survey brought to light evidence of prejudices against women in the society and workplace and showed that the adoption of our parallelism hypothesis has potential for increasing medical device maintenance practices in SSA hospitals.ConclusionsThere is an apparent need to further study the possible effects of this sociological model through leveraging local culture and domestic traditions in ways that could ultimately increase the leadership and numbers of women BMETs in SSA.

Biomedical laboratory scientists and technicians in digital pathology - Is there a need for professional development?

Digital pathology (DP) is moving into Danish pathology departments at high pace. Conventionally, biomedical laboratory scientists (BLS) and technicians have prepared tissue sections for light microscopy, but workflow alterations are required for the new digital era with whole slide imaging (WSI); digitally assisted image analysis (DAIA) and artificial intelligence (AI). We aim to explore the role of BLS in DP and assess a potential need for professional development. We investigated the roles of BLS in the new digital era through qualitative interviews at Danish Pathology Departments in 2019/2020 before DP implementation (supported by a questionnaire); and in 2022 after DP implementation. Additionally, senior lecturers from three Danish University Colleges reported on how DP was integrated into the 2023 bachelor's degree educational curricula for BLS students. At some Danish pathology departments, BLS were involved in the implementation process of DP and their greatest concerns were lack of physical laboratory requirements (69%) and implementation strategies (63%). BLS were generally positive towards working with DP, however, some expressed concern about extended working hours for scanning. Work-task transfers from pathologists were generally greeted positively from both management and pathologists; however, at follow-up interviews after DP implementation, job transfers had not been effectuated. At Danish university colleges, DP had been integrated systematically in the curricula for BLS students, especially WSI. Involving BLS in DP implementation and development may benefit the process, as BLS have a hands-on workflow perspective with a focus on quality assurance. Several new work opportunities for BLS may occur with DP including WSI, DAIA and AI, and therefore new qualifications are warranted, which must be considered in future undergraduate programmes for BLS students or postgraduate programmes for BLS.

Using interprofessional education to build dynamic teams to help drive collaborative, coordinated and effective newborn care

BackgroundAs countries strive to achieve sustainable development goal 3.2, high-quality medical education is crucial for high-quality neonatal care. Women are encouraged to deliver in health units attended by a skilled team. Traditionally, the team is doctors and nurses, but they are members of a large group of interdependent experts from other disciplines. Each discipline trains separately, yet the goal of good neonatal care is common to all. The use of interprofessional education breaks down these professional silos improving collaborative practice and promoting excellent clinical care. Introduction of new educational materials and training requires a rigorous approach to ensure sustainability.MethodsAn extensive needs assessment identified gaps in neonatal training. Specifically, there was a lack of inclusion of medical devices used in clinical care. In each country, national key stakeholders came together to develop and revise their own neonatal curricula, trainings or guidelines. A core writing education team were tasked to develop evidence-based materials on pertinent medical devices to include in these national materials. These then underwent internal and external review. A provider course for biomedical engineers and technicians was introduced. Skills labs were established to improve practical skills teaching. To improve the quality of teaching, a NEST360 generic instructors course (GIC) was developed.ResultsTwenty modules, 14 scenarios, 17 job aids and 34 videos have been published to date. Materials have been embedded into neonatal curricula and national trainings. Forty-one skills labs were installed in pre-service learning institutions and, up to June 2022, have been used by 7281 students. Pre- and in-service interprofessional training was implemented at all NEST360 institutions (clinical and biomedical). GIC courses were conducted at least twice a year in all countries. Three hundred seventeen nurses, biomedical and clinical staff have undertaken the GIC in all four countries. GIC participants report that the course has very positively influenced their teaching practice.ConclusionsInclusion of key stakeholders throughout has ensured training is embedded within the four countries. Use of interprofessional education and inclusion of biomedical engineers and technicians has been very successful. Introduction of the GIC has developed a pool of high-quality educators for neonatal care. This approach has ensured that high-quality interprofessional neonatal training is included within national agendas for neonatal care and beyond.

Exploring clinicians' beliefs and practices regarding Non-Invasive Ventilation devices: An international survey study

Introduction Non-invasive ventilation (NIV) has a significant role in supporting patients with respiratory failure with the goal of avoiding mechanical ventilation. Traditionally, NIV has been applied using dedicated NIV-specific devices but over the last decade, newer generation critical care ventilators have updated their capabilities to include NIV options with improved synchrony and leak compensation. No recent trials have compared the efficacy of new generation critical care ventilators to NIV ventilators. The purpose of this study was to evaluate clinicians attitudes and perceptions toward the use of NIV between the dedicated NIV and critical care ventilators. Methods An online survey of clinicians with seven questions regarding their thoughts and experience in using NIV in acute care settings was posted online and promoted through emails and social media. The survey was anonymous and an exemption of consent was obtained from the Institutional Review Board. Analysis of variants (ANOVA) was done for the total responses in each question, followed by multivariate analysis of variants (MANOVA) for responses per occupation. Results 514 responses from 54 countries were recorded. 151 from North America, 109 from South America, 125 from Europe, 97 from Asia, 21 from Africa, and 11 from Australia. 218 responders were physicians, 218 were respiratory therapists, 28 were nurses, and 50 were reported as other professionals (engineers, biomedical technicians). 346 (67.3%) reported using both types of ventilators for NIV, 91 (17.7%) use only NIV -specific devices, and 77 (15%) only use critical care ventilators (P 0.097), responses per occupation (P < 0.001). 290 (56.4%) have automatic synchronization software on either of their ventilators, 113 (22%) do not, while 111 (21.6%) are unsure if they do (P 0.22), with significant variation by occupation (P 0.008). Regarding synchrony, 233 (45.3%) said NIV ventilators are better, and 165 (32.1%) said critical care ventilators are better, while 116 (22.5%) said both are similar (P 0.59) with significant variation by occupation (P 0.04). Regarding leak compensation, 241 (46.9%) said NIV ventilators are better, and 146 (284%) said critical care ventilators are better, while 127 (24.7%) said both are similar (P 0.6) without significant variation by occupation (P 0.07). Regarding the general opinion of superiority, 273 (53.1%) said NIV ventilators are better, 131 (25.5%) said critical care ventilators are better, and 110 (21.4%) said both are similar (P 0.42) without significant variation by occupation (P 0.098). Conclusion Despite the lack of evidence, there is wide variability in opinion with no clear consensus regarding the clinicians’ attitude towards which ventilators are superior to use during NIV, especially according to surveyed occupation.

Evaluation of open-ended, clustering, and discrete choice methods for user requirements development in a low-income country context

High quality user requirements are positively correlated with successful design outcomes, but engaging stakeholders within low-income contexts can present financial and time-related challenges to product developers from non-local industrial and academic institutions with limited knowledge of the context. Existing literature provides guidance for engaging stakeholders during the early stages of product design in high-income country contexts, but few studies have examined the effectiveness of these methods in low-income country contexts. This study evaluated three user requirements elicitation and prioritization methods including open-ended, clustering, and discrete choice. Ghanaian healthcare delivery stakeholders with varying types of expertise, years of experience, and from various types of healthcare facilities were recruited to allow for diversity of responses. Participants included physicians (n = 10), nurses/midwives (n = 16), biomedical technicians (n = 14), and public health officers (n = 7). A hypothetical mechanical device for managing and treating postpartum hemorrhage was chosen to characterize each method's ability to elicit and prioritize user requirements. The open-ended method captured general requirements of a design concept, yet resulted in predominantly generic requirements. The results from the open-ended method were used to inform the clustering and discrete choice methods. The clustering and discrete choice methods were useful for inferring in-depth user requirements and eliciting stakeholder priorities. The clustering method revealed that usability and affordability were high-priority requirements among all four stakeholder groups. An individual difference scaling analysis was performed using the clustering method outcomes, which indirectly identified ease-of-use, availability, and effectiveness as the priority user requirements categories. Stakeholders ranked ease-of-use as the highest-priority user requirement, followed by performance, cost, and place-of-origin requirements, using the discrete choice method. Given the significance of the ease-of-use requirement, an analytical framework based on sub-requirements was developed for quantifying stakeholder needs. Lastly, the relative merits of the three elicitation approaches and their implications for use with different stakeholder groups were examined.

Assessment of core teaching competency of health professional educators in Ethiopia: an institution-based cross-sectional study

ObjectivesUnderstanding the competency of educators is key to informing faculty development, recruitment and performance monitoring. This study aimed to assess the core teaching competency of nursing, midwifery and biomedical educators,...

Comparative Analysis of Educational Regulations of the bachelor’s degree course in “Biomedical Laboratory Techniques” in the Lombard Universities

With the institution of university courses, the course of study of the biomedical laboratory technician has experienced a real revolution. At the basis of the training of university courses there are decrees and laws that aim to standardize, while maintaining the autonomy of the universities, the educational offer that is provided to the undergraduate nationally. The purpose of this document is to understand the basics of structuring a degree course and to compare the educational offer that the Lombard university system makes available to future biomedical laboratory technicians. Starting from the analysis of the study plans of the degree courses, obtained from the institutional sites of the five Lombard universities that offer this path, a comparison was made between the standard in force on the construction of the degree course in biomedical laboratory techniques and the distribution of ECTS operated by each university in its teaching plan. The analysis highlighted a substantial similarity between the organizations of the degree course and adherence to regulatory indications. The only exceptions are the presence in some didactic plans of training activities no longer present in the current legislation and a poor valorization in some universities of the MED / 46 (Biotechnology and Methods in Laboratory Medicine), the academic discipline of reference for the professional profile of the biomedical laboratory technician.

National surgical, obstetric, anaesthesia and nursing plan, Nigeria.

Recent evidence suggests that strengthening surgical care within existing health systems will strengthen the overall health-care system. However, Nigeria’s national strategic health development plan 2018–2022 placed little emphasis on surgical care. To address the gap, we worked with professional societies and other partners to develop the national surgical, obstetric, anaesthesia and nursing plan 2019–2023. The aim was to foster actions to prioritize surgical care for the achievement of universal health coverage. In addition to creating a costed strategy to strengthen surgical care, the plan included children’s surgery and nursing: two key aspects that have been neglected in other national surgical plans. Pilot implementation of the plan began in 2020, supported by a nongovernmental organization with experience in surgical care in the region. We have created specific entry points to facilitate the pilot implementation. In the pilot, an electronic surgery registry has been created; personnel are being trained in life support; nurses are being trained in safe perioperative care; biomedical technicians and sterile supplies nurses are being trained in surgical instrument repair and maintenance; and research capacity is being strengthened. In addition, the mainstream media are being mobilized to improve awareness about the plan among policy-makers and the general population. Another development partner is interested in providing support for paediatric surgery, and a children’s hospital is being planned. As funding is a key challenge to full implementation, we need innovative domestic funding strategies to support and sustain implementation.

Artificial Intelligence in Digital Pathology: What Is the Future? Part 2: An Investigation on the Insiders.

Motivation: This study deals with the introduction of artificial intelligence (AI) in digital pathology (DP). The study starts from the highlights of a companion paper. Objective: The aim was to investigate the consensus and acceptance of the insiders on this issue. Procedure: An electronic survey based on the standardized package Microsoft Forms (Microsoft, Redmond, WA, USA) was proposed to a sample of biomedical laboratory technicians (149 admitted in the study, 76 males, 73 females, mean age 44.2 years). Results: The survey showed no criticality. It highlighted (a) the good perception of the basic training on both groups, and (b) a uniformly low perceived knowledge of AI (as arisen from the graded questions). Expectations, perceived general impact, perceived changes in the work-flow, and worries clearly emerged in the study. Conclusions: The of AI in DP is an unstoppable process, as well as the increase of the digitalization in the health domain. Stakeholders must not look with suspicion towards AI, which can represent an important resource, but should invest in monitoring and consensus training initiatives based also on electronic surveys.

Forensically reconstructing biomedical maintenance labor: PDF metadata under the epistemic conditions of COVID-19.

This study examines the documents circulated among biomedical equipment repair technicians in order to build a conceptual model that accounts for multilayered temporality in technical healthcare professional communities. A metadata analysis informed by digital forensics and trace ethnography is employed to model the overlapping temporal, format‐related, and annotation characteristics present in a corpus of repair manual files crowdsourced during collaborations between volunteer archivists and professional technicians. The corpus originates within iFixit.com's Medical Device Repair collection, a trove of more than 10,000 manuals contributed by working technicians in response to the strain placed on their colleagues and institutions due to the COVID‐19 pandemic. The study focuses in particular on the Respiratory Analyzer subcategory of documents, which aid in the maintenance of equipment central to the care of COVID‐19 patients experiencing respiratory symptoms. The 40 Respiratory Analyzer manuals in iFixit's collection are examined in terms of their original publication date, the apparent status of their original paper copies, the version of PDF used to encode them, and any additional metadata that is present. Based on these characteristics, the study advances a conceptual model accounting for circulation among multiple technicians, as well as alteration of documents during the course of their lifespans.

Evaluation of infectious risk among biomedical agents in Morocco

Background: The Infectious risk among biomedical technicians and engineers is influenced by many variables like the health and immune status of the worker, the education and training they had, the suitability of the establishment for work with highly pathogenic agents, and availability of protective equipment. We report in this article the results of a survey carried out in the country and which was interested in the perception of the infectious risk by biomedical agents.Methods: It is a descriptive study of the infectious risk among BMTE in Morocco with an assessment of the knowledge, attitudes, and behaviors by the use of a questionnaire transmitted to participants by google form.Results: 84 persons participated in the survey. Biomedical agents report that the risk is either direct because they handle microorganisms (20%; 23/84), but above all indirect, since these are situations where they handle contaminated instruments or waste produced during care activities (41.7%; 48/84). The cutaneous route contamination showed a slight predominance (71.6%; 60/84) because they use sharp tools (64.3%; 54/84). Only half know they have to report this kind of incident (56.8%; 48/84) and Less than one in five (17.9%; 15/84) reported these accidents.Conclusions: Moroccan law has not ignored occupational risk and equipment of protection is available in the workplace. However, most of the participants did not receive specialized training in infection risk management, they do not benefit from medical supervision, and immunization and accidents are underreported.

Establishing Standardized Biomedical Laboratory Technician Education for the Development of Biotechnology Research in China

Chinese scientists have been actively engaged in biotechnology research since the mid-20th century. However, biotechnology education, especially biomedical laboratory technology education, is relatively scarce in China. More and more cutting-edge equipment and techniques have been introduced into biomedical laboratories in China, but there is a lack of high-quality technicians to apply these advancements to scientific research. In addition, the traditional education and apprenticeship systems have been demonstrated little progress. To address this gap, West China Hospital of Sichuan University established a 2-year educational program for laboratory technology in 2006 based on the residency training program. The project integrates scientific methods into the research laboratory technician training in relevant disciplines, and has developed a systematic, scientific, and effective standardized training system to cultivate high-level and stable experimental technician team for the need of advanced laboratories, which has been demonstrated greatly improve the efficiency of biomedical researchers and laboratory facilities. In this article, we introduce the practical experience in establishment and development of a standardized training system for biomedical laboratory technicians to ensure the sustainable development of medical researches.

A sustainability evaluation of a biomedical technician training program in Honduras

Engineering World Health (EWH) developed and executed a unique model to train biomedical technicians (BMET) in Rwanda, Honduras, and Cambodia. This model significantly decreased out-of-service equipment, one to two years after the training’s initiation, when comparing hospitals with EWH trained BMETs to similar hospitals with BMETs without EWH training [1–4]. Despite this model’s past evidence of impact, no study has shown evidence for sustained impact and continued delivery of services after the termination of funding. Here, one year after external funding ended for the EWH Honduras program, the model’s sustainability was assessed using qualitative interviews guided by an established sustainability framework and quantitative measures of continued impact on out-of-service rates of medical equipment. Interviews found the program, institutionalized within a technical training college, was strongly sustainable in each domain of an established sustainability framework. Additionally, there was evidence of continuing production of benefits to the health system. Technicians whose training through EWH had ended two years earlier had 35.37% less out-of-service equipment compared to similarly sized control hospitals, demonstrating continued impact of training (p < .0001). Overall, the program in Honduras was found to be strongly sustainable, albeit with some threats to continued sustainability.

Design and preliminary validation of a mobile application-based expert system to facilitate repair of medical equipment in resource-limited health settings.

BackgroundOne of the greatest barriers to safe surgery is the availability of functional biomedical equipment. Biomedical technicians play a major role in ensuring that equipment is functional. Following in-field observations and an online survey, a mobile application was developed to aid technicians in troubleshooting biomedical equipment. It was hypothesized that this application could be used to aid technicians in equipment repair, as modeled by repair of a pulse oximeter.MethodsTo identify specific barriers to equipment repair and maintenance for biomedical technicians, an online survey was conducted to determine current practices and challenges. These findings were used to guide the development of a mobile application system that guides technicians through maintenance and repair tasks. A convenience sample of technicians in Ethiopia tested the application using a broken pulse oximeter task and following this completed usability and content validity surveys.ResultsFifty-three technicians from 13 countries responded to the initial survey. The results of the survey showed that technicians find equipment manuals most useful, but these are not easily accessible. Many do not know how to or are uncomfortable reaching out to human resources. Thirty-three technicians completed the broken pulse oximeter task using the application. All were able to appropriately identify and repair the equipment, and post-task surveys of usability and content validity demonstrated highly positive scores (Agree to Strongly Agree) on both scales.DiscussionThis research demonstrates the need for improved access to resources for technicians and shows that a mobile application can be used to address a gap in the access to knowledge and resources in low- and middle-income countries. Further research will include prospective studies to determine the impact of an application on the availability of functional equipment in a hospital and the effect on the provision and safety of surgical care.

The continuing training program of oncology network of Piemonte and Valle d'Aosta: a model for improving the management of oncologic patients

Background: One of the goals of Oncologic Networks is to organize training courses for operators involved in the diagnostic and therapeutic pathways of cancer patients, in order to update everyone of them about innovations introduced every year. Methods: We yearly plan a training offer, both as residential and “on field” education, allowing to earn credits within the “continuos medical education program”. These courses have the dual purpose of technical-scientific updating and of raising relational and communicative skills. Results: During 2017 the Oncology Network of Piemonte e Valle d'Aosta has organized 31 residential courses: 7 dedicated to medical doctors, 10 to nurses, 5 to district directors and territorial nurses, 2 to biomedical lab technician, 7 to psycho-oncologist, administrative employees and social assistants. Reguarding “on field education”, 32 courses have been conducted, carachterized by 5 lessons/year and 20 CME credits: 18 for cancer-site specific groups, including 2 for hematologists, 5 for groups engaged in trasversal topics such as cardiooncology, support therapies, late toxicities, geriatric oncology and palliative care, 1 for nurses and 1 for hospital pharmacists. Moreover, 8 study groups composed of pathologists have been formed to allow clinical cases discussions and to enhance diagnostic uniformity. 108 recommandations and 17 consensus documents have been drafted during the last 5 years, and they are entirely published on Oncology Network web site (www.reteoncologica.it). Since 2016, P.I.C.O. System has been applied to draw up consensus documents. Conclusions: Continuous medical education is an effective and basic tool to enhance operators' knowledge. It allows to decrease mistakes and time and money waste, to improve and uniformate clinical assistance; training enables operators to acquire high innovative value interventions and to recognizetheir limits. Patients benefit by CME programs, and their negative experiences can reduce.

Modernizing the flow of blood: Biomedical technicians, working knowledge and the transformation of Swedish blood centre practices.

The early 1980s saw a 'paradigm change' in how donated blood was handled and used by blood centres, hospitals and pharmaceutical companies. In Sweden, a five-year state-financed R&D programme initiated a swift modernization process, an alleged 'revolution' of existing blood centre practices. In this article, we use interviews and archival material to analyse the role of female biomedical technicians in this rapid technical and organizational change. In focus is their working knowledge, or savoir-faire, of blood, instruments and techniques. We give a detailed analysis of technicians' embrained and embodied skills to create safety in blood and its representations, handle contingencies and invent new procedures and techniques. These transformations are analysed as sociomaterial entanglements, where the doing and undoing of gender, sociomaterial practices, hierarchies of authority and expertise, and emotions are intertwined.

Determinants in the number of staff in hospitals’ maintenance departments: a multivariate regression analysis approach

To date, there are no broadly accepted or accurate models to determine appropriate staffing [levels] for clinical engineering departments (CEDs). The purpose of this study is to determine what the determinants of the staffing levels are (total number of full time equivalents (FTEs)) in CEDs in healthcare organisations. In doing so, we used a cross-sectional exploratory approach by using a multivariate regression model over a secondary source of data information from the AAMI Benchmarking Solutions—Healthcare Technology Management database. Two hundred and one healthcare organisations were included in our study. Our study revealed that on average, there are almost 14 biomedical technicians (BMETs) per clinical engineer and one FTE per 1083.72 devices (SD 545.69). The results of this study also revealed that the total number of devices and the total technology management hours devoted to these devices positively affects the number of FTEs in a CED, whereas the hospital complexity, measured by healthcare organisation patient discharges matters inversely. The most important factor that matters in the number of FTEs in CEDs was the total technology management hours devoted to devices. A value of explained variance (i.e. R2) of 85% was obtained, indicating the strong power of the prediction accuracy of our multivariate regression model.

Important skills for biomedical services: The perspectives of Malaysian employers and employees.

Increase in the occurrence of existing diseases, continual emergence of new or exotic diseases and re-emergence of old diseases have placed increasing demands on biomedical services in Malaysia. Biomedical technicians play an important role in operating biomedical instruments. However, there are no clear specifications about characteristics and traits for these semi-professional employees. Employers in a few studies claimed that biomedical graduates are not ready to enter and face challenges in the job market. Therefore, the purpose of this study is to identify technical and generic skills for a biomedical technician from the perspectives of the biomedical technicians and their employers. A quantitative survey design was employed whereby data were obtained through the administration of an instrument developed by the researchers. The sample consisted of 20 hospital managers and 186 biomedical technicians who are currently working in Malaysian government hospitals. The findings show that there are no difference in the perceptions of hospital managers and biomedical technicians regarding technical and non-technical skills. These findings resulted in a checklist which can be used for institutions to produce future biomedical technician graduates in order to meet job demands. However, future research is needed to validate the findings and explore the variables in depth.

A pocket guide to electronic laboratory notebooks in the academic life sciences

Every professional doing active research in the life sciences is required to keep a laboratory notebook. However, while science has changed dramatically over the last centuries, laboratory notebooks have remained essentially unchanged since pre-modern science. We argue that the implementation of electronic laboratory notebooks (eLN) in academic research is overdue, and we provide researchers and their institutions with the background and practical knowledge to select and initiate the implementation of an eLN in their laboratories. In addition, we present data from surveying biomedical researchers and technicians regarding which hypothetical features and functionalities they hope to see implemented in an eLN, and which ones they regard as less important. We also present data on acceptance and satisfaction of those who have recently switched from paper laboratory notebook to an eLN. We thus provide answers to the following questions: What does an electronic laboratory notebook afford a biomedical researcher, what does it require, and how should one go about implementing it?

A pocket guide to electronic laboratory notebooks in the academic life sciences.

Every professional doing active research in the life sciences is required to keep a laboratory notebook. However, while science has changed dramatically over the last centuries, laboratory notebooks have remained essentially unchanged since pre-modern science. We argue that the implementation of electronic laboratory notebooks (eLN) in academic research is overdue, and we provide researchers and their institutions with the background and practical knowledge to select and initiate the implementation of an eLN in their laboratories. In addition, we present data from surveying biomedical researchers and technicians regarding which hypothetical features and functionalities they hope to see implemented in an eLN, and which ones they regard as less important. We also present data on acceptance and satisfaction of those who have recently switched from paper laboratory notebook to an eLN. We thus provide answers to the following questions: What does an electronic laboratory notebook afford a biomedical researcher, what does it require, and how should one go about implementing it?