Medical Radiation Technologists Research Articles

Evidence-based Practice for Medical Radiation Technologists

Recent revisions to the competency profiles for the four Canadian Association of Medical Radiation Technologists medical radiation technology (MRT) disciplines highlight the need for practitioners to understand and apply the principles of evidence-based practice (EBP). Adoption of EBP is important if MRT is to be recognized and advance professionally. This review article will introduce the principles of EBP and use a clinical scenario to apply the five steps: formulate a question, search for the answer, appraise the literature, apply the results, and evaluate the outcome. In the scenario, a fictitious radiological technologist encounters a clinical question and seeks an answer using the EBP framework. Barriers, challenges, and strategies to promote EBP for MRTs will also be discussed.

Reduction of Adult Fingers Visualized on Pediatric Intensive Care Unit (PICU) Chest Radiographs After Radiation Technologist and PICU Staff Radiation Safety Education

Purpose A recent publication from our centre revealed a disturbing finding of a significant incidence of adult fingers seen on the pediatric intensive care unit (PICU) chest radiographs. This is inappropriate occupational exposure to diagnostic radiation. We hypothesized that the incidence of adult fingers on PICU chest radiographs would decline after radiation safety educational seminars were given to the medical radiation technologists and PICU staff. Methods The present study's objectives were addressed by using a pretest-posttest design. Two cross-sectional PICU chest radiograph samples, taken before and after the administration of radiation safety education for our medical radiation technologists and PICU staff, were compared by using a χ 2 test. Results There was a 61.2% and 76.9% reduction in extraneous adult fingers, directly exposed to the x-ray beam and those seen in the coned regions of the film, respectively, on PICU chest radiographs (66.7% reduction overall). This reduction was statistically significant (χ 2 = 20.613, P < .001). Conclusions Limiting unnecessary occupational radiation exposure is a critical issue in radiology. There was a statistically and clinically significant association between radiation safety education and the decreased number of adult fingers seen on PICU chest radiographs. This study provides preliminary evidence in favour of the benefit of radiation safety seminars. Abrégé But Une récente publication de notre centre révèle la présence d'un nombre anormalement élevé de doigts adultes sur les radiographies pulmonaires. Cela témoigne d'une radioexposition anormale des technologues en radiologie et du personnel des USPI. Nous avons fait l'hypothèse que le nombre de cas diminuerait après les séminaires sur la sécurité radiologique que ceux-ci ont suivis. Méthodes La technique de mesure prétest post-test a été utilisée dans le cadre de cette étude. Deux échantillons transversaux de radiographies pulmonaires prises dans une USPI avant et après que nos technologues en radiologie et le personnel de l'USPI ont suivi la formation sur la sécurité radiologique ont été comparés à l'aide d'un test χ 2. Résultats On a remarqué une réduction de respectivement 61,2 % et 76,9 % de la présence de doigts adultes directement exposés aux rayons X et apparaissant dans les régions coniques des films) sur les radiographies pulmonaires prises à l'USPI, ce qui représente une baisse globale de 66,7 %. Cette réduction est significative d'un point de vue statistique (χ 2 = 20,613, P < 0,001). Conclusions La réduction de l'exposition professionnelle est un problème critique en radiologie. Nous avons constaté un lien statistique important entre la formation sur la sécurité radiologique et la baisse du nombre de doigts adultes apparaissant sur les radiographies pulmonaires prises à l'USPI. L'étude fournit des preuves préliminaires des bienfaits de la formation en sécurité radiographique.

2008 Leadership Academy for Educators

I had the honour of being selected by the Canadian Association of Medical Radiation Technologists (CAMRT) to attend the 6th Annual Leadership Academy for Educators hosted by the American Society for Radiological Technologists (ASRT). Between July 23 and 26, 2008, the tables were turned as 20 radiologic science educators from the United States, Canada, and Australia became students.

Radiation Safety Program: Principles and Regulations

Radiation safety principles are important to medical radiation technologists in the radiography, nuclear medicine, and radiation therapy disciplines. A combination of both federal and provincial regulations makes up the radiation safety program for a facility. The provincial governments, through the Ministry of Health and the Ministry of Labour, and the federal government through the Canadian Nuclear Safety Commission, provide guidelines of what a radiation safety program should entail for a facility. Programs will be designed and implemented by internal radiation safety specialists, based on the needs of the users of radioactive materials or radiation emitting devices. This article will explain the differences in the provincial and federal regulatory requirements and provide an overview for each, as well as outline the workers' responsibilities in regard to the specific regulations.

The Regulation of Health Professionals: An Overview of the British Columbia Experience

Although regulation is intended to protect the public interest, it also confers certain advantages to the profession with respect to recognition, credibility, and political influence. As more medical radiation technologists become regulated, it is important to understand and appreciate the purposes of regulation as well as its limitations and its implications for the profession. This paper provides an overview of the regulation of health professionals within Canada, specifically focusing on developments within British Columbia (BC).

2007 Leadership Academy for Educators

2007 Leadership Academy for Educators

Nephrogenic Fibrosing Dermopathy/Nephrogenic Systemic Fibrosis (NFD/NSF) and Gadolinium-Based Magnetic Resonance Contrast Agents (GBMCAs): A Literature Review

Health Canada and the Food and Drug Administration (FDA) in the United States have recently issued warnings pertaining to the use of gadolinium-based magnetic resonance contrast agents in patients with renal insufficiency. A strong temporal relationship between the administration of gadolinium agents and the development of nephrogenic fibrosing dermopathy/nephrogenic systemic fibrosis in this patient cohort has been established. This study presents a review of the literature, description of the disease, and discussion of possible contributing co-factors to its development. Best practice recommendations are provided for medical radiation technologists for management of patients with renal insufficiencies that may need to undergo magnetic resonance imaging with a gadolinium-based magnetic resonance contrast agent.

The Last Piece in the Puzzle—The Importance of Publishing and Establishing the Professional Status of Medical Radiation Technologists

The Last Piece in the Puzzle—The Importance of Publishing and Establishing the Professional Status of Medical Radiation Technologists

Implementation of a Multi-Source Feedback System for Quality Assurance for the College of Medical Radiation Technologists of Ontario

Under the Health Professions procedural code of the Regulated Health Professions Act, 1991 (RHPA), the College of Medical Radiation Technologists of Ontario (CMRTO) is required to provide a means to assess how people in the profession actually perform in practice. As the first step in satisfying the practice assessment requirement of the Quality Assurance program in 2004, the CMRTO retained Edumetrics Ltd. to undertake the development of a multi-source feedback (MSF) program specific to the profession of medical radiation technology. In a comprehensive study led by Dr. Claudio Violato, a professor in the Department of Community Health Sciences, Faculty of Medicine at the University of Calgary and an expert in the development of program evaluations, psychometrics, research methods and statistics, the CMRTO developed a 'multi-source' assessment process that provides a means for peers, colleagues, patients and the assessed person to complete a survey focused on the standards of practice. The assessed person receives a summary assessment report or feedback about his or her performance. The multi-source feedback assessment provides a formative evaluation, providing continuous reaction to the performance of a medical radiation technologist (MRT). It compares the MRT's clinical performance to that of other MRTs. The CMRTO multi-source practice assessment approach was piloted in 2005. A number of strategies were used to recruit 327 MRTs to take part in the pilot study. Recruitment strategies included consultation with MRTs respecting the standards of practice as the basis of the MSF project, a detailed communication strategy and telephone recruitment. Although the CMRTO staff experienced challenges in recruiting MRTs to take part in the pilot study and dealing with the resultant feedback, the pilot study was considered a success.

Evidence-Based Decision Making as a Tool for Continuous Professional Development in the Medical Radiation Technologies

All components of contemporary health care practice must be supported by the best available evidence in order to maximize the potential for successful patient care. As in other disciplines, researched-based evidence is a major contributor to the development of contemporary clinical practice and decision making in the medical radiation technologies. However, in recent years a rapid proliferation of clinical studies and journal publications combined with a growing complexity of diagnostic imaging methods has made it difficult for practicing medical radiation technologists (MRT's) to remain current with the relevant clinical research. Because we rely on this clinical research evidence to determine the efficacy and applicability of new diagnostic tests and treatments, it is essential that we possess the skills for the effective procurement and interpretation of the scientific literature. For MRT's, barriers to this task may include lack of training in: defining good clinical questions, the optimal use the bibliographic databases and search engines used in accessing scientific research literature, and the appraisal and integration of acquired research evidence. Evidence-based decision making (EBDM) is a systematic process that enables the “conscientious, explicit, and judicious use of the current best evidence in making health care decisions.” 1 The development of this approach is derived in large part by the need to manage information overload. Such information is essential to the management of skyrocketing health care costs, ensuring the delivery of best diagnosis and treatment. When combined with clinical skills and judgments, patient values and expectations, the EBDM approach serves to maximize the potential for achieving successful patient care outcomes. Specifically, the implementation of EBDM has been shown to: close the gap between knowledge and practice, decrease variability in practice, and increase the use of best research evidence in practice thereby improving the level of clinical care provided by health care professionals. In this directed study article, we define the EBDM process as it pertains to medical radiation technologies.

Assessing Medical Radiation Technologists in Practice: A Multi-Source Feedback System for Quality Assurance

Objective To develop and psychometrically evaluate (feasibility, reliability, validity) a questionnaire based multi-source feedback (MSF) system for quality assurance (QA) for medical radiation technologists (MRTs). Methods Surveys with 12, 14, 30 and 31 items were developed for assessment of MRTs by patients, co-workers, MRT colleagues and themselves, respectively, using 5-point scales with an “unable to assess” category. Core competencies assessed were related to legislation, standards of practice and ethics, equipment and materials, diagnostic examinations and radiation treatment, safe practice, relationship with patients, records and reporting, communications, team work and professional development. Each MRT was assessed by 25 patients, 6 MRT colleagues, and 6 co-workers. Feasibility was assessed with response rates for each instrument. Validity was assessed with a table of specifications, the percentage of participants unable to assess the MRT for each item, and exploratory factor analyses to determine which items grouped together into scales. Cronbach's α assessed reliability. Results A sample of 307 MRTs registered with the College of Medical Radiation Technologists of Ontario (CMRTO) volunteered to undergo MSF assessments. The number of respondents for the MRT peer questionnaire was 1,730, for the co-worker questionnaire was 1,745 and for the patient questionnaire were 7,007. The mean ratings ranged from 4 to 5 for each item on each scale. All of the instruments' full scales had very high Cronbach's α > .92. The factor analyses revealed a 5-factor solution (71.28% of the total variance) for the peer and self surveys, a 3-factor solution for the coworker questionnaire (74.28% of the variance), and a 2-factor solution for the patient questionnaire (81.53% of the variance). Conclusion An MSF system employing surveys that have high reliability, validity and feasibility were developed to provide feedback to MRTs on core competencies and skills.

Effects of Glutaraldehyde Exposure on Human Health

Glutaraldehyde (GA) is widely used in the industrial, scientific and biomedical fields. Many adverse health effects on humans have been reported in association with biomedical uses of GA, with 2-3.5% aqueous GA solution generally used for cold sterilization and GA exposure ranges of 0.001 to 2.6 ppm for this type of use. GA is metabolized extensively to CO(2), but urinary excretion of it is low. Sensory irritant effects, sensitization of skin and respiratory organs and other symptoms have been reported among endoscopy nurses and medical radiation technologists. The prevalence of chronic bronchitis and nasal symptoms in humans is significantly correlated with peak concentrations of GA exposure. The extent of primary skin irritation depends on the duration and site of contact, and the severity of symptoms is dose-related. Chronic inhalation affects the nose and respiratory tract, and lesions become severe with prolonged duration of exposure. Increases in neither mortality nor tumor incidence have been found in workers with less than 0.2 ppm GA exposure, no evidence of carcinogenic activity has been obtained in experimental animal studies. There has been no clear evidence of genetic toxicity of GA in either in vitro or in vivo studies, and neither developmental nor reproductive toxicity has been found in humans or animals. To prevent hazards from GA exposure, use of closed-system, fully automated washing machines is recommended, since numerous symptoms have been found in individuals with less than 0.05 ppm GA exposure, the recommended peak exposure limit in many countries.

A Critical Appraisal of the CAMRT Code of Ethics

A well-articulated code of ethics is an important centerpiece in the life and evolution of any health profession. It is part of a profession's covenant with society, and should serve to assist members in grappling with the ethical dimensions of practice. At a minimum a code of ethics must be consistent with the theoretical foundations and moral principles that guide ethical behaviour in the health professions. This article uses these principles as a framework to inform a critical appraisal of the Canadian Association of Medical Radiation Technologists (CAMRT) Code of Ethics, and to suggest that the time is ripe for the CAMRT to engage with members and other stakeholders to update and revise the Code. … there are two parts of good government; one is the actual obedience of citizens to the laws, the other part is the goodness of the laws which they obey… - Aristotle, Politics 1294a 3-6

Case report: hydroquinone and/or glutaraldehyde induced acute myeloid leukaemia?

BackgroundExposures to high doses of irradiation, to chemotherapy, benzene, petroleum products, paints, embalming fluids, ethylene oxide, herbicides, pesticides, and smoking have been associated with an increased risk of acute myelogenous leukemia (AML). Although there in no epidemiological evidence of relation between X-ray developer, fixer and replenisher liquids and AML, these included glutaraldehyde which has weakly associated with lymphocytic leukemia in rats and hydroquinone has been increasingly implicated in producing leukemia, causing DNA and chromosomal damage, inhibits topo-isomerase II, alter hematopoiesis and inhibit apoptosis of neoplastic cells.Case presentationTwo white females (A and B) hired in 1985 as medical radiation technologists in a primary care center, in Greece. In July 2001, woman A, 38-years-old, was diagnosed as having acute monocytic leukaemia (FAB M5). The patient did not respond to therapy and died threeweeks later. In August 2001, woman B, 35-year-old, was diagnosed with acute promyelocytic leukaemia (FAB M3). Since discharge, she is in continuous complete remission. Both women were non smokers without any medical history. Shortly after these incidents official inspectors and experts inspected workplace, examined equipment, archives of repairs, notes, interviewed and monitored employees. They concluded that shielding was inadequate for balcony's door but personal monitoring did not show any exceeding of TLV of 20 mSv yearly and cytogenetics analysis did not reveal findings considered to be characteristics of ionizing exposure. Equipment for developing photos had a long list of repairs, mainly leakages of liquids and increases of temperature. On several occasions the floor has been flooded especially during 1987–1993 and 1997–2001. Inspection confirmed a complete lack of ventilation and many spoiled medical x-ray films. Employees reported that an "osmic" level was continuously evident and frequently developed symptoms of respiratory irritation and dizziness.ConclusionThe findings support the hypothesis that the specific AML cases might have originated from exposure to chemicals, especially hydroquinone and/or glutaraldehyde. The report also emphasises the crucial role of inspection of facilities and enforcement of compliance with regulations in order to prevent similar incidents.

512-S: Occupational Radiation Exposure and Risk of Spontaneous Abortion among Medical Radiation Technologists in Canada

512-S: Occupational Radiation Exposure and Risk of Spontaneous Abortion among Medical Radiation Technologists in Canada

Medical Radiation Technologists: The Leader Within Us

Medical Radiation Technologists: The Leader Within Us

Employment of Medical Radiation Technology National Exam Candidates in Canada, 2000-2004: Prepared on Behalf of the Professional Practices Committee, Canadian Association of Medical Radiation Technologists

Since May 2000, candidates writing the Canadian Association of Medical Radiation Technology certification exams were asked to complete a current employment survey. The purpose of the survey was to determine the employment profile of national exam candidates. Results indicate that between 2000 and 2004, 57% or more of medical radiation technology graduates had employment by the time they wrote the national certification exams. Exam candidates in the disciplines experiencing serious shortages - radiation therapy, magnetic resonance and nuclear medicine - had an even higher rate of reporting employment (between 61% and 96%) and also had a high incidence of finding permanent full-time work by exam time while radiological technology exam candidates reported obtaining a higher percentage of casual/on call work. Gender differences were also noted with men obtaining a higher percentage of permanent full-time work by exam time and women reporting a higher rate of casual/on call work. Finally, provincial differences with respect to the type of work status exam candidates obtained were also noted.

Technologist Role in Planning a Translational Research Study in Animals: 123I IMT Imaging in the Rat Lymphoma Model

Translational research is the process through which novel scientifi c concepts are brought from the benchtop to the bedside. Interaction between scientists and clinical researchers helps advance the testing of basic concepts that can be applied clinically or, conversely, identify clinical challenges, which can be tested in the laboratory. Our experience in translational research can be illustrated with the radiolabeled amino acid 123I iodomethyl tyrosine (IMT). Following in vitro results at our centre that indicated the uptake of IMT by lymphoma cells, our group examined whether 123I IMT was taken up in vivo by the rat lymphoma model. Our results could justify further research to study the potential use of 123I IMT in humans with lymphoma. This paper describes the role of medical radiation technologists in translational research and outlines the steps involved in designing and performing an animal research study involving radiotracers. Opportunities for such involvement should be embraced by technologists, both as a means to further our scope of practice and to promote the role of medical radiation technologists in research.

Clinical supervision: designing a model to enhance clinical learning for medical imaging students

Medical Imaging students work under the close supervision of qualified Medical Radiation Technologists (MRTs), or Radiographers. In the New Zealand setting, some MRTs are formally appointed as clinical tutors by an educational institution providing medical imaging education, while others are senior staff who have supervision and some aspects of assessment incorporated within their job role. This article proposes a model of clinical supervision that supports and extends medical imaging students at their clinical placement.The model includes discussion relating to modes, scope, boundaries and relationships within clinical supervision, and also outlines important aspects within the actual process of supervision. This includes teaching, assessment and feedback.The model maintains the importance of critical analysis, clinical reasoning and reflection within the supervision relationship. It focuses on a form of professional practice and teaching which encourages the development of professional, adaptable MRTs, who have the ability to incorporate principles and theories into their practice.

Physician diagnosed asthma, respiratory symptoms, and associations with workplace tasks among radiographers in Ontario, Canada

Background: Medical radiation technologists (MRTs) or radiographers have potential exposure to chemicals including sensitisers and irritants such as glutaraldehyde, formaldehyde, sulphur dioxide, and acetic acid. Aims: To determine the prevalence...