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Benefits of Advanced Practice for Nuclear Medicine Technicians

Discuss about the Surface Interpolation With Radial Basis Functions For Medical.

Medical radiation workplace needs medical expertise with vast knowledge in nuclear medicine that will influence decision which comes along with the job description. Among those who are heavily relied upon are nuclear medicine technologists commonly abbreviated as NMT (Corot, C, 2007). They are responsible with interaction and diagnosis of the patient. Although their role is decision making, most of them don’t influence decision in their workplaces because physicians are sought for in any medical intervention. Most of them are restricted from patient radiotracer injection and decisions that require further imaging of the patient (Flower, M, 2012). While NMT’s have a critical role there is a concern for advanced practice options in order to progress in their careers. Advance practice pathway presents a beneficial aspect of career progression that is unfortunately limited in Australian medical radiation in comparison with the United Kingdom where the medical radiations has progressed much more with many advanced practice options. Therefore, this research report discusses and analyses how many students are aware of advanced practice and their opinions on advanced practice. In addition the research question expands further on the motivating factors of the students from Liverpool (UK) in undertaking an advanced practice component (Stabbin, M, 2008). Due to limited options that exist in NMT advanced practice in Australia, the technicians can advance their practice in new models of clinical care in medical imaging and radiation oncology according to Advanced Practice Working Group report to board of directors of Australian Institute of Radiography (AIR), May, 2009. This will go a long way to work for a long time in their professional field and translate the skills, knowledge gained to solve complex issues that come with their job prescription. Some of this advance practice options include: accident and emergency imaging, fluoroscopic and intervention imaging, ultrasound imaging, breast imaging, computer tonography, magnetic resonance imaging, image Guide and Adaptive Radiotherapy, breast radiotherapy, pediatric care, palliative care and cancer management.

According to journal of nuclear medicine technology, it states clearly that by getting advanced practice offers professional with clinical leadership abilities. This is because it improves a NMT’s competency level in workplaces, it creates a multiskilled personnel who bridges the gap of personnel shortages and opens doors of opportunities to technicians and improves service delivery due to improved decision making skill. Advance practice helps workplace evidence-based practice development this translates to better service management and planning (Rowe, C, 2010). Finally, when one earns good advance practice in skills and knowledge it earns them recognition and expertise. 

Method

Advanced practice is simply performing of tasks outside the prescribed professional boundaries of a nuclear medicine technician (Cho, Z, 2013). Normal tasks performed by nuclear medical technician are patient interaction, gathering patient information, inserting or injecting patients. Additionally, NMTs assist in radiotracer preparation, obtaining images once injection of radiotracer is done and administering some therapies on physician approval. Depending on the departmental needs, advanced practice technician may step in to the position of a physician when required (Hendee, W, 2013). Advanced practice technician example in United Kingdom allows the technician to decide on the type of further imaging, provide better patient service, discuss patient results with physicians and being able to report on findings which requires a more advanced level of knowledge. Unfortunately the type of advanced technician practice is limited in Australia limiting career progression of NMTs (Picano, E, 2014).

The research design was a survey scheme questionnaire by 2nd year undergraduate medical radiations from RMIT University Australia. The research questions were addressed to students from Liverpool currently undertaking their 1st year undergraduate programme in medical radiations. The research was designed with both open-ended and closed-ended questions. The questions focused on student’s opinion about advanced practice of nuclear medical technology (Thral, J, 2015). The students were asked if higher salary for advanced practice would motivate them to undertake advanced practice. A total of 5 questions were compiled for students in Liverpool to answer over an online platform. The students from Liverpool consisted of 60 medical imaging and 30 radiation therapy students.

The response rate by the 90 Liverpool students was low. In total each question had a different response rate and some of the respondents may have been unaware what advanced practice is as they are 1st year students. The results of the research are summarized below in table charts.

         Do you want to do advanced practice?

MI (24)

RT (18)

Don’t know what advanced practice is

3

1

Unsure

5

2

Yes

15

12

No

1

3


The majority of respondents would like to complete advanced practice with 15 MI students responding yes, and 12 RT students who want to complete advanced practice. Although most students understood the question only 24 out of 60 medical imaging students responded to the survey and the same can be seen with RT.

What motivates people to undertake advanced practice?

MI (24)

RT (18)

Unsure

3

3

Money

8

5

Knowledge/Skills

2

4

Career progression

9

3

Responsibility

1

2

Interest or research

7

2


Most MI students cited money and career progression as their main motivators to pursue advanced practice. 8MI students stated money while the other 9 stated progression in their careers. Money remained the key motivation to RT students for their undertaking of advance practice, with 5RT students citing money. Both MI and RT students shunned the responsibility aspect of the advance practice, with 1 MI and 2 RT citing responsibility that comes with this career progression. A significant number of MI students would like to undertake advanced practice due to interest or research with 7MI students.

 What would be the biggest reason for not doing advanced practice

MI (23)

RT (17)

Too much responsibility

1

2

Wanting to work

1

0

Time or Further training

5

2

Cost

4

2

Stress difficulty or workload

8

6

Other responsibilities

1

3

(Q37MI, Q44RT) Difference between staff who have bachelor degree vs advanced practice qualification

MI (23)

RT (17)

Respect/Confidence

2

1

Responsibility

5

8

Knowledge

2

2

Experience

5

1

Salary

3

1

Little-no difference/Just the qualification

6

2

Results

As seen by the results it is indicative that many students are well interested in advanced practice. This seen is seen table 1. Where 27 students responded yes in their vested plans in completing an advanced practice degree or training. Whilst only 4 students responded with their disinterest in pursuing an advanced practice training. This question was well responded to by the students in Liverpool with a minimal number of students being unaware of what advanced practice is. There are many advantages in pursuing advanced practice training for further career development but there are disadvantages as well, based on the students motivating factors are the deciding factors in which students will pursue a progression in their career (Abell, T, 2008). The students of Liverpool indicated clear expected responses of their motivating factors. There are a number of appealing factors which encourage students in pursuing a career progression such as Money, interest for the purpose of research, passion which goes hand in hand with satisfaction, responsibility and career progression. This is seen in table 2 from the respondent of the survey 13 students responded yes for money, 12 responded for career progression and 9 selected interest or research purposes. This question was well responded and the results were a direct reflection of why many people will consider advanced practice. Advanced practice improves the level of skill of the medical radiation occupational personnel in every medical radiations branch. Radiographers may be able to report findings on an x-ray assuming some tasks of a physician (Mahesh, M, 2011). A nuclear medicine technician may be able to inject sensitive areas etc. lymphoscintigraphy scan where the technician will inject a radiotracer into the breast tissue directly, many physicians assume this role due to the extreme sensitivity of the breast tissue and excruciating pain. Nuclear medicine technicians can also report on findings from the acquired imaging (Hende, R, 2009). This can be very efficient for hospital departments as there is a shortage of specialist physicians and they are usually extremely busy, reporting on finding will help reduce their workload stress and increase the technician’s responsibility. This responsibility will increase the job satisfaction as they are contributing more to the patient’s diagnosis. Furthermore advanced practice will increase job prospect and increase overall salary leading to more positive satisfaction. Table 3 shows the demotivating factors that contribute to students avoiding completion of advanced practice. Although completing advanced practice provides more advantages it does have a huge responsibility depending on the level of advanced practice. The NMT will have a high level of responsibility which will increase their stress levels especially with reporting on findings as there is a risk of mistaking a patient’s diagnosis as they must be well experienced with their knowledge. Cost and time are the other two demotivating factors that restrict students from continuing with advanced practice as it may be quite costly and some students may not have the money to pursue further career progression. In addition advanced practice is a high level in a career meaning it generally takes a long time to reach that level and most students see that as an issue unless they are genuinely passionate about their career in nuclear medicine. As seen by the results from table 3. 7 students selected time or further training, 6 students selected cost and 14 selected stress or workload. As seen by the results many students understood what advanced practice is and displayed the motivating factors of pursuing advanced practice. Many students responded to the questions well but unfortunately a survey questionnaire will always have a disadvantage. That is seen by the response rate as there was 60 medical imaging and 30 radiation therapy students the overall response rate was less than 60%. This result may affect the accuracy and reliability of the results. Wanting to work did not attract any response from RT students while only a student wanted to work for pursuing advanced practice (Carr, J, 2007).

Discussion

Many students are interested in advance practice after completing college or any training. Therefore, education and enlightment on advanced practice is needed to help students make informed decisions to advance their careers. This offers many advantages in pursuing advanced practice training for further career progression while excluding disadvantages that students base on deciding factors for career advancement. Career. Money, interest or research, career progression and responsibility remains to the key motivators in pursuing advanced careers. On the other hand, Increase in responsibility, cost and time remain to be the main demotivating factors for career progression.

There were several limitations within this study that affected the results by hindering the accuracy and the amount of data collated.

The questions asked to the students of Liverpool were not well perceived hence reducing question effectiveness. This was due to a miscommunication error as the rough draft questionnaire was submitted into the survey for students to answer. Furthermore the undergraduate students with 1 year into their course had not developed deep knowledge about advanced practice. This was seen whereby preconceived thought on answering questions did not match well with most students. The biggest limitation was communication between students from RMIT and Liverpool as we had surveys only to collate information for our research question. In terms of advanced practice it is an in depth topic where descriptive studies would be best suited for it. Furthermore the medical radiations cohort is progressively ahead by 1 year in their undergraduate in comparison to the Liverpool students. This factor could have limited the accuracy of the responses as the students are still in the beginning stages of learning they may be unaware of what advanced practice could be in depth (Mettle, F, 2008). In addition to using survey questions it is disadvantageous as it is difficult to acquire descriptive evidence to support the research question. Moreover the student’s that responded to the survey are undertaking studies in medical imaging and radiation therapy. Students from RMIT university Australia were limited to the specificity of the question in terms on nuclear medicine as their knowledge of nuclear medicine is possibly limited.

Conclusion

Due to the wish of various NMT (Nuclear Medicine Technicians) to pursue advanced practice, professionals have noticed a service gap in their workplaces that makes them assume extra responsibilities and roles. These reasons include ambition that come professionally or personally, service requirements and technological improvements. In Australia, public and patient perception have changed to standardize and steadily increase standard of medical practice in their workplaces. Educational establishments and professional organizations should be on the lead in enhancing these developments and encourage the nuclear medicine advanced practice.

References

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Stabin, M. G. (2007). MIRDOSE: personal computer software for internal dose assessment in nuclear medicine. Journal of Nuclear Medicine, 37(3), 538-546.

Cho, Z. H., Jones, J. P., & Singh, M. (2013). Foundations of medical imaging (pp. 71-84). New York:: Wiley.

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