1. Maintaining Value and Relevance: Importance of MRTs to our present and future healthcare system
2016 CAMRT Annual General Conference
June 9 – 12, 2016, Halifax, NS
My presentation explores the importance of Medical Radiation Technologies, and our profession, within the context of today’s healthcare system, with specific focus on the vital role CAMRT members provide in the patient’s health care team.
We will consider the tensions and challenges currently being experienced by our members within the context of our day to day operational realities, as we attempt to respond to innovations and advancements driven by new care processes and technological advancement.
I will share my perspective on protecting, preserving and promoting the importance and value of the MRT role, and that of CAMRT, into the future.

2. Disclosures
None
Opinions reflected within represent my own personal perspective

3. Objectives Review the evolution of the role of the MRT
Discuss our model of practice in light of our stakeholder’s needs
Consider proactive steps that CAMRT can take to ensure members are appropriately prepared for the future
Learning Objectives:
Gain an understanding of the importance of the MRT role in today`s healthcare system, and be able to articulate the importance of sustaining this into the future.
Appreciate the alignment of our professional practice models with the current and future needs of our stakeholders, identifying areas for potential change and improvement.
Build awareness with regards to the importance for the profession, guided by the CAMRT, to take proactive steps to ensure our members are appropriately prepared with the required competencies for the future practice environment.

4. The CAMRT Established in 1942 Currently over 12,000 members
National professional association, certifying body and Canadian Best Practices standards entity for
Radiography
Nuclear Medicine
MRI
Radiation Therapy
Internationally recognized, CAMRT provides national advocacy for the profession of medical radiation technology
Authoritative voice on critical issues affecting members and their practice
The CAMRT is the national voice for MRT professionals, fostering understanding between the profession, the public and government; and encouraging collaboration with industry and other healthcare organizations to promote professional excellence in all disciplines of the profession.
One of the CAMRT’s most important roles is as the national certifying agency that provides the credential for entry-to-practice for MRTs in Canada. Employers and patients can feel confident that, regardless of where the MRT trained, they have the knowledge, skills and judgment required to deliver excellent patient care.
CAMRT advocates on our behalf to advance and evolve the profession through the establishment of professional standards of practice, and to strengthen recognition of the major role medical radiation technologists play as part of the healthcare team. This is more important today than ever, with critical issues such as radiation safety, isotope supply shortages, scopes of practice and other health human resource strategies under review by government. 

5. Trends impacting MRT practice
Patient-centred care
New and changing diagnostic and therapeutic technologies
Human resource challenges
Regulatory changes in provinces
Governments slowing growth of healthcare costs
Evolving inter-professional collaboration and scopes of practice
Research and evidence-based practice
Patient expectations and knowledge
Digital media reinventing content-generation, sharing and learning
Traditional models of healthcare delivery are changing to organize the delivery of healthcare around the needs of the patient.
With the evolution of technology, the separation of MRT disciplines is disappearing, there is migration of out of the traditional medical imaging environment, and applications previously regarded as advanced (e.g., CT, hybrid imaging, mammography, etc.) are increasingly becoming commonplace. As a result, educational requirements are evolving and students require access to clinical sites to receive hands-on experience with this sophisticated equipment.
Many older MRTs are not retiring in favour of working more years to build up savings. There seem to be fewer full-time positions and more part-time. Current graduates are not all finding jobs. Given advances in technology, demographic patterns, changes at the workplace, and cost containment across the healthcare system, it is difficult to predict requirements for MRTs in the future.
More provinces are moving toward self-regulation of MRTs —affecting MRT associations in those provinces. Some provinces are also considering legislation that will regulate diagnostic sonographers (possibly with MRTs, as in Nova Scotia). With regulation comes a requirement for continuing education and CAMRT may experience an increased uptake of its offerings.
Governments are emphasizing the accountability of facilities and providers and putting into place more mechanisms to ensure value for funds invested in the system. All professions will have to look at innovations that preserve or enhance quality and save dollars.
Healthcare is moving into a more collaborative, team-based endeavour. In this environment, it is important to ensure that individuals are working to their optimal scope of practice and understand boundaries and potential overlaps.
Healthcare providers (and the system) are striving to find and use current best evidence to make decisions about the care of individual patients and the delivery of health services.
Never before have patients been so informed about their health care and treatment options. MRTs must be ready and able to inform these patients and, in many cases, allay fears. In addition, there is a growing expectation for timely access to quick, safe procedures, performed efficiently in a respectful and collaborative manner.
Source: CAMRT Strategic Plan

6. Is the mandate of CAMRT under threat?
National versus provincial / jurisdictional certification and registration
Variability of entry to practice requirements in provincial jurisdictions
Diploma versus degree
If we don’t pay attention now, the construct of a national profession is in jeopardy
Our collective challenge is to ensure that CAMRT preserves the important role it fulfils in the Canadian healthcare system
Recent developments with the evolution of provincial Colleges and jurisdictional registration will challenge the current construct of CAMRT with respect to the advocacy for, and establishment of, entry to practice competency profiles and standards of practice. Given the new certification and registration process being established by provincial jurisdictions, members are actively engaging in the debate of whether or not to remain members of the CAMRT, challenging the benefit and value that they perceive from the association. While CAMRT works in collaborative partnership under a Memorandum of Understanding with the provincial colleges, Alberta, Saskatchewan and Quebec are currently stand alone where MRT are not required to be a member of the CAMRT, and other provinces are soon to join their ranks further eroding our national fabric.
We are losing the national perspective on entry-to-practice requirements and competencies through the variable Diploma versus Degree curricula now operating in the 12 stand-alone training programs in Canada.

7. MRT – an evolving profession
Imaging Specialist - a unique skillset and expertise
Technology – the science of our profession
Point of Care technologies
Hybridization
Theranostic nanomedicine
Where to next?
Soft Skills – the art of our profession
Competencies
As a profession, I believe that we are at a cross-roads - we need to evaluate how our services are evolving and re-define the unique expertise that the MRT brings to the healthcare team in order to maintain relevance into the future. In so doing, we need to realign our entry-to-practice competencies with the future needs of our patients, driven by the new capabilities that technologies are placing at our doorstep.
Entry to practice competencies are evolving and becoming much more complex. Expectations placed on today’s MRT are significantly different than when I started my career in Computerization of the imaging industry was just emerging - CT was the new innovation of the ‘80s - there was no talk of new modalities like MRI or hybrid modalities. Things have dramatically changed over my 36 years as a CAMRT member.
Technological Change:
Computerization - Analog to Digital
Radiation Dose Reduction
Evolution of new modalities
Diagnostic to Interventional
Modality Hybridization
Theranostics - Personalized healthcare utilizing theranostic nanomedicine applications (which combine both therapeutic and diagnostic capabilities of nanoparticles) is starting to blur the lines between Molecular Laboratory Medicine, Pharmacy and Interventional. We can anticipate that this field will dramatically evolve in the years ahead, challenging our current paradigm of thinking, possibly blurring the lines between Interventional and Rad Therapy.
Technological impact has brought other professions under threat eg., Cytotechnology
Soft Skills
Patient Care skills – Focus on patient experience
Interpersonal competencies and communication skills
Critical thinking and Problem Solving
Multidisciplinary / Interdisciplinary team-based competencies – bringing added value to the patient care team
Professionalism and Ethics
Competencies
Entry-to-practice
Advanced Practice
We need to better define what is an entry to practice versus advanced practice competency. Technology such as CT should be a core competence for entry to practice given its mainstream utility. Are hybrid modalities also following a similar evolutionary pathway? What should be entry to practice as compared with post-entry continuing professional development?

8. Is the role of the MRT under threat?
Encroaching scopes of practice from other healthcare providers
What is the unique domain of the MRT into the future?
Changing scopes of practice:
Imaging domain is under threat from other disciplines. Point of Care technologies are changing the way healthcare teams interact with diagnostic tools.
Non-Radiologist physician specialties and Nursing scopes of practice are blurring with the traditional MRT domain, and there is no reason to assume that this will not continue and expand as new technologies further blur the lines of practice.
Hybridization is also challenging the traditional silos of MRT training by discipline, requiring competence in multiple domains, eg. Nuc Med and Radiography, Nuc Med and MRI, etc
I postulate that our future value as a profession lies in the knowledge management domain (not just technical production of an image), bringing added value to the interdisciplinary patient care team through the application of our expertise, and the diagnostic or theranostic interpretive assessment of the what, how, and why.

9. Our current Curriculum paradigm
Discipline specific / subspecialty training curriculum
Siloed in nature
Inconsistent with technology spread
Not aligned with the needs of our imaging services
Accreditation program
Presently, curriculum is developed and maintained within the traditional silos of Radiography, Nuclear Medicine, MRI and Radiation Therapy.
Technologists are schooled in one discipline, with minimal exposure to other modalities.
Hybridization is forcing employers to re-tool the workforce with skills that cross over the traditional boundaries. Our training programs need to catch up with the evolutions in practice to prepare cross-skilled MRTs that will be competent to work in this new inter-disciplinary practice environment upon entry-to-practice.
The Canadian Medical Association has indicated its intent to withdraw its training program accreditation service as of An alternative to the CMA model for training program accreditation will need to be identified, creating an opportunity for curriculum review and realignment to system needs.

10. Changing the Paradigm CAMRT Symposia on the Future of MRT Education
Inter-disciplinary Core Competency Framework as foundation
Discipline-specific modules
Balanced entry-to-practice competence profile – technical / soft skills
Engage with employers
We need to rethink how to train the MRT of tomorrow! Over the past several years, the CAMRT has been considering these issues and has brought Educators and key stakeholders together to discuss these issues and develop action strategies that align with our future needs.
Should we continue to build our competency frameworks around our technology OR
Do we flip things and build our future competency frameworks around the needs of our patients and the services we provide them?

11. A possible future MRT Value Proposition
Patient Care practitioner
Radiation Dose and Safety expert
Knowledge Management and Informatics - Imaging appropriateness consultant
Researcher

12. Conclusion
We are in a time of transition, and we need to pay attention
Although challenging to our current thinking, there are significant opportunities to improve how we prepare MRTs to be successful in our future practice environment
The CAMRT is the appropriate entity to “hold” this vision and nurture its development

13. Questions?