Volume 1, Issue 1, Winter 2017
A publication of the Alberta College of Medical Diagnostic and Therapeutic Technologists
Winter 2017
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In this special inaugural issue of
ViewPoint
Gamma Knife Beams in Alberta ............................ 4 Mummography A New Study of an Ancient Man ....... 5 The Ugly Duckling of CCP, Self-assessment and How to Get to the Swan ........... 13 Member Profile: Omer Hussein, MRT(R) ................... 16 Improving Healthcare for Transgender Patients in Diagnostic Imaging Departments . 17 Hearing Tribunal Members Standing Up for Professional, Ethical Behavior ............................. 20
Herbert M. Walsh Memorial Award ............................. 21
George C. Hall Invitational Address ........................ 21
Honourary Life Members ............ 22
Apology Legislation and Social Media Confidentiality ....... 23
Member Profile: Gail Astle, MRT(R) .......................... 25
Top 10 Causes of Unprofessional Conduct and what you can do ...................... 27
Nominate Someone for an ACMDTT award .............................. 31
ViewPoint
Volume 1, Issue 1, Winter 2017 Published by: The Alberta College of Medical Diagnostic and Therapeutic Technologists (ACMDTT)
Suite 800, 4445 Calgary Trail Edmonton, AB T6H 5R7 Phone 780.487.6130 Toll Free 1.800.282.2165 Fax: 780.432.9106 info@acmdtt.com www.acmdtt.com This publication is free for ACMDTT members Please notify the ACMDTT office immediately of any address changes For advertising, contact Colin MacPhail (cmacphail@acmdtt.com) PM NO. 40037229
Welcome to the inaugural issue of ViewPoint, a brand new initiative designed to engage MRTs and ENPs in Alberta with articles which reflect current issues, embrace our historical roots, and explore new horizons in the medical diagnostic and therapeutic landscape.
ViewPoint is spearheaded by individuals and teams from across the province who are making impactive differences for Albertans. It’s a tribute to the significant advances in diagnostic imaging from yesteryear, while also acknowledging the pioneer spirit that made these advances possible. Colleen McHugh, MRT(R) shares her passion of discovery through four decades of advancement from the 80’s, 90’s and into the 21st century. She and her colleagues delved into the intricacies of “unwrapping a mummy” through diagnostic imaging, and in the process, unveil how far we’ve come. Just imagine how pioneer brain surgeons of the late 1800s such as Rickman Godlee and William Williams Keen would have reacted if they were told that in the future, their scalpels wouldn’t be needed to address extremely sensitive neurological brain surgeries. We celebrate and embrace the latest technology as Alberta welcomes the brand new Gamma Knife at the University of Alberta Hospital, joining the amazing 3T MRI scanners. We also look at current issues, such as addressing the LGBTQ community with sensitivity and respect. We identify how our sometimes difficult self-assessments with continuing professional development can be a rewarding experience, both professionally and personally. We even learn from our legal allies about how to identify and address potential legal issues. The bottom line is that ViewPoint is about you, your teams and your colleagues. We recognize that your contributions to Albertans’ well-being is essential. We look forward to sharing your stories, your experiences, and your ViewPoints as together we explore our horizons together. We welcome your submission of articles. Next issue is Spring 2018 Contact Colin MacPhail (cmacphail@acmdtt.com)
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The future is here! What was once perhaps thought of as science fiction technology is now a reality in Alberta as the University of Alberta Hospital has introduced the leading edge Gamma Knife in Alberta. The 20-tonne apparatus offers intricate treatments for neurological patients. “Almost 200 individual The Gamma Knife provides pinpoint accuracy, allowing surgeons to access beams of Cobalt-60 hard-to-reach portions of the brain and remove gamma radiation can “Can zap an area as entire tumours. converge and pass small as one through brain tissue” It uses Cobalt-60 as its source of gamma radiation. millimeter without Almost 200 individual beams of radiation can damaging surrounding converge and pass through brain tissue, providing enough energy to halt tissue.” proliferating cancerous cells. It can zap an area as small as one millimeter without damaging surrounding tissue. This state-of-the-art technology providing new options for people with brain tumours, malformations and even disorders like Parkinson’s. Traditional surgery would require treatment having doctors peel back layers of scalp, exposing greater risk. With no need to open the skull, patients are spared scalpels, general anesthetic, blood loss, infection risks and prolonged recoveries, and can typically return home the same day. Together with the Gamma Knife, a research 3T
“Together with 3T MRI, provides amazing precision MRI, and the already in-place 3T Intraoperative from research to diagnosis to operating room”
MRI, the U of A Hospital’s Brain Centre stands as one of the very few Brain Units in the world than can provide 3T precision from research to diagnosis to the operating room. Bringing the $17.5-million Gamma Knife to Alberta was made possible through donations to the University of Alberta Hospital Foundation. This includes a $3 million donation from Jim and Sharon Brown and Guy and Shelley Scott, and the naming of the Scott and Brown Families Advanced Imaging & Gamma Knife Centre. VP
Did you know ... On November 25, 1884, Mr. Rickman J. Godlee performed the first recognized resection of a primary brain tumor.
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By Colleen McHugh, MRT(R), ACR
A New Study of an Ancient Man ... Since the discovery of x-rays in 1895, we have been obsessed with the inner workings of the human body. What better example of this curiosity than the first human mummy to be analyzed with x-ray imaging within months of this breakthrough in science.
1896
Walter Koenig was the first person to explore mummified remains radiographically; the results of his study were published in March 1896. Clearly, it wasn’t long after the technology was available that the potential in mummy research was realized! Koenig’s images were the first to demonstrate the potential for radiology and anthropology to be unconventional and innovative partners. From this primal (basic) investigation, to modern day CT (and even MRI), scientists from many faculties have taken steps to “uncovering” the hidden truths that lay behind the wrappings of the beautiful mummification process. Mummification was a tedious process, which could take up to 70 days! Here is a brief outline of that process:
The body was washed, covered with scented oils to preserve the skin Taylor, J.H. (1995). Egyptian Bookshelf: Unwrapping a Mummy. p.82 Slit made in the side of the body to remove organs Long hook was inserted through the nose to pulverize and remove the brain Heart was left within the body (it was believed to be the center of intelligence and feeling) Each (removed) organ was embalmed in a natural chemical solution (natron) and put in containers nearby Small bundles of natron wrapped linen were stuffed inside the body cavity The body was then wrapped in linen or cotton strips with a sticky tar-like mixture (resin) forming a protective outer coating
Before radiography, in order to study embalming practices, anatomic abnormalities, biological sex, age-atdeath, diseases, and cause of death, a mummy would have to be physically unwrapped and surgically autopsied.
This is an invasive and destructive process. It destroys information that could be studied more thoroughly in the future, as science and technology continue to advance. Many mummies were unwrapped in the past; unsalvageable information was lost.
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The Initial Investigation
1981
So how does a newly minted Clinical Educator in Edmonton get involved with a real Egyptian Mummy? Let us begin…
The artifact in question was an Egyptian Mummy and coffin donated to the University of Alberta by an Englishman in 1979. The history of the mummy (following an exodus from an ancient Egyptian tomb, to an antique shop in England), has been pieced together from verbal recollections and old newspaper articles.
The mummy was loaned to a friend a genealogist - who travelled around Alberta in an old Edmonton Transit bus. He used this mobile museum to showcase the mummy and various other maudlin graveyard paraphernalia. When not in the bus, the mummy was stored in the old Edmonton Hotel, where it was apparently discovered by some teenage boys who attempted to unwrap it.
Colleen and four Radiography students unloaded their precious cargo from a minivan and onto a hospital stretcher
At this point the coroner became involved, and the mummy was eventually turned over to the University of Alberta for safekeeping until rightful ownership could be determined. The mummy was officially donated to of the University of Alberta in 1979. In 1981, in an effort to investigate the mummy with non-invasive techniques, the curator of the University Museum Collections (University of Alberta) requested Dr. Castor (Professor of Radiology) and Dr. Baker (Faculty of Dentistry) to investigate the mummy radiologically at the Cross Cancer Institute. Their findings were the result of several panorex exams, plain films, and 17 CT slices. The results: 1. Ethmoid and sphenoid bones were fractured/displaced 2. Amulet present on chest 3. Heart located in the thorax, other organs removed 4. Malignant tumour of the right fibula 5. Presence of a false phallus Unfortunately, very few records or images were kept, which created the opportunity to reinvestigate.
C University of Alberta Museums, 2017 ○
This Brit obtained the mummy from a recently deceased friend. The new owner’s wife refused to have the mummy in their home, so the mummy was stored in his father’s home for approximately 25 years. Eventually, this man and his family emigrated to Canada, where unfortunately, he died in 1967. The son, travelling back to England to settle his father’s estate, brought the mummy back to Alberta.
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1996 - The Second Investigation The Second Investigation
1996
My story began in 1996, when the Chair of Radiology at the University of Alberta Hospitals (Dr. Don My story began in 1996, when the Chair of Radiology at the University of Russell) invited me to take part in the initial examination of the aforementioned Egyptian Mummy. (Dr. Alberta Hospitals (Dr. Don Russell) invited me to take part in the initial Russell had been recently approached by Dr. Lovell to partner in this investigation.) examination of the aforementioned Egyptian Mummy. (Dr. Russell had been recentlyabout approached by Dr. Lovelltotomy partner in this (no investigation.) At the time, I knew little, if anything mummies. I went local library internet yet!) and took out some very basic books on mummification. I also procured four of my Radiography students to At the time, I knew little, if anything about mummies. I went to my local library (no internet yet!) and took join us in the study (after each wrote a brief summary of why they wanted to be a part of this!) out some very basic books on mummification. I also procured four of my Radiography students to join us in the study (after each of wrote a brief summary We met in the parkade the hospital on a wintery March afternoon…unloading our precious cargo from of why they wanted to be a part of this!). a minivan and onto a hospital stretcher. We met in the parkade of the hospital on a wintery March afternoon…unloading our began our a study in the general radiography area, where we obtained some basic images of the skull, torso, and preciousWe cargo from minivan and onto a lower limbs, using x-ray cassettes and “guessing” at manual techniques. Afterwards, we proceeded to CT where we used an 8hospital stretcher. slice GE Hi-Speed Advantage scanner to acquire:
We began our study in the general radiography area, where we obtained some basic images of the skull, torso, and lower limbs, using x-ray 88 slices of the skull at 3mm intervals cassettes and “guessing” at manual techniques. Afterwards, we proceeded to CT where we used 129 slices of the torso at 5mm intervals an 8-slice GE Hi-Speed Advantage scanner to acquire: 98 slices of the lower limbs at 5mm intervals
3D reconstructions were done of the skull and lower limb
88 slices of the skull at 3mm intervals the first images came of the processor, we marveled at the beauty of the preservation! 129 As slices ofThe the torso at out 5mm intervals bones were crisp and delineated; the wrappings were magnificently preserved and presented as 98 slicesindividual of the lower beautiful, layers. limbs at 5mm intervals This amazing step the history of science 3D reconstructions werein done of the skull – the discovery of x-rays - could not only aid in medical decisions, C University but could also enable us to study history. It would forever give us the ability to partner with other faculties ○ of Alberta Museums, 2017 to explore the and lower limb “art” and science of radiography.
We thought our images were spectacular!As the first images came out of the processor,
we marveled at the beauty of the preservation! The bones were crisp and delineated; the a We met in the parkade of the hospital on a wintery March afternoon…unloading our precious cargo from wrappings were magnificently preserved and minivan and onto a hospital stretcher. presented as beautiful, individual layers. This amazing step in the history of science – discovery of x-rays – couldofnot aid in We began our study in the general radiography area, where wethe obtained some basic images theonly skull, but could also we enable us to torso, and lower limbs, using x-ray cassettes and “guessing” at medical manual decisions, techniques. Afterwards, C University of Alberta Museums, 2017 ○ study history. It would forever give us the proceeded to CT where we used an 8-slice GE Hi-Speed Advantage scanner to acquire: ability to partner with other faculties to explore the “art” and science of radiography. We thought our images were spectacular! When we “built” that first 3-D model of the face, we were Weastounded!! began our study in the general radiography area,hours wheretowe obtained some basic images of the skull, The 3D reconstructions took several produce. torso, and lower limbs, using x-ray cassettes and “guessing” at manual techniques. Afterwards, we We compiled images to create a presentation for Advantage the 54th annual CAMRT student awards competition proceeded to CT our where we used an 8-slice GE Hi-Speed scanner to acquire: (we came in second!).
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Conclusions of the 1996 Study The investigation in 1996 brought about disproving and re-evaluating a few of the conclusions made previously in 1981.
The results: 1. No tumour on the right fibula 2. No tooth on presumed amulet While CT in 1996 was not nearly as good as it is today, its advancement from the 15 years prior was enough to provide anthropologists with a more accurate picture of the Mummy.
2016
This time the mummy was under the careful watch of Museums and Collections Services (MACS), University of Alberta.
C University of Alberta Museums, 2017 ○
Fast forward to 2016, and a chance re-encounter with Dr. Nancy Lovell, (Professor Emeritus of Anthropology, University of Alberta); Nancy suggested we re-investigate the mummy from the 1996 study. So, along with the support from the Managers of the UAH Radiology department, we made plans for a second investigation.
Arriving at the hospital on the afternoon of October 29, 2016, encased and supported on a new pallet, the mummy was imaged again. This time the investigation involved two new Radiography students, Katelyn Bellerose and Mikiko Morris (both, coincidentally, former anthropology students of Dr. Nancy Lovell!).
C University of Alberta Museums, 2017 ○
The initial images (no more film!) were taken in the same general radiography room at the UAH as in 1996 (with upgraded equipment, of course!).
C University of Alberta Museums, 2017 ○
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C University of Alberta Museums, 2017 ○
26 general radiographs taken from the cranium to the feet 3 Panorex images of the Teet and mandible 5
CT scans 2 Topograms 1 Control scan for density thickness 1 Head scan 1 Body scan
Total 20,000+ images (includes reformatted images) Amulet?
Off to CT!
The most extraordinary change from 1996, was the advancement of CT. With the help of CT Technologist extraordinaire, Dave Gauvreau, MRT(R) we were able to scan the mummy from top to bottom in a mere 68 seconds! Heat loading, ram and matrix size all account for the increased speed and improved quality of the images. Volume Rendering
C University of Alberta Museums, 2017 ○
Volume rendering (VR) is a generic term that refers to a 3D volume reconstruction method that allows every voxel in the volume data to “add” to the reconstructed image.
C University of Alberta Museums, 2017 ○
Back in the late 1980s, a single VR of facial bones on a Dual Tape Disk, took over 24 hours to produce. Now a
single VR can be obtained as fast as one can click a mouse! A total of 20 VRs were obtained from the mummy’s cranium to his feet, using the bony C University of Alberta Museums, 2017 anatomy and the various ○ layers of skin and linen. Ten VRs of the skull were processed that included the skull, mandible, and facial bones. Four of the VRs of the skull included various layers of superimposed skin and linen.
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Oh, how far we’ve come! 2016 vs 1996 The quality difference between the CT images obtained in 1996 is vast when compared to those obtained in 2016. For example, the 3D reconstructed images of the skull from 1996 include more noise and less body detail. The clarity and detail between these similar images is evident. The 2016 scan provides much more information largely due to: Thinner slices (1mm vs 3mm) More skull slices (279 vs 88) More body slices (1755 vs 227) Larger matrix size (1280 x 1024 vs 512 x 512) Quick scan time (68.7 seconds vs unknown) Superior software
1996
C University of Alberta Museums, 2017 ○
2016
C University of Alberta Museums, 2017 ○
“The quality difference between the images in 1996 and 2006 is vast.”
1996
C University of Alberta Museums, 2017 ○
2016
C University of Alberta Museums, 2017 ○
Panorex The mummy had 3 panorex images taken. It took several attempts to determine where his mandible lay within the wrappings. These images provided an extra representation of any dental pathologies that could be present. C University of Alberta Museums, 2017 ○
Obtaining the panorex images was crucial to the Anthropologist; from the dental information such can be gleaned about diet, evidence of dentistry, and sometimes even cause of death (abscesses, periodontal disease, infections, etc.).
The 2016 investigation made a new discovery involving the eyes; the CT scan was able to distinguish the presence of artifacts over the orbits. It is speculated that these are funerary pieces placed over the eyes, made of faience, which is a type of Egyptian fired paste. Previous CT scans and the 1996 radiographic images could not distinguish the presence of the eye pieces.
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Conclusions The collaboration between MACS, Dr. Lovell, UAH staff and students is a testament to the attitudes, skills, and interest of all.
C University of Alberta Museums, 2017 ○
This most recent, non-invasive investigation of the mummy has met many objectives. The multi-disciplinary team were grateful for the opportunity to work together for the conservation and value of science; the impact on history, preservation, and dignity of the subject was foremost in our actions.
The advancements in the last twenty years have proved essential to finding and revising new “The advancements in Left to right: Katelyn Bellerose, MRT(R); and old information the last twenty years within the same Colleen McHugh, MRT(R); Mikiko Morris, MRT(R) have proved essential.” individual. Higher resolution assessment was key to supplementary findings and confirmation of data. All information has implications for the continued curation of the mummy. Thanks to radiology, “our” mummy remains whole and immortalized as his embalmers intended, as well as through our records of this radiologic study. Special thanks to: University of Alberta Museums and Collections Services and staff for partnering with us to scan the mummy again University of Alberta Hospital Diagnostic Imaging Department and staff for letting us use their resources Dr. Nancy Lovell for furthering her Anthropological research with us Dave Gauvreau, MRT(R), UAH To my students, Darlene DeWindt, Francine (Neville) Krupa, Christine (Spletzer) Visser, Sandra (Ludorf) Dixon – before computers and printers, digital images and photographs; you worked hard, helped build models, cut out posters, glued and typed. We had a blast! To my students, Katelyn and Mikiko: Thank you for sharing this most recent journey with me. Your dedication, excitement, and computer skills will not be forgotten! Congratulations on winning first place for the ACMDTT 2017 Student Research Award! Dr. Russell: Thank you for asking me to be a part of this rare experience back in 1996! You taught me that the world of Radiology is one of past and present man. You pushed me to seek more, learn more and teach more. I am forever indebted to you. Nancy: Thank you for your candor, expertise, and most of all, your friendship! VP
Object Credit: Egyptian Mummy (1979.6) University of Alberta Art Collection University of Alberta Museums
University of Alberta Museums is a network of 29 museum collections on the University of Alberta campus used daily for teaching and research. For more information please visit www.museums.ualberta.ca or contact museums@ualberta.ca
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ACMDTT SEEKING RADIATION THERAPIST FOR COUNCIL Are you an influencer who wants to positively affect how your profession is viewed?
Here’s your opportunity to:
Help make an impact on strategic issues and enable purposeful decisions for your colleagues who are regulated by the ACMDTT
Develop strong future focused policies for meaningful enhancement of your profession
Acquire new skills and become more connected with the regulatory College
Be mentored by experienced Council members and receive governance and leadership training and development
Testimonial “My first introduction to Council was via a colleague. He spoke with such enthusiasm and
commitment to the good of what the college stood for.
I wanted to know where my money was going (pretty sure I’m not alone in this), so I decided to put my name forward for a council position and find out first hand. It didn’t take me long to appreciate the “behind the scenes” work of the College. I enjoy the collaborative efforts of council and having a voice in helping to ensure that “we” (our professions) provide quality care to our patients. The professional connections, the regulatory education, networking with other professions under our college umbrella, and the friendships, only add to the experience around the table. Council members are treated very well. So if you’ve ever wondered about the workings of our College and Council, consider nominating yourself or a friend. It’s so worthwhile!” Wendy Read, MRT(T)
Please submit applications to: c/o ACMDTT Nominations Committee Chair Suite 800, 4445 Calgary Trail Edmonton AB T6H 5R7 or email to ahislop@acmdtt.com By December 6, 2017
All candidates should submit a resume and a short biography to be published and be prepared for a telephone interview with the Nominations Committee. For more information: 780.487.6130 TF 1.800.282.2165 email ahislop@acmdtt.com
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By Janet Maggio, Ontario Association of Medical Radiation Sciences
As regulated health professionals, we are required to complete continuing professional development (CPD) as a means to maintain and/or increase our clinical competence. This is true of most regulated professions and of utmost importance in healthcare. The goal is to improve the quality of care our patients experience while increasing the knowledge base and skillset of our members. Ultimately, effective CPD results in increased job satisfaction through an engaged, educated and current workforce, as well as having a direct improvement to the healthcare system with ensured competence of its practitioners.
“Ultimately, effective CPD results in increased job satisfaction”
However, as I completed my Masters degree in Health Science Education, I became aware of a significant trend in the practice of CPD which ultimately threatens its effectiveness. So, in this article, I’d like to bring your attention to the Self-Assessment component of CPD. As members of self-regulated professions within the ACMDTT, one of the mandates is that you participate in the required Continuing Competence Program (CCP). As you know, each year you are required to complete a Self-Assessment of Practice in order to reflect upon your skillsets, and plan your CCP. This then includes a Personal Learning Plan that speaks to the areas in your practice that you feel need work. ACMDTT has excellent resources available to help guide the process and “Self-diagnosed document its completion, and you have the luxury of choosing which activities to do, areas for with the caveat that some of these activities must be related to the learning objectives improvement you set for yourself during the (dreaded) Self-Assessment (SA). As you can see, I’ve hinted at my own feelings towards SA *cringe* and apparently, research shows that are more I’m not alone in my dislike of SA. But fear not! I’ve learned a few tricks which will help motivating” turn that ugly duckling into a beautiful swan in no time! Based on my research, it looks like ACMDTT has done an excellent job setting up a solid CPD program. But let’s talk about the elephant in the room. The point of the program is to select CPD activities that will help you address an identified gap in skill or knowledge of your practice that you identified in your SA. In fact, the entire cyclical process hinges on the SA piece and it is a critical first step! But what if this ‘dreaded’ step is skipped, not done well, or falsified? The criticality of completing an accurate SA lies in a couple of key areas. The first is that this step is motivating and em pow ering. W hen one seek s to enhance their k now ledge and sk ills and is responsible for implementing changes to improve their practice, it makes them feel good about doing so. In fact, research suggests that self-diagnosed areas for improvement are more motivating than those chosen for them or at random. It simply gives ‘personal meaning’ to the mandated practice of CPD.
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The second is that the SA creates a focused direction for the professional development (PD). Quite simply, you don’t need to learn what you already know. Selecting CPD activities based on areas requiring improvement helps the professional target those weak areas in an efficient manner, and leads to more obvious and meaningful improvement in practice.
“You don’t need to learn what you already know”
This leads directly to the third benefit of an accurate SA; the simple efficiency that it provides. How wonderful is it to do a self-assessment, decide what it is that you need to work on, and focus right on that? If I’m honest – that is the most important thing for me. I have little interest in completing PD that isn’t going to help me improve my practice. The clearer and more critical I can be with my SA only makes my plan for PD more relevant. As a busy professional, adding efficiencies in my life is very important! Sure, I learn things for fun everyday – but I don’t claim them in my CPD portfolio, as they don’t always have a tangible relation to my practice as a health professional. So why does the Self-Assessment have a homely little reputation? For many years it has been known that we (as a general rule) are naturally not very good at selfassessments. A brief review of the literature will solidify this point and highlights this as an area for improvement within models that follow self-regulation “We can mold and self-direction principles. The literature on SA points to a weakness in identifying gaps in one’s self-assessment from knowledge – some suggesting that this practice is mundane and dreaded indeed quite poor!
into the metaphorical swan.”
The process of SA may not come naturally, but it can be learned and is easily improved with a little training, guidance and practice! What that means is that there is hope. Over time, and with practice, we can mold the practice of SA from something mundane and dreaded into the metaphorical swan – the key piece of CPD that it is meant to be! As you know, the ACMDTT provides tools and a SA template, but there are many others out there if you decide something different works for you. In the attempt to understand the SA a little better, I wanted to draw your attention to the crucial elements involved in SA for professional development:
First,
you need something to compare yourself to. This would be a minimum set of standards or a ‘bar’ against which to assess yourself. Typically, this is established by the regulatory body to ensure patient safety is maintained. In your case, it is your Standards of Practice.
Next,
you need to reflect. Urgh. This is the part we tend to struggle with and is a challenge for most people! Let’s try to make it easy.
Take some time and reflect upon a typical workday (or maybe a more complex procedure if you are an experienced practitioner). Read through the Standards of Practice and ask yourself: where do you measure against that ‘bar’? Where can you improve? Did you hesitate today? Did you question yourself? Did a colleague do something more efficiently than you did? What do you do well? What could you do better?
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Keep in mind that this is a PERSONAL assessment. No one else needs to see this evaluation of your performance. Be honest. It is meant to be a safe and productive exercise to guide your professional development. It is not a punitive exercise! When studies show that the practice of SA is flawed, it is typically because the study participants are not completing the reflection piece effectively. If you find that you struggle with this, try asking a colleague for feedback. Think of your last employee evaluation – were there any surprises? Making an honest effort here will be much more valuable to you and your practice.
Third,
let’s set some goals. You have your self-assessment laid out in front of you. Select at least two goals to work on this year. These goals should be linked directly to the identified gaps (weaknesses) in your self-assessment so they will be highly relevant. But also consider their attainability – they should also be realistically achievable as well. It’s great to have goals, but let’s not start out setting ourselves up for failure either. The ACMDTT has a templated Personal Learning Plan that works well for this and helps you link the relevancy of your planned learning back to your identified gaps.
“Goals should be attainable, not setting ourselves up for failure.”
Fourth,
find learning activities to participate in that will target your goals and meet your needs. Sometimes this is a challenge. Access to learning opportunities may be difficult depending on your location and/or your workplace, but there are plenty of options out there. Look into: Online learning, webinars, journals, lunch-n-learn sessions, workshops, courses … the list goes on! Other things to consider include: cost, time off work, level of difficulty, pre-requisites, required travel, etc.
Finally,
we need to cycle back and re-evaluate. This is a phase that is often missed or skipped but is very important. Did you meet your goal? Did you learn anything new? Did you implement any changes or improve your performance or knowledge? Maybe you didn’t – and that’s okay too! You can’t climb Mount Everest in a day! You can carry any remaining gaps forward to the next cycle. This step can be really helpful to ensure that you have a complete and robust learning plan. Planning for appropriate and effective CPD means creating a CPD portfolio that is meaningful to your practice. There are many resources in place to help support you in doing so, but it is essential that you understand the importance of the SA component. Often unpopular and overlooked, this crucial piece is the key to building a professional development plan that is efficient and motivating to the member. Without this ‘duckling’, ensuring that regulated health professions continue to provide high standards of care by highly competent professionals becomes more of a moving target and less of a purposeful and valued practice. VP Janet Maggio is the Director of Professional Services at the Ontario Association of Medical Radiation Sciences. She holds dual certification as a Nuclear Medicine Technologist and an MRI Technologist and has taught in the medical imaging field for over 10 years. She recently completed her Masters of Science in Health Science Education through McMaster University. Reference Texts; Asadoorian, J., & Batty, H.P., (2005) An Evidence-Based Model of Effective Self-Assessment for Directing Professional Learning. Journal of Dental Education. 1315-1323. Regehr, G., and Eva, K. (2006) Self-assessment, Self-direction, and the Self-regulating Professional.
linical Orthopaedics and Related Research. 449, 34–38
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Omer Hussein, MRT(R) Going Far, Together As a Radiological Technologist with Northern Lights Regional Health Center in Fort McMurray, Alberta, I get to see people from all walks of life benefit from the important work that we do. With the help of an incredible and dynamic team, we are changing the lives of so many in our community for the better. Witnessing this impact motivates me to be aware and up to date on upcoming trends and advancements in imaging technology both locally and internationally. I’ve had the privilege of being trained at both NAIT and the University of Ottawa, although my journey has not been an easy one. I am the son of immigrant parents who migrated to Canada over three decades ago to seek a better life for their family. They came to a new country not knowing the language and culture, without their family and friends, and had to rebuild their life from scratch. My parents are my inspiration; I look up to them as they are the hardest working, most dedicated people I know. They remind me of how far I’ve come and that the sky's the limit when it comes to accomplishing my dreams, and it’s for this reason that I am so proud to be a part of the self-regulated Alberta College of Medical Diagnostic and Therapeutic Technologists. Being a part of the ACMDTT has enabled me to give back to the profession that has made me who I am today. My passion for radiation safety has allowed me to work with several committees including the local Joint Workplace Health and Safety Committee based here in Fort McMurray as well as the Workplace Health, Safety, and Wellness Committee through the Alberta Health Sciences Association. I am thrilled to have the opportunity to contribute to the growth and evolution of my profession. There is a popular African Proverb: “If you want to go fast, go alone. If you want to go far, go together.” This has proved to be true in my experience as an MRT as well as in my role with ACMDTT. As a Council member, I have felt a true sense of togetherness with colleagues involved with the College, who have encouraged me to voice my ideas and actively participate in bringing about the changes I want to see in the diagnostic imaging landscape. As such, I am encouraging all members to get involved in any capacity. As the saying goes, strength comes in numbers, and together we can ensure that we are providing the best possible care to those who need us most. VP
City of Calgary recognizes “MRT Week”. Mayor Nenshi wrote:
“The City of Calgary recognizes Nov 5-11, 2017 as Medical Radiation Technologists (MRT) Week and salutes the dedication and commitment of these professionals who demonstrate excellence in patient care.”
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Winter 2017
Article written by Virginia Sanders, MRT(R) and Sidsel Pedersen, MRT(R)
In January, 2017, National Geographic dedicated an entire issue to the Gender Revolution suggesting the binary model of male/female is shifting to a more diverse landscape regarding gender identity. Today, there are a multitude of genders and various LGBTQ organizations have listed at least 30 ways in which people may currently identify and express. In order to treat all patients with the respect and dignity they deserve, healthcare providers need to be aware of this shift. It is not necessary to discuss all of them in this article however, it is imperative that an understanding of the difference between gender and sex is established.
The Genderbread Person
(Killermann, 2017) helps to gain a better understanding of how identity, expression, biological sex and orientation relate to one another. Gender identity is how we think about ourselves. Gender expression is how w e ex press ourselves. Our clothing style and hairstyle are examples of expression. Biological sex refers to the reproductive organs w e were born with; male, female or intersex. Sexual orientation is w ho w e are attracted to, physically emotionally and spiritually. As healthcare professionals we must provide equal care to all patients regardless of their sexual orientation and therefore we will not be discussing that aspect in this article. It is important to be aware that these four factors are independent of one another. A biological male may identify as a female and express as a combination of feminine and masculine. As well as a biological female may identify and expresses with very masculine traits. As all these categories are on a sliding scale, you may also have someone right in the middle who does not identify as male or female. (androgynous/non-binary) A transgender person is someone whose gender identity and expression does not correspond with their biological sex. The term transmale refers to a person who identifies and expresses as male and was born as a biological female. The term transfemale refers to a person who was born with male reproductive organs but identifies, expresses and wishes to live as a female.
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Most government issued identification indicates only the assigned sex at birth. A formal process must be followed to have gender markers changed on government issued identification. This process includes mandating that a person must live as their desired gender full-time for one year. During that year the identification will not match the expression. In Ontario, provincial health cards no longer require a gender marker, and changes are also currently being discussed for drivers’ licenses in other provinces to be gender neutral. Healthcare providers may be faced with new situations when providing health services to a member of the transgender community. Some challenging situations may be a result of:
Gender markersi on identification may not be congruent with patient presentation Legal name may not be the preferred name Electronic medical records may inaccurately reflect the patients gender identity and/or expression
“We have a duty, bound by a Code of Ethics, to ensure all persons feel safe and respected.”
Having incongruent gender markers, or no gender markers, on a healthcare card can cause some confusion for us in healthcare as we may not address the person by the name they prefer or know to shield them appropriately from radiation. In ultrasound we may call in a patient that presents as female for a prostate exam and not understand what is happening. The confusion and uncertainty that we feel will also lead to patients feeling uncomfortable.
We believe that technologists must be given skills to better prepare and handle situations where a patient either does not have gender markers on their identification or in the situations where the gender markers do not match the patient’s expression and/or desired gender. We have a duty, bound by a Code of Ethics, to ensure all persons feel safe and “How can we make respected. the transgender The transgender community is marginalized. A U.S. survey on the transgender population (2015) states that due to living as their desired gender, transgender people are nine times more likely to commit suicide than the rest of the population. Additionally, they are being bullied and harassed on a regular basis. They are unsafe every time they walk out of their house.
community feel safe, comfortable and respected?”
So how can we help make the transgender community feel safe, comfortable and respected in our department? We have come up with the following ideas that we believe can help all technologists that are faced with a patient who’s expression, identity and/or biological sex that do not align.
Use preferred name and pronoun by asking them Explain why more personal questions are needed Don't make it weird
Use preferred name and preferred pronoun This is the simplest approach for all technologists and can make a very impactful difference for the patient. Start your introduction with using your name and pronoun then ask the patient, "What can I call you?'. This will serve to help the patient identify you as an allyii and start building patient rapport quickly. Once the patient has built trust with you, other potentially more personal questions will be more readily accepted.
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Explain why more questions are needed Next, it is important to explain why more questions are necessary to be asked. Remember to only ask questions that relate directly to the exam. It is important that all biological females are asked of any chance of pregnancy. Again this can be a delicate topic, as some transgender males no longer identify as female or have female gender markers. Depending on the situation here are some examples of how to address the patient: For exams that require choosing specific female/male gonadal shielding, it is important that the technologist inquires further “Are your reproductive organs internal or external?” Don’t make it weird We can’t stress this enough. Don’t make it weird. In healthcare, we work with a wide variety of cultures, genders, creeds and races. When we are with someone who we feel is different physically, mentally or spiritually, we do our best to make them feel as comfortable and safe as possible.
Article authors (left) Sidsel Pedersen, MRT(R), (right) Virginia Sanders, MRT(R)
The transgender patient is no different. If you are uncomfortable in any given situation however, the patient will feel uncomfortable too. If you make a mistake, apologize and move on. Give all patients the same respect and dignity. Try your best to work with the patient by asking them what name/pronoun they would prefer, and ask the right questions to get the right answers in a professional and respectful way just as we would anyone else. References Killermann, S. (2017, 05 08). It's pronounced metrosexual. Retrieved from It's pronounced metrosexual: http://itspronouncedmetrosexual.com/2012/01/the-genderbread-person/#sthash.U771Lngb.dpbs Footnotes i - Gender marker refers to gender that is displayed on identification such as passport, drivers’ licences and healthcare cards. ii - Ally refers to a person who supports the LGBTQ community VP
MRT Week recognized at Alberta Legislative Assembly Honourable Sarah Hoffman, Deputy Premier and Minister of Health introduced Karen Stone, CEO/Registrar ACMDTT; members of the University of Alberta Radiation Therapy program, Faculty of Medicine and Dentistry; and AHS medical radiation leaders to the Alberta Legislative Assembly on November 9, 2017 as part of MRT Week. Hoffman stated, “The integral role of diagnostic and therapeutic care is often overlooked, so it’s truly an honour to stand up with them and celebrate their hard work, dedication and expertise in making life better for Albertans.”
Left to right: Susan Fawcett, Mona Delisle, Fiona Mitchell, Jackie Middleton, Honourable Sarah Hoffman, Cynthia Palmaria, Laura Grose, Karen Stone
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Wherever our career paths takes us, we carry our experience, knowledge, skills and wisdom. This applies to all of us, regardless of our profession. However, it’s our intangible essence which distinguishes us as professionals. Integrity, respect, honesty and ethics are pillars of who we are and the values we expect of ourselves and our colleagues. Most importantly, it is what ia expected by the public. That’s why regulation exists. The ACMDTT exists so that the public is assured of receiving safe, competent and ethical diagnostic and therapeutic care by a regulated and continually advancing profession. We owe it to ourselves, our colleagues, and the public that we follow our mission and our Code of Ethics.
“Wisdom Integrity
is knowing the right path to take ...
is taking it”
- W. H. McKee
There’s a special opportunity for members to stand up for our professional, ethical behaviour; to ensure the safety of the public; and to assure regulations are met. The Hearings Tribunal consists of members who want to make a positive impact on substantiating regulation, and our regulatory College is looking for individuals who have “the right stuff”. Like some others, Christy McIntyre, MRT(NM) first thought being part of the Hearings Tribunal would be intimidating.
“Several years ago I was approached by an ACMDTT employee asking me if I would be interested in being a tribunal member for the College. I had never heard of that position and at first dismissed the idea. After some consideration, and asking a few questions I decided to accept the position. I was told that a tribunal member plays a vital role in maintaining the integrity of the professions represented by the ACMDTT, and that I would aid my peers by addressing issues of unprofessional conduct, ensuring public safety and upholding the Standards of Practice and Code of Ethics of the College.
“I’ve learned more about myself as a technologist”
I agreed to the new role although it was very intimidating at the time. The ACMDTT assisted greatly in easing my concerns, they provided a great support network as well as many training courses to help me understand my new role and accomplish the tasks assigned to me. These courses included how to chair a hearing, understanding evidence and writing decisions, as well as many others.
It has been a wonderful opportunity to serve in the capacity of a tribunal member.
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I have learned more about myself as a technologist, and a better understanding of our responsibility as a profession to the public. I can also take my experience into the community and feel confident serving on any number of boards or committees. I am really grateful I made the decision to become a tribunal member for the ACMDTT.” Are you an individual who abides by strong ethical values; is able to examine facts without information bias; adheres to confidentiality; shows fairness and empathy; looks at the whole picture and all the impacts of decisions; and is committed to the concept of Administrative Justice?
If you are interested in learning more about becoming part of the ACMDTT’s Hearing Tribunal, contact the College. Don’t be intimidated. As Christy learned, the personal and professional growth developed by being a member of the Hearings Tribunal, as well as knowing that you are making a positive impact for the public and your colleagues, is rewarding. VP
Herbert M. Welch was a pioneer in the field of medical radiation technology whose commitment and dedication aided in the growth of the profession. Mr. Welch, or Bert as he was known, was born in Ashton-under-Lyne, England in 1888 and immigrated to Canada in 1908 as an Electrician. When WWI broke out, he immediately enlisted and went overseas with the Engineers where his talents were used on the installation of X-Ray equipment for the Army. This is where his passion for the profession started. Upon his return to Canada, Bert underwent his X-Ray training in Toronto from where he joined the Col. Belcher Hospital in Calgary. Mr. Welch remained in Calgary until his death on March 24, 1951.
Laurie Walline, MRT(NM) (left) and ACMDTT Council President Kelly Sampson, MRT(T)
This award, first bestowed in 1964, is to honour a member of the College (full or retired/resigned in good standing, excluding current Council members) who has dedicated a minimum of 15 years of service to and has made a significant contribution to the outstanding growth of the profession. VP
George C. Hall was born in London, England and immigrated to a farm in Saskatchewan in 1927. In 1944, Mr. Hall graduated as a psychiatric nurse from Edmonton’s Alberta Hospital. Through nursing, Mr. Hall gained an appreciation and understanding for the field of x-ray technology and soon went on to train at Dr. Marshall Mallett’s office in Edmonton. Through his experience as a Radiological Technologist, George C. Hall was dedicated to the betterment of our profession. Illustrated by his service at the local, provincial and national levels, Mr. Hall led by example as to what a dedicated professional can do to make a difference and create an impact in his/her profession. An individual who has influenced the growth of the profession in clinical practice, education, research and/or administration may be nominated to deliver this address. The George C. Hall Invitational Address is delivered by the deserving honoree during the ACMDTT Annual Awards Luncheon. VP To nominate someone for the Herbert M. Welch Award, the George C. Hall Invitational Address, or any other award, go to acmdtt.com/members/awards/ or contact the ACMDTT office.
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Henri Becquerel: Discovery of Radioactivity In 1896 Henri Becquerel was using naturally fluorescent minerals to study the properties of x-rays, which had been discovered in 1895 by Wilhelm Roentgen. He exposed potassium uranyl sulfate to sunlight and then placed it on photographic plates wrapped in black paper, believing that the uranium absorbed the sun’s energy and then emitted it as x-rays. This hypothesis was disproved on the 26th-27th of February, when his experiment "failed" because it was overcast in Paris. For some reason, Becquerel decided to develop his photographic plates anyway. To his surprise, the images were strong and clear, proving that the uranium emitted radiation without an external source of energy such as the sun. Becquerel had discovered radioactivity. VP
The Honourary Life Membership is designed to honour an individual whose professional activities have promoted the profession provincially and/or nationally; whose leadership serves to motivate others to become involved in professional activities; and who has been involved in raising the profile of the ACMDTT and the profession. This award is delegated through a nomination process, either by an individual or by an ACMDTT Branch.
This award may only be bestowed to a non-practicing, previously regulated member who has made a significant contribution over at least 15 years of AAMRT/ACMDTT membership or service at a provincial and/or national level. In 2017, two individuals were bestowed the award in recognition of their outstanding service and dedication to the profession: Terry Ell, RTNM, PhD, FCAMRT and Kathy Hilsenteger, RTT, ACT. For many years, Terry has devoted himself to the development of MRTs provincially, nationally and internationally. He began his career as a Nuclear Medicine technologist in 1980 Honourary Life Member Terry Ell, RTNM, PhD, FCAMRT and over the years has been involved with many aspects of the profession. Kathy Hilsenteger was the first CEO/Registrar of the College taking on that role in 2003; however, Kathy started her career in the profession as a radiation therapist. Kathy graduated from the Cross Cancer Institute radiation therapist training program in 1977. From junior therapist to senior therapist, student mentor, floor supervisor and Assistant RT Manager and Process Coordinator, she always demonstrated qualities exemplifying a leader. VP
Honourary Life Member Kathy Hilsenteger, RTT, ACT
To nominate someone for the ACMDTT Life Membership, or any other award, go to acmdtt.com/members/awards/ or contact the ACMDTT office.
Winter 2017
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Legal Update for ACMDTT Regulated Members By Blair E. Maxston, BA, LLB Recurring Independent Legal Counsel for ACMDTT
Making Mistakes and “Apology Legislation” Many Canadian Provinces have enacted what is known as “apology legislation” to provide protection to persons who apologize for their actions. In the healthcare context, hospitals and their insurers have often been reluctant to allow healthcare providers to apologize for errors and mistakes due to a concern that apologies could be interpreted as an admission of guilt or wrongdoing. Unfortunately, the simple act of “saying sorry” often provides closure to an affected person and can even lead the individual to forgo lawsuits or other formal steps (such as a complaint to a regulatory body). In this province, changes to the Alberta Evidence Act now make it clear that:
Making an apology is not an admission of fault or liability in a lawsuit or other civil (as opposed to criminal) proceedings. An apology is not admissible in a court or similar proceeding as evidence of fault or liability. Making an apology does not negate any malpractice insurance coverage.
It is very important to remember that apology legislation does not prevent someone from starting a malpractice lawsuit or filing a complaint with a professional regulatory College but it does mean that the apology itself cannot be used in a lawsuit, discipline hearing or “Apology legislation does similar process as evidence of wrongdoing. not prevent someone from For healthcare providers such as members of the ACMDTT, the starting a malpractice importance of apology legislation is clear when a critical incident occurs. lawsuit or a filing a In those situations and altogether aside from legal liability complaint.” considerations, healthcare providers are often very interested in letting the patient know that they accept responsibility for an error or mistake and in expressing concern for and empathy with the patient. As well, apologies and expressions of empathy work to address not only the concerns of patients but also concerns of affected family members and other healthcare professionals and can play an important part in informing the patient of the circumstances or outside factors giving rise to an incident. Sincere apologies are often invaluable in terms of resolving conflict and repairing professional relationships with patients and co-workers. Apology legislation can of course be critical in facilitating apologies by not automatically incurring legal liability.
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Despite the obvious benefits of having apology legislation, MRTs and ENPs should be mindful of other considerations when deciding whether and when to offer an apology. Those factors include:
Employer policies and guidelines for the investigation and reporting of critical incidents and providing apologies.
The seriousness of the mistake and any adverse outcome or consequences for the patient.
The extent of malpractice insurance provided by the employer and the steps you are required to take (including reporting the incident internally) in order to maintain insurance coverage.
Social Media and Patient Confidentiality Members of the ACMDTT have a clear legal and ethical obligation to maintain the confidentiality of patient information. Those obligations arise because of court decisions, the College Code of Ethics and Standards of Practice, legislation such as the Health Information Act and employer policies and guidelines. With the advent of social media, Alberta’s MRTs and ENPs must always bear in mind that the duty of confidentiality reaches beyond the actual workplace and now exists in “virtual” cyberspace. The risk of liability for ACMDTT members in using social media and breaching patient confidentiality typically arises in two scenarios. First, many healthcare professionals will use social networks or discussion websites to post comments about workplace issues, concerns and experiences. Obviously, communications on social media websites such as Facebook, Twitter and even internal professional or employer sites can give rise to patient confidentiality breaches. Specifically, if you mention jobsite thoughts and experiences among your “circle of friends” on social media you have no control over whether the recipients of that information might forward it to other online “friends” or colleagues. Of course, the information can be distributed and disseminated almost indefinitely and even a single online transmission of information means that the information is no longer within your control. In short, social media allows for extremely quick and indiscriminate distribution of information that cannot be recalled. Even if you are sharing information on social media for legitimate professional reasons - such as asking for input from colleagues concerning a challenging case - the potential for unauthorized disclosure of patient information definitely exists. The very “You have no control over unique nature of a medical condition or the medical history of a patient and whether recipients of his or her condition can result in the patient’s identity being unintentionally information might forward it disclosed. If an ACMDTT member posts information on social media to other online “friends” or concerning workplace and patient conditions it is essential to provide colleagues.” absolutely no identifying information about the facility, the patient, the patient’s family, the patient’s job and where the patient lives among other things. Those same risk management considerations would apply to blogs and other similar forums. The second type of liability that an ACMDTT member could be faced with in this area arises from the fact that a great deal of social media information is stored on mobile devices such as smartphones and tablets. Due to their small size and portability those types of devices can easily be stolen or lost.
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As a result, Alberta MRTs and ENPs have a professional and legal obligation to ensure the safe storage and transportation of smartphones, tablets and similar devices and to use strong passwords and encryption to prevent unauthorized access by third parties. Additionally, some employers have policies prohibiting the use of those types of devices in the workplace and those policies must be strictly complied with.
“
Information on smartphones and tablets can easily be stolen or lost
Best practices require ACMDTT members to be mindful at all times of what workplace information they are disclosing on social media and, even where the information is seemingly generic, to maintain the integrity and security of smartphones, tablets and other mobile devices. VP
Gail Astle, MRT(R)
My name is Gail Astle and as a new Council member, I would like to take this opportunity to share a little about myself. I currently work for Alberta Health Services (AHS) as the Radiography Education Coordinator in the Edmonton Zone. I have been in this role with AHS for over twenty years and my responsibilities have definitely evolved through the years! Currently, I lead many image critiques and that is my protected time with the students to help educate them. The remaining responsibilities of my role are more coordination and I also Chair a couple of committees, one is a provincial committee focused to supporting general radiological technologists and the other one is for Diagnostic “My role has enabled me to Imaging Continuing Education in the Edmonton Zone. The one enjoy fueling the desire to constant that has remained one of my responsibilities throughout the last two decades is the technical orientation that I provide to the new help them become the best Radiology Residents for one month each year. technologists they can be.” “My role has enabled me to enjoy fueling the desire to help them become the best technologists they can be.”
As well, for many years I also worked for NAIT Continuing Education, supporting internationally educated technologists as well as technologists who were working on re-entry into the workforce. I am passionate about education and my role has enabled me to enjoy fueling the desire to help others become the best technologists they can be.
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My own educational roots were with NAIT many years ago and at the time I applied for the Radiological Technology program, I didn’t realize how much this was the perfect profession for me. The logical side of my brain was satisfied with the science of the profession and the art of radiography was for my creative side. Bringing this together in an education role was the best of all worlds! “The logical side of my brain was satisfied with the science of the profession, and the art of radiography was my creative side.”
I worked initially as a general duty technologist, then moved onto a supervisory role and then finally into education, where I have spent the majority of my career. I am definitely in the best headspace when I am helping others learn and I am also learning along the way too!
I am a big believer in continually learning as that is how I can feel more fulfilled and creative. During my time as an Educator, I served on an education committee through the CAMRT and also as a member of the Conjoint Committee on Accreditation through the Canadian “When you listen, Medical Association. The committee work was meaningful and rewarding and I you learn! When you could see the work was making a difference. share, you educate!.”
My career has afforded me with many opportunities to learn the fine art of being “politically correct”! As a seasoned professional, I would like to think that my work experience has also provided me with some level of wisdom. “When you listen, you learn! When you share, you educate!” This is something I live by and truly believe; it speaks to my passion for education and learning! I have had this posted on my office bulletin board for so many years, but unfortunately I do not know who the author of this quote is so I cannot actually give them the credit they deserve! I have been involved with the College and the professional association before, but this past year, I was approached to query if I would be interested in running for Council. The role of the ACMDTT Council is a new experience and will afford me with many more learning opportunities, which are inspiring and exciting! As the College crosses different modalities within diagnostic imaging as well as therapy, the impact that the ACMDTT has is very broad. With sonography soon to be part of our membership, the future is bright! I have found that through all the volunteering that I have done in my life, you can learn so much but you also develop wonderful friendships which can carry on long after the committee work is finished! If you see this as something you would be interesting in exploring, I encourage you to become involved at your Branch level and then expand your involvement by volunteering your time within the many opportunities through the ACMDTT. From a personal perspective, I spend a lot of time gardening; it brings me great joy and is a wonderful stress reliever! It also has the benefit of being a good physical workout! I have two fabulous children; both my daughter and son are married to wonderful spouses but the greatest joy comes from my two granddaughters! My kids are great parents, but there is nothing better than being a Grandma!! All the hard work of being a single Mom was worth it; I am definitely enjoying the fruits of my labour! I look forward to the future and the new experiences on the horizon! VP
Ernest Orlando: Nuclear medicine pioneer The origin of nuclear medicine started with the invention of the cyclotron by Ernest Orlando Lawrence (1901-1958). Lawrence began working at University of California in Berkeley in 1928 as a nuclear physicist.
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By James T. Casey, Q.C., Field Law Based on my experience over the years with hundreds of unprofessional conduct cases in a broad range of professions, the following is my unscientific list of the top ten causes of unprofessional conduct. In no particular order:
1
2
Failure to maintain currency of professional knowledge and competence Professions and the health care system evolve. Professionals must keep pace with the change. There are many complaints of unskilled practice about professionals who once were very competent but who have not maintained their competence. “That’s how we did it when I was trained 20 years ago”, is not a valid defence. What you can do: Maintaining competence on an ongoing basis is a central tenet of professionalism. Maintain a current knowledge base. Continuing Competence Programs are ideal tools. Use them. Take advantage of continuing education opportunities. Be familiar with your employer’s policies and procedures. Understand the standards of practice for your profession. Be active in professional organizations; read professional publications.
Failure to seek assistance or make appropriate referrals Professionals may encounter difficult situations for which they do not have the necessary skills. Unprofessional conduct may occur where the professional “ploughs ahead” without getting assistance. What you can do: Recognize that we all have limitations. Realize that seeking assistance is not a form of weakness; it is a sign of professional strength. Where necessary seek assistance from trusted colleagues or from your supervisor. Don’t be afraid to ask a colleague for a second opinion. Where appropriate, refer the patient to someone with the necessary skills.
3
Difficulties in a professional’s personal life affect their work-life
We rarely have “water-tight compartments” in our lives. Our work can affect our personal and home-life and difficulties in our personal and home-life can negatively affect our work. Personal difficulties might be related to problems with marriages, relationships, children, finances, or depression. It is common for serious personal difficulties being experienced by a professional to “spill -over” into the workplace giving rise to a risk of unprofessional conduct.
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What you can do: If you are experiencing serious difficulties in your personal or home-life, then realize the potential for the “spill-over effect.” Also realize that you might not be the most objective person with respect to whether your work is being adversely affected. If you are having difficulties coping with problems in your personal life and there begins to be a “spill-over” to work, then get help. Seek out family, friends, trusted colleagues. Consider taking some time off work. Consider counselling through Employee Assistance Programs.
4
Alcohol and drug addictions Alcohol and drug addictions are the root cause of some of the most serious cases of unprofessional conduct.
What you can do: Keep yourself well. Realize that addiction to prescription drugs is a danger for health care professionals because of easy accessibility. Many professionals with substance abuse problems have destroyed their entire professional career because they have either refused to seek help or sought help too late. Get help. Seek counselling. Contact Employee Assistance programs. There are addiction recovery programs in Alberta specially designed for health care professionals.
5
Poor communication Many unprofessional conduct complaints are caused by poor communication between the professional and the patient or between a professional and their colleagues.
What you can do: Appreciate that part of being a true professional is being a good communicator. Ask yourself: Are you a really good listener? Could you be a better communicator? Would it be useful to take an effective communication course? Realize that effective communication is at the heart of the “informed consent” process. Consider how your remarks are perceived by others. Avoid cavalier or “smart-aleck” comments in the presence of patients. These types of comments tend to startle and alarm patients and may prompt a complaint. Many comments that are appropriate when made only in the presence of colleagues are not appropriate in the presence of patients. “Don’t wash your dirty laundry in public.” You care about your patients. Do your patients understand that you care? Do your actions and your verbal and non-verbal communication demonstrate that you care? Retain professional distance and demeanour but demonstrate to your patients that you do care. How would you want to be treated if the situation was reversed and you were the patient? What would you expect if the patient was one of your family members? Very few patients file unprofessional conduct complaints about health professionals who they perceived to be caring. Patients who leave a health care facility feeling, “No one cared about me”, are more likely to file complaints.
6
Failure to appropriately address patient concerns
A patient or a family member with a concern about a patient’s care or a professional’s conduct will typically first approach the professional or a manager about their concerns. Many unprofessional conduct complaints are filed because the person felt that their concerns were not taken seriously by the institution or the professional.
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What you can do: Take all concerns and complaints seriously. “Actively listen” to the person making the complaint. Be careful of labelling a patient as a “whiner” or a “complainer”. Patients, and their families, can often be difficult and sometimes unreasonable. However we must remember that the patient and their family are often under significant emotional and physical stress in an environment which they do not fully understand. An individual who feels that a professional or an institution has been dismissive about their concerns is much more likely to file a formal professional conduct complaint. Understand the power of the “15 second apology” acknowledging the feelings of the person complaining. Example: “I am so sorry that all of this has resulted in you being distressed about your daughter’s care. I will advise my manager of your concerns.” You can often effectively address a person’s concerns without getting into a long debate about who was wrong or right. Persons who feel their complaint was taken seriously and effectively addressed rarely file a complaint of unprofessional conduct with a regulatory college. For most people, filing such a complaint is a last resort when they perceive that nothing else has worked.
7
Environmental factors
Various environmental factors can be a contributing cause to a professional engaging in unprofessional conduct. For example, there may be excessive work demands, a lack of mentoring and supervision, or inappropriate workplace practices. A professional may also be assigned tasks by their employer which the professional is not completely competent to perform due to inexperience or lack of training in a particular area.
What you can do: Remember that regardless of the environment, it is the professional’s personal obligation to ensure that their own work meets professional standards. If you have failed to maintain professional standards, a defence of “that’s how we all do it at work” is unlikely to be successful. If you have concerns about the environment’s effect on your ability to practice in a professional manner, seek advice from trusted colleagues. Raise the issue with your supervisor. If you do not obtain any assistance from your supervisor, seek the advice of your professional organization.
8
Personality conflicts escalate to unprofessional conduct
It is not unusual for the roots of unprofessional conduct to be in a personality conflict between a professional and a colleague, between a professional and his or her supervisor, or between a professional and a patient. A serious personality conflict can cause a professional to lose their objectivity and a minor dispute which should have been resolvable may escalate to a major confrontation. What you can do: Understand that there will always be colleagues, supervisors, and patients with whom it is difficult to get along. However, this does not alleviate you of the central obligation of maintaining a professional demeanour and professional interactions. If you are experiencing a personality conflict, ask yourself honestly whether it is affecting the quality of your work. Are your interactions still meeting professional standards? If you are experiencing a personality colleague with a colleague, deal with the issue privately and not in the presence of patients. If there is a serious personality conflict with a patient, consider arranging for the patient’s care to be provided by a different person. If you have been assigned to provide exclusive care to the patient, then you should obtain the patient’s consent to the transfer.
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Complacency about professional standards Some professionals with a great deal of experience become complacent about professional standards and begin to develop “sloppy” practices.
What you can do: Remember that a commitment to professionalism is a life-long commitment. Professional standards apply as much to a new graduate as a professional with 30 years experience. Regularly work on refreshing your understanding of professional standards. Don’t count on your experience and seniority to help you get away with sloppy practices.
10
Professional documentation
A failure to adequately chart or document causes significant problems for professionals. If you have acted professionally and appropriately, then proper documentation will be your best defence. Many unprofessional conduct complaints are referred to a hearing because of significant disagreements about what actually happened. If a case comes down to, “He said, she said,” then you are at risk. Appropriate documentation can objectively demonstrate what really happened. What you can do: Follow professional charting and documentation practices. Understand and follow your employer’s documentation practices with respect to critical incidents, patient complaints, etc. Document in accordance with professional standards: write legibly, write accurately, record concisely, record events chronologically, record information immediately or ASAP, ensure all documentation is dated and signed or initialled, write in ink, use uniform terminology and correct errors in documentation openly and honestly. When you know that concerns are being raised by a patient or family member, ensure that every step you take is adequately documented.
Professionalism is not about perfectionism. All professionals make mistakes. However, we all need to ensure that we learn from our mistakes. By being alert to some of the root causes of unprofessional conduct we can do our very best in ensuring that we act as “true professionals”. VP Jim Casey is a lawyer in the Edmonton office of Field Law working in the Firm’s Professional Regulatory Group. This article is re-published with the agreement of Jim Casey and Field Law.
Wilheim Röntgen: Discovery of X-Rays At the end of the 19th century, while studying the effects of passing an electrical current through gases at low pressure, German physicist Wilhelm Röntgen accidentally discovered X-rays - highly energetic electromagnetic radiation capable of penetrating most solid objects. His discovery transformed medicine almost overnight. Within a year, the first radiology department opened in a Glasgow hospital, and the department head produced the first pictures of a kidney stone and a penny lodged in a child’s throat. VP
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Do you know someone ... ...who leads your department in the right direction? ...whose professionalism inspires you and your colleagues?
2017 Award winner Glenda Laser, MRT(NM) (left)
Consider nominating them for the
Professional Excellence in Leadership Award!
Do you know someone ... ...whose patient care is outstanding? ...who serves as a respectful patient advocate?
2017 Award winner Patricia Linke, MRT(T) (centre)
Then don’t wait, nominate them for the
Professional Excellence in Patient Care Award!
Do you know someone ... ...who helps your department keep up with new technologies and procedures? ...who encourages continuing education?
2017 Award winner Gail Astle, MRT(R) (left)
They deserve the
Joan Graham Award
Do you work with a team‌ ...who embodies the concept of professional collaboration? ...who contributes to a common goal related to professional practice either technically or with humanity which has had a positive impact on the profession? Consider nominating them for the
Award for Excellence in Professional Collaboration!
2017 Award winner DMS Regulation Working Group
For more information on the awards and nomination forms go to acmdtt.com/members/awards/ Or contact the ACMDTT at 780.487.6130 TF 1.800.282.2165
PM 4150767 Return Undeliverable Canadian Addresses to: Alberta College of Medical Diagnostic and Therapeutic Technologists (ACMDTT) Suite 800, 4445 Calgary Trail Edmonton, Alberta T6H 5R7
780.487.6130 1.800.282.2165 info@acmdtt.com
www.acmdtt.com
Specialties the ACMDTT regulate:
Radiological Technologists Radiation Therapists Magnetic Resonance Technologists Nuclear Medicine Technologists Electroneurophysiology Technologists Soon to be regulated, Diagnostic Medical Sonographers