Training needs for professionals in conventional radiology (radiology technicians, physicists, radiologists) joining digital radiology

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1 Training needs for professionals in conventional radiology (radiology technicians, physicists, radiologists) joining digital radiology S Peer 1, R Peer 1, P Torbica 1, W Jaschke 1, E Vaño 2 Innsbruck University Hospital, Dept. of Radiology, Austria 1 Universidad Complutense de Madrid, Madrid Spain 2 This work forms part of the DIMOND III (Dose and Image Quality in Digital and Interventional Radiology) project sponsored by the European Communities Radiation Protection Research Program, contract number FIGM-CT there are no knobs to a piece of film, so no matter how clever your PACS interface, it will never be as easy as film. Dr.Reuben Mezrich Radiology plays an increasingly important role in modern medical practice Radiology uses 4% of the health care budgets of most Northern European countries but, according to the available data, less than 1% of medical education budgets are devoted to radiology education during pre-graduate training. The total length of medical education varies from weeks, but only 1-4 weeks (28 hours to 160 hours) are devoted to radiology. New and more accurate methods are constantly being introduced Under Article 7 of the European Directive on health protection of individuals against the dangers of ionising radiation in relation to medical exposure (Council Directive 97/43/Euratom) one of the paragraphs on training states that: Member States shall encourage the introduction of a course on radiation protection in the basic curriculum of medical and dental schools. The EAR proposes: 1. A course in systematic basic radiological anatomy and functional imaging. 2. An introductory course in clinical radiology. 3. A general course in imaging and interventional radiology. For pregraduate training of medical students For further information please contact: Uno Erikson, MD, PhD, Professor Department of Diagnostic Radiology Uppsala University Hospital S Uppsala Sweden

2 The Council Directive 97/43/EURATOM further states in article 7 that member states shall ensure that all staff involved in a radiological procedure have adequate theoretical and practical training for the purpose of radiological practices, as well as relevant competence in radiation protection. Syllabus for a course in "Diagnostic Imaging - Physical and Biological Aspects" for doctors undergoing specialist training in radiology By Prof. Dr. P. Dendy of the EAR Working Group of Radiation Protection and Prof. Dr. Jörgen Carlsson Finalised in September 1998 It further demands that continuing education and training after qualification is provided, with provision of appropriate training for practitioners conducting special practices. EC Guideline Radiation protection 116 Radiation Protection 116. Guidelines on Education and Training in Radiation Protection for Medical Exposures. EC Directorate General Environment Continuing medical education (CME) guidelines of the european association of radiology/uems radiology section and board Rationale of a survey Continuing increase of digital technique in daily radiology practice This may be regarded as a special practice in the sense of the directive Lack of dedicated programs?! To give advice on the structure of dedicated educational programs for basic and continuing training in digital radiology topics Questionnaire Questionnaire - Training needs for conventional/digital transition WP 4.2: Partner: General: What is your hospital total bed size? acute bed size? Total number of anual radiology exams: Staff members in radiology department: Radiologists: Radiology technicians: Physicists: : specify: Equipment: Number of modalities in your hospital? Digital Radiography (flat panel detector, CCD,...): Computed Radiography (storage phosphor): Digital Fluoroscopy: Digital Mammography: CT: MRI: Ultrasound: Do you run a PACS? RIS? HIS? Yes No

3 Questionnaire - Training needs for conventional/digital transition WP 4.2: Partner: Innsbruck Your profession: Radiologist: x Radiology technician: Physicist: Other: Training and education: When new digital modalities were introduced, which educational resources were used? Workshop with vendor Training on the job (assisted by vendor) Training on the job (learning by doing) Visit to other hospital Workshop at scientific meeting Dedicated educational program Which additional resources did you use? Literature Video/CD-Rom Internet specify: Which ongoing training measures do you use? In house training (continue below) Presentations,... Educational program On the job x Workshops, scientific meetings... Visits by specialists training hours do you consider reasonable? How many 15 more For initial training For continuous education on a 2-3 year basis Is there a training resource of any kind for digital radiology offered by a national society in your country? Yes No When computed/digital radiography was introduced, which of the following did you encounter? CR: DR: When digital mammography was introduced, which of the following did you encounter? When digital fluoroscopy was introduced, which of the following did you encounter? Is there a continuous program of evaluation/quality control for digital radiology? Technical quality Staff The following list includes educational and training issues relevant for digital radiology. State for each if you think you have sufficient knowledge about it, or if you might need additional education. (If you have no experience with the system give no marks) 1) Digital radiography: sufficient knowledge need additional education Dose level compared to conventional radiography Image/dose relationship Potential for dose reduction Postprocessing capabilities Measures for quality control Physical properties of imaging system Storage phosphors: Flat panel detector: Differences in image characteristics Results 12 Partner Hospitals Low return rate 40 radiologist questionnaires 5 physicist questionnaires 27 radiographer questionnaires Partly filled questionnaires not evaluated 9% When new digital modalities were introduced, which educational resources were used? Workshop with vendor 8% 35% 8% 28% Training on the job (assisted by vendor) Training on the job (learning by doing) Visit to other hospital Workshop at scientific meeting Dedicated educational program Which ongoing training measures do you use? In house Presentations,... When computed radiography was introduced, which of the following did you encounter? 27% 18% 9% 14% 5% 27% In house Educational program On the job Workshops, scientific meetings... Visits by specialists 24% 36% 4 Different image/dose relationship

4 Educational and training issues relevant for digital radiography (need additional education) Dose level compared to conventional radiography Image/dose relationship Potential for dose reduction How many training hours do you consider reasonable for initial training? % 11% 11% 1 Postprocessing capabilities Measures for quality control Physical properties of imaging system - Storage phosphors: - Flat panel detector: Differences in image characteristics more How many training hours do you consider reasonable for continuous education on a 2-3 year basis? so what? more 4 Guidelines on education and training for digital radiology 1. Introduction 2. Rationale and results of a survey 3. General considerations on the education and training of radiographers 4. General considerations on the education and training of medical physicists 5. General considerations on the education and training of radiologists and other medical doctors involved in X-ray diagnostics Annexes 1. Outline for general education and training aspects in digital radiology 2. Outline for specific education and training aspects in computed and digital radiography 3. Outline for specific education and training aspects in digital fluoroscopy 4. Outline for specific education and training aspects in digital mammography 5. Outline for specific education and training aspects in digital visualisation and reporting 6. Structure and content of specific training sessions for education in Interventional and Digital Radiology

5 Basic education (20 hours) Basic module for general digital radiology Basic module for digital mammography Basic module for digital fluoroscopy and interventional radiology Basic module for radiation protection and quality assurance Continuing education Follow up module for digital radiography (3 hours) Follow up module for digital mammography (2 hours) Follow up module for digital fluoroscopy and interventional radiology (2 hours) Follow up module for radiation protection and quality assurance (2 hours) Continuing education (radiographer) - Follow up module for digital radiography (3 hours) 1. Update on currently available systems for computed/digital radiography, their technical concept and physical properties as well as ongoing developments. Special focus should be put on differences between the new technologies and previously available systems (such as DR versus CR). 2. Update on image analysis: Image appearance, artefacts, dose dependence, image quality concepts. 3. Practical workshop with acquisition of phantom images and image quality analysis.