Under. Working. Medical Radiation Technologists Board Te Poari Ringa Hangarua Iraruke. New Zealand. Therapy Practitioners and their Supervisors

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1 New Zealand Medical Radiation Technologists Board Te Poari Ringa Hangarua Iraruke Working Under Supervision A Guide for Medical Imaging & Radiation Therapy Practitioners and their Supervisors

2 Working Under Supervision; A guide for medical imaging & radiation therapy practitioners and their supervisors This publication is copyright to the New Zealand Medical Radiation Technologists Board July 2014 THE MEDICAL RADIATION TECHNOLOGISTS BOARD IS RESPONSIBLE TO THE MINISTER OF HEALTH FOR ADMINISTRATION OF THE HEALTH PRACTITIONERS COMPETENCE ASSURANCE ACT 2003 IN RESPECT OF THE PROFESSION OF MEDICAL RADIATION TECHNOLOGY (MEDICAL IMAGING AND RADIATION THERAPY). THE PRIMARY RESPONSIBILITY OF THE BOARD IS TO PROTECT THE HEALTH AND SAFETY OF THE NEW ZEALAND PUBLIC BY ENSURING PRACTITIONERS REGISTERED IN THE PROFESSION OF MEDICAL RADIATION TECHNOLOGY (MEDICAL IMAGING AND RADIATION THERAPY) ARE COMPETENT AND FIT TO PRACTISE. 80 The Terrace PO Box , Wellington T: F: E: mrt@medsci.co.nz

3 What is Covered in this Booklet Working Under Supervision Purpose 4 Working Under Supervision Policy 5 Levels of Supervision 6 Supervision Plan 8 Requirements & Responsibilities of the Supervisor 9 Requirements & Responsibilities of the Practitioner 10 The MRTB s Code of Ethics 11 Reporting Requirements 12

4 Working Under Supervision Purpose The New Zealand public have the right to safe and competent medical imaging and radiation therapy services at all times, including from registered practitioners who are practising under supervision. Under the Health Practitioners Competence Assurance Act 2003 (the Act) the Medical Radiation Technologists Board (the Board) can place a condition on a practitioner s scope of practice that will ensure their competent practise. This can include: A condition that the applicant practise subject to the supervision of one or more nominated health practitioners or health practitioners of a stated class (Section 22 [3] [a]) Appropriate supervision provides assurance to the Board and the New Zealand public that a practitioner s practice is safe and does not pose a risk of harm to the public. This booklet sets out the principles and procedures essential for safe and effective supervision. Page 2 of 10 Medical Radiation Technologists Board

5 Working Under Supervision Policy 1. Practitioners working in the profession of medical imaging and radiation therapy may be required to work under supervision in a number of circumstances: a. All practitioners registered in a training scope of practice in magnetic resonance imaging, nuclear medicine, or ultrasound. b. Registered medical imaging or radiation therapy practitioners (excluding training scopes of practice) who have not held a practising certificate for over three years. c. Candidates undertaking a registration examination assessment (REA). d. Overseas-trained practitioners may be required to undertake a period of supervised practice to allow the Board to confirm their competency. 2. Supervision requirements may vary for each practitioner; therefore supervision is tailored to meet each practitioner s level of competence and experience. 3. Supervision may be provided at different levels to allow for flexibility to meet individual practitioner capabilities and learning needs across diverse practice settings. 4. REA candidates (for the purpose of registration) are not registered in New Zealand and therefore must receive Level One supervision throughout their REA familiarisation period. 5. Supervised practitioners are required to work within the parameters of a documented supervision plan. 6. Supervisory arrangements may be modified over time, accommodating for the practitioner s progression through the different levels of supervision. Working Under Supervision Page 3 of 10

6 Levels of Supervision Supervision can be provided at different levels to accommodate the needs of the practitioner being supervised, while at the same time protecting the health and safety of the patient. It is expected practitioners will progress through some or all of the defined levels of supervision during their period of supervised practise. Level One: The supervisor takes direct responsibility for individual patients. 1.1 The supervisor must be physically present and observing at all times when the supervised practitioner is undertaking examinations and/or treatment. 1.2 The supervised practitioner must consult the supervisor about the management of each patient before undertaking examinations and/or treatment. 1.3 Supervision via telephone (indirect) is not permitted. 1.4 The supervisor must conduct periodic reviews of the supervised practitioner s practice. Level Two: The supervisor and supervised practitioner share the responsibility for individual patients 2.1 The supervisor must be physically present within the workplace when the supervised practitioner is undertaking examinations and/or treatment. 2.2 The supervised practitioner must inform the supervisor at agreed intervals about the management of each patient; this may be after the examinations and/or treatment has been delivered. 2.3 Supervision must be primarily in person (direct). When the supervisor is not physically present, (but is within the workplace) (s)he is always accessible by telephone or other means of telecommunication. 2.4 The supervisor must conduct periodic reviews of the supervised practitioner s practice. Page 4 of 12 Medical Radiation Technologists Board

7 Level Three: The supervised practitioner has indirect supervision and takes primary responsibility for their practise, including individual patients. 3.1 The supervisor must ensure there are mechanisms in place to monitor the supervised practitioner s practise. 3.2 The supervised practitioner is permitted to work independently, provided a supervisor is contactable by telephone or other means of telecommunication. 3.3 The supervised practitioner may provide on-call and after hours services, provided a supervisor is available by telephone or is available on-site. 3.4 The supervisor must conduct periodic reviews of the supervised practitioner s practice. Level Four: The supervised practitioner has indirect supervision and takes full responsibility for their practise, including individual patients with general oversight provided by a supervisor. 4.1 The supervisor must oversee the supervised practitioner s practise. 4.2 The supervisor must be available for consultation if the supervised practitioner requires assistance. 4.3 The supervisor must conduct periodic reviews of the supervised practitioner s practise. Restrictions: In some circumstances practitioners may be restricted to a specific level of supervision: REA candidates who are applying for New Zealand registration must remain at Level One supervision at all times throughout their period of familiarisation (as they do not hold a current New Zealand registration). Practitioners working in a training scope of practice must remain at Level One supervision for a minimum of 6-months before being able to progress onto another level of supervision. Working Under Supervision Page 5 of 12

8 Supervision Plan The supervision plan is to be documented, signed by the supervisor and the supervised practitioner, and forwarded to the Board for approval. The supervisor plan is to include a summary of: The supervised practitioner s knowledge and skills; The level of supervision required; An orientation period plan; The frequency supervision reports are to be completed; The content and supporting evidence that is required within the supervision report; Details for progressing through the supervision levels. Any amendments to the supervision plan must be approved by the Board. A copy of the supervision plan template will be provided to supervisors and the supervised practitioner, and can be found on the Board s website under publications: Page 6 of 12 Medical Radiation Technologists Board

9 Requirements & Responsibilities of the Supervisor To be eligible to take on a supervisory role, as the supervisor you must: Hold a current practising certificate that does not contain any conditions on your practice. Formally agree to act as a supervisor through signing the supervision plan. Be enrolled in a Board-approved CPD programme. Have at least two-years post-qualification clinical experience. Have a sound understanding of the competencies required for registration in the relevant scope of practice, as prescribed by the Board. Declare any conflict of interest. Provide reports to the Board, that are honest, accurate and responsibly prepared using the Board s report template. As the Supervisor your responsibility to the supervised practitioner includes: Maintaining supervision, assessment integrity, and avoid or declare any conflicts of interest. Ensuring the health and safety of patients are paramount when designing the supervision plan. Maintaining a professional relationship with the supervised practitioner. Being contactable and readily available to the supervised practitioner. Establishing regular meetings with the supervised practitioner, and conducting regular performance reviews with timely remediation of any identified problems. Taking appropriate steps to ensure the practitioner is practising safely. Observing the supervised practitioner, conducting case reviews and providing constructive feedback. Taking responsibility for your own, and the supervised practitioner s, practise. As the supervisor, you must notify the Board immediately if: The relationship with the supervised practitioner breaks down. There are concerns regarding the conduct or fitness to practice of the supervised practitioner. The supervised practitioner is not complying with the conditions imposed, or undertakings accepted by the Board, or is not complying with the supervision plan. If the supervised practitioner leaves employment. Working Under Supervision Page 7 of 12

10 Requirements & Responsibilities of the Practitioner To be eligible to practise under supervision you must be registered with the Board and hold a current practising certificate. (This does not apply to REA candidates who are completing their 3-month familiarisation period). As a practitioner working under supervision you are responsible for: Maintaining a professional relationship with your supervisor. Being prepared for meetings with your supervisor. Adapting your practise to address the remediation of identified areas for any improvements that may arise. Recognising your professional limits, and practising within those professional limits. Immediately advising your supervisor of any issues and all clinical incidents. Practising within the Board s Code of Ethics. As a practitioner working under supervision, you must agree to, and sign a documented supervision plan. The MRTB s Code of Ethics is to act as a guide to any medical imaging & radiation therapy practitioners registered with the MRTB. It is to assist medical imaging & radiation therapy practitioners working in all modalities of medical radiation technology in maintaining a high level of ethical conduct. Page 8 of 10 Medical Radiation Technologists Board

11 The MRTB s Code of Ethics Medical imaging and radiation therapy practitioners will: Act in such a manner to justify public trust and confidence. This will be achieved through high standards of professional competency as well as through professional conduct and appearance. Demonstrate commitment to the provision of the best possible service to patients. Maintain a working knowledge of all legislation pertinent to their practice and operate within such legislation. Ensure they operate within their scope of practice, delivering only those services for which they are registered and competent to do so. Demonstrate commitment to keeping the radiation dose as low as reasonably achievable to produce diagnostic results or for treatment needs. Provide services in such a manner as to show respect for each individual. Act in the best interests of each patient and maintain their standards of practise for all patients. Have regard for a patients religious and political beliefs, gender, sexual orientation, race/ethnicity, nationality, social or economical status, and the nature of the person s health problems. Protect the patients right to privacy and keep all patient information in the strictest confidence. Continually strive to improve their knowledge and skills of their profession. Be respectful of fellow workers and work in a professional and co-operative manner with other health care workers. Be responsible for reporting any unethical conduct, unsafe practice, or illegal professional activities to the appropriate bodies. Be accountable for their clinical decision making. Working Under Supervision Page 9 of 10

12 Reporting Requirements The supervision reporting requirements are to be described in the supervision plan. The supervision report is to include any changes in the supervision arrangement over time. The supervision report is to include an evaluation of the practitioner s practise. If the practitioner has demonstrated deficiencies in any of the Board competencies required of their scope of practice the report is to include measures taken to address those, and the status of the practitioner s remediation efforts. Supervision reports and information regarding the competencies are available from the the website under the Publication tab: Page 10 of 12 Medical Radiation Technologists Board

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