Guide for Recently Registered Medical Imaging and Radiation Therapy Practitioners Medical Radiation Technology (medical imaging and radiation therapy)
July 2017
01 The Board 02 02 The Practitioner 06 03 Continuing Professional Development 10 04 Practitioner Audits 16 05 Changing Your Scope of Practice 06 Competence, Fitness to Practice and Professional Conduct 18 22 Throughout this booklet: MIT: Medical Imaging Technology RT: Radiation Therapy MRIT: Magnetic Resonance Imaging Technology NMT: Nuclear Medicine Technology Son: Sonography T-Scopes: Includes all training scopes of practice REA: Registration Examination Assessment the Health Practitioners Competence Assurance Act 2003 is referred to as the Act the Medical Radiation Technologists Board is referred to as the Board.
01 T h e Board Consultation Fairness Natural Justice MRTB Health and safety of the New Zealand public Consistency The Board provides practitioners with a framework for the delivery of safe medical imaging and radiation therapy services to the New Zealand public. Impartiality Approachability honesty The environment the Board operates within helps to determine its strategic direction. The Board works within an ever-changing environment that is subject to a number of influences including economic, political, social and technological. MRTB Guide for Recently Registered Practitioners
3 Board Functions The Medical Radiation Technologists Board (the Board) is one of sixteen New Zealand health regulatory authorities appointed by the Minister of Health under the Health Practitioners Competence Assurance Act 2003 (the Act). The Board is responsible for the administration of the Act in respect of the profession of medical radiation technology (encompassing the practices of 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 imaging and radiation therapy are competent and fit to practise. The Board has a number of functions defined by section 118 of the Act: Prescribe the qualifications required for scopes of practice within the profession, and for that purpose, accredit and monitor educational institutions and programmes. Authorise the registration of medical imaging and radiation therapy practitioners, and maintain registers. Consider applications for annual practising certificates. Review and promote the competence of medical imaging and radiation therapy practitioners. Recognise, accredit, and set programmes to ensure the on-going competence of medical imaging and radiation therapy practitioners. Receive and act on information from health practitioners, employers, and the Health and Disability Commissioner about the competence of medical imaging and radiation therapy practitioners. Notify employers, the ACC, the Director-General of Health, and the HDC when the practice of a medical imaging or radiation therapy practitioner may pose a risk of harm to the public. Consider cases of medical imaging and radiation therapy practitioners who may be unable to perform the functions required for their relevant scope of practice. Set the standards of clinical competence, cultural competence, and ethical conduct to be observed the profession. Liaise with other authorities appointed under the Act about matters of common interest. Promote education and training in the profession. Promote public awareness of the responsibilities of the Board.
4 Code of Ethics Introduction The Board sets and monitors standards in the interests of the public and the profession. The Board s primary concern is public safety. This Code outlines the standards of ethical conduct set by the Board under section 118(i) of the Act. This Code complements the legal obligations that medical imaging and radiation therapy practitioners have under the Act, the Health and Disability Commissioner (Code of Health and Disability Services Consumers Rights) Regulations 1996, the Health Information Privacy Code 1994 and the Radiation Safety Regulations. The Act and Code of Rights can be found at www.legislation.govt.nz. The Radiation Safety Regulations can be found at www.health.govt.nz. The Code of Ethics for medical imaging and radiation therapy practitioners is a set of standards defined by the Board describing the behaviour or conduct that registered medical imaging and radiation therapy practitioners are expected to uphold. Failure to uphold these standards of behaviour could lead to a disciplinary investigation. Te Tiriti o Waitangi/The Treaty of Waitangi The Code acknowledges Te Tiriti o Waitangi/The Treaty of Waitangi as the founding document of Aotearoa New Zealand, and recognises and respects the specific importance of health services for Māori as the indigenous people of Aotearoa New Zealand. The full code of ethics can be found on the Board s website: www.mrtboard.org.nz MRTB Guide for Recently Registered Practitioners
5 Code of Ethics 1.1 Act in such a manner to justify public trust and confidence. 1 2 Relationship with the New Zealand public: Relationship with colleagues and the profession 1.2 Demonstrate commitment to the provision of the best possible service to patients. 1.3 Demonstrate commitment to keeping the radiation dose as low as reasonably achievable to produce diagnostic results or for treatment needs. 1.4 Provide services in such a manner as to show respect for each individual. 1.5 Protect the patient s right to privacy and keep all patient information in the strictest confidence. 2.1 Continually strive to improve their knowledge and skills of their profession. 2.2 Be respectful of fellow workers and work in a professional and cooperative manner with other health care workers. 2.3 Be responsible for reporting any unethical conduct, unsafe practise, or illegal professional activities to the appropriate bodies. 2.4 Be accountable for their clinical decision making. 3 Cultural Competence 3.1 Practise with due care and respect for an individual patient s/client s culture, needs, values, world views and beliefs, including the needs, values and beliefs of Māori. The Code of Ethics acts as a guide to medical radiation technologist (medical imaging and radiation therapy) practitioners registered with the Board. It is to assist practitioners working in all modalities of medical radiation technology in maintaining a high level of ethical conduct.
02 T h e P r a c t i t i o n e r Under the Health Practitioners Competence Assurance Act 2003 (HPCA Act 2003), the Board is required to maintain a register of the practitioners it regulates. The register is accessible to the public and employers. Registration with the Board is a one off process, and you will remain on the register unless you request to be removed or are removed for disciplinary reasons. You can register in more than one scope of practice providing you meet the requirements of registration in each scope. Periodically the Board will conduct a review of the register, and will contact practitioners who have not held an APC for five consecutive years asking if they wish to remain on the register. Once registered as been granted, you will need to apply for an annual practising certificate before you commence practising. To do so, go to the website and click on apply for APC. A primary function of the Board is the registration of practitioners. In meeting its role to protect public safety, the Board has developed mechanisms to ensure registered practitioners meet required standards for safe and competent practice. MRTB Guide for Recently Registered Practitioners
7 Keeping the Board Informed You are required to notify the Board of any changes to your residential, postal or work address within one month of the change. You can do this by logging into My Profile on the website. Please note: email address changes cannot be altered using the My Profile portal and must be emailed to mrt@medsci.co.nz
8 Annual Practising Certificates An APC is valid for a maximum of twelve-months between 1st April of one year and 31st March of the next year. You can apply for an APC in either one or multiple scopes of practice, provided you are registered in each of those scopes and meet the Board's criteria for clinical practise hours. Clinical Practise Hours If you apply for an APC in one scope of practice you must have completed, within the three-years prior to your application, a minimum of 800 clinical hours with at least 360 of those involving patient contact. Should you wish to apply for an APC in more than one scope of practice you must have completed, within the three-years prior to your application, at least 360 hours of patient contact for each scope of practice and an additional 440 clinical hours across any of the scopes of practice that you hold an APC for. This balance of 440 hours may include any combination of: Patient contact; Direct supervision of staff in clinical practise; Delivery of educational activities; Quality assurance directly related to the delivery of medical radiation technology/ radiation therapy; Research activities which inform practice. Practising Without an APC As a registered Medical Imaging Practitioner or Radiation Therapist (any scope of practice) you are responsible for ensuring you are issued an APC, and work within the scope of that APC, and an application renewal is submitted to the Board for each year you intend to work in a New Zealand medical imaging industry; accompanied by the appropriate payment. MRTB Guide for Recently Registered Practitioners
If you wish to work in New Zealand as a Medical Radiation Technologist practitioner you must hold a current annual practising certificate (APC). 9 Declarations When you apply for an APC you are required to make a number of declarations including that you : Receive a satisfactory performance evaluation during the previous twelve-months; and Meet the requirements for clinical work experience; and Are enrolled in a Board-approved recertification programme; and Have no criminal convictions recorded against your name and/or no criminal charges pending that are punishable by imprisonment for a term of 3 months or longer*; and Are competent and fit to practise, and have no mental or physical or conditions that may compromise your competency. Please note: Declarations must be truthful. The Board may take action under section 172 of the Act if it discovers any declarations are false. It is illegal to practise without an APC and you could be fined up to $10,000, should the Board have it confirmed that you have been working without a current APC. *This may include convictions that have not resulted in an imprisonment term, but could have been; for example a conviction of driving with excess breath alcohol.
03 C o n t i n u i n g P r o f e s s i o n a l D e v e l o p m e n t Active engagement in continuing professional development is a way for you to demonstrate your on-going competence to be re-issued with an APC. All practitioners applying for registration must demonstrate they meet the Board s competencies and fitness to practise standards. Recertification includes a number of tools used by the Board to monitor the ongoing competence of all practising medical imaging and radiation therapy practitioners. Continuing professional development (CPD) is a critical feature of the Board s recertification programme. MRTB Guide for Recently Registered Practitioners
11 What is Continuing Professional Development (CPD) The ultimate purpose of CPD is to contribute to high-quality patient care. While the definitions of CPD are many they tend to be based on a number of common themes. Continuing professional development is a range of learning activities through which health professionals maintain and develop throughout their career to ensure they retain their capacity to practise safely, effectively and legally within their evolving scope of practice Health Professions Council (United Kingdom) The Value of CPD CPD will help you to maintain high levels of professional competence through continually upgrading your skills and knowledge. CPD: Ultimately benefits patients as it should lead to improved services Gives the Board, the public, and the health sector confidence that you are continuously improving your skills, knowledge and expertise Allows for you to take responsibility for your lifelong learning Helps you to be accountable for remaining current in your practise As a registered health practitioner you are expected to maintain your competence in medical imaging and/or radiation therapy practice. You are responsible for keeping your knowledge up-to date by undertaking relevant CPD. Continuing professional development should be: Continuous - professionals should always be looking for ways to improve performance The responsibility of the individual to own and manage Driven by the learning needs and development of the individual Evaluative rather than descriptive of what has taken place An essential component of professional life, never an optional extra Chartered Institute of Personnel and Development (United Kingdom)
12 An Overview of Mandatory Recertification Requirements Minimum of formally recorded CPD hours per triennium 60 hours Minimum of formally recorded CPD hours in any one year 10 hours Evidence of a minimum amount of substantive CPD activities in each triennium 35 hours Declaration that you have completed a minimum number of clinical practice hours per triennium Maintain detailed and verifiable records for all CPD activities for a period of four years (for any one triennium) Provide supporting evidential documents confirming your engagement in CPD activities 880 hours At least 10 supporting documents and 6 of those for substantive CPD activities Confirmation of a peer performance review within the previous 12-month period CPD Cycle The Board has fixed the trienniums to align with the annual practising certificate renewal date of 31st March. The next three trienniums are: 1st April 2017 to 31st March 2020 1st April 2020 to 31st March 2023 1st April 2023 to 31st March 2026 MRTB Guide for Recently Registered Practitioners
13 CPD is Mandatory CPD must be undertaken by all registered medical imaging and radiation therapy practitioners who are practising in New Zealand. If you are registered and practising in more than one medical imaging/radiation therapy scope of practice you must undertake substantive CPD activities in each scope. Minimum CPD Hours You must complete 60 hours of CPD activity over a three-year period triennium with a minimum of 10 hours in any one year. At least 35 hours of CPD activities within a triennium must be directly relevant to your scope(s) of practice. These are classed as Substantive CPD activities. These minimum CPD hours apply despite the tenure of your employment. That is, if you are practising as a medical imaging and/or radiation therapy practitioner on a fulltime, part-time or casual basis, you must meet the Board s CPD requirements, including the minimum number of CPD hours. Pro-Rata Formula If you have registered for the first time, or if you are returning to practice, in many cases you will commence CPD part-way through the term of a triennium. The Board has adopted a simple pro rata method for determining the number of CPD hours to be recorded for the APC period and for the triennium. The pro rata CPD rate is: Five hours per three-month period You may use this formula to determine the amount of CPD you are required to do for your first CPD year.
14 CPD for Practitioners who Practice Part-Time If you work part-time, you must still complete the mandatory CPD requirements. Competence does not equate to the hours you work but to the standard of practice you perform. Practitioners working only a few hours a week must be as equally competent during the hours they practise as their colleagues who work 40-hours a week. CPD for Practitioners Not Currently Practising If you do not hold a current practising certificate you are not required to meet the Board s mandatory CPD requirements. That said, if you are planning to return to practice, the Board recommends you maintain some degree of CPD activity during your non-practising period. If you return to practice after having more than 3-years away from the profession, any relevant CPD activities you have undertaken while away from practice will be assessed as part of your APC application. You will need to ensure you are able to provide the supporting evidence for any CPD undertaken while you were not practising. When you return to practise meeting the mandatory CPD requirements may be calculated on a pro rata basis. CPD Records You must maintain detailed and verifiable records for all CPD activities undertaken. The Board may require you to submit your CPD records at any point in time. You must retain your evidentiary record of CPD activities (and reflection) for all of the current triennium plus one additional year, that is, a minimum of four years for any one triennium. Records of CPD activity should include both the details of the activity and reflection on the learning gained from the CPD activity. MRTB Guide for Recently Registered Practitioners
15 Recording your CPD Activities Date, time and location of the activity Activity details e.g. journal article, seminar, lecture, workshop Source, reference or provider e.g. journal name, provider name Number of hours for the particular activity (exclusive of breaks) and the type of activity hours i.e. substantive or general Evidence of participation e.g. attendance certificate, copy of enrolment or sign-in sheet Reflection Reflecting on the impact each of your CPD activities has had on your professional practice and on your colleagues and patients is a critical aspect of your CPD. Critical reflection helps you to review and set your ongoing CPD goals. Reflection requires you to question the givens, assumptions, and sometimes uncertainties of an action. Critical thinking requires you to problem solve and work towards a solution. When planning or evaluating your CPD, you should think about the possible or actual outcomes from different perspectives including your own, your colleagues, your patients, and from a theoretical viewpoint. For added rigour, reflect on the outcomes of a CPD activity with a colleague or group of colleagues and ask them to provide constructive critical feedback. Reflective practice happens when you explore an experience you have had to identify what happened, and what your role in this experience was including your behaviour and thinking, and related emotions. This allows you to identify changes to your approach for similar future events. If reflective practice is performed comprehensively and honestly, it will lead to improved performance. Source: La Trobe University at www.latrobe.libguides.com
04 P r a c t i t i o n e r A u d i t s An essential component of the Board s CPD framework is an audit of practitioners compliance with the Boards requirements for holding an APC. An annual recertification audit enables the Board to measure compliance and thereby assuring the public and the Minister of Health that medical imaging and radiation therapy practitioners are engaging in appropriate CPD that supports their ongoing competence to practise. MRTB Guide for Recently Registered Practitioners
17 Selection of Practitioners for Audit Each year the Board selects 10% of all medical imaging and radiation therapy practitioners currently practising (that is, they hold an Annual Practising Certificate), to participate in a recertification audit. You will be notified of your selection approximately two-months prior to your recertification records having to be submitted to the Board. Practitioners may also be called for an audit in a number of other circumstances, including practitioners who (but not limited to): Were deferred from a previous audit Recently returned to practice after being away from the profession for more than three-years Were previously selected for an audit but did not respond or participate, and now wish to practise in New Zealand Were directed by the Board to participate in the audit subsequent to a competence review or a disciplinary hearing The MRTB audit is separate from any audit process undertaken by the CPD programme provider.
18 What Would be Required When you are selected for an audit you will need to forward all of your CPD records for the three-years prior the audit date. Your notification letter will specify the dates that your records need to include. You will be provided with a recertification audit declaration form that requires you to complete: 1. A signed declaration; and 2. A summary of your employment history; and 3. Confirmation of a peer review/performance appraisal within the previous 12-months In addition you will need to provide: 4. A log book listing your formally recorded CPD activities; and 5. Reflective statements; and 6. Evidential supporting documents. These last three requirements can be presented in a format of your choice, as long as the information provided is legible and logical. An unsuccessful audit may result in your next APC not being issued MRTB Guide for Recently Registered Practitioners
17 Exemption from Audits You may be exempted from a Board audit if you are currently: On maternity leave for greater than three-months; Working overseas; On long-term sick leave (i.e. more than three-months) and provide a medical certificate; Experiencing a family bereavement that results in non-practice for a period of greater than three-months. All exemption requests must be submitted by writing and will be reviewed by the Board s Recertification Committee.
05 C h a n g i n g Y o u r Scope Once you have gained the relevant qualification, and required clinical experience you may apply for registration in another scope of practice. o f Practise The Board has defined eight scopes: Medical Imaging Technologist Radiation Therapist Nuclear Medicine Technologist Magnetic Resonance Imaging Technologist Sonographer Trainee Nuclear Medicine Technologist Trainee Magnetic Resonance Imaging Technologist Trainee Sonographer The Board investigates all notifications regarding the competence, health and conduct of registered practitioners received. MRTB Guide for Recently Registered Practitioners
19 Training Scopes of Practice Suitably qualified registered health practitioners can apply for registration in a trainee scope of practice. You will be required to undertake a course of study as approved by the Board and complete a minimum number of supervised practise hours in a clinical setting. Upon completion of the relevant training programme, and meeting the requirements for demonstrating clinical competence, you are eligible to apply for registration in that scope of practice. Alternatively, if you are not registered in the profession of medical radiation technology but hold either an undergraduate degree in an appropriate health science as approved by the Board, and/or are registered with another New Zealand health registration authority, you may apply for a training scope of practice. Practitioners registered in a training scope of practice must work under supervision for the duration of their training. The Board must be advised of: the name of the clinical site where you will be working while undertaking the training programme; and the name of the registered medical radiation technologist who will supervise you throughout your training period. Your supervisor must hold a current practising certificate in the scope of practice for which you are seeking registration.
20 Clinical Hours Requirement If your qualification did not include an assessment of your clinical competence you will need to provide evidence you have completed 3360 clinical hours of practical clinical experience in the relevant scope of practice. You will also be required to undergo an Registration Examination Assessment (REA) at your own cost. Adding a Scope of Practice: After gaining your postgraduate qualification in Nuclear Medicine, Sonography, or Magnetic Resonance Imaging, and completing the required number of clinical hours, you may apply to the Board for registration in the relevant scope of practice. Remember; if your qualification did not include an assessment of your clinical competence you will need to provide evidence you have completed 3360 clinical hours of practical clinical experience in the relevant scope of practice. You will be required to undergo an Registration Examination Assessment (REA) at your own cost. You are not permitted to practise in an additional scope of practice until registration in that specific scope of practice has been approved, and an APC has been issued. However once you have completed your training you must apply for the Board to have the trainee condition removed from your APC. How to Apply for Registration in Another Scope of Practice To apply for a training scope of practice or to add another scope of practice, you must log onto My Profile and click on Add Scope button and follow the prompts. More information regarding training scopes of practice is available on the website: www.mrtboard.org.nz MRTB Guide for Recently Registered Practitioners
21 Supervision Under Section 22 (3) of the Act the Council can place a condition on a practitioner s scope of practice to ensure the competent practise of the applicant to protect the safety and well-being of the New Zealand public. 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]) The Board has a separate booklet called Working Under Supervision, this can be found on the Board s website, or requested by email: mrt@medsci.co.nz
06 F i t n e s s to P r a c t i s e, P r o f e s s i o n a l C o n d u c t and C o m p e t e n c e Professional Standards As a registered health professional you have a responsibility to notify the Board if you have any concerns about either your own or another practitioner s: Competence to practise; and/or Professional conduct; and/or A mental or physical health condition When concerns are raised about a registered health practitioner's standards of professional practise, the Board is required, under the Health Practitioners Competence Assurance Act 2003 to respond to such concerns, and at times will refer notifications to the Board s Professional Conduct Committee. MRTB Guide for Recently Registered Practitioners
23 Complaints when a health consumer has not been affected Under Section 34 of the Health Practitioners Competence Assurance Act 2003 (the Act) if you, as a registered health practitioner, have concerns that another registered health practitioner may pose a risk of harm to the public by practising below the required standard of competence, you may inform the Medical Radiation Technologists Board (the Board) in writing including the reasons on which your belief is based. Under Section 45 of the Act if you, as a registered health practitioner, believe that another registered health practitioner is unable to perform the functions required for the practice of a medical imaging and/or radiation therapy practitioner because of a mental or physical condition, you are owbliged to promptly inform the Board in writing of all the circumstances. The Board will consider all of the available information and determine the appropriate action to be taken. The three categories: competence, conduct, and health Concerns and complaints about health practitioners fall into one of three categories: Competence is the practitioner competent to practise? Health is the practitioner with a physical or mental health issue fit to practice? Conduct is the practitioner s conduct appropriate and safe? For each of these, we have a range of ways to respond, depending on the nature and seriousness of the concern or complaint. We examine each notification made under the Act, and decide whether it should be handled as a competence, conduct or health issue. Anonymous complaints The Board will not act on an anonymous complaint. The Act and the principles of natural justice require that the complainant participates in the process. Contact us if you have a concern or a complaint
24 Competency to Practise If concerns are raised about your competence as a registered medical radiation technologist, the Board is compelled to make enquiries and consider whether a review of your competence is necessary. A competence review is not disciplinary in nature. Rather, it is designed to protect the public by making an assessment in a collegial manner and to be educative with a focus on assisting you to improve your standard of practise. Competence reviews undertaken by the Board will be fair, constructive, supportive and educative. Making a Notification A notification is a formal written complaint made against a practitioner registered with the Board. The Board may review the competence of a practitioner if there is reason to believe that they have not maintained the required standard of competence, and/or there is evidence to suggest they pose a risk of harm to the public An employer must notify the Board when a practitioner has resigned or been dismissed for reasons relating to competence; Any health professional may notify the Board of a competence issue; Professional Conduct Committees appointed by the Board may also recommend a competence review. The notification is to be in writing to the Registrar and include the reasons why the person making the notification believes that the practitioner may pose a risk of harm to the public by practising below the required standard of competence. MRTB Guide for Recently Registered Practitioners
25 Professional Conduct Should the Board receive a complaint alleging that a practitioner s practise or conduct as a registered medical radiation technologist may pose a risk of harm or serious harm to the public, the Act enables the Board to appoint a professional conduct committee (PCC) to investigate that complaint, who will conduct its investigation independently to the Board. Should the Board be notified that a practitioner, having been convicted in a New Zealand Court of an offence punishable by imprisonment for a term of three-months or longer or any other offence as per section 67 of the Act, they will immediately refer them for investigation by a PCC. For example a drink driving conviction, even though it may not be imposed, can result in three-months imprisonment. A Mental or Physical Health Condition If a registered practitioner cannot make safe judgments, demonstrate acceptable levels of competence or behave appropriately in accordance with ethical, legal and practise guidelines because of a mental or physical condition, they can expect to be investigated by the Board. In determining if an investigation into a practitioner s health is appropriate, the Board s Professional Standards Committee may consider the following factors as increasing the likelihood for a health review to be undertaken: An incident directly involving the use or misuse of drugs and/or alcohol; Evidence of stress factors in the practitioner s personal and/or work environments; Evidence of physical or mental illness; Evidence of a previous mental or physical episode which adversely affected the practitioner s practise
Level 3, Panama House, 22 Panama Street, Wellington 6011 PO Box 11-905, Wellington 6142 04 801 6250 www.mrtboard.org.nz mrt@medsci.co.nz