New Skills Acquisition
Sal Martino, Ed.D., Everything that can be invented has been relate directly to new skills acquisition2 :
R.T.(R), CAE, and Teresa invented. ■ The rapid evolution of smaller,
Odle, B.A., for the Health - Charles H. Duell, commissioner, faster and less-expensive technol-
Care Industry Advisory U.S. Patent Office, 1899. ogy affects R.T.s today and will
Council Task Force on New exponentially influence everyday
Clinical Skills Acquisition. Nobody today faults Mr. Duell for practice and education in the
Dr. Martino is executive vice his lack of vision at the end of the 19th future. Molecular imaging may shift
president and chief academic century. After all, he witnessed Wilhelm radiology’s role from diagnosis and
officer of the American Society Conrad Roentgen’s amazing discovery cure to detection and prevention.
of Radiologic Technologists
of the x-ray 4 years earlier. But could Dr. ■ Emerging technologies are chang-
(ASRT) and chief operating
Roentgen or Mr. Duell have envisioned ing how students receive instruc-
officer of the ASRT Education
computed tomography (CT), magnetic tion. Educators must help students
and Research Foundation.
Ms. Odle is a freelance
resonance imaging or filmless radiol- interpret concepts and become life-
writer and editor. ogy departments? For that matter, could long learners. Radiologic technol-
A complete list of the HCIAC a radiologic technologist in the 1950s ogy students are older and often in
collaborators appears at the end forecast molecular imaging or could a a second career.
of this article. radiologic technologist today picture the ■ The workplace is changing rapidly.
use of NASA and government technol- Computer skills are critical for tech-
ogy in medical imaging design?1 “The nologists, and professional growth is
only certainty is that what we see today becoming more structured.
is just the beginning,” said Wolbarst ■ Legislative, regulatory and reim-
and Hendee of Georgetown University bursement influences could restrict
Medical Center in Washington, D.C.1 radiology use and demand that
The ASRT Education and Research health care providers demonstrate
Foundation and its Health Care Industry competence.
Advisory Council (HCIAC) have taken The HCIAC Task Force on New
steps to ensure that radiologic technolo- Clinical Skills Acquisition is a subcom-
gists continue to gain the skills they need mittee that focuses on how the industry
to practice effectively in the years ahead. can work with the ASRT, educators and
employers to respond to the thrusts of
Background major change, meeting continuing needs
In May 2006, the 10-member HCIAC for radiologic technology education and
Task Force on New Clinical Skills new skills acquisition. The task force met
Acquisition finalized a white paper that in October 2005 to review the concepts
outlined best practices for improving of adult learning, revisit the FutureScan
new skills acquisition for technologists. findings and discuss challenges and bar-
Two major industry imperatives drove the riers to technologist training and skills
task force and the American Society of acquisition. From this meeting, task force
Radiologic Technologists’ (ASRT) coop- members generated a list of best practices
eration on the project. First, HCIAC has for new skills acquisition.
asked the ASRT to join the council in The best practices are based on input
responding to major advances in technol- from industry and ASRT representa-
ogy and changes in the radiology industry tives, an understanding of adult learning
to improve new skills development and perspectives and the incorporation of
education for R.T.s. In addition, trends technology for gaining new skills. Today,
outlined by FutureScan, a 3-year research the average student in a radiography pro-
project undertaken by ASRT, demonstrate gram is older than 25 years, often enters
challenges and opportunities that will the program with prior work experience
affect R.T. education and future practice. and has a degree in hand.3 Educators are
Several key findings in FutureScan aware that adults engage in the learning
RADIOLOGIC TECHNOLOGY November/December 2006, Vol. 78/No. 2 97
process differently. Brain-based learning stresses the and R.T.s to work with R.T. employers to reach a shared
effect of experience on skills retention. goal of skills acquisition. They must base this goal on
The American Society for Training and Development evidence to overcome time and cost barriers.
(ASTD) has reported that over the next 10 years, about A 2000 report showed that, despite industry efforts,
74% of today’s working Americans will require retrain- imaging department managers were not always allotting
ing and that technical skills will require updating every the time required for technologists to complete applica-
4 years. The ASTD also reports that Web-based or com- tions training programs to ensure proper operation of
puter-based training has begun to replace many in-per- newly installed equipment. In addition, 1 manufactur-
son training sessions.4 er’s internal report showed that applications specialists
Unlike other industries, health care professions and were spending 40% of their time waiting for technolo-
radiologic sciences, in particular, have changed at the gists to return to applications training after being
core. The basics of imaging have evolved from image pulled away to perform patient examinations.5
capture in x-ray tubes and processing with film and While training time often is dependent on medical
chemicals to digital acquisition and computer process- imaging and radiation therapy personnel shortages
ing. In the near future, radiologic technologists will within a facility or within the industry, other studies
have to master the core concepts of molecular imaging. have shown a waning lack of commitment in health care
The message is clear that technologists will best suc- to information technology training. In 2004, health
ceed when poised for dynamic, lifelong skills acquisi- care executives rated cost pressures as the business
tion. The HCIAC task force meeting and white paper issue that would have the most impact on health care
represent the first concentrated and collaborative effort the next 2 years.6 However, when asked about the next
to identify best practices and recommendations for new 5 years, health care executives cited increasing patient
skills acquisition. safety, reducing medical errors, adopting new technol-
ogy and improving operational efficiency as among
Best Practices and Recommendations their top 5 business issues. Appropriately educating
■ Implement knowledge and skills preassessment radiologic technologists in new clinical and applications
prior to training technologists on new technol- skills is highly relevant to each of these strategies.
ogy, followed by postassessment to demonstrate Within health care, innovative solutions are under-
training value. way to educate nurses and other health professionals in
Radiologic technologists enter a training situation spite of time constraints.7 Other industries, such as met-
with different experience levels and educational back- alworking, are developing creative solutions in partner-
grounds. As the sophistication of technology increases, ship with industry suppliers and managers to teach new
these differences become more noticeable. The learn- skills without sacrificing productivity or profitability.8
ing experience of everyone involved, and the resulting Successful alliances will require partnership from
effectiveness of a training program, can be compro- the highest management levels, as well as support from
mised when inconsistencies in backgrounds are acute. staff. Obtaining management support will require dem-
Use of preassessment may help determine core onstration of the value of R.T. education to patient safe-
knowledge and skills, leading to improved educational ty, error reduction, operational efficiency and return on
program design. Because R.T.s learn differently, pre- investment.
assessment and postassessment may help with the ■ Provide off-site learning opportunities.
design of training and education programs. The ability Continuing education opportunities could include
to assess technologists’ skills and knowledge before and self-directed learning, off-site workshops or on-site
after an educational course or application training pro- activities. Applications training traditionally has
gram can help evaluate a program’s effectiveness and been conducted on site, although some training has
value and also can be used to evaluate and document a involved travel to distant locations. New and advanced
participant’s progress. technologies may require travel to specialized learning
■ Achieve a strong commitment for R.T. skills centers. Industry leaders and management can partner
acquisition from management at the institutional to find ways to allow technologists to attend this train-
and administrative levels. ing for the most technical and complex skills acquisi-
Maintaining a continuous learning environment for tion, when necessary.
technologists will require industry leaders, educators Often, the selection of off-site training arises from
98 November/December 2006, Vol. 78/No. 2 RADIOLOGIC TECHNOLOGY
the educator’s desire to present a complete and unin- Commitment to lifelong learning and continued
terrupted program. Many industries have turned to acquisition of new skills begins with education. The
an Internet-based curriculum or other technological technologist’s initial education forms the core skills
solutions that balance a worker’s time away from the needed to grasp the concepts on which new technolo-
job with the availability of training professionals. Use of gies are based. Although this charges the educator with
distance learning and electronic solutions has increased the responsibility of continuously updating the entry-
traditional education programs and undoubtedly will level curriculum, the ASRT, industry members and
continue to increase.4,9 Managers appear to be open management at clinical sites can support their efforts.
to a combination of learning methods (Management This ensures that graduating technologists remain cur-
panel discussion notes, May 5, 2005); additionally, the rent in their knowledge base.
FutureScan report encourages flexibility.2 In the Environmental Scan of the Radiographer’s
Offering off-site learning provides the opportunity Workplace, Phase 2, radiologic technologists said that
to combine other best-practice recommendations that patient care was the most important aspect of their job.
promote innovative solutions, such as self-directed com- Remaining current on new skills is critical to quality
puter-based learning and preassessment. The employer patient care. And, 95% of technologists reported that
may support paid time off for the technologist’s learn- “feeling they’ve mastered the profession” was an impor-
ing; industry can work with senior management to pro- tant attribute for job satisfaction.12
vide instructional materials or equipment for learning. In addition, a 2002 survey found that, although ful-
Learning highly technical or clinically-based skills filling registry and state licensing requirements was the
via computer might seem idealistic, but researchers primary reason for seeking continuing education, more
recently taught nonphysician crew members aboard than 93% of technologists cited updating discipline and
the International Space Station to perform complete specialty skills and knowledge as the reason they sought
ultrasound examinations in orbit.10 Live e-learning continuing education. Nearly 90% of respondents
and Web conferencing can enable greater flexibility in also reported that “broadening my knowledge of the
scheduling and the ability for staff to come together radiologic sciences in general” was a reason for seeking
with an instructor under a model other than the tradi- further education.13
tional on-site training or a model that requires travel These findings reflect the degree of technolo-
to off-site locations. It also can enable learning closer gists’ self-motivation for lifelong learning. However,
to the moment when the radiologic technologist most the Joint Commission on Accreditation of Healthcare
needs the information, otherwise known as “ just-in- Organizations (JCAHO) places some burden on the
time learning.” health care employer. JCAHO standards include HR3,
■ Educate appropriate users and potential trainers. which states, “Processes are designed to ensure that the
Ensuring new skills acquisition means training the competency of all staff members is assessed, maintained,
appropriate users, not just a supervisor who seldom demonstrated and improved on an ongoing basis.”5
performs patient care procedures. If frequent users are ■ Develop mentoring programs.
excluded from training, it compromises training effec- The highest level of knowledge is understanding,
tiveness and eventually affects efficiency and patient care. the process where a learner moves from absorbing and
Ideally, every radiologic technologist who uses new internalizing knowledge to the point where using the
technology will receive appropriate training and com- knowledge is generally intuitive. Technology can offer
mit to lifelong learning. Until that occurs, educating a innovative methods of delivering education about new
“super user” who in turn educates others for new skills skills, but only interaction with a teacher or mentor can
acquisition can be a solution in some instances. In move these skills to promote understanding.
fact, that practice occurs today, at least on an informal Mentoring programs can help R.T.s develop a com-
basis. In an ASRT survey of technologists who perform mitment to lifelong learning. Mentoring begins in the
CT scans, 68% of respondents said they rely on radi- clinical education setting and should continue as a
ologists and other technologists to remain up-to-date structured, positive experience when a radiologic tech-
in their specialty.11 nologist enters the work force or acquires a new skill.
■ Educate entry-level technologists about the Peer-to-peer information transfer in the clinical setting
influence of technology and the importance of leads to better understanding of new technologies and
lifelong learning. techniques. The best practices in new skills acquisition
RADIOLOGIC TECHNOLOGY November/December 2006, Vol. 78/No. 2 99
for R.T.s will appropriately combine innovative technol- 2. American Society of Radiologic Technologists. FutureScan.
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3. American Society of Radiologic Technologists. Faculty
Conclusion Development Needs Assessment Survey. Part 2, Educational
Program Details. Albuquerque, NM; 2004.
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Annual Meeting, August 2002; Nashville, Tenn.
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6. Healthcare Information and Management Systems Society.
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15th annual HIMSS leadership survey. Vendors project
their goals of quality patient care and keeping current that EMR implementation and patient safety will be top
in practice. Management will see the return on invest- priorities for their clients in the next two years, while focus
ment gained from committing time and dollars to on HIPAA privacy and security requirements is expected
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Available at: www.healthmgttech.com. Accessed Dec. 1, 2005.
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by providing new skills acquisition tools to educators, ingncenter.com/man/articles/m0801mp.htm. Accessed
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Most importantly, the partners in these efforts must instrumentation aboard ISS: just-in-time training for
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New Clinical Skills Acquisition will continue a dialog
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100 November/December 2006, Vol. 78/No. 2 RADIOLOGIC TECHNOLOGY