Transcript DIPLOMA IN X-RAY PATTERN RECOGNITION CURRICULUM

Radiographer’s Role-Extension
& Lessons for Healthcare
Engineering
Dr. Michael Kawooya, Associate
Professor of Radiology, Makerere
University, Kampala Uganda /
Director ECUREI, Kampala, a Fontys
University & Thomas Jefferson affiliate
imaging training institute. www.ecurei.com
Sam Byamukama, Biomedical Engineer,
Program Coordinator, Diploma in
Biomedical Engineering, ECUREI
OBJECTIVES 1
To illustrate how the radiographer can
extend the role of the radiologists in areas
where there is no radiologist
 Do draw the parallel of the radiographer
role extender and the ECUREI trained
biomedical technician
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RASCO 2008 MOMBASA
OBJECTIVES 2
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To illustrate how the ECUREI trained
biomedical technician can extend the role of
the engineer ( from equipment planning to
disposal) in the areas where there is no
engineer
RASCO 2008 MOMBASA
Role extension
“Taking on new non-traditional necessary
roles, entailing re-evaluation, restructuring,
retraining & redeployment”
ECUREI a case study for an
institution training for role extension
Is institute credible?
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Established in 2002
Registered by MOE
Located in Mengo
Hospital
Affiliated to 2
Universities: Thomas
Jefferson University
(USA) and Fontys
University of Applied
Sciences (Netherlands)
Signing of ECUREI-Fontys
University affiliation
Thomas Jefferson plaque
RASCO 2008 MOMBASA
Ratio of radiologist to population in
African countries
Country
Radiologist to population
USA, Europe, Canada
Approx 1: 50,000
South Africa
1:100,000
Kenya
1:400,000
Uganda
1:1,000,000
Tanzania
1:1,500,000
Up to 14 African countries have no radiologist. Most have less than 30 radiologists.
Workload per radiologist per year
Exam per
Exam per year for
Working days per
radiologist per yr
academic rad.
year
USA
12,000
10,000
220-250
UK
18,000
New
Zealand
15,000
7,500
S. Africa
12,500
7,500
Uganda
19,600
19,600
Country
220-250
220-250
280-300
Radiologists in less developed countries work longer hours, face challenges
Of constant machine breakdowns, low supply of consumables, poor infrastructure
Complex disease conditions.
Other facts
Most health professionals are in major cities
 Over 80% of our population is in rural areas
 Highly qualified professionals don't want to
work in rural areas
 Need to train a carder of people who can
serve the majority of our population
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RASCO 2008 MOMBASA
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Global health goals cannot be met unless
key health needs facing the majority of the
world’s population are addressed (HighLevel-Forum-For-MDGs, 2004)
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For the majority of developing countries,
human resource shortage is the limiting
factor to attaining the millennium
development goals (WHO, The World
Health Report , 2000), (WHO, The World
Health Report, 2006).
RASCO 2008 MOMBASA
Fifty six percent of patients requiring
imaging services in urban areas are imaged
compared to 10-13 % in rural .
 Currently, up to 90 % of people living in
rural Uganda who would benefit from
ultrasound are not scanned
 It is estimated that 90% of the plain x-ray
films from rural areas carry no imaging
report.
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RASCO 2008 MOMBASA
Who is taught?
Diploma in Radiography holders can
apply for BMI, BU, DDU, Dip Pattern
recognition
 Bachelors Degree in radiography can apply
for MMI, MMU, DDU, DIP Pattern
recognition
 Entrants from high school undertake 3-4
years courses
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First intake in BMI & BDU
First intake of MMI & MU
Who teaches?
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Total staffing of 25, with fulltime staff of 7
» Radiologists
» Radiographers
» Sonographers
» Sonologists
» Others
What is taught for role extension
radiographers?
DDU Ordinary and Higher Diploma in
Diagnostic Ultrasound
 Diploma in X-ray Pattern Recognition
 BMI Bachelors in Medical Imaging
 BDU, Bachelors in Diagnostic Ultrasound
 MMI, Masters in Medical Imaging
Technology
 MMU Masters in Diagnostic Ultrasound
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To what depth should the role
extension radiographer be trained?
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In the absence of a radiologist, especially in a
peripheral health unit, the referring doctor will
greatly value a comprehensive and detailed and
conclusive report, and not just a description of
shadows and patterns.
The role extension radiographer should be trained
to fit this purpose
Training for new tasks like CT,MRI, management,
informatics requires the same degree of
thoroughness
What methods are used? Student
centered learning
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The center has together with its affiliates successfully
developed & implemented the new concept of “Student
Centered learning” away from the traditional methods of
teaching
All bachelors degrees are use Problem Based Learning
In addition to lectures and guided hands-on sessions, the
student learns by himself/herself using teaching video
tapes, DVD, CD, internet, books, journals and hands-on
skills lab. Students share knowledge in discussion groups.
Center equipped with library and computer lab
Center equipped with a “skills lab” with US machines for
students to learn by scanning each other
GROUP DISCUSSION ARE IDEAL
ACQUIRING NEW INFORMATION
REQUIRED FOR THE NEW ROLES
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SKILLS LAB TRAINING
A lecture sessions
Group discussion (student centered)
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Training in the skills Lab
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THE LIBRARY
•STUDENT’S DISCUSSIONS
•SELF DIRECTED LEARNING SESSIONS BEING HELD IN A
WELL EQUIPED COMPUTERISED LAB
X-RAY PATTERN RECOGNITION
CLASS SDL SESSION
ULTRASOUND IS ANOTHER
IMPORTANT NEW ROLE
U/S HANDS-ON SESSION AT ECUREI
E-Learning programmes
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An E-learning Diploma programme in
Pattern Recognition has been developed
jointly with Fontys University and there are
several students now enrolled in the
programme
Is the role extension graduate fit for
purpose?
Internship at the work-place
 Informal feedback from the radiologists,
clinicians and hospital/clinic
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Successes
350 sonographers (some are radiographers
who have been trained to role extend in
ultrasound)
 21 pattern recognition (radiographers
trained with an additional post basic
diploma in pattern recognition)
 20 radiographers with Diploma in
radiography
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RASCO 2008 MOMBASA
TRAINING TO A
DIPLOMA/DEGREE LEVEL IN
THE NEW ROLES
ALTHOUGH TRAINING FOR NEW ROLES IS
INTENSIVE AND DEMANDING, IT IS NOT
AN IMPOSSIBLE TASK
Challenges in role extension at the
work place
Acceptance by radiologists and other
clinical staff
 Deployment, promotion
 Job description
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Conclusion
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Taking up the new function of role
extension will require:
» Reevaluate/research: Are we meeting needs
efficiently?
» Restructure/reorganize: Policies, standards,
guidelines, protocols defining the new roles : carreer
development .
» Re-advocate
» Retrain for new roles
» Redeploy
» Reevaluate
» Reintroduce and reassure quality in training and at
work place
Briefly about the Inception of
ECUREI’s DBE Program
By Sam Byamukama
Why introduce Diploma in
Biomedical Engineering (DBE)
The constant feedback from role-extension
graduates on how the lack of technical
support with their equipment has affected
their work
 The absence of any formal training in
biomedical engineering in Uganda
 Hence the efforts by ECUREI to focus on
developing capacity in this area.
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Range of subjects covered in
DBE across 3yrs
Medical Ethics
 Human Anatomy & Physiology
 Computer & Health Informatics
 Engineering Drawing
 Engineering Math
 Electronics / Electrical Engineering Science
 Medical Devices & Instrumentation
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Range of subjects covered in
DBE across 3 yrs cont’n
Imaging Devices & Instrumentation
 Entrepreneurship & Management Skills
 Asset Management
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How the Role-Extension Concept
in DBE
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Unlike the traditional diplomas for
technician training, besides repair and
maintenance ECUREI lays emphasis
on managing the entire life-cycle
of medical equipment
Phases of a typical life cycle of
medical equipment
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planning
acquisition (or procurement)
delivery, incoming inspection
inventory and documentation
installation, commissioning and acceptance
training of users
monitoring of use and performance
maintenance
replacement and disposal
Clearly MAINTENANCE is just
one element to be managed.
Proper management of each of
the other elements in the lifecycle
has an impact on the maintenance
function
ECUREI’s challenges in pioneering
biomedical engineering training
MAIN CHALLENGE: The capitalintensive nature of the training vis-a-vis
affordability of the course to parents/
students
 Demo equipment, tools and test equipment
 Shortage of tutors
 Lack of official recognition of the
biomedical engineering profession in the
public service structure
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THANK YOU
www.ecurei.com