THE IMPORTANCE OF QUALITY
Richard Siska, CNMT, NCT, NMAA
Member, NMTCB Board of Directors
What does that really mean? When we think of quality, we use descriptors such as "excellence" and "superiority." We hope for a product or service that is second to none, that is in fact, premier.
The word “quality” is featured in the Nuclear Medicine Technology Certification Boards’ mission statement and this year it is a key word for the Society of Nuclear Medicine and Molecular Imaging (SNMMI). As nuclear medicine professionals, this reminds us of our commitment to being experts in our field. This should also be ingrained and exhibited in the jobs we perform, in the care we give, and of course, in the organizations to which we associate.
Nuclear Medicine technology programs are tough programs in and of themselves. The education is immersive, fast-paced, and competitive. To effectively detect and measure these attributes there must be a process of examination with psychometrically sound methodology, which is the job the NMTCB Board was created to do.
I have been a certificant for over 15 years and now as part of the board and having participated in formulating, writing, and cut scoring not only on entry level exams but specialty and advanced level nuclear medicine examinations, I can attest to the time, care, research, and dedication that goes into crafting each exam. Every board member volunteers a great deal of time to govern and help ensure this organization is certifying quality technologists.
A reflection of the importance of the field is reflected in each certificant who passes one of those exams and you can see it manifest when he or she uses CNMT behind their name. In my mind, it is actually a very simple concept, to be good at something there must be a single focus. When there is focus on one profession, quality by virtue becomes the byproduct. Nuclear Medicine cannot just be another specialty; it must be THE specialty and the focus, and that is what drives this organization.
So be proud of your designation! The hardship that went into earning any one of the NMTCB designations that you use behind your name means you exhibit a knowledge and quality in the field of Nuclear Medicine that is second to none from the “Premier” Nuclear Medicine certifying organization.
The ABR/ABNM Proposal of 2015
& How It Could Have Affected Technologists
Earlier in 2015, the American Board of Nuclear Medicine (ABNM) and the American Board of Radiology (ABR) made a proposal to address some of the issues in Nuclear Medicine.
The proposal consisted of three parts:
1) A single training pathway that incorporates a diagnostic core curriculum with a dedicated NM curriculum, resulting in a new primary certificate in NM/DR (Nuclear Medicine/Diagnostic Radiology). The new pathway would replace the current NM residency and the current NR fellowship; 2) A new independent discipline of NM/DR would be created within the ABR, with ultimate dissolution of the ABNM. This new organization would become the re-certifying body for physicians with current ABNM and NR credentials as well as certifying future NM/DR trainees; 3) the ABR would have its single NR trustee replaced by NM/DR dedicated trustees with ABNM and/or ABR credentials to represent the new Discipline of NM/DR on the ABR’s Board of Trustees.
The main goals of the proposal were: to attract highly qualified young professionals into our specialty, provide the best education and training in the era of hybrid imaging, and support scientific and clinical advances in our specialty of Nuclear Medicine/Molecular Imaging.
However, there were many problems with the proposal:
1) The proposal includes both certification and training. However, the ABR and ABNM are certification boards, and training curricula and accreditation of training programs are done by the Residency Review Committees (RRCs), which are under the auspices of the Accreditation Council for Graduate Medical Education (ACGME). However, the ABNM does establish training requirements.
2) This proposal excludes people with backgrounds other than Radiology, such as Cardiology, Endocrinology, Neurology and Pathology.
3) The ABR never gave details of how they would support MOC for ABNM-only certified physicians, and apparently had no plans to support MOC for ABNM-only certified physicians with lifetime certification.
4) The ABR never gave details of how many Board members would be representing NM, and whether they had to be ABNM-certified or not.
5) I and many colleagues believe that with the dissolution of the ABNM, the field would be completely taken over by Radiology, which would stifle advancement in NM, as it would mean a loss of research, loss of industry support, and lack of input from other fields, such as Cardiology, Endocrinology and Neurology. It would mean that those who negotiate with government agencies, other regulators, payors and those who promote guidelines in NM would be from Radiology, not NM.
How would all of this affect the NM technologists, whether CNMT or ARRT (N)? A survey of NM technologists over the summer produced the following results: 60% did not even know about the proposal previously, and 69% of respondents did not support it. Almost half of the respondents, 48%, thought that it would affect their job, with some of the most common reasons being:
1) NMTs may need to be dual-certified or may be replaced by RTs,
2) NM procedures, especially therapies, would be stifled or become non-existent,
3) current ABR-certified Radiologists are inadequate to read NM studies.
The most astounding and concerning result of the survey was that 75% of technologists reported that they had been asked by a Radiologist to help with the interpretation of a NM study.
The dissolution of the ABNM would have meant that Nuclear Medicine would no longer have primary medical specialty status. This would be a huge disaster, as Nuclear Medicine, specifically the SNMMI, would have less authority to state that they represent the interests of NM to Congress, government regulators, and other agencies, including insurance companies. I also believe that there would have been less scientific advancement in the field of NM, due to less support from industry, less research, etc. A direct consequence to technologists is that less NM studies would be performed, and particularly, less radionuclide therapies would be performed.
Fortunately, the proposal was rejected by SNMMI and the entire NM community, and it will not be going forward. However, the SNMMI is forming a Task Force to address the important issues in NM, most of which are training issues. We hope that this approach will produce some positive results, including improving the quality of NM practice, and will ultimately help improve the job market for NM physicians.
Bennett S. Greenspan, MD, MS
Professor, Department of Radiology and Imaging
Medical College of Georgia, Augusta University
Member, NMTCB Board of Directors
Vice President-Elect, SNMMI
Congratulations to the newest group
of NMTCB(CT) technologists.
A group of 86 newly certified CT individuals may now call themselves "NMTCB(CT)" after they passed the November 20, 2015 exam.
At present there are 271 total NMTCB(CT) technologists nationwide!
For information on the NMTCB(CT) examination, please go HERE.
MEET THE NEW DIRECTORS
SARA JOHNSON, MEd, CNMT
Nuclear Medicine Program Manager
Hillsborough Community College
Sara is the Program Director of Nuclear Medicine Technology at Hillsborough Community College in Tampa, Florida, where she also serves as the college’s Radiation Safety Officer. Sara has been active in nuclear medicine for over thirteen years, gaining valuable experience in research, PET/CT, cardiac and general nuclear medicine. She has served in many roles including staff technologist, clinical instructor, clinical supervisor, clinical coordinator, instructor, and program manager. Sara is passionate about preparing future technologists for the advancements and changes the field of nuclear medicine may face.
After graduating with a Bachelor of Science degree in Nuclear Medicine Technology from Wheeling Jesuit University in 2002, Sara began her career in Nuclear Medicine at the Cleveland Clinic Foundation in Cleveland, Ohio. Sara also worked at a small community hospital in Ohio as the clinical supervisor and staff technologist before earning master’s degree in Adult Education from Muskingum University in 2010. Sara is active in the Society of Nuclear Medicine and Molecular Imaging Technologists Section (SNMMI-TS) having served on several committees, as a CE VOICE Reviewer, and most recently contributed to the latest edition of the SNMMI Curriculum Guide. She also serves on the executive council for the Florida Nuclear Medicine Technologists (FNMT) and as a site evaluator for the JRCNMT. Sara has been a speaker and moderator at the local, regional, and national level.
Outside of nuclear medicine, Sara is a proud mom and aunt to one nephew and two beautiful nieces. Her absolute favorite thing to do is spend with her son Jack. Her other hobbies include painting, bicycling, travelling, volunteering, and spending as much time outside as possible. Ms. Johnson is honored by her appointment to the NMTCB Board of Directors and is excited at the opportunity to further contribute to the field.
JAIME WARREN, CNMT
Director, Non-Invasive Cardiology
Program Dean, Norton CVT Program
Jaime is a graduate of University of Louisville with a Bachelors of Science in Nuclear Medicine and a Master of Business Administration from Aspen University. She has held several roles as a staff Nuclear Medicine Technologist, travel technologist, lead, manager, and to her current position as Director of Non-Invasive Cardiology Services for a hospital organization in Louisville, KY that includes six adult/pediatric hospital facilities and multiple outpatient centers.
In addition to her current role, Jaime is also a consultant for IAC Nuclear/PET, a speaker/Clinical Technical Consultant for Astellas, and teach high impact aerobics.
Welcome aboard, Sara and Jaime!
"What It Meant To Me"
Reflections from a Former NMTCB Director
Jennifer Prekeges, MS, CNMT
Interested individuals who wish to serve on the NMTCB Board of Directors may request an application form by emailing email@example.com.
I was privileged to serve as a director of the NMTCB from 1997 through 2005. I recall giving some deliberate thought to what areas of professional activity I would be most interested in. As a relative newcomer to the ranks of nuclear medicine educators, it seemed to me that I would gain the most by getting involved in the certifying agency in my field. In addition, I had some experience in writing practice exams, as my first teaching contract was for a registry review course.
My experience as a board member was positive from beginning to end. I was delighted to find that the directors took their responsibilities very seriously. We worked hard at semiannual board meetings, and if individuals accepted tasks to be carried out between meetings they followed through. Our biggest accomplishment during my time on the board was the development of the NCT and PET exams. I take special pride in contributing to a major advance in our field that allows technologists to demonstrate advanced knowledge and skills.
As I had hoped, I learned quite a bit by serving on the NMTCB board. A major part of the board’s work is oversight of exam quality, and that means looking at how every single item (multiple-choice question) is performing. There is considerable science behind writing and evaluating multiple-choice questions that I learned while serving as a director. Early on, I led a task analysis process, which is used to determine the procedures, equipment, and pharmaceuticals to be included on the entry-level exam, as well as ensuring that our list of tasks is up to date.
This led to some fascinating discussions about the future of the field, as well as decisions about how soon to include new technologies on the board exam. The work of the board ranges into such areas as the intricacies of computer-adaptive testing, falsification of credentials, and relations between the NMTCB and other organizations, and I found all of it interesting and informative.
The aspect of my board tenure that stays with me the most is the connections I made with other directors. Some assisted me in endeavors beyond our board service; many remain good friends. To this day, I always run into board members at the SNMMI annual meeting. Applying to become an NMTCB director led to an experience that I greatly enjoyed and that will continue to be a high point in my professional life.
EXECUTIVE DIRECTOR'S REPORT
Katie Neal, BS, MS
NMTCB Executive Director
Change is a constant in today’s rapidly evolving world of healthcare, particularly in the imaging community. But one thing remains a constant: the pursuit of quality within those areas.
The concept of quality is a common theme we see being addressed and promoted by professional societies and multiple advocacy groups. Value is another theme. These topics are increasingly intertwined, predominantly in the areas of education and credentialing. The healthcare field as a whole still struggles to define both quality and value and what the characteristics of each actually entail to the entities charged with displaying such concepts. If I were pressed to specifically define what ‘quality’ means to me, I would likely respond with an answer along the lines of “the systemic pursuit to create and achieve excellence.”
The NMTCB’s mission is to promote quality healthcare by certifying individuals through psychometrically sound examinations to practice and advance in Nuclear Medicine and Molecular Imaging. As I mentioned, change is a constant. But one constant that you can rely on is the quality and the value of the NMTCB credentials representing the areas of nuclear medicine.
The NMTCB’s long-standing tagline has been that this Board is responsible for the “Certification of Nuclear Medicine Technologists by Nuclear Medicine Technologists.” In doing so, it is the Board's belief that that by having not only a technologist, but also a previous NMT educator, as a part of our full-time staff will continue to enhance both the value and the quality of the NMTCB credentials. Therefore, I am thrilled to announce the hiring of NMTCB’s new Associate Executive Director, Mrs. Elpida Crawford, MS, CNMT.
Many of you may know Elpida from her long-term tenure as the Nuclear Medicine Technology Program Director and Clinical Rotation Coordinator at the University of Buffalo in New York. She has been involved in nuclear medicine for over three decades and brings an impressive breadth and depth of NMT knowledge and academic understanding to the Board’s substantial pool of resources. We have no doubt Elpida will be a great asset to our credentialing board and a knowledgeable voice and resource for our certified nuclear medicine technologists. Welcome aboard, Elpida!
Finally, I would like to take this opportunity to thank the NMTCB Board of Directors for all their hard work over this past year. I would like to particularly acknowledge Marcia Hess Smith, CNMT, Jimel Carpenter, CNMT, NCT, and Dr. James Patton, PhD, each of whom retired from the NMTCB Board of Directors this past year after an impressive 25 years of combined service. NMTCB is so very fortunate to have a dedicated Board of Directors who are devoted to advancing and enhancing the field of nuclear medicine.
In closing, I would like wish each of our certificants and friends in the imaging community a very happy and safe holiday season and best wishes for a wonderful new year.
We appreciate your feedback!
Since 1978, NMTCB has proudly offered certification examinations solely for the field of nuclear medicine technology- resulting in valid, high-quality professional credentials for qualified technologists. During this rapid change in healthcare procedures and policies, it is now more important than ever to keep your credentials up to date. Whether a technologist maintains a CNMT, NMTCB(CT), PET, NCT, or an NMAA credential – that particular credential is intended to be considered the “gold standard” for this profession.
Please let us know if we can be of assistance to you. We welcome your questions, suggestions, and feedback.
Feel free to email the NMTCB board at firstname.lastname@example.org.
BOARD OF DIRECTORS
Chair of the Board
Cindi Luckett-Gilbert, MHA, CNMT, PET
Angela Macci Bires, Ed.D., MPM, CNMT
Richard Siska, CNMT, NCT, NMAA
Mary Beth Farrell, CNMT, NCT
Jon Baldwin, DO
Kristina Biederstedt, CNMT
Cindy Brodnax, CNMT, NMTCB(CT)
Tina Buehner, CNMT
Ada Courtney, CNMT, PET
Misty Ehret, CNMT, PET
Fred Fahey, BS, MS, DSc
Bennett Greenspan, MD
George Hinkle, RPh, BCNP
Sara Johnson, CNMT
Michael Kroeger, CNMT, NCT, PET, NMAA
Cybil Nielsen, CNMT
Gregory G. Passmore, PhD, CNMT
Jon Shepard, MS, DABR, CNMT
Jaime Warren, CNMT
Katie Neal, BS, MS
Associate Executive Director
Elpida Crawford, MS, CNMT
Alfred L. Shellman
Certificant Services Manager
Elizabeth Rhodes, BS, MBA
Barbara T. Dixon
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