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Final Results of the ‘European Guidelines on Medical Physics Expert' Project Carmel J. Caruana EFOMP Past-Chair, Education and Training EFOMP representative.

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Presentation on theme: "Final Results of the ‘European Guidelines on Medical Physics Expert' Project Carmel J. Caruana EFOMP Past-Chair, Education and Training EFOMP representative."— Presentation transcript:

1 Final Results of the ‘European Guidelines on Medical Physics Expert' Project Carmel J. Caruana EFOMP Past-Chair, Education and Training EFOMP representative on European Guidelines on the Medical Physics Expert, MEDRAPET and EUTEMPE-RX projects Medical Physics Department, Fac. of Health Sciences, University of Malta

2 Methodology European Qualifications Framework (EQF) Summary of results –Definition of an MPE –Mission statement of the MPE –Definitions of key activities of the MPE –Qualification framework for the MPE: Need for early specialization –Inventory of learning outcomes for the MPE –Recommendations for recognition –Staffing levels for MP and MPE What next? The EUTEMPE Project 2

3 Methodology Comprehensive debate among the members of the consortium taking into account: –European documentation (directives, qualification frameworks) –The results of a survey on the MPE in Europe –The previous EFOMP qualification framework for MPs/MPEs (Policy Statement 12, 2009) –MP/MPE qualifications frameworks in various states –Work of specific workgroups set up by the consortium –Results of a European workshop (Seville). Invitees included representatives of European national Medical Physics organizations and other stakeholders e.g., EC, IAEA, ESR, EANM, ESTRO, EFRS, WHO … 3

4 European Qualifications Framework (EQF) European Qualification Framework - European Parliament and Council 2008/C 111/01 Educational levels: levels 1 to 8, 8 is the highest level, definitions of each level Curricula: Learning outcomes to be expressed in terms of: knowledge, skills and competences (KSC). The term ‘competence’ refers to ‘responsibility and autonomy’ 4

5 Definition of EQF Level 8 Knowledge at the most advanced frontier of a field of work and at the interface between fields, the most advanced and specialised skills and techniques, including synthesis and evaluation, required to solve critical problems in research / innovation and to extend / redefine existing professional practice, demonstrate substantial authority, innovation, autonomy, professional integrity and sustained commitment to the development of new ideas or processes at the forefront of work contexts including research (EQF) 5

6 Definition of MPE Legal definition: 2013/59/Euratom: Medical physics expert means an individual or, if provided for in national legislation, a group of individuals, having the knowledge, training and experience to act or give advice on matters relating to radiation physics applied to medical exposure, whose competence in this respect is recognized by the competent authority Guideline definition: An MPE is an MP who has achieved EQF Level 8 in one or more of the following specialties of Medical Physics: –Diagnostic and Interventional Radiology –Nuclear Medicine –Radiation Oncology ‘Group of individuals’: Given the ongoing rapid advances in technology it is becoming increasingly difficult for an individual to be MPE in all three specialties. Hence individual MPEs are increasingly being replaced by groups of MPEs in different specialties of Medical Physics which together provide a full MPE service. 6

7 Mission Statement “Medical Physics Experts will contribute to maintaining and improving the quality, safety and cost-effectiveness of healthcare services through patient-oriented activities requiring expert action, involvement or advice regarding the specification, selection, acceptance testing, commissioning, quality assurance/control and optimised clinical use of medical radiological devices and regarding patient risks from associated ionising radiations including radiation protection, installation design and surveillance, and the prevention of unintended or accidental exposures; all activities will be based on current best evidence or own scientific research when the available evidence is not sufficient. The scope includes risks to volunteers in biomedical research, carers and comforters” 7

8 11 Key Activities for MPs/MPEs (derived from revised 2013/59/Euratom, survey, workshop) Scientific Problem Solving Service, Dosimetry Measurements (ionising radiation and other physical agents as appropriate) Patient Safety / Risk Management (including volunteers in biomedical research, carers, comforters and persons subjected to non-medical imaging exposures), Occupational and Public Safety / Risk Management (when there is an impact on medical exposure or own safety), Clinical Medical Device Management (particularly specification, selection, acceptance testing, commissioning and quality assurance including quality control), Clinical Involvement, Development of Service Quality and Cost-Effectiveness, Expert Consultancy, Education of Healthcare Professionals (including Medical Physics trainees), Health Technology Assessment (HTA) and Innovation. 8

9 Qualification Framework for the Medical Physics Expert (MPE) in Europe EQF Level 6 (e.g., Bachelor with ECTS) (i) EQF Level 7 (e.g., Master with ECTS) (iii) The Qualifications Framework is based on the European Qualifications Framework (EQF). In the EQF Learning Outcomes are defined in terms of Knowledge, Skills, Competences (KSC) (European Parliament and Council 2008/C 111/01) MPE: “An individual having the knowledge, training and experience to act or give advice on matters relating to radiation physics applied to medical exposure, whose competence to act is recognized by the Competent Authorities” (Recast BSS) EDUCATION 5 year CPD cycle (x) RE-CERTIFICATION By Competent Authority as MPE in Medical Physics specialty (ix) RECOGNITION EQF Level 8 in Medical Physics Specialty (vii) Structured accredited clinical training residency in the specialty of Medical Physics in which the candidate seeks clinical certification. The duration should be typically two full-time year equivalents** (vi) Clinical Certification as Medical Physicist in a given specialty (v) ADVANCED EXPERIENCE and CPD Medical Physics* or equivalent (iv) Physics or equivalent (ii) Structured accredited advanced experience and CPD in the specialty of Medical Physics in which the candidate seeks certification as MPE. The duration would be an additional minimum of two full-time year equivalents*** (viii) CLINICAL TRAINING * Should include as a minimum the educational components of the Core KSC of Medical Physics and the educational components of the KSC of the specialty of Medical Physics (i.e., Diagnostic & Interventional Radiology or Nuclear Medicine or Radiation Oncology) for which the candidate seeks clinical certification. When this element of specialization is not included it must be included in the residency. ** The EQF level of the residency is intermediate between EQF levels 7 and 8. *** In states where the MPE is required to be certified in more than one specialty of Medical Physics the number of years would need to be extended such that the MPE will achieve level 8 in each specialty.

10 KSC Inventory: Methodology We analyzed the duties of the MPE in the recast BSS Three expert groups (one in each of the three Specialties i.e., Diagnostic & Interventional radiology, Nuclear Medicine, Radiation Oncology) independently produced inventories of KSC for their respective areas. A coordinator was responsible for integrating the three inventories into a single coherent document and to ensure that the final document is in agreement with good curricular practice and the recommendations of the EQF. 10

11 11 INVENTORY of 900 KSC Most comprehensive inventory

12 KSC Specific to D&IR 12 KnowledgeSkillsCompetence Comprehensive Scientific Problem Solving Service 1.List statutory and institutional requirements for Medical Physics Services in Diagnostic and Interventional Radiology with respect to Comprehensive Physics Problem Solving Service. 2.List the common imaging modalities (projection x-ray imaging, fluoroscopy, CT, CBCT, MRI, ultrasound) and explain their function as instruments for the measurement, mapping and imaging of the spatial distribution of different physical variables within the human body. 3.Discuss the advantages and disadvantages of imaging as a means of displaying spatially dependent signals and variables. 4.Explain in detail the principles of image quality measurement: linear systems theory, types of contrast (subject, image and display), unsharpness (LSR, PSF, LSF, MTF), lag, noise (including sources, noise power spectra, effect of lag on noise, noise propagation in image subtraction), SNR …. 5.Explain inverse problem mathematical techniques used in image reconstruction…. 1.For each modality, operate imaging devices at the level necessary for giving advice on optimization of imaging protocols, quality control, image quality manipulation, and carry out research when the available evidence for advice is not sufficient. 2.For each modality predict the effect on image quality and diagnostic accuracy when changing scanning and reconstruction parameters. 3.Manipulate acquisition parameters for all forms of projection x-ray imaging devices (e.g., kV, filtration, mAs, sensitivity (‘speed’), collimation, magnification, SID, SSD, frame rate, screening time, manual/AED modes, compression), explain the effect on image quality and relevant patient dose quantities … 1.Take responsibility for statutory and institutional requirements for Medical Physics Services in Diagnostic and Interventional Radiology with respect to Comprehensive Physics Problem Solving Service. 2.Carry out or supervise as appropriate the measurement of physical quantities relevant to the effective, safe and economical use of medical devices / ionising radiations (includ. other physical agents as approp.) in Diagnostic and Interventional Radiology…

13 Recommendations on Recognition of MPE Each Member State should consider designating, through a legal instrument, a Competent Authority specifically for the recognition of the MPE. Recognition should be achieved by registration. It is highly recommended that a professional register should be kept by an official authority (e.g. Ministry of Health or Radiation Protection Authority). This task could also be delegated to a professional body such as professional medical physics societies if an official mandate is given. The Competent Authority designated for the recognition of the MPE, should use the Qualifications Framework and KSC of the MPE specified in the present document, for the recognition of the MPE to Level 8 of the EQF. The educational establishments of each Member State involved in medical physics education and training should use the KSCs of the present guidelines. To allow the mobility of the MPE between Member States, it is recommended that the education and training of each MPE be recorded in a document that can be used as proof of the recognised competence. MPE education and training requires formal steps that should be implemented by the competent authorities as recommended in the Qualification and Curriculum Frameworks to be found in this document. It is highly recommended that MPE recognition should be overseen by a joint board of experts from the various stakeholders (i.e. Ministry of Education, Ministry of Health, Radiation Protection Authorities and Professional Societies, as appropriate). 13

14 Staffing Levels To ensure adequate protection of the patient it is essential to have the appropriate number of MPEs and supporting staff Need a certain number of Whole Time Equivalents (WTE) of medical physicists (MPS) out of which a certain number are MPE The number of MPS and MPE required will depend upon the number and type of equipment and their complexity together with the amount of patient activity Minimum number of MPS and MPE required Calculation of number of MPS/MPE based on factors depending on: –Type of devices –Number of patients –Type of services –Other activities e.g., research Excel worksheet for automatic calculation 14

15 Equipment Factors 15

16 What Next? EUTEMPE-RX 16 We urgently need an agreed programme of education and training that would lead an MP to MPE in each specialty as specified in the ‘Guidelines on the MPE’ document and to level 8 of the EQF. EUTEMPE-RX (EUropean Training and Education for Medical Physics Experts - Diagnostic and Interventional Radiology) - new EC funded project is setting up such a programme for MPEs in D&IR (to be followed by others in NM and RO) First Module: Development of the profession and the challenges for the MPE (D&IR) in Europe. Prague 9 – 13 February 2015

17 17 Module MPE01: Development of the profession and the challenges for the MPE (D&IR) in Europe Aims: This module aims to help the future MPE (Diagnostic and Interventional Radiology) acquire the knowledge, skills and competences necessary to exercise a leadership role within the profession in his own country and in Europe. The content of the module would address the development of the role of the MPE in D&IR in its entirety and would inform and provide a framework for discussions for all the other modules. In the face-to-face phase participants will have the opportunity to discuss the major issues directly with the present European leaders of the profession. The participants would also be updated with the latest EU directives, guidelines and activities impacting the role to ensure they are at the forefront of these developments. Learning Outcomes: MPE01.01Take responsibility for researching, evaluating, leading, and offering vision for the professional development of the role of the MPE (D&IR,) in the ambit of European and national legislation and a holistic vision of healthcare. MPE01.02Implement and evaluate strategic solutions to the challenges facing the MPE (D&IR) in own country and Europe. MPE01.03Evaluate the various models of management suitable for a Medical Physics Service including the issue of staffing levels. MPE01.04Take responsibility for researching, evaluating, leading, and offering vision for the development of the role of the MPE (D&IR) in advancing service quality and clinical governance in D&IR. MPE01.05Take responsibility for ethical issues in the area of radiation protection in D&IR and apply them in practice. MPE01.06Discuss the role of the MPE (D&IR) in health technology assessment (HTA), innovation and expert consultancy. MPE01.07Research, develop and lead the development of the role of the MPE (D&IR) in the education and training of medical physics trainees and other healthcare professionals. MPE01.08Manage inter-professional issues in D&IR. MPE01.09Manage priorities regarding radiation protection research and medical physics input to clinical research projects needing the support of MPEs. MPE01.10Implement safety culture in their management practice. MPE01.11Participate in networks for research and development at the European level. MPE01.12Take responsibility for the role of the MPE (D&IR) in accidental and unintended medical exposures in D&IR and radiation accidents. MPE01.13Interpret the significance of liaising with the Radiation Protection Expert Date and Location of Face-to-Face Component: Prague 9 – 13 February 2015

18 References 18Carmel J. Caruana, Medical Physics, Faculty of HealthSciences, University of Malta European Commission RP174 European Guidelines on the Medical Physics Expert doc/publication/174.pdf Phys Med Sep;30(6): European Federation of Organisations for Medical Physics (EFOMP) Policy Statement 12.1: Recommendations on Medical Physics Education and Training in Europe Caruana CJ, Christofides S, Hartmann GH

19 Thank you for your attention! 19 I would love him more if he’s an MPE of course!


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