Radiation Protection Dosimetry Advance Access published March 26, 2015 Radiation Protection Dosimetry (2015), pp. 1–4
doi:10.1093/rpd/ncv070
BASIC RADIATION PROTECTION TRAINING FOR NURSES AND PARAMEDICAL PERSONNEL: BELGIAN EXPERIENCE AND FUTURE PERSPECTIVES T. Clarijs1,*, M. Coeck1, Lodewijk Van Bladel2 and An Fremout2 1 Belgian Nuclear Research Centre SCK†CEN, Boeretang 200, Mol BE-2400, Belgium 2 Federal Agency for Nuclear Control (FANC), Ravensteinstraat 36, Brussels BE-1000, Belgium *Corresponding author: [email protected]
INTRODUCTION The use of ionising radiation for medical diagnosis or treatment requires adequate understanding of relevant radiation protection issues. Although educational programmes exist in Belgium for technologists in medical imaging (radiographers and technologists in nuclear medicine) and radiotherapy, the number of qualified persons is largely insufficient to cover the need of all hospitals to work with professionals who received this kind of dedicated training. The educational programmes for technologists in medical imaging are offered as professional bachelors in medical imaging by several institutes for higher education. The current lack of qualified radiographers and technologists can be partly attributed to a legal incertitude for this profession. Although the profession of radiographer (technologist in medical imaging) exists since 1997, the Federal Public Service of Health officially started the procedure for the formal recognition of the profession only in 2014. Persons who do not have the dedicated bachelor diploma but have been employed in this function for at least 3 y can benefit from a temporary regularisation measure to become recognised. As from December 2014, only recognised technologists can be employed. Due to the lack of formally recognised radiographers and technologists in Belgium, also nurses and other paramedics have been operating radioactive sources and the equipment emitting and/or detecting ionising radiation in medical exposures. According to the Belgian regulation on radiation protection (ARBIS(1)), nurses and paramedics can operate radiation sources for medical purpose only under the supervision of a medical doctor who holds the responsibility of the medical exposure and under the condition that they have successfully followed a specific training course in radiation protection. This specific training course is
organised as a vocational training course offered by various non-academic training institutes. The Belgian regulatory authority in radiation protection (FANC) ensures the implementation of the regulation in radiation protection, including the requirements on education and training, and validates the programmes of the vocational training courses for nurses and paramedics. COURSE FORMAT AND TOPICS TREATED The format and content of this training course are defined by the Royal Decree of 20 July 2001 (ARBIS(1)). It must be of a higher education but at non-academic level, with a minimum of 50 h including at least 20 % practical work and complemented by a knowledge assessment. The topics that must be treated during the training course include the fundamentals of radiation physics, dosimetry, relevant legislation and guidance on radiation protection, quality assurance and operational radiation protection for different medical applications. Particular attention to paediatric exposure, screening programmes, and high-dose applications such as CT and interventional radiology is legally required for this training. When working in nuclear medicine or radiotherapy, a minimum of 10 additional hours of training in radiation protection, specific for these domains, is required. No further specific content for this additional training is determined in the regulation. The requirement for these nurses and paramedics to maintain their knowledge and skills by continuous professional development (CPD) is only stated in very general terms in the legislation. The ultimate goal of the initial training course is to provide the trainees with the necessary background to
# The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please email: [email protected]
Downloaded from http://rpd.oxfordjournals.org/ at Yale University on July 24, 2015
When using ionising radiation for medical diagnosis or treatment of patients, understanding of relevant radiation protection principles and issues is indispensable. In Belgium, nurses and paramedical staff are required to acquire knowledge for protecting the patient against the detrimental effects of ionising radiation by means of a vocational training course. The experience with and challenges for this training course are presented here from a lecturer’s point of view, together with a proposal for a future approach that harmonises the training content, its level and quality, according to European recommended standards.
T. CLARIJS ET AL.
adopt the right attitude and behaviour towards radiation protection of the patient and thus nurture the radiation safety culture. BELGIAN EXPERIENCE The following observations and proposals for future optimisations regarding the education and training of nurses and paramedical personnel do not focus on particular training providers, but they intend to give an overall view and reflect the experience of the authors from a lecturer’s point of view. Training providers and course content
during and after the training course. For example, in their personal work description, some nurses and paramedics question the radiation protection-related information available to patients—both the carriers and their content—the required versus obtained diagnostic image quality and its influence on the radiation dose to the patient. During the public defence of their personal work description, some individuals explain and illustrate how they start to consciously apply the fundamental rules of practical radiation protection: time, distance and shielding, and some even put their personal protective equipment to the test. Evaluation and assessment
Practical training It is clear that a theoretical basic radiation protection training course does not, in itself, warrant a safe application of ionising radiation to the patient in daily practice. A practical training needs to complement the theoretical part to allow for development of skills. As is the case with the theoretical part of the training course, the practical aspects are organised differently by the various training institutes. Some training institutes merely require the employer to certify that the student has practised a number of hours under the supervision and responsibility of a person whom the same employer judges to be competent in radiation protection. Others require a personal work description, with or without a public defence at the training institute. No hands-on training with the medical devices is explicitly required, nor does legislation require to focus on the skills to implement optimisation of the medical exposure according to the ALARA principle. Dedicated training infrastructure for practical training with radiation sources for medical exposure is scarce in Belgium, and most practical training is organised as an on-the-job training in the hospitals. Change in attitude Although there is little to no focus on the development of skills, a change in attitude is often noticed
At the end of the training course, the acquired knowledge in radiation protection of the nurses and paramedics is most often assessed by a written exam. Some training institutes only require the presentation of a personal work describing the student’s practical application of radiation protection in the work environment, whereas other training providers have these presentations evaluated by the lecturers. Operational skills such as the manipulation of the medical devices are generally not assessed. Continuous professional development The Belgian regulation requires these health professionals to maintain their knowledge and skills in radiation protection by CPD but gives no details with regard to this requirement. As a result, this obligation is fulfilled in a highly variable way: some employers organise information sessions that touch upon radiation protection in their hospital, and others send their health professionals to dedicated training initiatives organised by third parties. A rigorous periodic assessment or follow-up of the CPD is often missing. AWAY FORWARD: RECOMMENDATIONS Harmonisation of training content In February 2014, the European Commission published guidelines on radiation protection education and training of medical professionals in the European Union N8 175 of its Radiation Protection series(2). This publication consists of the results of the MEDRAPET project (ENER/D4/212-2010) and contains learning outcomes, professional entry requirements and recommendations on the CPD. The learning outcomes are formulated in terms of knowledge, skills and competences according to the European recommendations for Life Long Learning(3). The European guidelines mention general core learning outcomes in radiation protection, as well as specific learning outcomes for different health-care professions, such as physicians, radiographers and
Page 2 of 4
Downloaded from http://rpd.oxfordjournals.org/ at Yale University on July 24, 2015
The training course is currently delivered by 12 different institutes for higher education across Belgium. There is an individual responsibility for the development of the training course, and there is no formal interaction between these institutes to exchange best practices. Most of these institutes work with guest lecturers, such as medical physics experts (MPE), radiation protection experts (RPE), researchers and medical doctors. Also, because the legal description of the course content is rather vague, the guest lecturers can have the freedom to determine the content of their own course topic. This results in a great variety of theoretical training courses, with equally varying levels of quality across the country.
BASIC RADIATION PROTECTION TRAINING FOR NURSES
Evaluation and assessment A formal assessment of all acquired learning outcomes in terms of knowledge, skills and competences for all training providers could further reduce the differences that presently are perceived. These assessments could be organised at unique and national level, but this would require a central coordination. A rigorous central quality assessment is recommended if the different training providers were still to be entrusted with these assessments. The creation of a collaboration platform between the current training providers, coordinated by the regulatory authority in radiation protection, would facilitate such harmonisation of the assessments.
Continuous professional development Given the highly technological and rapidly changing environment in the medical sector, national guidelines—or even binding requirements—for the CPD should be developed for this target audience. They should consist of reminders of competences already acquired in the past and of new elements: novel techniques, new radiopharmaceuticals and equipment, and new insights in radiation-related risks. Also, the practical implementation of the new regulations and guidelines in radiation protection must be a part of the CPD. Throughout their careers, medical professionals must enhance their knowledge, skills and competences by CPD to higher levels, especially for sophisticated diagnostic and therapeutic procedures. Following the European guidelines, specifically for radiographers, the CPD must be set at an EQF level that is at least equivalent or higher than the professional entry requirements. For radiographers, this level is put at EQF 6–7, and for nurses and other health-care workers not directly involved in the use of ionising radiation, this level is put at EQF 5–6. The licensee—most often also the employer—must allocate the required time and resources for maintaining and expanding the competences in radiation protection for all involved medical professionals. Stakeholder involvement A harmonisation of the format of the Belgian radiation protection training courses for nurses and paramedics will require a long-term collaboration between the training providers, the regulatory authorities, the medical device industry, the research community and the health-care sector. An additional difficulty with regard to this stakeholder involvement resides in the complex distribution of responsibilities among the different legal actors. In Belgium, education and training fall under the responsibility of the Communities (determined essentially by their language: Dutch, French or German). The responsibility of the federal radiation protection regulatory authority is limited to setting regulatory standards for radiation protection, including education and training requirements for the professionals involved. The radiation protection regulator has no authority with regard to the organisation of the education and training itself. Finally, the general requirements for healthcare professionals and services are determined by the public health authorities, both at federal state level and at the level of the Communities towards which competences are gradually shifting. In addition to the need for a collaborative effort by the different authorities, a better collaboration between the training providers could offer better guarantees for the regular availability of training courses specifically
Page 3 of 4
Downloaded from http://rpd.oxfordjournals.org/ at Yale University on July 24, 2015
maintenance engineers. However, the target audience of nurses and paramedics who use radiation sources for medical exposure are not included in these European guidelines. In the guidelines, it is stated that for disciplines where no specific learning outcomes are provided, the core learning outcomes are regarded as sufficient. Since nurses and paramedics, by following the vocational course in radiation protection, have been allowed to operate the same equipment as radiographers and technologists and the majority of these people already working in the field will also be regularised to continue doing this work, more efforts are required for the development of their competences. Therefore, a selection of specific learning outcomes from the radiographers section addressing the appropriate use of medical devices in an effective, safe and efficient way should be included. Following the European guideline, nurses and paramedics using multimodality systems for imaging studies require the knowledge, skills and competences in radiation protection for both diagnostic radiology and nuclear medicine. The professional entry requirements are formulated according to the European Qualification Framework (EQF) levels(4). Since the target audience of nurses and paramedics who use radiation sources for medical exposure is not specifically included in these European guidelines, reference is made to the professional entry requirements for radiographers, which is set at EQF level 6. According to the EQF, level 6 corresponds with advanced knowledge, skills and competences, such as acquired at a Bachelor level. It is also possible to refer to the category nurses and other health-care workers not directly involved in the use of ionising radiation, where the professional entry requirements are set at EQF level 5 for diagnostic radiology and level 6 for interventional radiology and radiotherapy. The implementation of the proposed core learning outcomes at the appropriate EQF level by all 12 training providers in Belgium would provide a better harmonisation in the training content.
T. CLARIJS ET AL.
adapted to the needs of the different target publics and for sharing the scarcely available training infrastructure. Conclusions
REFERENCES 1. Royal Decree of 20 July 2001 laying down the general regulations on the protection of the public, the workers and the environment against the hazards of ionizing radiation. (ARBIS/RGPRI) Official Gazette 30 August 2001, available through www.jurion.fanc.fgov.be. 2. Radiation Protection 175: Guidelines on radiation protection education and training of medical professionals in the European Union. DG ENER, February 2014, available through http://ec.europa.eu/energy/nuclear/radiation_ protection. 3. European Parliament and Council. Recommendation 2008/C 111/01 on the establishment of the European Qualifications Framework for Lifelong Learning. Official Journal of the European Union 6 may 2008 (2008). 4. EC. Explaining the European Qualification’s Framework for Lifelong Learning. Office for the official publications of the European Union (2008).
Page 4 of 4
Downloaded from http://rpd.oxfordjournals.org/ at Yale University on July 24, 2015
The current vocational training format and content for nurses and paramedics who operate radiation sources for medical exposure are very heterogeneously implemented in Belgium and insufficiently focussed on the development of practical skills. Improvements are necessary towards the harmonisation and assessment of the training content, an increased focus on practical training and the formal framework of CPD. Recent European guidelines on radiation protection education and training of medical professionals provide learning outcomes, professional entry requirements and recommendations for CPD that can be used as a valuable source of inspiration and information for harmonising the training format and content for the target group(s) concerned. The creation of a collaboration platform between the current training providers, coordinated by the regulatory authority in radiation protection, could be beneficial for the setting up of Belgian guidelines and regulation on this matter, with the ultimate goal of improving radiation protection for both patients and the health-care workers themselves. The Federal Agency for Nuclear Control, competent authority for radiation protection, is actively involved in discussions on all these matters with the federal health and social security authorities,
professional and scientific organisations, amongst others through the Belgian medical imaging platform (BELMIP). A recent change in the health regulations implies that medical imaging procedures can from now on only be entrusted—by licenced medical specialists—to persons formally recognised as ‘medical imaging technologists’. However, since transitory measures allow for many persons nowadays at work in the relevant departments to continue their activities, educational efforts to increase their knowledge and in particular their skills will remain necessary for the years to come.
doi:10.1093/rpd/ncv070
BASIC RADIATION PROTECTION TRAINING FOR NURSES AND PARAMEDICAL PERSONNEL: BELGIAN EXPERIENCE AND FUTURE PERSPECTIVES T. Clarijs1,*, M. Coeck1, Lodewijk Van Bladel2 and An Fremout2 1 Belgian Nuclear Research Centre SCK†CEN, Boeretang 200, Mol BE-2400, Belgium 2 Federal Agency for Nuclear Control (FANC), Ravensteinstraat 36, Brussels BE-1000, Belgium *Corresponding author: [email protected]
INTRODUCTION The use of ionising radiation for medical diagnosis or treatment requires adequate understanding of relevant radiation protection issues. Although educational programmes exist in Belgium for technologists in medical imaging (radiographers and technologists in nuclear medicine) and radiotherapy, the number of qualified persons is largely insufficient to cover the need of all hospitals to work with professionals who received this kind of dedicated training. The educational programmes for technologists in medical imaging are offered as professional bachelors in medical imaging by several institutes for higher education. The current lack of qualified radiographers and technologists can be partly attributed to a legal incertitude for this profession. Although the profession of radiographer (technologist in medical imaging) exists since 1997, the Federal Public Service of Health officially started the procedure for the formal recognition of the profession only in 2014. Persons who do not have the dedicated bachelor diploma but have been employed in this function for at least 3 y can benefit from a temporary regularisation measure to become recognised. As from December 2014, only recognised technologists can be employed. Due to the lack of formally recognised radiographers and technologists in Belgium, also nurses and other paramedics have been operating radioactive sources and the equipment emitting and/or detecting ionising radiation in medical exposures. According to the Belgian regulation on radiation protection (ARBIS(1)), nurses and paramedics can operate radiation sources for medical purpose only under the supervision of a medical doctor who holds the responsibility of the medical exposure and under the condition that they have successfully followed a specific training course in radiation protection. This specific training course is
organised as a vocational training course offered by various non-academic training institutes. The Belgian regulatory authority in radiation protection (FANC) ensures the implementation of the regulation in radiation protection, including the requirements on education and training, and validates the programmes of the vocational training courses for nurses and paramedics. COURSE FORMAT AND TOPICS TREATED The format and content of this training course are defined by the Royal Decree of 20 July 2001 (ARBIS(1)). It must be of a higher education but at non-academic level, with a minimum of 50 h including at least 20 % practical work and complemented by a knowledge assessment. The topics that must be treated during the training course include the fundamentals of radiation physics, dosimetry, relevant legislation and guidance on radiation protection, quality assurance and operational radiation protection for different medical applications. Particular attention to paediatric exposure, screening programmes, and high-dose applications such as CT and interventional radiology is legally required for this training. When working in nuclear medicine or radiotherapy, a minimum of 10 additional hours of training in radiation protection, specific for these domains, is required. No further specific content for this additional training is determined in the regulation. The requirement for these nurses and paramedics to maintain their knowledge and skills by continuous professional development (CPD) is only stated in very general terms in the legislation. The ultimate goal of the initial training course is to provide the trainees with the necessary background to
# The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please email: [email protected]
Downloaded from http://rpd.oxfordjournals.org/ at Yale University on July 24, 2015
When using ionising radiation for medical diagnosis or treatment of patients, understanding of relevant radiation protection principles and issues is indispensable. In Belgium, nurses and paramedical staff are required to acquire knowledge for protecting the patient against the detrimental effects of ionising radiation by means of a vocational training course. The experience with and challenges for this training course are presented here from a lecturer’s point of view, together with a proposal for a future approach that harmonises the training content, its level and quality, according to European recommended standards.
T. CLARIJS ET AL.
adopt the right attitude and behaviour towards radiation protection of the patient and thus nurture the radiation safety culture. BELGIAN EXPERIENCE The following observations and proposals for future optimisations regarding the education and training of nurses and paramedical personnel do not focus on particular training providers, but they intend to give an overall view and reflect the experience of the authors from a lecturer’s point of view. Training providers and course content
during and after the training course. For example, in their personal work description, some nurses and paramedics question the radiation protection-related information available to patients—both the carriers and their content—the required versus obtained diagnostic image quality and its influence on the radiation dose to the patient. During the public defence of their personal work description, some individuals explain and illustrate how they start to consciously apply the fundamental rules of practical radiation protection: time, distance and shielding, and some even put their personal protective equipment to the test. Evaluation and assessment
Practical training It is clear that a theoretical basic radiation protection training course does not, in itself, warrant a safe application of ionising radiation to the patient in daily practice. A practical training needs to complement the theoretical part to allow for development of skills. As is the case with the theoretical part of the training course, the practical aspects are organised differently by the various training institutes. Some training institutes merely require the employer to certify that the student has practised a number of hours under the supervision and responsibility of a person whom the same employer judges to be competent in radiation protection. Others require a personal work description, with or without a public defence at the training institute. No hands-on training with the medical devices is explicitly required, nor does legislation require to focus on the skills to implement optimisation of the medical exposure according to the ALARA principle. Dedicated training infrastructure for practical training with radiation sources for medical exposure is scarce in Belgium, and most practical training is organised as an on-the-job training in the hospitals. Change in attitude Although there is little to no focus on the development of skills, a change in attitude is often noticed
At the end of the training course, the acquired knowledge in radiation protection of the nurses and paramedics is most often assessed by a written exam. Some training institutes only require the presentation of a personal work describing the student’s practical application of radiation protection in the work environment, whereas other training providers have these presentations evaluated by the lecturers. Operational skills such as the manipulation of the medical devices are generally not assessed. Continuous professional development The Belgian regulation requires these health professionals to maintain their knowledge and skills in radiation protection by CPD but gives no details with regard to this requirement. As a result, this obligation is fulfilled in a highly variable way: some employers organise information sessions that touch upon radiation protection in their hospital, and others send their health professionals to dedicated training initiatives organised by third parties. A rigorous periodic assessment or follow-up of the CPD is often missing. AWAY FORWARD: RECOMMENDATIONS Harmonisation of training content In February 2014, the European Commission published guidelines on radiation protection education and training of medical professionals in the European Union N8 175 of its Radiation Protection series(2). This publication consists of the results of the MEDRAPET project (ENER/D4/212-2010) and contains learning outcomes, professional entry requirements and recommendations on the CPD. The learning outcomes are formulated in terms of knowledge, skills and competences according to the European recommendations for Life Long Learning(3). The European guidelines mention general core learning outcomes in radiation protection, as well as specific learning outcomes for different health-care professions, such as physicians, radiographers and
Page 2 of 4
Downloaded from http://rpd.oxfordjournals.org/ at Yale University on July 24, 2015
The training course is currently delivered by 12 different institutes for higher education across Belgium. There is an individual responsibility for the development of the training course, and there is no formal interaction between these institutes to exchange best practices. Most of these institutes work with guest lecturers, such as medical physics experts (MPE), radiation protection experts (RPE), researchers and medical doctors. Also, because the legal description of the course content is rather vague, the guest lecturers can have the freedom to determine the content of their own course topic. This results in a great variety of theoretical training courses, with equally varying levels of quality across the country.
BASIC RADIATION PROTECTION TRAINING FOR NURSES
Evaluation and assessment A formal assessment of all acquired learning outcomes in terms of knowledge, skills and competences for all training providers could further reduce the differences that presently are perceived. These assessments could be organised at unique and national level, but this would require a central coordination. A rigorous central quality assessment is recommended if the different training providers were still to be entrusted with these assessments. The creation of a collaboration platform between the current training providers, coordinated by the regulatory authority in radiation protection, would facilitate such harmonisation of the assessments.
Continuous professional development Given the highly technological and rapidly changing environment in the medical sector, national guidelines—or even binding requirements—for the CPD should be developed for this target audience. They should consist of reminders of competences already acquired in the past and of new elements: novel techniques, new radiopharmaceuticals and equipment, and new insights in radiation-related risks. Also, the practical implementation of the new regulations and guidelines in radiation protection must be a part of the CPD. Throughout their careers, medical professionals must enhance their knowledge, skills and competences by CPD to higher levels, especially for sophisticated diagnostic and therapeutic procedures. Following the European guidelines, specifically for radiographers, the CPD must be set at an EQF level that is at least equivalent or higher than the professional entry requirements. For radiographers, this level is put at EQF 6–7, and for nurses and other health-care workers not directly involved in the use of ionising radiation, this level is put at EQF 5–6. The licensee—most often also the employer—must allocate the required time and resources for maintaining and expanding the competences in radiation protection for all involved medical professionals. Stakeholder involvement A harmonisation of the format of the Belgian radiation protection training courses for nurses and paramedics will require a long-term collaboration between the training providers, the regulatory authorities, the medical device industry, the research community and the health-care sector. An additional difficulty with regard to this stakeholder involvement resides in the complex distribution of responsibilities among the different legal actors. In Belgium, education and training fall under the responsibility of the Communities (determined essentially by their language: Dutch, French or German). The responsibility of the federal radiation protection regulatory authority is limited to setting regulatory standards for radiation protection, including education and training requirements for the professionals involved. The radiation protection regulator has no authority with regard to the organisation of the education and training itself. Finally, the general requirements for healthcare professionals and services are determined by the public health authorities, both at federal state level and at the level of the Communities towards which competences are gradually shifting. In addition to the need for a collaborative effort by the different authorities, a better collaboration between the training providers could offer better guarantees for the regular availability of training courses specifically
Page 3 of 4
Downloaded from http://rpd.oxfordjournals.org/ at Yale University on July 24, 2015
maintenance engineers. However, the target audience of nurses and paramedics who use radiation sources for medical exposure are not included in these European guidelines. In the guidelines, it is stated that for disciplines where no specific learning outcomes are provided, the core learning outcomes are regarded as sufficient. Since nurses and paramedics, by following the vocational course in radiation protection, have been allowed to operate the same equipment as radiographers and technologists and the majority of these people already working in the field will also be regularised to continue doing this work, more efforts are required for the development of their competences. Therefore, a selection of specific learning outcomes from the radiographers section addressing the appropriate use of medical devices in an effective, safe and efficient way should be included. Following the European guideline, nurses and paramedics using multimodality systems for imaging studies require the knowledge, skills and competences in radiation protection for both diagnostic radiology and nuclear medicine. The professional entry requirements are formulated according to the European Qualification Framework (EQF) levels(4). Since the target audience of nurses and paramedics who use radiation sources for medical exposure is not specifically included in these European guidelines, reference is made to the professional entry requirements for radiographers, which is set at EQF level 6. According to the EQF, level 6 corresponds with advanced knowledge, skills and competences, such as acquired at a Bachelor level. It is also possible to refer to the category nurses and other health-care workers not directly involved in the use of ionising radiation, where the professional entry requirements are set at EQF level 5 for diagnostic radiology and level 6 for interventional radiology and radiotherapy. The implementation of the proposed core learning outcomes at the appropriate EQF level by all 12 training providers in Belgium would provide a better harmonisation in the training content.
T. CLARIJS ET AL.
adapted to the needs of the different target publics and for sharing the scarcely available training infrastructure. Conclusions
REFERENCES 1. Royal Decree of 20 July 2001 laying down the general regulations on the protection of the public, the workers and the environment against the hazards of ionizing radiation. (ARBIS/RGPRI) Official Gazette 30 August 2001, available through www.jurion.fanc.fgov.be. 2. Radiation Protection 175: Guidelines on radiation protection education and training of medical professionals in the European Union. DG ENER, February 2014, available through http://ec.europa.eu/energy/nuclear/radiation_ protection. 3. European Parliament and Council. Recommendation 2008/C 111/01 on the establishment of the European Qualifications Framework for Lifelong Learning. Official Journal of the European Union 6 may 2008 (2008). 4. EC. Explaining the European Qualification’s Framework for Lifelong Learning. Office for the official publications of the European Union (2008).
Page 4 of 4
Downloaded from http://rpd.oxfordjournals.org/ at Yale University on July 24, 2015
The current vocational training format and content for nurses and paramedics who operate radiation sources for medical exposure are very heterogeneously implemented in Belgium and insufficiently focussed on the development of practical skills. Improvements are necessary towards the harmonisation and assessment of the training content, an increased focus on practical training and the formal framework of CPD. Recent European guidelines on radiation protection education and training of medical professionals provide learning outcomes, professional entry requirements and recommendations for CPD that can be used as a valuable source of inspiration and information for harmonising the training format and content for the target group(s) concerned. The creation of a collaboration platform between the current training providers, coordinated by the regulatory authority in radiation protection, could be beneficial for the setting up of Belgian guidelines and regulation on this matter, with the ultimate goal of improving radiation protection for both patients and the health-care workers themselves. The Federal Agency for Nuclear Control, competent authority for radiation protection, is actively involved in discussions on all these matters with the federal health and social security authorities,
professional and scientific organisations, amongst others through the Belgian medical imaging platform (BELMIP). A recent change in the health regulations implies that medical imaging procedures can from now on only be entrusted—by licenced medical specialists—to persons formally recognised as ‘medical imaging technologists’. However, since transitory measures allow for many persons nowadays at work in the relevant departments to continue their activities, educational efforts to increase their knowledge and in particular their skills will remain necessary for the years to come.
