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Pathways to Education and Advancement in Medical Imaging

By Matt Skoufalos

In health care, just as in any industry, the skills that make a great clinical or technical professional aren’t always the ones that make a great leader. Despite the rigors of continuing education, and the breadth of opportunities that exist for advancement, determining a clear path forward to a management role isn’t always easy, particularly in the field of medical imaging.

Nicole Dhanraj, Ph.D., SHRM-SCP, GPHR, PMP, CPPS, CRA, R.T (R)(CT)(MR), radiology systems director for Northern Arizona Healthcare of Flagstaff, Arizona, said that imaging leaders can distinguish themselves from their peers by seeking opportunities to build skills that supplement, but are not necessarily established in, the medical field. These supplemental skills are crucial because, despite coming into a work assignment with strong, job-related skills, the modality-specific curricula that create a valuable clinician or technologist don’t always hone the expertise necessary for that same employee to thrive in a director-level position.

“In that space, as a leader, how do you make yourself stand out to others around you?” Dhanraj said. “It’s important that we gain industry-specific credentials but even more important that we look outside of our industry for credentials that help amplify our skills, knowledge, and abilities, to support being an effective leader.”

A variety of low- or no-cost options exist for acquiring some of the fundamentals in these areas of specialization, from informal, YouTube-hosted how-to videos to credentialed services like Coursera and edX, which host web-based classes and certificate and degree programs from hundreds of universities and private companies.

“You can start out and just fill your bucket of knowledge with things you don’t know, and then you can go to community colleges for foundational classes in other core subjects such as finance, or human resource management,” Dhanraj said. “There’s a lot you can get from these organizations. These pathways offer multiple perspectives of the business operation.”

For those just starting out in the medical imaging field, or seeking out continuing education opportunities to satisfy their annual learning requirements, a number of formalized training programs exist outside of tackling a higher-education degree.

The Medical Technology Management Institute (MTMI) offers a spectrum of medical-imaging-modality-based certification programs — for radiography, mammography, computed tomography (CT), magnetic resonance imaging (MRI) ultrasound, radiation therapy, nuclear medicine, dosimetry, fluoroscopy, bone density, PACS, interventional radiology, and vascular imaging.

These meet standards established by professional organizations such as the American Society of Radiologic Technologists (ASRT), the Society of MR Radiographers and Technologists (SMRT), the Commission on Accreditation of Medical Physics Education Programs (CAMPEP), and the Accreditation Council for Continuing Medical Education (ACCME).

The Certified Radiology Administrator (CRA) credential is the only one created specifically for radiology administrators; it highlights skills that span human resources, asset resources, finance, operations, and communication. It is managed by the self-governing Radiology Administration Certification Commission (RACC).

The Institute for Healthcare Improvement (IHI) offers a Certified Professional in Patient Safety (CPPS) credential, which educates health care professionals in patient safety culture​, leadership, risks and solutions, performance measurement and improvement, and human factors.

For those whose assignments will require more specialization in areas of human resources, The Society for Human Resource Management (SHRM) offers the SHRM-CP or SHRM-SCP certificates; the former is designed for those working in day-to-day HR functions, whereas the SCP certification is meant for senior-level HR professionals who work more in strategic roles.

The Human Resources Certification Institute (HRCI) also offers comparable certifications across eight other specific human resources assignments. Many radiology leaders are engaged in daily HR functions, and having this in-depth knowledge is beneficial to leading imaging teams.

The Project Management Institute (PMI) Project Management Professional (PMP) certification can help an imaging leader learn various styles of leading task-oriented teams, reinforcing the technical standards of successful project management, and connecting those project goals to a larger, organizational strategy.

“For a leader, there’s a lot of formalized training,” Dhanraj said. “You can go to school, you can get your degree, then you have all of these governing bodies that would support credentials for any leader.

“But a lot of people are stagnated with their education and they think, ‘that’s all we can get,’” she said. “To really amplify our knowledge, skills, and abilities with these general leadership credentials, joining professional associations and finding a mentor is critical. This way you have support navigating your operation, especially when challenges arise”

For those already in a leadership role, developing a fundamental understanding of skills more commonly taught in business school should be a priority, Dhanraj said. Disciplines including psychology, human resources, employment law, finance, and project management, are among them; more advanced skills including expertise in cultural intelligence, change management, and emotional intelligence, are especially valuable to any member of an organization tasked with a supervisory role, Dhanraj said.

“Leading people who are motivated is easy,” she said, “but how do you lead those employees who can be challenging? Effective communication relies on things like body language, human behavior, understanding underlying motivations, and cultural competency. We have such a diverse staff that it comes down to knowing what people want, how are they motivated, what their values are, and how they want to be led.”

For those whose medical careers began with military service, several free or low-cost resources exist to help them get started, including programs like Credentialing Opportunities On-Line (COOL) for each of the armed services divisions, and funding for four-year institutions provided through the GI Bill from the U.S. Department of Veterans Affairs.

When selecting an institution from which to pursue a degree or certificate, Dhanraj urges students to consider the accreditation itself as well as the university from which it’s attained.

“Employers do want the cream of the crop, but, to a great extent, aren’t necessarily expecting a person from Harvard or the like,” she said. “Employers want to ensure you have a terminal degree. Candidates should do their due diligence and ensure that their university is accredited, especially if they’re looking to transfer credits.

“I’m of the belief that higher cost does not necessarily mean higher quality,” Dhanraj continued. “We should be asking ourselves, What is my return on investment? How am I going to leverage this degree? If I get five different certifications, and I spent $10,000, am I expecting to get this $10,000 back in salary? Am I getting monetary return, or making sure that I’m really stellar at my job, or that I have the competitive edge as compared to my peers? In some cases, there may be more intangible benefits from our educational investment.”

Dhanraj also points out that completing a certificate program or even an advanced degree program isn’t necessarily a guarantee of higher earnings or an administrative title. Some believe they can earn a high-level position on the strength of their formal education alone, but they need to understand that’s not always the case, she said.

“Employers want leaders to have some sort of experience in the job requirements,” Dhanraj said. “Employers want to see a balance of knowledge and experience in their leaders, and those with the scholastic knowledge do not always have commensurate field experience to justify a directorship appointment.”

Retired U.S. Army Radiologic Technologist John J. Beall, now a strategic planner with the Veterans Health Administration in Washington, D.C., said it’s also important for medical imaging leaders to identify soft skills — those rooted in communication, personality, mindset, character, and emotion — in professional development, and learn how to leverage those to advance their careers while uplifting the staff who work with them.

“Until a leader truly becomes self-aware, I think this is one of the hardest things for them to manage,” Beall said. “Ensuring that your soft skill toolbox includes learning how to read body language and how to truly listen is paramount to be a successful leader.”

Like Dhanraj, Beall recommends that prospective leaders educate themselves on change management, a formalized approach to handling big changes in the workplace. Whether those changes are based in technological implementations, such as migrating from paper to digital health records, or portable imaging studies, for example, leaders “need to be the champions” of those changes, and demonstrate their engagement with the process, Beall said.

“Otherwise, the buy-in and successful implementation will drag on, and kill the morale, which then lowers the level of service as well as engagement scores,” he said.

Beall also notes that a commitment to continuing education is paramount to the longevity of any career, particularly one in health care.

“A successful leader is one that is always learning, whether it is academically or in a self-help setting,” Beall said. “I feel that I have learned more in the latter part of my career than I did in the beginning. I attribute that to the fact that a lot of my early career learning came via the fire-hose methodology instead of an as-needed basis.”

Beall believes that the ego he embodied and strong opinions he once held as a younger person “probably had a part to play” in those circumstances, as much as he is certain that strong, healthy relationships “helped me get through the tough spots.”

Kimlyn N. Queen-Weis shares Beall’s perspective that health care leadership comprises “true believers in continuous learning.” Queen-Weis is the operations director of both patient logistics services and virtual health/telehealth services for OhioHealth in Ohio. She is also a board member of the Association for Medical Imaging Management (AHRA), as well as the current president-elect of the organization.

“I believe that leaders are always learning, no matter what, whether it’s through informal channels or formal education,” she said. “The neat thing about imaging is that you get the opportunity to be exposed to multiple different modalities, which helps make you a well-rounded technologist.”

“Along with learning about the technical aspects of imaging, the hands on patient care and customer experience aspect; you also get to develop some early leadership skills, working with new students, and precepting new technologists as you advance in your role as technologists,” Queen-Weis said. “For people coming up, that’s how you start to gain some informal leadership.”

Those educational settings can appear quite informal, indeed: Queen-Weis said her own imaging career began just after high school, when she entered a two-year radiology program housed in the basement of the hospital in which she was working, back in 1990.

When she wanted to advance from a certified technologist to an undergraduate degree, Queen-Weis opted for a business administration track, which helped her to prepare for a management role and, subsequently, the CRA exam. That credential helped her continue moving forward as a director, a position from which she pursued (and earned) a master’s degree in finance, and a second master’s degree in business administration.

“I’ve always paired my formal education with informal education outside of the classroom as well, searching for opportunities to attend seminars and conferences,” Queen-Weis said. “Whether it was a leadership conference, or some kind of training provided at work, my career continued to advance throughout the years to different roles in imaging and health care leadership.”

Despite having attained an undergraduate degree and two graduate degrees, Queen-Weis must still pursue continuing education credits to maintain her certifications as a technologist. Including annual or local area AHRA meetings, or other, work-related conferences, there are various opportunities for medical imaging professionals to attain their technical and leadership specific continuing education credits on an annual basis. She urges those working in the field to keep an eye on the deadlines by which those credentials must be earned, and to adhere to them.

“I think what happens a lot of times is everyone’s really busy, and it sneaks up on people, and then they find themselves having to hurry, or falling short of the requirements,” she said. “Knowing what you have to have every year, and knowing your deadlines and all the ways to obtain your continuing education units (CEUs) is important.”

When selecting a CEU module, Queen-Weis urges professionals to try to match available offerings with skills they might be personally seeking to enhance their individual leadership development goals.

“What am I focused on right now as it relates to my team or something I may be working on as a special project?” she asked. “What’s going to help me, help my team, my organization, my personal growth and development; or, what do I need to know that might be going on in the industry? Those are the kinds of things that I look for when I consider a meeting, a program, an educational focus.”

Just as important as attaining that coursework individually is creating a bridge connecting those with the ability to demonstrate the skills in question to those seeking their knowledge. In the workplace, Queen-Weis urges pairing new leaders with seasoned leaders in a variety of settings, especially when welcoming new graduates into the workforce.

“You don’t just have all the skills when you walk out with your master’s degree,” she said. “We’ve all said the wrong thing because we weren’t prepared or no one showed us how. I think mentorship and fellowship, are great ways to bring up new leaders that have those soft skills.”

“I’m also a firm believer in hands-on learning,” Queen-Weis said. “As someone who’s been in leadership for a long time, one of the things that’s been beneficial to me is to have a coach, and I am also an executive coach for our organization. I offer that to people who are looking to grow and develop.”

“The world of Imaging is fast-paced and constantly changing, which I know a lot of leaders enjoy,” she said. “It has a lot of different paths that a person can go down, depending upon what type of leadership role they want or what career path they choose to follow. You can be a leader in a lot of different realms within imaging, whether you want to be in education, operations, on the vendor side, in sales or applications; there’s a lot of different opportunities to embrace.”



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