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continuing qualification requirement (CQR)
III. THE CONCEPT OF CONTINUING EDUCATION
- Changing Concepts
1. Recognising the need for improving professional knowledge
- CE as knowledge up-gradation
1. Improving professional knowledge
C. CE as a professional requirement
1. Meeting requirements of regulating bodies
IV. RADIOGRAPHERS AND CQR
A. Additional Requirements
B. Radiographers and CE
C. Radiographers and CQR
1. Importance of Radiation protection
2. New System
D. Advantages of CQR
E. Disadvantages of CQR
American Registry of Radiologic Technologists (ARRT) certifies medical care technologists working in diagnostic and treatment procedures. In the past these technologists once certified are licensed to work without any time limitations on their license. Recently there is a shift in this policy imposing time limitations on their certifications, necessitating the technologists to be re-evaluated and recertified periodically. ARRT registered Radiologic Technologists who earned their primary and post-primary certifications after January 1, 2011 are expected to renew their certification within 10 years through a process called Continuing Qualifications Requirement (CQR). The pros and cons of this proposed legislature are discussed.
Keywords: Radiographer, Certification, ARRT, Radiologic Technologist, Qualification, Continuing education, CE, CQR.
American Registry of Radiologic Technologists (ARRT) is an official organisation that awards certificates of recognition for medical care technologists. The certificate recognizes that an individual has the necessary qualification and meets certain standards. These certificates are in patient care disciplines of medical imaging, interventional procedures, and radiation therapy. Radiologic Technologists acquire their certificates after completing certain formalities and are also registered with ARRT as Registered Technologist (R.T.). The registration is renewed annually. ARRT Certificates did not have time limitations for a long time. But now a time limitation is imposed. Primary and post-primary certifications earned on or after January 1, 2011 are time-limited to 10 years. ARRT announced in 2012 that Radiologic Technologists with primary and post-primary certifications earned on or after January 1, 2011 are required to undergo a process called Continuing Qualification Requirement (CQR). The CQR process will begin after 7th year and will be completed by the end of 10 year period. ARRT may suspend or revoke registration of the technologist if the individual does not meet the requalification requirements. This is objected to by some R.T.s.
The concept of Continuing Education
Many institutions are discarding the concept that “once certified, forever qualified”. It is especially so in the field of Radiologic Technology. A technologist working in the fields of Radiation therapy, Medical Imaging, and Interventional Procedures gets the initial certificate after completing course work, passing examinations and meeting certain criteria. Certification is recognition that the individual has the required qualification, and the person meets required standards in his profession. The certificate assures the employer of the certificate-holder that the individual has required knowledge and skill to work in patient care. In the past a technologist once certified was no more burdened with further tests, the certificate was valid for a life time. But the new concept says the certificates should be time-limited and after the expiry of the time-limit the individual should requalify. ARRT has worked out programs to refresh and to update a technologist’s knowledge in the relevant field. This process is called Continuing Education (CE). Often a time frame is specified within which this process should be completed. Technologists have to complete the process within the time-limit such that the process of requalification is completed on or before the expiry of certificate. The process is made easy for health care professionals and the focus is on updating professional knowledge in their fields. The significance of this program is higher in case of Radiographers as their work involves radioactive materials.
Practicing technologists have different opinions regarding the necessity of requalification. Some argue against imposing the requalification criteria while some may agree to it. However professional bodies like ARRT or ASRT emphasize the importance of continuing education. The reasons cited are ever advancing technologies and the need for refreshing professional knowledge. Certification is only a means to assure medical institutions that technologists working in a health care institution have necessary qualifications. The public also should be able to feel that the hospitals they visit, the healthcare professionals they consult are competent to address their problems. Job responsibilities also may increase and this may require technologists to update their professional knowledge. CE requirements are designed to provide a system wherein the technologists are guided to upgrade their knowledge and remain competent in their professional work. The new concept adopted is “once certified, always learning”.
CE as knowledge up-gradation
Continuing Education (CE) is not difficult when done for the purpose of knowledge up gradation. It is studying at leisure various technological developments. This may be done by studying literature including journal reading, attending workshops conducted by professional organizations with or without a fee, attending various seminars conducted by peer professionals, or attending courses conducted by professional bodies. On line learning tools are also available.
CE as a professional requirement
CE done for requalification purpose has definite criteria. The certifying agency makes the methodology to recertify the technologist. The certifying agency defines the requirements and makes it mandatory to follow them. This usually means acquiring credits of a specified number. This may involve studying courses in specified disciplines, attending academic classes of approved institutions, passing approved examinations. The technologist seeking recertification has to apply enclosing reports of his performance in academic and professional works.
The Radiographers and CQR
Radiographers are Radiologic Technologists in the discipline of Radiography. Radiographers certified by and registered with ARRT are designated as R.T (R) (ARRT) where R.T stands for Registered Technologist. The following discussion will use the case of Radiographers but the rules apply to all R.T.s. Radiographers have already been following a biennial CE system. The new announcement from ARRT for CQR is an additional requirement to be followed once in ten years.
Radiographers and CE
The already existing CE system requires Radiographers to get 24 credits of category A or A+ every two years. This means Radiographers have to complete certain CE activities rated as category A or A+. They include on line study of high value articles, journal reading, self-study, or attending lecture classes rated as A or A+ category. At the end of a biennial period the Radiographer has to file application for renewal of his registration for a further period of two years. In the application Radiographer has to document all his CE activities for the biennial period. The application is specified by ARRT and sent to every R.T. one month before the end of biennial period. The biennial period ends with Radiographer’s birth month.
ARRT system of biennial CE works in the following manner. Every two years the technologist has to report 24 category A or A+ CE credits. 24 credits can be earned by any one of the following two methods.
- Pass an additional ARRT approved examination. As this is single activity, it may be done by concentrating an individual’s efforts on this activity. This may earn 24 credits. The exam should be passed well before the end of biennial period.
- There are several ARRT accepted activities belonging to category A or category A+. Some of them are given here.
- Activities approved by recognized CE evaluation mechanisms like American college of Radiology. Complete list of these is available with ARRT.
- Advanced CPR certification through reputed organizations like American Heart Association. A list of these is available with ARRT. This may earn 6 credits.
- Academic courses related to the field of individual’s specialization through accredited institutions. This may earn 12 to 16 credits. Details regarding this are available with ARRT.
Radiographers and CQR
One of the most important clinical technologies is radiography. Radiography is a clinical technology that also involves storing, handling radioactive substances and radiation exposure to human beings. The adverse effects of excessive radiation exposure are well known. If radioactive substances enter human body even in minute quantities, there will be serious long term health hazards and it may even result in death. There was an incident New Delhi (India) where a radioactive substance was transported into public domain by mistake. Coblat-60 pencils were stored for a long time in an institution and were forgotten. The equipment containing radioactive Cobalt pencils was sold as scrap. It found its way into one scrap dealer’s procurements. The scrap dealer, completely unaware of the nature of his newly procured stores, handled them with bare hands. The incident resulted in death of one person and hospitalization of some scrap yard workers and raised much furor. The regulating body revoked the license of the offending institution. Hence technologists in the field of radiography may find it very important to follow the CQR program.
The new CQR system announced by ARRT has a ten year span. It is applicable only to Registered Technologists who obtained their primary or post-primary certifications on or after January 1, 2011. The process of CQR is to begin three years prior to the end of ten year dead line. That is the first batch of Radiographers wouldn’t start till 2018. The CQR has three parts. In the first part the Radiographer has to assemble his professional profile in an interactive manner with ARRT. The profile will give details of his educational qualification, achievements in his professional career, and achievements of any special skills. This should give how the technologist has maintained his competence throughout the period starting from his initial certification. This gives a complete picture of the technologist. The second is a self-assessment process designed to make the Radiographer know his weak and strong points. The self-assessment procedure is developed by ARRT. After the second part, ARRT will send a list of areas to the technologist where he has to do CE activities. In the biennial CE the individual will choose from various recommended areas. But in the CQR process the list supplied by ARRT has specific areas. These will be selected based on self-assessment report.
The CQR process is a complementary to the above described CE. The first deadline since its inception is not until 2021. The process will begin only in 2018 for the existing technologists. Not completing CQR process will lead to discontinuation of Registered Technologist’s certification and registration. ARRT justifies this saying that patient care is very important. If certification and registration are discontinued the individual has to complete CQR and get his certification and registration reinstated. The individual also has to pay a fee to ARRT. Reinstatement can be done before the end of biennium period. If not it can be done within six months after the end of biennium period. If not reinstated within these periods then the individual may have to pass a separate examination of ARRT in addition to paying a higher fee.
Advantages of CQR. The CQR is aimed at a more professional approach to ensure the Radiographers or other R.T.s will be up to date with current technologies. It will ensure the senior professionals do not fall behind the latest qualifiers. It is undeniable that technology is advancing at a rapid pace. New equipment keeps appearing at regular intervals in almost every health care discipline. Improvement in quality of work has become a necessity in the health care professions. Through CQR the technologist can demonstrate that his knowledge and skills are up to date. CQR also makes the successful participant more confident in delivering patient care and consequently it makes the technologist enjoy his work.
This will put the technologists on par with other health care professionals who are also following Continuing Education system. This will give the technologists an insight into changes that have occurred since last reporting in his discipline.
Disadvantages of CQR. Continuous education is desired by every health care technologist and is usually followed by Radiographers without the need of prompting by regulatory agencies. The Radiographers already have two of stringent CE requirements. One is the annual renewal of registration. The renewal requires the Radiographers to have followed standards of ethics and providing information on CE activities of the period of report. The second is biennial CE regime which requires Radiographers to earn 24 credits in two years. This also means every year the Radiographers are filling an application enclosing documents. Over and above these, the additional CQR regime may prove to be burdensome. Many R.T.s are feeling that the biennial CE requirements are sufficient to ensure the technologist is up to date in his professional knowledge. The expenses incurred for state licenses and ARRT registrations are felt to be a lot. And CQR may cause some additional expenses if the individual cannot meet schedules.
There Radiographers and other technologists working in medical care professions need certificates of recognition from reputed institutions. Such certificates make them eligible for employment in respected organizations. It is also easy to understand that Radiologic Technologists should have up to date professional knowledge and latest skills in patient care. Regulating bodies like ARRT are putting emphasis on accountability. They want the technologists to meet the criteria for renewal of annual registration. They also want the technologists to meet the existing requirements of the Biennial Continuing Education. In addition to these ARRT wants technologists to meet the new Continuing Qualification Requirements. This makes the regulating bodies much confidant about the accountability of health care organizations. However the practicing technologists have to spend considerable time in compiling reports, preparing and submitting applications for renewals of their certificates. Hence it is prudent to have a single effective system to achieve these goals instead of having several systems imposing the same repetitive demands.
The American Registry of Radiologic Technologists. Available at
US National Library of medicine. National Institutes of Health. Available at
Adams, Nancy S. (2012). The Radiologic Technologist, Ethnics, and Patient Advocacy.
Conference of Radiation Control Program Directors, Inc. Newsbrief. (2012). The New Normal: Best: Practices in Archiving Radiation Protection.
The American Registry of Radiologic Technologists. Available at
Accessed on June 10, 2014.
The American Registry of Radiologic Technologists. Available at
https://www.arrt.org/Registration/CQR. Accessed on June 10, 2014.