TechNation recently invited several industry leaders to comment and share insights regarding education and training in the healthcare technology management and/or biomedical realm. Participating in the roundtable discussion are Injector Support and Service (ISS) Director of Procurement and Training Bruce Clarke, College of Biomedical Equipment Technology (CBET) President Dr. Richard L. “Monty” Gonzales, Innovatus Imaging Clinical, Technical and Commercial Specialist Ted Lucidi, Maull Biomedical Training LLC President Steve Maull, Probo Medical Senior Territory Manager Hobie Sears, Elite Biomedical Solutions CBET/Service Specialist Jake Walters and ReNew Biomedical Instructor and Field Service Tech Richard Woods.
Q: What are the most important things to look for when seeking training?
Clarke: Beyond the obvious of applicability of the training to the career path of the attendee, I would say presentation type. Is the training a straight lecture (snore)? Does the training include any dialogue between the presenter and other attendees? Are there any hands-on aspects to the training? The training presented by Injector Support and Service integrates the concept by Confucius of “Tell me, and I will forget. Show me, and I may remember. Involve me and I will understand.” into our training sessions. By implementing both the “show me” and “involve me” precepts into our training sessions, the attendees are far better prepared to work on injectors than those that sit in an audience, slipping in and out of lecture coma as the speaker rambles on and on.
Gonzales: Technicians seeking advanced education and training should carefully consider career objectives and return on investment. Purposely aligning one’s career path, education and training is an important first step. Considering the source of the training is also important – accreditation, flexibility, alignment with the industry, costs and outcomes are important factors. Today’s students should expect a partner in education that is willing to work as hard as they are to reach their academic and professional goals.
Lucidi: As we look at the right to repair movement, facilities need the right types of training as well as the proper tools to effectively service today’s complex medical devices. Two important criteria are overall cost and value to the organization. A successful strategy would have service training be negotiated into the purchase cost of any capital equipment. The purchase cost is only a fraction of the total cost of ownership across a device’s lifecycle. An individual who has attended an OEM training course should also have access to tools, such as diagnostics, similar to those used by the factory service reps. The cost of tools, such as diagnostics, is another factor that should be integral to the negotiations. If the responsibility of supporting a medical device will fall upon the HTM department, then the HTM staff needs support from the C-suite to effectively control costs though quality training initiatives.
Maull: The primary thing you need to ask yourself is “Will this training save us money?” When the training is finished, will my BMET be able to perform the tasks needed to take over the maintenance of the piece of equipment they are getting trained on? Or, is this just an overview course. Overview courses are fine, but you need to manage your expectations if you’re sending BMETs to an intro course or overview course. Also, you want to know something about the training company. How long have they been in business? Who is the instructor? Are they a professional instructor, truly an expert in the field or just some former BMET who knows how to do a task and he’s offering to show you how to do it. There’s a big difference between the two.
Sears: First, it’s important to ensure the instructor and company providing the training have the competency to educate on that subject. At Probo Medical, we use several of our experienced senior territory managers to provide our training. They each bring current field knowledge and experiences into the classroom, augmenting the normal course theory and hands-on time. Second, you need to be sure there is enough equipment to provide adequate access during lab/hands-on time. I have heard some sad stories over the years about folks who got little-to-no physical time on the unit being taught. Third, you should consider having a conversation with the instructor before signing up for the class. Even from a conversation, you’ll know if they’re a good trainer for you. It’s OK to be picky about finding the right instructor.
Walters: In my opinion, one of the more important things to consider is the technical knowledge of the facility that is providing the training. If leading a clinical engineering department, I would want to be sure that the technicians I sent to training would come back knowing considerably more than when they left. Another important thing to consider is if the training benefits your department/facility as a whole. One of the main goals of training (other than the personal development of the technician) should be to help the department run more efficiently.
Woods: Training is vital to career success and job performance. OEM instruction can influence your skill set, making you more credible and reliable among peers in your industry. It is important to consider the quality of training and whether it is valuable instruction to advance your performance or improve your field expertise. Pay close attention to what types of equipment PMs and repairs are most profitable for your organization and plan your calendar a year ahead to avoid missing valuable opportunities.
Q: How often should biomeds update their training on specific types of medical equipment?
Clarke: Depending upon the type of equipment, an update may never be required. Sort of like learning how to use Velcro shoelaces. However, if the equipment is complicated and their contact with the equipment is infrequent, once or twice a year, then a refresher course of some kind should be required/offered every two or three years or if modifications are made to the equipment.
Gonzales: We live in an exponential era propelled by rapid technological change. Staying ahead of the curve demands constant upskilling, training and education. The most obvious example of the changes we are seeing involve medical device integration and issues associated with cybersecurity. The short answer to this question is continuously and frequently.
Lucidi: No matter one’s current workload, individuals should be open to additional trainings as often as they become available. Technology changes too rapidly for HTM professionals to remain status quo. By continually investing in oneself, individuals will always be of value to their customers, their employer or a potential new employer willing to invest in their employees. Most importantly, continued training projects engagement, investment and value in one’s own future.
Maull: I can only speak to the devices we provide training on, but in general a BMET should not have to get refresher training every year or two. The equipment doesn’t change that much that often that they need to pay a company again to get updated training on a piece of medical equipment. Software training, maybe. But if you’re getting trained on the specifics of how to maintain a certain type of medical equipment, if the training is covering what it’s supposed to cover and it comes with good documentation, having to pay for a refresher course every year sounds like a money grab to me.
Sears: This will vary based on the type of equipment that is being considered. When manufacturers release new products, sometimes they don’t upgrade much, and new training probably isn’t necessary. However, if a new version of a product is released that significantly changes the product or structure, then training is advisable. Certainly, any new product would require training. Having a conversation with a prospective trainer should provide you with the answers you need.
Walters: That depends on how often the device has changes made to it, whether it be functional changes or otherwise. In my experience, devices such as infusion pumps do not change very often. I believe if you continue to work on these types of equipment on a semi-regular basis, further training is often not necessary. However, devices such as radiology or some telemetry equipment most likely will require training every few years as the OEM makes changes or improvements to the device.
Woods: It is essential to keep up with industry trends. We try to stay connected through email newsletters and notifications from all our equipment manufacturers. Our techs check quarterly with our biomed partners to ensure that there are no training updates that we inadvertently missed. Things like product warnings, recalls or software updates. The medical field is very competitive, introducing new equipment models frequently. There are always new features requiring a different PM than prior models.
Q: How important are certifications?
Clarke: Having a certification is great. However, certifications are sort of like toilet paper. Anybody can get one, it’s what you do with the certification after you receive it that’s important. If you never apply or use the training garnished from the certification process, what good is it? It ends up being a footnote on a resume or an ego booster thrown out in conversation. The same is true for college degrees. Just because you have a degree, doesn’t mean you know what you’re doing.
Gonzales: Certifications like those offered through AAMI, the DNV and other organizations, are an important component of the HTM and imaging career path. At the College of Biomedical Equipment Technology and the Imaging Academy, we purposely aligned the learning objectives and program outcomes with industry certifications in mind. Technicians and engineers should purposely map their career paths, seek advanced education and training, and obtain advanced industry certifications. Certifications are an excellent way to validate skills and expertise.
Lucidi: Only a portion of employers require certification as a condition for employment, and even fewer offer increased pay for achieving certification. I see certification as a commitment to oneself and to the HTM industry. When I sat for my certification, I did so for personal reasons only. I viewed it as a challenge, but also as something that might provide me an advantage. To that end, I value certifications. When considering choosing between two individuals with similar experience, interpersonal skills and personal recommendations, the certified individual would be my choice.
Maull: I believe that a BMET can professionally flourish without any certifications. There are plenty of outstanding BMETs out there who do not have their CBET or CRES. But, what certification does provide, along with the knowledge acquired to get certified, is that the BMET is serious about their own upward mobility. Having a certification is almost a requirement to land a managerial role. Without some sort of professional certification you stand very little chance of moving up the managerial chain in the HTM world
Sears: Certifications are important in the HTM field as a whole and I have great respect for those that have acquired those certifications. These certifications are yours to hang onto for your entire career. Simply put, more doors will open with them than without them.
Walters: While not required for employment in the biomedical engineering field, I think all BMETs should strive to obtain their certification. I will say that technicians who specialize in areas such as radiology or lab-equipment may find it necessary to get their certifications to find more employment opportunities. In my personal experience, studying for and obtaining my CBET not only expanded my career opportunities, but made me a better technician in all areas. This includes my technical skills, hospital knowledge, organization and my effectiveness in troubleshooting.
Woods: I believe certifications are very important to career path growth and product expertise. Biomed departments across the nation classify clinical technicians in different ways. BMETs are typically classified in three ways: BMET 1, BMET 2 and BMET 3, all subjectively based on experience. AAMI certifications are recognized nationwide and provide testing that supports consistent training expectations. Having been tested and certified through this association helps to ensure that all certification holders have been exposed and are knowledgeable in all levels of healthcare technology management.
Q: How does HTM training provide cost savings to health care facilities?
Clarke: Health care facilities with well-trained biomeds, save their facilities thousands of dollars simply by not calling in the OEM, and relying on their own staff of in-house professionals. This is especially true when the facility is not near a densely populated area or city. Just the travel time charged by the OEM can sometimes be nothing short of highway robbery. One should also consider the downtime of the equipment and what impact the downtime has on patients and patient health. A well-trained biomed with the proper tools and parts can greatly limit lab downtime, which in turn has a direct impact on patient throughput, hence patient care and ultimately provides the facility with monetary gains.
Gonzales: I will answer this question from the perspective of the technician. The first challenge health care organizations must consider is attracting talented technicians and embracing what our colleague Al Gresch refers to as the “Maturity Curve.” Investing early in professional development and education aligned with the organization’s mission is critically important to building a strong workforce. The second challenge is maintaining a strong workforce through a period of unprecedented opportunity and demand for skilled technicians. Again, investing in their continued education and training can be a powerful tool that ultimately saves organizations money and time.
Lucidi: Investing in HTM personnel is one of the keys to success with reducing service spend. Training enables facilities to reduce their dependence upon costly service contracts. The true value of a service contract is very seldom realized. Contracts are insurance policies, and service providers are betting on the facility not needing service and possibly not having to deliver upon certain commitments. Studies have shown that, with the right types of investments in training and staffing, and proper management, in-house service (including asset managers) can be much more cost-effective than outsourcing or supporting through service contracts. Investing in employee training shows team members that they are valued. In turn, this leads to greater job satisfaction, quicker advancement and, ultimately, lower employee turnover.
Maull: The most obvious answer to that question is the ability to take in-house equipment off outside contracts (whether it’s OEM or third-party). You know the old saying; give a man a fish and he eats for a day but teach a man to fish and he can save hundreds of thousands of dollars on service contracts.
Sears: It mostly provides labor cost savings. With proper training, many facilities can bring labor costs down by bringing services in-house. However, something that must be factored into this is the amount of time it will take the in-house person to service this new equipment. If you are training an already over-committed engineer, then the cost savings may not be as significant since you may still turn to outside labor to offset your labor demand. There will also be the modest cost savings that come from ordering the right part more often considering the engineer has more knowledge. These savings will grow with experience.
Walters: The cost savings can be huge when a clinical engineering team is appropriately trained. Rather than constantly sending devices in for repair or having an OEM technician come to your location, the technicians can perform repairs and/or evaluations at less of a cost. It may also save on future training costs if you have someone on your team who has previously been trained and can then train new and existing employees as a result.
Woods: To the biomed department, training provides cost savings to a hospital by reducing errors, maintenance time and third-party repair costs.
Q: How has COVID-19 impacted training preferences and expectations?
Clarke: Although many of the restrictions applied over the past year and a half are lifted or found to be knee-jerk reactions, some organizations are still placing travel restrictions on their staff. Limiting access to educational seminars offered at trade shows and access to off-site training provided by various vendors. Some training organizations chose to offer an online solution to this problem, while others have offered to take the training to the student and set up classes in the city of the facility in question.
Gonzales: Fortunately, we are seeing the effects of COVID-19 diminish. However, the pandemic added rocket fuel to many changes we were already seeing in education and training, and frankly, that genie cannot be put back in the bottle. Industrial era thinking associated with traditional fixed-site learning will never return to the prominent position it once maintained. We are going to see continued investment in online learning, mixed reality, short-term training programs, with high ROI for students. I do not believe we need to sacrifice quality for value. The technicians and engineers seeking continuing education and training should expect both.
Lucidi: Although hands-on, in-person trainings are much preferred and quite necessary depending upon the device, the COVID-19 pandemic has shown that virtual trainings can be effective and can provide similar value. Virtual trainings, and the technology that supports them, have taken a quantum leap since pre-COVID. Don’t get me wrong, there’s no substitute for a several-week hands-on training course for a CT or MRI. However, segments of the coursework could be transitioned to virtual sessions. This would enable maximized focus on the hands-on portion for a reduced amount of time. The result would be more effective use of the trainer’s time, reduced out-of-office time for the learner and lower travel costs for the facility.
Maull: Luckily Maull Biomedical implemented a remote learning option back in 2015. It was popular pre-COVID, but during COVID our demand for distance learning skyrocketed, as you can imagine. The expectations of the training did not change with COVID, but how the training was delivered was impacted. Pre-COVID, probably 10% of our training was done remotely. Since 2020 that has gone up to about 30%.
Sears: It depends on who you talk to. Personally, I don’t think it has impacted preferences. Most individuals know the best training is in-person with devices to work on during lab time. Therefore, I believe the preference is to train in-person for most products. However, there are some expectational differences since, in the COVID era, we must find ways to work differently provided we can create an equal experience. This, of course, is some type of virtual or remote class. As trainers, we must be able to deliver a class that is as equal as possible to live training. Otherwise, we are just providing training that checks a box for someone, which is often not beneficial.
Walters: COVID-19 has led some facilities to seek out virtual training rather than the traditional in-person training. I believe one of the few good things to come from the pandemic is the realization that learning does not have to exclusively be a face-to-face event, it can be accomplished from almost anywhere with an Internet connection. I think this has made training more accessible to people that may not have had the opportunity in the past.
Woods: At this time, some equipment manufacturers are only allowed to offer online training. Others allow hands-on training but only accept vaccinated students. Opting to host a trainer in your facility lowers travel costs and allows the possibility of training more technicians. Of course, the disadvantage is the missed opportunity to visit the manufacturer’s facility and see all models of their equipment, eliminating live hands-on time with various models.
Q: What else do you think TechNation readers need to know about training opportunities?
Clarke: Injector Support and Service offers a Level-II, troubleshooting, component replacement and repair training on the Medrad Stellant, Solaris, Provis and Mark 7 Arterion injectors. The training is offered in Orlando/Winter Garden, Florida the third week of each month.
Gonzales: A convergence across several domains, including healthcare, technology, and education, is ushering in unprecedented change and limitless possibility. These changes were accelerated because of COVID-19. We must create education and training models that meet the demands of the HTM workforce of tomorrow. Such an approach includes mixed reality content, including artificial intelligence, virtual and augmented reality, and other advanced technologies that will allow the HTM community to effectively address the education and training demands through a period of accelerated change.
Lucidi: Seek out partners that provide free training opportunities. Innovatus customers have access to in-the-can as well as custom training sessions relative to ultrasound technology. Our latest program, SafeTEE, has sessions designed for the clinical and support staff (Echo-techs and central processing techs), as well as service engineers. The focus of SafeTEE is on helping facilities reduce their overall service spend supporting TEE probes through quality, sustainable repairs as well as limiting the need for future repairs through customer education and preventive services.
Sears: First and foremost, training is necessary! When I hear stories about engineers that haven’t been to a training class in years and years it makes me wonder why. We all need to keep our skill levels up and make sure we are getting updated training as hospitals move on to new products. Second, as I mentioned earlier, talk with the person who will be teaching the class. Sometimes there are folks you just know you won’t learn from. If that is the case, find another avenue. I have had two situations like this early in my career and I still talk about how bad those experiences were to this day. In these cases, I didn’t have much control, but it goes to show how an instructor who you don’t connect with can make or generally break the training experience.
Walters: The only other thing I would say is to keep your eyes and ears open. There are many training and learning opportunities out there than you probably think there are, whether it be in-person, virtual, product specific or general technical knowledge. There is seldom an excuse to stop learning while in the health care field. Elite now offers a customized training program to BMETs so call or email to learn more. You can send an email to firstname.lastname@example.org
Woods: Never, never, never pass up an opportunity for free training! Even if the training is less relevant to your current job, it could be useful later. These experiences could expose you to an area of interest you had not previously considered. Keep a lookout for Webinar Wednesdays; they are a great resource. For anyone interested in building a firm foundation in the HTM industry, look into an AAMI-recognized apprenticeship program. These apprenticeship programs are an excellent opportunity to be compensated while mentored by experienced Journeyman. Certifications are highly encouraged and rewarded by the program.
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