In this installment of the monthly TechNation Roundtable article we look at training. We asked a panel of industry insiders to share their thoughts on training including what to look for when seeking out additional training and how to convince employers to pay for their employees to expand their HTM knowledge.
Those participating in the roundtable discussion on training are College of Biomedical Equipment Technology President Bill Bassuk, Injector Support and Service Vice President of Training Bruce Clarke, Summit Imaging Manager of Training and Education Kyle Grozelle, Tri-Imaging Solutions’ Lead Engineer/Instructor Ken Hable, Tri-Imaging Solutions Imaging Instructor/Trainer Ben Duffield Magee, Maull Biomedical Training LLC President Steve Maull, Trisonics Senior Territory Manager Hobie Sears, GE Healthcare Educational Program Lead, Networking Mary Swigart and Fluke Biomedical Global Training Manager Jerry Zion.
Q: What are the most important things to look for when seeking training?
Bassuk: At College of Biomedical Equipment Technology, we work with students across the country and overseas. When we meet with new students, their two biggest concerns are accessibility and professional standards. We no longer live in a brick and mortar age; students want to be guaranteed access to education and training when and where it fits their busy schedules. Professional standards and accreditation are also important, students want a quality education aligned with industry standards, which is exactly what we seek to provide.
Clarke: I like to use the acronym of WIIFM, “What’s In It For Me.” Probably the most important aspect of any training asks the question, “Does the training fit the needs of the attendee/audience?” Training that is not beneficial to the attendee or the organization is pretty much a waste of time, money and resources … WIIFM!
Magee: The most important thing to look for when seeking training is course content. You’ll want to qualify the course by asking yourself these questions. What will I be learning when attending the perspective school? Do they provide hands-on training or is it solely classroom based? Will I be able to use this newly acquired knowledge as a good return on my or my company’s investment?
Maull: Primarily, you want to ask yourself, “Will this training fill our needs?” Is this operation training, PM training, troubleshooting training? Is it all three? There is a lot of great training out there, but if you’re looking to get your medical device off of a service contract, you may want to make sure the training covers PM procedures, and that it’s not just an intro or operational course.
Sears: The first thing anyone needs to look for or at when planning training is the goal of that training. That may sound strange, but I am often amazed at how often the goal and eventual class selection don’t match up. An example is when an engineer who is going to be a facility’s ultrasound guru but has no experience will take a system specific course without first taking a basic ultrasound course. The inverse is also true, when those who might be planning on overseeing ultrasound repairs take several system courses, providing them with ample information that they never planned on using. The second item is making sure that you ask your potential provider about the course. Does it cover everything that you want it to and does it line up with your goals? Have you been able to personally talk to the instructor? You want an instructor who you can connect with and learn from.
Swigart: Understanding skill levels and employing self-assessments are useful when determining the appropriate level and depth of training needed. It’s also important to understand the type of training most effective for the individual (classroom, online or virtual), and the technology available (hands-on with equipment, augmented or virtual reality) to identify the best fit. For example, with product hardware-focused training, hands-on time with the equipment in a safe environment when the guidance of an experienced instructor is invaluable. Some abstract ideas may be difficult to envision, even with the equipment at your finger-tips. For instance, gas flowing through an anesthesia breathing system. With the use of 3D simulation, VR and AR, students can visualize these concepts regardless of whether they are in front of the machine or miles away from the actual device.
Zion: Training should help you do your job better, be more efficient and stay up to date.
Q: How often should biomeds update their training on specific types of medical equipment?
Bassuk: Biomeds must remain vigilant regarding their continuing education and professional development. Hardware and software updates, changes to safety or maintenance protocols and a host of other constantly evolving factors demand their attention. Avoiding a myopic view is important, biomed and HTM professionals need to look outward and see the changes before they are affected by them. This is not just a training issue, it is also about safety, liability and doing what is best for the clients they serve.
Clarke: In my opinion, there is not a cut and dry answer to this question. Several points need to be considered when biomeds decide to update their training on specific types of equipment. How proficient/familiar is the biomed with the equipment? How often does the biomed service the equipment? Has the manufacturer made any upgrades or modifications to the equipment which the biomed is unaware of or needs training on? With that said, a refresher course on a piece of equipment that is seldom serviced is always a good idea.
Magee: Clinical technology is continually and rapidly changing. I recommend that both biomeds and imaging service engineers attend as many schools as are available to them until up to speed with their current inventory. After obtaining the available knowledge for their specific inventory of equipment, I recommend perusing training on each new modality obtained by the health system to remain current in your knowledge base.
Maull: It really depends on the type equipment we’re talking about, but to be honest, most of the time, it’s really not needed (or at least it shouldn’t be). Has the equipment you were trained on a year or two or three ago changed? Is the documentation of your PM/Cal procedures you got sent home with so bad you need to go back to the company you got the training from to explain it to you again? So, unless the medical device in question has changed or been significantly updated, I would be leery of a training company that “requires” this. It’s more of a money grab in my opinion.
Sears: I don’t believe there is a set time frame in the ultrasound modality for training updates. The biggest influence on new training would be a significant change in a product. This would be a change that influences how you troubleshoot, not simply a product having some different parts or a simple update to software. However, if you are going to work on multiple manufacturers of ultrasound equipment then you should obtain training for each brand you expect to work on. While some general knowledge in ultrasound is applicable over the whole modality, each brand is a bit different and specific knowledge is necessary to be successful.
Swigart: As medical devices become more applications-driven, the pace at which they change is accelerating. In past years, individuals were trained as needed, often based upon purchasing decisions. Today, learning is a continuum. Traditional classroom training with hands-on labs and equipment is still important, but it is only a starting point. Technology-supported training such as virtual and augmented reality and simulation platforms, combined with task-based videos, micro learning and remote learning forums will aid in maintaining and developing an engineer’s skills.
Zion: HTM professionals should update their training and knowledge whenever any of the following occur:
Q: How does HTM training provide cost savings to health care facilities?
Bassuk: A well-trained staff reduces the need to outsource, mitigates risk, ensures compliance and understands the need to work within a budget. HTM professionals are the lynchpin to this entire system, a bridge between multiple departments and people. Properly trained HTM professionals are the surest way to guarantee hospitals stay within their budgets.
Clarke: By bringing equipment maintenance in-house, staff can quickly evaluate symptoms and crate an appropriate repair action. Elimination of lab downtime is paramount; for staff to quickly evaluate a unit’s failure and effect a repair plan will limit downtime and increase patient throughput and care.
Grozelle: Training is critical to lowering the total cost of ownership. By bringing service skills in house, engineers can quickly and effectively maintain and repair equipment without costly OEM service calls. Additionally, the lower impact to patient care and access to equipment will result in less rescheduling and missed diagnosis due to difficulties acquiring an image.
Magee: Health care facilities benefit not only from cost savings on the repair side but also an increase in patient throughput due to the decrease in downtime of the equipment on the clinical side. In-house service team members with proper training and knowledge can provide immediate on-site service within minutes of the call versus outside vendor service which is offsite and requires time to arrive. Even with first call ability, the savings can be huge as the in-house engineer/technician is already on site when the equipment failure happens. Many problems are easily fixable and do not require parts; additionally, this eliminates the need to pay a costly service bill for simple fixes which are the majority of the service calls.
Maull: Very simply it gives the hospital the ability to take the medical device off contract, and the savings can be significant; or it gives them the ability to go with a less-expensive contract (first look, repair only, etc.). It can also greatly reduce response and repair time.
Sears: It might seem obvious that training will allow a facility to reduce cost when it comes to maintenance. However, if your goals did not line up with your training, this could create a cost instead of a savings. An individual might be over or under trained and therefore not able to bring the expected savings back to the facility or have simply spent too much for extra unnecessary training. That being said, in most scenarios, proper training will lower (probably not eliminate) external labor costs for ultrasound service. One area specifically is that with system training the PMs will generally be done in house. For most facilities, this will pay for training by itself. Obviously, parts are still parts and training does not guarantee your parts costs will be less, but with proper training and experience, parts cost will come down over time.
Swigart: When equipment is down it has an immediate impact on the hospital’s ability to care for patients. If that equipment happens to be a clinical network or life support device, it can have an immediate and direct impact on a patient. If engineers can troubleshoot the issue, due in part to training, over time they will likely end up ordering less parts and spending less time researching and issues may be resolved faster helping to decrease down time. Education sessions can provide a mechanism for engineers to ask questions and share experiences with others outside of their immediate shop, which can help support service efficiencies.
Zion: Training makes HTM professionals more efficient in preventative and corrective maintenance on medical devices. Training helps reduce cost-of-ownership of medical devices and may improve availability of mission-critical medical devices.
Q: Can you explain the benefit of hands-on training compared to attending a lecture?
Bassuk: The two concepts go together, without the theory and lecture it is difficult to fully comprehend the hands-on; especially with the rate of change in the health care industry. Thanks to our many partners, we can deliver academic content consistent with the latest standards. Our use of 3D modeling and virtual reality training will revolutionize the way students are trained. Research indicates that retention is significantly higher when students experience hands-on training; therefore, students must also develop skills through practice in a real-world environment to be fully qualified. It is the combination of theory and practice that produces a BMET ready for the challenges they will likely face in the health care industry.
Clarke: The best answer comes from Benjamin Franklin and a Chinese proverb – “Tell me and I’ll forget. Show me and I may remember. Involve me and I’ll understand.”
Grozelle: Hands-on training is vital in today’s evolving medical imaging field. Not only hands-on to understand the physical build of a system, but hands-on experience with the software used to maintain and operate the equipment. Lectures have their place providing theory and updates, but with hands-on experience engineers can be confident when taking service in house.
Hable: Hands-on training is always important as we work in a hands-on role. Lecture is important at the fundamental level, early in the professionals’ education. As their knowledgebase grows and their fundamental understanding of the concepts is established, hands-on training becomes far more valuable. Laboratory time allows for actual repair/replacement opportunities and processes. This is the “real world” aspect of training where the program can introduce actual issues to provide troubleshooting opportunities followed by problem resolution procedures such as part replacement and calibration. The more advanced the training, the more hands-on time there should be committed to that training.
Maull: When I was a kid and I wanted to learn how to throw a ball, I didn’t attend a lecture on how to throw a ball. I went out in the yard with my friends and I threw a ball. Learning how to work on medical equipment is not theoretical, it’s not like learning math. It’s a physical, hands-on endeavor. So, when you learn how to do it, you should do it “hands on.”
Sears: A lecture is generally additive information. I do several lectures at facilities and conferences each year, and provide good, valuable information. They generally cover one topic, such as transducer care. However, this is not hands-on training and often without the proper background or previous training a lecture will yield poor retention. Most engineers that I have trained over the last 17 years tell me they learn most by getting their hands on the equipment and turning screws. Multiple-day, hands-on immersion on a product is the kind of training that an HTM professionals need to be successful!
Swigart: Good training is always a balance between presenting and applying concepts. Coursework that is focused solely on hands-on time may miss important foundational concepts, while a lecture-only format might lose the attention of students. Scenario-based learning is a way to keep students engaged while demonstrating real-world concepts. Once a class is familiar with a system, instructors can challenge them with troubleshooting scenarios, requiring them to consider the symptoms, apply the right tests using their service documentation and narrow down the problem until they find the root cause. Scenario-based learning does not necessarily require access to the actual equipment. Augmented and virtual reality simulations can produce the same experience.
Zion: Studies have shown that humans learn in three ways: visually, hearing, and hands-on. Combining hands-on with either or both of the other two ways and repeating/rehearsing the actions helps drive learning into long-term memory. When hands-on learning is provided in the form of specifically injected problems most often experienced in real life, the trainee develops problem solving skills while they have the help from instructors.
Q: How can HTM professionals persuade employers to pay for training sessions?
Bassuk: Investing in the future includes investing in people. The greatest technology and software in the world are of little use to a hospital with an untrained or unqualified staff. It is widely acknowledged that a massive exodus of BMET and HTM professionals is on the horizon. To address the shortfalls our industry will face in the next few years, we really have no choice but to invest in our employees. As a service company owner, I ask each of my employees to develop cost-savings proposals justifying product-specific training courses. Inevitably, I have found that training in-house is always less expensive than outsourcing.
Clarke: If an organization wants to keep the best and brightest of their employees, and provide the best services to their clients, then the organization needs to take it upon themselves to provide the continuing education for their employees. Training that is mandated by law or court order will always be accomplished. Of that there is no doubt. But professional development for biomeds should be viewed as a win-win situation for the organization, the biomed and the client. A method that can be used for the benefit of the organization and the biomeds is a follow-up seminar. At the follow-up seminar, the biomeds would present to others what the “takeaways” from the training are.
Grozelle: When considering training on a certain type of equipment, the cost of training is generally saved after 1-2 services compared with using an OEM, and with less down time. This means within 1 year you will notice a savings by bringing service in house. You can also catch training classes during local biomedical conferences or MD Expo, being able to fit 2-3 different classes in a week reducing the time out of office.
Hable: Demonstrate to the employer what you will be able to manage, repair and/or provide coverage of with the desired training. The facility is making an investment with training and there needs to be additional expansion of internal coverage and/or a reduction in external coverage of the related equipment. Another very important role training can fulfill is gaining the knowledge necessary to properly PM the equipment which is a primary focus of all governing and accrediting agencies.
Maull: Tout the cost savings … and if you can work in the phrase “patient safety” that’s always a winner. Another item you can bring up is career progression; it looks good for a department when it has a hand in the betterment and career advancement of its BMETs. It makes it a more desired place of employment.
Sears: I’m probably starting to sound very redundant here, however I will return to my statement about setting the goal of training. HTM professionals need to create a plan as to what their responsibilities are with their manager or employer. One way to be sure an employer will restrict future training is to waste training dollars by not having specific goals for how that training will be utilized. With that being said, this is a two-way street, once an HTM professional has done their job and worked out the goals, it is up to their manger or employer to be sure that training is provided for or that type of work is not included in the HTM professional’s goals, until such training can be completed.
Swigart: It’s important to first consider whether the training you want is applicable to your immediate role or part of your career progression. Next, have a candid conversation with your manager about why you feel this training is necessary and how it fits into your career plans. Do your homework and bring your results to this discussion. This includes investing time in building a return on investment model to justify the training. Highlight the potential benefits of expanded equipment coverage, reduced purchase service, the impact of increased equipment performance, and any additional variable cost productivity gains and potential overtime reductions. Finally, while you might prefer to travel to attend a one-week course, if it’s not in the budget there may be other options available, including virtual or online courses. It’s also worth asking if your manager can budget for training next quarter or next year to plan for it.
Zion: Funding training helps reduce cost of ownership of the medical devices for which the training is applicable.
Q: What else do you think TechNation readers need to know about training opportunities?
Bassuk: The renown educational theorist John Dewey predicted that the future of education would have greater respect for all sources of experience and suggested that the things that divide us should not be as important as the bigger issues that should unite us. We are at a crossroads in education and training. The new educational model is a hybrid of sorts, emphasizing online training and resources, partnerships with industry, in-house training programs supported by educational institutions, as well as traditional brick and mortar schools. We need to think in terms of revolution, not evolution, and look for opportunities to make learning available when needed, to make it affordable and to ensure the highest possible standards.
Clarke: Three main factors should be considered when it comes to training:
The presenter and their ability to know the subject and discuss it at a level that is understood by the attendees. Training at levels above or below the audience level will not be beneficial to any attendee and creates an environment in which the audience is lost to boredom or to their inability to comprehend the subject matter.
The attendee and their willingness to learn. Attendees coming to a training session to “get out of the office” or because it is “mandated training” are lost before they walk in the door.
The topic/subject of the training should have a direct application to the attendee or why they are attending the training in the first place.
Maull: This is a career that has a never-ending need to get schooled on the new equipment because there is always new stuff coming out. Training is a win/win; it elevates the BMETs knowledge and abilities and saves the hospital/company money. As a BMET, you should want to get trained on as many different medical devices as you can handle. It only helps in your career trajectory.
Sears: There are a numerous opportunities for training regardless of the modality. Your choice of a training vendor should be based on your expectations and the ability to meet your goals of training with that vendor. Find a course that fits your goals, talk to the instructor and get the details of how the class will run. Maybe you would like training taught by instructors in which training is all they do or maybe you prefer training taught by current field personnel who bring current real issues back into the training room. This is just one of many questions that you can ask the course instructor. Much of that conversation will help you to pick the course or vendor that fits you best. In some cases, this might be a once in a career type of training, so make sure you are getting what you need!
Swigart: Health care technical training is rapidly changing. Hands-on classroom training can be beneficial, but it is also important that learning continues outside of the classroom, such as in a continuing education format through online courses, videos and remote learning forums.
Zion: From the perspective of the trainee: training is a path to advancement because skills specific to the needs of the employer are obtained, therefore the employee becomes more valuable to the employer – the worker becomes more worthy of their hire. It is not just about preventative maintenance, it is about reducing cost of ownership of medical devices, improving patient safety and risk management.
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