Canadian MRT Practice Module!

Chapter 1: About CAMRT
Slide #1
Canadian Practice in Medical Radiation Technology
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Hi my name is Karine!
I am a Medical Radiation Technologist – an MRT.
I’m going to guide you through some important information about practice in Canada in our profession.
Slide # 3 (2/5)
Canadian Association of Medical Radiation Technologists
The Canadian Association of Medical Radiation Technologists (CAMRT) is the certifying body and
professional association for the disciplines of radiological technology, nuclear medicine technology,
magnetic resonance and radiation therapy.
In Canada, each discipline is a separate profession with an entry-to-practice certification exam. The
exception is the province of Quebec, where magnetic resonance is considered part of practice in
radiological technology.
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To work in a medical radiation technology discipline in Canada, technologists must pass an entry-to-
practice certification exam. The medical radiation technology organizations in all provinces recognize
the CAMRT certification exam. In addition, the province of Quebec has its own certification exam. There
is reciprocity between CAMRT and the regulatory authority for the province of Québec, recognizing each
other’s certification.
See the CAMRT website for more information on becoming certified to practice in Canada.
http://camrt.ca/certification/internationally-educated-medical-radiation-technologists-iemrts/
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Founded in 1942, the association has 12,000 members from all provinces and territories.
A board of directors sets policy and strategic direction for the CAMRT. The staff members at the CAMRT
office in Ottawa deliver programs and services in the following areas:
(Roll your mouse over each icon to find out the details.)
 Education - entry to practice, certification, continuing professional development
Copyright © CAMRT/ACTRM Page 1 of 15

 Professional practice – best practice guidelines, advanced practice, occupational health and
safety
 Membership – conferences, services to members, professional liability insurance
 Advocacy, communications – journal, newsletters, government relations, social media
 Finance and administration – financial policy and practices
For more information about CAMRT see www.camrt.ca
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Objectives of this module
The purpose of this module is to provide information about practice in the Canadian healthcare
environment for the medical radiation technologist (MRT).
The module will discuss the following topics:
 healthcare in Canada
 regulatory authorities and professional organizations
 professional practice for the MRT in Canada
 patient and MRT safety
 diversity and cultural competence
 interpersonal skills and the importance of effective communication
 CAMRT membership
Chapter 2: Working in Canada
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Healthcare in Canada
Healthcare in Canada is delivered through a publicly funded system and is mostly free at the point of use
of a service.
The primary objectives in Canada are to protect, promote and restore the physical and mental well-
being of residents, and to facilitate reasonable access to services without financial barriers. The services
are publicly funded from general tax revenues, without direct charge to the patient.
Click on the sample Ontario Health Card to find out more.
Health cards are issued by the provincial ministries of health to each individual who enrolls in the
program. Everyone receives the same level of care.
Care may vary by province. In some instances, such as dental and vision care, private insurance is
needed; this is often available through employers.

For more information see
http://www.cic.gc.ca/english/newcomers/after-health.asp
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Medical radiation technology in Canada
Medical radiation technologists (MRTs) are an integral part of the healthcare team, practicing safely and
effectively to provide diagnostic and therapy services to their patients and healthcare colleagues.
Most Canadian MRTs are working in hospitals, clinics or cancer centres.
For an idea of a typical work day for MRTs in Canada see Part 6 in the readiness self-assessment tools at
http://camrt.ca/certification/internationally-educated-medical-radiation-technologists-iemrts/making-
the-decision-to-live-and-work-in-canada/
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Medical radiation technology in Canada – regulated provinces
Regulation of the profession is delegated to a professional or occupational group by the government.
Professions are regulated to ensure that standards are in place to protect the public.
This is done by:
 setting a standard for entry level competency for safe and effective practice
 setting requirements for ongoing maintenance of competence of MRTs
 holding professionals accountable for their professional conduct
 providing a mechanism for the public to express a complaint

Click on the map to see where the profession is regulated.
Click on the "R" on the map to visit the province’s regulatory authority website.
Implementation of these standards is facilitated through a regulatory authority in each province that has
the privilege to be regulated.
To be a practicing technologist in these provinces, the MRT must be licensed by the provincial regulatory
authority.
Regulated provinces include: Alberta, Saskatchewan, Ontario, Quebec, New Brunswick and Nova Scotia.

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Medical radiation technology in Canada – non-regulated provinces
In the four Canadian provinces that are not regulated, a provincial organization exists to provide a
formal structure that:
 is the voice of the members in that province

 promotes and advocates the value of the profession
 provides education programming
 provides support for the advancement of the profession.
Please note that the province of Ontario, which is regulated, also has a provincial organization: OAMRS.
Click on the map to see where provincial organizations exist.
Click on the "PO" to visit the non-regulated province’s professional organization websites.
There are no established organizations for MRTs in the Northwest Territories, Nunavut or the Yukon.
Standards are established by the employer and may vary depending upon the service needed in the local
area.
Chapter 3: Professional practice in Canada
Slide #11 (1/4)

Description of practice
The CAMRT has developed a description of practice for medical radiation technologists working in
Canada. The two main attributes required of the MRT working in a Canadian healthcare environment
are
 Expertise (Click to read about)
MRTs must apply their expert knowledge, skills and judgment for clinical decision-making in
practice to deliver the highest quality imaging and radiation therapy treatments.
MRTs must apply critical thinking skills to assess the patient, modify routine protocols, provide a
safe environment, and educate the patient and other healthcare colleagues.
 Professionalism (Click to read about)
Patients are the primary focus for MRTs. Good communication skills, a commitment to patient
and family-centered care, respecting the patient’s rights and needs and treating all with dignity,

equality and respect are essential characteristics for a MRT. Practicing within a code of ethics,
scopes of practice and regulatory requirements where applicable is important.
MRTs practicing in Canada must have a commitment to continuing education and professional
development. It is essential to maintain competence in a rapidly changing environment, with
emerging technologies, changes in practice and working as part of an inter-professional team.
Visit the CAMRT Description of Practice

http://camrt.ca/mrt-profession/description-of-practice-2/
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Best practice guidelines
To guide technologists in their practice, the CAMRT has developed statements to assist in the delivery
of appropriate healthcare in diagnostic imaging and radiation therapy services. These statements
provide recommendations for practice and are called Best Practice Guidelines. They are an excellent
source of information for the MRT.
The guidelines have been developed to provide evidence-based information to help MRT practitioners
at all levels make decisions in daily practice, establish policy and procedure, and identify gaps in
competency.
Click on the topics to the left to see sample guidelines.
Patient Management
MRTs monitor all patients in their care by maintaining communication and visual contact (to the
greatest extent possible) throughout the procedure or treatment, and respond to changes in patient
condition
Patient History
Relevant patient history is obtained, reviewed and considered before an exam, procedure or treatment
Quality of Care
Patients being treated with palliative intent receive quality care that includes ongoing consideration of
appropriateness of treatment and possible change in performance status
Slide # 13 (3/4)
So what is best practice?
Best practice is providing the best possible outcome for the patient based on all the circumstances
surrounding the patient.
Best practice is based on
 judgements that meet the patient’s needs

 experience and evidence from clinical practice
 patient’s values and expectations
MRTs must integrate all of these elements into the decisions they make and the actions taken in the
care of the patients.
Visit the BPGs interactive website to explore the full list of guidelines with the Search and Index functions.
https://ww2.camrt.ca/bpg/
Slide #14 (4/4)

Code of Ethics
A Code of Ethics must articulate ethical behaviours expected of the MRT and allow for reflection and
self- evaluation.
It is a vital document created to:
 support day-to-day decision making

 provide guidelines for behaviour
 support the mission and vision of the organization
A Code of Ethics sets rules based on values and standards of conduct for practitioners, such as:
 respect
 dignity
 safety
 integrity
 confidentiality
 fairness
 accountability
 innovation
 collaboration
Visit the CAMRT website to see the full Code of Ethics.

http:/camrt.ca/mrt-profession/professional-resources/code-of-ethics/
Chapter 4: Safety and incidents
Slide # 15 (1/6)
Patient safety and incidents

The patient and the patient’s family are of the utmost importance to the Canadian healthcare worker.
Many initiatives have been created to improve patient safety and quality outcomes by an organization
called the Canadian Patient Safety Institute (CPSI).
CPSI provides many tools and resources to improve patient safety and quality care.
Two key areas of interest are:
1. Canadian disclosure guidelines

2. Incident analysis
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Canadian disclosure guidelines
In the Canadian healthcare environment, the patient has the right to be informed if they are involved in
a patient safety incident.
These guidelines have been created as a commitment to the concept of being open with the patient and
the patient’s family, by promoting:
 a clear and consistent approach to informing the patient

 the importance of working as an inter-professional team during the disclosure process
 the value of learning opportunities from the incidents
For more information on the patient’s right to be informed and the healthcare worker’s responsibility to
be open with the patient and the process to do so, visit the:
Patient Safety Institute

http://www.patientsafetyinstitute.ca/English/toolsResources/disclosure/Pages/default.aspx
and the CAMRT best practice guideline on disclosure and apology .
https://ww2.camrt.ca/bpg/patientsafety/patientsafetyincidents/disclosureofharmfulincidents/
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Incident analysis
Patient safety incidents occur and harm cannot always be prevented. Because these unfortunate
incidents happen, it is important to report them for many reasons which can impact the patient, the
patient’s family, the healthcare workers, and the employer.
As a healthcare worker, the safety of the patient must be the first concern. Reporting and following the
protocol established for reporting:
 identifies what happened

 identifies how and why it happened

 identifies what can be done to reduce future occurrence
 provides learning opportunities for the healthcare worker and the employer
This important process is not meant to place blame, but to recognize trends, improve process and
improve patient outcomes.
For more information, visit the Patient Safety Institute.

http://www.patientsafetyinstitute.ca/English/toolsResources/IncidentAnalysis/Pages/default.aspx
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Radiation protection
Diagnostic x-rays account for the major portion of man-made radiation exposure to the general
population. Doses associated with general x-ray procedures are usually quite low; however, exams
requiring computed tomography (CT) and fluoroscopy can result in significantly higher doses.
Exposure to ionizing radiation can result in harmful biological effects that may affect the exposed
individual and their children. The effect may occur within a short time frame or after many years,
depending on the exposure.
Doses for medical imaging are considered low-level radiation exposures, which have a negligible effect.
Current philosophy assumes that risk still exists and good radiation protection practices must be
enforced.
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Radiation protection
An approach to radiation protection management is implementation of the principle called ALARA (As
Low As Reasonably Achievable) to control exposures to radiation workers and the general public. For
patients requiring diagnostic imaging and radiation therapy treatment, the risk associated with exposure
must always be weighed against the benefit for the best patient outcome.
Click on each of the four icons to see the main concepts of radiation protection.
1. Patients should not be subjected to unnecessary exams

2. It is essential to protect the patient if an exam is required
3. Personnel must be protected during their work time
4. General public in the vicinity of imaging facilities must be protected
For further information refer to the Health Canada publication Safety Code 35: Safety Procedures for the
Installation, Use and Control of X-ray Equipment in Large Medical Radiological Facilities
http://www.hc-sc.gc.ca/ewh-semt/pubs/radiation/safety-code_35-securite/index-eng.php

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Occupational health & safety
All working Canadians have the fundamental right to a safe and healthy work environment.
MRTs are particularly vulnerable to a wide range of occupational health and safety hazards, causing
musculoskeletal injuries, infectious diseases, mental stress, and other work-related illnesses and injuries.
Recognizing this as a critical issue for MRTs in the workplace, the CAMRT has created a resource centre
to inform and assist the MRT in maintaining a safe and healthy work environment for themselves and
the patient.
Visit the CAMRT Occupational Health and Safety Resource Centre to find out more.
http://www.camrt.ca/mrt-profession/professional-resources/ohs-resource-centre/
Chapter 5: Cultural competence
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Diversity and cultural competence
In Canada, MRTs work in a healthcare environment with a very diverse culture.
Cultural diversity describes variation between people in ethnicity, national origin, race, gender, ability,
age, physical characteristics, religion, values, beliefs, sexual orientation, socio-economic class, or life
experiences.
Accepting and embracing diversity is a Canadian philosophy and tradition, supported by the federal
government through immigration and diversity legislation and policies.
Click here to find out more about Diversity in numbers
One in every five Canadians is foreign born
By 2031, nearly one-half (46%) of Canadians aged 15 and over would be foreign-born, or would have
at least one foreign-born parent.
In 2012, Canada received over 250,000 immigrants, at an immigration rate of 7.4 newcomers per 1,000
inhabitants, a rate fairly stable over the last decade. Over one in five Canadians are foreign-born. With
21.3% of foreign-born persons, in 2010 Canada had the 6th largest share of foreign-born persons of all
countries in the world.

Statistics Canada, National Household Survey, 2011 and Factbook 2012 - ISSN - © OECD 2012
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What this means to MRTs in Canada
The increasing cultural, religious and linguistic diversity of Canada means that the MRT must be
culturally competent to provide the patient with safe, culturally appropriate and responsive care.
Diversity is about all of us, and about us having to figure out how to walk through this world together. -
Jacqueline Woodson
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Cultural competence
Cultural competence embraces diversity and promotes a safe, respectful environment for diverse
patient groups.
The culturally competent MRT provides health care services that foster a relationship with the patient
that assures:
● an awareness of their cultural norms

● respect for cultural differences
● confidence that the best outcomes will be achieved
No one is 100% culturally competent - becoming competent is a continuing process.
Click here to see What is cultural competence?
“The ability of individuals and systems to respond respectfully and effectively to people of all
cultures, backgrounds, races, ethnicity and religions in a manner that recognizes, affirms and values
the cultural differences and similarities and the worth of individuals, families and communities, and
preserves and protects the dignity of each.” (Cross Cultural Health Care Program, 2002)
Many resources have been developed to assist with learning more about the cultures of Canada and the
importance of cultural competence in the delivery of safe, effective and equitable healthcare services .
Visit the Cultural Competence E-learning Module Series for examples.
Click here to see how You can improve your cultural competence
 Understand your own cultural and professional background

 Become aware of your own biases towards other cultures and of the cultural issues in
healthcare delivery
 Learn about diverse groups, with a focus on:
o health-related beliefs and practices

o relationship between patient and medical professional
 Learn to collect and assess relevant cultural data from the patient
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Cultural awareness in the patient-MRT relationship
The MRT often interacts with a patient both verbally and physically. When caring for patients from
diverse cultural backgrounds, it is important to gain and practice awareness of the patients’ cultural
norms.
Drag each of the notes from the board into this space to see some examples.
 Perception and acceptance of gender interaction: patients may be accustomed to being

examined and treated by a professional of their own gender. If the patient is a woman, a female
professional may be requested, or the presence of another female (a relative or another
professional) in the exam room.
 Touching and positioning the patient:
o it is important to explain why the MRT must touch the patient
o permission must be asked at all times
o the patient must consent before starting the procedure
o the patient has the right to withdraw consent during the procedure
 Privacy and modesty are critical values in many cultures. Some patients may not wish to reveal
parts of their body to a stranger, or to share family history and information.
 Perception of medical professional’s authority:
o patients may be shy about asking questions
o patients may be shy about expressing concerns or disclosing information such as
personal history, especially to a MRT of another gender
o patients may not know that working in a collaborative environment allows for
questioning of orders and prescriptions to ensure appropriate testing and outcomes
Chapter 6: Interpersonal skills
Slide #25 (1/3)

Interpersonal skills
Interpersonal skills are the life skills we use every day to interact and communicate with others.

Many professionals know that the employer wants “Canadian experience” and they go back to school to
acquire additional professional credentials, when they should give equal attention to improving
interpersonal skills.
Slide #26 (2/3)

Identify which are interpersonal skills and which are professional skills by dragging each item below into
the appropriate folder.
Verbal Communication - What we say and how we say it.
Non-Verbal Communication - What we communicate without words. We communicate through eye

contact, facial expressions, tone of voice, body language and posture, personal space.
Listening Skills - How we interpret both the verbal and non-verbal messages sent by others. Effective
listeners focus on what they hear, pay attention to what is said and how it is said, observe body
language and how it relates to the verbal message, and listen for what is left unsaid.
Negotiation - Working with others to find a mutually agreeable outcome.
Problem Solving - Working with others to identify, define and solve problems.
Assertiveness – Communicating our values, ideas, beliefs, opinions, needs and wants freely.
Academic Credentials - Diplomas, degrees and certificates issued by an educational institution to attest
professional competence. Professional Expertise - Work experience that applies your knowledge, skills
and ability to practice competently in your profession
Professional Experience - Expert skill, knowledge and judgment that is recognized by peers in your
profession. Expertise is developed through experience, continuing professional development and
research.
Slide #27 (3/3)

Communication in a healthcare environment
Healthcare delivery involves many interactions between patients and healthcare professionals with
different levels of knowledge and experience. In any hospital or clinic visit, a patient may see a
receptionist, an MRT, a physician and others. Team collaboration is essential to ensure that patient
information is well communicated. Good communication and interpersonal skills can improve patient
outcomes and working relationships.
Click here to see how to Communicate effectively with patients
How to communicate effectively with the patient:
 Use the NOD: tell the patient your name, your occupation and what you are going to do
 Greet the patient with a positive manner, making eye contact

 Explain the procedures clearly, using a pleasant tone of voice. Patients are anxious and may be
worried about the outcome
 Actively listen to the patient’s concerns, questions and explanations
 Ask the patient questions for clarification
 Use body language and gestures that portray an open and caring approach
 Be aware of the patient’s specific physical, cognitive and emotional needs and provide
assistance
Click here to see how to Communicate effectively with other members of the healthcare team
How to communicate effectively with other members of the healthcare team:
 Understand the message that is communicated and ask questions for clarification
 Interact honestly and give all necessary information
 Be respectful and be open to accept different opinions
 Remember that we are all working together to ensure the best outcome for the patient
Chapter 7: CAMRT membership
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Membership in the CAMRT and your provincial association organization is an investment in your career
and in the future of your profession.
The CAMRT
 advocates on your behalf on critical issues

 facilitates understanding between the profession, the public and government
 encourages collaboration with industry and other healthcare organizations to promote
professional excellence in all disciplines of the profession.
Click here to see the Key benefits of membership
The key benefits of CAMRT membership:
 protection through member-centered professional liability insurance

 professional development programs at discounted rates for members
 subscription to the Journal of Medical Imaging and Radiation Sciences and the CAMRT
newsletter
 volunteer opportunities to advance and affirm your professionalism
 an advocate who works to advance the profession
To see all the benefits visit http://www.camrt.ca/membership/membershipgettheadvantage/

Slide #29 (2/5)
Professional liability insurance
Professional liability insurance (PLI) is insurance that protects a professional from bearing the full cost of
defending against a negligence claim and of the resulting damages. Errors or omissions may occur in
practice, and the PLI gives coverage and legal protection in the rare event that a patient claims harm
from a service or advice provided by the MRT.
CAMRT, in collaboration with provincial organizations, has provided PLI for over 25 years. CAMRT
members are enjoying the peace of mind afforded by our PLI.
The CAMRT PLI website at http://pli.camrt.ca/ talks about:
 Eligibility: how to acquire PLI

 Coverage
 Common PLI myths
 Examples of claims and scenarios
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Continuing competency through professional development
A well-educated and competent MRT workforce is essential for the delivery of healthcare that promotes
on-going improvement in patient care and outcomes.
MRTs must have up-to-date knowledge and skills and to practice safely and effectively, therefore life-
long learning for MRTs is not an option – it is ESSENTIAL!
Continuing professional development is mandated in the regulated provinces.
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Continuing professional development
CAMRT advocates participation in professional development programs as it benefits the:
 patient – the public has the right to expect the MRT to be current and competent
 technologist – influences clinical practice
 profession – credibility and autonomy of the profession
 healthcare environment – effective member of the patient care team
CAMRT provides continuing professional development opportunities to members and non-members.
Slide #32 (5/5)

To become a member of the CAMRT, an internationally educated MRT must have their credentials
assessed and pass the certification exam in the discipline they wish to practice in Canada.

For more information and resources, visit the Internationally Educated MRTs’ page
http://camrt.ca/certification/internationally-educated-medical-radiation-technologists-iemrts/
Slide #33
Thank you for completing the module Canadian Practice in Medical Radiation Technology.
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Chapter 1: About CAMRT

I am a Medical Radiation Technologist – an MRT.

 Education - entry to practice, certification, continuing professional development

Copyright © CAMRT/ACTRM Page 1 of 15

For more information about CAMRT see www.camrt.ca

The module will discuss the following topics:

Chapter 2: Working in Canada

Click on the sample Ontario Health Card to find out more.

Copyright © CAMRT/ACTRM Page 2 of 15

Most Canadian MRTs are working in hospitals, clinics or cancer centres.

Regulation of the profession is delegated to a professional or occupational group by the government.

This is done by:

Click on the map to see where the profession is regulated.

Copyright © CAMRT/ACTRM Page 3 of 15

 is the voice of the members in that province

Click on the map to see where provincial organizations exist.

Chapter 3: Professional practice in Canada

Slide #11 (1/4)

 Expertise (Click to read about)

 Professionalism (Click to read about)

Copyright © CAMRT/ACTRM Page 4 of 15

Visit the CAMRT Description of Practice

Click on the topics to the left to see sample guidelines.

Best practice is based on

 judgements that meet the patient’s needs

Copyright © CAMRT/ACTRM Page 5 of 15

Slide #14 (4/4)

It is a vital document created to:

 support day-to-day decision making

Visit the CAMRT website to see the full Code of Ethics.

Chapter 4: Safety and incidents

Copyright © CAMRT/ACTRM Page 6 of 15

Two key areas of interest are:

1. Canadian disclosure guidelines

 a clear and consistent approach to informing the patient

Patient Safety Institute

 identifies what happened

Copyright © CAMRT/ACTRM Page 7 of 15

For more information, visit the Patient Safety Institute.

Slide #19 (5/6)

1. Patients should not be subjected to unnecessary exams

Copyright © CAMRT/ACTRM Page 8 of 15

Occupational health & safety

Chapter 5: Cultural competence

In Canada, MRTs work in a healthcare environment with a very diverse culture.

Click here to find out more about Diversity in numbers

One in every five Canadians is foreign born

Copyright © CAMRT/ACTRM Page 9 of 15

Slide #23 (3/4)

● an awareness of their cultural norms

No one is 100% culturally competent - becoming competent is a continuing process.

Click here to see What is cultural competence?

Visit the Cultural Competence E-learning Module Series for examples.

 Understand your own cultural and professional background

Copyright © CAMRT/ACTRM Page 10 of 15

Slide #24 (4/4)

 Perception and acceptance of gender interaction: patients may be accustomed to being

Chapter 6: Interpersonal skills

Slide #25 (1/3)

Copyright © CAMRT/ACTRM Page 11 of 15

Slide #26 (2/3)

Verbal Communication - What we say and how we say it.

Non-Verbal Communication - What we communicate without words. We communicate through eye

Negotiation - Working with others to find a mutually agreeable outcome.