Academic journal article Journal of Allied Health

Empirically Mapping the Subspecialties of Cardiovascular-Interventional Technology

Academic journal article Journal of Allied Health

Empirically Mapping the Subspecialties of Cardiovascular-Interventional Technology

Article excerpt

As the practice of cardiovascular interventional technology (CVIT) has evolved over the last 50 years, so has the role of radiographers employed in this specialty. In 1991, the American Registry of Radiologic Technologists (ARRT) initiated a certification program to recognize radiologic technologists practicing in CVIT The certification program consisted of a single examination that covered all aspects of CVIT (e.g., neurologic, cardiac, genitourinary). In 2000, the ARRT conducted a study to investigate further the nature of subspecialization occurring within CVIT. A comprehensive job analysis questionnaire was developed that consisted of 137 clinical activities organized into 19 general domains of practice. The questionnaire was completed by a national sample of 848 radiologic technologists working in CVIT, who indicated the frequency with which they performed each of the 137 activities. Responses were subjected to cluster analysis to classify technologists into homogeneous groups corresponding to different CVIT subspecialties. Results indicated that CVIT consists of two major subspecialties: one corresponding to cardiac procedures and one corresponding to procedures involving organ systems other than the heart. Other smaller subspecialties also emerged from the cluster analysis. A multidimensional scaling of the profiles suggested that CVIT subspecialization can be explained by two dimensions: (1) whether the procedures are diagnostic or interventional and (2) the type of organ system involved. The findings are discussed in terms of their implications for education, certification, and performance evaluation. J Allied Health. 2004; 33:95-103.

THE PRACTICE OF CARDIOVASCULAR interventional technology (CVIT) has roots traceable to the late 1950s, when the first selective catheterization of diseased coronary arteries was performed.1-3 In the early 1960s, radiologists were performing selective procedures on organ systems other than the heart.4-6 In 1976, the introduction of preformed coronary catheters facilitated studies of left ventricles and coronary arteries.7-9 Selective studies of the arteries in the neck, brain, thoracic cavity, abdominal cavity, and pelvic cavity and peripheral runoff studies of the upper and lower extremities were done.10,11 Percutaneous transluminal coronary angioplasty first was performed in 1978.12,13 This procedure altered the management of severely diseased coronary arteries from coronary bypass surgery to percutaneous methods. It used a tiny inflatable balloon that compressed obliterating luminal cholesterol plaque into the walls of a coronary artery.10,12 This technique has made the need to open arteries in the lower extremities obsolete14 and has become the gold standard for opening occluded arteries not only in the heart, but also in other major organs of the body. In the late 1980s, balloon expandable intracoronary stents first were used to maintain the patency of arteries that had been opened with the angioplasty balloons.15

As the medical side of CVIT evolved, the roles of the allied health professionals who assisted with these procedures also grew. In particular, the responsibilities of radiologic technologists expanded beyond activities related specifically to medical imaging. Radiologie technologists were assisting physicians with the procedures, assessing and monitoring patients, recording hemodynamic data such as pressures and electrocardiogram waveforms, and administering medications under the supervision of physicians.10,15

Recognizing these new roles for technologists, the American Registry of Radiologic Technologists (ARRT) initiated a comprehensive job analysis in 1986 to determine if CVIT warranted a specialty certification program.16 Job analysis, also called practice analysis, is the generally accepted procedure for documenting job responsibilities and for identifying the knowledge and skills required to carry out those responsibilities.17,18 The results of the practice analysis guided the development of a certification examination in CVIT, which was administered first in 1991. …

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