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SEPTEMBER 18, 2017

CONSULTATION: Examination Policy and

Guidelines

THE MEDICAL RADIATION TECHNOLOGISTS BOARD IS

PLANNING TO INTRODUCE AN ONLINE EXAMINATION AS A

PATHWAY FOR REGISTRATION FOR OVERSEAS-TRAINED

PRACTITIONERS. THIS CONSULTATION DOCUMENT SETS

OUT THE BOARD’S PROPOSED POLICY AND GUIDELINES

FOR AN ONLINE EXAMINATION.

THE BOARD IS SEEKING FEEDBACK FROM THE MEDICAL

IMAGING AND RADIATION THERAPY PROFESSION AND

OTHER INTERESTED STAKEHOLDERS IN RESPECT OF THE

PROPOSED POLICY AND GUIDELINES

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Contents Consultation: Online Examination ...................................................................................................................... 3

Consultation Feedback .................................................................................................................................... 3

Consultation Timeframe ................................................................................................................................. 3

Introduction ........................................................................................................................................................ 4

Policy Statement ............................................................................................................................................. 4

Who, How and What ........................................................................................................................................... 5

What is the basis for introducing an examination? ........................................................................................ 5

Who will be required to sit an examination? .................................................................................................. 5

How will practitioners know if they have to sit an examination? ................................................................... 6

What is the examination based on? ............................................................................................................... 6

Competence Standards for the Practice of Medical Imaging and Radiation Therapy in New Zealand ...... 6

How is an examination delivered? .................................................................................................................. 7

Sitting an examination ........................................................................................................................................ 8

How will an examination be structured? ........................................................................................................ 8

Taxonomy ............................................................................................................................................................ 9

Examination Rules ............................................................................................................................................. 14

Professional Conduct .................................................................................................................................... 14

Identification Requirements ......................................................................................................................... 14

How is an Examination Scored? .................................................................................................................... 15

Previous Examination Papers ........................................................................................................................ 15

Practice Examination ..................................................................................................................................... 15

Examination Results .......................................................................................................................................... 16

Failing an Examination .................................................................................................................................. 16

Special Considerations .................................................................................................................................. 16

The Board May Refuse to Grant Registration or Issue a Practising Certificate ............................................ 17

Additional Needs ........................................................................................................................................... 18

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Consultation: Online Examination

The Medical Radiation Technologists Board (the Board) is working on the development of an online examination as a pathway to registration for overseas-trained practitioners. In the longer-term an examination may also be used as mechanism for the issue of a practising certificate for practitioners returning to practice after an extended absence. In this consultation document we are seeking feedback from the medical imaging and radiation therapy profession and other interested stakeholders on the foundations of the examination framework the Board is intending to establish.

Consultation Feedback

Your feedback is important to the Board and to assist with ensuring the process allows for information to be provided in a consistent format and in a timely manner, we have prepared an online questionnaire. Click here to access the questionnaire.

Consultation Timeframe

The consultation questionnaire is open until

5.00 pm Friday 3rd November 2017

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Introduction From 20181 the Medical Radiation Technologists Board (the Board) will introduce an examination

for the purpose of registration and recertification under the Health Practitioners Competences

Assurance Act 2003 (the Act). This guideline provides information on the circumstances in which

sitting of an examination is required and information to assist candidates in their preparation for

the examination.

Policy Statement In certain circumstances, the Medical Radiation Technologists Board will require practitioners to sit an examination which has been designed as an assessment tool to measure an individual’s knowledge of foundational knowledge pertaining to the competencies required for the practice of medical imaging and radiation therapy in New Zealand.

The examination will be set under sections 12 and 15 of the Health Practitioners Competence

Assurance Act 2003 (the Act).

1 The exact date is yet to be determined

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Who, How and What What is the basis for introducing an examination? Under the Act, the Board is responsible for ensuring all practitioners wanting to practise medical

imaging and/or radiation therapy in New Zealand are competent and fit to practise.

The examination will be used where specific circumstances require a more detailed and objective

assessment of a practitioner’s competence to practise in the profession. It will be used to establish

a form of equivalence in professional competence to practise, and therefore meet the qualification

requirements for registration under sections 12 and 15 of the Act.

The examination is based on the Competence Standards for the Practice of Medical Imaging and

Radiation Therapy in New Zealand (March 2017) and is designed to assess a practitioner’s ability to:

Critically review, analyse, consolidate and synthesise knowledge; and

Differentiate theoretical concepts, to exercise critical thinking and judgement in identifying and solving problems; and

Use initiative and judgement in planning, problem solving and decision-making in

professional practice; and

Analyse a range of circumstances encountered in clinical practice and evaluate

options to maximise patient care; and

Adapt knowledge and skills in diverse contexts; and

Account for professional practice and inter-professional practice

Who will be required to sit an examination? The examination may be used in a number of circumstances to determine if a practitioner has the

required foundational knowledge to practise medical imaging or radiation therapy in New Zealand.

These include:

Before deciding an application for registration

Where a practitioner’s qualification is not on a list of approved or equivalent list

of programmes leading to registration

Practitioners returning to practice after an extended break from practice

Where there are concerns about the safe practice of a practitioner

Medical radiation practitioners who are registered in any of the three divisions of registration

(diagnostic radiography; nuclear medicine; radiation therapy) with the Medical Radiation Practice

Board of Australia are exempt from sitting the examination in line with the requirements of the

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Trans-Tasman Mutual Recognition Act (TTMRA)2

How will practitioners know if they have to sit an examination? The Board will advise practitioners in writing if they are required to sit an examination, inclusive of

the reasons for that decision.

What is the examination based on? The exam is based on the Board’s published Competence Standards for the Practice of Medical

Imaging and Radiation Therapy in New Zealand (March 2017) which sets the entry-level

requirements for medical imaging and radiation therapy practice. The standards form a part of

eligibility requirements for registration. These eligibility requirements are relevant to practitioners

who:

Qualified in New Zealand

Qualified overseas

Are returning to practice

Require remediation

The competence standards identify the minimum knowledge, skills and professional attributes

necessary for practice and it is expected that practitioners will demonstrate elements from a

number of competency domains in any given circumstance. This recognises that competent

professional practice is more than a sum of each discrete part but rather requires ability to draw on

and integrate the breadth of competencies to support overall performance.

Competent practice requires practitioners to apply their knowledge holistically to a clinical

problem and/or appropriately manage the clinical environment.

Graduates of programmes that have been accredited and/or approved by the Board as being

substantially equivalent have their professional competence assessed over a number of years and in

a variety of ways. For practitioners who have not completed an accredited or approved programme

of study, the Board may use an examination to evaluate their ability to apply knowledge and clinical

reasoning.

Competence Standards for the Practice of Medical Imaging and Radiation Therapy in New Zealand As indicated above, the Competence Standards for the Practice of Medical Imaging and Radiation

Therapy (March 2017) identify the minimum knowledge, skills and professional attributes necessary

for safe, independent practice in medical imaging technology, nuclear medicine technology,

radiation therapy, sonography, and magnetic resonance imaging (MRI) technology. In order to be

granted registration, a medical imaging/radiation therapy practitioner must be able to demonstrate

these competencies.

The competencies are grouped into domains which identify elements of practice. The domains for the

2 The provisions of the TTMRA do not apply to Australian-registered practitioners wanting to register in either the Sonographer or MRI Technologists scopes of practice in New Zealand

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competencies for medical imaging and radiation therapy practice are:

Domain 1: Professional and Ethical Conduct

Domain 2: Communication and Collaboration

Domain 3: Evidence-Based Practice and Professional Learning

Domain 4: Safety of Practice and Risk Management

Domain 5: Medical Imaging/Radiation Therapy Sciences Practice

Domain 5A: Medical Imaging Technologist

Domain 5B: Nuclear Medicine Imaging Technologist

Domain 5C: Radiation Therapist

Domain 5D: Sonographer

Domain 5E: MRI Technologist

Competent professional practice requires an ability to draw on and integrate the breadth

of competencies during the usual course of practice.

Consequently an examination will investigate a practitioner’s ability to apply elements from a

number of domains to gather information, establish the clinical question, consider evidence and

intuit, and conclude or devise a plan to answer or resolve the clinical question.

The Competence Standards for the Practice of Medical Imaging and Radiation Therapy (insert link)

can be found on the Board’s website.

How is an examination delivered? An examination will be delivered through an online environment – that is, practitioners will sit at

a computer terminal in an approved exam centre.

An exam is overseen by an examination supervisor or invigilator who is responsible for verifying the

identification of the practitioner taking the exam and making sure the instructions specified by the

Board are carried out.

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Sitting an examination An exam can be undertaken at an exam centre that has been approved by the Board. Those

exam centres are available in a number of countries.

When a practitioner registers for an examination they will be able to select an exam centre that is

convenient for them. The exam centre will be advised in an email that is also sent to the

practitioner, confirming the arrangements for their examination.

How will an examination be structured? The exam will be a computerised multiple choice question (MCQ) format. This form of

assessment asks respondents to select the best possible answer from a selection of choices.

The exam will allow a maximum period of 3-hours (180 minutes). However exam candidates must

be available for a total of 4-hours to allow for completion of registration procedures, and pre-

examination and post-examination administration activities.

The exam will contain up to 200 questions that can be separated into two broad categories:

Approximately 50% of questions will pertain to practice that is relevant to a

particular scope of practice (Domains 5A, 5B, 5C, 5D, 5E):

o Medical Imaging Technologist

o Nuclear Medicine Technologist

o Radiation Therapist

o Sonographer

o MRI Technologist

And

Approximately 50% of questions pertain to Domains 1 – 5 which are common

competencies for all scopes of practice.

Questions are not evenly distributed across Domains. For example, in any one examination, there

may be more questions from Domain 4 (safety of practice and risk management), than another

domain.

The exam includes questions related to all levels of the human lifecycle including in-utero, neo-

natal, paediatric, adult, and older adult.

Exam questions are mostly in the format of:

Single topic questions; or

A vignette or clinical scenario

All questions have four options, of which one is the correct answer and three are incorrect. The

correct answers are determined by the Board’s Examination Committee, with the correct answer

being the best, or most correct option in the view of the committee. The Examination Committee

reviews all questions for content validity and analyses their statistical reliability (this provides the

basis for further question development and improvement).

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Taxonomy

Common questions - Domains 1,2,3,4,5)

45-55%

Scope specific questions - Domains 5A, 5B, 5C, 5D, 5E

45-55%

Total

100%

Common Domains

Questions per Exam

1 Professional and ethical conduct

9 – 12%

2

Communication and collaboration

5 – 7%

3

Evidence-based practice and learning

1 – 3%

4

Radiation safety and risk management

18 – 20%

5

Medical imaging/radiation therapy sciences practice

12 – 14%

Total Common Domains Questions

45-55%

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An examination will include one of the following scope-specific practice domains:

5A – Medical Imaging Technologist

5B – Nuclear Medicine Technologist

5C – Radiation Therapist

5D – Sonographer

5E – MRI Technologist Questions from the scope-specific practice domains will make up between 45% and 55% of an examination

5A

Medical Imaging Technologist

Questions per Exam

General radiography examinations

26% – 30%

Fluoroscopy

7% - 9%

Computed tomography

7% - 9%

Mammography

2% - 4%

Safe management of radiation

2%

Quality control

1%

Total Medical Imaging Technologist Specific Questions

45% - 55%

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5B

Nuclear Medicine Technologist

Questions per Exam

Preparation and assessment of radiopharmaceuticals

5% - 6%

Biodistribution of radiopharmaceuticals including therapies

3% - 5%

Routine nuclear medicine imaging (may include PET)

20% - 24%

Computer tomography

5% -

Nuclear medicine radioisotope examinations

4%-6%

In vivo and in vitro laboratory procedures

2% - 3%

Nuclear medicine radioisotope therapies

3%

Nuclear medicine quality control

5%

Radiation and radioactivity safety

3%

Consultation and reporting

1%

Total Nuclear Medicine Specific Domain Questions

45%-55%

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5C

Radiation Therapist

Questions per Exam

Immobilisation/positioning devices

4% - 8%

Treatment simulation techniques

13% - 15%

Treatment planning

13% - 15%

Treatment techniques

13% - 15%

Radiation and radioactivity safety

2%

Total Radiation Therapy Specific Domain Questions

45% - 55%

5D

Sonographer

Questions per Exam

Principles and clinical applications of ultrasound

13% - 15%

Ultrasound examinations

20% - 24%

Judgement and decision-making

8% - 12%

Consulting and reporting

1%

Quality control

1%

Infection control

2%

Total Sonographer Specific Domain Questions

45% - 55%

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5E

MRI Technologist

Questions per Exam

Principles and applications of MRI

13% - 15%

MRI examinations

20% - 24%

Consulting and reporting

1%

MRI safety

10% - 14%

MRI quality control

1%

Total MRI Technologist Specific Domain Questions

45% - 55%

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Examination Rules All formal examinations have rules in relation to their conduct.

Before sitting the examination candidates will be required to agree to a set of terms and

conditions in respect of the examination, including keeping the content of the exam and

questions confidential.

Candidates are not allowed to take into the exam centre, or to use any reference material

(electronic or hard copy), during the examinations.

Mobile phones and other equipment are not allowed in the examination centre.

Access to the internet is not allowed in the examination room or in the examination waiting areas.

Professional Conduct Candidates sitting an exam are subject to the usual rules of ethical and professional conduct.

Failure to comply with the rules of an examination or any instruction of the invigilator may be

regarded as a breach of professional conduct. A notification may be made against a candidate

sitting an examination by any person, including an exam invigilator.

The Board regards misconduct during an examination as a serious matter. Falsifying results,

fraudulent or dishonest conduct in connection with an examination has the potential for

practitioners who are not qualified or otherwise competent and safe to practise, to be improperly

registered. The Board will consider any allegations of misconduct by a practitioner during an

examination. It may result in the candidate being denied registration. It could also involve referring

the matter for a substantive investigation by a Professional Conduct Committee (PCC) with the

potential for charges to be laid with the Health Practitioners Disciplinary Tribunal.

Identification Requirements Examination centres require practitioners to provide two forms of identification, one of which must

be a government-issued photo identification. To satisfy the identification requirements an

invigilator may ask the candidate to produce additional photographic identification. Examination

candidates should therefore take more than one form of photographic identification from a

reputable source, to the examination centre.

Should an invigilator have a reasonable concern about a candidate’s ability to properly establish

their identity or there is concern that identity documents are being misused, the candidate will be

refused access to the exam. Any candidate refused access to the exam forfeits the fee they have

paid to sit the exam.

Fraudulent use of identity documents is a serious matter and may be referred to the police.

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How is an Examination Scored? An examination operates as a pass/fail examination with the pass mark set to ensure practitioners adequately meet the Board’s Competence Standards for the Practice of Medical Imaging and Radiation Therapy in New Zealand (March 2017).

All questions are of equal value and there is no deduction of marks for wrong answers. Individual

questions are not weighted and contribute equally to the candidate’s overall examination score.

The passing score is determined by the Board’s Examination Committee and is set at a level that

ensures candidates are safe to practise. When setting the passing score the Committee considers

other data, including statistical and performance data to ensure the standard that must be

achieved is fair, valid and consistent with the principles and objectives of the Health Practitioners

Competence Assurance Act 2003.

The passing score may be adjusted after the conduct of an examination. As an example3 – on

occasion a particular question and its answer (and/or distractors) may have been impossible to use

accurately. This may be due to the grammar or expression used, or, on review, there is more than

one reasonable answer for a question. In these circumstances a question may be removed from

the exam and marks for all candidates adjusted accordingly.

Previous Examination Papers

Previous exam papers are not available.

Practice Examination A practice exam is available for practitioners who have registered and paid to sit an exam. The

practice exam is a sample set of questions that provides candidates with a sense of how the exam

is structured, the types and style of questions and how exam time will need to be managed.

3 Please note this example is given as an illustration only

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Examination Results Examination results will be provided approximately four weeks after the candidate has sat the examination.

Failing an Examination

If a candidate does not pass the exam the Board is of the general view that they are not able to

apply foundational knowledge and concepts to the minimum level required for safe practice. If the

Board proposes to decline an application for registration or issue of a practising certificate the

applicant will have an opportunity to be heard in respect of that matter.

Special Considerations Special considerations4 may be available to candidates who are unable to sit or complete an exam

due to exceptional circumstances beyond their control. Candidates may be given an opportunity to

re-sit the examination at the next available date without incurring an additional exam fee.

Special considerations:

Are only accepted from eligible candidates; and

Are not approved unless, in the view of the Board’s Examination Committee there are

exceptional circumstances beyond the control of the candidate; and

Must be supported by adequate evidence to satisfy the Examination Committee

Special consideration may be available when the following circumstances reasonably and

materially impact on a candidate’s ability to sit an exam (whether imminently or during an

exam):

Acute illness (such as hospital admission, onset or serious illness)

Loss or bereavement (e.g. death of a close family member)

Hardship or trauma (such as being a victim of crime, severe disruption to domestic life)

Unforeseen call-up for service (e.g. military service, court appearance, jury service,

emergency service)

Work commitments and circumstances beyond the candidate’s control (a letter on

company/organisation letterhead from an employer confirming this must be

attached to the application for special consideration)

Religious convictions (a letter from a religious leader must accompany the application)

Computer malfunction at the examination centre

4 Special consideration is a means for circumventing the Board’s usual examination process

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Bomb threat or similar such event necessitating the evacuation of the examination centre

A request for special consideration that is based on the content of the examination will not be

considered.

Special consideration will not lower the pass mark, nor will it improve a candidate’s overall score. A

successful application for special consideration only allows a candidate to sit (re-sit) a future

examination without incurring an additional fee levied by the Board.

The Board May Refuse to Grant Registration or Issue a Practising Certificate

The examination is set at the minimum competencies level for safe practice in the profession. The

Board may refuse a new application or an application for issue of a practising certificate for any of

the following reasons. The candidate has:

Not attempted the examination at least once in the same practising certificate period

Failed an examination on at least three occasions

Engaged in misconduct in connection with an examination

Not met all other requirements for registration or recertification under the Health

Practitioners Competence Assurance Act 2003

Preparing for the Examination5

To prepare for the examination candidates should:

Read and understand the requirements of the Competence Standards for the Practice of

Medical Imaging and Radiation Therapy in New Zealand (March 2017)

Review the reading resource list at Appendix 1 and use these resources in conjunction

with the Competence Standards for the Practice of Medical Imaging and Radiation

Therapy in New Zealand (March 2017)

Develop a programme of revision of academic and professional literature that aims

to meet the Competence Standards requirements

Attempt the practice examination

5 Medical imaging and radiation therapy practitioners with little or no recent study or practice are likely to

have difficulty with the examination

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Additional Needs Candidates with a disability are able to request support to provide appropriate assistance to

allow them to sit the examination. Special needs requests will need to be made to the Board by

email to mrtboard@medsci.co.nz at least 30 days in advance of a scheduled exam.

Candidates with special needs can be provided with facilities to support the following:

Mobility Condition: all exam centres have wide passages, wheelchair access, accessible

toilets and adjustable desks.

Visual Impairment: the examination can be delivered with larger fonts and higher

contrasting colour, and reader assistance.

Hearing Impairment: site support can be provided to ensure that invigilators can

communicate instructions in a satisfactory manner.

Other Physical or Mental Impairment: other impairments, supported by appropriate

documentation, are addressed case-by-case.