The RadiologistAssistant: A New

Member of the Radiology Teamj Lynn May, Albuquerque, NM

Agroup of radiologic technologists (RTs) willmake history when they graduate fromCalifornia’s Loma Linda University in the

summer of 2005. They will be the first 10 in the nationto provide an important new component of the medicalimaging team: radiologist assistants (RAs). Althoughinitially small in number, the ranks of RAs will even-tually expand and be commonplace alongside radiologynurses to provide quality patient care. This articleintroduces the radiology nursing community to theRA’s role and responsibilities in the clinical setting.

A PREVIEW OF THE RA

RAs will be experienced, registered RTs who havecompleted an advanced-level education in the radio-logic sciences and passed an advanced certificationexamination offered by the American Registry ofRadiologic Technologists. RAs’ educational prepara-tion will provide them with the additional skills andknowledge they need to be able to assist radiologists inthe diagnostic imaging environment. They will workunder the supervision of radiologists but will not inter-pret examinations or transmit observations of imagesto anyone other than the supervising radiologist.

The seeds for this new career level for RTs weresown in 2002, when the American Society of Radio-logic Technologists (ASRT) initiated discussions with

Lynn May is Chief Executive Officer for the American Society ofRadiologic Technologists.

The American Society of Radiologic Technologists represents morethan 118,000 members. For more information about the RA, visit theASRT Web site at www.asrt.org.

Address reprint requests to Ceela McElveny, American Society ofRadiologic Technologists, Director of Communications, 15000 CentralAve SE, Albuquerque, NM, 87123-3917. E-mail: cmcelveny@asrt.org

J Radiol Nurs 2005;24:31-32

1546-0843/$30.00

Copyright � 2005 by the American Radiological Nurses Association.

doi: 10.1016/j.jradnu.2005.01.003

VOLUME 24 ISSUE 2 www.radiology

other organizations to develop an advanced clinicalrole for registered RTs.

RTs, historically, have had few advancement op-portunities in the clinical environment. Skilled technol-ogists who want to climb the career ladder typicallymove into management, teaching, sales, or consultingto advance in their profession. Unfortunately, thesepositions often take the best technologists out of thepatient care setting.

The ASRT recognized that expanding the careerladder for RTs would provide an incentive for expe-rienced, expert technologists to remain in the clinicalenvironment. More importantly, it would increaseproductivity and efficiency at a time when the demandfor medical imaging services is soaring and shortages ofRTs and radiologists are widespread.

For the past 3 years, the ASRT has worked withphysician organizations, state regulatory agencies,certification bodies, educational programs, and otherstakeholders to reach consensus on the appropriatelevels of education, certification, and clinical responsi-bilities for the RA. The goals were to ensure that theintroduction of the RA would relieve radiologistsof some of the time pressures experienced because ofongoing workforce shortages, to create a profession-ally satisfying career path for RTs, and to ensure thehighest level of care for radiology patients.

ROLES AND RESPONSIBILITIES

The RA is neither a physician assistant nor a nursepractitioner. He or she is a radiologist extender whoworks under the supervision of a radiologist to providepatient care.

The RA will have three major areas of responsibility.First, he or she will take a leading role in patientmanagement and assessment. Duties in this area mightinclude determining whether a patient has been ap-propriately prepared for a procedure, obtaining patientconsent prior to beginning the procedure, answering

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May The Radiologist AssistantJOURNAL OF RADIOLOGY NURSING

questions from the patient and family, and adaptingexam protocols to improve diagnostic quality. The RAwould also be expected to serve as a patient advocate,ensuring that each receives quality care while in theradiology department or clinic.

Second, the RA will perform selected radiologyexaminations and procedures under the supervision ofa radiologist. In May 2003, the American College ofRadiology Council approved a policy statementregarding a list of roles and responsibilities of an RA.Although each RA’s responsibilities will vary, a few ofthe procedures on the American College of Radiology-approved list include assisting radiologists withinvasive procedures, performing fluoroscopy for non-invasive procedures under direct supervision of theradiologist, placing nasoenteric and oroenteric feed-ing tubes in uncomplicated patients, and performingselected peripheral venous diagnostic procedures. Thelevel of radiologist supervision will vary, depending onthe type of examination.

And, finally, the RA may be responsible forevaluating image quality, making initial image ob-servations, and forwarding those observations to thesupervising radiologist. The supervising radiologistwould remain responsible for providing a final writtenreport, interpretation, or diagnosis.

This list of responsibilities is impressive, but it isreally the higher levels of accountability, responsibility,and knowledge that will define the RA’s role. The RAwill not only perform each function competently butalso will understand how that activity fits into the entirecontinuum of a patient’s care. In this way, the RA willcontribute collaboratively in a team approach that willmake a positive impact on the quality of care eachpatient receives.

EDUCATION AND CERTIFICATION

RAs complete an advanced radiologic sciences curric-ulum at the baccalaureate level or higher. Organiza-tions involved in developing the RA believe that abaccalaureate-level program will be sufficient in scopeto allow the RT to acquire the necessary skills andknowledge to allow performance of the proposed rolesand responsibilities of the new career level.

The academic program is supplemented by a formalclinical preceptorship with a supervising radiologist.Through this preceptorship, the student RA acquiresthe hands-on skills required to perform radiologyexams and procedures.

The first RA educational program opened in 2003 atLoma Linda University with 10 students. Programs

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opened in 2004 at the University of Medicine andDentistry of New Jersey in Newark, NJ; MidwesternState University in Wichita Falls, TX; and VirginiaCommonwealth University in Richmond, VA. Severalother schools are likely to begin enrolling studentsin RA programs in 2005, including the University ofNorth Carolina at Chapel Hill.

A national certification method is being developedby the American Registry of Radiologic Technolo-gists so that graduates of RA programs can demon-strate that they are qualified to enter the profession.Certification will be based on a standardized nationalexamination, and a unique set of credentials will beawarded to those who pass the examination.

BENEFITS OF THE RA

Introduction of the RA will benefit patients, physicians,and the profession of radiologic technology in a numberof significant ways:

� The RA will offer a solution to radiology’schronic personnel shortages. Properly used, theRA will relieve the workload burden of radiol-ogists, increasing productivity and efficiency whilecutting costs.

� As demand for medical imaging services escalates,the RA will improve patients’ access to timelyradiologic care.

� By serving as a patient advocate, the RA willimprove the quality of communication betweenradiology patients, their families, and the radiol-ogy department.

� The creation of the RA career level will introducea pathway for RTs to advance in their profession.It will serve as an inducement for prospectivestudents to enter the profession of radiologictechnology and as an incentive for practicing RTsto remain in the profession. Advanced-level RTshave been working in the United Kingdom fornearly 30 years. According to reports fromEngland, as compared with nonadvanced RTs,these technologists report greater job satisfaction,enhanced self-esteem, stronger professional con-fidence, and increased morale. In addition, re-cruitment levels are higher.

The RA program provides an exciting opportunityfor RTs to improve their profession, expand their role,and enhance patient care. The ASRT looks forward tothe day when hundreds of RAs are working incollaboration with RTs, radiology nurses, and radiol-ogists to provide quality patient care.

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