PET Specialty Exam Proves Challenging for Techs

By Robert Popilock, CNMT

Last fall, the PET specialty examination was offered to certified nuclear medicine technologists for the first time. The examination was designed to test PET-specific knowledge and to ensure that those passing the examination could demonstrate comprehensive knowledge within the field of PET.¹ Of the 203 technologists who took the specialty examination, 105 (51.72 percent) successfully passed.

Given that eligible candidates needed to actively practice PET, and given the passing rate, it would appear that this specialty examination extended beyond routine clinical practice. According to a technologist who passed the examination, "The specialty examination went beyond the basics of FDG scanning knowledge and tested my understanding of such items as cyclotrons, isotope production, shielding and non-routine procedures, ensuring that I truly had an advanced understanding of my field."

Reasons for failure

According to Kathy Thomas, chair of the PET exam and chair of the NMTCB, "There are several factors that likely contributed to the low passing rate of the first PET exam. First, the content outline was not carefully reviewed and used as a study guide in preparation for the exam. Many have commented on the depth of the content outline; however, the depth of the content outline mirrors the content of the exam and it is important that technologists use this outline when preparing for the exam.

"Second, an assumption was made by the NMTCB that certified nuclear medicine technologists would easily answer entry-level items including meters, radiopharmaceutical issues, contamination issues, reporting levels, signage, etc. After all, that's the environment we live and work in. The assumption was that the entry-level items would be 'freebie' questions for the nuclear medicine community, but would allow the quality of the item to be tested for future exams. Unfortunately, that assumption was very wrong.

"Universally, technologists that passed the exam and technologists that did not pass the exam had a difficult time with the entry-level questions. Why? Most likely because they, like the [NMTCB], assumed that they knew this area and did not take the time to review basic instrumentation, quality control and related topics," Thomas said.

"Third, the majority of technologists in the PET community practice in an oncology environment. Few technologists have experience in either cardiology or neurology; however, the PET exam is a comprehensive test of knowledge and those areas could not be excluded. If technologists remember their entry-level nuclear medicine exam, they will remember that it included comprehensive, entry-level knowledge in nuclear medicine and was not limited to mainstream practice. The same is true for the PET and NCT exams.

"And finally, some challenged the exam without studying for it, relying on years of experience to successfully pass the exam and, regrettably, that also played a role in the failure rate for the exam. Although every technologist may be technically capable of producing a diagnostic PET exam, understanding how that image is produced and the factors that can impact the quality of that image separates the PET-certified technologist from the nuclear medicine technologist," Thomas concluded.

Understanding concepts

Some technologists commented on the use of "not," "never," "excluding," etc., in the exam questions, stating that it could mislead the examinee. Most questions ask for the identification of the correct answer. However, in this scenario, the questions provide three right answers and one wrong answer, which means the technologist not only has to understand the correct factors related to the concept, but also those factors that are not related to the concept.

That type of question requires a greater level of understanding of the topic and only those that truly understand the concept will be able to successfully identify the factor that is not correct. It should be noted that the NMTCB has invited PET-certified technologists to contribute to the evolution of the examination to assess current practice and maintain clinical relevance.

Additional resources

The NMTCB provides a content outline of topics likely to appear on the examination. It is widely recommended that technologists download this outline from the NMTCB website at www.nmtcb.org and use it as a study guide.

Second, seek assistance from professional organizations such as the SNM, AMI and ASRT for supporting texts, references and educational opportunities. Finally, don't assume that experience alone will allow you to successfully pass the PET exam.

Reference

1. NMTCB's Specialty Exams: Harder to Earn NCT, PET, SNM Newsletter, Danny Basso

Robert Popilock is a PET specialist working for King's Medical of Hudson in Ohio. This column was published in conjunction with the Academy of Molecular Imaging.