Overcoming the theory / practice gap

During my research it has become apparent that a gap between theory and practice exists.  This is linked with the need to understand / define the various roles within the hybrid imaging workforce.  Creating an environment whereby a system of work exists permitting the effective use of CT during hybrid imaging examinations is paramount.  This is only one of the integral aspects of working practices within a hybrid imaging environment, however it is crucial to the overall service delivery. 

The image below depicts the range of potential autonomy associated with using CT in a hybrid imaging environment.  There is the consideration of system / software specifications, but one of the most fundamental questions that does not seem to factor during the procurement / installation and subsequent use of a hybrid imaging system is 'how will you use it?'. 

It is pointless having a 64 slice CT unit attached to a gamma camera if all you intend to do is attenuation correction +/- localisation.  Will you use contrast agent? Will you need to specialist software which looks good, but actually it is not required.  Having the appropriate underpinning knowledge and understanding of hybrid imaging practice will always be linked to the relevant theory and principles.   

 

A committed hybrid imaging workforce should be able to flex and adapt as required, exploring new potential patient pathways and establishing their position within inter-disciplinary teams.  This is easier said than done, however we need to think about our community, the 'nuclear medicine fraternity' (image below).  There needs to be an understanding that a new workforce is emerging, those practitioner that do not have a tradition in non-hybrid practice.  This has merits in the form of a greater appreciation of anatomical imaging etc, however how does the nuclear medicine fraternity balance the development needs of the traditional workforce with the emerging workforce?  This equation does not even include the new trainees who may witness / be influenced by the sub-communities within nuclear medicine. 

Becker (1961) explored the notion that our social and technical order now requires us to deliver more and more (patient) services within the environment we work.  The effective delivery of these patient services depends upon esoteric knowledge and skills and it is crucial that trust exists between all practitioners, regardless of the sub-community belonging.