Updated: Nov 18, 2020
Have you been in the field of Intraoperative Neurophysiologic Monitoring for many years but have never quite felt like you had proper or complete training? If so, do NOT feel like you are alone. You are NOT by yourself if you get a lump in your throat when the surgeon starts questioning you and you just don't feel confident and competent to engage in conversation. A recent anonymous survey of over six hundred individuals currently employed by IOM Companies/Hospitals who list their primary responsibilities as Intraoperative Neuromonitoring, reveal that over 87% feel that they were not adequately trained!!! Even more disturbing is that more 65% of those who have been in the field FIVE years or longer, feel that they are STILL NOT adequately equipped, educationally, to intelligently discuss Intraoperative Neurophysiologic Monitoring with surgeons, anesthesiologists, or neurologists!!! The participants in the survey were asked about their knowledge in categories which ranged from modalities (tests) performed in surgery, neuroanatomical structures at risk in surgery , knowledge of anesthesia and its effects on neuromonitoring, knowledge of neuropathology, and knowledge of the technical aspects of IONM. The weakest self assessments were from categories of Neuropathology (weakest with an average competence of just 19%), Anesthesia (with an average competence of 27%), and Neuroanatomy (with an average competence of 34%). The majority felt they were most competent in technical skills (74%) and knowledge of modalities (68%).
The IOM Academy wants to change these statistics and do so sooner than later! Recently, while on a consulting project, our Director of Education was confided in by an individual who was amazingly vulnerable. This person was dually credentialed and had been working in the OR for a decade. "I know I am credentialed and I should know, but I DO NOT KNOW WHAT I AM DOING beyond connecting the patient and hoping I record what I need!" The technologist continued with, " But I TRULY WANT TO KNOW, I'VE JUST NEVER HAD ANYONE TEACH ME!". This statement is amazing and seems almost unbelievable to those in many other professions, especially professionals in the medical field. However, in the field of IONM it is a statement that could be made by MANY MORE were they to be as vulnerable as this brave person. It is very difficult to hide incompetence from those who are competent. It is hard to disguise a lack of education and training from those who are educated and trained properly. So let's just bring light to a subject that is often hidden due to ego, or fear, or frustration. The elephant in the (operating) room is that there is a dearth of education and training in the field of IONM. And while there have been great strides taken by organizations such as ASET and ASNM, the facts remain that due to a lack of regulatory influence (among others things such as greed and a rush to create "revenue generators") education and training is far from adequate!
There are FIVE ABRET approved, Pathway IV, Formal Education Programs. And of that FIVE four are focused primarily on in-house training of employees. The IOM Academy began as Neurodiagnostic Consultants' in-house training program as well. But after many years of utilizing this successful academic and clinical training program NDC began to offer consulting services to hospitals, neurologists, surgeons, and yes, even OTHER IOM companies! To offer to train our competition's employees allowed us to realize that our passion and our focus truly is education. And if there is anything missing in our profession it is a true academic and clinical training program! One whose PRIMARY FOCUS is to set standards of excellence in education and to produce thoroughly trained clinicians who know much more than just the technical aspects of the field. Clinicians who have a thorough understanding of neuroanatomy, anesthesia, and pathology and fully know how to monitor any case type!
A clinician educated in this manner will make a difference in the success of this profession. Neuromonitoring personnel have, for way too long, sat in the corner of the OR in silence HOPING that the surgeon would not question them and hoping that there would be no changes that they were unequipped to address. Many surgeons have lost confidence in neuromonitoring over the same period of time in which it has grown exponentially. Why? Because during the last twenty years unscrupulous business owners have seen IONM as their get-rich-quick and at any cost ticket! Having more employees in the OR means covering more cases and that means more money! And since there are very few restrictions on who can be in the OR there has been no shortage of people. Further, since training and educating people takes time, know-how, and money, there has been very little incentive to train properly. And this is EXACTLY why we have a profession filled with improperly and inadequately trained people- BY THEIR OWN ADMISSION!!! It is past time for a change!
SO what is the answer? Formal, thorough academic and clinical instruction, taught by experts with decades of experience, is the only realistic way to gain back respect as a profession, to operate ethically, and ultimately to provide a meaningful service to patients and to the surgeons and hospitals that care for them. For the many of you in the profession who were not trained properly...ADMIT IT- then CHANGE IT!!! Be like our friend who swallowed her pride and said, " I DONT KNOW WHAT I'M DOING" and then make the change, just as she did! There is so much at stake beginning with the patient's safety. In short, to become a better IONM professional it takes hard work, systematic and organized and thorough training, and a desire to do the right thing!
Contact us today and together, we will make a difference !