MRI —
Training activity: 9

Details

Review the department’s MR risk assessments and safety policies and recommend improvements where appropriate

Type

Entrustable training activity (ETA)

Evidence requirements

Evidence the activity has been undertaken by the trainee repeatedly, consistently, and effectively over time, in a range of situations. This may include occasions where the trainee has not successfully achieved the outcome of the activity themselves. For example, because it was not appropriate to undertake the task in the circumstances or the trainees recognised their own limitations and sought help or advice to ensure the activity reached an appropriate conclusion. ​

Reflection at multiple timepoints on the trainee learning journey for this activity.

Considerations

• Local rules and generic implant policies
• National guidance and legislation
• Identification of hazards and control measures
• Patient and staff exposure to electromagnetic fields
• Risk assessments
• Audit report including recommendations for action

Reflective practice guidance

The guidance below is provided to support reflection at different time points, providing you with questions to aid you to reflect for this training activity. They are provided for guidance and should not be considered as a mandatory checklist. Trainees should not be expected to provide answers to each of the guidance questions listed.

Before action

• Identify what is expected of you in reviewing and recommending improvements to MR risk assessments and safety policies. This involves understanding the legal and regulatory framework for MRI safety, and the principles of risk assessment in a clinical environment.
• Discuss with your training officer to gain clarity on the scope of the review (e.g., specific policies, recent incidents), the criteria for identifying improvements, and the format for presenting your recommendations. What constitutes a ‘good’ recommendation in this context?
• Think about what you already know about MR safety policies, risk assessments, and quality management systems within a healthcare setting. Have you previously observed or participated in policy reviews, or identified areas for improvement in clinical practice?
• Consider possible challenges you might face during the activity, such as interpreting complex policy language, identifying gaps or inconsistencies, or proposing practical and feasible improvements. How might you handle resistance to change or resource limitations in implementing recommendations?
• When reviewing policies and making recommendations, when would you need to seek advice or help, and from whom e.g., senior management, legal counsel, or other healthcare professionals?
• Do you feel confident in critically appraising existing documents, or are you concerned about the responsibility of suggesting changes to established policies?
• Consider the specific skills you want to develop, drawing upon any previous experiences in documentation review or quality improvement. Do you aim to improve your critical analysis skills, your ability to articulate clear and concise recommendations, or your understanding of governance and regulatory compliance in MRI?
• Identify the specific insights you hope to gain from engaging with this activity. For example, do you want to understand the common weaknesses in MR safety policies, or gain a deeper appreciation for the challenges of maintaining a robust safety culture?
• Consult any actions identified following previous experiences related to safety audits or policy reviews. Did you previously note a need to improve your understanding of specific safety regulations?
• Identify important information you need to consider before embarking on the activity. This could include reviewing national and international MRI safety guidelines, understanding local departmental workflows, and researching best practices in MR safety management.

In action

• During the review, is anything unexpected occurring in the department’s existing MR risk assessments or safety policies?
• Is there any specific policy or risk assessment element feeling different from what was anticipated when reviewing the department’s documentation? How is this experience comparing with previous experiences of reviewing safety documentation or similar policy appraisals?
• How are you reacting to any unexpected developments during the review of MR risk assessments and safety policies?
• How is this impacting on the actions you are taking, for example, is your response to an unforeseen gap or inconsistency appropriate? Are you adapting or changing your approach to identifying improvements? Is it affecting your ability to independently review and recommend improvements?
• How are you feeling in the moment; for example, is it difficult to adapt the review criteria? Is it affecting your confidence in proposing recommendations?
• What is happening following the actions you are taking whilst reviewing and recommending improvements for the department’s MR risk assessments and safety policies?
• How are you working within your scope of practice when appraising and advising on departmental safety procedures?
• What are you learning as a result of any unexpected development you are encountering during this review process?

On action

• Begin by summarising the key points of your experience reviewing MR risk assessments and safety policies. This might include the specific documents you examined, the areas where you identified weaknesses or strengths, and the improvements you recommended.
  • Consider specific events, actions, or interactions that felt important, such as discovering outdated policies, identifying discrepancies between policy and practice, or engaging in discussions with staff about real-world safety challenges.
  • Include any ‘reflect-in-action’ moments where you adapted your review methodology or prioritisation of recommendations as you gained deeper insights into the department’s safety culture or specific operational gaps. For example, did you initially focus on one aspect of safety but then realise another area e.g., patient screening was more critical?
  • Did you feel confident in your ability to critically appraise complex safety documentation, or did you feel challenged by the responsibility of identifying potential risks to patient and staff safety?
• Identify what learning you can take from this experience regarding MR safety management. What strengths did you demonstrate, such as analytical thinking, attention to detail, or ability to propose practical solutions? What skill or knowledge gaps were evident, such as understanding regulatory requirements or best practices in risk assessment methodology?
  • Compare this experience against previous engagement with similar activities e.g., reviewing other departmental policies or contributing to safety audits. Were any previously identified actions for development related to policy review or safety improvement achieved? Has your practice in enhancing MR safety frameworks improved?
  • Identify any challenges you experienced during the review, such as resistance to change, lack of comprehensive documentation, or difficulty in prioritising recommendations, and how you reacted to these. Did these challenges affect your ability to deal with the situation, and were you able to overcome them?
  • Did you need to seek advice or clarification from a senior safety officer, a clinical governance lead, or external guidelines to inform your recommendations?
  • Do you feel more capable of contributing to and leading MR safety initiatives?
• Identify the actions or ‘next steps’ you will now take to support the assimilation of what you have learnt from reviewing MR safety policies. What will you do differently next time you are involved in a safety review, perhaps employing a more structured approach or engaging with a broader range of stakeholders?
  • Has anything changed in terms of what you would do if you were faced with a similar situation again, such as how you would present your recommendations or advocate for their implementation?
  • Do you need to practise any aspect of this activity further, such as understanding the legal implications of safety policies or developing more effective communication strategies for proposed improvements?
  • Consider any feedback you received e.g., from your Training Officer or department head and how you will integrate it into your future practice.

Beyond action

• Have you revisited your experiences of reviewing MR risk assessments and safety policies?
• Review your actions from your previous reflections for this activity. What actions did you identify you needed to take to improve your ability to critically appraise policies, identify gaps, or formulate actionable recommendations for improvement? Have you completed these actions?
• Are you ready to demonstrate this new learning into practice when engaging with future policy reviews or safety audits, ensuring you can contribute effectively to a safer MR environment?
• Has discussing departmental safety culture or the implementation of policies changed your perspective on the importance of robust risk management and the role of the MRI physicist?
• How have these experiences impacted upon your current practice and contribution to MR safety?
• Consider how this learning will support you in preparing for observed ‘in-person’ assessments such as delivering training in MR safety to staff or discussing the results of a service review. Your insights from reviewing policies directly feed into these communication and advisory roles.
• Consider how your practice in evaluating and improving MR safety frameworks has developed and evolved over time. Do you now possess a more comprehensive understanding of the interplay between policy, practice, and potential risks, and can you more confidently identify when an issue requires escalation or a systemic change beyond your immediate scope of practice?

Relevant learning outcomes

#	Outcome
# 3	Outcome Appraise and advise on the safe application of MRI in the clinical environment.