Guest Lecture: Leadership and Career Development in Medical Imaging with Nate

Introduction and Professional Context

Host and Guest Introduction: * Erin: The course instructor for class MRAN 2027. * Nate: The Director of Imaging Services at Kingston Health Sciences Centre (KHSC). * Scope of Role: Nate oversees multiple clinical sites within Kingston, Ontario.
Nate’s Educational and Professional Background: * Initial Career: Nate started as a medical radiation technologist (MRT) specializing in nuclear medicine. * Training and Placements: He completed his nuclear medicine program and did placements in Nuclear Medicine (‘Nukemed’) and PET CT in Ottawa, as well as a placement in Kingston. * Career Trajectory: Worked casual roles in both Ottawa and Kingston before settling permanently in Kingston. * Advanced Education: He returned to school to complete a Master’s program in Healthcare Quality at Queen’s University. * Quality and Patient Safety: Following his Master’s, he worked for $3.5\,years$ as a Quality and Patient Safety Specialist at Providence Care Hospital. * Providence Care Context: A subacute care, rehab, and mental health facility. Nate supported $18$ community programs across the Southeast region (Belleville, Kingston, Brockville, and surrounding areas), involving outpatient rehab and mental health. * Managerial Roles: He served as the Manager for Imaging and Cardiac at Brockville General Hospital. Despite having no background in Cardiac, he managed teams performing echoes, stress tests, and event monitors. * Return to KHSC: rejoined the team in $2017$ as a Program Manager and has served as the Director for the past $4\,years$ .

Overview of Kingston Health Sciences Centre (KHSC)

Multi-Site Operations: * Kingston General Hospital (KGH) Site: A high-volume acute care and tertiary care hospital with a large inpatient population, emergency department, and busy critical care areas. * Hotel Dieu Hospital Site: Primarily an ambulatory setting featuring an urgent care center. * Breast Imaging Kingston (BIC): A dedicated breast health center opened in $2022$ located on Highway $15$ in Kingston.
Team Composition and Staffing: * MRT Workforce: The department employs approximately $130$ MRTs, including full-time, part-time, and casual staff. * Interdisciplinary Scope: The team includes specialists in X-ray, Ultrasound, PET CT (started last year), Nuclear Medicine, MRI, and a large Interventional Radiology (IVR) program. * Hybrid Roles: KHSC offers opportunities for MRTs to work in multiple modalities simultaneously (e.g., X-ray/Mammography, CT/X-ray, MRI/X-ray). * In-House Training: KHSC provides internal training programs to help staff develop into specialized areas such as IVR, Mammography, Bone Mineral Density (BMD), and CT.

Primary Success Traits and Philosophies

The Growth Mindset: * Nate identifies this as the number one trait for success in healthcare. * It involves the ability to absorb feedback, proactively ask for critiques, and approach mistakes as learning opportunities. * Nate observes that students who start at a lower skill level often outpace their peers specifically because of their diligence and commitment to continuous improvement.
The Importance of Relationships (Advice from ‘Jim’): * Nate shared an anecdote about a charge tech named Jim, with whom he worked in a small clinic (specifically in a ‘closet-sized’ hot lab). * Anecdote: During a stressful day performing myocardial perfusion studies ( $15$ to $16$ patients a day), Jim advised Nate to "enjoy the journey." * Key Lesson: Technology and equipment change, but the core of the career is people. If a practitioner does not enjoy the interactions with patients and colleagues, they will be miserable. One must take the extra second to listen to the patient during interviews.
Placements as ‘Working Interviews’: * Nate views clinical placements as a two-way evaluation. It is an opportunity for the student to see if the environment fits them and for the site to evaluate the student as a potential hire. * Advice: Be active and part of the team culture. Nate joined an imaging baseball team called ‘The Shadows’ (which ran for $25\,years$ prior to COVID-19) to integrate with the staff.

Leadership Principles and Career Advice

The "Spider Web Effect" of Leadership: * As a technologist, one might impact $15$ to $20$ patients per day directly. * In a leadership capacity, the impact is wider; by supporting a team of clinicians, a leader indirectly affects hundreds of patient experiences.
The Power of Saying "Yes": * Nate attributes his career growth to volunteering for small opportunities, such as a Sunday afternoon open house at Queen’s University. * Networking Chain Reaction: Volunteering for the open house led to meeting professors, which led to becoming a facilitator for the ‘IDEAS’ program, which led to finding a Master’s mentor, and eventually a seat on the graduate school committee.
Essential Skills for the Future: * Change Management: Understanding how to lead through the constant shifts in healthcare. * Quality Improvement (QI): Moving away from "top-down" management and toward empowering teams to use data and feedback to pivot and improve processes. * Reflective Practice: Looking back at situations that went poorly and those that went well to identify what to do differently next time.

Questions & Discussion

Motivation for Management (Question from Jesse): * Question: Why move to a director role involving paperwork when you missed imaging? * Response: Nate missed the people and the department environment. While he doesn't scan, the continuity of working with a consistent team satisfies the desire for connection. He views leadership as a way to have a larger positive impact.
Education for Leadership (Question from Maggie): * Question: What education was needed for the transition? * Response: The Master’s in Healthcare Quality was pivotal. He also emphasized the role of mentors like Karen Pearson, who encouraged him to expand his scope.
Demonstrating Student Leadership (Question from Isabelle): * Question: How can students show leadership without being in a role? * Response: By modeling right behaviors, being a good teammate, and bringing ideas forward positively. "Daily decisions define destiny."
Advice for Future Roles (Question from Jordan): * Response: Career-wise, say yes to everything early on to build connections. Healthcare is a small world where everyone knows everyone.
Building Professional Relationships and Feedback (Question from Melissa): * Question: How can students seek feedback and build relationships? * Response: Balance challenging the status quo with respecting the experience of veteran staff. When asking "why" something is done, use softer language like "I’m curious about this" to avoid appearing defensive or accusatory.
Nuclear Medicine Interests (Question from Jillian): * Response: KHSC is open to students shadowing in different modalities like Nukemed or MRI. There is currently work being done on "second discipline" programs for Nukemed, similar to the first-discipline program at Mohawk.
Conflict Resolution (Question from Sharmiga): * Question: How do you handle conflicts between new and experienced staff? * Response: Nate prefers coaching people to talk to each other directly rather than intervening immediately. Communication is almost always the root. However, if a complaint is widespread (e.g., $12$ people have the same issue), he will have a candid one-on-one with the individual.
Building Trust (Question from Dmitry): * Response: Follow through on promises. If you say you will adjust a plan based on feedback, do it. Respond to safety incidents with a learning approach rather than a punitive one.
The Danger of "Soft" Feedback (Question from Emma): * Question: What moment changed how you lead? * Response: Nate once tried to give a staff member constructive feedback using the "sandwich" method (positive-negative-positive). The staff member left thinking they were doing a "fantastic" job because the negatives were too softened. Nate learned that being direct and candid is necessary for effective improvement.