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In this paper, we examine the practice level of engineers and discuss whether Clinical Engineering is a profession or an occupation. Many think that occupation and profession are synonyms, but are they? One must explore the difference, if it exists, between these terms, and to accomplish that, clarification of these terms is being offered and established first. We conducted a review of the terms and proceeded to identify if the tenants that are expected to be associated with professional standing are included in applying clinical engineering practices and to what level if it is. Engineering is a profession that improves the quality of living and for the common good. The professional education of engineers requires the education to contain a body of specialized knowledge, problem-solving skills, ethical behavior, and good analytical judgment in the service of all people. The engineering education domains aim to form individuals who are intellectually trained, practically adept, and ethically accountable for their work. Especially within the healthcare delivery system, engineering work engages problem-solving dependent upon sufficient body of knowledge to deal with practical problems by understanding the why, knowing how and identifying the when. There are various levels of the expected body of knowledge within the clinical engineering field ranging from engineers with formal academic training at undergraduate and graduate levels to clinical engineering technologists and technicians having graduated from between 1-4 years of academic training. Engineers may further select to publicly proclaim their adequate preparation and mastering of knowledge to conduct their work through a credentialing process that can confer the term professional, registered, or certified engineer if successfully achieved. Once the differences of working characteristics and obligations between occupation and profession are understood, it is clear that clinical engineers must continuously commit to pursue and fulfill these obligations. Therefore, every professional engineer is called on to achieve a certain degree of intellectual and technical mastery and acquire practical wisdom that brings together the knowledge and skills that best serve a particular purpose for the good of humanity. Clinical engineers and technologists are critical for sustaining the availability of safe, effective, and appropriate technology for patient care. It is as important for their associations to collaborate on compliance with professional obligations that their jobs require.

To determine the maturity of a profession one must have knowledge of the individual attributes of the practitioners of that profession and the universal strength of unique skills among them. We have conducted an international survey of Clinical Engineering (CE) professionals associated with the management of technological tools developed for and deployed within the healthcare delivery system. The survey targeted participants who are practicing engineering tasks related to the safe and efficient management of technology used in the delivery of healthcare services. The participants, consisted of cohort of individuals whose contact information was collected from attendees at previous clinical and biomedical engineering events including: (1) presentation at congresses/regional meetings, (2) serving on international technical committees or task forces, (3) attending virtual clinical engineering events, or (4) subscribing to the Global Clinical Engineering Journal. The purpose of the survey was to identify the state of organization of CE professionals and the potential gaps, if any exists, in meeting their professional development needs. The survey was developed and conducted using on-line internet apps and links that provided access to a questionnaire in six different languages to facilitate optimal participation and response accuracy in as many geographical regions as possible. The survey was conducted in the early part of 2020 over period of 6 weeks. The overall response rate1 was over 5% (total of 14,400 individual contacts less estimated 1,750 contacts who did not open/bounced back). A total of 667 responses from 89 countries were received. This survey is considered an improvement, over previously reported international surveys2,3, with regard to response volume and rate. The strength of this survey, having larger response volume and geographical representation, when compared with previously documented CE surveys has improved even with narrower time window of data collection. The current survey consisted of twelve questions, beginning with information request about the respondent professional affiliation and moves on to request the ranking of the criticality of C.E. specific issues, while another question provided for comments in free formatting text style. The responses received were in all of the seven languages posted and included representation from all the continents. The analysis of the survey responses shows that about 60% of the responders identified themselves as clinical engineers, 16% as other type of engineers, 13% as technicians, and 12% as health professionals. Responses to particular questions demonstrate highest ratio of number of affirmative to negative responses. They were related to the perceived value responders placed on stronger international collaboration and on their willingness to engage in it. A conclusion, based on the analysis of the responses to this international survey, that the CE profession is awaiting the consolidation of the momentum generated by growing healthcare needs and present global conditions. The identified gap is lack of a dedicated international representation that is clearly identifiable within the CE field. Analysis of the survey data suggests the need of an international framework focusing on the various CE professional groups/associations and their members to face present challenges. The establishment of a global alliance to clearly identify the field of clinical engineering; to promote public awareness; to form liaison with government agencies and other healthcare decision makers, will improve global cooperation and inter CE societal relations that will serve patients as well.

Yadin David, EdD, PE, CCE, Matthew Baretich, PE PhD, William A. Hyman, PE, ScD, Wayne Morse, and James O. Wear, MSBME, CCE, FACCE From the Biomedical Engineering Consultants, LLC, Houston, Texas (Dr David); Baretich Engineering, Inc, Fort Collins, Colorado (Dr Baretich); Department of Biomedical Engineering, Texas AM Morse Medical, Linc Facility Services Company, Seattle, Washington (Mr Morse); Scientific Enterprises, Inc, North Little Rock, Arkansas (Mr Wear).

Clinical engineers are a subset of biomedical engineers, who are explicitly considered by the International Labour Organization (ILO) as health professionals. It seems reasonable that similar career paths and opportunities, including professional registration, certification, or licensure, are available to all health professionals for the benefit of public health and patient safety. Professional certification is the process of issuing a certificate formally attesting that a knowledge, know-how, skills, and competences acquired by professionals have been assessed and validated by a competent body against predefined standards. This chapter describes the introductory information, history, current status, and future prospects of certification in clinical engineering, and gives a number of examples of different national, transnational, and global models. Biomedicine and healthcare challenges in the twenty-first century urge regulation of all health professions worldwide, so one international umbrella program for certification in clinical engineering is among the priorities of the global clinical engineering community.

Certification of clinical engineering staff was started in the US in 1970 with the certification of biomedical engineering technicians by the Association for the Advancement of Medical Instrumentation (AAMI). In 1975 AAMI and the American Board of Clinical Engineering (ABCE) started in the US to certify individuals in clinical engineering. These two programs were merged in 1984 under the International Certification Commission (ICC). The US program was discontinued in 1999 by the ICC, but was initiated again in 2004 by the Healthcare Technology Certification Commission (HTCC). Certification of clinical engineering personnel exists in China (2005), in Taiwan (2001), in Japan (1987) and by the Commission for the Advancement of Healthcare Technology Management in Asia (CAHTMA) (2005) in Malaysia.

A survey was done of biomedical engineering programs in hospitals of under 100 beds. A random sampling of 400 hospitals was selected from the American Hospital Association Guidebook. Questions were asked with regard to the size, educational background and experience of the biomedical engineering staff. The organizational location of the program was surveyed, and most programs were part of facility engineering. Programs are discussed as full-time, part-time and outside service contracts. An in-depth analysis of the educational and training background of BMETs has been done. This part of the study covered the type of training and what additional training they felt they required.

The clinical engineering staff including engineers and technicians is an important element in the use of medical technology in health care facilities. The clinical engineer is a member of the technology management team, which is involved in the selection of new technology and the design of facilities for the use of the technology. What is the impact on healthcare delivery as a result of certified Clinical Engineers and Biomedical Engineering Technicians (BMETs)? Can a certified clinical engineering staff improve accreditation of hospitals? Certification of staff is one measure of quality control for medical technology. However, no country requires that the BMETs and Clinical Engineers be certified in order to perform any functions with medical technology. The history of certification will be presented including how it differs in different countries. The recognition of certification of BMETs and Clinical Engineers by the healthcare community will be discussed. The first certification programs were initiated in 1972 in the United States. A clinical engineer may be called a biomedical engineer or medical engineer and different terminology is also used for the BMETs.

The 2001 terrorist attacks in the United States and subsequent concerns about terrorist attacks at other US locations led the US Department of Veterans Affairs (VA) to determine that preparing for emergency mass-casualty events is part of the cost of operating the 163 VA hospitals across the nation. This report describes how VA assembled internal and external policy experts and developed a comprehensive hospital-wide emergency masscasualty decontamination program, entitled ‘‘Emergency Mass-Casualty Decontamination Program.’’ The program is cost-efficient, protective of hospital staff, and suitable for implementation at other US hospitals. The VA’s primary goals for creating a program are (1) to protect facilities, staff, and patients to ensure continuity of health care capabilities, and (2) to respond to emergency needs of civilian casualties overflowing from local community emergency capabilities. The VA program includes (1) formal evaluation of emergency decontamination needs at each VA hospital, (2) selection of equipment, and (3) development of an appropriate staff training program. The long-term program also addresses the sustainability, reporting requirements, oversight, and certification of the participants.

In a field such as healthcare facility management where technology is changing all the time, training is critical, says James O. Wear, Ph D, of the USA. This article is based on an International Federation of Hospital Engineering Congress paper.

Transference and solvation phenomena for the ions of lithium chloride in water and water-dioxane solvents have been studied. The transference numbers of the anion as a function of salt concentration in water and as a function of solvent composition are presented graphically and discussed in relation to relative solvation of the lithium and chloride ions. The amount of solvent transferred from the anode to the cathode is presented graphically and discussed.

EPR spectra differing in hyperfine splitting have been reported for Mn (II) ions in Ν,Ν-Dimethylformamide (DMF) when using Mn (ClO4) 2 and MnCl2. The difference in the reported spectra is shown to be due to the species MnCl4 2⊖ by a mole ratio plot. The presence of MnCl⊕ is also indicated by a mole ratio plot. Three basic spectra, differing in hyperfine splitting, are obtained for solutions of Mn (ClO4) 2 in DMF to which varying amounts of chloride ion have been added. ΔH° for the equilibrium reaction of the species Mn2⊕ und MnCl⊕ was determined from the variation of the formation constant, Kc, with temperature over the range 25° to 116°C. Values for ΔF° and ΔS° at 25°C are also given.

(1971). Biomedical Equipment Technicians—The Need and a Solution. Hospital Topics: Vol. 49, No. 2, pp. 29-33.

0.01 ᴍ solutions of Mn (ClO4)2, MnCl2 and MnSO4 in water-methanol mixtures were studied at 25 °C to determine the effect of these anions and of solvent composition on the ESR intensity and linewidth of Mn(II). A significant feature of the data was the large difference between the intensity of Mn(ClO4)2 and that for MnCl2 and MnSO4 in solutions containing greater than about 0.5 mole fraction methanol. A plot of linewidth versus mole fraction methanol shows little difference between Mn(ClO4)2 and MnCl2 but an increasingly greater difference between these salts and MnSO4 with increasing methanol content. These results are interpreted as being due to first coordination sphere complex formation in solutions containing Cl⊖, while the SO4 2⊖ data are affected by both first and second coordination sphere complexes depending upon the solvent dielectric constant. The Mn(ClO4)2 data were interpreted as showing that the primary solvation sphere of the Mn(II) ions was changing as the composition of the bulk solvent changed. These results are compared with similar data in aqueous solution and confirm that complex formation involving Cl⊖ or SO4 2⊖ ions and Mn(II) is extensive in water-methanol mixtures.

Transference and solvation phenomena associated with magnesium chloride in water and water-ethanol solvents have been studied as a function of concentration and solvent composition. The transference number and grammes of solvent transferred from anode to cathode are presented graphically and discussed in terms of relative solvation of the magnesium and chloride ions. In mixed solvents evidence is presented to substantiate the formation of MgCl + . Using Hittorf transference numbers and grammes of solvent transferred from anode to cathode, true transference numbers have been calculated for the salt in the various solvent systems. In addition relative solvation numbers were determined and used to substantiate explanations of the solvation of the cation and anion.

Transference and solvation phenomena for the ions of hydrochloric acid in water-dioxane solvents have been studied. The cation transference number and the grams of solvent transferred from anode to cathode are presented graphically as a function of solvent composition. The data are discussed in terms of the nature and extent of solvation of the ions of hydrochloric acid by the components of the solvent and the reference substance, α-methyl-D-glucoside. Comparison is made with the transference and solvation data of the ions of hydrochloric acid in the ethanol-water system.

Sodium azide solution can result in serious explosion hazards if the waste is disposed of in copper, brass or lead sinks, lines or fittings. Includes Editor's Note, "Does sodium azide waste enter copper or lead plumbing in your laboratory?" by Steere, Norman V.