Scope of Practice for Neurodiagnostic Technologists

ASET Position Statement

Preamble

This Scope of Practice document does not supersede state or federal laws or affect the interpretation or implementation of such laws. It may, however, serve as a model for the development or modification of licensure laws, and it should serve as a concise outline of neurodiagnostic skill sets, experience, and responsibilities.

Introduction

The purpose of this document is to define the Scope of Practice for neurodiagnostic technologists and to specify their role as members of the healthcare team following evidence-based outcomes and practice. The Scope of Practice document is based on current and evolving standards and practices, guidelines, regulatory requirements, and technologies.

The Scope of Practice defined in this document is based on neurodiagnostic procedures and the breadth of practice within neurophysiology. The modality-specific scope of practice is further delineated in the ASET Job Descriptions and National Competency Skill Standards. A technologist practices in one or more neurodiagnostic modalities based on levels of training, education, experience, and credentialing . Neurodiagnostic technologists may advance their current level of practice by pursuing additional education, credentialing, and by cross-training in other neurodiagnostic procedures to meet the needs of their expanding role.

Scope of Practice

Neurodiagnostics is the healthcare profession that records, monitors, and analyzes nervous system function to promote the effective treatment of pathologic conditions. Technologists record electrical activity arising from the brain, spinal cord, and peripheral nerves, and from somatosensory or motor nerve systems using a variety of techniques and instruments and are responsible for generating technical descriptions and preliminary reports. These duties are performed in a manner consistent with technologists’ training, education, experience, and credentialing under the direction of administrative and clinical leadership as defined by facility policies and procedures.

Neurodiagnostic procedures include but are not limited to the following:

• • Electroencephalography (EEG)
  • Long Term EEG Monitoring (LTM) (duration ≥ 2 hours)
    • LTM in the Epilepsy Monitoring Unit (EMU)
    • Continuous EEG (cEEG)
    • Critical Care Continuous EEG Monitoring
    • Ambulatory EEG (AEEG)
  • Evoked Potentials (EP)
  • Nerve Conduction Studies (NCS)
  • Neuromuscular Ultrasound
  • Polysomnography/Sleep Technology (PSG)
  • Intraoperative Neurophysiological Monitoring (IONM)
  • Magnetoencephalography (MEG)
  • Autonomic Function Testing
  • Transcranial Magnetic Stimulation
  • Transcranial Direct Cortical Stimulation
  • Transcranial Doppler

Neurodiagnostic competencies define the areas of specialty practice and were developed in part by recommendations found in the American Clinical Neurophysiology Society (ACNS) Guidelines.^1-7

ASET – The Neurodiagnostic Society provides national competencies for the neurodiagnostic procedures listed above.

Education, Training and Credentialing

Neurodiagnostic Education

Primary neurodiagnostic education is offered through certificates and/or degrees with 1- and 2- and 4-year options available. Neurodiagnostic education in both seated and distance learning environments is available. Many neurodiagnostic programs are accredited by the Commission on Accreditation of Allied Health Education Programs (CAAHEP). The Committee on Accreditation for Education in Neurodiagnostic Technology (CAAHEP CoA-NDT) evaluates neurodiagnostic technology and intraoperative neuromonitoring programs, and the Committee on Accreditation for Education in Polysomnographic Technology (CAAHEP CoA-PSG) evaluates polysomnography technology programs. The ASET EEG Core Curriculum offers additional opportunities to build a qualified workforce and establish a minimum education standard. ABRET-recognized neurodiagnostic programs are also available and offer a pathway to exam eligibility.

Credentialing

National organizations offer examination for registry and/or certification to demonstrate competence in all specialties of the profession.

References

1. Sinha SR, Sullivan L, Sabau D, et al. American Clinical Neurophysiology Society guideline 1: minimum technical requirements for performing clinical electroencephalography. J Clin Neurophysiol. 2016;33(4):303-307. doi:10.1097/WNP.0000000000000308.
2. American Clinical Neurophysiology Society. Guideline 9A: guidelines on evoked potentials. J Clin Neurophysiol. 2006;23(2)
3. American Clinical Neurophysiology Society. Guideline 11A: recommended standards for neurophysiologic intraoperative monitoring: principles. 2009 Oct. https://www.acns.org/pdf/guidelines/Guideline-11A.pdf.
4. American Clinical Neurophysiology Society. Guideline twelve: guidelines for long-term monitoring for epilepsy. J Clin Neurophysiol. 2008;25(3). https://www.acns.org/UserFiles/file/Guideline_Twelve__Guidelines_for_Long_Term.8.pdf.
5. Shellhaas RA, Chang T, Tsuchida T, et al. The American Clinical Neurophysiology Society’s guideline on continuous electroencephalography monitoring in neonates. J Clin Neurophysiol. 2011;28(6):611-617. doi:10.1097/WNP.0b013e31823e96d7.
6. López JR, Ahn-Ewing J, Emerson R, et al. Guidelines for qualifications of neurodiagnostic personnel: a joint position statement of the American Clinical Neurophysiology Society, the American Association of Neuromuscular & Electrodiagnostic Medicine, the American Society of Neurophysiological Monitoring, and ASET—The Neurodiagnostic Society. J Clin Neurophysiol. 2023;40(4):271-285. doi:10.1097/WNP.0000000000001004.
7. Herman ST, Abend NS, Bleck TP, et al. Consensus statement on continuous EEG in critically ill adults and children, part II: personnel, technical specifications, and clinical practice. J Clin Neurophysiol. 2015;32(2):96-108. doi:10.1097/WNP.0000000000000165.