A pan-Europe comparative review of allied profession roles in cardiac science

Introduction Over the last 75 years, Cardiac Science (CS) has evolved into a widely practised Allied Profession (AP) throughout Europe. Despite this prominence, there are limited comparative works on AP titles, regulation, scope of practice (SoP) and training routes. The recognition of CS as a profession in the United Kingdom dates from 1948 when the Society for Cardiac Science and Technology (SCST) was established. In the UK, the AP role has evolved into Cardiac Physiologists with education at bachelor’s degree level and Clinical Scientists at master’s level. The SoP has also developed over time, leading to more advanced training and practice. Similar progression in professional titles, SoP, education and training routes also occurred in other European countries. Purpose To compare Allied Professions in Cardiac Science (APCS) including professional nomenclature, regulation, education, SoP, and pan-European identity. Methods Data were collected from November 2023 to January 2024. European and country databases were scrutinised to determine nomenclature, professional status, regulation, and educational requirements. Online translation was used when information was not available in English. Results The analysis of databases revealed 15 APCS roles (Table 1). In 60% of the countries, the role is officially recognised by a professional body that provides advocacy, education, training, and defines SoP (Figure 1). Moreover, 47% of countries operate a mandatory licensing or registration scheme. In 33% of countries, APCS roles are incorporated within the Biomedical Science profession. In the remaining countries, nine alternate titles are used to describe the discipline. In most cases (66%), education is at bachelor’s level, while in others, particularly where recognition is more limited, it is at a vocational level. In four countries (Austria, Ireland, Iceland, and The Netherlands), SoP is broadly in line with the UK, covering electrocardiography, echocardiography, haemodynamics for invasive procedures, implantable devices, and electrophysiology. Conversely, in other countries SoP varies and can include nuclear medicine (Sweden and Denmark) or perfusion and respiratory (Italy and Portugal). Some countries restrict SoP to defined roles such as pacemaker or echo technicians (Spain, Luxembourg, and Switzerland). Notably, Finland, France, and Norway, as well as most Eastern European countries do not recognise APCS roles. Conclusion While APCS roles are widely acknowledged in Europe, they lack visibility compared to other health professions. The variability in professional titles, education, and SoP constrain the development of a unified identity. Collaborative works connecting APCS roles across Europe may enhance identity, improve quality of care and raise the profile of this discipline.