EAST TENNESSEE STATE UNIVERSITY

RADIOGRAPHY PROGRAM

CLINICAL COMPETENCY MANUAL

CLASS OF 2003 – 2005

All Contents Revised: 7/03

EAST TENNESSEE STATE UNIVERSITY

RADIOGRAPHY PROGRAM

CLINICAL COMPTENCY MANUAL

TABLE OF CONTENTS

Clinical Competency Education System – Description……….…………………………………4

ASRT Clinical Objectives…………………………………………………………………………5

Specific Clinical Objectives……………….………………………………………………….…..6

Guidelines for Positioning………………………………………………………………………..8

Program Faculty Descriptions……………….…………..…….………………………..……….9

Student Responsibilities…………………..…………………………………………………..…12

Fidelity…………………………………………………………………………..……….12 Ethics/Morals……………………………………………………………………..……..12

Confidentiality of Patient Records and Information……………………………..…….13

Impaired Functioning……………………………………………………………….…..13

Student Responsibilities………………………………………………………………....15

Faculty Expectations…………………………………………………………………….15

Injuries/Illness……….…………………………………………………………………..17

Penalties…………………………………………………………………………………19

Clinical Dress Code………………………………………………………………….…..20

Student Supervision……………………………………………………………………..21

Repeat Radiograph Policy………………………………………………………………21

University Sponsored Activities…………………………………………………………22

Absences Due to Emergency, Special Circumstances, or Illness………………………22

Appeal of the Faculty Member’s Decision………………………………………….…..22

Professional Activities & Day……………………………………………………….…..22

General Attendance Policy………………………………………………………….…..23

Clinical Attendance Policy………………………………………………………….…...23

Clinical Tardiness Policy……………………………………………………………..…23

Clinical Assignments………………………………………………………………..…..24

Clinical Education Transfers………………………………………………………..….24

Clinical Education – Meals/Breaks……………………………………………………..24

Malpractice Insurance…………………………………………………………….…….24

Compensatory Time – Clinical Education………………………………………..…….24

CPR Certification………………………………………………………………………..25

Lead Identification Markers…………………………………………………………….25

Clinical Competency Grading System………………………………………………..…25

Explanation of Categories………………………………………………………………25

Radiography Program – Clinical Grading Scale……………………………………….26

Clinical/Didactic Course Correlations and Rotations…………………………………………26

Clinical and Didactic Relationship……………………………………………………………..30

Clinical Education I – Syllabus……………………………………………………………..….31

Clinical Education I - Rotational Objectives………………………………………………..….40

Clinical Education II – Syllabus………………………………………………………………..50

Clinical Education II - Rotational Objectives………………………………………………….59

Clinical Education III – Syllabus………………………………………………………………65

Clinical Education III - Rotational Objectives…………………………………………………73

Clinical Education IV – Syllabus…………………………………………………………….…79

Clinical Education IV - Rotational Objectives……………………………………………..…..91

Clinical Education V – Syllabus……………………………………………………………….112

Clinical Education V - Rotational Objectives…………………………………………………113

COE Checklist………………………………………………………………………………….125

Elective Competencies………………………………………………………………………….126

Competency Performance Evaluations………………………………………………………..127

Introduction Performance Evaluation……………………………………………………..….135

Junior Performance Evaluation………………………………………………………..……..136

Senior Performance Evaluation……………………………………………………..………...138

Specialized Performance Evaluation……………………………………………………….…140

Comprehensive Evaluation…………………………………………………………………….141

Permanent Record of Clinical Performance…………………………………………………..142

EAST TENNESSEE STATE UNIVERSITY

RADIOGRAPHY PROGRAM

CLINICAL COMPETENCY EDUCATION SYSTEM

A competency based clinical educational experience has been designed to ensure a sequential, comprehensive experience exposing students to the many facets of the imaging sciences. The educational design (step-lock) promotes student’s application, synthesis, integration, critical analysis, and evaluation of theories and concepts in performing radiographic procedures. During five sequentially structured competency-based experiences, in conjunction with rotational objectives, course objectives, and didactic courses, student professional development reflecting recognition/appreciation of the health care team and patient centered care is examined and evaluated. Clinical experiences focus on competent patient care and assessment utilizing total quality management in the performance of radiologic procedures. Outcome assessment is based on achievement of clinical competency inclusive of the patient’s well-being prior, during and following radiologic procedures.

Imaging examinations performed by, and accompanying responsibilities assigned to, a radiographer shall be at the direction of physicians qualified to request and/or perform radiologic procedures. Upon completion of the program the radiographer shall be able to:

1. Apply knowledge of anatomy, physiology, positioning, and radiographic techniques to accurately demonstrate structures on imaging receptors.

2. Determine exposure factors to achieve optimum radiographic techniques with minimum radiation exposure to the patient.

3. Evaluate radiographic images for appropriate positioning and image quality.

4. Apply the principles of radiation protection for the patient, self, and others.

5. Provide patient care and comfort.

6. Recognize emergency patient conditions and initiate life-saving first aid and basic life-support procedures.

7. Evaluate the performance of radiologic systems, know the safe limits of equipment operation, and report malfunctions to the proper authority.

8. Exercise independent judgment and discretion in the technical performance of medical imaging procedures.

9. Participate in radiologic quality assurance programs.

EAST TENNESSEE STATE UNIVERSITY

RADIOGRAPHY PROGRAM

ASRT CLINICAL OBJECTIVES

(adopted from ASRT curriculum)

Execute imaging procedures with appropriate supervision levels

Adapt to changing/varying clinical experiences

Organizational theories focus encompassing team practice, membership roles, and

conflict resolution

Assess and evaluate patient's status prior, during, and following radiologic procedures utilizing appropriate actions

Accurate assessment and evaluation of psychological and physical changes in patient condition incorporating appropriate actions

Awareness of gender, culture, age, and socioeconomic factors that influence patient's compliance with procedural instructions, diagnosis, treatment, and follow-up

Awareness and procedural adaptation to meet age-specific, disease-specific, and cultural needs of patients

Deliver clinical service concentrating on effective patient-centered service regardless of age, gender, disability, special needs, ethnicity, or culture

Identify and incorporate appropriate patient and family education strategies ensuring comprehension

Provide psychosocial support in the management of patient and family interactions

Assess and record appropriate patient histories

Utilize ABC's of CPR in patient assessment and demonstrate basic life support procedures

Respond appropriately to patient emergencies

Identify and interpret patient side effects and/or complications of radiologic procedures, contrast administration incorporating appropriate actions

Differentiate between normal ECG rhythms and abnormal ECG tracings

Apply standard and transmission-basic precautions

Apply appropriate medical asepsis and sterile technique

Prepare technologies and methodologies to perform radiological procedures

Competently apply cardinal principles of radiation to include time, distance, shielding, and radiation monitoring

Apply the principles of total quality management

Report equipment malfunctions facilitating appropriate corrective actions

Validate procedure orders accurately and implement corrective changes inclusive of follow-up when applicable

Support safe, ethical, and legal practices

Integrate the radiographer's scope of practice and practice standards into clinical practice setting

Consistently maintain patient confidentiality standards

Apply principles of patient transfer, positioning, immobilizing, and restraining

Compliance to department/institution procedures for emergencies, disasters, and accident response

Adhere to national, institution and/or department standards, policies and procedures regarding care of patients, provision of radiologic procedures, and the reduction of medical errors

Break down the chain of command in emergencies, disasters, and accidents

Professional competency performance in technical factor selection in quality radiographic production utilizing principles of ALARA

Image assessment ensuring appropriate clinical information, image quality, and patient documentation.

Professional competence in determining corrective measures to improve inadequate images

EAST TENNESSEE STATE UNIVERSITY

RADIOGRAPHY PROGRAM

SPECIFIC clinical OBJECTIVES

I. CLINICAL PRACTICE

A. Code of ethics/professional behavior

1. Scope of practice

2. Practice standards

3. CARE bill

4. Incident reporting mechanism

5. Standards for supervision

a. Direct

b. Indirect

B. Professional communication

1. Patients

2. Patient’s family

3. Healthcare team

C. Role of health care team members

1. Technical

2. Professional

3. Patient’s Bill of Rights

D. Scheduling and sequencing of exams

II. PROCEDURAL PERFORMANCE

A. Order/requisition evaluation and corrective measures

B. Facilities set-up

C. Patient assessment (history), education, and care (pre, post-procedural)

1. Patient monitoring – emergency and non-emergency

a. Vitals

b. Equipment

(1) Crash cart

(2) Oxygen

(3) Suction

c. Patient emergencies

(1) Allergic reactions

(2) Cardiac/respiratory arrest

(3) Physical injury

(4) Seizures

(5) Diabetic emergencies

d. Basic life support

2. Interpretation of patient records using confidentiality

3. Documentation

4. Special considerations

a. Patient focused care

b. Standard precautions and transmission-based precautions

c. Medical asepsis

d. Sterile technique

5. Communication style

6. Age specific

7. Cultural and socioeconomic sensitivity

D. Imaging

1. Positioning

a. Body mechanics

b. Positioning accessories

2. Technical considerations

a. Manual

b. Automatic exposure control (AEC)

c. Digital/computed radiography with basic quality control

3. Reporting equipment failure

4. Image processing (automatic/digital)

5. Image analysis

a. Image quality

(1) Density

(2) Contrast

(3) Recorded detail

b. Image manipulation

(1) Conventional

(2) Digital

c. Legal requirements for image documentation

E. Patient/personnel protection

1. Cardinal Principles

a. Time

b. Distance

c. Shielding

2. Other Radiation Protection

a. Radiation monitoring

b. Exposure reduction techniques

c. Room design

3. Equipment/accessories

4. Beam restriction

a. Filtration

b. Positioning

c. Image receptor system

d. Scatter control techniques

(1) Grids

(2) Air gap techniques

(3) Reverse cassette

e. Technical factor selection

5. Medical error reduction

EAST TENNESSEE STATE UNIVERSITY

RADIOGRAPHY PROGRAM

guidelines for positioning

PROCEDURE PRACTICE FOR POSITIONING

The student will in a laboratory situation and given a phantom:

1. Correctly position the phantom, stabilizing or immobilizing as needed.

2. Select the correct film size.

3. Align the x-ray tube to part and film.

4. Adjust the cone or collimator to appropriate field size.

5. Apply necessary protective shielding.

6. Measure the part.

7. Select exposure factors.

8. Expose the film.

9. Evaluate the film for accuracy of positioning and exposure quality.

18 STEP PROCEDURE FOR POSITIONING

The student will:

1. Evaluate a requisition to determine the positions required.

2. Introduce self to 'patient' and explain the exam.

3. Verify correct identification of 'patient'.

4. Verify correct preparation, if any, of patient.

5. Prepare radiographic equipment.

6. Instruct 'patient' to lie on or sit beside the x-ray table.

7. Select appropriate film.

8. Position 'patient' longitudinally and transversely.

9. Immobilize as necessary.

10. Align tube and film.

11. Adjust collimator to appropriate field size.

12. Apply gonadal shields.

13. Measure part.

14. Select appropriate technique.

15. Instruct patient.

16. Make mock exposure(s).

17. Repeat procedure for each view required.

18. Assist patient from table.

EAST TENNESSEE STATE UNIVERSITY

RADIOGRAPHY PROGRAM

PROGRAM FACULTY DESCRIPTIONS

Three full-time didactic instructors are available and participate in the delivery of didactic courses. Assignments are made on the basis of individual expertise in cooperation with the program director.

In accordance with the "JRCERT Standards," each clinical education agency has a designated clinical instructor who devotes time to achieve objectives as outlined in the clinical competency manual. The clinical instructors are salaried by their respective hospitals with specific job descriptions that outline qualifications and responsibilities. The clinical instructor is responsible for clinical instruction and clinical competency evaluation of students. In addition, the clinical staff supports the educational process and assists with the students’ progress.

The Role of the Program Director

The program director is a full-time employee and salaried by the sponsoring institution, East Tennessee State University. The program director is responsible for all components of the radiography program including the organization, administration, periodic review, continued development, and program effectiveness. The program director’s responsibilities include:

1. Organizes, administers, reviews, develops, and assures program effectiveness.

2. Conducts on-going program assessment.

3. Participates in budget planning.

4. Evaluates and assures clinical education effectiveness.

5. Maintains current knowledge of the professional discipline and educational methodologies through continuing professional development.

6. Assumes the leadership role in the continued development of the program.

7. Directs student recruitment, selection, and advising.

8. Prepares and maintains course outlines and objectives, instructs and evaluates students, and reports progress.

9. Provides student counseling and advising as needed.

10. Reviews and revises course materials.

11. Participates in the program’s Advisory Committee meetings.

The Role of the Clinical Coordinator

The clinical coordinator is a full-time employee and salaried by the sponsoring institution, East Tennessee State University. The clinical coordinator works in conjunction with the program director to ensure effectiveness of the clinical component of the program. The clinical coordinator's responsibilities include:

1. Correlates clinical education with didactic education.

2. Evaluates students.

3. Coordinates clinical education and evaluates its effectiveness.

4. Cooperates with the program director in periodic review and revision of clinical and didactic course materials.

5. Maintains current knowledge of the professional discipline and educational methodologies through continuing professional development.

6. Maintains current knowledge of program policies, procedures, and student progress.

7. Participates in the student recruitment and selection process.

8. Prepares and maintains course outlines and objectives, instructs and evaluates students, and reports progress.

9. Provides student counseling and advising as needed.

10. Participates in the program’s Advisory Committee meetings.

The Role of the Didactic Instructor

The didactic instructor is a full-time employee and salaried by the sponsoring institution, East Tennessee State University. The didactic instructor is responsible for assisting the program director with ongoing program assessment as well as providing instruction to the students. The didactic instructor's responsibilities include:

1. Assists the program director with the outcome assessment of the program.

2. Prepares and maintains course outlines and objectives, instructs and evaluates students and reports progress.

3. Cooperates with the program director in periodic review and revision of course materials.

4. Maintains appropriate expertise and competencies through continuing professional development.

5. Participates in student recruitment, selection, and advising.

6. Provides student counseling and advising as needed.

7. Participates in the program’s Advisory Committee meetings.

The Role of the Clinical Instructor

Clinical instructors are employed by the respective health care agencies and are appointed as University Adjunct Faculty. Therefore, clinical instructors are responsible for the day-to-day guidance and supervision of the students assigned to that clinical agency. Clinical instructor responsibilities include:

1. Is knowledgeable of program goals.

2. Understands the clinical objectives and clinical evaluation system.

3. Provides students with clinical instruction/supervision.

4. Evaluates students’ clinical competence.

5. Provides student counseling (as needed).

6. Maintains competency in the professional discipline and in instructional and evaluative techniques through continuing professional development.

7. Maintains current knowledge of program policies, procedures, and student progress.

8. Provides open lines of communication with clinical coordinator and program director.

9. Maintains student records (time sheets, clinical education logs, Clinical Competency Examinations, and Monthly Performance Evaluations) and submission of these to the clinical coordinator at the end of each semester.

10. Assures of student professionalism at all times during clinical education.

11. Attends all Faculty and Advisory meetings.

12. Participates in student selection.

13. Discusses course syllabi at the beginning of each semester and discusses course requirements with the students.

14. Delivers curriculum as outlined in a timely and effective manner.

The Role of the Clinical Staff

The clinical staff is employed by the respective health care agencies and participate in the day-to-day guidance and supervision of the students assigned to that clinical agency. Clinical staff responsibilities include:

1. Understands the clinical competency system.

2. Supports the educational process.

3. Maintains current knowledge of program policies, procedures, and student progress.

EAST TENNESSEE STATE UNIVERSITY

RADIOGRAPHY PROGRAM

STUDENT RESPONSIBILITIES

I. FIDELITY

An obligation to uphold the dignity and honor of your chosen profession exists in your

personal and professional life. Achievement of professional and personal integrity will

enhance and promote the status of this allied health profession. This implies that you

will:

A. practice radiologic technology in accordance with recognized and accepted criteria. Identify yourself as a student technologist.

B. support and cooperate with local, state, and national societies that strive to advance the knowledge, understanding, and new developments in medical imaging.

C. holistically embody physical and emotional health that affords maximum proficiency. Consequently, personal, professional, social, and economic status will be enhanced.

D. respect the dignity and individuality of every human regardless of race, creed, nationality, color, economic, disability, or other status.

E. interpret the art and science of radiography and its role and function to individuals and the public to promote an understanding of radiologic technology.

II. ETHICS/MORALS

A. Students accepted into a program in the Department of Health Related Professions are expected to demonstrate professional behavior and demeanor that is expected of a health care provider. Professional behavior encompasses a broad range of expectations, including the expectation of trustworthiness and at all times keeping the welfare of the individual receiving care a priority.

B. To this end, any instance of student intent to misrepresent facts will be cause for immediate program dismissal. Misrepresentation of facts, verbal or written, can include but not necessarily be limited to, the following situations:

1. bribery in any form.

2. deliberate withholding information about a patient, patient care, and/or self.

3. plagiarism in written reports/assignments.

4. presenting another student's work as one's own.

5. cheating in any form.

6. forgery or falsification of any document in any form.

C. Students guilty of academic misconduct, either directly or indirectly through participation or assistance, are immediately responsible to the course instructor.

III. CONFIDENTIALITY OF PATIENT RECORDS AND INFORMATION

In the process of performing one's assigned duty in the healthcare facility, it is possible to overhear information regarding patients, physicians, and/or hospital staff, which must be considered confidential. You are directed, therefore, not to discuss outside the healthcare facility, or even with other healthcare facility students or employees these bits of information. Even casual conversation with other students may be overheard and thereby violate the right of privacy of others. Be particularly careful about your conversation in elevators, eating-places, and other places of assembly within or outside the healthcare facility.

A. Any discussion of patient information must occur for the purpose of fulfilling clinical assignments. Idle conversation regarding patient care is not exhibiting appropriate demeanor for healthcare professionals.

B. The patient owns the information contained in their medical record and the healthcare facility owns the medical record document. Therefore, students cannot remove original, microfilmed, or photocopied medical records from the facility's premise. Any health data that identifies a patient, physician, or healthcare provider by name is considered to be confidential information.

C. Confidential information is privileged information that may not be disclosed without proper, written authorization from the patient. Not only is medical information confidential, but also identifying information, such as a patient's age, address on discharge, and the service or medical unit on which the patient was hospitalized. Unauthorized disclosure of health information is a breach of confidentiality punishable by state or federal law. Students who release health information without proper authorization will be dismissed from the program.

IV. IMPAIRED FUNCTIONING

A. East Tennessee State University must maintain a safe, efficient, academic environment for students and provide effective, safe patient care while students participate in the clinical setting. The presence or use of substances, lawful or otherwise which interfere with student judgment or motor coordination, poses an unacceptable risk for patients, colleagues, the institution, and the healthcare agency. Therefore, the unlawful use, manufacture, possession, distribution, or dispensing of alcohol or illegal drugs, the misuse of legally prescribed or "over-the-counter" drugs, or being under the influence of such substances while engaged in any clinical experience poses an unacceptable risk and is strictly prohibited. For purposes of this policy, "being under the influence" is defined as meaning that the student's judgment or motor coordination is impaired due to the presence or use of any of the substances mentioned above.

B. If a student appears to be under the influence of alcohol or drugs, or is functioning in any impaired manner, the faculty or agency personnel responsible for that student has the responsibility of dismissing the student from clinical experience that day. All time missed must be made up in accord with the Program Attendance Policy.

1. ALCOHOL: Alcohol use by any student while performing assigned responsibilities is prohibited. "Being under the influence" means that alcohol or drugs, or a combination of drugs/alcohol affects the student, in any detectable manner, which interferes with safe performance of duties. Symptoms of influence are not confined to those consistent with misbehavior, nor to obvious impairments of physical and mental ability, e.g. slurred speech or difficulty in maintaining balance. A determination of "influence" can be established by a professional opinion, a scientifically valid test, and, in some cases such as alcohol, by a layperson's opinion.

2. LEGAL DRUGS: Being under the influence of a legal drug,

prescribed or self-administered, by any student while performing assigned responsibilities is prohibited if use or influence may affect safety of self, patients, co-workers, or the public. If determined that a student does not pose a safety threat to others and performance is not affected, the student will be allowed to carry out assigned responsibilities.

3. ILLEGAL DRUGS: The use, sale, purchase, transfer, or possession by any student of an illegal drug, which is defined as any drug (1) which is not legally obtainable, or (2) which is legally obtainable but has not been legally obtained, is prohibited. This includes marijuana. The presence in any detectable amount of illegal drugs while performing assigned responsibilities is prohibited. Students may be required to take blood tests, urinalysis, and/or other drug/alcohol screening tests:

a. as part of a periodic physical examination.

b. when clinical supervisory personnel (faculty or hospital employee), fellow students, or a student's self-professed use determine that the circumstances justify testing.

4. Student's consent to submit to such tests is required as a condition of program acceptance. Student refusal to submit to such tests may result in disciplinary action, including program dismissal, for a first refusal or any subsequent refusal. The student will assume testing cost.

5. Policy violation can result in disciplinary action including program dismissal for a first offense. A specific plan will be developed on an individual basis. Students may be required to provide evidence of routine or random laboratory testing and counseling.

6. ETSU provides student counseling and assistance services to those who are identified as requiring help. Upon program dismissal for policy violation, a plan for rehabilitation will be devised which may include mandatory counseling, periodic drug/alcohol screening, and periodic reporting before consideration of student program re-admission. The student must assume the responsibility for plan compliance before a student's request for program re-admission can be considered.

V. STUDENT RESPONSIBILITIES

A. To the Physician:

1. Competently carry out all orders of medical staff physicians.

2. Do not discuss or criticize a physician with a patient, the patient's family, and/or friends. The student should never express a personal preference for the services of any physician to the patient, patient's family, or friends.

3. Do not interpret radiographs or fluoroscopic images nor express an opinion of diagnosis or treatment to the patient, patient's family, or friends.

4. Accord healthcare team members with respect and consideration.

B. To the Patient:

1. Comprehend your responsibility to the profession and to the patient. Carelessness and neglect of any duty towards the treatment and care of patients is not tolerated.

2. Patients should be treated with compassion, dignity, and the right to privacy. The obligation of patient privacy extends from the onset of patient care to infinity. Under most circumstances you cannot divulge information concerning a patient's condition, state of affairs, or any other personal information.

C. To the Supervising Radiologic Technologist:

1. Recognize and appreciate the technical expertise of radiographers.

2. Demonstrate tolerance and understanding of limitations or inadequacies of others.

3. Resist adverse criticism of staff. As your technical competency increases, you should rely less on others for their assistance.

VI. FACULTY EXPECTATIONS

The faculty has high expectations of students enrolled in an allied health program. The following areas highlight these general expectations.

A. Conduct: Students are to refrain from gossiping, needless complaining, smoking except in designated areas, loud talking, boisterous laughing, gum chewing, and any other activities that could disturb patients or is out of place in the clinical/ university setting. Kind and courteous behavior and consideration for the patients, public, staff, and fellow students will enhance your professional image and afford personal satisfaction from your education. Personal conversations should not be conducted in the presence of patients. Conversations in or around patient rooms, waiting areas, or any area where patients/families are present should be limited to only those matters concerning the patient.

B. Conflict of Conscience: If requested or required to perform duties to which personal objection occurs because of religious or personal convictions, you should discuss this matter with your instructor. If relief is not immediately available, you will be expected to complete the assignment and then bring the matter to the attention of your instructor. Resolution will be aimed to the mutual advantage of the clinical agency and the student.

C. Criticism: It is easy to criticize but more difficult to make suggestions or modifications necessary to improve conditions. Complaints and/or grievances should be discussed directly with whom the complaint or grievance is directed. This may involve the clinical instructor, clinical coordinator, didactic instructor, and/or program director. Hostile attitudes will not resolve conflicts. It is recommended that energy be used to promote improvements.

D. Ethics: All individuals participating in healthcare share the responsibility of observing a Code of Ethics that requires, in general, that good is to be done and evil is to be avoided. The Code of Ethics requires truthfulness, honesty, and personal integrity in all human activities. Furthermore, all clinical students share some degree in the responsibility for observing a Code of Ethics that regulate the activities of doctors, nurses, and allied health personnel. In general, the following applies to all clinical settings and students:

1. All information concerning patients or the healthcare facility's business must be kept in strict confidence and not discussed with non-concerned parties. Confidential information should never be discussed with individuals outside the healthcare facility. Refer to confidentiality of patient records and information for additional description.

2. A student's private, as well as professional life, should be conducted according to the highest moral standards. Students are not to burden patients or employees with their own personal problems.

E. Horseplay: Playful friskiness is always out of place in the clinical environment. Such actions frequently result in neglect of duty and in unfortunate accidents or incidents. Students are expected to reflect the seriousness of their involvement by dignified and faithful performance of their duties.

F. Impaired Functioning: Unauthorized possession or consumption of intoxicating drugs or beverages on the healthcare facility/university premises by students is prohibited. Students who report for clinical education in an intoxicated condition or use intoxicants during clinical experience are subject to disciplinary action that may include dismissal. Students should report incidents of apparent intoxication whether involving students or others to their clinical instructor, clinical coordinator, and/or program director. Drug possession and/or use is likewise prohibited. Please refer to the section on IMPAIRED FUNCTIONING for Additional information on this subject.

G. Language: Boisterous or coarse language is always out of place in the clinical setting. Students will be expected to use appropriate language in all conversations.

H. Personal Affairs: Students should not discuss personal problems or business matters at a healthcare facility. It is inappropriate for students to unburden themselves to others at a clinical agency. Students should not approach physicians for attention to their personal needs. Students requiring a physician's attention should make suitable arrangements. Physicians should not be "circumstanced" by students while attending to their hospitalized patients.

I. Strangers and Difficult Persons: Proper handling of difficult persons is important in order not to disturb patients. In all cases, the clinical instructor or clinical supervisor should be notified immediately to secure help from qualified healthcare facility/university personnel. Do not use force, except in self-defense against other employees, students, patients, or visitors. All students should be aware for unauthorized persons loitering in or around the healthcare facility. Reporting the presence of suspicious persons to a supervisor, clinical instructor, clinical coordinator, security guard, or administrative personnel is required.

J. Telephone Courtesy: Courtesy in using a telephone can make friends for the healthcare facility and make clinical experience more pleasant for you and for those interacting with you. Appropriate telephone etiquette can enhance client/facility relationships. In using a telephone, please keep in mind the following rules:

Answer promptly.

Identify yourself by name/department.

Give accurate and careful answers.

Read back messages for clarity.

Transfer calls tactfully.

Always say "please" and "thank you".

Use a helpful and pleasant tone of voice at all times.

Hang up gently.

K. Theft: Since clinical healthcare facilities are open 24-hours, you should be alert to entry of unauthorized persons. If individuals who do not appear as an employee or a student, or who might be outside their work area, please offer assistance in destination direction. Employee and student cooperation is imperative to minimize theft. Students need to ensure that supplies and equipment are stored in approved areas and maximum-security measures are observed. Bringing excessive amounts of money or valuables to the healthcare facility or university is not recommended. Healthcare facilities and ETSU are not responsible for the loss or theft of personal items. Clinical/university property may not be removed from the premises except by written authorization from the department head or administrator in advance. Theft by students is, of course, cause for student termination.

L. Tips and Gifts: Acceptance of money by students from a patient or other persons with whom the healthcare facility does business is not permitted. Anyone wishing to make a donation or gift to the hospital should be referred to a supervisor or to administration. Solicitation of personal gifts or donations by students is prohibited. Sometimes patients and others wish to provide a nominal gift, such as a box of candy at Christmas time or other appropriate times, as an expression of appreciation for goodwill or services. These may be accepted graciously but should not be encouraged. It is emphasized that gifts of more than nominal value must be refused as they are inappropriate and unacceptable.

M. Weapons: Students are forbidden to bring firearms, knives (other than ordinary pocketknives), or other weapons to the healthcare facility/university premises. Violation of this policy or engagement in violence of any type on the healthcare facility/university premises is subject to dismissal from the clinical agency and disciplinary action by university officials.

VII. INJURIES/ILLNESS

The Department of Health Related Professions attempts to maintain a safe environment for students enrolled in a program of study. Should an incident occur while a student is performing assigned clinical responsibilities, the following policies must be followed:

A. Supervising faculty, and if appropriate, clinical personnel, must be notified immediately upon student injury or illness requiring medical attention. Students (as stated in contractual agreements) are considered guests in the clinical agency and are therefore, responsible for securing and financing any medical treatment required as a result of accidental injury or illness. Students must realize that although a medical facility may offer/suggest treatment within the facility, the student will assume charges for service. All students are individually responsible for obtaining adequate health insurance or for bearing any costs incurred for medical treatment while on campus or in assigned clinical facilities. A student wishing to purchase health insurance through a policy available to ETSU students may contact the Comptroller's Office for appropriate forms. Students are strongly encouraged to have adequate health insurance while enrolled in a program of study.

B. For injuries or health problems occurring during a clinical assignment requiring treatment and not life threatening, options to consider are:

1. treatment from an independent physician and/or facility of the student's choice at cost to the student.

2. treatment by the clinical agency’s emergency department at cost to the student.

C. Supervising and program faculty and appropriate clinical personnel must be immediately contacted if any student is responsible, or involved in, an unusual incident in the clinical area. Examples of such include, but are not limited to:

1. unusual occurrences to self, patient, staff, or visitor

2. injury to self, patient, staff, or visitor

3. formal complaints lodged against a student

4. major equipment damage attributed to student misuse

5. misadministration of pharmaceuticals or procedures to correct

patient

6. contamination of patient or environment

7. any activity which may, or does, result in adverse consequences to patients or personnel.

D. The student and clinical instructor must submit a completed report to the program director within 24 hours. Additionally, clinical facility's incident protocol procedures must be strictly followed and necessary reports completed and properly signed.

VIII. PENALTIES

Radiography students must follow stated policies and procedures of the program, the

university, and the clinical agencies. In the advent of policy/procedure non-

compliance standing punitive protocol recognizes the following actions:

A. Unprofessional and/or unethical conduct (review/action individually assessed).

B. Student falsification of any record, clinical or didactic will be individually assessed.

C. Whenever a student is going to report to the clinical facility later than the

designated time, she/he must inform the clinical instructor or supervisor. Clinical instructors/supervisors must be notified by 7:30 A.M., if not, students will receive a fifty percent (50%) grade reduction in the attendance/ethics category for each absence.

D. Unexcused clinical absences will result in a 20% grade reduction in the

attendance category of the clinical grade.

E. Excused and unexcused clinical absences must be made up within a one (l) week period (7 days) of the absence. Each unexcused absence, which is not compensated for in this time frame, will result in a 20% reduction in the attendance category of the clinical grade.

F. One tardy/semester will not constitute a grade cut. Successive tardy(s) will result

in a 20% grade reduction in the attendance category of the clinical grade.

G. Students will receive a 50% reduction in the attendance category for leaving the clinical facility without approval from the appropriate personnel.

H. Any student found in a clinical session without their film badge will receive a ten- percent (10%) deduction in the Ethics section of the clinical grade and WILL BE SENT HOME to retrieve his/her radiation monitor. This time must be compensated.

IX. CLINICAL DRESS CODE (AT THE CLINICAL AGENCY)

This profession is one in which a person must maintain himself/herself in a neat,

professional, and conservative manner at all times during their clinical experience.

Students must dress as follows:

A. Two student identification pins must be purchased. Student identification pins and film badges must be worn. (Film badges to be worn at collar level).

B. Uniforms are to be purchased from the Uniform Corner (formally known as Wink’s Uniforms). The program faculty has selected approved uniforms. Students may choose only from selected styles:

a. Shirts, white - select from faculty approved shirts

b. Slacks or skirt, white – select from faculty approved shirts

c. Lab jacket, white (all students must purchase at least one lab jacket with a monogram). Purchase faculty approved lab jacket

C. Program patch with semicircular “student patch” must be sewed on the left shoulder of shirts and lab jackets two inches below the shoulder seam. The patch was sewed on free of charge and is provided by the Uniform Corner.

D. Solid white shoes with a solid white rubber sole, socks, hose, etc.

(Standard). Shoes must be polished and kept clean. Clogs are NOT permitted in

the clinical agencies.

E. Uniforms are to be kept neat, clean, pressed, and in good repair at all times.

F. No large or cumbersome jewelry may be worn. Long earrings and hoops will not be permitted. (Subject to institutional discretion).

G. No perfume or cologne is allowed in the clinical area. Conservative makeup is acceptable.

H. Students must maintain a professional appearance at all times. A conservative appearance in grooming is mandatory.

I. Students who have long hair must wear it pulled back or on top of their heads. (Subject to institutional discretion).

J. Beards must be kept neat and clean.

Compliance to this dress code is essential. If non-compliance occurs, a reduction of 10%

will result in the dress category of the clinical grade for each infraction. In addition, the

student may be sent home to comply with the dress code and will be required to return to

clinical that day. All time missed must be made up in accord with the Program

Attendance Policy.

Some clinical agencies require an additional hospital identification badge. This is to be worn with your student program pin and not to replace it.

All students must adhere to this dress code. Furthermore, individual clinical agencies may or may not have additional stipulations.

X. STUDENT SUPERVISION

A. All students during their clinical assignments must be supervised by the following

standards:

1. The clinical instructor shall assume responsibility for supervision and

evaluation for the radiography student at each clinical agency.

2. A qualified registered radiographer reviews the request for the radiographic examination to:

(a) determine student capabilities to successfully complete the examination; or

(b) determine if patient condition contraindicates student performance of the examination; or

B. If any of the above is questionable or negative, the radiographer should be present in the radiographic room.

C. The qualified registered radiographer must check and approve the radiographs in

reference to image quality prior to patient dismissal. Direct supervision regarding

film critique is mandatory throughout the program.

D. Prior to competency validation, the radiography student is under direct supervision of a registered technologist. Once competency is obtained and the

above circumstances warrant such action, the student will be under indirect

supervision.

1. Direct supervision is defined by the JRCERT as student supervision by a qualified practitioner who reviews the procedure in relation to the student’s achievement, evaluates the condition of the patient in relation to the student’s knowledge, is present during the procedure, and reviews and approves the procedure.

2. Indirect supervision is defined by the JRCERT as student supervision by a qualified practitioner immediately available to assist students regardless of the level of student achievement. Immediately available is interpreted as the physical presence of a qualified practitioner adjacent to the room or location where a radiographic procedure is being performed. This availability applies to all areas where ionizing radiation equipment is in use.

E. Under NO circumstances should a student perform mobile radiography without

supervision. A technologist MUST ACCOMPANY a student during mobile

radiography regardless of competency level.

XI. REPEAT RADIOGRAPH POLICY

Students will be allowed to repeat radiographic examinations one time only, and this must be performed with a registered radiologic technologist present in the radiographic room to assist. If the repeat is not satisfactory, the technologist must perform the additional films while the student observes.

Repeats shall be recorded in the appropriate portion of the Clinical Log Book. This

document will be reviewed by program faculty and included in the written clinical

objective grade.

XII. UNIVERSITY SPONSORED ACTIVITIES

Absences occasioned by university sponsored activities absences must be excused by all faculty members as long as the number of absences does not exceed the number prescribed in an established and previously announced departmental policy and the faculty member has been informed in advance of the intended absence. An excused absence means only that students must be allowed a reasonable opportunity to complete all assignments and tests missed because of the excused absence. It is the responsibility of the student and of the faculty or staff sponsor of the activity to inform the faculty member in charge of the cause of the upcoming absence. Transmitting a Class Absence Authorization form to the faculty member should provide this information. These forms can be obtained from the office of the Vice President for Student Affairs. However, it is not necessary to obtain permission for absences from the office of the Vice President for Student Affairs, nor does this office inform the faculty members of the expected absences.

XIII. ABSENCES DUE TO EMERGENCY, SPECIAL CIRCUMSTANCES, OR

ILLNESS

In the case of an emergency (e.g., deemed appropriate, death in the family or illness) absence from class and/or clinical may be excused, and the student will be allowed a reasonable opportunity to complete all assignments and tests missed. In such cases it is the responsibility of the student to explain the situation to the faculty member as soon as possible. The faculty member may require verification of the emergency situation or illness from the student. Students confined at home or in a hospital for an extended period of time should notify the faculty member from whose class/clinical site he/she will be absent so that arrangements can be made for completion of assignments if feasible. The number of such absences may not exceed stated policy for the class and the student must make arrangements to complete missed assignments and/or clinical education time.

XIV. APPEAL OF THE FACULTY MEMBER ' S DECISION REGARDING EXCUSED/UNEXCUSED ABSENCES

If the student has evidence that a faculty member has not excused an absence which should have been excused within the guidelines stated above, the student can appeal the decision of the faculty member to the chairperson of the department and/or dean of the college or school in which the course was offered.

XV. PROFESSIONAL ACTIVITIES & DAY

Student involvement in different professional organizations/functions is encouraged. Clinical time accumulated due to professional educational activities must be pre- approved by the program director. The use of professional educational time requires a 24-hour notice to the clinical instructor. Professional educational activities cannot be used to shorten program length or be scheduled during the last semester clinical week.

One professional day is available to each student during the program of study to provide an opportunity for advancement within the field (orientation, interviews, etc.). A request must be submitted in writing with appropriate documentation one (1) week prior to the designated date to the program director, clinical coordinator, and clinical instructor. Each request will be reviewed and evaluated on an individual basis and professional merit. Activities reviewed as non-professional will follow the unexcused absence policy.

XVI. GENERAL ATTENDANCE POLICY

Attendance is a contract between faculty and students. It is expected that students will attend class and clinical regularly and provide the faculty with a reason for any absence. Failure to attend classes or clinical regularly can affect students' grades and financial aid. Each department within the university has the right to set a maximum number of absences (including absences due to university activities and illnesses) permitted during an academic term.

A. The program recognizes all breaks and holidays as published in the academic calendar.

B. Absences due to university-sponsored activities are excused if they do not exceed course credit number and faculty are informed in advance.

C. Attendance to professional activities may be allowed in lieu of normal class attendance. Prior approval by the program director must be obtained.

D. All students must abide by the attendance policy as stated in the university catalog.

E. No delinquent clinical time is carried from one semester to the next – unless approved by the Program Director.

XVII. CLINICAL ATTENDANCE POLICY

Protocol regarding student absence from the clinical area is as follows:

A. Notify the: 1. Clinical instructor; or 2. Supervising technologist prior to scheduled time. NO EXCEPTIONS (Prior to 7:30 AM). If a student fails to notify either of the above, a 50% grade reduction will occur in the attendance/ethics category.

B. Unexcused clinical absences will result in a 20% grade reduction in the

attendance category of the clinical grade.

C. Excused and/or unexcused clinical absences must be made up within a one-(l) week period (7 days) of the absence. Each unexcused absence, which is not compensated for in this time frame, will result in a 20% reduction in the attendance category of the clinical grade.

D. The student assumes responsibility for obtaining clinical course notes missed due to his/her absence.

E. The clinical instructor will state make-up test policy. Unless notified otherwise, tests will be given the next class meeting in the event of inclement weather.

F. Each semester the designated number of clinical hours must be completed according to the course syllabus. No delinquent clinical time will be carried over from one semester to the next unless approved by the program director/division chair.

G. Excused and unexcused clinical absences must be made up within a one-(l) week period (7 days) of the absence and approved by the clinical instructor. Each absence, which is not compensated for in this time frame, will result in a 20% reduction in the attendance category of the clinical grade.

XVIII. CLINICAL TARDINESS POLICY

A. Excessive tardiness is not tolerated. Tardiness is when any student reports to the clinical facility or classroom later than the scheduled time.

B. Whenever a student is going to report to the clinical facility, or didactic class later than the designated time, he/she must inform the appropriate instructor. Clinical instructors must be notified by 7:30 A.M. and university professors by 8:00 A.M. on the day of occurrence. One tardy/semester will not constitute a grade cut. A second and/or successive tardy(s) will result in a 20% grade reduction in the attendance category of the clinical grade.

C. Missed clinical time resulting from a tardy must be made-up and scheduled as approved by the clinical instructor.

XIX. CLINICAL ASSIGNMENTS

Radiography student clinical assignments criteria is as follows:

A. The number of student seats in accordance to professional standards and clinical agency resources.

B. Clinical agency and student residence proximity.

C. Conflict of interest.

The ETSU radiography program cannot guarantee any student specific clinical agency site assignment(s). The program reserves the right to alter clinical education assignments as needs dictate.

XX. CLINICAL EDUCATION TRANSFERS

Due to the limited student enrollment according to professional standards and clinical resources, clinical site transfers are limited and require faculty approval.

Clinical site transfer protocol is as follows:

A. A written request including rationale and justification and request to convene a faculty meeting must be submitted to the program director. The program director will notify the student of the meeting date/time.

B. The student will attend the scheduled faculty meeting and allowed an opportunity to discuss request rationale and justification addressing pertinent faculty questions and/or statements.

C. The faculty, in closed discussion, will recommend transfer approval vs. non- approval.

D. The program director and/or clinical coordinator will notify the student in writing of the faculty's decision regarding their transfer request.

XXI. CLINICAL EDUCATION - MEALS/BREAKS

Meal and break times are inclusive of the scheduled clinical education hours. Students are not allowed to leave the clinical education center during meal/break times unless approved by the clinical instructor.

XXII. MALPRACTICE INSURANCE

The ETSU Radiography Program requires all students to purchase and maintain professional liability insurance. Provider information and cost is distributed during initial program registration. All students must document coverage prior to participation in clinical. Liability insurance must be renewed annually. Students are required to submit appropriate documentation to program officials.

XXIII. COMPENSATORY TIME - CLINICAL EDUCATION

Missed clinical time must be made-up (within seven (7) days), pre-arranged and approved by the clinical instructor and documented utilizing the instructor-student conference form.

It is the student's responsibility to ensure all time is recorded promptly and accurately on appropriate forms (kept by the clinical instructor). Student participation in clinical education is permitted only during scheduled hours. At no time can a student participate in program activities exceeding 40 hours, unless on a voluntary basis. Clinical education hours cannot be accumulated prior to normal scheduling unless approved by the program director and under no circumstances to shorten program length.

XXIV. CPR CERTIFICATION

Students must provide documentation of current CPR certification to continue participation in the clinical phase of the Radiography Program. Failure to present such documentation will result in clinical course failure.

XXV. LEAD IDENTIFICAITON MARKERS

Radiography students must use their own-initialed right and left lead markers to properly identify radiographic anatomy. These markers will be made available for your purchase at the clinical site. NOTE: These markers must be present on all films that the student performs for competency grading requirements.

XXVI. CLINICAL COMPETENCY GRADING SYSTEM

Grades will be determined by: (For Clinical I, II, III, and IV)

Rotational Objectives 10%

Performance Evaluations 15%

Clinical Written Objectives 10%

Attendance/Ethics/Dress Code 15%

Competency Performance Evaluations 20%

Mid-term & Final Clinical Exam (Written) 15%

Comprehensive Evaluations 15%

Grades will be determined by: (For Clinical V)

Rotational Objectives 10%

Performance Evaluations 15%

Clinical Written Objectives 10%

Attendance/Ethics/Dress Code 15%

Graduate Performance Competencies 20%

Final Clinical Exam (Written) 15%

Comprehensive Evaluations 15%

XXVII. EXPLANATION OF CATEGORIES

Rotational Objectives - Clinical instructor evaluates each objective as the student

masters it.

Performance Evaluations - The clinical instructor will evaluate student progression

monthly.

Clinical Written Objectives - Will involve a grade for all written objective assignments

and reading assignments. The Clinical Log Book is included in this category.

The clinical coordinator grades the clinical written objectives.

Attendance/Ethics/Dress Code - Compliance to the attendance and tardiness policies is essential. Refer to the policies with regard to attendance and tardiness is located in this manual. Ethics is an integral part of being a healthcare provider. Conducting his/herself in a professional manner is required of all students. A reduction points will occur and the amount will be based on the infraction. The dress code is also essential. If non- compliance of the dress code occurs, a reduction of ten (10) percent will result for each infraction.

Competency Performance Evaluations - Clinical instructors and/or clinical coordinator must evaluate each examination to ascertain the competency level of the student.

Comprehensive Evaluation - Completed by the clinical instructor & clinical coordinator at mid-term and at the end of the semester (or as required). Student competency and progression will be evaluated.

Mid-term & Final Clinical Examinations (Written) - Examinations regarding clinical objectives covered during courses. This category may also include quizzes (announced or unannounced) that are given during the semester.

Elective Performance Competencies - Elective competencies have been provided by the ARRT. Students must complete a minimum of fourteen elective competencies during the program. Three elective competencies must be completed by the end of the second semester.

Graduate Performance Competencies - A total of seven graduate performance competencies must be completed during the fourth and fifth semesters of the clinical experience. Three of the graduate competencies must be completed on pediatric patients (ages 0-6). A maximum of three graduate performance competencies may be completed during the fourth semester and the remainder must be completed during the fifth semester. An average of 85 must be achieved on each graduate performance competency.

XXVIII. RADIOGRAPHY PROGRAM - CLINICAL GRADING SCALE

A EXCELLENT 96-100

A- 95

B+ ABOVE AVERAGE 94

B 91-93

B- 90

C+ AVERAGE 89

C 86-88

C- 85

D+ FAILURE 84

D 81-83

D- 80

F FAILURE 0-79

EAST TENNESSEE STATE UNIVERSITY

RADIOGRAPHY PROGRAM

CLINICAL/DIDACTIC COURSE CORRELATIONS AND ROTATIONS

Clinical Education will occur during the following hours:

Daytime Rotations: 7:30 AM - 4:00 PM (1/2 hour for lunch)

After Hours Rotation: 1 PM - 9:30 PM (1/2 hour for lunch)

Clinical Education I:

The student completes clinical requirements at a single clinical agency facilitating proficiency in general radiographic studies. Clinical course content includes introduction to clinical radiography, procedural instruction care and use of radiographic equipment, department operation, routine chest and abdomen examinations, and basic concepts of contrast media and patient care. Clinical education coincides with Radiographic Procedures I and Lab that explores radiography of the appendicular skeleton, thorax, abdominal, gastrointestinal, and genitourinary systems. Clinical hours are to be used in observation and assistance where capable in assigned rotational areas. They will spend a minimum number of weeks indicated below per practical assignment area unless competency is not obtained. Should competency not be obtained, the student may spend additional time as warranted by the clinical instructor and/or clinical coordinator.

Rotational Assignments Assigned Weeks

Clerical/File Room/Transport/Darkroom	2
Radiography	3
Mobile Radiography/Surgery	3
Fluoroscopy	2
IV Contrast Studies	2
After Hours (2 weeks evenings, 1 weekend)	3
TOTAL	15

Clinical Education II:

The student remains at the same clinical agency as Clinical I for an additional 15 weeks to increase clinical competency and obtaining additional skills in general radiographic procedures to include skull radiography, axial skeletal, and gastrointestinal and genitourinary systems. They will spend a minimum number of weeks indicated below per practical assignment area unless competency is not obtained. Should competency not be obtained, the student may spend additional time as warranted by the clinical instructor and/or clinical coordinator.

Rotational Assignments Assigned Weeks

Radiography	4
Mobile Radiography/Surgery	3
Fluoroscopy	3
IV Contrast Studies	2
After Hours (2 weeks evenings, 1 weekend)	3
TOTAL	15

Clinical Education III:

Clinical Education III reinforces knowledge attained in Radiographic Procedures I and II that includes the appendicular and axial skeletal radiography, gastrointestinal and genitourinary systems. Students demonstrate continued competence of radiographic procedures.

Students will attend clinical for 40 hours per week, which strengthens the student’s clinical skills. The student will remain at the same clinical site as Clinical I and II for the first ten weeks of the summer clinical to become proficient in general radiographic studies and also fluoroscopic procedures. The student is expected to gain competency in all prerequisite general areas and to become secure in the performance of these areas. Students rotate to a different clinical agency during the eleventh week.

All students must rotate through a Level I Trauma Center. Therefore, students will rotate from a small hospital to large hospital. If at all possible, students will rotate from a large hospital to a small. Rotational assignments are based on geographics, availability of examinations or procedures, clinical staff, and imaging equipment.

Rotational Assignments Assigned Weeks

Radiography	3
Mobile Radiography/Surgery	3
Fluoroscopy	3
IV Contrast Studies	1
After Hours (2 weeks evenings, 1 weekend)	3
TOTAL	13

Clinical Education IV:

Clinical Education IV is the fourth course for clinical competency in the practice of radiography. All students will remain at the clinical site at which rotation occurred at the end of Clinical III. Students will spend one to three weeks, depending upon the clinical assignment in each rotational area.

This clinical education course provides the opportunity for the student to apply and reinforce the knowledge attained in previous procedural classes. Clinical instruction will concentrate in the areas of special procedures and specialized imaging areas. In Clinical Education Centers which currently do not possess some specialized imaging areas, the student will rotate to an alternate facility for those experiences.

Rotational Assignments Assigned Weeks

Radiography	2
Mobile Radiography/Surgery	3
Fluoroscopy	3
Special Procedures/Interventional	3
Clinical Elective	2
After Hours (2 weeks evenings)	2
TOTAL	15

Elective Rotations

Competent students may submit justification for elective rotations. Elective rotation approval

requires satisfactory student competency and progress, faculty approval, equipment availability,

and clinical staff.

Elective rotations include:

Cardiac Catheterization Ultrasonography

CT/MR Nuclear Medicine

Clinical Education V:

Students will rotate back to their original clinical agencies and spend a minimum of three weeks in diagnostic imaging modalities. Students perform as competent individuals proficient in all aspects of radiography under the indirect supervision of the clinical staff. Emphasis is placed on competencies not obtained.

Rotational Assignments Assigned Weeks

Radiography	4
Mobile Radiography/Surgery	3
Fluoroscopy	4
Clinical Elective	2
After Hours (2 weeks evenings)	2
TOTAL	15

Elective Rotations

Competent students may submit justification for elective rotations. Elective rotation approval

requires satisfactory student competency and progress, faculty approval, equipment availability,

and clinical staff.

Elective rotations include:

Cardiac Catheterization Ultrasonography

CT/MR Nuclear Medicine

Radiation Therapy

EAST TENNESSEE STATE UNIVERSITY

RADIOGRAPHY PROGRAM

CLINICAL AND DIDACTIC RELATIONSHIP

(Each Division = One Semester)

Introduction to Allied Health

Patient Care and Assessment

JUNIOR LEVEL

I. Image Production & Evaluation

Radiographic Procedures I

Clinical Education I

Radiographic Procedures I Lab

Leadership in Allied Health

II. Radiographic Procedures II

Radiographic Procedures II Lab

Clinical Education II

Imaging & Quality Control

Radiation Physics

ENTRY LEVEL COMPETENCY

III. All Junior Courses Clinical Education III

SENIOR LEVEL

IV. Radiographic Pathology_____________________________

Radiation Biology

Clinical Education IV

Research in Allied Health

Special Topics in Allied Health Law___________________

V. Radiopharm. & Spec. Proced. ________________________

Digital Imaging

Clinical Education V

Seminar

Principles of Radiological Health_____________________

COURSE SYLLABUS

EAST TENNESSEE STATE UNIVERSITY

BACHELOR OF SCIENCE IN ALLIED HEALTH

RADIOGRAPHY CONCENTRATION

CLINICAL EDUCATION I

RADT 3040

COURSE: Clinical I

LEVEL OF SUPERVISION: DIRECT/INDIRECT

CLOCK HOURS: 240 (2 days a week x 15 weeks)

CREDIT: 2 Semester Credits

GRADE COMPUTATION: Practical Rotational Objectives 10%

Performance Evaluations 15%

Clinical Written Objectives 10%

Attendance/Ethics/Dress Code 15%

Competency Performance Evaluations 20%

Clinical Examinations (Mid-term and

Final, Written) 15%

Comprehensive Evaluations 15%

EXPLANATION OF CATEGORIES:

Rotational Objectives - Clinical instructor evaluates each objective as the student

masters it.

Performance Evaluations - The clinical instructor will evaluate student progression

monthly.

Clinical Written Objectives - Will involve a grade for all written objective assignments

and reading assignments. The Clinical Log Book is included in this category. The clinical coordinator grades the clinical written objectives.

Attendance/Ethics/Dress Code - Compliance to the attendance and tardiness policies is essential. Refer to the policies with regard to attendance and tardiness is located in this manual. Ethics is an integral part of being a healthcare provider. Conducting his/herself in a professional manner is required of all students. A reduction points will occur and the amount will be based on the infraction. The dress code is also essential. If non-compliance of the dress code occurs, a reduction of ten (10) percent will result for each infraction.

Competency Performance Evaluations - Clinical instructors and/or clinical coordinator must evaluate each examination to ascertain the competency level of the student.

Mid-term & Final Clinical Examinations (Written) - Examinations regarding clinical objectives covered during courses. This portion of the grade may also include quizzes (announced or unannounced) that are given during the semester. This category may also include quizzes (announced or unannounced) that are given during the semester.

GRADE SCALE:

96-100 A

95 A-

94 B+

91-93 B

90 B-

89 C+

86-88 C

85 C-

84 D+

81-83 D

80 D-

0-79 F

TEXTBOOK: Ballinger, P. W. & Frank, E. D. (2003). Merrill's atlas of

radiographic positions and radiologic procedures. (10th Edition). St. Louis, Missouri: Mosby-Year Book Publishers.

DESCRIPTION: (Prerequisite: Program admission. Corequisites: RADT 3000, RADT 3020, RADT 3021). This competency-based clinical experience will introduce the radiography student to learning opportunities in ancillary areas and current imaging technologies available at clinical agencies. Student participation in patient assessment and care, and observing and performing medical imaging procedures as presented in RADT 3020/3021 under direct supervision will occur. Students will demonstrate cognitive, affective, and psychomotor skills with a focus on outcomes assessment.

COMPETENCY EXAMINATIONS:

Chest Wrist Foot

Abdomen (KUB) Forearm Ankle

Hand Elbow Lower Leg

Finger Shoulder Knee

PRACTICAL ASSIGNMENTS:

Rotational Assignments Assigned Weeks

Clerical/File Room/Transport/Darkroom	2
Radiography	3
Mobile Radiography/Surgery	3
Fluoroscopy	2
IV Contrast Studies	2
After Hours (2 weeks evenings, 1 weekend)	3
TOTAL	15

ROTATIONAL OBJECTIVES:

Each student will be responsible for the distribution and successive completion of rotational objectives documented by registered radiographers. This checklist will be due at the completion of the rotation. The student must achieve 85% of the objectives in a satisfactory manner. Any student who achieves less than 85% of the objectives will be assigned additional rotations in order to complete the objectives satisfactorily.

COURSE GOALS

1. The student shall display professional conduct as outlined in the American Society of Radiologic Technologist's code of ethics.

2. The student shall practice professional conduct in all interactions with patients and peers.

3. The student shall professionally mitigate moral and ethical dilemmas arising with patients, peers, consumers, and health care team members.

4. The student will effectively communicate with patients, peers, and healthcare team members.

5. The student will adhere to legal practice standards including all federal, state, and institutional regulations related to patient care.

6. The student will display pride in their chosen profession.

7. The student will provide appropriate patient care that maximizes patient care practices to meet the healthcare needs of the community.

8. The student will deliver patient care and service unrestricted by personal attribute concerns or the nature of the disease or illness, and without discrimination regardless of sex, race, creed, religion, or socioeconomic status.

9. The student will comprehend the basic functions of the radiographic control panel and demonstrate the operation of the radiographic machines (locks, etc.) and state the function of each.

10. The student shall demonstrate competency in the clinical rotational objectives.

11. The student shall obtain proficiency and demonstrate skills as delineated in the rotational objectives.

12. The student will participate as a member of the healthcare team.

13. The student shall identify and state the chain of command in the radiography program and radiology department.

14. The student shall apply and gain knowledge in film quality.

15. The student shall practice proper patient care of all patients.

16. The student shall complete category I of the competency performance objectives. This is to be completed after the student has practiced the examination in simulation and/or procedural laboratory. Category I examinations must be observed and graded by the clinical instructor, clinical coordinator, or program director in actual room conditions on an actual patient.

CLINICAL WRITTEN OBJECTIVES

1. Students must submit the Clinical Record Book representing competency in simulation.

2. Students will formulate a protocol list of all routine radiographic examinations and routine positions for each.

3. Students will list each radiographic room and explain what types of examinations are performed in each room in the morning.

4. Students will read Chapter 10 (Chest) in Volume I and chapter 16 (Abdomen) in Volume II of Merrill’s Atlas and paraphrase the importance of each chapter.

5. Students must document repeats in his/her clinical record book. Repeat Policy: Students will be allowed to repeat a radiographic film ONE time ONLY, and a registered radiographer must supervise the repeat. If the repeat is not satisfactory the radiographer must perform the additional films while the student observes. All repeat radiographs must be documented (NO EXCEPTIONS).

6. Additional assignments may be required as deemed necessary by the faculty.

COURSE OBJECTIVES

The course objectives for RADT 3040 are divided into the following four categories of instructional objectives:

1. Cognitive - Recalling and understanding information and applying it to other material or new situations. Problem solving.

2. Affective - Awareness of and reaction to an activity, situation, or phenomenon. Attachment of worth to an activity, situation, or phenomenon. Commitment to a value that is reflected in behavior.

3. Psychomotor - Awareness of a stimulus and readiness to perform a motor skill. Practice in motor skills with increasing proficiency. Ability to alter procedures or create new movements.

4. Cognitive and Psychomotor - Recalling and understanding information and applying it

performing motor skills.

So that the student may better determine the expectations of this course, the objectives listed below are categorized. Some objectives belong to more than one category and will be listed accordingly.

COGNITIVE OBJECTIVES

The student will:

1. State the general organization and function of a radiology department.

2. State the general layout of the hospital.

3. Identify and state the chain of command in the radiography program and radiology department.

4. Explain types of examinations performed in each diagnostic room in the morning.

5. Explain the correct procedure for answering the telephone.

6. Read Chapters 10 (Chest) and 16 (Abdomen) in Ballinger's and paraphrase the importance of each chapter.

7. Complete additional assignments as required.

8. Differentiate between types of radiographic examinations.

9. Identify each film/cassette size including extremities, ultrasound, duplication, etc.

10. Identify the components of the radiographic control panel and state the function of each.

11. Identify procedures to be done in specific areas.

12. State procedure for critical patients.

13. State location of emergency equipment (crash cart, drugs).

14. Examine radiographic requests and verify accuracy and completeness of form.

15. Accurately and professionally question female patients regarding possible pregnancy.

16. Demonstrate correct methodology for transporting all types of in-patients including wheelchair, stretchers, IV's, oxygen, etc.

17. Identify contrast agents utilized and correlate with examinations.

18. Review anatomy on all radiographs.

19. Differentiate between patient disabilities and distinguish when assistance is necessary.

20. Recognize and critique diagnostic film quality.

21. Explain principles of IV Contrast Studies on an introductory level.

22. Identify additional equipment and state basic utilization of each.

23. Process a patient requisition following prescribed protocol methodology.

24. Differentiate between the outpatient process versus in-patient process.

25. Maintain confidentiality of all patient information.

26. State rationale of filming system.

27. Properly file permanent record cards in the appropriate place (if applicable).

28. State the rationale for the filing system.

29. Demonstrate methods to check out or send radiographs.

30. Distinguish between films that have and have not been recorded.

31. Identify monitoring devices for temperature and the correct temperature for operation for the processor.

32. State basic principles of processing.

33. Identify and state the function of ancillary darkroom equipment.

34. Identify correct methodology for automatic daylight processing.

35. Demonstrate and observe procedural methodology and centering points on all examinations (including placement of tube, table, and film).

36. Practice independent selection of technical factors under direct supervision.

37. Exercise judgment and correlate instruction in the revision of technical factors concerning repeat radiographs.

38. Select appropriate film/screen and/or grid combinations.

39. Identify basic anatomy on extremity radiographs.

40. Identify basic anatomy on chest and abdomen radiographs.

41. State proper patient preparations for various fluoroscopic procedures.

42. Review IV Contrast Studies radiographs to recognize basic anatomical structures.

43. Exhibit knowledge of medical terminology and provide correlation to examinations prescribed.

44. Differentiate between the different types of hospital emergency codes.

45. Locate department fire alarms and execute fire plan.

AFFECTIVE OBJECTIVES

The student will:

1. Exhibit professional conduct with moral and ethical dilemmas in clinic.

2. Demonstrate an interest as a member of the healthcare team.

3. Establish professional student-patient-technologist relationships.

4. Communicate effectively with patients, staff, and peers.

5. Practice proper care of all patients.

6. Accurately ascertain information regarding pregnancy policy.

7. Display professional conduct as outlined in the American Society of Radiologic Technologist's code of ethics.

8. Practice professional conduct in all interactions with patients and peers.

9. Practice professional conduct with moral and ethical dilemmas arising with patients, peers, consumers, and healthcare team members.

10. Effectively communicate with patients, peers, and healthcare team members.

11. Adhere to legal practice standards including all federal, state, and institutional regulations related to patient care.

12. Display pride in their chosen profession.

13. Provide appropriate patient care that maximizes patient care practices to meet the health care needs of the community.

14. Deliver patient care and service unrestricted by personal attribute concerns or the nature of the disease or illness, and without discrimination regardless of sex, race, creed, religion, or socioeconomic status.

PSYCHOMOTOR OBJECTIVES

The student will:

1. Submit Clinical Record Book representing competency in simulations.

2. Demonstrate competence in all clinical competency examinations for this semester and complete Category I of the clinical competency examinations. Category I examinations must be observed and graded by the clinical instructor, clinical coordinator, or program director in actual room conditions on actual patients.

3. Obtain proficiency and demonstrate skills as delineated in the rotational objectives.

4. Manipulate the radiographic tube in all directions and place on center lock.

5. Place radiographic tube at varying SIDs.

6. Observe examinations in assigned area.

7. Provide an aseptic environment (table, cassettes, etc.).

8. Demonstrate warm-up procedure for each radiographic room at the clinical agency.

9. Demonstrate proper methodology for barium preparation.

10. Interact as a member of the medical team during fluoroscopy and radiographic examinations.

11. Deliver films during overhead filming on GI and BE exams, if applicable.

12. Correctly manipulate accessories for the radiographic table (hand holds, foot rest, and shoulder rest).

13. Exercise care with the use of equipment.

14. Provide assistance to patient in dressing and undressing to preserve patient's modesty.

15. Demonstrate proper methodology of transferring patients.

16. Assist patient in movement to wheelchair and stretcher utilizing proper body mechanics and maintaining patient care and modesty.

17. Demonstrate procedure to dispense films (microfilming) when applicable.

18. Demonstrate process to file films in proper place.

19. Provide assistance to file room, transport, and darkroom personnel as much as possible.

20. Demonstrate the procedure to activate and deactivate the automatic processor.

21. Demonstrate methods to replenish the processing system.

22. Process exposed radiographic film accurately.

23. Demonstrate correct methodology to load and unload film from cassettes and grids.

24. Correctly operate all controls (automatic exposure control, spot film, bucky, fluoro timer, kV/mA/sec selectors, and backup controls).

COGNITIVE AND PSYCHOMOTOR OBJECTIVES

The student will:

1. Complete category I of the competency performance objectives. This is to be completed after the student has practiced the examination in simulation and/or procedural laboratory. Category I examinations must be observed and graded by the clinical instructor, clinical coordinator, or program director in actual room conditions on actual patients.

2. Exhibit professional conduct and apply knowledge to the practice with patients, peers, and fellow radiographers.

3. Differentiate, compare, and analyze different protocol in accordance to examination parameters.

4. Perform examinations under indirect supervision once competency is documented.

5. Practice the 18-step positioning procedure in doing all radiographic examinations.

6. Utilize effective immobilization techniques.

7. Apply and gain knowledge in diagnostic film quality including contrast, density, centering points, etc.

8. Practice methods of radiation protection to patients, self, and others.

9. Accurately place lead markers on images receptors.

10. Dispose of contaminated items as outlined by OSHA guidelines.

11. Practice standard precautions.

12. Maximize collimation to area of interest, thereby, reducing patient's exposure.

13. Instruct patient of appropriate breathing instructions during examination.

14. Prepare all necessary supplies for GI and BE examinations.

15. Assist staff during fluoroscopic and radiographic studies.

16. Observe all centering points for each examination.

17. Perform correctly, after instruction, preliminary films as indicated.

18. Demonstrate correct methodology for transporting all types of in-patients including wheelchair, stretchers, IV's, oxygen, etc.

19. Correctly dismiss patients according to status.

20. Demonstrate warm-up procedures for each radiographic room at clinical education facility.

21. Demonstrate sterile and/or aseptic techniques as required.

22. Demonstrate and observe machine operation in all tomographic procedures.

23. Identify and correlate alterations in technical factors in the performance of tomographic procedures.

24. Identify and demonstrate proper operation and adjustment of mobile equipment.

CLINICAL I: COURSE SCHEDULE

WEEK #1 Introduction and orientation: Disaster plans/hospital fire procedure/ emergency situations, codes, and patients are people

WEEK #2 Darkroom, radiographic controls, overhead tube manipulation, and table locks

WEEK #3 Anatomy, procedures, centering points, and technical factors for chest radiography.

WEEK #4 Anatomy, procedures, centering points, and technical factors for abdominal radiography including supine, erect, and decubitus

First Monthly Performance Evaluation Due

WEEK #5 Anatomy, procedures, centering points, and technical factors for the hand, fingers, and wrist including navicular and carpal tunnel projections

WEEK #6 Review

WEEK #7 Second Monthly Performance Evaluation

WEEK #8 Anatomy, procedures, centering points, and technical factors for forearm and elbow including axial projections

Written Midterm Examination

Midterm Comprehensive Evaluation Due

WEEK #9 Anatomy, procedures, centering points, and technical factors for the shoulder, scapula, A.C. joints, and S.C. joints

WEEK #10 Anatomy, procedures, centering points, and technical factors for foot, toes, and ankle

Third Monthly Performance Evaluation

WEEK #11 Anatomy, procedures, centering points, and technical factors for lower leg, and knee.

WEEK #12 Anatomy, procedures, centering points, and technical factors for mobile radiography of the chest

WEEK #13 Critique of radiographs

Fourth Monthly Performance Evaluation

WEEK #14 Semester review of all course material. All written assignments due.

WEEK #15 Written Final Examination

Rotational Objectives Due

Final Comprehensive Evaluation Due

*THIS SYLLABUS IS SUBJECT TO CHANGE AT FACULTY'S DISCRETION*

According to Pre-Finals Week Policy, no formal final examination schedule exists for laboratory courses. The faculty have determined that all clinical education courses are deemed “laboratory” courses.
REFERENCES - RADT 3040

Brown, M., & Pound, P. (1997). Patient rapport in radiologic technology. Radiologic Technology Journal of the American Society of Radiologic Technologists, 68(5), 427-428.

Campbell, D. (1994). Making the most of clinical education. Radiologic Technology Journal of the American Society of Radiologic Technologists, 66(2), 127-128.

Dowd, S., & Wilson, B. (1995). Informed patient consent: A historical perspective. Radiologic Technology Journal of the American Society of Radiologic Technologists, 67(2), 119-124.

Dowd, S., & Tilson, E. (1996). Re-engineering via patient-centered care. Radiologic Technology Journal of the American Society of Radiologic Technologists, 67(5), 421-424.

Follo, L. (1996). Hand vs. finger radiographs. Radiologic Technology Journal of the American Society of Radiologic Technologists, 67(3), 249-250.

Hiss, S. S. (1997). Introduction to Health Care Delivery and Radiology Administration. Philadelphia: W. B. Saunders Company.

Purtilo, R. (1990). Health Professional and Patient Interaction. (4th ed.). Philadelphia: W. B. Saunders Co.

Steves, A. (1993). Teaching your students to care. Radiologic Technology Journal of the American Society of Radiologic Technologists, 65(2), 119-120.

EAST TENNESSEE STATE UNIVERSITY

RADIOGRAPHY PROGRAM

ROTATIONAL OBJECTIVES

CLINICAL EDUCATION I

RADIOGRAPHY

COMPLETED

OBJECTIVE	YES	NO
Exercise priorities required in daily clinical practice.
Execute imaging procedures under the appropriate level of supervision.
Adapt to changes and varying clinical situations.
Effectively communicate and maintain professional relationships with patients, the public, and members of the health care team.
Assess the patient and record patient histories.
Carry out principles of transferring, positioning, immobilizing, and restraining of patients.
Practice the 18-step positioning procedure in doing all radiographic exams.
Repeat radiographs according to policy.
Practice standard precautions.
Apply radiation protection to protect the patient and staff.
Observe, assist, and/or perform all examinations.
Provide collimation to area of interest.
Accurately ascertain information regarding pregnancy possibility.
Effectively operate radiographic equipment and accessories.
Observe and apply correct procedure methodology utilizing centering points on all exams (including placement of tube, table, and image receptor)
Critique and recognize diagnostic film quality.
Select appropriate image receptor and/or grid combinations.
Use proper SID and angulations for the radiographic procedure.
Identify radiographic anatomy recorded on radiographs.

EAST TENNESSEE STATE UNIVERSITY

RADIOGRAPHY PROGRAM

ROTATIONAL OBJECTIVES

CLINICAL EDUCATION I

FLUOROSCOPY

COMPLETED

OBJECTIVE	YES	NO
Exercise priorities required in daily clinical practice.
Execute imaging procedures under the appropriate level of supervision.
Adapt to changes and varying clinical situations.
Effectively communicate and maintain professional relationships with patients, the public, and members of the health care team.
Assess the patient and record patient histories.
Carry out principles of transferring, positioning, immobilizing, and restraining of patients.
Practice the 18-step positioning procedure in doing all radiographic exams.
Repeat radiographs according to policy.
Practice standard precautions.
Apply radiation protection to protect the patient and staff.
Observe, assist, and/or perform all examinations.
Provide collimation to area of interest.
Accurately ascertain information regarding pregnancy possibility.
Effectively operate radiographic/fluoroscopic controls, equipment, and accessories.
Observe and apply correct procedure methodology utilizing centering points on all exams (including placement of tube, table, and image receptor)
Critique and recognize diagnostic film quality.
Select appropriate image receptor and/or grid combinations.
Use proper SID and angulations for the radiographic procedure.
Identify radiographic anatomy recorded on radiographs.
Provide patient education regarding procedures.
Prepare contrast media according to institutional protocol.
Demonstrate sterile and/or aseptic techniques as required.
Correctly set up fluoroscopic/radiographic equipment.
Perform preliminary films as indicated.
Assist radiologist and/or radiographer during fluoroscopic studies.

EAST TENNESSEE STATE UNIVERSITY

RADIOGRAPHY PROGRAM

ROTATIONAL OBJECTIVES

CLINICAL EDUCATION I

IV CONTRAST STUDIES

COMPLETED

OBJECTIVE	YES	NO
Exercise priorities required in daily clinical practice.
Execute imaging procedures under the appropriate level of supervision.
Adapt to changes and varying clinical situations.
Effectively communicate and maintain professional relationships with patients, the public, and members of the health care team.
Assess the patient and record patient histories.
Carry out principles of transferring, positioning, immobilizing, and restraining of patients.
Practice the 18-step positioning procedure in doing all radiographic exams.
Repeat radiographs according to policy.
Practice standard precautions.
Apply radiation protection to protect the patient and staff.
Observe, assist, and/or perform all examinations.
Provide collimation to area of interest.
Accurately ascertain information regarding pregnancy possibility.
Effectively operate radiographic equipment and accessories.
Observe and apply correct procedure methodology utilizing centering points on all exams (including placement of tube, table, and image receptor)
Critique and recognize diagnostic film quality.
Select appropriate image receptor and/or grid combinations.
Use proper SID and angulations for the radiographic procedure.
Identify radiographic anatomy recorded on radiographs.
Obtain signed consent forms and histories from all patients (under direct supervision)
Identify and state classic reaction symptoms.
Prepare contrast media utilizing aseptic technique.
Demonstrate sterile and/or aseptic techniques as required.
Perform correctly, after instruction, preliminary films as indicated.
State the basic procedure and protocol involved in urology radiography.
Dispose contaminated items in prescribed manner.

EAST TENNESSEE STATE UNIVERSITY

RADIOGRAPHY PROGRAM

ROTATIONAL OBJECTIVES

CLINICAL EDUCATION I

MOBILE RADIOGRAPHY

COMPLETED

OBJECTIVE	YES	NO
Exercise priorities required in daily clinical practice.
Execute imaging procedures under the appropriate level of supervision.
Adapt to changes and varying clinical situations.
Effectively communicate and maintain professional relationships with patients, the public, and members of the health care team.
Assess the patient and record patient histories.
Carry out principles of transferring, positioning, immobilizing, and restraining of patients.
Practice the 18-step positioning procedure in doing all radiographic exams.
Repeat radiographs according to policy.
Practice standard precautions.
Apply radiation protection to protect the patient and staff.
Observe, assist, and/or perform all examinations.
Provide collimation to area of interest.
Accurately ascertain information regarding pregnancy possibility.
Effectively operate radiographic equipment and accessories.
Observe and apply correct procedure methodology utilizing centering points on all exams (including placement of tube, table, and image receptor)
Critique and recognize diagnostic film quality.
Select appropriate image receptor and/or grid combinations.
Use proper SID and angulations for the radiographic procedure.
Identify radiographic anatomy recorded on radiographs.
Identify correct patient and examination according to requisition.
Locate and drive the portable to the patient's room.
Politely ask visitors to wait outside the room until examination is complete.
Examine room and adjust furniture before bringing in the portable unit.
Identify and demonstrate proper operation and adjustment of mobile equipment.
Adjust the patient into the erect or supine position, as appropriate.
Accepts and uses constructive criticism.
Exhibit knowledge of medical terminology and provides correlation to examinations prescribed.
Demonstrate procedures in maintaining a sterile field.
Return the portable unit to the proper location and charge it if needed.
Patient identification (flash) and film processing is appropriate.

EAST TENNESSEE STATE UNIVERSITY

RADIOGRAPHY PROGRAM

ROTATIONAL OBJECTIVES

CLINICAL EDUCATION I

AFTER HOURS - EVENINGS

COMPLETED

OBJECTIVE	YES	NO
Demonstrate and observe all positioning methodology.
Practice standard precautions.
Practice 18-step positioning procedure for all examinations.
Demonstrate recognition of diagnostic quality.
Identify chain of command and department protocol.
Modify positioning techniques when patient condition warrants.
Participate in the radiography of trauma patients.

ROTATIONAL OBJECTIVES

CLINICAL EDUCATION I

AFTER HOURS - WEEKEND

COMPLETED

OBJECTIVE	YES	NO
Demonstrate and observe all positioning methodology.
Practice standard precautions.
Practice 18-step positioning procedure for all examinations.
Demonstrate recognition of diagnostic quality.
Identify chain of command and department protocol.
Modify positioning techniques when patient condition warrants.
Participate in the radiography of trauma patients.
Gain a sense of independence in performing radiographic exams.
Demonstrate responsibility for actions with patients and technologists.
Understand the concept of teamwork in a radiology department.

EAST TENNESSEE STATE UNIVERSITY

RADIOGRAPHY PROGRAM

ROTATIONAL OBJECTIVES

CLINICAL EDUCATION I

CLERICAL

COMPLETED

OBJECTIVE	YES	NO
Process patient requisitions according to protocol.
Greet patients, verify patient identity and appropriate examination.
Notify appropriate staff of patient arrival.
Assure examination completion.
Demonstrate procedure to execute an order in the computer.
Demonstrate procedure to cancel an order in the computer.
Identify records and forms for patient information purposes.
Properly file radiographs.
State the rationale for the filing system.
Demonstrate proper method to answer the telephone.
Demonstrate the procedure to transfer calls, etc.
Demonstrate the operation of typewriters, computers, etc.
Differentiate between the out-patient process versus in-patient process.
Provide a neat and clean working environment.
Demonstrate proper methodology for patient scheduling, under direct supervision.
Maintain confidentiality of all patient information.
Exercise care in the use of equipment.

EAST TENNESSEE STATE UNIVERSITY

RADIOGRAPHY PROGRAM

ROTATIONAL OBJECTIVES

CLINICAL EDUCATION I

TRANSPORT

COMPLETED

OBJECTIVE	YES	NO
Verify patient identification and assure correct radiographic procedure order.
Ask visitors to step out of room, explaining where and the length of time the patient will be gone.
Assist patient in movement to wheelchair/stretcher utilizing body mechanics.
Move furniture (etc.) allowing transportation device within patient access.
Raise footrests before allowing patient in or out of the wheelchair.
Demonstrate proper method of patient transfer procedure.
Demonstrate proper method of wheelchair operation.
Place wheelchair to aid patient keeping it locked.
Demonstrate proper method for security urinary catheters, chest tubes, IV’s.
Place and lock stretcher appropriately for patient occupation.
Transport patient safety maintaining patient modesty and comfort.
Practice standard precautions.
Demonstrate procedure for portable oxygen administration.
Provide assistance to the transport personnel as much as possible.
State the layout of the hospital.
Provide appropriate support to injured and/or critically injured patients.
Demonstrate proper placement of medical equipment (IV’s, catheters, oxygen, etc.)
Differentiate between disabilities and when assistance is required.
Place stretcher appropriately for patient occupation.
Differentiate between disabilities and distinguish when assistance is needed.
Communicate effectively with patients, staff, and peers.

EAST TENNESSEE STATE UNIVERSITY

RADIOGRAPHY PROGRAM

ROTATIONAL OBJECTIVES

CLINICAL EDUCATION I

FILE ROOM

COMPLETED

OBJECTIVE	YES	NO
Demonstrate procedure to dispense films (microfilming).
Demonstrate process to file films in proper place.
State rationale of filming system.
Demonstrate method to check out or send films out.
Distinguish between films that have and have not been recorded.
Provided assistance to file room personnel as much as possible.
Provide a clean and orderly environment.

EAST TENNESSEE STATE UNIVERSITY

RADIOGRAPHY PROGRAM

ROTATIONAL OBJECTIVES

CLINICAL EDUCATION I

DARKROOM (IF APPLICABLE)

COMPLETED

OBJECTIVE	YES	NO
Demonstrate the procedure to activate and deactivate the automatic processor.
Identify monitoring devices for temperature and the correct operational temperature.
Identify and locate sizes and types of available films.
Provide a neat and clean environment.
Load automatic film holders.
Correctly place radiographs on the entrance tray.
Identify purpose and operation of the safelight.
Identify difference between single and double emulsion film.
Identify differences between regular radiographic film and specialty film (US, NM, MRI).
Demonstrate method to replenish chemicals.
State basic principles of processing.
Demonstrate method for cleaning and maintaining screens.
Identify and state the function of ancillary darkroom equipment.
Process exposed radiographs accurately.
Demonstrate correct methodology to load and unload film from cassettes.

EAST TENNESSEE STATE UNIVERSITY

RADIOGRAPHY PROGRAM

CLINICAL EDUCATION I

COMPETENCY PERFORMANCE OBJECTIVES

GRADE	EXAMINATION	DATE	PT'S ID#	CL.ED.CT
	CHEST
	ABDOMEN (KUB)
	FINGER
	HAND
	WRIST
	FOREARM
	ELBOW
	SHOULDER
	FOOT
	ANKLE
	LOWER LEG
	KNEE

If a student completes a performance examination and is graded, the student may be given a mastery examination on any of these completed performance examinations at any time after their completion. (It is not recommended for a student to complete the performance examination or a mastery level examination and forget how to do these examinations. Repetition in testing will occur).

COURSE SYLLABUS

EAST TENNESSEE STATE UNIVERSITY

BACHELOR OF SCIENCE IN ALLIED HEALTH

RADIOGRAPHY CONCENTRATION

CLINICAL EDUCATION II

RADT 3050

COURSE: Clinical II

LEVEL OF SUPERVISION: DIRECT/INDIRECT

CLOCK HOURS: 240 (2 days a week x 15 weeks)

CREDIT: 2 Semester Credits

GRADE COMPUTATION: Practical Rotational Objectives 10%

Performance Evaluations 15%

Clinical Written Objectives 10%

Attendance/Ethics/Dress Code 15%

Competency Performance Evaluations 20%

Clinical Examinations (Mid-term and

Final, Written) 15%

Comprehensive Evaluations 15%

EXPLANATION OF CATEGORIES:

Rotational Objectives - Clinical instructor evaluates each objective as the student

masters it.

Performance Evaluations - The clinical instructor will evaluate student progression

monthly.

Clinical Written Objectives - Will involve a grade for all written objective assignments

and reading assignments. The Clinical Log Book is included in this category. The clinical coordinator grades the clinical written objectives.

Attendance/Ethics/Dress Code - Compliance to the attendance and tardiness policies is essential. Refer to the policies with regard to attendance and tardiness is located in this manual. Ethics is an integral part of being a healthcare provider. Conducting his/herself in a professional manner is required of all students. A reduction points will occur and the amount will be based on the infraction. The dress code is also essential. If non-compliance of the dress code occurs, a reduction of ten (10) percent will result for each infraction.

Competency Performance Evaluations - Clinical instructors and/or clinical coordinator must evaluate each examination to ascertain the competency level of the student.

GRADE SCALE:

96-100 A

95 A-

94 B+

91-93 B

90 B-

89 C+

86-88 C

85 C-

84 D+

81-83 D

80 D-

0-79 F

TEXTBOOK: Ballinger, P. W. & Frank, E. D. (2003). Merrill's atlas of

radiographic positions and radiologic procedures. (10th Edition). St. Louis, Missouri: Mosby-Year Book Publishers.

DESCRIPTION: (Prerequisites: Program admission and RADT 3040. Corequisites:

RADT 3010, RADT 3030, RADT 3031, and RADT 3060). A competency

based clinical experience that intensifies the cognitive, affective, and

psychomotor skill levels of students in the performance of imaging

procedures of the axial and appendicular skeleton. Students continue to

focus on outcomes assessment and to master procedures from RADT

3040.

COMPETENCY EXAMINATIONS:

Humerus Portable Chest Lumbar Spine

Patella Stretcher Chest Trauma Extremity

Femur Decubitus Abdomen Exam in Surgery

Hip Cervical Spine

Pelvis Thoracic Spine

PRACTICAL ASSIGNMENTS:

Rotational Assignments Assigned Weeks

Radiography	4
Mobile Radiography/Surgery	3
Fluoroscopy	3
IV Contrast Studies	2
After Hours (2 weeks evenings, 1 weekend)	3
TOTAL	15

ROTATIONAL OBJECTIVES:

Each student will be responsible for the distribution and successive completion of the rotational objectives as documented by registered radiographers. This checklist will be due at the completion of the rotation. The student must achieve 85% of the objectives in a satisfactory manner. Any student who achieves less than 85% of the objectives will be assigned additional rotations in order to complete the objectives satisfactorily.

COURSE GOALS:

1. The student will display professional conduct as outlined in American Society of Radiologic Technologist's code of ethics.

2. The student shall practice professionalism conduct at all times.

3. The student shall professionally mitigate moral and ethical dilemmas arising with patients, peers, family, consumers, and health care team members.

4. The student will effectively communicate with patients, peers, radiographers, and other health caregivers.

5. The student will adhere to legal practice standards including all federal, state, and institutional regulations related to patient care.

6. The student will display pride in their chosen profession.

7. The student will provide appropriate patient care that minimizes patient risk factors.

9. The student will apply and gain knowledge in film quality.

10. The student will practice proper care of patients.

11. The student shall obtain proficiency and demonstrate skills as delineated in the rotational objectives.

12. The student must complete category II of the competency performance objectives. This is to be completed after the student has practiced the examinations in simulation and/or in procedural laboratory. Category II examinations must be observed and graded by the clinical instructor, clinical coordinator, or program director in actual room conditions on actual patients.

CLINICAL WRITTEN OBJECTIVES:

1. Students must submit the Clinical Record Book representing competency in simulation.

2. Students will compose an essay detailing how they perceive the ideal technologist. Duties, responsibilities, code of ethics, patient care, code of ethics, etc. may be included.

3. Students will create a technique book, which will be approved by a clinical instructor at the assigned clinical site. Milliamperage, time, kVp, distance, body habitus, and screen-film combination must be included.

4. Students must document repeats in his/her clinical record book. Repeat Policy: Students will be allowed to repeat a radiographic film ONE time ONLY, and a registered radiographer must supervise the repeat. If the repeat is not satisfactory the radiographer must perform the additional films while the student observes. All repeat radiographs must be documented (NO EXCEPTIONS).

5. Additional assignments may be required.

COURSE OBJECTIVES:

The course objectives for RADT 3050 are divided into four categories of instructional objectives.

They are:

l. Cognitive - Recalling and understanding information and applying it to other material

or new situations. Problem solving.

2. Affective - Awareness of and reaction to an activity, situation, or phenomenon.

Attachment of worth to an activity, situation, or phenomenon.

Commitment to a value which is reflected in behavior.

3. Psychomotor - Awareness of a stimulus and readiness to perform a motor skill.

Practice in motor skills with increasing proficiency. Ability to alter

procedures or create new movements.

4. Cognitive and

Psychomotor - Recalling and understanding information and applying it to performing

motor skills.

So that the student may better determine the expectations of this course, the objectives listed below are categorized. Some objectives belong to more than one category and will be listed accordingly.

COGNITIVE OBJECTIVES:

The student will:

1. Students will compose an essay detailing how they perceive the ideal technologist. Duties, responsibilities, code of ethics, patient care, code of ethics, etc. may be included.

2. Complete additional assignments as required.

3. Students will compose a report providing an in depth discussion of exposure factors and their role in image formation. Milliamperage, time, kVp, distance, body habitus, screen-film combination, and collimation must included.

4. Recognize and critique diagnostic film quality.

5. Continue to demonstrate and observe procedural methodology and centering points on all examinations (including placement of tube, table, and film).

6. Practice independent selection of technical factors under direct supervision.

7. Exercise judgment and correlate instruction in the revision of technical factors concerning repeat radiographs.

8. Continue to select appropriate film/screen and/or grid combinations.

9. Identify basic anatomy on all radiographs.

10. State patient preparations for various fluoroscopic procedures.

11. State rationale of technical factors and what pathological conditions necessitate a technical factor revision for competency examinations this semester.

12. Evaluate radiographic, fluoroscopic, tomographic, and mobile radiographic films for diagnostic quality.

AFFECTIVE OBJECTIVES:

The student will:

1. The student will continue to display professional conduct as outlined in American Society of Radiologic Technologist's code of ethics.

2. The student will continue to professionally mitigate moral and ethical dilemmas arising with patients, peers, family, consumers, and health care team members.

3. The student will continue to effectively communicate with patients, peers, radiographers, and other health caregivers.

4. The student will continue to adhere to legal practice standards including all federal, state, and institutional regulations related to patient care.

5. The student will continue to provide appropriate patient care that minimizes patient risk factors.

6. The student will continue to display pride in their chosen profession.

7. The student will continue to deliver patient care and service unrestricted by personal attribute concerns or the nature of the disease or illness, and without regard to race, creed, religion, or socioeconomic status.

PSYCHOMOTOR OBJECTIVES:

The student will:

1. Submit Clinical Record Book representing competency in simulation.

2. Complete category II of the competency performance objectives. This is to be completed after the student has practiced the examinations in simulation and/or in procedural laboratory. Category II examinations must be observed and graded by the clinical instructor, clinical coordinator, or program director in actual room conditions on actual patients.

3. Obtain proficiency and demonstrate skills as delineated in the rotational objectives.

4. Demonstrate procedures which are acceptable in patient transfer modes (on/off table, etc.).

5. Provide an aseptic environment (table, cassettes, etc.) and stock radiographic room.

6. Continue to manipulate accessories for the radiographic table (hand holds, foot rest, and shoulder rest).

7. Correctly operate all controls (spot film, bucky, fluoro timer, kV/mAs/sec selectors, and backup controls).

8. Assist radiologist during fluoroscopic studies.

9. Demonstrate the proper method to prepare barium.

10. Instruct patient regarding ingestion of barium during fluoroscopic procedures.

11. Assist in preparing the IV Contrast Studies examination room for various examinations.

COGNITIVE AND PSYCHOMOTOR OBJECTIVES:

The student will:

1. Apply knowledge and critique diagnostic film quality to include contrast, density, positioning, centering points, etc. of all procedures which competency is documented.

2. Perform examinations under indirect supervision upon procedural competency.

3. Practice the 18-step positioning procedure in all radiographic examinations as indicated in the clinical manual.

4. Practice effective immobilization techniques.

5. Actively participate in trauma radiography.

6. Continue to practice methods of radiation protection to patient, self, and others.

7. Continue to accurately place lead markers on image receptors.

8. Continue to practice standard precautions.

9. Continue to maximize collimation to area of interest, thereby, reducing patient exposure.

10. Continue to properly instruct patient of appropriate breathing instructions for all examinations.

11. Correctly prepare all necessary supplies for GI and BE examinations.

12. Interact as a member of the health care team during fluoroscopic and radiographic studies.

13. Continue to observe all centering points for each examination.

14. Continue to correctly perform preliminary films as indicated.

15. Correctly identify appropriate transport methodology.

16. Continue to correctly dismiss patients according to status.

17. Continue to demonstrate sterile and/or aseptic techniques as required.

18. Identify the applications and movements in all tomographic procedures.

19. Prepare tomographic contrast media utilizing aseptic technique.

20. State and practice procedure for a contrast reaction.

21. Continue to identify and correlate alterations in technical factors in the performance of tomographic procedures.

22. Differentiate, compare, and analyze protocol in accordance to examination parameters.

23. Continue to identify and demonstrate proper operation and adjustment of mobile equipment.

24. Modify positioning techniques when patient condition warrants.

25. Select appropriate technical factors for overhead radiographs after fluoroscopic procedures.

26. Perform overhead radiographs after a fluoroscopic procedure as directed by the radiologist.

27. Manipulate digital image for diagnostic quality including contrast and density windows, crop, zoom in, etc.

28. Retrieve digital image manually and by Post Acquisition Computerized Enhancement.

29. Retrieve and manipulate digital image on the fluoroscopy tower.

30. Position pediatric patients correctly for radiographic examinations.

31. Review anatomy on pediatric radiographs.

32. Demonstrate competence in all previous clinical competency examinations and complete Category II of the clinical competency examinations. Category II examinations must be observed and graded by the clinical instructor, clinical coordinator, or program director in actual room conditions on actual patients.

CLINICAL II: COURSE SCHEDULE

WEEK #1 Welcome Back - Anatomy, procedures, centering points, and technical factors of the humerus, patella, and femur

WEEK #2 Anatomy, procedures, centering points, and technical factors of hip, S.I. joints, pelvis, and Judet views of pelvis

WEEK #3 Review of radiography of the chest and abdomen including anatomy, procedures, centering points, and technical factors for portable chest, stretcher chest, and decubitus abdomen

WEEK #4 First Monthly Performance Evaluation Due

WEEK #5 Anatomy, procedures, centering points, and technical factors of the cervical and thoracic spine

Deadline for Clinical Written Objective #2 (must be submitted to the Clinical Coordinator at the Nave Center)

WEEK #6 Anatomy, procedures, centering points, technical factors of lumbar spine, sacrum, and coccyx

WEEK #7 Review for Mid-Term Examination

Second Monthly Performance Evaluation Due

WEEK #8 Written Midterm Examination

Mid-Term Comprehensive Evaluation

WEEK #9 Mobile radiography to include radiation protection, tube locks, exposure factors, cassettes, grids, etc.

WEEK #10 Third Monthly Performance Evaluation Due

WEEK #11 Surgical radiography to include radiation protection, sterile technique, tube locks, technical factors, digital imaging, etc.

WEEK #12 Radiography of pediatric chest

Deadline for Clinical Written Objective #3 (must be submitted to the Clinical Coordinator at the Nave Center already signed and dated by the Clinical Instructor)

WEEK #13 Anatomy, procedures, centering points, technical factors of the skull, facial bones, nasal bones, and sinuses

Fourth Monthly Performance Evaluation Due

WEEK #14 Review for final examination

WEEK #15 Written Final Examination

Rotational Objectives Due

Final Comprehensive Evaluation Due

*THIS SYLLABUS IS SUBJECT TO CHANGE AT FACULTYS’ DISCRETION*

According to Pre-Finals Week Policy, no formal final examination schedule exists for laboratory courses. The faculty have determined that all clinical educational courses are deemed "laboratory" courses.

References - RADT 3050

Brown, M., & Pound, P. (1997). Patient rapport in radiologic technology. Radiologic Technology Journal of the American Society of Radiologic Technologists, 68(5), 427-428.

Campbell, D. (1994). Making the most of clinical education. Radiologic Technology Journal of the American Society of Radiologic Technologists, 66(2), 127-128.

Cox, L. (1996). The shaken baby syndrome: Diagnosis using CT and MRI. Radiologic Technology Journal of the American Society of Radiologic Technologists, 67(6), 513-520.

Dowd, S., & Wilson, B. (1995). Informed patient consent: A historical perspective. Radiologic Technology Journal of the American Society of Radiologic Technologists, 67(2), 119-124.

Dowd, S., & Tilson, E. (1996). Re-engineering via patient-centered care. Radiologic Technology Journal of the American Society of Radiologic Technologists, 67(5), 421-424.

Hiss, S. S. (1997). Introduction to Health Care Delivery and Radiology Administration. Philadelphia: W. B. Saunders Co.

Purtilo, R. (1990). Health Professional and Patient Interaction. (4th ed.). Philadelphia: W. B. Saunders Co.

Reitherman, R. (1993). Non-surgical biopsy: Providing a choice. Radiologic Technology Journal of the American Society of Radiologic Technologists, 65(2), 122-122.

Reuter M. (1996). Trauma of the chest. European Radiology Journal, 6(5), 707-716.

Steves, A. (1993). Teaching your students to care. Radiologic Technology Journal of the American Society of Radiologic Technologists, 65(2), 119-120.

EAST TENNESSEE STATE UNIVERSITY

RADIOGRAPHY PROGRAM

ROTATIONAL OBJECTIVES

CLINICAL EDUCATION II

RADIOGRAPHY

COMPLETED

OBJECTIVE	YES	NO
Exercise priorities required in daily clinical practice.
Execute imaging procedures under the appropriate level of supervision.
Adapt to changes and varying clinical situations.
Effectively communicate and maintain professional relationships with patients, the public, and members of the health care team.
Assess the patient and record patient histories.
Carry out principles of transferring, positioning, immobilizing, and restraining of patients.
Practice the 18-step positioning procedure in doing all radiographic exams.
Repeat radiographs according to policy.
Practice standard precautions.
Apply radiation protection to protect the patient and staff.
Observe, assist, and/or perform all examinations.
Provide collimation to area of interest.
Participate in trauma radiography exhibiting improvised techniques to obtain diagnostic film quality.
Accurately ascertain information regarding pregnancy possibility.
Effectively operate radiographic equipment and accessories.
Observe and apply correct procedure methodology utilizing centering points on all exams (including placement of tube, table, and image receptor)
Critique and recognize diagnostic film quality.
Select appropriate image receptor and/or grid combinations.
Use proper SID and angulations for the radiographic procedure.
Identify radiographic anatomy recorded on radiographs.

EAST TENNESSEE STATE UNIVERSITY

RADIOGRAPHY PROGRAM

ROTATIONAL OBJECTIVES

CLINICAL EDUCATION II

FLUOROSCOPY

COMPLETED

OBJECTIVE	YES	NO
Exercise priorities required in daily clinical practice.
Execute imaging procedures under the appropriate level of supervision.
Adapt to changes and varying clinical situations.
Effectively communicate and maintain professional relationships with patients, the public, and members of the health care team.
Assess the patient and record patient histories.
Carry out principles of transferring, positioning, immobilizing, and restraining of patients.
Practice the 18-step positioning procedure in doing all radiographic exams.
Repeat radiographs according to policy.
Practice standard precautions.
Apply radiation protection to protect the patient and staff.
Observe, assist, and/or perform all examinations.
Provide collimation to area of interest.
Accurately ascertain information regarding pregnancy possibility.
Effectively operate radiographic/fluoroscopic controls, equipment, and accessories.
Observe and apply correct procedure methodology utilizing centering points on all exams (including placement of tube, table, and image receptor)
Critique and recognize diagnostic film quality.
Select appropriate image receptor and/or grid combinations.
Use proper SID and angulations for the radiographic procedure.
Identify radiographic anatomy recorded on radiographs.
Provide patient education regarding procedures.
Prepare contrast media according to institutional protocol.
Demonstrate sterile and/or aseptic techniques as required.
Correctly set up fluoroscopic/radiographic equipment.
Perform preliminary films as indicated.
Assist radiologist and/or radiographer during fluoroscopic studies.
Correctly place all necessary supplies for GI and BE examinations.
Identify patient preparation for various gastrointestinal studies.

EAST TENNESSEE STATE UNIVERSITY

RADIOGRAPHY PROGRAM

ROTATIONAL OBJECTIVES

CLINICAL EDUCATION II

IV CONTRAST STUDIES

COMPLETED

OBJECTIVE	YES	NO
Exercise priorities required in daily clinical practice.
Execute imaging procedures under the appropriate level of supervision.
Adapt to changes and varying clinical situations.
Effectively communicate and maintain professional relationships with patients, the public, and members of the health care team.
Assess the patient and record patient histories.
Carry out principles of transferring, positioning, immobilizing, and restraining of patients.
Practice the 18-step positioning procedure in doing all radiographic exams.
Repeat radiographs according to policy.
Practice standard precautions.
Apply radiation protection to protect the patient and staff.
Observe, assist, and/or perform all examinations.
Provide collimation to area of interest.
Accurately ascertain information regarding pregnancy possibility.
Effectively operate radiographic equipment and accessories.
Observe and apply correct procedure methodology utilizing centering points on all exams (including placement of tube, table, and image receptor)
Critique and recognize diagnostic film quality.
Select appropriate image receptor and/or grid combinations.
Use proper SID and angulations for the radiographic procedure.
Identify radiographic anatomy recorded on radiographs.
Obtains signed patient consent form.
Identify and state classic reaction symptoms.
Prepare contrast media utilizing aseptic technique.
Demonstrate sterile and/or aseptic techniques as required.
Perform correctly, after instruction, preliminary films as indicated.
State the basic procedure and protocol involved in urology radiography.
Dispose contaminated items in prescribed manner.
Ensure that the patient's bladder is empty before completing initial radiographs.
Set up all equipment and supplies (patient gown, shield, markers, tape, alcohol, tourniquet, needles, syringes, butterflies, stopper, gauze, number markers, appropriate contrast material.
State and practice procedure for a contrast reaction.
Obtain scout and nephrograms at appropriate fulcrum levels and time intervals.
Demonstrate recognition of good film quality.
Identify and correlate alterations in technical factors in the performance of tomographic procedures.

EAST TENNESSEE STATE UNIVERSITY

RADIOGRAPHY PROGRAM

ROTATIONAL OBJECTIVES

CLINICAL EDUCATION II

MOBILE RADIOGRAPHY

COMPLETED

OBJECTIVE	YES	NO
Exercise priorities required in daily clinical practice.
Execute imaging procedures under the appropriate level of supervision.
Adapt to changes and varying clinical situations.
Effectively communicate and maintain professional relationships with patients, the public, and members of the health care team.
Assess the patient and record patient histories.
Carry out principles of transferring, positioning, immobilizing, and restraining of patients.
Practice the 18-step positioning procedure in doing all radiographic exams.
Repeat radiographs according to policy.
Practice standard precautions.
Apply radiation protection to protect the patient and staff.
Observe, assist, and/or perform all examinations.
Provide collimation to area of interest.
Accurately ascertain information regarding pregnancy possibility.
Effectively operate radiographic equipment and accessories.
Observe and apply correct procedure methodology utilizing centering points on all exams (including placement of tube, table, and image receptor)
Critique and recognize diagnostic film quality.
Select appropriate image receptor and/or grid combinations.
Use proper SID and angulations for the radiographic procedure.
Identify radiographic anatomy recorded on radiographs.
Identify correct patient and examination according to requisition.
Locate and drive the portable to the patient's room.
Politely ask visitors to wait outside the room until examination is complete.
Examine room and adjust furniture before bringing in the portable unit.
Identify and demonstrate proper operation and adjustment of mobile equipment.
Adjust the patient into the erect or supine position, as appropriate.
Accepts and uses constructive criticism.
Exhibit knowledge of medical terminology and provides correlation to examinations prescribed.
Demonstrate procedures in maintaining a sterile field.
Return the portable unit to the proper location and charge it if needed.
Patient identification (flash) and film processing is appropriate.
Demonstrate and observe differences in procedure of examinations.
Identify and demonstrate proper operation and adjustment of mobile equipment for extremity radiography.
Identify and demonstrate proper operation and adjustment of mobile equipment for chest radiography.
Identify and demonstrate proper operation and adjustment of mobile equipment during a trauma procedure.
Actively participates in the performance of surgical radiography procedures.
Returns furniture to original place.
Assist in operation of C-arm.
Practice procedure for hooking C-arm up.

EAST TENNESSEE STATE UNIVERSITY

RADIOGRAPHY PROGRAM

ROTATIONAL OBJECTIVES

CLINICAL EDUCATION II

AFTER HOURS - EVENINGS

COMPLETED

OBJECTIVE	YES	NO
Perform and/or assist with all examinations.
Practice Standard Precautions.
Apply protective devices to all patients.
Practice 18-step procedure for doing all patients.
Differentiate and state differences in radiographic procedures.
Assist in the radiologic examination of trauma patients.
Assist the health care team in stressful situations.
Evaluate and initiate correct imaging protocol.

ROTATIONAL OBJECTIVES

CLINICAL EDUCATION III

AFTER HOURS - WEEKEND

COMPLETED

OBJECTIVE	YES	NO
Perform and/or assist with all examinations.
Practice Standard Precautions.
Apply protective devices to all patients.
Practice 18-step procedure for doing all patients.
Differentiate and state differences in radiographic procedures.
Assist in the radiologic examination of trauma patients.
Assist the health care team in stressful situations.
Evaluate and initiate correct imaging protocol.
Function as a member of the imaging team.
Identify chain of command and department protocol.
Independently perform examinations in which competency has been documented.
Modify positioning techniques when patient condition warrants.
Participate in the radiography of trauma patients.
Demonstrate responsibility with patients and technologists.

EAST TENNESSEE STATE UNIVERSITY

RADIOGRAPHY PROGRAM

CLINICAL EDUCATION II

COMPETENCY PERFORMANCE OBJECTIVES

GRADE	EXAMINATION	DATE	PT'S ID#	CL.ED.CT
	HUMERUS
	PATELLA
	FEMUR
	HIP
	PELVIS
	PORTABLE CHEST
	STRETCHER CHEST
	DECUB ABDOMEN
	CERVICAL SPINE
	THORACIC SPINE
	LUMBAR SPINE
	TRAUMA EXTREMITY
	EXAM IN SURGERY

COURSE SYLLABUS

EAST TENNESSEE STATE UNIVERSITY

BACHELOR OF SCIENCE IN ALLIED HEALTH

RADIOGRAPHY CONCENTRATION

CLINICAL EDUCATION III

RADT 3060

COURSE: Clinical III

LEVEL OF SUPERVISION: DIRECT/INDIRECT

CLOCK HOURS: 520 (5 days a week x 13 weeks)

CREDIT: 5 Semester Credits

GRADE COMPUTATION: Practical Rotational Objectives 10%

Performance Evaluations 15%

Clinical Written Objectives 10%

Attendance/Ethics/Dress Code 15%

Competency Performance Evaluations 20%

Clinical Examinations (Mid-term and

Final, Written) 15%

Comprehensive Evaluations 15%

EXPLANATION OF CATEGORIES:

Rotational Objectives - Clinical instructor evaluates each objective as the student

masters it.

Performance Evaluations - The clinical instructor will evaluate student progression

monthly.

Clinical Written Objectives - Will involve a grade for all written objective assignments

and reading assignments. The Clinical Log Book is included in this category. The clinical coordinator grades the clinical written objectives.

Attendance/Ethics/Dress Code - Compliance to the attendance and tardiness policies is essential. Refer to the policies with regard to attendance and tardiness is located in this manual. Ethics is an integral part of being a healthcare provider. Conducting his/herself in a professional manner is required of all students. A reduction points will occur and the amount will be based on the infraction. The dress code is also essential. If non-compliance of the dress code occurs, a reduction of ten (10) percent will result for each infraction.

Competency Performance Evaluations - Clinical instructors and/or clinical coordinator must evaluate each examination to ascertain the competency level of the student.

Mid-term & Final Clinical Examinations (Written) - Examinations regarding clinical objectives covered during courses. This category may also include quizzes (announced or unannounced) that are given during the semester.

GRADE SCALE:

96-100 A

95 A-

94 B+

91-93 B

90 B-

89 C+

86-88 C

85 C-

84 D+

81-83 D

80 D-

0-79 F

TEXTBOOK: Ballinger, P. W. & Frank, E. D. (2003). Merrill's atlas of

radiographic positions and radiologic procedures. (10th Edition). St. Louis, Missouri: Mosby-Year Book Publishers.

DESCRIPTION: (Prerequisites: Program admission and RADT 3050). A competency based clinical practicum that requires higher cognitive, affective, and psychomotor skill levels. This clinical experience provides learning opportunities in fluoroscopy of physiological body systems, cystography, advanced extremity, mobile, trauma, skull work, and surgical radiographic procedures. Mastery of knowledge from previous clinical practicums with a focus on outcomes assessment will occur. All classes occur at the clinical agencies.

COMPETENCY EXAMINATIONS:

Ribs Portable Abdomen IVP

Acute Abdomen Portable Orthopedics UGI

Trauma Hip (cross table lat) Facial Bones Barium Swallow

Trauma Cervical (cross table lat) Nasal Bones Small Bowel

Pediatric Chest Sinuses Barium Enema

C-Arm Case

PRACTICAL ASSIGNMENTS:

The student will rotate to a different clinical education center for the last three weeks of the summer semester and will remain at that site during the fall semester to diversify their knowledge, enhance their clinical skills, and adapt to changing environments.

Rotational Assignments Assigned Weeks

Radiography	3
Mobile Radiography/Surgery	3
Fluoroscopy	3
IV Contrast Studies	1
After Hours (2 weeks evenings, 1 weekend)	3
TOTAL	13

ROTATIONAL OBJECTIVES:

COURSE GOALS:

1. The student shall display professional conduct as outlined in the American Society of Radiologic Technologist's code of ethics.

2. The student shall exhibit professional conduct in all interactions with patients, families, other caregivers, and peers.

3. The student shall professionally mitigate moral and ethical dilemmas arising with patients, peers, consumers, and health care team members.

4. The student will effectively communicate with patients, peers, and health care team members.

5. The student will adhere to legal practice standards including all federal, state, and institutional regulations related to patient care.

6. The student will display pride in their chosen profession.

7. The student will provide appropriate patient care that maximizes patient care practices to meet the health care needs of the community.

9. The student will apply knowledge under actual patient conditions demonstrating clinical proficiency skills.

10. The student will competently critique film quality.

11. The student must complete Category III of the Clinical Competency Examinations. This is to be completed after the student has practiced the examinations in simulation and procedural laboratory and satisfactorily completed the full routine in simulation without assistance. Category III examinations must be observed and graded by the clinical instructor, clinical coordinator, or program director in actual room conditions on actual patients.

12. The student shall obtain proficiency and demonstrate skills as delineated in the rotational objectives.

13. The student will competently function as a member of the health care team.

CLINICAL WRITTEN OBJECTIVES:

1. Students must submit the Clinical Record Book representing competency in simulation.

2. Students must perform one case study. Specific requirements will be announced. Students may opt to compete in TSRT Vogel Essay Contest.

3. Students must read assigned sections in texts.

5. Additional assignments may be required as deemed necessary by the faculty.

COURSE OBJECTIVES:

The course objectives for RADT 4000 are divided into four categories of instructional

objectives. They are:

l. Cognitive - Recalling and understanding information and applying it to

other material or new situations. Problem solving.

2. Affective - Awareness of and reaction to an activity, situation, or

phenomenon. Attachment of worth to an activity, situation,

or phenomenon. Commitment to a value which is reflected

in behavior.

3. Psychomotor - Awareness of a stimulus and readiness to perform a motor

skill. Practice in motor skills with increasing proficiency.

Ability to alter procedures or create new movements.

4. Cognitive and Psychomotor - Recalling and understanding information

and applying it to performing motor skills.

So that the student may better determine the expectations of this course, the objectives listed below are categorized. Some objectives belong to more than one category and will be listed accordingly.

COGNITIVE OBJECTIVES:

The student will:

1. Perform a case study or participate in the Vogel Essay Contest. Specific requirements will be announced.

2. Read assigned sections in texts.

3. Complete additional assignments as required.

4. Continue to critique diagnostic radiographs.

5. Continue to demonstrate and observe procedural methodology and centering points on all examinations (including placement of tube, table, and film).

6. Continue to practice independent selection of technical factors under direct/indirect supervision.

7. Continue to exercise judgment and correlate instruction in the revision of technical factors concerning repeat radiographs.

8. Continue to select appropriate film/screen and/or grid combinations.

9. Continue to identify anatomy of all radiographs.

10. Select proper patient preparation for various fluoroscopic procedures.

11. Identify classic reaction symptoms to contrast media.

12. Evaluate radiographic, fluoroscopic, tomographic, and mobile radiographic films for diagnostic quality.

13. State basic procedure and protocol involved in mammographic procedures.

14. Demonstrate recognition of diagnostic quality of mammographic radiographs.

15. Differentiate, compare, and analyze erect and supine portable chest radiographs.

16. Differentiate and analyze decubitus chest radiographs and pathology.

17. Differentiate, compare, and analyze digital radiography and spot films.

AFFECTIVE OBJECTIVES:

The student will:

1. Continue to display behavior as outlined in the American Society of Radiologic Technologist's code of ethics.

2. Continue to exhibit professional conduct in all interactions with patients, families, other caregivers, and peers.

3. Continue to professionally mitigate moral and ethical dilemmas arising with patients, peers, consumers, and health care team members.

4. Continue to effectively communicate with patients, peers, and health care team members.

5. Continue to adhere to legal practice standards including all federal, state, and institutional regulations related to patient care.

6. Continue to display pride in their chosen profession.

7. Continue to deliver patient care and service unrestricted by personal attribute concerns or the nature of the disease or illness, and without discrimination regardless of sex, race, creed, religion, or socioeconomic status.

PSYCHOMOTOR OBJECTIVES:

The student will:

1. Submit Clinical Record Book representing competency in simulation.

2. Demonstrate competence in all previous clinical competency examinations and complete Category III of the competency examinations. This is to be completed after the student has practiced the examinations in simulation and procedural laboratory without assistance. Category III examinations must be observed and graded by the clinical instructor, clinical coordinator, or program director in actual room conditions on actual patients.

3. Obtain proficiency and demonstrate skills as delineated in the rotational objectives.

4. Competently demonstrate procedures which are acceptable in patient transfer for inpatients (wheelchair, stretcher, on-off table, etc.).

5. Competently prepare the IV Contrast Studies room for an IVP examination.

6. Correctly manipulate accessories for the radiographic table (shoulder rest, compression, etc).

7. Competently operate all controls (automatic exposure control, spot film, bucky, fluoro timer, kV/mAs/sec selectors, backup controls).

8. Continue to provide an aseptic environment (bucky, cassettes, mobile equipment, etc.) and stock radiographic room.

9. Competently assist radiologist during fluoroscopic studies.

COGNITIVE AND PSYCHOMOTOR OBJECTIVES:

The student will:

1. Demonstrate competence in all previous clinical competency examinations and complete Category III of the competency examinations. This is to be completed after the student has practiced the examinations in simulation and procedural laboratory without assistance. Category III examinations must be observed and graded by the clinical instructor, clinical coordinator, or program director in actual room conditions on actual patients.

2. Competently critique film quality.

3. Practice the 18-step positioning procedure in all radiographic examinations as indicated in the clinical competency manual.

4. Utilize effective immobilization techniques.

5. Actively participate in trauma radiography demonstrating technique and improvisation to obtain diagnostic radiographs.

6. Continue to practice methods of radiation protection to patients, self, and others (lead apron, gonadal shield, thyroid shield, etc.).

7. Continue to accurately place lead markers on image receptors.

8. Continue to dispose of contaminated items according to OSHA guidelines.

9. Continue to practice standard precautions.

10. Competently maximize collimation to area of interest thereby reducing patient exposure.

11. Continue to instruct patient of appropriate breathing instructions for all examinations.

12. Independently prepare all necessary supplies for GI and BE examinations.

13. Assist staff during all fluoroscopic and radiographic studies.

14. Continue to observe all centering points for each examination.

15. Independently perform preliminary films as indicated.

16. Continue to transport all types of patients including wheelchair, stretchers, IV's, oxygen, etc.

17. Practice sterile and/or aseptic techniques as required.

18. Prepare tomographic equipment for all IVP procedures.

19. Prepare tomographic contrast media utilizing aseptic technique.

20. Demonstrate procedure for a contrast reaction.

21. Identify and correlate alterations in technical factors in the performance of tomographic procedures.

22. Demonstrate, compare, and analyze different protocol in accordance to examination parameters.

23. Independently operate and adjust mobile equipment (indirect supervision).

24. Demonstrate procedures in maintaining a sterile field.

25. Modify positioning techniques when patient condition warrants.

26. Demonstrate and observe all positioning methodology for mammographic procedures.

27. Select appropriate technical factors to produce quality mammographic radiographs.

28. Actively demonstrate knowledge of previous objectives relative to radiography rotation.

29. Actively demonstrate knowledge of previous objectives relative to fluoroscopy rotation.

30. Actively demonstrate knowledge of previous objectives relative to mobile radiography rotation.

31. Actively demonstrate knowledge of previous objectives relative to IV Contrast Studies rotation.

32. Demonstrate the operation of C-arm equipment.

33. Select correct technical factors during mobile and surgical examinations.

34. Manipulate C-arm digital image for diagnostic quality.

35. Retrieve a digital image from the C-arm.

36. Practice radiation safety to patient, self, and surgical team during surgical examinations.

37. Manipulate and retrieve digital images for diagnostic quality including contrast window, crop, zoom-in, PACs, etc.

38. Manipulate, save, and send digital image via teleradiography (if applicable).

39. Perform and/or assist in geriatric fluoroscopic procedures.

40. Perform and/or assist in pediatric fluoroscopic procedures.

CLINICAL III: COURSE SCHEDULE

WEEK #1 Welcome Back - Anatomy, procedures, centering points, and technical factors of mobiles and surgery – including the C-Arm.

WEEK #2 Anatomy, procedures, centering points, and technical factors of the ribs and abdomen.

WEEK #3 Anatomy, procedures, centering points, pathology, and technical factors of the gastrointestinal system to include UGI, Barium Swallow, Small Bowel, and Barium Swallow.

First Monthly Performance Evaluation Due

WEEK #4 Anatomy, procedures, pathology, and technical factors of the biliary system including ERCP, T-tube cholangiogram, and Oral Cholangiogram.

WEEK #5 Review for Midterm Examination

Second Monthly Performance Evaluation Due

WEEK #6 Written Midterm Examination

Midterm Comprehensive Evaluation Due

WEEK #7 Contrast media including different types, contraindications, treatments, and purposes.

WEEK #8 Anatomy, procedures, centering points, pathology, IV Contrast Studies, and technical factors of the urinary system including IVP's and cystograms.

Third Monthly Performance Evaluation Due

WEEK #9 Anatomy, procedures, centering points, pathology, IV Contrast Studies, and technical factors of headwork including skull, facial bones, nasal bones, and sinsuses..

Case Study is Due

Rotational Objectives Due

Final Comprehensive Evaluation Due

WEEK #10 Written Final Examination

Case Study Presentations at each clinical site

Rotational Objectives Due

Final Comprehensive Evaluation Due

WEEK #11 Orientation to new clinical site

WEEK #12 Orientation to new clinical site

WEEK #13 Orientation to new clinical site

Fourth Monthly Performance Evaluation Due (1^st Grade for the Fall Semester)

*THIS SYLLABUS IS SUBJECT TO CHANGE AT FACULTY'S DISCRETION*

EAST TENNESSEE STATE UNIVERSITY

RADIOGRAPHY PROGRAM

ROTATIONAL OBJECTIVES

CLINICAL EDUCATION III

RADIOGRAPHY

COMPLETED

OBJECTIVE	YES	NO
Exercise priorities required in daily clinical practice.
Execute imaging procedures under the appropriate level of supervision.
Adapt to changes and varying clinical situations.
Effectively communicate and maintain professional relationships with patients, the public, and members of the health care team.
Assess the patient and record patient histories.
Carry out principles of transferring, positioning, immobilizing, and restraining of patients.
Practice the 18-step positioning procedure in doing all radiographic exams.
Repeat radiographs according to policy.
Practice standard precautions.
Apply radiation protection to protect the patient and staff.
Observe, assist, and/or perform all examinations.
Independent selection of technical factors.
Observe and demonstrate centering points on all examinations.
Provide collimation to area of interest.
Participate in trauma radiography and modify positioning of the tube and image receptor to obtain diagnostic film quality.
Accurately ascertain information regarding pregnancy possibility.
Effectively operate radiographic equipment and accessories.
Observe and apply correct procedure methodology utilizing centering points on all exams (including placement of tube, table, and image receptor)
Critique and recognize diagnostic film quality.
Select appropriate image receptor and/or grid combinations.
Use proper SID and angulations for the radiographic procedure.
Identify radiographic anatomy recorded on radiographs.

EAST TENNESSEE STATE UNIVERSITY

RADIOGRAPHY PROGRAM

ROTATIONAL OBJECTIVES

CLINICAL EDUCATION III

FLUOROSCOPY

COMPLETED

OBJECTIVE	YES	NO
Exercise priorities required in daily clinical practice.
Execute imaging procedures under the appropriate level of supervision.
Adapt to changes and varying clinical situations.
Effectively communicate and maintain professional relationships with patients, the public, and members of the health care team.
Assess the patient and record patient histories.
Carry out principles of transferring, positioning, immobilizing, and restraining of patients.
Practice the 18-step positioning procedure in doing all radiographic exams.
Repeat radiographs according to policy.
Practice standard precautions.
Apply radiation protection to protect the patient and staff.
Observe, assist, and/or perform all examinations.
Provide collimation to area of interest.
Accurately ascertain information regarding pregnancy possibility.
Effectively operate radiographic/fluoroscopic controls, equipment, and accessories.
Observe and apply correct procedure methodology utilizing centering points on all exams (including placement of tube, table, and image receptor)
Critique and recognize diagnostic film quality.
Select appropriate image receptor and/or grid combinations.
Use proper SID and angulations for the radiographic procedure.
Identify radiographic anatomy recorded on radiographs.
Provide patient education regarding procedures.
Prepare contrast media according to institutional protocol.
Demonstrate sterile and/or aseptic techniques as required.
Correctly set up fluoroscopic/radiographic equipment.
Perform preliminary films as indicated.
Assist radiologist and/or radiographer during fluoroscopic studies.
Correctly place all necessary supplies for GI and BE examinations.
Identify patient preparation for various gastrointestinal studies.

EAST TENNESSEE STATE UNIVERSITY

RADIOGRAPHY PROGRAM

ROTATIONAL OBJECTIVES

CLINICAL EDUCATION III

IV CONTRAST STUDIES

COMPLETED

OBJECTIVE	YES	NO
Exercise priorities required in daily clinical practice.
Execute imaging procedures under the appropriate level of supervision.
Adapt to changes and varying clinical situations.
Effectively communicate and maintain professional relationships with patients, the public, and members of the health care team.
Assess the patient and record patient histories.
Carry out principles of transferring, positioning, immobilizing, and restraining of patients.
Practice the 18-step positioning procedure in doing all radiographic exams.
Repeat radiographs according to policy.
Practice standard precautions.
Apply radiation protection to protect the patient and staff.
Observe, assist, and/or perform all examinations.
Provide collimation to area of interest.
Accurately ascertain information regarding pregnancy possibility.
Effectively operate radiographic equipment and accessories.
Observe and apply correct procedure methodology utilizing centering points on all exams (including placement of tube, table, and image receptor)
Critique and recognize diagnostic film quality.
Select appropriate image receptor and/or grid combinations.
Use proper SID and angulations for the radiographic procedure.
Identify radiographic anatomy recorded on radiographs.
Obtains signed patient consent form.
Identify and state classic reaction symptoms.
Prepare contrast media utilizing aseptic technique.
Demonstrate sterile and/or aseptic techniques as required.
Perform correctly, after instruction, preliminary films as indicated.
State the basic procedure and protocol involved in urology radiography.
Dispose contaminated items in prescribed manner.
Ensure that the patient's bladder is empty before completing initial radiographs.
Set up all equipment and supplies (patient gown, shield, markers, tape, alcohol, tourniquet, needles, syringes, butterflies, stopper, gauze, number markers, appropriate contrast material.
State and practice procedure for a contrast reaction.
Obtain scout and nephrograms at appropriate fulcrum levels and time intervals.
Demonstrate recognition of good film quality.
Identify and correlate alterations in technical factors in the performance of tomographic procedures.

EAST TENNESSEE STATE UNIVERSITY

RADIOGRAPHY PROGRAM

ROTATIONAL OBJECTIVES

CLINICAL EDUCATION III

MOBILE RADIOGRAPHY

COMPLETED

OBJECTIVE	YES	NO
Exercise priorities required in daily clinical practice.
Execute imaging procedures under the appropriate level of supervision.
Adapt to changes and varying clinical situations.
Effectively communicate and maintain professional relationships with patients, the public, and members of the health care team.
Assess the patient and record patient histories.
Carry out principles of transferring, positioning, immobilizing, and restraining of patients.
Practice the 18-step positioning procedure in doing all radiographic exams.
Repeat radiographs according to policy.
Practice standard precautions.
Apply radiation protection to protect the patient and staff.
Observe, assist, and/or perform all examinations.
Provide collimation to area of interest.
Accurately ascertain information regarding pregnancy possibility.
Effectively operate radiographic equipment and accessories.
Observe and apply correct procedure methodology utilizing centering points on all exams (including placement of tube, table, and image receptor)
Critique and recognize diagnostic film quality.
Select appropriate image receptor and/or grid combinations.
Use proper SID and angulations for the radiographic procedure.
Identify radiographic anatomy recorded on radiographs.
Identify correct patient and examination according to requisition.
Locate and drive the portable to the patient's room.
Politely ask visitors to wait outside the room until examination is complete.
Examine room and adjust furniture before bringing in the portable unit.
Identify and demonstrate proper operation and adjustment of mobile equipment.
Adjust the patient into the erect or supine position, as appropriate.
Accepts and uses constructive criticism.
Exhibit knowledge of medical terminology and provides correlation to examinations prescribed.
Demonstrate procedures in maintaining a sterile field.
Return the portable unit to the proper location and charge it if needed.
Patient identification (flash) and film processing is appropriate.
Demonstrate and observe differences in procedure of examinations.
Identify and demonstrate proper operation and adjustment of mobile equipment for extremity radiography.
Identify and demonstrate proper operation and adjustment of mobile equipment for chest radiography.
Identify and demonstrate proper operation and adjustment of mobile equipment during a trauma procedure.
Actively participates in the performance of surgical radiography procedures.
Returns furniture to original place.
Assist in operation of C-arm.
Practice procedure for hooking C-arm up.

EAST TENNESSEE STATE UNIVERSITY

RADIOGRAPHY PROGRAM

ROTATIONAL OBJECTIVES

CLINICAL EDUCATION III

AFTER HOURS - EVENINGS

COMPLETED

OBJECTIVE	YES	NO
Perform and/or assist with all examinations.
Practice Standard Precautions.
Apply protective devices to all patients.
Practice 18-step procedure for doing all patients.
Differentiate and state differences in radiographic procedures.
Assist in the radiologic examination of trauma patients.
Assist the health care team in stressful situations.
Evaluate and initiate correct imaging protocol.

ROTATIONAL OBJECTIVES

CLINICAL EDUCATION III

AFTER HOURS - WEEKEND

COMPLETED

OBJECTIVE	YES	NO
Perform and/or assist with all examinations.
Practice standard precautions.
Apply protective devices to all patients.
Utilize practices of standard self-protection.
Practice 18-step procedure for doing all patients.
Identify specific procedural protocol depending upon the examination and physician.
Independently perform radiographic examinations of trauma patients.
Manage stressful situations effectively and efficiently.
Function as member of the radiology team.
Identify chain of command and department protocol.
Demonstrate responsibility with patients and technologists.
Independently evaluate and initiate correct imaging protocol.
Independently perform examinations in which competency has been documented.
Modify positioning techniques when patient condition warrants.

EAST TENNESSEE STATE UNIVERSITY

RADIOGRAPHY PROGRAM

CLINICAL EDUCATION III

COMPETENCY PERFORMANCE OBJECTIVES

GRADE	EXAMINATION	DATE	PT'S ID#	CL.ED.CT
	RIBS
	ACUTE ABDOMEN
	TRAUMA HIP (cross table lat)
	TRAUMA CERVICAL (cross table lateral)
	PEDIATRIC CHEST
	PORTABLE ABDOMEN
	PORTABLE ORTHOPEDICS
	FACIAL BONES
	NASAL BONES
	SINUSES
	IVP
	UGI
	BARIUM SWALLOW
	SMALL BOWEL
	BARIUM ENEMA
	C-ARM CASE

COURSE SYLLABUS

EAST TENNESSEE STATE UNIVERSITY

BACHELOR OF SCIENCE IN ALLIED HEALTH

RADIOGRAPHY CONCENTRATION

CLINICAL EDUCATION IV

RADT 4010

COURSE: Clinical IV

LEVEL OF SUPERVISION: DIRECT/INDIRECT

CLOCK HOURS: 360 (3 days a week x 15 weeks)

CREDIT: 3 Semester Credits

GRADE COMPUTATION: Practical Rotational Objectives 10%

Performance Evaluations 15%

Clinical Written Objectives 10%

Attendance/Ethics/Dress Code 15%

Competency Performance Evaluations 20%

Clinical Examinations (Mid-term and

Final, Written) 15%

Comprehensive Evaluations 15%

EXPLANATION OF CATEGORIES:

Rotational Objectives - Clinical instructor evaluates each objective as the student

masters it.

Performance Evaluations - The clinical instructor will evaluate student progression

monthly.

Clinical Written Objectives - Will involve a grade for all written objective assignments

and reading assignments. The Clinical Log Book is included in this category. The clinical coordinator grades the clinical written objectives.

Attendance/Ethics/Dress Code - Compliance to the attendance and tardiness policies is essential. Refer to the policies with regard to attendance and tardiness is located in this manual. Ethics is an integral part of being a healthcare provider. Conducting his/herself in a professional manner is required of all students. A reduction points will occur and the amount will be based on the infraction. The dress code is also essential. If non-compliance of the dress code occurs, a reduction of ten (10) percent will result for each infraction.

Competency Performance Evaluations - Clinical instructors and/or clinical coordinator must evaluate each examination to ascertain the competency level of the student.

GRADE SCALE:

96-100 A

95 A-

94 B+

91-93 B

90 B-

89 C+

86-88 C

85 C-

84 D+

81-83 D

80 D-

0-79 F

TEXTBOOK: Ballinger, P. W. & Frank, E. D. (1999). Merrill's atlas of

radiographic positions and radiologic procedures. (9th Edition). St. Louis, Missouri: Mosby-Year Book Publishers.

DESCRIPTION: (Prerequisite: RADT 4000). Corequisites: RADT 3070 and RADT

4030). This clinical experience will occur at a different clinical agency

thereby diversifying the clinical applications of cognitive, affective, and

psychomotor skills. Students will participate in diagnostic imaging,

specialty areas, and interventional radiography to become a true part of the

health care team. Students will complete minor/major special

competencies emphasizing outcomes assessment.

COMPETENCY EXAMINATIONS:

Geriatric Fluoroscopy

Pediatric Fluoroscopy

Minor Special

Major Special

C-Arm Case (Must be completed at the new clinical site)

***A maximum of three graduate performance competencies may be completed during this semester and the remainder must be completed during the fifth semester.

PRACTICAL ASSIGNMENTS:

Rotational Assignments Assigned Weeks

Radiography	2
Mobile Radiography/Surgery	3
Fluoroscopy	3
Special Procedures/Interventional	3
Clinical Elective	2
After Hours (2 weeks evenings)	2
TOTAL	15

Elective Rotations

Competent students may submit justification for elective rotations. Elective rotation approval

requires satisfactory student competency and progress, faculty approval, equipment availability,

and clinical staff.

Elective rotations include:

Cardiac Catheterization Ultrasonography

CT/MR Nuclear Medicine

ROTATIONAL OBJECTIVES:

Each student will be responsible for the distribution and successive completion of rotational objectives by a registered radiographer. This checklist will be due at the completion of the rotation. The student must achieve 85% of the objectives in a satisfactory manner. Any student who achieves less than 85% of the objectives will be assigned additional rotations in order to complete the objectives satisfactorily.

COURSE GOALS:

1. The student will continue to display professional conduct as outlined in the American Society of Radiologic Technologist's code of ethics.

2. The student will continue to professionally mitigate moral and ethical dilemmas arising with patients, family, peers, consumers, and health care team members.

3. The student will expressively communicate with patients, peers, family, and health care team members.

4. The student will continue to adhere to legal practice standards including all federal, state, and institutional regulations related to patient care.

5. The student will continue to display pride in their chosen profession and pursue life long learning resources by participating in professional societies.

6. The student will provide appropriate patient care that maximizes patient care practices to meet the healthcare needs of the community.

7. The student will deliver patient care and service unrestricted by personal attribute concerns or the nature of the disease or illness, and without discrimination regardless of sex, race, creed, religion, or socioeconomic status.

8. The student will apply knowledge of previous experiences and independently perform examinations (indirect supervision) on actual patients demonstrating clinical proficiency skills.

9. The student will demonstrate competency in film quality recognition and recommend needed corrections.

10. The student will advance professional objectives to provide services to humanity with full respect for the dignity of mankind.

11. The student will demonstrate competence in all previous clinical competency examinations and complete Category IV of the clinical competency examinations. Category IV examinations must be observed and graded by the clinical instructor, clinical coordinator, and/or program director.

12. The student will recognize the economic, social, and cultural factors in the community that impact healthcare delivery.

13. The student will act as an agent through observation and communication to obtain pertinent information to aid in the diagnosis and treatment management of patients.

CLINICAL WRITTEN OBJECTIVES:

1. The student must submit Clinical Record Book representing competency.

2. The student must compose a research paper on interventional radiography.

3. Additional assignments may be required.

COURSE OBJECTIVES:

The course objectives for RADT 4010 are divided into four categories of instructional objectives. They are:

l. Cognitive - Recalling and understanding information and applying it to other

material or new situations. Problem solving.

2. Affective - Awareness of and reaction to an activity, situation, or

phenomenon. Attachment of worth to an activity, situation, or

phenomenon. Commitment to a value which is reflected in

behavior.

3. Psychomotor - Awareness of a stimulus and readiness to perform a motor skill.

Practice in motor skills with increasing proficiency. Ability to alter

procedures or create new movements.

4. Cognitive and recalling and understanding psychomotor - information and

applying it to performing motor skills.

So that the student may better determine the expectations of this course, the objectives listed below are categorized. Some objectives belong to more than one category and will be listed accordingly.

COGNITIVE OBJECTIVES

The student will:

1. Compose a research paper on interventional radiography.

2. Read assigned sections in texts.

3. Complete additional assignments as required.

4. Identify examinations and protocols for all routine radiographic procedures.

5. Critique radiographs evaluating to film quality and positioning.

6. Demonstrate an understanding of the technical aspects of radiographic imaging equipment.

7. Recognize the need for medical attention to patients.

8. Differentiate and state procedural methodology commonly completed after hours.

9. Identify CT equipment and accessories (gantry, couch, control panel, etc.).

10. Prepare and observe contrast media administration for CT scanning procedures.

11. Identify location of contrast media reaction materials and procedures for implementing counteractive measures during CT scanning procedures.

12. Identify and review all basic anatomy relevant to routine CT procedures.

13. Evaluate all CT images for the proper demonstration of relevant anatomy.

14. Identify CT procedures and protocol.

15. Observe the manipulation and processing of the CT digital image.

16. Observe and identify special procedures protocol.

17. Review and identify all basic anatomy relevant to routine special procedures.

18. Identify contrast medias and state indications and contraindications of each.

19. Identify the operation of the EKG monitor and other devices.

20. Recognize normal radiographic anatomy on angiography studies.

21. Observe the manipulation and processing of the digital angiographic image.

22. Identify and observe different types of procedures and protocols for interventional radiography.

23. Identify basic pathology on angiographic radiograph.

24. Critique, under direct supervision, completed GI and BE radiographs in regard to positioning and exposure quality.

25. Identify pathology as illustrated on special Fluoro studies such as ERCP's, T-tube cholangiograms, OPMS, etc.

26. Identify protocol for GI and BE examinations.

27. Observe and participate in pre and post patient education methodology for each fluoroscopic examination.

28. Identify and demonstrate basic anatomy relevant to routine ultrasound procedures.

29. Identify basic equipment for ultrasound procedures (transducer, computer, monitor, gel, etc.).

30. Evaluate all ultrasound images for the proper demonstration of relevant anatomy.

31. Identify the functions of different transducers to be utilized for ultrasound procedures.

32. Observe the manipulation and processing of ultrasound images.

33. Identify procedures and protocol for ultrasound.

34. Identify contraindications of certain nuclear medicine studies when done in series.

35. Distinguish the effect of certain contrast medias that may affect nuclear medicine scans.

36. Differentiate between various nuclear medicine collimators.

37. State procedures for disposal of radioactive waste.

38. Identify nuclear medicine equipment and accessories (computer, couch, single and dual head gamma camera, hot lab, ventilation perfusion machine, etc.).

39. Observe the manipulation and processing of nuclear medicine images.

AFFECTIVE OBJECTIVES

The student will:

1. Continue to display professional conduct as outlined in the American Society of Radiologic Technologist's code of ethics.

2. Continue to professionally mitigate moral and ethical dilemmas arising with patients, family, peers, consumers, and healthcare team members.

3. Continue to expressively communicate with patients, peers, family, and health care team members.

4. Continue to adhere to legal practice standards including all federal, state, and institutional regulations related to patient care.

5. Continue to display pride in their chosen profession and pursue life long learning resources by participating in professional societies.

6. Continue to provide appropriate patient care that maximizes patient care practices to meet the healthcare needs of the community.

8. Continue to demonstrate competency in film quality recognition and recommend needed corrections.

9. The student will recognize the economic, social, and cultural factors in the community that impact health care delivery.

10. Function effectively in stressful situations and maintain composure.

PSYCHOMOTOR OBJECTIVES

The student will:

1. Demonstrate competence in all previous clinical competency examinations and complete Category IV of the clinical competency examinations. Category IV examinations must be observed and graded by the clinical instructor, clinical coordinator, or program director in actual room conditions on actual patients.

2. Submit Clinical Record Book representing competency in simulation.

3. Obtain proficiency and demonstrate skills as delineated in the rotational objectives.

4. Demonstrate procedures which are acceptable in patient transfer (on/off table, etc.) during all procedures.

5. Demonstrate warm-up procedure for each radiographic room at clinical education facility.

6. Correctly manipulate accessories for the radiographic table (hand holds, foot rest, and shoulder rest).

7. Correctly operate all controls (automatic exposure control, spot film, bucky, fluoro timer, kV/mAs/sec selectors, and backup controls).

8. Provide an aseptic environment (table, cassettes, equipment, etc.).

9. Assist radiologist during fluoroscopy.

10. Assist in preparing the IV Contrast Studies examination room.

11. Competently (minimum of 85% satisfactory) perform graduate performance competencies as required. These will be selected and graded by the clinical instructor, clinical coordinator, and/or program director.

COGNITIVE AND PSYCHOMOTOR OBJECTIVES:

The student will:

1. Perform and/or assist with all examinations.

2. Continue to practice standard precautions for all rotational assignments and situations.

3. Continue to practice radiation protection by applying protective devices to patients in all rotations (lead aprons, gonadal shielding, etc.).

4. Continue to practice standard self-protection from ionizing radiation in all situations.

5. Perform safety checks on equipment and accessories.

6. Perform examinations which competency has been documented.

7. Continue to observe and demonstrate centering points on all examinations.

8. Continue to practice 18-step positioning for all patients as outlined in the clinical competency manual.

9. Stock appropriate supplies in imaging room at clinical education facility.

10. Identify and set exposure factors on the control panel.

11. Operate radiographic/fluoroscopic equipment as procedures dictate.

12. Under direct supervision, perform minor fluoroscopic procedures such as ERCP's, T-tube cholangiograms, OPMS, etc.

13. Evaluate and initiate correct imaging protocol.

14. Demonstrate methods to modify positioning methodology in cranial radiography to accommodate the trauma patient.

15. Apply immobilization techniques to obtain diagnostic radiographs.

16. Perform and/or assist with all mobile examinations.

17. Observe and demonstrate sterile and isolation procedures performed during mobile radiography.

18. Demonstrate proper operation and adjustment of mobile equipment.

19. Demonstrate proper procedures in surgical and mobile trauma radiography.

20. Evaluate and initiate correct imaging protocol of mobile radiography.

21. Independently utilize accessory equipment in mobile imaging (grids, etc.).

22. Perform surgical examinations.

23. Perform and/or assist with all examinations scheduled after hours.

24. Participate actively in the radiographic examination of trauma patients.

25. Evaluate and initiate correct imaging protocol while performing examinations after hours.

26. Assist and observe CT room preparation and equipment set-up.

27. Demonstrate basic computer skills.

28. Demonstrate proper CT film methodology.

29. Utilize a computer to recall a specific scan.

30. Manipulate the digital CT image for diagnostic quality and process film.

31. Maneuver CT equipment (gantry, couch, etc.).

32. Assist and observe special procedures room preparation and equipment set-up.

33. Assist in preparing equipment for special procedures.

34. Practice aseptic/sterile techniques as required (prepare injection site, drape patient, and set up tray).

35. Assist radiologist during special procedures (scrub).

36. Assist and demonstrate sterile techniques in preparation for a special procedure.

37. Prepare fluoroscopic equipment for use in special procedures.

38. Position patient and select techniques required for preliminary filming of special procedures.

39. Place contrast media into the automatic injector.

40. Prepare injection site and drape patient maintaining a sterile field.

41. Practice proper methodology of disposing of contaminated items.

42. Correctly select programming as appropriate.

43. Prepare laboratory specimens and dispense of them in the prescribed manner.

44. Exhibit correct methodology in sterile application of gowns and gloves.

45. Evaluate and initiate correct imaging protocol for special procedures.

46. Correctly place radiographs on viewer for viewing.

47. Manipulate the digital angiographic image for diagnostic quality and process/print film.

48. Perform and/or assist with all fluoroscopic examinations.

49. Apply protective devices to all patients undergoing fluoroscopic procedures (where possible).

50. Practice standard self-protective techniques while participating in fluoroscopy procedures.

51. Effectively evaluate and initiate correct methodology to image all patient types and habitus.

52. Assist radiologist with all procedures.

53. Observe and demonstrate centering points for all overhead filming during fluoroscopic procedures.

54. Perform and/or assist with all ultrasound examinations.

55. Prepare and/or assist with patient preparation for an ultrasound examination.

56. Assist and observe ultrasound room preparation and equipment selection.

57. Load and process ultrasound films.

58. Activate ultrasound equipment to ready mode.

59. Demonstrate a basic understanding of ultrasound equipment operation.

60. Perform and/or assist with nuclear medicine examinations.

61. Prepare and/or assist with patient preparation for nuclear medicine examinations.

62. Assist and observe nuclear medicine room preparation and equipment selection.

63. Maneuver nuclear medicine equipment (gantry, lung inhaler, etc.).

64. Operate and demonstrate a basic understanding of the technical aspects of nuclear medicine equipment.

65. Practice principles of radiation protection relevant to nuclear medicine.

66. Load cassettes and process nuclear medicine films.

67. Manipulate digital nuclear medicine image for diagnostic quality and process/print film.

68. Demonstrate competence in all previous clinical competency examinations and complete Category IV of the clinical competency examinations. Category IV examinations must be observed and graded by the clinical instructor, clinical coordinator, and/or program director.

CLINICAL IV: COURSE SCHEDULE

WEEK #1 Schedules and syllabus

Anatomy, procedures, centering points, pathology, IV Contrast Studies, and technical factors of the urinary system including IVP's and cystograms.

WEEK #2 Review of advanced C-Arm, portable radiography, and surgical radiography

WEEK #3 Sterile technique for minor and major specials and surgical procedures

WEEK #4 Review of anatomy, positioning, technical factors, and radiation protection for fluoroscopic procedures including gastrointestinal, biliary, and urinary systems

First Monthly Performance Evaluation

WEEK #5 Anatomy, technical factors, sterile/aseptic technique, radiation protection, and pathology for various minor special procedures to include myelography

WEEK #6 Anatomy, technical factors, sterile/aseptic technique, radiation protection, and pathology for minor special procedures such as venography and arthrography

WEEK #7 Review for Mid-term Examination

Second Monthly Performance Evaluation

WEEK #8 Written Midterm Examination

Midterm Comprehensive Examination

WEEK #9 Introduction to major special procedures

WEEK #10 Anatomy, positioning, technical factors, sterile/aseptic techniques, radiation protection, and pathology for various major special procedures to include arteriography and interventional radiography

Third Monthly Performance Evaluation

WEEK #11 Introduction to nuclear medicine

WEEK #12 Introduction to ultrasonography

WEEK #13 Introduction to CT scanning

Fourth Monthly Performance Evaluation

WEEK #14 Review for Final Examination

WEEK #15 Written Final Examination

Rotational Objectives Due

Final Comprehensive Evaluation

*THIS SYLLABUS IS SUBJECT TO CHANGE AT FACULTY’S DISCRETION*

REFERENCES - RADT 4010

Adler, A., Carlton, R., & Wold, B. (1992). An analysis of radiographic repeat and reject rates. Radiologic Technology Journal of the American Society of Radiologic Technologists, 63(5), 308-314.

Bakardjiev, A. I., Barnes, P. D., Goumnerova, L. C., Black, P. M., Pomeroy, S. L., Billett, A., Loeffler, J. S. & Tarbell, N. J. (1996). Magnetic therapy for childhood low grade astrocytoma. Cancer Journal, 78(4), 864-873.

Barrington, S. F., Kettle, A. G., O'Doherty, M. J., Wells, C. P., Somer, E. J. & Coakley, A. J. (1996). Radiation dose rates from patients receiving iodine-131 therapy for carcinoma of the thyroid. European Journal of Nuclear Medicine, 23(2), 123-130.

Basset, L. W. (1996). The regulation of mammography. Seminars in Ultrasound, CT, and MR, 17(5), 415-423.

Cesar, L. (1997). Computed radiography: Its impact on radiographers. Radiologic Technology Journal of the American Society of Radiologic Technologists, 68(3), 225-232.

Cecil, H., Reed, D., & Holtz, J. (1995, February). Norplant removal facilitated by the use of ultrasound. J. Family Practice, 40(2), 182-183.

Dowd, S., & Wilson, B. (1995). Informed patient consent: A historical perspective. Radiologic Technology Journal of the American Society of Radiologic Technologists, 67(2), 119-124.

Dowd, S., Wilson, B., Hall, J., & Steves, A. (1996). Review of techniques used to image aortic dissection. Radiologic Technology Journal of the American Society of Radiologic Technologists, 67(3), 223-230.

Dowd, S., & Tilson, E. (1996). Re-engineering via Patient-Centered Care. Radiologic Technology Journal of the American Society of Radiologic Technologists, 67(5), 421-424.

Haapaniemi, J. (1996). Comparison of ultrasound and x-ray maxillary sinus findings in the school-aged children. Ear Nose and Throat Journal, 76(2), 102-106.

Heyd, R. L., Kopecky, K. K., Sherman, S., Lehman, G. A., & Stockberger, S. M. (1996). Radiation exposure to patients and personnel during interventional ERCP at a teaching institution. Gastrointestinal Endoscopy, 44, 287-292.

Jansen, J. T., Geleijns, J., Zweers, D., Schultz, F. W., & Zoetelief, J. (1996). Calculation of computed IV Contrast Studies dose index to effective dose conversion factors based on measurement of the dose profile along the fan shaped beam. British Journal of Radiology, 69(817), 33-41.

Kay, C. L., & Curry, N. S. (1996). Intravascular injection of iodinated contrast media (letter). Clinical Radiology Journal, 52(5), 403.

Leach, J. L., Jones, B. V., Tomsick, T. A., Stewart, C. A., & Balko, M. G. (1996). Normal appearance of arachnoid granulations on contrast-enhanced CT and MR of the brain: Differentiation from dural sinus disease. American Journal of Neuroradiology, 17(8), 1523-1532.

McMillan, P. (1993). Computed IV Contrast Studies in spiral mode. Radiologic Technology Journal of the American Society of Radiologic Technologists, 65(2), 117-118.

Newman, J. (1996). Advances in lithotripsy and stone disease treatment. Radiologic Technology Journal of the American Society of Radiologic Technologists, 67(6), 479-496.

Newman, J. (1997). Radiographic imaging of small bowel disease. Radiologic Technology Journal of the American Society of Radiologic Technologists, 68(6), 491-508.

Njeh, C. F., Boivin, C. M., & Langton, C. M. (1996). The role of ultrasound in the assessment of osteoporosis: A review. Osteoporosis International Journal, 7(1), 7-22.

Perkins, A. C., Yeoman, P., Hindle, A. J., Vincent, R. M., Frier, M., Winter, R. J., & Wastie, M. L. (1996). Bedside nuclear medicine investigations in the intensive care unit. Nuclear Medicine Communications Journal, 18(3), 262-268.

Pomerantz, S. M., Daly, B., Krebs, T. L., NessAiver, M., & Kepes, S. Y. (1996). Quality assurance for abdominal CT: A rapid, computer-assisted technique. American Journal of Roentgenology, 167(5), 1141-1145.

Poston, L. (1996). CT scanner in emergency room allow for faster diagnosis of trauma patients. Medcom: Vanderbilt University Medical Center.

Prasad, P. V. (1996). Noninvasive evaluation of intraarenal oxygenation with BOLD. Circulation Journal, 94(12), 3271-3275.

Purtilo, R. (1990). Health Professional and Patient Interaction. (4th ed.). Philadelphia: W. B. Saunders Co. Reuter, K. L., Cohen, S., Furey, L., & Baker, S. (1996). Sonographic appearance of the endometrium and ovaries during cycles stimulated with human menopausal gonadotropin. Journal of Reproductive Medicine, 41(7), 509-514.

Sandmayr, H., & Wallentin, D. (1996). Computer integrated radiology system: Analogue goes digital. European Radiology (Suppl. 3), 7, S90-S93.

Stabin, M. G. (1996). MIDROSE: Personal computer software for internal dose assessment in nuclear medicine. Journal of Nuclear Medicine, 37(3), 538-546.

Steves, A. (1993). Teaching your students to care. Radiologic Technology Journal of the American Society of Radiologic Technologists, 65(2), 119-120.

Sutter, C. W., & Shelton, D. K. (1996). Three-phase scan in osteomyelitis and other musculoskeletal disorders. American Family Physician Journal, 54(5), 1639-1647.

Utter, D. (1997). Survey of contrast media use in southeastern U.S. hospital. Radiologic Technology Journal of the American Society of Radiologic Technologists, 68(5), 386-390.

Valls, C., Rene, M., Gil, M., Sanchez, A., Narvaez, J. A., & Hidalgo, F. (1996). Giant cavernous hemangioma of the liver: Atypical CT and MR findings. European Radiology Journal, 6(4), 448-450.

Webber, R. L., Horton, R. A., Underhill, T. E., Ludlow, J. B., & Tyndall, D. A. (1996). Comparison of film, direct digital, and tuned-aperture computed IV Contrast Studies images to identify the location of crystal defects around endosseous titanium implants. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology and Endodontics Journal, 81(4), 480-490.

Willis, J. R., Chokshi, H. R., Zuckerman, G. R., & Aliperti, G. (1996). Enteroscopy-

enterolysis: Experience with a combined endoscopic radiographic technique. Gastrointestinal

Endoscopy, 45, 163-167.

EAST TENNESSEE STATE UNIVERSITY

RADIOGRAPHY PROGRAM

ROTATIONAL OBJECTIVES

CLINICAL EDUCATION IV

RADIOGRAPHY

COMPLETED

OBJECTIVE	YES	NO
Exercise priorities required in daily clinical practice.
Execute imaging procedures under the appropriate level of supervision.
Adapt to changes and varying clinical situations.
Effectively communicate and maintain professional relationships with patients, the public, and members of the health care team.
Assess the patient and record patient histories.
Carry out principles of transferring, positioning, immobilizing, and restraining of patients.
Practice the 18-step positioning procedure in doing all radiographic exams.
Repeat radiographs according to policy.
Practice standard precautions.
Apply radiation protection to protect the patient and staff.
Observe, assist, and/or perform all examinations.
Perform safety checks on equipment/accessories; report malfunctions appropriately
Provide collimation to area of interest.
Independent selection of technical factors.
Observe and demonstrate centering points on all examinations.
Actively participate in trauma radiography exhibiting improvised techniques and modified positioning to obtain diagnostic film quality.
Accurately ascertain information regarding pregnancy possibility.
Effectively operate radiographic equipment and accessories.
Observe and apply correct procedure methodology utilizing centering points on all exams (including placement of tube, table, and image receptor)
Critique and recognize diagnostic film quality.
Select appropriate image receptor and/or grid combinations.
Use proper SID and angulations for the radiographic procedure.
Identify radiographic anatomy recorded on radiographs.

EAST TENNESSEE STATE UNIVERSITY

RADIOGRAPHY PROGRAM

ROTATIONAL OBJECTIVES

CLINICAL EDUCATION IV

FLUOROSCOPY

COMPLETED

OBJECTIVE	YES	NO
Exercise priorities required in daily clinical practice.
Execute imaging procedures under the appropriate level of supervision.
Adapt to changes and varying clinical situations.
Effectively communicate and maintain professional relationships with patients, the public, and members of the health care team.
Assess the patient and record patient histories.
Carry out principles of transferring, positioning, immobilizing, and restraining of patients.
Practice the 18-step positioning procedure in doing all radiographic exams.
Repeat radiographs according to policy.
Practice standard precautions.
Apply radiation protection to protect the patient and staff.
Observe, assist, and/or perform all examinations.
Provide collimation to area of interest.
Accurately ascertain information regarding pregnancy possibility.
Effectively operate radiographic/fluoroscopic controls, equipment, and accessories.
Observe and apply correct procedure methodology utilizing centering points on all exams (including placement of tube, table, and image receptor)
Critique and recognize diagnostic film quality.
Select appropriate image receptor and/or grid combinations.
Use proper SID and angulations for the radiographic procedure.
Identify radiographic anatomy recorded on radiographs.
Provide patient education regarding procedures.
Prepare contrast media according to institutional protocol.
Demonstrate sterile and/or aseptic techniques as required.
Correctly set up fluoroscopic/radiographic equipment.
Perform preliminary films as indicated.
Assist radiologist and/or radiographer during fluoroscopic studies.
Correctly place all necessary supplies for GI and BE examinations.
Identify patient preparation for various gastrointestinal studies.
Identify positions and anatomy demonstrated during UGI, SB, and BE examinations.
Identify the Valsalva Technique and its applicability.
Acknowledges four different body habitus and demonstrate appropriate positioning methodologies.
Identify Trendelneburg position and its use in diagnosis of GI abnormalities.
Identify the indications/contraindications between single and double contrast GI studies.
Identify the function and use of glucagon.
Identify the term “reflux” and where it typically occurs in the GI system
State indications/contraindications for contrast media.
Identify common pathologies visualized in the gastrointestinal system.
Identify procedures & list major indications/contraindications of the hepatobiliary system.
Identify indications/contraindications for ERCP, UGI, & BE examinations.

EAST TENNESSEE STATE UNIVERSITY

RADIOGRAPHY PROGRAM

ROTATIONAL OBJECTIVES

CLINICAL EDUCATION IV

MOBILE RADIOGRAPHY

COMPLETED

OBJECTIVE	YES	NO
Exercise priorities required in daily clinical practice.
Execute imaging procedures under the appropriate level of supervision.
Adapt to changes and varying clinical situations.
Effectively communicate and maintain professional relationships with patients, the public, and members of the health care team.
Assess the patient and record patient histories.
Carry out principles of transferring, positioning, immobilizing, and restraining of patients.
Practice the 18-step positioning procedure in doing all radiographic exams.
Repeat radiographs according to policy.
Practice standard precautions.
Apply radiation protection to protect the patient and staff.
Observe, assist, and/or perform all examinations.
Provide collimation to area of interest.
Accurately ascertain information regarding pregnancy possibility.
Effectively operate radiographic equipment and accessories.
Observe and apply correct procedure methodology utilizing centering points on all exams (including placement of tube, table, and image receptor)
Critique and recognize diagnostic film quality.
Select appropriate image receptor and/or grid combinations.
Use proper SID and angulations for the radiographic procedure.
Identify radiographic anatomy recorded on radiographs.
Identify correct patient and examination according to requisition.
Locate and drive the portable to the patient's room.
Politely ask visitors to wait outside the room until examination is complete.
Examine room and adjust furniture before bringing in the portable unit.
Identify and demonstrate proper operation and adjustment of mobile equipment.
Adjust the patient into the erect or supine position, as appropriate.
Accepts and uses constructive criticism.
Exhibit knowledge of medical terminology and provides correlation to examinations prescribed.
Demonstrate procedures in maintaining a sterile field.
Return the portable unit to the proper location and charge it if needed.
Patient identification (flash) and film processing is appropriate.
Demonstrate and observe differences in procedure of examinations.
Actively participates in the performance of surgical radiography procedures.
Returns furniture to original place.
Perform surgical examinations.
Practice procedure for hooking C-arm up.
Independently utilize accessory equipment in mobile imaging (grids, etc).
Function effectively in stressful situations.
Demonstrate proper procedures in surgical and mobile trauma radiography.

EAST TENNESSEE STATE UNIVERSITY

RADIOGRAPHY PROGRAM

ROTATIONAL OBJECTIVES

CLINICAL EDUCATION IV

AFTER HOURS - EVENINGS

COMPLETED

OBJECTIVE	YES	NO
Perform and/or assist with all examinations.
Practice standard precautions.
Apply protective devices to all patients.
Utilize practices of standard self-protection.
Utilize calipers for determining exposures.
Practice 18-step procedure for doing all patients.
Differentiate and state differences in procedures.
Participate actively in the radiographic examination of trauma patients.
Function effectively in stressful situations.
Evaluate and initiate correct imaging protocol.

EAST TENNESSEE STATE UNIVERSITY

RADIOGRAPHY PROGRAM

ROTATIONAL OBJECTIVES

CLINICAL EDUCATION IV

SPECIAL PROCEDURES

COMPLETED

OBJECTIVE	YES	NO
Identify department and institutional emergency response protocol.
Prepare the technologies and methodologies for the performance of radiographic procedures.
Exercise priorities required in daily clinical practice.
Execute imaging procedures under the appropriate level of supervision.
Adapt to changes and varying clinical situations.
Integrate use of appropriate and effective written, oral, and nonverbal communications with the patients, the public, and members of the health care team.
Adapt procedures to meet age-specific, disease-specific and cultural needs of patients.
Assess the patient and record patient histories.
Carry out principles of transferring, positioning, immobilizing, and restraining of patients.
Demonstrates professional competence in determining corrective measures to improve inadequate images.
Evaluation patient’s status and condition before, during and following the radiographic procedure to demonstrate competence in assessment skills.
Act consistently to maintain patient confidentiality.
Apply appropriate medical asepsis and sterile technique.
Practice standard precautions.
Apply protective devices to all patients (i.e., lead aprons, gonadal shielding, etc.)
Identify 3 symptoms of shock.
Recognize indications/contraindications of various radiographic procedures.
Identify blood flow through the heart.
Apply radiation protection to protect the patient and staff.
Differentiate between normal and abnormal ECG rhythms and ECG tracings.
Identify vasovagal reaction symptoms.
Demonstrate flushing techniques.
Identify patient preparation required for various angiographic procedures.
Identify preferred site and method for catheter introduction.
Identify alternative approaches to arteriography
Differentiate between use of catheter sheaths, different types of catheters, and guidewires.
State various interventional procedures and their applications.
Assist and observe room preparation & equipment set-up.
Assist and/or observe with all examinations; identify procedure protocol.
Practice aseptic techniques as required (prepare injection site & drape patient).
Assist radiologist during special procedures (scrub).
Assist and demonstrate sterile techniques in preparation for a special procedure.
Prepare laboratory specimens and dispense of them in the prescribed manner.
Instill contrast media into the automatic injector; identify indications and contraindications.

EAST TENNESSEE STATE UNIVERSITY

RADIOGRAPHY PROGRAM

ROTATIONAL OBJECTIVES

CLINICAL EDUCATION IV

ELECTIVE - CARDIAC CATH

COMPLETED

OBJECTIVE	YES	NO
Exercise priorities required in daily clinical practice.
Execute imaging procedures under the appropriate level of supervision.
Adapt to changes and varying clinical situations.
Integrate use of appropriate and effective written, oral, and nonverbal communications with the patients, the public, and members of the health care team.
Adapt procedures to meet age-specific, disease-specific and cultural needs of patients.
Assess the patient and record patient histories.
Carry out principles of transferring, positioning, immobilizing, and restraining of patients.
Demonstrates professional competence in determining corrective measures to improve inadequate images.
Evaluation patient’s status and condition before, during and following the radiographic procedure to demonstrate competence in assessment skills.
Act consistently to maintain patient confidentiality.
Apply appropriate medical asepsis and sterile technique.
Practice standard precautions.
Apply radiation protection to protect the patient and staff.
Assist and/or observe on all examinations.
Prepare and/or assist with patient preparation including contrast media.
Prepare the technologies and methodologies for the performance of radiographic procedures.
Identify different types of equipment and indications of each.
Identify and demonstrate anatomy relevant to cardiac catheterization.
Demonstrate a basic understanding of equipment operation used for cardiac catheterization.
Evaluate all images for the proper demonstration of relevant cardiac anatomy.
Maintain sterile field.
Identify proper filming methodology utilized for cardiac catheterization.

EAST TENNESSEE STATE UNIVERSITY

RADIOGRAPHY PROGRAM

ROTATIONAL OBJECTIVES

CLINICAL EDUCATION IV

ELECTIVE - CT

COMPLETED

OBJECTIVE	YES	NO
Exercise priorities required in daily clinical practice.
Execute imaging procedures under the appropriate level of supervision.
Adapt to changes and varying clinical situations.
Integrate use of appropriate and effective written, oral, and nonverbal communications with the patients, the public, and members of the health care team.
Adapt procedures to meet age-specific, disease-specific and cultural needs of patients.
Assess the patient and record patient histories.
Carry out principles of transferring, positioning, immobilizing, and restraining of patients.
Demonstrates professional competence in determining corrective measures to improve inadequate images.
Evaluation patient’s status and condition before, during and following the radiographic procedure to demonstrate competence in assessment skills.
Act consistently to maintain patient confidentiality.
Apply appropriate medical asepsis and sterile technique.
Practice standard precautions.
Apply radiation protection to protect the patient and staff.
Assist and/or observe on all examinations.
Prepare and/or assist with patient preparation including contrast media.
Prepare the technologies and methodologies for the performance of procedures.
Identify different types of equipment and indications of each.
Identify location of contrast media reaction materials and procedures for implementing counteractive materials.
Identify CT equipment and accessories (gantry, couch, control panel, etc.)
Demonstrate a basic understanding of equipment operation used for CT.
Prepare and observe contrast media administration for CT scanning procedures.
Identify location of contrast media reaction materials and procedures for implementing counteractive measures during CT scanning procedures.
Identify and review all basic anatomy relevant to routine CT procedures.
Evaluate all CT images for the proper demonstration of relevant anatomy.
Identify proper filming methodology utilized for CT.
Identify CT procedures and protocol.
Utilize a computer to recall a specific scan.
Observe the manipulation and processing of the CT digital image.

EAST TENNESSEE STATE UNIVERSITY

RADIOGRAPHY PROGRAM

ROTATIONAL OBJECTIVES

CLINICAL EDUCATION IV

ELECTIVE - MRI

COMPLETED

OBJECTIVE	YES	NO
Exercise priorities required in daily clinical practice.
Execute imaging procedures under the appropriate level of supervision.
Adapt to changes and varying clinical situations.
Adapt procedures to meet age-specific, disease-specific and cultural needs of patients.
Assess the patient and record patient histories.
Carry out principles of transferring, positioning, immobilizing, and restraining of patients.
Demonstrates professional competence in determining corrective measures to improve inadequate images.
Evaluate patient’s status and condition before, during and following the radiographic procedure to demonstrate competence in assessment skills.
Act consistently to maintain patient confidentiality.
Apply appropriate medical asepsis and sterile technique.
Practice standard precautions.
Assist and/or observe on all examinations.
Prepare and/or assist with patient preparation including contrast media.
Assist and observe room preparation and equipment (coil) selection
Identify and demonstrate anatomy relevant to routine procedures.
Evaluate all images for the proper demonstration of relevant anatomy.
Demonstrate a basic understanding of equipment operation.
Load and process MRI films.
Demonstrate magnet safety.
Identify advantages of MRI in musculoskeletal imaging.
Describe the basic principles of MRI.
State patient and operator safety issues during MRI procedures.

EAST TENNESSEE STATE UNIVERSITY

RADIOGRAPHY PROGRAM

ROTATIONAL OBJECTIVES

CLINICAL EDUCATION IV

ELECTIVE - ULTRASONOGRAPHY

COMPLETED

OBJECTIVE	YES	NO
Exercise priorities required in daily clinical practice.
Execute imaging procedures under the appropriate level of supervision.
Adapt to changes and varying clinical situations.
Integrate use of appropriate and effective written, oral, and nonverbal communications with the patients, the public, and members of the health care team.
Adapt procedures to meet age-specific, disease-specific and cultural needs of patients.
Assess the patient and record patient histories.
Carry out principles of transferring, positioning, immobilizing, and restraining of patients.
Demonstrates professional competence in determining corrective measures to improve inadequate images.
Evaluation patient’s status and condition before, during and following the radiographic procedure to demonstrate competence in assessment skills.
Act consistently to maintain patient confidentiality.
Apply appropriate medical asepsis and sterile technique.
Practice standard precautions.
Assist and/or observe on all ultrasound examinations.
Prepare and/or assist with patient preparation.
Assist and observe room preparation and equipment selection for an ultrasound examination.
Identify and demonstrate anatomy relevant to routine procedures.
Evaluate all images for the proper demonstration of relevant anatomy.
Identify the function of different transducers to be utilized.
Load and process ultrasound films.
Activate equipment to ready mode.
Demonstrate a basic understanding of equipment operation.
Describe the similarities and differences between gynecologic and obstetric imaging.
Discuss imaging protocol for various examinations.
Explain why a full bladder is required to image the female reproductive tract.

EAST TENNESSEE STATE UNIVERSITY

RADIOGRAPHY PROGRAM

ROTATIONAL OBJECTIVES

CLINICAL EDUCATION IV

ELECTIVE - NUCLEAR MEDICINE

COMPLETED

OBJECTIVE	YES	NO
Exercise priorities required in daily clinical practice.
Adapt to changes and varying clinical situations.
Integrate use of appropriate and effective written, oral, and nonverbal communications with the patients, the public, and members of the health care team.
Adapt procedures to meet age-specific, disease-specific and cultural needs of patients.
Assess the patient and record patient histories.
Carry out principles of transferring, positioning, immobilizing, and restraining of patients.
Demonstrates professional competence in determining corrective measures to improve inadequate images.
Evaluation patient’s status and condition before, during and following the radiographic procedure to demonstrate competence in assessment skills.
Act consistently to maintain patient confidentiality.
Apply appropriate medical asepsis and sterile technique.
Practice standard precautions.
Practice principles of radiation protection relevant to nuclear medicine.
Assist and/or observe on all examinations.
Prepare and/or assist with patient preparation including contrast media.
Assist and observe room preparation and equipment selection.
Prepare the technologies and methodologies for the performance of procedures.
Identify different types of equipment and indications of each.
Distinguish the effect of certain contrast media that may have an effect on nuclear medicine scans.
Identify NM equipment and accessories.
Demonstrate a basic understanding of equipment operation used for NM.
Prepare and observe administration of radioactive materials for NM procedures.
Identify and review all basic anatomy relevant to routine NM procedures.
State procedure for disposal of radioactive waste.
Evaluate all NM images for the proper demonstration of relevant anatomy.
Identify proper filming methodology utilized for NM.
Identify NM procedures.
Identify contraindications of certain nuclear medicine studies when done in series.
Observe the manipulation and processing of the NM digital image.

EAST TENNESSEE STATE UNIVERSITY

RADIOGRAPHY PROGRAM

CLINICAL EDUCATION IV

COMPETENCY PERFORMANCE OBJECTIVES

GRADE	EXAMINATION	DATE	PT'S ID#	CL.ED.CT
	GERIATRIC FLUOROSCOPY
	PEDIATRIC FLUOROSCOPY
	MINOR SPECIAL
	MAJOR SPECIAL
	C-ARM CASE

Students may complete a maximum of three graduate competencies during this semester. An average of 85 must be achieved on each graduate performance competency.

COURSE SYLLABUS

EAST TENNESSEE STATE UNIVERSITY

BACHELOR OF SCIENCE IN ALLIED HEALTH

RADIOGRAPHY CONCENTRATION

CLINICAL EDUCATION V

RADT 4020

COURSE: Clinical V

LEVEL OF SUPERVISION: DIRECT/INDIRECT

CLOCK HOURS: 360 (3 days a week x 15 weeks)

CREDIT: 3 Semester Credits

GRADE COMPUTATION: Practical Rotational Objectives 10%

Performance Evaluations 15%

Clinical Written Objectives 10%

Attendance/Ethics/Dress Code 15%

Graduate Performance Competencies 20%

Final Clinical Examination (Written) 15%

Comprehensive Evaluations 15%

EXPLANATION OF CATEGORIES:

Rotational Objectives - Clinical instructor evaluates each objective as the student

masters it.

Performance Evaluations - The clinical instructor will evaluate student progression

monthly.

Clinical Written Objectives - Will involve a grade for all written objective assignments

and reading assignments. The Clinical Log Book is included in this category. The clinical coordinator grades the clinical written objectives.

Attendance/Ethics/Dress Code - Compliance to the attendance and tardiness policies is essential. Refer to the policies with regard to attendance and tardiness is located in this manual. Ethics is an integral part of being a healthcare provider. Conducting his/herself in a professional manner is required of all students. A reduction points will occur and the amount will be based on the infraction. The dress code is also essential. If non-compliance of the dress code occurs, a reduction of ten (10) percent will result for each infraction.

Competency Performance Evaluations - Clinical instructors and/or clinical coordinator must evaluate each examination to ascertain the competency level of the student.

GRADE SCALE:

96-100 A

95 A-

94 B+

91-93 B

90 B-

89 C+

86-88 C

85 C-

84 D+

81-83 D

80 D-

0-79 F

TEXTBOOK: Ballinger, P. W. & Frank, E. D. (1999). Merrill's atlas of

radiographic positions and radiologic procedures. (9th Edition). St. Louis, Missouri: Mosby-Year Book Publishers.

DESCRIPTION: (Prerequisite: RADT 4010 or permission of instructor). Corequisites:

RADT 4040 and RADT 4060).The clinical experience consists of assignments in general radiography/fluoroscopy as well as elective rotations in specialty areas (cardiac catheterization, CT, MRI, NM, radiation therapy). Students will demonstrate the highest level of cognitive, affective, and psychomotor skills to complete graduate competencies, outcomes assessment, and program requirements.

GRADUATE PERFORMANCE COMPETENCIES:

A total of seven graduate performance competencies must be completed during the fourth and fifth semesters of the clinical experience. Three of the graduate competencies must be completed on pediatric patients (ages 0-6). A maximum of three graduate performance competencies may be completed during the fourth semester and the remainder must be completed during the fifth semester. An average of 85 must be achieved on each graduate performance competency.

These competencies will be selected by the clinical instructor, clinical coordinator, and/or program director. These competencies will account for 20% of the course grade.

PRACTICAL ASSIGNMENTS:

Students will return to their original clinical agency this semester.

Rotational Assignments Assigned Weeks

Radiography	4
Mobile Radiography/Surgery	3
Fluoroscopy	4
Clinical Elective	2
After Hours (2 weeks evenings)	2
TOTAL	15

Elective Rotations

Competent students may submit justification for elective rotations. Elective rotation approval

requires satisfactory student competency and progress, faculty approval, equipment availability,

and clinical staff.

Elective rotations include:

Cardiac Catheterization Ultrasonography

CT/MR Nuclear Medicine

Radiation Therapy

ROTATIONAL OBJECTIVES:

COURSE GOALS:

1. The student will continue to display professional conduct as outlined in the American Society of Radiologic Technologist's code of ethics.

2. The student shall evaluate radiographic quality.

3. The student will continue to professionally mitigate moral and ethical dilemmas arising with patients, family, peers, consumers, and healthcare team members.

4. The student will expressively communicate with patients, peers, family, and healthcare team members.

5. The student will continue to adhere to legal practice standards including all federal, state, and institutional regulations related to patient care.

6. The student will continue to display pride in their chosen profession and pursue life-long learning resources by participating in professional societies.

7. The student will provide appropriate patient care that maximizes patient care practices to meet the healthcare needs of the community.

9. The student shall review all aspects of the program and actively explore areas of efficiency.

10. The student shall master all clinical components including techniques and procedures.

11. The student will independently operate a fluoroscopic and radiographic room with minimal assistance.

12. The student will advance professional objectives to provide services to humanity with full respect for the dignity of mankind.

13. The student will recognize the economic, social, and cultural factors in the community that impact healthcare delivery.

14. The student will act as an agent through observation and communication to obtain pertinent information to aid in the diagnosis and treatment management of patients.

15. The student will provide ethical decision making that is consistent with professional code of ethics for the respective concentrations.

16. The student will function effectively and maintain composure in stressful situations.

17. The student will demonstrate knowledge of legal and ethical situations that may be encountered in the practice of radiography.

CLINICAL WRITTEN OBJECTIVES:

1. Students must document repeats in his/her clinical record book. Repeat Policy: Students will be allowed to repeat a radiographic film ONE time ONLY, and a registered radiographer must supervise the repeat. If the repeat is not satisfactory the radiographer must perform the additional films while the student observes. All repeat radiographs must be documented (NO EXCEPTIONS).

2. The student must submit Clinical Record Book representing competency.

COURSE OBJECTIVES:

The course objectives for RADT 4020 are divided into four categories of instructional objectives. They are:

l. Cognitive - Recalling and understanding information and applying it to

other material or new situations. Problem solving.

2. Affective - Awareness of and reaction to an activity, situation, or

phenomenon.

Attachment of worth to an activity, situation, or

phenomenon. Commitment to a value which is reflected in

behavior.

3. Psychomotor - Awareness of a stimulus and readiness to perform a motor skill. Practice in motor skills with increasing proficiency. Ability to alter procedures or create new movements.

4. Cognitive and Recalling and understanding psychomotor - information

and applying it to performing motor skills.

So that the student may better determine the expectations of this course, the objectives listed below are categorized. Some objectives belong to more than one category, and will be listed accordingly.

COGNITIVE OBJECTIVES:

The student will:

1. Utilize appropriate supplies for each radiographic examination.

2. Demonstrate awareness of all procedures and protocols related to those radiographic examinations completed.

3. Independently critique radiographs in regard to film quality, positioning, density, contrast, repeat ratio, detail, etc.

4. Identify pathology on all radiographs.

5. Independently demonstrate an understanding of the technical aspects of imaging equipment.

6. Discuss interpretations of pathology with radiologists.

7. Distinguish and identify contrast medias used for all fluoroscopic procedures (invasive vs. noninvasive).

8. Identify radiologist protocol for GI and BE examinations.

9. Competently and professionally provide all patients with pre and post patient education concerning each examination.

10. Recognize normal radiographic anatomy on all radiographic studies.

11. Identify and demonstrate basic anatomy relevant to routine MRI procedures.

12. Evaluate all MRI images for the proper demonstration of relevant anatomy.

13. Identify basic MRI equipment (couch, computer, magnet, gantry, etc.).

14. Observe manipulation and processing/printing of MRI images.

15. Observe preparation and injection of gadolinium.

16. Identify indications and contraindications for MRI.

17. Identify different types of equipment used in the oncology department (molds, blocks, couch, gantry, etc.)

18. Observe methods of treatment for various disease processes in the oncology department.

19. Observe treatment planning and dosimetry in the oncology department.

20. State the hazards of radium implants and handling patients receiving interstitial or brachytherapy treatments.

21. Identify different types of equipment used in the cardiac catheterization department.

22. Identify and demonstrate basic anatomy relevant to cardiac catheterization.

23. Evaluate all images for the proper demonstration of relevant cardiac anatomy.

24. Identify proper filming methodology utilized for cardiac catheterization.

AFFECTIVE OBJECTIVES:

The student will:

1. Continue to display professional conduct as outlined in the American Society of Radiologic Technologist's code of ethics.

2. Continue to professionally mitigate moral and ethical dilemmas arising with patients, family, peers, consumers, practitioners, caregivers, policy makers, and healthcare team members.

3. Continue to effectively communicate with patients, peers, family, and healthcare team members.

4. Continue to adhere to legal practice standards including all federal, state, and institutional regulations related to patient care.

5. Continue to display pride in their chosen profession and pursue life long learning resources by participating in professional societies.

6. Continue to provide appropriate patient care that maximizes patient care practices to meet the healthcare needs of the community.

8. Function effectively in stressful situations maintaining composure - act, not react to the situation.

9. Continue to demonstrate a caring and compassionate attitude toward patients.

10. Demonstrate knowledge of legal and ethical situations that may be encountered in the practice of radiography.

11. The student will provide ethical decision making that is consistent with professional code of ethics for the respective concentrations.

12. The student will advance professional objectives to provide services to humanity with full respect for the dignity of mankind.

13. The student will recognize the economic, social, and cultural factors in the community that impact healthcare delivery.

14. The student will provide ethical decision making that is consistent with professional code of ethics for the respective concentrations.

PSYCHOMOTOR OBJECTIVES:

The student will:

1. Submit Clinical Record Book representing competency in simulation.

2. Obtain proficiency and demonstrate skills as delineated in the rotational objectives.

3. Master proper procedures which are acceptable in patient transfer (stretchers, on/off table, etc.) during all procedures.

4. Competently assist radiologist during fluoroscopic studies.

5. Independently prepare the IV Contrast Studies examination room for all tomographic examinations.

6. Independently prepare all supplies for all fluoroscopic examinations.

7. Assist in preparing the oncology room.

8. Assist in preparing the MRI room.

9. Assist in preparing the cardiac cath equipment.

10. Demonstrate competency in all previous clinical competency examinations. All competency performance examinations must be observed and graded by the clinical instructor, clinical coordinator, and/or program director.

COGNITIVE AND PSYCHOMOTOR OBJECTIVES:

The student will:

1. Perform and/or assist with all examinations in assigned rotations.

2. Continue to utilize standard precautions in all rotational assignments.

3. Apply protective devices to all patients (lead aprons, gonadal shielding, etc.) in all rotations.

4. Demonstrate radiation protection for self (wears film badge, lead apron, thyroid shield, and protective eyewear as deemed necessary, etc.).

5. Master technical factors employment for all patients during every examination.

6. Perform all previously mastered examinations without hesitation demonstrating a thorough knowledge of all aspects of care.

7. Master centering points/landmarks on all examinations.

8. Master the 18-step positioning procedure for doing all patients, as indicated in the clinical competency manual.

9. Provide a clean and orderly environment for each assigned area.

10. Demonstrate thorough knowledge of R/F equipment and successfully perform radiographic and fluoroscopic procedures independently (indirect supervision).

11. Competently demonstrate the usage of immobilization techniques to obtain diagnostic radiographs on all difficult patients.

12. Master procedural modification methodology in all aspects of care in the trauma patient, i.e., skull, cervical spine, thoracic spine, lumbar spine, etc.

13. Independently evaluate and initiate correct imaging protocol.

14. Initiate life saving techniques if required (CPR certified).

15. Assess the patient as the need for medical attention arises and activate proper departmental protocols.

16. Independently perform safety checks on equipment and accessories, actively participate in departmental quality assurance program.

17. Recognize defective equipment by performing safety checks on equipment and accessory equipment.

18. Exercise independent decision making relating to completed radiographs in regards to positioning and exposure quality.

19. Effectively evaluate and initiate correct methodology to image all patient types and habitus.

20. Independently assist radiologist with fluoroscopic procedures.

21. Independently perform overhead radiographs for fluoroscopic procedures, if applicable.

22. Perform geriatric fluoroscopic procedures.

23. Perform pediatric fluoroscopic procedures.

24. Administer barium through feeding tube.

25. Identify procedure for performing a colostomy BE.

26. Master all mobile examinations.

27. Observe and demonstrate sterile and isolation procedures during mobile radiography.

28. Master proper operation and adjustment of mobile equipment.

29. Master proper procedures in surgical and mobile trauma radiography.

30. Master correct mobile imaging protocol.

31. Independently modify positioning methodology when patient condition warrants during mobile radiography.

32. Independently perform surgical examinations.

33. Perform and/or assist with all procedures performed after hours.

34. Independently perform trauma radiographic examination of patients after hours.

35. Assist and/or observe on all MRI examinations.

36. Prepare and/or assist with patient preparation for MRI including contrast media.

37. Assist and observe MRI room preparation and equipment selection.

38. Demonstrate a basic understanding MRI equipment operation.

39. Load and process/print MRI films.

40. Demonstrate basic understanding of computer operation in MRI including manipulation of digital image.

41. Demonstrate basic understanding of oncology and the treatment process.

42. Perform and/or assist in the calculation of dosage for radiation treatment.

43. Position blocks in appropriate place.

44. Manipulate gantry in oncology.

45. Master competency in the basic skills necessary to properly perform all radiographic examinations.

46. Competently (minimum of 85% satisfactory) perform graduate performance competencies as required. These will be selected and graded by the clinical instructor, clinical coordinator, and/or program director.

49. Demonstrate competency in all previous clinical competency examinations. All competency performance examinations must be observed and graded by the clinical instructor, clinical coordinator, and/or program director.

CLINICAL V: COURSE SCHEDULE

WEEK #1 Introduction and Welcome Back

WEEKS #2-14 Individualized Instruction per Rotational Area

WEEK #2 Introduction to cardiac catheterization

WEEK #3 Introduction to radiation oncology

WEEK #4 Introduction to MRI

First Monthly Performance Evaluation Due

WEEK #7 Second Monthly Performance Evaluation Due

WEEK #8 Midterm Comprehensive Evaluation Due

WEEK #10 Third Monthly Performance Evaluation Due

WEEK #13 Fourth Monthly Performance Evaluation Due

WEEK #15 Written Final Examination

Final Comprehensive Evaluation Due

*THIS SYLLABUS IS SUBJECT TO CHANGE AT THE INSTRUCTOR'S DISCRETION*

According to Pre-Finals Week Policy, No formal final examination schedule exists for laboratory courses. The faculty have determined that all Clinical Educational courses are deemed "laboratory" courses.

REFERENCES - RADT 4020

Aldridge, H. E., Chisholm, R. J., Dragatakis, L., & Roy, L. (1997). Radiation safety in the cardiac catheterization laboratory. Canadian Journal of Cardiology, 13(5), 459-467.

Bakardjiev, A. I., Barnes, P. D., Goumnerova, L. C., Black, P. M., Pomeroy, S. L., Billett, A., Loeffler, J. S., & Tarbell, N. J. (1996). Magnetic therapy for childhood low grade astrocytoma. Cancer Journal, 78(4), 864-873.

Bird, H. A. (1996). Imaging in clinical trials. Bailliers Clinical Rheumatology Journal, 10(4), 699-709.

Check, W. A. (1989, January). MRI raises basic questions about efficacy and cost. Observer - American College of Physicians, 9(1), 12, 18, 19.

Coleman, C. N., & Stevenson, M. A. (1996). Biologic basis for radiation oncology. Oncology Journal, 10(3), 399-411.

Dowd, S., & Wilson, B. (1995). Informed patient consent: A historical perspective. Radiologic Technology Journal of the American Society of Radiologic Technologists, 67(2), 119-124.

Hilderley, L. J. (1996). Radiation therapy for lung cancer. Seminars in Oncology Nursing Journal, 12(4), 304-311.

Laissy, J. P., Benyounes, M., Limot, O., Cinqualbre, A., Benamer, H., Kenouch, S., Henry-Feugeas, M. C., Falise, B., Chillon, S., Valere, P. E., & Schouman-Claeys, E. (1996). Screening of renal artery stenosis: Assessment with magnetic resonance angiography at 1.0 T. Magnetic Resonance Imaging, 14(9), 1033-1044.

McKetty, M. H. (1996). Study of radiation doses to personnel in a cardiac catheterization laboratory. Health Physics Journal, 70(4), 563-567.

Newman, J. (1997). Radiographic imaging of small bowel disease. Radiologic Technology Journal of the American Society of Radiologic Technologists, 68(6), 491-508.

Purdy, J. A., & Perez, C. A. (1996). Quality assurance in radiation oncology in the United States. Rays Journal, 21(4), 505-540.

Purtilo, R. (1990). Health Professional and Patient Interaction. (4th ed.). Philadelphia: W. B. Saunders Co.

Raggner, C., Klestil, T., Kathrein, A., Inderster, A., & Hamid, L. (1996). Influence of magnetic resonance imaging on indications for arthroscopy of the knee. Clinical Orthopedics and Related Research Journal, 330, 133-142.

Reitherman, R. (1993). Non-surgical biopsy: Providing a choice. Radiologic Technology Journal of the American Society of Radiologic Technologists, 65(2), 121-122.

Sandmayr, H., & Wallentin, D. (1996). Computer integrated radiology system: Analogue goes digital. European Radiology (Suppl. 3), 7, S90-S93.

Smith, C. W. (1996). Orthovoltage x-ray beams (0.5 mm-4.0 Cu HVL). British Journal of Radiology, (Suppl. 25), 24-38.

Steves, A. (1993). Teaching your students to care. Radiologic Technology Journal of the American Society of Radiologic Technologists, 65(2), 119-120.

Thomas, J. D. (1996). Magnetization transfer in magnetic resonance imaging. Radiologic Technology Journal of the American Society of Radiologic Technologists, 67(4), 297-306.

Utter, D. (1997). Survey of contrast media use in southeastern U.S. hospitals. Radiologic Technology Journal of the American Society of Radiologic Technologists, 68(5), 386-390.

Valls, C., Rene, M., Gil, M., Sanchez, A., Narvaez, J. A., & Hidalgo, F. (1996). Giant cavernous hemangioma of the liver: Atypical CT and MR findings. European Radiology Journal, 6(4), 448-450.

Wapniarz, M., Lehmann, R., Reincke, M., Schounaue, E., Llein, K., & Allolio, B. (1996). Determinants of radial bone density as measured by PQCT in pre-and postmenopausal women: The role of bone size. Journal of Bone and Mineral Research, 12(2), 248-254.

Zorzetto, M., Bernardi, G., Morocutti, G. & Fontanelli, A. (1996). Radiation exposure to patients and operators during diagnostic catheterization and coronary angioplasty. Catheterization and Cardiovascular Diagnosis, 40(4), 348-351.

EAST TENNESSEE STATE UNIVERSITY

RADIOGRAPHY PROGRAM

ROTATIONAL OBJECTIVES

CLINICAL EDUCATION V

RADIOGRAPHY

COMPLETED

OBJECTIVE	YES	NO
Exercise priorities required in daily clinical practice.
Execute imaging procedures under the appropriate level of supervision.
Adapt to changes and varying clinical situations.
Effectively communicate and maintain professional relationships with patients, the public, and members of the health care team.
Assess the patient and record patient histories.
Carry out principles of transferring, positioning, immobilizing, and restraining of patients.
Practice the 18-step positioning procedure in doing all radiographic exams.
Repeat radiographs according to policy.
Practice standard precautions.
Apply radiation protection to protect the patient and staff.
Observe, assist, and/or perform all examinations.
Independently perform safety checks on equipment/accessories; actively participate in departmental quality assurance program.
Provide collimation to area of interest.
Independent selection of technical factors.
Independently demonstrate an understanding of the technical aspects of imaging equipment.
Observe and demonstrate centering points on all examinations.
Actively participate in trauma radiography exhibiting improvised techniques and modified positioning to obtain diagnostic film quality.
Accurately ascertain information regarding pregnancy possibility.
Effectively operate radiographic equipment and accessories.
Observe and apply correct procedure methodology utilizing centering points on all exams (including placement of tube, table, and image receptor)
Critique and recognize diagnostic film quality.
Select appropriate image receptor and/or grid combinations.
Demonstrate a thorough knowledge of all aspects of care.
Demonstrate awareness of all procedures and protocol.
Demonstrate awareness of all procedures and protocol.
Function effectively in stressful situations; maintain composure – act not react
Use proper SID and angulations for the radiographic procedure.
Identify radiographic anatomy recorded on radiographs.
Identify pathology on radiographs.

EAST TENNESSEE STATE UNIVERSITY

RADIOGRAPHY PROGRAM

ROTATIONAL OBJECTIVES

CLINICAL EDUCATION V

FLUOROSCOPY

COMPLETED

OBJECTIVE	YES	NO
Exercise priorities required in daily clinical practice.
Execute imaging procedures under the appropriate level of supervision.
Adapt to changes and varying clinical situations.
Effectively communicate and maintain professional relationships with patients, the public, and members of the health care team.
Assess the patient and record patient histories.
Carry out principles of transferring, positioning, immobilizing, and restraining of patients.
Practice the 18-step positioning procedure in doing all radiographic exams.
Repeat radiographs according to policy.
Practice standard precautions.
Apply radiation protection to protect the patient and staff.
Observe, assist, and/or perform all examinations.
Provide collimation to area of interest.
Accurately ascertain information regarding pregnancy possibility.
Effectively operate radiographic/fluoroscopic controls, equipment, and accessories.
Observe and apply correct procedure methodology utilizing centering points on all exams (including placement of tube, table, and image receptor)
Critique and recognize diagnostic film quality.
Select appropriate image receptor and/or grid combinations.
Use proper SID and angulations for the radiographic procedure.
Identify radiographic anatomy recorded on radiographs.
Provide patient education regarding procedures.
Prepare contrast media according to institutional protocol.
Demonstrate sterile and/or aseptic techniques as required.
Correctly set up fluoroscopic/radiographic equipment.
Perform preliminary films as indicated.
Assist radiologist and/or radiographer during fluoroscopic studies.
Correctly place all necessary supplies for GI and BE examinations.
Identify patient preparation for various gastrointestinal studies.
Identify procedure for performing a colostomy BE.
Provide to patients pre and post patient education concerning each examination.
Effectively evaluate and initiate correct methodology to image all patient types and habitus.
Discuss interpretation of pathology with radiologists.
Distinguish and identify contrast media’s used for all fluoroscopic procedures (Invasive vs. Non-invasive).
Identify radiologist protocol for GI and BE examinations.
Administer contrast media through feeding tube.

EAST TENNESSEE STATE UNIVERSITY

RADIOGRAPHY PROGRAM

ROTATIONAL OBJECTIVES

CLINICAL EDUCATION V

MOBILE RADIOGRAPHY

COMPLETED

OBJECTIVE	YES	NO
Exercise priorities required in daily clinical practice.
Execute imaging procedures under the appropriate level of supervision.
Adapt to changes and varying clinical situations.
Effectively communicate and maintain professional relationships with patients, the public, and members of the health care team.
Assess the patient and record patient histories.
Carry out principles of transferring, positioning, immobilizing, and restraining of patients.
Practice the 18-step positioning procedure in doing all radiographic exams.
Repeat radiographs according to policy.
Practice standard precautions.
Apply radiation protection to protect the patient and staff.
Observe, assist, and/or perform all examinations.
Provide collimation to area of interest.
Accurately ascertain information regarding pregnancy possibility.
Effectively operate radiographic equipment and accessories.
Observe and apply correct procedure methodology utilizing centering points on all exams (including placement of tube, table, and image receptor)
Critique and recognize diagnostic film quality.
Select appropriate image receptor and/or grid combinations.
Use proper SID and angulations for the radiographic procedure.
Identify radiographic anatomy recorded on radiographs.
Identify correct patient and examination according to requisition.
Locate and drive the portable to the patient's room.
Politely ask visitors to wait outside the room until examination is complete.
Examine room and adjust furniture before bringing in the portable unit.
Identify and demonstrate proper operation and adjustment of mobile equipment.
Adjust the patient into the erect or supine position, as appropriate.
Accepts and uses constructive criticism.
Exhibit knowledge of medical terminology and provides correlation to examinations prescribed.
Demonstrate procedures in maintaining a sterile field.
Return the portable unit to the proper location and charge it if needed.
Patient identification (flash) and film processing is appropriate.
Demonstrate and observe differences in procedure of examinations.
Actively participates in the performance of surgical radiography procedures.
Returns furniture to original place.
Perform surgical examinations.
Practice procedure for hooking C-arm up.
Independently utilize accessory equipment in mobile imaging (grids, etc).
Function effectively in stressful situations.
Demonstrate proper procedures in surgical and mobile trauma radiography.
Independently function effectively in stressful situations.
Independently evaluate and initiate correct imaging protocol.
Independently modify positioning methodology when patient condition warrants.

EAST TENNESSEE STATE UNIVERSITY

RADIOGRAPHY PROGRAM

ROTATIONAL OBJECTIVES

CLINICAL EDUCATION V

AFTER HOURS - EVENINGS

COMPLETED

OBJECTIVE	YES	NO
Perform and/or assist with all examinations.
Practice standard precautions.
Apply protective devices to all patients.
Utilize practices of standard self-protection.
Utilize calipers for determining exposures.
Practice 18-step procedure for doing all patients.
Identify specific procedural protocol depending upon the examination and physician.
Independently actively participate in the radiographic examination of trauma patients.
Manage stressful situation effectively and efficiently.
Independently evaluate and initiate correct imaging protocol.

EAST TENNESSEE STATE UNIVERSITY

RADIOGRAPHY PROGRAM

ROTATIONAL OBJECTIVES

CLINICAL EDUCATION V

ELECTIVE - CARDIAC CATH

COMPLETED

OBJECTIVE	YES	NO
Exercise priorities required in daily clinical practice.
Execute imaging procedures under the appropriate level of supervision.
Adapt to changes and varying clinical situations.
Integrate use of appropriate and effective written, oral, and nonverbal communications with the patients, the public, and members of the health care team.
Adapt procedures to meet age-specific, disease-specific and cultural needs of patients.
Assess the patient and record patient histories.
Carry out principles of transferring, positioning, immobilizing, and restraining of patients.
Demonstrates professional competence in determining corrective measures to improve inadequate images.
Evaluation patient’s status and condition before, during and following the radiographic procedure to demonstrate competence in assessment skills.
Act consistently to maintain patient confidentiality.
Apply appropriate medical asepsis and sterile technique.
Practice standard precautions.
Apply radiation protection to protect the patient and staff.
Assist and/or observe on all examinations.
Prepare and/or assist with patient preparation including contrast media.
Prepare the technologies and methodologies for the performance of radiographic procedures.
Identify different types of equipment and indications of each.
Identify and demonstrate anatomy relevant to cardiac catheterization.
Demonstrate a basic understanding of equipment operation used for cardiac catheterization.
Evaluate all images for the proper demonstration of relevant cardiac anatomy.
Maintain sterile field.
Identify proper filming methodology utilized for cardiac catheterization.

EAST TENNESSEE STATE UNIVERSITY

RADIOGRAPHY PROGRAM

ROTATIONAL OBJECTIVES

CLINICAL EDUCATION V

ELECTIVE - CT

COMPLETED

OBJECTIVE	YES	NO
Exercise priorities required in daily clinical practice.
Execute imaging procedures under the appropriate level of supervision.
Adapt to changes and varying clinical situations.
Integrate use of appropriate and effective written, oral, and nonverbal communications with the patients, the public, and members of the health care team.
Adapt procedures to meet age-specific, disease-specific and cultural needs of patients.
Assess the patient and record patient histories.
Carry out principles of transferring, positioning, immobilizing, and restraining of patients.
Demonstrates professional competence in determining corrective measures to improve inadequate images.
Evaluation patient’s status and condition before, during and following the radiographic procedure to demonstrate competence in assessment skills.
Act consistently to maintain patient confidentiality.
Apply appropriate medical asepsis and sterile technique.
Practice standard precautions.
Apply radiation protection to protect the patient and staff.
Assist and/or observe on all examinations.
Prepare and/or assist with patient preparation including contrast media.
Prepare the technologies and methodologies for the performance of procedures.
Identify different types of equipment and indications of each.
Identify location of contrast media reaction materials and procedures for implementing counteractive materials.
Identify CT equipment and accessories (gantry, couch, control panel, etc.)
Demonstrate a basic understanding of equipment operation used for CT.
Prepare and observe contrast media administration for CT scanning procedures.
Identify location of contrast media reaction materials and procedures for implementing counteractive measures during CT scanning procedures.
Identify and review all basic anatomy relevant to routine CT procedures.
Evaluate all CT images for the proper demonstration of relevant anatomy.
Identify proper filming methodology utilized for CT.
Identify CT procedures and protocol.
Utilize a computer to recall a specific scan.
Observe the manipulation and processing of the CT digital image.

EAST TENNESSEE STATE UNIVERSITY

RADIOGRAPHY PROGRAM

ROTATIONAL OBJECTIVES

CLINICAL EDUCATION V

ELECTIVE - MRI

COMPLETED

OBJECTIVE	YES	NO
Exercise priorities required in daily clinical practice.
Execute imaging procedures under the appropriate level of supervision.
Adapt to changes and varying clinical situations.
Adapt procedures to meet age-specific, disease-specific and cultural needs of patients.
Assess the patient and record patient histories.
Carry out principles of transferring, positioning, immobilizing, and restraining of patients.
Demonstrates professional competence in determining corrective measures to improve inadequate images.
Evaluate patient’s status and condition before, during and following the radiographic procedure to demonstrate competence in assessment skills.
Act consistently to maintain patient confidentiality.
Apply appropriate medical asepsis and sterile technique.
Practice standard precautions.
Assist and/or observe on all examinations.
Prepare and/or assist with patient preparation including contrast media.
Assist and observe room preparation and equipment (coil) selection
Identify and demonstrate anatomy relevant to routine procedures.
Evaluate all images for the proper demonstration of relevant anatomy.
Demonstrate a basic understanding of equipment operation.
Load and process MRI films.
Demonstrate magnet safety.
Identify advantages of MRI in musculoskeletal imaging.
Describe the basic principles of MRI.
State patient and operator safety issues during MRI procedures.

EAST TENNESSEE STATE UNIVERSITY

RADIOGRAPHY PROGRAM

ROTATIONAL OBJECTIVES

CLINICAL EDUCATION V

ELECTIVE - ULTRASONOGRAPHY

COMPLETED

OBJECTIVE	YES	NO
Exercise priorities required in daily clinical practice.
Execute imaging procedures under the appropriate level of supervision.
Adapt to changes and varying clinical situations.
Integrate use of appropriate and effective written, oral, and nonverbal communications with the patients, the public, and members of the health care team.
Adapt procedures to meet age-specific, disease-specific and cultural needs of patients.
Assess the patient and record patient histories.
Carry out principles of transferring, positioning, immobilizing, and restraining of patients.
Demonstrates professional competence in determining corrective measures to improve inadequate images.
Evaluation patient’s status and condition before, during and following the radiographic procedure to demonstrate competence in assessment skills.
Act consistently to maintain patient confidentiality.
Apply appropriate medical asepsis and sterile technique.
Practice standard precautions.
Assist and/or observe on all ultrasound examinations.
Prepare and/or assist with patient preparation.
Assist and observe room preparation and equipment selection for an ultrasound examination.
Identify and demonstrate anatomy relevant to routine procedures.
Evaluate all images for the proper demonstration of relevant anatomy.
Identify the function of different transducers to be utilized.
Load and process ultrasound films.
Activate equipment to ready mode.
Demonstrate a basic understanding of equipment operation.
Describe the similarities and differences between gynecologic and obstetric imaging.
Discuss imaging protocol for various examinations.
Explain why a full bladder is required to image the female reproductive tract.

EAST TENNESSEE STATE UNIVERSITY

RADIOGRAPHY PROGRAM

ROTATIONAL OBJECTIVES

CLINICAL EDUCATION V

ELECTIVE - NUCLEAR MEDICINE

COMPLETED

OBJECTIVE	YES	NO
Exercise priorities required in daily clinical practice.
Adapt to changes and varying clinical situations.
Integrate use of appropriate and effective written, oral, and nonverbal communications with the patients, the public, and members of the health care team.
Adapt procedures to meet age-specific, disease-specific and cultural needs of patients.
Assess the patient and record patient histories.
Carry out principles of transferring, positioning, immobilizing, and restraining of patients.
Demonstrates professional competence in determining corrective measures to improve inadequate images.
Evaluation patient’s status and condition before, during and following the radiographic procedure to demonstrate competence in assessment skills.
Act consistently to maintain patient confidentiality.
Apply appropriate medical asepsis and sterile technique.
Practice standard precautions.
Practice principles of radiation protection relevant to nuclear medicine.
Assist and/or observe on all examinations.
Prepare and/or assist with patient preparation including contrast media.
Assist and observe room preparation and equipment selection.
Prepare the technologies and methodologies for the performance of procedures.
Identify different types of equipment and indications of each.
Distinguish the effect of certain contrast media that may have an effect on nuclear medicine scans.
Identify NM equipment and accessories.
Demonstrate a basic understanding of equipment operation used for NM.
Prepare and observe administration of radioactive materials for NM procedures.
Identify and review all basic anatomy relevant to routine NM procedures.
State procedure for disposal of radioactive waste.
Evaluate all NM images for the proper demonstration of relevant anatomy.
Identify proper filming methodology utilized for NM.
Identify NM procedures.
Identify contraindications of certain nuclear medicine studies when done in series.
Observe the manipulation and processing of the NM digital image.

EAST TENNESSEE STATE UNIVERSITY

RADIOGRAPHY PROGRAM

ROTATIONAL OBJECTIVES

CLINICAL EDUCATION V

ELECTIVE – RADIATION THERAPY

COMPLETED

OBJECTIVE	YES	NO
Exercise priorities required in daily clinical practice.
Adapt to changes and varying clinical situations.
Integrate use of appropriate and effective written, oral, and nonverbal communications with the patients, the public, and members of the health care team.
Adapt procedures to meet age-specific, disease-specific and cultural needs of patients.
Assess the patient and record patient histories.
Carry out principles of transferring, positioning, immobilizing, and restraining of patients.
Demonstrates professional competence in determining corrective measures to improve inadequate images.
Evaluation patient’s status, condition, and pain level before, during and following the procedure to demonstrate competence in assessment skills.
Act consistently to maintain patient confidentiality.
Apply appropriate medical asepsis and sterile technique.
Practice standard precautions.
Observe methods of treatment for various disease processes in the oncology department.
Observe treatment planning and dosimetry in the oncology department.
Assist and/or prepare patients for procedures.
Observe and assist in preparing equipment to deliver treatments.
Identify different types of equipment used in the oncology department and indications of each.
State the hazards of radium implants and handling of patient receiving institial or intracavitary treatments.

EAST TENNESSEE STATE UNIVERSITY

RADIOGRAPHY PROGRAM

ROTATIONAL OBJECTIVES

CLINICAL EDUCATION V

ELECTIVE – RADIATION THERAPY (Cont.)

Respond to the Following 5 Questions following a one-week rotation in radiation oncology and submit to your clinical instructor:

1. Describe the procedure from start to treatment.

2. What action is taken to measure daily quality assurance of equipment.

3. How does the physician determine treatment is being delivered accurately?

4. What is the #1 type of cancer deaths in America for men & women.

5. What educational value did you take from your time spent in Radiation Oncology?

EAST TENNESSEE STATE UNIVERSITY

RADIOGRAPHY PROGRAM

CLINICAL EDUCATION V

GRADUATE COMPETENCIES

GRADE	EXAMINATION	DATE	PT'S ID#	CL.ED.CT
	ABDOMEN/GI
	SURGICAL/MOBILE
	CHEST/BREAST
	HEAD/NECK
	GENITOURINARY
	TRAUMA
	MUSCULOSKELETAL

These competencies will be selected by the clinical instructor, clinical coordinator, and/or program director. These competencies will account for 20% of the course grade.

The ARRT defines trauma as:

... radiographic examinations that the patient cannot move and assume the position used for routine radiographic procedures. Radiographic and accessory equipment are moved around the patient to avoid causing additional injury or discomfort. Professional judgment and creativity are part of trauma radiography.

EAST TENNESSEE STATE UNIVERSITY

RADIOGRAPHY PROGRAM

COMPETENCY PERFORMANCE EVALUATIONS

The ARRT requires that each applicant demonstrate core clinical competencies to establish certification eligibility. These competencies are categorized in sequential clinical courses. Students must demonstrate competency in all 39 mandatory radiologic procedures. At least 30 of the mandatory radiologic procedures must be demonstrated on patients (no simulations/phantom substitutions). In addition, the student must demonstrate competency in fourteen elective competencies. Examination results are included in the semester grade. Students are required to complete 20% (3) of the fourteen elective competencies by the end of the second semester.

Four general patient care competencies are also required prior to program completion. Those competencies are CPR, patient assessment to include vital signs, venipuncture, and oxygen administration.

Competency performance examinations are administered during each semester by the clinical instructor and/or program faculty. (Subject to clinical site protocol.) The student must receive a passing score of 85% or higher on each examination before they can continue to the next clinical course. These examinations will be practical in nature, and the grades are part of the student's permanent record.

ELECTIVE COMPETENCY EXAMINATIONS

There are core clinical competencies that all individuals must demonstrate to establish eligibility for ARRT certification. In addition to the competencies that are delineated for each semester, the student must complete a minimum of fourteen elective competencies as delineated below. These examinations will be entered into the grade in the semester which they are completed. The student must complete 20% (3) of the fourteen elective competencies by the end of the second semester.

EAST TENNESSEE STATE UNIVERSITY

RADIOGRAPHY PROGRAM

COE CHECKLIST

NAME ___________________________________ ENROLLMENT: Class of 2003 – 2005

EAST TENNESSEE STATE UNIVERSITY

RADIOGRAPHY PROGRAM

ELECTIVE COMPETENCIES (MINIMUM REQUIRED – 14 by the end of Clinical IV)

STUDENT’S NAME: ________________________________

EXAMINATION	ID	DATE	VERIFIED
Decubitus Chest
Sternum
Larynx (Soft Tissue Neck)
Scapula
Clavicle
AC Joints
OR Gallbladder
Toes
Myelogram
Os Calcis
Sacrum/Coccyx
Skull
Mandible
Orbits
S.I. Joints
Scoliosis Series
Zygomatic Arches
Cystography or Cystourethrography
Pediatric Extremity
Digital Radiography
Trauma Shoulder (Y-view or Transthoracic)
Standing Knees
Standing Feet
Cervical/ Lumbar Flexion/Extension
Navicular
Sella Turcica
Bone Survey
Retrograde Urography
Modified GI
ERCP
Modified Barium Swallow/ OPMS
Panorex
CT Head w/o Contrast

Revised: 7/1/03, 8/21/01

* Bone Age does not count as an elective competency *

EAST TENNESSEE STATE UNIVERSITY

RADIOGRAPHY PROGRAM

COMPETENCY PERFORMANCE EVALUATION

STUDENT'S NAME: _______________________ DATE: _________________

CL. ED. CENTER: _______________________ GRADE: _________________

PATIENT ID#: _______________________ # REPEATS: _________________

PROCEDURE: _________________________

* 85% MINIMUM REQUIRED FOR COMPETENCY

PROJECTIONS

A. ___________________________

B. ___________________________

C. ___________________________

D. ___________________________

E. ___________________________

CHECKS PLACED IN THE FOLLOWING CATEGORY WILL BE AVERAGED FOR A MAXIMUM OF 5 POINTS:

PERFORMANCE EFFICIENCY

A	B	C	D	E
					Excellent - 5
					Very Good - 4
					Good - 3
					Fair - 2
					Poor - 1
					Unacceptable - 0

_______ Average Performance Efficiency

ADDITIONAL COMMENTS:

**** Patient ID, date, and radiographer verification are required in order for the competency examination to be valid.

PLACE CHECKS WHERE IMPROVEMENTS ARE NECESSARY

A	B	C	D	E	I. PATIENT CARE AND MANAGEMENT
					Properly Evaluated Requisition; Appropriate Patient Assessment
					Identified Patient and Self; Projected Positive Image/Self Confidence
					Adapt to Changes and Varying Clinical Situations
					Appropriate Patient Transfer, Immobilization, and Restraining
					Apply Standard and Transmission-Based Precautions
					II. EQUIPMENT UTILIZATION
					Properly Prepared Physical Facilities
					Manipulated Tube/Bucky Adequately
					Utilized Proper SIDs, OIDs, CR Angulation
					Record Radiographic Image on Correct Image Receptor
					Selected Correct Cassette Sizes, Types (grid), and Placement (crosswise & lengthwise)
					Utilized Accessory Equipment (sponges, grids, etc.) when needed
					III. RADIOGRAPHIC PROCEDURE
					Positioned Part Correctly
					Centered CR Correctly (angled if necessary)
					Organized the Examination to Facilitate Speed
					Proper Breathing Instructions Given While Observing Patient
					IV. IMAGE EVALUATION
					Proper Anatomical Structures Demonstrated
					Proper Alignment Demonstrated
					Proper Technical Factors Demonstrated on Radiographs
					Correct Image Identification & Quality
					Knowledge of Related Anatomy/Pathology
					V. RADIATION PROTECTION
					Proper Collimation to Part
					Demonstrated Competency – Cardinal Principles of Protection
					Proper Radiation Protection to Patient, Self, and Others; ALARA
					Questioned Patient Regarding LMP

________ Grade (Sections I-V)

(+) Plus

________ Performance Efficiency

________ Final Grade

Radiographer: _____________________________________ Date: _________________

Clinical Instructor: _________________________________ Date: _________________

Student: __________________________________________ Date: _________________

COMMENTS: ________________________________________________________________

_____________________________________________________________________________

_____________________________________________________________________________
EAST TENNESSEE STATE UNIVERSITY

RADIOGRAPHY PROGRAM

COMPETENCY PERFORMANCE EVALUATION

SURGICAL AND SPECIAL PROCEDURES

STUDENT'S NAME: _______________________ DATE: _________________

CL. ED. CENTER: _______________________ GRADE: _________________

PATIENT ID#: _______________________ # REPEATS: _________________

PROCEDURE: ________________________

* 85% MINIMUM REQUIRED FOR COMPETENCY

PROJECTIONS

A. ___________________________

B. ___________________________

C. ___________________________

D. ___________________________

E. ___________________________

CHECKS PLACED IN THE FOLLOWING CATEGORY WILL BE AVERAGED FOR A MAXIMUM OF 5 POINTS:

PERFORMANCE EFFICIENCY

A	B	C	D	E
					Excellent - 5
					Very Good - 4
					Good - 3
					Fair - 2
					Poor - 1
					Unacceptable - 0

_______ Average Performance Efficiency

ADDITIONAL COMMENTS:

**** Patient ID, date, and radiographer verification are required in order for the competency examination to be valid.

PLACE CHECKS WHERE IMPROVEMENTS ARE NECESSARY

A	B	C	D	E	I. EQUIPMENT SETUP/UTILIZATION
					Identification of all Controls
					Radiograph Production Static/Dynamic (C-Arm)
					Equipment Connection/Setup/Alignment
					Equipment Manipulation (AP vs Lateral)
					Correct Exposure Factors
					Organization of Examination Procedure
					Availability of Procedural Supplies/Contrast Media
					II. IMAGE EVALUATION
					Proper Contrast and Density
					Proper Anatomical Structures Demonstrated/Identified
					Patient Data Entry - (Identification, Markers, etc.)
					Imaging Protocol
					III. STERILE TECHNIQUE/SETUP
					Set-up/Maintenance of Sterile Field (Gowns, Catheter, Openings, etc.)
					Proper Attire
					Standard Precautions
					IV. PROFESSIONALISM
					Punctuality
					Confidence
					Equipment Maintenance (Cleanliness)
					Communication with Health Care Team/Patient Care
					Patient Education
					Order/Entry Examination (Simulation Accepted)
					V. RADIATION PROTECTION
					Proper Collimation
					Minimize Tube On-Time
					Lead Apron Utilization
					Patient/Personnel/Self Protection

________ Grade (Sections I-V)

(+) Plus

________ Performance Efficiency

________ Final Grade

Radiographer: _____________________________________ Date: _________________

Clinical Instructor: _________________________________ Date: _________________

Student: __________________________________________ Date: _________________

COMMENTS: ________________________________________________________________

_____________________________________________________________________________

_____________________________________________________________________________
EAST TENNESSEE STATE UNIVERSITY

RADIOGRAPHY PROGRAM

CT COMPETENCY PERFORMANCE EVALUATION

STUDENT'S NAME: _______________________ DATE: _________________

CL. ED. CENTER: _______________________ GRADE: _________________

PATIENT ID#: _______________________

* 85% MINIMUM REQUIRED FOR COMPETENCY

PERFORMANCE EFFICIENCY

	Excellent - 5
	Very Good - 4
	Good - 3
	Fair - 2
	Poor - 1
	Unacceptable - 0

_____ Average Performance Efficiency

ADDITIONAL COMMENTS: ____________________________________________________

______________________________________________________________________________

**** Patient ID, date, and radiographer verification are required in order for the competency examination to be valid.

PLACE CHECKS WHERE IMPROVEMENTS ARE NECESSARY

	I. PATIENT CARE AND MANAGEMENT
	Properly Evaluated Requisition and Patient Assessment
	Identified Patient and Self
	Projected Positive Image/Self Confidence
	Effectively Communicated with Patient
	II. EQUIPMENT UTILIZATION
	Properly Prepared Physical Facilities
	Manipulated Console/Gantry Controls Adequately
	Utilized Accessory Equipment (sponges, grids, etc.) when needed
	III. SCAN SETUP
	Positioned Part Correctly
	Centered Part in Gantry Correctly and Angled if Necessary
	Selected Correct Scan Protocol
	Organized the Examination to Facilitate Speed
	Proper Instructions Given While Observing Patient
	IV. IMAGE EVALUATION
	Proper Anatomical Structures Demonstrated
	Proper Alignment Demonstrated
	Proper Technical Factors Demonstrated
	Knowledge of Related Anatomy/Pathology
	V. RADIATION PROTECTION
	Shielded Patient
	Proper Radiation Protection to Patient, Self, and Others
	Questioned Patient Regarding LMP

________ Grade (Sections I-V)

(+) Plus

________ Performance Efficiency

________ Final Grade

Radiographer: _____________________________________ Date: _________________

Clinical Instructor: _________________________________ Date: _________________

Student: __________________________________________ Date: _________________

COMMENTS: ________________________________________________________________

_____________________________________________________________________________

_____________________________________________________________________________
EAST TENNESSEE STATE UNIVERSITY

RADIOGRAPHY PROGRAM

GRADUATE PERFORMANCE COMPETENCIES

STUDENT'S NAME: _______________________ DATE: _________________

CL. ED. CENTER: _______________________ GRADE: _________________

PATIENT ID#: _______________________ # REPEATS: _________________

PROCEDURE: _________________________

* 85% MINIMUM REQUIRED FOR COMPETENCY

PROJECTIONS

A. ___________________________

B. ___________________________

C. ___________________________

D. ___________________________

E. ___________________________

CHECKS PLACED IN THE FOLLOWING CATEGORY WILL BE AVERAGED FOR A MAXIMUM OF 5 POINTS:

PERFORMANCE EFFICIENCY

A	B	C	D	E
					Excellent - 5
					Very Good - 4
					Good - 3
					Fair - 2
					Poor - 1
					Unacceptable - 0

______ Average Performance Efficiency

ADDITIONAL COMMENTS:

**** Patient ID, date, and radiographer verification are required in order for the competency examination to be valid.

PLACE CHECKS WHERE IMPROVEMENTS ARE NECESSARY

A	B	C	D	E	I. PATIENT CARE AND MANAGEMENT
					Properly Evaluated Requisition; Appropriate Patient Assessment
					Identified Patient and Self; Projected Positive Image/Self Confidence
					Adapted Communication Style to the Difficult/Trauma Patient
					Appropriate Patient Transfer, Immobilization, and Restraining
					Apply Standard and Transmission-Based Precautions
					II. EQUIPMENT UTILIZATION
					Properly Prepared Physical Facilities
					Manipulated Tube/Bucky Adequately
					Utilized Proper SIDs, OIDs, CR Angulation
					Record Radiographic Image on Correct Image Receptor
					Selected Correct Cassette Sizes, Types (grid), and Placement (crosswise & lengthwise)
					Utilized Accessory Equipment (sponges, grids, etc.) when needed
					III. RADIOGRAPHIC PROCEDURE
					Positioned Part Correctly
					Centered CR Correctly (angled if necessary)
					Used Critical Thinking Skills in Performing the Procedure
					Proper Breathing Instructions Given While Observing Patient
					IV. IMAGE EVALUATION
					Proper Anatomical Structures Demonstrated
					Proper Alignment Demonstrated
					Proper Technical Factors Demonstrated on Radiographs
					Correct Image Identification & Quality
					Knowledge of Related Anatomy/Pathology
					V. RADIATION PROTECTION
					Proper Collimation to Part
					Demonstrated Competency – Cardinal Principles of Protection
					Proper Radiation Protection to Patient, Self, and Others; ALARA
					Questioned Patient Regarding LMP

________ Grade (Sections I-V)

(+) Plus

________ Performance Efficiency

________ Final Grade

Radiographer: _____________________________________ Date: _________________

Clinical Instructor: _________________________________ Date: _________________

Student: __________________________________________ Date: _________________

COMMENTS: ________________________________________________________________

_____________________________________________________________________________

_____________________________________________________________________________
EAST TENNESSEE STATE UNIVERSITY GRADE _________

RADIOGRAPHY PROGRAM

INTRODUCTION PERFORMANCE EVALUATION

Students are evaluated on application of classroom philosophies, clinical progression, comprehension, proficiency, and competency. Students are made aware of areas of achievement and/or deficiency. Evaluation design is generic ensuring applicability to various ancillary assignments. The design of this evaluation tool is very basic in order to be applicable to the first monthly evaluation during Clinical I. The purpose is to allow the student to recognize areas of achievement and/or deficiency.

Student’s Name: ______________________ Rotation Dates: ____________________

Clinical Agency: _____________________ Rotation Areas: ______________________

SLIDING SCALE) (4) (3.5) (3.0) (2.5) (2.0) (1.5) (1.0) (0)

PUNCTUALITY

ALWAYS PROMPT

USUALLY PROMPT

NEEDS IMPROVEMENT

CONTINOUSLY LATE

PATIENT AWARENESS

SHOWS UTMOST CONCERN

USUALLY CONCERNED

SOMETIMES NOT OBSERVANT

TREATS PATIENT RUDELY

USE & CARE OF EQUIPMENT

SHOWS CARE & INTEREST IN MAINTENANCE

USUALLY CAREFUL

SOMETIMES MISUSES

CARELESS & WASTEFUL

ACHIEVEMENT ROTATIONAL OBJECTIVES

MEETS OBJECTIVES READILY

LITTLE DIFFICULTY

DIFFICULTY IN MEETING OBJECTIVES

UNABLE TO SATISFY OBJECTIVES

COMMUNICATION

EFFECTIVELY COMMUNICATES

LITTLE DIFFICULTY

COMMUNICATION MISTAKES OCCUR OFTEN

UNABLE TO COMMUNICATE

MECHANICAL ABILITY

WORKS EQUIPMENT WELL

ABLE TO UTILIZE EQUIPMENT

CONSTANT DIRECTION REQUIRED

UNABLE TO WORK EQUIPMENT

PROFESSIONALISM

DISPLAYS IN ALL SITUATIONS

DISPLAYS IN MOST SITUATIONS

DISPLAYS SOME OF THE TIME

DOES NOT

DEMONSTRATE

ATTITUDE

COOPERATIVE & ASSISTS INDEPENDENTLY

USUALLY COOPERATIVE & ASSISTS

INDEPEND-ENTLY

SOMETIMES COOPERATIVE & ASSISTS INDEPENDENTLY

UNCOOPERATIVE AND DOES NOT ASSIST

INTERPERSONAL SKILLS

WORKS WELL WITH OTHERS

LITTLE DIFFICULTY IN WORKING WITH OTHERS

SOME DIFFICULTY IN WORKING WITH OTHERS

DOES NOT WORK WELL WITH OTHERS

ACCURACY & EFFICIENCY

WORKS QUICKLY AND WELL

WORK AVERAGE, FEW ERRORS

DIFFICULTY IN PERFORMANCE

CARELESS, DOES NOT PERFORM

Clinical Instructor: _____________________________ Date: _________________

Student: ____________________________________ Date: _________________

Comments:

EAST TENNESSEE STATE UNIVERSITY GRADE ____%

JUNIOR PERFORMANCE EVALUATION

STUDENT'S NAME: ___________________________ ROTATION DATES: _________________________

CL. ED. CTR: _________________________________ ROTATION AREAS: _________________________

Completed monthly by the clinical instructor evaluating the student’s progress in obtaining course objectives an identifying the

student’s strengths and weaknesses. Clinical Instructors review Performance Evaluations monthly with each student.

DIRECTIONS: The maximum sectional score is defined to the left. The total score for all sections will equal 100%. Please CIRCLE the letter in sections where IMPROVEMENTS are NECESSARY with corresponding point reductions.

I. RADIATION PROTECTION

a. Explains and demonstrates methods of radiation protection to patients.

(8) b. Practices standard self-protection.

c. Demonstrates collimation procedures.

d. Attention and care about repeat radiographs (RT present).

_________ AWARDED POINTS

COMMENTS:

II. PATIENT CARE

a. Performs and/or assists with all examinations (assist radiologists).

b. Assess patient condition and provides adaptations as required.

(16) c. Demonstrates proper method of patient transfer and body mechanics.

d. Utilizes Standard Precaution procedures.

e. Identifies location and function of special care equipment (0₂, IVs, etc.).

f. Identifies protocol for critical patients (codes, contrast reactions).

g. Demonstrates consideration and respects the patients' rights and needs.

h. Demonstrates genuine compassion to all patients.

_________ AWARDED POINTS

COMMENTS:

III. ENVIRONMENT

a. Provides clean and orderly environment.

(6) b. Stock rooms daily or as required.

c. Identifies location and function of supplies as required.

_________ AWARDED POINTS

COMMENTS:

IV. COMMUNICATION

a. Establishes professional-student-technologist relationships.

b. Properly performs patient identification and verification.

(10) c. Effectively communicates with staff.

d. Instructs patients in a clear and well-defined manner.

e. Explains examination procedure to patients and provides patient education.

_________ AWARDED POINTS

COMMENTS:

V. EQUIPMENT MANIPULATION

a. Manipulates tube and table in all direction and places on center lock.

(6) b. Identifies and utilizes the various components on the control panel.

c. Properly utilizes upright bucky and film holders.

_________ AWARDED POINTS

COMMENTS:

VI. QUALITY ASSURANCE

a. Provides proper procedure for record and file maintenance.

b. Proper radiographic identification (film identification and markers).

c. Utilizes calipers and/or technique charts.

(14) d. Determines and sets exposure factors as required.

e. Recognizes diagnostic film quality.

f. Utilizes and selects proper cassette/film sizes.

g. Coordinates/alters exposure factors as required.

_________ AWARDED POINTS

COMMENTS:

VII. DEPENDABILITY AND INITIATIVE

a. Exhibits motivation in the performance of medical imaging procedures.

b. Utilizes time to achieve clinical educational objectives.

c. Participates in the clinical component willingly.

d. Punctual in meeting assignments.

e. Follows through with all clinical assignments.

(20) f. Executes independent action and logically organizes oneself.

g. Reliable work accuracy, thoroughness, strives to improve on competency examinations.

h. Tolerates and functions under stress.

i. Actively participates and demonstrates interest in the clinical education component.

j. Attendance; promptness, number of tardy days, absences, proper notification when absent.

_________ AWARDED POINTS

COMMENTS:

VIII. CLINICAL ABILITY

a. Identifies procedures and protocols for observed examinations.

b. Demonstrates competence for previous mastered examinations.

(10) c. Demonstrates efficiency and organization in procedure(s) performance.

d. Knowledge of procedures, duties, and departmental functions.

e. Demonstrates psychomotor and cognitive parameters in the performance of radiographic exams.

_________ AWARDED POINTS

COMMENTS:

IX. PROFESSIONALISM

a. Attires in proper uniform and clean shoes.

b. Exhibits acceptable grooming and cleanliness.

c. Exhibits professional conduct in all situations with a courteous and pleasant manner.

(12) d. Independently accepts additional responsibilities and assignments.

e. Demonstrates consideration and respects others.

f. Demonstrates ability to work with staff and fellow students.

_________ AWARDED POINTS

COMMENTS:

ADDITIONAL COMMENTS:

Clinical Instructor: ___________________________________________ Date: ______________________

Student: ____________________________________________________ Da te: ______________________

EAST TENNESSEE STATE UNIVERSITY GRADE ______%

SENIOR YEAR PERFORMANCE EVALUATION

STUDENT'S NAME: ___________________________ ROTATION DATES: _________________________

CL. ED. CTR: _________________________________ ROTATION AREAS: _________________________

Completed monthly by the clinical instructor evaluating student achievement of course and rotational objectives and assignments, competency

proficiency, clinical skill development, and professional progress. Student’s strengths & weakness are identified. Correlated between student

achievement and the number of points awarded in each category correspond. Clinical Instructors review Performance Evaluations monthly with each

student.

I. RADIATION PROTECTION

a. Applies gonadal shielding and evaluate pregnancy possibility.

(8) b. Accurately applies radiographic collimation.

c. Protects occupied areas, patient, staff and employs ALARA principles.

d. Attention and care about repeat radiographs (RT present).

_________ AWARDED POINTS

COMMENTS:

II. PATIENT CARE

a. Obtains and validates patient history and correlates with radiographic examination.

b. Explains examination to patient; provides patient education; attention; and comfort.

(8) c. Explains delays, reassures patients, demonstrates consideration, and respects the patient rights.

d. Maintains professional relationships and rapport; avoids extraneous conversation with others.

_________ AWARDED POINTS

COMMENTS:

III. PROFESSIONALISM

a. Maintains acceptable grooming and cleanliness, attires in proper uniform and clean shoes.

b. Demonstrates ethical conduct, practice, and empathy for patients.

(10) c. Maintains professional relationships with peers, instructors, technologists, and patients.

d. Demonstrates self-confidence in the performance of imaging procedures.

e. Independently accepts additional responsibilities and assignments.

_________ AWARDED POINTS

COMMENTS:

IV. ATTITUDE

a. Appears interested, asks questions, is enthusiastic and participates fully in rotational assignments.

b. Displays cooperation & assists other independently; willing participant of the health care team

(8) c. Displays punctuality in meeting clinical objectives and the clinical experience.

d. Listens to and accepts constructive criticism positively; recognizes deficiencies and strives to

overcome.

_________ AWARDED POINTS

COMMENTS:

V. COMMUNICATION

a. Displays effective speaking skills with patients, hospital staff, faculty, and fellow students.

(6) b. Utilizes effective writing skills on patient requisitions (including medical terminology), time

cards, & evaluations.

c. Consistently displays proper written communication documentation and skills.

_________ AWARDED POINTS

COMMENTS:

VI. QUALITY ASSURANCE

a. Utilizes proper record and file procedures; assures appropriate radiographic identification (film identification and markers).

b. Utilizes calipers and/or technique charts.

(8) c. Recognizes diagnostic film quality; utilizes and selects proper image receptor sizes.

d. Evaluates pathology; patient habitus; and other factors requiring adjustment of exposure factors.

_________ AWARDED POINTS

COMMENTS:

VII. CLINICAL COMPETENCY

a. Demonstrates standard positioning, centering points, and CR angles.

b. Illustrates department procedure and radiographic routines.

c. Properly selects technical factors, film, screens, and grids.

d. Provides adequate compensation techniques for body habitus and pathology

(20) e. Functions effectively during stressful situations.

f. Demonstrates care in the use of all equipment.

g. Illustrates ability to improvise when deviations from the routine as necessary.

h. Demonstrates organization and efficiency during clinical procedure performance.

i. Provides clean and orderly environment.

j. Identifies location and function of supplies as required; stock rooms daily or as required.

_________ AWARDED POINTS

COMMENTS:

VIII. EQUIPMENT MANIPULATION

a. Manipulates tube and table in all direction and places on center lock; identify/demonstrate remote controls.

(6) b. Identifies and utilizes the various components on the control panel.

c. Properly utilizes upright bucky and film holders.

_________ AWARDED POINTS

COMMENTS:

IX. DEPENDABILITY, INITIATIVE, AND ACHIEVEMENT

a. Exhibits motivation in the performance of medical imaging procedures.

b. Utilizes time to achieve clinical educational objectives.

c. Participates in the clinical component willingly; punctual in meeting assignments.

e. Assumes responsibility for actions.

(14) f. Retains knowledge and skills previously achieved.

g. Follows through on procedural and/or departmental protocol.

h. Attendance; promptness, number of tardy days, absences, proper notification when absent.

_________ AWARDED POINTS

COMMENTS:

X. QUALITY/QUANTITY OF PERFORMANCE

a. Consistently produces radiographs of optimum quality with minimum errors.

(12) b. Consistently utilized correct radiographic markers, image receptor sizes, and types.

c. Completes radiographic examinations in an acceptable time period.

d. Completes assignments satisfactorily and seeks additional responsibility.

e. Displays adaptability; adjusts to changes in work environment (different hospitals, equipment, and/or personnel).

f. Produces a satisfactory amount of output concerning radiographic procedures and/or associated functions.

_________ AWARDED POINTS

COMMENTS:

ADDITIONAL COMMENTS:

Clinical Instructor: ___________________________________________ Date: ______________________

Student: ____________________________________________________ Da te: ______________________

EAST TENNESSEE STATE UNIVERSITY GRADE: _______

RADIOGRAPHY PROGRAM

SPECIALIZED PERFORMANCE EVALUATION

(Cardiac Cath, Ultrasound, CT, MRI, NM, Radiation Therapy)

Completed weekly by clinical staff evaluating student achievement of objectives in specialized diagnostic imaging areas. Student evaluation is in general reference to that modality (cardiac catheterization, ultrasound, CT, MRI, NM, radiation therapy.)

STUDENT'S NAME: ______________________ ROTATION DATES: ________________

CLINICAL AGENCY _____________________ ROTATION AREA:__________________

SLIDING SCALE) (4) (3.5) (3.0) (2.5) (2.0) (1.5) (1.0) (0)

PUNCTUALITY

ALWAYS PROMPT

USUALLY PROMPT

NEEDS IMPROVEMENT

CONTINOUSLY LATE

PATIENT AWARENESS

SHOWS UTMOST CONCERN

USUALLY CONCERNED

SOMETIMES NOT OBSERVANT

TREATS PATIENT RUDELY

USE & CARE OF EQUIPMENT

SHOWS CARE & INTEREST IN MAINTENANCE

USUALLY CAREFUL

SOMETIMES MISUSES

CARELESS & WASTEFUL

ACHIEVEMENT ROTATIONAL OBJECTIVES

MEETS OBJECTIVES READILY

LITTLE DIFFICULTY

DIFFICULTY IN MEETING OBJECTIVES

UNABLE TO SATISFY OBJECTIVES

COMMUNICATION

EFFECTIVELY COMMUNICATES

LITTLE DIFFICULTY

COMMUNICATION MISTAKES OCCUR OFTEN

UNABLE TO COMMUNICATE

MECHANICAL ABILITY

WORKS EQUIPMENT WELL

ABLE TO UTILIZE EQUIPMENT

CONSTANT DIRECTION REQUIRED

UNABLE TO WORK EQUIPMENT

PROFESSIONALISM

DISPLAYS IN ALL SITUATIONS

DISPLAYS IN MOST SITUATIONS

DISPLAYS SOME OF THE TIME

DOES NOT

DEMONSTRATE

ATTITUDE

COOPERATIVE & ASSISTS INDEPENDENTLY

USUALLY COOPERATIVE & ASSISTS

INDEPENDENTLY

SOMETIMES COOPERATIVE & ASSISTS INDEPENDENTLY

UNCOOPERATIVE AND DOES NOT ASSIST

INTERPERSONAL SKILLS

WORKS WELL WITH OTHERS

LITTLE DIFFICULTY IN WORKING WITH OTHERS

SOME DIFFICULTY IN WORKING WITH OTHERS

DOES NOT WORK WELL WITH OTHERS

ACCURACY & EFFICIENCY

WORKS QUICKLY AND WELL

WORK AVERAGE, FEW ERRORS

DIFFICULTY IN PERFORMANCE

CARELESS, DOES NOT PERFORM

Clinical Instructor: _____________________________ Date: _________________

Student: ____________________________________ Date: _________________

Comments:

EAST TENNESSEE STATE UNIVERSITY GRADE ____%

COMPREHENSIVE EVALUATION (MID-TERM & FINAL)

Student’s Name: __________________ Cl. Ed. Ctr: _______________ Date: _______

The clinical instructor in conjunction with the clinical coordinator will evaluate each student's progress at mid-term and at the end of each semester. This evaluation reflects student progress in achieving objectives and expected competency levels. A satisfactory (passing) score is required to retain unconditional program status.

Please indicate the category which the student exhibits comparable performance.

UNSATISFACTORY SATISFACTORY

RATING SCALE: 0 Not Acceptable 2.5 Acceptable

1 Limited Demonstration 3 Above Average

2 Below Average 4 Superior

I. Attendance: Consider number of tardy days, absences, etc.

_____ Satisfactory _____ Unsatisfactory

II. Motivation: Desire to achieve, strive to excel.

_____ Satisfactory _____ Unsatisfactory

III. Clinical Competency: Obtaining desired levels as stated in course objectives.

_____ Satisfactory _____ Unsatisfactory

IV. Appearance: Follows dress code as outlined in policy.

_____ Satisfactory _____ Unsatisfactory

V. Patient Care: Exhibits proper patient care practices and relationships.

_____ Satisfactory _____ Unsatisfactory

VI. Professionalism: Exhibits professional relationships and conduct in all situations.

_____ Satisfactory _____ Unsatisfactory

Identify areas of achievement: ___________________________________________________ _____________________________________________________________________________

Identify areas in which improvement could occur: ____________________________________

_____________________________________________________________________________

Additional Comments: __________________________________________________________

_____________________________________________________________________________

Clinical Instructor: _____________________________ Date: _________________

Clinical Coordinator: ___________________________ Date: _________________

Student: ____________________________________ Date: _________________

EAST TENNESSEE STATE UNIVERSITY

RADIOGRAPHY PROGRAM

PERMANENT RECORD OF CLINICAL PERFORMANCE

CLASS of 2003 - 2005

STUDENT’S NAME: __________________________________ GRADUATION DATE: 2005

Fall Semester: Clinical Education I: GRADE

Practical Rotational Objectives (10%)…………………………______

Performance Evaluations (15%)………………………………...______

Clinical Written Objectives (10%)……………………………...______

Attendance/Ethics/Dress Code (15%)…………………………..______

Competency Performance Evaluations (20%)…………………..______

Mid-term and Final Clinical Exam (Written) (15%)……………______

Comprehensive Evaluations (15%)……………………………..______

Final Grade……………………………………………………...______

Spring Semester: Clinical Education II:

Practical Rotational Objectives (10%)………………………….______

Performance Evaluations (15%)………………………………...______

Clinical Written Objectives (10%)……………………………...______

Attendance/Ethics/Dress Code (15%)…………………………..______

Competency Performance Evaluations (20%)…………………..______

Mid-term and Final Clinical Exam (Written) (15%)……………______

Comprehensive Evaluations (15%)……………………………..______

Final Grade……………………………………………………...______

Summer Semester: Clinical Education III:

Practical Rotational Objectives (10%)………………………….______

Performance Evaluations (15%)………………………………...______

Clinical Written Objectives (10%)……………………………...______

Attendance/Ethics/Dress Code (15%)…………………………..______

Competency Performance Evaluations (20%)…………………..______

Mid-term and Final Clinical Exam (Written) (15%)……………______

Comprehensive Evaluations (15%)……………………………..______

Final Grade……………………………………………………...______

Fall Semester: Clinical Education IV:

Practical Rotational Objectives (10%)………………………….______

Performance Evaluations (15%)………………………………...______

Clinical Written Objectives (10%)……………………………...______

Attendance/Ethics/Dress Code (15%)…………………………..______

Competency Performance Evaluations (20%)…………………..______

Mid-term and Final Clinical Exam (Written) (15%)……………______

Comprehensive Evaluations (15%)……………………………..______

Final Grade……………………………………………………...______

Spring Semester: Clinical Education V:

Rotational Objectives (15%)…………………………………...______

Performance Evaluations (15%)……………………………….______

Clinical Written Objectives (10%)……………………………...______

Attendance/Ethics/Dress Code (10%)………………………….______

Graduate Performance Competencies (20%)…………………..______

Final Clinical Exam (Written) (15%)………………………..…______

Comprehensive Evaluations (15%)…………………………….______

Final Grade……………………………………………………..______

Revised: 7/1/03, 8/27/01, 2/19/01

EXAMINATION	ID	DATE	VERIFIED
Chest
Abdomen (KUB)
Finger
Hand
Wrist
Forearm
Elbow
Shoulder
Foot
Ankle
Lower Leg
Knee

EAST TENNESSEE STATE UNIVERSITY

RADIOGRAPHY PROGRAM

CLINICAL COMPETENCY MANUAL

CLASS OF 2003 – 2005

All Contents Revised: 7/03

Explanation of Categories………………………………………………………………25

ASRT CLINICAL OBJECTIVES

EAST TENNESSEE STATE UNIVERSITY

RADIOGRAPHY PROGRAM

SPECIFIC clinical OBJECTIVES

EAST TENNESSEE STATE UNIVERSITY

RADIOGRAPHY PROGRAM

guidelines for positioning

PROGRAM FACULTY DESCRIPTIONS

The Role of the Program Director

I. FIDELITY

II. ETHICS/MORALS

III. CONFIDENTIALITY OF PATIENT RECORDS AND INFORMATION

IV. IMPAIRED FUNCTIONING

V. STUDENT RESPONSIBILITIES

VI. FACULTY EXPECTATIONS

VII. INJURIES/ILLNESS

VIII. PENALTIES

IX. CLINICAL DRESS CODE (AT THE CLINICAL AGENCY)

X. STUDENT SUPERVISION

XI. REPEAT RADIOGRAPH POLICY

XII. UNIVERSITY SPONSORED ACTIVITIES

XIII. ABSENCES DUE TO EMERGENCY, SPECIAL CIRCUMSTANCES, OR

ILLNESS

XIV. APPEAL OF THE FACULTY MEMBER ' S DECISION REGARDING EXCUSED/UNEXCUSED ABSENCES

XV. PROFESSIONAL ACTIVITIES & DAY

XVI. GENERAL ATTENDANCE POLICY

XVII. CLINICAL ATTENDANCE POLICY

XVIII. CLINICAL TARDINESS POLICY

XIX. CLINICAL ASSIGNMENTS

XX. CLINICAL EDUCATION TRANSFERS

XXI. CLINICAL EDUCATION - MEALS/BREAKS

XXII. MALPRACTICE INSURANCE

XXIII. COMPENSATORY TIME - CLINICAL EDUCATION

XXV. LEAD IDENTIFICAITON MARKERS

XXVI. CLINICAL COMPETENCY GRADING SYSTEM

XXVII. EXPLANATION OF CATEGORIES

XXVIII. RADIOGRAPHY PROGRAM - CLINICAL GRADING SCALE

EAST TENNESSEE STATE UNIVERSITY

RADIOGRAPHY PROGRAM

CLINICAL/DIDACTIC COURSE CORRELATIONS AND ROTATIONS

EXPLANATION OF CATEGORIES:

EXPLANATION OF CATEGORIES:

EXPLANATION OF CATEGORIES:

EXPLANATION OF CATEGORIES:

EXPLANATION OF CATEGORIES:

A minimum of 3 Elective Competencies must be completed this semester.

A minimum of 3 Elective Competencies must be completed this semester.

A minimum of 8 Elective Competencies must be completed this semester. A minimum of 14 elective comps must be completed this semester.