Radiologic Technology Program

Master Plan of

Clinical Education Class of 2013-2015

Waccamaw Community Hospital

South Strand Ambulatory Care Center

Parkway Medical Complex

Table of Contents Master Plan summary page 1 Rules and Guidelines page 2 Attendance Policies page 2 Clinical Times page 3 Clinical Attendance Policy page 3 Reporting Absences and Tardies page 3 Clinical Training Make-up Policy page 4 Disciplinary Procedures and Suspension page 5 Methods of Clinical Evaluation page 6 Clinical Grading Scale page 7 Semester Clinical Requirements page 8- 9 Clinical Evaluation Outcomes page 10 New Site Orientation Checklist page 11 Room/Equipment Competency page 12 Competency Forms

General Radiography page 13 Contrast Competency page 14 Pediatric Competency page 15 Mobile Competency page 16 Special Procedure checklist page 17 Surgical Checklist- C-Arm- Ortho page 18 Surgical Checklist- C-Arm- Non-Ortho page 19 Arthrogram/Myelogram Checklist page 20 Special Procedure Competency page 21 Sterile Tray/Technique page 22 CT Competency page 23

Terminal Competency Explanation page 24 Terminal Competency Evaluation page 25 Professional Development with Outcomes page 26 1st through 6th semester PD form page 27 Professional Development Progress Sheets page 28-29 Venipuncture Policy page 30 Venipuncture Competency page 31 Clinical Progression Policy page 32 ARRT Required Competencies page 33 ARRT- Radiography Didactic and Clinical Competency Requirements Appendix A ARRT Content Specifications for the Examination in Radiography Appendix B

HGTC Drug Screen and Student Background Check Policy Appendix B

HORRY-GEORGETOWN RADIOLOGIC TECHNOLOGY PROGRAM

MASTER PLAN OF CLINICAL EDUCATION

Clinical education takes place in various health care settings. It begins with observation of procedures and gradually the student learns to assist in procedures. After completing didactic and laboratory sessions, the student performs radiographic examinations unassisted, with the direct supervision of a qualified radiographer. After a determined number of exams have been completed, the student may request a clinical competency evaluation. Upon successful completion of the competency, the student may perform the exam with indirect supervision. At no time can a student perform portable exams outside of the department, or Operating room procedures without direct supervision: RT must be immediately available. Throughout the 6 semesters, students gradually become competent in more complicated procedures, until all competency categories are completed. At the end of Spring Semester II, the student will perform terminal competencies before he /she qualifies for graduation. Before taking a competency evaluation in any given area, a student must be directly supervised at all times by a qualified radiographer. Direct supervision is defined by the Standards of an Accredited Program in Radiologic Sciences, as follows: Until the student achieves and documents competency in any given procedure, all clinical assignments shall be carried out under the direct supervision of qualified radiographers. The parameters of direct supervision are:

1. A qualified radiographer reviews the request for examination in relation to the students achievement 2. A qualified radiographer evaluates the condition of the patient in relation to the students’ knowledge 3. A qualified radiographer is present during the performance of the examination 4. A qualified radiographer reviews and approves the radiographs

After demonstrating competency, students may perform procedures with indirect supervision. “Indirect supervision is defined as that supervision provided by a qualified radiographer immediately available to assist students regardless of the level of student achievement. Immediately available is interpreted as the presence of a qualified radiographer adjacent to the room or location where radiographic procedures are being performed. This means that a qualified radiographer is within hearing distance, with no electronic means of contact, such as beepers or phones acceptable.” This applies to all areas where ionizing radiation equipment is in use. To ensure continued competence, students may AND WILL be re-comped at any time during their clinical education. In order to receive and maintain accreditation status, these standards must be adhered to at all times.

1. RULES AND GUIDELINES FOR CLINICAL EDUCATION

Radiography students are under the direct supervision of the clinical instructor for all educational functions within the clinical affiliate. Students will also receive instruction and directions from the radiographer to

whom they are assigned. In turn, the radiographer provides input to the clinical instructor regarding the student’s progress. Students are not to perform procedures on patients without proper instruction and supervision as described in the Joint Review Committee Standards of an Accredited Program in radiography. Students are to participate in a team effort with staff to perform department activities as needed; such as maintaining department cleanliness, replenishing supplies, and transporting patients as appropriate. Students are to participate in planned learning activities as assigned by the Clinical Instructor.

ATTENDANCE POLICIES

The daily times of attendance will vary somewhat depending on the clinical assignment. Total hours of class time and clinical education will not exceed 40 hours per week. Absence and/or tardiness will have a detrimental effect on attainment of clinical and professional goals and will reflect in the student’s performance. Tardiness is unprofessional and will be documented on your professional development sheets. After 3 tardies, the student will receive a verbal warning and be charged with 1 day absent. Tardy is any time after the scheduled start time. Additional tardies will be counted and each 3 will count as one day absent. 7 tardies in any one semester will result in termination from program. Two (2) days per semester are allotted for sickness. * Absences must be reported to the CI and CC 30 minutes before the clinical assignment is set to begin.

Failure to report to the CI and the CC 30 minutes prior to start time will result in a mandatory

make-up day regardless of amount of previous days absent. No Exceptions!

If the site clinical instructor is not available at time of call, the student must call back and speak with the CI. Any illness of more than 2 days may require a written explanation from a physician. Absences past the allowed 2 must be made up. The make-up time must be approved by the clinical instructor and the clinical coordinator. Excessive tardiness and any unexcused absences shall be cause for disciplinary action. Falsifying attendance is grounds for immediate dismissal. Deficiency of assignments due to absence will be rescheduled by the CI and/or the CC. Available time is limited to semester breaks and final exam week. Make up time must be completed by the end of the semester. In the event that a student receive the grade of Incomplete, they have a time limit of 2 weeks to make-up any missed work/time. In the 4-th- 6th semester, all students are required to rotate through one weekend shift (includes a Saturday and a Sunday), as well as a week of evening rotation; Monday ,Wednesday and Friday- 1:30-9 pm.

2. Clinical Times

In semester 1 the student will attend clinic on Tuesday and Thursday, hours 8:30-am-3:30 pm. These hours are mandatory and are not subject to change for any reason. Semester 2-3 hours: Tuesday and Thursday-8am-3:30 pm. In semester 4- 6 the student will attend clinic Monday, Wednesday and Friday from 8am- 3:30. In addition, during the 4th-6th semester students must rotate through a weekend shift to include Saturday and Sunday, hours to be discussed. The following week the student will be off Monday and Wednesday. Students must also rotate through a week of evening shift in the 4th through 6th semester. The hours will be M, W and F – 1:30-9 pm.

Clinical Attendance Policy Each semester the number of allowed days off will be determined and discussed in the corresponding syllabus. This number will be determined based on 90% attendance. Depending on total number of days for each semester; verbal, written and final warning will be documented. Any absence after a final warning will result in termination from the Radiography program. Any absences in excess of 2 during any semester must be made up during the semester the absences occurred.

No Exceptions!!! 3 tardies to class or clinic assignments will be equal to one absence and will be counted with total days absent.

Reporting Absences or Tardiness

If it is necessary for you to be absent on a clinic day, you MUST call:

1. The clinical instructor at your assigned site – if not available at time of call, leave a message and call later and speak directly with the Clinical Instructor

AND

2. The clinical coordinator- office- 477-2180 cell- 655-6049

Leave a voice message or a text message!! You must call 30 minutes prior to scheduled start time. Failure to call these 2 persons at the correct time WILL result in a mandatory make-up day regardless of total days missed. 2 no-calls will result in a final warning.

NO EXCEPTIONS!!!!

At any time while a student in the radiology program a second final warning letter is grounds for immediate dismissal!

3. Clinical Training Make-up Policy

This policy serves to identify the procedure and criteria for making up days in excess of the 2 allotted for illness during the academic semester. Early departure from the assigned clinic area for any reason other than illness prior to the completion of the assigned clinic hours will be unacceptable and will result in a warning letter being placed in the students file. (Two warning letters may result in dismissal) Sick leave days which exceed the allotted 2 days must be accounted for by the student in order to complete their clinical education and receive the recommendation of the program director to sit for the American Registry of Radiologic Technologists Certification Exam. Missing clinic means you will not be able to accomplish your clinical objectives. Any time taken which exceeds the allowed 2 days must be made-up before final grade is given. The following criteria will serve as guidelines for the student to reestablish their good standing in the clinical phase of their educational process.

1. All make-up time must be pre-approved by the site Clinical Instructor and Clinical Coordinator. 2. If the student misses the assigned make-up time they will be assigned an additional make-up day. 3. Make-up time will be made up within the same semester of the missed day. 4. Make-up time is limited to vacation time and Final exam week. 5. The missed time is to be made-up in one block. Ex.- If a seven hour day is missed, the time must be

made-up in a 7 hour block. 6. The student must comply with the programs dress code on days the time is being made up. 7. During the 4th through 6th semester, if an evening or weekend rotation is missed, the student must

make up an evening or weekend, regardless of total days absent. These guidelines will be utilized by the Radiologic Technology program to provide the student with a mechanism to complete their clinical education when students’ attendance has been affected by adverse circumstances.

4. CORRECTIVE DISCIPLINARY PROCEDURES

The following progressive guidelines are followed for corrective disciplinary procedures: Level One The first step in corrective discipline is a verbal warning. The reason for the warning and the result if the behavior is repeated will be communicated to you. These warnings are routinely documented. Level Two A written or second Level warning is the next step in the corrective discipline procedure. The reason for the warning and the result if the behavior is repeated will be documented for your personal file. The program director and/or clinical coordinator will be notified of this event. Level Three A final, written warning involving the same offense or a variety of offenses will be documented. The program director and/or clinical coordinator will be immediately notified of this event for evaluation and recommendation of further action. A level three warning will constitute grounds for immediate dismissal from the clinical affiliate and/or dismissal from the program.

At any time while a student in the radiology program, 2 final warning letters is grounds for immediate dismissal.

DISCIPLINARY SUSPENSION

Some offenses are serious enough to be cause for immediate dismissal from the program. Unprofessional, unethical or amoral conduct includes but is not limited to:

1. Breaching patient confidentiality, revealing personally identifiable facts obtained as a result of a student patient relationship or access to patient records, without prior consent of the patient.

2. Performing a task which the student knows or has reason to know that he/she is not competent to perform unsupervised.

3. Reporting to the clinical site under the influence or with the smell of alcohol or drugs; or carrying out student responsibility while the ability to perform is impaired by alcohol, drugs, or mental disability.

4. Impersonating another health care practitioner. 5. Independently delegating a task assigned to him/her by an instructor or supervisor to another

individual. 6. Willfully harassing, abusing, or intimidating another individual. 7. Refusal to follow instructions or to complete an assignment. 8. Dishonesty, including theft, plagiarism, cheating or falsification of records 9. Carelessness in handling drugs or drug records. 10. Conduct endangering the welfare of patients, employees or visitors. 11. Possession of dangerous weapons on hospital premises. 12. Fighting, assault and battery. 13. Solicitation, posting or distributing articles/literature of any nature on hospital premises without

approval.

5.

METHOD OF CLINICAL EVALUATION

Clinical Competency/Professional Development

The student begins his/her clinical participation by assisting the radiographer in the performance of radiographic procedures. The rate of student progress depends on the students’ ability to comprehend and perform the various tasks required by the program. As the student becomes experienced in a given procedure or procedures, he/she will perform the procedure unassisted and directly supervised by the radiographer. CLINICAL COMPETENCIES MAY ONLY BE PERFORMED AFTER THE DIDACTIC INSTRUCTION IS COMPLETE. STUDENTS WILL PERFORM PROCEDURES UNDER THE DIRECT SUPERVISION OF A RADIOGRAPHER UNTIL CERTIFIED AS COMPETENT IN THAT EXAM. ONCE COMPETENCY HAS BEEN VERIFIED, STUDENT MAY PERFORM THAT PROCEDURE INDIRECTLY SUPERVISED. Students may request competency examinations or the clinical instructor may direct students to perform a competency according to the following procedure:

1. a request for competency evaluation or check-off is initiated 2. clinical educator verifies all prerequisites have been met

The evaluator will complete the appropriate clinical competency evaluation form based on students’ performance of the exam. The grade is calculated and evaluated with the student after the exam. Students must receive a minimum grade of 84% to pass the competency. A student who receives less than 80% will have an opportunity to repeat the competency ONCE during that grading period. The repeat exam grade will be averaged in with the other competency exam for the final competency grade. Students who do not successfully complete the required competencies for each grading period will lose points toward final clinic grade.

6. The scale for conversion of Clinical Competency percentage is as follows:

100-96%- A 4 quality points 95-90%- B 3 quality points 89-84%- C 2 quality points 83-80%- D 1 quality point 79-0%- F 0 quality points The scale for conversion of Professional Development score is as follows: Grade A Grade B 4.0 - 100% 3.74 – 3.60 - 95% 3.99- 3.94 - 99% 3.59 – 3.50 - 94% 3.93- 3.88 - 98% 3.49 – 3.40 - 93% 3.87- 3.82 - 97% 3.39 - 3.30 - 92% 3.81- 3.75 - 96% 3.29 – 3.20 - 91% 2.91 – 3.0 - 90% Grade C 2.90 - 2.80 - 89% Grade D 2.79 - 2.70 - 88% 1.99 – 1.80 - 83% 2.69 – 2.60 - 87% 1.79 – 1.60 - 82% 2.59 – 2.40 - 86% 1.59 – 1.50 - 81% 2.39 – 2.30 - 85% 1.49 – 1.0 - 80% 2.29 – 2.0 - 84% Below a 1 or 79% is failing for clinical grades The scale for conversion of final quality point averages to the final letter grade is as follows: 3.75-4.0- A 3.0-3.7 B 2.0-2.9 C 1.0-1.9- D 0.0-.99- F *Any area of clinical grading is subject to change

7. Competency exams are divided by semester according to the level of difficulty, with only semester 1 having specific requirements. Students’ must complete the specified number of requirements per semester to receive a Final Grade (See Competency Requirements per Semester)

Summer semester I 1. Male CXR 5. 5 PD’s 2. Female CXR 6. 3 Room Competencies 3. KUB 7. Site Orientation Form 4. Upper Limb Exam

Fall semester I 1. 12 (minimum) CC’s 3. 5 PD’s 2. 3 Re-comps- CXR, KUB, Upper Limb

Spring semester I

1. 12 (minimum) CC’s 5. 5 PD’s 2. 4 Re-Comps- CXR, Knee, Elbow, Shoulder 3. 3 room Competencies 4. Site Orientation Form

Summer semester II

1. 15 (minimum) Competencies 2. 5 Re-Comps- 3. 5 PD

Fall semester II

1. 15 (minimum) Competencies 2. 1 CT checklist 3. 5 Re-comps 4. 5 PD 5. 3 room Competencies 6. Site Orientation Form

Spring semester II

1. 15 (minimum) Competencies/ 1 CT checklist/ Terminal Comp Exam 2. 5 PD 3. Re-Comps

* Head Work- may include: facial bones, skull, mandible series, orbits, zygomatic arches,

- all to include 3 view minimum series Cannot be: nasal bones, Panorex, 1 view sinuses There are a specific number of competencies that are assigned each semester. A Terminal Competency examination will be required in the 6th semester. Its intent is to evaluate the students’ ability to integrate previously learned clinical skills. Students must receive a C or better to pass. A student who receives a D or F must repeat and earn a C to pass the course. Beginning in semester II, re-comps will be due each semester. The “re-comp” exam will be specifically assigned by the CC or can be requested at any time by the clinical instructor at students’ assigned site. The “re-comp” grade will be part of the semester final grade.

8.

Summer I

Fall I- 12 Spring I-12 Summer II-15 Fall II-15 Spring II-15

The above chart in semester 2-6 are suggestions only. Semester 1 has specific requirements. Semester 2-6 require specific numbers rather than exams. Students may progress more rapidly in the CC areas as their ability allows, but MUST complete the minimum requirements to advance to the next semester. All 39 exams must be completed prior to Program Directors signature for National credentialing examination. 20 of the 30 electives must also be completed prior to graduation and CANNOT be simulated. Initial CC’s should be 1st year student appropriate. 2nd and 3rd CC must be at a higher level of difficulty. Meeting the HGTC program requirements satisfies the ARRT requirements and program requirements. Sem 1- Thorax, Abdomen and Upper Limb covered in class. Sem 2- Lower Limb, Pelvis/Hip, shoulder, Spine covered in class Sem 3- Bony Thorax, Fluoro Studies, IVU, all Head and facial bone studies covered in class.

9

Clinical Evaluation Outcomes Failure to demonstrate starred items results in a score of 79% Preparation

1. Identify the procedure

Required CC’s Male- Routine CXR • female- Routine CXR • KUB Upper Extremity

Suggested CC’s • finger • thumb • hand • wrist • forearm • elbow • humerus • shoulder • shoulder- trauma • clavicle • toes • foot • ankle • leg • knee • femur • pelvis • hip • C-Spine • T-Spine • L-Spine Abd. Series

Suggested CC’s • IVU or UGI -not previously comped on Hip AP and frog OR AP and XTL Mobile chest Cervical spine Lumbar spine Shoulder W/ axillary view OR Y-view (trauma)

Suggested CC’s • Thoracic Spine • Ribs • Sinuses • Hip - not previously comped on • Shoulder -not previously comped on

Suggested CC’s • Barium Enema ●Ped. Competency ●Surgical Checklist ●Special Procedures checklist ●Pediatric Chest ● Headwork

Suggested CC’s ● CT checklist ● CT Worksheet ● Trauma- adult lower Ext.-must include XTL Terminal Competency

2. Call and pronounce the patients name 3. Recall the patients age and sex 4. Identify the mode of transportation 5. Determine the positions and precautions required 6. Provide an adequate number of appropriate sized cassettes 7. Position the tube, table and film correctly 8. Set technical factors on control panel 9. Select and prepare contrast material, if required 10. Provide clean and orderly work area

Patient Care Methods 1. Verify correct identification of the patient

2. Assess patient condition 3. Assist patient to and from room and x-ray table 4. Explain exam to patient- age appropriate 5. Verify patient preparation, when appropriate 6. Record LMP and/or check for possible pregnancy in females age 10-50

7. Check for and remove undiagnostic material from area of interest 8. Document clinical and allergic history

9. Complete consent form if required 10. Assist patient throughout exam while maintaining patient modesty 11. Follow standard precautions 12. Monitor and communicate with patient throughout exam

13. Demonstrate consideration for patient comfort 14. Explain post exam instructions as needed

* 15. Utilize radiation protection for all persons involved Positioning and Technical Skills

1. Accurately position anatomic area 2. Direct central ray appropriately 3. Utilize proper SID 4. Align tube, part and film 5. Give proper breathing instructions

* 6. Accurately place correct lead identification marker on film 7. Properly collimates 8. Make exposure while observing patient

* 9. Select appropriate technique Image Evaluation

1. No motion present 2. Contrast and density adequate to demonstrate part 3. Lead marker visible and properly placed 4. Projections identified correctly

* 5. Evaluation criteria a. Pertinent anatomical information included in proper perspective b. Evidence of collimation c. Answer questions relevant to exam

10. Student Site Orientation

Student-___________________________ Site-_______________________ Student initial CI signature Date

Grading Explanation

Required paperwork

Department Tour

Rad. Rooms -equipment -control panel -supply area

Dressing area

Reading rooms

Main supply area

File room

Pt. hold areas

Drug cart/s

O2 locations

Emer. Shut-offs

Other Departments Tour: ER, OR, ICU, Admissions, Outpatient Lab, CT, MRI

Dept. protocol Handouts

Student parking instructions

Codes Organization “Nickname”

Action Ex-How to call

Cardiac and-or Respiratory Arrest Fire Severe Storm Bomb Threat Baby/Child Abduction Trauma What does R.A.C.E stand for?______________________________________________________________ Name of disinfectant used to clean x-ray equipment-____________________________________________ What does HIPAA stand for?__________________________________________

11.

HGTC Radiologic Technology Program Equipment Competency Form

Student-______________________________ Date-_____________________ Clinical Site-__________________________ Evaluator-_________________ The student was able to demonstrate mastery of the following area-specific skills: (to be done for each radiographic room) Competency Area YES NO

CONTROL PANEL / CONSOLE 1. The student was able to locate and identify the kVp selector 2. Given a specific kVp, the student was able to correctly set the indicated value 3. The student was able to locate and identify the mAs selector. 4. Given a specific mAs , the student was able to accurately set the indicated value. 5. The student was able to locate and identify the phototimer. 6. Given a specific chamber to select, the student was able to accurately manipulate the phototimer to select the indicated cell(s).

7. The student was able to correctly identify the rotor and exposure switch. 8. The student was able to rotor and make an exposure. 9. The student was able to locate and identify the overload reset.

TABLE YES NO 1. The student was able to identify the control for moving the table top. 2. The student was able to correctly move the table from left-to-right. 3. The student was able to correctly move the table top from inferior to superior. 4. The student was able to identify the control for table angle. 5. Given a specific degree of angle, the student was able to accurately angle the table to that given angle.

6. The student was able to remove the foot rest. 7. The student was able to replace the footrest, ensuring it was locked in place.

BUCKY TRAY YES NO 1. The student was able to open the table bucky tray. 2. The student was able to open the upright bucky tray 3. Given a cassette of any size, the student was able to insert and lock it into bucky. 4. The student was able to close the bucky tray completely. 5. The student was able to remove the cassette from the bucky tray.

COLLIMATOR YES NO 1. Identify collimator controls 2. Manipulate collimator to varying cassette and/or IR sizes

DETENT YES NO 1. Center the tube to the upright bucky – detent. 40 inches 2. Center the tube to the upright bucky- detent – 72 inches 3. Center the tube to the table bucky – detent- 40 inches. 4. The student was able to determine 40 inches from tube to table-top. Evaluator - _______________________________ Comments- remarks should be written for any NO check-marks. Any no check-marks will result in a “re-comp” for that area/room. Student signature-__________________________

12.

HGTC Radiological Technology Program Clinical Competency Evaluation – GENERAL RADIOGRAPHY

Student-__________________________ Date-_____________Final Grade-___________ Examination-______________________ Clinical Site-____________________________ Patient Name-_____________________ ID Number-____________________________

PREPARATION YES NO 1. Select appropriate cassettes 2. Prepare room and obtain necessary supplies- set up console 3. Provide clean and orderly work area * 4. Evaluate the request (orders) for exam and patient information PATIENT CARE METHODS * 5. Verify correct patient I.D 6. Assess patient condition 7. Assist patient to and from exam room 8. Explain exam to patient-age appropriate * 9. Check for possible pregnancy in females age 10-60 *10. Inquire and Document relevant clinical history 11. Check for and remove any non-diagnostic material from area of interest 12. Assist patient through exam while maintaining modesty. 13. Follow Standard Precautions 14. Monitor and communicate with patient throughout exam 15. Demonstrate consideration for patient comfort *16. Utilizes radiation protection for all involved persons

AP/PA LAT OBL OBL Other POSITIONING SKILLS YES NO YES NO YES NO YES NO YES NO 17. Correctly position anatomic area 18. Direct CR appropriately 19. Utilize proper SID 20. Align tube, part and film 21. Gives proper breathing instructions *22.Correctly place lead marker on film 23. Properly collimates 24. Select appropriate technique * Mandatory- Kvp-___ MAS-_______

25. Make exposure while observing patient 26. Complete position with 2.5 minutes

AP/PA LAT OBL OBL Other IMAGE EVALUATION YES N0 YES NO YES NO YES NO YES NO 27. Image free of visible motion * 28. Identify views correctly * 29. All anatomy included * 30.Know Eval Crit. and related anatomy 31. Properly annotates and orients image 32. Proper exposure factors used 33. Patient ID clearly visible

**Failure to demonstrate starred items result in automatic score of 79%. Must be re-comped and both scores averaged for final grade. Average ** (((Techniques are required for all exams-even with DR and CR equipment. )))

13.

Evaluator-________________________________________________ Student Signature-_________________________________________ Comments-_____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ Grading Scale- Total Possible Points: 100%-96% = A 1 projection - 33 points 95-90% = B 2 projections- 50 points 84-89% = C 3 projections- 67 points 83-80% = D 4 projections- 84 points 79-0% = F 5 projections- 101 points * This form is not be acceptable unless all sections are completed, including titles, signatures and comments. Rev 3-07ms

13 HORRY-GEORGETOWN TECHNICAL COLLEGE

CLINICAL COMPETENCY EVALUATION: CONTRAST RADIOGRAPHY Student-____________________________ Date-__________________Grade-___________

Examination-_______________________Pt.Name-_________________________________ Site-_____________________________ ID #-______________________________ PREPARATION YES NO 1. Select appropriate cassettes (if applicable) 2. Technical factors set for fluoro.- control panel- KVP-_____MAS-_____ 3. Spot film/digital imaging ready for exposure 4. Prepare room and obtain necessary equipment *5. Contrast Media ready for administration 6. Locate emergency supplies *7. Evaluate the request/orders for procedure and documents history PATIENT CARE METHODS YES NO 8. Verify correct ID of patient 9. Assess patient condition 10. Assist pt. to and from room 11. Explain exam and risks to patient-age appropriate 12. Check for possible pregnancy in females age- 10-60 13. Document clinical and allergy history 14. Complete consent form as required 15. Check for and remove any non-diagnostic material from area. 16. Assist pt. throughout exam while maintaining modesty 17. Follow standard precautions 18. Monitor and communicate with pt. throughout exam 19. Demonstrate consideration for pt. comfort 20. Utilize proper radiation protection for all involved 21. Explain post-exam instructions to patient AP/PA Lat. Obl. Obl. Other

POSITIONING SKILLS YES NO YES NO YES NO YES NO YES NO22. Correctly position anatomical area 23. Direct central ray correctly 24. Use proper alignment, SID and collimation 25. Gives proper breathing instructions * 26. Correctly place lead markers on film 27. Selects appropriate techniques 28. Makes exposure while observing patient 29. Completes position within 2 ½ minutes

AP/PA Lat Obl Obl Other IMAGE EVALUATION YES NO YES NO YES NO YES NO YES NO30. Image free of visible motion * 31. Identify views correctly * 32. Identify eval. criteria and related anatomy * 33. All anatomy included 34. Technique adequate to demonstrate part 35. Patient ID clearly visible 36. Lead marker visible

*Failure to perform the starred items results in immediate 79%

14.

Evaluator- _______________________________________________ Student Signature-_________________________________________

Comments- Total Possible Points 1 projection – 36 points 100%-96%- A 2 projections- 50 points 95%-90%- B 3 projections- 64 points 84%-89%- C 4 projections- 78 points 83%-80%- D 5 projections- 92 points 79%-0- F

This form will not be accepted unless all sections are completed, including titles, signatures and comments.

Must include techniques used

Rev 3/09 ms

14. HORRY-GEORGETOWN TECHNICAL COLLEGE

CLINICAL COMPETENCY EVALUATION- PEDIATRIC RADIOGRAPHY Student-________________________ Date-__________________ Grade-_____________ Exam-_________________________ Pediatric- up to 3 years old Site-___________________

Pt. DOB-_______________________ Pt. ID-_______________ Pt. Age-_______________ PREPARATION YES NO 1. Select appropriately sized cassettes 2. Prepare physical facilities and obtain necessary equipment 3. Provide clean and orderly work area *4. Evaluate request/orders for procedure and patient information PATIENT CARE METHODS YES NO 5. Verify ID of child with guardian 6. Call child by name and establish rapport 7. Assess the childs physical condition and developmental age 8. Assist child to and from radiographic room 9. Explain exam to child- age appropriate 10. Provide explanation to childs guardian 11. Document clinical history 12. Check for and remove non-diagnostic material 13. Assist child through exam while maintaining modesty 14. Follow standard precautions 15. Monitor and communicate with child and guardian throughout exam 16. Demonstrate empathy for childs comfort *17. Set correct technique MAS-_________ KvP-_________ 18. Utilize shielding for all involved 19. Ensure child safety by providing adult supervision at all times 20. Return child to guardian

POSITIONING SKILLS YES NO YES NO YES NO YES NO YES NO21. Position area correctly 22. Direct CR correctly 23. Utilize proper SID 24. Align tube, part and film 25. Give proper breathing instructions *26. Correctly place lead markers 27. Properly collimate 28. Make exposure while observing child

IMAGE EVALUATION YES NO YES NO YES NO YES NO YES NO 29. Image free of motion *30.All anatomy included 31. Lead marker visible *32. Identify views correctly *33. Identify EC -from Merrills *34. Technique adequate to demo. part 35. Patient ID clearly visible Failure to demonstrate starred items results in automatic 79% Evaluator-_________________________________________________

15. Student Signature-___________________________________________ Comments-

Total Possible Points 1 projection- 34 points 100-96%- A 2 projections- 48 points 95%-90%- B 3 projections-62 points 84%-89%- C 4 projections- 76 points 83%-80%- D 5 projections – 90 points 79-0= F *This form will not be accepted unless all sections are completed, including titles, signatures and comments. Rev. 07-10 ms

15.

Horry-Georgetown Technical College Radiography Program

Mobile Radiography Competency

Name-__________________________Site-___________ Date-_____________Grade-________ Exam-________________________Pt Name-______________________ID#-_________________ PREPARATION YES NO *1. Identifies correct patient and exam according to requisition. 2. Locates and drives the mobile unit to the patients room 3. Politely asks visitors to wait outside the room. 4. Introduces self to patient and explains the procedure. *5. Correctly ID’s the patient. 6. Obtains and documents the history prior to exam. *7. Inquires about possible pregnancy in females. Age- 10-60 8. Removes all radiopaque foreign bodies. 9. Respects patient modesty and provides comfort to the patient. 10. Examines patient and selects appropriate cassette. 11. Adjusts the patient into the correct position for the procedure. 12. Able to manipulate the machine with ease. 13. Positions the machine correctly at patient bedside. 14. Instills confidence in pt by exhibiting self-confidence throughout exam. *15. Provides radiation protection for self and all involved. 16 . Leaves room and patient neat and comfortable. POSITIONING YES NO 1. Places the cassette properly. 2. Centers the tube to the cassette correctly. 3. Adjusts the tube to the proper SID. *4. Correctly places lead marker on cassette to not obstruct anatomy. 5. Lead marker correctly shows on image. 6. Correctly collimates at minimum to the cassette size. 7. Stands at least 6 feet away during exposure. 8. Gives proper breathing instructions. *9. Sets the proper exposure factors. kVp-______ MAS-_______ 10. Completes the exam within a reasonable time frame. 11. Returns the mobile unit to the proper place and charges the unit. 12. Correctly identifies (flashes) image.

16. IMAGE EVALUATION YES N0 1. Image free of visible motion * 2. Identify views correctly * 3. All anatomy included

* 4.Know Eval Crit. and related anatomy 5. Properly annotates and orients image 6. Proper exposure factors used 7. Patient ID clearly visible Total Possible Points: 35 100%-96% = A 95-90% = B 84-89% = C 83-80% = D 79-0% = F Technologist signature-_________________________________ Comments Student signature-______________________________________

16.

Special Procedure CHECKLIST

Student__________________________ Date-________________ Clinical Site-______________________ Exam-________________ GENERAL YES NO Evaluation of request Set up of room. Gather appropriate cassettes. Place/remove headboard, shoulder/knee brace as needed. Gather appropriate supplies as needed. ** Set a tray using sterile technique. Prepare Contrast Media for administration. Name of contrast__________ Identify patient and place on table. Explain procedure. Check chart for consent form. Assist MD with needle puncture maintaining sterile technique. Change films and assist patient with positioning. Inform patient of post-procedure instructions. Fill out necessary paperwork as per procedure protocol. Follow Standard precautions. Faculty Signature-_____________________________ Student Signature-_____________________________ Pass-_____________ Fail-__________________ Comments-

17.

CHECKLIST FOR SURGERY / C-Arm- Orthopedic

Student-____________________ Date-____________ Clinical Site-________________ Evaluator-____________ Procedure performed-________________________ GENERAL YES NO Wear appropriate apparel for O.R (shoe cover, mask, scrubs, head cover) * Provide radiation protection for all involved in procedure. Verify pregnancy status in females. Locate sterile field in OR and demonstrate proper sterile techniques. Demonstrates proper loading of film in designated darkroom. Complete request with appropriate information (fluoro.time, films, etc.) Disinfect mobile unit regarding fluids post OR procedure. Demonstrate operation of C-Arm. Turn fluoro on/off. Properly set control panel for fluoro. Properly set control panel for spot films. Correctly connect TV monitor and Mobile C-Arm. Accurately load patient information into TV monitor. Store and retrieve image from disk drive. Produce permanent film from stored image. Place C-Arm tube in vertical position. Place C-Arm tube in horizontal position Skillful operation of all locks. Application of C-Arm drapes. MUST: State size of film (if applicable) and average technique for common OR exams on average patient: ___________________________________________________________________________ Briefly describe procedure performed- Lateral C-Spine-_________________________________________ Lateral L-Spine-_________________________________________ Hip-___________________________________________________ Wrist-__________________________________________________ Knee-__________________________________________________ Technologist Signature-______________________________ Student Signature-__________________________________ Pass (100%)-__________ Fail (79%)-_______________________ Comments-

2-12ms

18.

CHECKLIST FOR SURGERY / C-Arm- Non-Orthopedic

Student-____________________ Date-____________ Clinical Site-________________ Evaluator-____________

Procedure performed-________________________ GENERAL YES NO Wear appropriate apparel for O.R (shoe cover, mask, scrubs, head cover) * Provide radiation protection for all involved in procedure. Verify pregnancy status in females. Locate sterile field in OR and demonstrate proper sterile techniques. Demonstrates proper loading of film in designated darkroom. Complete request with appropriate information (fluoro.time, films, etc.) Disinfect mobile unit regarding fluids post OR procedure. Demonstrate operation of C-Arm. Turn fluoro on/off. Properly set control panel for fluoro. Properly set control panel for spot films. Correctly connect TV monitor and Mobile C-Arm. Accurately load patient information into TV monitor. Store and retrieve image from disk drive. Produce permanent film from stored image. Place C-Arm tube in vertical position. Place C-Arm tube in horizontal position Skillful operation of all locks. Application of C-Arm drapes. MUST: State size of film (if applicable) and average technique for common OR exams on average patient: ___________________________________________________________________________ Briefly describe procedure performed- Technologist Signature-______________________________ Student Signature-__________________________________ Pass (100%)-__________ Fail (79%)-_______________________ Comments- 02-12ms

19.

HORRY-GEORGETOWN TECHNICAL COLLEGE CLINICAL COMP EVALUATION:

Myelogram/Arthrogram

Student-____________________________ Date-__________________Grade-___________ Examination-_______________________Pt.Name-_________________________________ Site-_____________________________ ID #-______________________________ PREPARATION YES NO 1. Select appropriate cassettes (if applicable) *2. Technical factors set for fluoro.- control panel- KVP-_____MAS-_____ 3. Spot film/digital imaging ready for exposure 4. Prepare room and obtain necessary equipment *5. Contrast Media ready for administration 6. Locate emergency supplies *7. Evaluate the request for procedure and documents history PATIENT CARE METHODS YES NO 8. Verify correct ID of patient 9. Assess patient condition 10. Assist pt. to and from room 11. Explain exam and risks to patient-age appropriate 12. Check for possible pregnancy in females age- 10-60 13. Document clinical and allergy history 14. Complete consent form as required 15. Check for and remove any non-diagnostic material from area. 16. Assist pt. throughout exam while maintaining modesty 17. Follow standard precautions 18. Monitor and communicate with pt. throughout exam 19. Demonstrate consideration for pt. comfort 20. Utilize proper radiation protection for all involved 21. Explain post-exam instructions to patient AP/PA Lat. Obl. Obl. Other

POSITIONING SKILLS YES NO YES NO YES NO YES NO YES NO22. Correctly position anatomical area 23. Direct central ray correctly 24. Use proper alignment, SID and collimation 25. Gives proper breathing instructions * 26. Correctly place lead markers on film 27. Selects appropriate techniques 28. Makes exposure while observing patient 29. Completes position within 2 ½ minutes

AP/PA Lat Obl Obl Other IMAGE EVALUATION YES NO YES NO YES NO YES NO YES NO30. Image free of visible motion * 31. Identify views correctly * 32. Identify eval. criteria and related anatomy * 33. All anatomy included 34. Technique adequate to demonstrate part 35. Patient ID clearly visible 36. Lead marker visible

*Failure to perform the starred items results in immediate 79%

20. Evaluator- _______________________________________________

Student Signature-_________________________________________ Comments- Total Possible Points 1 projection – 36 points 100%-96%- A 2 projections- 50 points 95%-90%- B 3 projections- 64 points 84%-89%- C 4 projections- 78 points 83%-80%- D 5 projections- 92 points 79%-0- F

This form will not be accepted unless all sections are completed, including titles, signatures and comments.

Must include techniques used Rev 7/10- ms

20.

Special Procedure Competency

***For “special exams” performed in general Rad department- Ex. ERCP, cysto study, hysterosalpingogram,etc

Student__________________________ Date-________________ Clinical Site-______________________ Exam-________________ GENERAL YES NO N/A Evaluation of request Set up of room. Gather appropriate cassettes. Place/remove headboard, shoulder/knee brace as needed. Gather appropriate supplies as needed. Set a tray using sterile technique. Prepare Contrast Media for administration. Name of contrast__________

Identify patient and place on table. Explain procedure. Check chart for consent form. Assist MD with needle puncture maintaining sterile technique. Change films and assist patient with positioning. Inform patient of post-procedure instructions. Fill out necessary paperwork as per procedure protocol. Follow Standard precautions. Performs images as / if instructed Faculty Signature-_____________________________ Student Signature-_____________________________ Pass-(all Yes/NA checks)-100% _____________ Fail-(any No checks)-79%__________________ Comments-

21.

HGTC Radiological Technology Program Clinical Competency Evaluation – Sterile Tray/ Technique

Student-__________________________ Date-________________ Final Grade- P-100% / F-0 Examination-______________________ Site-_________________ A.Prepare a sterile tray properly, as described below: Yes No 1. Wash hands thoroughly 2. Check tray label and expiration date 3. Place on clean cart; have extra supplies near to add to tray 4. Open 1st corner away from you, 2ndside corners from center, and last toward you 5. Do not touch the inside parts of the tray B. Add extra supplies to the sterile tray properly, as described below: Yes No 1. Gather extra supplies (syringes, needles, etc) and add to the tray 2. Grasp the outside wrapper of the sterile package and peel open; do not touch the inside of the wrapper or the item

3. “Drop” items into the sterile tray without touching the tray or item 4. Discard the outside wrapper C. Add sterile solutions to the sterile tray properly, as described below: Yes No 1. Gather liquids (contrast, medications, etc) to add to the tray 2. Verify the contents of the bottle, and check expiration date 3. Remove seal and cap from bottle correctly 4. Pour solution slowly and in the correct position 5. Discard remaining fluid and bottle, after procedure complete D. Open and apply sterile gloves properly, as described below: Yes No 1. Wash hands thoroughly 2. Remove outer and inner glove wrapper 3. Identify right and left glove 4. With non-dominant hand, grasp inside cuff of glove and properly apply glove to hands 5. Interlock fingers of glove to ensure proper fit E. Dispose of sterile gloves properly, as described below: Yes No 1. Grasp outside of the cuff, with the other gloved hand 2. Pull glove off, turning inside out, discard in trash 3. Slide fingers underneath cuff and pull of remaining glove and dscard 4. Wash hands Pass / Fail- ____________ RT(R) Signature-____________________________________ Student Signature-___________________________________

22

HORRY-GEORGETOWN TECHNICAL COLLEGE CLINICAL COMPETENCY EVALUATION: Computerized Tomography

Student-____________________________ Date-__________________Grade-___________

Examination-_______________________Pt.Name-_________________________________ Site-_____________________________ ID #-______________________________

ROOM PREPARATION N/A YES NO 1. CT room ready prior to patient entering.(cleanliness, orderly) 2. Gantry and table set up correctly. 3. Table at correct height. 4. CM prepared and ready. 5. Console properly set up for patient and exam. 6. Injector armed

PATIENT CARE N/A YES NO 1.Communicate (as needed) with patient during exam. 2. Patient ID’d correctly prior to exam 3. Patient sufficiently monitored during exam. 4. Compassion shown to patient throughout exam. 5. Explain exam to patient

PACS N / A YES NO 1. Images correctly saved to PACS 2. Patient history entered correctly and thoroughly. 3. Images saved and correctly sent to PACS.

WORK PERFORMANCE N/A YES NO 1. Correctly zeroes out machine 2. Patient positioned correctly 3. Shielding used appropriately 4. Correct use of workstation 5. Correctly manipulates gantry 6. Scout images manipulated correctly 7. Exam ended 8. Images sent 9. Patient released correctly

Comments- C.T Technologist Sig-__________________________CI Signature-______________________________ Student Sig.-_________________________________

23.

HORRY-GEORGETOWN TECHNICAL COLLEGE TERMINAL COMPETENCY EVALUATION

* Failure to demonstrate the following objectives, when applicable, indicates incompetence and an automatic failure will be recorded. 1. Verify correct identification of the patient. 2. Record LMP and/or check for possible pregnancy in females of childbearing age (according to department protocol). 3. Document clinical history relevant to examination. 4. Follow Standard precautions. 5. Correctly place lead identification markers on film. 6. Utilize lead shielding when appropriate.

I. PREPARATION- evaluation of room preparation, selection of appropriate cassettes and review of requisition for pertinent information.

3 points- ____ room clean and properly prepared ____ correct size and # of cassettes selected No Improvement Needed ____requisition thoroughly reviewed 2 points ____minor negligence in room preparation ____most films selected appropriately in size and number Improvement Needed ____requisition not thoroughly checked 1 point ____major negligence in room preparation ____incorrect film sizes chosen Marginally Acceptable ____requisition glanced at 0 points- Gross Negligence Unacceptable

II. PATIENT CARE - evaluation of assessment of patients condition, assistance and consideration during procedure, explanation of procedure and removal of possible film artifacts.

3 points ____excellent evaluation and communication No Improvement Needed 2 points ____minor negligence Improvement Needed 1 point ____major negligence Marginally Acceptable 0 point ____gross negligence Unacceptable

24. III. POSITIONING AND TECHNICAL SKILLS-evaluation of Instructions given; correct positioning,

central ray direction and alignment; use of collimation; proper exposure factors set. 3 points

____exact positioning and angulation ____less than 1” misalignment of film, part or CR No Improvement Needed ____beam limited to area of interest 2 points ____minor inaccuracy of positioning or angulation ____more than 1- 2” misalignment of film, part or CR Acceptable ____inaccurate collimation 1 point ____major error in positioning and/or angulation ____more than 2” misalignment of film, part or CR Marginally Acceptable ____poor collimation 0 point ____gross error in positioning and/or angulation ____misalignment of film, part or CR (enough to clip anatomy) Unacceptable ____no collimation or over collimation to obscure area of interest

IV. IMAGE EVALUATION- evaluation of overall density and contrast, ability to identify proper evaluation criteria

3 points ____evaluation criteria properly identified per view ____good understanding of contrast and density No Improvement Needed ____all areas of interest well visualized 2 points ____minor error in identifying evaluation criteria per view ____minor misconceptions of contrast and density Acceptable 1 point ____major errors in identifying evaluation criteria ____major misconceptions of contrast and density Marginally Acceptable 0 points ____no correct identification of evaluation criteria ____no understanding of contrast and density Unacceptable Terminal Competency based on 6-9 projections. Grading scale: A: 92-100 B: 84-91 C: 76-83 D: 68-82 F: 0-67 *Students must receive a C or better to pass the Terminal Competency Evaluation. * All TC grades will be averaged for Final Grade. 24.

HORRY-GEORGETOWN TECHNICAL COLLEGE

TERMINAL COMPETENCY EVALUATION

STUDENT NAME-_______________________________DATE-__________________ I. Preparation- 0-3 points total for entire study _____total points II. Patient Care- 0-3 points total for entire study _____total points III. Positioning and Technical Skills _____total points EXAMS 1.__________________ 2.___________________ 3._________________ Proj.1 _______pts. Proj.1 _________pts. Proj. 1.________pts. Proj.2 _______pts. Proj.2 _________pts. Proj. 2. _______ pts. Proj.3 _______pts. Proj.3. ________ pts. Proj. 3. _______ pts. IV. Image Evaluation ____total points Proj.1 _______pts Proj.1._________pts Proj. 1. ______pts. Proj.2 _______pts. Proj.2._________pts. Proj. 2. _______pts. Proj.3 _______pts. Proj.3._________pts. Proj. 3. _______pts. TOTAL POINTS/PERCENTAGE/GRADE: Add total from I., II.,III. and IV. and divide by total possible points for final grade. 60 points 54 points 48 points 42 points 59-98% 53-98% 47-98% 41-97% 58-97% 52-96% 46-96% 40-95% 57-95% 51-94% 45-94% 39-93% 56-93% 50-93% 44-92% 38-90% 55-92% 49-91% 43-90% 37-88% 54-90% 48-89% 42-88% 36-86% 53-88% 47-87% 41-85% 35-83% 52-86% 46-85% 40-83% 51-85% 45-83% 50-83% Scale- 92-100 A

84-91 B 76-83 C 68-83 D 0-67 F

Evaluator-_______________________Student Signature-______________________________ Comments-

25.

Professional Development Professional Evaluations will account for 50% of final grade for ALL clinical rotations.

PD’s are due on specific dates. If a PD is submitted late, and is un-excused, the grade will be counted as a 0. Weekly progress sheets must be submitted to assigned technologist at beginning of each week. The radiographer will fill out and submit directly to the Clinical Instructor. Students may view progress sheets at conclusion of semester, if requested. 1st through 6th semester Professional Evaluation outcomes

1. Demonstrate appropriate patient care through the following behaviors a. Checks M.D. orders and reviews with RT to ensure reason – diagnosis is relative to exam b. Obtains detailed history from patient and properly records the information c. Speaks professionally in an audible tone of voice: clearly/distinctly with sufficient volume d. Uses appropriate radiation protection for all involved members – shielding and proper

collimation e. Shows concern for patient needs and maintains a safe/modest environment throughout

procedure f. Follow standard precautions and cleans and tidy's room before/after each patient g. Refers to patient by proper name and communicates well, shows sufficient concern

2. Demonstrate radiographic abilities according to level of instruction a. Demonstrates knowledge of radiographic equipment b. Demonstrates proper use of patient transport equipment – wheelchair, cart, moving devices c. performs exams effectively/efficiently to increase patient comfort d. Works independently and with focus on task at hand e. Marks images correctly during exam f. Able to obtain quality images for level reached – properly post – processes g. Shows knowledge of daily hospital/department policies h. Consistently utilizes suggestions for improving performance i. Does not unnecessarily repeat tasks/images – able to modify routine based on patient condition j. Strives for understanding of control panel – when able, makes proper technique selections

3. Demonstrates professional behavior and a willingness to learn a. Arrives on time and promptly begins assignments b. Shows initiative – uses time appropriately when department is slow c. Stays with the signed tech and notifies them when leaving area d. Speech and actions are appropriate for clinical setting – with RT, patients, MDs, healthcare

team e. Treats patients, RT's, healthcare team with respect and courtesy f. Follows dress code and comes prepared to clinic – technique book, dosimeter, lead markers g. Has a positive attitude, refrains from negative talk and actions h. Maintains composure in all situations i. Accepts advice and takes responsibility for actions – uses advice constructively j. Recognizes supervisory role of C I, RT's, MDs and administrators k. Communicates/works well with healthcare team/helps others when available

26.

HGTC Radiologic Technology Program Professional Development Evaluation 1st -6th semesters

Name-_______________________Site-_____________________Date-____________________ 4- Excellent, 3-Above average, 2- average, 1-below average 0- not demonstrated, N/A- not applicable Patient Care Pts 1. Checks MD orders and reviews with RT to ensure reason-diagnosis is relative to exam 2. Obtains detailed history from patient and properly records the information 3. Speaks professionally in an audible tone of voice: clearly / distinctly with sufficient volume 4. Uses appropriate rad protection for all involved members- shielding and proper collimation 5. Shows concern for pt needs and maintains a safe/modest environment throughout procedure 6. Follows site protocol regarding Patient Identification before exam performance 7. Follows standard precautions and cleans and tidies room before/after each patient 8. Refers to patient by proper name and communicates well, shows sufficient concern

Total-(1-4)-_______ Radiographic Abilities / Work Performance/ Efficiency/ Use of Equipment Pts 9. Demonstrates knowledge of radiographic equipment 10. Demonstrates proper use of Patient Transport Equipment – (WC, cart, moving devices) 11. Performs exams effectively/efficiently to increase patient comfort 12. Works independently and with focus on task at hand 13. Mark images correctly during exam – properly post-processes 14. Able to obtain quality images for level reached- properly positions 15. Shows knowledge of daily hospital /department policies 16. Consistently utilizes suggestions for improving performance 17. Does not unnecessarily repeat tasks/images- able to modify routine based on pt condition 18. Strives for understanding of control panel- when able, makes proper technique selections

Total-(1-4)-_______ Professionalism Pts 19. Arrives on time and promptly begins assignments-Days missed/tardy- 20. Shows initiative- uses time appropriately when department is slow- ex. practices positioning 21. Stays with assigned tech and notifies them when leaving area 22. Speech and actions are appropriate for clinic setting- with RT’s, patients, MD’s, healthcare

team

23. Treats patients, RT’s, MD’s, healthcare team with respect and courtesy 24. Follows dress code and comes prepared to clinic- technique book, dosimeter, lead markers 25. Has a positive attitude , refrains from negative talk and actions 26. Maintains composure in all situations 27. Accepts advice and takes responsibility for actions- uses advice constructively 28. Recognizes supervisory role of CI, RT’s, MD’s and administrators 29. Communicates / works well with healthcare team/ helps others when available ie.stock,

prep,etc

Total-(1-4)-_______

27.

COMMENTS-

Clinical Scale Conversions for Grade Percentages Grade A __ Grade B_____ 4.0 - 100% 3.74 – 3.60 - 95% 3.99- 3.94 - 99% 3.59 – 3.50 - 94% 3.93- 3.88 - 98% 3.49 – 3.40 - 93% 3.87- 3.82 - 97% 3.39 - 3.30 - 92% 3.81- 3.75 - 96% 3.29 – 3.20 - 91%

2.91 – 3.0 - 90% Grade C _ 2.90 - 2.80 - 89% Grade D____ 2.79 - 2.70 - 88% 1.99 – 1.80 - 83% 2.69 – 2.60 - 87% 1.79 – 1.60 - 82% 2.59 – 2.40 - 86% 1.59 – 1.50 - 81% 2.39 – 2.30 - 85% 1.49 – 1.0 - 80% 2.29 – 2.0 - 84% Below a 1 or 79% is failing for clinical grades All Total- ______________ Percent- ____________________ CI-Signature-_____________________________ Student Signature-___________________________

27. Professional Development Progress Sheets

In addition to the required PD evaluation Sheets, weekly progress sheets must be completed by the staff technologists and clinical instructors at the sites. These will help with constructive input from all rotations throughout the department. These forms are required weekly by every student and CI’s will instruct the student on which technologist should be completing them. Once completed, the forms will go directly to the CI and will be used in tallying the PD Evaluation sheet, which is part of the students final grade. These forms are helpful to the students in addressing a weakness or strengths. The student does not have weekly access to the results but may, upon request meet with the CC and review them, or request to view them at the end of the grading semester. ● Please be aware that the progress sheets are for weekly assessment and the PD Evaluations are the forms that are used for the final grade and must be handed in when due. You will receive a schedule of due dates for your PD Evaluations. It is your responsibility to carry your Clinical Handbook to your clinical rotations and have copies of all required updated Paperwork. Every form you will need is in this handbook. It will be to your advantage to have it available at all time and to review it periodically. ● Please. Also be aware that changes can be made to any/all paperwork at any time. In this event the students will be informed, as will the staff at your clinical sites.

28.

HGTC Radiologic Technology Program Professional Development Progress Sheet 1st -6th semesters

Name-________________________ Site-____________________Date-__________________ 4- Excellent, 3-Above average, 2- average, 1-below average 0- not demonstrated, N/A- not applicable Patient Care Pts 1. Checks MD orders and reviews with RT to ensure reason-diagnosis is relative to exam 2. Obtains detailed history from patient and properly records the information 3. Speaks professionally in an audible tone of voice: clearly/ distinctly with sufficient volume 4. Uses appropriate rad protection for all involved members- shielding and proper collimation 5. Shows concern for pt needs and maintains a safe/modest environment throughout procedure 6. Follows site protocol regarding Patient Identification before exam performance 7. Follows standard precautions and cleans and tidies room before/after each patient 8. Refers to patient by proper name and communicates well, shows sufficient concern Total-________ Radiographic Abilities / Work Performance/ Efficiency/ Use of Equipment Pts 9. Demonstrates knowledge of radiographic equipment 10. Demonstrates proper use of Patient Transport Equipment – (WC, cart, moving devices) 11. Performs exams effectively/efficiently to increase patient comfort 12. Works independently and with focus on task at hand 13. Mark images correctly during exam -properly post-processes 14. Able to obtain quality images for level reached- properly positions. 15. Shows knowledge of daily hospital /department policies 16. Consistently utilizes suggestions for improving performance 17. Does not unnecessarily repeat tasks/images- able to modify routine based on pt condition 18. Strives for understanding of control panel- when able, makes proper technique selections Total-_________ Professionalism Pts 19. Arrives on time and promptly begins assignments Days missed/tardy- 20. Shows initiative uses time appropriately when department is slow- ex. practices positioning 21. Stays with assigned tech and notifies them when leaving area 22. Speech and actions are appropriate for clinic setting- with RT’s, pts, MD’s, healthcare team 23. Treats patients, RT’s, MD’s, healthcare team with respect and courtesy 24. Follows dress code and comes prepared to clinic- technique book, dosimeter, lead markers 25. Has a positive attitude , refrains from negative talk and actions 26. Maintains composure in all situations 27. Accepts advice and takes responsibility for actions- uses advice constructively 28. Recognizes supervisory role of CI, RT’s, MD’s and administrators 29. Communicates / works well with healthcare team/ helps others when available ie.stock,

prep,etc

(ms 09/11) Total-________

29.

Horry-Georgetown Technical College Radiography Program

Venipuncture Policy

1. The college lecture portion of venipuncture is taught in Positioning II, however, affiliates may require additional in-house training before the student is allowed to attempt the procedure on patients.

2. When a student is performing venipuncture, a qualified staff member must be present in the room for

the entire procedure, form the needle stick through the complete injection of contrast medium. Qualified staff may include physicians, nurses, or radiographers who have been certified competent in venipuncture through regular hospital procedures.

3. At no time is a student to be left alone in a radiographic room during venipuncture or the injection of

contrast medium. This rule applies even after the student has obtained competence.

4. A student is normally permitted only one stick per patient. At the hospitals discretion, a supervising staff member may authorize an additional attempt by the student. Under no circumstances is a student permitted a third attempt at a needle stick.

5. The Venipuncture Competency Form is the form that will be used to verify competency. The form

must be signed by the Clinical Instructor and kept on file with the Clinical Coordinator.

6. The hospital may add additional venipuncture policies or requirements, as deemed necessary and students are required to abide by all policies.

30.

Horry-Georgetown Technical College

Radiography Program

VENIPUNCTURE COMPETENCY

Evaluator-______________________ Student Name-________________________ Evaluator: Each student must successfully perform venipuncture on THREE (3) separate patients before attempting this competency. Reminder: Students are never to inject contrast without a technologist present in the room. Practice #1________________ #2__________________ #3___________________ Competency PASS_____________ REPEAT_____________________ SKILL S U Identify location of crash cart Assemble all necessary materials prior to beginning venipuncture Identify patient Explain procedure to the patient Obtain allergy history and consent form Select proper contrast material Select proper needle/infusion set Wash hands Apply gloves Skin prep with alcohol, circular motion Apply tourniquet for venipuncture Select optimum vessel Insert butterfly at 10-15 degree angle, bevel up Obtain flashback of blood into tubing/syringe Secure needle with tape Release tourniquet Inject contrast Observe for extravasation Observe for adverse effects Remove needle and apply pressure to site Dispose of infusion set properly Apply pressure dressing to venipuncture site Remove gloves and wash hands

31.

Clinical Progression Policy

Aug 09

Students must be able to progress in clinical rotation by completing the expected requirements. Students who have not completed the minimum requirements for the semester will be graded accordingly. For example a student needing five Competencies and five Professional Developments, and has only completed three Competencies, will receive zeros for the two not completed and the grades will be averaged. If the student has not completed enough Competencies to attain a grade of “C” or above, they will fail the clinical requirement of the program. If the student has not completed all required competencies, but has high enough grades from the other competencies to pass, the student will be given that grade, but will also be placed on Clinical Probation and will receive a written warning stating that all of the previous missed competencies must be completed by the following semester. Students may choose to attend clinic over breaks, during daytime hours to catch up with clinical work. Students may not receive more than one Clinical Probation letter. A second Clinical Probation will result in dismissal from the program. Students who have not completed the required work during their last semester, will follow the same policy. If the student’s averaged grade is a “C” or above they must complete all unfinished competencies within two weeks of graduation. If the student does not finish the required work within two weeks, they will “fail” the last clinical semester.

32.

ARRT Requirements Rev 3-2012 Student- THORAX Date Date

Chest, Routine- PA/Lat m Chest- AP & lat - WC m Chest- AP & lat- stretcher m Chest, Lateral decubes e ST Neck e Ribs (uni or bilat) m Sternum e EXTREMITIES Date Finger m Thumb e Hand m Wrist m Forearm m Elbow m Humerus m Shoulder, axillary view m Foot m Feet- weight bearing e Ankle m Lower leg m Knee m Knees wt bearing e Patella m Femur m Trauma- up. Ext.-non-shoulder m Trauma- low. Ext-adult m Scapula e Clavicle e AC joints e Trauma shoulder-y view m Toes e Os Calcis e HEAD & NECK Date Date Facial bones e Nasal bones e Sinuses m Skull m Orbits e Zygoma/ arches e Mandible e Panorex e PEDIATRICS– (0-3 y/o) Date Date Chest m Upper extremity m Lower extremity m Abdomen e Mobile study e

33. SPINE & PELVIS Date Date

Cervical spine m XTL C-spine m C-Sp flex/ ext e Thoracic spine m Lumbar spine m L-Sp flex/ext e Pelvis m Hip w/ frog m AP & XTL hip m Scoliosis Study e Sacrum & Coccyx e SI joints e ABDOMEN / GI Date Date KUB m Abdomen Series m Abdomen.- decubes m UGI Series m Sm.Bowel Series m Esophagus study m BE- w/ air m BE- w/out air e IVU m MOBILE/SURGICAL Date Date Portable Chest m Port. Abdomen- adult m Port. Orthopedic- adult m Myelogram e Arthrogram e CystoStudy/ERCP/hyster-non OR ↑ Spec Proc checklist m

Surg checklist/C-arm ortho m Surg checklist.C-arm non O m Sterile Technique/tray m Venipuncture Comp e Terminal Comp m CT Head e CT Abd w/o contrast e CT Neck w/ contrast e CT Chest w/contrast e CT Pelvis w/ contrast e CT CC’s do not count in final # of electives

33.

RADIOGRAPHY DIDACTIC AND CLINICAL COMPETENCY REQUIREMENTS

Eligibility Requirements Effective January 2012* Candidates for certification are required to meet the Professional Requirements specified in Article II of the ARRT Rules and Regulations. This document identifies the minimum didactic and clinical competency requirements for certification referenced in the Rules and Regulations. Candidates who complete a formal educational program accredited by a mechanism acceptable to the ARRT will have obtained education and experience beyond the requirements specified here. Didactic requirements

Candidates must successfully complete coursework addressing the topics listed in the A RRT content specifications for the examination and radiography. These topics are presented in a format suitable for instructional planning in the A SRT radiography curriculum (2007).

Clinical requirements

As part of their educational program, candidates must demonstrate competence in the clinical activities identified in this document. Demonstration of clinical competence means that the program director or designee has observed the candidate performing the procedure, and that the candidate perform the procedure independently, consistently, and effectively. Candidates must demonstrate competence in the areas listed below.

Six mandatory general patient care activities. 31 mandatory imaging procedures. 15 electives imaging procedures to be selected from a list of 35 procedures. One electives imaging procedure from the head section. 2 electives imaging procedures from the fluoroscopy study section, one of which must

be either an upper G.I. or Barium Enema. Documentation

The following pages identify specific clinical competency requirements. Candidates may wish to use these pages, or their equivalent, to record completion of the requirements. The pages do NOT need to be sent to the ARRT.

To document that the didactic and clinical requirements have been satisfied, candidates must have the program director (and authorized faculty member if required) signed the ENDORSEMENT SECTION of the Application for Certification included in the Certification Handbook.

* Note: candidates who complete their educational program during 2012 or 2013 may use either the previous requirements (effective 2005) or the current requirements (effective 2012). Candidates who graduate after December 31, 2013 may no longer use the previous competency requirements.

Copyright © 2010 by The American Registry of Radiologic Technologists ® . All rights reserved.

Radiography

Clinical Competency Requirements

The clinical competency requirements include the six general patient care activities listed below in a subset of the 66 imaging procedures identified on subsequence pages. Demonstration of competence should include variations in patient characteristics (e.g. age, gender, medical condition).

1. General Patient Care Requirement: candidates must demonstrate competence in all six patient care activities listed below. The activities should be performed on patients; however, simulation is acceptable (see footnote) if state or institutional regulations prohibit candidates from performing the procedures on patients. General patient care Date

Completed Competence Verified By

1. CPR 2. Vital signs (blood pressure, pulse, respiration) 3. Sterile and aseptic technique 4. Venipuncture 5. Transfer of patient 6. Care of patient medical equipment (e.g., oxygen tank, IV

tubing

Note: The A RRT requirements specify that certain clinical procedures may be simulated. Simulations must meet the following criteria: (a) the student is required to competently demonstrate skills as similar as circumstances permit to the cognitive, psychomotor, and effective skills required in the clinical setting; (b) the program director is confident that the skills required to competently perform the simulated task will generalize or transfer to the clinical setting, and, if applicable, the student will evaluate related images. Examples of acceptable simulations include: demonstrating CPR on a mannequin, positioning a fellow student for a projection without actually activating the x-ray beam, and performing venipuncture by demonstrating aseptic technique on another person, but then inserting the needle into an artificial forearm or grapefruit.

Radiography

Clinical Competency Requirements (cont.)

2. Imaging Procedures

Requirement: Candidates must demonstrate competence in all 31 procedures identified as mandatory (M). Procedures should be performed on patient; however, up to eight mandatory procedures may be simulated (see previous page) if demonstration on patients is not feasible. Candidates must demonstrate competence in 15 of the 35 elective (E) procedures. Candidates must select one elective procedure from the head section. Candidates must select either upper G.I. or barium enema plus one other elective from the fluoroscopy section. Elective procedures should be performed on patients; however, electives may be simulated (see previous page) if demonstration on patients is not feasible. Institutional protocol will determine the positions or projections used for each procedure. Demonstration of competence includes requisition evaluation, patient assessment, room preparation, patient management, equipment operation, technique selection, positioning skills, radiation safety, image processing, and image evaluation. Imaging Procedure

Mandatory or Elective

Date Completed

Patient or Simulated

Competence Verified By

Chest and Thorax 1. Chest Routine M 2. Chest AP (WC or stretcher) M 3. Ribs M 4. Chest Lateral Decubitus E 5. Sternum E 6. Upper Airway (Soft-Tissue Neck) E Upper Extremity E 7. Thumb or Finger 8. Hand M 9. Wrist M 10. Forearm M 11. Elbow M 12. Humerus M 13. Shoulder M 14. Trauma: Shoulder (Scapular Y, Transthoracic, or Axillary) *

M

15. Clavicle E 16. Scapula E 17. AC Joints E 18. Trauma: Upper Extremity (Nonshoulder) *

M

* Trauma is considered a serious injury or shock to the body. Modifications may include variations in positioning, minimal movement of the body part, etc.

Radiography

Clinical Competency Requirements (cont)

Imaging Procedure Mandatory or Elective

Date Completed

Patient or Simulated

Competence Verified By

Lower Extremity 19. Toes E 20. Foot M 21. Ankle M 22. Knee M 23. Tibia-Fibula M 24. Femur M 25. Trauma: Lower Extremity* M 26. Patella E 27. Calcaneus (Os Calcis) E Head- Candidates must select at least one elective procedure from this section.

28. Skull E 29. Paranasal Sinuses E 30. Facial Bones E 31. Orbits E 32. Zygomatic Arches E 33. Nasal Bones E 34. Mandible E Spine and Pelvis 35. Cervical Spine M 36. Trauma: Cervical Spine (Cross Table Lateral) *

E

37. Thoracic Spine M 38. Lumbar Spine M 39. Pelvis M 40. Hip M 41. Cross Table Lateral Hip M 42. Sacrum and/or Coccyx E 43. Scoliosis Series E 44. Sacroiliac Joints E Abdomen 45. Abdomen Supine (KUB) M 46. Abdomen Upright M 47. Abdomen Decubitus E 48. Intravenous Urography E * Trauma is considered a serious injury or shock to the body. Modifications may include variations in positioning, minimal movement of the body part, etc.

Radiography

Clinical Competency Requirements (cont.)

Imaging Procedure

Mandatory or Elective

Date Completed

Patient or Simulated

Competence Verified By

Fluoroscopy Studies- Candidates must select either Upper GI or Barium Enema plus one other elective procedure from this section.

49. Upper GI Series (Single or Double Contrast)

E

50. Barium Enema (Single or Double Contrast)

E

51. Small Bowel Series E 52. Esophagus E 53. Cystography/Cystourethrography E 54. ERCP E 55. Myelography E 56. Arthrography E Surgical Studies 57. C-Arm Procedure (Orthopedic) M 58. C-Arm Procedure (Non-Orthopedic) E Mobile Studies 59. Chest M 60. Abdomen M 61. Orthopedic M Pediatrics (age 6 or younger) 62. Chest Routine M 63. Upper Extremity E 64. Lower Extremity E 65. Abdomen E 66. Mobile Study E

CONTENT SPECIFICATIONS FOR THE EXAMINATION IN RADIOGRAPHY

Publication Date: August 2010 Implementation Date: January 2012

The purpose of the ARRT Examination in Radiography is to assess the knowledge and cognitive skills underlying the intelligent performance of the tasks typically required of the staff technologist at entry into the profession. To identify the knowledge and skills covered by the examination, the ARRT periodically conducts practice analysis studies involving a nationwide sample of staff technologists1. The results of the most recent practice analysis are reflected in this document. The complete task inventory, which serves as the basis for these content specifications, is available from our website www.arrt.org.

The table below presents the five major content categories, along with the number and percentage of test questions appearing in each category. The remaining pages provide a detailed listing of topics addressed within each major content category.

This document is not intended to serve as a curriculum guide. Although certification programs and educational programs may have related purposes, their functions are clearly different. Educational programs are generally broader in scope and address subject matter not included in these content specifications.

CONTENT CATEGORY

% OF TEST

NUMBER OF QUESTIONS 2

A.

Radiation Protection 22.5% 45 B. Equipment Operation and Quality Control 11.0% 22 C. Image Acquisition and Evaluation 22.5% 45 D. Imaging Procedures 29.0% 58 E. Patient Care and Education 15.0% 30

100% 200

1. A special debt of gratitude is due to the hundreds of professionals participating in this project as committee members, survey respondents, and reviewers.

2. Each exam includes up to an additional 20 unscored (pilot) questions. On the pages that

follow, the approximate number of test questions allocated to each content category appears in parentheses.

Copyright © 2010 by The American Registry of Radiologic Technologists . All rights reserved. Reproduction in whole or part is not permitted without the written consent of the ARRT.

A. RADIATION PROTECTION (45)

1. Biological Aspects of Radiation (10)

A. Radiosensitivity

1. dose-response relationships

2. relative tissue radiosensitivities (e.g., LET, RBE)

3. cell survival and recovery (LD50)

4. oxygen effect

B. Somatic Effects

1. short-term versus long-term effects

2. acute versus chronic effects

3. carcinogenesis

4. organ and tissue response (e.g., eye, thyroid, breast, bone marrow, skin, gonadal)

C. Acute Radiation Syndromes

1. CNS

2. hemopoietic

3. GI

D. Embryonic and Fetal Risks

E. Genetic Impact

1. genetic significant dose

2. goals of gonadal shielding

F. Photon Interactions with Matter

1. Compton effect

2. photoelectric absorption

3. coherent (classical) scatter

4. attenuation by various tissues

a. thickness of body part (density)

b. type of tissue (atomic number)

2. Minimizing Patient Exposure (15)

A. Exposure Factors

1. kVp

2. mAs

B. Shielding

1. rationale for use

2. types

3. placement

C. Beam Restriction

1. purpose of primary beam restriction

2. types (e.g., collimators)

D. Filtration

1. effect on skin and organ exposure

2. effect on average beam energy

3. NCRP recommendations (NCRP #102, minimum filtration in useful beam)

E. Exposure Reduction

1. patient positioning

2. automatic exposure control (AEC)

3. patient communication

4. digital imaging

5. pediatric dose reduction

6. ALARA

F. Image Receptors (e.g., types, relative speed, digital versus film)

G. Grids

H. Fluoroscopy

1. pulsed

2. exposure factors

3. grids

4. positioning

5. fluoroscopy time

(Section A continues on the following page)

A. RADIATION PROTECTION (cont.)

3. Personnel Protection (11)

A. Sources of Radiation Exposure

1. primary x-ray beam

2. secondary radiation

a. scatter

b. leakage

3. patient as source

B. Basic Methods of Protection

1. time

2. distance

3. shielding

C. Protective Devices

1. types

2. attenuation properties

3. minimum lead equivalent (NCRP #102)

D. Special Considerations

1. portable (mobile) units

2. fluoroscopy

a. protective drapes

b. protective Bucky slot cover

c. cumulative timer

3. guidelines for fluoroscopy and portable units (NCRP #102, CFR-21)

a. fluoroscopy exposure rates

b. exposure switch guidelines

4. Radiation Exposure and Monitoring (9)

A. Units of Measurement*

1. absorbed dose

2. dose equivalent

3. exposure

B. Dosimeters

1. types

2. proper use

C. NCRP Recommendations for Personnel Monitoring (NCRP #116)

1. occupational exposure

2. public exposure

3. embryo/fetus exposure

4. ALARA and dose equivalent limits

5. evaluation and maintenance of personnel dosimetry records

D. Medical Exposure of Patients (NCRP #160)

1. typical effective dose per exam

2. comparison of typical doses by modality * Conventional units are generally used. However, questions referenced to specific reports (e.g., NCRP) will use SI units to be consistent with such reports.

B. EQUIPMENT OPERATION AND QUALITY CONTROL (22)

1. Principles of Radiation Physics (9)

A. X-Ray Production

1. source of free electrons (e.g., thermionic emission)

2. acceleration of electrons

3. focusing of electrons

4. deceleration of electrons

B. Target Interactions

1. bremsstrahlung

2. characteristic

C. X-Ray Beam

1. frequency and wavelength

2. beam characteristics

a. quality

b. quantity

c. primary versus remnant (exit)

3. inverse square law

4. fundamental properties (e.g., travel in straight lines, ionize matter)

2. Imaging Equipment (9)

A. Components of Radiographic Unit (fixed or mobile)

1. operating console

2. x-ray tube construction

a. electron sources

b. target materials

c. induction motor

3. automatic exposure control (AEC)

a. radiation detectors

b. back-up timer

c. density adjustment (e.g., +1 or –1)

4. manual exposure controls

5. beam restriction devices

B. X-Ray Generator, Transformers, and Rectification System

1. basic principles

2. phase, pulse, and frequency

C. Components of Fluoroscopic Unit (fixed or mobile)

1. image intensifier

2. viewing systems

3. recording systems

4. automatic brightness control (ABC)

D. Components of Digital Imaging (CR and DR)

1. PSP - photo-stimulable phosphor

2. flat panel detectors - direct and indirect

3. start up and shut down

4. CR plate erasure

5. equipment cleanliness (imaging plates, CR plates)

E. Types of Units

1. dedicated chest unit

2. tomography unit

F. Accessories

1. stationary grids

2. Bucky assembly

3. image receptors

3. Quality Control of Imaging Equipment and Accessories (4)

A. Beam Restriction

1. light field to radiation field alignment

2. central ray alignment

B. Recognition and Reporting of Malfunctions

C. Digital Imaging Receptor Systems

1. artifacts (e.g., non-uniformity, erasure)

2. maintenance (e.g., detector fog)

3. display monitor quality assurance

D. Shielding Accessories (e.g., lead apron and glove testing)

C. IMAGE ACQUISITION AND EVALUATION (45)

1. Selection of Technical Factors (20)

A. Factors Affecting Radiographic Quality. Refer to Attachment C to clarify terms that may occur on the exam. (X indicates topics covered on the examination)

1.

Density/Brightness

2.

Contrast/Gray Scale

3.

Recorded Detail/Spatial Resolution

4.

Distortion

a. mAs X b. kVp X X c. OID X (air gap) X X d. SID X X X e. focal spot size X f. grids* X X g. filtration X X h. film-screen X X i. beam restriction X X j. motion X k. anode heel effect X l. patient factors (size,

pathology) X X X X

m. angle (tube, part, or receptor) X X

* Includes conversion factors for grids

B. Technique Charts

1. pre-programmed techniques – anatomically programmed radiography (APR)

2. caliper measurement

3. fixed versus variable kVp

4. special considerations

a. casts

b. anatomic and pathologic factors

c. pediatrics

d. contrast media

C. Automatic Exposure Control (AEC)

1. effects of changing exposure factors on radiographic quality

2. detector selection

3. anatomic alignment

4. density control (+1 or –1)

D. Digital Imaging Characteristics

1. spatial resolution

a. sampling frequency

b. DEL (detector element size)

c. receptor size and matrix size

2. image signal (exposure related)

a. quantum mottle (noise)

b. SNR (signal to noise ratio) or

CNR (contrast to noise ratio)

(Section C continues on the following page)

C. IMAGE ACQUISITION AND EVALUATION (cont.)

2. Image Processing and Quality

Assurance (12)

A. Image Identification

1. methods (e.g., photographic, radiographic, electronic)

2. legal considerations (e.g., patient data, examination data)

B. Film Screen Processing

1. film storage

2. components*

a. developer

b. fixer

3. maintenance/malfunction

a. start up and shut down procedure

b. possible causes of malfunction (e.g., improper temperature, contamination, replenishment, water flow)

C. Digital Imaging Processing

1. electronic collimation (masking)

2. grayscale rendition (look-up table (LUT), histogram)

3. edge enhancement/noise suppression

4. contrast enhancement

5. system malfunctions (e.g., ghost image, banding, erasure, dead pixels, readout problems)

6. CR reader components

D. Image Display

1. viewing conditions (i.e., luminance, ambient lighting

2. spatial resolution

3. contrast resolution/dynamic range

4. DICOM gray scale function

5. window level and width function

E. Digital Image Display Informatics

1. PACS

2. HIS

3. RIS (modality work list)

4. Networking (e.g., HL7, DICOM)

5. Workflow (inappropriate documentation, lost images, mismatched images, corrupt data)

* Specific chemicals in the processing solutions will not be covered (e.g., glutaraldehyde).

3. Criteria for Image Evaluation (13)

A. Brightness/Density (e.g., mAs, distance)

B. Contrast/Gray Scale (e.g., kVp, filtration, grids)

C. Recorded Detail (e.g., motion, poor film- screen contact)

D. Distortion (e.g., magnification, OID, SID)

E. Demonstration of Anatomical Structures (e.g., positioning, tube-part-image receptor alignment)

F. Identification Markers (e.g., anatomical, patient, date)

G. Patient Considerations (e.g., pathologic conditions)

H. Image artifacts (e.g., film handling, static, pressure, grid lines, Moiré effect or aliasing)

I. Fog (e.g., age, chemical, radiation, temperature, safelight)

J. Noise

K. Acceptable Range of Exposure

L. Exposure Indicator Determination

M. Gross Exposure Error (e.g., mottle, light or dark, low contrast)

A.

B. Chest

Ribs A.

B.

Skull

Facial Bones S.

T. Bone Survey

Long Bone C. Sternum C. Mandible Measurement

D. Soft Tissue Neck D. Zygomatic Arch U. Bone Age AbSt

omen and GI

dies (8) E. Temporomandibular

Joints V. Soft Tissue/Foreign

Bodies

D. IMAGING PROCEDURES (58)

This section addresses imaging procedures for the anatomic regions listed below (1 through 7). Questions will cover the following topics:

1. Positioning (e.g., topographic landmarks, body positions, path of central ray, immobilization devices).

2. Anatomy (e.g., including physiology, basic pathology, and related medical terminology).

3. Technical factors (e.g., including adjustments for circumstances such as body habitus, trauma, pathology, breathing techniques).

The specific radiographic positions and projections within each anatomic region that may be covered on the examination are listed in Attachment A. A guide to positioning terminology appears in Attachment B.

1. Thorax (10) 5. Head (5) 6. Extremities (cont.)

2.

u

A. Abdomen

B. Esophagus

C. Swallowing Dysfunction Study

D. Upper GI Series, Single or Double Contrast

E. Small Bowel Series

F. Barium Enema, Single or Double Contrast

G. Surgical Cholangiography

H. ERCP

F. Nasal Bones

G. Orbits

H. Paranasal Sinuses

6. Extremities (20)

A. Toes

B. Foot

C. Calcaneus (Os Calcis)

D. Ankle

E. Tibia, Fibula

F. Knee

7. Other (2)

A. Arthrography

B. Myelography

3. Urological Studies (3)

A. Cystography

B. Cystourethrography

C. Intravenous Urography

D. Retrograde Pyelography

4. Spine and Pelvis (10)

A. Cervical Spine

B. Thoracic Spine

C. Scoliosis Series

D. Lumbar Spine

E. Sacrum and Coccyx

F. Sacroiliac Joints

G. Pelvis and Hip

G. Patella

H. Femur

I. Fingers

J. Hand

K. Wrist

L. Forearm

M. Elbow

N. Humerus

O. Shoulder

P. Scapula

Q. Clavicle

R. Acromioclavicular Joints

E. PATIENT CARE AND EDUCATION (30)

1. Ethical and Legal Aspects (4)

A. Patient’s Rights

1. informed consent (e.g., written, oral, implied)

2. confidentiality (HIPAA)

3. additional rights (e.g., Patient’s Bill of Rights)

a. privacy

b. extent of care (e.g., DNR)

c. access to information

d. living will; health care proxy

e. research participation

B. Legal Issues

1. examination documentation (e.g., patient history, clinical diagnosis)

2. common terminology (e.g., battery, negligence, malpractice)

3. legal doctrines (e.g., respondeat superior, res ipsa loquitur)

4. restraints versus immobilization

C. ARRT Standards of Ethics

2. Interpersonal Communication (5)

A. Modes of Communication

1. verbal/written

2. nonverbal (e.g., eye contact, touching)

B. Challenges in Communication

1. patient characteristics

2. explanation of medical terms

3. strategies to improve understanding

4. cultural diversity

C. Patient Education

1. explanation of current procedure

2. respond to inquiries about other imaging modalities (e.g., CT, MRI, mammography, sonography, nuclear medicine, bone densitometry regarding dose differences, types of radiation, and patient preps)

3. Infection Control (5)

A. Terminology and Basic Concepts

1. asepsis

a. medical

b. surgical

c. sterile technique

2. pathogens

a. fomites, vehicles, vectors

b. nosocomial infections

B. Cycle of Infection

1. pathogen

2. source or reservoir of infection

3. susceptible host

4. method of transmission

a. contact (direct, indirect)

b. droplet

c. airborne/suspended

d. common vehicle

e. vector borne

C. Standard Precautions

1. handwashing

2. gloves, gowns

3. masks

4. medical asepsis (e.g., equipment disinfection)

D. Additional or Transmission-Based Precautions

1. airborne (e.g., respiratory protection, negative ventilation)

2. droplet (e.g., particulate mask, restricted patient placement)

3. contact (e.g., gloves, gown, restricted patient placement)

E. Disposal of Contaminated Materials

1. linens

2. needles

3. patient supplies (e.g., tubes, emesis basin)

(Section E continues on the following page)

E. PATIENT CARE AND EDUCATION (cont.) 4. Physical Assistance and Transfer (4)

A. Patient Transfer and Movement

1. body mechanics (balance, alignment, movement)

2. patient transfer

B. Assisting Patients with Medical Equipment

1. infusion catheters and pumps

2. oxygen delivery systems

3. other (e.g., nasogastric tubes, urinary catheters, tracheostomy tubes)

C. Routine Monitoring

1. equipment (e.g., stethoscope, sphygmomanometer)

2. vital signs (e.g., blood pressure, pulse, respiration)

3. physical signs and symptoms (e.g., motor control, severity of injury)

4. documentation

5. Medical Emergencies (5)

A. Allergic Reactions (e.g., contrast media, latex)

B. Cardiac or Respiratory Arrest (e.g., CPR)

C. Physical Injury or Trauma

D. Other Medical Disorders (e.g., seizures, diabetic reactions)

6. Pharmacology (3)

A. Patient History

1. medication reconciliation (current medications)

2. premedications

3. contraindications

4. scheduling and sequencing examinations

B. Complications/Reactions

1. local effects (e.g., extravasation/ infiltration, phlebitis)

2. systemic effects

a. mild

b. moderate

c. severe

3. emergency medications

4. radiographer’s response and documentation

7. Contrast Media (4)

A. Types and Properties (e.g., iodinated, water soluble, barium, ionic versus non-ionic)

B. Appropriateness of Contrast Media to Exam

1. patient condition (e.g., perforated bowel)

2. patient age and weight

3. laboratory values (e.g., BUN creatinine, GFR)

C. Patient Education

1. verify informed consent

2. instructions regarding preparation, diet, and medications

3. pre- and post-examination instructions (e.g., discharge instructions)

D. Venipuncture

1. venous anatomy

2. supplies

3. procedural technique

E. Administration

1. routes (e.g., IV, oral)

2. supplies (e.g., enema kits, needles)

Attachment A

Radiographic Positions and Projections

1. Thorax A. Chest

1. PA upright 2. lateral upright 3. AP Lordotic 4. AP supine 5. lateral decubitus 6. anterior and posterior

obliques B. Ribs

1. AP and PA, above and below diaphragm

2. anterior and posterior oblique

C. Sternum 1. lateral 2. RAO breathing technique 3. RAO expiration 4. LAO 5. PA sternoclavicular joints 6. anterior oblique

sternoclavicular joints D. Soft Tissue Neck

1. AP upper airway 2. lateral upper airway

2. Abdomen and GI studies

A. Abdomen 1. AP supine 2. AP upright 3. lateral decubitus 4. dorsal decubitus

B. Esophagus 1. RAO 2. left lateral 3. AP 4. PA 5. LAO

C. Swallowing Dysfunction Study D. Upper GI series*

1. AP scout 2. RAO 3. PA 4. right lateral 5. LPO 6. AP

E. Small Bowel Series 1. PA scout 2. PA (follow through) 3. ileocecal spots 4. enteroclysis procedure

F. Barium Enema* 1. left lateral rectum 2. left lateral decubitus 3. right lateral decubitus 4. LPO and RPO 5. PA 6. RAO and LAO 7. AP axial (butterfly) 8. PA axial (butterfly) 9. PA post-evacuation

G. Surgical Cholangiography 1. AP

H. ERCP 1. AP

* single or double contrast

3. Urological Studies A. Cystography

1. AP 2. LPO and RPO 60º 3. lateral 4. AP 10-15º caudad

B. Cystourethrography 1. AP voiding

cystourethrogram female 2. RPO 30º, voiding cystogram

male C. Intravenous Urography

1. AP, scout, and series 2. RPO and LPO 30º 3. PA post-void 4. AP post-void, upright 5. nephrotomography 6. AP ureteric compression

D. Retrograde Pyelography 1. AP scout 2. AP pyelogram 3. AP ureterogram

4. Spine and Pelvis

A. Cervical Spine 1. AP angle cephalad 2. AP open mouth 3. lateral 4. cross table lateral 5. anterior oblique 6. posterior oblique 7. lateral swimmers 8. lateral flexion and extension 9. AP dens (Fuchs)

10. PA dens (Judd) B. Thoracic Spine

1. AP 2. lateral, breathing 3. lateral, expiration

C. Scoliosis Series 1. AP/PA scoliosis series

(Ferguson) D. Lumbar Spine

1. AP 2. PA 3. lateral 4. L5-S1 lateral spot 5. posterior oblique 45º 6. anterior oblique 45º 7. AP L5-S1, 30-35º cephalad 8. AP right and left bending 9. lateral flexion and extension

E. Sacrum and Coccyx 1. AP sacrum, 15-25º cephalad 2. AP coccyx, 10-20º caudad 3. lateral sacrum and coccyx,

combined 4. lateral sacrum or coccyx,

separate

F. Sacroiliac Joints 1. AP 2. posterior oblique 3. anterior oblique

G. Pelvis and Hip 1. AP hip only 2. cross-table lateral hip 3. unilateral frog-leg, non-trauma 4. axiolateral inferosuperior,

trauma (Clements-Nakayama) 5. AP pelvis 6. AP pelvis, bilateral frog-leg 7. AP pelvis, axial anterior pelvic

bones (inlet, outlet) 8. anterior oblique pelvis,

acetabulum (Judet) 5. Head

A. Skull 1. AP axial (Towne) 2. lateral 3. PA (Caldwell) 4. PA no angle 5. submentovertical (full basal) 6. PA 25-30º angle (Haas) 7. trauma cross table lateral 8. trauma AP, 15º cephalad 9. trauma AP, no angle

10. trauma AP, axial (Towne) B. Facial Bones

1. lateral 2. parietoacanthial (Waters) 3. PA (Caldwell) 4. PA (modified Waters)

C. Mandible 1. axiolateral oblique 2. PA no angle 3. AP axial (Towne) 4. PA semi-axial, 20-25º

cephalad 5. PA (modified Waters) 6. submentovertical (full basal)

D. Zygomatic Arch 1. submentovertical (full basal) 2. parietoacanthial (Waters) 3. AP axial (Towne) 4. axial oblique 5. lateral

E. Temporomandibular Joints 1. lateral (Law) 2. lateral (Schuller) 3. AP axial (Towne)

F. Nasal Bones 1. parietoacanthial (Waters) 2. lateral 3. PA (Caldwell)

G. Orbits 1. parietoacanthial (Waters) 2. lateral 3. PA (Caldwell)

H. Paranasal Sinuses 1. lateral 2. PA (Caldwell) 3. parietoacanthial (Waters) 4. submentovertical (full basal) 5. open mouth parietoacanthial

(Waters)

6. Extremities G. Patella N. Humerus A. Toes 1. lateral 1. AP non-trauma

1. AP, entire foot 2. oblique toe 3. lateral toe

B. Foot 1. AP angle toward heel 2. medial oblique 3. lateral oblique 4. mediolateral 5. lateromedial 6. sesamoids, tangential 7. AP weight bearing 8. lateral weight bearing

C. Calcaneus (Os Calcis) 1. lateral 2. plantodorsal, axial

2. supine flexion 45º (Merchant) 3. PA 4. prone flexion 90º (Settegast) 5. prone flexion 55º (Hughston)

H. Femur 1. AP 2. mediolateral

I. Fingers 1. PA entire hand 2. PA finger only 3. lateral 4. oblique 5. AP thumb 6. oblique thumb 7. lateral thumb

2. lateral non-trauma 3. AP neutral trauma 4. scapular Y trauma 5. transthoracic lateral trauma 6. lateral, mid and distal, trauma

O. Shoulder 1. AP internal and external

rotation 2. inferosuperior axial, non-

trauma 3. posterior oblique (Grashey) 4. tangential non-trauma 5. AP neutral trauma 6. transthoracic lateral trauma 7. scapular Y trauma

3. dorsoplantar, axial J. Hand P. Scapula D. Ankle 1. PA 1. AP

1. AP 2. lateral 2. lateral, anterior oblique2. AP mortise 3. oblique 3. lateral, posterior oblique3. mediolateral K. Wrist Q. Clavicle 4. oblique, 45º internal 1. PA 1. AP 5. lateromedial 2. oblique 45º 2. AP angle, 15-30º cephalad6. AP stress views 3. lateral 3. PA angle, 15-30º caudad

E. Tibia, Fibula 4. PA for scaphoid R. Acromioclavicular Joints – AP1. AP 5. scaphoid (Stecher) Bilateral With and Without2. lateral 6. carpal canal Weights 3. oblique L. Forearm S. Bone Survey

F. Knee 1. AP T. Long Bone Measurement1. AP 2. lateral U. Bone Age 2. lateral M. Elbow V. Soft Tissue/Foreign Body3. AP weight bearing 1. AP4. lateral oblique 45º 2. lateral 7. Other Procedures 5. medial oblique 45º 3. external oblique A. Arthrography 6. PA 4. internal oblique B. Myelography 7. PA axial – intercondylar 5. AP partial flexion

fossa (tunnel) 6. axial trauma (Coyle)

Attachment B

Standard Terminology for Positioning and Projection

Radiographic View: Describes the body part as seen by the image receptor or other

recording medium, such as a fluoroscopic screen. Restricted to the discussion of a radiograph or image.

Radiographic Position: Refers to a specific body position, such as supine, prone,

recumbent, erect, or Trendelenburg. Restricted to the discussion of the patient’s physical position.

Radiographic Projection: Restricted to the discussion of the path of the central ray.

POSITIONING

TERMINOLOGY A. Lying

Down

1. supine lying on the back 2. prone lying face downward3. decubitus lying down with a horizontal x-ray4. recumbent lying down in any position

B. Erect or Upright

1. anterior position facing the image receptor2. posterior position facing the radiographic3. oblique position erect or lying down

a. anterior (facing the image receptor)

i. left anterior oblique body rotated with the left anterior portion closest to the image receptor

ii. right anterior oblique body rotated with the right anterior portion closest to the image receptor

b. posterior (facing the radiographic tube)

i. left posterior oblique body rotated with the left posterior

portion closest to the image receptor ii. right posterior oblique body rotated with the right posterior

portion closest to the image receptor

Anteroposterior Projection Posteroanterior Projection

Right Lateral Position Left Lateral Position

Left Posterior Oblique Position Right Posterior Oblique Position

Left Anterior Oblique Position Right Anterior Oblique Position

Attachment C

ARRT Standard Definitions

Term Film-Screen Radiography Term Digital Radiography

Recorded Detail

The sharpness of the structural lines as recorded in the radiographic image.

Spatial Resolution

The sharpness of the structural edges recorded in the image.

Density Radiographic density is the degree of blackening or opacity of an area in a radiograph due to the accumulation of black metallic silver following exposure and processing of a film.

Density = Log i n ci dentl i ghtintensi ty transm i tted l i ghtintensi ty

Brightness Brightness is the measurement of the luminance of a monitor calibrated in units of candela (cd) per square meter on a monitor or soft copy.

Density on a hard copy is the same as film.

Contrast Radiographic contrast is defined as the visible differences between any two selected areas of density levels within the radiographic image.

Scale of Contrast refers to the number of densities visible (or the number of shades of gray).

Long Scale is the term used when slight differences between densities are present (low contrast) but the total number of densities is increased.

Short Scale is the term used when considerable or major differences between densities are present (high contrast) but the total number of densities is reduced.

Contrast Image contrast of display contrast is determined primarily by the processing algorithm (mathematical codes used by the software to provide the desired image appearance). The default algorithm determines the initial processing codes applied to the image data.

Scale of Contrast is synonymous to “gray scale” and is linked to the bit depth of the system. ‘Gray scale’ is used instead of “scale of contrast” when referring to digital images.

Film Latitude

The inherent ability of the film to record a long range of density levels on the radiograph.

Film latitude and film contrast depend upon the sensitometric properties of the film and the processing conditions, and are determined directly from the characteristic H and D curve.

Dynamic Range

The range of exposures that may be captured by a detector. The dynamic range for digital imaging is much larger than film.

Film Contrast

The inherent ability of the film emulsion to react to radiation and record a range of densities.

Receptor Contrast

The fixed characteristic of the receptor. Most digital receptors have an essentially linear response to exposure. This is impacted by contrast resolution (the smallest exposure change or signal difference that can be detected). Ultimately, contrast resolution is limited by the dynamic range and the quantization (number of bits per pixel) of the detector.

Exposure Latitude

The range of exposure factors which will produce a diagnostic radiograph.

Exposure Latitude

The range of exposures which produces quality images at appropriate patient dose.

Subject Contrast

The difference in the quantity of radiation transmitted by a particular part as a result of the different absorption characteristics of the tissues and structures making up that part.

Subject Contrast

The magnitude of the signal difference in the remnant beam.

HGTC STUDENT BACKGROUND CHECK, DRUG SCREENING

& IMMUNIZATION/HEALTH TRACKING PACKET

Criminal Background Checks: To comply with the requirements of accrediting organizations, clinical/field placement partners, and State and Federal laws governing licensing, HGTC students are required to have acceptable criminal background checks and/or urine drug screening and/or appropriate health information/immunizations to participate in placement(s) at clinical and field facilities. Typically, these checks and proof of health information/immunizations must be provided prior to the start of the first semester requiring clinical/field placement. NOTE: Should your enrollment be interrupted (you miss a semester), new results for background checks, urine drug screening and/or health/immunization will be required. All fees and costs associated with any checks, screenings or immunization are the responsibility of the student. Admission to any of the programs listed below is conditional. Unsatisfactory results on the criminal background check or urine drug screening, or failure to complete any required health/immunization standards WILL prevent enrollment or result in removal from enrollment in the program of study. Criminal Background Check/Urine Drug Screening/Immunization Tracker REQUIRED WITHIN 30 DAYS PRIOR TO START of 1st clinical/field class