Medstar Washington Hospital Center Medical Imaging School Handbook. Revised

Transcription

1 Medstar Washington Hospital Center Medical Imaging School Handbook Revised

2 Introduction Welcome to the Medical Imaging School. As part of your training for this program, you should refer to this handbook often for the duration of the program. Information in this handbook includes clinical protocols as well as policies and Procedures of the school. As part of the radiology department, you will also need to adhere to the policies and procedures established by the hospital. Please remember this handbook is your responsibility. By accepting this manual, you agree to adhere to our policies and procedures. If you have any questions, please do not hesitate to ask any of our school staff. We hope that you will enjoy being part of our program here at the Medstar Washington Hospital Center.

3 Table of Contents Medical Imaging School Handbook A. Expectations For Department Procedures B. Classroom Etiquette and Proper student Behavior Page 12: Orientation Schedule Page 13: Mission Statement, Program Goals, and Student Learning Outcomes Page 14: MWHC Mission and Vision Page 15-16: Medstar General Information Page 17: Program Effectiveness Data (5 Year) Page 18-19: Philosophy Page 20: Vacation, Sick leave, and Holidays Page 21-22: Entrance requirements Page 23: Graduation Requirements Page 24: Part Time Policy, Transfer and Advance Placement Policies Page 25: Conferences, Counseling, and Student Records Page 26: Part time Work Page 27-28: Dress code Page 29: Disability& Hospital Policy Disclaimer Page 30-39: Pregnancy Policy Page 40: MRI Safety Policy Page 41: MRI Safety Orientation Screening Form Page 42: Clinical Competency Requirement Schedule Page 43: School Calendar Page 44: JRCERT Recognized Clinical Sites Page 45-46: Attendance Policy Page 47: Dosimeters Page 48: Program Faculty Roster Page 49: Clinical & Supervisor MWHC Roster Page 50: GUH Roster of Clinical instructors and Staff

4 Page 51: NRH Roster of Clinical Instructors Page 52: Children s Roster of Clinical Instructors and Staff Page 53: Students Clinical Assignment rotations Page 54: Academic Courses Page 55-56: Professional Course Descriptions Page 57: Medical Imaging School Organizational Chart Page 58: MWHC Radiology Department Organizational Chart Page 59-60: Disciplinary Action Page 61: Failing grades & Exams Policy Page 62: Grievance Policy Page 63: Honor Code Page 64: Communicable Disease Policy Page 65-68: Radiology Department Policies Page 69-71: Enrollment Agreement, Tuition Agreement, and Tuition & Fees Page 72-73: Clinical Grading Process Page 74: Textbook List Page 75: Clock in and out Procedure Page 76: Comp time & Early Departure Policy Page 77: Telephone log Page 78-83: Washington Hospital Center Radiology Standard Projections Page 84: Direct/Indirect Supervision of student Radiographers Page85: Trauma Rotation and Proficiencies Page 86: Clinical Make up time form Page : Learning Objectives of clinical areas Page 130: Clinical Schedule Page : JRCERT Standards

5 Section A & B Class and Clinical Expectations

6 A School of Medical Imaging Expectations for Department Procedures Whenever individuals work together, as in the Medical Imaging School, it is necessary to establish reasonable standards of performance and conduct. Such standards are intended to promote cooperation, efficiency and safety for all individuals interacting each day. These standards provide guidance to assist both the employee and the supervisor in: Achieving the goals of the School, the Imaging Department, MedStar Washington Hospital Center, and MedStar Health, and Understanding the student's role in contributing to those goals. As a reminder, all students are expected to follow the standards outlined in this document, as well as applicable MedStar Washington Hospital Center policies. Regular and Punctual Attendance Students are expected to be regular and punctual in their attendance at work. Students are expected to adhere to the schedule to which they are assigned. Students are to report dressed and ready for work or instruction at their job location and quit work at their job location at the time designated by the School. Department Hours of Operation (Example: Core office hours 8:00 a.m. 4:00 p.m.) Performance of Duties Students are expected to perform their duties efficiently, promptly and safely. You are responsible for using your work time for department business, being alert, and using appropriate judgment, discretion, and integrity at all times. Consistent excellence in service to both internal and external customers is expected. Students are expected to be present and on time for classroom lectures. This means the student is present and prepared for class to begin on time. Students are expected to exhibit the qualities of dependability and timeliness while on assignment in clinical rotations. Notification of Absences/Tardies Students who cannot report to work as scheduled are required to personally call and leave a voice message for the Director and/or the Clinical Coordinator 2 hours prior to the scheduled starting time. If the student is scheduled to be in Clinic, the Clinical Area must also be notified. No one else may call for the student. Students may not leave a message with another student. Absences due to personal illness of 3 days or longer will require a physician s note. The faculty reserves the right at any time to ask for proof of a scheduled or unscheduled absence. This will include a health care provider s note, court document, towing or garage receipt, etc.

7 A Severe Weather Conditions In the event of inclement weather, the Medical Imaging School will remain open. The hospital does not have the option to close during inclement weather, as patients need care every day. Each person is expected to plan for a safe and timely arrival to the Hospital Center for assigned shifts. Students scheduled on a regular school day are responsible for making every effort to come to work for their scheduled shift during emergency operations, inclusive of inclement weather. Clocking In Students should use the designated Radonline School software application to clock in. ID Badges Pursuant to hospital dress code policy HRP 402d, you re WHC ID badge must be worn at all times on WHC premises. Early Departures Students are to report dressed and fit for work at their job location and quit work at their job location at the time designated by the School. Advance notice is required for scheduled leave and/or any absence from the work area. Any early departure without prior authorization from the Supervisor constitutes schedule abuse and may subject the student to progressive discipline. Personal Cell Phones Personal cell phones should not be used during scheduled work hours. Staff Meetings Attendance at department staff meetings is mandatory. The School Director must be notified immediately if an employee is unable to attend a meeting. Department Telephones All calls should be answered according to the Washington Hospital Center greeting script. Personal telephone calls should be kept to a minimum and should only occur during an authorized break period. Following these standards should lead to a continued successful work experience for all in the Imaging Department. Should you have any questions or need additional clarification on these expectations, please feel free to speak to the Director. Disciplinary Action Failure to follow these reasonable expectations or violation of any hospital policy may result in disciplinary action, up to and including termination. Page 59 in the student handbook lists conduct that is unacceptable, and which may result in discipline and/or removal from the school program. A student may be dismissed from the Program at any time during the program. Dismissal from the program is permanent, and does not allow for reapplication to the program.

8 A Reasons for dismissal may include but are not limited to: The student s academic or clinical records are unsatisfactory. The student is absent for three consecutive days without notifying the program. The student has committed a breach of a major or critical rule or regulation of the hospital, Department of Radiology, or Medical Imaging School. The student displays an antagonistic disposition or any other undesirable trait, making them unsuitable for the field of medical imaging. Failure to adapt to any program requirements. Reporting to the Program under the influence or any intoxicant, hallucinogenic, or narcotic or where the presence of any such agent can be established by a for cause drug test. Unauthorized possession or use of an intoxicant, hallucinogenic, or narcotic while on the premises. Failure to submit to an alcohol or drug screening. Unauthorized possession of a firearm or deadly weapon on the premises. Fighting, issuing threats or verbal abuse, or other disorderly conduct on the premises, or while engaged in Medstar business. Absence from the Program for three consecutive without notification with a satisfactory reason. This type of absence constitutes Program abandonment. Breach of HIPAA or inappropriate disclosure of protected healthcare information.(phi) Failure of three clinical rotations. I have received and copy of this document and understand the above statements. Employee Signature Date Supervisor Signature Date

9 B Medstar Washington Hospital Center Medical Imaging School Classroom Etiquette and Proper Student Behavior The way you present yourself in the classroom makes an impression on your instructor and your classmates. Do you present yourself as a serious, dedicated student, or do you come off as uninterested or maybe even disruptive? As a Medical Imaging student, you are expected to act in a mature manner. Below is a list of Do s and Don ts for the Radiography classroom that will help facilitate a learning centered atmosphere: Take responsibility for your education Instructors are here to create a learning environment whether or not you learn Depends on your willingness to listen, ask appropriate questions, and do the work necessary to pass the course. Attend class Students, who attend class, listen to the instructor, ask questions, and take good Notes are more likely to pass with a higher grade. If you must miss a class, Contact your instructor ahead of time to let him or her know that you will not be in class. DO NOT ask the instructor to repeat material you missed because you skipped a class. Be on time Walking in late disturbs everyone. At this School and many places of Employment, tardiness communicates lack of interest and lack of dependability. If you cannot avoid being late, make sure to be unobtrusive about your entry. Come to class prepared turn your work in on time Complete assigned reading before coming to class. Make sure to bring common Classroom supplies such as a pencil, paper, textbook, test materials, etc. along with completed homework. Students who attempt to complete their assigned homework in classroom at the last minute often earn lower grades and are more likely to miss deadlines. Do not get up and walk out halfway through the class It disturbs people and gives the unmistakable impression that you don t respect The class, the other students or the instructor. The instructor has the right to finish his or her thought at the end of the class period and conclude the class in an orderly fashion without people standing up and walking out.

10 Unpack before class / pack after The sound of zippers on backpacks along with the rustling of papers and/or jackets also disrupt the classroom and indicate lack of respect. B Ask appropriate questions It s good to ask questions and make comments, but keep them related to the discussion at hand. Dominating class time with too many questions or comments prohibits other students from participating in discussions. Practice common courtesy Remember that in college, as in every other area of life, politeness and respect count. Do not have private conversations with your neighbors during class. Turn off cell phones. The noise is distracting to other students. Respect all opinions. Others may have different ideas and opinions, they may ask questions that you perceive to be stupid, but they deserve the same level of respect from you as you wish from them. Respect your instructor Openly challenging the instructor s knowledge or authority in the classroom is improper. If you have differences with your instructor s information or teaching methods, you may want to discuss your issues with the instructor outside of the classroom in a non-confrontational manner. If you are struggling with your coursework, seek assistance. Your instructors are willing to assist you; however, there are many other ways to get help. Contact your instructor for some one on one assistance after class. Or Study groups. Reading of materials, newspapers, textbooks from other courses, etc. Reading of materials, other than those pertaining to the class you are in, should not occur in the classroom. Homework should not be done in class it should be completed outside the classroom. Do not cut the instructor off at the end of class The instructor has the right to finish her or his thought at the end of class and conclude in an orderly manner without people walking out, juggling materials, coats, etc. You may also miss important information if you are not present to the end of class. The ten minutes between classes is plenty of time to take a break.

11 B Sleeping in class is not acceptable Sleeping in class is disrespectful (especially when someone is giving a presentation or there is a guest speaker). If you re tired you might as well stay home and get the sleep. Class attendance is based on both presence and on participation (which won t occur while you are sleeping). Don t interrupt others and be polite in your speech and manners - no profanity or lewd language. Respect the Facilities Students are expected to help maintain the appearance of the classroom. Whatever you bring into the classroom should leave with you. After class discard/recycle all trash. Someone else does not want to sit in your mess. Do not chat with your neighbor during class Most instructors don t mind if you ask your neighbor something quietly, but talking to classmates during lecture and presentations (whether a student or guest speaker) disrupts the normal learning environment. If you desire to engage in such behavior, you may be asked to leave the class. If you need the professor to slow down or to review some material raise your hand and ask them to do so it s much more effective than complaining to your neighbor. If you need to catch up with a friend, find time to do so outside of class. There should never be talking during a test until the instructor announces that the test is over. If you need to have a discussion go outside of the testing environment after you have finished your test. If you make an effort to participate and get the most out of class, your professors will see that effort and reward it. Remember we expect all MWHC associates, including students, to uphold and follow the spirit values.

12 12 Orientation Schedule Monday (Date TBD) 8am -430pm: Hospital Orientation Tuesday (Date TBD) 9 am-noons: School Orientation (Handbook and Policies) Noon to 1pm: Lunch 1pm to 4pm: Hospital Orientation Continued Wednesday (Date TBD) 9is to noon: School Orientation Noon to 1pm: Lunch 1pm-4pm: Radiation Safety Orientation/ MRI Safety Thursday (Date TBD) 9is to noon: School Orientation (Computer applications)/equipment Demonstration Noon to 1pm: Lunch 1pm-4pm: Radiation Safety Friday (Date TBD) 9am to 11am: Q&A Tuition collection and enrollment agreements SITEL Modules transcripts collected 11am to noon: Orientation Quiz Noon to 1pm: Lunch (Welcome Reception) 2pm to 4pm: Clinical Tours 12

13 13 Medstar Washington Hospital Medical Imaging School Mission Statement MedStar Washington Hospital Center Medical Imaging School will provide a comprehensive, quality education in the field of radiography to qualified individuals, to prepare them for careers in medical imaging, and to provide radiographers for the health care community. Program Goals 1. The students will demonstrate professionalism-program Effectiveness Student Learning Outcomes The graduates will be satisfied with the program The students will successfully complete the program Students will become registered in Radiography RT(R) within six months of graduation Students will become employed as radiographers within six months after graduation Employers will be satisfied with the program's graduates based on follow up feedback 2. Students will demonstrate strong clinical skills Student Learning Outcomes Students will position patients to provide diagnostic images Students demonstrate high quality patient care to all patients Students will demonstrate appropriate radiation safety for self and others 3. Students will develop strong critical thinking skills Student Learning Outcomes Students will demonstrate strong problem solving skills _ Students will recognize non-routine clinical situations and make appropriate modifications Students will identify quality diagnostic images and make appropriate changes when needed 4. Students will develop strong communication skills Student Learning Outcomes Students will learn the language of medicine Students will demonstrate strong communication skills with peers Students will demonstrate strong communication skills with patients 5. Students will continue their education through lifelong learning, professional development and growth Student Learning Outcomes Students will demonstrate professional development and growth Students will understand the importance of life-long learning Graduates will continue their education through fellowships Students will demonstrate professionalism at all times 13

14 14 Mission, Vision, and Values Mission MedStar Washington Hospital Center, a valued member of MedStar Health, is dedicated to delivering exceptional PATIENT FIRST health care. We provide the region with the highest quality and latest medical advances through excellence in patient care, education and research. Our Vision To be the trusted leader in caring for people and advancing health. Guiding Principle To treat each patient as we would a member of our own family by providing the best medical treatment with caring and compassion, responsive service, and intelligent use of resources. Through this achievement, we will be recognized as a national model for excellence in patient-centered care. Values Service - We strive to anticipate and meet the needs of our patients, physicians and co-workers. Patient First - We strive to deliver the very best to every patient every day. The patient is the first priority in everything we do. Integrity - We communicate openly and honestly, build trust and conduct ourselves according to the highest ethical standards. Respect - We greet each individual, those we serve and those with whom we work, with the highest professionalism and dignity. Innovation - We embrace change and work to improve all we do in a fiscally responsible manner. Teamwork - System effectiveness is built on the collective strength and cultural diversity of everyone, working with open communication and mutual respect. 14

15 Stats MedStar Washington Hospital Center is a not-for-profit, 912-bed, major teaching and research hospital in the nation s capital. The Hospital Center is among the 100 largest hospitals in the nation,* and is renowned for handling the Washington region s most complex cases. Its cardiology program is highly acclaimed and its cardiac surgery program has consistently earned the highest designation three stars from the Society of Thoracic Surgeons. A long-standing leader in cardiovascular care, MedStar Washington Hospital Center is home to MedStar Heart & Vascular Institute, which formed a first-of-its kind clinical and research alliance with Cleveland Clinic Heart & Vascular Institute in The Hospital Center operates the Washington region s first Comprehensive Stroke Center and the District s only Cardiac Ventricular Assist Device program, both certified by The Joint Commission. The hospital is also home to MedSTAR, a nationallyverified level I trauma center with a state-of-the-art fleet of helicopters and ambulances, and also operates the region s only adult Burn Center. Beds/Staff Licensed Beds Associates... 5,933 Nurses... 1,743 Medical/Dental Staff Physicians... 1,351 Advanced Practice Clinicians Medical Education and Research Residents/Fellows Residency/Fellowship programs Clinical research studies Patient Care Inpatient admissions... 36,816 Outpatient visits...390,047 Cancer admissions...1,432 Cancer outpatient visits... 66,695 Cardiac admissions... 6,900 Cardiac surgeries... 1,733 Ventricular assist device procedures Heart transplants...16 Neuro admissions...2,645 15

16 16 ED visits... 86,771 ED admissions... 21,530 MedSTAR Trauma admissions... 2,551 MedSTAR ground critical care transports...1,132 MedSTAR helicopter missions... 1,826 Inpatient surgeries...11,884 Outpatient surgeries...11,335 Births...3,564 Community Commitment Charity care... $17.7 million Bad debt...$72 million 16

17 17 MedStar Washington Hospital Center: Five year Program Effectiveness Data Graduating Year # of # of Accepted Graduates Students # took National Registry # Passing # Passing First Time Registry # of Students Job Placed # of Actively Seeking Employment # of Not Actively Seeking Employment Graduate Satisfaction (82%) 10 (100%) 10 (91%) % (45%) 8 (88%) 9 (82%) % (46%) 12 (100%) 10 (78%) % (71%) 7 (100%) 7 (100%) % (100%) 11 (100%) 11 (100%) % 52 Total Examinees 35 # of Passing the First Attempt Five year average pass rate first attempt: 69% Five year average pass rate including all attempts: 98 % Five year average job placement rate: 90% Five year average employer satisfaction: 100% *Not actively seeking employment is defined by: 1. Graduate fails to communicate with program officials regarding employment status after multiple attempts OR 2. Graduate is unwilling to seek employment that requires relocation 3.Graduate is unwilling to accept employment due to salary or hours OR 4. Graduate is on active military duty OR 5. Graduate is continuing education 17

18 18 GENERAL INFORMATION The Washington Hospital Center has a 22-month program in Radiologic Technology. Students receive a certificate upon completion of the program. They are then eligible to sit for the board examination of the American Registry of Radiologic Technologists. The program is Accredited by the Joint Review Committee on Education in Radiologic Technology. The Standards for an Accredited Educational Program in Radiologic Sciences published by the Joint Review Committee is available in your Handbook. PHILOSOPHY The primary purpose of the radiographer is to assist a qualified physician in making a diagnosis through the application of ionizing radiation to produce an image. To adequately perform the duties of a radiographer, it is necessary to have good physical and mental health. Radiography can be a physically strenuous field. It requires the ability to lift and move patients, and to operate heavy equipment. Radiography also requires the use of independent judgment and initiative. A radiographer must have empathy for the patient, an appreciation of medical ethics and an understanding of patient care procedures. This includes an awareness and attention to adequate radiation protection for patients as well as self and others. The radiographer must also have an extensive knowledge of anatomy, positioning and radiographic technique in order to produce diagnostic images, and must be able to evaluate the quality of the radiographs produced. The following months of training will be extremely demanding. Your ability, interest and desire for proficiency will govern your degree of success. As an integral part of the hospital team, you will have special responsibilities. You must be prepared and willing to assist those who come to our hospital seeking care and assistance. Your training will occur in the presence of and in association with physicians, radiographers, nurses and students of various educational and technical levels, all concerned with providing the best possible care and treatment of the sick at any hour of the day or night. As a student you must be receptive and immediately willing to grasp the goals and purposes of this institution. The hospital has many functions to perform including the prevention of disease, the education of both health professionals and patients and the conduct of clinical research. All of these activities must be conducted with an overriding concern for the patient and recognition of his/her dignity as a human being. 18

19 19 Since the hospital offers the patient many services, each phase of the complex structure depends upon the equally efficient and effective operation of all services. Every job, small or large, is important, and every student has a serious responsibility to his studies, his work and to support and contribute to the overall effectiveness of the hospital 1 s efforts to provide comprehensive patient care. The making of a radiographer is a slow process. Proficiency is acquired most often by gradual accumulation of practical experience in the Radiology Department. Some individuals have an inherent appreciation of dealing with patients while others must acquire it. There is no substitute for the actual experience in the Radiology Department under the guidance of a competent medical radiologist and radiographer. CLINICAL SCHEDULE Each student is assigned to a radiographic room under the supervision of a registered or registry eligible radiographer for a period of 1-4 weeks. The majority of hours are scheduled on the day shift from 8:00a.m. - 4:00p.m. Monday through Friday. Seniors are scheduled to work evenings for a maximum of 3 weeks. Hours on the evening shift for students are 12:00 p.m.-8:00p.m. Students should be aware that because of the nature of our profession, it is not always possible to leave on time. First year clinical rotations include diagnostics, fluoroscopy, outpatient radiology, Cystology, OR, critical care, portables, scheduling desk, film room, tech work area, and the lnterventional Recovery room. Senior rotations include continued rotation through the areas listed above and the additional rotations of critical care MedStar - evening shift, computerized tomography, interventional radiology, main OR, quality control, imaging overview of MRI, Sonography, nuclear medicine and radiation therapy. 19

20 20 VACATION, SICK LEAVE AND HOLIDAYS Students have 4 weeks of vacation and 1day month of sick/personal leave over the course of the academic calendar year. Over the Course of 22 months the students have a grand total of 6 weeks and 1 personal day a month. One week of vacation is given during each class break: winter, spring, and two weeks for the summer break each year. Students who use more than their allotted days of sick/personal leave may have this time deducted from their vacation days. Any student who uses up more than their combined sick and personal time will be required to make up this time before the semester is completed. The hospital recognizes 9 holidays per year. These holidays and the vacation periods are listed in the school calendar. Students are not allowed to make up time on Institutional Holidays. The students will be off on those holidays. The school gives the student two personal floating holidays a year Veterans Day and Presidents Day. This means half of the students will be in clinical and the other half will be off. The students that work that holiday will earn a holiday comp day they can use at any time, the students that were off will work the next holiday (president s day) and will follow the same process. The students that work veteran s day will be automatically off president s day. The minimum hours needed to graduate the program is 3000 hours and there is no maximum. The student is expected to be here on scheduled and operational hours. Vacation weeks at the end of the semester the senior students are required to be in clinical the week the juniors are on vacation. And the juniors are required to be in clinical the week seniors are on vacation. There will be 1 week and 1 day that the juniors will be required to be in clinical the entire week the seniors are off for board/capstone review. The seniors will be in clinical 1 week during medical imaging school orientation for new junior class. Summer clinical will start the day after Memorial Day until their summer vacation which will be two weeks in August. The maximum time the student can be here per day is 10 hours. Only two hours per day can be made up during regular program hours. Students can volunteer to make up time the day after thanksgiving which is not an institution Holiday. They can also volunteer to make up time on weekends with prior approval. 20

21 21 ENTRANCE REQUIREMENTS Candidates for admission to the School of Radiography must submit a current H R application, with a $25.00 non-refundable application fee. All fees must be made with a check or money order and made payable to Medstar Washington Hospital Center and mailed to the Radiology Administrative Manager, cash is not accepted. All applicants must have graduated high school with Academic Diploma. All transcripts from college must be submitted. The top rated qualified students are then required to come in for an interview. Students must have a minimum of an Associate's Degree or be able to achieve the degree at the time of graduation. A 3.0 course cumulative and specific GPA is recommended. Candidates must have completed Mathematical/Logical Reasoning, Written/Oral Communication and Natural sciences with Anatomy & Physiology recommended. The remaining general education courses should be in the areas which include: Arts and Humanities, Information Systems and Social/Behavioral Sciences. 21

22 22 Admission decisions are based on a scoring system in which points are awarded the applicant based on prior education and training, experience working with patients, and an applicant interview. The student should have at minimum 3.0 GPA or higher or the equivalent, and a strong background in English, Science and Math. Applicants must be able to demonstrate the ability to meet the essential functions of a Radiologic Technologist to qualify for training. The students are now required to Take the TEAS exam to be a qualified candidate for the program. The student must obtain a physical examination by the hospital's Occupational Health and Safety Department prior to beginning on the School. The student must be in good health, and must be able to demonstrate the ability to evaluate, monitor and communicate with the patient visually and orally. Students must be able to lift and move patients, heavy equipment and to manipulate Radiographic equipment. Students must also be up to date on immunizations and receive negative results on drug and alcohol testing and submit to a criminal background check. Occupational Health and Human Resources must clear students before appointment to the program is permitted. Once accepted the student will submit a $50.00 nonrefundable admission fee. The Medical Imaging School evaluates all candidates without regard to race, color, religion, handicap, sex, sexual orientation, age, political affiliation, veteran's status or national origin. There are a limited number of spaces in the program so not all qualified applicants are accepted. 22

23 23 GRADUATION REQUIREMENTS The student must complete all academic and clinical aspects of the program and achieve an 80% On the final comprehensive exam (Capstone). Verbal and written presentations are required. Students will only have one retake of the capstone allowed with in 1 week of failing the capstone. IF this requirement is not met the student will not graduate the program and will not be granted permission to take the boards. The student must achieve a minimum grade of 80% in all classes, and must complete all clinical grading with an 85% or higher average. All Clinical Competency forms must be submitted into the online competency system within 2 weeks of completing them. Comp time forms must be turned within 2 weeks of earning the time. Reimbursement for parking at Georgetown University Hospital must be submitted during the clinical rotation, not before. The student must complete a minimum of 22 months in the program, and must make-up any time missed in excess of the allotted sick and vacation time each semester. The student must follow the required time and attendance policies and all hospital, radiology and school policies. The student must complete any required make-up work for all didactic and clinical courses prior to the end of each trimester. A grade of "l will be given if the semester work is not complete. The student will have (2) weeks to complete all coursework. Failure to do so will result in an "F." for The course and dismissal from the program, except for minor courses. Failure to take a required Exam or assignment may lead to dismissal. The student must pay all fees owed to the school and return any materials prior to progressing to the next trimester. Failure to do so will prevent the student from going to the next trimester. Any fees owed the school prior to graduation must be paid or the student will not be allowed to graduate. Policies may change as needed. Students will be informed of changes in a timely basis. 23

24 24 PART-TIME POLICY Students will not be admitted into the program on a part-time basis. However, if the need arises due to medical or personal reasons, a student may cut back to part-time attendance on a temporary basis. Part-time attendance should include attending all academic classes. Any clinical time missed must be made up prior to graduation. Attending part-time may result in a student's delayed graduation from the program. TRANSFER and ADVANCED PLACEMENT POLICY Students may be admitted into the program as transfer students if they have completed at least 6 months or 1/4 of the professional curriculum including clinical training in an accredited radiography program. They must present academic and clinical transcripts to school staff for evaluation and may also be asked to present copies of tests and clinical evaluations. In addition, school staff will need copies of student handbooks/catalogs from the original program. The applicant for transfer will be interviewed by school staff and may be required to take comprehensive examinations to determine proper placement in the program. School staff will determine how much academic credit and clinical credit to award the transfer student. The student may be required to repeat academic and/or clinical work depending on how closely the original and transfer program correlate and on how recently the prior training was completed. A transfer student must complete a minimum of 6 months of academic and clinical training in the program to qualify for graduation. Transfer students may take more than 22 months to complete training due to delays caused by differences in sequencing between programs or the need to repeat some academic courses or clinical rotations. The transfer student will be required to meet all of the requirements for graduation from the program. 24

25 25 CONFERENCES At mid semester and the semester's end the student will be called to a conference with the school staff to review their academic and clinical progress. More frequent conferences may be called at the discretion of school staff if specific problems arise. Students will be given midsemester progress reports and report card at the end of the semester. Students will be able to view their grades in their personal access to their online grade report through the quick schools application. Students also will be able to monitor their own time and attendance and clinical grades and evaluations through the online radiography school system. COUNSELING Students who desire assistance with either academic or clinical problems can consult with school staff at any time. For problems of a more personal nature, there is a professional counseling referral service available through the hospital's Employee Assistance Program. School staff or self referral can refer a student. The E.A.P. coordinator can be reached at extension The office is in room G008 in the hospital's East Building. STUDENT RECORDS In accordance with the Family Educational Rights and Privacy Act of 1974, students are entitled to examine their records at any time. Student records are kept confidential. The release of information in the student s file to anyone other than the student, school or hospital staff will Occur only with the student's permission with the following exceptions: the law permits Authorities of the Veteran's Administration, Title IV Student Aid programs and accrediting agencies to examine student records without the student's release. Allow two weeks for transcript Requests. 25

26 26 PART TIME WORK The broad aspect of training encompassed in the program leaves little free time for the student. Therefore students are encouraged to limit outside employment during training especially during the first few months of the program. If students are interested in part-time employment within the Main Radiology, Outpatient Radiology, MRI or CT departments, they should check with the appropriate supervisor or the chief technologist as to job availability. May include work as an Image library clerk, receptionist, hall monitor or transporter. Temporary work may also be available for special research projects or for film purging activities. Any work performed by the student inside or outside the hospital, may not conflict with regularly scheduled student hours. 26

27 27 DRESS CODE As part of the hospital team, students are expected to present a professional appearance at all times. This includes wearing a clean, pressed uniform and being well groomed. The student uniform consists of Forest/Hunter Green scrub suits, white socks or stockings, and sneakers. (Tops and bottoms should match.) Hospital scrubs must be worn in hospital operating rooms and in interventional radiology. Long hair should be pulled back for your protection from infection. Perfumed products (this includes not only perfume and cologne but aftershave and any heavily perfumed hair or skin product) should not be worn as they create respiratory problems in patients suffering from Asthma, allergies or chronic obstructive pulmonary diseases. We suggest that you not wear jewelry As it may pick up germs or may be damaged. Visible body piercing and visible tattoos are prohibited. Fingernails should be no longer than 1/4nch in length.. Students are required to wear their hospital identification at all times when on hospital property. HRP211 ( ) 27

28 28 DRESS CODE AND APPAREL INFORMATION Dress Code: The required uniform for the first year of training is Hunter/forest Green scrub suits. White Socks with nursing shoes or tennis shoes (no extreme colors) are appropriate. Uniforms should be neat and clean. No hip hugger style pants or short tops are not allowed. It is suggested to purchase at least three sets of scrubs. Your uniform also includes your ID badge and film badge (you will receive these during orientation). These items must be worn every day. Hospital issued scrubs may be worn if the student is assigned to the main operating room (MOR), the third floor outpatient operating room (TFO), or interventional radiology(ir). If the student soils his/her school uniform during a clinical rotation, hospital scrubs may be substituted. Some areas of the hospital are colder in temperature than others. You may purchase Hunter/forest green or white scrub jackets to wear over your uniform. T-shirts, if worn under your scrub suit should not be long sleeved and should be tucked inside the scrub suit. Uniforms should be worn everyday in the clinical areas unless otherwise notified. Students must wear their hair pulled back if hair is longer that shoulder length..tattoos must always be covered. No nose or facial Piercings. Earrings are allowed but must be smaller than a Dime. No extreme hairstyles, hair colors, excessive jewelry, extreme piercings (eye, lip, nose, tongue) Are allowed. Uniform Vendors: just suggestions) Uniform City- 406 North Howard Street, Baltimore, MD, Linn's Uniforms-7423 Annapolis Road, Landover Hills, MD, Rivers Mill Road, Rockville, MD, Nurses Call the Shots Festival Way, Waldorf, MD, Gallos and family dollars also offer scrubs Most Wal-Mart stores carry a limited variety of scrubs, located in the women's section. Online Vendors:

29 29 Hospital Policies may be found on Starport the medstar Intranet website under MyHR tab. DISABILITY If a disability arises during training that requires a leave of absence or restrictions on academic or clinical training, the student must present a letter from their doctor stating the nature of the problem, the probable duration of the problem and the restrictions that must be placed on the student's training. School staff will refer the student to Occupational Health/Managed Disability and they will evaluate the physician's recommendations. The student must also submit documentation to Occupational Health/ Managed Disability from their physician when they are ready to return to normal status. Occupational Health/Managed Disability will make the final determination on a student's ability to return to training. A leave of absence may be granted to a student for personal reasons at the discretion of school staff. Academic and clinical work, and time missed must be made up prior to a student's graduation from the program. If the leave of absence or academic or clinical restriction occur at a critical point in the program or are prolonged, the student may be required to restart the program from the beginning or re-enter the program at the point where the separation or restrictions occurred. If a student's physician states that the disability is permanent and that the disability would prevent the student from performing the tasks required of an entry level radiographer, the student will be dismissed from the program. 29

30 30 PREGNANCY POLICY the policy follows NRC Guide 8.13 If a female student becomes pregnant during training, she has the option of informing or not informing school staff of her pregnancy. If she decides to inform school staff, it must be in writing and include the expected date of delivery. If a student discloses her pregnancy to school staff, she will have the following options of continuing her course of training: 1) Continue training without modification or interruption, or 2) Modify clinical assignments to reduce radiation risk to the developing embryo/fetus, or 3) Limit attendance to academic classes only, or 4) Take a leave of absence for part of or for the full duration of the pregnancy. 5) Options for student include but are not limited to: The student will be granted a leave of absence for the birth of the child. When the student is ready to return to training, she must process back in through the Occupational Health departments before returning to training. A student who informs school staff of pregnancy and wishes to continue with clinical training will be issued an additional radiation dosage badge to wear at waist level to monitor fetal exposure. She will also receive counseling on radiation exposure during pregnancy from the Radiation Safety Officer or his designee. Dosage will be checked on a monthly basis. If the student takes a leave of absence or modifies their academic or clinical schedule during pregnancy or after delivery, the student will be required to make up any clinical or academic work missed in order to qualify for graduation from the program 30

31 31 Washington Hospital Center Standard Practice Title: Declared Pregnant Worker Exposed to Radiation Section: 200 Series Purpose: This policy specifies the actions that should be taken when a worker voluntarily identifies herself in writing through her supervisor to the Department of Radiation Safety as a Declared Pregnant Worker. Number: Effective Date: I. Scope This Standard Practice applies to all Washington Hospital Center employees, contract and agency staff. II. Policy and Practices _ A. Formally Declaring Pregnancy 1. WHC encourages any worker who is exposed to radiation in the course of performing job duties and who believes that she may be pregnant to formally declare her pregnancy. WHC acknowledges that any such declaration should only be on a voluntary basis because the worker desires the increased level of radiation protection safety that will be provided. A Declared Pregnant Worker can revoke at any time and for any reason this declaration by formal written notification. WHC is committed to maintaining the radiation exposure of all workers lows reasonably achievable (ALARA). 2. WHC encourages any worker who believes that she may be pregnant or who is planning to become pregnant to review the instructions in the Nuclear Regulatory Commission's REGULATORY GUIDE 8.13, "INSTRUCTION CONCERNING PRENATAL RADIATION EXPOSURE." Each female employee assigned a radiation monitor was given this information as part of the instruction prior to being assigned a film badge. Additional copies of REGULATORY GUIDE 8.13 are available from the Radiation Safety Office. 3. By regulation, the decision to become a Declared Pregnant Worker is voluntary, must be declared in writing, and may be revoked (in writing) at any time for any reason by The worker. 4. Many occupational activities that may/could include radiation exposure at WHC do not result in annual exposures greater than 100 millirem (about 20% of the Declared Pregnant Worker limit). WHC would not change a Declared is. In the event that the exposure level may/could exceed 100 millirem requiring such monitoring, the supervisor with the advice of the 31

32 32 Radiation Safety Department may make assignment changes to limit potential exposure. 5. WHC recognizes that many workers regard their pregnancy status as a personal Matter and WHC will make every effort to maintain the privacy of Declared Pregnant Workers within the limits of implementing the increased radiation protection safety requirements. This means Department of Radiation Safety staff that are associated with providing dosimetry (Dosimeters or TLD rings), providing radiation training relevant to exposure of the embryo/fetus, and program oversight may be informed of the Declared Pregnant Worker's status B. How the Declaration of Pregnancy is Made A declaration of pregnancy must be made in writing through the employee's supervisor to the Department of Radiation Safety. The employee contacts her supervisor to obtain a Declaration Form from the Department of Radiation Safety. C. Dosimetry Actions 1. When a declaration of pregnancy is received, the Department of Radiation Safety will evaluate the Declared Pregnant Worker's monitoring needs and ensure that adequate dosimeter is issued and processed in order to provide timely dose monitoring. 2. Records of declared pregnancies, associated revocations, doses (both the Declared Pregnant Worker and the embryo/fetus) must be maintained and reported as required by 10 CFR Part If it is determined that a Declared Pregnant Worker's embryo/fetus is not likely to receive a cumulative dose of 100 mrem from external radiation, or 100 mrem from internal radiation, it is not required by 10 CFR Part 20 to provide dosimeter. However, dosimeter may be provided to Declared Pregnant Workers who routinely access Restricted Areas. 4. The Radiation Safety Officer (or designee) will review and sign the Declared Pregnant Worker declaration. III. Responsibilities A. Declared Pregnant Worker 1. Any worker who believes she may be pregnant and who desires the increased level of radiation protection provided by formally declaring her pregnancy must inform the Department of Radiation Safety through her supervisor, in writing, of her pregnancy. 2. The worker contacting the Department of Radiation Safety or her supervisor initiates This process. The Department of Radiation Safety will provide a form (Exhibit 1) This should be used to declare the pregnancy. 32

33 33 3. A physician or other caregiver should also confirm an estimated date of conception in writing as the Declared Pregnant Worker dose limit is based on the nine-month gestation period. 4. Upon travel to another facility where the Declared Pregnant Worker could receive occupational exposure, the Declared Pregnant Worker should inform the other facility other Declared Pregnant Worker status. 5. Any dose received at another facility must be reported to WHC. 33

34 34 6. It is the Declared Pregnant Worker's responsibility to notify Dosimetry upon termination of her pregnancy declaration. This is accomplished in writing using the Declared Pregnant Worker form. B. Department of Radiation Safety Dosimetry 1. Evaluate the personnel dosimetry monitoring needs, ensure adequate participation in the Dosimetry Program, and provide timely dose monitoring for all Declared Pregnant Workers. 2. Review and maintain all records of declared pregnancies and associated revocations. A record of dose received by the embryo/fetus must be maintained and reported to the Declared Pregnant Worker on an annual basis. 3. If a Declared Pregnant Worker indicates that additional information is desired, or if the Declared Pregnant Worker could potentially exceed 500 mrem during the gestation period, the Department of Radiation Safety will initiate appropriate action and ensure instruction is provided to the Declared Pregnant Worker. Individual instruction will be based on the Declared Pregnant Worker's request and potential to exceed any dose limit. 4. Maintain this policy and the Declared Pregnant Worker declaration form (Exhibit 1); and ensure that applicable WHC staff receives initial and annual training on this policy. 5. Inform and copy documentation to Managed Disability of changes in the status of a Declared Pregnant Worker. C. Supervisor/Manager 1. Promptly have any employee who desires to declare a pregnancy complete the Declared Pregnant Worker declaration form. 2. Contact Department of Radiation Safety to answer any questions that may arise concerning the policy and its implementation. 3. Written declarations of pregnancy must be forwarded to the Radiation Safety Officer. Retain a copy for department records. 4. Work with the Department of Radiation Safety to evaluate and modify work schedules and job responsibilities, if needed, to stay within dose limits. 34

35 DECLARATION OF PREGNANCY FORM This form is used by workers whose job duties may result in exposure to radiation and who desire to formally request status as a Declared Pregnant Worker, or to revoke this status if it has been previously declared. Please read this form carefully. Staff in the Department of Radiation Safety is available to answer any of your questions. 1. Please check one of the following boxes: D I am formally declaring that I am pregnant. In accordance with 10 CFR Part 20, this disclosure is voluntary and is made for the purpose of lowering the dose limit for my embryo/fetus. I realize that work restrictions may be imposed to ensure that my embryo/fetus does not receive a dose in excess of that given in 10 CFR (500 mrem during the entire gestation). I authorize WHC to release this information as necessary to implement the dose limit for my fetus. Estimated date of conception: (Must be supported by medically certified documentation) D I am withdrawing my previous declaration of pregnancy. I understand that, as a result of signing and submitting this form, any work restrictions that have been imposed as a result of my previously submitted "Declaration of Pregnancy" will be lifted. 2. Separately, check one of the following boxes: D!would D Wouldn t Like to receive information about radiation exposure or the policy concerning the declaration of my pregnancy from someone in the Department of Radiation Safety. (Please indicate what type(s) of concern(s) you have.) 35 Printed name: Signature: _ Date: Submission of this form will in no way affect the benefits, seniority, or potential for promotion of the person signing this form. Return this completed form to Radiation Safety, EB If declaring a pregnancy, please attach medical certification from your health care provider. 35

36 Reviewed by Dosimetry Assistant: _ Reviewed by Radiation Safety Officer: Date: Date: Dosimetry assigned: Form 0.08 Revised 10/8/99 36

37 Protecting Pregnant Worl<ers Fairness Act - Know Your Rights in the District of Columbia - *** 37 Accommodations for Pregnancy, Childbirth and Breastfeeding The Protecting Pregnant Workers Fairness Act {PPW) requires District of Columbia employers to provide reasonable workplace accommodations for employees whose ability to perform job duties is limited because of pregnancy, childbirth, breastfeeding, or a related medical condition. The employer must engage in good faith and in a timely and interactive process to determine the accommodations. Types of Accommodations Employers must make all reasonable accommodations,* including but not limited to: More frequent or longer breaks; Time off to recover from childbirth; Temporarily transferring the employee to a less strenuous or hazardous position; Prohibited Actions by Employers Employers may not Purchasing or modifying work equipment, such as chairs; Temporarily restructuring the Employee s position to provide light duty or a modified work schedule; Having the employee refrain from heavy lifting; Relocating the employee's work Area; or Providing private {non-bathroom) Space for expressing breast milk. Refuse an accommodation unless it would cause significant hardship or expense to the business; Take adverse action against an employee for requesting an accommodation; Deny employment opportunities to the employee because of the request or need for an accommodation; Require an employee to take leave if a reasonable accommodation can be provided; or Require employees to accept an accommodation unless it's necessary for the employee to perform her job duties. Certification from Health Care Provider The employer may require an employee to provide certification from a health care provider indicating a reasonable accommodation is advisable. The certification must include: (1) the date the accommodation became or will become medically advisable ;(2) an explanation of the medical condition and need for a reasonable accommodation; and (3) the probable length of time the accommodation should be provided. Filing a Complaint of a Violation If you believe an employer has wrongfully denied you a reasonable accommodation or has discriminated against you because of your pregnancy, childbirth, need to breastfeed or a related medical condition, you can file a complaint within one year with the DC Office of Human Rights (OHR). To file a complaint, visit: Online at ohr.dc.gov; or In-Person at 441 4th Street NW, Suite 570N, Washington, DC A case can also be initiated through the Department of Employment Services (DOES) Office of Wage and Hour Compliance by calling (202) All cases must be filed and investigated by OHR. Once OHR issues a decision, a DOES administrative law judge will decide if a violation of the statute occurred. The DOES decision may be appealed to the DC Office of Administrative Hearings. 37

38 38 *A "reasonable accommodation" is one that does not require significant difficulty in the operation of the employer's business or significant expense for the employer, with consideration to factors such as the size of the business. Its financ i al resources and the nature and structure of the business. 38

39 Medstar Washington Hospital Center Medical Imaging School MRI Safety Disclaimer The MRI system has a very strong magnetic field that may be hazardous to individuals entering the MRI environment if they have certain metallic, electronic, magnetic, or mechanical implants, devices, and or objects, to observe MRI procedures on patients, students must initially undergo the same screening procedure as patients in order to enter the MRI environment. MRI Policy Students may rotate thru MRI as an elective observation rotation in their senior year. Students need to be aware of the MRI zones when in the MRI Area. Information on MRI safety and MRI zones will be discussed in MRI Safety Orientation and Screening form will be completed for students by the senior technologist in MRI. Before entering the MR environment or MR system room, students may be advised to remove the following metallic objects including hearing aids, dentures, partial plates, keys, beeper, cell phone, eyeglasses, hair pins, barrettes, jewelry, body piercing jewelry, watch, safety pins, paperclips, money clip, credit cards, bank cards, magnetic strip cards, coins, pens, pocket knife, nail clipper, tools, clothing with metal fasteners, & clothing with metallic threads. Rev 6/02/

40 Imaging School MRI Rotation Orientation Checklist Student: Safety orientation from Sr Technologist Student completes safety questionnaire Screen student for contraindicated implant/metal Watch safety video Review of safety procedures/policy Operational overview Rotation expectations discussed with students Student assigned training location Student given a opportunity to ask questions Complete Task Yes No Comments MRI Associate Print Name Date Signature of Employee Print Name Date 40

41 Clinical Competency Requirement Schedule The following clinical requirements are due at the end of each semester. It is suggested to turn in competencies thr the semester to avoid last minute turn-ins. Semester I (fall) Juniors Semester IV (fall) seniors 3 check off exams 10 competencies 3 competencies 7 bi-weekly evaluations 5 bi-weekly evaluations 3 handbook quizzes 2 handbooks quizzes 1 trauma evaluation All equipment check off exams Patient care (sterile and aseptic technique) Patient care (transfer of patient) CPR Semester II (spring) Juniors Semester V (spring) Senior 5 check off exams 10 competencies 5 competencies 7 bi-weekly evaluations 7 bi-weekly evaluations 3 handbook quizzes 2 handbooks quizzes 1 MOR evaluation Patient Care (oxygen administration) Semester III (summer) Junior Patient care (vein puncture) Semester VI (summer) Senior (10 Weeks) 7 competencies 7 bi-weekly evaluations 7 bi-weekly evaluations * all competencies and quizzes should be 2 handbook quizzes completed by the TBA date. Patient care (vital signs) 41

42 MEDICAL IMAGING SCHOOL CALENDAR AUG 27 AUG SEPTEMBER 3 August 27 NOV 12 NOV DEC 07 DEC DEC DEC 25 DEC 24 JAN JAN 21 FEB 18 April 5 April April 8-12 APRIL 22 May 6 th MAY 27 MAY 22 May 24 May 28 JULY 4 AUG 2 AUG 5-16 AUG FALL SEMESTER STARTS ORIENTATION FIRST YEAR LABOR DAY HOLIDAY CLASSES BEGIN VETERANS DAY HOLIDAY Personal THANKSGIVING HOLIDAY CLASSES END FIRST YEAR STUDENTS OFF THIS WEEK SENIORS OFF THIS WEEK CHRISTMAS DAY HOLIDAY SPRING SEMESTER STARTS NEW YEAR S DAY MARTIN LUTHER KING HOLIDAY PRESIDENTS DAY HOLIDAY Personal CLASSES END FIRST YEAR STUDENTS OFF SENIOR YEAR STUDENTS OFF THIS WEEK SUMMER SEMESTER STARTS Senior Capstone MEMORIAL DAY HOLIDAY SENIOR GRADUATION CLASS ENDS CLINIC SESSION BEGINS INDEPENDENCE DAY HOLIDAY COMPLETION OF SUMMER CLINIC FIRST YEAR STUDENTS OFF TWO WEEKS FALL SEMESTER STARTS 42

43 NOTE: ALL DATES SUBJECT TO CHANGE Clinical Rotations: As part of the Medical Imaging School Curriculum Students will be given equitable clinical rotations at Medstar Washington Hospital Center Medical Imaging School. As part of the clinical rotations the students will rotate at various locations of Radiology at Medstar Washington Hospital Center. They will also rotate at our recognized clinical affiliate sites. The sites with address are listed below. All Clinical Sites are JRCERT Recognized. Medstar Washington Hospital Center (main campus MWHC) 110 Irving St NW Washington, DC Phone: (202) Medstar National Rehabilitation Hospital (0.9 miles from MWHC) 102 Irving St NW, Washington, DC Phone: (202) National Children s Medical Center (0.3 miles from MWHC) 111 Michigan Ave NW, Washington, DC Phone :( 202) Medstar Georgetown University Hospital (4.5 miles from MWHC) 3800 Reservoir Rd NW, Washington, DC Phone:

44 Attendance Policy: Students are required to request time off 5 working days in advance, 2 days in advance for a doctor s appointment. All leave requests must be made through the online attendance system (SharePoint calendar). Students are required to log in and out each day. A record of the student s attendance will be kept in the school office. Students are expected to make every effort to attend classes and clinical rotations. The student is allowed 1 personal day a month these are not cumulative. All time outside of the one day must be made up before continuing to the next semester. Failure to make up time before the next semester will result in an incomplete grade and the inability to move to the next semester. This will mean the student will be terminated from the program. However, this does not apply to special circumstances, and will be the school staff s discretion to decide the most appropriate action depending on the circumstances. Excessive absenteeism or tardiness as well as absence from class or clinic or leaving early without the permission of the appropriate supervisor or school staff may result in loss of points from students clinical or class day depending on the day absent or disciplinary action. This can lead to dismissal from the program. If a chronic problem of absenteeism or tardiness develops, the student will be required to provide documentation of the tardy or absentee excuses and may be dismissed from the program depending on the circumstance. Any time a student is late or cannot make it to class or clinic; they must call in and speak to the school staff or send an to school staff documenting the occurrence and reason. If the school staff is not available, the student should leave a message. If the student does not call in, they are considered to have abandoned their position. The first time this occurs it will result in an automatic 2 day suspension. If the abandonment is longer than 2 days or occurs a second time, it will result in dismissal of the program. Comp Time and Early Departure approvals: Comp time must be pre approved by the Director or Coordinator and approved in writing before done unless you stay late from a case/clinic. An must be sent with the comp time sheet for final approval from the Director or Coordiantor. Clinical comp time should only be done if you are missing time that needs to be made up unless you are staying late to get more practice. Students are permitted a maximum of 2hours Monday through Friday. Students are not permitted to make up time on institutional holidays. Request for early departure must be approved by the director or coordinator and documentation must be on the share point calendar. If an emergency arrises and you need to leave please notify your clinical area and send the director and coordinator an or phone call. Students can not 44

45 take it upon themselves to leave without approval this is considered abandonment of position. And disciplinary action will be enforced. Unexcused absences will be counted accordingly on a rolling calendar year and the following disciplinary action will take place. Unexcused Tardiness is anything after the 6 min grace period. Disciplinary Action as Follows: 4 Unexcused Tardiness will result in Coaching and Counseling 6 Unexcused Tardiness will result in Written Warning 8 Unexcused Tardiness will result in 1 Day suspension and Written Warning 10 Unexcused Tardiness will result in 3 Day suspension and written warning. 12 unexcused Tardiness will result in Termination from the program. Absences: Unexcused absences outside of personal day and comp time. Also, please note that a student may not be approved for a personal day. We will allow no more than 2 students from each class per day to be off. The only exceptions are floating holiday, illness, jury duty, Parental Activity, and or special circumstance that have to be approved with school staff. All absences that are lasting 3 or more days continuous require a doctor s note if the student was ill. It will only count as one absence if there is no break in between days out. All time must be made up. Jury Duty is an excused absence with proper documentation. Excessive absences outside of the personal day or a special circumstance will be subject to disciplinary action. Disciplinary Action as Follows: 4 Unexcused Absence will result in Coaching and Counseling 6 Unexcused Absence will result in Written Warning 8 Unexcused Absence will result in 1 Day suspension and Written Warning 10 Unexcused Absence will result in 3 Day suspension and written warning. 12 unexcused Absence will result in Termination from the program. 45

46 Dosimeters Dosimeters are required to be worn with your uniform at the collar level, unless you have a fetal monitor as well and that is worn at the waist. The dosimeters are given to the students monthly. There is a Landuer Badge holder in the classroom this is where the students can pick up their dosimeter and leave the old dosimeter for collection by the radiation safety department. Radiation reports are kept in the clinical coordinators office and students will be given the opportunity to see their report each month. Students should come to the office to view their report of dosage and initial that they have seen the report no later than 30 days after the report has been made available. Dosimeters that become lost should be reported immediately to receive proper replacement of dosimeter. Care should be taken not to leave your badge in areas that radiation not pertaining to your job may be picked up. Students should not take Dosimeters home they should be left on dosimeter holder or in their assigned locker. Students are permitted to take dosimeter to clinical rotations outside of Washington Hospital Center. 46

47 Program Faculty Shirley M Douglass MA, RT(R) Director of Radiology Education and Operations Morris Hernandez, BS, RT(R) Radiology Education Coordinator Paramita Sengupta MS Radiation Physicist Troy Dean RT(R) RIS Analyst Academic Instructor Adam Christian PACS Administrator Academic Instructor Dr. James Jelinek Chairman of Radiology Medical Advisor and Instructor Karen Lackey BS, RT(R) Diagnostic Radiology Supervisor Clinical & Academic Instructor Melissa Truluck RT(R) Academic and Clinical Instructor Samantha Poznanski RT (R) Senior Technologist Academic and Clinical Instructor Sade Persad BS, RT (R) Academic and Clinical Instructor 47

48 Clinical Supervisory Staff Administrative: Gayle Thompson: Senior Director of Imaging Raymond Ross: Radiology Clinical Manager Kimberley Miller: Administrative Manger Radiology Karen Lackey: Diagnostic Radiology Supervisor David Ritter: Diagnostic Radiology Supervisor Vaughn Williams: Evening Supervisor Kenny Statom: IR Manager Kathy Vines: RIS Manager Victor Fenwick: CT & MRI Manager Clinical Instructor Staff: Bill Battle: Critical Care Radiology (evenings) Sandi Brewer: Fluoroscopy Donna McKamey: TFO Serki Getachew: MOR Eric Olfus: MOR Samantha Poznanski: POB LaTanya Lewis: Ortho Judy Harmon: Ortho Melissa Truluck: Ports Tanisha Thornhill: Diagnostic Beverly Hawkins: CCR El Mabry: CT Addie Williams: CT Carlos Portillo: MRI Tanya Robinson: MAMMO Sujata Mohapatra: IR Donna Mentzer: IR RECOVERY ROOM Jamia Taylor Tameru Abe Sade Persad Technologists that can grade: Kellie Manago Eric Yalley Wayne Williams Steven Debnam Sidi Olateju 48

49 Clinical Instructors and Staff at Georgetown University Hospital Clinical Instructors: Menghes Ogbamicael & Jacqueline Duvall Staff: Alem Mulugeta Ashford Opoku Ashleigh Wharton Jun Young Keith Galloway Lisa Woodward-Lloyd Sonya Day Christie Selman Darrell Williams 49

50 National Rehabilitation Hospital Clinical Instructors: Brittany Harley Richard Meehan Staff: Elizabeth Opoku 50

51 Children s Staff and Clinical Instructors Clinical Instructor: Sanya Tyler TBA Staff: Jolisssa Cooper Kandace Fenwick Eric Heilman Brad Jenkins John Kelly Kelly Kenealy Staci Lightfoot Stacy Mckissick Yordanos Michael Melinda Miller Kimberlyn Murphy Henry Navas Orlando Occenad William Powell Janelle Parker Allister Ramrattan Amy Rose Kia Seaforth Jessica Sheehan Robert Smith Monique Thrower-Reeder Shannon Triggs Sharon Tucker Sara Turner 51

52 Student Clinical Rotations Assignment: Scheduling Desk Image Library Main Operating Room Portables Third Floor Operating Room- Cystology Georgetown University Diagnostic Radiology Children s National Medical Center Outpatient Radiology Orthopedics Fluoroscopy National Rehabilitation Hospital Mammography Critical Care (Days and Evenings) Interventional Radiology Interventional Radiology Recovery Computerized Tomography Sonography Magnetic Resonance Imaging 52

53 Academic Course of Study Orientation Introduction to Radiologic Sciences Patient care in Radiologic Sciences Clinical Practice 1, 2, 3, 4, 5, 6 Special Imaging Equipment Radiation Biology & Radiation Production and Characteristics National Board Review Medical Terminology Human Structure and Function 1 Human Structure and Function 2 Image Analysis Radiation Protection Radiographic Pathology Digital Image Acquisition and Display CPR Scientific Research Paper Power Point Presentation Radiographic Procedures 1,2,3,4 Radiographic Imaging 1,2,3,4 53

54 Professional Course Descriptions Orientation: One week of orientating students to policies of the program and Hospital. Introduction to Radiography: Orientation to the policies of the school, department and Hospital. Introduction to principles of radiation, universal precautions, and body mechanics. Overview of the profession including areas of specialization, education, registration and licensure. (40 Contact Hours) Patient Care in Radiologic Sciences: Inquiry into the principles of medical ethics and professional conduct. Evaluation of the specific duties and responsibilities of a radiographer and medical-legal issues relating to radiology. Orientation to the field of healthcare including selected knowledge and patient care skills to meet the needs of the hospitalized patient with an emphasis on procedures relevant to radiology. Taught by lecture, demonstration and simulation practice sessions. (40 contact hours) Radiographic Procedures: Provides detailed instruction in fundamental principles and practical applications of positioning the human body to demonstrate a variety of structures. Includes relevant topographical anatomy and terminology. Taught by lecture and demonstration. (150 Contact Hours) Radiographic Procedures Lab: Provides detailed instruction in the proper positioning of the human body. Hands on application of all radiological procedures as they pertain to the radiology department and the field of radiology. (150 contact hours) Medical Terminology: Is a self study course of programmed instruction approach to the study of the language of medicine. Emphasis placed on the utilization of medical words, prefixes, suffices and word roots. Teacher will proctor all tests. (40 contact hours) Imaging: The radiation Physics in which the major emphasis is placed in the study of the physics of matter and energy including an atomic structure, electrostatics, electro dynamism, magnetism, electromagnetism, generators, motors, transformers, rectifiers, and the x-ray circuit and tube. Special attention is centered on the principles related to the operation of the x-ray equipment and the production of a quality radiograph. Establish a basic knowledge of atomic 54

55 structure and terminology. Also presented are the nature and characteristics of radiation, x-ray production and the fundamentals of photon interaction with matter. (150 Contact Hours) Computers in Radiology: The history and development of computers, their workings and their applications into eh radiology department with emphasis on digital imaging. (30 Contact Hours) Human Structure and Function: Is designed for the acquisition of knowledge of the structure of the human body as it related to function and the organization and interrelationship of body structures as they form an integrated functional organism. The study of the relationship between physiology and anatomy, the interaction among the organ systems and the relationship of each organ system to homeostasis will be presented. (120 Contact Hours) Radiographic Pathology: Normal and pathological structure and function of the nervous, circulatory, respiration, digestive, urinary, reproductive and endocrine systems of the body. Both clinical and radiographic signs are discussed. Lecture, discussion and image review. (45 Contact Hours) Radiobiology/Radiation Safety: Evaluation of the hazards of exposure to ionizing radiation including molecular and cellular effects, and early and late effects to body tissues and organs. Radiation safety practices are discussed and demonstrated. Formulas used in Radiology are also introduced. (120 Contact hours) Special Imaging Systems: A study of all of the imaging procedures and equipment: CT, Tomography, Fluoroscopy, Mobile Imaging, MRI, Angiography, Mammography and Ultrasound. (30 Contact Hours) National Board Review Course: This is a senior course to prepare the student to sit for the national board exam. (45 Contact Hours) Research Paper and Presentation: The student will do a research paper on a radiographic imaging topic and present their project on their research. (Contact Hours 45) 55

56 Medical Imaging School Organizational Chart Shirley Douglass MA, RT(R) Program Director Morris Hernandez Radiology Education Coordinator Academic Instructors Clinical Students 56

57 President WHC VIce President of Professional Service Senior Director of Imaging Director of Radiology Education and Operations Radiology Education Coordinator Academic & Clinical Instructors Staff/Radiologic Technologists Students 57

58 DISCIPLINARY ACTION Disciplinary action may consist of a verbal or written reprimand, probation, suspension, loss of points on the clinical grade, loss of personal hours, or dismissal. The action taken will depend on the nature of the disciplinary problem and the frequency of its occurrence. The following are examples of major violations of hospital or school rules which will subject a student to immediate disciplinary action up to and including dismissal: Patient abuse or negligence Neglect of duty Insubordination Damage, destruction or theft of property Falsification of records Excessive absenteeism or tardiness or a chronic pattern of Absenteeism or tardiness Absence from class or clinic area without permission Abandonment of position Unauthorized possession or use of alcohol or narcotics, or such use as to make you Unfit for duty Unauthorized possession or use of weapons or explosives Willful disregard of safety or fire regulations Unauthorized solicitation during work time, or interfering with the work of others Accepting or offering unauthorized gifts Unauthorized disclosure of patient data or other confidential information Disregard of personal hygiene, appearance or job related dress code Personal conduct damaging to hospital operations, image or morale (fighting, Horseplay, sleeping on duty, threatening others, discourtesy to patients, visitors, or other employees) Incompetence or inability to perform satisfactorily maintain a 85% clinical grade Cheating - giving or receiving unauthorized assistance on any examination, test, quiz or assignment 58

59 Inability due to physical, mental or emotional reasons to perform the essential functions required in entry-level radiography Performing clinical exams without proper supervision (see p.24 on direct supervision, indirect supervision, repeat exams) 59

60 Failing Grades Failing grades in class or clinic at the time of a trimester conference will result in the student being placed on academic or clinical probation. If the grades have not improved by the next trimester conference, the school staff may consider dismissal of the student from the program. A final average in class of less than 80% or clinic below the official passing mark of 85 % for clinic may result in dismissal of the student from the program. Exams All exams must be taken at the scheduled time. Exams not taken at the scheduled time without the instructor s prior approval while you are in attendance will mandate suspension and may lead to dismissal. The student will receive an F for this occurrence. Exams not taken due to absence must be taken the first day of return back to school. If the absence is unexcused it will result in loss of points. The loss of points is the instructor s discretion. Personal days will only count as an excused absence if it was placed before the announcement of the test. 60

61 DUE PROCESS: Grievances: disciplinary action and other issues. Students will be informed of decisions in a conference with school staff. During that conference, the student will be allowed to hear or examine any evidence the staff may have relating to the problem, and the student will be given the opportunity to present evidence in his/her defense. After a thorough review of all evidence, the school staff will decide the most appropriate course of action to be taken. If a student is subject to suspension or dismissal, they will be informed of this decision in writing. A student may appeal an action taken by the school staff by completing the following steps: Step 1: Step 2: Discuss the concerns directly with the person involved within 5 work days. If unresolved, the student submits a written appeal within 5 work days to the Assistant Director of Education, who will respond within 5 work days. Step 3: If unresolved, the student submits a written appeal to the Director of Education within 5 workdays, who will respond within 5 work days. Step 4: Step 5: Step 6: Step 7: If unresolved, the student submits a written appeal to the Administrative Director of Radiology within five 5 working days. The Administrative Director of Radiology or his/her designee will reply to the appeal within 5 work days If unresolved he/she may submit a written appeal to the Medical Director of the Radiography Program within five (5) working days. The Medical Director will respond within 5 working days. If unresolved the student may submit their concern in writing to the Radiography Advisory Committee within (5) workdays. The Committee will respond within 10 work days. If the student is not satisfied with the decision of the Radiography Advisory Committee, he/she may submit a written appeal to the Director of Personnel Relations within five (5) working days. The Director of Personnel relations will respond within 10 work days. Step 7 is the final level of appeal for disciplinary decisions. If a student is reinstated to the program following the appeals process, they will be required to make up all academic and clinical coursework missed prior to graduation from the program. 61

62 HONOR CODE The school governs it's affairs by means of an honor code which assumes that every student is worthy of trust and will behave in an honest and honorable way. Cheating - giving or receiving unauthorized assistance on any examination, test, quiz or assignment - is considered academic misconduct and is a serious breach of the school's honor code. Any student found to be involved in or actively participating in such misconduct is subject to immediate dismissal from the program. 62

63 COMMUNICABLE DISEASE POLICY Students will receive a physical examination from the hospital's Occupational Health Department prior to formal enrollment in the program, and again at the beginning of their senior year. Students will be required to submit a complete written physical history, and will be given blood tests, tuberculin skin tests and alcohol and drug testing as part of their physical exam. If the student has a negative rubella titer they will be required to undergo immunization prior to patient contact. If any of their test results are positive, they may be required to undergo further testing and treatment. Occupational Health must clear students for appointment to the program. A positive result on drug or alcohol testing will prevent the student from being appointed to the program. If during the course of clinical training, a student is exposed to a patient with a communicable disease prior to initiation of isolation procedures or is exposed through needle stick, minor laceration or mucous membrane exposure to body fluid, the student will be referred to Occupational Health for appropriate testing, prophylactic measures or treatment. Occupational Health will inform the school staff of the student's ability to attend school. Students are required to follow the hospital's infection control policies (covered in Appendix B of the handbook) in handling all patients. Instructions on infection control will be given during the orientation classes and re-emphasized in Patient Care class. If a student is exposed to or contracts a communicable disease outside of the hospital (such as chickenpox,) it is the student's responsibility to inform Occupational Health immediately! Occupational Health will confirm the diagnosis with the student's physician, and determine if and when the student may return to school. Other students who may have been exposed to the infected student will be referred to Occupational Health for appropriate testing and/or treatment. Immunization for Hepatitis B is available to students through the Occupational Health and Safety Department. Students receive counseling on the Hepatitis B vaccine during their physical exam, and are strongly encouraged to take advantage of the immunizations. 63

64 RADIOLOGY DEPARTMENT POLICIES Calling in - when calling in sick or late, speak to school staff or leave a message. The Radiology Department school office number is (202) or (202) Computer Log and Time Cards - are punched at the beginning and end of each day while you are here. It is against school, department and hospital policy to falsify documents by punching someone else s card! Failure to adhere to this policy will result in disciplinary action, including dismissal from the program. If you forget to punch in or out, have your card initialed by school staff or a supervisor. Incidents - any incident involving either a patient or an on the job injury should be reported immediately to a supervisor and the appropriate forms should be filled out. Confidentiality - Patients are never to be given their hospital charts or a report or reading on their x-rays. It is the responsibility of the patient's physician or the Radiologist to convey this information to the patient, not yours. Patient information should also not be given to anyone else without the consent of the patient's physician. You should avoid discussing patients with other employees unless this information directly relates to the work you are performing. Radiation Protection - Patients are to be shielded on all exams, which permit the use of shields. Tight collimation should be practiced to reduce patient dose. Technical factors should be carefully selected to minimize patient dose also (hi kvp - low mas combinations). Since the fetus is more susceptible to radiation effects, it is important to ask all females if they may be pregnant. If pregnant you must receive our Radiologists approval before taking x-rays of them. You must also be conscious of radiation protection measures as they apply to yourself and other hospital personnel. Wear lead shields when remaining in the room during an exposure. Put as much distance as possible between yourself and the radiation source. Always wear your radiation dosage badge to keep track of your exposure. A permanent record will be kept of this information. It is hospital policy that technologists and students SHOULD NOT holds patients during exposures. It is preferable that no one holds the patient for exams so whenever possible, use restraints or film holders. If someone does hold the patient, be sure to have him or her wear lead apron and gloves, collimate tightly and don't point the primary beam at them. When you are taking x-rays in other hospital areas such as the OR and on portables, realize that other hospital personnel are concerned about the radiation exposure they may be receiving. Please have the courtesy to inform them when you are getting ready to shoot an x-ray in their vicinity. 64

65 PATIENT IDENTIFICATION- ALWAYS CHECK TWO METHODS OF IDENTIFICATION: HAVE THE PATIENT RESTATE THEIR NAME AND STATE THEIR DATE OF BIRTH...ALWAYS check the armband of in-house patients before taking their x-rays to make sure you have the correct person. With out-patients double-check their name on the x-ray requisition. People frequently answer to the wrong name so careful checking is important to prevent unnecessary radiation exposure. It is also important to check an in-house patient's chart and an outpatient's referral to ensure that the correct type of examination is performed and that a history for the exam is available. Never leave a patient unattended in a room. Whenever possible have personnel stay with the patient. Leave the door open so that the patient can be heard if they call for assistance. Have respect for the patient's dignity; please make sure that they are well covered up when the door has to be left open. Any patient who arrives in restraints should be left in restraints or the restraints should be immediately replaced when the exam is completed. These patients should not be left alone - they may pull out catheters or IV s or tries to get off the table or stretcher and fall. Either asks someone else to run your films or to stay with your patient. If this is not possible, make sure the restraints are back on and the patient is secure in their wheelchair or stretcher with side rails up before you leave the room. Keep in mind the fact that you will be caring for patients with respiratory problems. For this reason, it is school policy that you should not wear any type of perfumed or scented product in the clinical area. You will also be caring for patients on restrictive diets and patients experiencing nausea so eating and drinking are restricted to specific non-patient areas in the department. Smoking is prohibited inside the hospital. It is recommended that you wash your hands before and after each patient for your protection and to prevent the spread of infection to other patients and personnel. You will be required to follow infection control policies in dealing with patients and specific information on this topic will be presented to you as part of orientation and Patient Care class. You need to be aware that in many parts of the department, conversations are easily overheard. Be careful what you say and how you say it as patients may overhear and misunderstand your conversation. Please consider all patient information confidential and only discuss it when it relates to the work you are performing. Paperwork - it is your responsibility to ensure that paperwork and computer data entry are completed accurately and completely on all cases you perform and that films have correct identification and anatomical marker visible on them. Left or right anatomical markers are required on all x-ray films both for proper patient care and for medical-legal purposes. Only use your own markers with your identification number. 65

66 IMAGES - A Technologist or Radiologist must check all images taken by students a senior Technologist should check all outpatient images. Never allow a patient to leave the department before having the films checked. A Radiologist must check all outpatient films before the patient leaves. Never repeat an image unless directed to do so by a technologist, or Radiologist. All students repeat exams must be performed with a technologist present in the room. Failure to follow this policy will result in disciplinary action. Clinical Assignments - when you leave your assigned area for lunch, class or any other purpose, check out first with your supervisor and/or the technologist assigned to your area. It is your responsibility to be in your assigned room whenever an exam is performed. You should be observing, assisting or attempting to perform the exam. This is the only way to become proficient at taking x-rays. HOSPITAL POLICIES Annual Physicals - all hospital employees and students are required to undergo an annual physical exam, and Radiology department personnel with direct patient contact are required to have TB skin tests. Occupational Health/Managed Disability - will conduct the required annual physical and will also examine employees or students when an accident occurs at work. A referral form from school staff or a supervisor is needed to visit Occupational Health/Managed Disability. Health Insurance - is provided for student radiographers. Information about insurance will be provided to students during the Human Resource Department's orientation. For additional information on the insurance provided or for claim forms, the student should Contact the hospital's Benefits Department in the East Building. I.D. Cards - all hospital personnel and students are required to wear I.D. cards at all times on hospital property. These will be issued by the Human Resources Department on the first day of school. Scrubs - hospital-issued scrubs are hospital property and are not to be removed from hospital grounds. If you take hospital scrubs home, you may be prosecuted for theft by the hospital. Students are required to wear a clean pair of hospital scrubs when assigned to the 3rd floor OR, and main OR. Change into a clean pair of scrubs when you report in, then wear a gown or lab coat over the scrubs whenever you leave the area. Code Blue- Indicates a patient suffering a cardiac or respiratory arrest somewhere in the Hospital. A code blue team responds to this emergency. If any problem occurs with a patient in Radiology, call your supervisor and a Radiologist to check the patient. If you need to call a code blue, the extension is In a code blue situation in Radiology, assist by clearing the immediate area for 66

67 easy access by the code blue team and by bringing the code blue cart, oxygen and suction to the area. You will be trained in cardiopulmonary resuscitation as part of your training. Code Yellow/Trauma Response - announcement indicates a shock-trauma patient is about to arrive in MedStar. Code Orange - signifies a major external/internal disaster with casualties. Check with your supervisor for instructions. Code Green - signifies an external/internal hazardous material or chemical spill. Check with your supervisor for instructions. Dr. Red - a page for Dr. Red indicates a fire somewhere in the hospital. The fire alarm is coded with a specific number of rings for each hospital area. You can count the sequence of rings and check the chart posted in your area, to locate the fire. If there is a fire or drill in your area, pull the nearest fire alarm and obtain an extinguisher. Call X to report the fire giving your name and the location of the fire. Remove patients from the area, close doors and turn off electrical equipment. Ideally you will have help so that you can coordinate the activities listed above. Make a point of observing the location of alarms and extinguishers in all Radiology work areas and near the classroom. Instruction on how to handle fire safety will be given to you during hospital orientation. Code Pink - signifies an infant abduction from the delivery room or nursery areas. Information on proper procedure will be given during hospital orientation Code EVAC (By location) - partial evacuation of the hospital. Instructions on this code will be covered in hospital orientation. Code EVAC - all areas - total hospital evacuation. Instructions on this code will be covered in hospital orientation. 67

68 Medstar Washington Hospital Center Radiology Department Medical Imaging School Class of 2019 PROCEDURE: STUDENT TUITION and FEES 1. Application fee for the School of Radiography is $25.00.The Admission fee is $ Tuition for the employment option: $2,250 per year, total (total $4,500). 3. Tuition for the education option is $4,500 per year, total 9,000. The tuition payment schedule for the school is as follows: First year tuition payments Employment I Education Options August 24 (Payment 1) $ December 15 (Payment 2) $ March 15 (Payment 3) $ Second year tuit ion payments August 25 (Payment 4) $ December 15 (Payment 5) $ March 15 (Payment 6) $ Payment for tuition (cash is not accepted) should be in the form of a money order, cashier's check or commercial check and made payable to the Washington Hospital Center and sent to Attn: Kim Miller 68

69 Medstar Washington Hospital Center Imaging Reimbursement Manager Radiology Rm BA Irving Street NW Washington, DC Student tuition Page 2 of 2 3. Tuition payments not received within 30 days of the Due date will be subject to a Late Payment Fee of $50, per month, until tuition is paid up to date. 4. Students whose tuition payment is 60 days overdue will Be subject to Administrative Termination from the School. 5. Within thirty days after the start date of the course, the student will be entitled to a 50% tuition refund, provided the student is leaving on good terms. Beyond 30 days the tuition payment will be considered NON REFUNDABLE. 6. Students may resign from the course at any time, without penalty. Students are responsible for all tuition payments due before the date that a written request of resignation is received by the Education Director. Students will not be responsible for tuition payments due after the date of resignation. 7. Tuition may change during the course of the program. I understand and agree to the above tuition payment procedure. (Circle one) Employment Option I Education option Name (Print) Sign Name: Date: - Washington, DC

70 MedStar Washington Hospital Center 8/ Irving Street, NW Washington, DC PHONE medstarwashington.org Medical Imaging School Enrollment Agreement Form In consideration of accepting an appointment* to The Medical Imaging School at Medstar Washington Hospital Center, I the undersigned, agree to pay all school tuition and fees as required. Tuition, fees and policies may change as needed. Students accepting the employment option for tuition agree to accept employment if offered with Medstar Washington Hospital Center as a full time Radiographer for two full consecutive years immediately after graduation. Failure to complete this commitment will require repayment of the employment track benefits. If no positions are available than the commitment void. A fifty percent tuition refund is permitted within thirty days of the start of the program provided the student is leaving in good standing. Beyond thirty days tuition is non-refundable. It is agreed and understood that the student may be dismissed at any time for the following reasons: a. Unprofessional Conduct b. There is any breach of personnel rules or regulations of the hospital radiology department, or imaging school c. If it is found that the student is incapable for any reason of performing the duties of a radiological technologist d. Failure to maintain an 80% academic and 85% clinical average and successfully complete all aspects of the program e. Failure to pay appropriate fees and return all items Signature of student * Appointment to the school is conditional on receiving clearance from the hospitals ' Occupational Health Department. Perspective students will be required to successfully complete a physical examination including alcohol and drug screening and background check before enrollment into the program. date 70

71 Clinical Education Introduction This section of the handbook was prepared to give you a basic understanding of the clinical portion of your training. It contains information regarding clinical scheduling, clinical rotations, clinical grading and the learning objectives for each clinical assignment. In addition, back ground information and reading assignments. CLINICAL GRADING PROCESS First Year Grading - During the course of your 2 years of training, you will undergo a clinical grading process. The first step will be learning and practicing radiographic procedures in your Positioning class on Monday and Friday afternoons Image Analysis class will occur on Wednesday afternoons to correlate with Positioning. After you have had a number of opportunities to practice a procedure in lab, you will be required to pass a written and practical exam on that procedure. The written exam will be based on reading assignments and material covered in class lectures and demonstrations. The Practical exam will grade you on your ability to meet the behavioral objectives listed later This handbook. After you have passed the written and lab practical exam, you will be able to begin the second phase of clinical grading, competencies. Lab practicals are performed in the clinic on fellow students. These simulations may be graded by school staff. Lab practicals are marked on a pass-fail basis. Once you have passed a lab practical on a particular procedure, you may go on to attempt a Check off on a patient. The check off must be done in the presence of a registered technologist. The final competency is also performed In the clinical setting on a real patient, but it may only be graded by either school staff or specific designated technologists. Each f.c.e. must be passed with at least an 85%. Final competencies must be done with no help from the technologist. During the first year of training, each student must complete a minimum of 20 final competency exams and 5 elective exams. It is the student's responsibility to initiate the grading process, and to keep track o (the simulations and competencies completed. A record will also be maintained by school staff. The student s record will be checked at each trimester conference. The first year clinical grade will be based on: Final competency exams f.c.e. 35% Clinical handbooks 10% Clinical Instructor evaluations 20% Bi-Weekly Evaluations 20% Attendance 15% Total 100% 71

72 Senior Grading- In the senior year, the student continues the clinical grading process by completing 36 mandatory and final competency exams and 15 elective exams. These exams are performed on real patients and graded by school staff or designated technologists. Each exam must be passed with an 85%. Exams must be completed in the following categories: critical care I shock trauma, upper extremity shoulder girdle, lower extremity-pelvic girdle, thoracic I abdominal, headwork, contrast I special studies, operating room, CT and pediatrics. In the senior year, the clinical grade will be based on: Final competency exam grades 35% Clinical quizzes 10% Clinical instructor evals 20% Bi-Weekly Evaluations 20% Attendance 15% 100% Conferences- At the end of each semester, the student s academic and clinical progress will be reviewed at a conference with school staff. If there have been any problems clinically or if the clinical average is less than 85% or clinical grading is incomplete, the student may be placed on clinical probation. Clinical probation for two consecutive trimesters or more than twice during the two years of training may result in the student's dismissal from the program. Remediation -The student must pass every written test and final competency exam with at least an 85%. If the student fails any exam, they will be required to complete the following remediation before repeating the practical/competency exam: Written Test- Complete reading assignment in Merrill s, review material with the clinical coordinator, repeat written exam. Final competency exam- Complete reading assignment in Merrill s, review material with the clinical coordinator, repeat lab practical with the clinical coordinator if deemed necessary, repeat competency exam 72

73 Medical Imaging School Textbook List Medical Terminology: ISBN: Leonard, Peggy (Elsevier) 8 th or 9 th Ed Merrill s Atlas of Radiographic Positioning & Procedures, ISBN: Long (Elsevier) 13 Ed Workbook ISBN: Long (Elsevier) 13 Ed Merrill s Pocket Guide to Radiography 13ed- ISBN: (Elsevier) Comprehensive Radiographic Pathology: ISBN: Eisenberg (Elsevier) 5 th or 6th Radiologic Sciences for Technologists: ISBN: Bushong (Elsevier) 10 th or 11th Mosby s comprehensive Review of Radiography: ISBN: Callaway (Elsevier) 7th Ed Introduction to Radiologic Imaging Sciences and Patient Care: ISBN: Adler (Elsevier) 6 th Ed Radiation Protection in Medical Radiography: ISBN: Statkiewics-Sherer (Elsevier) Digital Radiography and Pacs: ISBN: Carter 2 nd Ed (Elsevier) Radiography Examination: ISBN: Sais (McGraw-hill Company) Ed 11 or 12 Lange Q &A edition 10 or 11 ISBN: Saia (McGraw-Hill Company) Fundamentals of Anatomy and Physiology: ISBN: Rizzo (Delmar) Study Guide: ISBN: Rizzo (Delmar) 73

74 Clock-In and Clock-out Instructions for Online Rad School (Student) 1. Go to 2. Under school log in: a. School ID is 107 b. Student ID is your initials and the number you are on the roster. c. Your password is the first 3 letters of your first name and the last 3 numbers on your employee ID. 3. Click continue, and then open time clock. 4. Select the location that you are clocking in/out from. Ex. WHC, Children s, GUH. 5. Type in your employee ID number and hit enter. 6. You are now clocked in. 7. Follow the same procedure for clock out. When the online rad- school is down or you forget to clock in or out, please the following people with your clock in and out time along with an explanation. 1. Morris Hernandez ( Morris.B.Hernandez@medstar.net) 2. Shirley Douglass (Shirley.m.douglass@medstar.net) When logging in or out of the systems, you should only use your ID and password. Logging in or out from Cell phones and computers outside of the hospital or approved clinical sites is not permitted. Any student caught in violation of this is subject to immediate termination from the program. Students are also allowed to view their attendance and clinical evaluations and comps in this system in their profile. 74

75 Comp Time And Early Departure approvals Comp time must be pre approved By Morris Hernandez and approved in writing before done ( unless you stay late for a case.) An must be sent with the comp time sheet for Final Approval to Shirley Douglass. Clinical Comp Time should only be done if you are missing time that needs to be made up unless you need more practice or you are staying for a special case. Students are permitted a maximum of 2 hours of comp time a day ( Monday thru Friday). Comp Time must be pre approved by to Morris Hernandez. Turn in Signature form immediately afterwards. Request for early departure requires approval from Morris Hernandez and documentation in share point. In an event of an emergency the student should Morris Hernandez and Shirley Douglass. Students cannot take it upon themselves to leave without approval it is considered abandonment of position. Not following these policies will lead to further disciplinary action including suspension and or termination. 75

76 Phone List Shirley Kim Miller Classroom Morris 7x6434 7x6429 7x6343 7x6867 Troy Diao CCR Fluoro TFO MOR MRI CT DEXA Mammography Ortho POB IR SONO Image Library Front Desk Portable 7x5978 7x6760 or 7x9302 7x3616 7x6469 7x0501 7x7387 7x9760 7x5301 7x9345 7x4078 6x1074 7x4710 7x6495 7x6030 7x0025 7x6481 7x9259 GUH

77 Standard Radiographic Projections Radiology Department Washington Hospital Center All radiographic studies requested should be performed according to the standards Contained within, whenever possible. All requested examinations must be supported by a pertinent clinical history. Also All examinations should be supported by written physician orders. Unsupported Examinations should be referred to the quality control technologist or Radiologist) For proper patient management. Confirmation of undocumented examination orders should be obtained by calling The medical unit and having the nurse fax the order. For examinations of all long bones, whenever possible include both joints on all Images. Scoliosis series and bone surveys should be done on the stat scan whenever Possible. Requests for intravenous pyelograms need to be referred to a radiologist because they are no longer done at WHC. Requests for skull, sinuses, TMJ's, nasal bones, facial bones, mastoids, and orbits should also be referred to a radiologist. These exams should be done in CT. A panorex of the mandibles are done in the oral surgery clinic. All films submitted for interpretation are to be properly marked with patient s identification, date, accession #, and anatomic markers with your initials clearly in evidence. All students need to have films checked by ar.t. (R) Technologist before sending to pacs. REV. 8/14 These are all the projections for different studies. Always check orders in the chart or the orders from the Orthopedic Doctor to see exactly what is wanted or needed. Chest: PA & Lateral Projections 77

78 Limited Study - PA Only (used for the following): 1. Pre-Employment 2. Immigration Physical 3. Pre-operative patients under age 40 yrs. 4. Cardiothoracic (CD ratio 5. Pneumothorax Abdomen- Supine: AP Projection Abdomen- Erect: When performed as a part of an Acute Abdomen Series include a PA chest and supine abdomen film. Finger: PA Projection of entire hand; Oblique & Lateral Projections of the injured finger. * IF THE INJIIRED FINGER IS THE THUMB, include the first carpomeacarpal joint in all projections. Hand: PA, Oblique, & Lateral projections (to include the wrist). Wrist: PA, Oblique, & Lateral Projections *NAVICULAR SERIES- Routine projections plus PA Axial (Stretcher Method) Projection [ulnar flexion; CR- 20 degrees towards elbow]. Forearm: AP & Lateral Elbow: AP, Medial & Lateral Oblique s, & Lateral projections Humerus: AP & Lateral Projections Shoulder: Two AP projections with internal & external rotation 78

79 *FOR DISLOCATION INJURIES- Include an Inferosuperior Axial, Scapular Y or Transthoracic lateral projection Clavicle: AP projection (w/ perpendicular CR) AP projection (w/ 25 degree cephalic CR) Sternum: RAO & Lateral projections Scapula: AP& Lateral Projections Tibia: AP & Lateral projections Knee: AP, Medial & lateral Oblique s, & Lateral projections *IF EXAM HISTORY INDICATES TRAUMA- includes "crossable" lateral projection; Beclere & Settegast Methods should include routine projections as well. Femur: AP & Lateral projections Pelvis: AP projection (with internal rotation) Axial projection (Cleaves Method ["Frog leg" Lateral]) *FOREIGN BODY LOCALIZATION- AP & Lateral projection only. Hip: IF NEW INJURY (Non-Trauma- Use Pelvis Protocol IF NEW INJURY (Trauma) - AP Pelvis & Axiolateral projections IF OLD INJURY (Re-evaluation) - AP Hip & Axiolateral projections Foot: 79

80 AP (w/ l0 degree CR), Medial Oblique, & Lateral projections *INCLUDE ANKLE SERIES WITH ALL FOOT REQUESTS EXCEPT POST REDUCTION EXAMINATIONS Toes: AP & Medial Oblique projections of the foot Calcaneus: Axial & Lateral Projections Ankle: AP, Medial Oblique, & Lateral projections * INCLUDE FOOT SERIES WITH ALL ANKLE REQUESTS EXCEPT POST REDUCTION EXAMINATIONS. Sacroiliac Joints: Axial or Unilateral AP Oblique projections Cervical Spine: AP, AP Open Mouth, *Both Oblique s, & Lateral projections - INCLUDE CERVICOTHORACIC LAT PROJECTION IF C7 IS NOT DEMONSTRATED ON THE ROUTINE LATERAL PROJECTION. *OBLIQUE PROTECTIONS ARE NOT REQUIRED IN CCR/MEDSTAR. Thoracic Spine: AP & Lateral Projections Lumbar Spine: AP, Both Oblique s, Lateral, & Lat L5- S1 projections. *OBLIQUE PROJECTIONS ARE NOT REQUIRED IN CCR/MEDSTAR. Ribs: AP & Oblique projections (affected side) Cranium: AP/PA Axial, Both Laterals, & SMV projections 80

81 * IF ERECT LATERAL PROJECTIONS ARE NOT POSSIBLE "BROW UP'' CROSSTABLE LATERAL PROJECTIONS SHOULD BE DONE. Sinuses: Erect PA Axial, Lateral, Parietoacanthial, & SMV projections *PA AXIAL PROJECTION SHOULD INCLUDE MAXILLARY ANTRA Mandible: PA, Both Oblique s, & PA Axial projections Zygomatic Bone: SMV & Parietoacanthial projections Erect (or Brow up) Lateral projection to include the sphenoid sinus Facial Bones: If site of injury is specified, follow indicated exam protocol. If site unspecified- Parietoacanthial and erect (or Brow up) Lateral projections of the face Nasal Bones: Parietoacanthial & Both Lateral projections Orbits: Parietoacanthial, Parietoacanthial Oblique (Rhese), & PA Axial (Caldwell) projection Bone Surveys: Met static: Lateral Cranium AP & Lateral Thoracic & Lumbar Spines AP Pelvis Lateral Cervical Spine AP projection any long bone where patient indicates pain Metabolic: Lateral Cranium Lateral Thoracic & Lumbar Spines 81

82 AP Pelvis Bilateral AP projections of the Hands Bilateral AP projections of the Clavicles 82

83 Direct / Indirect Supervision of Student Radiographers This policy serves to identify the current guidelines for clinical supervision of student radiographers in reference to the direct and indirect provisions stated in the Standards for an Accredited Educational Program in Radiologic Sciences Direct Supervision All students are required to perform radiographic imaging procedures under direct supervision until they have achieved and documented successful completion of a core competency and a qualifying exam for a particular exam category. The parameters of direct supervision are: 1. A qualified radiographer (ARRT registered in Radiography) reviews the request for examination in relation to the student's level of clinical competence. 2. A qualified radiographer evaluates the condition of the patient in relation to the student's level of clinical competence. 3. A qualified radiographer is present during the performance of the examination to offer advice and assist the student radiographer if needed. 4. A qualified radiographer reviews and approves all images. 5. A qualified radiographer is present during any repeat exposures. Indirect Supervision After achieving and documenting successful completion of a core competency and a qualifying examination for a particular exam category, the student may perform those imaging procedures under indirect supervision. Indirect supervision is defined as supervision that is 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 a radiographic procedure is being performed. This availability applies to all areas where ionizing radiation equipment is in use. The parameters of indirect supervision are: 1. A qualified radiographer certifies the student s ability to perform under indirect supervision. 2. The student evaluates the request for examination and the patient s condition and consults with a qualified radiographer, if necessary. 3. The student performs the radiographic imaging procedure under indirect supervision. 4. A qualified radiographer reviews and approves all radiographic images. 5. A qualified radiographer is present during any repeat exposures (Direct supervision). 6. NO provisions are made for performing the following examinations under indirect supervision. Direct supervision guidelines must be followed regardless of the student s level of clinical competence: a. Mobile examinations b. OR examinations c. Special procedures 83

84 Proficiency Examinations Critical Care Radiology and Medstar (shock trauma) Each senior must complete one proficiency examination in the following categories in order to attain the student learning outcomes. A bullet denotes a required proficiency. Competency in each area must be achieved before proficiency is attempted. Completion of all proficiencies will fulfill requirements for the evening shift. Evening hours are Monday, Wednesday and Friday, 12noon 8pm Trauma Proficiency Exams Evening Shift Critical Care Radiology and Medstar (shock trauma unit) Chest (wheelchair/stretcher) Chest (decubitus) Acute abdomen series Trauma upper extremity/shoulder girdle Trauma lower extremity Trauma hip (cross table lateral) Trauma cervical spine Trauma thoracic spine Trauma ribs Trauma skull Portable neonate chest C-arm case Facial bones 84

85 Clinical Make up Time Sheet Area Time in Time out Date Initial of tech Initial of Student Student Signature Senior Tech Signature Date The above student is making up clinical time. Clinical Make up time is done voluntarily. The senior technologist/supervisor in the clinical area must sign this form for each occurrence. Your signature verifies their attendance and total number of hours present in your clinical area. Students should not be here no more than 10 hours each day. Students are not allowed to make up time on institutional holidays. 85

86 Learning Objectives for Clinical Areas Students will be provided a clinical workbook that will be comprised of the objectives, quizzes, ARRT competency requirements. This workbook will also contain information for children s rotation as well. 86

87 Scheduling Desk and Image Library The scheduling and image library areas are all critical support areas for the Radiology department. You will spend some time rotating through each of these areas to gain a more comprehensive view of the entire radiology process. At the scheduling desk, patients are scheduled for contrast examinations and given instructions on pre-exam preparations required. If the correct instructions are not given to a patient at the time they are scheduled, it may not be possible to perform their examination. This area of the department also handles a variety of enquiries about the radiology operations. The image library is where patients and physicians can get CD s of images and where images are imported from outside facilities. This area is also responsible for printing and faxing radiology reports. Careful attention is needed her to correctly identify patients and correct information through Radnet. 87

88 Mobile Radiography There are some patients whose physical condition requires only bedside or portable radiography. These may include orthopedic patients, cardiac patients, burn patients and isolation patients among others. Reporting to the patients charge nurse and carrying through all her suggestions about positioning is essential. With ortho patients, the technologist must take care not to disturb the patient s traction. Weights should never be removed and ropes and pulleys should not be manipulated in any way. A comparatively high number of portables requested will be on patients with heart disease. It is important to check with the patients nurse on limitations on the patient s movement and activity. It may not be advisable to sit the patient up for an erect exam. These patients can be deceptive. They may appear to be much healthier than they actually are. Most critically ill patients present a common problem from a radiographic point of view: inability to cooperate in stopping motion. It is advisable to choose a high KVP/Low mas technique to reduce exposure time thereby reducing motion. In taking portable radiographs you should take advantage of the maneuverability of the portable equipment. In ordinary radiography, the patient s body is moved into position for each projection. In portable radiography, the patient s body should be handled as little as possible and instead the tube and Image receptor should be manipulated to obtain the projection needed. The technologist should always check the requisition and if possible the patients chart to verify the type of exam requested and the reason or medical history for the exam. Chest x-rays for tube or line placements require higher techniques. You need to over penetrate the chest in order to demonstrate the position of the tube or line. Positioning may also need to be adjusted for some types of tubes. A dobhoff fro instance usually requires a lowered centering point than a routine chest. Also verifying what exam was ordered and why can save you from talking the wrong exam on the wrong patient. If the requisition or chart is not available to you, verify the type of exam and history with the patient s doctor or nurse. Also always verify that you are shooting the correct patient by checking the armband. Patients are sometimes moved to a different room before you get there to take their x-rays. Always enlist the help and advice of the patients nurse for any type of portable x-ray!!! 88

89 Listed below are some of the various tubes, lines and catheters that you may encounter on portable patients. One of the challenges of portables is positioning the patient and the image receptor without disrupting these lines. If you run into any problems, report them immediately to the patients nurse! Nasogastric or NG Tube: a tube of soft rubber or plastic inserted through a nostril and into the stomach to instill liquid food or remove stomach contents. Chest Tube: a tube inserted into the chest cavity for the removal of air, fluid or both. Routinely used after thoracic surgery or trauma. Urinary catheter: A flexible tube inserted into the urethra to drain urine from the bladder. T-Tube: a tube inserted in the biliary tract after removal of the gallbladder to promote drainage. Endotracheal or ET tube: an airway catheter inserted into the trachea by way of the mouth or nose. Allows removal of mucous secretions and adequate air passage. Can be used with a mechanical ventilator. CVP line: a long, fine catheter inserted into a vein ( usually subclavian vein) to measure central venous pressure and or to administer fluids, antibiotics or other medications. Dobbhoff Tube: A tube used for feeding the patient a high protein, high calorie diet. When dealing with portable patients who are in contact isolation, the following technique is used: 1. Obtain an Image receptor cover. 2. Technologist should put protective garments on before entering the room 3. Dirty technologist handles patient and moves furniture out of way. 4. Clean technologist covers the bed with clean sheet so if the portable touches the bed it will not be contaminated. The clean technologist positions the portable machine. 5. Clean technologist places the unexposed IR in the IR cover and hands it to the dirty technologist. 6. The dirty technologist will position the IR and patient. 7. The clean technologist makes the exposure 8. Dirty technologist retrieves the IR and holds the cover open so that the clean tech can remove it. 9. Clean tech removes machine from room 10. Dirty tech makes patient comfortable 11. Technologist removes and discards Protective equipment and washes their hands. 89

90 Learning Objectives: at the end of one or more rotations on portables, the student will be able to: Set up a logical schedule for performing portables and communicate this schedule to the receptionist or technologist coordinating portables. Always call down to the coordinator before returning to department. Turn equipment on and off Use the control panel including: mas, kvp, meters, rotor and exposure switch. Use technique chart to determine exposure factors. Operate portable machine including locks, collimation, angulations and movement. Operate auxiliary equipment Properly place anatomical markers on Image receptor Evaluate requisition fro exam, history and patient information and check with information in chart. Double check patients name and medical record number with arm band. Always solicit the assistance of the patients nurse: check with the nurse as to restrictions on patient position (if a patient has a recent heart attack or has very low blood pressure, sitting up may be dangerous for them). Introduce yourself to the patient and explain the exam (hearing is the last sense to go; a comatose patient may be able to hear you.) Show awareness and concern for the patient s physical and emotional needs: assist them to move into position, make them comfortable, and be supportive and respectful. Be cautious in moving orthopedic and heart patients and adapt your approach as needed to the condition of the patient and their ability to cooperate. Evaluate the patient to determine if modification of normal procedures is indicated by patient condition. Properly position the patient for the radiographic procedure ordered. Clear room of obstacles before positioning machine. Avoid disruption of lines, tubes and traction attached to the patient. Practice proper radiation protection measures for patient, self and others. Make the patient comfortable and put the bed and furniture back to their original position before leaving. Check with nurse s station for other portables on that unit before continuing to next unit. Call department for more portables. 90

91 CYSTOLOGY- 3RD FLOOR O.R. Cystology is the area in the 3rd floor operating room where surgical procedures to visualize the urinary tract are performed. There are several different studies done in this area all of which concentrate on structure of the urinary tract as opposed to function. For example, these studies might be performed to locate a stone or a constricted area of a ureter. If a doctor is interested in demonstrating function of the urinary system, an IVP in Radiology or a renal scan in nuclear medicine would be ordered to demonstrate the kidneys ability to perform their normal function of filtering certain materials out of the blood. Depending on the patient's medical history and condition, the Urologist will decide if the procedure should be performed under local or general anesthesia. Most of the time, you will be asked to take a pre-film of the abdomen before the procedure begins. The advantage of taking a pre-film is that it gives you an opportunity to check your technique and positioning both of which are critical to producing a diagnostic film after injection of the contrast material. For the exam, the Urologist inserts a cyst scope through the urethra into the patient's bladder. A cyst scope is a hollow metal tube with an electric light bulb on the end which illuminates the interior of the patient s bladder. By means of special lenses and mirrors, the doctor can examine the lining of the bladder for inflammation, stones and tumors. One of the most common exams performed in Cysto is the cystogram- a study to visualize only the bladder. The patient's bladder is catheterized - inserted with a flexible tube through the urethral opening in the bladder wall, and then the bladder is filled to capacity with a dilute solution of contrast material. The average bladder capacity is cc in an anaesthetized patient. Once filled to capacity, the catheter is clamped off, and one KUB film is taken. The Image receptor should be centered a little lower than a routine KUB so that all of the bladder will show on the film. Cystograms are done to examine the contour of the bladder, to check for reflux of fluid from the bladder into the ureters and to rule out stones. A patient history of incontinence (inability to control urination,) frequency of urination or pelvic pain can be an. indication for a cystogram. --- An urethrogram is a study of the urethra. It is helpful in determining if there is a blockage anywhere in the urethra which may be causing urinary retention. The patient is placed in an oblique position and again centering should be lower than normal in order to include all of the urethra. Immediately after injection of the contrast by the Urologist, one film is taken. 91

92 CYSTOLOGY- 3RD FLOOR O.R. (Continued) A voiding cystourethrogram is sometimes included with a cystogram. Again the bladder is filled to capacity with contrast material via a catheter, then the catheter is removed and the patient is asked to void. While the patient is voiding, several KUB films are taken with the patient in an oblique position. This study enables the Urologist to see how the bladder empties and shows the entire length of the urethra. Another study performed in Cysto is a retrograde pyelogram. The root word pyelo- refers to the renal pelvis. This area of the kidney is the upper expanded end of the ureter that connects to the calices. A retrograde pyelogram can be either unilateral or bilateral in a unilateral study only one side of the urinary tract is examined. In a bilateral study, both sides are examined, one at a time. The term retrograde means going against the normal flow. The normal flow of urine is from the kidneys through the calyces and renal pelvis into the ureters and from the ureters down to the bladder and out the urethra. In a retrograde study, a catheter is threaded through the urethra and bladder and into the lower opening of the ureter. Contrast is injected into the Ureteral opening and flows up the ureter and into the renal pelvis. A retrograde study is usually done to see the structure of the renal calyces and pelvis and the entire length of the ureter. In positioning the patient, it is best to center as you would for a routine KUB or slightly higher to include the entire kidney. In special cases if there is a stricture or narrowing of the ureter, catheters of increasingly larger size can be inserted in the hope of expanding the narrowed area of the ureter. Each time a catheter is inserted, contrast is injected and a image is taken. In Cysto, stones are sometimes manipulated or removed. For example, if a stone is found in the ureter, it can be removed with a small wire basket. First a cyst scope is inserted in the bladder, then a guide wire is inserted and contrast is injected to find the exact location of the stone. Then a thin wire basket is inserted and forced just above the level of the stone and opened. The Urologist then pulls back on the wires and if all goes well, the stone will catch in the basket as the wires are pulled back and the basket closes. You will be involved in other types of x-ray cases in the 3rd floor OR which will use either portable machines or c-arm fluoroscopes to evaluate patients in recovery or to follow the placement of a variety of lines or catheters and to perform heart biopsies. All procedures require a knowledge and adherence to the principles of surgical asepsis, and require proper OR garb to enter the OR suites. Learning Objectives: At the end of one or more rotations through Cystology- 3rd floor OR, the student will be able to: Turn equipment on and off, perform tube warm-up procedure and recognize and report equipment malfunctions. Use the control panel including: ma, kvp, sec settings, focal spot, meters, ABC- cells, Bucky and density settings, ready & overload lights, rotor & exposure switch. Use technique and tube rating charts to determine exposure factors. 92

93 6. urokinase- a drug used to dissolve clots in the arteries or veins. The drug is infused over a course of hours via a catheter placed at the site of the clot. This is an exciting aspect of special procedures that is constantly growing in importance. Learning Objectives: The student will be able to assist interventional staff in the following functions: Room preparation including stocking equipment, setting up trays, preparing contrast, filling power injectors and tube warm-up procedures. Patient care including transfer on & off table, checking patient identity, monitoring patient for problems, checking requisitions and charts for complete and accurate information, providing support and explanation of procedures, assisting in preparation of the patient for the exam and any emergency situation including code blues. Digital operations including entering patient and exam information, programming exam parameters, adjusting for image quality and taking multiformat films. Darkroom functions including running films, using the duplication/subtraction machine, marking films correctly. Information systems functions including entering correct patient and exam information in the Radnet system. Radiographic functions including positioning of the patient, radiographic/fluoroscopic equipment and table for the exam. Image review and critique for technical quality and identification of anatomy and pathology. Quality assurance tests and reporting of problems or malfunctions. Following correct radiation protection procedures for patient, self and others. 93

94 CHEST RADIOGRAPHY- Room 12, Outpatient Radiology, CCR Chest x-rays are one of the most common exams performed in the Radiology Department. This study provides information about the lungs and bronchi and the structures located in the Mediastinum of the chest. Each lung sits inside a sac called the pleura. Below each pleural sac and attached to it, is a sheet of muscle called the diaphragm. Contraction and relaxation of the diaphragm along with the intercostals muscles located between the ribs causes air to flow into and out of the lungs. The lungs are roughly cone-shaped. The uppermost part of the cone which sits above the clavicle is called the apex. The bottom of the lung is the base. The lower corners of the lung are called the costophrenic angles. The word costophrenic is derived from costo-meaning ribs and phrenic meaning diaphragm. The mediastinum is the area of the chest that sits between the two pleural sacs. It contains a number of important structures including the heart, Blood and lymph vessels, esophagus, trachea and main stem bronchi. Two shots are routinely taken of the chest, a PA projection and a lateral projection. The PA projection is a frontal view showing lungs, heart, aorta, ribs and diaphragm. The heart lies slightly to the left of midline. The right diaphragm normally lies higher than the left diaphragm; it is pushed up by the 94

95 liver lying beneath it. On the lateral shot, both lungs are superimposed, the aorta can be seen rising from the heart and arching backwards. The PA projection of the chest is preferred to the AP projection because the PA position places the heart closer to the film and therefore it is less magnified on the radiograph. This is also why chests are shot at 72. (Distance) A shorter distance will magnify the heart making it appear enlarged. The left lateral is usually preferred to the right lateral for the same reason- it puts the heart closer to the film so the heart is less magnified. Chests are preferably shot erect (patient standing or sitting) so that air-fluid levels can be seen. Gravity will cause fluid to layer out at the bottom of the chest. Air being lighter will rise to the top of the chest-the apices. The erect position will also lower the diaphragm allowing fuller inflation of the lungs. The presence of air outside of the lungs (either along the border or at the apex) is called a Pneumothorax. This means the lung has a hole in it and air is leaking out. Fluid in the pleural sac is called a pleural effusion. The presence of either air or excess fluid in the plural sac is abnormal. Doctors will insert a chest tube into the sac to drain out the air or fluid. Correct placement of the chest tube is essential so a chest x-ray is usually taken after insertion to check the chest tube s position. 95

96 If the routine chest x-ray (PA and Lateral) demonstrates either a pneumothorax or a pleural effusion, additional views of the chest in a lateral decubitus position may be ordered. In the lateral decubitus position, the patient lies on their side with the film behind them and the beam directed horizontally. In this position gravity will cause fluid to layer out at the bottom and air to layer out at the top. If you are looking for fluid in a lung, you place the lung with the effusion on the down side, for instance, for a right pleural effusion you would shoot a right lateral decubitus chest. On the other hand, when looking for air in a lung, you place that side up, so for a right pneumothorax you would shoot a left lateral decubitus chest. On the other hand, when looking for air in a lung, you place that side up, so for a right pneumothorax you would shoot a left lateral decubitus chest. Prior to shooting any images, the patient s clinical history should be checked in the patient s chart or on an out-patient s prescription (script) slip. The exact images taken may depend on this history. Many of the chest x-rays shot here at the hospital are pre-operative studies.these are taken prior to surgery to determine the patient s ability to handle being put under anesthesia. For patient s under 40, only a PA projection is needed. Pre-op chests require an immediate reading by the Radiologist. 96

97 Some chest x-rays are ordered to check the placement of a feeding tube called Dobhhoff. (N-G tube) The end of this feeding tube will be located in the upper abdominal cavity below the diaphragm. You will need to center lower than you normally would for a chest x-ray in order to see the end of the Dobhoff (N-G tube) on the film. Other chest x-rays you shoot will be to check the placement of pacemakers, CVP lines, swan ganz lines, and chest tubes as well as dobhoff and other feeding tubes. It is usually a good idea to shoot these at a higher technique than a routine chest since the doctors are looking for placement rather than at the lungs. The pacemaker is an electrical device that regulates the heartbeat, a CVP is a soft flexible tube called a catheter that is placed in the right atria chamber of the heart to measure central venous pressure or to inject nutrients or medications, a swan ganz is also a catheter but this one is placed in the pulmonary arteries leading from the heart to the lungs. It is critical that each of these lines be inserted correctly so insertion is always followed by a chest x- ray to check placement. If placement is not correct, the patient s doctor will move the line or tube (advance or pull) and another x-ray will be taken. Do not let any patient leave the department without having your Images checked first by a technologist or supervisor. All out-patient Images must be checked by a Radiologist. Occasionally, the Radiologist may request that additional images may be taken before the patient leaves. It is crucial to get a 97

98 complete and pertinent history for the x-rays so that the Radiologist has background knowledge of the patient s condition when reading the Images. Learning Objectives; at the end of one or more rotations through chest radiography rooms, the student will be able to: Stock and prepare the room. Turn equipment on and off and perform tube warm-up procedure. Use the control panel including; MA, KVP, SEC SETTINGS, FOCAL SPOT, METERS, AEC-CELL, BACKY AND DENSITY SETTINGS, Anatomical programmer, ready and overload lights, rotor and exposure switch. Use technique and tube rating charts to determine exposure factors. Adjust chest stand position and handlebars for patient. Properly place anatomical markers on stand. Evaluate requisition for exam, history and patient information and check with information. Use the control panel including: ma, kvp, secs, focal spot, meters AEC equipment (cell Bucky and density settings,) and exposure switch. Use technique and tube rating charts to determine exposure factors. 98

99 Make exposures manually and with automatic exposure control. Operate overhead tube, table, table Bucky, stand and stand Bucky. Operate auxiliary equipment. Properly place anatomical markers on the image receptor. Evaluate requisition for exam, history and patient information and check with information in chart or on prescription slip. Double-check the patient s name and medical record number with armband or with question, chart or on prescription slip. Double-check the patient s name and medical record number with armband or with question. Introduce yourself to the patient, explain the exam and obtain relevant medical history for the Radiologist. Show awareness and concern for the patient s physical and emotional needsassist them to move into position, make them comfortable, and be supportive and respectful. Properly position the patient for PA, AP, and lateral chest images and for erect abdomen images. Avoid disruption of lines and tubes attached to the patient. 99

100 Practice proper radiation protection measures for patient, self and others. Follow proper quality control procedures in marking images and paperwork, completing computer data entry and having images checked before releasing patient. Evaluate Images in terms of proper technique and positioning, presence of artifacts, patient and anatomical identification. Recognize basic anatomy and begin to recognize pathology. Report equipment malfunctions to appropriate supervisory, QA or equipment maintenance. Use the control panel including: ma, kvp, secs, focal spot, meters, AEC equipment (cells, Bucky and density settings) ready and overload lights, rotor and exposure switch. Use technique and tube rating charts to determine exposure factors. Make exposures manually and with automatic exposure control. Operate overhead tube, table, table Bucky, stand and stand Bucky. Operate auxiliary equipment. Properly place anatomical marker on image receptor. 100

101 Evaluate requisition for exam, history and patient information and check with information in chart or on prescription slip. Double-check the patient s name and medical record number with armband or with questions, chart or on prescription slip. Double check the patient s name and medical record number with armband or with questions. Introduce yourself to the patient, explain the exam and obtain relevant medical history for the Radiologist. 101

102 INTERVENTIONAL RECOVERY ROOM Your rotation through the interventional recovery room will give you an opportunity to observe and practice many of the patient care skills you have studied in Patient care class. You will be working with and under the supervision of the interventional nursing staff. You will have on opportunity to follow a patient through their care in this area beginning with their initial pre-op assessment by the nursing staff, the explanation of the exam and obtaining of consent forms by the Radiologist, the administration of pre-medications and the preparation of the sterile field. Then you will observe the interventional procedure and nursing support offered to the patient during the exam. Finally, you will follow the patient to the recovery room to observe to follow-up nursing assessment during the recovery period. You will also get a chance to observe proper record keeping and the techniques of surgical asepsis, and will have an opportunity to practice taking vital signs. Part of your rotation will also involve becoming more familiar with the code cart. You may observe both contrast reactions and treatment for contrast reactions during this rotation. 102

103 We would recommend that you review both your notes from Patient Care Class and your Patient Care textbook. LEARNING OBJECTIVES: By the end of the rotation, the student will be able to: Locate the code cart, suction, oxygen, blood pressure cuff and stethoscope. Locate and identify the different components of the code cart. Take and record patient vital signs. Correctly interpret and write chart notes. Identify common pre-medications and their effects. Identify common dedications used in contrast reactions and their effects. Demonstrate an awareness and understanding of the patient s physical and emotional needs during an interventional exam, and demonstrate the ability to meet those needs. 103

104 GENERAL DIAGNOSTICS EXAMS - Rooms 20 and Outpatient Radiology Room 20 in Main Radiology and the diagnostic rooms in Outpatient Radiology are used for general radiographic exams. The radiographic Procedures performed in these rooms include x rays of the spinal Column, upper and lower extremities, shoulder girdle, pelvic girdle and Bony thorax as well as chest and abdominal images. In these rooms you will have ample opportunity to practice the variety of radiographic procedures learned in positioning class. This is a good opportunity for you to complete simulations and initial and final competency exams. In this Handbook, you will find a list of standard radiographic projections used at Washington Hospital Center for each type of diagnostic radiographic procedure. Use this as a reference when working in these areas. Learning Objectives: At the end of one or more rotations through this area, the student will be able to: Stock and prepare the room. 104

105 Turn equipment on and off. Introduce yourself to the patient, explain the exam and obtain relevant medical history for the Radiologist. Show an awareness and concern for the patient's physical and Emotional needs - assist them to move into position, make them Comfortable, and be supportive and respectful. Properly position the patient for the radiographic procedures ordered. Avoid disruption of lines and tubes attached to the patient. Practice proper radiation protection measures for patient, self and others. Follow proper quality control procedures in marking images and paperwork, completing computer data entry and having images checked before releasing patient. Evaluate images in terms of proper technique and positioning, presence of artifacts, patient and anatomical identification. 105

106 Recognize basic anatomy and begin to recognize pathology. Report equipment malfunctions to appropriate supervisory, QA or equipment maintenance person 106

107 Upper Gastrointestinal Tract Room 27 In the UGI room, studies of the stomach, esophagus, small bowel, gallbladder and biliary tree are performed. These studies are done under fluoroscopy because fluoro allows observation of movement of materials through the organs. Movement in the digestive tract is called peristalsis a series of contractions which push food along. Examination of the intestinal tract requires that the patient be carefully prepared in advance. The patient is allowed nothing to eat or drink from midnight the day of the exam until after the study is completed. This preparation is done to prevent food or drink within the stomach or intestines from interfering with visualization of the organs. The patient is said to be NPO after midnight (nothing passed orally.) It is not easy to visualize the organs of the intestinal tract on radiographs. They are so similar in density and structure to surrounding soft tissue that they don t stand out the way bones do. For this reason, it is necessary to use contrast materials to demonstrate these organs. A contrast material is a substance of high anatomic weight and density. It is too dense for x-rays to penetrate so any organs contain the contrast will show up white o the x-ray. For UGI s, the contrast used is barium sulfate. For a stomach examination, the patient is given a heavy barium sulfate concentrate to drink along with sodium carbonate crystals that the patient must swallow. The crystals (fizzies) produce gas in the stomach which pushes the barium out along the walls of the stomach giving it an even coating. This allows the Radiologist to closely examine the lining of the stomach for ulcers, polyps, tumors and other abnormalities of the stomach wall. The radiologist will have the patient move into various positions to ensure that all areas of the stomach are demonstrated and evaluated. During the examination, the doctor will also have the patient drink a concentration of thin barium solution in order to examine the esophagus and cardiac orifice (opening between the esophagus and stomach). For an examination of the esophagus ordered on its own, the doctor will have the patient drink a thin concentrate of barium under fluoroscopy while images are taken. The patient may be asked to swallow one or two spoonfuls of a thick barium paste called esophatrast or of bread or other food soaked in barium. The radiologist will also observe this under fluoro and take images. In the afternoon, 107

108 studies called modified barium swallows on patients from the hearing and speech department are performed in much the same way to evaluate the patient s ability to swallow. If the requisition asks for either a barium swallow or an ugi with esophagus check with the radiologist before feeding the patient to determine what type of barium the patient should be given. Examinations of the small bowel are also done in Fluoro. They are preceded by the regular exam of the stomach (UGI). Then the patient is given another cup of barium to drink. After a half hour has passed, the patient is brought back into a room for a radiograph of their abdomen. Films of the abdomen are taken at half hour intervals until the barium has traveled all the way through the small intestines to the ileocecal valve which connects to the large intestine. The radiologist may wish to fluoro the patient once the barium has reached the ileocecal valve. For gallbladder exams (oral cholecystograms) the patient must be NPO after midnight. They are also given 6 capsules of a contrast called oragraffin to take at 11:00pm the night before the exam. The oragraffin will cause the gallbladder to appear white on the x-rays. The patient is x-rayed in both the supine and erect positions. Placing the patient erect will cause the gallstones to layer out in the bile because the pull of gravity. Some stones will float in a layer on top of the bile; heavier stones will sink to the bottom of the gallbladder. Another contrast study occasionally performed in this room is a T-tube cholangiogram. This is a study of the biliary tree after removal of the gallbladder. The biliary tree is a series of ducts connecting the gallbladder, liver and duodenum (first section of small intestine). When injected with contrast, this set of ducts resembles the branching of a tree, after a patient has their gallbladder removed; a drainage tube is left in place to drain off the bile and other fluids. This tube is in the shape of a T. the upper bar of the T sits inside the common bile duct and the bottom bar exits through his abdominal wall for drainage. In a T-tube cholangiogram, iodinated contrast is injected through the drainage tube. Any gallstones or other obstructions remaining in the ducts will be demonstrated on the x-rays. Occasionally, fistulograms are performed in this room as well. Fistulas are abnormal tube like passages in the body. They may be congenital or the result of surgery, trauma, and or disease. In a fistulogram, contrast material is injected 108

109 into the fistula in order to see how extensive it is and to follow its passage through the body. In the afternoon, hysterosalpingograms are performed in fluoro. This is a study of the female reproductive tract-uterus and fallopian tubes. It is most often performed to check the patency of the fallopian tubes in women who are having problems in becoming pregnant. Patency refers to whether the fallopian tubes which connect the ovaries to the uterus are open so that an egg can pass through to implant in the uterine wall. Contrast material is injected through the cervix into the uterus and images are taken as the contrast spills into the fallopian tubes. Other studies you may see in fluoroscopy include fluoro of the diaphragm which allows the Radiologist to evaluate the extent to which the diaphragm (muscle that sits below the lungs) moves during inhalation and exhalation, sialograms which are contrast studies of the salivary ducts in the mouth that usually are performed to evaluate the presence of a stone or tumor and bronchograms which are contrast studies of the trachea and bronchial tree. Each radiologist follows slightly different procedures in performing these exams so it is important to check the protocol reference on the radiologist that is kept in the fluoro control area (check with the fluoro charge tech). Learning objectives: at the end of one or more rotations through UGI s, the student will be able to: Stock and prepare the room Turn equipment on & off Use the control panel Use technique chart Operate table, Bucky, image receptor and fluoro carriage buttons Operate auxiliary equipment Prepare contrast and injection materials Locate emergency medicines, oxygen, suction equipment, blood pressure cuff, code blue cart and emergency call button. Operate the dedicated oxygen and suction device Evaluate requisition for exam, history and patient information and check with information in chart or on prescription slip. 109

110 Double check the patients name & medical record number with their armband Introduce yourself to the patient, explain the exam and obtain relevant medical history for the radiologist Show an awareness and concern for the patients physical and emotional needs- assist them to move into positions, make them comfortable, and be supportive and respectful. Follow the proper procedures for positioning and feeding the patient for the radiographic examinations ordered according to the radiologist protocol. Avoid disruption of lines and tubes attached to the patient. Practice proper radiation protection measures for patient, self and others. Follow proper quality control procedures including completing paperwork, completing data entry in the fluoro room and in the Radnet system, and having images checked before releasing the patient. Recognize basic anatomy and begin to recognize pathology Recognize and report equipment malfunctions to the appropriate supervisory, QA equipment maintenance personnel. 110

111 Rm 35: Myelograms, Arthrograms and Lumbar punctures Myelography is an examination of the structures of the central nervous system which lie within the spinal canal. This aids in the evaluation of lesions, pinched nerves and herniated discs. All the supplies needed for the exam are included in a disposable myelogram tray. The only additional supply needed is the contrast media and a 25 gauge needle. The contrast used in myelography most often is a non-ionic water soluble solution which is absorbed by the body and excreted through the urinary tract. Usually a patient scheduled for a myelogram is kept on clear liquids just prior to the exam. The patient is usually placed on the table in the prone position. A drape is taped to the patients back just below the puncture site which is usually between L-3 & L-4. Sometimes a roll is placed beneath the patient s stomach prior to the insertion of the needle into the intervertebral space. The doctor will prep the patients back with beta dine and numb the puncture site with xylocaine before inserting the needle. Fluoro is used to locate the exact puncture site before the needle is inserted. After the needle is inserted, a small amount of cebrospinal fluid is collected and sent to the lab for analysis. Then contrast media is injected and the table is tilted to run the contrast up and down the spinal cord. If the lumbar spine is being examined, radiograph projections may include a PA, Oblique s and a cross table lateral. The myelogram is usually followed by a computerized tomography scan. The contrast material in the spinal canal gives excellent contrast-enhanced images. The myelogram & CT scan are usually performed on an outpatient basis, but inpatients may have them as well. Arthrograms are also performed in RM 35. They can be performed on any synovial joint in the body but are most frequently performed on the knee and shoulder joints. Pre radiographs are taken of the area. Then the doctor scrubs the injection site with beta dine, numbs it with xylocaine and then inserts the needle into the joint space. A water soluble iodinated contrast is injected, sometimes followed by injection of air. Supplies for the injection include a 10cc syringe filled with 1% xylocaine with a 22 gauge needle, a 10 cc syringe with iodinated 111

112 contrast with a K-50 extension tube with a 20 gauge needle. If air is to be injected a 60 cc syringe filled with 35 cc of air would be used. Sometimes post injection films are taken. At the end of the study patients are taken to MRI for a MRI scan. A lumbar puncture (LP) or (spinal tap) is another type of exam that is performed by a radiologist in fluoroscopy. An LP is sometimes performed by other physicians in the hospital; however, if other physicians are not able to gain access, a request is made for our radiologist to perform the procedure for them. An LP is a needle insertion usually in the lumbar region down to the area in the spinal canal called the subarachnoid space. In this space, free flowing fluid called CSF (cerebrospinal fluid) bathes the spinal cord. The radiologist may either perform a diagnostic procedure by aspirating small samples of CSF from that area for analysis; or may perform a therapeutic procedure by withdrawing excess amounts of CSF to relieve pressure caused by an overproduction of CSF. The technologist ( or monitored student) assisting the radiologist prepares the room for the procedure, gathers all the necessary items used for the procedure such as a lumbar tray, antiseptic solution, sterile gloves for the radiologist and other items needed according to the protocol. The patient is placed on the table, stomach down and a cloth is taped to the patients back just below the puncture site which is usually between L-3 & L-4. Occasionally a bolster (roll) is placed beneath the patient s stomach prior to the insertion of the needle. The roll changes the curvature of the spine making it easier to insert the needle. After the needle is inserted, a small amount of CSF is collected and sent to the lab for analysis, or excess CSF withdrawn for relief. Learning Objectives: At the end of one or more rotations, the student will be able to: Stock and prepare room Set up trays and prepare contrast for procedures Turn on equipment on & off Use the generator control panel and operate all radiographic and fluoroscopic equipment Locate emergency medicines and equipment Follow hospitals universal precautions policy 112

113 Evaluate requisition for exam, history and patient information Lower Gastrointestinal Tract- Barium Enemas Barium enemas are studies of the large intestine or colon. Like the rest of the gastrointestinal tract, it is difficult to pick up much information from plain x- rays so contrast material has to be introduced. A contrast material is a substance of high atomic weight and density. It is too dense for x-rays to penetrate so any organs containing the contrast will appear white on the x-ray films. For studies of the colon, the contrast materials used are barium sulfate and air. These are administered to the patient as an enema. For this examination to be successful, the patient has to be carefully prepared in advance. The day before the exam, the patient takes a laxative to clean out their intestines and maintain a liquid diet. After 7:00pm, they are allowed nothing to eat or drink until after the exam is completed. The purpose of this procedure is to rid the intestines of fecal material and gas. If the intestines are not well cleaned out, it is difficult to visualize the walls of the intestine clearly and pathology can be missed. Once the patient is brought into your room, the first step is to take a scout or preliminary radiograph. This x-ray will show the radiologist is the patient s colon is sufficiently clean so the examination can proceed. It will also show the radiographer if his assessment of the patient in terms of positioning and technique is correct. 113

114 If the patient is sufficiently clean, the enema tip can be inserted. The choice of whether to use a regular or balloon tip will depend on the patient s condition. The regular tip is smaller and more comfortable for the patient, but the balloon tip when inflated can help the patient retain the barium during the exam. The patient is placed on their left side with the right knee bent toward the chest. The tip is lubricated and placed in the patient s rectum. Extreme care should be taken in inserting and inflating the tip as damage to the rectum can occur. It is the policy of the MWHC radiology department, that the Radiologist should insert the enema tip and inflate balloon tips. Be sure to wear gloves when removing an enema tip. Caution: Deflate balloon first before removing enema tip. The radiologist will examine the patient under fluoroscopy while the radiographer administers the barium. The doctor will take images during the exam. After sufficient barium is introduced, the doctor will have the radiographer shut off the barium and administer air to the patient. The air will help to push the barium against the walls of the intestine giving it an even coating that makes it easier to see pathological changes. The patient is advised to breathe slowly and deeply through their mouth while the barium and air is administered, this pattern of breathing relaxes the muscles which makes the patient more comfortable and the exam go more smoothly. 114

115 After the doctor has completed the exam, the radiographer may take several overhead x-rays of the patient. When these are completed, the patient s colon is drained of barium and air, and the patient is allowed to use the bathroom. In many cases, the doctor will request a post-evacuation x-ray of the colon-the patient goes to the bathroom and then returns for an abdominal x-ray. Generally the x-rays that the doctor and technologist take will demonstrate the entire colon, and specific shots will be done to demonstrate the sigmoid colon and colic flexures. Usually an AP or PA of the entire colon will be shot. A lateral or angled shot will be taken to demonstrate the sigmoid colon (the s- shaped last section of the colon before the rectum.) Occasionally, the oblique shots will be taken to demonstrate the flexures of the colon. The right or hepatic flexure located below the liver is demonstrated in the LPO shot. The left or splenic flexure is demonstrated with the RPO shot. Usually, lateral decubitus x- rays will be taken of the entire colon showing a layering out effect of barium and air. Occasionally, you may have to perform a barium enema on a colostomy patient. These patients have had part of their intestines removed, and waste is now excreted through an opening called a stoma on their anterior or posterior abdominal wall rather than through their anus. Instead of using the regular BE tips, special catheter- flexible tubing with a balloon tip-is inserted into the 115

116 colostomy opening. The catheter is connected to the enema bag and barium and air enter the patient through the colostomy opening. Extreme caution is recommended in inserting and removing the tip and particularly in inflating the balloon as the stoma can be easily damaged. You should have everything set up for the doctor to insert the tip and inflate the balloon. The regular procedure is followed unless the doctor decides to modify it. After the procedure is completed, the catheter should not be removed until you have positioned the patient to drain into a cup or toilet. Again, be extremely careful in removing the tip. After the patient is cleaned, they should be given a clean colostomy bag from the supply kept in the fluoro kitchen. Some patients may prefer to use one of their own bags they have brought from home. You will need to realize that patients are sensitive about having a colostomy so you will need to be especially tactful and considerate in dealing with them. Sometimes the barium enema patient is scheduled for a combination of studies. All non Barium imaging of the abdomen-pelvic region area should be scheduled first: spine, pelvis, IVP, sonogram, Cholecystogram so that barium in the intestines will not interfere with these studies. If a GIT (gastrointestinal tract) is ordered, the barium enema is performed on the first day and UGI on the second day at least 48 hours after the 1 st exam for an outpatient. 116

117 Each radiologist may have a slightly different procedure for performing barium enemas. Radiologist change their protocols from time to time so it is advisable when you start a rotation in fluoro to double check the protocol reference on radiologists kept in the fluoro control area (check with the fluoro charge tech). Other fluoro exams: You may become involved in examinations of the female reproductive tract or the salivary glands that are performed in the afternoons in fluoro. The study of the female reproductive system is called HSG (hysterosalpingogram) and is usually performed to see if the fallopian tubes are open (patent) so that an egg can become fertilized. The salivary gland study is called a sialogram and is performed to check for stones, tumors or strictures in the salivary glands or ducts. You may also have a chance to observe and participate in bronchograms: studies of the trachea and bronchial tree using contrast media and fluoroscopy. Learning objectives: at the end of one or more rotations through BE s, the student will be able to: Stock and prepare room Turn equipment on and off Use the control panel Use techniques Make exposures manually and with photo timing 117

118 Operate overhead tube, table, table Bucky, Image receptor, and fluoro carriage controls Operate auxiliary equipment Prepare contrast and injection materials Locate emergency medicines and equipment Operate dedicated oxygen and suction device Properly place anatomical markers on image receptor Evaluate requisition for exam, history and patient information and check with information in chart or on prescription slip Double check patients name and medical record number with armband Introduce yourself to patient, and explain the exam and obtain relevant medical history for the radiologist Show an awareness and concern for the patients physical and emotional needs: assist them to move into position, make them comfortable, be supportive 118

119 Operating Room (MOR): The types of exams performed in the MOR are considerably complex and diverse procedures. These will range from pacemaker insertions and hip nailing to cholangiograms, orthopedics, Vascular, Neurosurgical. You will be learning how to position Image receptors and machines within the constraints of a surgical asepsis environment. When in the presence of any aseptic procedure, it will be your responsibility to think constantly of possible sources of contamination and scrupulously avoid them. You need to develop an aseptic conscience. You have to take the responsibility for correcting mistakes or breaks in aseptic technique that only you may be aware of. There are several points to remember in applying sterile technique: All articles used in operation have been sterilized previously. Persons who are sterile touch only sterile articles. Persons who are not sterile touch only non sterile articles. If in doubt about sterility of anything, consider it unsterile. Nonsterile persons should avoid reaching over a sterile field. Sterile persons should avoid reaching over nonsterile areas. Tables are sterile only at table level. Gowns are considered sterile only from the waist to the shoulder levels in front and the sleeves. The edge of anything that encloses sterile contents is not sterile. Sterile persons keep well within the sterile area. No sterile persons keep away from sterile areas. Sterile persons keep contact to sterile areas to a minimum. Moisture may cause contamination: sterile packages are laid on dry areas. When bacteria cannot be eliminated from a field, they must be kept to an irreducible minimum. It is recognized that perfect asepsis is an ideal that can be approached only. It is not absolute as the skin cannot be sterilized. If a glove is punctured during an operation or procedure, it is changed at once. Unsterile personnel turn his back to a sterile field when passing. The air is contaminated by dust and droplets so there for masks are worn over the nose and mouth. Talking is kept to a minimum. Sneezing and coughing should be avoided. Doors from corridors are kept closed Sterile trays without wrappers are not carried through corridors. Never store sterile and unsterile articles together. Wetness is considered unsterile. 119

120 In an operating room never pass between the sterile table and the patient. Color coded tape is used in this hospital to secure packs. Packs on which the tape lines have changed color are considered unsterile. Working within the operating room will require knowledge of the OR layout and the uses of each room. It also requires the ability to interpret the posted OR schedule to anticipate which procedures will require x-rays and which machines will be needed for each exam. In some cases x-ray equipment must be put into place prior to the beginning of the operation. Your rotation through the OR will also afford the opportunity to observe operations that do not require x-rays as part of your general orientation to the operating room. Scrub suites are located in linen services on the ground floor. You may request access to a scrub machine; however there may or may not be linen cart with paper scrubs available. Therefore we highly suggest you obtain scrubs from Linen Department. In front of the OR desk there is a cabinet with Bonnets and shoe covers, paper jacket. These are necessary before going in the OR. Once you are properly dressed you may then enter the OR. Please remember a Surgical Mask is on your face as you enter an OR suite. Work AREA: is next to OR #12 OR exams are processed in RADNET by using the following functions: 1. Log exam under department order entry 2. Verify exam under exam management 3. Enter QA data under exam management 120

121 MAMMOGRAPHY Mammography is a low dose breast x-ray designed to help in the early detection of breast cancer. Mammograms can identify breast cancer, in some cases, up to 2 years before it can be detected by physical examination or other methods of diagnosis. Mammography is also useful in continuing the presence of other breast diseases or abnormalities. The natural incidence of breast cancer is II% or 1 out of every 9 women. This number has increased over the last few years. This makes it critical to detect cancer of the breast as early as possible when survival rates are close to 100%. As with all x-ray procedures, mammography exposes the patient to small doses of radiation, but the benefits of early detection and treatment far outweigh the risk. The current recommendation of the American Cancer Society and the American College of Radiology is that asymptomatic women over the age of 50 should have a yearly mammographic exam, women between the ages of 40 and 5O should have annual or biannual exams, and Women between the ages of 35 and 40 should have a baseline exam. Women with a personal or Family history of breast cancer may need to be examined more frequently. Also any woman Displaying a symptom or sign of breast cancer including lumps in the breast or armpit, discharge From the nipple, thickening in the breast, puckering or dimpling of the breast or abnormal skin on the breast should receive a mammogram. To prepare for a mammogram, the patient is instructed to wear a 2 piece outfit. It is also requested that a patient not wear any deodorants, powders, ointments or perfumes on the Breasts, arm pits or chest as these substances can leave residues (such as aluminum chlorhydrate) which can be detected by x-rays. These trace metals may cause smudging or mimic micro calcifications that can be mistaken for very serious breast disorders. This can lead to Further unnecessary radiation or more seriously to misdiagnosis and possibly even surgery. Mammograms at Washington Hospital Center are performed on dedicated mammogram units which are used solely for this purpose. There are 2 basic mammogram exams: the diagnostic mammogram and the screening mammogram. The diagnostic mammogram is performed on patients with specific breast problems such as palpable nodules or lumps, skin thickening, breast pain, personal or family history of breast cancer, or history of surgery for benign breast disease. After completing the exam, the technologist has the films reviewed by the radiologist. Any follow-up films are taken before the patient leaves the department. This exam directly involves the radiologist. The other type of mammogram is a screening mammogram. This is performed on asymptomatic patients only (patients who have no suspected problem.) A true screening mammogram is indicated on patients over the age of 35 with no family history of breast cancer and no previous breast surgery. Once the history sheet is completed and the films are processed, the images are checked for diagnostic quality, correct positioning, patient identification and markers. After the Images are cleared, the patient is released. The extremely important to remember two things: 1. Document everything! - All breast scars, patient refusal to accept full compression, patient unsteadiness, and anything else that may cause sub-optimal film quality. This information will give the radiologist necessary background information about your patient and may help in the diagnosis. 121

122 2. The other thing you must keep in mind is the anxiety involved for the patient in returning for follow up images. In most cases, the patient is afraid, some may cry and some are openly Hostile. For this reason every image should be carefully scrutinized for quality prior to release of the patient. No patient should be put through call back and follow-up because of careless, avoidable mistakes such as motion, underpenetrated films or inaccurate positioning. The standard exam recommended by the American College of Radiology consists of a cranialcaudal projection shooting from the top of the breast through to the bottom, and a medial-lateral oblique projection shooting from the middle of the breast to the outside border. The Radiologist may request additional special views if needed. The woman's breast is placed against the cassette and then compressed with a plastic compression device. Compression can cause the patient discomfort. You should be as understanding as possible and exercise care in Compressing the breast. The purpose of compression is to equalize the differences in tissue thickness and reduce tissue thickness from the subcutaneous tissue to the chest wall. Proper compression has been achieved when the breast tissue feels taut to the touch. However each patient has a different tolerance level for discomfort; never compress a patient's breast beyond their reasonable comfort level. This provides a radiograph with more uniform density which can be more accurately interpreted by the Radiologist. Compression also decreases the geometric distortion of the breast structures and decreases motion artifacts on the film. It also reduces the patient's radiation dose. The criteria for evaluating the cranio-caudad projection includes: As much of the most medial portion of the breast and as much of the most lateral portion of the Breast as possible are demonstrated on the film without rotation, the nipple should be centered on the film and in profile unless this will sacrifice breast tissue. Criteria for the mediolateral projection include: the pectoral muscle is well seen and extends to or below the nipple line, deep and superficial breast structures are separated and the inframammary fold is open. Bilateral mammograms are always performed as it is important that the Radiologist be able to compare tissue in both breasts to make an accurate diagnosis. If the patient has old mammogram films, these should be pulled from the Film Library and given to the Radiologist for comparison with the current study MAMMOGRAPHY Some final suggestions for your manual-no rotation: Always keep in mind that the mamma patient has very special needs; most patients are very intimidated just by coming in. Keep your conversations very general and direct. Your patient takes everything you say literally and personally. ALWAYS; Make sure you introduce yourself to the patient. Ask if there are any questions before you begin positioning. Indicate to your patient your intentions before you begin to touch the breast (even if they have had a mammogram before.) Be pleasant! NEVER: Use terms such as big cassette or small cassette (your patient may think this refers to personal breast size.) The correct terms are 24 X30 Image receptor or 18 X 24 Image receptor

123 Never make any references to pathology when imaging (if you notice anything out of the ordinary inform the Radiologist.) Never give opinions about the patient's physician even when asked. Required Reading: Mammographic Quality Control Radiologic Technologist Manual, pp You can borrow this from the mammogram technologist. Learning Objectives: At the end of one or more rotations through mammography, the student Will be able to: Stock and prepare the room. Turn equipment on and off Use the control panel including: ma, kvp, sec settings, focal spot, meters, photo timing- cells, Bucky and density settings, ready & overload lights, rotor & exposure switch. Use technique and tube rating charts to determine manual and photo timing exposure factors. Make proper exposures. Operate mammography unit including auxiliary devices. Properly place anatomical markers on film. Evaluate requisition for exam; history and patient information and check with information in Chart or on prescription slip. Double-check the patient's name and medical record number with armband or with questions. Introduce yourself to the patient, explain the exam and obtain relevant medical history for the Radiologist. Complete the mammography information sheet. Show an awareness and concern for the patient's physical and Emotional needs - assist them to move into position, make them comfortable, and be supportive and respectful. Properly position the patient for cranio-caudad, medial-lateral oblique; a n o t h e r special projections as ordered. Practice proper radiation protection measures for patient, self and others. Follow proper quality control procedures in marking films and paperwork, completing computer data entry and having films checked before releasing patient. 123 Radiography

124 Interventional Recovery Room Your Rotation through the interventional recovery room will give you an opportunity to observe and practice many of the patient care skills you have studied in Patient care class. You will be working with and under the supervision of the interventional nursing staff. You will have an opportunity to follow a patient through their care in this area beginning with their initial pre-op assessment by the nursing staff, the explanation of the exam and obtaining of consent forms by the radiologist, the administration of pre-medications and the preparation of the sterile field. Then you will observe the interventional procedure and nursing support offered to the patient during the exam. Finally, you will follow the patient to the recovery room to observe to follow up nursing assessment during the recovery period. You will also get a chance to observe proper record keeping and the techniques of surgical asepsis, and will have an opportunity to practice vital signs. Part of you rotation will also involve becoming more familiar with code cart. You may observe both contrast reactions during this rotation. We recommend that you review both notes from patient care class and your patient care textbook. Learning Objectives: By the end of the rotation, the student will be able to: Locate the code cart, suction, oxygen, blood pressure cuff and stethoscope. Locate and identify the different components of the code cart. Take and record patient vital signs. Correctly interpret and write chart notes. Identify common pre-medications and their effects. Identify common dedications used in contrast reactions and their effects. Demonstrate an awareness and understanding of the patients physical and emotional needs during an interventional exam, and demonstrate the ability to meet those needs. 124 Radiography

125 Interventional Radiography A wide variety of examinations are performed in Interventional Radiology including arteriogram, venograms, digital subtraction angiograms, biopsies and interventional studies. Arteriogram is a study in which arteries are opacified by the injection of contrast media. The basic routine for any patient who is scheduled to have an arteriogram is for the patient to be placed on a clear liquid diet the day prior to the exam and the patient is given some pre-medication to relieve some of the anxiety of the test. The pre-medications used include demurral (meperidine) which makes the patient drowsy, valium (diazepam) which helps to relax the patient, phentanyl or versed which tends to make the patient forget. The type and the amount of drug used will depend on the patient s age, weight, medication history and allergic history. After the patient is brought into the room, the injection site is shaved and prepped using sterile technique. Most arteriogram is done via a femoral puncture. Before the groin is prepped, the femoral pulse must be located (midway between the asis and pubic symphsis). After location of a good femoral pulse, the groin is shaved and then scrubbed with beta dine using a circular motion. Next the patient is draped with sterile sheets and towels. This establishes a sterile field on which the doctor can place sterile instruments close to the injection site. It is extremely important that the sterile field remain sterile. If contamination occurs, the contaminated towel, glove, instrument, etc. must be removed and replaced with an article that is sterile. Infection during a sterile procedure can be a very serious complication. After the patient has been prepped, the radiologist will use the Seldinger technique to advance the catheter to the area of interest. The type of catheter and guide wire used and the number of lines will depend on the area of interest and the patient history. One common study performed is an aorta gram and run-off study to examine the aorta, aortic branches, aortic bifurcation and the arterial circulation to the lower extremities. Another common study is an arch and carotid arteries study to examine the aortic arch and the 3 vessels branching off the aorta arch. Three separate runs are included: one of the arch and its branches, and a selective of each carotid artery. The 3 vessels or intracranial study is an even more selective way to look at the circulation of the head and face. The 3 vessels studied are both common carotid arteries and one of the vertebral arteries. A pulmonary arteriogram examines the pulmonary circulation. Other selective studies of specific arteries may also be performed. Digital Subtraction angiography uses a computer in conjunction with imaging to examine blood flow. DSA can be performed with either a venous or arterial injection. Almost any area of the body can be examined, but the most common exams performed are the arch and carotids, renal arteriogram, aorta grams, run-offs and PA grams. In some cases, DSA can be performed on an outpatient. Over the past several years there has been an increase in interventional procedures to provide treatment for many different conditions. Interventional procedures may help a patient avoid surgery, decrease the length of stay in the hospital, decrease the cost of treatment of a disease and/or speed up the patients recovery time. New interventional procedures are being developed all the time. Interventional Procedures include: PTA- a special catheter with a balloon on the end that pushes plaque against the wall of a blood vessel increasing the diameter of the lumen. Atherectomy: treatment for arterial occlusion by using a catheter with a special cutting blade and collection chamber for removal of plaque. 125 Radiography

126 Vascular Stents: metal structures which when expanded remain permanently in the patient to keep stenotic vessels open. Embolization: to Decrease bleeding preoperatively for tumors or to slow down or stop GI Bleeds. IVC filters: wire mesh structures placed in the inferior vena cava to prevent emboli traveling from the lower extremities to the pulmonary arteries. 126 Radiography

127 COMPUTERIZED TOMOGRAPHY Computerized tomography is used to produce a series of cross-sectional images of the body. The area of interest is cut into slices for scanning and viewing purposes to eliminate the superimposition of many different structures that occurs in a standard x-ray. The images obtained can be reconstructed so as to view them on different planes, and even in 3-D. The patient is placed on a table. The table is then moved to place the area of interest within the gantry. Laser centering lights are used for precise patient positioning. The gantry contains an x-ray tube which moves in a spiral pattern around the patient's body, and detectors that respond to any radiation emerging from the body. Radiation hitting the detectors is converted into electrical current and the information contained in this current is then fed into an analog to digital converter before being processed by the computer. The final cross-sectional image produced by the computer is viewed on a CRT screen. The appearance of the image can be changed by changing the window and level settings on the viewing console. Window controls the number of densities demonstrated - this is similar to contrast on a regular x- ray. Level is the central point of your window densities. CT is excellent in its ability to demonstrate contrast between structures. It is not as good at demonstrating resolution or detail - the structural lines are not as sharp as on an overhead film. The CT unit scans the patient in the transverse and coronal planes, but also has the ability to reconstitute images in either the sagittal, coronal, paraxial, oblique and perpendicular planes. The CT units also have the capability of 3-dimensional imaging. Contrast materials are used for some CT studies. Iodinated or non-iodinated water soluble contrast may be used for head, abdominal or pelvic CTs. Barium or gastrografin may be used for abdominal or pelvic studies. Occasionally, the CT exam is scheduled to follow an IVP or a myelogram to take advantage of the contrast already introduced in the body for these studies. If a patient is to receive iodinated contrast, they should be NPO for 2 hours prior to the exam. If the abdominal or pelvic area is to be imaged, the patient must be NPO for 4 hours prior to the exam. CT is also used on occasion to perform biopsies on various body parts. As on standard x-rays, artifacts can occur on a CT scan. Motion is probably the most common artifact. Metallic shunts or prostheses in the body may also cause artifacts to appear. Learning Objectives: At the end of this rotation, the student will be able to: Position the patient on the table for a variety of examinations. Be familiar with the operation of the table, gantry, scan console and viewer console. Demonstrate a comprehension of information on the requisition and patient chart relating to the CT scan. Assist in preparation and administration of contrast media. Demonstrate an understanding of the applications of contrast media in CT - why and when they are used, possible adverse reactions and treatments to reactions. 127 Radiography

128 Demonstrate an understanding of the patient preps for various CT exams. Use the laser imaging camera. Begin to recognize cross-sectional anatomy of the body. Process paperwork and films. Recognize and report equipment malfunction to the appropriate supervisory, QA or equipment personnel. 128 Radiography

129 Clinical Schedules: The clinical schedule is prepared from the master schedule of the program. Students will get their semester clinical schedule from the coordinator at the beginning of the semester. The clinical semester will not be changed at the students request. Everyone will rotate through all the areas of Radiography with the exception of MRI if the student fails the screening tool. 129 Radiography

130 JRCERT Standards: The next section of the handbook contains the Standards set forth by the JRCERT the accrediting body of the radiography program. Please note the standards for Hospital Based programs are set to change in the year Radiography

131 Standards For an Accredited Educational Program in Radiography EFFECTIVE JANUARY 1, 2014 Adopted by: The Joint Review Committee on Education In Radiologic Technology - October Radiography

132 Joint Review Committee on Education in Radiologic Technology 20 N. Wicker Drive, Suite 2850 Chicago, IL (Fax) The Joint Review Committee on Education in Radiologic Technology (JRCERT) is dedicated to excellence in education and to the quality and safety of patient care through the accreditation of educational programs in the radiologic sciences. The JRCERT is the only agency recognized by the United States Department of Education (USDE) and the Council on Higher Education Accreditation (CHEA) for the accreditation of traditional and distance delivery educational programs in radiography, radiation therapy, magnetic resonance, and medical dosimeter. The JRCERT awards accreditation to programs demonstrating substantial compliance with these STANDARDS. Copyright 2014 by the JRCERT 132 Radiography

133 Introductory Statement The Joint Review Committee on Education in Radiologic Technology (JRCERT) Standards for an Accredited Educational Program in Radiography is designed to promote academic excellence, patient safety, and quality healthcare. The STANDARDS require a program to articulate its purposes; to demonstrate that it has adequate human, physical, and financial resources effectively organized for the accomplishment of its purposes; to document its effectiveness in accomplishing these purposes; and to provide assurance that it can continue to meet accreditation standards. The JRCERT accreditation process offers a means of providing assurance to the public that a program meets specific quality standards. The process helps to maintain program quality and stimulates program improvement through program assessment. There are six (6) standards. Each standard is titled and includes a narrative statement supported by specific objectives. Each objective, in turn, includes the following clarifying elements: Explanation - provides clarification on the intent and key details of the objective. Required Program Response - requires the program to provide a brief narrative and/or documentation that demonstrates compliance with the objective. Possible Site Visitor Evaluation Methods - identifies additional materials that may be examined and personnel who may be interviewed by the site visitors at the time of the on-site evaluation to help determine if the program has met the particular objective. Review of additional materials and/or interviews with listed personnel is at the discretion of the site visit team. Following each standard, the program must provide a Summary that includes the following: Major strengths related to the standard Major concerns related to the standard The program s plan for addressing each concern identified Describe any progress already achieved in addressing each concern Describe any constraints in implementing improvements The submitted narrative response and/or documentation, together with the results of the on-site evaluation conducted by the site visit team, will be used by the JRCERT Board of Directors in determining the program s compliance with the STANDARDS.

134 Standards for an Accredited Educational Program in Radiography Table of Contents Standard One: Integrity...4 The program demonstrates integrity in the following: representations to communities of Interest and the public, pursuit of fair and equitable academic practices, and treatment of, and respect for, students, faculty, and staff. Standard Two: Resources...23 The program has sufficient resources to support the quality and effectiveness of the educational process. Standard Three: Curriculum and Academic Practices...35 The program s curriculum and academic practices prepare students for professional practice. Standard Four: Health and Safety...47 The program s policies and procedures promote the health, safety, and optimal use of radiation for students, patients, and the general public. Standard Five: Assessment...57 The program develops and implements a system of planning and evaluation of student learning and program effectiveness outcomes in support of its mission. Standard Six: Institutional/Programmatic Data...64 The program complies with JRCERT policies, procedures, and STANDARDS to achieve and maintain specialized accreditation. Awarding, Maintaining, and Administering Accreditation Radiography

135 135 Radiography

136 Standard One Integrity Standard One: The program demonstrates integrity in the following: Objectives: In support of Standard One, the program: Representations to communities of interest and the public, Pursuit of fair and equitable academic practices, and Treatment of, and respect for, students, faculty, and staff. 1.1 Adheres to high ethical standards in relation to students, faculty, and staff. 1.2 Provides equitable learning opportunities for all students. 1.3 Provides timely, appropriate, and educationally valid clinical experiences for each admitted student. 1.4 Limits required clinical assignments for students to not more than 10 hours per day and the total didactic and clinical involvement to not more than 40 hours per week. 1.5 Assures the security and confidentiality of student records, instructional materials, and other appropriate program materials. 1.6 Has a grievance procedure that is readily accessible, fair, and equitably applied. 1.7 Assures that students are made aware of the JRCERT Standards for an Accredited Educational Program in Radiography and the avenue to pursue allegations of non-compliance with the STANDARDS. 1.8 Has publications that accurately reflect the program s policies, procedures, and offerings. 1.9 Makes available to students, faculty, and the general public accurate information about admission policies, tuition and fees, refund policies, academic calendars, clinical obligations, grading system, graduation requirements, and the criteria for transfer credit Makes the program s mission statement, goals, and student learning outcomes readily available to students, faculty, administrators, and the general public Documents that the program engages the communities of interest for the purpose of continuous program improvement. 136 Radiography

137 1.12 Has student recruitment and admission practices that are non-discriminatory with respect to any legally protected status such as race, color, religion, gender, age, disability, national origin, and any other protected class Has student recruitment and admission practices that are consistent with published policies of the sponsoring institution and the program. 137 Radiography

138 1.14 Has program faculty recruitment and employment practices that are non-discriminatory with respect to any legally protected status such as race, color, religion, gender, age, disability, national origin, and any other protected class Has procedures for maintaining the integrity of distance education courses.

139 1.1 Adheres to high ethical standards in relation to students, faculty, and staff. Explanation: High ethical standards help assure that the rights of students, faculty, and staff are protected. Policies and procedures must be fair, equitably applied, and promote professionalism. Required Program Response: Describe the procedure for making related policies and procedures known. Provide copies of policies and procedures that assure equitable treatment of students, faculty, and staff. Possible Site Visitor Evaluation Methods: Review of student handbook Review of employee/faculty handbook Review of course catalog Review of student records Interviews with faculty Interviews with students Interviews with staff 139 Radiography

140 1.2 Provides equitable learning opportunities for all students. Explanation: The provision of equitable learning activities promotes a fair and impartial education and reduces institutional and/or program liability. The program must provide equitable learning opportunities for all students regarding learning activities and clinical assignments. For example, if an opportunity exists for students to observe or perform breast imaging, then all students must be provided the same opportunity. If evening and/or weekend rotations are utilized, this opportunity must be equitably provided for all students. Required Program Response: Describe how the program assures equitable learning opportunities for all students. Possible Site Visitor Evaluation Methods: Review of published program materials Review of master plan of education Review of course objectives Review of student clinical assignment schedules Interviews with faculty Interviews with clinical instructors Interviews with clinical staff Interviews with students 140 Radiography

141 1.3 Provides timely, appropriate, and educationally valid clinical experiences for each admitted student. Explanation: Programs must have a process in place to provide timely, appropriate, and educationally valid clinical experiences to all students admitted to the program. Students must have sufficient access to clinical settings that provide a wide range of procedures for competency achievement including mobile, surgical, and trauma examinations. Clinical settings may include hospitals, clinics, specialty/imaging centers, orthopedic centers, and other facilities. With the exception of observation site assignments, students must be provided the opportunity to complete required program competencies during clinical assignments. Clinical placement must be non-discriminatory in nature and solely determined by the program. A meaningful clinical education plan assures that activities are educationally valid and prevents the use of students as replacements for employees. The maximum number of students assigned to a clinical setting must be supported by sufficient human and physical resources. The number of students assigned to the clinical setting must not exceed the number of clinical staff assigned to the radiography department. The student to radiography clinical staff ratio must be 1:1. However, it is acceptable that more than one student may be temporarily assigned to one technologist during uncommonly performed procedures. Students assigned to advanced imaging modalities, such as computed tomography, magnetic resonance, angiography, and sonography, are not included in the calculation of the authorized clinical capacity (unless the clinical setting is recognized exclusively for advanced imaging modality rotations). Once the students have completed the advanced imaging assignments, the program must assure that there are sufficient clinical staff to support the students upon reassignment to the radiography department. The utilization of clinical assignments such as file room, reception area, and patient transportation should be limited. Additionally, traditional programs that require students to participate in clinical education during evenings and/or weekends must assure that: students clinical clock hours spent in evening and/or weekend assignments must not exceed 25% of the total clinical clock hours. program total capacity is not increased through the use of evening and/or weekend assignments. The JRCERT defines the operational hours of traditional programs as Monday - Friday, 5:00 a.m. - 7:00 p.m. Programs may permit students to make up clinical time during term or scheduled breaks; however, they may not be assigned to clinical settings on holidays that are observed by the sponsoring institution. Program faculty need not be physically present; however, students must be able to contact program faculty during makeup assignments. Also, the program must assure that its liability insurance covers students during these makeup assignments. Required Program Response: 141 Radiography

142 Describe the process for student clinical placement. Provide current student assignment schedules in relation to student enrollment. Describe how the program assures a 1:1 student to radiography clinical staff ratio at all clinical settings. Describe how the program assures that all students have access to a sufficient variety and volume of procedures to achieve program competencies. Submit evening and/or weekend rotation(s) calculations, if applicable. 142 Radiography

143 Possible Site Visitor Evaluation Methods: Review of published program materials Review listing of enrolled students in relation to clinical assignments, including evening and/or weekend, if applicable Review of clinical placement process Review of student clinical records Interviews with faculty Interviews with clinical instructors Interviews with students 143 Radiography

144 1.4 Limits required clinical assignments for students to not more than 10 hours per day and the total didactic and clinical involvement to not more than 40 hours per week. Explanation: This limitation helps assure that students are treated ethically. For the safety of students and patients, not more than ten (10) clinical hours shall be scheduled in any one day. Scheduled didactic and clinical hours combined cannot exceed forty (40) hours per week. Hours exceeding these limitations must be voluntary on the student s part. Required Program Response: Describe the process for assuring that time limitations are not exceeded. Provide documentation that required student clinical assignments do not exceed ten (10) hours in any one day and the total didactic and clinical involvement does not exceed forty (40) hours per week. Possible Site Visitor Evaluation Methods: Review of master plan of education Review of published program materials Review of student schedules Interviews with faculty Interviews with clinical instructor(s) Interviews with clinical staff Interviews with students 144 Radiography

145 1.5 Assures the security and confidentiality of student records, instructional materials, and other appropriate program materials. Explanation: Appropriately maintaining the security and confidentiality of student records and other program materials protects the student s right to privacy. Student records must be maintained in accordance with the Family Education Rights and Privacy Act (Buckley Amendment). If radiation monitoring reports contain students dates of birth and/or social security numbers, this information must be maintained in a secure and confidential manner. Required Program Response: Describe how the program maintains the security and confidentiality of student records and other program materials. Possible Site Visitor Evaluation Methods: Review of institution s/program s published policies/procedures Review of student academic and clinical records Tour of program offices Tour of clinical setting(s) Interviews with administrative personnel Interviews with faculty Interviews with clinical instructor(s) Interviews with clinical staff Interviews with students

146 1.6 Has a grievance procedure that is readily accessible, fair, and equitably applied. Explanation: A grievance is defined as a claim by a student that there has been a violation, misinterpretation, or inequitable application of any existing policy, procedure, or regulation. The program must have procedures to provide students an avenue to pursue grievances. The procedure must outline the steps for formal resolution of any grievance. The final step in the process must not include any individual(s) directly associated with the program (e.g., program director, clinical coordinator, clinical instructors, diagnostic imaging department director). The procedure must assure timely resolution. The program must maintain a record of all formal grievances and their resolution. Records must be retained in accordance with the institution s/program s retention policies/procedures. The records must include information on how the grievance was resolved and assurance that there are no trends that could negatively affect the quality of the educational program. Additionally, the program must have a procedure to address any complaints apart from those that require invoking the grievance procedure. The program must determine if a pattern of complaint exists that could negatively affect the quality of the educational program (e.g., cleanliness of the classroom). Required Program Response: Describe the nature of any formal grievance(s) that would jeopardize the program s ability to meet its mission. Describe the nature of any complaint(s) that would jeopardize the program s ability to meet its mission. Provide a copy of the grievance procedure. Provide a copy of any formal grievance(s) resolution. Possible Site Visitor Evaluation Methods: Review of institutional catalog Review of student handbook Review of formal grievance(s) record(s), if applicable Review of complaint(s) record(s), if applicable Interviews with faculty Interviews with students 146 Radiography

147 1.7 Assures that students are made aware of the JRCERT Standards for an Accredited Educational Program in Radiography and the avenue to pursue allegations of non-compliance with the STANDARDS. Explanation: The program must assure students are cognizant of the STANDARDS and must provide contact information for the JRCERT. Students have the right to submit allegations against a JRCERT-accredited program if there is reason to believe that the program has acted contrary to JRCERT accreditation standards or that conditions at the program appear to jeopardize the quality of instruction or the general welfare of its students. Contact of the JRCERT should not be a step in the formal institutional/program grievance procedure. The individual must first attempt to resolve the complaint directly with institution/program officials by following the grievance procedures provided by the institution/program. If the individual is unable to resolve the complaint with institution/program officials or believes that the concerns have not been properly addressed, he or she may submit allegations of non-compliance directly to the JRCERT. Required Program Response: Describe the procedure for making students aware of the STANDARDS. Describe how students are provided contact information for the JRCERT. Possible Site Visitor Evaluation Methods: Review of program publications Interviews with faculty Interviews with students 147 Radiography

148 1.8 Has publications that accurately reflect the program s policies, procedures, and offerings. Explanation: Maintaining published information regarding the program s current policies, procedures, and offerings provides interested parties with an accurate overview of program requirements and expectations. Required Program Response: Provide program publications that reflect program policies, procedures and offerings. Possible Site Visitor Evaluation Methods: Review of published program materials Review of student handbook Interviews with faculty Interviews with students 148 Radiography

149 1.9 Makes available to students, faculty, and the general public accurate information about admission policies, tuition and fees, refund policies, academic calendars, clinical obligations, grading system, graduation requirements, and the criteria for transfer credit. Explanation: The institutional and/or program policies must be published and made readily available to students, faculty, and the general public on the institution s/program s Web site to assure transparency and accountability of the educational program. For example, requiring the general public to contact the institution/program to request program information is not adequate. Policy changes must be made known to students, faculty, and the general public in timely fashion. It is recommended that revision dates be identified on program publications. The institution and/or program must establish and publicly disclose the criteria used when determining the transfer of credit earned from other institutions and/or programs. Also, programs must publicly disclose a list of institutions with which the program has established an articulation agreement. The program s academic calendar must be published and, at a minimum, identify specific start and end dates for each term, holidays recognized by the sponsoring institution, and breaks. Student clinical obligations (e.g., drug screening, background checks, and associated fees) must be clearly identified in appropriate program publications. Additionally, if evening and/or weekend clinical assignments are required or if students must travel to geographically-dispersed clinical settings, this information must also be included. Required Program Response: Describe how institutional and/or program policies are made known to students, faculty, and the general public. Provide publications that include these policies. Possible Site Visitor Evaluation Methods: Review of institutional materials Review of published program materials Review of institutional and/or program Web site Interviews with faculty Interviews with Admissions personnel Interviews with Registrar Interviews with students 149 Radiography

150 1.10 Makes the program s mission statement, goals, and student learning outcomes readily available to students, faculty, administrators, and the general public. Explanation: Program accountability is enhanced by making its mission statement, goals, and student learning outcomes available to the program s communities of interest on the institution s/program s Web site to assure transparency and of the educational program. Requiring the general public to contact the institution/program to request program information is not adequate. Example: Mission: The mission of the radiography program is to prepare competent, entry-level radiographers able to function within the healthcare community. Goal: Students will be clinically competent. Student Learning Outcomes: Students will apply positioning skills. Students will select technical factors. Students will utilize radiation protection. Goal: Students will demonstrate communication skills. Student Learning Outcomes: Students will demonstrate written communication skills. Students will demonstrate oral communication skills. Goal: Students will develop critical thinking skills. Student Learning Outcomes: Students will adapt standard procedures for non-routine patients. Students will critique images to determine diagnostic quality. Goal: Students will model professionalism. Student Learning Outcomes: Students will demonstrate work ethics. Students will summarize the value of life-long learning. 150 Radiography

151 Required Program Response: Describe how the program makes its mission statement, goals, and student learning outcomes available to students, faculty, administrators, and the general public. Provide copies of publications that contain the program s mission statement, goals, and student learning outcomes. Possible Site Visitor Evaluation Methods: Review of published program materials Review of institutional and/or program Web site Interviews with administrative personnel Interviews with faculty Interviews with students 151 Radiography

152 1.11 Documents that the program engages the communities of interest for the purpose of continuous program improvement. Explanation: Communities of interest are defined as institutions, organizations, groups, and/or individuals interested in educational activities in radiography. Obtaining formal feedback on program operations, student progress, employer needs, etc. from communities of interest allows the program to determine if it is meeting expectations and assures continuous program improvement. The program can use a variety of tools to obtain this feedback. Required Program Response: Describe the process of obtaining feedback. Provide representative samples of appropriate meeting minutes, evaluations (e.g., course and faculty), and surveys (e.g., graduate and employer). Possible Site Visitor Evaluation Methods: Review of meeting minutes Review of evaluations Review of surveys Interviews with members of various communities of interest 152 Radiography

153 1.12 Has student recruitment and admission practices that are non-discriminatory with respect to any legally protected status such as race, color, religion, gender, age, disability, national origin, and any other protected class. Explanation: Non-discriminatory practices assure applicants have equal opportunity for admission. Statistical information such as race, color, religion, gender, age, disability, national origin, and any other protected class may be collected; however, this information must be voluntarily provided by the student. Use of this information in the student selection process is discriminatory. Required Program Response: Describe how admission practices are non-discriminatory. Provide institutional and/or program admission policies. Possible Site Visitor Evaluation Methods: Review of published program materials Review of student records Interviews with faculty Interviews with Admissions personnel Interviews with students 153 Radiography

154 1.13 Has student recruitment and admission practices that are consistent with published policies of the sponsoring institution and the program. Explanation: Defined admission practices facilitate objective student selection. In considering applicants for admission, the program must follow published policies and procedures. Required Program Response: Describe the implementation of institutional and program admission policies. Provide institutional and program admission policies. Possible Site Visitor Evaluation Methods: Review of published program materials Interviews with faculty Interviews with Admissions personnel Interviews with students 154 Radiography

155 1.14 Has program faculty recruitment and employment practices that are non-discriminatory with respect to any legally protected status such as race, color, religion, gender, age, disability, national origin, and any other protected class. Explanation: Recruitment and employment practices that are non-discriminatory assure fairness and integrity. Equal opportunity for employment must be offered to each applicant. Employment practices must be applied equitably to all faculty. Required Program Response: Describe how non-discriminatory employment practices are assured. Provide copies of employment policies and procedures that assure non-discriminatory practices. Possible Site Visitor Evaluation Methods: Review of employee/faculty handbook Review of employee/faculty application form Review of institutional catalog Interviews with faculty 155 Radiography

156 1.15 Has procedures for maintaining the integrity of distance education courses. Explanation: Programs that offer distance education must have processes in place that assure that the students who register in the distance education courses are the same students that participate in, complete, and receive the credit. Programs must verify the identity of students by using methods such as, but not limited to: secure log-ins, pass codes, and/or proctored exams. These processes must protect the student s privacy. Student costs associated with distance education must be disclosed. Required Program Response: Describe the process for assuring the integrity of distance education courses. Provide published program materials that outline procedures for maintaining integrity of distance education courses. Provide published program materials that identify associated fees for students enrolled in distance education courses. Possible Site Visitor Evaluation Methods: Review of published program materials Review the process of student identification Review of student records Interviews with faculty Interviews with students 156 Radiography

157 Summary for Standard One 1. List the major strengths of Standard One, in order of importance. 2. List the major concerns of Standard One, in order of importance. 3. Provide the program s plan for addressing each concern identified. 4. Describe any progress already achieved in addressing each concern. 5. Describe any constraints in implementing improvements. 157 Radiography

158 Standard Two: Resources Standard Two: The program has sufficient resources to support the quality and effectiveness of the educational process. Objectives: In support of Standard Two, the program: Administrative Structure 2.1 Has an appropriate organizational structure and sufficient administrative support to achieve the program s mission. 2.2 Provides an adequate number of faculty to meet all educational, program, administrative, and accreditation requirements. 2.3 Provides faculty with opportunities for continued professional development. 2.4 Provides clerical support services, as needed, to meet all educational, program, and administrative requirements. Learning Resources/Services 2.5 Assures JRCERT recognition of all clinical settings. 2.6 Provides classrooms, laboratories, and administrative and faculty offices to facilitate the achievement of the program s mission. 2.7 Reviews and maintains program learning resources to assure the achievement of student learning. 2.8 Provides access to student services in support of student learning. Fiscal Support 2.9 Has sufficient ongoing financial resources to support the program s mission For those institutions and programs for which the JRCERT serves as a gatekeeper for Title IV financial aid, maintains compliance with United States Department of Education (USDE) policies and procedures. 158 Radiography

159 2.1 Has an appropriate organizational structure and sufficient administrative support to achieve the program s mission. Explanation: The program s relative position in the organizational structure helps facilitate appropriate resources and assures focus on the program. To operate effectively, the program must have sufficient institutional administrative support. Both organizational structure and administrative support enable the program to meet its mission and promote student learning. Required Program Response: Describe the program s relationship to the organizational and administrative structures of the sponsoring institution and how this supports the program s mission. Provide institutional and program organizational charts. Possible Site Visitor Evaluation Methods: Review of organizational charts of institution and program Review of meeting minutes Review of published program materials Review of master plan of education Interviews with faculty and institutional officials Interviews with clinical instructor(s) 159 Radiography

160 2.2 Provides an adequate number of faculty to meet all educational, program, administrative, and accreditation requirements. Explanation: An adequate number of faculty promotes sound educational practices. A full-time program director is required. Faculty teaching loads and release time must be consistent with those of comparable faculty in other health science (allied health) programs in the same institution. Additionally, a full-time equivalent clinical coordinator is required if the program has more than five (5) active clinical settings or more than thirty (30) students enrolled in the clinical component. The clinical coordinator position may be shared by no more than four (4) appointees. If a clinical coordinator is required, the program director may not be identified as the clinical coordinator. The clinical coordinator may not be identified as the program director. The program director and clinical coordinator may perform clinical instruction; however, they may not be identified as clinical instructors. A minimum of one clinical instructor must be designated at each recognized clinical setting. The same clinical instructor may be identified at more than one site as long as a ratio of one full-time equivalent clinical instructor for every ten (10) students is maintained. Required Program Response: Provide, if available, institutional policies in relation to teaching loads and release time. Describe faculty teaching loads and release time in relation to a comparable health science (allied health) program within the institution. Describe the adequacy of the number of faculty and clinical staff to meet identified accreditation requirements and program needs. Possible Site Visitor Evaluation Methods: Review institutional policies in relation to teaching loads and release time Review of master plan of education Review of position descriptions Review of clinical settings Interviews with faculty Interviews with clinical instructor(s) Interviews with students 160 Radiography

161 2.3 Provides faculty with opportunities for continued professional development. Explanation: Continued professional development results in more knowledgeable, competent, and proficient faculty. Opportunities that enhance and advance educational, technical, and professional knowledge must be available to program faculty. Required Program Response: Describe how continued professional development opportunities are made available to faculty. Possible Site Visitor Evaluation Methods: Review of institutional and program policies Review of program budget or other fiscal appropriations Review of evidence of faculty participation in professional development activities Interviews with administrative personnel Interviews with faculty 161 Radiography

162 2.4 Provides clerical support services, as needed, to meet all educational, program, and administrative requirements. Explanation: Clerical support services necessary to assist in meeting educational, program, and administrative requirements of the program must be provided as appropriate. Required Program Response: Describe the availability and use of clerical support services. Possible Site Visitor Evaluation Methods: Review of program s staffing plan Interviews with administrative personnel Interviews with faculty Interviews with students 162 Radiography

163 2.5 Assures JRCERT recognition of all clinical settings. Explanation: JRCERT recognition helps assure an appropriate learning environment for student clinical education. All clinical settings must be recognized by the JRCERT. Recognition of a clinical setting must be obtained prior to student placement. A minimum of one (1) clinical instructor must be identified for each recognized clinical setting. An observation site is used for student observation of the operation of equipment and/or procedures. If the program uses observation sites, these sites do not require recognition by the JRCERT. These sites provide opportunities for observation of clinical procedures that may not be available at recognized clinical settings. Students may not assist in, or perform, any aspects of patient care during observational assignments. Facilities where students are participating in service learning projects or community-based learning opportunities do not require recognition. Required Program Response: Assure all clinical settings are recognized by the JRCERT. Describe how observation sites, if used, enhance student clinical education. Possible Site Visitor Evaluation Methods: Review of JRCERT database Review of clinical records Interviews with faculty Interviews with clinical instructors Interviews with clinical staff Interviews with students 163 Radiography

164 2.6 Provides classrooms, laboratories, and administrative and faculty offices to facilitate the achievement of the program s mission. Explanation: Learning environments are defined as places, surroundings, or circumstances where knowledge, understanding, or skills are studied or observed such as classrooms and laboratories. Learning environments must be consistent with those of comparable health science programs in the same institution. Provision of appropriate learning environments facilitates achievement of the program s mission. Although a dedicated classroom and/or laboratory are not required, scheduled accessibility to facilities conducive to student learning must be assured. Faculty office space should be conducive to planning and scholarly activities. Space should be made available for private student advisement. Required Program Response: Describe how classrooms, laboratories, and administrative and faculty offices facilitate the achievement of the program s mission. Possible Site Visitor Evaluation Methods: Tour of the classroom, laboratories, and administrative and faculty offices Interviews with faculty Interviews with students 164 Radiography

165 2.7 Reviews and maintains program learning resources to assure the achievement of student learning. Explanation: The review and maintenance of learning resources promotes student knowledge of current and developing imaging technologies. The program must provide learning resources to support and enhance the educational program. These resources must include: a print or electronic library with a variety of materials published within the last five years, computer access, and additional learning aids (e.g., educational software, classroom/laboratory accessory devices, etc.). The JRCERT does not endorse any specific learning resources. Required Program Response: Describe the available learning resources. Describe the procedure for review and maintenance of learning resources. Possible Site Visitor Evaluation Methods: Tour of learning facilities Review of learning resources Review of surveys Review of meeting minutes Interviews with faculty Interviews with students 165 Radiography

166 2.8 Provides access to student services in support of student learning. Explanation: The provision of appropriate student services promotes student achievement. At a minimum, the program must provide access to information for: personal counseling, requesting accommodations for disabilities as defined by applicable federal (Americans with Disabilities Act) and state laws, and financial aid. Additional student services may be provided at the discretion of the program. These services should be sufficient to assure student learning. All services provided must be made known to students and the general public. Required Program Response: Describe the students access to student services. Provide published program materials that outline accessibility to student services. Possible Site Visitor Evaluation Methods: Review of published program materials Interviews with faculty Interviews with students 166 Radiography

167 2.9 Has sufficient ongoing financial resources to support the program s mission. Explanation: Adequate, ongoing funding is necessary to accomplish the program s mission and to support student learning. The sponsoring institution must demonstrate ongoing financial commitment to the program and its students by providing adequate human and physical resources. Required Program Response: Describe the adequacy of financial resources. Provide copies of the program s budget and/or expenditure records. Possible Site Visitor Evaluation Methods: Review of program budget and/or other fiscal appropriations Interviews with administrative personnel Interviews with faculty 167 Radiography

168 2.10 For those institutions and programs for which the JRCERT serves as gatekeeper for Title IV financial aid, maintains compliance with United States Department of Education (USDE) policies and procedures. Explanation: A gatekeeper is defined as an agency holding responsibility for oversight of the distribution, record keeping, and repayment of Title IV financial aid. The program must comply with USDE requirements to participate in Title IV financial aid. If the program has elected to participate in Title IV financial aid and the JRCERT is identified as the gatekeeper, the program must: maintain financial documents including audit and budget processes confirming appropriate allocation and use of financial resources, have a monitoring process for student loan default rates, have an appropriate accounting system providing documentation for management of Title IV financial aid and expenditures, and inform students of responsibility for timely repayment of Title IV financial aid. Required Program Response: Provide evidence that Title IV financial aid is managed and distributed according to the USDE regulations to include: o recent student loan default data and o results of financial or compliance audits. Describe how the program informs students of their responsibility for timely repayment of financial aid. Possible Site Visitor Evaluation Methods: Review of records Interviews with administrative personnel Interviews with faculty Interviews with students 168 Radiography

169 Summary for Standard Two 1. List the major strengths of Standard Two, in order of importance. 2. List the major concerns of Standard Two, in order of importance. 3. Provide the program s plan for addressing each concern identified. 4. Describe any progress already achieved in addressing each concern. 5. Describe any constraints in implementing improvements. 169 Radiography

170 Standard Three Curriculum and Academic Practices Standard Three: The program s curriculum and academic practices prepare students for professional practice. Objectives: In support of Standard Three, the program: 3.1 Has a program mission statement that defines its purpose and scope and is periodically reevaluated. 3.2 Provides a well-structured, competency-based curriculum that prepares students to practice in the professional discipline. 3.3 Provides learning opportunities in current and developing imaging and/or therapeutic technologies. 3.4 Assures an appropriate relationship between program length and the subject matter taught for the terminal award offered. 3.5 Measures the length of all didactic and clinical courses in clock hours or credit hours. 3.6 Maintains a master plan of education. 3.7 Provides timely and supportive academic, behavioral, and clinical advisement to students enrolled in the program. 3.8 Documents that the responsibilities of faculty and clinical staff are delineated and performed. 3.9 Evaluates program faculty and clinical instructor performance and shares evaluation results regularly to assure instructional responsibilities are performed. 170 Radiography

171 3.1 Has a program mission statement that defines its purpose and scope and is periodically reevaluated. Explanation: The program s mission statement should be consistent with that of its sponsoring institution. The program s mission statement should clearly define the purpose or intent toward which the program s efforts are directed. Periodic evaluation assures that the program s mission statement is effective. Required Program Response: Provide a copy of the program s mission statement. Provide meeting minutes that document periodic reevaluation of the mission statement. Possible Site Visitor Evaluation Methods: Review of published program materials Review of meeting minutes Review of master plan of education Interviews with faculty 171 Radiography

172 3.2 Provides a well-structured, competency-based curriculum that prepares students to practice in the professional discipline. Explanation: The well-structured curriculum must be comprehensive, appropriately sequenced, include current information, and provide for evaluation of student achievement. A competency-based curriculum allows for effective student learning by providing a knowledge foundation prior to performance of procedures. Continual refinement of the competencies achieved is necessary so that students can demonstrate enhanced performance in a variety of situations and patient conditions. In essence, competency-based education is an ongoing process, not an end product. Programs must follow a JRCERT-adopted curriculum. An adopted curriculum is defined as: the latest American Society of Radiologic Technologists professional curriculum and/or another professional curriculum adopted by the JRCERT Board of Directors following review and recommendation by the JRCERT Standards Committee. Use of a standard curriculum promotes consistency in radiography education and prepares the student to practice in the professional discipline. At a minimum, the curriculum should promote qualities that are necessary for students/graduates to practice competently, make good decisions, assess situations, provide appropriate patient care, communicate effectively, and keep abreast of current advancements within the profession. Expansion of the curricular content beyond the minimum is at the discretion of the program. The program must submit the latest curriculum analysis grid (available at Required Program Response: Describe how the program s curriculum is structured. Describe the program s competency-based system. Submit current curriculum analysis grid. Describe how the program's curriculum is delivered, including the method of delivery for distance education courses. Identify which courses, if any, are offered via distance education. Describe alternative learning options, if applicable (e.g., part-time, evening and/or weekend curricular track). Possible Site Visitor Evaluation Methods: Review of master plan of education Review of didactic and clinical curriculum sequence Review of analysis of graduate and employer surveys Interviews with faculty Interviews with students Observation of a portion of any course offered via distance delivery 172 Radiography

173 Review of part-time, evening and/or weekend curricular track, if applicable 173 Radiography

174 3.3 Provides learning opportunities in current and developing imaging and/or therapeutic technologies. Explanation: The program must provide learning opportunities in current and developing imaging and/or therapeutic technologies. It is the program s prerogative to decide which technologies should be included in the didactic and/or clinical curriculum. Programs are not required to offer clinical rotations in developing imaging and/or therapeutic technologies; however, these clinical rotations are strongly encouraged to enhance student learning. Required Program Response: Describe how the program provides opportunities in developing technologies in the didactic and/or clinical curriculum. Possible Site Visitor Evaluation Methods: Review of master plan of education Interviews with faculty Interviews with students 174 Radiography

175 3.4 Assures an appropriate relationship between program length and the subject matter taught for the terminal award offered. Explanation: Program length must be consistent with the terminal award. The JRCERT defines program length as the duration of the program, which may be stated as total academic or calendar year(s), total semesters, trimesters, or quarters. Required Program Response: Describe the relationship between the program length and the terminal award offered. Possible Site Visitor Evaluation Methods: Review of course catalog Review of published program materials Review of class schedules Interviews with faculty Interviews with students 175 Radiography

176 3.5 Measures the length of all didactic and clinical courses in clock hours or credit hours. Explanation: Defining the length of didactic and clinical courses facilitates student transfer of credit and the awarding of financial aid. The formula for calculating assigned clock/credit hours must be consistently applied for all didactic and all clinical courses, respectively. Required Program Response: Describe the method used to award credit hours for lecture, laboratory and clinical courses. Provide a copy of the program s policies and procedures for determining credit hours and an example of how such policy has been applied to the program s coursework. Provide a list of all didactic and clinical courses with corresponding clock or credit hours. Possible Site Visitor Evaluation Methods: Review of published program materials Review of class schedules Interviews with faculty Interviews with students 176 Radiography

177 3.6 Maintains a master plan of education. Explanation: A master plan provides an overview of the program and allows for continuity among, and documentation of, all aspects of the program. In the event of new faculty and/or leadership to the program, the master plan provides the information needed to understand the program and its operations. The plan should be evaluated annually, updated, and must include the following: course syllabi (didactic and clinical courses) and program policies and procedures. While there is no prescribed format for the master plan, the component parts should be identified and readily available. If the components are not housed together, the program must list the location of each component. If the program chooses to use an electronic format, the components must be accessible by all program faculty. Required Program Response: Identify the location of the component parts of the master plan of education. Provide a Table of Contents for the program s master plan. Possible Site Visitor Evaluation Methods: Review of master plan of education Interview with program director Interviews with faculty 177 Radiography

178 3.7 Provides timely and supportive academic, behavioral, and clinical advisement to students enrolled in the program. Explanation: Appropriate advisement promotes student achievement. Student advisement should be formative, summative, and must be shared with students in a timely manner. Programs are encouraged to develop written advisement procedures. Required Program Response: Describe procedures for advisement. Provide sample records of student advisement. Possible Site Visitor Evaluation Methods: Review of students records Interviews with faculty Interviews with clinical instructor(s) Interviews with students 178 Radiography

179 3.8 Documents that the responsibilities of faculty and clinical staff are delineated and performed. Full-time Program Director: Assures effective program operations, Oversees ongoing program assessment, Participates in budget planning, Maintains current knowledge of the professional discipline and educational methodologies through continuing professional development, and Assumes the leadership role in the continued development of the program. Full-time Clinical Coordinator: Correlates clinical education with didactic education, Evaluates students, Participates in didactic and/or clinical instruction, Supports the program director to help assure effective program operation, Coordinates clinical education and evaluates its effectiveness, Participates in the assessment process, Cooperates with the program director in periodic review and revision of clinical course materials, Maintains current knowledge of the discipline and educational methodologies through continuing professional development, and Maintains current knowledge of program policies, procedures, and student progress. Full-time Didactic Program Faculty: Prepares and maintains course outlines and objectives, instructs and evaluates students, and reports progress, Participates in the assessment process, Supports the program director to help assure effective program operation, Cooperates with the program director in periodic review and revision of course materials, and Maintains appropriate expertise and competence through continuing professional development. Part-time Didactic Program Faculty: 179 Radiography

180 Prepares and maintains course outlines and objectives, instructs and evaluates students, and reports progress, Participates in the assessment process, when appropriate, Cooperates with the program director in periodic review and revision of course materials, and Maintains appropriate expertise and competence through continuing professional development. Clinical Instructor(s): Is knowledgeable of program goals, Understands the clinical objectives and clinical evaluation system, Understands the sequencing of didactic instruction and clinical education, Provides students with clinical instruction and supervision, Evaluates students clinical competence, Maintains competency in the professional discipline and instructional and evaluative techniques through continuing professional development, and Maintains current knowledge of program policies, procedures, and student progress. Clinical Staff: Understand the clinical competency system, Understand requirements for student supervision, Support the educational process, and Maintain current knowledge of program policies, procedures, and student progress. Explanation: The clear delineation of responsibilities facilitates accountability. Faculty and clinical staff responsibilities must be clearly delineated and must support the program s mission. Full- and part-time status is determined by, and consistent with, the sponsoring institution s definition. At all times when students are enrolled in didactic and/or clinical components, the program director and/or clinical coordinator must assure that their program responsibilities are fulfilled. Required Program Response: Provide documentation that faculty and clinical staff positions are clearly delineated. Possible Site Visitor Evaluation Methods: Review of position descriptions 180 Radiography

181 Review of handbooks Interviews with faculty and clinical staff to assure responsibilities are being performed Interviews with students 181 Radiography

182 3.9 Evaluates program faculty and clinical instructor performance and shares evaluation results regularly to assure instructional responsibilities are performed. Explanation: The performance of program faculty and clinical instructor(s) must be evaluated minimally once per year. Evaluation assures that instructional responsibilities are performed and provides administration and faculty with information to evaluate performance. Evaluation promotes proper educational methodology and increases program effectiveness. Evaluation results must be shared minimally once per year with the respective program faculty and clinical instructor(s) being evaluated to assure continued professional development. Any evaluation results that identify concerns must be discussed with the respective individual(s) as soon as possible. Required Program Response: Describe the evaluation process. Describe how evaluation results are shared with program faculty and clinical instructor(s). Provide samples of evaluations of program faculty. Provide samples of evaluations of clinical instructor(s). Possible Site Visitor Evaluation Methods: Review of program evaluation materials Review of clinical instructor evaluation Interviews with administrative personnel Interviews with program faculty Interviews with clinical instructor(s) Interviews with students 182 Radiography

183 Summary for Standard Three 1. List the major strengths of Standard Three, in order of importance. 2. List the major concerns of Standard Three, in order of importance. 3. Provide the program s plan for addressing each concern identified. 4. Describe any progress already achieved in addressing each concern. 5. Describe any constraints in implementing improvements. 183 Radiography

184 Standard Four Health and Safety Standard Four: The program s policies and procedures promote the health, safety, and optimal use of radiation for students, patients, and the general public. Objectives: In support of Standard Four, the program: 4.1 Assures the radiation safety of students through the implementation of published policies and procedures that are in compliance with Nuclear Regulatory Commission regulations and state laws as applicable. 4.2 Has a published pregnancy policy that is consistent with applicable federal regulations and state laws, made known to accepted and enrolled female students, and contains the following elements: Written notice of voluntary declaration, Option for student continuance in the program without modification, and Option for written withdrawal of declaration. 4.3 Assures that students employ proper radiation safety practices. 4.4 Assures that medical imaging procedures are performed under the direct supervision of a qualified radiographer until a student achieves competency. 4.5 Assures that medical imaging procedures are performed under the indirect supervision of a qualified radiographer after a student achieves competency. 4.6 Assures that students are directly supervised by a qualified radiographer when repeating unsatisfactory images. 4.7 Assures sponsoring institution s policies safeguard the health and safety of students. 4.8 Assures that students are oriented to clinical setting policies and procedures in regard to health and safety. 184 Radiography

185 4.1 Assures the radiation safety of students through the implementation of published policies and procedures that are in compliance with Nuclear Regulatory Commission regulations and state laws as applicable. Explanation: Appropriate policies and procedures help assure that student radiation exposure is kept as low as reasonably achievable (ALARA). The program must maintain and monitor student radiation exposure data. This information must be made available to students within thirty (30) school days following receipt of data. The program must have a published protocol that identifies a threshold dose for incidents in which dose limits are exceeded. Programs are encouraged to identify a threshold dose below those identified in NRC regulations. Required Program Response: Describe how the policies are made known to enrolled students. Describe how radiation exposure data is made available to students. Provide copies of appropriate policies. Possible Site Visitor Evaluation Methods: Review of published program materials Review of student records Review of student dosimetry reports Interviews with faculty Interviews with students 185 Radiography

186 4.2 Has a published pregnancy policy that is consistent with applicable federal regulations and state laws, made known to accepted and enrolled female students, and contains the following elements: Written notice of voluntary declaration, Option for student continuance in the program without modification, and Option for written withdrawal of declaration. Explanation: Appropriate radiation safety practices help assure that radiation exposure to the student and fetus are kept as low as reasonably achievable (ALARA). The policy must include appropriate information regarding radiation safety for the student and fetus. The program must allow for student continuance in the clinical component of the program without modification. The program may offer clinical component options such as: (1) clinical reassignments and/or (2) leave of absence. Required Program Response: Describe how the pregnancy policy is made known to accepted and enrolled female students. Provide a copy of the program s pregnancy policy. Possible Site Visitor Evaluation Methods: Review of published program materials Review of student records Interviews with faculty Interviews with clinical instructor(s) Interviews with students 186 Radiography

187 4.3 Assures that students employ proper radiation safety practices. Explanation: The program must assure that students are instructed in the utilization of imaging equipment, accessories, optimal exposure factors, and proper patient positioning to minimize radiation exposure to patients, selves, and others. These practices assure radiation exposures are kept as low as reasonably achievable (ALARA). Students must understand basic radiation safety practices prior to assignment to clinical settings. Students must not hold image receptors during any radiographic procedure. Students should not hold patients during any radiographic procedure when an immobilization method is the appropriate standard of care. As students progress in the program, they must become increasingly proficient in the application of radiation safety practices. The program must also assure radiation safety in energized laboratories. Students utilization of energized laboratories must be under the supervision of a qualified radiographer who is readily available. If a qualified radiographer is not readily available to provide supervision, the radiation exposure mechanism must be disabled. Programs are encouraged to develop policies regarding safe and appropriate use of energized laboratories by students. Required Program Response: Describe how the curriculum sequence and content prepares students for safe radiation practices. Provide the curriculum sequence. Provide policies/procedures regarding radiation safety. Possible Site Visitor Evaluation Methods: Review of program curriculum Review of radiation safety policies/procedures Review of student handbook Review of student records Review of student dosimetry reports Interviews with faculty Interviews with clinical instructor(s) Interviews with clinical staff Interviews with students 187 Radiography

188 4.4 Assures that medical imaging procedures are performed under the direct supervision of a qualified radiographer until a student achieves competency. Explanation: Direct supervision assures patient safety and proper educational practices. The JRCERT defines direct supervision as student supervision by a qualified radiographer who: reviews the procedure in relation to the student s achievement, evaluates the condition of the patient in relation to the student s knowledge, is physically present during the conduct of the procedure, and reviews and approves the procedure and/or image. Students must be directly supervised until competency is achieved. Required Program Response: Describe how the direct supervision requirement is enforced and monitored in the clinical setting. Provide documentation that the program s direct supervision requirement is made known to students, clinical instructors, and clinical staff. Possible Site Visitor Evaluation Methods: Review of published program materials Review of student records Review of meeting minutes Interviews with faculty Interviews with clinical instructor(s) Interviews with clinical staff Interviews with students 188 Radiography

189 4.5 Assures that medical imaging procedures are performed under the indirect supervision of a qualified radiographer after a student achieves competency. Explanation: Indirect supervision promotes patient safety and proper educational practices. The JRCERT defines indirect supervision 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 physical presence of a qualified radiographer adjacent to the room or location where a radiographic procedure is being performed. This availability applies to all areas where ionizing radiation equipment is in use on patients. Required Program Response: Describe how the indirect supervision requirement is enforced and monitored in the clinical setting. Provide documentation that the program s indirect supervision requirement is made known to students, clinical instructors, and clinical staff. Possible Site Visitor Evaluation Methods: Review of published program materials Review of student records Review of meeting minutes Interviews with faculty Interviews with clinical instructor(s) Interviews with clinical staff Interviews with students 189 Radiography

190 4.6 Assures that students are directly supervised by a qualified radiographer when repeating unsatisfactory images. Explanation: The presence of a qualified radiographer during the repeat of an unsatisfactory image assures patient safety and proper educational practices. A qualified radiographer must be physically present during the conduct of a repeat image and must approve the student s procedure prior to re-exposure. Required Program Response: Describe how the direct supervision requirement for repeat images is enforced and monitored in the clinical setting. Provide documentation that the program s direct supervision requirement for repeat images is made known to students, clinical instructors, and clinical staff. Possible Site Visitor Evaluation Methods: Review of published program materials Review of student records Review of meeting minutes Interviews with faculty Interviews with clinical instructor(s) Interviews with clinical staff Interviews with students 190 Radiography

191 4.7 Assures sponsoring institution s policies safeguard the health and safety of students. Explanation: Appropriate sponsoring institutional policies and procedures assure that students are protected. These policies must, at a minimum, address emergency preparedness, harassment, communicable diseases, and substance abuse. Policies and procedures must meet federal and/or state requirements as applicable. Enrolled students must be informed of policies and procedures. Required Program Response: Provide program policies that safeguard the health and safety of students. Possible Site Visitor Evaluation Methods: Review of published program materials Review of student records Interviews with faculty Interviews with students 191 Radiography

192 4.8 Assures that students are oriented to clinical setting policies and procedures in regard to health and safety. Explanation: Appropriate orientation assures that students are cognizant of clinical policies and procedures. The policies and procedures must, at a minimum, address the following: hazards (fire, electrical, chemical), emergency preparedness, medical emergencies, HIPAA, and Standard Precautions. Required Program Response: Describe the process for orienting students to clinical settings. Provide documentation that students are apprised of policies and procedures specific to each clinical setting. Possible Site Visitor Evaluation Methods: Review of orientation process Review of student records Interviews with faculty Interviews with clinical instructor(s) Interviews with students 192 Radiography

193 Summary for Standard Four 1. List the major strengths of Standard Four, in order of importance. 2. List the major concerns of Standard Four, in order of importance. 3. Provide the program s plan for addressing each concern identified. 4. Describe any progress already achieved in addressing each concern. 5. Describe any constraints in implementing improvements. 193 Radiography

194 Standard Five Assessment Standard Five: The program develops and implements a system of planning and evaluation of student learning and program effectiveness outcomes in support of its mission. Objectives: In support of Standard Five, the program: Student Learning 5.1 Develops an assessment plan that, at a minimum, measures the program s student learning outcomes in relation to the following goals: clinical competence, critical thinking, professionalism, and communication skills. Program Effectiveness 5.2 Documents the following program effectiveness data: Five-year average credentialing examination pass rate of not less than 75 percent at first attempt within six months of graduation, Five-year average job placement rate of not less than 75 percent within twelve months of graduation, Program completion rate, Graduate satisfaction, and Employer satisfaction. 5.3 Makes available to the general public program effectiveness data (credentialing examination pass rate, job placement rate, and program completion rate) on an annual basis. Analysis and Actions 5.4 Analyzes and shares student learning outcome data and program effectiveness data to foster continuous program improvement. 5.5 Periodically evaluates its assessment plan to assure continuous program improvement. 194 Radiography

195 5.1 Develops an assessment plan that, at a minimum, measures the program s student learning outcomes in relation to the following goals: clinical competence, critical thinking, professionalism, and communication skills. Explanation: Assessment is the systematic collection, review, and use of information to improve student learning and educational quality. An assessment plan helps assure continuous improvement and accountability. Minimally, the plan must include a separate goal in relation to each of the following: clinical competence, critical thinking, professionalism, and communication skills. The plan must include student learning outcomes, measurement tools, benchmarks, and identify timeframes and parties responsible for data collection. For additional information regarding assessment, please refer to Required Program Response: Provide a copy of the program s current assessment plan. Possible Site Visitor Evaluation Methods: Review of assessment plan Review of assessment tools Interviews with faculty 195 Radiography

196 5.2 Documents the following program effectiveness data: Five-year average credentialing examination pass rate of not less than 75 percent at first attempt within six months of graduation, Five-year average job placement rate of not less than 75 percent within twelve months of graduation, Program completion rate, Graduate satisfaction, and Employer satisfaction. Explanation: Credentialing examination, job placement, and program completion data must be reported annually to the JRCERT. Graduate and employer satisfaction data must be collected as part of the program s assessment process. Credentialing examination pass rate is defined as the number of student graduates who pass, on first attempt, the American Registry of Radiologic Technologists (ARRT) certification examination or an unrestricted state licensing examination compared with the number of graduates who take the examination within six months of graduation. Job placement rate is defined as the number of graduates employed in the radiologic sciences compared to the number of graduates actively seeking employment in the radiologic sciences. The JRCERT has defined not actively seeking employment as: 1) graduate fails to communicate with program officials regarding employment status after multiple attempts, 2) graduate is unwilling to seek employment that requires relocation, 3) graduate is unwilling to accept employment due to salary or hours, 4) graduate is on active military duty, and/or 5) graduate is continuing education. Program completion rate is defined as the number of students who complete the program within 150% of the stated program length. The program must establish a benchmark for its program completion rate. The program specifies the entry point (e.g., required orientation date, final drop/add date, final date to drop with 100% tuition refund, official class roster date, etc.) used in calculating program s completion rate. Graduate and employer satisfaction may be measured through a variety of methods. The methods and timeframes for collection of the graduate and employer satisfaction data are the prerogative of the program. Required Program Response: Provide actual outcome data in relation to program effectiveness. Possible Site Visitor Evaluation Methods: Review of program effectiveness data Interviews with faculty 196 Radiography

197 5.3 Makes available to the general public program effectiveness data (credentialing examination pass rate, job placement rate, and program completion rate) on an annual basis. Explanation: Program accountability is enhanced by making its effectiveness data available to the program s communities of interest and the general public. In efforts to increase accountability and transparency, the program must publish, at a minimum, its five -year average credentialing examination pass rate, five-year average job placement rate, and program completion rate data on its Web site to allow the public access to this data. The program effectiveness data should clearly identify the sample size associated with each associated measure (i.e., number of first time test takers, number of graduates actively seeking employment, number of graduates). Additionally, the JRCERT will post five-year average credentialing examination pass rate, five-year average job placement rate, and program completion rate data at The program must publish the JRCERT URL ( to allow the public access to this data. Required Program Response: Provide copies of publications that contain the program s program effectiveness data (credentialing examination pass rate, job placement rate, and program completion rate). Provide samples of publications that document the availability of program effectiveness data via the JRCERT URL address from the institution s/program s Web site. Possible Site Visitor Evaluation Methods: Review of program publications Review of institutional and/or program Web site Interviews with faculty Interviews with students 197 Radiography

198 5.4 Analyzes and shares student learning outcome data and program effectiveness data to foster continuous program improvement. Explanation: Analysis of student learning outcome data and program effectiveness data allows the program to identify strengths and areas for improvement to bring about systematic program improvement. This analysis also provides a means of accountability to communities of interest. It is the program s prerogative to determine its communities of interest. The analysis must be reviewed with the program s communities of interest. One method to accomplish this would be the development of an assessment committee. The composition of the assessment committee may be the program s advisory committee or a separate committee that focuses on the assessment process. The committee should be used to provide feedback on student achievement and assist the program with strategies for improving its effectiveness. This review should occur at least annually and must be formally documented. For additional information regarding assessment, please refer to Required Program Response: Describe how the program analyzes student learning outcome data and program effectiveness data to identify areas for program improvement. Describe how the program shares its student learning outcome data and program effectiveness data with its communities of interest. Describe examples of changes that have resulted from the analysis of student learning outcome data and program effectiveness data and discuss how these changes have led to program improvement. Provide a copy of the program s actual student learning outcome data since the last accreditation award. This data may be documented on previous assessment plans or on a separate document. Provide documentation that student learning outcome data and program effectiveness data has been shared with communities of interest. Possible Site Visitor Evaluation Methods: Review of student learning outcome data and program effectiveness data to support the assessment plan Review of representative samples of measurement tools used for data collection Review of aggregate data Review of meeting minutes related to the assessment process Interviews with faculty 198 Radiography

199 5.5 Periodically evaluates its assessment plan to assure continuous program improvement. Explanation: Identifying and implementing needed improvements in the assessment plan leads to programmatic improvement and renewal. As part of the assessment cycle, the program should review its assessment plan to assure that assessment measures are adequate and that the assessment process is effective in measuring student learning outcomes. At a minimum, this evaluation must occur at least every two years and be documented in meeting minutes. For additional information regarding assessment, please refer to Required Program Response: Describe how this evaluation has occurred. Provide documentation that the plan is evaluated at least once every two years. Possible Site Visitor Evaluation Methods: Review of meeting minutes related to the assessment process Review of assessment committee meeting minutes, if applicable Interviews with faculty 199 Radiography

200 Summary for Standard Five 1. List the major strengths of Standard Five, in order of importance. 2. List the major concerns of Standard Five, in order of importance. 3. Provide the program s plan for addressing each concern identified. 4. Describe any progress already achieved in addressing each concern. 5. Describe any constraints in implementing improvements. 200 Radiography

201 Standard Six Institutional/Programmatic Data Standard Six: The program complies with JRCERT policies, procedures, and STANDARDS to achieve and maintain specialized accreditation. Objectives: In support of Standard Six, the program: Sponsoring Institution 6.1 Documents the continuing institutional accreditation of the sponsoring institution. 6.2 Documents that the program s energized laboratories are in compliance with applicable state and/or federal radiation safety laws. Personnel 6.3 Documents that all faculty and staff possess academic and professional qualifications appropriate for their assignments. Clinical Settings 6.4 Establishes and maintains affiliation agreements with clinical settings. 6.5 Documents that clinical settings are in compliance with applicable state and/or federal radiation safety laws. Program Sponsorship, Substantive Changes, and Notification of Program Officials 6.6 Complies with requirements to achieve and maintain JRCERT accreditation. 201 Radiography

202 6.1 Documents the continuing institutional accreditation of the sponsoring institution. Explanation: The goal of accreditation is to ensure that the education provided by institutions meets acceptable levels of quality. The sponsoring institution must be accredited by: an agency recognized by the United States Department of Education (USDE) and/or Council for Higher Education Accreditation (CHEA), The Joint Commission (TJC), or equivalent standards. Required Program Response: Provide documentation of current institutional accreditation for the sponsoring institution. This may be a copy of the award letter, certificate, or printout of the institutional accreditor s Web page. 202 Radiography

203 6.2 Documents that the program s energized laboratories are in compliance with applicable state and/or federal radiation safety laws. Explanation: Compliance with applicable laws promotes a safe environment for students and others. compliance must be maintained for the program s energized laboratories. Records of Required Program Response: Provide certificates and/or letters for each energized laboratory documenting compliance with state and/or federal radiation safety laws. 203 Radiography

204 6.3 Documents that all faculty and staff possess academic and professional qualifications appropriate for their assignments. Full-time Program Director: Holds, at a minimum, a master s degree, Is proficient in curriculum design, program administration, evaluation, instruction, and academic advising, Documents three years clinical experience in the professional discipline, Documents two years of experience as an instructor in a JRCERT-accredited program, and Holds American Registry of Radiologic Technologists current registration in radiography or equivalent (i.e., unrestricted state license for the state in which the program is located). Full-time Clinical Coordinator: Holds, at a minimum, a baccalaureate degree, Is proficient in curriculum development, supervision, instruction, evaluation, and academic advising, Documents two years clinical experience in the professional discipline, Documents a minimum of one year of experience as an instructor in a JRCERT-accredited program, and Holds American Registry of Radiologic Technologists current registration in radiography or equivalent (i.e., unrestricted state license for the state in which the program is located). Full-time Didactic Program Faculty: Holds, at a minimum, a baccalaureate degree, Is qualified to teach the subject, Is knowledgeable of course development, instruction, evaluation, and academic advising, Documents two years clinical experience in the professional discipline, and Holds American Registry of Radiologic Technologists current registration in radiography or equivalent (i.e., unrestricted state license for the state in which the program is located). 204 Radiography

205 Part-time Didactic Program Faculty Holds academic and/or professional credentials appropriate to the subject content area taught and Is knowledgeable of course development, instruction, evaluation, and academic advising. Clinical Instructor(s): Is proficient in supervision, instruction, and evaluation, Documents two years clinical experience in the professional discipline, and Holds American Registry of Radiologic Technologists current registration in radiography or equivalent (i.e., unrestricted state license for the state in which the clinical setting is located). Clinical Staff: Holds American Registry of Radiologic Technologists current registration in radiography or equivalent (i.e., unrestricted state license for the state in which the clinical setting is located). Explanation: Appropriate knowledge, proficiency, and certification (if appropriate) provide a foundation that promotes a sound educational environment. Faculty and staff must possess academic and professional qualification(s) appropriate for their assignment. Clinical instructors and clinical staff supervising students performance in the clinical component of the program must document ARRT registration (or equivalent) or other appropriate credentials. Appropriate credentials, other than ARRT registration (or equivalent), may be used for qualified health care practitioners supervising students in specialty areas (e.g., registered nurse supervising students performing patient care skills, phlebotomist supervising students performing venipuncture, etc.). Required Program Response: For all program officials not previously identified on the program s database, submit a request for recognition of program officials including a current curriculum vitae and documentation of current registration by the American Registry of Radiologic Technologists* or equivalent. For all currently recognized program officials [program director, educational coordinator (if applicable), full-time didactic faculty, and all clinical preceptors], submit a current registration by the American Registry of Radiologic Technologists* or equivalent. *These may be copies of current registration cards or ARRT Identification page available at Radiography

206 6.4 Establishes and maintains affiliation agreements with clinical settings. Explanation: Formalizing relations between the program and the clinical setting helps assure the quality of clinical education by delineating appropriate responsibilities of the program and the clinical setting. An appropriate termination clause assures that students will have an opportunity to complete the clinical education component. The JRCERT defines an affiliation agreement as a formal written understanding between an institution sponsoring the program and an independent clinical setting. An affiliation agreement must identify the responsibilities of all parties and, specifically, must address student supervision, student liability, and provide adequate notice of termination of the agreement. An affiliation agreement is not needed for clinical settings owned by the sponsoring institution; however, a memorandum of understanding between the clinical setting and the sponsoring institution is recommended. At a minimum, the memorandum should address responsibilities of both parties and student supervision. Required Program Response: Provide copies of current, signed affiliation agreements with each clinical setting. 206 Radiography

207 6.5 Documents that clinical settings are in compliance with applicable state and/or federal radiation safety laws. Explanation: Compliance with applicable laws promotes a safe environment for students and others. Records of compliance must be maintained for each clinical setting. Clinical settings may be recognized by The Joint Commission (TJC), DNV Healthcare, Inc., Healthcare Facilities Accreditation Program (HFAP), or an equivalent agency, or may hold a state-issued license. Required Program Response: Provide letters, certificates, or printouts of Web pages demonstrating the current recognition status of each clinical setting. 207 Radiography

208 6.6 Complies with requirements to achieve and maintain JRCERT accreditation. Explanation: Programs must comply with JRCERT policies and procedures to maintain accreditation. JRCERT accreditation requires that the sponsoring institution has primary responsibility for the educational program and grants the terminal award. Sponsoring institutions may include educational programs established in vocational/technical schools, colleges, universities, hospitals, or military facilities. The JRCERT also recognizes a consortium as an appropriate sponsor of an educational program. A consortium is two or more academic or clinical institutions that have formally agreed to sponsor the development and continuation of an educational program. The consortium must be structured to recognize and perform the responsibilities and functions of a sponsoring institution. The JRCERT does not recognize branch campuses. The JRCERT requires that each program location have a separate accreditation award. Additionally, the JRCERT will not recognize a healthcare system as the program sponsor. A healthcare system consists of multiple institutions operating under a common governing body or parent corporation. A specific facility within the healthcare system must be identified as the sponsor. The JRCERT requires programs to maintain a current and accurate database. Updates should be reflected within thirty (30) days of effective change date. Additionally, the JRCERT requires notification of substantive changes within thirty (30) days of implementation. Required Program Response: Report any database changes. Report any substantive change not previously submitted. 208 Radiography

209 Summary for Standard Six 1. List the major strengths of Standard Six, in order of importance. 2. List the major concerns of Standard Six, in order of importance. 3. Provide the program s plan for addressing each concern identified. 4. Describe any progress already achieved in addressing each concern. 5. Describe any constraints in implementing improvements. 209 Radiography

210 Awarding, Maintaining, and Administering Accreditation A. Program/Sponsoring Institution Responsibilities 1. Applying for Accreditation The accreditation review process conducted by the Joint Review Committee on Education in Radiologic Technology (JRCERT) can be initiated only at the written request of the chief executive officer or an officially designated representative of the sponsoring institution. This process is initiated by submitting an application and self-study report, prepared according to JRCERT guidelines, to: Joint Review Committee on Education in Radiologic Technology 20 North Wacker Drive, Suite 2850 Chicago, IL Administrative Requirements for Maintaining Accreditation a. Submitting the self-study report or a required progress report within a reasonable period of time, as determined by the JRCERT. b. Agreeing to a reasonable site visit date before the end of the period for which accreditation was awarded. c. Informing the JRCERT, within a reasonable period of time, of changes in the institutional or program officials, program director, clinical coordinator, full-time didactic faculty, and clinical instructor(s). d. Paying JRCERT fees within a reasonable period of time. e. Returning, by the established deadline, a completed Annual Report. 210 Radiography

211 f. Returning, by the established deadline, any other information requested by the JRCERT. Programs are required to comply with these and other administrative requirements for maintaining accreditation. Additional information on policies and procedures is available at Program failure to meet administrative requirements for maintaining accreditation will lead to being placed on Administrative Probationary Accreditation and result in Withdrawal of Accreditation. 211 Radiography

212 B. JRCERT Responsibilities 1. Administering the Accreditation Review Process The JRCERT reviews educational programs to assess compliance with the Standards for an Accredited Educational Program in Radiography. The accreditation process includes a site visit. Before the JRCERT takes accreditation action, the program being reviewed must respond to the report of findings. The JRCERT is responsible for recognition of clinical settings. 2. Accreditation Actions JRCERT accreditation actions for Probation may be reconsidered following the established procedure. JRCERT accreditation actions for Accreditation Withheld or Accreditation Withdrawn may be appealed following the established procedure. Procedures for appeal are available at All other JRCERT accreditation actions are final. A program or sponsoring institution may, at any time prior to the final accreditation action, withdraw its request for initial or continuing accreditation.

213 Educators may wish to contact the following organizations for additional information and materials: accreditation: Joint Review Committee on Education in Radiologic Technology 20 North Wacker Drive, Suite 2850 Chicago, IL (312) curriculum: American Society of Radiologic Technologists Central Avenue, S.E. Albuquerque, NM (505) certification: American Registry of Radiologic Technologists 1255 Northland Drive St. Paul, MN (651) Copyright 2014 by the JRCERT

214 Subject to the condition that proper attribution is given and this copyright notice is included on such copies, JRCERT authorizes individuals to make up to one hundred (100) copies of this work for non-commercial, educational purposes. For permission to reproduce additional copies of this work, please write to: JRCERT 20 North Wacker Drive Suite 2850 Chicago, IL (312) (312) (fax) ( )