University of the West of England Faculty of Health and Applied Sciences Module Handbook Module Title: Diagnostic Imaging Clinical Practice 1 Code: UZYSXK-30-1 Cohort: 2015 Clinical Practice Dates: 11 th April 2016-15 July 2016 1
Contents Contact Details Introduction General Overview of Module Timetable Module Specification Module Reading Strategy Assessment Guidelines Guidelines on citations and references Submissions Re-Enrolment Additional Information 2
Contact Details Module Leader Name: MRS A BAILEY Module Leader Room: 2K18 Module Leader Telephone: 0117 3288623 Module Leader Email: Angela.Bailey@uwe.ac.uk Module Team: Angela Bailey Karen Dunmall Simon King Kerry Mills Simon Messer Donna Dimond Ben Whistance Contributes to: BSc (Hon) Diagnostic Imaging 3
Introduction to module Aims: This module is primarily concerned with the practical application of professional and technical skills involved in imaging: Axial and appendicular skeleton Thoracic and abdominal cavities Respiratory and cardiovascular systems. The preparation for this module is taught in the Foundations of Radiographic Imaging and Care of the Patient in Clinical Imaging modules to integrate the theory and practice. It is essential that students take active participation in both modules to enable them to progress to clinical proficiency. Learning approaches used: A variety of approaches will be used to consolidate the practice during the weeks prior to clinical placement. These will include tutorials in practice and The assessment of this module is by weekly reflective diary, clinical competencies, clinical appraisals, modality objectives to be submitted at the end of the clinical placement. The clinical documentation detailed in this handbook will be distributed during clinical skills week. Handbooks This handbook should be read in conjunction with other appropriate information: http://www1.uwe.ac.uk/hls/currentstudents.aspx 4
ACADEMIC SERVICES MODULE SPECIFICATION Part 1: Basic Data Module Title Diagnostic Imaging Clinical Practice 1 Module Code UZYSXK-30-1 Level 1 Version 4 Owning Faculty Health and Applied Sciences Field Allied Health Professions Contributes towards BSc(Hons) Diagnostic Imaging UWE Credit Rating 30 credits ECTS Credit Rating 15 Module Type Professional Practice Pre-requisites None Co- requisites None Excluded UZY-S6J-20-1 Module Entry N/A Combinations UZY-RSH-60-1 requirements Valid From September 2015 Valid to September 2021 CAP Approval Date Part 2: Learning and Teaching Learning Outcomes On successful completion of this module students will be able to: Perform radiographic examinations commensurate with the first clinical placement in a safe and efficient manner with consideration to the use of ionising radiation. (Component A) Perform effective patient care with due respect for the individual s needs (Component A) Demonstrate clinical proficiency equitable to the clinical objectives and clinical assessments under the directions of a state registered practitioner. (Component A) Demonstrate a proactive approach to problem solving in the clinical setting (component A) Demonstrate the ability to work independently under supervision within a legal and ethical framework (component A) Reflect upon personal and professional development within clinical practice. (component B) Syllabus Outline Practical application of Professional Skills Radiographic technique and protocols including the qualitative assessment of the resulting radiographic appearances for: Axial and appendicular skeleton; Thoracic and abdominal cavities; 5
Respiratory and cardiovascular systems; Patient preparation and care prior to, during and after specific imaging procedures; Management of electronic and non-electronic patient data Radiation Protection Practical methods of dose measurements, dose reduction and the radiation dose received from specific examinations. Applied radiation protection to incorporate; Core knowledge, Schemes of work and local rules. Health & Safety at Work Act (1974), to include current legislation and professional codes of conduct, basic life skills and manual handling. Practical application of Radiographic Imaging processes The imaging process and methods of producing, manipulation and viewing images in analogue and digital formats. Storage and transferral of images. Departmental routine Overview of the main areas in a diagnostic department. Clinical placement practice in General radiography, Accident and Emergency, Fluoroscopy, Experiential learning of the process for the management and care of patients in a radiography department Imaging of a diverse patient group with a range of non-complex needs The values of the NHS Constitution are implicit within this module. Contact Hours Prior to placement there is the delivery of clinical documentation (including Professional code of conduct) and clinical skills sessions (e.g. Basic Life Support and Manual Handling). Whilst on placement there are support visits by a link liaison lecturer. Whilst on clinical placement students will engage in a 14 week period at a designated Diagnostic Imaging department within the AGW region of AQP. This will include one half day study per week (excluding bank holiday weeks). The total working week will be equivalent to 37.5 hours. This is approximately 472.5 hours (excluding seasonal variations that occur due to the timing of Easter). Students are provided with opportunities to develop and demonstrate clinical and technical skills in simulation, prior to applying them in practice placement. Students work under direct clinical supervision and will be provided with support from practice educators and clinical staff throughout their clinical placement. 6
Regular support meetings are held throughout placement with the practice educators. Teaching and Learning Methods Key Information Sets Information Students are expected to attend a desirable minimum of 90% of clinical practice time and an absolute minimum of 80% of clinical practice time as stipulated by The Society and College of Radiographers in order to meet professional requirements satisfactorily. https://www.sor.org/learning/document-library/student-radiographer-attendance-managementguidelines/student-radiographer-attendance-management (members only access) Placement learning: a practice placement encompassing the general areas of practice (please see placement documentation) consisting of approximately 472.5 hours (allowing for seasonal variation of bank holidays especially around Easter).The clinical competencies are assessed by Practice Educators. Key Information Sets (KIS) are produced at programme level for all programmes that this module contributes to, which is a requirement set by HESA/HEFCE. KIS are comparable sets of standardised information about undergraduate courses allowing prospective students to compare and contrast between programmes they are interested in applying for. Key Information Set - Module data Number of credits for this module 30 Hours to be allocated Scheduled learning and teaching study hours Independent study hours Placement study hours Allocated Hours 540 15 52.5 472.5 540 Please note that the placement hours may vary due to Bank Holidays. The table below indicates as a percentage the total assessment of the module which constitutes a - Practical Exam: practical skills assessment Written- reflective diary Please note that this is the total of various types of assessment and will not necessarily reflect the component and module weightings in the Assessment section of this module description: Total assessment of the module: Written exam assessment percentage 0% Coursework assessment percentage 50% Practical exam assessment percentage 50% 100% Reading Strategy Core reading 7
Any core reading will be indicated clearly, along with the method for accessing it, e.g. students may be expected to purchase a set text, be given a study pack or be referred to texts that are available electronically, or in the Library. Module guides will also reflect the range of reading to be carried out. Further reading Further reading is advisable for this module, and students will be encouraged to explore at least one of the titles held in the library on this topic. A current list of such titles will be given in the module guide and revised annually. Access and skills Formal opportunities for students to develop their library and information skills are provided within the induction period. Additional support is available through the Library Services web pages, including interactive tutorials on finding books and journals, evaluating information and referencing. Sign-up workshops are also offered by the Library. Indicative Reading List The following list is offered to provide validation panels/accrediting bodies with an indication of the type and level of information students may be expected to consult. As such, its currency may wane during the life span of the module specification. Current advice on additional reading will be available via the module guide or Blackboard pages. Carver, B. (2012) Medical Imaging: Techniques, Reflection and Evaluation. 2nd ed. London: Churchill Livingstone Easton, S. (2008) An Introduction to Radiography. London: Churchill Livingstone. Ellis, H., Logan, B. and Dixon, A. (2009) Human Sectional Anatomy: Pocket Atlas of Body Sections, CT and MRI Images. 3rd edition. Florida: CRC Press Gunn, C. (2012) Bones and Joints A guide for students. 6th ed. London: Churchill Livingstone. Sloane, C. and Stewart Whitley. A., Anderson, C., and Holmes, K. (2010) Clark's Pocket Handbook for Radiographers. Florida: CRC Press Stewart Whitley A (2005) Clark s Positioning Radiography 12th ed. Florida: CRC Press Sutherland, R. (2007) Pocketbook of Radiographic Positioning 3rd ed. London: Churchill Livingstone Assessment Strategy Part 3: Assessment Pass/fail clinical competency portfolio- assesses the competencies according to the SCoR and HCPC guidelines Component A:To consist of a portfolio of competencies Component B:- Reflective diary of practice Rationale: An opportunity for the student to demonstrate clinical competence through formative and summative assessment. The portfolio is assessed in practice and marked as pass / fail as students need to meet a minimum requirement to practice safely at this level. The academic team will oversee and moderate the marking of the portfolio. 8
There is opportunity for students to demonstrate progression of competencies through continuous assessment (where appropriate) and receive formative feedback throughout the placement. A reflective weekly diary will be assessed and used to feedback and feedforward on the personal and professional SWOBs (Strengths, Weaknesses, Opportunities and Barriers). This is in preparation for level 2 when they will be presenting their progress. Identify final assessment component and element Component B Element 2 A: B: % weighting between components A and B (Standard modules only) First Sit Component A (controlled conditions) Description of each element Element weighting 1. Clinical competency portfolio Pass/Fail Component B Description of each element Element weighting 1. Reflective diary of practice 100% Resit (further attendance at taught classes is not required) Component A (controlled conditions) Description of each element 1.Pass/ fail clinical competency portfolio Component B Description of each element Element weighting Pass/Fail Element weighting 1. Reflective diary of practice 100% If a student is permitted an EXCEPTIONAL RETAKE of the module the assessment will be that indicated by the Module Description at the time that retake commences. Assessment Guidelines The assessment of this module is by weekly reflective diary, log book, clinical competency appraisals and modality objectives to be submitted at the end of the clinical placement, details on page 21. 9
Guidelines on citations and references In the course of your studies you will be expected to acknowledge books, journal articles and web sites etc, used in the preparation of assignments, projects, essays, and dissertations by producing a list of references and/or a bibliography with each one. The reference list gives details of sources you have referred to (cited) within your text; the bibliography lists sources you have used but not referred to directly. References (citations) within the body of an assignment should be linked to the reference list using the Harvard system of referral. This requires the authors surname and the year of publication to be inserted at every point in the text where reference is made to a particular document. Why reference? There are a number of reasons why you should provide references: to demonstrate that you have considered other people's opinions and read around your subject; to acknowledge other people's work and/or ideas - and thus avoid accusations of plagiarism (plagiarism: is the act of presenting the ideas or discoveries of another as one's own); to provide evidence for a statement; to illustrate a point or offer support for an argument/idea you want to make; to enable readers of your work to find the source material, e.g. for a particular methodology you have used; and to direct readers to further information sources. Up to date information and guidance is available at: http://www1.uwe.ac.uk/students/studysupport/studyskills/referencing.aspx When preparing reports, essays, etc. for assignments at UWE, if you wish to refer to something you have read you MUST give a reference for this material. Referencing styles There are a number of different referencing systems in use. Each one has been developed to suit the particular needs of specific users. The UWE Harvard system is the referencing system used within the Faculty of Health and Applied Sciences. 10
UWE Library Services have undertaken an extensive review and provide UWEapproved guidance on what is expected by all UWE Faculties that use the UWE Harvard style. For details of how to reference according to the UWE approved Harvard referencing style, please visit the Referencing section of UWE Library Services. You can also download a pdf booklet from the site and during autumn term 2015 obtain a printed quick-reference handbook on referencing from your campus library, for a small fee. You will find advice on how to list references within the body of the text, as well as how to present the reference list. Examples and guidance on over 60 different types of resources are given to assist you. If you require further assistance with referencing, visit the Library Services web site: http://www1.uwe.ac.uk/students/studysupport/studyskills/referencing.aspx Submissions Please refer to student information for details of processes relating to submissions, Late Work, Extenuating Circumstances, Field and Award Board details, resubmission, and the publication of results. Re-Enrolment Students who have been referred at the first opportunity of this module will be required to await an Award Board Decision before being able to take a re-sit. 11
Additional Information SUGGESTED LEARNING STRATEGY FOR EACH AREA OF RADIOGRAPHIC TECHNIQUE It is suggested that radiographic technique can be learned with the following format in mind. As you can see this also contains elements of the appraisal form and has been shown to be a good memory aid to many students in the past. Each area should be divided into the following sections: 1. Preparation of the Patient 2. Equipment and accessories 3. Radiation protection 4. Projections 5. Patient positioning 6. Centering point 7 Exposure factors 8. Image quality 9. Radiographic evaluation 10. Common pathology 12
CLINICAL EDUCATION Demonstration of clinical proficiency by the student on completion of the award route is one of the primary aims of the programme. Thus the clinical practice constitutes a fundamental and integral part of the student's education over the three years of the programme. The learning outcomes of the module are designed to ensure that the student is able to develop the clinical skills, knowledge, application and critical awareness required in a practicing radiographer. YEAR 1 Diagnostic Imaging clinical Practice 1 Following an academic block, the students are required to undertake a 14-week practice placement in order to assist in the integration of their knowledge with the practical clinical experience. In year one the 14-week practice placement commences on Monday 11th April to Friday 15th July 2016. During the placement the student will undertake the following placements: 1 week in a chest room 1 week in a fluoroscopy suite (for procedure experience) 1 week of contrast studies (CT, Angiography, IVU if available) 2 weeks on mobiles/theatres 4 weeks in general rooms (to include clerical and departmental clinical skills) 4 weeks in A+ E rooms 1 week to include 1 day s experience in each of the following: - RNI, U/S, MRI and 2 days in CT. It is recognised that some departments may not have dedicated rooms or may wish to give the other experiences in 1-2 day blocks over the course of the placement. This is acceptable providing that the overall time spent in the area is equivalent to that shown above i.e. 37.5 for each week (including study) The students' individual rota is compiled by the Clinical Coordinator with assistance from the clinical departments themselves. Circumstances such as equipment breakdown or illness may force alterations to become necessary. During this 14 week placement the students will undertake various forms of assessment that will be outlined in another section of this document. 13
Hours of attendance All students will be working a 37.5 hr. week in line with departmental hours, normally between the hours of 9.00am - 5.30pm Monday to Friday. However some Departments operate different start and finish times, with some units operating a shift system. As you will become a member of the radiographic team you will be expected to participate in the normal working practice of the Department to which you have been allocated. Half day study per week Students will be entitled to 1 study session per week for academic study (half day per week) during the 14 weeks. The timings of these study sessions must be agreed with the placement and cannot be accumulated. Please note that during weeks when there is a Bank Holiday then there will be no allocated half day study that week. Sickness reporting: If for any reason you are unable to attend your practice placement please call: 1. Your Practice Placement as near to the start of your shift as possible. Advise them if you are sick or unable to attend placement for any other reason. Note: for infection control purposes, if you have diarrhoea or sickness you will be required to remain off placement for 48 hours following the last episode. 2. Your Link Lecturer/Clinical Coordinator if your period of sickness is likely to be substantial and therefore affect your ability to complete the requirements of your practice placement, you must inform your Link Lecturer and/or Clinical Coordinator as soon as possible. If your period of sickness is likely to affect your ability to submit by the assessment deadline, you must fill in an EC1 form within 5 days of the assessment date. 14
Holidays: You must not arrange to take holiday inside the dates given for your placement. Unauthorised absence or extended periods of sickness may seriously affect your ability to meet the requirements of the clinical learning objectives and assessment of practice and thus progress on the award. If you are experiencing any difficulties please talk to your Practice Educators, the Clinical Liaison/Link lecturer or the Clinical Co-ordinator as soon as possible. Attendance records. The College of Radiographers regards an attendance of 90%in the planned clinical practice component of the course as being the desirable minimum. This is to enable students to meet professional requirements satisfactorily. There is a register in the Clinical Placement Forms book which should be initialled daily by a member of staff. This assists the clinical co-ordinator in the assessment of your clinical placement experience. Any absence that is not reported as sickness or approved leave will be recorded as unauthorised - you are advised that this may be detrimental to your employment reference. If there is a personal situation that requires you to seek compassionate leave please discuss with the Clinical Coordinator or Personal Tutor or Link Lecturer. Radiography Placement Locations for year one:- The following Hospitals provide the clinical experience for students on the Award: North Bristol Healthcare Trust ( Southmead and Cossham Hospitals and Yate Health Centre) Gloucestershire Hospitals: this includes Gloucester Royal and satellites Stroud, Berkeley,Dilke and Cheltenham General and satellite Cirencester. United Bristol Healthcare Trust (Bristol Royal Infirmary, South Bristol Community Hospital (SBCH), Bristol Haematology and Oncology Centre (BHOC), Bristol Children s Hospital (BCH) and The Chesterfield Hospital, Clifton. Weston General Hospital and satellites The Spire Hospital, Bristol and Clevedon Community Hospital. 15
Great Western Hospital, Swindon. Royal United Hospital, Bath and satellites The Royal Mineral Hospital and Paulton Community Hospital. As you will remember you have signed an agreement to be flexible with respect to the location of your placement. You are reminded therefore that we can make no guarantee that you will be placed in any specific location during any of your placement periods. The Clinical Co-ordinator must have the flexibility to organise rotas which will make best use of available resources and provide the optimal and comparable experience for all students. The rotas are designed to ensure you receive the appropriate experience to meet the learning outcomes of the programme. However as you will be working in an ever changing, high technology environment sometimes flexibility is required to take account of the unexpected! Your placements are determined by a placement officer: - Tim Porter tel. 0117 3281153, (Timothy.Porter@uwe.ac.uc) any issues with the placement prior to commencement should be addressed with Tim in the first instance. SUPPORT WHILST ON PLACEMENT Within Clinical Departments: All clinical and ancillary staff have a role in teaching and supporting students during practice placement periods. PRACTICE EDUCATORS However at each of the placement locations there are a number of clinical staff who have been trained to act as PRACTICE EDUCATORS. These radiographers perform an essential role within the programme, as they are responsible for: ensuring that students gain the appropriate clinical experience monitoring students progress throughout the placement periods conducting appraisals of clinical skills providing support and guidance to students whilst on placement liaising with the academic centre via the Clinical Liaison/Link lecturer and Clinical Co-ordinator Each Department operates in slightly different ways - on a day-to-day basis you may or may not be working in a team where there is a Practice Educator. The Practice Educators should be your initial point of contact if you have any concerns regarding 16
your clinical education or of a personal nature that cannot be addressed by the other staff with whom you are working. There may be a named Practice Educator who acts as the co-ordinator of your placement experience at the specific location- you will be introduced to this radiographer during the Induction period. This person is known as the KEY PRACTICE EDUCATOR. CLINICAL LIAISON/LINK LECTURERS The Radiography lecturers act as a clinical liaison/link lecturer for specific hospital locations. Their role is to visit you three times when on practice placement to provide support and to monitor your progress in developing your clinical skills Please remember the clinical liaison/link lecturer provides an additional point of contact for students, providing help with any academic, clinical or personal issues you may have. A list of the link lecturers and contact details will be distributed with your clinical documentation. CLINICAL CO-ORDINATOR There is a named person in the School who has the responsibility for organising and monitoring your placement experience. The Co-ordinator communicates with Clinical Managers, Practice Educators, Liaison Lecturers and the Faculty s Placement Unit to ensure you receive the appropriate clinical education over the three years of the programme. If you have any issues/difficulties related to your placement experience you should discuss these with the Clinical Co-ordinator. Clinical Co-ordinator: Angela Bailey Tel: 0117 3288623 e-mail: Angela.Bailey@uwe.ac.uk CLINICAL PLACEMENT WEEKLY REPORTS AND MODALITY OBJECTIVES It is important to note that there are 14 weekly report forms relating to each week of the placement and these form an integral part of the overall assessment. The form should act as a negotiated statement of the student s experience during the week. All boxes (attendance and competencies) need to be initialed by an appropriately qualified member of staff. For a pass to be achieved, the student must demonstrate satisfactory progress. In the event of an area being identified as below the required standard and scored as a 1, an ACTION PLAN needs to be produced. 17
The Action Plan This plan will be negotiated between the student and the clinical supervisor and will aim to redress the identified shortcoming. If this is not achieved within the agreed time frame, the link lecturer will intervene. If a 1 is received in a clinical competency in the last 2 weeks of placement the student may fail the clinical placement. ASSESSMENT The Diagnostic Imaging Clinical Practice 1 module is assessed by employing the following methods: Component A - Clinical based competency evidence, which consists of a log book, appraisals and weekly competencies and modality objectives. Component B - Written reflective weekly diary and EOP reflection. The clinical based competency evidence and the modality objectives are assessed as PASS/FAIL The written reflective weekly diary and End of Placement student reflection will be given a mark. Students will have to successfully complete and pass both elements of the clinical portfolio before they are deemed to have passed the module. In the clinical based competency evidence this means passing all clinical appraisals, completing the log book to the required standard and completing all aspects of the clinical paperwork with the required signatures and dates. All modality objectives must also be marked and signed off as being at the required standard by supervisors. Your written reflective diary must gain a mark of 40% or above The clinical assessments (appraisals) are subject to the University of the West of England's assessment regulations and as such should be conducted in a fair and just manner in accordance with these guidelines. Any breach in procedure could result in an appeals procedure and action taken against those who are deemed to be at fault. 18
WORKBOOK Included in your portfolio is a Clinical Appraisal Workbook, this workbook is meant as a tool to assist you in your preparation for the 1 st year appraisals. This work will not be marked and is not a pre-requisite of the appraisal but the Practice Educator will ask you prior to the appraisal if you have completed the relevant section and note that on the appraisal form. Modality Objectives and Clinical Skills Competency Students will be required to complete the four Modality Objectives and the Clinical Skills Competencies during their clinical placement. The guidelines for the completion of the Modality Objectives can be found in the front of the Clinical Placement Forms book. These will be signed off by supervisors in practice once they are at the required level. Please note that you are given a half day study per week in which to complete written modality objectives and weekly reflective logs. The Clinical Appraisal Scheme. During the 14-week placement each student will be required to complete the following appraisals: 1 upper/ lower extremity joint (main joints only e.g. wrist, elbow, ankle, knee) 1 abdomen (plain) 1 chest 1 Spine The timing of these appraisals should be spread as evenly as is possible throughout the placement. It will obviously be governed by factors such as suitability of workload and availability of Practice Educators. The onus is on the student to negotiate with the Practice Educator in order to complete all the appraisals in the 14 week period. Ideally, these appraisals should take place during the allotted time in the relevant area e.g. Chest appraisal - chest room, There are pre-requisites for the appraisals: - 1. The completion of a minimum of 5 unassisted examinations pertaining to the appraisal (See table 1, appendix 2) 2. It is advised that students complete the relevant sections of the Appraisal Workbook prior to each appraisal but this is not mandatory. The Practice Educator will then initial the box on the appraisal form and write yes or no. This will require the student showing that they have completed the relevant 19
section BUT IT DOES NOT HAVE TO BE READ OR MARKED as it is for formative purposes. If the student has not completed the relevant section of the workbook prior to the appraisal this is not a fail. Students are only allowed one assessment opportunity for each appraisal, a second opportunity may be granted (subject to award board approval) if the first assessment has been failed and NOT as a means of bettering the mark received. The first assessment opportunity of the appraisal must be taken by the end of the 14 week placement period otherwise it is deemed to have been taken and further opportunities may be granted at the Award board. Any time lost from placement due to illness or extenuating circumstances must be supported by the submission of evidence and an EC1 form from the one stop shop. IF THE STUDENT FAILS ON THE FIRST ASSESSMENT OPPORTUNITY WITHIN THE 14 WEEK PLACEMENT PERIOD THERE IS NO AUTOMATIC RIGHT TO FURTHER OPPORTUNITIES/ATTEMPTS AT PROFESSIONAL PRACTICE MODULES. THE MARKS WILL GO INTO THE PORTFOLIO FOR CONSIDERATION AT THE AWARD BOARD. The appraisals should be conducted using the approved clinical appraisal form (see Appendix 3). PRACTICE EDUCATORS ARE REMINDED THAT THE FORMS CARRY A UWE COPYRIGHT LOGO AND AS SUCH ARE REGARDED AS PROPERTY OF THE UNIVERSITY AND SHOULD NOT BE GIVEN TO OTHER PARTIES WITHOUT WRITTEN PERMISSION. The students have been provided with 5 forms. ALL forms must be submitted as part of the completed portfolio. Should anymore appraisal forms be required because of loss or damage contact the Clinical Coordinator for a replacement. If a student carries out an examination that has more than two projections then a supplementary page can be used from within the extra copies provided. Each sheet is constructed so that the form is in triplicate. Once completed the sheets should be separated and then filed in the appropriate place i.e.: WHITE - copy to be retained by student but submitted with your portfolio. YELLOW - copy to be forwarded to the clinical co-ordinator or collected by link tutor. PINK - copy to be kept by the Practice Educator. 20
The Appraisal form (Appendix 3) All sections of the form should be completed. Once complete both the student's and the Practice Educator's signatures are also required. The choice of a suitable patient should be left to the discretion of the Practice Educator. (It is however envisaged that, in level 1, any examination carried out should not require too much adaptation of basic technique). The patient should always be asked by the Practice Educator for their consent prior to the appraisal. Once the appraisal begins the Practice Educator can answer any questions the student asks and can give assistance if required this however will be regarded as prompting and will be marked accordingly. Marking guide Before an appraisal is considered the pre-requisite conditions should have been met and approved by the Practice Educator. It is not counted as an assessment opportunity until the appraisal is commenced. The front sheet should be answered with either a "yes" or "no" response as indicated. A "no" response is regarded as an automatic failure and the appraisal should be terminated at this point. During the appraisal if at any time the Practice Educator feels the student's actions could be regarded as being dangerous then the appraisal should be terminated and recorded as a failure. All other sections are marked using the following criteria: F-Non-completion of task and deemed a dangerous act and is an automatic failure of this assessment opportunity 0-Did not perform task. 1-Required assistance /prompting (see log book definition of assisted). 2-Works unassisted but lacks proficiency (see log book definition of unassisted). 3-Worked proficiently An allocation of 0 for any task should be used to indicate that a student was unable to perform that task without the Practice Educator giving direct supervision and instruction. Proficiency is regarded as the student s performance being proficient for the level of training i.e. year 1. This criterion is also helpful in that it can be used to introduce a time element. Students that correctly carry out the task but take a lot longer should receive a lower mark than they would have been given if they had carried out the examination correctly and at a reasonable pace. 21
Each section is marked using these criteria and a total can be calculated after any deductions have been taken into consideration. If the examination requires more than two projections then a further copy of page 2 should be used and then the mark should be averaged. (When averaging the projection marks the score for the first attempt and not the repeat should be used to calculate the average projection mark). Once completed the marks should be totalled and any deductions made from this total as indicated on the form. The total marks available are 87. The pass mark is 80%; that is, achieving more than 70 marks out of 87. The Log Book element (Appendix 4) Student radiographers must be supervised by a qualified radiographer at all times whilst undertaking radiographic examinations. The degree of supervision will of course range from direct within the first few weeks to a more remote level once competency has been achieved. The minimum number of examinations is approximately 1000 over 3 years. At least half of these should be carried out unassisted under supervision. All entries are to be signed by a supervising radiographer at the time of completion of the examination and entered in the log book (an example section of which is included in appendix 4). Initial assisted examinations must be entered in the logbook together with unassisted ones. It is important for the clinical co-ordinator to see the range of patients encountered by the student during their placement. If examinations in a specialist area are observed then this should be indicated in the log book also. The minimum numbers (see table 2, appendix 5) for each placement covers areas taught within the academic element of the relevant Professional practice module. The recommended numbers of examinations are set to ensure that there will be a breadth of techniques covered each year. This will help to ensure that new techniques are practised and skills already acquired are maintained and developed. It is the responsibility of the student to negotiate time in which they should fill in their logbook. They are advised to get them signed at the time of examination. Radiographers are under no obligation to sign entries that have been carried out a long time beforehand. Minimum numbers should be exceeded by the end of the placement or you may risk your portfolio being considered incomplete and below the required standard to progress. These numbers will be reviewed intermittently and records 22
kept of the student s progress throughout the course. In addition to the minimum, students should continue to record all examinations they perform. Please note that when working in modality areas (MRI, US, RNI and CT) it is a requirement that you record the observed/assisted examinations. A minimum of 5 observed/assisted examinations are required in each of these areas. PORTFOLIO COMPLETION AND SUBMISSION DATE All the completed clinical documentation must be submitted BY 2.00PM on 19/07/16 to 2B24. ALL THE SIGNATURES REQUIRED IN THE PORTFOLIO (SUPERVISOR AND STUDENT) MUST BE OBTAINED PRIOR TO SUBMISSION. You are reminded that forgery of any signatures of staff is an assessment offence which can result in the requirement to withdraw from the programme. Failure to submit a completed portfolio will result in failure of this assessment and you may only be granted a second opportunity at the discretion of the Award Board. Failure of this module has a direct effect on your progression to year 2. PORTFOLIO RE-SUBMISSION DATE Students who are granted a second opportunity by the award board must submit their completed portfolios at a pre-arranged date with the Clinical Co-ordinator after the agreed time period. 23
Appendix 1 Extra Preparation/Submission Time for Disabled Students Every disabled student who registers with the FHLSC is invited to have his or her academic needs reviewed by a student advisor. Where a student has been assessed as having a disability, then the student advisor maintains a record of any additional time or support required and passes those needs onto the examinations officer and the module leader(s) concerned. The following refers to those students who have been confirmed by a student advisor as being eligible for extra time in examinations and assessments. 1. A standard 25% extra time in any written assessment that is sat under examination conditions. 2. Where information for an examination or assessment under timed conditions is given out in advance, a 25% time addition will be added to the normal advance time period where the assessment date is 4 weeks or less from the pre-information date. 3. A standard extension of 7 days to the normal advance time period will be given where the examination date is over 4 but fewer than 8 weeks from the normal date of publication of pre-information. 4. For coursework, an extension of 25% of the time between the assessment notification date to the submission date will be given where the submission date is 4 weeks or less from the notification date. 5. Where the submission date for coursework is over 4 but fewer than 8 weeks from the assessment notification date, a standard extension of 7 days will be given. Further information or advice can be sought from the student advisors. 24
Appendix 2 Table 1: - Pre-requisite examinations and clinical case studies for the clinical appraisal If there are insufficient patient numbers requiring, for example, a thoracic spine*, it is at the Practice Educator s discretion to continue with the appraisal if all other criteria have been met. However, the student should reach the minimum number by the end of the placement. Any problems regarding the minimum numbers required should be addressed to the clinical co-ordinator or clinical link lecturer. Appraisal Region Upper/ Lower Limb Relevant section of Appraisal Workbook (not mandatory) Upper/lower limb Pre-requisite unassisted examination 20 upper limb examinations to include:- 5 hands and wrists 5 Feet (should include knowledge of technique for toes) 5 Ankles 5 knees Abdomen Abdomen 5 Abdomens (Diaphragm to pubis), 5 pelvis (Iliac crest to greater trochanter or low centred pelvis for hips) Spine Spine 5 C.spine 5 T.spine 5 L.Spine See above * Chest Chest 5 Chests. Lateral chests should not be included in the above number, but can used in the final required total. 25
CLINICAL APPRAISAL LEVEL ONE Name of Hospital.. Name of Practice Educator.. Name of Student... Examination Assessed.. Date ------------------------------------------------------------------------------------------------------------------ Do not proceed with the appraisal if the following pre-requisites have not been met. 1. Has the student completed the minimum number of unassisted examinations that are pre-requisite for this appraisal? (The log- book should be signed by the Practice Educator to indicate this has been checked.) 2. Has the relevant section of the Workbook been completed prior to the appraisal? (please state yes/no plus your initial) ----------------------------------------------------------------------------------------------------------------- NB The appraisal can be halted and an automatic failure recorded if:- The Practice Educator deems that the student is committing a dangerous act. If the answer to any question marked * is NO 1. *The student has considered the possibility of patient pregnancy. 2. *The student has checked that the request form was completed in accordance with departmental protocol (E.g. verified by signature) YES (1Mark) NO 3. * The student has obtained a positive identity check 4. *The student has justified the examination with regards to IRMER. 5. *The student has correctly identified which projections they will take. SUB-TOTAL 26
CA /L1/1 White copy to student, yellow copy to UWE, pink copy to Practice Educator. The student has considered viewing previous radiographs or reports (even when films/reports are not available). YES=1 mark, NO= -3 marks. Y N The student has understood and explained the medical terms stated on the request form. No (0) Partial (1) YES (2) MARKING GUIDE (Using the log book definitions of assisted and unassisted): F. NON COMPLETION OF THIS TASK* IS DEEMED A DANGEROUS ACT AND IS AN AUTOMATIC FAILURE OF THIS ASSESSMENT OPPORTUNITY 0. Not completed 1. Required assistance 2. Worked unassisted but lacked proficiency 3. Worked proficiently 1. PRIOR TO THE PROCEDURE Did the student correctly prepare the: - a) Room? 0 1 2 3 b) Equipment? c) Patient? d) Wash/gel hands 2. DURING THE PROCEDURE Projection 1 Projection 2 Did the Student 0 1 2 3 0 1 2 3 Correctly position the patient? * F F Correctly position the image receptor? Correctly position and manipulate the equipment? * F F Accurately locate the centering point?* F F Collimate the beam appropriately prior to the exposure? Correctly select markers/legends? F F Correctly adjust all control/console settings?* F F Communicate clearly and appropriately with the patient?* F F Give full consideration to the correct care of patient?* F F Record exposure factors and/or DAP meter reading? TOTAL average score if more than 1 projection 27 F
CA /L1/2 White copy to student, yellow copy to UWE, pink copy to Practice Educator. 3. AFTER THE PROCEDURE Did the student: - a) Communicate the correct information to the patient? * b) Deliver the after-care relevant to the patients needs? * 0 1 2 3 F F 4. STUDENT S CHECKING OF THE RADIOGRAPH The Practice Educator is checking that the student has inspected the radiograph for each item and that the student s assessments are correct and at the appropriate level for the stage of training. Projection 1 Projection 2 The student s assessment of the following was 0 1 2 3 0 1 2 3 complete and correct :- Patient identification (personal and anatomical) F F Relevant area under examination Correct patient position Image quality relevant to image capture system Kvp selection (penetration) Exposure indicators sharpness Collimation of the beam to the area of interest Anatomical features Pathology Artefacts TOTAL Average score Did the student recognise the need for supplementary or repeat projections? YES=1 mark, NO= -3 marks. YES NO PASS MARK 80%= 70/ 87 SCORE TOTAL MARKS AVAILABLE 87 Total % 87 x 100 CA /L1/3 White copy to student, yellow copy to UWE, pink copy to Practice Educator. 28
Evaluation and Feedback Student s reflection What do I feel I did well during this examination? What would I do differently in the future and why? Student s signature Date.. CA /L1/4 White copy to student, yellow copy to UWE, pink copy to Practice Educator. 29
Evaluation and Feedback Practice Educator s feedback on student s overall performance (including areas for development) Practice Educator s Name. Practice Educator s signature. Date.. CA /L1/5 White copy to student, yellow copy to UWE, pink copy to Practice Educato 30
Appendix 4 Clinical Practice 1: - Fingers, Thumbs and Hands Definitions Assisted [A] - If the student/trainee requires physical intervention by Radiographer / clinical tutor during the procedure e.g. altering parameters, position or exposure or requires constant verbal re-assurance at every stage this will be classed as Assisted. Date Patient ID Clinical indication Exposure factors Radiographer Initials A/O Rad Initials U Unassisted [U] -If the student/trainee carries out the procedure with very limited requirement for verbal re-assurance e.g. is this okay, this will be classed as Unassisted. Observed [O] If the student observes only any modality procedure, e.g. MRI, RNI, US, CT or Mammography, this will be classed as Observed. Fingers, Thumb and Hand Skull Wrist/ Forearm Ward/ Portable radiography Elbow/ Humerus Theatre radiography Shoulder Girdle Fluoroscopy. Foot and Toes Angio /Venography Ankle and Calcaneum Contrast Studies Tibia and Fibula Dental Knee/ Femur Mammography Hip/ Pelvis Paediatrics Chest and Thoracic contents M.R.I. Abdomen and pelvic contents C.T. Cervical Spine R.N.I. Thoracic Spine Ultrasound Lumbar Spine/ coccyx Miscellaneous Total 31
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Appendix 5 Table 2: - Minimum numbers of unassisted/assisted examinations required by the end of year 1 clinical placement. Region Minimum Unassisted numbers by the end of year 1 placement Required numbers of observed /assisted examinations in brackets Fingers, Thumb 10 Skull (5) and Hand Wrist/ Forearm 10 Ward/ Portable radiography (5) Elbow/ Humerus 5 Theatre radiography (5) Shoulder Girdle 5 Fluoroscopy. (5) Foot and Toes 10 Angio /Venography (5) Ankle and 10 Contrast study IV (5) Calcaneum Tibia and Fibula 5 Dental (5) Knee/ Femur 10 Mammography Hip/ Pelvis 10 Paediatrics (5) Chest and Thoracic contents 30 M.R.I. (5) Abdomen and 10 C.T.(5) pelvic contents Cervical Spine 10 R.N.I.(5) Thoracic Spine 5 Ultrasound (5) Lumbar Spine/ coccyx 10 Miscellaneous TOTAL 140 60 The student MUST total the unassisted and assisted numbers and complete the table of similar format to that above which is in the front of the logbook BEFORE submitting it as part of their portfolio. 33