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MEDICAL RADIATION SCIENCES Joint Degree / Diploma Program

COURSE OUTLINE/SYLLABUS

Course Title: Radiographic Methodology III

The Michener Institute Course Code University of Toronto Course Code RARA250 MRS207H1

Program Chair: Susan Weltz, Chair

Course Start Date: January 2012 Revision Date: November 2011

PROGRAM: MEDICAL RADIATION SCIENCES, Radiological Technology

COURSE NUMBER: RARA250/MRS207H1

COURSE TITLE: Radiographic Methodology III

DATE: January 2012

FACULTY: Bonnie Sands, Taran Dorrington REVISED: December 2011

CHAIR SIGNATURE:

© Michener/University of Toronto Medical Radiation Sciences Program 2

Radiographic Methodology III

Course Information

Course Number RARA250/MRS20741

Credits 0.5

Contact Hours 104

Instructor Bonnie Sands, Taran Dorrington

E-mail Address [email protected] , [email protected]

Office 1146

Office Phone 416-596-3101 ext. 3416

Beginning Date 01/03/2012

Number of Weeks 13

Description

This course is a study in radiographic and fluoroscopic imaging of the body systems. Methodology III will explore the importance and application of contrast media in the visualization of the gastrointestinal, genitourinary, reproductive, musculoskeletal, central nervous and cardiovascular system. This course will enhance the fundamental knowledge and skills acquired in Radiographic Methodology I and II pertaining to positioning, patient care, image assessment, and radiation protection. Anatomical variants and pathology pertaining to the systems covered in this course will be discussed. This course is a combination of both theory (classroom based) and practice (laboratory).

Prerequisites

Radiographic Methodology II (RARA240/MRS120H1)

Special Topics in Patient Care III (PCRD210/MRS268H1)

Co- Requisite; Special Topics in Patient Care III (PCRA250/MRS208H1)

Co- Requisite; Medical Imaging Pathology (PGRA240/MRS119H1)

Textbooks

K. L. Bontrager & J. Lampignano. Textbook of Radiographic Positioning & Related Anatomy. Mosby. 2010. Edition: 7th. ISBN: 978-0-323-05419-2. Required.

A. M. Snopek. Fundamentals of Special Radiographic Procedures. Saunders Elsevier. 2006. Edition: 5th. ISBN: 13: 978-0-7216-0632. Required.




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Torres, L., Linn-Watson Norcutt, T., Dutton, A. Patient Care in Imaging Technology. Lippincott Williams and Wilkins. 2010. Edition: 7th. ISBN: 078177183. Required.

CAMRT- The Radiological Technology Competency Profile Task Group. Radiological Technology Competency Profile 2006. CAMRT. Edition: Jan 2011. Required.

College of Medical Radiation Technologists Of Ontario (CMRTO). Standards of Practice. 2011. Required.

SAFETY CODE 35 (on-line). Not Required.

Learner Supplies

Methodology III Lab Manual. Required.

Required Texts. Required.

Core Abilities

A. Exhibit professional behaviour

B. Communicate clearly and effectively

C. Manage the use of time and other resources to complete tasks and attain goals

D. Solve problems using a variety of strategies

E. Take responsibility for his/her own actions

F. Work effectively in teams

Competencies

1. Determine the appropriate examination and the corresponding positions/projections used to demonstrate each of the systems being studied.

Learning Objectives

a. Define and utilize the correct medical terminology associated with radiographic positioning.

b. Review different types of request for consultation forms (a.k.a. requisitions).

c. Develop a plan for performing imaging studies prior to bringing the patient into imaging room.

d. Communicate necessary and relevant information/instructions to patients while performing simulated imaging studies.

e. Position the anatomical area(s) of interest using anatomical landmarks, central ray, collimation and image receptor.

f. Utilize accessory imaging equipment found in general radiography rooms (when necessary).




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g. Establish a safe environment for patients undergoing imaging studies.

2. Provide correct preparatory steps and post-procedural instructions/management techniques required for each radiologic procedure.

Learning Objectives


b. Develop a plan for performing imaging studies prior to bringing the patient into imaging room.

c. Communicate necessary and relevant information/instructions to patients while performing simulated imaging studies.

d. Adapt routine positioning protocols.

e. Establish a safe environment for patients undergoing imaging studies.

3. Perform/participate in the correct method of inserting a rectal tube for the administration of contrast media using an anatomic patient model.

Learning Objectives




d. Utilize accessory imaging equipment found in general radiography rooms (when necessary).


4. Perform/participate in the correct method of catherization of the bladder using an anatomic patient model.

Learning Objectives




d. Utilize accessory imaging equipment found in general radiography rooms (when necessary).


5. Demonstrate safe radiation protection practices.

Learning Objectives




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a. Employ appropriate radiation protection devices/apparel during imaging studies.

b. Utilize protective practices specific to general radiography.

c. Discuss protective practices specific to mobile radiography.

d. Ascertain the pregnancy status of female patients and how to proceed if patient is/might be pregnant.

e. Examine radiation safety guidelines as per the Healing Arts and Radiation Protection Act (HARP) and Safety Code 35.

Grading Information

Grading Rationale

Week 4 Rectal Tube Insertion P/F Week 6 Midterm Exam 20% Week 7 Bladder Catheterization P/F Week 10/11 Presentation: "My Case" 10% Week 12/13 Group Project & Presentation 30% Week 14/15 Final Exam (exam period) 40% For group submissions, all students of the group will receive the same mark. However, if it is found that a group member has not contributed reasonably that student might be asked to resubmit part or all of the assignment individually. A pass mark for this course is 60% or higher.

Guidelines for Success

Policies Please refer to the Michener Institute for Applied Health Sciences and University of Toronto, Faculty of Medicine Medical Radiation Sciences Program Student Handbook and my.michener.ca for Academic and Health and Safety policies.

Attendance This is a 13 week course and every session is important. The Medical Radiation Sciences Program Student Handbook, Academic Policies states that "Attendance in laboratory sessions, examinations and clinical courses is mandatory". Contact your instructor in person, via email, or via voicemail message, to notify of any absence If you miss a class session, or if you know you will miss a class session notify your instructor. Plan ahead and review the schedule to request attending an alternate lab group session. (Refer to the learning plans and the syllabus schedule.)

Safety, Housekeeping, and Property Guidelines Tools belong to The Michener and are not to be taken. All tools are to be used safely and with




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respect. Tools are to be returned to their proper storage space at the end of each class. Supplies are provided and are to be used with discretion. Wasting supplies will not be tolerated. Students must wear closed toed shoes any time they are working in the lab. Good housekeeping is important to safety in any operation. Students are expected to keep their work areas neat and orderly, minimizing potential safety hazards.

Anatomic patient models/Task trainers This course requires skills demonstration using anatomic patient models. You will have the opportunity to practice and perform a rectal tube insertion and bladder catherterization in a simulated learning experience performance environment. Professional behaviour should be demonstrated when working with the anatomic patient models.




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Schedule

Session Topics

Week 1 Introduction to course Upper Gastric System (Lecture) UGI/film critique (Lab)

Week 2 Lower Gastric System (Lecture) LGI/film critique, rectal tub insertion demo (Lab)

Week 3 Biliary Systems (Lecture) LGI/film critique, rectal tub insertion practice (Lab)

Week 4 Gastric Systems Pathology (Lecture) LGI/film critique, rectal tube insertion assessment, lab manual assignment (Lab)

Week 5 BMD and “My Case” Intro (Lecture) GI film review/critique (Lab)

Week 6 MIDTERM EXAM (Lecture) Open Lab- Research for “My case”

Week 7 Urinary/Reproductive Systems and Mammography (Lecture) Urinary system imaging, lab manual assignment, bladder catheterization demo (Lab)

READING WEEK

Week 8 Intro to Interventional Procedures Urinary/Reproductive, mammography films review/critique, lab manual assignment during lab session, perform bladder catheterization (Lab)

Week 9 Angiography: Thoracic and Visceral (Lecture) Power injectors, catheters and guidewires, lab manual assignment (Lab)

Week 10 Angiography: Cerebral and Cardiac (Lecture) Film review/critique, lab manual assignment (Lab)

Week 11 No Lecture- Open time for Group assignment My Case Presentation (Lab)

Week 12 GROUP PRESENTATION (Lecture) My Case Presentation (Lab) / Review (Lab)

Week 13 GROUP PRESENTATION (Lecture)

No Lab

Week 14/15 FINAL EXAM




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Radiographic Methodology III Performance Assessment Task 1

Rectal Tube Insertion (Week 4) P/F

Target Competency

Perform/participate in the correct method of inserting a rectal tube for the administration of contrast media using an anatomic patient model.

Directions

For this performance assessment you will demonstrate the correct method for inserting a rectal tube for the purpose of performing a contrast enema procedure. This competency will be assessed in the laboratory environment. Equipment, instruments, tools, supplies, and materials will be provided, you will be required to select the appropriate items needed to complete the task. Practice the skill and self-assess according to the scoring guide. Schedule your skill assessment with your instructor. At the time of the assessment be sure to: 1. Gather the required tools, equipment, instruments, materials and/or supplies. 2. Don the appropriate personal safety clothing and equipment. 3. Provide for the comfort and safety of your client or patient. 4. Perform each step of the task. 5. Follow all safety procedures. 6. Explain the steps of the tasks as you perform them. (what, why, how, precautions) 7. Answer any questions posed by the evaluator or your client/patient.

Scoring Standard

You must earn a rating of 'Satisfactory' on each criterion in order to pass this assessment. You must pass this evaluation in order to complete the course.

Rating Scale




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Unsatisfactory Fails to perform skill adequately or does not attempt to perform skill

Satisfactory Performs adequately with no more than one minor prompt and without critical mistakes.

Scoring Guide

Criteria Ratings

1. Selected the correct tools, equipment, instruments, materials or supplies

satisfactory unsatisfactory

2. Employed the principles of medical asepsis satisfactory unsatisfactory

3. Positioned the patient correctly satisfactory unsatisfactory

4. Lubricated the rectal tube prior to insertion satisfactory unsatisfactory

5. Inserted the tube at the correct angle and direction satisfactory unsatisfactory

6. Performed the procedure in a safe manner satisfactory unsatisfactory

7. Verbalized an explanation of the process to the patient as you performed it


8. Decision-making demonstrated sound reasoning satisfactory unsatisfactory




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Performance Assessment Task 2

Midterm Exam (Week 6) 20%

Target Competency

Determine the appropriate examination and the corresponding positions/projections used to demonstrate each of the systems being studied.

Provide correct preparatory steps and post-procedural instructions/management techniques required for each radiologic procedure.

Directions

The Midterm Exam will be written as MC, True/False, short answer questions. The Midterm exam will be held during the lecture. All evaluations are closed book. To pass this midterm exam, you must achieve at least 60%.




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Bladder Catheterization (Week 7) P/F

Target Competency

Perform/participate in the correct method of catherization of the bladder using an anatomic patient model.

Directions

For this performance assessment you will demonstrate the correct method for bladder catheterization. This competency will be assessed in the laboratory environment. Equipment, instruments, tools, supplies, and materials will be provided; you will be required to select the appropriate items needed to complete the task. Practice the skill and self-assess according to the scoring guide. Schedule your skill assessment with your instructor.

At the time of the assessment be sure to: 1. Gather the required tools, equipment, instruments, materials and/or supplies. 2. Don the appropriate personal safety clothing and equipment. 3. Provide for the comfort and safety of your client or patient. 4. Perform each step of the task. 5. Follow all safety procedures. 6. Explain the steps of the tasks as you perform them. (what, why, how, precautions) 7. Answer any questions posed by the evaluator or your client/patient.

Scoring Standard

You must earn a rating of 'Satisfactory' on each criterion in order to earn credit for this assessment. You must pass this evaluation in order to complete the course.

Rating Scale

Unsatisfactory Fails to perform skill adequately or does not attempt to perform skill

Satisfactory Performs adequately with no more than one minor prompt and without critical mistakes.




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Scoring Guide

Criteria Ratings

1. Selected the correct tools, equipment, instruments, materials or supplies


2. Employed the principles of medical asepsis satisfactory unsatisfactory

3. Positioned the patient correctly satisfactory unsatisfactory

4. Lubricated the bladder catheter prior to insertion satisfactory unsatisfactory

5. Inserted the tube at the correct angle and direction satisfactory unsatisfactory

6. Performed the procedure in a safe manner satisfactory unsatisfactory

7. Verbalized an explanation of the process to the patient as you performed it


8. Decision-making demonstrated sound reasoning satisfactory unsatisfactory




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"My Case" Presentation (Week 10 or 11) 10%

Target Competency



Demonstrate safe radiation protection practices.

Directions

The purpose of this Presentation "My Case" is to provide students with the opportunity to demonstrate the required knowledge in the imaging of a body system (e.g. digestive, cardiac). For this performance assessment the learner will present a system methodology examination. Each learner will be responsible for researching and presenting a topic to their lab group. The Learner is responsible for creating a student handout using the categories outlined in the grading rubric. The presenter should use 10 minutes maximum to present their imaged system methodology case. Students will be evaluated on the content of the Student Handout, which summarizes the systems methodology imaging procedure, and their oral presentation. This assessment will occur during Radiographic Methodology III in week 10 or 11 during the learner's scheduled lab time.

Scoring Guide 1

Rating Scale

0 Information is missing, incorrect, or incomplete, unacceptable

1 Does not meet expectations

2 Needs improvement

3 Meets expectations, satisfactory

4 Exceeds expectations through creativity, complexity, or attention to detail, accomplished




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Scoring Guide

Criteria Ratings

1. Presentation: Presentation was creative Presenter was professional Presenter maintained adequate volume Presenter encouraged audience participation Conforms to time limits

0 1 2 3 4

2. Student Handout: 1. Definition and purpose of procedure 2. Contraindications

0 1 2 3 4

3. Pathological indications for procedure 0 1 2 3 4

4. Clear overview of the procedure and equipment required 5. Patient preparation 6. Contrast media (type, preparation, assessment for hypersensitivity/ contraindications)

0 1 2 3 4

7. Sequence of procedure is outlined: Overview of required images (protocols) for procedure, projections, central ray, centre point. image receptor, collimation, required anatomy

0 1 2 3 4

8. Post-procedure patient management 0 1 2 3 4

9. Alternate imaging modalities/procedures 0 1 2 3 4

3. References are cited 0 1 2 3 4




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Group Project Assignment (Week 12/13) 30%

Target Competency



Demonstrate safe radiation protection practices.

Directions

Each group will be responsible for researching an assigned imaging procedure and presenting it to the class. The group should use 10 minutes (up to a maximum of 15 minutes) to discuss and illustrate the assigned radiological procedure. There will be at least 5 minutes for questions at the end of the 15 minute time allotment. As a group, plan your presentation and prepare a written student handout listing: 1. Overview of the procedure, 2. Indications/contraindications, 3. Equipment and supplies, 4. Contrast media 5. Sequence of procedure, 6. Patient management- pre and post procedural instructions and care (this will be handed in week 11). Your presentation should follow a clear outline as indicated in the grading rubric. The presentation format is up to each group to decide, so be creative. You could use role play, a talk-show format, a traditional group format, or something altogether different. Presentations are meant to evoke discussion and stimulate new ideas from the listeners. If possible, get the audience involved: ask questions, incorporate a video clip, conduct a mini quiz, etc. All group members should contribute in some way (if not speaking, then by preparing the PowerPoint slides, handouts, etc.). Submission on week 11 to the course supervisor in electronic copy (either via email or CD format),must include: 1. final copy of PowerPoint slides 2. A list of items required for your presentation (i.e. LCD unit, VCR or DVD player, overhead projector, laser pointer, flip-chart, etc.) should be submitted to the course instructor one week in advance of your presentation. 3. Student Handout The purpose of this Group Project Presentation is to provide students with the opportunity to gain experience working in small groups, encourage self-directed learning, and learn more about their future profession. The Formative Group Peer Evaluation is to be completed for each of your group members to provide feedback on their teamwork skills. The group as a whole will be evaluated on the presentation by the course instructors using the Group project evaluation form and be assigned a grade. All students in the group will receive the same mark. However, if it is found that a group member has not contributed reasonably that student might be asked to resubmit part or all of the assignment individually. This group project presentation will occur during Radiographic Methodology III in week 12 or during lecture time.




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Formative Peer Evaluation Scoring Standard

Each peer evaluation assesses each of the group members individually. The Formative Group Peer Evaluation is to be completed for each of your group members to provide feedback on their teamwork skills

Rating Scale

0 Minimal performance/contribution to project

1 Below average, did the basics

2 Performed at expected standard with equal contribution to team

Scoring Guide

Criteria Ratings

1. Responsibility Participated in planning and performed all duties assigned for individual role in team presentation

2 1 0

2. Responsibility Always did the assigned work without having to be reminded

2 1 0

3. Contribution Completed his/her portion of work in reasonable time; Demonstrated good time management

2 1 0

4. Values Others Viewpoints Allows others to have input, listens to others and considers all views, is not argumentative, always helps team to reach a fair decision

2 1 0

5. Interpersonal Skills Worked collaboratively with the group; Able to work independently when required; demonstrated ability to give/accept feedback

2 1 0

Group Assignment Evaluation

Scoring Standard

This evaluation contributes 30% of the final grade.

Rating Scale

0 Information is missing, incorrect, or incomplete

1 Does not meet expectations

2 Needs improvement

3 Meets expectations, satisfactory

4 Exceeds expectations and demonstrated creativity, complexity, and/or attention to detail




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Scoring Guide

Criteria Ratings

1. Presentation slides/ student handouts submitted by due date

4 0

2. Written Presentation: The material is adequately prepared Language used is clear and concise Information is logically organized

4 3 2 1 0

3. Student Handouts contain all required information 1. Overview of the procedure, 2. Indications/contraindications, 3. Equipment and supplies, 4. Contrast media , 5. Sequence of procedure, 6. Patient management- pre and post procedural instructions and care

4 3 2 1 0

4. Content of presentation: Overview of anatomy (gross, relational) and physiology of body system being imaged Discussion of related disciplines in order to review data, reports, images of previous studies (radiographic modalities, ultrasound, MRI, Nuclear medicine, Health Records, Lab reports)

4 3 2 1 0

5. Clear overview of the imaging procedure is presented: -Indications/contraindication for the procedure -Provides examples of clinical information required for the examination (patient history, pathology, level of patient cooperation required for exam)

4 3 2 1 0

6. Contrast media is discussed: Type, preparation, assessment for hypersensitivity/ contraindications

4 3 2 1 0

7. Equipment is discussed: -Environment (imaging fluoro room, OR, mobile, interventional suite, CT etc) -Procedural supplies; sterile tray, catheters, needles, wires etc

4 3 2 1 0

8. Pre- procedure patient management: -Patient preparation (dietary, bloodwork, medications, consent)

4 3 2 1 0

9. Post-procedure patient management: -Counsel patient with respect to; dietary, bloodwork,

4 3 2 1 0




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medications, bowel habits, hemorrhage

10. Sequence of procedure is outlined: Overview of required images (protocols) for procedure, projections, central ray, centre point, image receptor, collimation, required anatomy

4 3 2 1 0

11. Health care collaborations are identified and discussed: - Team members roles and responsibilities

4 3 2 1 0

12. Presentation style: Presentation was creative Presenters were professional Presenters maintained adequate volume Presenters encouraged audience participation

4 3 2 1 0

13. Presentation conforms to time limits References: All sources are referenced

4 3 2 1 0




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Final Exam (Weeks 14 or 15) 40%

Target Competency



Directions

For this performance assessment you will complete a written final examination that encompasses all of the materials covered in the course; lectures, laboratories, required readings and peer presentations. The Final Exam will be written as MC, True/False, and short answer questions. The Midterm exam will be held during the exam period. At the time of the performance you should be able to: 1. Determine the appropriate examination to be performed based upon a patient history. 2. Determine the appropriate contrast media to be utilized based upon the procedure and the patient history. 3. Provide the correct pre-procedural instructions for a patient based upon the radiologic procedure being performed. 4. List the items required to perform a given radiological procedure. 5. Describe the appropriate imaging to be performed for a given radiological procedure (modality, projection, timing, etc.). 6. Describe the appearance of the pathological processes covered in the course. 7. List the clinical signs and/or symptoms associated with the pathological processes covered in this course. This exam contributes to 40% of the final grade

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