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12/02

Revised: 1/17; 11/17; 7/18

Clinical Handbook Page 1 of 89

Clinical Handbook

12/02

Revised: 1/17; 11/17; 7/18

Clinical Handbook Page 2 of 89

12/02

Revised: 1/17; 11/17; 7/18

Clinical Handbook Page 3 of 89

Clinical Contact #’s

Sovah Health - Danville Holly D. Reese, BAS, RT(R) Charlotte Adkins, AAS, RT(R)

Surgery/ED 434-799-2160 Cardiac Cath 434-799-2163 CT 434-799-4437 Lab Care 434-792-4149 Nuclear Medicine 434-799-4596 Radiation Therapy 434-799-4592 Specials/Fluoro 434-799-4439 Transport 434-773-7832

(*Leave message with Front Desk Reception to contact transport) Ultrasound: 434-799-4438

Sovah Danville Imaging Center

Sarah Brandes, RT(R)(CT) 434-799-0934 ext. 7222

Sovah Health - Martinsville

Kristin G. Doss, BBA RT(R) Tammy Bennett, RT(R) 276-666-7224

UNC Rockingham Health Care Meghan S. Price, AAS, RT(R) Tim Hill, RT(R) 336-623-9711 ext. 2310

Spectrum Medical Carla Soyars, AAS, RT(R) 434-793-4711 ext. 1128

12/02

Revised: 1/17; 11/17; 7/18

Clinical Handbook Page 4 of 89

Clinical Log Sheets

Clinical Handbook Page 5 of 89

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Revised: 10/15; 8/16; 12/16; 11/17

PATIENT EXAM LOGSHEET

A – Assisted

M - Minimally Assisted

U - Unassisted

DATE EXAM A M U

Clinical Handbook Page 6 of 89

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PATIENT EXAM LOGSHEET

DATE EXAM A M U

Clinical Handbook Page 7 of 89

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PATIENT EXAM LOGSHEET

DATE EXAM A M U

Clinical Handbook Page 8 of 89

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Clinical Handbook Page 9 of 89

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STUDENT CLASS OF Students will be graded on professionalism, technical performance and quality of films. This form must be completed to meet graduation

requirements. The Registered Technologist completing the check-off must initial these pages in the appropriate spot(s). The following

exams are a part of the graduation requirements shown in the Semester Competency Goals on page 13 of this section. They are required

to be performed on actual patients and may NOT be simulated.

*Category Competencies to be completed by Clinical Coordinator/Instructor/or Designee Only!

EXAMINATION DATE INITIALS EXAMINATION DATE INITIALS

*UPPER EXTREMITY *CHEST & THORAX

Finger/Thumb (3) Chest, Routine (10)

Hand (3) Chest, W-chair or Stretcher (3)

Wrist (3) Chest, Pediatric (≤ 6 years of age) (3)

Forearm (3) Ribs (3)

Elbow (3) Geriatric Chest (≥65) x (3)

Humerus (3) *SPINE & PELVIS

Shoulder (3) Cervical Spine (3)

Trauma Shoulder: (Scapular Y or

Trans-thoracic)1 (3)

Thoracic Spine (3)

Trauma Upper Ext.(non-shoulder)1 (3) Lumbosacral Spine (3)

Clavicle (2) Cross Table (Horizontal Beam) Lateral

Spine (2)

Geriatric Upper Extremity (≥65) x (3) Pelvis (3)

*LOWER EXTREMITY

Hip (3)

Foot (3) Trauma Hip (X-table)1 (3)

Ankle (3)

Tibia & Fibula (3)

MOBILE & SURGICAL

Knee (3) C-Arm Procedure with sterile field

(surgical) (2)

Femur (3) C-Arm Procedure with multiple (2

or more) projections - (2)

Trauma Lower Ext. (non-hip)1 (3) Portable Chest (3)

Geriatric Lower Extremity (≥65) x (3) Portable Abdomen (3)

*ABDOMEN

Portable Orthopedics (3)

Abdomen, Supine (KUB) (3)

FLUOROSCOPY

Abdomen, Upright (3)

BE or UGI*(circle exam performed) (3)

HEAD (Minimum 2 Views) Elective Fluoroscopic Procedure (1)

(Candidates must perform one additional contrast study)

Exam__________________________

Skull, Facial Bones, or Sinuses (circle

exam performed) (1)

1Trauma is considered a serious injury or shock to the body that has occurred within the past 48 hours. Modifications may include variations in positioning, minimal movement of the body part, etc.

xGeriatric: Physically or Cognitively impaired as a result of aging (ARRT). We will identify it as those ≥65 years of age.

CLINICAL COMPETENCY RECORD

Clinical Handbook Page 10 of 89

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Revised: 10/15; 8/16; 12/16; 1/17

COMPETENCY RECORD (continued). Students MUST demonstrate competence in 15 of the following elective procedures. Elective procedures should be performed on actual patients. If demonstration on patients is not feasible, simulations MAY be performed. In order to ensure competency in these areas, each student will be required to perform each of the exams under direct supervision or under simulation conditions with the clinical instructor. These exams are to be recorded on the patient log sheets provided. The ARRT requirements specify that certain clinical procedures may be simulated. Simulations must meet the following criteria:

a. The student is required to competently demonstrate skills as similar as circumstances permit to the cognitive, psychomotor, and affective

skills required in the clinical setting.

b. The program director is confident that the skills required to competently perform the simulated task will generalize or transfer to

the clinical setting, and if applicable, the student will evaluate related images.

EXAMINATION DATE INITIALS EXAMINATION DATE INITIALS

UPPER EXTREMITY CRANIUM

Scapula (3) Mandible (1)

AC Joints (1) Nasal Bones (1)

Orbits (1)

LOWER EXTREMITY Zygomatic Arches (1)

Patella (2) Facial Bones** (1)

Os Calcis (2) Sinuses** (1)

Toes (2) Skull** (1)

SPINES SURGICAL EXAMS

Sacrum and/or Coccyx (2) Surgical Cholangiogram (2)

Scoliosis Series (2) Retrograde Pyelogram (2)

SI Joints (1)

FLUOROSCOPIC EXAMS THORAX/ABDOMEN

UGI** (3)

Abdomen Decubitus (1)

Barium Enema** (3)

Chest Lateral Decubitus (1)

Small Bowel Series (1)

Sternum (1)

Esophagus (1) Airway (Soft Tissue Neck) (3)

Cystogram (1) IVU/IVP (1)

ERCP (1) PEDIATRICS

(≤ 6 years of age)

Myelogram (1) Upper Extremity (3)

Arthrogram (1) Lower Extremity (3)

Abdomen (3)

Mobile Study (3)

** One Mandatory MUST be either an UGI or BE. The other mandatory may be any from this list. No exam may be used for both! (No duplicates)

Competencies / checkoffs for UGI and Esophagrams cannot be performed at Sovah Health - Martinsville due

to variances in protocols

Clinical Handbook Page 11 of 89

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Revised: 10/15; 8/16; 12/16; 1/17

Competency Schedule Check List:

This schedule provides a timetable, by course, for the required completion and documentation of required competencies. This document must be completed by faculty only.

RAD 131 RAD 232

Exams (3) Exams (10) (Min: to date 27)

Equip. Manipulation Final Comps. (2)

RAD 132 Fluoro List

Exams (6) (Min: to date 9) Spectrum Lists (2)

General Radiology List RAD 290

Portables List Exams (13) (Min: to date 40)

RAD 231 Final Comps. (3)

Exams (8) (Min: to date 17) Surgery List

Patient Care List C-Arm Competency

Special Procedures List

CT List

Venipuncture List

This form documents the individual work of the student whose signature appears below.

STUDENT DATE

DIRECTOR DATE

Clinical Handbook Page 12 of 89

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Clinical Handbook Page 13 of 89

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SEMESTER COMPETENCY GOALS (*40 total MANDATORY check-offs required)

Checklists must be completed prior to graduation; however they may be completed at any time during the year assigned.

First Year

Second Year

RAD 131 FIRST SEMESTER

*Three (3) Exam Check-offs

Equipment Manipulation

RAD 132 SECOND SEMESTER

*Six (6) Exam Check-offs (Minimum to date 9)

General Radiology Check List

Portable Check List

RAD 231 THIRD SEMESTER

*Eight (8) Exam Check-offs (Minimum to date 17)

Patient Care Checklist

RAD 232 FOURTH SEMESTER

*Ten (10) Exam Check-offs (Minimum to date 27)

Two (2) Final Comps from page 3 (Clinical Competency Record)

Fluoroscopy Check List

Spectrum Pain Management

Spectrum Radiology-4th Floor

RAD 290 FIFTH SEMESTER

*Twelve (13) Check-offs (Minimum to date 40)

Three (3) Final Comps from page 3 (Clinical Competency Record)

Surgery Checklist

C-Arm Competency Form

Special Procedures Checklist

CT Checklist

Venipuncture

*IMPORTANT NOTE: The exams required for this total are the exams listed on the first page of the clinical competency record.

Fifteen (15) additional Elective exam categories are required for graduation. These exams are listed on the second page of the competency record. These exams may be performed on patients, phantoms or through simulations. They will not count toward the mandatory 40 exam total for check-off requirements!

Clinical Handbook Page 14 of 89

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STUDENT COMPETENCY DATA FORM Student Name:

Date:

Exam:

Technologist:

Exposure Factors: Standard Final Elective Spot Check

Projection

Projection

Projection

Projection

mAs kVp LGM/S/EI ______

mAs kVp LGM/S/EI ______

mAs kVp LGM/S/EI

mAs kVp LGM/S/EI ______

Patient Identification Code:

M F Age

Pregnancy/LMP

Shielded

Markers

# of Images Taken

# of Repeats

Reason for repeat (s)

Comments/Patient Hx.

STUDENT COMPETENCY DATA FORM Student Name:

Date:

Exam:

Technologist:

Exposure Factors: Standard Final Elective Spot Check

Projection

Projection

Projection

Projection

mAs kVp LGM/S/EI ______

mAs kVp LGM/S/EI

mAs kVp LGM/S/EI

mAs kVp LGM/S/EI

Patient Identification Code:

M F Age

Pregnancy/LMP

Shielded

Markers

# of Images Taken

# of Repeats

Reason for repeat (s)

Comments/Patient Hx.

Clinical Handbook Page 15 of 89

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Clinical Objectives

Section 2

Clinical Handbook Page 16 of 89

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STUDENT OBJECTIVES

ORIENTATION TO CLINICAL EDUCATION

Under direct/indirect supervision, the Student will: 1. Begin to comprehend the interrelationship among the major areas of the clinical facility, which

includes but is not limited to:

a. Fluoroscopy b. General Radiography c. Front Desk and File Room d. Portables e. Out-patient facilities

2. Identify the major areas of the clinical facility and the procedures performed in each.

3. Observe the work performed by the technologists and fellow students.

4. Attain skill in equipment manipulation for each room.

5. Begin to administer basic patient care to include:

a. Communication b. Assistance to and from room and/or table c. Assistance in movement through clinical facility d. Assistance in gowning for examination e. Providing articles for comfort

6. Begin to comprehend and master clinical objectives of the program.

Clinical Handbook Page 17 of 89

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Checklists

Clinical Handbook Page 18 of 89

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Clinical Handbook Page 19 of 89

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EQUIPMENT MANIPULATION CLINICAL COMPETENCY FORM

The student must successfully perform each of the following to "check off".

PASS FAIL

Turn machine "ON" and perform warm-up

Move tube from horizontal to vertical and vice versa utilizing correct locks

Move Bucky tray utilizing locks

Move table from horizontal to vertical and Vice versa utilizing correct controls

Move chest board utilizing correct lock

Correctly insert and remove image receptor

Demonstrate proper use of calipers

Demonstrate proper use of technique chart

Correctly demonstrate selection of given set of technical factors at control panel

Identify correct marker placement on images

Manipulate portable unit using proper precautions and locks

Correctly demonstrate selection of given set of technical factors on portable control panel

Locate and explain use of emergency circuit breaker for room

Student Signature Date

Instructor Signature Date

Clinical Handbook Page 20 of 89

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Clinical Handbook Page 21 of 89

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STUDENT OBJECTIVES

GENERAL RADIOLOGY

Under direct/indirect supervision the Student will: 1. Demonstrate proper care and use of equipment focusing on; tube warm-up procedure,

ability to select given exposure factors, Proper use of table locks and controls, x-ray tube locks and controls.

2. Demonstrate appropriate patient care and communication by performing the following

tasks;

a. Prepare room as necessary before beginning examination. b. Greet patient in a proper manner.

1. Address patient as Mr., Mrs., or Ms. Jones etc. 2. Introduce yourself (ie. my name is _.) 3. Communicate information pertinent to the procedure to be performed and

allow for questions or concerns. 4. Instruct patient in using gowns, robes etc.

c. Use care when positioning and radiographing patient. d. Observe NCRP standards for radiation protection. e. Utilize calipers and technique charts when selecting exposure factors. f. Assist with and/or perform routine examinations.

3. Keep rooms and adjoining areas clean and stocked at all times. (gowns, towels, sheets,

urinals, bedpans etc.)

Other Responsibilities:

Assist staff and Fellow Students with all procedures.

Locate and identify emergency drug box, suction and emergency respiratory equipment.

Clinical Handbook Page 22 of 89

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Revised: 10/15; 8/16; 12/16; 1/17

GENERAL RADIOLOGY CHECKLIST

Under direct/indirect supervision the Student will perform the following tasks:

Explain and/or perform tube warm-up.

Identify emergency power shut off.

Demonstrate ability to properly select appropriate exposure factors.

Demonstrate proper use of table locks and controls.

Manipulate tube using proper controls/locks and center to;

table bucky chest bucky

Demonstrate proper use of collimators and explain importance.

Locate and Identify Emergency Drug Box.

Identify location of the following patient care supplies.

bed pans urinals emesis basins oxygen, airways, etc.

sheets gowns and robes suction equipment

Staff Technologist Signature Date

Student Signature

Clinical Handbook Page 23 of 89

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STUDENT OBJECTIVES

PORTABLES

Under direct/indirect supervision, the Student will: 1. Demonstrate proper care and use of equipment focusing on;

a. Tube warm-up procedure. b. Ability to select given exposure factors. c. Proper use of x-ray tube locks and controls. d. Properly prepare equipment for patient examination.

2. Demonstrate appropriate patient care and communication by performing the following

tasks; a. Knock and/or ask permission to enter patient’s room.

1. Greet patient in a proper manner. 2. Address patient as Mr., Mrs., or Ms. Jones etc. 3. Introduce yourself (i.e. my name is _.) 3. Communicate information pertinent to the procedure to be performed and

allow for questions or concerns. b. Make positive identification of patient. c. Prepare patient’s room as necessary before beginning examination. d. Use care when positioning and radiographing patient. e. Observe NCRP standards for radiation protection. f. Utilize calipers and technique charts when selecting exposure factors as

appropriate. g. Assist with and/or perform routine examinations.

3. Correctly manipulate the mobile units with regard to:

a. Manipulation of unit and tube head b. Locks c. Charging unit:

1. Switch main power switch (circuit breaker) to "On" position when charging. 2. Switch main power to "off" position when not charging

d. Accessories (shield, grids, etc.) 4. Utilize rules of body mechanics for the safety of both patients and technologists.

5. Make necessary adjustments in exposure factors and positioning specific to bedside

procedures with regard to:

a. Proper use of grids d. Life support systems b. Positioning limitations e. Physical limitations of patients c. Casts and/or traction f. Pathology

6. Describe procedure for the reading of "stat" images.

7. Use proper precautions against electrical and safety hazards:

a. Never force locks b. Never use cables to move the tube head c. Use the main circuit breaker whenever a major problem arises

Clinical Handbook Page 24 of 89

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Revised: 10/15; 8/16; 12/16; 1/17

PORTABLES CHECKLIST

Equipment Operation (Portable):

Charge unit

Set exposure factors

Properly utilize locks

Drive forward and backward

Locate on/off switch

Use collimator

Demonstrate proper radiation safety

Uses care in operation of equipment

Properly cleans equipment

Utilizes aprons and shields when appropriate

Setting Exposure Factors:

Identifies exposure factors according to size/age of patient

Identifies pathological conditions which need technique manipulation

"Stat" Reports:

Describe procedure for the reading of stat images Staff Technologist Signature Date

Student Signature

Clinical Handbook Page 25 of 89

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STUDENT OBJECTIVES

PATIENT CARE

Under direct/indirect supervision, the Student will:

1. Assist with the reception of incoming patients.

2. Practice communication skills.

3. Assist with needs of patients waiting in the clinical facility:

a. Serve as communication link between patients and areas of the clinical facility. b. Provide reading materials. c. Provide necessary articles, i.e. emesis basin, urinal, bedpan, pillow, blanket. d. Provide proper covering.

4. Assist transporters with moving stretchers, oxygen, I.V.'s, etc.

5. Check dressing booths and bathrooms periodically.

6. Maintain neat waiting areas.

Clinical Handbook Page 26 of 89

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Clinical Handbook Page 27 of 89

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PATIENT CARE CHECKLIST

This checklist may be completed by a faculty member ONLY!

The following must be completed by the end of RAD 231-C.

Identify procedure for Codes (Cardiac Arrest, etc.) Locate crash cart

Locate oxygen tank and demonstrate usage Locate patient care supplies

Locate airways/Ambu Bag Locate emergency drug box

Correctly obtain vital signs & give normal values

Demonstrate proper body mechanics when assisting patient

_moving from stretcher to table _walking to table

_moving from wheelchair to table

Demonstrate proper transportation of

_stretcher patient

_wheelchair patient

_Give proper instructions to patient about gowning and artifacts for specific exam

_Correctly correlate identification of patient & request

_Correctly verbalize pregnancy policy

_Correctly record patient information on request

_Demonstrate/verbalize the proper STAT reading/call report procedures

_Properly demonstrate assisting a patient with bedpan/urinal

_Identify types of allergic reactions

_Identify proper treatment for allergic reactions

Demonstrate methods of patient restraint:

_adult/wrist restraints _pediatric/Pigg-O-Stat

Identify the following infection control procedures:

_Airborne Precautions _Contact Precautions _Droplet Precautions

Identify common medical emergencies and treatment of:

_fainting _shock _seizure, convulsions

_vomiting _bleeding _loss of consciousness

_respiratory arrest _cardiac arrest

Clinical Handbook Page 28 of 89

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Revised: 10/15; 8/16; 12/16; 1/17

The following items cannot be performed by a student unassisted until such time that competency has been demonstrated!

Advanced Patient Care Competencies Date Completed Competence Verified By

CPR

Vital Signs (BP, pulse, respiration, temperature)

Sterile and Aseptic Technique

Venipuncture

Transfer of Patient

Proper disconnect and reconnect of in-wall oxygen source to an oxygen tank

Care and movement of IV equipment (tubing, poles, etc)

Proper transport and care of drainage tubes. (Urinary, Chest Tubes, etc.)

Blood Pressure Cuff (disconnect and reconnect)

EKG Monitor (disconnect and reconnect) Leads themselves should NEVER be removed by a student

Pulse Oximeter (disconnect and reconnect)

Reference: Current patient care textbook, department protocols and related articles.

Student Signature Date

Faculty Member Signature

Clinical Handbook Page 29 of 89

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SPECTRUM RADIOLOGY CHECKLIST (4th Floor)

Under direct/indirect supervision the Student will perform the following tasks: _____ Explain and/or perform turning equipment on/off. _____ Identify emergency power shut off. _____ Demonstrate ability to properly select appropriate exposure factors. _____ Demonstrate proper use of table locks and controls. _____ Manipulate tube using proper controls/locks and center to; table bucky _____chest bucky _____ Demonstrate proper use of collimators and explain importance.

____ Demonstrate use of the U-Arm and the ability to move in all directions.

_____ Locate and Identify Emergency Drug Box.

____ Demonstrate proper use of Lead aprons

____ Navigate around the computer system as needed to perform images

____ Demonstrate correct use of the Pager System

____ Label/mark x-rays correctly

Identify location of the following patient care supplies.

bed pans urinals

emesis basins table paper

gowns oxygen, airways, etc

Staff Technologist Signature Date

Student Signature

Clinical Handbook Page 30 of 89

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Clinical Handbook Page 31 of 89

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SPECTRUM PAIN MANAGEMENT CHECKLIST (3rd Floor)

Under direct/indirect supervision the Student will perform the following tasks:

Explain and/or perform turning equipment on/off

Identify emergency power shut off

Demonstrate ability to properly select appropriate exposure factors.

Demonstrate proper use of table locks and controls.

Manipulate tube using proper controls/locks and center to;

table bucky chest bucky

Demonstrate proper use of collimators and explain importance.

____ Label/mark x-rays correctly

____ Demonstrate proper use of Lead aprons

____ Demonstrate use of the C-Arm and the ability to move during procedures

____ Locate Epidural Trays and be able to set up the room for a procedure

____ Clean and prepare the procedure rooms

____ Locate and Identify Emergency carts (2)

____ Navigate around the computer system as needed to perform images

____ Room patients and take vital signs

Identify location of the following patient care supplies.

bed pans table paper

gowns oxygen, airways, etc

urinals emesis basins

Staff Technologist Signature Date

Student Signature

Clinical Handbook Page 32 of 89

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Clinical Handbook Page 33 of 89

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STUDENT OBJECTIVES

FLUOROSCOPY

Under direct/indirect supervision, the Student will:

1. Demonstrate proper care and use of equipment focusing on; tube warm-up procedure, ability to select given exposure factors, Proper use of table locks and controls, x-ray tube locks and controls. Properly prepare room for patient examination, to include tube, table and control panel. Identify and locate suction equipment, oxygen and drug box.

2. Organize routine fluoroscopy examinations with regard to: a. Patient preparation b. Contrast media employed and quantity c. Special equipment utilized d. Routine procedure of radiologist e. Demonstration of anatomy f. Performing overheads as required g. Identify the contrast agents used for contrast studies.

1. Obtain pertinent medical history using the Radiology requisition and other appropriate recording mechanisms.

2. Record pertinent medical history using the Radiology requisition and other appropriate recording mechanisms.

3. Note contrast expiration date and lot number 4. Have consent form signed when applicable.

3. Demonstrate appropriate patient care and communication by performing the following tasks: a. Prepare room as necessary before beginning examination. b. Greet patient in a proper manner.

1. Address patient as Mr., Mrs., or Ms. Jones etc. 2. Introduce yourself (ie. my name is _.) 3. Communicate information pertinent to the procedure to be performed and allow

for questions or concerns. 4. Instruct patient in using gowns, robes etc.

c. Use care when positioning and radiographing patient. d. Observe NCRP standards for radiation protection. e. Utilize calipers and technique charts when selecting exposure factors. f. Assist with and/or perform routine examinations.

4. Correctly perform routine Fluoro examinations including: gastrointestinal series,

barium enema, barium swallow with regard to: a. General procedure b. Room preparation c. Contrast media and method of administration d. Care of patient e. Projections required

5. Become familiar with specialty examinations: ERCP, hysterosalpingography, arthrography and myelography.

6. Assist the radiologist during fluoroscopy.

7. Observe and practice overhead routines.

8. Begin to recognize anatomy demonstrated on each examination.

9. Assist with and/or perform routine radiographic examinations.

Clinical Handbook Page 34 of 89

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Other Responsibilities:

1. Prepare Barium Sulfate and/or other contrast agents as needed. 2. Assist Fellow Students and staff with examinations. 3. Keep rooms clean and stocked. 4. Check dressing booths periodically. 5. Share responsibilities with fellow students and perform other duties as designated by

supervisory personnel. 6. Identify the general procedures, room preparation, contrast media, special care of

patient, and routine projections associated with exams performed in these areas. 7. Prepare contrast media for examinations.

Clinical Handbook Page 35 of 89

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FLUOROSCOPY ROTATIONAL CHECKLIST

Equipment manipulation:

Move table from horizontal to vertical position.

Move table top in all directions.

Locate and utilize locks on intensifier.

Correctly move tube horizontally.

Detent tube to table.

Attach and remove foot board.

Correctly operate equipment from control panel and intensifier.

Correctly enter patient identification into the digital fluoroscopy computer.

Demonstrates proper technique of using sterile gloves.

Demonstrate proper preparation of a sterile field for invasive studies.

Properly fill/prepare syringes for contrast injections/mix barium sulfate solutions.

Supplies: Identify location of...

Emesis basins urinals

Bedpans sheets

Gowns barium

barium enema kits drug box

suction crash cart Identify routine positions for: Upper gastrointestinal series

Barium enema

Barium enema with air

Small bowel series

Staff Technologist Signature Date

Student Signature

Clinical Handbook Page 36 of 89

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Clinical Handbook Page 37 of 89

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STUDENT OBJECTIVES

SURGERY

Under direct/indirect supervision, the Student will:

1. Identify the physical plan of the surgery suite and the location of:

a. Dressing rooms b. Cysto room c. Portable units d. Image receptor, grids, markers, calipers, technique charts

2. Learn to manipulate and set up the mobile image intensifiers.

3. Identify proper dress attire for surgery suite.

4. Use proper sterile technique for surgery cases.

5. Participate in the following procedures when accessible:

a. Retrograde pyelography b. Cystography c. Operative cholangiography d. Orthopedic cases (hip pinning, open and closed reductions) e. Neurological cases f. Cardiac cases/other cases

6. Identify the procedure for specific examinations that require a radiologist's

interpretation during the procedure. 7. Take proper precautions against electrical and safety hazards:

a. Be aware of anesthesia equipment. b. Never force locks. c. Never use cables to move units.

8. Practice radiation safety at all times.

Clinical Handbook Page 38 of 89

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Revised: 10/15; 8/16; 12/16; 1/17

SURGERY CHECKLIST

The Student named below has been oriented to the following protocols and has demonstrated competency with regard to knowledge of each item:

Scrub clothes

"Booties" storage & hair covers

Dressing areas for both males and females

Different masks and correct way to wear them

Cleaning supplies for x-ray tubes and accessory equipment

Technique charts

Storage area for x-ray supplies and accessories

Entrances to recovery room

Image Intensifier-C-arm function, storage and set-up

Location of locker rooms, front desk, workroom

Location of portable units left in OR and recovery room

Scrub table and sterile field with regard to approaching the area, placement of x-ray equipment and working around "scrub" side of OR table

Operation of OR tables, proper image receptor placement Staff Technologist Signature Date

Student Signature

Clinical Handbook Page 39 of 89

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Scoring: 0 = Unacceptable

2 = Needs Minor Improvement

3 = Fulfills Basic Requirements

4 = Exceeds Basic Requirements

C-Arm Competency Verification Form This exam may NOT be simulated! It MUST be performed during an actual OR case,

with a sterile field. Each item MUST be completed an initialed by staff tech.

Tech

The student demonstrated the ability to properly: 0 2 3 4 Initials

1. Drive/move the C-arm around the surgery suite and under the examination table with care.

2. Connect the components of the c-arm.

3. Connect the c-arm to the power source and energize the unit.

4. Drape the c-arm as appropriate in order to maintain sterile field.

5. Manipulate the c-arm from AP/PA to lateral while under the examination table while maintaining a sterile field.

6. Acquire an image on the display monitor.

7. Manipulate the image L ↔ R and Up ↕ Down.

8. Store/archive the images for post exam display.

9. Recall stored images from the hard drive.

10. Student’s overall ability to perform c-arm exams.

A minimum score of three (3) is required for each item in order to meet competency. A score below “3” in any item will require the student to repeat the competency.

COMMENTS:

Student Signature Date

Technologist Signature Date

Technologist completing this form must also sign and verify the student’s competency in the student’s clinical competency record found in section 1 of the student handbook.

This original form will be placed in the student’s permanent record and a copy will be forwarded to the technologists’ manager/supervisor.

PROPERTY OF THE RADIOLOGIC TECHNOLOGY PROGRAM - CONFIDENTIAL INFORMATION: This paper is to be neither copied nor disseminated. If found please return to: Sovah - School of Health Professions

Radiologic Technology Program 109 Bridge Street, Suite 200 Danville, VA 24541

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STUDENT OBJECTIVES

SPECIAL PROCEDURES

Under direct supervision, the Student will:

1. Properly perform the tasks learned during the first rotation.

2. Explain scheduling tasks:

a. Paper work b. Steps taken before patient comes down for exam

3. Assist in preparing a room for procedures.

4. Describe various trays used for exam and state proper names.

5. Assist in setting sterile tray.

6. Identify specific utensils contained on a sterile tray.

7. Assist scrub technologist during a procedure.

8. Assist in positioning patient for a procedure.

9. Identify basic anatomy for each procedure performed.

10. Identify and perform programming and imaging protocols.

11. Identifies specific equipment in Specials suite.

a. Injector b. EKG/ Blood Pressure monitor c. C-arm Image Intensifier d. DSA Image Processing

12. Demonstrates interest in learning by observing procedures when not performing above

tasks.

13. Perform other tasks as deemed necessary by supervisory personnel.

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SPECIAL PROCEDURES

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CHECKLIST

The following must be completed by the second rotation in vascular imaging:

State precautions taken before contrast media injection

Participate in obtaining and recording vital signs

Demonstrate proper manipulation of equipment as applicable

Identify basic anatomy on images

Manipulate angio table

Demonstrates proper technique of using sterile gloves

Assist in setting sterile tray

Assist in clean up procedure

Identify steps taken for a vasovagal reaction

Assist in processing images Staff Technologist Signature Date

_ Student Signature

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STUDENT OBJECTIVES

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COMPUTED TOMOGRAPHY

Under direct supervision, the Student will:

1. Identify the advantages and disadvantages of Computed Tomography.

2. Correctly log patients.

3. Assist the technologist in preparing patients for exams.

4. Identify contrast media vs. saline.

5. Correctly manipulate equipment in order to:

a. Enter data for scans b. Move table and gantry

6. Position for the following exams

a. Head b. Sinuses c. Thorax d. Spines e. Abdomen & Pelvis

7. Identify the following anatomical structures:

a. Head b. Abdomen

Optic nerve Liver Ribs Optic muscle Pancreas Spine Sinuses Aorta Psoas muscle Ventricles Kidney Diaphragm Sella turcica Spleen

8. Assist in maintaining a neat and orderly clinical facility.

9. Identify the location of the fire alarm, fire extinguisher and emergency exit.

10. Identify the location of oxygen, suction and drug box.

11. Practice radiation safety at all times.

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COMPUTED TOMOGRAPHY

CHECKLIST

The following must be completed by the second rotation in CT: Positioning:

Head Abdomen Spine Lung

Anatomy:

Head Abdomen Spine Lung

Scanning:

Head Abdomen Spine (May be simulated if necessary) Lung

Equipment Operation:

Manipulate gantry in the positive and negative direction Properly move table Properly apply injector syringes Properly connect saline/contrast to corresponding injector syringe Properly connect contrast tubing to patient IV

Scanner Consoles:

Enter patient data Correctly set scan parameters

Patient Care:

Demonstrates proper preparation of sterile field for IV injection Demonstrates proper removal of IV from patient Explains importance of obtaining lab values prior to administering IV contrast

Staff Technologist Signature Date

Student Signature

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STUDENT OBJECTIVES

ELECTIVE

The Student is expected to adhere closely to the specific objectives provided for the respective clinical area elected. It is our goal that the student will accept the responsibilities associated with this area and that he/she will expand in knowledge and skills by:

1. Actively engaging in patient procedures.

2. Properly positioning patients for examinations.

3. Utilizing and manipulating appropriate equipment.

4. Practicing radiation protection measures.

5. Identifying anatomical structures as demonstrated on images.

6. Comprehending the role of the technologists in providing quality patient care.

7. Sharing responsibilities with the technologists for efficient and courteous patient care.

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Clinical Handbook Page 43 of 89

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Clinical Grading

Section 3

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DEFINITIONS

CATEGORY - Radiographic examinations that constitute a grouping.

COMPETENCY - The ability to function within a realm of limited supervision and assume those duties and responsibilities as set forth in course and clinical objectives.

COMPETENCY EVALUATION -

Procedure by which a student's performance and the resulting image is evaluated. SPOT CHECK - Once a student has checked off on an exam or series of exams he/she will be “spot

checked” to assure competency is maintained. This exam will be graded the same as a check off or final competency.

EXAMINATION - A series of radiographic exposures of an anatomical part sufficient to permit diagnostic

evaluation of that part. SIMULATION - Performance of an examination on a live subject (not a patient) and simulating the

exposure.

LABORATORY - Area for student practice.

DIRECT SUPERVISION* - Student supervision by a Registered Technologist, who reviews the procedure in relation to the student’s achievement, evaluates the condition of the patient in relation to the student’s knowledge, is present during the procedure, and reviews and approves the procedure. A Registered Technologist is present during student performance of any repeat of any unsatisfactory radiograph. (Within sight and hearing distance of the patient and student). For repeats this means that the staff technologist must be in the room with the student during the repeated procedure.

INDIRECT SUPERVISION* - That supervision provided by a qualified practitioner immediately available to assist students regardless of the level of student achievement. Immediately available is interpreted as the physical presence of a Registered Technologist 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. (Within sight or hearing distance of the patient and student.)

*A student may not perform any procedure without either direct or indirect supervision, based on the above criteria.

STUDENT OBJECTIVES -

Expected level of performance and/or behavior from the student.

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CLINICAL COMPETENCY

In order to meet the graduation requirements of this program, the student must demonstrate competency in the following categories:

1. Equipment manipulation 2. Thorax 3. Upper extremities 4. Lower extremities 5. Head & Neck 6. Spines & Pelvis 7. Abdomen & GI Tract 8. Mobile & Surgical 9. Specialty areas/exams 10. General Patient Care

CATEGORY COMPETENCY EVALUATION

FINAL COMPETENCIES MAY ONLY BE PERFORMED DURING THE SENIOR YEAR.

Pre-requisite objectives:

1. Successfully complete didactic and laboratory instruction on each examination in each category.

2. Perform, under direct supervision, the specified number of exams of each type in each competency category. These exams will be documented on the Patient Log Sheets.

3. Petition the clinical instructor or his/her clinical designee for the final competency evaluation in each category.

A Category Competency Evaluation shall consist of the student successfully performing and critiquing all views required for the examination. The Criteria for Performance Evaluation" will be the standard. A passing score is a 77 with no “U” score.

A final category competency evaluation will be performed as above except that the student will notify the instructor/staff when he/she is prepared to perform the final category competency evaluation. The examination will be performed on a patient and will be graded according to the published criteria. Petitioning the clinical instructor/staff for a final category competency is an indication that the student is prepared to perform any required examination in that category.

If the student successfully completes a Final Category Competency, he/she may perform the examinations in that category under indirect supervision. Following a Final Category Competency the student proceeds to work on the remaining categories under direct supervision.

Students who fail to successfully complete a Final Category Competency, MUST receive individual instruction from the clinical instructor on the uncompleted examination(s). Following remediation, the student must complete three (3) additional examinations in that category before attempting a repeat final competency.

After this time all students will undergo further evaluation by way of “spot checks” in order to assure that clinical competency has been maintained. Students MUST successfully complete the assigned “spot checks”. Failure to do so will result in a point deduction from grade.

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GUIDELINES FOR CHECK-OFFS, SPOT CHECKS AND FINAL COMPETENCIES I. Declaration

a. The student must declare their intent to perform a check-off/final competency to the technologist prior to beginning the examination. Once the declaration has been made to the technologist, the student is obligated to complete the examination as a check-off/final competency.

II. Performance

a. The student is responsible for preparation and performance of examination and should perform all duties without assistance. These duties shall include identification of the patient, obtaining clinical history, selection of technical factors, positioning and radiation protection of the patient, processing of the images and completion of necessary paperwork.

b. All required paperwork/forms must be completed at the time of the competency/checkoff and given to the supervising technologist at the time of exam completion.

c. A score of “77” or higher is required to pass with no “U” in any category. d. The correct routine for the student’s assigned site must be performed for the exam ordered. e. Anatomical marker and evidence of radiation protection/shielding must be visible on the processed

image. Shielding and collimation must be utilized on all patients. Collimation should be to film size or less if allowable.

f. Repeats are acceptable under certain circumstances. Examples of non-acceptable repeats (which would result in a score of unsatisfactory “U”) would include, but not be limited to: failure to detent the tube to the table/wall bucky, failure to center tube to film, failure to correctly select technical factors, incorrect placement of anatomical markers.

g. If the technologist feels that the student should or should not be given credit for the exam performed, they must document in detail the circumstances.

*IMPORTANT: Please be sure that your A S S I G N E D marker(s) is (are) visible on all images. If the technologist can verify that markers were correctly placed on the image, notation must be included documenting correct marker placement. Failure of the technologist to follow this protocol will result in an automatic “U”. Checkoffs and competencies that do not show the official assigned markers will be voided. If you lose your marker(s), notify the Program Director immediately so that a substitute set may be assigned while the replacement markers can be ordered. Handmade markers are not acceptable.

III. Evaluation

a. If the score is “77” or above, a member of the faculty must then review the images and evaluate the student’s ability to provide information concerning the examination they have performed.

b. If the score is below a “77”, or a “U” is given in any category, the student will not be awarded credit for the check-off/final competency.

IV. Remediation

a. If the student does not successfully complete the check-off/final competency, five points will be deducted from their final clinical average.

b. The student will then be required to schedule remedial instruction with the faculty for the particular examination that has been attempted.

c. The student will not be allowed to reattempt this exam until they have completed the remedial instruction.

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CLINICAL GRADING SYSTEM

All course grades, both clinical and didactic, are issued each semester based on the following grading scale:

A = 93-100 Consistently Exceeds Minimum Requirements B = 85-92 Exceeds Minimum Requirements C = 77-84 Meets Minimum Requirements F = 00-76 Does Not Meet Minimum Requirements

The student begins each semester with 100 points. The following criteria will be observed in the assignment of clinical grades with each infraction resulting in the subtraction of the specified number of points:

I. CLINICAL COMPETENCY/CLINICAL RECORDS 50 POINTS

The student is expected to complete the required competencies for the specified semester and to maintain accurate, neat records of clinical exams. Average competency scores will be used to determine points awarded in this category.

AVERAGE COMPETENCY SCORE: X .20 = POINTS

(2nd year) AVERAGE FINAL COMP SCORE: X .20 = POINTS

FILM CRITIQUE AVERAGE: X .10 = POINTS A. Unsuccessful attempted check off/final competency -5 points

B. Failure to adhere to competency schedule -10 points

C. Lost identification markers (R and/or L) -10 points

II. ATTENDANCE 25 POINTS

The student must comply with attendance policies as outlined in handbook to attain maximum number of points in this category.

A. Failure to follow call in policy (site and instructor) - 2.5 - 5 points per occurrence

B. Three (3) or more tardy occurrences - 5 points

C. More than two (2) days absent -5 points per occurrence

III. CLINICAL EVALUATIONS 25 POINTS

The student must return all clinical evaluations in a timely manner and receive a satisfactory evaluation as well as adhering to clinical policies to attain a maximum number of points in this category. Staff clinical evaluations are worth 100% of the total point in this category. Points may be deducted in this category at the discretion of the Clinical Instructor/Coordinator based on level of clinical performance. The decisions of the Clinical Instructor/Coordinator are final.

A. Being placed on clinical probation - 5 points

B. Dress code / clinical policy infringement - 5 points

C. Following consultation with clinical staff, points may be deducted at the discretion of the director, clinical coordinator or instructor based on the student’s level of performance. -5 to -10 points

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Clinical Handbook Page 48 of 89

RAD 131 CLINICAL EVALUATION GRADE CALCULATION FORM

NAME

SEMESTER COURSE #

I. CLINICAL COMPETENCY/CLINICAL RECORDS (50 points)

The student is expected to complete the required competencies for the specified semester and to maintain accurate, neat records of clinical exams. Average competency scores will be used to determine points awarded in this category.

AVERAGE COMPETENCY SCORE: X .50 = POINTS

POINTS COMMENTS Unsuccessful attempted check offs/final competencies (-5 points per occurrence)

Failure to adhere to competency schedule (-10 points)

check offs

objective check list

Lost identification markers (R and/or L) (-10 points)

Sub Total __________ II. ATTENDANCE (25 POINTS) (list dates in blocks below and attach forms)

Failure to follow call in policy (-2.5 - 5 points)

More than two (2) absences (-5 per occurrence) (3 tardy occurrences = 1 absence)

absences failure to clock in/out

tardy occurrences

Sub Total __________ III. CLINICAL EVALUATIONS (25 POINTS)

Sub Total __________

TOTAL _______ ___________________________ ________ ____________________________ ________ Staff Signature Date Student Signature Date

Semester Evaluation Average x .25 points

Being placed on clinical probation (-5 points)

Dress code/clinical policy infringement (-5 points)

Following consultation with clinical staff, points may be deducted at the discretion of the director, clinical coordinator or instructor based on the student’s level of performance (-5 to 10 points)

*Clinical grades given at the “End of Semester” conferences are tentative. Clinical grades are not finalized until the last day of the semester. If there is any question concerning a clinical grade on your final transcript, please contact your clinical instructor.

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Clinical Handbook Page 49 of 89

RAD 132 -231

CLINICAL EVALUATION GRADE

CALCULATION FORM

NAME

SEMESTER COURSE #

I. CLINICAL COMPETENCY/CLINICAL RECORDS (50 points)

The student is expected to complete the required competencies for the specified semester and to maintain accurate, neat records of clinical exams. Average competency scores will be used to determine points awarded in this category.

AVERAGE COMPETENCY SCORE: X .40 = POINTS

FILM CRITIQE SCORE: X .10 = POINTS

POINTS COMMENTS Unsuccessful attempted check offs/final competencies (-5 points per occurrence)

Failure to adhere to competency schedule (-10 points)

check offs

objective check list

Lost identification markers (R and/or L) (-10 points)

Sub Total __________ II. ATTENDANCE (25 POINTS) (list dates in blocks below and attach forms)

Failure to follow call in policy (-2.5 - 5 points)

More than two (2) absences (-5 per occurrence) (3 tardy occurrences = 1 absence)

absences failure to clock in/out

tardy occurrences

Sub Total __________ III. CLINICAL EVALUATIONS (25 POINTS)

Sub Total __________

TOTAL __________ ___________________________ ________ ____________________________ ________ Staff Signature Date Student Signature Date

Semester Evaluation Average x .25 points

Being placed on clinical probation (-5 points)

Dress code/clinical policy infringement (-5 points)

Following consultation with clinical staff, points may be deducted at the discretion of the director, clinical coordinator or instructor based on the student’s level of performance (-5 to 10 points)

*Clinical grades given at the “End of Semester” conferences are tentative. Clinical grades are not finalized until the last day of the semester. If there is any question concerning a clinical grade on your final transcript, please contact your clinical instructor.

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Clinical Handbook Page 50 of 89

RAD 232 -290

CLINICAL EVALUATION GRADE

CALCULATION FORM

NAME

SEMESTER COURSE #

I. CLINICAL COMPETENCY/CLINICAL RECORDS (50 points)

The student is expected to complete the required competencies for the specified semester and to maintain accurate, neat records of clinical exams. Average competency scores will be used to determine points awarded in this category.

AVERAGE COMPETENCY SCORE: X .20 = POINTS

AVERAGE FINAL COMP SCORE: X .20 = POINTS

FILM CRITIQE SCORE: X .10 = POINTS

POINTS COMMENTS Unsuccessful attempted check offs/final competencies (-5 points per occurrence)

Failure to adhere to competency schedule (-10 points)

check offs

objective check list

Lost identification markers (R and/or L) (-10 points)

Sub Total __________ II. ATTENDANCE (25 POINTS) (list dates in blocks below and attach forms)

Failure to follow call in policy (-2.5 - 5 points)

More than two (2) absences (-5 per occurrence) (3 tardy occurrences = 1 absence)

absences failure to clock in/out

tardy occurrences

Sub Total __________ III. CLINICAL EVALUATIONS (25 POINTS)

Sub Total __________

TOTAL ________ ___________________________ ________ ____________________________ ________ Staff Signature Date Student Signature Date

Semester Evaluation Average x .25 points

Being placed on clinical probation (-5 points)

Dress code/clinical policy infringement (-5 points)

Following consultation with clinical staff, points may be deducted at the discretion of the director, clinical coordinator or instructor based on the student’s level of performance (-5 to 10 points)

*Clinical grades given at the “End of Semester” conferences are tentative. Clinical grades are not finalized until the last day of the semester. If there is any question concerning a clinical grade on your final transcript, please contact your clinical instructor.

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Clinical Evaluations

Section 4

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CLINICAL ORIENTATION

EVALUATION

STUDENT AREA__________________

WEEK OF

Please mark appropriate space and comment on possible improvements.

[S] = Satisfactory [U] = Unsatisfactory

DOES THE STUDENT S U COMMENTS

adequately observe/assist during procedures?

ask questions to clear up problems?

listen to explanations well?

assist in being attentive to the needs of the patient?

maintain composure during stressful procedures or conditions?

conduct themselves in a professional manner?

understand and complete necessary paperwork?

arrive in assigned area promptly?

follow established dress code?

demonstrate initiative and interest?

Additional comments or suggestions for the student:

Technologist Signature Date Completed

Student Signature Date Reviewed

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CLINICAL PERFORMANCE EVALUATION NAME ASSIGNMENT________

EVALUATION PERIOD SEMESTER_______________________

Please mark appropriate space using the key below:

U = Unacceptable B = Fulfills basic requirements N = Needs minor improvement E = Exceeds basic requirements

RADIOGRAPHIC EXAMINATION SKILLS

U

N

B

E

1. Ability to evaluate all aspects of requisition (exam requested, clinical information, etc.)

2. Preparation of room and equipment (proper supplies, cassettes, accessories, etc.)

3. Manipulation of equipment (proper use of controls & locks, alignment of CR, selection of technical factors on control panel)

4. Knowledge and application of routines and positions according to level of education

5. Knowledge and adherence to radiation safety practices (proper use of shielding, collimation, etc.)

6. Calculation and adjustment of exposure factors (proper use of technique chart and adjustments for patient condition, size, pathology, clinical history)

7. Room clean up and follow through on procedure (replacement of supplies, completion of paperwork, etc.)

8. Completion of procedures in timely manner (efficient use of time according to clinical experience)

QUALITY ASSURANCE

U

N

B

E

1. Demonstration of proper markers and patient data (use of initial markers, position markers, patient ID card)

2. Performance in image handling and processing

3. Demonstration of proper collimation

4. Ability to evaluate image quality (anatomical structures, density, contrast, detail, etc. and make appropriate corrections if repeat needed)

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COMMENTS: TOTAL

Technologist Signature Date Completed

Student Signature Date Reviewed

PATIENT CARE

U

N

B

E

1. Demonstrates proper patient identification techniques (checks request, ID band, chart, verbal confirmation)

2. Attention to patient's psychological needs (explains procedure, ensures privacy and comfort, etc.)

3. Attention to patient's physical safety (observes closely, proper use of restraints, locks, side rails, proper transportation/transfer methods)

4. Attention to special needs patients (evaluates & compensates for trauma, physically disabled, psychiatric, critically ill)

5. Communicates effectively with patient during procedure (patient responds correctly to instructions, patient verbalizes understanding where appropriate. Student speaks in a clear, concise, well-toned voice)

ADHERENCE TO RULES AND REGULATIONS

U

N

B

E

1. Attendance (reports as scheduled or follows call in procedure)

2. Punctuality (reports on time as scheduled)

3. Dress Code (prescribed uniform; shoes polished; neat hair style)

PROFESSIONAL AND ETHICAL CONDUCT

U

N

B

E

1. Maintains confidentiality of patient information

2. Demonstrates respectful and courteous attitude with patient

3. Demonstrates respectful and courteous attitude with coworkers

4. Initiative (eagerness to learn, assist and perform exams)

5. Cooperation and effort (demonstrates good attitude, willing to help, enhances morale, displays sincere interest)

6. Manages time appropriately with regard to patient flow (uses available time to prepare for next patient or as study time)

OVERALL PERFORMANCE ACCORDING TO LEVEL OF EDUCATION

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CLINICAL PERFORMANCE SPECIALITY AREAS

NAME ASSIGNMENT________

EVALUATION PERIOD SEMESTER_________________

Please mark appropriate space using the key below:

U = Unacceptable B= Fulfills basic requirements N = Needs minor improvement E = Exceeds basic requirements

SKILLS / PERFORMANCE U N B E

Demonstrates proper patient identification techniques (checks request, ID band, chart verification, and uses two (2) verbal identifiers if applicable)

Demonstrates ability to evaluate all aspects of the requisition (exam requested, patient information, clinical history)

Demonstrates attention to patients’ psychological needs (ensures privacy and comfort, communicates effectively during procedure)

Demonstrates respectful and courteous attitude with patients

Demonstrates respectful and courteous attitude with coworkers

Initiative, Cooperation and effort (demonstrates good attitude, willing to help, eagerness to learn, enhances morale, displays sincere interest)

Assists and / or performs exams according to level of education

Room preparation and clean-up (assists prior to and after procedures)

Ability to follow directions (accurate / repeated errors)

Appearance (meets published dress code)

Attendance

Punctuality (arrives promptly in assigned area)

General Progress

TOTAL

COMMENTS:

Technologist Signature Date Completed

Student Signature Date Reviewed

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TYPE OF COMPETENCY

Standard Competency

Final Competency

Spot Check

STUDENT IDENTIFICATION#

TECHNOLOGIST .

EXAM GERIATRIC ( )≥65 years PEDIATRIC ( ) 6 and <

PREPARATION: U N M

1. Evaluates request to correlate exam with clinical history.

2. Makes proper patient identification.

3. Demonstrates proper introduction to patient and patient’s family where applicable.

4. Maintains professional student/patient relationship.

5. Communicates effectively with patient prior to and during procedure. (Effectively verbalizes instructions to

patient. Speaks in a clear, concise well-toned voice.)

6. Obtains and documents pertinent medical history. (i.e.: reason for visit, site of injury/pain, previous injury

or surgery to area, chance of pregnancy where appropriate, etc.)

EXAMINATION PERFORMANCE:

1. Attention to patient’s psychological needs. (Ensures privacy and comfort of patient)

2. Positions patient to properly align tube, body part, and image receptor (IR).

3. Collimates to IR size, less if appropriate and uses protective shielding when possible.

4. Selects and manipulates technical factors using calipers and chart if appropriate.

Compensates for patient size, condition and pathology when selecting factors.

5. INDEPENDENTLY completes ALL aspects of the exam in timely and efficient manner.

IMAGE EVALUATION:

1. Correct patient ID on image(s).

2. Correct use of personal markers and others as necessary.

3. Acceptable diagnostic image.

Number of images taken Number of images repeated

Reason for repeat image(s)

COMMENTS:

Scoring: U = Unacceptable N = Needs Minor Improvement M = Meets Basic Requirements

Competencies may not include a score of "U" in any area. A score of “U” will require the competency to be repeated.

Staff Signature Date

Staff Technologist completing this form must also sign the Clinical Competency Record and the Patient Exam Log!

CLINICAL

COMPETENCY

EVALUATION

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IMAGE CRITIQUE

This portion to be completed by Faculty only!

MEDICOLEGAL INFORMATION: U N M

1. Patient ID/Exam Date: Patient’s DOB Initials_

2. ID Markers

3. Clinical History

PROTECTION MEASURES:

1. Proper Collimation/Field Reduction/Image Receptor Size

2. Shielding Appropriate For Age

3. LMP/?Pregnancy Not Required

ASSESSMENT OF RADIOGRAPHIC QUALITY

1. Photographic Properties (Density & Contrast etc.) (High/Low? Short/Long?)

2. Recorded Detail/Exposure Criteria

3. Exposure Factors: Projection LGM/S/EI

Projection LGM/S/EI

Projection LGM/S/EI

Projection LGM/S/EI

POSITIONING (80% accuracy required)

1. Projections/Anatomy Identification

2. Patient Positioning-Centering Criteria/Image Critique

Necessary modifications for quality Improvement:

Student Signature Instructor Signature

PROPERTY OF THE RADIOLOGIC TECHNOLOGY PROGRAM - CONFIDENTIAL INFORMATION: This paper is to be neither copied nor disseminated. If found please return to: Sovah - School of Health Professions

Radiologic Technology Program 109 Bridge Street, Suite 200

Danville, VA 24541

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Clinical Syllabi

Section 5

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CLINICAL PRACTICE

RAD 131 - Elementary Clinical Procedures I RAD 132 - Elementary Clinical Procedures II RAD 231 - Advanced Clinical Procedures I RAD 232 - Advanced Clinical Procedures II RAD 290 - Advanced Clinical Procedures III

Description

Clinical Experiences are broken into five (5) sequential semesters that build on one another. The educational requirements are basically the same with a higher degree of expectation being placed on the students each semester. The content and clinical practice experience is designed for sequential development, application, critical analysis, integration, synthesis and evaluation of concepts and theories in the performance of radiologic procedures. Through structured sequential, competency-based assignments in clinical setting, concepts of team practice, patient centered clinical practice and professional development shall be discussed, examined and evaluated. Clinical practice experiences are designed to provide patient care and assessment, competent performance of radiologic imaging and total quality management. Levels of competency and outcomes measurement shall ensure the well-being of the patient prior to, during and following the radiologic procedure.

Evaluation

Students will be evaluated bi-weekly by Staff Technologists and/or Clinical Instructor(s) and at semesters end by the Clinical Instructor(s). The following Likert Scale is used to score students on various clinical activities/objectives.

Scoring: U= Unacceptable (0 points) B = Fulfills Basic Requirements (3 points)

N = Needs Minor Improvement (2 points) E = Exceeds Basic Requirements (4 points)

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Objectives

1. Exercise the priorities required in daily clinical practice. 2. Execute imaging procedures under the appropriate level of supervision. 3. Adhere to concepts of team practice that focus on organizational theories, roles of team members and conflict

resolution. 4. Adapt to changes and varying clinical situations. 5. Support patient-centered clinically effective service for all patients regardless of age, gender, disability, special needs,

ethnicity or culture. 6. Integrate the use of appropriate and effective written, oral and nonverbal communication with patients, the public and

members of the health care team (peers, physicians, nurses, administration, etc.) in the clinical setting. 7. Choose patient and family education strategies appropriate to the comprehension level of patient / family. 8. Manage interactions with the patient and family in a manner that provides the desired psychosocial support. 9. Evaluate the patient’s status and condition before, during and following the radiologic procedure to demonstrate

competence in assessment skills. 10. Demonstrate skills in assessment and evaluation of psychological and physical changes in the patient’s condition and

carry out appropriate actions. 11. Examine gender, cultural, age and socioeconomic factors that influence patient compliance with procedures,

diagnosis, treatment and follow-up of patients. 12. Adapt procedures to meet age-specific, disease-specific and cultural needs of patients. 13. Assess the patient and record patient histories. 14. Assess patient using the ABCs of CPR and demonstrate basic life support procedures. 15. Respond appropriately to patient emergencies. 16. Interpret patient side effects and/or complications of radiologic procedures, contrast administration and take

appropriate actions. 17. Document care in the patient’s record. 18. Differentiate between normal ECG rhythms and abnormal ECG tracings. 19. Apply standard and transmission-based precautions. 20. Apply the appropriate medical asepsis and sterile technique. 21. Prepare the technologies and methodologies for the performance of radiologic procedures. 22. Demonstrate competency in the principles of radiation protection standards to include time, distance, shielding and

radiation monitoring. 23. Apply the principles of total quality management. 24. Report equipment malfunctions to assist with appropriate corrective actions. 25. Examine procedure orders for accuracy and follow-up to make corrective changes when applicable. 26. Support safe, ethical and legal practices. 27. Integrate the radiographer’s scope of practice and practice standards into clinical practice setting. 28. Act consistently to maintain patient confidentiality standards. 29. Carry out principles of transferring, positioning, immobilizing and restraining of patient. 30. Comply with departmental and institution procedures for response to emergencies, disasters and accidents. 31. Break down the chain of command in emergencies, disasters and accidents. 32. Differentiate between emergency and non-emergency procedures. 33. Adhere to national, institutional and/or department standards, policies and procedures regarding care of patients,

provision of radiologic procedures and the reduction of medical errors. 34. Ensure that performance reflects professional competence in the selection of technical factors to produce quality

diagnostic images with lowest radiation exposure possible. 35. Critique images for appropriate clinical information, image quality and patient documentation. 36. Performance reflects professional competence in determining corrective measures to improve inadequate images.

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Content to be covered

I. Clinical Practice A. Code of ethics/professional behavior

1. Scope of practice 2. Practice standards 3. CARE bill 4. Incident reporting mechanisms 5. Standards for supervision

a. Direct b. Indirect

B. Professional communication 1. Patients 2. Patient’s family 3. Health care team

C. Role of health care team members 1. Technical 2. Professional 3. Patient’s Bill of Rights

D. Scheduling and sequencing of exams

II. Procedural Performance

A. Order/requisition evaluation and corrective measures

B. Facilities set-up

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

1. Patient monitoring – emergency and non-emergency a. Vitals b. Equipment

1) Crash cart 2) Oxygen 3) Suction

c. Patient emergencies 1) Allergic reactions 2) Cardiac/respiratory arrest 3) Physical injury

d. Sterile technique 5. Communication style 6. Age specific 7. Cultural and socioeconomic sensitivity

D. Imaging

1. Positioning a. Body mechanics b. Positioning accessories

2. Technical considerations a. Manual b. Automatic exposure control (AEC) c. Digital/computed radiography 1) Basic quality control 2) Reporting equipment failure

3. Image processing (automatic/digital) 4. Image analysis

a. Image quality 1) Density 2) Contrast 3) Recorded detail

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b. Image manipulation 1) Conventional 2) Digital

c. Legal requirements for image documentation

E. Patient/personnel protection

1. Radiation a. Time, Distance, Shielding b. Radiation monitoring c. Exposure reduction techniques d Room design

2. Equipment/accessories a. Beam restriction b. Filtration c. Positioning d. Image receptor system e. Scatter control techniques

1) Grids 2) Air gap techniques 3) Reverse cassette

f. Technical factor selection 3. Medical error reduction

III. Competency (Mandatory, Elective See Handbook for precise requirements)

A. Upper Extremity a. Finger/Thumb b. Hand c. Wrist d. Forearm e. Elbow f. Humerus g. Shoulder h. Trauma Shoulder (Scapular Y or Trans-Thoracic) i. Trauma Upper Extremity j. Geriatric Upper Extremity (≥65) k. Clavicle

B. Lower Extremity a. Foot b. Ankle c. Tibia & Fibula d. Knee e. Femur f. Trauma Lower Extremity (Non-Hip) g. Geriatric Lower Extremity (≥65)

C. Abdomen a. Abdomen, Supine (KUB) b. Abdomen, Upright

D. Chest & Thorax a. Chest, Routine b. Chest, Wheelchair or Stretcher c. Chest, Pediatric d. Ribs e. Geriatric Chest (≥65)

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E. Spine & Pelvis a. Cervical Spine b. Thoracic Spine c. Lumbosacral Spine d. Pelvis e. Hip f. Trauma Hip (X-Table) g. Cross Table (Horizontal Beam) Lateral Spine

F. Head a. Skull, Facial Bones or Sinuses

G. Mobile & Surgical a. C-Arm Procedure with Sterile Field (Surgical) b. C-Arm Procedure with Multiple (2 or more) Projections c. Portable Chest d. Portable Abdomen e. Portable Orthopedic

H. Fluoroscopy a. BE, UGI, or Esophagram

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COURSE SYLLABUS

I. COURSE TITLE Elementary Clinical Procedures I

II. COURSE PREFIX/NUMBER RAD 131

III. CREDIT HOURS 3

IV. CLINICAL HOURS 16 clinical hours/wk

V. OUTSIDE PREP HOURS 45*

VI. COURSE PREREQUISITES COREQUISITES RAD 121

VII. COURSE DESCRIPTION

Develops advanced technical skills in fundamental radiographic procedures. Focuses on manipulation of equipment, patient care, osseous studies, skull procedures, and contrast studies. Provides clinical experience in cooperating health agencies.

VIII. COURSE OBJECTIVES

Upon completion of this course the student will be able to:

1. Develop competency in the performance of radiographic examinations of the chest, abdomen, and extremity. 2. Develop proficiency with equipment manipulation. 3. Demonstrate the use of beam-limiting devices, lead aprons and other protective devices that must

be employed when radiographing the abdomen and chest. 4. Practice basic patient care skills for patients undergoing radiographic procedures. 5. Identify supplemental projections of the abdomen, chest, and extremities. 6. Participate in lab demonstrations and simulated performance of the radiographic examinations under study. 7. Describe the anatomy that must be included in each projection of the abdomen, chest, and extremities. 8. Demonstrate proper communication skills with patients, visitors and medical personnel 9. Maintain a system of radiographic examinations in which the student has assisted and performed.

IX. REQUIRED TEXTS AND OTHER REFERENCES

Radiologic Technology Program Faculty. (2002). Radiologic Technology Program Student Handbook. Unpublished

manuscript.

X. METHOD OF EVALUATION

Exam Competencies

50 % Written Evaluations 25 % Adherence to Policies 25 %

93-100 A 4.0 grade points Frequently Exceeds Minimum Requirements 85-92 B 3.0 grade points Exceeds Minimum Requirements 77-84 C 2.0 grade points Meets Minimum Requirements 76-below F 0.0 grade points Does Not Meet Minimum Requirements

*Students must achieve a “C” in each course for successful academic progression. A grade of “F” (below 77) will result in academic dismissal.

XI. Method of Delivery Residential

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COURSE SYLLABUS

I. COURSE TITLE Elementary Clinical Procedures II

II. COURSE PREFIX/NUMBER RAD 132

III. CREDIT HOURS 3

IV. CLINICAL HOURS 16 clinical hours/wk

V. OUTSIDE PREP HOURS 74*

VI. COURSE PREREQUISITES RAD 131

VII. COURSE DESCRIPTION This course is a continuation of RAD 131. Develops advanced technical skills in fundamental radiographic procedures. Focuses on manipulation of equipment, patient care, osseous studies, skull procedures, and contrast studies. Provides clinical experience in cooperating health agencies.

VIII. COURSE OBJECTIVES

Upon completion of this course the student will be able to: 1. Develop competency in the performance of radiographic examinations of the chest, abdomen and upper

and lower extremities. 2. Participate in the performance of radiographic examinations of gastrointestinal, genitourinary,

reproductive systems. 3. Demonstrate the use of beam-limiting devices, lead aprons and other protective devices that must

be employed when radiographing the upper and lower extremities. 4. Demonstrate continued development of proficiency with equipment manipulation. 5. Practice patient care skills for patients undergoing radiographic procedures. 6. Participate in lab demonstrations and simulated performance of the radiographic examinations under study. 7. Describe the anatomy that must be included in each projection of the appendicular skeleton. 8. Identify supplemental projections and their application for the upper and lower extremities. 9. Maintain a system of radiographic examinations in which the student has assisted and performed.

IX. REQUIRED TEXTS AND OTHER REFERENCE

Radiologic Technology Program Faculty. (2002). Radiologic Technology Program Student Handbook. Unpublished manuscript.

X. METHOD OF EVALUATION

Exam Competencies

50 % Written Evaluations 25 % Adherence to Policies 25 %

93-100 A 4.0 grade points Frequently Exceeds Minimum Requirements 85-92 B 3.0 grade points Exceeds Minimum Requirements 77-84 C 2.0 grade points Meets Minimum Requirements 76-below F 0.0 grade points Does Not Meet Minimum Requirements

*Students must achieve a “C” in each course for successful academic progression. A grade of “F” (below 77) will result in academic dismissal.

XI. Method of Delivery: Residential

*OUTSIDE PREPARATION TIME:

Clinical Prep 2 hrs/wk 12 wks 24 hrs

Exam (√-offs & Case Studies)

2 hrs ea 8 16

Checklists 1 hr ea 2 2 Final Comps 3 hrs ea 0 0 Film Critique/ Quizzes/Tests

8 hrs ea 4 32

74 hrs

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COURSE SYLLABUS

I. COURSE TITLE Advanced Clinical Procedures I

II. COURSE PREFIX/NUMBER RAD 231

III. CREDIT HOURS 5

IV. CLINICAL HOURS 24 clinical hours/wk

V. OUTSIDE PREP HOURS 88*

VI. COURSE PREREQUISITES RAD 132

VII. COURSE DESCRIPTION Develops advanced technical skills in fundamental radiographic procedures. Focuses on manipulation of equipment, patient care, osseous studies, skull procedures, and contrast studies. Provides clinical experience in cooperating health agencies.

VIII. COURSE OBJECTIVES

Upon completion of this course the student will be able to:

1. Develop proficiency for radiographing the cranium, spine, upper and lower extremities.

2. Participate in the performance of radiographic examinations of gastrointestinal, genitourinary, reproductive systems.

3. Participate in preparing contrast agents used in each examination. 4. Display proficiency in equipment manipulation for radiographic examinations of the cranium, spine,

upper and lower extremities. 5. Discuss chronology and procedure followed when performing each radiographic examination. 6. Demonstrate the use of beam-limiting devices, lead aprons and other protective devices which must be

employed when radiographing the cranium, spine, gastrointestinal, biliary, genitourinary, reproductive systems.

7. Identify anatomical structures from radiographs that must be included in each projection for the cranium, spine, gastro-intestinal, biliary, genitourinary, reproductive systems.

8. Maintain a system of radiographic examinations in which the student has assisted and performed.

IX. REQUIRED TEXTS AND OTHER REFERENCES

Radiologic Technology Program Faculty. (2002). Radiologic Technology Program Student Handbook. Unpublished manuscript. X. METHOD OF EVALUATION

Exam Competencies

50 % Written Evaluations 25 % Adherence to Policies 25 %

93-100 A 4.0 grade points Frequently Exceeds Minimum Requirements 85-92 B 3.0 grade points Exceeds Minimum Requirements 77-84 C 2.0 grade points Meets Minimum Requirements 76-below F 0.0 grade points Does Not Meet Minimum Requirements

*Students must achieve a “C” in each course for successful academic progression. A grade of “F” (below 77) will result in academic dismissal.

XI. Method of Delivery Residential

*OUTSIDE PREPARATION TIME:

Clinical Prep 3 hrs/wk 15 wks 45 hrs

Exam (√-offs & Case Studies)

2 hrs ea 9 18

Checklists 1 hr ea 1 1 Final Comps 3 hrs ea 0 0 Film Critique/ Quizzes/Tests

8 hrs ea 3 24

88 hrs

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COURSE SYLLABUS

I. COURSE TITLE Advanced Clinical Procedures II

II. COURSE PREFIX/NUMBER RAD 232

III. CREDIT HOURS 5

IV. CLINICAL HOURS 24 clinical hours/wk

V. OUTSIDE PREP HOURS 98*

VI. COURSE PREREQUISITES RAD 231

VII. COURSE DESCRIPTION

Reinforces technical skills in fundamental radiographic procedures. Introduces more intricate contrast media procedures. Focuses on technical proficiency, application of radiation, protection, nursing skills, and exposure principles. Teaches advanced technical procedures and principles of imaging modalities, correlating previous radiographic theory, focusing on full responsibility for patients in technical areas, perfecting technical skills, and developing awareness of related areas utilizing ionizing radiation. Provides clinical experience in cooperating health agencies.

VIII. COURSE OBJECTIVES

Upon completion of this course the student will be able to:

1. Assist in examinations utilizing advanced imaging modalities.

2. Practice appropriate patient care skills for advanced imaging modalities. 3. Demonstrate continued competency and proficiency in the performance of radiographic examinations

studied. 4. Demonstrate continued competency and proficiency of equipment manipulation for all examinations studied. 5. Demonstrate the use of beam-limiting devices, lead aprons and other protective devices that must be

employed when using ionizing radiation for imaging. 6. Display self-kept records of radiographic examinations in which the student has assisted and performed.

IX. REQUIRED TEXTS AND OTHER REFERENCES

Radiologic Technology Program Faculty. (2002). Radiologic Technology Program Student Handbook. Unpublished manuscript.

X. METHOD OF EVALUATION

Exam Competencies

50 % Written Evaluations 25 % Adherence to Policies 25 %

93-100 A 4.0 grade points Frequently Exceeds Minimum Requirements 85-92 B 3.0 grade points Exceeds Minimum Requirements 77-84 C 2.0 grade points Meets Minimum Requirements 76-below F 0.0 grade points Does Not Meet Minimum Requirements

*Students must achieve a “C” in each course for successful academic progression. A grade of “F” (below 77) will result in academic dismissal.

XI. Method of Delivery: Residential

*OUTSIDE PREPARATION TIME:

Clinical Prep 3 hrs/wk 15 wks 45 hrs

Exam (√-offs & Case Studies)

2 hrs ea 11 22

Checklists 1 hr ea 1 1

Final Comps 3 hrs ea 2 6

Film Critique/ Quizzes/Tests

8 hrs ea 3 24

98 hrs

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COURSE SYLLABUS

I. COURSE TITLE Advanced Clinical Procedures III

II. COURSE PREFIX/NUMBER RAD 290

III. CREDIT HOURS 5

IV. CLINICAL HOURS 24 clinical hours/wk

V. OUTSIDE PREP HOURS 102*

VI. COURSE PREREQUISITES RAD 232

VII. COURSE DESCRIPTION

This course is a continuation of RAD 232 and all required clinical competency examinations must be completed. Reinforces technical skills in fundamental radiographic procedures. Introduces more intricate contrast media procedures. Focuses on technical proficiency, application of radiation, protection, nursing skills, and exposure principles. Teaches advanced technical procedures and principles of imaging modalities, correlating previous radiographic theory, focusing on full responsibility for patients in technical areas, perfecting technical skills, and developing awareness of related areas utilizing ionizing radiation. Provides clinical experience in cooperating health agencies.

VIII. COURSE OBJECTIVES

Upon completion of this course the student will be able to:

1. Participate in examinations utilizing advanced imaging modalities. Practice appropriate patient care skills for advance imaging modalities.

2. Demonstrate continued competency and proficiency in the performance of radiographic examinations studied.

3. Demonstrate continued competency and proficiency of equipment manipulation for all examinations studied. 4. Demonstrate the use of beam-limiting devices, lead aprons and other protective devices that must be

employed when using ionizing radiation for imaging. 5. Display self-kept records of radiographic examinations in which the student has assisted and performed.

IX. REQUIRED TEXTS AND OTHER REFERENCES

Radiologic Technology Program Faculty. (2002). Radiologic Technology Program Student Handbook. Unpublished manuscript.

X. METHOD OF EVALUATION

Exam Competencies

50 % Written Evaluations 25 % Adherence to Policies 25 %

93-100 A 4.0 grade points Frequently Exceeds Minimum Requirements 85-92 B 3.0 grade points Exceeds Minimum Requirements 77-84 C 2.0 grade points Meets Minimum Requirements 76-below F 0.0 grade points Does Not Meet Minimum Requirements

*Students must achieve a “C” in each course for successful academic progression. A grade of “F” (below 77) will result in academic dismissal.

XI. Method of Delivery: Residential

*OUTSIDE PREPARATION TIME:

Clinical Prep 3 hrs/wk 12 wks 36 hrs

Exam (√-offs & Case Studies)

2 hrs ea 14 28

Checklists 1 hr ea 5 5 Final Comps 3 hrs ea 3 9 Film Critique/ Quizzes/Tests

8 hrs ea 3 24

102 hrs

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APPENDIX I

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Declaration of General Health

This student has passed a pre-enrollment health and physical examination which was performed by a licensed health care provider qualified to perform such examinations. Results of this examination are maintained by our Employee Health Department located on the 3rd floor of the “D” building at Sovah Health - Danville.

Student Signature Date

Kevin L. Murray, MS Ed Date Director, Radiologic Technology Program

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Financial Records Maintenance

All financial documents regarding this student’s enrollment are, by law, maintained by the Financial Aid Officer @ 109 Bridge Street, Suite 200, Danville, VA. Any inquiries concerning finances must be made to the Financial Aid Officer at 434-799-2271 ext. 5504.

Student Signature Date

Kevin L. Murray, MS Ed Date Director, Radiologic Technology Program

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EMERGENCY CONTACT FORM

STUDENT’S NAME

STREET ADDRESS

CITY STATE ZIP

Home Phone Work Phone Cell/Pager/Other In case of emergency contact:

1)_

Contact’s Name

Contact’s Street Address

Contact’s City State Zip

Contact’s Home Phone Daytime Phone Cell/Pager/Other

In case of contact “1” cannot be reached:

2)_ Contact’s Name

Contact’s Street Address

Contact’s City State Zip

Contact’s Home Phone Daytime Phone Cell/Pager/Other

The names, numbers and addresses provided will be used, EXCLUSIVELY by the Sovah - School of Health Professions’ Radiologic Technology Program Faculty or their appointees, for emergency contact purposes ONLY.

Student’s Signature Date

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Exceptional Quality/Performance

Student’s Name: Date:

Observed Performance:

Staff Technologist Signature

Clinical Site

Exceptional Quality/Performance

Student’s Name: Date:

Observed Performance:

Staff Technologist Signature

Clinical Site

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Occurrence Form

Student Name

Date of Violation Clinical Facility

⃞ Absent ⃞ Tardy: time arrived ___ ⃞ Parking Violation

⃞ Failure to call when absent ⃞ Dress Code Infraction ⃞ Other

Description of occurrence:

Staff Technologist Signature ______________________________________

(Bottom section to be filled out by Faculty)

⃞ Warning ⃞ Corrective Action Required

Student Signature _______________________________________

Faculty Signature _______________________________________

Occurrence Form

Student Name

Date of Violation Clinical Facility

⃞ Absent ⃞ Tardy: time arrived ___ ⃞ Parking Violation

⃞ Failure to call when absent ⃞ Dress Code Infraction ⃞ Other

Description of occurrence:

Staff Technologist Signature ______________________________________

(Bottom section to be filled out by Faculty)

⃞ Warning ⃞ Corrective Action Required

Student Signature _______________________________________

Faculty Signature _______________________________________

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Remedial Instruction Documentation Form Student Name: Date: _

Check-off/Exam requiring repeat:

Reason repeats required:

Remedial Instruction Required: _

Faculty Signature Date

Student Signature Date

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PREGNANCY AND IONIZING RADIATION POLICY

The student is under NO OBLIGATION to inform anyone of her pregnancy status. The Radiography Program at Sovah Health – Danville takes the position that the reporting of pregnancy to program officials be voluntary on the part of the student. It will be assumed that all students are NOT pregnant until such time that an official declaration has been made in writing to the Program Director. Students who declare their pregnancy must observe the following procedures in regard to class and clinical experiences/attendance.

Classes: Class attendance will continue to follow the standard attendance policy and will be enforced. Therefore, the student MUST REQUEST, if possible, a leave of absence based on the programs’ GENERAL/MEDICAL LEAVE of ABSENCE POLICY (see policy above). Failure to abide by the requirements of this policy will result in the student’s termination from the Radiologic Technology Program.

Clinical: Clinical experience, which involves the student being assigned to radiation areas, is a crucial part of this instructional program. Medical evidence however suggests that a fetus should not be exposed to any unnecessary radiation throughout the nine (9) month gestation period.

Due to the nature of the clinical activities a medical release from the student’s physician will be required for return to clinical activities. If she so chooses, the student may elect to “rescind” her declaration of pregnancy at any time.

Students must understand that they will be exposed to a variety of radiological examinations in order to complete the requirements of this program. Those who choose to notify the director of their pregnancy should do so as soon as possible. The student will then be scheduled to review radiation safety practices and will be provided an additional radiation monitoring device to be worn at waist level (Fetal level) at all times while in the clinical setting. This badge must always be worn under the protective lead aprons.

Upon confirmation of pregnancy the student may select one of the following scenarios:

The student may elect to withdraw from the program and be reinstated at that same point in the program twelve (12) months hence, or

The student may elect to remain in the program and be placed in a radiation environment that is in

accordance with the NRC's regulations at 10 CFR 20.1208, "Dose to an Embryo/Fetus” where total fetal dose will not exceed 0.5 rem (5 mSv). All mandatory clinical experiences must be completed prior to program completion, or

The student may elect to remain in the current and future clinical settings/rotations in an unaltered status for the duration of the program.

Regardless of the above option selected, the student will be required to complete all aspects of the program in order to graduate.

The student should also be aware that until a pregnancy is declared, the normal dose rate for an occupationally exposed person of 5.0 rems (50 mSv) per year will apply. The lower dose rate will not take effect until such notification is made in writing to the Program Director.

A copy of the U.S. Nuclear Regulatory Commission’s Regulatory Guide 8.13 is available for the students review and a copy will be provided upon request.

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DECLARATION OF PREGNANCY

I hereby declare my pregnancy and have selected the option checked above. I further acknowledge that I have read, understand and agree to abide by the Sovah - School of Health Professions Radiologic Technology Program PREGNANCY AND IONIZING RADIATION POLICY.

Student Signature Date

Program Director Signature Date

Upon confirmation of pregnancy the student may select one of the following scenarios:

The student may elect to withdraw from the program and be reinstated at that same point in the program twelve (12) months hence, or

The student may elect to remain in the program and be placed in a radiation environment that is in accordance with the NRC's regulations at 10 CFR 20.1208, "Dose to an Embryo/Fetus” where total fetal dose will not exceed 0.5 rem (5 mSv). All mandatory clinical experiences must be completed prior to program completion, or

The student may elect to remain in the current and future clinical settings/rotations in an unaltered status for the duration of the program.

*Regardless of the option selected, the student will be required to complete all aspects of the program in order to graduate.

*Due to the nature of the clinical activities a medical release from the student’s physician will be required for return to clinical activities. *If she so chooses, the student may elect to “rescind” her declaration of pregnancy at any time.

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PREGNANCY AND IONIZING RADIATION POLICY ACKNOWLEDGEMENT PAGE

I hereby acknowledge that I have read, understand and agree to abide by the

Sovah - School of Health Professions Radiologic Technology Program PREGNANCY AND IONIZING RADIATION POLICY.

Student Signature

Date

This acknowledgement is to be signed, removed and placed in the student’s permanent record during orientation.

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Page 80 of 89 Student Handbook

STUDENT CONSENT TO DRUG TESTING AND

AUTHORIZATION FOR RELEASE OF INFORMATION

I, understand and agree that a requirement of my admission to (name, printed)

Sovah - School of Health Professions includes a urine/blood test for the presence of drugs/alcohol.

I understand that by checking the box marked "consent" below and signing this form, I will be giving my consent to

Sovah Health - Danville, or its assigned agent, to collect and test a urine/blood sample from me for drugs/alcohol. This

test will be performed during the admission/orientation process and may be performed randomly or “for cause” during my

enrollment period. In the event that Sovah Health – Danville designates another laboratory or health ca re provider to

collect or test the sample, I will be giving my consent to that process and I will be authorizing the laboratory or health care

provider to release the results of the tests to the Medical Center.

I understand that if I decline to indicate my consent on this form or in any other way refuse to take the test, I will not be

admitted as or continue as a student. I also understand that if the test results indicate the presence of illegal or

unauthorized drugs/alcohol in my system, I will not be permitted to continue as a student.

I understand that in addition to positive test results for illegal drugs/alcohol, positive results of a drug test for a controlled

prescription medication will disqualify me for entrance to Sovah – School of Health Professions unless I indicate on

this form I am on medication and can produce either my prescription or current medication container.

I have taken the following drugs or substances, including over-the-counter drugs or prescription drugs, within the last 30

days (identify name, amount, and when taken):

I hereby consent refuse to consent to this drug/alcohol screening test

_________________________________________________ Student Signature

_______________________________________________ Witness Printed Name

_______________________________ Date

_______________________________________________ Witness Signature

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Page 81 of 89

Student Handbook

STUDENT ACKNOWLEDGEMENT OF DRUG AND ALCOHOL POLICY

I understand that Sovah - School of Health Professions has a Drug and Alcohol Testing Policy. I understand that

I am subject to drug/alcohol testing as a part of the entrance and continued enrollment process to the School. I

understand that if I test positive, refuse to be tested, or attempt to alter or tamper with a sample or any other

part of the testing process, I will not be permitted to enter the School. I further understand that any time after

entering the School, I will be subject to corrective action, up to and including dismissal from the School, if I

violate this policy, either in its current form or as it may be changed from time to time. Finally, I understand

that the policy is not a contract or an offer to contract and that the Sovah - School of Health Professions

maintains the exclusive right to interpret, modify, or eliminate any part of the policy at any time.

Student Signature

Student Name (printed)

Date

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Page 82 of 89

Student Handbook

APPENDIX II

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Clinical Handbook Page 83 of 89

[Type here] [Type here] [Type here]

Sovah - School of Health Professions

ORGANIZATION CHART

Board of Trustees

President & CEO

Sovah Health -Danville

Dean of the School of Health Professions

Radiologic

Technology Program

Advisory Committee

Director - School of

Health Professions

Financial Aid

Officer

Radiologic Technology

Program

Clinical Coordinator

& Didactic Faculty

Didactic/Clinical

Faculty

Legend:

Direct Line of Authority

Cooperation/Communication

Revised 12/14klm

Clinical Handbook

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Appendix III

Clinical Handbook

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ARRT Certification Graduates of the Sovah - School of Health Professions’ Radiologic Technology Program are eligible to sit for the American Registry of Radiologic Technologists Certification Examination (the Registry). Radiologic Technologists must, in most states, be certified by the ARRT.

The American Registry of Radiologic

Technologists®

ARRT is the world's largest credentialing organization that seeks to ensure high quality patient care in radiologic technology. We test and certify technologists and administer continuing education and ethics requirements for their annual registration.

Our Mission The American Registry of Radiologic Technologists promotes high standards of patient care by recognizing qualified individuals in medical imaging, interventional procedures and radiation therapy.

The modalities of interest include, but are not necessarily limited to: radiography, nuclear medicine technology, radiation therapy, cardiovascular-interventional radiography, mammography, computed tomography, magnetic resonance imaging, quality management, sonography, bone densitometry, vascular sonography, cardiac- interventional radiography, vascular-interventional radiography, and breast sonography.

In support of this mission, the ARRT:

Adopts and upholds standards for educational preparation for entry into the profession;

Adopts and upholds standards of professional behavior consistent with the level of responsibility required by professional practice;

Develops and administers examinations which assess the knowledge and skills underlying the intelligent performance of the tasks typically required by professional practice in the modality.

In addition to initial recognition, ARRT provides a mechanism to recognize individuals who continue to demonstrate their qualifications through adherence to the standards of professional behavior and compliance with the continuing education requirements.

For more information contact us at:

The American Registry of Radiologic Technologists®

1255 Northland Drive St. Paul, Minnesota 55120-1155 USA

Phone (651) 687-0048

Or visit us on the web at: www.arrt.org

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Licensure in the State of Virginia

Radiologic Technologists and graduates of radiologic technology programs in the State of Virginia must apply for and receive a Virginia state license prior to employment. Please visit

the web site listed at the bottom of this page or call the Virginia Board of Medicine at the numbers provided below for details on who is required to have this license, when it is required

to be obtained and to download the most recent copy of the application.

Department of Health Professions Perimeter Center

9960 Mayland Drive, Suite 300 Richmond, Virginia 23233

Phone: (804) 367-4400 Fax: (804) 527-4475

Complaints: (800) 533-1560

The Virginia Department of Health Professions works to assure the safe and competent delivery of health care to the citizens of the Commonwealth of Virginia through the process of examining, licensing and disciplining health

care practitioners governed by one of the 13 state health care boards.

Department of Health Professions Perimeter Center

9960 Mayland Drive, Suite 300 Richmond, Virginia 23233

Phone: (804) 367-4600 Fax - Licensure: (804) 527-4426 Fax - Discipline: (804) 527-4429

Complaints: (800) 533-1560

Radiological Technology Advisory Board

www.dhp.state.va.us/medicine/advisory/rt/

Clinical Handbook

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STUDENT HANDBOOK ACKNOWLEDGEMENT I hereby acknowledge that I have read and familiarized myself with the Student Handbook for the Sovah - School of Health Professions Radiologic Technology Program and do hereby agree to abide by the policies and procedures set forth in this handbook.

Student Signature

Date