Last revision: June 20, 2006 June 6, 2005

July 2004 May 2003

August 2002

Radiography Program

Clinical Education Handbook

2006-2007

University of Alabama at Birmingham School of Health Professions

Department of Diagnostic and Therapeutic Sciences Birmingham, AL 35294-1270

2

Table of Content

I. Introduction

Disclaimer ……………………………………………………………………………………… 6 Mission Statement and Goals ………………………………………………………………… 7 Program Officials and Clinical Affiliates…….…………………………………………………. 8 Student Clinical Responsibilities …….. ………………………………………………………. 10

II. General Clinical Education

Rules and Regulations ….……………………………………………………………………… 12 Clinical Attendance Policy …………………………………………………………………… 12 Tardiness Policy ………..……………………………………………………………………… 14 Dress Code ……..……………………………………………………………………………. 15 Dosimeters ……..……………………………………………………………………………. 16 ID markers ……..…………………………………………………………………………… 18 Name badges ……..…………………………………………………………………………. 18 Accidents in the Clinical Sites………………………………………………………………..... 18 Rules and Penalties for Clinical Education Centers…………………………………………… 18 Failure of Follow Policies and Procedures ……………………………………………………. 18 Rules Violation ……………………………………………………………………………… 19 Due Process Procedures …..………………………………………………………………… 21 Clinical Grade Policy ……………………………………………………………………….. 21 General Plan for Clinical Education and Competency Evaluation …………………………. 22 Pregnancy Policy …….……………………………………………………………………… 22

V. Radiography Clinical Competency Evaluation System

Introduction …..……………………………………………………………………………… 25 Clinical Competency Evaluation System …..………………………………………………. 25 The Radiographic Procedure Evaluation (RPE) Form ……………………………………... 26 General Performance Evaluation Form (GPE) and Affective Evaluation ………………… … 27 Clinical Grade Determination ………………………………………………………………. 28 Grading a Competency Examination ……………………………………………………….. 28 Clinical Experience Reports ……….……………………………………………………….. 30 Advanced Standing Options …………………………………………………………………... 31 Clinical Assignment Objectives………………………………………………………………... 32

VI. Appendices

JRCERT Standards for an Accredited Education Program in Radiologic Sciences ………….. .. 37 Radiographic Procedure Evaluation .…………………………………………………………… 60 General Performance Evaluation ……………………………………………………………... 63 Affective Evaluation ………………………………………………………………………….. 65 UAB Radiography Program Competency Requirements ……………………………………. 68 Completed (graded) Radiographic Procedure Evaluation ……………………………………. 70 Clinical Course Syllabi ………………………………………………………………………... 72 Student’s Daily Report of Clinical Experiences (A-Sheet) …………………………………… 88 Monthly Clinical Experience Record (C-Sheet) ………………… …………………………… 90 Program Progression Policy . . . ……………………………………………………………….. 93 SHP Organization Chart ……………………………………………………………………. .. 95 Advance Imaging Concentration – Elective Phase …………………………………………… . 97 Specialty Rotations …………………………………………………………………………….. 99

4

SHP Grievance Procedures for Violation of Academic Standards…………………….………. 101 UAB Radiography Program Clinical Affiliates Information Sheet …………………………… 108 SHP Student Health Policy..…………………………………………………………………… 110 Criminal Background Check Policy for SHP Students…………………………………………. 115 UAB Undergraduate Programs Attendance and Excused Absence Policy . . . . . . . . . . . . . . . . . 118

VII. Acknowledgments Declared Pregnancy Acknowledgement ……………………………………………………… 120 Radiation Risk During Pregnancy and Declared Pregnancy Acknowledgement …………….. 121 Waiver of Program Liability …………………………………………………………………. 122 Venipuncture Waiver Form …………………………………………………………………… 123 Consent to Drug Testing and Release of Drug Test Results ………………………………… 124 Handbook Acknowledgement ………………………………………………………………… 125

5

INTRODUCTION

6

DISCLAIMER

Although this Clinical Education Handbook intends to reflect currently any policies or rules of the SHP Radiography Program, students are cautioned that changes or additions to such policies or rules may have become effective since the publication of this material.

July 2004

7

Mission Statement and Goals The Radiography option of the B.S. in Radiologic Sciences is a health profession program of the School of Health Profession at the University of Alabama at Birmingham. It is designed to provide the radiologic health team with a member who uses ionizing radiation in an investigative function, contributing to the diagnosis in cases of disease and injury. The students develop technical and social skills through active participation in an organized sequence of didactic, laboratory, and competency based clinical education experiences provided in the curriculum. The student performs radiographic examinations with the skill and knowledge of total patient care that is appropriate to all health care providers especially radiology and effective measures of radiation protection. The technical and interpersonal abilities of the graduate radiographer will enable the health care team to improve community health services and provide upward mobility for career development. Program Mission The mission of the BS in Radiologic Sciences, Radiography program is to educate and train students to become entry-level radiographers capable of functioning in a number of clinical settings and to provide career mobility within the field. Career options within the radiography program include introduction into the following specialty areas: magnetic resonance imaging (MRI), computed tomography (CT), vascular interventional radiography (VI), cardiac interventional radiography (CI), and ultrasound (U/S). The goals of the radiography program are: GOAL 1 The program will graduate students that will be competent, entry-level radiographers prepared for

the healthcare field GOAL 2 The student will demonstrate appropriate communication skills GOAL 3 The student will demonstrate appropriate critical-thinking and problem-solving skills GOAL 4 The student (graduate) will understand the importance of professional values and life-long learning GOAL 5 The program will graduate students capable of fulfilling the needs of the healthcare community in

radiologic sciences

Last revised: May 2006

8

UAB Radiography Program Officials

Audrey Harris, M.A.Ed., R.T. (R)(CT)(M)(QM) Dr. Robert Koehler, MD Director, Radiography Program Medical Advisor, Radiography Program University of Alabama at Birmingham University of Alabama at Birmingham Bettye G. Wilson, M.A.Ed., R.T.(R)(CT), RDMS Steven Dowd, Ed.D., R.T.(R)(CT)(M)(MR)(QM) Associate Professor Associate Professor University of Alabama at Birmingham University of Alabama at Birmingham Chalonda L Jones, B.S., R.T. (R) Clinical Coordinator / Teacher University of Alabama at Birmingham

Clinical Affiliates Clinical Instructor

Baptist Medical Center Montclair Joanne Vann

Baptist Medical Center Montclair Diagnostic Center Kelli S. Culwell

Baptist Medical Center Princeton Cathy Hopper Kay McDevitt

Baptist Medical Center Shelby Cynthia Dunlap

Baptist Medical Center Shelby Diagnostic Center Joy Steadman

Baptist Medical Center Walker Rebecca Sharpton

Brookwood Medical Center Scott Glidewell

Brookwood Diagnostic Center Kristal King

The Children’s Hospital of Alabama Karen Knight Children’s South Andrea Black

Cooper Green Hospital _________________

Coosa Valley Medical Center Susan Martin

Health South Medical Center Christopher Cumbest

9

Clinical Affiliates Clinical Instructor

The Kirklin Clinic Kristi Eden

Riverview Medial Center Tommie Bailey

UAB Medical West Jackie Harris

University of Alabama at Birmingham Hospital Chalonda Jones

Veterans Administration Medical Center Gary Coley

Class Representatives Jason Patton UAB Radiography Program Class of 2006 Tonya Drinkard UAB Radiography Program Class of 2007

(see appendix xv for further information on UAB radiography program clinical affiliates)

10

Student Clinical Responsibilities

A. Adhere to the SHP calendar and the Student Health Policy found at http://main.uab.edu/Shrp/Default.aspx?pid=40537 B. Incorporate oneself into the individual department routine. Starting times, coffee breaks and lunch periods are

scheduled according to scheduling and staffing need and constraints.

C. Consistently attends all scheduled experiences on time. If absence or lateness is unavoidable, both the Clinical Instructor and the Program Office must be contacted within 30 minutes of the scheduled starting time

D. Wear student ID badges and personnel monitoring devices provided.

E. Wear clinical attire as required by the Radiography Program. F. Observe universal precautions when handling patients or patient specimens. G. Demonstrate professional behavior at all times by:

1. refraining from criticizing and/or comparing hospitals, technologists or other students. 2. refraining from any discussion concerning the patient with colleagues in patient areas and/or in any way

which is not pertinent or relevant to the procedure or patient care. 3. refraining from speaking within the patient�s hearing range. 4. refraining from extraneous or boisterous conversation while any procedure is in progress. 5. avoiding the display of emotional reactions (distaste, disgust, and surprise) in the presence of patients. 6. displaying concern, patience and interest in the patient. 7. maintaining confidentiality of patient records and/or any information offered by the patient. 8. refraining from discussing one patient with another

H. Demonstrate professional judgment and responsibility by:

1. observing the rules and regulations of the department. 2. working in an orderly fashion with the assigned Clinical Instructor. 3. considering consequences before acting. 4. recognizing which decisions require approval. 5. recognizing own limitations and responsibilities in the work situation.

6. adjusting the pace to situation requirements.

I. Assume some responsibility for one’s own learning by:

1. utilizing all available resources (e.g., books, journals, charts, and health team personnel). 2. using unstructured time wisely. 3. functioning without prodding. 4. showing interest by asking questions and seeking new learning experiences. 5. accepting constructive criticism gracefully. 6. evaluating one�s own performance and checking those perceptions with Instructors.

J. Complete all clinical evaluation forms as specified in the Clinical Education Handbook. K. Evaluate the Clinical experiences at each site at the conclusion of each semester L. Cellphones and pagers are not allowed in the clinical education setting

11

GENERAL CLINICAL EDUCATION

12

Rules and Regulations Students are subject to all rules and regulations of the Clinical Education Center, both institutional and departmental. A request to remove a student from a Clinical Education Center mandates a faculty review of that student’s total performance. If such review is not favorable for the student, the Academic Clinical Coordinator shall recommend to the Program Director that the student be dismissed from the Program. It is the student’s responsibility to provide transportation that will permit prompt and dependable reporting for each Clinical Education assignment.

Clinical Attendance Policy Clinical Attendance 1. Punctual attendance is mandatory; arrival more than 5 minutes after assigned beginning time is

considered tardy and must be made-up. 2. If absence or tardiness is unavoidable, both the Clinical Instructor at the assigned clinical

education site and the Radiography Program’s Academic Clinical Coordinator must be notified at least 30 minutes prior to the scheduled arrival time at that clinical site. The Radiography Program telephone number is: (205) 934-3595. Leave a voice mail message if calling before 8:00a.m.

3. Students who are absent from their regularly scheduled clinical education assignment must

make up the hour(s) missed before the end of the semester. Make up hour(s) must be completed at the clinic where the absence took place. Documentation of each absence and the make-up time must be completed on the appropriate form and turned in to the program office by the end of the semester.

The goal of make-up time is to assure clinical competence of the student. However, it cannot be guaranteed that make-up time will result in exactly the same experiences as regularly scheduled time. Make-up time is normally contracted between the student and the clinical site’s Clinical Instructor. If no acceptable resolution is found, the student should contact the Academic Clinical Coordinator, who will then decide on an appropriate day for make-up. Make-up time is not to be scheduled during regular class time. Students still having to make-up time at the end of the semester will be assigned an “I”. If all makeup time is not completed before the beginning of the next semester, the student will be given a grade of “F” for that clinical education course. A grade of “F” for any UAB Radiography Program course is grounds for immediate dismissal. In all cases, the Academic Clinical Coordinator should be consulted about absence beyond those hours granted. This assures the student that he or she is operating within the rules and expectations of the Program. The student is expected to show cause for absence time so an acceptable resolution may be found. If it appears that competency cannot be achieved in a semester due to missing assignments, the student can be asked to consider withdrawing from the Program.

13

Students missing in excess of personal days allowed will be asked to meet with the Academic Clinical Coordinator to determine options for the student. This will be scheduled at mid-term or the end of the semester, as appropriate. Excused absences, with the exception of granted hours, are absences due to illness with a practicing physician�s return to work excuse, death of an immediate family member (i.e. sibling, parent, spouse, child, grandparent) and military leaves. Valid proof of absence must be given to the program faculty immediately upon the student’s return (i.e. military orders, obituary, etc.). The Academic Clinical Coordinator and the Program Director in the above cases will determine the exact amount of time needed for make-up.

5. Excessive absences are defined as more than the allowed number of personal

days granted for that semester.

6. Excessive, unexcused absences WILL adversely affect the final clinical grade. 7. Absences beyond the allowed personal day(s) each semester will result in the

student having to make up ALL time missed for that semester, to include the personal day(s)

8. Absences should be made up before the end of the semester in which they

occurred.

9. A student that is AWOL, fails to report to the clinical assignment at the appropriate time, fails to contact the clinical instructor and program due to absence, or leaves the clinical assignment without notification or approval of the clinical instructor will be suspended for one week. All time missed due to a suspension MUST be make up prior to the beginning of the next semester. Finally, suspension days will be counted as unexcused absence and WILL adversely affect the final clinical grade for that semester.

10. Three tardies in one semester is equivalent to one day of absence. This day is to

be made-up just as any other absence and will enter into the determination of the final clinical grade.

11. Students are allowed personal leave day(s) each semester in recognition of

normal sick time, doctor’s appointments, emergencies, etc., based on the number of days assigned to clinical sites according to the following criteria:

2 days assigned to clinicals = 1 personal day that semester; 3 days assigned to clinicals = 2 personal days that semester; 4 or 5 days assigned to clinicals = 3 personal days that semester. This time is allowed under the following conditions:

a. Students must call the Clinical Instructor and the Radiography

Program’s Academic Clinical Coordinator to request a personal day. The appropriate personal day request form must be completed and APPROVED by the Academic Clinical

14

Coordinator prior to taking the day off. If possible, request for a personal day should be received 1 week in advance.

b. Personal days can only be taken in whole day (8 hour) increments. c. If the aforementioned criteria is not followed, the absence will be

considered unexcused. 12. Falsification of clinical attendance records will be grounds for automatic

dismissal from the program. 13. If class cancellation occurs due to bad weather (snow and ice) on an assigned

clinic day, call 934-2606 or tune in to WBHM-FM 90.3 for the latest report on the University closing. If the University is closed, stay home, if not, use common sense! Your safety should always take priority.

Tardiness Policy

Students are expected to report to their clinical site at their assigned time or earlier. Students who know they will be late are expected to call the designated clinical instructor at their facility and the Academic Clinical Coordinator at least 30 minutes PRIOR to their assigned clinical education report time. Students late more than two hours will be considered an unexcused absence and MUST make-up the time during the break between semesters. A student who is late will receive a written warning and will have to make up the time as outlined. Accumulation of three tardies will be equivalent to an unexcused absence. A written warning will be issued each time a student is late but not suspended. The following summarizes the Tardiness Policy: 1 hour or less more than 1 hour more than 2 hours

1. Verbal warning & 1. Written warning & 1. Verbal warning and assessed an unexcused make-up time that day make-up time that day absence (a 7 point deduction from the final clinical education grade)

2. Written warning & 2. Written warning & 2. Written warning assessed and unexcused make-up time that day make-up time that day absence (a 14 point deduction from the final

clinical education grade)

3. Written Warning and an Unexcused absence 3. Written warning and assessed an unexcused absence (for each unexcused absence, 7 points will be (a 21 points deduction from the final clinical deducted from the final clinical grade) education grade)

4. Written warning and assessed an unexcused absence 4. Failure of the clinical education course and dismissal (a 14 points deducted from the final clinical grade) from the program

5. Written warning and assessed an unexcused absence (a 21 points deduction from the final clinical education grade)

6. Failure of the clinical education course and dismissal

from the program

15

Dress Code

A professional image must be presented at all times; therefore the following regulations apply whenever a student is in uniform: 1. Institutional scrub suits MUST NOT be worn outside the Clinical Education Center. 2. Inappropriately fitting uniforms will not be permitted.

3. All students must wear neat, clean approved uniforms and shoes.

4. Uniforms and shoes are available at LeJoy’s Uniforms. Choices are limited to approved styles only.

5. A long sleeve, white lab coat may be worn over the uniform. Length should be below the hips.

6. Only Solid white T-shirts or turtlenecks can be worn under uniform.

7. All white leather shoes or all white nursing shoes are required. No clog type, sandals, open toe, heels, or high tops are permissible. Choices limited to approved styles only.

8. Lightweight solid white knee-high hose or socks must be worn.

9. Jewelry, perfume, after-shave, nail polish and make-up should be professional and understated.

10. A watch with a second hand must be worn while in a clinical area.

11. Approved jewelry consists of: a. A watch b. Only one ring per hand

c. Only small conservative stud earrings may be worn. No loud colors are allowed and only one earring per ear.

12. Only nail polish that is clear or neutral in color may be worn. Nails should be short and well groomed. No acrylic nails will be allowed.

13. A conservative amount of make-up may be worn with a light shade of lipstick. 14. Facial hair must be kept short, well trimmed and clean. 15. Hair should be neat in appearance. Longer hair, of any style, must be worn up or secured off the face. 16. The program patches should be worn (sewn) onto your uniforms on the scrub tops (to include

the v-necks with the two bottom pockets), on the upper left side just above the breast area and on the left shoulder of the lab coat (deltoid region)

The above specifications are minimum requirements. The clinic site may indicate additional requirements. It is the student’s responsibility to determine each clinic’s requirement

16

Dosimeters * Radiography students are issued a radiation dosimeter badge to monitor whole body radiation

exposure * Students are responsible for the security of their radiation dosimeters, and are expected to wear

them appropriately in the laboratory and clinical setting * The radiation film badge will be worn at the collar at all times and outside the apron during

fluoroscopic procedures * No student will be allowed in a laboratory or clinical education assignment without properly

dated and displayed radiation-monitoring devices * Students must secure currently dated radiation dosimeter badges and return the previous

radiation dosimeter devices by the first day of each month. If the first day of the month falls on a weekend, the badge must be exchanged the Friday prior to the weekend in order to be prepared for clinical assignments on Monday

* Failure to return the badge by the due date will result in a seven-point final grade reduction per

day until returned. These reductions will be applied to the final lab or clinical grade (which ever is applicable). Students will not be allowed in the laboratory or clinical education sites until the current badge is properly displayed on their person.

* All time missed in the laboratory or clinical education assignments must be made up * Further disciplinary actions, including dismissal, will be taken toward students who display

ongoing problems in not returning or securing radiation dosimeter badges as described above.

17

Important Points to Remember Regarding the Care of the Radiation Monitoring Devices

1. The radiation monitoring devices must be removed while having personal diagnostic

medical or dental radiographs 2. Protect the badge from direct sunlight, they should not be left in a vehicle or in a

radiographic room 3. Report immediately any accident with or loss of the radiation monitors to the person

responsible for the radiation monitoring program for students 4. A written follow-up report must be submitted within 24 hours concerning an accident

with or the loss of a radiation monitoring device 5. Students are required to pay at a cost of $5.00 for each lost film badge. 6. Monthly radiation reports will be available in the office of the person responsible for the

radiation monitoring of students 7. Students are required to review and initial their individual dose results contained on the

report each month 8. The student’s monthly radiation dose report should not exceed:

60 mrem/month - deep, whole body radiation - film badge (GI) 195 mrem/month - hand and forearm radiation - ring badge (U3)

9. The monthly radiation dosage must not exceed the maximum permissible dosage for

occupationally exposed persons as established by the state and federal agencies for radiologic health. The values are as follow:

5 rem/year - Whole body 15 rem/year - lens of eyes 50 rem/year - extremities

10. Limit on declared pregnant worker is: 50 mrem/month Note: 1 rem = 1,000 mrem

18

Identification (ID) Markers Student must have their film ID (side/part) markers with them at all times while in the Clinical Education and Laboratory settings. Failure to have the makers can result in dismissal from the clinical area for the day and the laboratory.

Name Badges Students must wear a program selected name badge at all times while in the Clinical and Laboratory areas. See Dress Code on where the name badges must be purchased.

Accidents in the Clinical Sites

Students, who are involved in accidents resulting in personal injury, should immediately report the incident to the clinical instructor at their clinical education site. The clinical instructor will assist in the student completing an incident report that will be forwarded to the Academic Clinical Coordinator or Program Director at the program within 24 hours of the incident. If warranted, the student will seek medical attention from their personal physician, the emergency department at the assigned clinical education site, or the UAB Student Health Services. The proper order of procedures for treatment of an accident at the clinical site is first the UAB Student Health, or the assigned clinical site’s emergency room in the case of a severe injury, or the student’s personal physician. Please be advised however, students who receive treatment at the clinical site where they are assigned maybe responsible for the cost associated with the medical treatment.

Rules and Penalties for Clinical Education Centers

In identifying Program rules and the consequences of violating them, the Program has tried to maintain an approach that will discourage unprofessional behavior. However, students in the health care disciplines should realize that some violations WILL NOT be tolerated even once. It is the student�s responsibility to know and abide by the rules. Additionally, the student must maintain the health, safety, and ethical standards of the Clinical Education Centers. Extremely unethical conduct or disruptive behavior may result in immediate dismissal by the Clinical Education Center or the Program.

Failure to Follow Policies and Procedures Students are required to follow the policies and procedures outlined in the Clinical Education Handbook and the clinical education site to which they are assigned. Ignorance of the contents of the Clinical Handbook is not an excuse for noncompliance.

19

Violations of the policies and procedures will be handled in the following manner. First violation: The Academic Clinical Coordinator will review the policy or procedure with the student to ensure that the student understands the expected behavior. The counseling (verbal warning) session will be documented in writing and maintained in the student�s file. Second violation: The student will receive written notification that he/she is being placed on probation for failing to adhere to policy or procedure for the second time. The period of probation will extend for the remainder of the semester in which the second violation took place and the following semester. All time absent from the clinical education assignment must be made up by the end of the semester. Third violation: The third infraction will result in the student’s immediate dismissal from the Program. NOTE: Please be advised however, that some infractions that are more severe in nature, will

result in immediate dismissal from the program.

Rules Violations INFRACTION OCCURRENCE ACTION 1.0 Failure to participate 1 verbal warning (perform assigned duties) 2 written warning and probation 3 dismissal 2.0 Failure to maintain proper dress, 1 verbal warning appearance, or hygiene 2 written warning and probation 3 dismissal 3.0 Insubordination 1 verbal warning 2 written warning and probation 3 dismissal 4.0 Discourteous treatment of others 1 verbal warning 2 written warning and probation 3 dismissal 5.0 Incompetence, neglect of duty, or 1 verbal warning poor performance 2 written warning and probation 3 dismissal

20

6.0 AWOL, failure to report, or leaving clinical 1 verbal warning education center without notifying 2 written warning and probation clinical instructor 3 dismissal 7.0 Violation of safety rules & regulations 1 verbal warning 2 written warning 3 dismissal 8.0 Divulging confidential patient information 1 dismissal 9.0 Gambling on hospital property 1 dismissal 10.0 Use of profanity within hearing distance 1 verbal warning

of patients or hospital personnel 2 written warning and probation 3 dismissal 11.0 Refusal to work in an assigned area 1 verbal warning 2 written warning and probation 3 dismissal 12.0 Physically fighting 1 dismissal 13.0 Absenteeism 1 verbal warning 2 written warning and probation 3 dismissal 14.0 Absent 3 consecutive scheduled days each student must present a due to illness doctor’s excuse and release form upon returning 15.0 Theft or falsification of records 1 dismissal 16.0 Reporting to clinical education site 1 dismissal under the influence of drugs or alcohol 17.0 Possession or consumption of drug 1 dismissal

or alcohol on clinical education site premises 18.0 Frequent or continual verbal or written 1 verbal warning warnings (3) or suspensions for different 2 written warning and probation violations 3 dismissal 19.0 Failure to maintain student records 1 verbal warning 2 written warning and probation 3 dismissal 20.0 Unauthorized (excessive) use of cellphones 1 verbal warning in the clinical setting (see rule 1.0) 2 written warning and probation 3 dismissal

21

Due Process Procedures

The grievance procedure is intended to provide an orderly process by which grievances of a professional nature are examined or resolved within the established structure of the University. For further clarification on the SHP Grievance Procedures for Violations of Academic Standards, please see appendix xiv on page 96 of this document.

Clinical Grading Policy

A. An evaluation of student performance, both behavioral and technical, is completed by

the Clinical Instructor(s) at the conclusion of each rotation.

B. The weighing of these areas for the final clinic grade is as follows: 1. Radiographic Procedure Evaluations (average) 40% 2. General Performance Evaluation (average) 30% 3. Affective Evaluation 30% Total 100% 4. Other Factors:

a. Unexcused absences (7 point deduction from the final clinical grade for EVERY UNEXCUSED ABSENCE).

b. Non completion of required number of competencies

(-10 points each competency required but not completed)

c. Students must return the previous monitoring badges by the fifth of the month proceeding that wear date. Failure to return these badges by the due date will result in a SEVEN point deduction per day until returned.

All point deductions in this category will be applied to the final averaged clinical grade.

22

General Plan for Clinical Education and Competency Evaluation

Each UAB Radiography Program clinical affiliate has a designated clinical instructor responsible for supervision, instruction, and evaluation of assigned students. The clinical instructor or a designated qualified technologist(s) supervises the student in the clinical education center. Supervision of radiography students may be direct or indirect. The type of supervision depends on the progress of the student in the Program. Direct Supervision - means the supervising technologist is present in the radiographic room when the student is performing any examination. Indirect Supervision - allows the student to perform radiographic procedures without the presence of a qualified technologist in the room. This type supervision of requires that a qualified technologist(s) be near if needed to assist the student or supervise any “repeat” radiographs the student must perform. Any “repeat” radiograph by a student requires the presence of an ARRT registered radiologic technologist in the radiographic room at the time of the “repeat”.

Pregnancy Policy The purpose of the student pregnancy policy is to assure students a safe pregnancy and to be in compliance with federal and state radiation control regulations as well as the Equal Employment Opportunity Commission guidelines. Pregnant student radiologic technologists may continue in the Radiography program. It is the individual student’s responsibility to utilize the guidelines set forth in this policy for protection of the embryo/fetus and self. (see Pregnancy Acknowledgement) Procedure: 1. Any suspected or known pregnancy can be voluntarily reported to the Program Director

and/or the Academic Clinical Coordinator in writing. The program faculty will discuss with the pregnant radiographer student the effects of irradiation in utero inclusive of radioprotective procedures.

2. The pregnant student will sign the Pregnancy Release form to acknowledge

comprehension of the information provided by the Program faculty. The student will also be referred to the ASRT guidelines and other pertinent references on the subject.

3. The pregnant student will be issued an additional fetal monitor (radiation dosimeter)

which will be worn at the waist and under the protective apron while in a fluoroscopic environment.

4. According to the NCRP Report # 53, the maximum permissible dose equivalent from

occupation exposure to the expectant mother is 500 mrem (5 mSv) for the entire pregnancy.

23

5. The monthly radiation exposure report inclusive of accumulative dose for each individual is made available to the Program faculty and the student.

6. In accordance with the pregnancy policy of the specific clinical assignment, if fluoroscopy

and mobile radiography are performed, the pregnant student radiographer must wear an apron with a minimum of 0.5 mm lead equivalent, which will attenuate approximately 88% of the 75 kVp primary beam. If available, a1.0 mm lead equivalent apron that attenuates 99% of the 75 kVp primary beam should be worn.

7. It is not recommended that pregnant student radiographers perform radiographic

procedures on patients with intracavitary or interstitial source gamma radiation. 8. Clinical rotation schedules may be modified to schedule the pregnant student through low

radiation areas especially during the first trimester. 9. The pregnant student radiographer is expected to meet all objectives and clinical

competencies of each clinical education course without exception. Failure to complete all required clinical assignments could possibly result in a failing grade for that clinical course.

10. For further information on this matter, visit the NRC website at www.ncr.gov then

proceed by using the following prompts: - electronic reading room - basic reference - key guidance documents - regulatory guides - occupation health - 8.13

11. A student is offered two alternatives after the consultation with the Program Director upon

voluntarily declaring pregnancy. These options are:

a. The declared pregnant student can immediately withdraw from all clinical and didactic courses and write a letter to the Radiography Program Director requesting re-entry the following year.

b. The declared pregnant student can continue in the program after being given specific

instruction regarding radiation safety practices, additional radiation monitoring, and specific clinical and laboratory assignments.

24

RADIOGRAPHY CLINICAL COMPETENCY

EVALUATION SYSTEM

25

Introduction

The responsibility of the Radiographer has grown in complexity with the development of more sophisticated procedures and equipment in the medical imaging sciences. It is essential that the University of Alabama at Birmingham and the clinical affiliates work together to provide the best educational experiences to all students. During the clinical experience, students must have the opportunity to perform all types of routine radiographic procedures. Only in this manner will they be prepared for entry into the profession. Students are responsible for their performance. However, there must be a competency-based curriculum, both academic and clinical. Efforts have been made to develop a clinical evaluation system whereby students may progress through clinical education with their strengths and deficiencies identified. Every effort will be made to correct identified deficiencies. Competency based evaluation is a means of checking the progression rate of students by determining whether or not they are able to meet specified objectives, thus demonstrating proficiency. Students’ knowledge and skills are directly evaluated in the classroom and indirectly evaluated throughout their educational experience. Their application of skills is evaluated in the energized laboratory at the University of Alabama at Birmingham and during their clinical experience in each of the clinical affiliates. In order to properly evaluate student application skills, it is essential to determine the level of performance ability. Only through the use of a competency based evaluation system can we objectively determine the proficiency level a student has achieved. It is very important that knowledge and skills be reinforced and evaluated in the clinical setting to maximize the students’ clinical effectiveness. It is the role of the clinical affiliates to provide clinical experiences designed to bridge the gap between theory and application. This can only be accomplished through quality supervision of clinical experiences in each medical facility. The clinical portion of the Radiography Program within the Department of Diagnostic and Therapeutic Sciences at UAB is an integral part of the total curriculum. All persons involved with the program must thoroughly understand the structure and function of the clinical evaluation system for the total education experience of a student to be effective.

Clinical Competency Evaluation System

The goal of the Program’s clinical evaluation system is two-fold. One is to measure the students’ ability in the clinical environment to produce diagnostic radiographs of various anatomical parts. The second is to measure behavioral characteristics including punctuality, work attitude, cooperation, quality of work, and initiative in the same environment. Three evaluation forms are used. The first area (ability to produce diagnostic radiographs) is measured using a RADIOGRAPHIC PROCEDURE EVALUATION FORM (see Appendix ii). The second area (behavioral characteristics) is measured using a GENERAL PERFORMANCE EVALUATION FORM (see Appendix iii) and an AFFECTIVE DOMAIN EVALUATION FORM (see Appendix iv) The Affective Evaluation with input from the General Performance Evaluation Forms will account for 30% of the total clinical grade. The Radiographic Procedure Evaluation Form will determine the remaining 40% of the final clinical grade.

26

THE RADIOGRAPHIC PROCEDURE EVALUATION (RPE) FORM

Each term the student is graded on a minimum number of designated examinations completed unassisted. All examinations required for clinical competency will be discussed in the associate radiographic procedures course and evaluated in the laboratory. The student must perform a minimum of three (3) examinations in the competency area prior to being evaluated. In the clinical setting, students who have observed, assisted, and performed a particular examination satisfactorily may notify the Clinical Instructor of their readiness to perform the examination unassisted but under direct supervision for a grade (competency exam). The Clinical Instructor may give permission to the student to proceed. The student must notify the Clinical Instructor before performing a competency examination. The student processes the film and each projection is evaluated separately using the Radiographic Procedure Evaluation Form. The evaluator must review the procedure and the radiographs with the student present, and appropriately fill out the Radiographic Procedure Evaluation Form. If any projections require repeating, the student receives a maximum grade of 60 for that specific projection. If the student understands the problem, the film must be repeated and evaluated on the repeat (not for a grade, only an “S” or a “U”). If assistance is required in the repeat of the film, the student becomes responsible to repeat the entire examination, completed satisfactorily and unassisted before the end of the term. The repeat examination must be graded and documented to complete the semester. Grades will be assigned on the first attempt for any competency examination. Any repeats must be done on an “S” or “U” basis. The “S” (satisfactory) or “U” (unsatisfactory) is utilized to show that the student was able or unable to demonstrate competency on a specific projection needed to be repeated. “S” or “U” is not used in the numerical grade determination, only to show student competency on repeated radiographs. NOTE: An “S” or a “U” is applied to an examination of a previously unsuccessful procedure

evaluation (less than 75% correct) and is repeated by the student. An “S” is assigned to a repeated projection if fewer than four (4) errors are made during the performance of the repeat projection(s) and the radiograph is acceptable per the department standards. A “U” is assigned to a repeated projection(s) if four (4) or more errors are made while performing the repeat projections(s) or if the projection must be or should be repeated.

On the Radiographic Procedure Evaluation (RPE) Form, any evaluative category may be checked more than once. For example, if the student has positioned the patient incorrectly, a check mark ( ) would be placed in the positioning box. If the student also did not adequately center the part to the film, another check mark would be given for incorrect positioning. Each check mark is equal to minus seven (-7) points. Students will not be required to perform any radiographic examinations that exceed their educational or clinical experience without assistance. A student may be asked to file, transport patient, or perform other tasks that are pertinent to radiographic examinations of patients.

27

The Radiographic Procedure Evaluation Form (RPE) is very important, and when used properly, can give a measure of a student’s ability to adequately produce a diagnostic radiograph for a specific anatomical part. Utilizing the form, one can quickly identify a student’s problem area(s). At the end of any given period of time, we will have documentation of the student’s ability to perform various diagnostic radiographs. Before any competency evaluation of a procedure can be performed, the student must produce records of 3 of the same or similar procedures: 1 - observation 1 - assisted 1 - perform accurately with supervision only; i.e. with no repeats and no correction while

the procedure is in progress

(see Appendix v for competency requirements per semester) The General Performance Evaluation Form (GPE) and Affective

Evaluation

The second set of evaluation forms (see Appendices iii & iv respectively) are intended to be used by the clinical affiliate supervising technologist and the Clinical Instructor. The general performance evaluation form will be filled out for each student three (3) times per semester by the supervising technologist. These ratings shall be discussed with each student upon completion. The student will be asked to sign these evaluation forms. These evaluations will enter directly into the grade calculations for the term. They are a primary means of early recognition and correction of possible problems. The Clinical Instructor will complete the Affective Evaluation (AE) at the end of each semester. Since performance characteristics are weighed greater than personal characteristics, this evaluation form will not have as high a grade percentage assigned it as the Radiographic Evaluation Procedure Form (RPE). In order for students to adequately pass each clinical assignment, they must show satisfactory evidence of ability to perform diagnostic radiographic procedures and demonstrate professional traits reasonably consistent with criteria established by faculty and clinical instructors. Regardless of the grade attained on the Radiographic Evaluation Form, a student will not be allowed to continue in the program if, at the end of any given semester, a cumulative average of the General Performance Evaluation Forms is less than a “C”. Should a student receive three (3) consecutive evaluations with a score below 75%, the student will be placed on probation. If the student continues to score below 75% after being placed on probation, he/she may be recommended for dismissal. It is the Clinical Instructor’s responsibility to see that the appropriate forms are filled out and signed each semester.

28

Clinical Grade Determination A. An evaluation of student performance, both behavioral and technical, is completed by

the Clinical Instructor(s) at the conclusion of each rotation.

B. The weighing of these areas for the final clinic grade is as follows: 1. Radiographic Procedure Evaluations (average) 40% 2. General Performance Evaluation (average) 30% 3. Affective Evaluation 30% Total 100% 4. Other factors that may influence the student’s final clinical grade:

a. Unexcused absences (SEVEN point deduction from the final clinical grade for EVERY UNEXCUSED ABSENCE).

b. Non-completion of required number of competencies

(-10 points each competency required but not completed)

c. Students must return the previous monitoring badges by the fifth day of the month proceeding the wear date. Failure to return badges by the due date will result in a SEVEN-point deduction per day until returned.

All point deductions in this category will be applied to the final averaged clinical grade.

• students with excused absences during the semester will be allowed until the last day of finals to complete the required clinical competency evaluations

• On the last day of finals, grades will be calculated and sent to the UAB Registrar’s Office

with all rules for calculations applying at that time

Grading a Competency Examination

When grading with the Radiographic Procedure Evaluation Form (RPE), the evaluator reviews each projection (example toe competency) and makes a check mark in the area(s) where a problem exists (see Appendix ii). For example, if on the AP projection, the toes are slightly off center to the right, a check mark [ ] was placed in the positioning column for this projection. A check mark [ ] represents minus seven (-7) points. However, the radiograph did not need to be repeated.

29

If on the oblique projection, the student makes no mistakes (a perfect radiograph), no check marks are given for this projection. However, on the lateral projection for toes, the student failed to immobilize the toes. Item 3 under this projection is again checked for positioning. However, the radiograph did not require a repeat. In this case, the student received an averaged score for the toe competency of 95.33% (93% for the AP projection, 100% for the oblique projection, and 93% for the lateral projection). (see appendix vi) If the student repeats the examination with assistance, it is not evaluated. However, before the end of the term, the student must perform another of the same type examination unassisted and receive a successful evaluation. At that time, it would be evaluated using the Radiographic Evaluation Form, and an “S” or “U” assigned. This evaluation should be attached to the original form to document the student’s success. In grading, all repeat evaluations receive only an “S” or “U”. The student has one chance to do a competency of a specific examination for a grade; repeats are graded “S” or “U” to show only the ability, or lack of it, to perform a projection that required repeating. Using the example of the toes, if the student received a 93% for the AP, 100% for the oblique, and a 0% for the lateral due incorrectly marking the film, the student would have an averaged score of 64% for the toe competency which is a failing grade. The lateral projection was repeated to prove competency (due to film being rejected on the first attempt) and receives an “S”. For a competency evaluation attempted to be credited toward fulfillment of the required number for any term, it must be: a. Completed with a percent accuracy for each projection as stated in each Clinical Education Course Syllabi (see Appendix vii);

b. Examinations evaluated below their required percent accuracy must have a repeat evaluation of that projection on record with an “S” grade.

NOTE: The effect of erroneously identifying the anatomical side or part (right or left) or failure to use an anatomical side marker when performing a procedure to prove competency is severe. The result of this error is that the Clinical Instructor will assign an accuracy rating of “0” for the projection being performed. This “0” will be recorded and will enter into the average grade for the procedure in which it occurs. Students seem to make this error and continue to do so with apparent unconcern. This policy is deemed necessary to discourage the practice in the future. Should a student continue this error when not being evaluated for competency, the student will experience lower scores when the General Performance Evaluation (GPE) and the Affective Evaluation (AE) are completed. Penalties for incorrectly marking radiographs may be easily avoided by the student--they must mark radiographs correctly. Before any competency evaluation of a procedure is attempted, the student must produce records of 3 of the same or similar procedures being observed (1) assisted (1) and performed accurately with supervision (1), i.e. with no repeats and no corrections while the procedure is in progress. The only possible exception to this policy would be in procedures involving headwork.

30

Clinical Experience Reports

• All student clinical experiences during the educational program must be reported • Documentation of experiences is the basis for evaluation of clinical success in the

Radiography Program

• Copies of A-sheets (see Appendix viii) and C-sheets (see Appendix ix) can be found in each student’s Radiography Clinical Practicum book.

• The A-sheet must provide a record of radiographic procedures or other activities observed,

assisted or performed independently

• Students are responsible for keeping accurate and current records

• Both A-sheets and C-sheets are to be submitted to the clinical instructor at the end of each month, and on the last day of the clinical assignment

• Failure to complete proper forms may result in a grade of “I” submitted to the UAB

Registrar’s Office for semester records that are missing

• A grade of “I” becomes an “F” by the end of the subsequent semester with continued absence of records

Documentation of Clinical Experience is a basis for the evaluation of success in the Clinical Education component of the Radiographer Program. This documentation must be complete and accurate. Falsification of any clinical document will result in automatic dismissal from the program. Each student shall complete information requested by the forms and submit them to the Clinical Instructor for verification. Copies of the Clinical Experience Report Form are kept in each student's folder in the Office of the Clinical Instructor at the Clinical Education Center of assignment. The Clinical Experience Forms provide a record of the examinations, which the student has observed, assisted with, or performed. Students are responsible for properly completing these records and keeping them current. The forms in use are commonly referred to as "A" sheets and "C" sheets. The "A" sheet is a Daily Experience form that is completed by the student and submitted daily to the individual Clinical Coordinator. The "A" sheets will be needed by the student at the end of each month to complete the "C" sheet. The "C" sheet is a monthly summary of the Clinical Experiences of the individual student. A student will submit both completed forms to the Clinical Instructor at each Clinical Education Center at the end of each month or the last Clinical assignment day of the semester. Completing the Clinical Experience Report Form:

31

Enter the full name of the student on the designated line.

Enter the name of the Clinical Education Center under "Institution" and enter either inpatient (IP) or outpatient (OP) radiography under "Division".

The type of experience refers to the performance of a procedure. This is information which appears on the "A" sheet in the column headed "O/A/I".

An "O" in this column denotes the student observed only.

An "A" in this column denotes the student assisted in the performance of the procedure.

An "I" in this column denotes the student performed the procedure independently. If the student is performing patient transport, clerical duties, or processing of radiographs,

these activities may be recorded at the bottom of the "A" sheet (section labeled: "PROCEDURES/ACTIVITIES OTHER THAN DIAGNOSTIC PROCEDURES") by completing the information requested.

To be a valid report, the signature of the Clinical Coordinator or supervising technologist must appear on each Clinical Experience Report form.

All Clinical Experiences should be performed adhering to the Clinical Procedure Performance Objectives. Students should review these periodically. All Clinical Experiences of a student during the Educational Program must be reported. Students failing to complete and submit "A" and "C" sheets by the fifth (5th) day of any month or before the last day of final examinations for any semester respectively, will be asked to complete them before returning to their Clinical Education assignment. A grade of "I" will be submitted to the UAB Registrar's Office for the semester in which the records are missing and this grade will remain until the delinquent records are submitted to the Office of the Academic Clinical Coordinator or until the end of the subsequent semester when, it becomes an "F" with the continued absence of the records.

Advanced Standing Options

All students enrolled in the advance standing options of the program will follow the policy and procedures of that particular modality set forth by the course master (coordinator) of that modality.

CIT CT Bettye G. Wilson MRI Bradley Newcomer U/S Bettye G. Wilson

32

Clinical Assignment Objectives

Routine Radiography Students are assigned repeatedly to the general radiography areas during the first and second year of the program. These rotations are designed to give the student clinical experience in performing routine radiographs and chest x-rays on varying types of patients. Rooms should be cleaned and stocked daily. Additionally, the student should be able to:

1. manipulate the radiographic table to assist with patient placement 2. manipulate the tube to position collimator beam properly 3. discuss and manipulate the locks on the machine 4. calculate the mAs from selecting the mA and time 5. select proper kVp and mAs, to accommodate the procedure and patient body habitus

from the posted technique chart 6. position patient according to class instruction 7. process resulting radiographs 8. load and unload radiographic cassettes 9 explain AEC

IVP area Students are assigned repeatedly to the IVP area during the first and second year of the program. These rotations are designed to give the student clinical experience in performing various Genitourinary and tomographic procedures on varying types of patients. Rooms should be cleaned and stocked daily. Additionally, the student should be able to:

1. manipulate the radiographic table to assist with patient placement 2. manipulate the radiographic tube to position collimator beam properly 3. discuss the locks on the machine 4. calculate the mAs from selecting mA and time 5. select proper kVp and mAs, to accommodate the procedure and patient body habitus

from the posted technique chart 6. position patient according to class instruction 7. process resulting radiographs 8. load and unload radiographic cassettes 9. discuss, set, and manipulate the fulcrum 10. set the proper tube arc angle 11. assemble and dis-assemble the tomographic unit

NOTE: see Appendix x – venipuncture waiver

33

Fluoroscopy area Students are assigned repeatedly to the fluoroscopy areas during the first and second year of the program. These rotations are designed to give the student clinical experience in performing a variety fluoroscopic procedures on varying types of patients. Rooms should be cleaned and stocked daily. Additionally, the student should be able to:

1. manipulate the radiographic table to assist with patient placement 2. manipulate the tube to position collimator beam properly 3. discuss and manipulate the locks on the machine 4. calculate the mAs from selecting the mA and time 5. select proper kVp and mAs, to accommodate the procedure and patient body habitus

from the posted technique chart 6. position patient according to class instruction for each particular procedure 7. process resulting radiographs 8. load and unload radiographic cassettes 9. load and unload the spot film device 10. enter proper patient information for digital imaging 11. set up sterile trays

Emergency and Trauma Room Students are assigned repeatedly to the emergency and trauma area during the first and second year of the program. These rotations are designed to give the student clinical experience in performing a variety emergency and trauma radiographic procedures on varying types of patients in a fast paced Level I Trauma center. Rooms should be cleaned and stocked daily. Additionally, the student should be able to:

1. manipulate the radiographic table to assist with patient placement who may have limited mobility

2. manipulate the tube to position collimator beam properly 3. discuss and manipulate the locks on the machine 4. calculate the mAs from selecting the mA and time 5. select proper kVp and mAs, to accommodate the procedure and patient body habitus

from the posted technique chart 6. position patient according to class instruction for each particular procedure 7. process resulting radiographs 8. load and unload radiographic cassettes 9. conduct oneself professionally and proficiently under potentially life-threatening

situations 10. develop confidence, speed, and accuracy in performing procedures in a high stress

environment

O.R. Students are repeatedly assigned to the OR (surgical)areas during the second year of the program. These rotations are designed to give the student clinical experience in performing a variety fluoroscopic and surgical procedures on varying types of patients in a sterile environment. Additionally, the student should be able to:

1. manipulate the GU radiographic table to assist with patient placement 2. manipulate the tube to position collimator beam properly 3. discuss and manipulate the locks on the machine 4. calculate the mAs from selecting the mA and time 5. select proper kVp and mAs, to accommodate the procedure and patient body habitus

from the posted technique chart 6. position patient according to class instruction for each particular procedure 7. process resulting radiographs 8. load and unload radiographic cassettes 9. set up and operate a C-arm machine 10. manipulate the locks and transfer images from screen to screen on the C-arm

machine Portables Students are assigned repeatedly to portables during the first and second year of the program. These rotations are designed to give the student clinical experience in performing a variety portable procedures on varying types of patients with indwelling tubes, catheters, and ventilation machines. Additionally, the student should be able to:

1. manipulate the portable radiographic machine to assist with cassette placement 2. manipulate the tube to position collimator beam properly 3. discuss and manipulate the locks on the machine 4. properly aligning portable tube with film 5. select proper kVp and mAs, to accommodate the procedure and patient body habitus 6. utilize proper body mechanics when lifting and rolling patients 7. load and unload the cassettes 8. enter proper patient information for image processing 9. set up sterile trays

35

APPENDICES

36

Appendix i JRCERT Standards for an Accredited Education Program in Radiologic

Sciences

37

Standards

for an Accredited Educational Program in Radiologic Sciences

EFFECTIVE JANUARY 1, 2002

Adopted by: The Joint Review Committee on Education

in Radiologic Technology: January 1996; Revised 2001 Essentials initially adopted:

Radiography-1944; Revised 1955, 1969, 1978, 1983, 1990, 1994 Radiation Therapy-1968; Revised 1976, 1981, 1988, 1994

The Joint Review Committee on Education in Radiologic Technology is dedicated to excellence in education and to quality and safety of patient care through the accreditation of educational programs in radiation and imaging sciences.

The Joint Review Committee on Education in Radiologic Technology (JRCERT) is recognized by the United States Department of Education to accredit educational programs in radiography and radiation therapy. The JRCERT awards accreditation to programs demonstrating substantial compliance with these STANDARDS. Copyright © 2001 by the JRCERT

38

Statement on Assessment of Program Effectiveness 1

The Joint Review Committee on Education in Radiologic Technology (JRCERT) believes that the accreditation process offers a means of providing public assurance that a program meets standards and of stimulating programmatic improvement. The JRCERT Standards for an Accredited Educational Program in Radiologic Sciences (STANDARDS) require a program to articulate its purposes; to demonstrate that it has adequate human, financial, and physical resources effectively organized for the accomplishment of its purposes; to document its effectiveness in accomplishing its purposes; and to provide assurance that it can continue to meet accreditation standards. A variety of assessment approaches in its evaluation processes strengthens a program’s ability to document its effectiveness. The JRCERT believes that assessment leads to programmatic improvement. The JRCERT does not prescribe a specific approach to assessment. That determination should be made by the program in terms of its own purposes and resources. Assessment is not an end in itself but a means of gathering information that can be used in evaluating the program’s ability to accomplish its purposes. An effective assessment process provides information that assists program officials in making useful decisions about the program and in developing plans for its improvement. The JRCERT expects programs to develop a system of planning and evaluation to demonstrate its effectiveness in relation to student achievement. The program is expected to describe and document student learning outcomes and the pursuit of academic excellence.

Introduction The Standards for an Accredited Educational Program in Radiologic Sciences are directed at the assessment of program and student outcomes. Using these STANDARDS, the goals of the accreditation process are to: protect the student and the public, stimulate programmatic improvement, provide protective measures for federal funding or financial aid, and promote academic excellence. Each STANDARD is titled and includes a narrative statement, supported by objectives, describing the outcome required for compliance with the STANDARD. Selected key terms are underlined and defined in the Glossary to clarify the meaning. The definitions contained in the Glossary are considered a component of the STANDARDS and, as such, must be satisfied to comply with the STANDARDS. 1This Statement is based on a similar Statement developed by the Commission on Institutions of Higher Education, North Central Association of Colleges and Schools. The JRCERT acknowledges, with thanks, the permission of the North Central Association for its use.

39

Standards for an Accredited Educational Program in Radiologic Sciences

Table of Contents Standard One: Mission/Goals, Outcomes, and Effectiveness ................................................................ 1 The program, in support of its mission and goals, develops and implements a system of planning and evaluation to determine its effectiveness and uses the results for program improvement. Standard Two: Program Integrity ........................................................................................................... 2 The program demonstrates integrity in representations to communities of interest and the public, in pursuit of educational excellence, and in treatment of and respect for students, faculty, and staff. Standard Three: Organization and Administration............................................................................... 3 Organizational and administrative structures support quality and effectiveness of the educational process. Standard Four: Curriculum and Academic Practices............................................................................ 4 The program’s curriculum and academic practices promote the synthesis of theory, use of current technology, competent clinical practice, and professional values. Standard Five: Resources and Student Services ..................................................................................... 5 The program’s learning resources, learning environments, and student services are sufficient to support its mission and goals. Standard Six: Human Resources.............................................................................................................. 6 The program has sufficient qualified faculty and staff with delineated responsibilities to support the program’s mission and goals. Standard Seven: Students ......................................................................................................................... 9 The program’s and sponsoring institution’s policies and procedures serve and protect the rights, health, and educational opportunities of all students. Standard Eight: Radiation Safety .......................................................................................................... 10 Program policies and procedures are in compliance with federal and state radiation protection laws. Standard Nine: Fiscal Responsibility ..................................................................................................... 11 The program and the sponsoring institution have adequate financial resources, demonstrate financial stability, and comply with obligations for Title IV federal funding, if applicable. Glossary ..................................................................................................................................................... 12 Awarding, Maintaining, and Administering Accreditation .................................................................. 15

1

1

Standard One: Mission/Goals, Outcomes, and Effectiveness The program, in support of its mission and goals, develops and implements a system of planning and evaluation to determine its effectiveness and uses the results for program improvement. Objectives: In support of Standard One, the program: 1.1 Has a mission statement that defines its purpose and scope. 1.2 Has written goals that outline what the program is designed to achieve. 1.3 Makes its mission statement and goals readily available to students, faculty, administrators, and

the general public. 1.4 Develops and implements an assessment plan that identifies benchmarks for the measurement of

outcomes in relation to its mission statement and goals and includes:

• program completion rate; • clinical performance and clinical competence; • problem solving skills and critical thinking; • communication skills; • professional development and growth; • graduate satisfaction; and • employer satisfaction.

1.5 Documents outcomes consistent with each of the following JRCERT policies:

• over the past five years, credentialing examination pass rate average of not less than 75% at first attempt; and

• over the past five years, job placement rate of not less than 75% within six months of graduation.

1.6 Regularly solicits feedback from students, faculty, radiologists/radiation oncologists, graduates,

employers, and other communities of interest. 1.7 Analyzes and uses feedback from communities of interest and outcome data for continuous

improvement of its policies, procedures, and educational offerings. 1.8 Periodically evaluates its mission statement, goals, and assessment plan and makes revisions as necessary to achieve continuous quality improvement.

2

2

Standard Two: Program Integrity The program demonstrates integrity in representations to communities of interest and the public, in pursuit of educational excellence, and in treatment of and respect for students, faculty, and staff. Objectives: In support of Standard Two, the program: 2.1 Adheres to high ethical standards in relation to students, faculty, and staff. 2.2 Has program faculty recruitment and employment practices that are nondiscriminatory with

respect to any legally protected status such as race, color, religion, gender, age, disability, and national origin.

2.3 Publishes statements accurately reflecting the program’s offerings. 2.4 Has due process procedures that are readily accessible, fair, and equitably applied. 2.5 Has a policy that assures timely and appropriate resolution of complaints regarding allegations of

non-compliance with JRCERT STANDARDS and maintains a record of such complaints and their resolution.

2.6 Regularly evaluates program policies, procedures, and publications and revises as appropriate. 2.7 Documents the continuing accreditation of the sponsoring institution. 2.8 Documents the continuing recognition of each clinical education setting by applicable regulatory

agencies. 2.9 Maintains JRCERT recognition of all clinical education settings. 2.10 Maintains JRCERT recognition of all applicable faculty appointments. 2.11 Complies with requirements to achieve and maintain JRCERT accreditation.

3

3

Standard Three: Organization and Administration Organizational and administrative structures support quality and effectiveness of the educational process. Objectives: In support of Standard Three, the program: 3.1 Has organizational and administrative structures that support the program’s mission and

student learning outcomes. 3.2 Establishes and maintains affiliation agreements with clinical education settings. 3.3 Assures the security and confidentiality of student records, instructional materials, and other appropriate program materials. 3.4 Assures an appropriate relationship between program length and the subject matter taught and the

objectives for the degree or credential offered. 3.5 Measures the length of all didactic and clinical courses in clock hours or credit hours.

4

4

Standard Four: Curriculum and Academic Practices The program’s curriculum and academic practices promote the synthesis of theory, use of current technology, competent clinical practice, and professional values. Objectives: In support of Standard Four, the program: 4.1 Maintains a master plan of education. 4.2 Follows a JRCERT recognized and accepted curriculum that prepares the student to practice in

the professional discipline. 4.3 Provides a curriculum that promotes professional values, life-long learning, and competency in critical thinking and problem solving skills. 4.4 Provides a well-structured, competency based curriculum that supports the program’s mission and

goals.

4.5 Has a curriculum that reflects assessment of affective, cognitive, and psychomotor domains. 4.6 Provides learning opportunities in current and developing imaging and/or therapeutic

technologies. 4.7 Provides equitable learning opportunities.

5

5

Standard Five: Resources and Student Services The program’s learning resources, learning environments, and student services are sufficient to support its mission and goals. Objectives: In support of Standard Five, the program: 5.1 Provides classrooms, laboratories, clinical education settings, administrative and faculty offices,

and other facilities to support its mission and goals. 5.2 Provides clinical observation sites, as appropriate. 5.3 Has clinical education settings that provide students with a variety and volume of procedures for competency achievement. 5.4 Reviews, evaluates, and maintains learning resources to assure the achievement of student

learning outcomes and program goals. 5.5 Reviews, evaluates, and maintains student services to assure the achievement of student learning

outcomes and program goals.

6

6

Standard Six: Human Resources The program has sufficient qualified faculty and staff with delineated responsibilities to support program mission and goals. Objectives: In support of Standard Six, the program: 6.1 Documents that all faculty and staff possess academic and professional qualifications appropriate

for their assignments.

• Full-time Program Director:

Holds, at a minimum, a masters degree; Is proficient in curriculum design, program administration, evaluation, instruction, and counseling; Documents the equivalent of three years full-time experience in the professional discipline; Documents two years experience as an instructor in a JRCERT accredited program; Holds American Registry of Radiologic Technologists certification or equivalent and registration in the pertinent discipline.

• Didactic Program Faculty:

Is qualified to teach the subject; Is knowledgeable of course development, instruction, evaluation, and academic counseling; Holds appropriate professional credentials, if applicable.

• Full-Time Clinical Coordinator:

Holds, at a minimum, a baccalaureate degree; Is proficient in curriculum development, supervision, instruction, evaluation, and counseling; Documents the equivalent of two years full-time experience in the professional discipline; Documents a minimum of one year of experience as an instructor in a JRCERT accredited program; Holds American Registry of Radiologic Technologists certification or equivalent and registration in the pertinent discipline.

7

7

• Radiography Clinical Instructor(s) or Radiation Therapy Clinical Supervisor(s):

Is proficient in supervision, instruction, and evaluation; Documents the equivalent of two years full-time experience in the professional discipline; Holds American Registry of Radiologic Technologists certification or equivalent and registration in the pertinent discipline.

• Clinical Staff:

Hold American Registry of Radiologic Technologists certification or equivalent and registration in the pertinent discipline.

6.2 Documents administrative, faculty, and clinical staff responsibilities are delineated and support

the fulfillment of the program’s mission and goals.

• Program Director:

Organizes, administers, reviews, develops, and assures program effectiveness; Conducts on-going program assessment; Participates in budget planning; Evaluates and assures clinical education effectiveness; Maintains current knowledge of the professional discipline and educational methodologies through continuing professional development; Assumes the leadership role in the continued development of the program.

• Didactic Faculty:

Prepare and maintain course outlines and objectives, instruct and evaluate students, and report progress; Cooperate with the program director in periodic review and revision of course materials; Maintain appropriate expertise and competencies through continuing professional development.

• Clinical Coordinator:

Correlates clinical education with didactic education; Evaluates students; Coordinates clinical education and evaluates its effectiveness;

8

8

Cooperates with the program director in periodic review and revision of clinical course materials; Maintains current knowledge of the professional discipline and educational methodologies through continuing professional development; Maintains current knowledge of program policies, procedures, and student progress.

• Radiography Clinical Instructor(s) or Radiation Therapy Clinical Supervisor(s):

Is knowledgeable of program goals; Understands the clinical objectives and clinical evaluation system; Provides students with clinical instruction/supervision; Evaluates students’ clinical competence; Maintains competency in the professional discipline and in instructional and evaluative techniques through continuing professional development; Maintains current knowledge of program policies, procedures, and student progress.

• Clinical Staff:

Understand the clinical competency system; Support the educational process; Maintain current knowledge of program policies, procedures, and student progress.

6.3 Provides an adequate number of faculty to meet all educational, program, administrative, and accreditation requirements. 6.4 Provides support services to meet all educational, program, and administrative requirements. 6.5 Provides faculty with opportunities for continued professional development. 6.6 Evaluates didactic and clinical faculty performance regularly to assure instructional

responsibilities are performed.

9

9

Standard Seven: Students The program’s and sponsoring institution’s policies and procedures serve and protect the rights, health and educational opportunities of all students. Objectives: In support of Standard Seven, the program: 7.1 Has student recruitment and admission practices that are consistent with published policies of the

program and sponsoring institution. 7.2 Uses student recruitment and admission practices that are non-discriminatory with respect to any

legally protected status such as race, color, religion, gender, age, disability, and national origin. 7.3 Makes available to prospective students accurate information about admission policies, transfer

credit, tuition and fees, refund policies, academic calendars, academic policies, graduation requirements, and student services.

7.4 Makes available to enrolled students accurate information about admission policies, transfer

credit, tuition and fees, refund policies, academic calendars, academic policies, grading policies, graduation requirements, and student services.

7.5 Provides timely and supportive academic, behavioral, and clinical advisement to students enrolled in the program. 7.6 Provides student academic and clinical activities that are educationally valid and support

attainment of student learning outcomes. 7.7 Safeguards the health and safety of students associated with educational activities through

implemented policies and procedures in regard to workplace hazards, harassment, communicable diseases, and substance abuse.

7.8 Limits required clinical and academic involvement for students to not more than 40 hours per

week.

10

10

Standard Eight: Radiation Safety Program policies and procedures are in compliance with federal and state radiation protection laws. Objectives: In support of Standard Eight, the program: 8.1 Safeguards the health and safety of students associated with educational activities through the

implementation of published policies and procedures that are in compliance with Nuclear Regulatory Commission regulations and state laws as applicable.

8.2 Has a pregnancy policy that is published and made known to accepted and enrolled female

students that: • is consistent with applicable federal regulations and state laws; • includes notice of voluntary disclosure; and • provides options for student continuance in the program.

8.3 Assures that students use equipment and accessories, employ techniques, and perform procedures

in accordance with accepted equipment use and radiation safety practices to minimize radiation exposure to patients, selves, and others.

8.4 Assures that radiation therapy procedures are performed under the direct supervision of a qualified practitioner. 8.5 Assures that medical imaging procedures are performed under the direct supervision of a qualified practitioner until a radiography student achieves competency. 8.6 Assures that medical imaging procedures are performed under the indirect supervision of a qualified practitioner after a radiography student achieves competency. 8.7 Assures that radiography students repeating unsatisfactory radiographs are under the direct

supervision of a qualified practitioner. 8.8 Maintains documentation that learning environments are in compliance with applicable state and

federal radiation safety laws.

11

11

Standard Nine: Fiscal Responsibility The program and the sponsoring institution have adequate financial resources, demonstrate financial stability, and comply with obligations for Title IV federal funding, if applicable. Objectives: In support of Standard Nine, the program: 9.1 Has sufficient on-going financial resources to support the program’s mission and goals. 9.2 Provides the program director an opportunity to participate in the budget planning process. 9.3 For those institutions and programs for which the JRCERT or a mixed accreditor serves as gatekeeper for Title IV financial aid, maintains compliance with USDE policies and procedures.

12

Glossary

Affiliation Agreement - A formal written understanding between an institution sponsoring the program and an independent clinical education setting. American Registry of Radiologic Technologists Certification or Equivalent - Certification by the American Registry of Radiologic Technologists or unrestricted state license to operate radiation producing equipment. Assessment - The systematic collection, review, and use of information to improve student learning, educational quality, and program effectiveness. Assessment Plan - Provides direction for actions and is a way to determine progress. At a minimum, an assessment plan should include goals, evaluation criteria and benchmarks, outcomes, and a plan of action. Clinical Coordinator - Required if the program has 6 or more clinical education settings or more than 30 students enrolled in the clinical component. The clinical coordinator may not serve as program director. The clinical coordinator position may be considered equal to a full-time equivalent but may be shared by no more than four appointees. Clinical Instructor(s) - In radiography one full-time equivalent clinical instructor for every 10 students involved in the competency achievement process. Clinical Supervisor(s) - In radiation therapy, one clinical supervisor for each clinical education setting. Clinical Education Setting - A facility recognized by the JRCERT as meeting appropriate qualifications for delivering clinical education and evaluation of clinical competency. A minimum of one clinical instructor/supervisor is designated at each site. Clinical Observation Site - An observation site is used for student observation of the operation of equipment and/or procedures. Clinical Staff - For radiography, the ratio of students to staff prior to student competency achievement in a given examination or procedure shall not exceed 1:1. For radiation therapy, the ratio of students to staff shall always be 1:1. Communities of Interest - Institutions, organizations, groups and/or individuals interested in educational activities in radiologic sciences. Competency Based - Student attainment of a specified level of proficiency. Credentialing Examination Pass Rate - The number of graduates who pass the American Registry of Radiologic Technologists Credentialing examination or an unrestricted state licensing examination compared with the number of graduates who take the examination.

13

Direct Supervision - Student supervision by a qualified practitioner 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 qualified radiographer is present during student performance of a repeat of any unsatisfactory radiograph. Due Process - The formal procedure for resolution of a grievance or complaint that identifies timeframes for completion of each step and provides for a final appeal to a source external to the program. Gatekeeper - An agency with responsibility for oversight of the distribution, record keeping, and repayment of Title IV financial aid. Goals - Ends or results the program wants to achieve. Indirect Supervision - For radiography, 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 qualified practitioner 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. Job Placement Rate - The number of students employed in the radiologic sciences compared to the number of students actively seeking employment in the radiologic sciences. Learning Environment - Places, surroundings or circumstances where knowledge, understanding, or skills are studied or observed such as classrooms, laboratories and clinical education settings. Learning Resources - Media and reference materials utilized to support and enhance the educational program and scholarly activity. Master Plan of Education - Documentation of the entire course of study that includes at a minimum: didactic and clinical curricula, program policies and procedures, and strategies for assessing program effectiveness. Mission Statement - A means to communicate an educational vision and purpose. Mixed Accreditor - An accrediting agency whose responsibilities for accreditation include situations where the agency accredits the only educational program in an institution. Where there are multiple educational programs in an institution, the agency selected as the institutional accreditor. Outcomes - Results, end products, or actual consequences resulting from the educational process. Outcomes include what the students demonstrated/accomplished or what the program achieved. Program Completion Rate - The number of students who complete the program compared to the number of students initially enrolled in the program. Program Length - Duration of the program which may be stated as total academic or calendar year(s), or total semesters, trimesters, or quarters.

14

Qualified Practitioner - A radiation therapist or radiographer possessing American Registry of Radiologic Technologists certification or equivalent and active registration in the pertinent discipline and practicing in the profession. Recognized and Accepted Curriculum - 1) The latest American Society of Radiologic Technologists professional curriculum and/or 2) other professional curriculum adopted by the JRCERT Board of Directors following review and recommendation by the JRCERT Standards Committee. Sponsoring Institution - The facility or organization that has primary responsibility for the educational program and grants the terminal award. A sponsoring institution must be accredited by a recognized agency or meet equivalent standards. Educational programs may be established in: community and junior colleges; senior colleges and universities, hospitals, medical schools, postsecondary vocational/technical schools and institutions; military/governmental facilities; proprietary schools; and consortia (two or more academic or clinical institutions that have formally agreed to sponsor the development and continuation of an educational program). Consortia must be structured to recognize and perform the responsibilities and functions of a sponsoring institution. Title IV Financial Aid- Monies for education loaned or granted by the Federal government, e.g. Perkins loans, Stafford loans, PLUS loans, Pell grants, Supplemental Educational Opportunity grants and work-study programs.

15

Awarding, Maintaining, and Administering Accreditation A. Program/Sponsoring Institution Responsibilities 1. Applying for Accreditation

The accreditation review process conducted by the Joint Review Committee on Education in Radiologic Technology (JRCERT) can be initiated only at the written request of the chief executive officer or an officially designated representative of the sponsoring institution.

This process is initiated by submitting an application and self-study report, prepared according to JRCERT guidelines, to:

Joint Review Committee on Education in Radiologic Technology 20 North Wacker Drive, Suite 900 Chicago, IL 60606-2901

2. Administrative Requirements for Maintaining Accreditation

a. Submitting the self-study report or a required progress report within a reasonable

period of time, as determined by the JRCERT. b. Agreeing to a reasonable site visit date before the end of the period for which

accreditation was awarded. c. Informing the JRCERT, within a reasonable period of time, of changes in the

institutional or program officials, program director, clinical coordinator, and clinical supervisor(s) or clinical instructor(s).

d. Paying JRCERT fees within a reasonable period of time. e. Returning, by the established deadline, a completed Annual Report. Programs are required to comply with these and other administrative requirements for maintaining accreditation. Additional information on policies and procedures is available from the JRCERT.

Program failure to meet administrative requirements for maintaining accreditation may lead to being placed on Administrative Probationary Accreditation and ultimately to Withdrawal of Accreditation.

16

B. JRCERT Responsibilities

1. Administering the Accreditation Review Process

The JRCERT reviews educational programs to assess compliance with the Standards for an Accredited Educational Program in Radiologic Sciences. The accreditation process includes a site visit.

Before the JRCERT takes accreditation action, the program being reviewed must respond to the report of findings.

The JRCERT is responsible for recognition of clinical education settings.

2. Accreditation Actions

JRCERT accreditation actions for Probation may be reconsidered following the established procedure. JRCERT accreditation actions for Accreditation Withheld or Accreditation Withdrawn may be appealed following the established procedure. All other JRCERT accreditation actions are final. Procedures for reconsideration and appeal are published in the JRCERT Accreditation Handbook and are available upon request. A program or sponsoring institution may, at any time prior to the final accreditation action, withdraw its request for initial or continuing accreditation.

Educators may wish to contact the following organizations for additional information and materials:

accreditation: Joint Review Committee on Education in Radiologic Technology 20 North Wacker Drive, Suite 900

Chicago, IL 60606-2901 (312) 704-5300 www.jrcert.org

curriculum: American Society of Radiologic Technologists

15000 Central Avenue, N.E. Albuquerque, NM 87123-3917

(505) 298-4500 www.asrt.org

certification: American Registry of Radiologic Technologists

1255 Northland Drive St. Paul, MN 55120-1155

(651) 687-0048 www.arrt.org

58Copyright © 2001 by the JRCERT

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

20 North Wacker Drive

Suite 900 Chicago, IL 60606-2901

(312) 704-5300 (312) 704-5304 (Fax)

email: mail@jrcert.org www.jrcert.org

59

Appendix ii Radiographic Procedure Evaluation Form

60UAB Radiography Program RADIOGRAPHIC PROCEDURE EVALUATION FORM Date ______________________________________________ Student’s name ______________________________________________ Please check one of the following options: _____ Pediatric _____ Trauma _____ Surgical Clinical Education Site _______________________________________________ _____ Portable _____ Other Case Number _______________ Procedure Evaluated: __________________________________________________________________________________ Patient Age _______________ Pathology / Diagnosis: _____________________________________________________________________________________ Projection __________ Projection __________ Projection __________ Projection ___________ COMMENTS COMMENTS COMMENTS COMMENTS 1. Patient Care 2. Identification 3. Positioning 4. Exposure Factors 5. Film / Cassette / CR / DR

6. Radiation Protection 7. Equipment Manipulation 8. Other (specify) to include anatomy, etc. 9. Portable and Surgical skills

10. Fluoroscopic Skills 11. Film Repeated? should/was Student signature and date Evaluator signature & Date Evaluator signature & Date Evaluator signature & Date Evaluator signature & Date NOTES: 1. A radiography demonstrating no side/part marker or an incorrect side/part marker is an automatic “0” for the projections in which it occurs

2. Any projection performed, which is not a part of the routine procedure or specifically ordered by a physician is awarded a “0”. The grade enters the grade Calculation for the procedure on an equal basis as other projections performed for the procedure.

3. a. Each check mark in evaluation criteria 1-10 = -7 points (more than one check per box can be utilized when necessary). b. a check mark for evaluation criteria #11 = - 40 points

61BASIC CRITERIA FOR EVALUATION OF COMPETENCY OF STUDENTS TO PERFORM RADIOGRAPHIC PROCEDURES

1. Patient Care 7. Equipment Manipulation

a. assists/escorts patient to room a. manipulates tube correctly and carefully b. assists patient to table, chest chamber, etc. b. selects correct equipment for use for examination c. explains procedure to patient so he/she understands c. manipulates all parts which lock carefully and correctly d. gives proper breathing instructions for each projection d. other

e. gowns patient properly for examination f. completes examination in a timely manner 8. Other g. locates all types of supplies quickly when needed a. Injectable Media and Procedures h. other 1. uses sterile techniques to fill syringes

2. achieves and maintains sterile integrity of materials, areas or 2. Identification patient body part a. uses correct markers (R, L, time, etc) for each radiography/procedure 3. assists with application of tourniquet or sterile dressings b. uses markers appropriately (i.e. post-void, open, closed, erect, etc.) 4. assures immediate availability of correct procedure tray, contrast c. transfers accurate patient information to each radiograph in set material, and emergency drugs (quantity, not out of date, etc.) d. correctly identifies patient and examination requested 5. other e. places lead markers appropriately and to be visible on the radiograph b. Image Evaluation f. other 1. reviews radiographs for technical quality using proper sequences, equipment, and academic abilities that are needed 3. Positioning 2. relates requisitions to projections and patient condition a. part positioned correctly for projections 3. assesses procedure for correct projections, demonstration of area b. part centered to film and aligned accurately of area of interest, artifacts, recorded and visible detail, density c. CR centered and directed to film/part accurately and contrast adequate to provide required diagnostic image d. grid, if used, is used correctly 4. identifies image problem(s) caused by radiographer’s performance e. uses details of patient’s physique to position the part correctly 5. accurately answers clinical instructor’s questions related to f. other radiographic quality 6. determines accuracy of alignment and centering of film holder, 4. Exposure Factors part, and central ray a. uses details/patient’s physique to establish correct exposure factors 7. other – ANATOMY, etc. b. sets machine factors (kVp, mA, time) correctly c. Processing Procedures c. checks and uses accurate SID (also TFD, FFD, etc) 1. correctly places patient I.D. on each radiograph d. uses automatic exposure back-up timer correctly 2. correctly uses processing or daylight practices in the clinical site e. select and uses correct screen-film combination (if applicable) 3. keeps film bin supplied f. other 4. maintains a clean, dry environment in the darkroom 5. other 5. Image Receptors a. selects correct size and type film for part 9. Portable and Surgical Skills b. places cassette correctly (crosswise or lengthwise) a. uses proper isolation or sterile techniques c. uses appropriate intensifying screens b. uses image intensifier and other equipment correctly d. uses appropriate grid correctly c. uses C-arm correctly and properly e. other d. uses portable equipment properly e. other 6. Radiation Protection a. collimates properly and accurately for each projection 10. Fluoroscopic Skills b. shields patient whenever possible a. changes spot film in a timely manner c. utilizes good self-radiation protection practices all the time b. manipulates locks correctly d. limits exposure of patient and others to a minimum c. sets up fluoroscopic equipment correctly e. limits number of exposures to medically diagnostic ones d. has supplies set up and properly prepared f. other e. anticipates need of patient and physician during procedure

f. other

11. Repeat Films If radiograph MUST/SHOULD be repeated for any reason, check this box and any other area related to the cause(s) for the need to repeat

62Appendix iii

General Performance Evaluation Form

63 University of Alabama at Birmingham RADIOGRAPY PROGRAM – B.S. in Radiologic Sciences General Performance Evaluation Student ______________________________ Clinical Education Site ___________________________ Evaluator ____________________________ Semester _______________ Date ____________ Excellent Above Average Good Below Average Unsatisfactory Cooperation excellent team works well with average at times, arrogant, causes problems, And Attitude worker, positive others impression passive, imprudent inclined to be leader and or surly quarrelsome Professional excellent above average does what uses poor judgment negative Ethics relationship with impression; takes is expected comments; patients and staff charge attitude, rude Quality superior – produces above average average - frequently repeats requires constant quality work in performance does what is necessary supervision and required often repeats Quantity of superior amount of very industrious; satisfactory - slow – just enough has to be prodded, Work quality work above average meet minimum to get by works very slow requirements Ability to learns rapidly; above average; average hesitate to respond; headstrong, ignores Follow implements and follows instructions retention needs reassurance instructions Instructions retains knowledge well Self- Superior; self reliant above average self - average – self below average self too independent; Confidence esteem assurance assurance; stands ignores policies back and procedures Care of justifies complete self-reliant; requires average; needs afraid to take charge inadequate skills Patients confidence – makes little help some wise decisions; takes instruction charge Use and Care justifies complete very knowledgeable adequate needs to be told careless and of Equipment confidence wasteful Ability to Read excellent abilities makes few mistakes average; careless errors constantly needs Charts and requires little assistance; frequent Adjust assistance repeated mistakes Techniques Positioning superior skills above average; makes average; below average; makes frequent Skills rarely need assistance few mistakes normal application of mistakes mistakes knowledge poor Organization superior; knows what above average; needs average below average confused; appears of Work to do first and does it little help – learns needs to be told when lost from mistakes to do things Initiative Superior – always very industrious meets has to be told or lazy looks for things to minimum reminded do requirements ______________________________________________________ ____________________________________________________ student signature date evaluator’s signature date Comments:

64

Appendix iv Affective Evaluation Form

65University of Alabama at Birmingham

RADIOGRAPHY PROGRAM AFFECTIVE EVALUATION

Student ________________________________ Date ____________________________

Clinical Education Site ______________________ Semester __________________________ Purpose: To document strengths and weaknesses so the student will know what areas of clinical performance needs

improvement; so a plan of action for improvement can be established for more quality productivity 1. ATTENDANCE

the faithfulness of coming to the assigned clinical assignment daily and conforming to clinical requirements, reporting to clinical assignment on time

5 ______ consistently prompt and reliable; no days or hours missed; no tardies 4 ______ very prompt; reliable in attendance; only 1 day missed, 1 tardy or short hours one day

3 ______ usually present on time; 2 days missed, 2 tardies or short hours 2 different days 1 ______ frequently late or absent; 3 days missed, 3 tardies or short hours 3 different days 0 ______ more than 4 days missed or 4 tardies

2. PERSONAL APPEARANCE

consider cleanliness, grooming and neatness 5 ______ consistently presents professional image; always groomed and careful about appearance 4 ______ usually well groomed and careful about personal appearance 3 ______ satisfactory personal appearance, but sometimes needs remind of dress code 1 ______ below average – occasionally untidy and careless about personal appearance 0 ______ frequently untidy; personal appearance unsatisfactory 3. COOPERATION AND ATTITUDE

the ability to work with others, the ability to do their share of workload, and the ability to accept instruction and constructive criticism

5 ______ excellent attitude and spirit of cooperation; good team player 4 ______ above average – cooperative, interacts well with staff and instructors 3 ______ satisfactory – does what is expected 1 ______ sometimes accepts direction in a manner showing displeasure; can be difficult to work with 0 ______ inclined to be difficult to work with; spirit of cooperation and attitude is not positive 4. PROFESSIONAL ETHICS

consider integrity, loyalty, impression the student makes on others and professional judgment

5 ______ conducts self in a professional manner at all time conforming to professional standards of

conduct; inspiring to others and impressive in professional performance 4 ______ above average professional manner; frequently uses good judgment in stressful situations 3 ______ adheres to professional standards in an acceptable manner; uses good judgment in stressful situations 1 ______ often does not follow professional standards when dealing with others

0 ______ consistent negative attitude, rude, and/or arrogant to clients, peers, staff and fellow students. Uses poor professional judgment

665. INITIATIVE ability to think constructively and originates action in meeting objectives 5 ______ thinks and acts constructively; looks for things to do; hard worker; always productive 4 ______ consistently above average; utilizes time efficiently and rarely needs encouragement to do so 3 ______ utilizes time efficiently and sometimes needs encouragement 1 ______ puts forth little effort, frequently has to be told, sometimes lazy, does just enough to get by 0 ______ puts forth practically no effort, lazy; most of the time needs to be told what to do 6. QUALITY OF PERFORMANCE in meeting professional standards, includes positioning, expediency, room readiness, radiation protection, client care, and organization of work 5 ______ superior; consistently competent, exceptionally high quality of performance in all phases of practical applications 4 ______ is exact, precise, requires little correction, consistently above average; recognizes mistakes

and takes corrective measures 3 ______ usually accurate, makes only average number of mistakes 1 ______ careless, makes recurrent errors 0 ______ makes frequent errors, demonstrates little retention; poor client care and organization 7. JUDGMENT ability to apply knowledge and skills to practical applications 5 ______ always handles clinical situations with ease and confidence 4 ______ impressive in thinking things through and making good decisions 3 ______ sometimes becomes frustrated or uses poor judgment in clinical situations 1 ______ frequently uses poor judgment; often becomes frustrated in clinical situations 0 ______ consistently uses poor judgment in clinical situations This item is the opinion of the instructor(s) and does not reflect in point value TOTAL PERFORMANCE professional opinion of ability and potentiality _______ consistently above average; superior skills in all areas of performance _______ above average; excellent _______ average; satisfactory _______ below average _______ unsatisfactory, not acceptable COMMENTS / RECOMMENDATIONS STUDENT COMMENTS ____________________________________________ Total Points _______ Clinical instructor signature date ____________________________________________ Evaluation Points _______ Student signature date

67

Appendix v Competency Requirements

68UAB Radiography Program

Competency Requirements Chest and

Thorax Upper Extremity

Lower Extremity

Cranium

Spine and Pelvis

Abdomen

Fluoroscopy Studies

Surgical Studies

Mobile portable) Studies

Pediatric Studies (< 6 y.o.)

Electives

Spring I 1 2 1 - 1 1 - - 1 - 3 Summer I 1 2 2 - 2 1 1 - 1 - 3 Fall II 1 2 2 - 2 1 1 - 1 - 3 Spring II - 2 2 1 1 2 1 1 - 1 11 3 Summer II - 3 1 11 2 - - 11 - - 3 2Mandatory Procedures (46) Chest and

Thorax Upper Extremity

Lower Extremity

Cranium

Spine and Pelvis

Abdomen

Fluoroscopy Studies

Surgical Studies

Mobile (portable) Studies

Pediatric Studies (< 6 y.o.)

Chest, routine

Thumb or finger

Foot

Skull

C-spine (AP, Lat, Odontoid)

KUB

UGI

C-arm

PCXR

Chest

Chest, WC or ST

Hand

Ankle (AP & Lat.)

Sinuses

C-spine (Obliques)

Abdomen (decub or ↑)

ACBE

PABD

Ribs

Wrist (AP & Lat)

Ankle (Obliques)

C-spine (XTL)

Acute abdomen series

Single-contrast BE

Port. Upper Extremity

Wrist (Obliques)

Knee (AP & Lat.)

T-spine

IVP Port. Lower Extremity

Forearm

Knee (Obliques)

L-spine (AP, Lat, spot)

Elbow (AP & Lat)

Tib-Fib

L-spine (Oblique)

Elbow (Obliques)

Femur

Pelvis

Humerus

Trauma Lower Ext.

Hip (AP, frogleg Lat)

Shoulder (int. & ext.)

Hip (XTL)

Trauma3 Shoulder

Trauma 4 Upper Ext.

5Elective Procedures (15) Chest and

Thorax Upper Extremity

Lower Extremity

Cranium

Spine and Pelvis

Abdomen

Fluoroscopy Studies

Surgical Studies

Mobile (portable) Studies

Pediatric Studies (< 6 y.o.)

Chest, Decubitus

Clavicle

Patella

Facial Bones

Sacrum

SBS/SBFT

Surgical Cholangiogram

Upper Extremity

Sternum

Scapula

Os Calcis (calcaneus)

Orbits

Coccyx

BaS

Retrograde Pyelogram

Lower Extremity

Soft Tissue Neck

AC joints

Toes

Zygomatic Arches

Scoliosis Series

Cystography

Abdomen

Nasal bones

SI joints

Cysto- urethrography

Mobile Study

Mandible

ERCP

Myelogram

Arthrogram

NOTES: 1 competency

examinations on these procedures can be done during any semester they are available but MUST be completed by the semester they are required

-------------------- 2 these 45

procedures MUST be performed on actual patients

-------------------- 3 acceptable

projections for this examination are: scapular-Y, axillary, transthoracic.

-------------------- 4 this procedure

must be a non-shoulder trauma upper extremity

------------------ 5 these 15

procedures CAN be simulated

Students may perform up to 6 procedures over the required number of competency procedures each semester. Base the selection of these extra competency procedures on your current clinical assignment and the availability of these examinations at other clinical affiliates. Last revised: May 22, 2006

69

Appendix vi Completed Radiographic Procedure Evaluation Form

70 Radiography Program RADIOGRAPHIC PROCEDURE EVALUATION FORM AVG 95.33 Date December 12, 2001 Student’s name Jane Doe Please check one of the following options: _____ Pediatric __X__ Trauma _____ Surgical Clinical Education Site University Hospital (ER) _____ Portable _____ Other Case Number 000010011 Procedure Evaluated: Right Toes Patient Age 21 Pathology / Diagnosis: Fell skateboarding, R/O fracture Projection ___AP_____ Projection ___Oblique____ Projection ___Lateral__ Projection ___________ COMMENTS COMMENTS COMMENTS COMMENTS 1. Patient Care 2. Identification 3. Positioning X -7 off center to right 4. Exposure Factors X -7 too light (no repeat) 5. Film / Cassette / CR / DR

7. Radiation Protection 7. Equipment Manipulation 93 100 93 8. Other (specify) to include anatomy, etc. 9. Portable and Surgical skills

11. Fluoroscopic Skills 11. Film Repeated? should/was Student signature and date Evaluator signature & Date Evaluator signature & Date Evaluator signature & Date Evaluator signature & Date Audrey Harris, R.T. 12-12-01 Audrey Harris, R.T. 12-12-01 Audrey Harris, R.T. 12-12-01 NOTES: 1. A radiography demonstrating no side/part marker or an incorrect side/part marker is an automatic “0” for the projections in which it occurs 2. Any projection performed, which is not a part of the routine procedure or specifically ordered by a physician is awarded a “0”. The grade

enters the grade Calculation for the procedure on an equal basis as other projections performed for the procedure. 3. a. Each check mark in evaluation criteria 1-10 = -7 points (more than one check per box can be utilized when necessary). b. a check mark for evaluation criteria #11 = - 40 points

71

Appendix vii

Syllabi

72

Department of Diagnostic and Therapeutic Sciences B.S. IN RADIOLOGIC SCIENCES RADIOGRAPHY PROGRAM COURSE NUMBER: RAD 310 COURSE TITLE: CLINICAL PRACTICUM I COURSE DESCRIPTION: Supervised clinical practice of radiographic examinations, stressing

experience in performing radiography of the extremities (upper and lower) and girdles, routine plain radiography of the chest and abdomen. Includes image critique sessions, instruction in care and management of patients with indwelling tubes, operation of department equipment, and procedure protocols.

COURSE PLACEMENT: Spring Semester INSTRUCTOR: Audrey Harris, M.A.Ed., R.T. (R) (CT)(M)(QM) CONTACT HOURS: 200 CREDIT HOURS: 4 Semester Hours TEXT: Student Handbook for Education in the Radiography Program

Policy and Procedure Manual(s) of the assigned Radiology Department REFERENCES: Texts from Radiography Program academic courses METHODS OF INSTRUCTION: Lecture, demonstration, clinical coordinator/technologist supervised

practice by the student, and directed self-study by the student. PASSING SCORE: Radiographic Evaluations (average) 60%

General Clinical Evaluations (average) 20% Affective Evaluation 20% GRADE: The course grade reported to the UAB Registrar for recording will be:

90 - 100 A 80 - 89 B 75 - 79 C 70 - 74 D Less than 70 F

*Any absence occurring during the term must be made up before the beginning of the next term. Absences are calculated in the term grade. *No competency evaluations will be allowed during make-up time.

73

Course Objectives: At the end of this rotation, the student will:

A. correctly use prescribed practices and devices for the radiation protection of the patient, other

personnel, and self.

B. perform simple routine radiography of the extremities and girdles, thorax and abdomen (without contrast media), completing nine (9) radiographic procedure competency evaluations in these procedures.

C. correctly establish exposure factors at the control panel for any radiographic examination.

D. discuss any radiograph of the extremities and girdles, thorax, or abdomen with regard to

correctness of positioning of the patient, part, what it should be like for any projection, and identify the anatomy revealed in the image.

E. discuss correctly the methods of performing any radiographic examination experienced during

the current term, particularly those which use the same patient positioning stressed during this term.

F. be evaluated using the General Performance Evaluation and the Affective Evaluation (professional

traits and characteristics) by the clinical instructor; discuss the evaluation with the clinical instructor and sign it to signify that it was discussed with him/her. These evaluations will be based on the following criteria:

a. technical knowledge g. personal and professional b. quality of work appearance c. initiative exhibited h. patient attitude exhibited d. efficiency of work i. use and care of radiographic e. work attitude equipment f. judgement exhibited j. communication skills

k. overall performance

G. be evaluated on ten (10) competencies in the radiographic procedures listed in the categories for radiographic practice of: chest and thorax, upper and lower extremities, spine and pelvis, abdomen, mobile studies, and electives.

Chest and Thorax - 1 procedure Upper Extremity - 2 procedures Lower Extremity - 1 procedure Spine and Pelvis - 1 procedure Abdomen - 1 procedure Mobile Studies - 1 procedure Electives - 3 procedures

Details for competency evaluation, guidelines, methods of application, sample evaluation forms, criteria for performance, scoring and grade scales found in the Clinical Education Handbook (CEH) for Radiography Students.

H. be evaluated in the basic procedures upon which most radiographic practice is based; i.e.,

patient care and management, file management, processing procedures, receptionist skills and procedures, and basic equipment and procedural activities.

74

I. make and maintain a daily diary of the clinical experiences obtained in the term. Compile the daily records for a monthly report to be submitted with the daily log sheets.

J. complete the student evaluation of clinical experience and clinical instructor evaluation forms

included in the clinical experience II notebook.

75

Department of Diagnostic and Therapeutic Sciences B.S. IN RADIOLOGIC SCIENCES RADIOGRAPHY PROGRAM COURSE NUMBER: RAD 320 COURSE TITLE: CLINICAL PRACTICUM II

COURSE DESCRIPTION: Supervised clinical practice of radiographic examinations,

stressing experience in performance of the remaining examinations of the thorax and abdomen, the vertebral column, the urinary system, the gastrointestinal system and heads. Includes image critique sessions, all types of radiographic examinations, operation of all types of radiographic equipment, and procedure protocols.

COURSE PLACEMENT: Summer Semester INSTRUCTOR: Audrey Harris, M.A.Ed., R.T. (R) (CT) (M) (QM) CONTACT HOURS: 350 CREDIT HOURS: 6 Semester Hours PREREQUISITES: RAD 310 TEXT: * Student Handbook for Education in the Radiography Program

* Policy and Procedure Manual(s) of the assigned Radiology Department

REFERENCES: Texts of Radiography Program academic courses from

previous and current terms METHODS OF INSTRUCTION: Lecture, demonstration, clinical coordinator/ technologist

supervised practice by the student, and directed self-study by the student.

PASSING SCORE: Radiographic Evaluations (average) 40%

General Clinical Evaluations (average) 30% Affective Evaluation 30%

76

76

GRADE: The course grade reported to the UAB Registrar for recording will be:

90 - 100 A 80 - 89 B 75 - 79 C 70 - 74 D Less than 70 F

*Any absence occurring during the term must be made up before the beginning of the next term. Absences are calculated in the term grade.

* No competency evaluations will be allowed during make-up time.

Course Objectives: At the end of this rotation, the student will:

A. correctly use prescribed practices and devices for the radiation protection of the patient, other personnel, and self.

B. perform routine radiography of the extremities and girdles, thorax and abdomen ,

vertebral column, urinary system, and gastrointestinal system.

C. correctly establish exposure factors at the control panel for any radiographic / fluoroscopic examination.

D. discuss any radiograph of the extremities and girdles, thorax, abdomen, vertebral

column, genitourinary tract, and gastrointestinal tract with regard to positioning of the patient part, its appearance in each projection, and identify the anatomy revealed in the image.

E. correctly discuss methods of performing any radiographic examination

experienced during the current term, especially those which use the same patient positioning stressed during this term.

F. be evaluated using the General Performance Evaluation and the Affective Evaluation

(professional traits and characteristics) by the clinical coordinator; discussing the evaluation with the clinical coordinator and signing it to signify that it was discussed with him/her. These evaluations will be based on the following criteria:

a. technical knowledge g. personal and professional

b. quality of work appearance c. initiative exhibited h. patient attitude exhibited d. efficiency of work i. use and care of radiographic e. work attitude equipment f. judgement exhibited j. communication skills

k. overall performance

77G. be evaluated on thirteen (13) competencies in the radiographic procedures listed in the

categories for radiographic practice: chest and thorax, upper and lower extremities, spine and pelvis, abdomen, fluoroscopy studies, mobile studies, elective category with NO REPEATS.

Chest and Thorax - 1 procedure Upper Extremity - 2 procedures Lower Extremity - 2 procedures Spine and Pelvis - 2 procedures Abdomen - 1 procedures Fluoroscopy Studies - 1 procedure Mobile Studies - 1 procedure Elective category - 3 procedure

Details for competency evaluation, guidelines, methods of application, sample evaluation forms, criteria for performance, scoring and grade scales found in the Clinical Education Handbook (CEH) for Radiography Students.

H. be evaluated in the basic procedures upon which most radiographic practice is based; i.e., patient

care and management, file management, processing procedures, receptionist skills and procedures, and basic equipment and procedural activities.

I. make and maintain a daily diary of the clinical experiences obtained in the term. Compile the daily

records for a monthly report to be submitted with the daily log sheets. J. complete the student evaluation of clinical experience and clinical instructor evaluation forms

included in the clinical experience II notebook.

78

Department of Diagnostic and Therapeutic Sciences B.S. IN RADIOLOGIC SCIENCES RADIOGRAPHY PROGRAM COURSE NUMBER: RAD 410 COURSE TITLE: CLINICAL PRACTICUM III COURSE DESCRIPTION: Supervised clinical practice of radiographic examinations, stressing

experience in performance of the head and specialized studies of the previous categories of emphasis. Includes image critique sessions, all types of radiographic examinations, operation of all types of radiographic equipment, and procedure protocols.

COURSE PLACEMENT: Fall Semester INSTRUCTOR: Audrey Harris, M.A.Ed., R.T. (R)(CT)(M)(QM) CONTACT HOURS: 200 CREDIT HOURS: 4 Semester Hours PREREQUISITES: RAD 320 TEXT: * Student Handbook for Education in the Radiography Program

* Policy and Procedure Manual(s) of the assigned Radiology Department

REFERENCES: Texts of Radiography Program from current and previous terms METHODS OF INSTRUCTION: Lecture, demonstration, clinical coordinator/ technologist supervised

practice by the student, and directed self-study by the student. PASSING SCORE: Radiographic Evaluations (average) 40%

General Clinical Evaluations (average) 30% Affective Evaluations 30% GRADE: The course grade reported to the UAB Registrar for recording will be:

90 - 100 A 80 - 89 B 75 - 79 C 70 - 74 D Less than 70 F

*Any absence occurring during the term must be made up before the beginning of the next term. Unexcused absences are calculated in the semester grade.

*No competency evaluations will be allowed during make-up time.

79Course Objectives: At the end of this rotation, the student will:

A. correctly use prescribed practices and devices for the radiation protection of the patient, other personnel, and self.

B. perform routine radiography of the extremities and girdles, thorax and abdomen, vertebral

column, urinary system, gastrointestinal system and head. Competency evaluation will be successfully completed in all categories listed as outlined here and in the students contract.

C. correctly establish exposure factors at the control panel for any radiographic/ fluoroscopic

examination.

D. discuss any radiograph of the extremities and girdles, thorax, abdomen, vertebral column, genitourinary tract, and gastrointestinal tract with regard to positioning of the patient part, its appearance in each projection, and identify the anatomy revealed in the image

E. correctly discuss methods of performing any radiograph examination experienced during the

current term, especially those which use the same patient positioning stressed during this term. F. be evaluated using the General Performance Evaluation and the Affective

Evaluation (professional traits and characteristics) by the clinical instructor; discussing the evaluation with the clinical instructor and signing it to signify that it was discussed with him/her. These evaluations will be based on the following criteria:

a. technical knowledge g. personal and professional b. quality of work appearance c. initiative exhibited h. patient attitude exhibited d. efficiency of work i. use and care of radiographic e. work attitude equipment f. judgement exhibited j. communication skills

k. overall performance

G. be evaluated on thirteen (13) competencies in the radiographic procedures listed in the categories for radiographic practice of chest and thorax, upper and lower extremities, spine and pelvis, abdomen, fluoroscopy studies, mobile studies, and electives with NO REPEATS.

Chest and Thorax - 1 procedure Upper Extremity - 2 procedures Lower Extremity - 2 procedures Spine and Pelvis - 2 procedures Abdomen - 1 procedure Fluoroscopy Studies - 1 procedure Mobile Studies - 1 procedure Elective category - 3 procedures

Details for competency evaluation, guidelines, methods of application, sample evaluation forms, criteria for performance, scoring and grade scales found in the Clinical Education Handbook (CEH) for Radiography Students.

H. be evaluated in the basic procedures upon which most radiographic practice is based; i.e., patient

care and management, file management, processing procedures, receptionist skills and procedures, and basic equipment and procedural activities.

I. make and maintain a daily diary of the clinical experiences obtained in the term. Compile the daily

records (A-sheet) for a monthly report (C-sheet) to be submitted with the daily log sheets to the clinical coordinator at the end of the semester.

80 J. Complete the Student Evaluation of Clinical Experience and Clinical Instructor

Evaluation forms included in the Clinical Experience III notebook.

81

Department of Diagnostic and Therapeutic Sciences B.S. IN RADIOLOGIC SCIENCES RADIOGRAPHY PROGRAM COURSE NUMBER: RAD 412 COURSE TITLE: CLINICAL PRACTICUM IV COURSE DESCRIPTION: Supervised clinical practice of radiographic examinations,

stressing experience in the performance of the head procedures and specialized studies of the previous categories of emphasis. Includes image critique sessions, all types of radiographic examinations, operation of all types of radiographic equipment, and procedure protocols.

COURSE PLACEMENT: Spring Semester INSTRUCTOR: Audrey Harris, M.A.Ed., R.T. (R)(CT)(M)(QM) CONTACT HOURS: 200 CREDIT HOURS: 4 Semester Hours PREREQUISITE: RAD 410 TEXT: * Student Handbook for Education in the Radiography Program

* Policy and Procedure Manual(s) of the assigned Radiology Department

REFERENCES: Texts of Radiography Program from current and previous terms

METHOD OF INSTRUCTION: Lecture, demonstration, clinical coordinator

/technologist supervised practice by the student, and directed self-study by the student. PASSING SCORE: Radiographic Evaluations (average) 40%

General Clinical Evaluations (average) 30% Affective Evaluations 30% GRADE: The course grade reported to the UAB Registrar for

recording will be:

90 - 100 A 80 - 89 B 75 - 79 C 70 - 74 D Less than 70 F

82

82

*Any absence occurring during the term must be made up before the beginning of the next term. Absences are calculated in the term grade. *No competency evaluations will be allowed during make-up time.

Course Objectives: At the end of this rotation, the student will:

A. correctly use prescribed practices and devices for the radiation protection of the patient, other personnel, and self.

B. perform routine radiography of the extremities and girdles, thorax and abdomen ,

vertebral column, urinary system, gastrointestinal system, heads, and special projections used in these categories. Competency evaluations will be successfully completed in all categories listed in the student's contract.

C. correctly establish exposure factors at the control panel for any radiographic/

fluoroscopic examination.

D. discuss any radiograph of the extremities and girdles, thorax, abdomen, vertebral column, genitourinary tract, gastrointestinal tract, head, and special projections of each of these categories with regard to positioning of the patient part, its appearance in each projection, and identify the anatomy revealed in the image, exposure techniques, and radiographic quality.

E. correctly discuss methods of performing any radiographic examination experienced

during the current term, especially those which use the patient positioning stressed during this term.

F. be evaluated using the General Performance Evaluation and the Affective Evaluation

(professional traits and characteristics) by the clinical instructor; discussing the evaluation with the clinical instructor and signing it to signify that it was discussed with him/her. These evaluations, will be based on the following criteria:

a. technical knowledge g. personal and professional b. quality of work appearance c. initiative exhibited h. patient attitude exhibited d. efficiency of work i. use and care of radiographic e. work attitude equipment f. judgement exhibited j. communication skills

k. overall performance

83G. be evaluated on thirteen (14) competencies in radiographic procedures as specified in

the categories of: upper and lower extremities, cranium, spine and pelvis, fluoroscopy studies, mobile studies, pediatric studies, and the elective category with NO REPEATS.

Upper Extremity - 2 procedures Lower Extremity - 2 procedures Cranium - 1 procedure Spine and Pelvis - 2 procedures Abdomen - 1 procedure Fluoroscopy Studies - 1 procedures Mobile Studies - 1 procedure

Pediatric Studies - 1 procedure Elective category - 3 procedures Details for competency evaluation, guidelines, methods of application, sample evaluation forms, criteria for performance, scoring and grade scales found in the Clinical Education Handbook (CEH) for Radiography Students.

H. be evaluated in the basic procedures upon which most radiographic practice is based; i.e.,

patient care and management, file management, processing procedures, receptionist skills and procedures, and basic equipment and procedural activities.

I. make and maintain a daily log of the clinical experiences obtained in the term. Compile the daily

records for a monthly report to be submitted with the daily log sheets to the clinical coordinator at the end of each month and at the end of the term.

J. complete the student evaluation of clinical experience and clinical instructor evaluation forms

included in the clinical experience IV notebook.

84

Department of Diagnostic and Therapeutic Sciences B.S. IN RADIOLOGIC SCIENCES RADIOGRAPHY PROGRAM COURSE NUMBER: RAD 414 COURSE TITLE: CLINICAL PRACTICUM V COURSE DESCRIPTION: Supervised clinical practice of radiographic examinations,

stressing experience in performance of the head and specialized studies of the previous categories of emphasis. Includes image critique sessions, all types of radiographic examinations, operation of all types of radiographic equipment, and procedure protocols.

COURSE PLACEMENT: Summer Semester INSTRUCTOR: Audrey Harris, M.A.Ed., R. T. (R) (CT) (M) (QM) CONTACT HOURS: 300 CREDIT HOURS: 6 Semester Hours PREREQUISITE: RAD 412 TEXT: * Student Handbook for Education in

the Radiography Program * Policy and Procedure Manual(s) of the assigned

Radiology Department REFERENCES: Texts of Radiography Program from current and previous

terms METHODS OF INSTRUCTION: Lecture, demonstration, clinical coordinator/ technologist

supervised practice by the student, and directed self-study by the student.

PASSING SCORE: Radiographic Evaluations (average) 40%

General Clinical Evaluations (average) 30% Affective Evaluation 30% GRADE: The course grade reported to the UAB Registrar for

recording will be:

90 - 100 A 80 - 89 B 75 - 79 C 70 - 74 D Less than 70 F

85*Any absence occurring during the term must be made up before

the beginning of the next term. Absences are calculated in the term grade.

*No competency evaluations will be allowed during make-up time.

Course Objectives: At the end of this rotation, the student will:

A. correctly use prescribed practices and devices for the radiation protection of the patient, other personnel, and self.

B. perform radiography of the extremities and girdles, thorax and abdomen , vertebral

column, urinary system, gastrointestinal system, heads, and special projections used in these categories.

C. correctly establish exposure factors at the control panel for any radiographic/ fluoroscopic examination.

D. discuss any radiograph of the extremities and girdles, thorax, abdomen, vertebral

column, genitourinary tract, gastrointestinal tract, head, and special projections of each of these categories with regard to positioning of the patient part, its appearance in each projection, identify the anatomy revealed in the image, exposure techniques, and radiographic quality.

E. correctly discuss methods of performing any radiographic examination

experienced during the current term, especially those which use the patient positioning stressed during this term.

F. be evaluated using the General Performance Evaluation and the Affective Evaluation

(professional traits and characteristics) by the clinical instructor; discussing the evaluation with the clinical instructor and signing it to signify that it was discussed with him/her. These evaluations will be based on the following criteria:

a. technical knowledge g. personal and professional

b. quality of work appearance c. initiative exhibited h. patient attitude exhibited

d. efficiency of work i. use and care of radiographic e. work attitude equipment f. judgement exhibited j. communication skills

k. overall performance

G. be evaluated on eleven (11) competencies in radiographic procedures as specified in the categories of: upper and lower extremities, cranium, spine and pelvis, surgical studies, and the elective category with NO REPEATS.

Upper Extremity - 3 procedures Lower Extremity - 1 procedure Cranium - 1 procedure Spine and Pelvis - 2 procedures Surgical Studies - 1 procedure Elective category - 3 procedures

86

Details for competency evaluation, guidelines, methods of application, sample evaluation forms, criteria for performance, scoring and grade scales found in the Clinical Education Handbook (CEH) for Radiography Students.

H. be evaluated in the basic procedures upon which most radiographic practice is based; i.e., patient

care and management, file management, processing procedures, receptionist skills and procedures, and basic equipment and procedural activities.

I. make and maintain a daily diary of the clinical experiences obtained in the term. Compile the daily

records for a monthly report to be submitted with the daily log sheets to the clinical coordinator at the end of each month and at the end of the term.

J. complete the student evaluation of clinical experience and clinical instructor evaluation forms

included in the clinical experience V notebook

87

Appendix viii A-sheet

88Department of Diagnostic and Therapeutic Sciences

RADIOGRAPHY PROGRAM

Student’s Daily Report of Clinical Experience

Name of Student Clinical Education Site Clinical Instructor

Date Case # Patient Type Examination / Procedure Room O/A/I Comments 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25

Procedures / Activities other than Diagnostic Radiographic Procedures

Date Activity Time Comments 1 2 3 4 5

A

89Appendix ix

C-sheet

90Department of Diagnostic and Therapeutic Sciences RADIOGRAPHY PROGRAM Semester Monthly Clinical Experience Record Clinical Site ______________________ Name of Student __________________________________ Clinical Instructor ______________________

Categories / Procedures Total Thorax Mandatory Category Chest, PA and Lateral Chest, < 6 years Chest, WC or stretcher Ribs Elective Category Sternum Extremities Mandatory Category Finger or thumb Hand Wrist (AP & Lateral) Wrist (obliques) Wrist (scaphoid) Forearm Elbow (AP & Lateral) Elbow (obliques) Humerus Shoulder (int. & ext. rotation) Foot Ankle (AP & Lateral) Ankle (obliques) Tib-Fib Knee (AP & Lateral) Knee (obliques) Femur Trauma extremity Elective Category Extremity (< 6 years) Scapula Clavicle AC joints Trauma shoulder (transthoracic or Y) Toes Os Calcis Head and Neck Mandatory Category Skull, routine Facial bones Nasal bones Paranasal sinuses Elective Category Orbits Zygomatic Arches Mandible Soft tissue neck

C

91C-sheet page 2

Categories / Procedures Total Spine and Pelvis Mandatory Category C-spine (AP, Lateral, odontoid) C-spine (obliques) C-spine (XTL) C-spine (flexion and extension) T-spine L-spine (AP, Lateral, spot) L-spine (obliques) Pelvis Hip (AP, frogleg lateral) Hip, trauma (XTL) Elective Category Scoliosis series Sacrum Coccyx SI joints Abdomen and GI Mandatory Category BaS KUB Acute Abdomen Abdomen, decubitus UGI SBS, SBFT ACBE or Full column BE Elective Category Other Mandatory Category EXU / IVP Myelogram Nephrotomograms Elective Category Cystogram VCU Digital Fluoro Digital Radiography Mobile and Surgical Mandatory Category PCXR PABD Portable Upper Extremity Portable Lower Extremity C-arm Elective Category Operative Cholangiogram Retrograde Urogram

92Appendix x

Program Progression Guidelines

93UAB Radiography Program

Progression Policy For purposes of academic status in the UAB Radiography program, the grade point average of a student admitted in good standing will be accumulated for work completed while enrolled in the program. Since students in the professional phases of this program will participate in clinical practice and graduates must provide a quality health care service, all students will be required to maintain an overall C average in ALL courses and earn no letter grade less than C (< 75%) in any professional phase course to continue in the program. If a student makes less than a C (< 75%) in any courses taught during any semester of the program, he/she will not be able to continue in the Radiography program and must petition for readmission to the program. READMISSION IS NOT GUARANTEED. If the student’s petition for readmission is accepted, they will:

a. Be placed on academic probation for the remainder of the program b. Be required to reenter the program the following year one term prior to the

semester of their course failure. c. Be required to take a remedial clinical practicum (RAD 300 or RAD 400) prior

to the semester in which they resume their didactic courses to be repeated. d. Be required to retake all courses that were taken during the term of the failure

and obtain a letter grade of “C” or higher (> 75%). This will include those courses successfully completed as well as those courses failed. This requirement is necessary to insure a student’s knowledge and clinical skills are current to guarantee the program’s high clinical practice standards.

e. Be limited to the General Radiography elective courses (RAS 452 and RAS 462) during their final term for program completion.

SPECIFIC EXCEPTION FOR ELECTIVE ROTATION COURSES: When receiving a letter grade less than C (< 75%) in any of the Elective Rotation courses, a student must petition the program and it’s faculty to remain in the program. If their petition is accepted by the program then the student will be required to take the General Radiography elective courses (RAS 452 and RAS 462) as an alternative for finishing the program requirements the following semester. They will not be required to sit out an entire year from the program unless they fail more than the elective rotation courses that term. DEFINITIONS: Petition process: A student must write a letter to the program director explaining why a student should remain in the program or be readmitted to the program. The student must also schedule an appointment to meet face-to-face with the program director concerning their petition. Once this appointment is completed, the program director will meet with the faculty who will then vote on the student’s petition.

Last revised: May 22, 2006

94

Appendix xi

SHP Organizational Chart

95

SHRP Organizational Chart

Revised August 2004

DeanHarold P. Jones, PhD

HIPAA CoordinatorC. Michael Brooks, EdD

Assoc Dean for Academic& Student AffairsClaire Peel, PhD

Administrative & Fiscal SvcsMel anie Montgomery

Director

Director of DevelopmentCathleen Erwin

Ofc of Health Professions Educ.& Workforce Development

Stephen N. Coll ier, PhDDirector

Speech & HearingSciences Student Servi ces

Dept of C ritical C areEdward Huechtker, MPA

Chair

Dept of Diagnostic &Therapeuti c SciencesVictor Skrinska, PhD

Chair

Dept of Health Svcs AdminGerald Glandon, PhD

Chair

Dept of Nutrition SciencesW. Timothy Garvey, MD

Chair

Dept of Occupational TherapyPenelope Moyers, EdD

Chair

Dept of Physical TherapySharon Shaw, PhD

Chair

BS in RespiratoryTherapy

BS in SurgeonPhysician Assist ant

Masters ofNurse Anesthesi a

BS inCytotechnology

BS in MedicalTechnology

BS in NuclearMedi cine

Technology

BS in RadiologicSciences

Radiography

BS in RadiologicSciences

Radiation Therapy

MS in ClinicalLaboratory

Sciences

BS inHealth Sciences

BS in HealthInformation

Management

MS in HealthAdministration

MS in HealthInformati cs

PhD inAdministrationHealth Sciences

Center for HealthServices Continuing

Education

Biochemistry &Molecular Biology

Pediatri cNutrition

Physiology &Metabolism

Public HealthNutrition

PhD in NutritionSciences

Clinical Nut rition& Dieteti cs

DieteticInternship

MS inClinicalNutrition

MS inOccupational

Therapy

MS inOccupational Therapy

Post Prof.

MS inPhysical Therapy

DPT inPhysical Therapy

DSc PT inPhysical Therapy

Certi fi cat e inLow Vision R ehabilitation

96

Appendix xii

Advanced Imaging Concentration – Elective Phase

97

ELECTIVE PHASE ADVANCED IMAGING CONCENTRATION

A selected concentration is required. The concentration may be selected in an advanced imaging modality to include CT, MRI, CIT, or US or may focus in advanced coursework in the areas of General Radiography or Quality Assurance. Semester Hours CARDIOVASCULAR INTERVENTIONAL TECHNOLOGY (CIT) RAS 441 Cardiovascular Interventional Technology 4 RAS 451 Cardiovascular Interventional Technology Clinical Practicum 4 COMPUTED TOMOGRAPHY (CT) RAS 460 Computed Tomography 4 RAS 470 Computed Tomography Clinical Practicum 4 MAGNETIC RESONANCE IMAGING (MRI) RAD 417 Physics and Instrumentation of NMR 3 RAS 442 Magnetic Resonance Imaging 3 RAS 443 Magnetic Resonance Imaging Clinical Practicum 4 ULTRASOUND (US) RAS 480 Diagnostic Medical Ultrasound 4 RAS 481 Diagnostic Medical Ultrasound Clinical Practicum 5 RAS 482 Diagnostic Medical Ultrasound Lab 1

98

Appendix xiii

Specialty Rotations

99

SPECIALTY ROTATIONS – CT, CIT, MRI, AND US

Although each student will earn a BS in Radiologic Sciences upon successful completion of the radiography curriculum, no student can be guaranteed an advanced imaging component. Clinical availability will limit the number of students who can select a modality; if there are not any available clinics you will be place in general radiography. Therefore, the following procedure is used for the specialty rotations:

1. Students will identify an advanced imaging concentration in the Spring semester of the senior year. Students will indicate their 1st, 2nd, and 3rd choices to the Program Director. Failure to indicate choices by the established deadline will result in placement in the general radiography concentration.

Students who have not completed required ARRT clinical competencies will also be assigned to the general radiography concentration. Students granted the MRI concentration will begin in the preceding summer term and all other areas will begin in the fall term.

2. A scoring method will be used to determine eligibility to the advanced specialty areas and

will be based on three factors: a. Cumulative GPA 30% b. Modality Area Visit 30% c. Program GPA 40%

3. A maximum of 10 students can be assigned to the clinical component of MRI and CT; 5 students to US and CIT per semester.

4. A modality with less than 5 students will not be offered, however, students will receive

their 2nd or 3rd choice.

100

Appendix xiv SHP Grievance Procedures for Violations of Academic Standards

101

102

103

104

105

106

107

Appendix xv Clinical Affiliates Information Sheet

108

UAB Radiography Program CLINICAL AFFILIATES INFORMATION

Affiliate Clinical Hours Clinical Instructor Phone number Brookwood Medical Center 7:00am – 3:00pm Scott Glidewell 877-2156 Brookwood Diagnostic Center 7:30am – 3:30pm Kristal King 802-6826 Children’s Hospital of Alabama 7:30am – 3:30pm Karen Knight 939-9933 Children’s South 7:00am – 3:00pm Andrea Black 8244745 Cooper Green Hospital 7:30am – 3:30pm ____________ 930-3278 Coosa Valley Baptist 7:00am – 3:00pm Susan Martin 256-249-5140 Health South Medical Center 7:00am – 3:00pm Chris Cumbest 930-7130 Kirklin Clinic 7:00am – 3:00pm Kristi Eden 801-8793 Trinity Medical Center 7:00am – 3:00pm Joanne Vann 592-1255 (formerly BMC Montclair) Montclair Diagnostic Center 7:00am – 3:00pm Kelli Culwell 599-3900 or

8:00am – 4:00pm (student decides) Princeton 8:00am – 4:00pm Cathy Hopper 783-3700 Kay McDevitt Riverview Medical Center (contact CI for hours) Tommy Bailey (256) 543-5382 Shelby Baptist Medical Center 7:00am - 3:00pm Cynthia Dunlap 620-8619 Shelby Diagnostic Center 8:00am – 4:00pm Joy Steadman 620-8026 University Hospital 7:30am – 3:30pm Chalonda Jones 934-1262 UAB Medical West 7:30am – 3:30pm Jackie Harris 481-7299 VAMC 8:00am – 4:00pm Gary Coley 933-8101 Dona Kloss-Owen ext. 5064 Walker Baptist Medical Center 6:30am – 2:30pm Rebecca Sharpton 205-387-4067

Last revision: May 22, 2006

109

Appendix xvi Student Health Policy

110

111

112

113

114

Appendix xv Consent to State and/or Federal Background Checks for Clinical Assignment

115

116

117

Appendix xvi UAB Undergraduate Programs Attendance and Excused Absence Policy

118

Attendance and Excused Absence Policy for Undergraduate Programs The University of Alabama at Birmingham recognizes that the academic success of individual students is related to their class attendance and participation. Each course instructor is responsible for establishing policies concerning class attendance and make-up opportunities. Any such policies, including points for attendance and/or participation, penalties for absences, limits on excused absences, total allowable absences, etc., must be specified in the course syllabus provided to students at the beginning of the course term. Such policies are subject to departmental oversight and may not, by their specific prescriptions, negate or circumvent the accommodations provided below for excused absences. The University regards certain absences as excused and in those instances requires that instructors provide an accommodation for the student who misses assignments, presentations, examinations, or other academic work of a substantive nature by virtue of these excused absences. Examples include the following: • Absences due to jury or military duty, provided that official documentation

has been provided to the instructor in a timely manner in advance. • Absences of students registered with Disabilities Services for disabilities

eligible for “a reasonable number of disability-related absences” provided students give their instructors notice of a disability-related absence in advance or as soon as possible.

• Absences due to participation in university-sponsored activities when the

student is representing the university in an official capacity and as a critical participant, provided that the procedures below have been followed: o Before the end of the add/drop period, students must provide their instructor a schedule of

anticipated excused absences in or with a letter explaining the nature of the expected absences from the director of the unit or department sponsoring the activity.

o If a change in the schedule occurs, students are responsible for providing their instructors with advance

written notification from the sponsoring unit or department. • Absences due to other extenuating circumstances that instructors deem excused. Such classification is at the

discretion of the instructor and is predicated upon consistent treatment of all students. In these instances, instructors must devise a system for reasonable accommodation including, for example, policies allowing for dropped exams/quizzes, make-up exams, rescheduling of student classroom presentations or early or later submission of written assignments.

Date of implementation: Fall 2006

119

ACKNOWLEDGEMENTS

120

The University of Alabama at Birmingham School of Health Profession

Division of Diagnostic and Therapeutic Sciences Radiography Program

Declared Pregnancy Acknowledgement

Due to the danger to an unborn fetus, especially in the first three (3) months, a student who becomes pregnant during the educational process SHOULD VOLUNTARILY DECLARE their pregnancy to the Program Director at the earliest confirmation of pregnancy. The declared pregnant student will be required to sign an “Acknowledgement of Radiation Risk During Pregnancy” waiver and the “UAB Radiography Program Declared Pregnancy” form. Any excessive absenteeism for either didactic or clinical education coursework must be made up in order for the student to graduate. A student is offered two alternatives after the consultation with the Program Director. They are:

c. The declared pregnant student can immediately withdraw from all clinical and didactic courses and write a letter to the Radiography Program Director requesting re-entry the following year.

d. The declared pregnant student can continue in the program after being given specific instruction regarding

radiation safety practices, additional radiation monitoring, and specific clinical and laboratory assignments. By signing below, I acknowledge that I have read and fully understand the UAB Radiography Program Declared Pregnancy Policy. ______________________________________________ __________________ Student signature Date

Last revision: September 2002 November 2002

February 2004

121

The University of Alabama at Birmingham School of Health Profession

Division of Diagnostic and Therapeutic Sciences Radiography Program

Radiation Risk During Pregnancy and Declared Pregnancy Acknowledgement

Due to the danger to an unborn fetus, especially in the first three (3) months, a student who becomes pregnant during the educational process SHOULD VOLUNTARILY DECLARE their pregnancy to the Program Director or Academic Clinical Coordinator at the earliest confirmation of pregnancy. The declared pregnant student will be required to sign this “Radiation Risk During Pregnancy and Declared Pregnancy Acknowledgement” form. Any excessive absenteeism from either didactic or clinical education courses must be made up in order for the student to graduate. A student is offered two alternatives after the consultation with the Program Director. They are:

1. The declared pregnant student can immediately withdraw from all clinical and didactic courses and write a letter to the Radiography Program Director requesting re-entry the following year.

2. The declared pregnant student can continue in the program after being given specific instruction regarding

radiation safety practices, additional radiation monitoring, and specific clinical and laboratory assignments.

NOTE: The student must be able to progress in her educational experience both clinically and a academically. If the student cannot, she will be strongly advised to withdraw as indicated in

alternative one above. Option selected: __________________ By signing below:

a. I acknowledge that I have read and fully understand the UAB Radiography Program Declared

Pregnancy Policy. b. Additionally, I am voluntarily declaring my pregnancy with an anticipated date of delivery of

_______________________________.

c. If option 2 is selected, I understand that the University of Alabama at Birmingham Radiography Program, in which I am enrolled, assumes NO LIABILITY for any birth defects that my unborn child might have due to my decision to remain in the program.

______________________________________________ ________________________________ Student signature Date COMMENTS:

Last revision: September 2002 November 2002

June 2003

122

The University of Alabama at Birmingham Radiography Program

Waiver of Program Liability Employment Form

I, _____________________________________________________, have applied for employment with (Name of Student) ____________________________________________ as (a) (an)__________________________ (Employer’s Name) (Position / Title) The application has been accepted and I (will begin / began) this employment on the following date: ______________________________, 20___. I expect to work a shift of ______ hours per day, ______ hours per week, beginning at ____________ (a.m. / p.m.). I understand that the University of Alabama at Birmingham Radiography Program, in which I am enrolled, assumes NO LIABILITY for any act I may commit in connection with or during the performance of responsibilities concomitant with my employment. _______________________________________________ __________________ Student’s signature Date _______________________________________________ Student’s social security number

123

DIAGNOSTIC & THERAPEUTIC SCIENCES

UNIVERSITY OF ALABAMA AT BIRMINGHAM

BS IN RADIOLOGIC SCIENCES/RADIOGRAPHY PROGRAM Venipuncture Waiver Form

I, the undersigned student in the Radiography Program will not perform venipuncture on a patient while in said Radiography Program. I, understand that the said program, in which I am enrolled, assumes no liability for a venipuncture I may commit while in the clinical setting. ___________________________________ STUDENT SIGNATURE ____________________________________________ STUDENT NAME (PLEASE PRINT) ___________________________________ STUDENT SOCIAL SECURITY NUMBER ___________________________________ DATE

124

UAB School Health Professions Consent to Drug Testing and Release of Drug Test Results

For and in consideration of my participation in clinical education experiences, I understand that I may be required to submit to drug testing as a prerequisite to my assignment to certain clinical sites. I hereby consent to be tested for drugs and consent to the release of any such drug test results to the Program Director, and the subsequent release of such drug test results by the Program Director to the clinical site that required the test. ________________________________ ___________________________ Student’s Signature (if over 19) Date ________________________________ Signature of parent/ legal guardian (sign only if student is under 19)

125

The University of Alabama at Birmingham Radiography Program

Acknowledgement of Clinical Education Handbook 2006-2007 I have received and thoroughly read the University of Alabama at Birmingham Radiography Program Student / Clinical Education Handbook. I understand the policies and regulations contained therein and the responsibilities to be undertaken. I further understand that failure to comply with the established Policies and Procedures may result in my suspension or possible dismissal from the Radiography Program. By signing below, I acknowledge that I have read and fully understand the UAB Radiography Program Student / Clinical Education Handbook and agree to comply with these policies and procedures. ______________________________________________ __________________ Student signature Date ______________________________________________ __________________ Witness Date