School of radiologic technology


QUALIFYING PROCEDURE FOR PROFICIENCY EVALUATIONS



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QUALIFYING PROCEDURE FOR PROFICIENCY EVALUATIONS



  1. The examination must have been reviewed in Lab and checked off by the instructor prior to attempting performance in the clinical setting.

In cases when the examination has been deferred from the previous semester, the examination must be completed by the end of the following semester to avoid reduction in grade.
II. The student attempt an examination as many times as is needed to become comfortable in performing the exam before requesting to perform the exam for competency.
III. The student must inform the R.T. Evaluator of his/her intent to challenge a proficiency evaluation prior to the exam.
IV. The Student must successfully complete the challenge:

A. Without assistance

When an obvious error that would invalidate the examination or would

or would endanger the patient is seen, the R.T. evaluator must intervene

and complete the examination. This condition would warrant a failure on

the evaluation, and the student would be advised to a reinforcement

practice period before attempting another challenge of that examination

type.


B. With direct supervision

See A. above

Reference: glossary of terms, Standards (JRCERT)

C. Without any repeats

D. With 85% accuracy

E. In view of hospital/clinic policies, students will be allowed to assist rather

than perform certain radiographic procedures. These are indicated on the

student checklists, by and (*).


V. Grading shall be completed by the R.T. evaluator.

Grading: Total number of points attainable = 32

29-32 = A

26-28 = B

25 & below = F (failure)
Mastery vs. Non-Mastery is the factor in the grading system of this evaluation tool. When a student challenges a proficiency evaluation, he/she should feel just that – proficient. A rating of 0 would indicate that an area of performance was unacceptable. In other words, the area had NOT been mastered. A rating of 2 would indicate an acceptable area, or mastery of that area.
In view of the nature of Radiologic Technology, its source, its patient contact, and its constant strive toward professional recognition, it is felt that student of the field should strive for complete mastery of its skills and knowledge.
VI. If one failure of a specific challenge is recorded, only one (1) return challenge will be permitted.
VII. Upon successful mastery of a specific radiographic examination, the student may then proceed to challenge the proficiency evaluations to complete the requirements for that specific semester.
VIII. Continued competency refers to continuously attaining competency over and

over again in the performance of procedures already challenged to continue to

improve the skills required that that procedure. Procedures will be duplicated

each semester throughout the program.


IX. The categories are specified below and listed are the exams included in each. The student should consult this list each semester and maintain their own record of those exams completed previously by using the enclosed checklist. The Clinical Coordinator will send out an updated Master list of proficiencies completed at least twice each semester for the student to review.

CATEGORIES FOR CLINICAL PROFICIENCIES
UPPER EXTREMITY LOWER EXTREMITY PELVIS/SPINE
Finger or thumb Toes Pelvis

Hand Foot Hip

Wrist *Calcaneus *SI joints

Forearm Ankle Cervical sp.inc.obls.

Elbow Tibia/fibula Thoracic spine

Humerus Knee Lumbar sp.inc.obls

Shoulder *Patella *Trauma cerv.spine

Trauma extremity Femur to include XTL

*Clavicle Trauma Extremity Trauma Hip

*Scapula to include XTL

*AC joints *Sacrum

Trauma shoulder *Coccyx

*Bone survey *Larynx-soft tissue

*Soft tissue extremity *Scoliosis series



Examinations NOT marked with an asterisk* are Mandatory.

Examination marked with an asterisk * are defined as Electives.

THORAX SKULL GI/ABDOMEN

Chest routine *Skull (diag. or trauma) *Esophogram

*Chest decub. *Mandible GI series

Chest wheelchair or stretcher *Facial bones *Small bowel

Ribs *Sinuses Barium Enema

*Sternum *Orbits *BE with air

*Chest- obl or lordotic *Zygomas KUB

Ped. Chest (6y/o) *Nasal bones Abdomen series

include supine & upright

*Abdomen inc. decub

*Any cholecystogram/

cholangiogram

*Oper. Cholangio

*ERCP


*VSA

*Digital Fluoroscopy

*Digital Radiography
GU (GENITO-URINARY) SPECIAL PROCEDURES

(actively participate in)

*IVP *Myelogram

*Cystogram/VCU *Body Section Radiography

*Digital Radiography *Arthrogram

*Digital Fluoroscopy *HSP – Hysterosalpingogram

*Fetal Detail

CT – Head, Chest, and Abd/Pelvis


MOBILE AND SURGICAL PROCEDURES

Chest – routine

*Thorax

*Abdomen/KUB



*Upper Extremity

*Lower Extremity

*GI (Gastrointestinal)

*GU (Genitourinary)

*Spine

*Pelvis/Hips



*Skull

*Special Orthopedic exams (clubfoot, etc)


X. MINIMUM REQUIREMENTS: with the exception of the first semester of the program (no proficiencies required), all students shall complete the minimum number of radiographic exams per semester. Students not achieving a minimum of exams will be given a grade determined by dividing the number of exams performed by the number of exams required.  Required exams not completed by the end of the semester will be carried over to the next semester and added to the required exams for that semester.  This will result in a reduction in Proficiency grade for that semester. All proficiencies must be completed by the end of the last semester in order to graduate from the program. Simulation of exams that are not often available may be allowed as necessary.


XI. For the proficiency list – see the proficiency charts which follows.

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Applied Clinical Proficiency Performance

Student __________________________________ Semester _______________

Date Exam

Performed ___________________ Time______Hospital __________Room ___

Patient Information: Exam__________________________________________

Projections/Views __________________________________________________
Rating:

0 = Unsatisfactory 1 = Acceptable/needs Improvement 2 = Satisfactory/acceptable





PERFORMANCE CRITERIA:


RATING


COMMENTS:


1. Interpretation of Request







2. Facilities readiness/room/equipment, supplies







3. Equipment Use/Manipulation







4. Patient Care, Safety







5. Proper selection – film and accessories







6. Correct Positioning – anatomy/rotation/angle







7. Correct centering – film(IR), part, tube







8. Correct Technical Factors







9. Radiation Protection – collimation, shielding







10. Correct Markers and film/image I.D.








IMAGE EVALUATION CRITERIA:






1. Correct centering and tube part film (IR) alignment







2. Proper Density, Contrast, and Recorded Detail







3. Correct position/part rotation







4. Correct Patient/film ID and Markers







5. Radiation protection/collimation and shielding







6. Performance in: communication, problem-solving, and critical thinking.








TOTAL POINTS OF PERFORMANCE EVALUATION





PROF. GRADE:____


The exam was performed by the student with appropriate supervision and no repeated films. I observed the performance and reviewed the films/images with the student.


RT Signature ______________________________ Date: ___________________

CRITERIA FOR APPLIED CLINICAL PROFICIENCY EVALUATIONS
Students will be able to:
I. PERFORMANCE CRITERIA

1. Interpretation of Requisition



  • Identify the procedure to be done and the history

  • Identify the patient’s name, age, and mode of travel

2. Facilities Readiness

  • Radiographic table and equipment turned on, clean, cassettes ready

  • Room stocked with linens, emesis basins, syringes, etc

3. Equipment use

  • Safely operate standard radiographic and fluoroscopic or mobile equipment

  • Safely operate tomographic equipment or any other equipment required to perform the exam being evaluated

  • Turn tube from horizontal to vertical and vice versa, identify and utilized tube locks

  • Insert and remove cassettes properly

  • Select technical factors; use technique chart, measuring patient

4. Patient care and handling

  • Locate correct patient and assist patient to and from room and table

  • Have patient gowned properly; keep covered for privacy

  • Explain procedure to patient in calm manner

  • Give proper moving and breathing instructions

  • Follow correct procedures for isolation patient

5. Correct Accessory selection and use

  • Select the proper cassette size or IR, grids, etc.

  • Use immobilization devices as needed, sponges, sandbags, etc.

  • Fill syringes with correct contrast media or other solutions using aseptic technique when applicable

6. Correct radiographic positions

  • Place the patient correctly on the table and assist in required positions

  • Place cassette and body part in correct relationship

  • Correct angulation and centering of tube

7. Correct centering

  • Align center of part to the center of the film

  • Center CR to the center of the IR and part

  • Angle CR to correct anatomical part

8. Correct technical factors

  • Measure the patient and use a technique chart

  • Adjust exposure factors for body habitus, pathology, and motion

  • Adapt exposure factors for changes in FFD, Grid ratio, collimation

9. General Radiation protection

  • Cone and collimate to the part

  • Use gonadal shields where applicable

  • Select proper exposure factors

  • Wear lead apron and gloves as appropriate

  • Keep door to radiographic room closed; ask any person in vicinity of the patient to move away before making an exposure

10. Correct markers

  • Properly place right or left markers and patient ID on film

  • Use time markers correctly as needed


II. IMAGE CRITERIA

1. Correct centering and alignment



  • Correct transverse and longitudinal centering

  • Correct tube-part-film alignment

  • Correct SID and CR angulation

  • Correct anatomical part

2. Correct density, contrast and recorded detail



  • Proper density, contrast and recorded detail

  • Factors adjusted for pathology or motion

  • Correct cassette, grid, etc

  • No motion, grid lines, or artifacts

3. Correct position and rotation of part



  • Body part in proper position and rotation

4. Correct patient ID and Markers



  • Right/left markers correctly placed

  • Time and/or position markers correctly placed

  • Patient information; name, number, etc. visible

5. Evidence of radiation protection



NOTE : The student will be able to critique the image and identify anatomical structures demonstrated.

CLINICAL PROFICIENCY CHECKLIST- FIRST SEMESTER

Revised 11/2015

STUDENT_______________ ________ CLASS OF_20 _ Spring 20


EXAM DATE GRADE

1. CHEST (ROUTINE) (M)





2. CHEST (ROUTINE) (M)





3. RIBS (M)







4. STERNUM*






5. .THUMB or FINGERS (M)






6. HAND (M)






7. WRIST (M)






8. FOREARM (M)






9. ELBOW (M)






10. HUMERUS (M)






11. CLAVICLE*






12. SCAPULA *






13. SHOULDER (M)









14. TRAUMA SHOULDER (M)






15. A-C JOINTS or S-C JOINTS *






16. TOES*






17. FOOT (M)






18. OS CALCIS*






19. ANKLE (M)






20. TIBIA/FIBULA (M)






21. KNEE (M)






22. PATELLA*









23. FEMUR (M)




24. HIP (M)







25. ANY UPPER EXTREMITY









26. ANY LOWER EXTREMITY


















20 Exams must be completed this semester. All Mandatory (M) exams must be completed. * Indicates elective exam


CLINICAL PROFICIENCY CHECKLIST- SECOND SEMESTER
STUDENT:______________ _______ CATEGORY SYSTEM Summer 20_



EXAM DATE GRADE

1. CHEST (ROUTINE) (M)





2. CHEST (ROUTINE) (M)





3. CHEST (Wheelchair) (M)





4. CHEST (Stretcher) (M)




5. PORTABLE CHEST (M)






6. CERVICAL SPINE (M)






7. THORACIC SPINE (M)






8. LUMBAR SPINE (M)






9. SACRUM/COCCYX*






10. SI JOINTS *






11. PELVIS & HIPS (M)






12. BA SWALLOW *







13. UPPER GI w/o AIR (M)








13. UPPER GI w AIR (M)






14. SMALL BOWEL *






15. BE (M)






16. BE with AIR *






17. ABDOMEN COMPLETE (M)






18. ABDOMEN with DECUBITUS *






19. TRAUMA SHOULDER (M)






20. ANY UPPER EXT. (M)






21. ANY LOWER EXT. (M)






22. ANY TRAUMA EXT. (Non-Shoulder)(M)







23. GU EXAM (IVP, Cystogram, Cystourethrogram)*









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