L2, Ch 5: Introduction to Clinical Education

Importance of Clinicals

• allows the student to integrate the knowledge gained from didactic courses into clinical practice while caring for patients

• Education as a medical imaging professional will include three areas of learning:

  • Cognitive - behaviors requiring various levels of thought: knowledge, understanding, reason, and judgment

  • Affective - behaviors guided by feelings and emotions that are influenced by an individual’s interests, attitudes, values, and beliefs

  • Psychomotor - behaviors involving physical actions, neuromuscular manipulations, and coordination

• Requires prior learning in the classroom and laboratory

• Permits one-on-one, direct patient contact

Learning is a

continuum

• As your education proceeds, it will necessarily shift from didactic instruction to more clinical education, in a variety of clinical settings

Learning Process

• Based on performance objectives

• Learning observed and measured by way of competencies

• Learning outcomes → treat these goals as a staircase trying to reach the top

Competencies

• ARRT has established a minimum number of clinical competencies in various exam categories

• Clinical competence must be performed independently consistently, and effectively

• Student supervision can be direct and indirect.

• Eligibility for the ARRT credentialing examination requires all clinical skills and competencies completed and documented by program officials

Competencies Requirements

• Ten mandatory general patient care activities

• 37 mandatory imaging procedures

• 15 elective imaging procedures selected from a list of 34 procedures

  • One of the 15 elective imaging procedures must be selected from the head section; and

  • Two of the 15 elective imaging procedures must be selected from the fluoroscopy studies section, one of which must be either upper GI or contrast enema

Stages of clinicals

• observation

• assistance

• performance

Direct Supervision

• qualified radiographer

  • review the request for examination in relation to the student’s achievement

  • evaluate the condition of the patient in relation to the student’s knowledge

  • be physically present during the conduct of the procedure

  • review and approve the procedure and/or image

Indirect Supervision

qualified radiographer

• reviews, evaluates, and approves the procedure as for direct supervision

• immediately available to assist students regardless of the level of student achievement

  • “Immediately available” is interpreted as the physical presence of a qualified radiographer adjacent to the room or the location where a radiographic procedure is being performed

Major Clinical Education Policies

• Supervision

• Performance of actual examinations

• Simulations

• Assessments

• Radiation protection

• Practices

• Disciplinary Procedures

• Professional ethics

• Practice standards

• HIPAA

• Professional appearance and behavior

• Attendance and tardiness

• Pregnancy

Getting Comps or Signed off

Students who want to get an exam signed off must perform the following steps. Note: If one of these steps does not happen, you cannot get signed off and will need to try again

1. Ask to be signed off prior to getting the patient.

2. Once you get the okay from a technologist or CI, there can be no assistance from the technologist

3. If the technologist intervene at any time of the procedure you have failed and will need to try again

4. Getting signed off involves naming anatomy, setting the technical factors. etc.

Student Course Development

• The curriculum is not designed to make the student fail, rather to make the student succeed in delivering optimum patient care.

• JCERT Standards

• Competency based

• Designed in three phases

• Allows for the translation of theory into practice in a real-world setting

Do’s and Dont’s in Clinical Setting

• Do arrive early or on time

• Do not arrive late. Arriving late shows a lack of RESPECT the department, the CI, and yourself.

• Do not argue with the tech or get into department politics.

• Do not compare what you were taught to what the technologists teaches you. Remember, you have to learn both

• When you have time to lean, you have time to clean.

TeamSTEPPS to Patient Safety

• an evidence-based teamwork system

• TeamSTEPPS approach uses highly effective teams, necessary to the best patient outcomes.

• Consists of five (5) key principles

  • Team structure

  • Communication

  • Leadership

  • Situation monitoring

  • Mutual support

TeamSTEPPS to Patient Safety Videos

Root cause of medical errors

poor communication

Joint Commission #2 the effectiveness of communication among

caregivers to Implement a standardized approach to handoff including

an opportunity to ask and respond to questions

Patient-Centered Care

treating patients as partners, involving them in planning their health care and encouraging them to take responsibility for their own health

SBAR

A strategy to improve communication when “handing off” a patient from one health care worker to another Consist of four (4) elements

• Situation

• Background

• Assessment

• Recommendation

SBAR is a structured communication process that provides for accurate sharing of patient information between health care workers when patient handoff occurs

SBAR Video

Transfer of learning

The principle of transfer of learning is exemplified in the clinical education component, with the student recalling prior knowledge learned and using this knowledge in performing diagnostic or therapeutic procedures to develop both the skills and the confidence to work with a wide variety of patients

competency

the observable, successful achievement of the performance objectives

Organizational chart for radiologic science program

• The program director works full time in organizing, administering, and assessing the radiography program. This person is responsible for the didactic and clinical effectiveness of the program.

• The clinical coordinator works closely with the program director in ensuring program effectiveness through a regular schedule of coordination, instruction, and evaluation.

• The clinical instructor works directly with the student in the clinical setting

• Members of the clinical staff are employees of the healthcare institution and provide student supervision and guidance

Interprofessional education (IPE)

one approach to teaching students and healthcare workers how to interact and work with each other in the clinical setting. IPE allows for healthcare and social care workers or students, from two or more professions, to engage in learning with, from, and about each other. This interprofessional learning environment cultivates professional collaborative practice to support patient-centered healthcare

DMI Application Window

July 10 - August 15

DMI Application is submitted

online only

DMI Application: Volunteer Hour Verification

• 40 hours of patient and radiographer observation in general radiographic procedures in acute hospital (not rehabilitation, not urgent care, not film library, not ambulatory care/clinic etc)

  • 40 hours in general radiography (skeletal, chest XR, fluoroscopy, surgery) or

  • 30 hours in general radiography and 10 hours in another modality (MRI, CT, US, Mammo, DEXA, IR)

• Don’t list only chest XR’s lol

DMI Application: Professional Questions

• If more than 2 incorrect/poorly answered questions, application disqualified

• College level writing

• Wikipedia is not a reputable source

DMI Application: Academic Requirements

• Prerequisite Courses GPA: 2.5

• Overall GPA: 2.0

• Grades lower than “C” and “Pass/No Pass” are not acceptable in prerequisite courses

• Prerequisites

  • General college chemistry + lab

  • English

  • Human anatomy + lab

  • Human physiology + lab

  • Intermediate Algebra

  • Introductory physics + lab

• If prereq done at different college, need Dean of department sign off course equivalency

• Academic history more than 2 incomplete grades, withdrawals, or repetition in last 7 years of prerequisite courses due to failures, academic probation, etc may be cause for application disqualification

DMI Application: Drug Screen

no marijuana

DMI Application: Felonies or Misdemeanors

• federal level background check

• If applicant has felony or misdemeanor conviction, ARRT must determine eligibility for the Registry examination before applicant has completed the program

DMI Application: cohort

Fall or Spring