Generally accepted criteria that serve to differentiate a profession from other occupations or trades
Professional Ethic
deals with the "rightness and wrongness" of an act or behavior as compared with natural reason. Combination of societal laws and values.
Ethics
Ethical reflections that emphasize an intimate personal relationship value system that includes such virtues as sympathy, compassion, fidelity, discernment, and love.
Ethics of Care
Sources for Ethical Attitudes.
Science Culture Religion Experience
defined by laws, rules and regulations, ordinances, and so on.
Societal behavior
Practice behaviors that are defined by members of a profession.
Standards of Professional Conduct
Defined by two distinct documents, professional Standards of Conduct and Scope of Practice. Establishes norms for professional conduct.
Professional behavior
Manners and attitudes generally accepted by members of a profession.
Professional Etiquette
Regulations established by government and applicable to people within a certain political subdivision. Can be limiting and are not comprehensive in controlling all possible behaviors. Can be politically motivated and applied unequally.
Laws
Laws need _________ and ______________
enforcement and authority
Rights of individuals or groups that are established and guaranteed by law.
Legal Rights
Basis for rights-based ethical theory; each individual is protected and allowed to pursue personal projects.
Liberal Individualism
Generally accepted customs, principles, or habits of right living and conduct in a society and the individual's practice in relation to these.
Morals
Rights of individuals, or groups that exist separately from governmental or institutional guarantees; usually asserted based on moral principles or rules.
Moral Rights
General, universal guides to action that are derived from so-called basic moral truths that should be respected unless a morally compelling reason exists not to do so; also referred to as ethical principles.
Moral Principles
Articulated statement of role morality as seen by the members of a profession.
Code of Ethics
ARRT's mandatory standards of minimally acceptable professional conduct. These are enforcable and can result in sanctions should the ARRT determine the certificate holder has violated any of the rules
Rules of Ethics
The ARRT Code of Ethics is composed of two parts. What are these two parts and what do they deal with?
Part A - deals with behaviors a professional should aspire to achieve Part B - deals with mandatory rules of acceptable professional conduct
typically static and slow to change in order to reflect changing societal trends and values.
Ethical codes
Situations requiring moral judgement between two or more equally problem-fraught alternatives; two or more competing moral norms are present, creating a challenge about what to do. occur when the correct choice is not clear and personal values may conflict.
Ethical Dilemmas
Ethical Analysis steps
Identification of the problem Developing alternative solutions Selecting the best solution Defending the selection
Bodies of systematically related moral principles used to resolve ethical dilemmas
Ethical Theories
List Ethical Theories.
Consequentialism Nonconsequentialism Social Contracts Rights-based ethics Principle-based ethics Virtue-based ethics
Belief that the worth of actions is determined by their ends or consequences; actions are right or wrong according to the balance of their good and bad consequences.
Consequentialism
Belief that actions themselves, rather than consequences, determine the worth of actions; actions are right or wrong according to the morality of the acts themselves.
Nonconsequentialism
Relationship that exists when two mutually dependent groups in a society recognize certain expectations of each other and conduct their affairs accordingly.
Social contract
Collection or set of values that an individual or group has as each person's personal guide.
Value system
based on an understanding of human rights (right to health care, rights of health professions)
Rights-based ethics
use of moral principles as a basis for defending a chosen path of action in resolving and ethical dilemma
Principle-based ethics
Belief system based on a set of moral principles that are embedded in a common morality.
Principlism
Traits of character that are socially valued, such as courage.
Virtues
use of virtues in establishing right reason in action
Virtue-based ethics
__________ and __________ form the framework of Virtue-based ethics.
Character Virtue
List the basic ethical principles.
Beneficence Nonmaleficence Autonomy Veracity Fidelity Justice
Perform actions that benefit others. Decide and act always to benefit the patient. bringing about good
Beneficence
Above all do no harm. Never perform or allow acts that may harm the patient. preventing harm
Nonmaleficence
Perform actions that respect the independence of other persons. The patient must decide what is done to his or her person. acting with personal self reliance
Autonomy
Being truthful is right To tell the truth is expected. telling the truth
Veracity
Performing acts that observe covenants or promises is right. Be faithful
Fidelity
Performing acts that ensure the fair distribution of goods and harm are right. Be fair or equity
Justice
List the different Professional relationships.
Toward patients Toward physicians Toward co-workers/other health care providers
How to avoid Ethical conflicts.
Understand some situations are unavoidable Clearly understand the right/wrong thing to do Choose right thing to do When unsure, research professional standards of conduct and ethical principles as a guide
Gross violation of commonly held standards of decency or human rights.
Ethical Outrage
Deals with variety of human societies and cultures and examines their similarities and differences.
Human diversity (Cultural diversity)
Establish behaviors of people. Can be for a lifetime and provide comfort.
Cultures
Globalization
people now cross borders into other countries to work, go to school, receive medical care, visit, and live.
List the key diversity traits.
Age Ethnicity/national origin Race Gender Sexual orientation Mental ability Physical ability
Play major role in how individuals perceive others.
Personal biases
Process by which people of diverse backgrounds slowly give up their original cultural language and identity and try to merge into another culture (usually the majority). Diminishes the accomplishments, contributions, and values of one culture in favor of those of the mainstream.
Assimilation
The ability of an individual to be able to negotiate competently two or more cultures (the mainstream's culture & their own culture).
Biculturalism
U.S. Mainstream Values
-Activity and hard work -Personal achievement and success Individualism -Efficiency and practicality -Affluence, consumerism, and material comfort -Competition -Openness, directness, and being well informed
List the the aging generations (subsets of population).
World War II Baby Boomers (1946-1964) Generation X (1965-1980) Generation Y (1981-1999) Generation Z (2000-present
The most significant subset, because of the impact they will have on the population. This subset is considered to be generally healthy and well educated.
Baby Boomers
Relates to a person's distinctive racial, national, religious, linguistic, or cultural heritage.
Ethnicity
Defined as possessing a set of attitudes, behaviors, and policies that come together in a system, or among individuals, that enable effective interactions in a cross-cultural framework.
Cultural competency
Five elements that contribute to becoming culturally competent.
Value diversity Develop capacity for cultural self-assessment Become aware of dynamics of cross-cultural interaction Institutionalize cultural knowledge Develop adaptations of service delivery that reflects an understanding of a multicultural environment
To provide high-quality and effective care for all patients, health care providers need to understand the following six areas of human cultural diversity and how these areas influence the delivery of care.
Communication Space Time Environmental control Biologic variations Social organizations
Results in ionization of atoms.
Loss of electrons
___________ must outweigh the ________ of any x-ray diagnostic study.
Benefits risks
Two sources of ionizing radiation
natural and manmade
_____________ and __________ x-ray examinations make up the largest portion of human-made radiation exposure.
Medical and dental
Conditions necessary for x-ray production.
Source of electrons (Cathode filament)(negative) Means of accelerating electrons/high-speed motion (Voltage) Mechanism stopping electrons abruptly/deceleration (Target/Anode)(positive)
Energy of beam is expressed in __________.
Kiloelectron volts (keV)
Three possible paths an x-ray beam can undergo.
Total absorption Pass through with no energy loss Scattering/secondary interaction with loss of energy
Five types of x-ray interactions with matter.
Classic coherent scattering Photoelectric interactions Compton scattering Pair production Photodisintegration
Who does photoelectric interactions expose?
Patient
Who does compton scattering expose?
Radiographer/Tech
Involves very-low energy x-rays. No ionization occurs.
Classic Coherent Scattering (Thompson scattering)
What does coherent scattering do to an atom?
Atom becomes excited and emits x-ray with same energy.
Classic Coherent Scattering occurs when x-rays possess energy levels below what keV?
10 keV
Occurs within the diagnostic x-ray energy range
Photoelectric effect Compton scattering
Incoming x-ray photon is completely absorbed by collision with inner-shell(k-shell) electron.
Photoelectric effect
What does Photoelectric effect do to an atom?
-Electron (photoelectron) leaves atom, creating an ion pair. -Free electron eventually unites with other matter. -Secondary radiations created as a result of electron cascade from outer shells to inner shells.
In the Photoelectric effect, which electron produces an x-ray with energy high enough to impact your image?
The electron that drops in to the hole in the k-shell
Radiation interaction responsible for most hazard to patients. Why?
Photoelectric effect Because there is complete absorption in the patient
Incoming photon collides with outershell electron
Compton Scattering
What does Compton Scattering do to an atom?
-Incoming photon collides with outershell electron, creating a free Compton electron (recoil) and an ion pair. -Incoming photon loses some of its energy through collision, scatters off in a random direction (scatter angle), and undergoes other interactions until its energy is gone. -The electron vacancy is filled nearly instantly.
Reaction with matter that requires very high energy photons.
Pair Production
For the pair production to occur, the energy of the incoming x-ray photon must be at least:
1.02 MeV
What does Pair Production do to an atom?
-The incoming photon interacts with the force field around the nucleus then disappears. -Two particles reappear, each with equal energy (0.51 mEv). -The positron collides with a free electron and creates an annihilation reaction. -Annihilation reaction creates two photons at opposites angles to each other.
Reaction with matter that requires the energy of the photon to be extremely high.
Photodisintegration
What does Photodisintegration do to an atom?
-Incoming photon interacts with nucleus of atom, creating nuclear instability. -Nuclear fragment is given off as nucleus seeks stability
Common interaction in the nuclear industry
Photodisintegration
Measures exposure in air and is not used to express absorbed dose to individuals. A measure of ionization in air as a result of exposure to x-rays or gamma rays
Roentgen (Coulombs per Kilogram)
Measures the amount of energy absorbed in any medium, defined as 100 ergs of energy absorbed in 1 g of absorbing material
Radiation absorbed dose(rad) (Gray)
___ Gy = _____ rad
1 Gy = 100 rad
Unit of dose equivalence. Accounts for different types of radiation and their biologic effects
Radiation equivalent man (rem) (Sievert)
formula for rem
rem = rad × QF(quality factor)
Used to measure energy transferred from radiation to a material
Air Kerma
What is KERMA?
"kinetic energy released in matter"
Measures the activity of a radioactive material (radionuclide) Used in nuclear medicine and radiation therapy
Curie (Becquerel)
What is curie equal to?
1 Ci = 3.7 × 10^10 Bq
Who regulates the Standards of Exposure?
FDA and its Center for Devices and Radiological Health (CDRH).
ALARA
As Low As Reasonably Achievable
Dose equivalent for radiation workers is based on radiation received from what source?
Occupational exposure
The annual whole-body effective dose limit for the occupational worker is ____ mSv (____ rem).
50 mSv (5 rem)
Two major parts of a cell.
Nucleus Cytoplasm
____% of cell content is water
80%
Two classes of human cells.
Somatic (any cell that is not a genetic cell) Genetic (will affect future generations)
Perform all the body's functions
Somatic Cells
How many chromosomes does a somatic cell posses?
46 (23 pairs)
Reproductive cells of an organism. Very radiosensitive.
Germ cells
How many chromosomes does a germ cell possess?
23
Two theories of cellular irradiation damage exist.
Direct-hit theory Indirect-hit theory
According to the law of Bergonie and Tribondeau, cells are more radiosensitive if they are __________.
Highly mitotic Primitive in structure
Cells are most sensitive to radiation during __________.
Active division (More immature/rapidly dividing)
Results of radiation to a cell
Cellular death Delayed mitosis Altered mitotic rate
Acute radiation syndrome stages. Requires large amounts of total body exposure.
Prodromal stage Latent period Manifest stage Recovery or death
Radiation Syndromes
Bone marrow syndrome Gastrointestinal syndrome Central nervous system syndrome -Results in eventual death.
Cardinal rules of protection of patient.
Time (lowest possible) Distance Shielding
Three popular monitoring technologies
Pocket dosimeter Optically stimulated luminescence dosimeter(OSL) Thermoluminescent dosimeter (TLD)
Personal radiation monitor that will provide a near immediate reading of radiation exposure.
Pocket dosimeter
Occupational Personnel Monitoring Rules
Worn at the collar level Worn outside of lead apron Device should face forward. Pregnant radiographers may have a second device worn at waist level and under the lead apron
Monthly equivalent dose to fetus should not exceed _____mSv (____ rem)
0.5 mSv (0.05 rem)
Diagnostic yield
Amount of clinically useful information on a diagnostic image. Must outweigh the input factors of the procedure ordered. (Is the correct test being ordered?)
Competent imaging professionals will strive to maximize diagnostic yield using a minimum of _________ factors.
input
Diagnostic efficacy
Accuracy of diagnostic information on a medical image. (Did the test provide the information that was needed?)
Any extraneous information on an image that does not reflect the patient's true medical condition _________ from diagnostic efficacy
detracts
What is included in the X-Ray Machine Design Features?
X-ray tube and x-ray tube support Collimator assembly Radiographic table X-ray generator and control Upright image receptor
Tube is inside the lead-lined tube housing. The X-Ray tube is made of ________ glass with high vacuum. The tube produces x-radiation when high-energy electricity passes through. Then X-radiation exits the tube through a window in the housing and is directed toward a patient.
Pyrex
The ___________ _______________ Projects a high-intensity light field on the patient, which represents the area of the x-ray field exposure.
Collimator Assembly
Collimation May be manual or automatic (PBL). What does PBL stand for?
Positive beam limitation
The radiographic Tabletop is highly ______________.
radiolucent
Tilting radiographic tables will tilt from __________ to __________ to __________. These tables typically do not have variable _________ capabilities.(used in fluroscopy)
Horizontal Vertical upright Trendelenburg Height
Within the tabletop, radiographic grid oscillates during exposure to blur out the ________ ________ ________.
lead grid lines
The interface between the radiographer and electronics of the x-ray machine
Control console
Three key factors for exposure technique.
kVp mA Time
Facilitate easy and efficient positioning of the x-ray tube assembly around the patient in any orientation.
X-Ray Tube Supports
Overhead Tubecrane (OTC) motions.
Longitudinally Vertically Transversely
Receives remnant radiation from patient and captures the x-ray energy for processing.
Image Receptor
Image Receptor technology is classified as __________ or __________.
Cassette-based (CR) Cassette-less (DR)
Cassette-based receptor systems.
Film-screen Computed radiography (CR)
Systems that use thin-film technology (TFTs).
DR systems (Referred to as flat panel technology)
Only radiation that is of any clinical value.
Radiation absorbed by detector Radiation able to be converted to an image
Converts x-ray to light before converting it to an electrical signal.
Indirect digital detector technology Photostimulable Phosphor (PSP) storage-phosphor technology computed radiography (CR)
CR plates are extra sensitive to ______ energy radiation after they have been exposed.
low
Technology that converts an x-ray into an electrical signal.
Direct digital detector technology
________ technology has improved spatial resolution and lower patient dose. It is more dose efficient.
DR
Provides live, real-time images of patients using x-rays.
Fluoroscopy
Fluoroscopy performed in surgery is typically accomplished with __________.
Portable C-arm system
Commonly referred to as a "portable"
Mobile X-Ray Imaging
Intercepts the x-ray photons that are able to exit the patient (remnant radiation). Converts the energy of x-rays into an image.
Image receptor (IR)
Classes of Diagnostic Radiographic Imaging.
Film-screen Computed Radiography (CR) Digital Radiography (DR) Fluoroscopic imaging (NOTE: there are also cassette-based and cassette-less systems)
Requirements for x-ray production.
1. Vacuum inside x-ray tube 2. Source of electrons 3. Method to accelerate electrons to great speed 4. Method to stop electrons
Source of electrons.
1. Cathode 2. Filament (Within the cathode)
Method to accelerate electrons to great speed
Voltage (kVp)
Method to stop electrons
Target(Anode)
Classes of Radiation
Primary radiation Scatter radiation Absorbed radiation Remnant radiation
Primary radiation
The radiation (beam of photons) before it interacts with a patient's body. (Leaves the tube)
Scatter radiation
Type of radiation that provides little diagnostic information to image. Detracts from image quality with the creation of 'fog'.
Absorbed radiation
Radiation that does not exit the patient.
Remnant radiation
Radiation that exits the patient and creates an image in the IR. Creates chemical changes within the receptor that are invisible.
What is the reason an x-ray tube must have a vacuum?
The vacuum removes all of the air so gas molecules will not interfere with the production of x-rays
Attenuation
Loss of radiation energy as a result of passing through an absorbing material (body).
High attenuation
Degree of attenuation that occurs in radiopaque matter. (X-rays cannot pass through.)
Low attenuation
Degree of attenuation that occurs in radiolucent matter.
Differential absorption
Different materials absorb radiation energy differently based primarily upon density and atomic number.
Latent image
Invisible image created after exposure but before processing. (It must be processed to convert it to a visible image)
Considered an analog type of imaging
Film-screen systems
photostimulable phosphor (PSP) technology or storage phosphor technology
Computed radiography (CR)
Two methods of digital image capture. Can be indirect or direct?
Digital radiography (DR)
Digital radiography key features.
Uses no cassettes Image is displayed in seconds Detectors can be direct or indirect Uses thin-film transistors (TFT) Image brightness is not the same as radiographic density and is not related to exposure
Direct
Type capture that x-ray photons are immediately converted into an electrical signal.
Indirect
Type capture that x-ray photons are converted to light and then converted into an electronic signal.
Determines image quality in digital cassette-less systems. The more _________ the better the image.
Pixels
How do Film-screen systems work?
Intensifying screens convert the X-ray energy to light, and light energy creates chemical changes in film.
Exposed X-ray film is chemically processed in a ________ _____________ automatic processor.
wet chemistry
Exposure Index (EI)
A numeric representation of total x-ray exposure to the receptor. It is not an indicator of the patient's absorbed dose.
Prime technical exposure factors that a radiographer has direct control over.
Milliampere-second (mAs) Kilovoltage peak (kVp) Source-to-image distance (SID)
A proper balance between _____________ and __________ qualities is required for optimum image quality.
photographic and geometric
Photographic qualities
affecting the visibility of the image
The two primary image photographic quality factors:
IR exposure/Density Contrast
Geometric qualities
Contribute to image quality by affecting image resolution, size, and shape. Affect sharpness and accuracy of the image. Also known as recorded detail, sharpness of detail, and definition.
radiographic density
The overall darkness or blackness of an image as demonstrated on a polyester-based film media
What aspects primarily affects Image Receptor Exposure?
milliamperage (mA), exposure time (S), source-to-image distance (SID), kVp
mAs
Determines how many x-rays are produced by the x-ray tube. (It directly controls the quantity of x-ray photons produced)
quantity of x-ray production
mA
What is the relationship between mAs and density?
Directly proportional If the mAs is doubled the density is doubled. If the mAs is halved the density is halved
_____________ is the electrical current passing through the xray tube
mA
_____ is the duration of the exposure
S Can be expressed in decimals, fractions or milliseconds
mAs reciprocity law
Regardless of the mA and time combinations, the same mAs value will yield the same exposure
kVp
Measure of the electrical pressure forcing the current through the tube. It controls penetrating ability of the beam. (It affects the quality and quantity of x-ray photons produced)
X-ray beam is ______________ or _______________________.
poly-energetic or heterogeneous.
Higher kVp values _________ skin exposure to patients.
reduce
Increasing kVp ?% will double image receptor exposure
15
To maintain exposure, if increasing kVp by 15%, must ________ mAs
half
Grid
Used to reduce scatter. It intercepts a portion of the remnant radiation and improves image quality. Requires higher exposure technique when used.
SID
Distance between point of x-ray emission in the x-ray tube (focal spot) and the IR. (It affects intensity of radiation that reaches the IR as well as the geometric properties of the image)
What law deals with distance and intensity?
Inverse Square Law
What is the formula for the Inverse Square Law?
I1/I2= D2²/D1²
What law deals with distance and mAs?
Direct Square Law
What is the formula for the Direct Square Law?
mAs1/mAs2 = D1²/D2²
Can improve image quality and reduce dose as well as control scatter
Beam modification
Two types of primary beam modification:
-Filtration -Beam limitation (collimation)
Beam modification that involves use of attenuating material (aluminum) and removes low energy x-ray photons to decrease patient exposure. The more __________ used, the less intense the beam.
Filtration
Beam modification that decreases patient dose as well as improving image quality.
Beam limitation (collimation)
Factors affecting recorded detail
Motion Object unsharpness Focal spot size SID OID Material unsharpness Distortion
Most common cause of image unsharpness.
Motion distortion (Caused by voluntary and involuntary patient motion)
Object unsharpness
Loss in resolution caused by the inherent shape of the patient's anatomic structures relative to the divergence of the x-ray beam.
Optimum use of __________, __________, and __________ can lessen object unsharpness.
Focal point size OID SID (Increased SID makes image sharper)
The smaller the focal spot size, the __________ the detail.
Greater
Distortion
Any misrepresentation of the true size or shape of the patient's anatomy.
Two types of distortion.
Size Shape
Size distortion is minimized by using _________ and __________.
Longer SIDs Minimum OIDs
Shape distortion
Distortion controlled by alignment of central ray, patient's anatomy, and IR. It is also called 'true distortion'.
Deliberate distortion
Accomplished by angling or rotating the patient relative to the central ray. Helps overcome superimposition of anatomic structures.
Image density
Overall darkness or blackness of an image. It is directly related to x-ray exposure hitting the IR.
Half-Value layer
Term used for the amount of absorbing material that will reduce the intensity of the x-ray beam to half its original value. It is a way to express x-ray beam quality.
_________________ is most popular filtration material.
Aluminum
_________ detect the remnant radiation from the patient and convert it into chemical or electrical changes that make up the latent image
IRs
Three types of image receptors
Film/screen systems -Close to obsolescence Storage phosphor technology (CR) Flat-panel detectors using thin-film-transistor (TFT) technology
CR Technology
Exposed IP in cassette is placed in a reader for electronic processing of the latent image into a manifest image displayed on a monitor. Ultimately creates a digital image through computer software
Exposure to plate is stored in ___________ _________ ________ that create electron "traps."
barium fluorohalide crystals
Underexposure will produce an image that is "grainy" or noisy due to _____________.
quantum mottle
How does CR work?
-Cassette with IP placed in CR reader -Reader scans the IP with laser energy and recovers the energy from the electron traps -Energy converts into manifest image
__________ detector uses cesium iodide as a scintillator with amorphous silicon.
Indirect
Digital Cassetteless Systems use ____________ arranged in a matrix
Detector elements(DEL)
How does Indirect Detector Technology work?
-Uses a scintillator material bonded to amorphous silicon -Scintillator receives the X-ray energy and converts it to light energy. -Light energy is captured by amorphous silicon and converted to electrons. -Electrons are collected by TFT and sent to computer.
uses amorphous silicon (aSi)
Indirect DR
Digital detectors possess ___________ exposure latitude than conventional film-screen systems.
greater
DR systems can be operated at varying system sensitivities, known as ___________ _________.
system speed
How does Direct Detector Technology work?
.-Uses amorphous selenium as the active detector material -Uses TFT to capture electrons from X-ray interactions -TFT collects and amplifies the electron signal. -Electron signals are converted to computer data and displayed as an image.
uses amorphous selenium (aSe)
Direct DR
controls image brightness.
window level
controls contrast.
Window width (WW)
During __________, x-ray exposures are much less than radiographic exposures. Use of x-rays to create real-time images of patient anatomy and function Images taken are digital images and can be played back for review or sent to an archival system for long term storage (PACs)
Fluoroscopy
Defines the purpose of the hospital's existence and provides guidance in its community service.
Hospital Mission Statement
What the governance of a hospital begins with:
Board of directors (governing board)
Who are hospital divisions and departments accountable to?
Chief Executive Officer (CEO)
Responsible for recruitment, retention, benefits, and compensation of all employees who work in the hospital.
Human resources department
Sub-departments of radiology.
Diagnostic radiography Ultrasound (US) Nuclear medicine (NM) Positron emission tomography (PET) Computed tomography (CT) Magnetic resonance imaging (MRI) Interventional radiology (IR) (special procedures)
Typically reports directly to upper hospital administration, requires strong business management skills, and works closely with the Medical Director of Radiology. Not necessarily a radiologic technologist.
Administrative Director of Radiology
Principle responsibility is for overseeing the quality of patient care, works closely with the Administrative Director, and may also serve as the Department Chair. Typically a physician.
Medical Director
The primary functions of management.
Planning Organizing and facilitating Staffing Directing Controlling Coordinating
Key management traits
Leadership skills "Coaching" staff
Functions of management are evolving from the traditional roles of directing and controlling employees to leading, coaching, and supporting employees. The influence for this change comes from the movement toward __________, __________, or __________.
Continuous Quality Improvement (CQI) Total Quality Management (TQM) Performance Improvement (PI)
Regulates the quality and safety of care provided to patients and the way a health care organization is supervised and operated
The Joint Commission (TJC)
Federal agency that establishes standards for safety in the workplace.
Occupational Safety and Health Administration (OSHA)
Regulate operations in a hospital. Vary from hospital to hospital and are typically committee based.
Internal regulatory agencies
List of internal regulatory groups.
Safety Committee Infection Control Committee Radiation Safety Committee Pharmacy and Therapeutics Committee Risk Management and Corporate Compliance Picture Archive and Communications Systems (PACs
Education as a medical imaging professional will include three areas of learning:
-Cognitive -Affective -Psychomotor
Cognitive
Area of learning (domain) that includes behaviors requiring various levels of thought: knowledge, understanding, reason, and judgment.
Affective
Area of learning (domain) that includes behaviors guided by feelings and emotions that are influenced by an individual's interests, attitudes, values, and beliefs
Psychomotor
Area of learning (domain) that includes behaviors involving physical actions, neuromuscular manipulations, and coordination.
Component of the radiography curriculum that includes procedures and activities that occur in the clinical educational settings.
Clinical
What is the purpose of clinical education?
To provide an environment in which the student can transfer learning from the didactic and laboratory settings to real-world patient-care experiences has one-on-one patient experience
During clinical experiences, interactions with _________, __________, __________, and __________ occur.
Inpatients, Outpatients, Emergency patients, and Specialty patients of all ages
Component of the radiography curriculum that deals with informational and instructional activities related to radiography.
Didactic
Settings in which didactic activities occur:
1. Classroom 2. Lab 3. Instructional media viewing area 4. Learning resource center
Instructional (didactic) activity should be well planned with __________, __________, and __________ provided for the students.
1. Documented goals 2. Objectives 3. Learning activities
Setting that serves as a bridge to connect classroom with clinical activities.
Lab
Is exemplified in the clinical education component of radiography education with the students recalling prior knowledge learned and using this knowledge in performing radiographic procedures to develop both the skills and the confidence to work with a wide variety of patients.
The principle of transfer of learning
Learning is a __________.
Continuum
The learning process is based on __________, __________, and __________.
1. Performance objectives 2. Learning observed by way of competencies 3. Learning outcomes
Must be performed independently, consistently, and effectively.
Clinical competence
The professional organization that provides a curriculum articulating educational guidelines to ensure that entry level radiographers posses the necessary skills and knowledge for practice.
American Society of Radiologic Technologists (ASRT)
The accrediting body for the profession that establishes standards for educational programs incorporating the ASRT curriculum.
Joint Review Committee on Education in Radiologic Technology JRCERT
The professional certifying agency which identifies the minimum didactic and clinical competency requirements for certification.
American Registry for Radiology Technology
According to __________, the program (Clinical Education) is to provide a well-structured competency-based curriculum that prepares students to practice in the professional discipline.
Standards for an Accredited Educational Program in Radiography
Developed Standards for an Accredited Educational Program in Radiography.
JRCERT
Individuals who work together to assist the student in understanding and accomplishing the goals and objectives of the program.
1. Program director 2. Didactic faculty 3. Clinical coordinator 4. Clinical faculty 5. Clinical staff
What are the two types of general categories for competencies for Radiography?
1. Procedural 2. General patient care
How many mandatory general patient care activities are there?
10
How many mandatory imaging procedures are there?
37
How many elective imaging procedures must you complete?
15 elective imaging procedures selected from a list of 34 procedures •1 of the 15 elective procedures must be from the head section • 2 of the 15 elective procedures must be selected from the fluoroscopy section • 1 of which must be either Upper GI or contrast enema
Qualified practitioner is present during the exam
Direct Supervision
Qualified practitioner is adjacent to the room or location to assist students
Indirect Supervision
What does TeamSTEPPS stand for?
Team Strategies and Tools to Enhance Performance and Patient Safety
What is SBAR?
a structured communication process that provides for accurate sharing of patient information between health care workers when patient hand off occurs.
4 elements of SBAR:
1. Situation 2. Background 3. Assessment 4. Recommendation
Phases of clinical learning:
Observation Assistance Performance
Stress
Produced by life events that place a perceived demand on daily activities, Causes emotional and biologic changes in the body
A prolonged state of constant alert over time; can result in serious __________ or _________ illness.
physical or emotional
Fight - or - Flight response
Physiologic response to real or imagined threat arising from emotions of both fear and anger.
Physiologic responses of fight or flight include:
1. Increased metabolism and fats/sugars 2. Release of hormones 3. Increased blood flow and cardiac output 4. Stimulated central nervous system
Strategies to deal with stress.
1. Self- image is important 2. Understand environment around you that is adding to your stress 3. Adopt a strategy of positive thoughts/emotions 4. Learn to politely say "no" to those who want to place extraordinary demands on you
Signs of stress.
1. Are physiologic 2. Family/friends can often sense your stress 3. Emotions may be noticeably altered 4. Stressors vary
Stressors
Any event that adds stress. It is unique to the individual and best dealt with by using strategies to "buffer" the stress event. Recognize that many of these are out of your control.
Strategies to deal with stressors.
1. Know difference between stressors and a "hassle" 2. Recognize your stress 3. Plan positive activities to balance effects of hassles and stressors 4. Avoid conversations with "out - of - control" language and replace it with "in - control" language 5. Take responsibility for yourself 6. Understand the "worry" process and that all stress can never be eliminated completely
_________ is a "worry contributor."
Procrastination
"Worry" Survival techniques.
1. Avoid procrastination 2. Take control of worry process 3. Identify events over which you have some degree of control and exercise it accordingly 4. Understand most worrisome events never turn out as your thought they would 5. Don't build "worry" mountains
Time as a stressor:
1. Practice time-management 2. Avoid indecisiveness when making choices 3. Set realistic completion times 4. Practice self-management
_____________ can help reduce harmful effects of stress.
Stress buffers
Examples of stress buffers.
1. Exercise 2. Proper nutrition 3. Introspective visualization and meditation
Good study skills process.
1. Review material as soon as it's introduced 2. Use as many senses as possible 3. Plan regular schedule of study 4. Plan study group 5. Attitude helps with remembering (Keep positive attitude)
Test taking tips.
1. Avoid last minute cramming 2. Wear bright colors 3. Avoid heavy, high carbohydrate meal 4. Arrive early and prepare mentally 5. Scan entire test to develop strategy 6. Review test carefully and make appropriate corrections 7. When done, put the test behind you
____________ involves sound professional judgment applied with high ethical standards and integrity.
Critical thinking
Problem and Critical thinking steps.
1. Identify/clarify problem 2. Perform objective analysis of problem 3. Develop realistic solution 4. Consider all viable solutions 5. Select best solution and implement it
Medical radiation sciences uses ----- to create images of the human body.
energy
Radiation
Energy that is transmitted by waves through space or through a medium (matter).
Energy
the capacity to do work
Ionization
Process by which a neutral atom gains or loses an electron, thus gaining a net charge.
Medical Radiation Sciences
Uses energy to create images of the human body. Various energy forms may be used and some energies create ionizations in human tissue
What are the energy forms for imaging?
Electromagnetic -X-rays (ionizing) -Radio waves Sound -Medical sonography Electrical -Electrocardiography Heat (thermal) -Thermography Magnetic -Magnetic resonance imaging Nuclear -Gamma radiation
How are x-rays created?
X-rays are created when high-speed electrons are slowed or suddenly stopped.
Radiography
Uses electromagnetic energy in the form of x-rays to create medical images.
Medical Sonography
Field study that creates images by recording reflected sound waves. It is non-ionizing and has a wide variety of medical applications.
Non-ionizing radiation
Radiation that has enough energy to move atoms in a molecule around or cause them to vibrate, but not enough to remove electrons
Magnetic Resonance Imaging
Uses the energy of high-strength magnetic fields and radio waves to create images of the human body; Non-ionizing imaging modality
CT Scanning
Uses x-ray energy and sophisticated software to create sectional images of the human body. Creates hundreds of views of patient anatomy.
Methods of Electrical imaging.
1. Electrocardiography 2. Electroencephalography
Electrocardiography
Method of imaging the electrical activities of the heart.
Electroencephalography
Method of imaging the electrical activities of the brain
Nuclear Medicine
Uses the energy of the atom to create medical images
Nuclear Medicine Technology uses energy to create images of both __________and __________.
1. Anatomic structures 2. Physiologic actions
What is nuclear medicines energy form? How are they made?
gamma radiation. Uses radioactive isotopes to create gamma radiation
What type of imaging requires the use of a catheter and the injection of x-ray contrast material to visualize anatomy?
Cardiovascular Interventional Imaging
Radiation Therapy
Uses very-highenergy ionizing radiation to treat malignant tumors (cancer)
Thermograms
Images produced by the body's naturally emitted heat energy that can be useful in demonstrating conditions such as changes in the body's circulation.
Who was the German physicist that discovered the x-rays? When?
Wilhelm C. Rontgen, November 8, 1895
What was Rontgen's first known x-ray image?
His wife's hand
Crookes Tube
Large, partially evacuated glass tube made up of a cathode and anode attached to an electrical supply invented by Sir William Crookes. It is also the forerunner of the modern x-ray tube.
The Crookes Tube was also called a __________.
"Cathode Ray" tube
Received a Nobel Prize in Physics in 1901.
Rontgen
Predominantly a diagnostic service that focuses on imaging of patients to diagnose their medical condition
Radiology
What are most health careers referred to as?
Allied Health
What are the three different classifications for organizations?
1. Accreditation 2. Certification 3. Professional Organizations
Accreditation
A process to ensure high quality of operations and offerings. Sets conditions under which new members qualify for entry into the profession.
List of Accreditation agencies.
1. Joint Review Committee on Education in Radiologic Technology (JRCERT) 2. Joint Review Committee on Education in Diagnostic Medical Sonography (JRCDMS) 3. Joint Review Committee on Education in Nuclear Medicine Technology (JRCNMT)
JRCERT
Agency concerned with compliance with education standards developed by and for the profession of radiologic technology. Governed by a Board of Directors known as the Joint Review Committee. Requires demonstrated compliance with minimum requirements known as the Essentials and Guidelines or Standards.
What year was JRCERT established?
1969
Programs JRCERT currently accredits in.
1. Radiography 2. Radiation Therapy Technology 3. Medical Dosimetry 4. Magnetic Resonance Imaging
JRCDMS
Agency concerned with compliance with education standards developed by and for the profession of medical sonography. It is sponsored by 9 organizations and currently accredits approximately 170 institutions dealing with medical sonography.
JRCNMT
Agency concerned with the education standards developed by and for the profession of nuclear medicine technology. Currently accredits approximately 100 nuclear medicine technology programs and is sponsored by 4 organizations.
Certification
Deals with the demonstration of minimum competencies in recognized professional skills and knowledge. It is a voluntary process highly sought after by professionals within health care. It is your personal responsibility to achieve and maintain. Once achieved, you will be listed in a national registry. Provides the privilege of displaying professional credentials as earned.
Popular Certification Agencies in Medical Imaging.
1. American Registry of Radiologic Technologists (ARRT) 1922 2. American Registry of Diagnostic Medical Sonographers (ARDMS) 1975 3. Nuclear Medicine Technology Certification Board (NMTCB) 1977
List of a Professional Society's duties.
1. Education 2. Scholarships 3. Research and special reports 4. Governmental affairs and appointments 5. Malpractice insurance plans