Clinical Competency Evaluation Handbook Daily Clinical ...

STATE COLLEGE OF FLORIDA, MANATEE-SARASOTA
HEALTH PROFESSIONS DIVISION - RADIOGRAPHY PROGRAM
BRADENTON CAMPUS
Clinical Competency Evaluation Handbook
and
Daily Clinical Examination Log
for
STUDENT RADIOGRAPHERS
MISSION STATEMENT
THE MISSION OF THE RADIOGRAPHY PROGRAM IS TO PROVIDE THE COMMUNITY WITH
COMPETENT AND CARING ENTRY-LEVEL RADIOGRAPHERS WHO ARE ABLE TO PERFORM QUALITY
RADIOGRAPHIC PROCEDURES AND FUNCTION AS AN INTEGRAL MEMBER OF THE HEALTH-CARE
TEAM. IN ORDER TO ACHIEVE THIS, THE PROGRAM PROVIDES THE STUDENT WITH INNOVATIVE
EDUCATIONAL OPPORTUNITIES TO PREPARE FOR A REWARDING CAREER IN RADIOLOGIC
TECHNOLOGY.
PROGRAM GOALS
THE GOALS OF THE RADIOGRAPHY PROGRAM ARE AS FOLLOWS: 1. THE PROGRAM WILL PROVIDE
STUDENTS WITH EDUCATIONAL AND CLINICAL OPPORTUNITIES THAT PROMOTES ENTRY-LEVEL
COMPETENCY IN RADIOLOGIC TECHNOLOGY. 2. THE PROGRAM WILL ASSURE THAT IT MEETS THE
. .
NEEDS OF THE HEALTHCARE COMMUNITY, AND THE CURRICULUM REFLECTS THE CURRENT
PRACTICE OF THE PROFESSION. 3. THE PROGRAM WILL PROVIDE AN EDUCATIONAL
ENVIRONMENT THAT ENCOURAGES EFFECTIVE COMMUNICATION, CRITICAL THINKING, AND
LIFELONG LEARNING.
Reviewed and Revised 7/19/10

STATE COLLEGE OF FLORIDA, MANATEE-SARASOTA
RADIOGRAPHY PROGRAM
STUDENT'S NAME: ------------------­
ADDRESS:
(optional) ---------------------­
SEMESTER:
CLINICAL EDUCATION SITE:
---------------
DATES _________ to _
ATTENDED

CONTENTS
Description Pagels)
Explanation ofCompetency Evaluation ... .................... .......... ........... 1 - 6
Competency Evaluation Form ,. 7,8
Daily Log Sheet '" ............................................... .... ...... ........................... 9
Clinical Evaluation Form (midterm and final) 10 - 12
Competency Evaluation Check-Off Form 13 - 15
CES Summary - Task Analysis/Orientation/Sterile Tray/ Random Exams Form... 16
Laboratory Simulation Check-Off Form 17, 18
Task Analysis For Radiographic Rooms '" 19,20
Task Analysis For Portable and C-Ann '" 21
Task Analysis For Sterile Tray Setup 22
RoomlDept. Objectives 23
Main Work Area Objectives 24
Transportation Objectives ,. " , , 25
Policy - Procedure Participation Documentation 26
Procedure Participation Checklist Form '" '" '" 27
Policy - Uniformed Absence 28
Policy - One Student-One Patient Ratio '" '" ... ... .. .. 29
Policy - When Clinical InstructorIs Not On The Premises 30
Policy - Venipuncture 31
Policy - Equitable Exam Policy : ,.......... 32
Policy - Fluoroscopic GI Competency Overhead Images - Minimum Requirements 33
Limitations ofUnsuccessful Competency Attempts '" .. , '" ,. 34
Maximum Number of Unsuccessful Competency Exams 35
Policy - Imaging Modality Observation Requirements '" 36,37

Clinical Documents Checklist Summary , '" '" , , ..
Clinical Orientation Task Analysis Form .. , .. 39
Absence and/or Late Form
Lab Simulation Performance Evaluation .. 41
Student Clinical Rotation Evaluation (Biweekly) .. 42
Due Process Flow Chart For Students Who Are Performing Satisfactory , 43
Due Process Flow Chart For Students Who Are Not Performing Satisfactory . 44,45
Policy - Random Competency Guidelines '" .. , '" '" . 46
Policy - Competency Exam Deadlines (for GI, decub. Abdomen, XTL hip) 47
Clinical Education Site - Student Rotation form 48
Policy - Random Competency Deadlines and Maintenance ... '" ...... ... ... ... ... 49
Policy - Simulating Mandatory Clinical Competencies and Electives '" .. ,." 50
..
38
40

EXPLANATION OF COMPETENCY EVALUATION
Now that you have been introduced to Radiography, it is time to present to you the competency
evaluation system.
Competency is defined as "having requisite or adequate ability or qualities: have the capacity
to function or develop in a particular way" (Webster's Dictionary). This is accomplished through
didactic study, laboratory practice and clinical performance. The old adage "practice makes perfect" is
applicable to this segment of your education.
In radiology, there are numerous positions used to obtain diagnostic images. Of these, many are
used as routine studies. Your objective in this Program is to learn these procedures, correctly perform
them, demonstrate competence through the competency evaluation system and maintain that competency.
When you initially report to your clinical assignments, you will be observing and assisting the
Radiographers while they perform various procedures. As you progress, you will be able to perform the
procedure with less assistance from the Radiographer.
At the same time, you will be given didactic information on various procedures/exams during the
procedures courses. Some of this information will be immediately supported in the clinical setting and
some will be used at a later date. Likewise, you will see and may very well be asked to perform
procedures for which you have no didactic preparation. This limitation does not mean you cannot
perform the procedure. In fact, you can perform ANY procedure, under DIRECT supervision*.
Remember to have all requisitions checked by a registered Radiographer (ARRT). A registered
Radiographer (ARRT) prior to the Radiologist interpretation must evaluate all radiographic images taken.
In order to assure the safety of patients and students, student supervision in the clinical setting is based on
student competence. Prior to proving competency in a radiographic procedure, the exam is conducted
under direct supervision.
* Direct supervlSlon as defined in the Standards for an Accredited Educational
Program in Radiologic Sciences (JRCERT) is "Student supervision under the following
parameters:
"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".
Also, the examinations you have assisted with or those you have performed with indirect
supervision are to be recorded in the daily log book along with other information such as the correct date,
examination, patient ID number, assisted (direct supervision) or unassisted (direct or indirect supervision)
A registered radiographer's initials are required on all completed procedures.
Once you have been presented with the material in the procedures course, pass a laboratory
assessment on that procedure, complete at least one (1) unassisted examination under direct
supervision (see exceptions on page 5), and feel competent to perform the procedure satisfactorily by
yourself, notify the clinical instructor. He or she will evaluate you, or assi2n a certified evaluator to
evaluate you, as you perform the next examination of this type to come to the department, regardless of
the patient's condition. A certified evaluator should only be utilized when the Clinical Instructor (CI) is
1

Summary of Steps Students Must Follow
1. Have studies presented to you in the procedures courses.
2. Complete a lab simulation of that procedure and record
in the logbook. A lab simulation is not required on all procedures. (see pgs. 17, 18)
3. Have all requisitions checked by a qualified radiographer (ARRT)
4. Perform procedures under DIRECT supervision until competent
(Mark cases in appropriate spot in logbook and have initialed where
necessary)
5. Have all images verified by a registered radiographer prior to
being submitted to a Radiologist.
6. Satisfactorily perform at least one unassisted study and record with
appropriate initial from a qualified Radiographer. (see exceptions on pg. 5)
7. Contact the clinical instructor (who may appoint a certified evaluator) or
Program faculty for competency evaluation
8. Continue to perform exams satisfactorily with INDIRECT
supervision in order to maintain competence.
9. Keep records up-to-date.
10. If your performance should become less than satisfactory for any procedure you
have completed the competency exam on, that competency will be retracted (CI or
faculty will "white out" exam in log book) and you will be required to repeat the
entire competency procedure process over.
*REFER TO FLOW CHART (pg.6)
On the following pages you will find a daily log for you to record your clinical experiences. Under
each clinical day you will note spaces for you to log the examination performed, patient's ID number,
assisted (direct supervision), unassisted (direct or indirect supervision), staff initials and time of study.
Upon arriving at their respective clinical facility the student is required to log into the designated
computer and clock in. Also before leaving the facility for the day, the student is required to clock out
from the designated computer. On the bottom of each log sheet is a section for radiographer's comments
and overall performance evaluation, which may be completed by a registered radiographer whom you
worked with the most during that day. When you finish for the day, your clinical instructor will validate
the page by placing their initials where indicated. Note: A staff radiographer or a clinical instructor with
whom you worked with the most, will be filling out a Bi-Weekly Evaluation during your rotation in that
area of the CES. (Le. ER, OR, etc.)
This log is part of the student record and is expected to be kept up-to-date at all times. It will be
reviewed daily by the clinical instructor, and periodically by faculty. The logbook will be handed in at the
end of each semester so that faculty can check clinical progress and verify that minimum requirements
have been met. The completed log sheets will be retained by the clinical coordinator and new sheets for
next semester will be handed out to replace the ones that were used during that semester. Any falsification
of these documents will be grounds for dismissal pending a hearing by those involved in your clinical
experience.
Probation is a process by which students are informed that they are not satisfying the requirements of the
Radiography Program. For other unsatisfactory performance, not warranting probation, a letter of warning
will be issued stating the reason for the letter, and the corrective action needed for improvement. If
unsatisfactory performance continues, the student will be placed on probation.
4

The procedures explained in this booklet are subject to change by written
notice from the Program Faculty at any time.
MINIMUM NlTMBER OF COMPETENCIES
TO BE COMPLETED
REQUIRED BY MIDTERM
Practicum I 5* including (KUB) o
Practicum II 10* 5
Practicum III A & B 12* 6
Practicum IV 13* 6
Practicum V 12* 6
*Practicum I through N requires one random competency. Practicum V requires six random terminal
competencies (see pg. 46) (one from each of the following categories - gastrointestinal, spine,
genitourinary, mobile/portable, extremities, and trauma). If a terminal competency is completed by a
certified evaluator, documentation from the clinical instructor must be included that assures the clinical
instructor was not available to perform the random competency. Also refer to pages 25 and 26 in this
book on "Procedure Participation Documentation" which is required for all Practicums.
PORTABLE PROCEDURES
NOTE: For portable procedures, an UNASSISTED is NOT REQUIRED if the student has
satisfactorily completed a competency in that procedure in the department. If this has not been
accomplished, the student must perform an UNASSISTED, either a portable or in the other areas where
images are performed, prior to that portable competency. The only exception to this is chest radiography.
An UNASSISTED portable MUST be completed prior to doing a portable chest.
UNSATISFACTORY CLINICAL COMPETENCY
PROCEDURE POLICY
When a student unsatisfactorily attempts a competency procedure, for the first time, the student must
complete the required remediation activities as designated by the program faculty and then may re-attempt
the competency exam. If the student unsatisfactorily attempts the competency procedure during a second
attempt, the student must complete the required remediation activities in addition to completing an
unassisted exam before re-attempting the competency exam for the third time. (see flow chart pg. 6)
UNASSISTED EXAM EXEMPTIONS
The requirement of obtaining an unassisted exam is waived for all elective procedures. This waiver also
applies to the following mandatory procedures: all fluoroscopic procedures, trauma cervical spine, 6-yearold
or younger chest; trauma extremity; all exams of the cranium; plus all portable procedures (except
chest) if a competency has been satisfactorily completed in that portable procedure, in the department (as
explained above).
5

OVER-RIDING CRITICAL ELEMENTS FOR ALL PROCEDURES
RADIOGRAPHY PROGRAM
THE STUDENT WILL:
1. Evaluate the patient's requisition identifying the procedure to be
performed; (the patient's name, and age; the ordering physician; mode of
transportation, etc).
2. Evaluate the patient's chart to identify the name of the patient; procedure
validity by checking physician's orders; any unusual precautions or concerns
that need to be taken.
3. Confirm patient identity by observation and verbal acknowledgment prior to
performing a procedure. If verbal is not possible, documented observation
will take place.
4. Appropriately document and/or discuss (with appropriate personnel)
information acquired from patient.
5. Assess patient risk factors for procedures requiring the use of contrast
media.
6. Wash hands before and after each procedure.
7. Demonstrate the use of isolation precautions at all times.
8. Explain the procedure being performed in an understandable manner to the
patient.
9. Confirm the patient's pregnancy status by asking a female under the age of
55 the appropriate pregnancy questions and documenting their response.
10. Confirm that all radiopaque materials that may interfere with the procedure
have been removed.(according to the affiliate protocol)
11. Prepare the exam room for the procedure to be performed.
12. Use personal and patient shielding during the procedure (except when
interfering with the procedure being performed)
13. Demonstrate quality patient care and professional rapport throughout the
procedure.
14. Demonstrate the ability to adapt to any change in a patient's condition.
15. Perform the procedure in a timely manner which does not compromise the
patient or the facility.
16. Identify the structure being radiographed with the correct lead and/or
electronic marker(s) and ensure that the marker(s) is/are visible on the
finished radiograph (image) and outSide of the area of interest based on
facility protocol.
17. Ensure that the patient's "ID" is on the finished radiograph (image).
18. Properly complete paperwork, and submit images for interpretation.
19. Appropriate image receptor orientation as indicated by proper: blocker
location; indicator. (color) bar location; or correct landscape/portrait
selection.
NOTE:
THE ABOVE OBJECTIVES MUST BE PERFORMED PROPERLY FOR A
SUCCESSFUL COMPETENCY. IF ANY ARE NOT, THE COMPETENCYIS
UNSATISFACTORY AND THE STUDENT MUST PROCEED AS STATED IN THE
"COMPETENCY EVALUATION HANDBOOK."
7

DAILY LOG SHEET
Day# _ Date _ CI Initials ----
Time arrived _
1
2
3
4
5
6
7
8
1
19
10
11
12
h;­
14
15
16
17
18
Examination Performed
Area Assigned _
Left _ Total hours in clinic _
DIRECT!
INDIRECT
(D ORID)
Patient ID# A
(A) assisted (VA) unassisted - no help given except lifting help if needed
optional comments
9
U
A
Staff
Initials Time

State College of Florida, Manatee-5aras6ta
RADIOGRAPHY PROGRAM
CRITERIA FOR CLINICAL EVALUATION FORM
(minimum criteria)
NOTE: THIS IS AN EVALUATION OF THE ENTIRE SEMESTERS PERFORMANCE
WHEN DOING THE FINAL EVALUATION!!
1. Interpreted physicians' orders correctly in determining radiographic procedures to be performed.
A. the student satisfactorily interpreted requisitions for the procedures performed.
B. the student satisfactorily interpreted physicians' orders for the procedures performed.
C. the student satisfactorily interpreted other orders for the procedures performed.
2. Documents information acquired from the patient appropriately
A. the student documented patient information as required by the protocol for the facility.
B. the student documented patient history in the appropriate manor as required by the protocol of the facility.
C. the student documented all other pertinent information as required by the protocol of the facility.
3. Demonstrates performance of radiographic procedures.
A. the student demonstrated knowledge through proper position, use of equipment. etc. to assure a satisfactory result.
B. the student demonstrated knowledge by answering questions satisfactorily about the procedures performed.
C. the student demonstrated knowledge by performing procedures with little difficulty and in a timely manner.
D. the student performed procedures in such a way that the patients safety was not jeopardized.
E. the student performed the procedures using proper exposure factors in such a way as to achieve a diagnostically
acceptable image without jeopardize the patients safety.
F. the student demonstrated effective positioning without jeopardizing the safety of the patient.
G. the student demonstrated proper use of eqUipment without jeopardizing the safety of the patient.
H. the student demonstrated knowledge and proper performance of medical and surgical asepsis as required by the protocol
of the facility.
4. Utilizes problem-solving skills to make appropriate decisions related to patient care'and procedures.
A. the student demonstrated the use of problem solVing skills when the need was there.
B. the student demonstrated good decision making skills for the level of competency at the time of the procedure.
5. Requests supervision in performing procedures if required level of competency has not been met.
A. the student did not perform any procedure without direct supervision unless they had satisfied the protocol of the program
with regard to the competency evaluation criteria.
B. the stUdent did perform those procedures which were satisfactorily completed through the competency evaluation
procedure with continued competence.
C. the student demonstrated good sense when patient condition required a more experienced, qualified Radiographer for
successful completion.
D. the student asked for assistance when a situation was outside their knoWledge and/or experience level.
E. the student demonstrated knowledge of the available resources and when to use them.
6. Employs legal and ethical guidelines in administering patient care.
A. the student followed legal and ethical gUidelines in administering patient care.
B. the student followed the ethical standards of the American Society of Radiologic Technologist.
C. the student followed the guidelines established by the facility as presented in the orientation of the student.
D. the student recognized their limitations in the clinical environment and did not knOWingly communicate untrue or misleading
information.
E. based on pertinent HIPAA criteria, the student maintained confidentiality at all times with regard to all issues in the clinical
setting.
F. based on pertinent HIPAA criteria, the student maintained confidentiality regarding information about others.
G. the student used the proper channels to solve problems or to seek information.
H. the student recognized the proper chain of communication when dealing with the patient and the physician.
I. the student followed proper procedures if a competency was not satisfactory completed '
7. Demonstrates initiative by seeking out learning experiences.
A. the student sought out procedures to be performed based on their level of competency.
B. the student did not avoid procedures to be done when an opportunity for gaining further knowledge was at hand.
C. the student was eager to help with procedures even if they had little or no prior knowledge of that procedure.
D. the student leamed other things about the facility, department, equipment etc. when not performing procedures to increase
their competency.
8. Demonstrates behaviors which show empathy and appropriate interpersonal skills with patients and the health care team.
A. the student demonstrated proper use of terminology when carrying on a conversation with anyone.
B. the student demonstrated empathy and respect to everyone they came in contact with.
C. the student maintained good rapport with the patient.
9. Adheres to program/affiliate policies and procedures.
A. the student followed all program policies and procedures satisfactorily.
B. the student followed all affiliate policies and procedures which apply to them satisfactory
C. Effectively maintains a clinical journal.
10. Performed the number of competencies reqUired at the time of this evaluation
A. the student performed the number of reqUired competencies by mid-term and the end of the semester satisfactorily.
B. the student performed the proper number of RANDOM competencies.
.RniIed 1011006; Rniewed 712008, 71200'
C:\Gowenk\Radiography\Fornu\C'lfnkaI Xval Fvrm #Ill
11

COMPETENCY EVALUATION CHECK-OFF
UNASSISTED COMPETENCY
Unsatisfactory
Competencies
EXAMS DATE AFFILIATE . EVAL ' DATE AFFILIATE EVAL DATE(S)
CHEST AND THORAX
1. Chest, Routine
2. Ribs
3. Chest AP and Lateral (Wheelchair
or Stretcher)
4. Upper Airway (Soft-tissue neck)* X
X X
5. Chest Lateral Decubitus* X X X
6. Sternum* X X X
UPPER EXTREMITY
1. Finger or Thumb '.
2. Hand
3. Wrist
4. Forearm
5. Elbow
6. Humerus
7. Shoulder
8. Trauma Shoulder (scapular Y,
transthoracic or axillary)
9. Clavicle*
X X X
X X X
10. Scapula* X X X
11. AC Joints* X X X
12. Trauma: Upper Extremity
(nonshoulder)
LOWER EXTREMITY
1. Femur
X X X
2. Trauma: Lower Extremity X X X
3. Foot
4. Ankle
5.Knee
6. Tibia-Fibula
7. Patella* X X X
8. Toe* X X X
9. Calcaneous (as Calcis)* X X X
CRANIUM
1. Facial Bones* X X X
2. Nasal Bones* X X X
13

COMPETENCY EVALVATlON CHECK-OFF
Unsatisfactory
UNASSISTED COMPETENCY Ct' ompe encles
EXAMS DATE AFFILIATE EVAL DATE AFFILIATE EVAL DATE(S)
3. Paranasal Sinuses X X X
4. Skull X X X
5. Orbits* X X X
6. Zygomatic Arches* X X X
7. Mandible* (Panorex acceptable) X X X
SPINE AND PELVIS
1. Cervical Spine
2. Trauma Series Cervical Spine
Including (XTL)#
3. Thoracic Spine
4. Lumbosacral Spine
5. Pelvis
6. Hip
X X X
7. Trauma Hip Series including
(XTL)+
8. Scoliosis Series* X X X
9. Sacrum and/or Coccyx* X X X
10. Sacroiliac Joints* X X X
ABDOMEN
1. Abdomen Supine (KUB)
2. Abdomen Decubitus or Upright
+
3. Intravenous Urography* X X X
FLUOROSCOPY STUDIES
1. Upper GI Series+ (single or
double contrast)
X X X
2. Small Bowel Series+* X X X
3. Barium Enema (single or
double contrast)+ .
X X X
4. Esophagus* X X X
5. Cystography/Cystourethrograpy* X X X
6. ERCP* X X X
7. Myelography* X X X
8. Arthography* X X X
14
\

MOBILE AND SURGICAL Date Affiliate Eval. Date Affiliate Eva!. Date(s}
1. Portable Chest
2. Portable Abdomen
3. Portable Orthopedics
4. C-Arm Procedure (surgical)
X X X
5. Surgical
Cholangiography*
6. Retrograde Pyelography* X X X
STERILE PROCEDURE
Any procedure requiring a sterile
tray to be setup and used.
Procedure performed - X X X
PEDIATRICS (age 6 or younger)
1. Chest Routine
2. Upper Extremity*
3. Lower Extremity*
4. Abdomen*
5. Mobile Study*
UNASSISTED COMPETENCY
Unsatisfactory
Ct' ompe enCles
DATE AFFILIATE EVAL DATE AFFILIATE EVAL DATE(S)
X X X
X X X
X X X
X X X
X X X
..
(*) Elective procedures of which a minimum of fifteen MUST BE successfully performed In order to qualify for
graduation. In order to qualify for graduation all mandatory procedures MUST BE successfully performed
prior to graduation. Mandatory procedures = 37 (not including the general patient care items below)
(+) These procedures must be completed no later than the end of the Fall semester - second year.
(#) Trauma C-Spine must be completed no later than midterm of the Spring semester - second year.
Note: The ARRT defines trauma as· "trauma is considered a serious injury or shock to the body.
Modifications may include variations in positioning, minimal movement of the body part, etc."
GENERAL PATIENT CARE
In addition to the radiological procedures above,
students must complete the following mandatory
General Patient Care (on patients if possible)
CPR (card must be good for the entire time student is
enrolled in the program)
Vital ,Signs (blood pressure, pulse,
respiration, temperature)
Venipuncture
Care of patient medical equipment (e.g. oxygen tank, IV
tubinq)
Transfer of patient
Sterile and aseptic technique
15
Date
Completed
Competence Verified By
CPR card located in student
file
Initials of person verifying
\

1.
2.
3.
4.
5.
6.
7.
1.
2.
3.
4.
5.
6.
7.
CES -Task Analysis (see pgs. 19,20,21) Date Completed Cllnitial
Clinical Orientation Task Analysis (see pg. 39)
CES - Sterile Tray Setup (pg. 22)
1.
. .
CES - Clinical Education Site
CES equipment task analysis (see pgs.19,20,21) must be logged in on the above form, after the
task analysis for radiographic rooms and portable and C-arm arm are completed for each clinic.
Clinical orientation task analysis (pg. 39) must be logged in on the above form after the orientation
form is filled out. CES sterile tray setup (pg. 22)- will be completed only once during the second
year after instruction in class and laboratory in Radiographic Procedures III. Sterile tray setup must
be completed no later than midterm of the Spring semester. (see form for all details)
1.
2.
3.
4.
PRACTICUM I - IV RANDOM EXAMS
CATEGORY EXAM DATE CES CI
INITIAL
1. Gastrointestinal
2. Spine
3. Genitourinary
4. Mobile/Portable
5. Extremity
6. Trauma
-l
PRACTICUM V - RANDOM TERMINAL EXAMS
I
16
--t­
-----J.
I
I
UNSATISFACT-ORY
STUDIES

Procedure Abdomen - decubitus
or upright
Ankle
Calcaneus/Os Calcis
Cervical Spine
Chest - Routine
Chest - wheelchair or
stretcher - AP and LAT
Clavicle
Elbow
Esophagram
Facial Bones
Femur
Finger or thumb
Foot
Forearm
Hand
Hip (non-trauma and
trauma - XTL)
Humerus
Knee
Laboratory Simulations
Date
I
Faculty Resim Faculty Resim Faculty
Initials Date Initials Date Initials
Note: If an exam is not on the list to be simulated, then the student can attempt an unassisted (if one is
required) and/or competency after the information has been taught and demonstrated in class. If the
student is absent when the exam was covered/instructed in class, then that student must wait until the
written unit exam is taken.
17

I Ribs
Laboratory Simulations
Faculty Resim Faculty Resim Faculty
Procedure Date Initials Date Initials Date Initials
KUB
Lumbar Spine
Leg (Tibia/Fibula)
Lower GI (single
and double contrast)
Mandible
Pelvis
Sacrun1
Scapula
Shoulder with T.T.
Skull
Thoracic Spine
Toes
Upper GI
(single/double)
Wrist
Zygomatic Arches
Note: If an exam is not on the list to be simulated, then the student can attempt an unassisted (if
one is required) and/or competency after the infonnation has been taught and demonstrated in class. If
the student is absent when the exam was covered/instructed in class, then that student must wait until the
written unit exam is taken.
18
I

1. CONTROL PM'EL:
MANATEE COMMUNITY COLLEGE
RADIOGRAPHY PROGRAM
TASK ANALYSIS
FOR
RADIOGRAPHIC ROOMS
THE STUDENT WAS ABLE TO EXPLAIN AND DEMONSTRATE'
·Place a check (-V) in the appropriate box. Ifnot applicable, use (NA).
1. CORRECT ON/OFF PROCEDURES
2. CORRECT USAGE OF THE AEC INCLUDING CHAMBERS
3. CORRECT USAGE OF MAS, TIME, MA AND KVP CONTROLS
4. CORRECT USAGE OF MISe. CONTROLS (F.S., BUCKY, TABLE)
5. CORRECT EXPOSURE PROCEDURES (including warm-up)
6. OTHER
II RADIOGRAPHIC TUBE
1. CORRECT USAGE OF ALL LOCKS
2. CORRECT USAGE OF THE COLLIMATOR (Auto AND Man.)
3. CORRECT MOVEMENT OF THE TUBE
4. HOW TO ATTACH ACCESSORIES (CONES, WEDGE FILTERS, ETC.)
5. OTHER
ill RADIOGRAPHIC TABLE'
1. CORRECT USAGE OF ALL CONTROLS ON THE TABLE
2. HOW TO PLACE ALL ACCESSORIES ON THE TABLE (FOOTSTAND; STRAPS)
3. HOW TO CONNECT ADDITIONAL ACCESSORIES (FLUORO, TOMO)
4,OTHER _
IV FLUORO UNIT
1. CORRECT OPERATION OF FLUORO CONTROLS ON CONTROL PANEL
2. CORRECT SET UP PROCEDURES FORFLUORO STUDffiS
3. CORRECT OPERATION OF FLUORO TOWER AND CONTROL PANEL
4. OTHER. _
19
ROOM #
I

V. GENERAL SUPPLIES AND EMERGENCY EQUIPMENT:
THE STUDENT WAS ABLE TO EXPLAIN AND DEMONSTRATE:
'Place a check C") in the appropriate hox. Ifnot applicable, use (NA).
1. WHERE ALL PERTINENT SUPPLIES FOR THAT ROOM ARE KEPT
2. WHERE ALL EMERGENCY SUPPLIES ARE KEPT
3. CORRECTLY EXPLAIN PROPER CODE PROCEDURES
4. OTHER
ROOM #
FRESHMAN STUDENTS ARE REQUIRED TO HAVE ONE OF THESE COMPLETED FOR EACH UNIT BY THE END OF EACH
CLINICAL ROTAnON DURING THEIR FRESHMAN YEAR.
THE SOPHOMORE STUDENT WILL NEED TO HAVE ONE OF THESE COMPLETED BY THE MIDTERM OF EACH SEMESTER,
UNLESS ONE IS ALREADY ON RECORD FROM THAT FACILITY FOR THAT STUDENT. TIllS FORM IS TO BE FILLED OUT ONLY
BY A CERTIFIED EVALUATOR, CLINICAL INSTRUCTOR OR FACULTY.
EACH STUDENT AT A FACILITY MUST HAVE A RECORD OF SUCCESSFUL COMPLETION OF THE ABOVE ON ALL EQUIPMENT
IN A DEPARTMENT. IF THE EXACT SAME UNIT IS IN ANOTHER ROOM THEN ONLY ONE EVALUATION IS NEEDED.
ANY STUDENT WHO DOES NOT COMPLETE THESE TASKS FOR EVERY ROOM IN A FACILITY AS ABOVE IS SUBJECT TO AN
INCOMPLETE OR WITHDRAWAL FROM THE PRACTICUM COURSE.
ALL COMPLETED TASK ANALYSIS FORMS MUST BE TURNED IN TO THE CLINICAL COORDINATOR AT THE END OF EACH
SEMESTER (FRESHMAN). NO LATER THAN ONE WEEK AFTER MIDTERM (SOPHOMORE).
Student Signature Date
Certified Evaluator, Clinical Instructor, or Faculty Signature Date
20

1. PORTABLE UNIT:
MAt"

The student is able to correctly
explain and demonstrate how to:
1. Open and unwrap glove.
2. Place hands into gloves.
3. Open and unwrap a sterile tray.
Manatee Community College
Radiology Program
TASK ANALYSIS
for
STERILE TRAY SETUP and DISPOSAL
4. Determine if the tray has been sterilized.
5. Manipulate equipment on sterile tray while maintaining sterile technique.
6. Add or remove equipment on sterile tray while maintaining sterile technique.
7. Cover sterile stray.
8. Dispose oftray.
9. Remove contaminated gloves.
10. Pour sterile fluids into appropriate containers on sterile tray and draw sterile
fluids with a syringe.
11. Check expiration dates of materials added to sterile tray.
Evaluator Comments:
S U
----------------------------
Student Signature Date
Evaluator Signature Date
Note: The student may attempt this competency after completing the laboratory demonstration
in Radiographic Procedures III - RTE 2523C. This form must be completed no later than midterm
of the Spring semester before the student graduates. It is the student's responsibility to
show the Clinical Coordinator the completed form no later than one week after it is due. Only a
Certified Evaluator, Clinical Instructor, or Faculty may fill out this form.
Revised 7/30/02 c:\...\Competency Log Book\Task Analysis Sterile Tray
22

The clinical instructor or certified evaluator can evaluate the following objectives. Please
place a check mark next to each applicable objective. When rooms/equipment is similar,
an evaluation will be required only for the unique difference(s) from room-to-room.
Rooms for each clinic only have to be evaluated once for the duration ofthe program.
(i.e. if a student returns to the same clinic a second time they do not have to do room
objectives again).
Room/Department Objectives
Ob'
Jlectlves Rooms/Departments
Before the end of each room/department
rotation the student should be able to:
Recall the location of supplies
Demonstrate room stocked first thing in the
morning as well as throughout the day
Demonstrate room is kept neat and clean at
all times
Locate emergency supplies and recall where
emergency crash/code cart is located
Demonstrate the ability to initiate code
procedures
Demonstrate proper use of all accessory
equipment
Abide by all department and program
protocols/policies/regulations
Demonstrate operation of wall and tank
oxygen units
Demonstrate operation of wall suction
Report dangerous/unsafe conditions to
appropriate personnel on a timely basis
Demonstrate use of emergency equipment
(i.e. BP cuffs/stethoscope)
Explain the protocol for an unusual
incidence/occurrence
Explain cardiopulmonary resuscitation
process
Note: demonstratIOn ofproper equipment mampulation will be evaluated when the task analysis is done.
Evaluator Signature Date
Student Signature Date
23

Main Work Area Objectives
Must be completed for each new clinical education site. By midterm of each
semester the student should be able to:
1) Demonstrate the procedure for getting hospital patients to and from
the department
2) __ Discuss proper phone etiquette
3) __ Demonstrate proper paperwork/data flow
4) __ Explain the special instructions for stat exams
5) __ Demonstrate how to access information from a patient chart
6) __ Demonstrate how to accurately enter information into a patient chart
7) __Explain where the exam/patient/surgery schedules are located
8) __ Discuss the distribution of radiographic images
9) __ Demonstrate how to enter data into the computer
10)__ Demonstrate that the student area is kept neat and clean
11)__ Demonstrate where the supplies are stored in the main work room
Evaluator Signature Date
Student Signature Date
24

Transportation Objectives
Must be completed by the end ofPracticum I only. This will be a one-day
rotation. The Clinical Instructor may designate a particular transporter to
fill out this part of the evaluation. By the end of Practicum I the student
should be able to:
1) __ Identify the general layout of hospital in order to efficiently and safely
transport patients (i.e. elevators)
2) __Assess the patient condition in order to safely transport.
3) __Explain how to contact/communicate with the patient's nurse when
appropriate
4) __ Discuss paperwork/chart flow and entries
5) __ Employ the protocols for disconnecting various tubes and lines and
then properly reconnecting
6) __ Demonstrate how to correctly identify patients
7) __Employ proper standard precautions
8) __ Demonstrate how to efficiently and safely, transfer and transport each
patient
9) __ Demonstrate attending to patient needs/comfort
Evaluator Signature Date Student Signature Date
25

Category Date
Completed
Procedure Participation Checklist
Radiography Program - Manatee Community College
Technologist's
Signature
I. Chest VI. Spine
1.
2.
3.
4.
5.
6.
II. Abdomen VII. Portables
1.
2.
3.
4.
5.
6.
Category Date
Completed
1.
2.
3.
4.
5.
6.
1.
2.
3.
4.
5..
6.
III. Upper Extremity VIII. Surgery
1.
2.
3.
4.
5.
6.
IV. Lower Extremity Ix.. GU
1.
2.
3.
4.
5.
6.
V.GI
1.
2.
3.
4.
5.
6.
1.
2.
3.
4.
5.
6.
1.
2.
3.
4.
5.
6. I
v
A. Miscellaneous
I echnologist's
Signature
Note: If any of the above categories are not completed because of the lack of patient exams
then the clinical instructor must verify by writing a note below.
Clinical Instructor Signature Date
27
1.
2.
3.
4.
5.
6.
.,
\ .

Policy Name:
Date Implemented
or Revised:
Purpose/
Rationale:
Policy:
Venipuncture Policy
7/12/04
Policy Name Venipuncture
Category Clinical
Number 071204
Manatee Community College
Radio graphy Program
To provide clinical guidelines for venipuncture and administration of
contrast media Since clinical education sites have varying policies
regarding venipuncture and contrast administration, this policy will
provide universal guidelines for all sites.
Radiography sttidents rotating through clinical education sites are limited
to the observation ofvenipuncture. At no 'tiIne are students peImitted to
perform venipuncture.
Students may admin; ster contrast media, intravenously, under the direct
supervision ofa registered radiologic technologist or registered nurse.
However, patent venous access must be alr.eady established., since students
may not perfOIID. venipuncture. .
31

P olley Name:
Date Implemented
or Revised:
Purpose/
Rational:
Policy: .
RAG
Lateral
Esonhogram
Manatee Cornmunit"f College
Radiography Program
Fluoroscopic G1 Competencies and Overhead Imaging
8/23/04
To assure that ail students perform overhead imaging during a
fluoroscopic competency ofthe gastrointestinal tract.
A fluoroscopic procedure that normally requires overhead images (i.e. GT
tract imaging) may be used to fulfill a competency requirement only if
overhead images are taken during the examination. Ifoverhead images are
not taken at the clinical education site, then the student will have to
complete the G1 competency at another facility. This will assure that all
students are given the opportunity to perform overhead imaging during a
G1 competency examination.
"
Ifa radiologist requests an abbreviated number 9f overhead images, then at
least half of the positions must be done for the radiologist and the,
remaining standard positions must simulated by the evaluator immediately
after the exam is completed.
Lateral
RAG
GI Standard Overhea.d Images
. Upper GI
Policy Name Fluorscopic GI Competencies &
Overhead Imaging
Category Clinical
Number 8/23/04
-Assorted KUB' s
33
I Luwer GI
Both Obliques
Both Decubes ifAle
. Lateral Rectum
Sigmoid

Policy Name:
Date Implemented
or Revised:
Purpose/
Rationale:
Policy:
Manatee Community College
Radiography Program
Limitations of Unsuccessful Competency Attempts
1/6/06, 6/2/09
Policy Name Limitations of Unsuccessful
Competency Attempts
Category Clinical
Number 01606-1
In the past, there was not a limit on the number of unsuccessful
competency exams that a student could attempt. Faculty believe that if
students have an excessive amount of unsuccessful competency exams
during a practicum, they are not progressing appropriately in the course.
In order to assure adequate student progression, this policy will place a
limit on the number ofunsuccessful competencies a student may obtain
during each practicum course.
A student cannot obtain more that four unsuccessful competency exams
during any practicum course. Ifthese limits are exceeded, the student will
be given a grade of "unsatisfactory" for the specific practicum course, and
the student will not be able to continue in the course. The student will be
able to continue enrollment and complete other radiography courses for
that semester. However, they will be unable to continue in the program
once the current semester has ended. The student will have a one-time
option to re-enter the program the following year on a space available
basis.
34

Policy Name:
Date Implemented
or Revised:
Purposel
Rationale:
Policy:
Manatee Community College
Radiography Program
Maximum Number of Unsuccessful Competency Exams
8118/08
Policy Name Maximum Number of
Unsuccessful
Competency Exams
Category Clinical Policy
Number 081808
To assure appropriate student progression and competency while enrolled
in the program.
This policy was developed as a result of the discussion that took place
between the clinical instructors and program faculty during the Summer
2008 Clinical Instructor workshop. The Clinical Instructors and faculty
believe that this policy will help students understand the importance of
being properly prepared before attempting a competency exam.
Students who acquire more than 12 unsuccessfully attempted competency
exams during the duration ofthe program will be dismissed. Additionally,
students are limited to a maximum number of four unsuccessfully
completed competency exams per practicum course. (See sister policy,
Limitations ofUnsuccessful Competency Attempts, # 01606-1 for additional information)
35

....
Imaging Modality Date Verifietl. by
Computed Tomography
Magnetic Resonance Ima.,...oing
Ultrasound
AngiolInterventional
Nuclear Medicine
After observing the imaging modality for a day, please answer the following questions aD, a.separate
paper. . .' .
1, Descnoe·the basic imaging principles ofthe modality you observed..
2. Whit procedures did you observe?
3. What are the main advantages ofthis modalitY? Disadvantages?
4. Whatrislcs to the patient are associated with this modality? Technologist?
5. What educational requirements are required to work in this modality?
6. What did you :find most interesting about this modality? . "
7. How does this modality supplement radiography?
37
'.'

Clinical Documents Checklist
for
Manatee Community College Radiography Program
D Student Clinical Rotation Schedules pg. 48 Student required to submit with 1 st biweekly
evaluation.
Clinical Perform
D Clinical Orientation Task Analysis pg. 39
D Clinical Room/Dept. Objectives pg. 23
D Main Work Area Objectives pg. 24
D Transportation Objectives pg. 25
D Task Analysis for Rooms/C-arm/Portable
Pgs.19-21
D Procedure Participation Form pg. 27
D Sterile Tray Set-Up pg. 22
Clinicafe"alua
D Student Clinical Rotation Evaluation (Biweekly)
pg. 42
D Mid-Term Evaluation pg. 10
D Final Clinical Evaluation pg. 10
Imaging Modality Observation pgs. 36,37
Clinical Journal Entries (done on ANGEL)
Submit with 1st biweekly evaluation
Completed at the end of each room/dept rotation.
Completed by Midterm.
Competed by the end of Practicum I only.
Task analysis for Practicum I and II is due at the
end of the semester. For all remaining semesters,
the task analysis is due at midterm.
End of each semester.
Midterm of Practicum V.
Bi-weekly, based on current semester schedule.
(refer to handout given each semester)
Mid-Term of current semester.
End of current semester.
Practicum ,", IV, V (completed before graduation)
By noon every Saturday
Homework (done on ANGEL through Practicums) Sunday midnight
Note: most of the clinical forms are submitted electronically by clinical Instructors, evaluators or
faculty. Students should follow-up with the person to make sure it was submitted to the college.
Reviewed 7/03, 7/04 Revised 7/05 Revised 7/07 Revised 7/09
38

Radiography Program
Student Clinical Rotation Evaluation
Student Name: _ Date: _
Affiliate: _ Clinical Rotation: _
The purpose of this evaluation is to assist in determining the student's clinical progress in the program.
Please evaluate the student using the criteria below. Base your evaluation on the student's performance
during the last clinical rotation with you. Also, while evaluating the student, consider the student's level in
the program. For example, is the performance appropriate for a student who has been in the program for
six months, one year, etc.
(Check appropriate box)
Performs radiographic procedures accurately.
1a. Positions patients accurately
1b. Properly manipulates equipment
1c. Completes procedures in a timely manner
1d. Unsuccessful Competency Exams
(To be completed by CI, only)
2. Administers appropriate patient care.
3. Communicates effectively with patients and
members of the healthcare team.
4. Utilizes appropriate radiation protection
principles.
5. Accurately assess and completes paperwork.
6a. Exhibits appropriate level of motivation.
6b. Actively participates in procedures. (excluding OR)
(To be completed by CI, only)
7. Demonstrates professionalism.
8. Maintains radiographic rooms.
9. Seeks staff/CI input when necessary.
10. Maintains journal with entries that demonstrate
thoughtful reflection of daily experiences.
Satisfactory Needs Unsatisfactory
Improvement
D 0
D
D
D
D
D (0)
D
D
D
D
D
D (30)
D
D
D
D (1)
D
D
D
D
D
D (20)
D
D
D
0
D
D
D (2)
D
D
D
D
D
CI (15)
CI
D
D College Fr9Ully Use ( nly---D
---­
Additional Comments: (Please Note: Unsatisfactory responses require a comment)
Thank you for your valuable input.
C.I Signature _
Reviewed 06/08; Revised 06/08
Technologist's Name (Please print) _
Technologist's Signature: _
Student's Signature:, _
42
D

Flow Chart for SCF Students That Are Not Performing Satisfactory in Practicum
Student •Begins Clinic
Orientation (requirements, expectations, objectives etc.)
Student is not performing at the level they should be at this time
1
Biweekly evaluation reflects needs improvement and/or unsatisfactory (ies)
1
No improvement is demonstrated - biweekly reflects unsatisfactory(ies)
1
Clinical instructor meets with student to explain the skill(s) that is/are unsatisfactory and
offer suggestions how the student can improve and start receiving satisfactory evaluations
1
Faculty will meet with student to go over evaluation and determine what help they can
provide to improve student's skills
1
If no improvement is demonstrated and midterm evaluation is due, then unsatisfactory (ies) will
be marked in those skill areas
Student will be placed on probation when an unsatisfactory is/are given and the clinical
coordinator (and possible other faculty) will meet with the student to find out why the student
is not progressing and what faculty can do to help.
1
Student continues to show no improvement. Biweeklies are marked unsatisfactory in at least
one skill area. Meetings with the student •continue with clinical instructor ahd faculty.
Final evaluation reflects at least one "U" - unsatisfactory.
+
Student fails out ofthe program
Original 9/22/04
Revised 7/12/10 44