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AppendixAThePracticeStandardsforMedicalImagingandRadiationTherapyRadiographyPracticeStandards
AppendixBProfessionalOrganizations
AppendixC StateLicensingAgencies
AppendixD TheAmericanRegistryofRadiologicTechnologistsCodeofEthics
AppendixECommonlyUsedDrugsbyBrandandGenericNames
AppendixFThePatientCarePartnership:UnderstandingExpectations,Rights,andResponsibilities
StudentLabs
ReviewQuestions
Index
3251RiverportLane StLouis,Missouri63043
INTRODUCTIONTORADIOLOGICANDIMAGINGSCIENCESANDPATIENTCARE,7thEDITION
Copyright©2019,ElsevierIncAllRightsReserved Previouseditionscopyrighted2016,2012,2007,2003,1999,1994
ISBN:978-0-323-56671-1
AllrightsreservedNopartofthispublicationmaybereproducedortransmittedinanyformorbyanymeans,electronicormechanical,including photocopying,recording,oranyinformationstorageandretrievalsystem,withoutpermissioninwritingfromthepublisherDetailsonhowtoseek permission,furtherinformationaboutthePublisher’spermissionspoliciesandourarrangementswithorganizationssuchastheCopyright ClearanceCenterandtheCopyrightLicensingAgency,canbefoundatourwebsite:wwwelseviercom/permissions ThisbookandtheindividualcontributionscontainedinitareprotectedundercopyrightbythePublisher(otherthanasmaybenotedherein) Notices
KnowledgeandbestpracticeinthisfieldareconstantlychangingAsnewresearchandexperiencebroadenourunderstanding,changesin researchmethods,professionalpractices,ormedicaltreatmentmaybecomenecessary
Practitionersandresearchersmustalwaysrelyontheirownexperienceandknowledgeinevaluatingandusinganyinformation,methods, compounds,orexperimentsdescribedhereinInusingsuchinformationormethodstheyshouldbemindfuloftheirownsafetyandthesafetyof others,includingpartiesforwhomtheyhaveaprofessionalresponsibility
Withrespecttoanydrugorpharmaceuticalproductsidentified,readersareadvisedtocheckthemostcurrentinformationprovided(i)on proceduresfeaturedor(ii)bythemanufacturerofeachproducttobeadministered,toverifytherecommendeddoseorformula,themethodand durationofadministration,andcontraindicationsItistheresponsibilityofpractitioners,relyingontheirownexperienceandknowledgeoftheir patients,tomakediagnoses,todeterminedosagesandthebesttreatmentforeachindividualpatient,andtotakeallappropriatesafety precautions
Tothefullestextentofthelaw,neitherthePublishernortheauthors,contributors,oreditors,assumeanyliabilityforanyinjuryand/ordamageto personsorpropertyasamatterofproductsliability,negligence,orotherwise,orfromanyuseoroperationofanymethods,products,instructions, orideascontainedinthematerialherein
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ContentStrategist:SonyaSeigafuse SeniorContentDevelopmentManager:LukeHeld PublishingServicesManager:JulieEddy SeniorProjectManager:CindyThoms DesignDirection:ReneeDuenow MarketingManager:JenniferRolwes PrintedinCanada
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Dedication ToDon,Meredith,andKatieAdlerandtoD RaleighandHazelCarlton and
InmemoryofRonaldJBerg,awonderfulpatientmodel
Contributors ArleneMAdler,MEd,RT(R),FAEIRS, ProfessorEmerita,RadiologicSciencesPrograms,IndianaUniversityNorthwest,Gary,Indiana
AngieArnold,MEd,RT(R), DepartmentChairandProgramDirector,RadiologicTechnology,SinclairCommunityCollege,Dayton,Ohio
VesnaBalac,MS,RT(R)(MR), ProgramDirectorandAssistantClinicalProfessor,RadiologicSciencesPrograms,IndianaUniversity Northwest,Gary,Indiana
NormanEBolus,MSPH,MPH,CNMT,FSNMMI-TS, AssistantProfessorandProgramDirector,NuclearMedicineProgram,Universityof AlabamaatBirmingham,Birmingham,Alabama
JanBruckner,PhD,PT,CLT-LANA, PhysicalTherapist,PhysicalMedicineandRehabilitation,AriaHealth-Jefferson,Philadelphia, Pennsylvania
LynnCarlton,MSRS,RDMS,RT(R)(M), FormerDirectorandAssistantProfessorofDiagnosticMedicalSonography,GrandValleyState University,GrandRapids,Michigan
RichardRCarlton,MS,RT(R)(CV),FAEIRS, FormerChairandAssociateProfessorofRadiologicSciences,GrandValleyStateUniversity, GrandRapids,Michigan
ElizabethCloyd,BS,RT(R)(CT)(MR), CourseDirector,NuclearMedicineDepartment,UniversityofAlabamaatBirmingham,Birmingham, Alabama
MelynieDurham,MS,RT(R)(MR), ClinicalAssistantProfessor,RadiologicSciencesPrograms,IndianaUniversityNorthwest,Gary,Indiana LindaC Galocy,MS,RHIA,FAHIMA, ProgramDirectorandClinicalAssociateProfessor,HealthInformationManagementPrograms,Indiana UniversityNorthwest,Gary,Indiana
JulieGill,PhD,RT(R)(QM), DepartmentChairandProfessor,AlliedHealth,UniversityofCincinnatiBlueAshCollege,Cincinnati,Ohio
JoanneSGreathouse,EdS,RT(R),FASRT,FAEIRS, EducationalConsultant,SunCity,Arizona
RandyGriswold,MPA,RT(R), Instructor,NortheastWisconsinTechnicalCollege,EducationalConsultantandLecturer,GreenBay,Wisconsin
KelliWelchHaynes,EdD,RT(R), ProgramDirectorandAssociateProfessor,NorthwesternStateUniversity,Shreveport,LA
KenyaHaugen,DM,MS,RT(R), ClinicalAssistantProfessor,RadiologicSciences,TheUniversityofNorthCarolinaatChapelHill,ChapelHill, NorthCarolina
TracyHerrmann,PhD,RT(R), InterimAssociateDeanofAcademicAffairs,Professor,AlliedHealth,UniversityofCincinnatiBlueAshCollege, BlueAsh,Ohio
JamesMKetchum,MSEd,DHA,RT(R), AssistantProfessor,RadiologicSciencesProgram,UniversityofMississippiMedicalCenter, Jackson,Mississippi
RebeccaLamberth,MJ,MS,RT(R)(MR),CRA,FAHRA, DirectorofImagingServices,SaintDavid’sSouthAustinMedicalCenter,Austin, Texas
KristiMoore,PhD,RT(R)(CT), Chair,ProgramDirectorandAssociateProfessor,RadiologicSciencesProgram,UniversityofMississippi MedicalCenter,Jackson,Mississippi
AnnMObergfell,JD,RT(R), AssociateViceChancellorandProfessor,IndianaUniversityFortWayne,FortWayne,Indiana
BettyeGWilson,MAEd,RT(R)(CT),ARRT,RDMS,FASRT, EducationConsultantandAssociateProfessorEmerita,SchoolofHealth Professions,UniversityofAlabamaatBirmingham,Birmingham,Alabama
Reviewers JerryFox,MEd,RT(R)(N), Director,RadiographyProgram,KishwaukeeCollege,Malta,Illinois
ErickaMLasley,MSRS,RT(R), ProgramManager/Director,MaryWashingtonHospitalSchoolofRadiologicTechnology,Fredericksburg, Virginia
ThomasGSandridge,MS,MEd,RT(R), ProgramDirector,NorthwesternMemorialHospitalSchoolofRadiography,Chicago,Illinois
Preface Ithasnowbeenover25yearsand7editionssincewefirstpublishedIntroductiontoRadiologicandImagingSciencesandPatientCareWe continuetobepleasedwiththesuccessofthebook,becauseitwasquicklyadoptedinradiologicandimagingscienceclassrooms,andwe continuetoreceivecommentsandsuggestionsfromourcolleaguesastheymakeitpartoftheirteachingWehavebeendelightedwiththe successofmanyofourcontributingauthorsovertheyears,andwethinkyouwillfindthisneweditiontobenoexceptioninthequalityand relevanceoftheircoverageofthecriticalissuesforbeginningclinicalpracticeinourfield
Wearealwayspleasedwhenwearecontactedbyateacherandevenmorepleasedwhenwearecontactedbyastudentinregardtothisbook Weencourageyoutoemail,phone,write,orsimplycomeupandtalkwithusatprofessionalmeetingsWeconsiderdialoguewithyoutobe absolutelycriticaltoimprovingourprofession,andwedovalueeachandeverycomment,suggestion,correction,orimprovementthatyoucan provideAswithallourneweditions,therearenumerousupdates,clarifications,expandedcoverage,andnewtopicsthatweaddedasaresultof thecommentarywereceivedfromstudentsandfaculty
WeremaincommittedtoprovidingareasonablypricedbutcomprehensiveintroductiontoourprofessionWecontinuetostrivetoprovidethe breadthnecessarytopermitwell-informedandproperlyorientedstudentstheirfirstrealclinicalpracticeWeattempttosufficientlypryopenthe doorstotechnicalareassothatstudentswillrespectnotonlywhattheyknowbuthowmuchtheydon’tknowaswellWehavefoundthatthemost dangerouspersoninaschoolmaywellbethefirst-yearstudentwhohashadanintroductiontopsychologybuthasnotyetglimpsedthevastdepth ofknowledgeinthisfieldHeorsherunsaroundtryingtoapplyelementaryconceptsininterpersonalrelationshipsjustenoughtothoroughly damagethefriendshipswithanyonefoolishenoughtotaketheiradviceThedanger,ofcourse,isnotinwhatthestudentknows,butinthefailure toappreciatewhattheydonotknowWehopewehaveavoidedsettinganyoneupforthiserrorbytreatingourreadersasseriousnew professionals,whoareperfectlycapableofdeducingthepotentialdangersoftheclinicalenvironmentwhileatthesametimebeginningtolearn howtofunctioncompetentlyinamannerthatbeginstomakeacontributiontoourfield Themajorchangesyouwillfindintheseventheditionincludethefollowing:
1. •UpdatesmadeconsistentwiththerelevantIntroductionandPatientCaresectionsoftheASRTcurriculum
2. •ExpansionandsignificantupdatestoIntroductiontoClinicalEducation
3. •Additionalethicaldilemmaexamples
4. •Updatesonthecurrentstatusofdigitalimaginginstrumentation
5. •AncillarysupportforteachersthatincludesanupdatedtestbankandPowerPointslides,aswellasallartworkforcutandpasteuseby facultymembers thisisavailableontheaccompanyingEvolvesiteonlineathttps://evolve.elsevier.com.
6. •Patientcarelaboratoriesandreviewquestionsareincludedintheprintedtextandarealsoavailabletostudentsontheaccompanying Evolvewebsiteathttp://evolve.elsevier.comtoprovideevidencethatstudentshavemetthenecessaryclinicalprerequisiteinformation beforebeginningclinicalexperience.
Wecontinuetoassumefullresponsibilityforanyerrors,includingthosethatmaybeconstruedashavingarisenfromquotingothersoutofcontext WehavemadeeveryefforttoensuretheaccuracyoftheinformationWeaskthatyourememberthatitistheresponsibilityofeverypractitionerto evaluatetheappropriatenessofaparticularprocedureinthecontextofanactualclinicalsituationConsequently,neithertheauthorsnorthe publishertakeresponsibilityoracceptanyliabilityfortheactionsofpersonsapplyingtheinformationcontainedhereininanunprofessional manner
WehighlyvalueyourpointofviewWehavelearnedthatthemostpreciouscommoditytoanauthoriscriticismAsthereader,yourperceptions areveryimportanttousandwealwaysappreciatethatyoucommunicatewithusregardinganyaspectofthebookyoulike,dislike,orwouldlike toseechangedAsinallourbooks,wepointoutthatabooksuchasthisisneverfinishedbutmerelyabandoneduntilthenextedition ArleneM Adleremailaddress:aadler@iunedu, IndianaUniversityNorthwest RichardR CarltonAdleremailaddress:carltonr@gvsuedu, GrandValleyStateUniversity
Acknowledgments Studentsarealwaysthebestteachers,andwehavehadsomeoftheverygreatestatIndianaUniversityNorthwestinGary,Indiana;Michael ReeseHospitalinChicago;GrandValleyStateUniversityinGrandRapids,Michigan;WilburWrightCollegeinChicago;LimaTechnicalCollege inLima,Ohio;CityCollegeofSanFrancisco;Mills-PeninsulaSchoolofRadiologicTechnology,Burlingame,California;Memphis’Methodist SchoolofRadiologicTechnology;andArkansasStateUniversityWethankyouallforlisteningandvaluingwhatwehavetriedtoteachyou RickoffersmanythanksfortheconstantandsolidsupportofLynnCarlton,MS,RDMS,RT(R)(M)atGrandValleyStateUniversityArlenewould liketothankherprofessionalcolleagues:RobinJones,MS,RT(R);SharonLakia,RDMS,MS,RT(R);VesnaBalac,MS,RT(R)(MR);Amanda Sorg,BS,RT(T);SueWoods,AS,RT(R);ShannonBaimakovich,AS,RT(R)AngelaBrite,AS,RT(R),HelenCampbell,RT(R);CharGilpin, RT(R);SueJanosky,BS,RT(R);HeatherGovert,BS,RT(R),PatriciaLewis,RT(R);SheriStremplewski,BS,RT(R);BeckyWantlandRT(R);Sue Wilson,AS,RT(R);andLauraZlamal,RT(R),allwiththeRadiologicSciencesProgramsatIndianaUniversityNorthwest SpecialthanksareowedtotheRadiologyDepartmentatMethodistHospitalSouthlakeinMerrillvilleandJulieAguayo,AS,RT(R),StRita’s MedicalCenterinLima,Ohio;RonaldandRitaBerg,EdytaPostolowicz,DennisStryker,BrianNye,JohnJacobs,JillSteinbrenner;SallySinger, JeffLloyd,andKayWilliamsatSpectrumHealthinGrandRapids,MichiganAppreciationisalsoextendedtoourphotographers,JohnGeiger andJennyTorbett,fromtheBiomedicalCommunicationsDepartmentatTheOhioStateUniversity;thelateGeorgeD GreathouseofPhoenix, Arizona;andCurtSteeleofArkansasStateUniversityOurearlyeditionphotographsweregreatbecauseofthespectacularperformanceofthe bestpediatricmodelever,MeredithAdler,whohasnowheadedofftocollegeandbeenreplacedbythespectacularperformancesofLandon ParkisonandEmmaSpeck
ArleneM Adler,MEd,RT(R),FAEIRS
RichardR Carlton,MS,RT(R)(CV),FAEIRS
1 1IntroductiontoImagingandRadiologicSciences
2 2ProfessionalOrganizations
3 3EducationalSurvivalSkills
4 4Critical-ThinkingandProblem-SolvingStrategies
CardiovascuarnterventonaTechnology(CVIT)Radiologicproceduresforhedagnossandtreamenofdseasesohecardiovascuar system CompuedTomography(CT)Recordingofapredetermnedplanenthebodyusinganx-raybeamthatsmeasuredrecordedandhen processedbyacompuerfordspayonamonor DagnosicMedcalSonographyVsuazaionofdeepsructuresofthebodybyrecordingtherelectonsopulsesofutrasoncwavesdrected notheissue EnergyCapacityooperateorwork
IonzatonAnyprocessbywhchaneuraaomgansorosesanelectronthusacquirnganecharge MagnetcResonanceImagng(MR)Processofusngamagnetcfedandradofrequencesocreatesectionamagesohebody MammographyRadographyofhebreast
NuclearMedcineTechnologyBranchofradiologyhanvolvesthentroductionofradioacivesubstancesinothebodyforbohdiagnostcand therapeutcpurposes
PostronEmssonTomography(PET)Thecreaionofsectionamagesofthebodyhademonstratethephysiologicfunctonovarousorgans andsystems RadatonEnergyransmtedbywaveshroughspaceorhroughamedium
RadatonTherapyBranchofradoogynvovednthereatmentodseasebymeansofx-raysorradioacivesubstances RadographyMakingofrecords(radographs)ofnernastructuresofthebodybypassingx-raysorgammaraysthroughthebodytoacon specalysensiizedfimoranmagngpaeorsysem
RadoogicTechnoogst(RT)Generaltermappedtoanndvdualwhoperformsradiographyradatontherapyornucearmedcnetechnoogy RadoogisPhyscianwhospecializesnheuseofx-raysandotherormsobothonzngandnonionizngradatonnthediagnosisand treatmentofdisease
RadoogisAsssan(RA)Anadvanced-leveradographerwhoextendsthecapaciyoftheradiologistnthediagnostcmagingenvronment therebyenhancingpaientcare
RadoogyBranchoftheheathscencesdeangwthradoactvesubstancesandradiantenergyandwththediagnosisandtreatmento diseasebymeansobohonzng(eg,roentgenrays)andnononzing(egutrasound)radaton RoentgenRaySynonymorx-ray
X-rayEecromagneticradiatonofshortwavelengthhasproducedwhenelectronsmovngahghvelocyaresuddenlysopped DurngWorldWarIthedemandforx-rayechnciansnmitaryhosptaswassogreatthatashortageotechncaworkersbecameacuteat homeThevaueofthewe-ranedechncianwasemphaszedandtheradoogstwasnoongersatsfedwthsomeonewhoknewonyhowo throwheswtchanddeveopflms
MargaretHongTheFrsLadyoRadoogcTechnology AHistoryoftheAmercanSocetyofX-RayTechnicans1952
MedicalRadiationSciences
WhenthetermradaionsusedtgenerallyevokesconcernandasenseodangerThscrcumsancesunfortunatebecauseradaionnotony shepfubutasosessentialtofeRadiatonsenergythatistransmittedbywavesthroughspaceorthroughamedium(mater);has permeaedheuniversesncehebegnningoftmeandsanaturalpartofaofourivesForexampethesunradiatesightenergyandastove radatesheatenergy EnergyisthecapacityooperateorworkThemanydferentformsofenergyncludemechancaeectrcaheatnucearandeectromagnec energyManyormsoenergyareusedinmedcnetocreaeimagesofanatomcstrucuresorphysiologicactonsThesemagesareessena fortheproperdagnossofdseaseandreatmentohepatenAloheseenergyformscanbedescribedasradiatonbecausetheycanbe andnmanyinstancesmustbetransmitedthroughmater Somehgherenergyformsncudingx-rayshavetheabiytoonzeaomsnmaterIonzatonisanyprocessbywhichaneutraatomgainsor osesanelectronthusacqurnganechargeThsprocesshastheabitytodisruptthecomposiionofthematterandasaresutscapabeof disruptngfeprocessesSpecaprotectonshouldbeprovidedopreventexcessveexposuretoonzngradiaton Soundsaformomechancaenergy stransmttedthroughmatterandimagesofthereturnngsoundwavescanbecreaedDagnostic medcasonographyisthefieldofstudythatcreatesanaomcmagesbyrecordingrefectedsoundwavesSoundwavesareaformof nononzngradiaton ElectrocardographyandeecroencephaographyaremethodsofmagingtheeecrcalactvesofthehearandohebranrespectvelyThe graphstheyproduceprovdeuseunformaionaboutthephysoogcacivitesoheseorgans ThebodysnaturalyemtedheatenergycanasoproducemagesfordagnosticpurposesThesemagesarecaedhermogramsandtheycan beusefuindemonstraingcondtonssuchaschangesinhebodyscircuaon NuclearenergyisemttedbyhenucleusofanaomNucearmedicnetechnoogyusesthstypeofenergytocreatemagesobohanaomc strucuresandphysoogcaconsItinvolvesthentroducionofaradoacvesubstancenothebodyfordagnostcandtherapeucpurposes ThesesubsancesemigammaradiatonromthernuceGammaradatonsaformofeectromagnetcenergyhahastheabiytoonze atomsAsaresutproperradatonprotectonsmportantnthenucearmedicnedepartment Electromagnetcenergyhasmanyforms(Fig11)Manyoftheseformsareusedinmedicneodeverhigh-quaitypatentcareForexampe ightisanessenaenergyformnmanyofthescopesusedbyphyscanstoviewnsdehebodyInadditonx-raysareahuman-madeormof electromagnetcenergyTheyarecreatedwhenelectronsmovingathghspeedaresuddenlystoppedX-raysalsocaledroengenraysnamed aftertheirdscovererWihelmConradRöntgenallowphyscianstovisualzemanyoftheanatomicsructureshawereoncevsibeonya surgery Radographyshemakngofrecordsknownasradiographsofinternalstrucuresohebodybypassageox-raysorgammaraysthroughthe bodyoacon,historcayspecaysenszedimormostcommonly,onadgtamagingplateordetectorInthedagnosticradiography deparmenimagesarecreatedusngx-raysthatpassthroughhebody(Fig12)Inaddtonvery-hgh-energyx-raysareusedintheradaion therapydeparmenforthetreatmentomanyformsofcancerInbothohesedepartmensproperradatonprotectonsessenta RadowavesareanotherormoeecromagnetcradatonTheyareanonionizingformofradaionandaremportantnmagnetcresonance maging(MRI)(Fig13) MedcaradiatonscencenvolvesthestudyoheuseoradaionhroughoumedcineThefactthatmanyormsoradiatonareusedinal branchesomedicneshouldbeapparentBecausemanyaypeopeassumethatthetermsradiatonandonzngradiatonareused nerchangeabythetermmagingscenceshasbeenpreferredtohetermradiatonorradoogcsciencesinareasthatuseanonionizingform ofradiatonsuchasdagnosicmedicalsonographyandMRIFurthermorebecauseradiatontherapyisprmarlynvolvednreatmentandnot maginghetermimagngscencesalonesnotencompassingenoughAsaresutmanyfeethatourprofessionsbestdescrbedbyboth termsmagingandradiatonorradoogcsciencesWthregardotheprofessionhetermradiologictechnoogyisusedbyheAmercan RegsryofRadoogcTechnoogsts(ARRT)toencompassalloourndvdualdiscpines
Fg13Sagttamageofhebrancreatedusngmagneticresonancemaging CourtesyJuleAguayoASRTR]MethodstHosptaSouhakeCampusMerrllveIN OverviewoftheHistoryofMedicine
Humankndsattempttotreatandcurediseasescanbedatedbackalmost5000yearstoEgypandMesopotamawhereevdenceexiststhat medcinewasbeingpracicedincombinatonwthregousbeliefsPrehstorcskulsfoundinEuropeandSouhAmericaalsodemonstratethat earyhumansdeliberatelyremovedbonefromheskusuccessfuyWhetherhsacionwasperformedasasurgcatreamenorasareigious attempttoreleaseevspirtsisunknownnaddtonevdenceexststhatmanypotentdrugssinuseodaysuchascasoroiandopumwere usednancientEgyptformedcnapurposesHowevertheEgypansdemonstratedteknowedgeofanatomydesptehersophstcated embalmingskis TheundersandngofhumananatomyandphysoogybytheearlyGreekphiosopherswasofsuchhghqualityhattwasnotequaedfor hundredsoyearsHippocraes(c460–370BC)wasaGreekphyscianwhosconsderedhefatherofWesternmedcineLttlesrealyknown abouthmbuhefactthathewasacontemporaryofSocratesandwasoneofthemosamousphysciansandeachersomedicneofhistme sgenerayacceptedMorehan60medcatreaisescaedheHippocraicCorpustradiionayhavebeenatrbuedohim;however HippocraesddnowrtemostothemhimselThewrtngsaresmiarnthattheyemphaszeratonalandnaturaexplanatonsorthereatment ofdseaseandrejectsorceryandmagicHippocraesemphaszedthemportanceocareullyobservngthepaientHebeevednthepowersof nauretohealovertmeandaughtthepreventionofdseasethrougharegimenofdeandexercseHesasoattributedwithdeveopingahgh standardofethicalconductasncorporatedintheHppocratcOathwhchprovdedgudenesorphysican-patientreatonshpsforherghtso patientsoprivacyandfortheuseoftreatmentforcuratvepurposesonyTheHppocraticOahsigovernstheethcaconducofphysicans today TheRomansrecognzedthemportanceopropersanitationforgoodpubcheathevdencedbytherconstrucionofaqueductsbahssewers andhosptasUnortunaeydurngtheMddleAgesthedesructonorneglectoftheRomansaniaryfacltesresutednmanyocaepidemcs thatevenuayledtothegreatpagueknownasheBackDeathduringthe14thcenturyMedcnewassrongycontroedbyregousgroups duringthsperodandtwasnotuntheearly1500sthataphysicaninEnglandhadtobelicensedtopractce Bythe17thcenurymedcinebegantodeveopanincreasngyscientcexpermentaapproachWlamHarvey(1578–1657)anEngsh physicansconsderedbymanyscholarsohaveladthefoundationofmodernmedicneHarveywasfrsttodemonstratethefuncionofthe heartandthecrcuatonotheboodThsfeatsespecalyremarkablebecausetwasaccompishedwthouttheaidofamicroscopeBytheend ofhe17thcenurybacterahadbeendescrbedbyAntonVanLeeuwenhoek(1632–1723)aDutchzooogstwhoisolaedhemicroorgansm wihamcroscopehemadeWthhedevelopmenofimprovedmcroscopesthediscoveryofthecaplarysysemoheboodhelpedcomplete Harvey’sexpanatonobloodcircuaton
Durngthe18hcenturyasgnicantnumberofdevelopmentsnmedcneoccurredSurgerywasbecominganexpermentascencealarge numberofreformsweretakingplacentheareaofmentalheath,andtheheartdrugdgtaliswasntroducedn1796,EdwardJenner(1749–1823)anEngshphyscanntroducedavaccnetoprevensmalpoxwhenhenocuaedan8-year-odboywhchprovedthatcowpoxprovided mmuntyagainstsmalpoxThsdiscoveryservedasthefoundationforthefedofmmunology Inhe19thcenturyhetheorythatgermscausediseasewasesabishedLousPaseur(1822–1895)aFrenchchemistworkedwthbacteriato provethegermtheoryofinfectonThroughhsworkheprocessopaseurzatonwasdeveopedRobertKoch(1843–1910)aGerman bacteroogstesabishedthebaceracauseformanynecionssuchasanhraxtubercuossandcholeraIn1905KochreceivedaNobe PrizeforhsworkndevelopingtuberculnasaesortubercuosisDurngthemd-1800sForenceNghtngae(1820–1910)anEngshnurse deveopedhefoundatonsformodernnursngn1895,WhelmRöngendscoveredx-rays,andheradioogicimagngscienceshadtherstart The20thcenturysawdeveopmenoftheuseofthescentfcmethodthroughoutmedicneTheearlypartofthecenturywelcomeddscoveryo thersantboicsSirAlexanderFlemng(1881–1955)aScotshbacteroogsdscoveredpeniclnn1928Furhermedcaadvances ncudedheincreaseduseofchemotherapyandabetterunderstandngoheimmunesysemwhchresutedntheincreasedprophylactcuse ofvaccnessuchastheSalkvaccinedscoveredbyJonasSalk(1914–1995)whichhepedtocontroandpreventpoiomyeltsIncreased knowedgeoheendocrnesystemhashelpedtoreatdseasesresuingfromhormonembaancencludngheuseonsunotreadabetes In1953atCambridgeUniverstynEngandFrancisCrck(1916–2004)anEngshscientstandJamesWatson(b1928)anAmercan biologistannouncedthattheyhaddscoveredthesecreoflifeThroughtherworkheydentfedthemoecuarsructureofdeoxyrbonuclecacd (DNA)akeyoheredityandgenecsCurrentlymuchresearchsbengdevotedtothefedogenetcsCompetedin2003theHuman GenomeProec(HGP)wasa13-yearinternatonalscentfcresearchprojectcoordinaedbytheUSDepartmenofEnergyandtheNatona InsttutesofHeathDurngtheearlyyearsoftheHGPtheWecomeTrust(UnitedKngdom)becameamaorpartner;addiionapartnerscame fromJapanFranceGermanyChnaandohersTheproecgoaswereto: 1 Identfyaotheapproxmaey20000to25000genesinhumanDNA
2 Determnehesequencesofthe3biionchemicalbaseparsthatmakeuphumanDNA
3 Storethsnormationndatabases 4 Improveoolsfordataanayss 5 Transferreatedtechnoogesotheprvaesector 6•Addresstheethcaegaandsocassuesthatmayarisefromtheproect
AlthoughheHGPsinshedanalysesofthedatawcontnueformanyyearsThereplacemenoffaultygenesthroughgenetherapyofers promsesofcuresforavarietyoheredarydseasesandthroughgeneicengineerngmportantpharmaceutcashavebeendeveloped HistoryofRadiologicTechnology
TheedoradiologicechnologybeganonNovember81895whenWihemRöntgenaGermanphyscistwasworkingnhslaboratoryahe UniverstyoWurzburgRöngenhadbeenexpermentngwithcahoderaysandwasexporingtherproperiesoutsdeglassubesHehad coveredthegasstubetoprevenanyvisbeghtfromescapngDurngthsworkRöntgenobservedthatascreenthathadbeenpantedwth barumplatnocyandewasemittnggh(luorescing)ThseffecthadobecausedbyinvsberaysbengemtedromtheubeDurngthenext severaweeksRöngennvesgatedtheseinvsibleraysDuringhsnvesigaionhesawheveryfrstradiographcmagehsownskeeton Röngenbecametheirsradographerwhenheproducedaseriesofphotographsoradographcmagesmostnotablyheimageofhiswfes hand(Fig14)Hetermedtheseinvsibleraysx-raysbecausexsthesymboforanunknownvarable WlhemRöntgenwasbornnLennepGermanyonMarch271845In1872hemarredAnnaBerhaLudwig(1839–1919)andtheyhadone adopteddaughterIn1888RöntgenbeganworkingaheUniversyoWurzburgnhephyscsdepartmentDurngthe1870sand1880smany physicsdepartmentswereexpermeningwhcathoderayselectronsemanatingfromthenegatve(cathode)termnaofatubeDurnghs discoveryRöntgenworkedwithaCrookestubeSirWlamCrookes(1832–1919)usedaargepartialyevacuatedglassubeha encompassedacathodeandananodeatachedoaneectrcasuppyHstubewastheearlyversonofthemodernfuorescenghCrookes acuayproducedx-raysdurnghisexperimentatoninthe1870sbutfaledtograspthesgncanceohsfindingHeofenfoundthat photographicpatesstorednearhsworkabewereoggedHeevenreturnedfoggedphotographcplatestothemanufacturercaminghey weredefecveManyphyscistscreatedx-raysduringthecourseoherworkwhcathoderaysbutRöntgenwasthefirsttoappreciatehe sgnicanceothepenetraingrays
TheactuadaythatthesgnfcanceofRöntgensindingbecameclearohimisthesubectomuchdebateHoweverFridayNovember8,1895, sbeievedbyhsorianstobethedayhaRöngencreatedthefamousmageohswieshand(seeFg14)OnSaturdayDecember28 1895RöngensubmitedhisfrstreporttedOnaNewKndofRaysotheWurzburgPhysco-MedicalSoceyThroughhsinvestigative methodsRöngendentfedthepropertesox-raysHsmethodsweresohoroughthatnosignifcanaddonshavebeenmadeohiswork ForhseffortsRöntgenwashonoredn1901withtheirsNobelPrzeinphyscsHerefusedtopatentanypartohsdiscoveryandrejected manycommercacompanyoffersAsaresulthesawlittefnancarewardforhsworkHediedonFebruary101923ocoloncancer Throughoutthe20thcenturytheuseox-raysadvancedsignifcanlyoncudethemagingofamostaaspectsofthehumanbodyandhe treatmentofdiseaseswihradaionherapyInaddition,radioactivesubstancescamentouseforbothimagng(nuclearmedcine)and treatmentBythe1970smaginghadfurtheradvancedtoincudedagnostcmedcasonographycomputedtomography(CT)andMRIToday throughtheuseofhybridscannershacombnenuclearmedcinemagingwheherCTorMRbothanatomcandphysoogcfunconcanbe assessednasngeexaminaon
radographwasanmageoWhemRöntgenswfeshand
OpportunitiesinRadiologicTechnology
Radoogictechnoogysthetechncascencethatdealswiththeuseofx-raysorradoacvesubstancesfordagnosticortherapeuicpurposes nmedcneRadoogctechnoogst(RT)isageneratermappedopersonsquaiiedtousex-rays(radography)orradoactvesubsances (nucearmedicne)oproduceimagesofthenernapartsofthebodyfornterpretationbyaphyscianknownasaradoogisRadiologic technoogyalsonvolvestheuseofx-raysorradioacivesubstancesinthetreatmentodisease(radiatonherapy) Inaddionousingx-raysandradioactivesubstances,RTsareasoinvovednusinghgh-frequencysoundwaves(diagnostcmedca sonography)andmagnetcfedsandradowaves(MRI)ocreateimagesofthenernaanaomyofthebody
Fg15Aradiographerpostonsapatenoraradographicexamnation
CourtesyPhipsMedcaSystems
TheARRTsthecredentangorganzatonformedcaimagngnervenionaproceduresandradationtherapyTheorganizatondenieshe folowngdscpnesthatarencludednheprofessionofradoogctechnoogy:radiography(R)nucearmedicneechnology(N)radiaton therapy(T)magneicresonancemaging(MR)sonography(S)cardiovascuar-inerventionaradiography(CV)mammography(M)compued tomography(CT)quaymanagemen(QM)bonedensometry(BD)vascuarsonography(VS)cardiac-interventionaradiography(CI) vascular-nterventonalradography(V)breastsonography(BS)andradiologisassistants(RRA)Fromthsistonecanseehowallencompassngheprofessonofradoogctechnoogytrulys
Radiography
AnRTspecaizingntheuseofx-raystocreateimagesofthebodyisknownasaradographer(Fg15)Radiographersperformawdevarey ofdagnostcx-rayproceduresncudingexamnaonsoftheskeletasystemthechesandheabdomenTheyadmniserconrasmedato permtvsualizatonohegastronesinal(GI)tractandthegenourinarysystemTheyasoasssttheradoogstdurngmorespecazedcontrast medaproceduressuchashoseusedtovisualzehespnacord(myeography)andtheontspaces(arhrography) Tobecomearegsteredradiographer,onemuscompeteanARRT-recognzedradiographyprogramProgramsaremostcommonlysponsored byhosptalscommunycoegesanduniverstesThereareapproxmately730ARRT-recognzedradiographyprogramsprmarlyntheUnted StatesOnsuccessfucompetonoarecognzedprogramindivduasareawardedacertfcateanassociatedegreeorabaccalaureae degreeandareegbetoakehenaionaexamnatoninradographyoferedbyheARRTEffectveJanuary12015acanddatesmushave earnedanacademicdegreetoqualfyforthscertfcatonAregisteredradographerusesthenitialsRT(R)(ARRT)aterhsorhernameThis abbreviatonmeansregsteredechnologist(radography)
Radographerscanspecialzenperormngradoogcexamnaionsofthecardovascuarsystemadiscpnecalledcardovascuar nervenionatechnoogy(CVIT)(Fg16)Theseproceduresnvovethenectonofodinatedcontrastmedafordagnosngdseasesofthe heartandboodvessesAngographystheermforradiologicexamnatonoheboodvesselsaternjectionofacontrastmedumMostoften thecontrastmaerialisinecedthroughacatheter,whichcanbedirectedtoavaretyofmajorarteresorveinsorvsuazaonofthese strucuresBywayofacatheternectngcontrastmedaintostructuressuchasthecarotidartereseadingothebrantherenaareresleadng tohekidneysthefemoraarteryoftheegandmanyohersiesisreatveyeasy PlacngacatheterintooneofhechambersofheheartstermedcardiaccatheterizationThscaheerthencanbedrecedntooneorbotho thewomanartereshasuppyboodotheheartselfThesearteriesarecaedthecoronaryareres Coronaryarteriographysanextremelyvauabetooindagnosngaherosclerosiswhichcanbockthecoronaryareresandcauseaheart attack(myocardalinarcion)BywayofaspecacatheterwthabaloontpefecivetreatmentofatherosclerosisispossbeThstreatmentoa blockedboodvesseisermedangoplastyAngoplastysusedtotreatpatenswhouhavngtousenvasveopenheartsurgeryInaddtonto angoplastybockedvessesareasotreaedbypacingastentnthevesseltophyscaykeepitopen CVITnvovesheuseohghyspecializedequpmentandcompexproceduresThisspecazatonofequpmentandsuppeshasresultedina needforradiographerstobespeciallypreparednthsadvancedtechnoogyMostohisadvancededucatonoccurshroughcontnuing educatoncassesandon-the-jobcncaexperienceIn1991theARRTbeganofferingapostprmaryexaminatoninCVThsexamnaionsno ongerofferedbuthasbeenspltinotwoseparaeexamnationsoneforcardiacntervenona(C)technoogyandanoherforvascuar nerveniona(V)technoogyToquaytoakeeiherexamnationindvdualsmustbeARRTceriednradographyandmeetcnca requrementsAnARRT-certfedndvdualusesthenitialsRT(CI)(ARRT)and/orRT(VI)(ARRT)afterhsorhername Mammography
RadographerscanspecialzenperormngradoogcexamnaionofthebreastaprocedurecaedmammographyMammographysa valuabledagnostictooortheearlydeecionofbreasdseaseespecaybreastcancerCurrentsasicsindicatethatoneofeveryeightor nnewomenintheUnitedStateswlldeveopbreastcancerMenarenotexcludedfromhisdsease;approximately1%ofbreascancersare foundnmenEarlydeecionofbreascancersimporanosuccessfutreamenandcureAsaresutheAmercanCancerSocietyhas recommendedreguarmammographyscreeningforawomenoderthan40years Thsemphassonscreeningmammographyhasresutednanncreaseinhenumberofmammographicexamnationsbengperformedacross thecountrySpecabreasmagngcentershavebeenbuittoaccommodaethedemandforheseproceduresEqupmentandsuppessuchas aspecalydesignedx-raytubeandhgh-resoluiondigiaimagngdetectorsareusedtocreaehgh-quaybreasmagesThisspecialzatono equpmentandsuppieshasresultedinaneedforradographerstobespecaypreparedinthsadvancedechnologyMosofthsadvanced educatonoccurshroughcontnungeducaoncassesandon-the-jobcncaexperienceIn1992theARRTbeganoferingapostprmary examnaionnmammographyToquaiyotaketheexamnatonndvduasmustbeARRTcertifiedinradiographyandmeeteducaionaand cincarequiremensAnARRT-ceriiedindividuausesheintasRT(M)(ARRT)aferhsorhername
RadiologistAssistant
Aradoogstassstant(RA)isanadvanced-leveradographerwhoextendsthecapaciyoftheradiologistnthediagnostcmagingenvronment therebyenhancingpaientcareTheRRAsanARRT-certedradographerwhohascompletedanadvancedacademicprogramencompassing anaonayrecognizedRRAcurricuumandaradoogst-directedclincapreceptorshipRRAsperormawdevaretyofpatencareprocedures underthedrectonoftheradiologistTheseproceduresincudeluoroscopicexamnationssuchasGstudiesmyelogramsarthrogramsand cenralvenouslnepacementsalongwihcontrastmediaandgeneramedcaonadmnsraonRAsasoevaluatemagesforcompleteness anddagnosticquatyandreporcnicaobservaionstotheradoogst
TheconceptoheRRAhasmovednandoutopopuartyntheUntedStatesPlotprogramsaheUniversyofKenuckyandDukeUnversty wereaunchednthemd-1970soeducaetechnoogstsocarryoutceranaskstradtonallyperormedbyradiologistsTheprograms producedasmallnumberofgraduatesbeforetheywereforcedtocosewhenfederaundngwascunthelate1970sTheAmercanCollegeo Radoogywasnotinsupporoftheconceptandtheprogramsslowydedoverhenex20yearsAneweraofRRAprogramsbeganin1995 whenWeberStateUnversitynUtahsareda2-yeareducatonalprogramforregisteredRTswhohadaeast5yearsofexperienceandwaned toworknanadvancedclnicalroleAlthoughthsprogramhasasobeensomewhacontroversialitwasjonedn2003byaBacheoroScence programaLomaLndaUniverstynCalifornaandn2004byseveraotherundergraduateprogramsaroundthecountryIn2005theARRT beganofferingaposprmaryexaminatonforRRAsToquaytotaketheexamnatonndvdualsmustbeARRTcerifiedinradiographyearna bachelorsdegreehaveateast1yearoacceptabecnicalexperenceinradographycompeeanARRT-approvedRRAeducaonprogram andmeettheeducatonalethcsandexaminaonsandardsestablshedbytheARRTCurrentyeghtARRT-RecognzedRRAEducaiona ProgramsarelistedontheARRTwebsiteathtp:/wwwarrorgInaddtontoRRAsthereareRTswhohaveasocompetedaphyscian assstantprogramandwhoworkwthradoogssmuchastheRRAdoesAnARRT-certifiedindivduausestheniasRRA(ARRT)aterhs orhername
Fg17Anucearmedcnetechnoogsperformsproceduresrequirngtheuseoradioactivesubstances CourtesyPhipsMedcaSystems NuclearMedicine
Thebranchofradiologictechnoogythatinvolvesprocedureshatrequretheuseofradioacivemaerasfordiagnostcorherapeutcpurposes snuclearmedcinetechnology(Fig17)Nuclearmedcineproceduresusualynvolvethemagngofapatensorganssuchasheliverhear orbranaftertheintroductonofaradoactvematerialknownasaradiopharmaceutcaRadopharmaceuicalsareusualyadminsered nravenouslybutcanbeadmniseredorayorbynhaaionProcedurescanalsobeperormedonspecmenssuchasboodorurneSampes fromapatentcanbecombinedwtharadoacvesubstancetomeasurevariousconsiuensnthesampeRadiopharmaceutcasarealso usedoperformposironemssiontomography(PET)proceduresAterthenectonofapostron-emtingradosoopePETscanscreate seconaimagesofthebodythatdemonstraethephysoogcfunctionofvarousorgansandsystemsTodaymanyPETscannersarecombined wihCTorMRtoacqureboththeunctonalmagesthatPETcanprovdewththeanatomcreferenceshatCTandMRaccompishThese hybrdmagngechnqueshaveadvantagesoverehersystemperformedseparatey
Fg18AradiatontherapistadmnistersradiatontreamenstopatentswihesionsAradiatontherapssusngaspecazedoncology computedtomographyunoperformintareatment-pannngstudiesonapaient CourtesyPhipsMedcaSystems TobecomearegsterednucearmedcnetechnoogstcompenganaccredednucearmedcnetechnoogyprogramisnecessaryThereare approximately115ARRT-recognzedprogramsprmariyintheUnitedStatesMoscommonysponsoredbyhospitascommuntycoegesor universtestheseprogramsvaryinenghrom1-yearprogramso4-yearbaccaaureaeprogramsOne-yearprogramsareusuaydesignedfor personswhoareadyhodcredentasnradiographymedicaltechnoogyornursingorwhopossessabaccaaureatedegreeinoneofthebasc sciencesEfecveJanuary1,2015,allcandidaesmusthaveearnedanacademcdegreetoquayforARRTceriicatonGraduatesofan accreditedprogramareegbetoakehenaonaexamnationnnuclearmedcineechnologyoferedbyehertheARRTortheNucear MedcineTechnoogyCerificatonBoard(NMTCB)Successulcompeonofoneofthesetwoexamnaonssusualyrequredorempoymen AnARRT-certfedpersonusestheinasRT(N)(ARRT)afterhsorhernamemeanngregiseredtechnoogst(nuclearmedcinetechnoogy) AnNMTCB-ceriedindividuausesheintasCNMTafterhsorhernamesgnfyngceriiednuclearmedcinetechnologst RadiationTherapy Aradaonherapyechnologistorradiatontherapisisapersonwhoadminsersradationtreatmentstopatientsaccordngtotheprescripton andnstrucionsofaphyscianknownasaradatononcoogst(Fg18)Radaononcoogynvovestheuseohgh-energyionizingradaionto treatprmarlymagnanumors(cancer)Therapstsareresponsibleforadmnisterngapannedcourseofprescrbedradatontreatmentsusng hgh-technoogytherapeutcequpmentandaccessoriesTheyprovdespecaizedpaientcareandobservethecncaprogressoftherpatients RadatontherapsscanspecazeintheareaofmedcadosmeryMedcadosimetrstsarenvovedntreatmentpanninganddose cacuatonsThsspecazedareausuayrequiresadvancededucaionandcerificaton TobecomearegsteredradiatontherapisitsnecessarytocompleteanARRT-recognzedradiatontherapyprogramThereareapproximately 110educatonalprogramsprmaryntheUntedSaesProgramsaremostcommonlysponsoredbyhospiascommuntycolegesor universtesandvaryinlengthrom1-yearprogramsto4-yearbaccaaureateprogramsOne-yearprogramsareusuaydesgnedorpersonswho alreadyhavecredeniasnradographyorwhocandemonstratecompeencentheareasidentifiedintheessentasforaradaonherapy
ARRTcertfednradographynucearmedcnetechnoogy(orNMTCBcertfed)orradationtherapyandmeetcnicalrequrementsAnARRTcertedndviduauseshentasRT(BD)(ARRT)aterhsorhername ComputedTomography
Compuedomography(CT)stherecordngoapredeterminedpaneinhebodyusnganx-raybeamthatismeasuredrecordedandthen processedbyacompuerfordspayonamonor(Fg19)Thstechnologyallowsphyscanstovisualzepaientanatomyinvaroussectiona planes CTnvolvestheuseofhighlyspecazedequpmentandcomplexprocedureswhchhasresuednaneedorradographerstobespecaly preparednthsadvancedtechnoogyMostofthisadvancededucaionoccursthroughcontnungeducaioncoursesandon-the-jobcnca experencen1995heARRTbeganoferngaposprimaryexamnatoninCTToquafytoakeheexamnationindvdualsmustbeARRT certednradographynucearmedicneechnology(orNMTCBceriied)orradiatontherapytechnoogyandmeecncarequremensAn ARRT-certedndviduauseshentasRT(CT)(ARRT)afterhsorhername
Fg19Acompuedomographictechnoogsusesacompuerzedx-raysystemoproducesectonalanatomcmagesothebody CourtesyPhipsMedcaSystems
Fg110Adiagnostcmedcasonographeruseshigh-frequencysoundwavestocreaemages CourtesyPhipsMedcaSystems DiagnosticMedicalSonography
Dagnosicmedcalsonographyishevsuazaionofstructuresofthebodybyrecordngherefecionsofpusesofhgh-requencysound (utrasound)wavesdirectedintothetissueApersonwhospecazesnthsfieldisknownasadiagnostcmedcasonographer(Fg110) SonographersmayhaveprevousexperienceasradiographersbuthsexperienceisnotrequredTobecomeasonographerhecandidae canethercompeteadagnostcmedcasonographyprogramorlesscommonybepreparedonthejobOn-the-obcnicaexperenceis typcayprovdedonytopersonswhohavepreviousexperencenanotherhealhspecatysuchasradographyIndivdualsareegbetotakea naonaexamnationofferedbytheAmercanRegstryofDagnostcMedcaSonographers(ARDMS)throughavarietyofpathwaysA regstereddiagnostcmedcasonographerusesheintasRDMSaterhsorhernameAregiseredvasculartechnoogsusestheinasRVT afterhisorhernameAregsereddiagnostccardacsonographerusesheintasRDCSafterhisorhernameInadditionacardiovascuar credentangnternaionaorganzatonprovdescardacsonographerswthacredenialthataowsthemousethenitialsCCIaftertheirnames
Fg111Amagnetcresonance magingtechnoogstuseseecromagneticsspecicallyradiowavesandmagnetsmtocreaedagnosicsectionamagesofhebody CourtesyPhipsMedcaSystems In1999theARRTbeganoferngapostprmaryexamnaonnsonographyToqualifyotaketheexaminatonndviduasmustbeARRT certednradographynucearmedicneechnology(orNMTCBceriied)radiatonherapyorMRI(orARDMScertified)andmeecnca requrementsCandidatescanasobecomeegbetoakeheexamnationbycompetngaformaARRT-recognzededucaionaprogramin sonographyThereareapproxmaey165ARRT-recognizedsonographyprogramsprimariyntheUnedSaesEfeciveJanuary12015all canddatesmusthaveearnedanacademcdegreetoquafyforARRTceriicatonAnARRT-certfedndvdualusesthenitialsRT(S)(ARRT) afterhisorhername MagneticResonanceImaging MRIusesastrongmagnetcfedandradowavesalongwhacompuertogenerateseconaimagesofpatenanaomy(Fg111)LkeCT thsadvancedtechnoogyuseshighlyspecazedequpmentandrequiresspecazededucatonAthoughmanyMRIechnologistshaveobtaned thereducaonhroughcontnuingeducatoncoursesandon-the-obcnicalexperenceormaeducatonaprogramsnowexistwh baccalaureateassocateorcertfcatecredentialsForthemostpartMRIechnologistshavecredenialsnradographyandmanyarealso experencedCTtechnoogstsIn1995theARRTbeganoferingapostprmarypahwayforheceriicatonexamnationnMRIToquaytotake theexaminatonndvduasmustbeARRTcertifiedinradiographynucearmedcnetechnoogy(orNMTCBcertfed)radationtherapyor sonography(orARDMScered)andmeetclnicalrequrementsCandidaescanasobecomeegbetoakeheprmarymagneticresonance examnaionbycompletingaformaleducatonalprograminMRapprovedbyheARRTThereareapproxmatey60ARRT-recognzed educatonaprogramsinMREfeciveJanuary12015alcandidaesmusthaveearnedanacademcdegreetoquayforhiscertificaonAn ARRT-certedndviduauseshentasRT(MR)aferhisorhername AdditionalOpportunities
Regardessoheareanwhichanndvdualchoosestospecazewihintheprofessonofradoogctechnoogyaddtonalopporuniiesexsn educatonmanagementandcommercialfrms
Education
IndvdualswhohaveannteresneachinganyofthespecfcdiscpnescanfindopporuniiesnhospascollegesandunversitiesCareers ncudeclncalnstructordidacticacutymembercncacoordnaorandprogramdrecor Acncainstrucorteachessudentsprmariyonaone-on-onebassinthecncasettngAdidacicfacuymemberteachessudentstypcaly throughclassroomlecturesandaboraoryactvesAcincacoordnatorhasteachngresponsbltesaongwithadmnstratvedutesin overseeingcincaeducatonmostotennprogramsusingmanyclnicaleducatoncentersAprogramdirectorhasteachingresponsibiesas weasoveraladminstratveresponsibiyforheentireeducatonalprogramAdvancedcourseworkneducaionsdesrabeforhese posonsProgramdrectorsarerequiredtohaveamastersdegree Administration Personswhohaveaninterestinthemanagementotheradiologyservcesinagvenfactycanspecaizeinawdespecrumofsupervsoryand admnistratvepostonsManydepartmentshavesupervisorypositionsnareassuchasCTMRIinterventionamammographysonography andQMIn1997theARRTbeganoferngapostprmaryexamnaionnQMTobeegbetoakeheexamnaionindivduasmustbeARRT certednradographynucearmedicneechnology(orNMTCBceriied)orradiatontherapyandmeettheeducationaandclinca requrementsAnARRT-certfedndvdualusesthenitialsRT(QM)(ARRT)aferhsorhernameTheQMcredentawinoongerbeissuedafter June302018TheARRTsurveyedQMpracttonersandtheresutsindicatedthatinadgtalmagingenvironmenmanyoftheprevousQM taskshavenowbecomeobsoeteandtheexamwinoongerbeoferedInaddondependingontheszeofthedeparmenupper managementpositionsareavalabesuchascheftechnoogstandradoogymanageroradmnstratorAlongwhexperenceadvanced courseworkinmanagemensdesrabeforhesepostons
CommercialFirms
OpportuntesforRTsexsnavareyofareaswhincommerciacompaniesnvovedntheseingofx-rayequipmentimagereceptorsystems andreatedx-raysuppesThesecompaniesneedsalesrepresentatveswihtechncaknowledgeoftheradoogcproceduresandequpmen asweasheabtytoselInadditoncompaneshreapplcaionspecastswhoarenodirectynvovednsaesbutwhoarenvovedwhhe educatonandtranngohestafattheseswhereheequipmensnstaledSalesrepresentatvesandechncaspecialstsgeneralyhave sometraverequrementsaspartoftherresponsibies
HealthCareTeam
AwdearrayofspecialstsmakeuphehealthcareteamAhoughnotaofthevarousdscpnescanbedealedheresomeheathcare servceshatanRTencountersonareguarbassarehghightedTheseservcesncludemedcineandosteopathynursngandtheheathcare careersthatencompassmanyohedagnosicservicesherapeuticservcesandhealthnformatonservcesPersonsemployednhealthcare fndopportunitesnakndsoenvronmentssuchashosptalscnicsdoctorsofcesong-ermcareaciiesschoolsandindustry ManyheathcareworkerssharethetitesoftechnoogsttechnicanandtherapistTechnoogssageneraltermhaappiesoanindivdua skiedinapractcaartThshealthcareproviderappesknowedgetopracticalandheoretcproblemsinhefedTechnicansaermthat applestoapersonwhoperormsproceduresharequreatentontoechncadeaiTechnicansworkunderthedirectonoanoherheathcare provderThetermstechnologstandechncianareotenusedinterchangeablywhichcancreaeproblemsindscpnesinwhchtheermsare usedodenotedifferingevesofeducatonInheclncalaboraoryscencesamedicaltechnoogst(MT)hasearneda4-yeardegreeanda medcaaboratoryechncian(MLT)hascompeeda2-yearprogramngeneraltechnoogssarenvovednhighereveprobem-sovng suaionsandhavemoreextensveeducaionapreparatonthandoechnciansTechnoogssandtechnicansworkhroughouallareasof heathcare;manyprovidedrecpaientcarewhereasohersserveinsupportroles TherapstsspecalzencarryngouttreatmentsdesgnedtocorrectorimprovethefunconofaparticuarbodypartorsystemTherapss possessvariedevesofeducaonaexperiencesrangingrom2-yearo4-yeartograduaecoegedegrees MedicineandOsteopathy
PhyscansareprmarycareprovderswhopromotetheoptmahealhoftheirpatensandwhoprovdeforpatentscareduringanlnessTwo princpaltypesofphysciansarethemedcadoctor(MD)andthedocorofosteopathy(DO)MDsgeneralycompeteabaccaaureaedegree programwithascencemaorsuchasboogyorchemstryandthencompete4yearsofmedicalschoolDOshaveeducaionssmiartohoseof MDsThephlosophyoosteopathcmedcnedfersfromhaoftraditonamedcneInadditiontolearningthemportantconcepsofmedcne DOsaretaughodomanipulaionsofmuscesandbonesasapartohehealingprocessBothMDsandDOsmusbestatecensedto practice AfermedcaschoomosMDsandDOscompeeadditionacnicalexperenceknownasaresidencynanareaofspecializaton Resdenciesareusuay3or4yearsandmayincudehefollowingbranchesofmedcne
1 AnesthesoogyStudyoheuseofmedcationtocauseossosensationduringsurgery
2•Cardoogy:Sudyofdseasesothecardiovascuarsystem
3 FamiypractceStudyodiseasesnpatientsofalages
Inaddionmanyphysicanschooseasubspecatyorexampeheprimarydutesoapedatriccardiovascuarsurgeonncludeperormng surgeryonthehearandboodvesselsofchldren Nursing
Anurseprovidesdrecpaientcare,typcayunderthedrectionofphysciansNursesareclassfedasnursngassisans,lcensedpractca nurses(LPNs)orregsterednurses(RNs)RNshaveavarietyofdutesdependngonherareaoexperiseNursesofenchoosetowork exclusivelynonespecatyarea(egpedatricsorhopedcsntensivecaretheemergencydeparmen)TobecomeanRNthecanddatemust passasaeicensingexamnaonafercompeonofa2-3-or4-yearprogramofstudy Advancededucationforthenursecaneadtoworkasanursepraciioner(NP)anursemdwfeoranurseanesthetstAnNPperormsphysical examnaionsordersandnterpretssometestsandnsomesaesprescrbesmedcaonsAnursemdwieprovdespernaacareandcan deverinantsunderthesupervsionofanobstetrcianAnurseanesthetstprovdesanesthesaunderthesupervsonoananesthesoogs NursingassistantsandLPNsgenerayworkunderthedrectionoanRNoraphysciantoprovdebasccaretopaientsNursngassistants generayhavelmedrainngmosofwhchsdoneonhejobLPNsgeneraycompeea1-yearprogramandcanlegayadmnsterdrugs exceptbytheintravenousroue
DiagnosticServices
Heathcareworkersindagnosticservceareasperformtestsorevauaonshaaidhephyscianndeermningthepresenceorabsenceoa diseaseorcondtonManyheathcarespecialstsperformdagnosticproceduresForexampecardovasculartechnoogssoperateequpment thatrecordstheeecrcampusesofheheartandeectroneurodiagnostctechnoogstsoperateequpmenttorecordtheelectricalimpulsesof thebrainasapartoftherresponsibies
ThecnicalaboratoryscencesinvoveawdevaretyofcareersnheathcareAnMTworksintheaboraoryperormngtestsandanayzing resusSeveralareasofspecalzatonexstintheaboraoryincudnghematoogymcrobiologycincachemsrymmunoogyandbood bankngMLTsgeneralyworkunderthesupervsionofanMToraphysicanoperformbasiclaboratorytestsinalthevariousdeparmentsofthe aboratoryOtheraboratorypersonnelncudethecyoechnologistwhospecazesnthepreparationandscreeningofcelsandthehstoogc technoogstwhospecaizesnhepreparatonotissues
RadoogyispredominantyadagnoscserviceThesecareershaveareadybeendetaiedEducatonarequrementsforcareersinthe diagnostcservicesvaryconsderabyacrossthedscplnesbutmostpostonsrequire2to4yearsofeducatonbeyondhghschool TherapeuticServices
TherapstsprovdeservcesdesgnedtoheppatensovercomesomeformofphysicalorpsychoogcadsabiyExampesnclude occupaonatherapss,whoeachusefuskllstopatentswithphysicaloremoionainesses;physcatherapists,whohelptorestoremuscle strengthandcoordinatonhroughexerciseandtheuseofspecialdevcessuchasbracesorcrutches;radationtherapstswhotreacancer patientsusnghigh-energyx-raysandgammarays;andrespraorytherapstswhoheptotreapaientswthbreathngdfcultesEducatonal requrementsvaryconsiderabyacrossthediscpinesbutmostpositionsrequre2to6yearsofeducationbeyondhghschoo HealthInformationServices
Heathinformatonservcesnvovecareersthaareresponsibleforthemanagemenofhealthnformatonsuchasthatconanednhepatens heathrecordThesecareersdonotinvovedirectpatencontactbutareessentaotheeficentoperaionofanyheathcareacityFor exampeheahnformationtechnoogstsarenvolvednhecodingofpatencondtonsandhesecodesareusedtodetermnetheamountof moneyafacitysrembursedforprovdngcaretoapatentEducaionarequiremensorcareersnheathinformatonmanagemenvary consderabyacrossdiscpnesbumostposiionsrequre2to4yearsofeducaionbeyondhghschoo
OtherHealthServices
AvastnumberofothercareersexstwthnthehealhcareenvironmenOtherhealhservcesincudesuchdscpnesascommuncation sciencescounsengdentaheathdetetcsandpsychology
Summary
1 Radiatonisenergytransmtedbywavesthroughspaceorthroughamedum(matter)tsbothhepfuandessentialforfeEnergyshe capactytooperateorworkOneformofenergyiseecromagneticenergywhchncudesradiowavesghtandx-raysManyformsof energyareusednmedcinetohepdiagnoseandtreatpatensSomehgherenergyormssuchasx-raysarecapableofcausng ionizatonThisprocessiscapableocausingbologcdamageandcautionshoudbeexercsedopreventunnecessaryexposureto ionizngradation
2 X-raysweredscoveredbyWlhemConradRöntgenonNovember81895ForhsdscoveryRöntgenwasawardedthefrstNobePrize inphyscsn1901
3 Radiologictechnoogyisthetechncalscencethatdealswiththeuseofx-raysorradioacivesubstancesfordagnostcorherapeutic purposesnmedcineRadoogcechnologistsageneraermappliedtoanndvduaqualifiedtousex-rays(radography)orradoacve substances(nuclearmedcine)oproduceimagesofthenernapartsofthebodyfornterpretationbyaphyscianknownasaradiologist RTsasousex-raysorradioacivesubstancesinthetreatmentodisease(radiatonherapy)
4 Inaddiiontousngx-raysandradoactvesubstancesRTshavebecomenvovednusnghgh-requencysoundwaves(dagnostc medicalsonography)andmagnetcfieldsandradowaves(MRI)tocreateimagesofthenternaanatomyofthebodyAddtonal opportuntesasoexsorRTsineducatonmanagementandcommercarms
5 TheheahcareteamcomprsesawdearrayofspecialistsRTsworkasapartoftheheathcareeamandneractwithmanyoftheother healthcaremembersonareguarbassTheseohermembersareemployednsuchheathservcesasmedcineandoseopathynursng andtheotherhealthcareersthatencompassmanyofthediagnostcservcestherapeutcservicesandheathnormatonservices 6 Indvduasempoyednheathcarendopportunesnallkndsofenvironmentssuchashospitasclincsdocorsofceslong-term careaclitesschoosandindusry
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GrggERNThetraioftheinvisibeighSprngieldIl:CharlesCThomas;1965 GureyLTCaowayWJIntroductiontoradoogctechnologyed7StLous:Mosby;2010 PappJQuaitymanagementntheimagngsciencesed5StLous:Mosby;2014 RöngenWCOnanewkindoraysNature1896;53:1369 SimmersLMSmmers-NarkerK,Smmers-KobeakSSmmersDHO:HealthScenceed8Abany,NY:DelmarCengageLearnng;2013
ProfessionalOrganizations RichardR Carlton,MS,RT(R)(CV),FAEIRS,andArleneM Adler,MEd,RT(R),FAEIRS
1 AccreditationofSchools,
1 JointReviewCommitteeonEducationinDiagnosticMedicalSonography,
2 JointReviewCommitteeonEducationinNuclearMedicineTechnology,
3 JointReviewCommitteeonEducationinRadiologicTechnology,
2 CertificationofIndividuals,
3 AmericanRegistryofDiagnosticMedicalSonographers,
1 AmericanRegistryofRadiologicTechnologists,
2 MedicalDosimetryCertificationBoard,
4 NuclearMedicineTechnologyCertificationBoard,
1 StateLicensingAgencies,
5 ProfessionalSocieties,
1 AmericanAssociationofMedicalDosimetrists,
2 AmericanHealthcareRadiologyAdministrators,
3 AmericanSocietyofEchocardiography,
4 AmericanSocietyofRadiologicTechnologists,
5 AssociationofEducatorsinImagingandRadiologicSciences,
6 AssociationofVascularandInterventionalRadiographers,
7 InternationalSocietyforMagneticResonanceinMedicine–SectionforMagneticResonanceTechnologists,
8 InternationalSocietyofRadiographersandRadiologicTechnologists,
9 SocietyofDiagnosticMedicalSonographers, 10 SocietyofNuclearMedicine–TechnologistSection,
11 SocietyforVascularUltrasound,
12 StateandLocalRadiologicTechnologySocieties,
6 RadiologistandPhysicistOrganizations,
1 AmericanAssociationofPhysicistsinMedicine,
2 AmericanBoardofRadiology,
3 AmericanCollegeofRadiology,
4 AmericanInstituteofUltrasoundinMedicine,
5. AmericanMedicalAssociation,
6. AmericanRoentgenRaySociety,
7. AmericanSocietyforTherapeuticRadiologyandOncology,
8. InternationalSocietyforClinicalDensitometry,
9. RadiologicalSocietyofNorthAmerica, 10. SocietyforImagingInformaticsinMedicine, 11. SocietyofNuclearMedicine, 7. Summary,
Objectives
Oncompletionofthischapter,thestudentwillbeableto:
•Differentiateaccreditation,certification,andrepresentationfunctionsofvariousprofessionalorganizations
•Describetheorganizationsthatcarryouttheprofessionalaspectsofaspecificradiologictechnologyareaofspecialization
•Describetherelationshipofvariousradiologistandphysicistorganizationswithradiologictechnology KeyTerms
Accreditation Voluntarypeer-reviewprocessthroughwhichanagencygrantsrecognitiontoaninstitutionforaprogramofstudythatmeets specifiedcriteria
Certification Voluntaryprocessthroughwhichanagencygrantsrecognitiontoanindividualondemonstration,usuallybyexamination,of specializedprofessionalskills
EssentialsandGuidelines Documentspecifyingtheminimumqualitystandardsfortheaccreditationofaneducationalprogramasapprovedby theappropriatejointreviewcommitteesponsors
JointReviewCommittee(JRC) Groupofpersonsappointedbysponsoringorganizationstooverseetheaccreditationprocess Licensure Processbywhichagovernmentalagency(usuallyastate)grantspermissiontoindividualstopracticetheirprofession Registry Listofindividualsholdingcertificationinaparticularprofession
SponsoringOrganization Professionalorganizationthatappointsmemberstoajointreviewcommitteeboard Standards Documentspecifyingtheminimumrequirementsforaccreditationofaneducationalprogrambyajointreviewcommittee
Beactiveinyourlocal,stateandnationalorganizations;neverbesatisfieduntilthehighestgoalhasbeenattained
ProfessorEdC Jerman FatherofRadiologicTechnology,c1920
AccreditationofSchools AccreditationofschoolssetstheconditionsunderwhichnewmembersqualifyforentryintotheprofessionAccreditedprogramshave satisfactorilydemonstratedcompliancewitheducationalstandardsdevelopedbyandfortheprofessionThesestandardsaresetbythe organizationsthatsponsortheaccreditingagencyEachsponsoringorganizationappointsoneormorememberstotheboardofdirectorsknown asaJointReviewCommittee(JRC)Thisboardisthegoverningbodyoftheorganization,anditsmembersmakerecommendationsregarding
theaccreditationstatusofschoolsThesponsoringorganizationsoftheJRCsapproveadocumentknownaseithertheEssentialsand GuidelinesortheStandards,whichdetailstheminimumrequirementsforhowanaccreditedprogrammustoperateThesedocumentstypically requireaprogramtodemonstrateitspurposes,itsresources,theeffectivenessofitsoutcomes,andotherelementsdeemedimportantbythe sponsoringorganizations
TheprocessofaccreditationbeginswithanapplicationfromtheprogramOnapprovaloftheapplication,acomprehensivedocumentknownas aself-studymustbecompiledbytheprogramaccordingtoguidelinessetbytheaccreditingagencyOnsubmissionofthisdocument,ateamof sitevisitorsissenttoverifytheinformationprovidedintheself-studySitevisitorsarevolunteersfromtheprofessionwhoservewithoutpay, althoughtheprogrambeingvisitedpaystheirexpensesThesite-visitingteamsubmitsareporttotheaccreditingagency,andtheagencystaff reviewsthisreportandpresentsittotheboardforavoteontherecommendedaccreditationstatusTypicalaccreditationawardclassifications includeprovisional,probationary,andupto8-yearstatus(althoughthismayvarywiththespecificaccreditationagency)Feesarecollectedfor theapplicationandthesite-visitexpenses,asisanannualfeefromthesponsoroftheprogramandsometimesforclinicaleducationsites Accreditationisavoluntarypeer-reviewprocessAlthoughaccreditationisvoluntary,fewprogramschoosenottoundergotheaccreditation processNearlyallschoolsvaluetheiraccreditationstatushighlyandworkhardtomaintainstandardsthatmeet,andoftenexceed,allthe accreditationrecommendationsAprogrammaychoosenottopursueprogrammaticaccreditationandmayrelyontheaccreditationawardedto acollegeoruniversityunderaregionalinstitutionalaccreditingagencyAlistofaccreditingagencies,certificationagencies,andprofessional societiesissuppliedinAppendixB
JointReviewCommitteeonEducationinDiagnosticMedicalSonography TheJointReviewCommitteeonEducationinDiagnosticMedicalSonography(JRCDMS)wasestablishedin1983andiscurrentlysponsoredby thefollowingnineorganizations:
1. •AmericanCollegeofCardiology:http://www.acc.org
2. •AmericanCollegeofObstetriciansandGynecologists:http://www.acog.org
3. •AmericanCollegeofRadiology(ACR):http://www.acr.org
4. •AmericanInstituteofUltrasoundinMedicine(AIUM):http://www.aium.org
5. •AmericanSocietyofEchocardiography(ASE):http://www.asecho.org
6. •AmericanSocietyofRadiologicTechnologists(ASRT):http://www.asrt.org
7. •SocietyofDiagnosticMedicalSonography:http://www.sdms.org
8. •SocietyforVascularSurgery:http://www.vascularweb.org
9. •SocietyforVascularUltrasound:http://www.svunet.org
TheJRCDMSaccreditsnearly200institutions,whichmayhavefromonetothreeaccreditedprogramseach(Thewebsiteaddressis http://wwwjrcdmsorg)
JointReviewCommitteeonEducationinNuclearMedicineTechnology TheJointReviewCommitteeonEducationinNuclearMedicineTechnology(JRCNMT)wasestablishedin1970andiscurrentlysponsoredby fourorganizations:theACR,theASRT,theSocietyofNuclearMedicine,andtheSocietyofNuclearMedicine–TechnologistSectionThe JRCNMTaccreditsapproximately100nuclearmedicinetechnologyprograms(Thewebsiteaddressishttp://wwwjrcnmtorg)
JointReviewCommitteeonEducationinRadiologicTechnology RadiographyisconsideredtobethefiftholdestalliedhealthprofessionbecausethefirstEssentialsdocumentwasestablishedin1944,afterthe occupationaltherapy,medicaltechnology,physicaltherapy,andmedicalrecordsadministrationNotuntil1969wastheJointReviewCommittee onEducationinRadiologicTechnology(JRCERT)establishedTheJRCERTboardiscurrentlynominatedbytheACR,theASRT,the AssociationofEducatorsinImagingandRadiologicalSciences,andtheAmericanHealthcareRadiologyAdministrators(AHRA)TheJRCERT accreditsmoreprogramsthananyotheralliedhealthprofession:approximately700programsinradiography,radiationtherapy,medical dosimetry,andmagneticresonanceimaging(MRI)programs(Thewebsiteaddressishttp://wwwjrcertorg)
CertificationofIndividuals Professionalcertificationisaprocessthroughwhichanagencygrantsrecognitiontoanindividualondemonstration,usuallybyexamination,of specializedprofessionalskills.Itisavoluntaryprocessandistheresponsibilityoftheperson,notoftheperson’sschooloremployer.Each certificationorganizationsetsrequirementsfortherecognitionofprofessionalsthroughregistration,certification,orotherrecognitionofskillsby examinationFeesarechargedfortheseservicesEspeciallyimportantaretheannualfeesforcontinuedrecognitionFailuretopaythesefeesor meetotherrequirements,suchasverificationofcontinuingeducationactivities,resultsintheremovalofanindividualfromtheregistrationlistsof theprofessionReinstatementmayinvolveretakinganexaminationorreturningtoschool,andaspecialfeeisoftenchargedInmanystates,loss ofprofessionalcertificationwillincludelossoftheindividual’sstatelicensetopractice(andthereforemayresultinthelossofajob) Actually,aregistryissimplyalistofindividualsholdingaparticularcertificationThetermregistryiscommonlyappliedtotheagencythatcarries outthecertificationfunctionandmaintainstheregistrylistEachregistryissponsoredbyappropriateprofessionalorganizationsThesponsoring organizationsappointthemembersoftheboard,andthisboardthendeterminesthestandardsfortheregistry,suchaseligibilityrequirements, examinationquestions,fees,andethicalstandards
NearlyallhospitalsintheUnitedStatesrequireappropriateprofessionalcertificationasaconditionofemploymentPhysicianswhodesirehighqualityimagingalsoinsistonappropriateprofessionalcertificationforthetechnologistswhoperformradiography,ultrasonography, mammography,computedtomography(CT),MRI,andotherimagingortreatmentservicesintheirofficesandclinics
Mostprofessionalsocieties,aswellasmanyotherprofessionalorganizations,maintainapresenceontheInternetonFacebookandTwitter Especiallyforstudents,thesesitescanprovidevaluableinsightintohowaprofessionaloperatesonthelocal,state,andnationalstages
AmericanRegistryofDiagnosticMedicalSonographers TheAmericanRegistryofDiagnosticMedicalSonographers(ARDMS)offersvoluntarycertificationthroughexaminationtoeligiblesonographers andvasculartechnologistsSinceitsinceptionin1975,ARDMShascertifiedapproximately96,000personsARDMSholdsaccreditationwith theNationalCommissionforCertifyingAgencies(NCCA)ARDMSoffersfourcredentials:registereddiagnosticmedicalsonographer(RDMS),
registereddiagnosticcardiacsonographer(RDCS),registeredvasculartechnologist(RVT),andregisteredphysicianinvascularinterpretation (RPVI)SpecialtyareaswithintheRDMScredentialincludeabdomen,breast,neurosonology,obstetricsandgynecology,andfetal echocardiographySpecialtyareaswithintheRDCScredentialincludeadult,pediatric,andfetalechocardiographyEachspecialtyarearequires twoexaminations,oneonphysicsandinstrumentation,andtheotheronthespecialtyprocedures(Thewebsiteaddressishttp://wwwardmsorg)
AmericanRegistryofRadiologicTechnologists TheAmericanRegistryofRadiologicTechnologists(ARRT)wasfoundedin1922bytheRadiologicalSocietyofNorthAmerica(RSNA),withthe supportoftheAmericanRoentgenRaySociety(ARRS)andthecooperationoftheCanadianAssociationofRadiologistsandtheAmerican SocietyofX-RayTechnicians(nowknownastheASRT)In1936theARRTwasincorporated,andin1944theACRandtheASRTbecame cosponsorsoftheARRTCurrently,theASRTappointsfivememberstotheARRTboard,andtheACRappointsfourmembers ThepurposesoftheARRTincludeencouragingthestudyandelevatingthestandardsofradiologictechnology,examiningandcertifyingeligible candidates,andperiodicallypublishingalistingofregistrantsThismissionisaccomplishedthroughvoluntarycertificationbyexaminationOnce anindividualhaspassedtheappropriateexamination,heorsheislistedintheregistryandgrantedtherighttouseanappropriateprofessional titleThisdesignationisregisteredtechnologist(RT),withaspecialtydesignationforradiographer(R),radiationtherapy(T),nuclearmedicine (N),cardiacinterventionaltechnology(CI),vascularinterventionaltechnology(VI),mammography(M),CT,MRI,orqualitymanagement(QM)In addition,theARRThasaddedsonography(S),vascularsonography(VS),breastsonography(BS),bonedensitometry(BD),andradiologist assistant(RA)examinationsForexample,aregisteredradiographerisdesignatedasRT(R)(ARRT)Thisdesignationisaregistered trademark,anditsusebynon–ARRT-registeredindividualsisillegal
IndividualsmustpayanannualfeetomaintainactivestatuswiththeARRTandmustadheretotheARRTcodeofethicsMembersofthe professionwhoviolatethecodeofethics,usuallythroughcriminalactivity,mayhavetheirregistrationrevokedForexample,formerRTswhohave beenconvictedofstealingfromtheiremployersoftenhavetheirregistrationrevokedARRTregistrantsalsomustcertifythattheyhaveattended 24hoursofcontinuingeducationduringtheprevious2yearstomaintaintheirregistrationstatusContinuingeducationbecamemandatoryfor ARRTregistrantsin1995
TheARRTbeganofferingregistrationinnuclearmedicinetechnologyandradiationtherapyin1962andstartedpostprimaryexaminationsin 1991.Currently,theARRTlistsmorethan330,000registeredtechnologists,manyofwhomhavebeencertifiedinmorethanoneprofessional specialty.(Thewebsiteaddressishttp://www.arrt.org.)
MedicalDosimetryCertificationBoard TheMedicalDosimetryCertificationBoard(MDCB)credentialsprofessionalswhopracticemedicaldosimetry,oneoftheoncologicprofessions TheMDCBoffersthecredentialCertifiedMedicalDosimetrist(CMD)tothosewhopasstheirexaminationinmedicaldosimetry(Thewebsite addressishttp://wwwmdcborg)
NuclearMedicineTechnologyCertificationBoard TheNuclearMedicineTechnologyCertificationBoard(NMTCB)wasfoundedin1977tocertifytechnologistsinnuclearmedicineandmolecular imagingCurrentsponsorsincludetheSocietyofNuclearMedicine,theSocietyofNuclearMedicine–TechnologistSection,theAmericanSociety ofClinicalPathologists,theCollegeofPhysicists,theAmericanSocietyofMedicalTechnology,andtheAssociationofPhysicistsinMedicine TheNMTCBconsistsof15personsplusanadvisorycouncil,thechairofwhichalsositsontheboard
ThepurposesoftheNMTCBincludeexaminingandcertifyingeligiblecandidatesandperiodicallypublishingalistingofregistrantsThismission isaccomplishedthroughvoluntarycertificationbyexaminationOnceanindividualhaspassedtheappropriateexamination,heorshebecomes registeredandisgrantedtherighttousethetitlecertifiednuclearmedicinetechnologistTheNMTCBhasapproximately15,000registrantsThe NMTCBalsooffersthreespecialtyexaminationsfornuclearmedicinetechnologists,thenuclearcardiology(NCT),positronemissiontomography (PET),andtheNuclearMedicineAdvancedAssociate(NMAA)examinations(Thewebsiteaddressishttp://wwwnmtcborg)
StateLicensingAgencies RequirementstopracticetheradiologicprofessionsvaryfromstatetostateMost,butnotall,statesandterritoriesrequirealicense,whichcan usuallybeobtainedonprovidingproofofcertificationfromtheappropriatenationalcertificationorganization(aprocessknownaslicensure)The lawsineffectvarytremendouslyfromonestatetoanotherandcanvaryfromyeartoyearwithinastateasaresultofnewlegislationMost radiologicandimagingsciencesprofessionalsdonotexperiencedifficultyinmovingemploymentfromonestatetoanotherbecauseproper licensingisusuallyamatterofsubmittingtheappropriatepaperworkandfeesVerifyingcurrentlicensingrequirementsisimportantbefore practicinginanewstatebecausepenaltiesmaybeassessedforpracticingwithoutalicenseManyprofessionalsocietiesmaintaincurrentlists ofcontactinformationforallstateswithlicensingrequirementsfortheirmembers.(Forexample,gototheASRTwebsiteandsearchfor“state licensing”toobtaintheircurrentlist.)(SeeAppendixC.)
ProfessionalSocieties ProfessionalsocietiesrepresenttheinterestsofvariousgroupstothepublicandtogovernmentalbodiesTheradiologicscienceshavemany suchorganizations,withnewonesformingandotherscombiningorceasingoperationsfromtimetotimeTheseorganizationsusuallypublish professionaljournals,conducteducationalmeetings,andrepresenttheirmemberstogovernmentalbodiesTheyalsooftenprovidecontinuing educationverification,scholarships,specialreports,informationnetworking,recruitmentandpromotionalmaterials,malpracticeinsurance,and otherservicesfortheirmembersMostprofessionalsocietiesoffersignificantdiscountstostudentmembersandscholarshipsandresearch grantsspecificallydesignedtofosterprofessionaldevelopmentofstudentsintheprofessionsSomeofthemostimportantprofessionalsocieties aredescribedhere
AmericanAssociationofMedicalDosimetrists TheAmericanAssociationofMedicalDosimetrists(AAMD)isaninternationalsocietyestablishedtopromoteandsupporttheMedical DosimetryprofessionAAMDpublishesthejournalMedicalDosimetry,providescontinuingeducation,andrepresentsMedicalDosimetrists Therearecurrentlymorethan3000members(Thewebsiteaddressishttp://wwwmedicaldosimetryorg) AmericanHealthcareRadiologyAdministrators
TheAHRAwasorganizedtopromotemanagementpracticeintheadministrationofimagingservicesMembershipisopentoprofessionals engagedinthepracticeofradiologyadministrationinbothhospitalandnonhospitalsettings,aswellastoothersinserviceoreducationwho havelimitedmanagementresponsibilitiesTheyhaveapproximately4000members AHRAprovidesabroadrangeofservicesforitsmembers,includingthejournalRadiologyManagement,anewsletter,andmonographsThe associationholdsregulareducationalmeetingsandanannualconferenceTheyoffertheCertifiedRadiologyAdministrator(CRA)examination forradiologyadministratorsAHRAhasstrongcooperativetieswithotherprofessionalassociationsandhasspearheadedtheSummiton Manpower,aconsortiumofradiologyandhealthcareorganizationsconcernedwithlaborshortagesinradiology(Thewebsiteaddressis http://wwwahraonlineorg)
AmericanSocietyofEchocardiography TheASEisanorganizationofphysicians,scientists,laboratorymanagers,cardiovascularsonographers,andnursescommittedtoexcellencein cardiovascularultrasoundanditsapplicationtopatientcarethrougheducation,advocacy,research,innovation,andservicetobothmembersand thepublicASEwasfoundedin1975andhasmorethan17,000membersnationallyandinternationallyTheypublishcurricularandstandards documentsforsonographersTheypublishtheJournaloftheAmericanSocietyofEchocardiography(Thewebsiteaddressis http://wwwasechoorg)
AmericanSocietyofRadiologicTechnologists TheASRTwasfoundedin1920AsthemostprominentnationalprofessionalvoiceforRTs,theASRTrepresentsindividualpractitioners, educators,managersandadministrators,andstudentsinradiography,radiationtherapy,andnuclearmedicine,aswellasthemanyspecialties withineachmodalityTheASRThasmorethan153,000members(nearlyhalfoftheRTsintheUnitedStates)
ThegoalsoftheASRTaretoadvancetheprofessionsofradiologictechnologyandimagingspecialties,tomaintainhighstandardsofeducation, toenhancethequalityofpatientcare,andtofurtherthewelfareandsocioeconomicsofRTsTheASRTpublishespeer-reviewed,refereed journals(RadiologicTechnologyandRadiationTherapist)andproduceseducationalcurricularguidesandothermaterialsofalltypes(The websiteaddressishttp://wwwasrtorg)
AssociationofEducatorsinImagingandRadiologicSciences TheAssociationofEducatorsinImagingandRadiologicSciences(AEIRS)wasfoundedin1967Itsprimarypurposesaretoencouragethe exchangeofteachingconcepts,tohelpestablishminimumstandardsforteachingradiologictechnologies,andtoadvanceradiologiceducation byencouragingeducationalresearchandtechnicalwritingbyitsmembersAEIRSisanationalassociationofeducatorsItholdsmeetingsand publishesRadiologicScienceandEducation,Spectrum,andothereducationaldata(Thewebsiteaddressishttp://wwwaeirsorg)
AssociationofVascularandInterventionalRadiographers TheAssociationofVascularandInterventionalRadiographers(AVIR)wasorganizedtorepresentradiographersandalliedhealthcare professionalsspecializingincardiovascularandinterventionalradiology.TheAVIRoffersmembersanewsletterandregionalmeetings.(The websiteaddressishttp://www.avir.org.)
InternationalSocietyforMagneticResonanceinMedicine–SectionforMagneticResonanceTechnologists TheInternationalSocietyforMagneticResonanceinMedicine(ISMRM)wasfoundedin1981Itsmajorpurposeistofurtherthedevelopmentand applicationofmagneticresonancetechniquesinmedicineandbiologybypromotingcommunications,researchdevelopmentapplications,and theavailabilityofinformationinthefieldsofMRIandspectroscopyToaccomplishthispurpose,theISMRMholdsmeetingsandworkshops, publishesjournalsandotherdocuments,providesinformationandadviceonaspectsofpublicpolicyconcernedwithmagneticresonancein medicine,andotherwiseperformscharitable,scientific,andeducationalfunctionswithrespecttomagneticresonanceinmedicineandbiology TheISMRM’speriodicalsincludeanewslettercalledResonanceandajournaltitledMagneticResonanceinMedicineTheSectionforMagnetic ResonanceTechnologists(SMRT)publishesanewsletterandajournal,MagneticResonanceImagingTechnology(Thewebsiteaddressis http://wwwismrmorg/smrt)
InternationalSocietyofRadiographersandRadiologicTechnologists TheInternationalSocietyofRadiographersandRadiologicTechnologists(ISRRT)wasfoundedin1959asanorganizationofnationalsocieties ofRTsTheISRRTisaninternationalnongovernmentalorganizationwithofficialrelationswiththeWorldHealthOrganization TheprimaryobjectivesoftheISRRTaretofacilitatecommunicationamongRTsworldwide,toadvancethescienceandpracticeofradiologic technology,andtoidentifyandhelpmeettheneedsofradiologictechnologists(RTs)indevelopingnationsTheISRRTholdsWorldCongresses ona2-yearcycleTheISRRTpublishesasemiannualnewsletter,proceedingsofmeetings,andtranslationsofvariousdocumentsofinterestto theprofession
Over70membercountriesrepresentingmorethanahalfmillionradiographersbelongtotheISRRTEachmembercountryappointsa representativetotheISRRTWorldCouncil,whichservesasthegoverningbodyThesecretary-generaloftheorganizationservesastheliaison forthecouncil,aswellastheofficeTheISRRToffersassociatemembershiptoindividualswishingtosupporttheorganization(Thewebsite addressishttp://wwwisrrtorg)
SocietyofDiagnosticMedicalSonographers TheSocietyofDiagnosticMedicalSonographers(SDMS)isthelargestprofessionalsocietyforsonographers,representingeveryspecialtyand levelofexpertiseSDMSwasfoundedin1970toanswertheneedsofnonphysicianswhowereperformingdiagnosticsonographicprocedures Itsgoalsaretopromote,advance,andeducateitsmembersandthemedicalcommunityinthescienceofdiagnosticmedicalsonographyand therebycontributetotheenhancementofpatientcareThisgoalisaccomplishedthrougheducationalprograms,scientificandprofessional publications,andrepresentationandcollaborationwithotherorganizationsSDMSpublishestheJournalofDiagnosticMedicalSonography(The websiteaddressishttp://wwwsdmsorg)
SocietyofNuclearMedicine–TechnologistSection
TheSocietyofNuclearMedicine(SNM)isamultidisciplinaryorganizationofphysicians,physicists,chemists,radiopharmacists,technologists, andothersinterestedinthediagnostic,therapeutic,andinvestigationaluseofradiopharmaceuticalsFoundedinSeattlein1954,theSNMisthe largestscientificorganizationdedicatedtonuclearmedicine
TheTechnologistSectionoftheSNMwasformedin1970tomeettheneedsofthenuclearmedicinetechnologistItisascientificorganization formedwith,butoperatingautonomouslyfrom,theSNMtopromotethecontinueddevelopmentandimprovementoftheartandscienceofnuclear medicinetechnologyItsongoingobjectivesaretoenhancethedevelopmentofnuclearmedicinetechnology,tostimulatecontinuingeducation activities,andtodevelopaforumfortheexchangeofideasandinformationTheTechnologistSectionprovidesnuclearmedicinetechnologists withamechanismtodealdirectlywithissuesthatconcernthem,suchascontinuingeducation,academicaffairs,andsocioeconomicissuesThe organizationpublishesajournalcalledJournalofNuclearMedicineTechnology,orJNMT(Thewebsiteaddressishttp://wwwsnmorg)
SocietyforVascularUltrasound TheSocietyforVascularUltrasound(SVU)representsvasculartechnologists,vascularphysicians,vascularlaboratorymanagers,nurses,and otheralliedmedicalultrasoundprofessionalsSVUwasfoundedin1977andhasmorethan4200membersSVUpublishescurricularand standardsdocumentsforvascularsonographersandtechnologistsItsjournalistheJournalforVascularUltrasound(Thewebsiteaddressis http://wwwsvunetorg)
StateandLocalRadiologicTechnologySocieties Nearlyallstatesandmanycitiesandregionshavelocalprofessionalsocietiesthatcarryoutmanyofthefunctionsofthelargernational organizationsfortheirstatesorregionsInmanyinstances,theseorganizationsserveaschaptersoraffiliatesofthelargergroups,althoughthese connectionsmaybeformalorsimplylooseaffiliationsStateandlocalsocietiesoftenmakespecialeffortstocatertotheneedsofstudentsand newmembersofprofessionswithopportunitiestobeginacareerthroughscholarships,studentcompetitions,publishing,exhibits,andcommittee work,aswellasthroughpositionsasboardmembers
RadiologistandPhysicistOrganizations AmericanAssociationofPhysicistsinMedicine TheAmericanAssociationofPhysicistsinMedicine(AAPM)isthemostprominentorganizationofradiationphysicists,withover8000members ItsannualmeetingisheldinconjunctionwiththeRSNAmeetingeachyearinChicago
AmericanBoardofRadiology TheAmericanBoardofRadiology(ABR)wasestablishedin1934toconductthecertificationofradiologistsTheABRhasthreecertification divisions:radiology,diagnosticradiology,andtherapeuticradiologyThebasicrequirementforeligibilityfortheseexaminationsisamedical degreeplus4yearsofresidencytrainingAwrittenexaminationmustbepassedbeforeacandidateiseligiblefortheoralexaminationTheABR alsoofferscertificationforradiologicphysicistsandaspecialcompetenceexaminationinnuclearmedicine
AmericanCollegeofRadiology Withmorethan30,000members,theACRistheprincipalorganizationofphysicianstrainedinradiologyandmedicalradiationphysicsinthe UnitedStatesTheACRisaprofessionalsocietywhoseprimarypurposesaretoadvancethescienceofradiology,improveservicetothe patient,studythesocioeconomicaspectsofthepracticeofradiology,andencouragecontinuingeducationforradiologistsandpersons practicinginalliedprofessionalfields
AmericanInstituteofUltrasoundinMedicine
Physicians,engineers,scientists,sonographers,andotherprofessionalsinvolvedwithdiagnosticmedicalsonographymakeuptheAIUMThe AIUMpromotestheapplicationofultrasoundinclinicalmedicine,diagnostics,andresearch;promotesthestudyofitseffectsontissue; recommendsstandardsforitsapplications;andpromoteseducationintheuseofultrasonicsformedicalpurposes
AmericanMedicalAssociation
TheAmericanMedicalAssociation(AMA)wasfoundedinPhiladelphiain1847andisconsideredthelargestandmostactivemedical organizationintheworldAtthefoundingmeeting,thedelegatesadoptedthefirstcodeofmedicalethicsandestablishedthefirstnationwide standardsforpreliminarymedicaleducationandthedegreeofMedicalDoctorMorethan300,000USphysicians(approximately70%ofthose practicing)belongtotheAMATheactivitiesoftheAMAincludepromotionandregulationofallaspectsofmedicineintheUnitedStates, includingthealliedhealthprofessionsTheAMApublishesthemostwidelydistributedmedicaljournalintheworld,theJournaloftheAmerican MedicalAssociation,alsoknownasJAMA,whichispublishedweekly
AmericanRoentgenRaySociety TheARRSistheoldestUSradiologicsocietyFoundedin1900inStLouis,thesocietyhadapproximately7000membersbytheearly1990sIts primaryobjectivesareeducational,whicharemetthroughmeetingsandpublicationoftheAmericanJournalofRoentgenology
AmericanSocietyforTherapeuticRadiologyandOncology ThepurposeoftheAmericanSocietyforTherapeuticRadiologyandOncology(ASTRO)istoextendthebenefitsofradiationtherapytopatients withcancerorotherdisorders,toadvanceitsscientificbasis,andtoprovidefortheeducationandprofessionalfellowshipofitsmembers Thesocietywasformallyincorporatedin1958asanorganizationofphysicianswhobelievedthatradiation,formerlyusedonlyasadiagnostic tool,hadpotentialvalueasaninterventionalmodalityinthetreatmentofmalignantdisease.Today,ASTROhasmorethan4000members (includingmanyradiationtherapists)andistheleadingorganizationforradiationoncology,biology,andphysics.ASTROpublishesanewsletter
andanannualmembershipdirectoryTheorganizationalsomakesamajorcommitmenttoeducationandresearchthroughawards,fellowships, travelgrants,andcontributionstoaccreditedtechnologyprograms
InternationalSocietyforClinicalDensitometry TheInternationalSocietyforClinicalDensitometry(ISCD)wasfoundedin1993andprovidesacentralresourceforscientificdisciplineswithan interestinbonemassmeasurementThesocietyhasmorethan4000membersandoffersatechnicalcertificationexaminationforindividuals whoperformbonedensitometry,aswellascontinuingeducationandaccreditationforclinicalsites
RadiologicalSocietyofNorthAmerica TheWesternRoentgenSocietywasfoundedinChicagoin1915inresponsetoaneedforanationalradiologyorganizationbecausetheARRS hadbecomeaneasternorganizationIn1920theorganizationwasrenamedtheRSNAtoreflectthenatureofitsmembershipSince1918, RSNAhaspublishedthemostinfluentialjournalinAmericanradiology,knownsimplyasRadiologyandoftenreferredtoasthegrayjournal becauseofitstraditionalcolor,representingtheshadesofgraythatmakeuptheradiologicimageIn1981asecondjournal,RadioGraphics,was addedTheorganizationhasmorethan53,000membersfrom140countriesRSNAconductstheworld’slargestradiologymeeting,withmore than55,000registrantsinChicagoeachNovemberTheorganizationalsoprovidesresearchgrantstotalingseveralmilliondollarsannuallyto membersoftheprofessions
SocietyforImagingInformaticsinMedicine TheSocietyforImagingInformaticsinMedicine(SIIM),formerlytheSocietyforComputerApplicationsinRadiology(SCAR),wasfoundedin 1980toserveasaresourceforimagingprofessionalsinterestedinthecurrentandfutureuseofcomputersinmedicalimagingTheorganization providesafocalpointforpicturearchivingandcommunicationsystems(PACSs)andotherradiologyinformaticsusers
SocietyofNuclearMedicine SeethediscussionontheSocietyofNuclearMedicine–TechnologistSection
Summary 1 •Amajorpartofthefabricofaprofessionisitsorganizations,especiallytheaccreditingagenciesforeducationalprograms,the certificationbodiesforindividuals,andtheprofessionalsocietiesthatrepresenttheinterestsoftheprofessiontothepublicand government
2 •RadiologictechnologyaccreditationiscarriedoutthroughthevariousJRCs:theJRCDMS,theJRCERT,andtheJRCNMT,whichperform bothradiographyandradiationtherapyaccreditation
3 •IndividualsarecertifiedbythevariousregistriesandbystateandterritoriallicensingagenciesThenationalregistriesaretheARDMS,the ARRT,andtheNMTCBTheARRToffersregistrationinradiography,nuclearmedicine,radiationtherapy,cardiovascularinterventional technology,mammography,CT,MRI,dosimetry,andQM
4 •RTsarerepresentedbynumerousprofessionalsocietiesattheinternational,national,state,andlocallevelsAmongthemostprominent oftheseorganizationsareAHRA,ASRT,AEIRS,AVIR,ISRRT,SDMS,SMRT,andSNM–TechnologistSection
5 •RadiologistsandphysicistsarealsorepresentedbynumerousorganizationsAmongthosewiththestrongesttiestoradiologictechnology areAAPM,ACR,AIUM,AMA,ARRS,ASTRO,ISCD,RSNA,SIIM,andSNMTogether,theseorganizationsconstitutethefullstrengthof theradiologicsciencesprofessionbytheiractivitiesinaccreditation,certification,andrepresentation
Bibliography AmericanMedicalAssociation Healthcarecareersdirectory ed40Chicago:TheAssociation,Chicago;2012
EisenbergRL Radiology:anillustratedhistory StLouis:Mosby;1992
ArleneMAder,MEd,RT(R),FAEIRS,andRchardRCarlton,MS,RT(R)(CV),FAEIRS Outine
1WhatsSress?
1Fight-or-FightResponse 2CausesandEffects 2Intervenions 1Change 2Language 3Worry 4ManagngTime, 3BufferingStressors 1Exercise 2Nutrition 3VsualizatonandMedtaton 4StudySkillsandTestTakng 1StudySklTechnques 2Test-TakingTps 5Summary
Objectves
Oncompetionofthschapterhestudentwillbeabeo: Dscussthecausesandsympomsofstress Explanbehavorsandthoughtsthatncreasethefght-or-fghtresponse Anayzenterventonsthatcanbeusedtoreduceorbufferstressors
•Descrbeseveralsurvivaltechniquestoreducestress
Enumeratestepstomanagetmethroughorganzatonlmitsettingandsef-evauation Explanthebenefitofupiftsnrelationtohasses
IdentifyfoodsthatcanbeeatentosuppythebodynutrtionallywithadditonavtamnCvitaminBcomplexandmagnesium Fosterstudytechniquestoenhanceretentonandtobudnformatonintocompexconcepts •Lstthestepsforsuccessfultesttakng KeyTerms
BuffersActvitesthatdecreasethenegatveeffectsofstressbutdonotchangethestressors Fght-or-FlighResponsePhysiologicresponseresutngfromangerandfearandtrggeredbyareaormagnedthreat HassesUnexpectednegativechangesorevents
In-ControLanguageStatementsthatreflectanattitudeofchoiceandevokepostiveeelings Out-of-ControLanguageWordsorphraseshatexpressalackofcontrooverastuation StressDemandontimeenergyandresourceswthanelementofthreat StressorsEventsbothreaandmagnedthatncreasefeeingsofanxiety TimeManagementPractceofself-managementrelatedtohowtimeisused UpliftsPannedpostiveactvitestobaancehassles
WorryTimeandenergyspentconcernedforthingsoverwhichwehaveittleornocontrol
Therealvoyageofdscoveryconsissnotinseekngnewlandscapesbutinhavngneweyes MarcelProust
WhatisStress?
Thebusywordoftheradologicsciencesstudentsfledwithnewideasconceptsdemandngclassandclncaschedulesandchangngfocus LittlethoughtsgiventomanagingthestressorsassociatedwhsomuchchangeThehopeistosurvvemdtermsandfinas;tosurvivethe changngdemandsofcinicalinstructors;andtosurvvework,famiyresponsblties,andschoodemandsThefeengassocatedwiththis survvalefformayleavethestudentanxioustredhumoressirritableuncreativebutonrareoccasonsthrilledThepaththroughallofthese emotonsprovdesthebackgroundforfinalysayingImstressedout!Thefocusofthischaperisonpossbleinterventionstomanageorconrol stressorsincludngimemanagementstudyhabitsandtest-takngstrategiesandothersef-careinterventions Stresssproducedbyeventsthatarepercevedasdemandsontme,energyorresourceswiththethreatthatnotenoughtme,energy,or resourceswlbeavaabetofulfilanobligatonStudyngforanimportantexaminationsdffcultwhenafeengexstshatnotenoughtimeis avaiabletocompletehetaskThepressureisonandtheresutcanbeoverwhelminganxietyInfact thethreatisrealenoughtotheindivdua thehearrateincreasesbreathingbecomesshalowandrapidandthepersonmayhaveasurgeofenergythatseemsbetterhandledwhie pacngthefoorThebodysreadyforabigeventanddoesnotdstnguishbetweenreadinessfora100-yarddashandreadnessorapaperand-penciltestThechemstryofthebodyrespondstothebran’smessageandpreparesforphyscaactvtyWhenheresponseofthebodys tostayandcontinuestudyngthechemicalsofthebodyhavetodssipateontheirown UsualywedealwthmorethanoneeventatatimehomeandfamyresponsbilitesschooassignmentsandworkactvtiesIncombnaton theseeventsproduceacompoundingeffecFinallywesayImstressedout!Thsdecaratonshepleaforhepwhentheimitsoftoerancefor juggingmanyresponsbiliteshavebeenreached
Fight-or-FlightResponse
Thefight-or-fightresponseisthephysioogcreactontoarealorimaginedthreatarisngfromemotonsofbothfearandangerItisthebodys wayofpreparngforchangethatispercevedasthreateningThsresponseservedourspecieswelmanyyearsagowhenoursurvvalwas threaenedItprovidedawayobattletheeementsThephysioogcresponsesncudethereeaseohormonestoncreasemetabolsm increasesinfatsandsugarsforenergyandncreasesinheartrateandrespiratonBloodfowsatagreater-than-normaratetothelongmusces oftheextremiesandthecentralnervoussystemsstimuatedThisresponsesthepreparationforbattleorescape Anexampeoftrggeringofthefght-or-fightresponseiswhentheteephoneringsa2AM,wakingtheindivduafromadeepsleepAlsysems aregoassoonastheringsheardinanticpatonofbadnews;thebodyisreadyforthebatleThecallturnsouttobeawrongnumberThe outcomepresentsnoemotonaorphysicalinurybutthebodyhasreadieditselfautomaticallyforaphysicalresponseForseveralmnutesafter suchaneventapersonisunderthenfuenceothebodyschemcaresponseothepoteniathreatUntithebodyreaduststothe nonthreateningenvironment,neithersleepnorrelaxatonwilreurnThesameresponseoccursnthesettingofthreatssuchasmisseddeadines, lossofsef-esteempoortesresutsossofrendshpovercommitmentandnabltytosepersonamitsLivingnastateofconstantaertover timecanresutinserousphyscaoremotonalness
AtttudesabouselfandtheroetheenvronmentplaysntheabiitytocounterorcauseastressresponsearemportanttorecognzeWhasn themndsinthebodyIself-defeatngnegatvethoughtsarepredomnanthenbohconsciousyandsubconsciousyhebodyrespondswithan excessvereeaseofchemcasovertime,thesechemcasproducewearandtearonorgans,resulinginseriouslnessPostivehoughtsand anoptimisticviewpointcanactualydecreasethepotentalforlheathandreducehemetabolismthatchemcalytriggerstheight-or-fligh responsePositivethoughtsalsoserveasasef-fulfilngprophecyattitudesthataccuratelypredictgoomorhappnessdictatewhetherwe managedailystressorsposiveyornegatively
CausesandEffects
ThecompoundngefectofsressoverseveraweekstomonthscancontrbutetopooremotionalandphyscahealthExamplesincluderepeated cods,ulcersmuscestiffness,eevatedchoesterol,excessveseepng,irritability,andheadachesStress-reatedsymptomsareofen discountedandarenotconsderedseriousbuttheseprobemsareearlywarnngsandcanhavebothphyscaandemotonaconsequences Stresscanbecausedbysuchfactorsasadeadne;agoaoachevingallAsinschool;familyprobemsincludngunsupportvepartnersoroverdemandingparents;overcommitmen;poororganizatonaskls;healthproblems;alackofsef-confdenceorpoorself-esteem;fnancal problems;traffic;andcartroublesTheseevensaresressorsWhatisstressfutoonepersonmaynotaffectsomeoneelsebecauseof perspectveslfeexperiencesandpersonalcrcumsancesSresssndvduaandintervenionsusedtoreduceorbufferstresscanbe effectveonlywhenndvduaydentfedWhatishelpuforonepersonmaynotbehelpfuforanotherTheimportantpontsaretorecognizeyour stressorstodevelopintervenionsandtorecognizeheneedfortakngresponsbiityforyoursef Interventions
Change
FormostpeoplemaorfeeventsarestressfulandnsomecasesoverwhelmingMospeopehaveobservedothersexperiencngandcopng withmajorchangessuchasdvorcedeathofafamymemberorfriendmarriagejobossorcareerchangeByobservingthesemaorevents theobservermakesdecisonsabouthowheorshewoudhandleasimilarstuationfconfrontedWhathasnotbeenlearnedshowtohandle minorchangesorhassesInabusyetheseminorchangeshavegreatmpactExamplesareanunexpeceddeourinthenormaltraveroute toworkorschooaas-minutechangenexaminatonimeaamlyargumentandcartroubleTheseunexpectedeventscreategreatstress andthebodyrespondsinthefght-or-fghtmodeOnceagainthebodyproducesachemcaresponseandthesechemcasdisspateslowly throughincreasedrespirationincreasedheartratemuscletensonandoccasionalydigestiveupsetResponsetothesesressorsmayoccur frequentyenoughthatthebodydoesnothaveenoughtimetogetbacktoahomeostaiccondionInotherwords,thebodycanbeconstantyon alertasaresutoftheback-to-backchangngconditonsthataresomuchapartofabusyresponsbeexisence MinorchangescanbecounteredbybalancingunexpectedchangewthplannedposiveactvityThemnorchangesofenelctnegatve responsesnheformofangerdepressionpoorself-concepfrustrationordefeaPlannedpositveactiviesprovdeopportunitesto experiencejoyhappinesspostivesef-conceptoptmismandasenseofwe-beingTheseactvtiesorupiftsareotensmpeandeasyo carryoutExamplesncludecomplmentingsomeone,watchngafavortetelevsonprogram,takingawalk,beingeffcentandorganized, relaxnghavngfunhuggingandlaughing
Inyourchosenfiedostudynewconceptswillbentroducedtheanguageoftheartwillhavetobemasteredanddeadlneswlneedtobemet bothforhewelfareothepaientandfortheeficiencyofthedepartmentAsgoasareaccomplishedgreatreefandoyareexperiencedbut reachingthesegoaswithoutsomeplannedpostiveactviteswilltakeanemoionalandphysicalto SurvivalTechniqueforChange
Planpostiveactvitescaedupliftstobalanceunexpectednegativechangeorhassles Language
StressendstobecontagousWhensomeoneisinaperodofgreatstresssuchasaroundthetmeoffnaexaminatonshisorherwordsofen cearlyexpresshefearandfrustratonfeltasaresutoftheconcernthattimeenergyorresourceswlbeinsuffcenttogeteverythng accompshedTheexpressionofthsconcernmayalarmothersaswelasaugmenttheindividua’sfeengofrustraion ManyfactorsinfluencehowwefeeaboutevensoccurringarounduseverydayInternaevents(fghtorfght)happenevenasaresuloftheoutof-controanguageweuseTheuseofwordsorphrasesthatexpressalackofcontrolpromoesthsfeeingofbeingoutofcontrolwhichs apparentnsuchstatementsasIhavetostudyoratestandInevergettodowhatIwanttodoStatementsusedoexpressafeelngofnot havnganycontrolincudeIhaveto must never tsawfuandtsunfar TheseexampesofanguageexpressnotonyossofcontrolbuasomuchemotionthatistedtoeachphraseSayngwordssuchas“never” musthaveoawuandunfairwthoutsomestrongemoionassociatedwtheachsvruaympossbeJussayingeachofthesewords awakensfeelngsofangerfrustrationordespairinthespeaker Ifou-of-controwordscanevokenegatvefeengsthenusngn-controanguagewlproducepositvefeelngsSubstitutetermnoogytha producesfeengsofmoreconrolandlessofafght-or-fghtresponseincudesstaementssuchasIdecdedIchooseIwanttoIikeand “Ican”Itsdffculttohavestrongnegativefeelngswhenutteringstatementssuchas“Ihavedecidedtostudythiseveningformytest”and“ choosetousethismehodtocompleethisprocedureEachstatementreflectsanattitudeofchoceandevokesposivefeelingsThese statementsproducetheexpectationofreachinganattainablegoaaswelasfeelingsofdeterminatonsef-controandpleasure Inmanynstancestermsthatmaximizestressresponsesareusedwhennfactpersonalchoiceshavebeenmadebuttheyareexpressed negaivey:“IhavetogooclassThehopesthattheunsaidportions“IchosethisfeldofstudyandIhavetogotoclasstoreachmygoaNot onycanweexpresssuchchoicesnegatively,butalsoweoftenosesightofthegoaThevisionofwhomorwhatwewillbecomedrvesour choices;wthpractceourlanguagecanrefecthesedecisonspostively SurvivalTechniqueforLanguage PracticelanguagetharefectschoiceandexpressescontroloverasuationIn-conrollanguagereducestheflight-or-fightresponse Worry Duringhigh-stresstimeseveryonetendstobeoverlyconcernedaboutoutcomesandtoengagenamentaactvtyofWhatwillIdo
partofworrywoudbeelimnatedThebgprobemwthprocrastinatonsthataconstantfeeingofgultaccompanesputtingoffunpeasant tasksThebestnewsaboutprocrastnatonandtheworrytcausesitisthatwehavefulcontroloverthemDosomehngtoreducetheanxiety! Doingsomethingwrongmaybebetterhandongnothngaal!
ConsiderworrythswayMosofthethingsaboutwhichweworryneverhappenorturnoutbetterthanwethoughttheywoudAsmaportonof whaworresusistheresutoprocrastnation,whichcanbeelmnatedbytakngactonAminorpartofworrysconcernovermattersthatdonot direclyconcernusandthatmayinvolvetheworreshaotherpeoplehave SurvivalTechniqueforWorry
Whenworryingusethefolowngchecklsttoantcpatethedegreeofcontroyouhaveoverthestuation:
1 Itprobablywilnothappen
2•Itwillurnoutbeterthanexpected
3•Takingactioncanchangetheoutcome
4 Itsnotmyconcern
5 Ihavenocontroovertheoutcome
6 AmImakingamountainoutofamoehil?
ManagingTime
AnimportantpartofmanagingstressislearnngtomanagetmeCommonlypeopebelevethatnotenoughtmeisavaiabetoaccomplshal thatneedstobedoneoralthatwewanttodoBecausetheamountotmeavailablecannotbecontroledpractcngimemanagement becomesnecessary;timemanagementsself-managementrelatedtohowtmeisused ManyexternalinterrupionsarethievesoftimeTheseinterruptionsincludeteephonecastextse-massocalneworksmstakesand incompletenformationaboutassignmentsorobs,andoutsideactivitesThesefacorscanbecontrolledbysettinglmtsonhelengthof telephonecalsfyouchooseoreceivecalslmitingtimespenonsocalmedagettingaulunderstandingofassignmentsbytakngafew extraminutestocarfyandimitngoutsideactivitestemporarly SettngparameersonavailabletmesalsomportantInmanyinstancestoomanytasksareattemptedatonceThisfaluretosetparameters regardingtmehappenstothestudentwhohasresponsibliesthatncludenotonlyschooassignmentsbutasoworkhomeorfamiy responsbiitesInadditontoattempingtoomuchatonce,wemaybefacedwthothercompoundngissues,incudngsettingunreaistc deadinesfangtosaynoprocrastnatingandhavingageneraackoforganizaton ThebiggesthefoftmesndecisionThefearofmakingamistakeorofbengmperfectpromptsndecisionWithmuchtobedoneinaimited timeossofenergythroughworryandindecsonsdestruciveandwastefulIfndecisionistheproducoffearingamistakeconsderthinkngof amstakeasanopportuntytolearnandmproveonfutureactvtiesanddecsions
Settngdeadinescanprovdeopportunitesoscheduletimeforstudy,makeandtakeelephonecals,assistfamiymembers,andsocialize SchedulngactivitesgivessomeassuranceofbeingabletomeetobigationswithouslghtnganyoneApoentiaprobemassociatedwth schedulingactivtiesisthatofbengtrappedbythescheduleDeadinescangverisetofeeingsofdesperationandhelpessnessespecay whenthenumberofactivtiesthatcanbeaccompshedwthnhealottedtimeframehasbeenoverestmatedforexampealowng3hoursin anevenngtostudyforatestaongwthdongsomeotherminoractivitesonlytodscoverthatthe3-hourtmeframewasnotenoughThe individualisthentrappedintohavingtomeettheotheroblgationsandyetstlfindingtimetocompletehestudyng AlthoughschedungactvitesswisereaistctmeramesmustbesetUnrealisticestimatesofthetimeneededtocompeteapaperstudyfor anexamnatonortravetoclasscangverisetofeengsofpancThspanccantriggerthefght-or-fightresponsewhichhendeeatsthe purposeoftmemanagementThebeswaytocombattheresutofunderestmatingtmeneededistobuidncontingencypansIapapertakes longertowrtethanexpected,whataternatvesdoIhave?”“CanItakeanotherroutetoschoofthestreetrepartiesuptrafic?”Providngaway outreducesfeengsofpancandthenegativeeffectsofthefght-or-fghtresponse Thebeswaytomanagetmestopracticeself-managementThisgoanvovesfoursteps: 1KnowyourselfEvaluateyourpersonalstyleandrecognzethetmeswhenyouarenpeaksandvaleysofefectivenessCaptaizeon yourpeaktimes,andplantodoheactivitesthataremostdemandingAskyourselffyouareamornngpersonoranghtowWhendo youthnkmostclearlyandforhowlongcanyouconcentrateononeactvty?Generallythebestresultscomefromstudyngfor50to60 minutesnoneblockofimethenbreakingfor10mnutesRepeatngthscycereducesfatgueandalowsmoreproduciveuseoftime 2PrortizeresponsbiitesIdentifyatheroesyouhavethatnvoveresponsbilitythatisstudentemployeeorhousekeeperPrortize atheserolesfromhghesttolowestprortyEvaluatetmeavalableaftercassesandafterpersonalneedsandoblgationsaremet Carefuevauationofacivitiesandresponsibtiesshouldbedonetodeterminewhichitemscanberealstcaycontinuedandwhchneed tobedelegatedtosomeoneelse 3PrortizeactvitesSetprioritesaccordingtogoasandtheengthoftimethatwlbeneededtocompeteanactivitySettingaplanfora fulweekmonhortermandschedulngstudyresearchandsociaactvitesduringthesebocksoftimemaybehelpfuByookingata ong-termplanrushngatheastminutecanbeavoidedandsocalobligatonscanbemetGoalssuchasgraduatingcompetnga semester,orgettingaBinacoursemustbesetsothatactiviteswilbedrvenbythegoal 4Panforsef-careBecauseweahaveaneedforreaxatonwhichncludesexercisegamesrestandsocializinghstimeshoudbe antcpatedandplannedForsomepeopeplanningforself-careisnecessarybecausetheyearnedthework-before-payethcChances arethataloftheworkwneverbedoneconsequentyltteatentionsgventosocialactivtieseadngtoanegativevewoflifein generaForoherpeopetheoppositemaybethenormThelackofdiscipnetocompeteworkmayeadtodisappointingresuts educatonalyAbalancesrequiredbetweenworkandplaysothatthegoalscanbemetsuccessfulyandwithenthusasm
SurvivalTechniqueforManagingTime
Planyourtimeandsetgoalsbythefollowingactions
1 Knowngwhenyouaremostefective
2 Prortiznganddelegatingresponsbltywhenaddtionalresourcesexis
3•Pannngandschedulingactivtiesasfarnadvanceaspossbletoavoidlast-mnuterushing
4 Scheduingtmeorrelaxatonandfun
BufferingStressors
EvenwhenalthepostivestepstoreducestressaretakenstresscannotbeelminatedBecausemuchofhestressexperencedonadaily basscannotbechanged,thenextbestinterventionstobufertheeffectsofstressJustasamutemuflestheharshnotesoabrassinstrument, buffersarenecessarytoreducetheharmfuleffectsofthefght-or-flghtresponse
Exercise
Thefight-or-fightresponsereadiesthebodyforactonCirculationncreasesintheongmuscesandtheheartrateandrespiratonratencrease tosupplymoreoxygenothemuscesSugarsandfasaredumpedinothesysemosuppyheneededenergyforphysicalactivityIfyouare beratedinfronofyourpeers,angerrage,fear,andindignatonboilinyoursystemandcanbefetmmediatelyAchemical,norepinephrne,is releasedintothebodydurngpreparatonforactionThischemicalheghtenstheemotonaresponsehatthestresscausesIfirritatonby someoneorsomethngsthecausetheresponseisangerwhichsoftenoutoproportontothemagnitudeotheeventIfthepersonfees threaenedtheresutmaybeunreasonablefearThsresponseaccountsfortheextremereactionsoftenelctedntheormoirritabilityandloss ofsenseofhumorwhensomeonehasbeenundersressforprolongedperiodswthoutpropernterventonsParticpatoninreguaraerobc activitycontinuousrhyhmicactivitythatnvoveslargemusclesisnecessarytodsspatetheundesirabechemicalsnthesystemresuling fromstressAerobcmeansusingairtoperformtheactvtyExampesarerunningwalkingbikngandothernoncompetitiveexerciseBecause ofthedesretowinexercisedurngacompetitveeventmayincreasetensionratherthandecreaseit Exercseisnotonlynecessarytodisspateundesrablechemcasproducedbythebodybuttcanalsobeameansopreventnegativephysca andemotionalresponsesAminmumof30minutesofaerobcexercsethreetofivetmesperweekcanhavesomepositvehealthbenefts Somephysicalbeneftsarereducedrskforheartdisease,decreasedboodcholesteroeves,andreducedmuscletension ManyofourefortsnsocetyaredirectedagettingandkeepingthecompettiveedgeEgo-involvedactivitesalmostneverresutneelingsof reducedstressInfacttheymayhavethereverseefecThenoncompettiveformsofexercsearethemostbeneficalmentalyExercisings donebecausefeesrightAsenseowe-beingsproducedasaresutoftheactvityThissenseofwell-bengafterexercsingsaresultnot onyofreducngharmfulchemicalsproducedunderstressbuasoofreeasinghappychemicalsnhebrainthatproduceasenseofpeasure themostnotableofthelatterchemicalsaretheendorphnsEndorphinsreeasednhebraindurngphysicalactivityhaveareaxingeffectonthe bodyandprovdeasenseofwel-bengThseelingcontrbutestowhatiscommonlycaedtherunnershighPeoplewhoexerciseregularyook forwardothereaxngbeneftsoftheaerobcactvtywhchusualypromotesmprovedsleeppatternsincreasedenergyandstressolerance andsuppressedappette Ifpossble,fndafriendtopartcpatewithyouYouwlgiveencouragementtoeachotherTimespentwakngwithafriendprovdessomesocal timeaswelSharingamutuanterestisarewardingandsaisfyingexperence
SurvivalTechniqueforBufferingStress
Exercseaerobicallyhreetofivetimesperweekforamnimumof30mnutesasabuffertohechemcasproducedinthebodyasaresultofthe fight-or-flightresponse
Nutrition
WhenwearebusiestweareleastabletoprovidegoodnutrtionforourselvesStresscanbebufferedbyeatngthreewel-balancedmealseach dayWhenourbodyundergoesthefight-or-lghresponseonanyregularbass,levelsofthreenutrtionalsubstancesthatareimportanttousboth physicalyandmentallyvtamnCvitaminBcomplexandmagnesumaregreatyreduced VitaminCsneededforthegrowthandreparofthetissuesnthebodyandhasbeenshownobeimportantinsupportingtheimmunesystem ResearchhasshownthatvtamnChasnotreducedtheriskforgettingacommoncoldbutitmghtdecreasehelengthofthecoldand/orresutin midersymptomsFrequently,whensomeoneexperiencesastressor,suchasgettngthroughfnaexaminations,heorshemaydevelopacold andsorethroaatthattmeAsvitaminCsdepletedourresistancesdecreasedOnewaytoreplacethedepetedvitaminCstosartadiet thatncudesdark-greeneafyvegetablesfrusbroccoiBrusselssproutspotatoesandtomatoes ThecomplexofBvtamnsseemstosupportandprovdenecessaryenergytosustainusfromdayodayWhenunderagreatdealofstresswe mayoversleeporfeegroggymuchofthetmeLostvitaminBcomplexcanbereplacedbyeatingbananasgreeneayvegetablesleanmeat poutry,mk,eggs,andwholegrains MagnesumsupportstheimmunesystemReplacementofmagnesiumcomesfromeatingbananasishnutsandwhoegransAdietrichn carbohydrates(egwhebread)andsmplesugarstendstocausesuddenrisesandfalsnbloodsugarevesThisfuctuatoncancause seepnesssuggishnessandmentalethargyInaddionbecauseoftheresponseofnsuntothentroductionofsugarintohedigestvetract bloodsugarevesfasharpyThsrapddecreaseinbloodsugarlevelsprovdesthephysoogcconditonsthatcaneadtomisnterpreting informatonormakingmountansouofmoehillsVendngmachneoodsandfastoodsareotenmaorsourcesofcarbohydratesandneedo beavodedorateastcarefulyselected Goodnutrtionincudesadetthatprovidesapproprateservingsfromalfoodgroups(Fg31)TheUSDepartmenofAgricuture(USDA)has updaedthehstorcafoodpyramdwthMyPatewhichemphaszestheimportanceofhealthyfoodchoicesandbeingactveeverydayThe dietarygudelnesbeginbyemphasizngtheimportanceofbuildingaheathyplateconsstngoffivefoodgroups:fruitsvegetabesgrans protenfoods,anddaryRecommendationsincludemakinghalofyourplatefruitsandvegeables,switchngtoskmor1%mlk,makngateast hafofyourgrainswholegrainsandvaryingyourprotenfoodchocesAdditonalytsrecommendedthatindividualschoosefoodsanddrnks withitleornoaddedsugarstowatchforthesatinfoodsandoeatfewerfoodsthatarehighinsoldfatsIdentifyngyourpersonacaoriemit andstayingwthtsmportanttomaintainaheathyweghtassbengphysicallyactveMaintaningagoodnutritonabaancewilnotchange yourstressors,butitwillplaceyouaanadvantageforstayngbothphysicallyandmentalyhealthyduringstressfuleventsFormoredetaled informatonfromtheUSDAvisititswebsiteathttp://wwwchoosemypategovThswebsteprovdesatremendousvarietyofresourcesincuding oninetoolsandtipsdesignedforcolegestudentsInadditonathttps:/healhgov/detarygudelines/2015/guidenes/averycomprehensiveset ofdetaryguidenesareprovdedwhcharedesignedtopromoteaheathydetandpreventdiet-reatedchroncdiseases
Fg31USDepartmentofAgriculturesMyPate
SurvivalTechniqueforBufferingStress
Eathreenutritonalybaancedmeaseachdaytoreplacevitaminsandmineralsostthroughstress VisualizationandMeditation
OtherbuffersostressncludevsualizatonandmedatonThroughvisuaizationthendvidualcantakeamni-vacatonbymentalyrevisitnga pleasantexperienceor10or15secondsMaybeyourecallthepeaceofsttngonabeachandhearngthewaveslaptheshoreItmightbethe senceandcoolnessogettingupearlyandwtnessingasunriseMaybetstheremembranceofacampfre,ncludingthesmeofwood burningthesoundofwoodsnappingthefeeloftheheatfromthefamesandtheoyofsharingtheexperiencewithfrendsEachofthesementa eventsactualyprovidesanopportunitytoescapeandreaxbyrelvingtheeventsmomentarilyItalsoreducesthefeelingofstressandthefghtor-flghtresponsethusprovidngabriefbutrealopportunitytogetintouchwthfeengsofreaxationThisactivtyhelpsbufferday-to-day stresses MedatonasoprovdesamechansmtoescapestressbyemptyingthemndofathoughtsandfocusingononyonewordoronestatementIn Christianmeditation maybetheprocessofsharngtheweghtofresponsbilityortheblessingofsupportthroughGodsoveandacceptance Otherbuffersostressncludeprogressivereaxationdeep-muscereaxation(usuayguidedbyaudiorecordngs)bofeedbackandguided imageryItsasomportanttorelyonschoolandcommuntyresourcessuchasacampuscounselortutorsandfinancialadadvisorswhenever needed
SurvivalTechniqueforBufferingStress
Regularypractcevsualizatonorsomeformofmedtatonandutlzeschoolandcommunityresources
StudySkillsandTestTaking
StudySkillTechniques
Duringthenextewyearsofcolegeandadvanced-evestudyyouwlberequredtolearntechncanformatonthatistesteddurngeachtermIn additonyouwhavetorecapecesoflearnedinformationmuchaterandaddthemtonewmoreadvancedconceptsBecauseofthebudng ofnformatonntocomplexconceptshigher-levellearningnotsmpyabrefregurgitationoffactsmusttakeplaceAnexceentwaytoncrease theeffectvenessofstudytimeistoapplytheconceptoftmemanagementodeveopgoodstudysklsThisprocessinvolvesfiveechniques (Box31): BOX31StudySkTechniques
Reviewthematerialsoonaftertsntroduced Useasmanysensesaspossibe Planareguarscheduleofstudy Studyinagroup Atttudehepsremembering!
1RevewthemateralsoonaftertisntroducedMostinformationintroducedincasssforgottenwithin24hoursunlessstepsaretakento renforceearningit(Fg32)StudentsofendonotbegintostudyforatestbeforetheweekofthetestUsualy,agreatdealoftimehas eapsedandmuchofthemateriahasbeenforgottenAcommonthemeexpressedduringast-mnutestudyisThenstructorddntexpan verywellorTheinstrucornevertodusthat!Ifmateriasrevewedmmediatelyorwthnashorttimeaftercasstheinformationcanbe renforcedandrememberedlongerThispracticealsohepsidentfyquesionableareasinwhichunderstandngislacking
Fig32TopMassedstudyBotomSpacedrevews
2UseasmanysensesaspossbleInreviewofnformatonwritngkeyelemensorwordshasbeenshowntobebenefcalThsvisual stmuatonthroughwrtingimprntsadditonaandongerastinginformationnthebran,whichenhancesrecalaterBesideswritingthe nformatonrecethemateraaloudSayingthewordshepsformuateanotherdimensonoftheconceptandalowspracticeatsayng unamartermsThecombinationofseeingsayingandhearingusngseveralsenseshasbeenshowntoprovdeopportunitesor ncreasedretentionofinformaionandrecalDevelopingamnemonccanasobehelpfulAmnemoncisadevceusedasanadfor rememberngForexampetoremembertheheartvavesthinkleftatrumbcuspdrightatriumtrcuspd(LABRAT) 3PanaregularschedueofstudyWaitnguntitheastminutetostudyncreasesanxietytoapointthatitactualymayinterferewiththe abilitytolearnandrecainformationFrustrationsetsnasthetmetcksawayStudyingorcrammingforatestattheasmnutemayead toconfusionaboutdetaisCrammingprovidesonlyshort-termrecalPlanreguarreviewandsudyofasubectsfromthetmethemateral sirstintroducedThisacionmaybeassimpeasplanningtorereadnoteseveryotherdayforashorttimeStudeshaveshownthatshort regularperiodsostudyandreviewresulingreaterrecathanaongperodofstudyfolowedbyalongperiodofnoexposuretothe nformatonStudyingfor1hour/weekbeforeatestwithnoreviewinbetweencanresutina50%lossofrecal 4StudynagroupStudynginsmallgroupsofnomorehanfvehelpsestyourundersandingofthemateralThevareyofpercepions ofersopportuntiestoconceptualizethenformatonfrommorethanoneviewpointIfaargeamountofmaterahastobecovereddivideit amongthegroupeachpersonpreparinganareathatmaybewthintheindivduasinterestandexperiseWorknginagroupprovdesan opportunitytoeelsupportedandencouraged,thusenhancingapersonalexpecatonosuccessThestudygroupneedstofocusonagoa withmutualagreementonthepurposeofmeetngandhetaskobeaccompshedThsapproachisnecessarytoavoidtheemptatonto usethetmeforsocalzngratherthanstudyingOncethebusnessofstudyiscompetedreaxingandenjoyingthecompanyofthegroups mportantandappropriate 5AttitudehepsrememberingHavingapositveattitudeaboutthereasonforstudyingenhancesyourabltytolearnandrememberYou havesetagoaforyourprofessonafutureApproachtwthenhusasmandacan-doatitudeBecomepartoftheself-uflingprophecy thatsaysyouareincontroofyoursuccessesandfaluresAfeelingofcontronurnreducesthestressresponseandenhancesyour chancesforaheathyperodoflearning
SurvivalTechniqueforStudySkills
Planyourtimeandpreparebythefolowingactons:
1•Revewnewmateralsoonafterntroducion
2 Useasmanysensesaspossbleseeingsayingandwrting
3 Panaregularsudyschedue
4 Studywithagroupoccasonay
5 Deveopapostivecan-doattitude
Test-TakingTips
Inaddtiontopossessnggoodstudysklsfoowngafewtest-takingstrategesisalsohepfulHerearesomeusefuipsforest-takngsuccess: 1TakethedayofffromstudybeforeacomprehensivetesttoreaxandpreparebothmentallyandphysicallyLast-mnuecrammngadds toanxietyandthepossbilityofreezngonthetest
2Wearbright-coloredcothesforthetestCoorhasgreateffectonmoodsandaertness;tasorefectsfeeingsaboutthendvidual Brghtcolorspromotepostiveandoptimisticfeeings
3AvodadietulofcarbohydratesthedaybeforeandthedayoftheesCarboadingmaybehelpfutoarunnerpreparngoraongdstanceracebutnotforapersonsittngandtakinganexamnationThecarbohydratesconvertosugarprovidngtherunnerwithextra energyasheorsherunsCarbohydratesandsugarsleavethenonrunnersluggshandsleepybecauseoftheneedtometabozeallhe sugarwthoutexeringmuchenergyAwe-balanceddethatincudesprotensandcarbohydratesprovdesimprovedmentaalertness necessarywhentakingatest
4GetagoodnghtsseepbeforetheexamnatonRestaowsclearthnkingandmprovednterpretaton 5GetothetestearlytoalowyourselftmetoreaxbeorebegnningRushngattheastminuteincreasesanxetywhchcandecrease yourmentaleffectveness
6Scanthetest,andansweralthequestonsyouaresureyouknowDonotwastetimeinitalyonquestionsthatareproblematcforyou GobackandrepeattheprocedureaowngyourselfaitlemoretimetoanswerLeavequestionswhoseanswersaredffcuttorecalunt thelastThswayftsatime-mitedexaminaionmostquestonswlbeansweredevenifyouarecaughtshortoftme 7RevewyourtestwhendoneandmakecorrectionsasneededDonotbeafradtochangeanswersSomerecalmayhaveoccurred duringthetestsomequestonsprovideakeytoanswersforotherquestonsMakecertainyouhaveansweredallthequestonsIfyouare recordinganswersonananswersheetthatrequiresbackeningcircesorboxesbecertainthatthenumberofthequestoncorresponds
managingself-care 2 Bufferngofstressoccurswhentheeffectsofthefght-or-flghtresponsecanbeoffsetthroughotheractvitesMostofourstressorswillnot goawaybutwecanexerciseregularyeatwel-baancedmeasandsnacksandusesomeformofmeditationorvisuazationtoreduce temporarythephysicalandemoionaleffectsofstressTheseactivtieswlnotchangeourstressorsbuttheycanofferanopportunityto balancesomeothenegatve
3•Forsudentsagreatdealofstressistheresutofthephysicaandemotonaeffortofpreparngforclassroomandcinicaltess SuccessutesttakingdependsongoodtimemanagementandappropratestudysksaswelasongoodnutritonandrestDeveopng ndvidualzedstudyskilsnvovesmanagngtimetoalowforregularreviewperiodicstudyngroupsandpractcngmethodstoenhance earningandrememberingLettngasmanysensesaspossiberenforcenformationassstsnmprntngnformatononthebrainThis approachsespecialyimportanasconceptsarebutfromcoursetocourseAsystematcapproachtotakingthetestprevensrunnngout otmebeforealquestionshavebeenconsderedCompletealtheeasestquestonsfrstandreturnomoredifficutquestonslaterThs methodhelpsyoureaxandbudconfdenceandthelpstriggerrecalbecausequesionsareofteninterrelated 4 Mostofamaintanapostivecan-doattitudeAttitudebecomesasef-fufingprophecyIfyoubeeveyoucanacheveyourgoasyou willAssociatewhotherswhohnkpositvelyAposiveatttudeiscontagiousandneedstobefosteredbyyouandbypeopearoundyou Bibliography
DetaryGuideinesforAmericans2015-2020:EightEditonAvaiabeat:https://healthgov/dearygudelines/2015/guideinesAccessed November272017
EllsDBecomingamasterstudented15StamfordConnCengageLearning;2014 GrdanoDAEverlyGSDusekDEControllngstressandtensioned9SanFrancsco:BenamnCummings;2012 HarounLCareerdevelopmentforheathprofessionas:successinschoolandonthejobed3StLouisSaunders;2011 KirtbawskiPATest-takngskils:givingyourselfanedgeNursing1990;90(20):6 USDepartmentofAgricutureChooseMyPlategovAvalabeathttp://wwwchoosemypategov/
Critical-ThinkingandProblem-SolvingStrategies TracyHerrmannPhDRT(R)andAngieArnoldMEdRT(R) Outline
1WhatAreCriticalThinkingandProblemSolving?
1WhyLearntoThinkCriticallyandSolveProblemsintheRadiologicSciences?
2StepsinCriticalThinkingandProblemSolving, 1IdentifytheProblem, 2InvestigatetheProblem, 3FormulateViableSolutionstotheProblem, 4SelecttheBestSolution
5CriticalThinkingintheClassroomandLaboratory 6CriticalThinkingintheClinicalSetting
7AffectiveCriticalThinking, 3ClinicalApplicationsofCriticalThinkingandProblemSolving, 1Ethics, 2TechnicalSkills, 3PatientCare
4MaintainingCritical-ThinkingSkills
5Summary
Objectives
Oncompletionofthischapter,thestudentwillbeableto:
•Definecriticalthinkingandproblemsolving
•Discusstheimportanceofcriticalthinkingandproblemsolvingintheradiologicsciences
•Describetheroleofcriticalthinkinginclinicalethicalandtechnicaldecisionmaking
•Usethestepsinvolvedinproblemsolving
Applyteamworkandself-reflectionincriticalthinkingandproblemsolving Analyzeanddetermineappropriateactionsforsituationsthatrequirecriticalthinking
•Identifyprofessionalsituationsthatusecritical-thinkingandproblem-solvingskills
•Developcritical-thinkingandproblem-solvingskillsasaradiologicsciencesprofessional KeyTerms
AnalysisCarefulexaminationofthecomponentsofacomplexsituationorproblem CaseStudiesReal-lifepatientsituationsthatarestudiedandassessedforlearningpurposes
CriticalThinkingCreativeactionbasedonprofessionalknowledgeandexperienceinvolvingsoundjudgmentappliedwithhighethicalstandards andintegrity
CritiqueTypeofevaluationthatprovidesfeedbackonthequalityofaworkorcreationintheformofanopinionorreview EvaluationJudgmentordeterminationofthequalityofaworkorcreation LaboratoryExperimentsExercisesoractivitiesusedtoreinforcecognitiveconceptsthroughtheperformanceofplannedstepsusuallyinvolving theanalysisofdataandansweringofquestions
PortfolioCollectionandself-assessmentofrepresentativestudentworkandaccomplishments
PracticeStandardsDefiningstatementsoftheprofessionalroleandperformancecriteriaforapractitioner ProblemSolvingAnsweringquestionsinamethodicmannertoresolveachallengingsituation ReflectionUseofrecordinginajournalandpersonalreviewofcurrentandpastpracticestoimprovefuturedecision-makingprocesses RolePlayingActingoutasituationinarealisticmannerintheclassroomorlaboratory SynthesisCombiningmultipleareasofknowledgetocreateanewworkorunderstanding TeamworkCollaborationwithothersonthehealthcareteamtoprovidequalitypatientcare Educationisnotthefillingofapail,butthelightingofafire
WilliamButlerYeats
WhatareCriticalThinkingandProblemSolving?
Inthebroadestsense,criticalthinkingistheartofreflectingonandevaluatingyourthoughtprocessforthepurposeofimprovingitInthe radiologicsciences,criticalthinkingisareflectivedecision-makingprocessthatisnecessarybecauseeverypatientpresentsanewsituationor challengeNotwoproceduresortreatmentsarethesameEachpatientisanindividualwhomustbecaredforinauniqueandoftencreative mannerApatientsindividualityorpathologicconditioncancreateasituationthatrequiresaquickandinventiveresponsefromtheradiologic sciencesprofessionalThiscreativeactionwhenperformedappropriatelybasedonprofessionalknowledgeandexperienceisconsidered criticalthinkingCriticalthinkinginvolvessoundprofessionaljudgmentappliedwithhighethicalstandardsandintegrity CriticalthinkingisrequiredinmosthealthcaresituationsAnuncomfortableordifficultdecisionthatmustbemadeaboutapatient’scarelikely involvescritical-thinkingskillsIdentifyinginappropriateactionsorsituationsandcorrectingthemalsoinvolvecriticalthinkingChallengeswith communication,modifyingproceduresortreatmentsfromthenormalroutinewithregardtopatientcondition,andsolvingequipmentmalfunctions ortechnicalproblemsarejustafewexamplesofsituationsthatinvolveproblemsolvingandcriticalthinking WhyLearntoThinkCriticallyandSolveProblemsintheRadiologicSciences?
Professionalstandardsoftheradiologicsciencessupportanddefineproblem-solvingandcritical-thinkingskillsexpectedintheworkplace CredentialingagenciessuchastheAmericanRegistryofRadiologicTechnologists(ARRT)publishcodesofethics(seeAppendixD)These codesaddresstheexpectedconductofradiologicsciencesprofessionalstoperformprocedureswhileprovidingthehighestqualityofcareand toactinthebestinterestofthepatientinanethicalmannerProfessionalsocietiessuchastheAmericanSocietyofRadiologicTechnologists (ASRT)alsopublishpracticestandards(seeAppendixA)thatdefinespecificprofessionalexpectationsandresponsibilitiesInherentinthese professionalstandardsaretheelementsofappropriatedecision-makingskillsassociatedwithproblemsolvingandcriticalthinkingFuture employerswillexpectgraduatestohavedevelopedskillsintheseareas Topreparestudentsfortheworkforce,educationalprogramsreinforcetheexpectationsoftheprofessionalstandardsdescribedpreviouslyIn addition,theprogrammaticandinstitutionalaccreditingagenciesthatguideeducationalinstitutionsrequirethepreparationofstudentsfor thinkinganddecisionmakingthatgoeswellbeyondmemorizationForexample,theJointReviewCommitteeonEducationinRadiologic TechnologyStandardsforanAccreditedProgramintheRadiologicSciencesrequiresthatradiologicsciencesprogramsassesstheproblemsolvingandthecritical-thinkingskillsoftheirstudentsThegoalsandobjectivesofthestudentprogrammayincludeelementsofcriticalthinking includinganalysissynthesisevaluationandcritiqueDevelopmentandassessmentofthesegoalsmaybeaccomplishedinavarietyofunique waysforeachaccreditedprogramStudentsarelikelytoencounterroleplayingcasestudiesscenariosclinicalskillassessmentslaboratory experiments,complexcalculations,multifacetedmultiple-choicequestions,team-basedproblems,andmanyadditionalformsoflearning experiences,alldesignedtoevaluatestudents’critical-thinkingskillsStudentsmaybeaskedtocreateproductsoflearningordemonstrate learningthroughaportfolio,self-evaluation,orreflectionthroughrecordinginajournalStudentsmustbeopentouniquelearningexperiencesthat requirethishigherorderofthinking
StepsinCriticalThinkingandProblemSolving
ThekeytomasteringcriticalthinkingistoextendlearningbeyondmemorizationoftheconceptsoftheradiologicsciencesprofessionStudents shouldpursueadeeplong-termunderstandingofprofessionalconceptsandstandardsStudentsmaylearneffectivelybycreatingascaffoldof knowledgethatwillallowthemtomakeadditionsandrevisionsasthestudents’masteryoftheprofessiondevelopsStudentsshouldconsider eachelementoftheireducationabuildingblockorpuzzlepiecethattheymayneedtouselatertosolveacomplexclinicalproblemAfterall,the knowledgebaseoftheprofessionwillgrowwithorwithoutthestudentTable41liststhestepsinproblemsolvingandcriticalthinkingand associatedquestionsthatareansweredduringtheprocess
IdentifytheProblem
AkeyelementofcriticalthoughtisproblemsolvingThefirststepinproblemsolvingistoidentifytheproblemThisstepcanbechallenging,given thatproblemsareoftendifficulttodefineAnunclearproblemcancausefrustrationanddiscomfortAsituationortechniquemaynotbeworking foryou,and,asastudent,youmayhavedifficultydeterminingthecause InvestigatetheProblem
ThenextstepistoinvestigatebyundergoinganobjectiveexaminationofaproblemWhatdoyoualreadyknowabouttheproblem?Reviewand examineallaspectsoftheproblemandthefactorsthatmightinfluencetheoutcomeWhatarethekeyelementsoftheproblem?Whoorwhatis ormaybeaffectedbythisproblem?Whataretheimplicationsoftheproblemthatmightresultinsafetyrisksandliability?Whatarethetechnical considerations?Willmorethanonesolutionortypeofsolutionbeneeded?Identifyingtheelementsoftheproblemisimportantsothatyoucan proceedwithfindingthesolution
FormulateViableSolutionstotheProblem
Consider,develop,andformulateallpossibleviablesolutionstoaproblemBeobjectiveandbasedecisionsonprofessionalknowledge,ethics, andstandardsLooktotheseprofessionalstandards,andmodifythemtofittheuniquesituationthattheproblempresentsAcquireanyadditional informationorexpertiseasneededHaveyouexperiencedsimilarproblemsthatcanguideyoutopossiblesolutions?Besuretorefertoyour professionalreferencesorconsultwithanexpertwhennecessaryMakesureyoursourcesofinformationarereliableBecreativeandkeep safetyinmindwhencreatingsolutions
