Radiography Policy Procedures Manual

Imaging Sciences Radiography Program Policy & Procedures Manual 2026-2027

University of Arkansas Fort Smith Radiography Program 2026-2027 Policy and Procedures Manual

Table of Contents WELCOME ............................................................................................................................................ 5 INTRODUCTION UAFS Mission, Role and Scope, and Vision........................................................................................... 5 Program Mission Statement ................................................................................................................ 6 Program Goals ..................................................................................................................................... 6 Program Strategies .............................................................................................................................. 6 About the Profession ............................................................................................................................7 Administration and Faculty .................................................................................................................. 8 Faculty Positions .................................................................................................................................. 9 Clinical Sites ....................................................................................................................................... 11 ACADEMIC POLICIES Policy and Procedures Introduction .................................................................................................. 12 Student Rights and Responsibilities ................................................................................................... 12 Degree Awarded ................................................................................................................................. 13 Academic Standards .......................................................................................................................... 13 Grading System .................................................................................................................................. 13 Registry Eligible .................................................................................................................................. 14 Technology Requirements .................................................................................................................. 15 Testing Policy ..................................................................................................................................... 16 Professional Conduct in the Classroom ............................................................................................. 17 Attendance in the Classroom ............................................................................................................. 18 Tardies in the Classroom .................................................................................................................... 19 Make-up Procedures in the Classroom .............................................................................................. 19 Emergency Information ....................................................................................................................... 19 Energized On-Campus Radiography Laboratory Usage Policy ........................................................... 19 Pregnancy Policy ................................................................................................................................. 20 Miscellaneous Policies ....................................................................................................................... 22 Outstanding Clinician Award ............................................................................................................. 22 Academic Award ................................................................................................................................ 22 Graduation/Pinning ........................................................................................................................... 23 Dress Code for Pinning Ceremony ...................................................................................................... 23 ACADEMIC AND CLINICAL POLICIES Unprofessional Conduct .................................................................................................................... 23 Disciplinary Action .…………………………..…………………………………………………………………………………..........24 Probation Guidelines ......................................................................................................................... 25 Dismissal ............................................................................................................................................ 26 Sanction Rubric ................................................................................................................................. 27 Grievance Policy …..….…………….…………………………………………………………………………………………………….29 The Grievance Process…………………………………………………………………………………………………………………..32 Progression ........................................................................................................................................ 33

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University of Arkansas Fort Smith Radiography Program 2026-2027 Policy and Procedures Manual Readmission Criteria and Procedure ................................................................................................. 33 Substance Abuse Policy ..................................................................................................................... 34 Cell Phones and Electronic Devices Policy ......................................................................................... 43 Visitors ............................................................................................................................................... 43 Contingency Plan ............................................................................................................................... 43 Cancellations (Severe Weather) …………………………………………………………………. ................................... 44 Breaks/Holidays ................................................................................................................................. 44 Student Employment ......................................................................................................................... 44 Social Media Policy ............................................................................................................................. 45 Student Health Requirements .......................................................................................................... 46 Extended Illness and Disease ............................................................................................................. 48 Bereavement Leave ……...................................................................................................................... 48 CLINICAL POLICIES Professional Conduct in Clinical ......................................................................................................... 48 Clinical Participation .......................................................................................................................... 49 Dress Code ......................................................................................................................................... 51 Name Badge ...................................................................................................................................... 52 Lead Markers and Initials .................................................................................................................. 53 Personal Radiation Monitor .............................................................................................................. 53 Radiation Safety Policy and Procedures ............................................................................................. 53 Supervision and Repeat Policy ........................................................................................................... 54 Mammography Clinical Rotation Policy ............................................................................................. 55 Magnetic Resonance Imaging (MRI) Safety Policy ............................................................................. 55 Background Check Policy ................................................................................................................... 56 Attendance Policy in Clinical .............................................................................................................. 57 Tardy Policy in Clinical ....................................................................................................................... 58 Make-up Procedure in Clinical ........................................................................................................... 58 Incomplete Make-up Time ................................................................................................................ 59 Advanced Make-up Time ................................................................................................................... 59 Insurance Coverage and Accidents ……………………………………………………………………………………. ............ 59 Communicable Disease Policy ........................................................................................................... 60 Accidental Exposure to Blood or Body Fluids .................................................................................... 60 SIGNATURE PAGES Acceptance of Policy Guidelines ........................................................................................................ 63 Health Insurance Coverage ................................................................................................................ 64 Standard Precautions Statement ....................................................................................................... 65 Substance Abuse Release and Acceptance Form ………………………………………………………….….. ............. 66 Honor Code .. ...................................................................................................................................... 67 HIPAA Statement ................................................................................................................................ 68 Magnetic Resonance Imaging (MRI) Screening Form ........................................................................ 69

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University of Arkansas Fort Smith Radiography Program 2026-2027 Policy and Procedures Manual MRI Safety Policy Acknowledgement ................................................................................................ 70 Physical Abilities Requirement ........................................................................................................... 71 FORMS Counseling Record ............................................................................................................................. 73 Acknowledgement of Pregnancy Policy ............................................................................................. 75 Accident Report ………………………………………………………………..……………………………………………..…………..76 Medical Options Following Exposure to Body Fluids ............................................................................. 77 Documentation of Personal Radiation Monitor Reading Over 100 Mr ............................................. 78 EVALUATIONS Student Evaluation of Clinical Instructors .......................................................................................... 80 Student Evaluation of Clinical Training Sites ...................................................................................... 83 Clinical Performance Evaluations of Students ................................................................................... 86 MISCELLANEOUS Academic Success Center ................................................................................................................... 93 Appendix A, American Registry of Radiologic Technologist Code of Ethics ....................................... 94 Appendix B, JRCERT Practice Standards ……………………………………………………………………………..………….96 Appendix C, ASRT Standard ............................................................................................................. 149

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University of Arkansas Fort Smith Radiography Program 2026-2027 Policy and Procedures Manual

Welcome Congratulations on being selected to participate in the UAFS Radiography program. The faculty and staff at UAFS expect that your progress through the program will provide the knowledge and skills necessary for you to perform competently in your chosen profession.

This manual is designed to serve as a guide to general information about the Radiography program’s policy and procedures. Please feel free to address questions or concerns you may have with the program faculty or clinical instructors.

Please read this manual carefully. You will be held accountable for all information related to you in this manual. After reading it, you must sign and return all the forms found under “Signature Pages” to the Executive Director of Imaging Sciences by the end of the first week of school.

Introduction UAFS Mission, Role and Scope, and Vision Mission

UAFS empowers the social mobility of its students and the economic growth of the River Valley through exceptional educational opportunities and robust community partnerships.

Role and Scope

Founded in 1928, UAFS has grown in stature, role, and scope over the years into a singularly distinctive, hybrid institution. Organized and focused on teaching and learning, UAFS offers multifaceted academic and technical educational opportunities. The university provides these learning opportunities at times and places convenient to students and clients. Programs include single courses of instruction, certificates of proficiency, technical certificates, and associate, bachelor’s, and master’s degrees designed to meet a demonstrated demand of the region. In addition to certificate and degree programs, UAFS provides a wide range of customized, on-site education and training services – both pre- and postemployment –designed to meet the workforce education and retraining needs of business and service organizations.

UAFS provides a variety of public service activities for the people and organizations within its service area. Included are noncredit courses, seminars, workshops, lectures, travel, telecourses, and teleconferences organized by the University’s Center for Business and Professional Development. UAFS makes campus facilities and resources available to community organizations and enriches the quality of life of the community through sponsored activities and events.

Vision

Through dynamic academic programs, innovative research opportunities, and transformational centers of intellectual and economic development, UAFS will advance its community and become an institution renowned for educating and inspiring the ambitious students who call it home.

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University of Arkansas Fort Smith Radiography Program 2026-2027 Policy and Procedures Manual

Program Mission Statement The radiography program at UAFS College of Health, Education, and Human Sciences was established to serve the needs of the population and healthcare industry in the community and surrounding area. The program is committed to providing high-quality education through didactic courses and clinical experiences in medical radiography to produce competent and registry-eligible radiographers.

Program Goals Goal 1: Students will develop critical thinking skills.

Student Learning Outcomes: A. Students will use problem-solving skills to modify standard procedures to accommodate patient conditions and other variables.

B. Students will be able to critique images for diagnostic quality and make appropriate improvements.

Goal 2: Students will demonstrate communication skills.

Student Learning Outcomes: A. Students will demonstrate written communication skills.

B. Students will demonstrate oral communication skills.

Goal 3: Students will model professionalism.

Student Learning Outcomes: A. Students will demonstrate professional and ethical behaviors in clinical practice.

B. Students will participate in personal and professional growth opportunities.

Goal 4: Students will have the knowledge and skills required to be clinically competent in all radiographic tasks necessary for an entry-level radiographer.

Student Learning Outcomes: A. Students will apply positioning skills.

B. Students will select technical factors.

C. Students will apply the principles of radiation protection for patients, themselves, and others.

D. Students will be able to anticipate and provide appropriate patient care, safety, and comfort.

Program Strategies To achieve its mission, goals, and objectives, the program and its personnel will strive to: A. Cultivate and enhance partnerships with pertinent healthcare institutions, including institutions offering specialized and/or advanced training in the imaging sciences.

B. Prepare studies for a technologically changing workplace by providing instruction, equipment, upto-date resource material, and clinical experiences utilizing current and future technologies.

C. Conduct continuing assessments of student and employer needs in the field of radiography.

D. Appoint and retain high-quality faculty and clinical supervisors.

E. Offer a comprehensive and up-to-date radiography curriculum as suggested by the field’s recognized professional organizations including, but not limited to: ASRT, ARRT, and JRCERT. F. Address short-term and long-term continuing education needs of current and future imaging science practitioners in the community.

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University of Arkansas Fort Smith Radiography Program 2026-2027 Policy and Procedures Manual G. Provide opportunities for students to attend and participate in local and regional professional meetings and educational seminars while in the program.

H. Establish interpersonal relationships between students and faculty maximizing open and clear lines of communication, which encourage student success and personal growth as well as a desire for lifelong learning.

I. Regularly and consistently evaluate student competencies in proper positioning, exposure, protection, and patient care, in addition to the various cognitive and affective domain objectives in the program.

This program makes every effort to structure its curriculum in an effective manner thereby enabling the student radiographer to achieve the objectives set forth above. While every effort is made to provide accurate information in all materials published by this program, the University reserves the freedom to change without notice admission and certificate requirements, curriculum, courses, faculty, policies, fees, regulations, and any other information contained in its publications, should such change be deemed necessary for the improvement of the education provided by the University. This aspect of evaluation shall be an ongoing monitoring of student progress and performance to determine if objectives are being met. A final evaluation of each student’s ability to meet the program objectives shall be the student’s performance on the American Registry examination, with the determination being a pass/fail score. The results of these examinations shall be a valuable indicator in the evaluation of overall program effectiveness and may be used as a basis for change in the educational format from time to time.

The educational process for this program strives to provide a balance between the didactic and clinical experiences for the student, allowing the student to apply knowledge and skills attained in the didactic portion to the development of cognitive psychomotor, ethical, and professional skills in the clinical portion in a progressive manner.

About the Profession The curriculum of the University of Arkansas - Fort Smith’s radiography program as previously outlined has been developed to ensure that students are well qualified for their chosen profession and to meet the accreditation guidelines as set forth by the JRCERT (Joint Review Committee on Education in Radiologic Technology).

Radiographer

Occupational Description: Radiographers provide patient services using imaging modalities, as directed by physicians qualified to order and/or perform radiologic procedures. When providing patient services, they continually strive to provide quality patient care and are particularly concerned with limiting radiation exposure to patients, themselves, and others.

Radiographers exercise independent judgment in the technical performance of medical imaging procedures by adopting variable technical parameters of the procedure to the condition of the patient and by initiating lifesaving first aid and basic life support procedures as necessary during medical emergencies.

Job Description: Professional competence requires that radiographers apply knowledge of anatomy, physiology, positioning, and radiographic techniques in the performance of their duties. They must also be able to communicate effectively with patients, other health professionals, and the public. Additional 7

University of Arkansas Fort Smith Radiography Program 2026-2027 Policy and Procedures Manual duties may include processing film, evaluating radiologic equipment, managing a radiographic quality assurance program, and providing patient education relevant to specific imaging procedures. The radiographer displays personal attributes of compassion, courtesy, and concern in meeting the special needs of the patient.

Employment Characteristics: Most radiographers are employed in hospitals. However, there are also positions open to qualified professionals in specialized imaging centers, urgent care clinics, private physicians’ offices, industry, and civil service and public health service facilities.

Radiographers who are employed full-time usually work 40 hours per week. Salaries and benefits vary according to experience, ability, and geographic location, but are generally competitive with those of professions requiring comparable educational preparation. Employment opportunities are available throughout the nation but may vary geographically.

Administration and Faculty Administration Dr. Terisa Riley Chancellor

Dr. Raymond Green Provost and Vice Chancellor of Academic Affairs Dr. D. Antonio Cantù, Ph.D., Dean College of Health, Education, and Human Sciences Dr. Paula Julian, APRN, FNP-C, CPN Associate Dean/Executive Director Nursing College of Health, Education, and Human Sciences

Faculty

Angie Elmore, M.Ed., R.T. (R) Assistant Professor, Executive Director Imaging Sciences Jodi Callahan, M.S.R.S., R.T. (R), RDMS, RVT Assistant Professor, Imaging Sciences Program Director, Diagnostic Medical Sonography Casey Harmon, M.S.R.S., R.T. (R) Assistant Professor, Imaging Sciences Clinical Coordinator – Radiography Alisa Cole, M.S.R.S., R.T. (R), RDMS Assistant Professor, Imaging Sciences Clinical Coordinator, Diagnostic Medical Sonography Stacy Gregory, M.Ed., R.T. (R), RDMS Senior Instructor, Imaging Sciences Alicia Redding, R.T. (R), RDMS, RVT Assistant Professor, Imaging Sciences 8

University of Arkansas Fort Smith Radiography Program 2026-2027 Policy and Procedures Manual

Faculty Positions Executive Director of Imaging Sciences

The Executive Director of Imaging Sciences is responsible for the organization, development, and coordination of the didactical and clinical portions of the radiologic technology program. This includes, but is not limited to: A. Assuring effective program operations.

B. Overseeing ongoing program assessment.

C. Participating in budget planning.

D. Maintaining current knowledge of the professional discipline and educational methodologies through continuing professional development, and E. Assuming the leadership role in the continued development of the program.

F. Official reports and recommendations G. Advisement and counseling of student course and career needs.

Clinical Coordinator

The clinical coordinator is given the responsibility for assisting in the organization, supervision, and coordination of clinical education in each of the affiliate hospitals. This responsibility includes but is not limited to: A. Correlating clinical education with didactic education.

B. Evaluating, counseling, and advising students in the clinical environment C. Participating in didactic and /or clinical instruction.

D. Assisting the clinical instructor as needed.

E. Supporting the program director to help ensure effective program operation.

F. Coordinating clinical education and evaluating its effectiveness.

G. Participating in the assessment process.

H. Cooperating with the program director in periodic review and revision of clinical course materials.

I. Maintaining current knowledge of the discipline and educational methodologies through continuing professional development, and J. Maintaining current knowledge of program policies, procedures, and student progress.

Clinical Instructor

In each clinical facility, a technologist is designated to be the clinical instructor. In addition to their responsibilities for the day-to-day operation of the department, these individuals are responsible for the supervision of clinical education. This includes, but is not limited to: A. Knowledge of program goals.

B. Understanding the clinical objectives and clinical evaluation system.

C. Understanding the sequencing of didactic instruction and clinical education.

D. Being available to assist and advise in clinical situations.

E. Evaluating students’ clinical competence.

Clinical Staff

In each clinical facility, staff radiographers assist the students in building a strong foundation in the field of Imaging Science. They provide ongoing feedback to the students. Clinical instructors and staff are considered mentors. This includes but is not limited to: 9

University of Arkansas Fort Smith Radiography Program 2026-2027 Policy and Procedures Manual A. B. C. D. E. F. G.

Understanding the clinical competency system.

Understanding the requirements for student supervision.

Establishing and maintaining open lines of communication.

Encouraging and promoting active participation and quality work.

Supporting the educational process.

Holding students accountable for all aspects of professionalism Having an understanding that these students are adult learners with a multitude of backgrounds and life experiences.

H. Sharing knowledge and professional experiences.

I. Maintaining current knowledge of program policies, procedures, and student progress.

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University of Arkansas Fort Smith Radiography Program 2026-2027 Policy and Procedures Manual

Clinical Sites/Instructors Advanced Orthopedic Specialist - Fayetteville

Mercy -Clinic - Orthopedics - River Valley

Mercy - Hospital - Paris

3900 N. Parkview Drive

3501 W.E. Knight Drive

500 E. Academy Street

Fayetteville, AR 72703

Fort Smith, AR 72903

Paris, AR 72855

479-966-4187

479-709-8333 ext. 2000

479-963-6101

Kaitlin Ingle, R.T. (R),

Braylee Calvert, R.T.(R)

Brittany Robberson, R.T. (R)

Clinical Instructor

Clinical Instructor

Clinical Instructor

Clinical Instructor

Mercy - Hospital - Booneville

Mercy - Hospital - Waldron

Arkansas Children's Northwest (ACNW)

880 W. Main Street Booneville, AR 72927

1341 W. 6th Street Waldron, AR 72958

2601 Gene George Blvd.

479-675-2800

479-637-4135

Springdale, AR 72762

John Elmore, R.T. (R)(CT), RDMS

Andrea Johnston, R.T. (R)

479-279-2059

Supervisor Lab & Imaging Services

Clinical Instructor

Taliana Gregory, R.T (R)

Karen Posey, R.T. (R), RDMS

Clinical Instructor

Clinical Instructor

Mercy - Tower West

Baptist Health - Fort Smith

Mercy - Hospital - Ozark

6801 Rogers Avenue Fort Smith, AR 72903

1001 Townson Avenue

801 W. River Street

479-274-2862

Fort Smith, AR 72901

Ozark, AR 72949

Glenda Gholston, R.T.(R)(RDMS)

479-441-5166

479-667-4138

Director

Angie Roundtree, MBA-HM,R.T. (R)(CT),RDMS

Donna Randolph, R.T. (R)(CT)

Tracie Miller, R.T. (R)

RDMS Director

Clinincal Instructor

Clinical Instructor

Clinical Instructor

Mercy - Hospital - Fort Smith

Washington Regional Medical Center

Paris Morgan, R.T. (R) Clinical Instructor

7301 Rogers Avenue

3215 N. Northhills Blvd

Fort Smith, AR 72903

Fayetteville, AR 72703

479-314-6200

479-463-5432

Baptist Health - Van Buren

Jana Duncan, R.T. ®

Garry Quam, R.T. (R)

211 Crawford Memorial Drive

Supervisor Diagnostic Imaging

Clinical Instructor

Van Buren, AR 72956

Michelle Gipson, R.T. (R)

Courtnie Miller, R.T. (R)

479-474-3401

Clinical Instructor

Clinical Instructor

Sadie Matthews, R.T. (R),

Kelly Hardy, R.T. (R)

Kellie Deer, R.T.(R)(CT),RDMS Clinical Instructor

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University of Arkansas Fort Smith Radiography Program 2026-2027 Policy and Procedures Manual

Academic Policies and Procedures Introduction All students in the radiography program at UA Fort Smith will assume responsibility for observing the university rules and regulations as stated in the current university catalog and this program manual.

Each clinical affiliate has rules and regulations that must be observed while the student is assigned to a particular affiliate. Failure to comply with these rules will adversely affect student evaluations. Dismissal from the radiography program may result if, after counseling, the student fails to correct the errors.

When accepted as a student in the radiography program, the student also accepted a commitment for 21 months to become registry eligible. Please remember that you have been selected for admittance into a program, with limited entry, over others desiring entrance.

All affiliate personnel having a direct role in the education and training of the students are required to observe the policy guidelines contained in the manual. Each hospital and clinic will provide a clinical instructor who will have primary responsibility for student supervision during clinical rotations. All clinical instructors work in conjunction with and should maintain constant communication with the clinical coordinator.

The radiography program at UAFS has been developed following the guidelines set by the Joint Review Committee on Education in Radiologic Technology. The university is proud of its high educational standards and expects the radiography program to exemplify this reputation. The responsibility for maintaining these standards lies with the students, clinical instructors, administrative directors, clinical coordinator, and ultimately the Executive Director of Imaging Sciences and the administration of UAFS. NOTE: The Executive Director of Imaging Sciences reserves the right to alter or revise policy guidelines at any time.

Student Rights and Responsibilities UAFS will establish standards and regulations which will be designed to ensure unimpeded university functions and activities and to maximize the learning environment on campus.

Each student enrolling in the university assumes an obligation to behave in a manner compatible with the university’s functions as an educational institution. Conduct that is not compatible is specified in this policy and the student may be subject to disciplinary action for violations of these codes. The goal of disciplinary proceedings. Most of which will be conducted as administrative proceedings, will be to help a student avoid further inappropriate behavior and become a responsible member of the university community.

The Radiography Program has established standards to ensure that all students graduate with a high level of competency and the ability to elevate the profession's public image.

Each student accepted into the program assumes an obligation to conduct himself or herself in a manner compatible with this goal. Conduct which is found not to be compatible with program goals and policies may be subject to disciplinary action.

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University of Arkansas Fort Smith Radiography Program 2026-2027 Policy and Procedures Manual

Clinical and Academic Rights

A student will have a right to: A. Be informed of the policies and procedures of the program and its clinical affiliates.

B. Be informed of specific radiography course requirements.

C. Be evaluated based on his/her academic and/or clinical performance as outlined on the syllabus for a given course.

D. Experience competent instruction, in both academic and clinical settings.

E. Expect protection against an instructor’s or clinical supervisor’s improper disclosure of a student’s views, beliefs, or other information that may be confidential in nature.

F. Expect protection, through established procedures, against prejudiced or capricious evaluation.

Student Academic and Clinical Responsibilities

A student will have the responsibility to: A. Further inquire about program policies if he/she does not understand them or is in doubt about them.

B. Adhere to the standard of academic and clinical performance as outlined in the C. Radiography Policy and Procedures Manual and Clinical Portfolio.

D. Diligently adhere to the program policies and procedures as outlined in the E. Radiography Policy and Procedures Manual and Clinical Portfolio.

F. Adhere to the policies and procedures of each clinical rotation site to which he/she may be assigned.

G. Pursue the proper grievance procedures as outlined in both the Radiography Policy and Procedures Manual and the University of Arkansas-Fort Smith Student Handbook & Code of Conduct if he/she believes his/her academic or clinical rights have been violated.

H. Complete all program coursework and clinical assignments in the specific semester allotted, subject to time and facility constraints, and as outlined in the Radiography Policy and Procedures Manual, Clinical Portfolio, and individual course syllabi.

Degree Awarded Associate of Applied Science Degree

Academic Standards

Radiography students must maintain a 2.0 (“C” average) cumulative grade point average. Students receiving a grade less than “C” in any course in the radiography curriculum which does not carry the RISP prefix will be required to repeat the course (or an acceptable alternative). If a student receives a grade lower than a “C” in the repeated course, he/she will be subject to dismissal from the program.

Students receiving a grade of less than a “C” (75%) in any course with the RISP prefix will be dismissed from the program.

Grading System

Didactic: Grades for regular college classes will be determined by the appropriate instructors and in conjunction with UAFS policy. The program instructional staff will determine grades for radiography classes. The University of Arkansas - Fort Smith grading policy is:

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University of Arkansas Fort Smith Radiography Program 2026-2027 Policy and Procedures Manual Grading Scale: A= B= C= F=

93-100 84-92 75-83 0-74

Clinical: The Clinical Coordinator in collaboration with the Clinical Instructors will determine clinical education grades. All clinical grades will be based on criteria as outlined in the student clinical portfolios.

Because of the heavy curriculum load during the first and second semesters of enrollment in the program, it is NOT recommended that students get extra jobs, part-time or full-time.

We are aware that some students must work. However, classes and clinical are scheduled with learning objectives in mind, so student employment must be scheduled around the courses. No student’s schedule will be adjusted to accommodate the student's outside employment schedule.

(Students having trouble with grades should discuss them with the instructor as soon as possible in the semester).

Registry Eligible

To be eligible to sit for the ARRT Registry Exam (American Registry of Radiologic Technologists), all academic requirements for graduation and all clinical criteria must be successfully completed. No student will be recommended to sit for the registry examination until these requirements are met.

National Registry The American Registry of Radiologic Technologists (ARRT) is the only examining and certifying body for radiologic technologists in the United States. To become a Registered Technologist in Radiography, R.T. (R) (ARRT), students will have to successfully complete the ARRT examination.

ARRT 12225 Northland Dr. St. Paul, MN 55120-1155 Telephone Number: 651-687-0048 The ARRT examination is offered any day after student’s graduate. Students will need to make an appointment to take the examination. It is suggested that students take the examination as soon after graduation as possible.

One issue addressed for certification eligibility is the conviction of a crime, including a felony, a gross misdemeanor, or a misdemeanor with the sole exception of speeding and parking violations. All alcohol and /or drug-related violations must be reported. All potential violations must be investigated by the ARRT to determine eligibility. Individuals may file a pre-application with the ARRT to obtain a ruling on the impact of their eligibility for the examination. This pre-application may be submitted at any time either before or after entry into an accredited program. For pre-application contact the ARRT at: Ethics Review Preapplication - ARRT.

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University of Arkansas Fort Smith Radiography Program 2026-2027 Policy and Procedures Manual

Technology Requirements Purpose

Technology readiness is critical to students’ success in the Radiography online learning environment.

UAFS is a 100% bring your own device university and, while technology products must meet required technical specifications; students can select technology products based on preference.

Students should use the following technical requirements to guide their selection of a technology package for use during their academic program at UAFS. Systems purchased new within the past two years will typically come with the following recommended features.

Students should be able to do the following essential computer tasks: A. B. C. D. E. F.

Word processing Create a presentation (PowerPoint) E-mail Install/update software on their computer.

Browse the internet.

Record video on their smartphone or a camera and load that video on their computer or an online service or drive (YouTube, Google Drive). *Students may develop some of these skills in required classes as part of their degree.

Recommended Operating System and Devices

Note: Older versions may work with a supported web browser. Most new devices should work as well.

Operating Systems A. Windows 8 or newer B. Mac OS X v10.12. or higher C. Note: Chromebooks operate with Chrome OS, which is not supported by Blackboard Learn, although you may experience success with some features.

D. Note: Although you can perform many tasks in Blackboard Learn on a mobile device (iPad, iPhone, Android tablet, or phone), either through a mobile browser or the Blackboard mobile application, not all Learn’s features support a mobile format.

Minimum hardware for video, sound, Internet connection, etc.

NOTE: If you have an unsupported browser or a dial-up connection, you will have difficulties running Blackboard courses.

A. Keyboard and mouse or laptop touch pad B. RAM: 4 GB or higher C. Monitor with minimum 1024 x 768 or higher strongly recommended.

1. Sound Card and Speakers 2. Minimum broadband connection (cable or DSL) with at least a 1.5 Mbps download speed.

3. Students should have a Broadband Internet connection for running video.

4. CD-ROM and/or DVD readable drive, or USB ports and drives.

5. A webcam with a built-in microphone.

6. A computer/USB microphone, if your webcam does not have a microphone.

7. A laptop or mobile device with a camera and microphone (as an alternative to a desktop with a camera and mic).

8. Privacy screen (required).

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University of Arkansas Fort Smith Radiography Program 2026-2027 Policy and Procedures Manual NOTE: Students are required to have anti-virus software and are strongly recommended to have antimalware software. Students may be held responsible for passing along viruses if they do not have adequate software installed. Some telecommunications providers, Cox Communications for example, provide anti-virus software free of charge in addition to their service. See the provider's website for more information.

Supported Browsers:

Microsoft Internet Explorer is NOT supported. Adobe Flash support is being discontinued by all browsers by the end of 2020.

A. Google Chrome™, the most recent stable version, and two preceding versions.

B. Mozilla® Firefox®, the most recent stable version, and two preceding versions.

C. Apple® Safari® for MacOS and iOS, the two most recent major versions.

D. Microsoft® Edge® most recent stable version and two preceding versions.

Browser Checker

Students can check to see if their Web browser is supported by Blackboard by clicking the link: Blackboard Browser Checker

Additional System Requirements for Online Proctored (OLP) Assessments: A. B. C. D.

USB port or USB-compatible dongle adapter WIN 7 or Higher/Mac OS 10.11 or Higher Hard Drive Remaining Space > 20MB Internal Storage > 32MB

Supported Mobile Technology

Students can download the Blackboard app for iOS and Android mobile devices. The app should be a free download for UAFS students on both platforms.

Other Software

Plug-ins - Java (JRE) versions 7 or 8 are recommended.

Applications - UAFS recommends the following applications for online classes: A. Microsoft Office 365 B. Adobe Acrobat Reader C. VLC Media Player

Accessibility

Blackboard recommends the following screen readers: A. For Windows systems – The JAWS screen reader B. For Mac systems – The VoiceOver screen reader

Testing Policy All examinations will be administered via Examplify using a student’s personal laptop, computer, or iPad. Students must ensure adequate system requirements to use Examplify before the start of the examination. Any questions regarding software should be directed to ExamSoft help resource: (866) 429-8859 open 24/7. Students are expected to take each exam on a computer or iPad. Students will receive a download reminder prior to each exam and are responsible for downloading the 16

University of Arkansas Fort Smith Radiography Program 2026-2027 Policy and Procedures Manual exam prior to the exam date and time. Students who do not download in advance of the exam may forfeit the right to take the exam and may be given a grade of 0.

On exam days, in preparation for taking an exam using Examplify, students should: A. B. C. D. E.

Complete any computer updates in advance, as they frequently occur.

Turn off all programs, including antivirus software, and close all documents.

Fully charged computer or iPad; supplemental power may not be available.

Password must be in working order.

Respect other students during the exam by maintaining a quiet environment.

Exam Guidelines

A. A privacy screen must be on the testing device (compute or iPad). The student will not be able to test without a screen in place.

B. Leave all personal items against the back wall of the classroom, including books, notes, backpacks, bags, large coats, phones, electronic devices, smartwatches, etc.

C. No food is allowed during the exam.

D. Turn off all electronic devices except for testing device. All other devices; Cell phones smartwatches, etc; should be kept in a bag or backpack at the on the back wall.

E. A single sheet of paper can be used during the exam. Brain dumping is not allowed. Students should bring a pencil or pen. Place your name on this paper. Only your approved electronic testing device, pencil, and sheet of paper will be permitted on your desk. (No food, tissues, pencil boxes, etc. will be permitted). Remember to submit all scratch paper to the instructor prior to leaving the room once the exam is completed.

F. Wear comfortable and appropriate attire when taking an exam. No hats, scarves, caps, earbuds, earplugs, hoodies, or lab coats are permitted except for religious headgear.

G. Seats may be assigned.

H. Do not talk for any reason after you are seated for your exam.

I. Keep your eyes on your computer or iPad. Do not look around the room.

J. Keep your paper flat on your desk and between you and your computer.

K. Do not tap pencils, fingers, etcetera on the desk.

L. Leaving the room for any reason is not permitted. Go to the restroom before the exam if necessary.

M. Academic dishonesty of any type will not be tolerated (see the University honor code).

N. Exams cannot be retaken.

Professional Conduct in the Classroom Students are expected to behave professionally. Each student must take responsibility for his/her own actions, successes, and failures. If a student disagrees with the instructor, that student should approach the instructor respectfully. Students should be seeking information to learn and understand the material as well as improve in a clinical setting. In the event of a disagreement, students should refrain from being disruptive in class. Questions regarding the material should be asked during class time, with all other questions to be asked outside of class to provide the instructor with an opportunity to remedy the situation before or after class.

Anyone caught cheating or falsifying information, whether on a test, assignment, clinical documentation, or written and/or verbal disclosures, will receive a zero for a test or assignment and will be placed on probation. Other intentional misrepresentations will be addressed on an individual 17

University of Arkansas Fort Smith Radiography Program 2026-2027 Policy and Procedures Manual basis with consequences dependent upon the severity of the infraction. Actions may include dismissal.

Students are expected to come to class and/or lab prepared for that day’s lesson. Preparedness includes reading the assigned material, preparing assignments on time, and bringing necessary books and materials to class or lab. Tardiness will not be tolerated. Habitual tardiness is a sign of a poor attitude.

Tardy students disrupt the class and can interrupt the learning of other students.

Attendance in the Classroom Absenteeism

Attending class is correlated with student success. Students are required to regularly attend all scheduled classes, labs, and clinical assignments. Attendance and punctuality are two of your most important responsibilities as a student radiographer.

Any absence should be avoided. Excused absences (with supporting documentation, that must be submitted either before the absence or before returning to class/clinic/lab) may include but are not limited to: A. Illness, death of a student’s immediate family member, vehicle accident, jury duty, court appearance, or other extenuating circumstances. The Imaging Sciences ED reserves the right to review all absences and make the final determination whether the absence is excused or unexcused.

Elective surgery should be scheduled during university breaks. Doctors’ appointments should be made outside of class and clinic. Unless extenuating circumstances are determined by the executive director, the classroom absences will be treated in the following manner.

A. Students must notify each faculty of any absence. Students must email their faculty for each day of absence, at least 15 minutes prior to the start of the scheduled class or lab. The email should be specific regarding the class and reason why the student is going to miss the class. Sending a message with another student or friend does not meet this requirement. Failure to notify faculty of an absence will be considered an unexcused absence and result in a zero for all class work missed during the absence. A physician’s excuse may be requested by the instructor.

B. The second absence from class will result in a warning.

C. The third absence from class will result in an instructor/student conference.

D. After the fourth absence from class, the student will be dropped from the program, unless prior arrangements have been made with the program instructor.

E. ALL make-up work and tests are due the day the student returns to class. Ten points will be deducted each day the make-up work is late.

F. Absences to attend interviews, weddings, wedding rehearsals, vacations, etc. will not be an excused absence.

G. Failure to meet probationary guidelines will jeopardize the student’s standing in the Radiography program and may result in the student being dismissed from the program. Students will only be allowed 2 unexcused absences in a RISP course in one semester.

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University of Arkansas Fort Smith Radiography Program 2026-2027 Policy and Procedures Manual

Tardies in the Classroom For all radiography classroom courses, each tardy will be treated as an unexcused absence unless the instructor has been notified before the scheduled class time. A tardy in the classroom is defined as arriving past the scheduled starting time for class. The door will be closed and locked after the scheduled start time and the student will be considered absent.

Make-up Procedures in the Classroom Only excused absences are approved for make-up. Classwork and/or tests scheduled for the day of the absence are due the day the student returns to class. All work assigned on the day of the absence may be made up and turned in no later than the next scheduled class period. It is the student’s responsibility to ask for make-up work, turn in late assignments (due to the absence), or schedule the make-up test with the instructor the day he/she returns to class. If an excused absence occurs on a scheduled test day, the student should be prepared to take a make-up test which will differ from the test given to the class.

Emergency Information

It is the student's responsibility to provide his/her current address, telephone number, and person to call in case of an emergency to the program faculty. This is necessary for notification of family in case of an emergency or if there is a need to contact the student concerning classes or labs.

Energized On-Campus Radiography Laboratory Usage Policy Students are encouraged to utilize the campus laboratory for positioning practice whenever possible.

The following guidelines must be followed when using the laboratory.

Under no circumstances shall students be allowed to operate ionizing equipment without the guidance of a faculty member. If faculty is not present, the X-ray generators will be locked in the “Off” position.

Also, the C-arm power cord will be locked to prevent the unit from being plugged into the wall. The portable unit is equipped with an integrated access code, known exclusively to faculty, who are responsible for entering it to unlock the device. This will prevent the possibility of non-compliance with accepted radiation safety practices.

Exposures may only be made using phantoms or other inanimate objects. Humans may not be imaged in the X-ray lab. Any student found x-raying a human in the lab will be dismissed.

All students must wear radiation-monitoring devices during all labs requiring exposure (no exceptions).

All equipment will be returned to its designated storage position before leaving the laboratory. Turn off all lights before leaving the laboratory.

Handle x-ray equipment and accessories with care using the guidelines taught in Radiographic Procedures classes.

Should a problem arise with any equipment while in the laboratory, inform the faculty as soon as possible.

Pick up after yourself to always keep the laboratory clean and in perfect order.

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University of Arkansas Fort Smith Radiography Program 2026-2027 Policy and Procedures Manual

Pregnancy Policy The National Council on Radiation Protection and Measurements (NCRP) recommends an occupational radiation fetal dose limit of 5.0 mSv during an entire pregnancy and less than 0.5 mSv per month as stated by the American Society of Radiologic Technologists.

Students enrolled in the Radiography program are instructed in proper safety precautions and personnel monitoring prior to being admitted to an ionizing radiation area. Students are required to abide by all safety precautions. The importance of the ALARA concept (keeping exposure as low as reasonably achievable through a combination of time, distance, and shielding) is stressed. Due to the number and variety of courses in the curriculum, and the importance of maintaining a rotational schedule through the various assignments, the amount and type of clinical rotations will not be altered based solely on pregnancy. However, reasonable modifications may be provided when medically necessary or requested through the Title IX process. Pregnant students must continue to meet all clinical education requirements. The order of clinical rotations may be changed with the approval of the faculty and the student.

Pregnancy Declaration Options

A. Not Declared Pregnant Student A student has the right to not declare their pregnancy, in which case, the student will be treated as though she were not pregnant.

B. Declared Pregnant Student A student who has voluntarily informed the Radiography Program Director, in writing, of her pregnancy and the estimated date of delivery is considered a declared pregnant student. A student has the right to declare her pregnancy and at such a time, the requirements for continuing students listed below must be followed.

The student has the option to withdraw their declaration of pregnancy in writing at any point, for any reason, without explanation. All students will be required to sign a form stating they are aware of this policy and realize that the University of Arkansas Fort Smith, the affiliated clinical sites, and personnel cannot be held liable for the problems which may occur should a student DECLARE or UNDECLARE her pregnancy.

Post Declaration Options

Following the voluntary written disclosure of pregnancy, one of the following options must be chosen and taken: A. Voluntarily withdraw from the program. No other action will be needed. If the student wants to be readmitted, the readmittance policy will be followed.

B. Continue full-time status with no modifications.

Requirements for Continuing Students

Upon declaration of pregnancy and continuing fulltime status the student will: 20

University of Arkansas Fort Smith Radiography Program 2026-2027 Policy and Procedures Manual A. Submit physician’s statement verifying pregnancy and due date. The written statement must grant permission to continue the clinical rotation by the student’s physician. The statement will be filed as content in the student’s file.

B. Counsel with the Clinical Coordinator regarding the nature of potential radiation injury associated with in-utero exposure, the regulation established by the NCRP, and the required preventative measure to be taken throughout the gestation period.

C. The student must understand that all attendance, absence, and make-up policies will still be enforced.

D. The student has the option to withdraw their declaration of pregnancy in writing at any point, for any reason, without explanation.

E. If a pregnant student elects to continue in the program after counseling, the student will be required to sign the Acknowledgement of Pregnancy Policy form (found in the Forms section).

F. Be required to attend the regular class schedule.

G. Be required to abide by the following: 1. Strict adherence to all safety precautions for protection purposes.

2. The student must provide documentation from her physician regarding any medical concerns or recommendations related to continuing full-time clinical and didactic participation. Any modifications or limitations recommended by the physician will be considered in consultation with the program faculty and, if necessary, the Title IX Coordinator.

3. Wear two (2) personnel monitoring devices, one placed on the collar and one on the abdomen for fetal monitoring. The second issued fetal dose film badge will be worn on the abdomen and under the protective apron at all times while in a radiation environment. Monthly readings will be monitored by the Clinical Coordinator and the student will be subject to an immediate leave of absence from the clinical environment if at any point the Clinical Coordinator deems it necessary. The National Council on Radiation Protection and Measurements (NCRP)recommends an occupational radiation fetal dose limit of 5.0 mSv during an entire pregnancy, and less than 0.5 mSv per month.

4. Exposure limits will apply until: the student gives birth, the student notifies the Clinical Coordinator in writing that she is no longer pregnant, or the student informs the Clinical Coordinator that she no longer wishes to be considered pregnant by revoking her previously declared pregnancy in writing.

5. At any time, the pregnant student feels that she is working in an unsafe area or under conditions she feels are detrimental, the student should remove herself immediately and report to the Program Director, Clinical Coordinator, or Clinical Instructor.

6. At no time and for no reason will the pregnant student place herself in the primary beam of radiation.

H. Be informed that, dependent on the course requirements and length of absence, she may be required to retake course(s) in their entirety.

I. A student who takes pregnancy-related leave will be permitted to return to the program at the same academic status held prior to the leave. The timing of the student’s return will be determined by the student and her healthcare provider. Upon return, the student will be provided an opportunity to complete any missed coursework or clinical competencies in 21

University of Arkansas Fort Smith Radiography Program 2026-2027 Policy and Procedures Manual accordance with program policies.

J. Realize that the student must complete, upon her return, all requirements for graduation, including required courses, clinical competencies, and rotations.

Miscellaneous Policies Policy guidelines for the following issues are outlined in the UAFS Student Handbook and Code of Conduct and will be maintained by this program: A. Alcohol And Drugs B. Student Code of Conduct C. Firearms, Explosives, Hazardous Materials, and Weapons D. Property E. Title IX Policy for Complaints of Sexual Assault and Other Forms of Sexual Harassment

Outstanding Clinician Award The radiography faculty will select a student from the graduating class to receive the “Outstanding Clinician in Radiography” Award. The recipient of this award will be presented with a plaque at the UAFS Student Recognition Award Ceremony and will have his/her name engraved on a plaque that is kept in the division’s office.

Criteria

A. Demonstration of leadership ability.

B. Demonstration of the application of theory to clinical practice.

C. Demonstration of the following professional characteristics: 1. Attendance and punctuality.

2. Ability to work with others.

3. Enthusiasm for the practice of radiography.

4. Professional conduct and appearance.

Procedure

A. The name of each student meeting the criteria above will be placed on a ballot.

B. A ballot will be given to all clinical instructors, Radiography Faculty, the clinical coordinator, and the executive director.

C. The selection will be made by majority vote.

D. The recipient of this award will not be announced until the night of the Radiography Pinning Ceremony.

Academic Award The Academic Award will be presented to the graduating student with the highest cumulative grade point average over the course of the radiography program. The recipient of this award will be presented a plaque at the UA Fort Smith Student Recognition Award Ceremony and will have his/her name engraved on a plaque that is kept in the division’s office.

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University of Arkansas Fort Smith Radiography Program 2026-2027 Policy and Procedures Manual

Graduation/Pinning Students completing the AAS degree in Radiography can walk in the May commencement ceremony.

The Radiography pinning ceremony will be held one evening during the week of commencement.

The Pinning Ceremony reflects the tradition of entering the healthcare profession and pledging an oath that the graduates will honor the Standards and Ethics of Radiologic Technology in their practice.

Dress Code for Pinning Ceremony Students will be required to dress in professional attire for the Pinning Ceremony.

A. Women may wear a solid black dress, skirt, or pants. The shortest acceptable length for dresses or skirts is the hem reaching the top of the kneecap (no exceptions). If wearing a skirt or pants, you must wear a solid white blouse. The blouse must not be see-through or low-cut. It must be clean and ironed.

B. Men should wear black pants with a solid white shirt. The shirt is to have a collar and be clean and ironed. A necktie is required.

C. Black shoes should be worn. NO flip-flops or athletic shoes.

Academic and Clinical Policies Unprofessional Conduct The following behaviors are considered unprofessional conduct and will place the student in the counseling pathway that may result in dismissal from the program: A. Lying or cheating.

B. Disrespect toward program faculty, classmates, clinical staff, UAFS faculty/staff, or patients.

C. Unauthorized possession of an exam.

D. Plagiarism.

E. Inaccurate recording, falsifying, or altering of patient information and/or wrongful conduct relating to drugs.

F. Illegal possession, sale, or distribution of drugs or other unlawful conduct relating to drugs.

G. Illegal possession of weapons.

H. Theft.

I. Charges and/or conviction of a felony.

J. Excessive tardiness or absenteeism.

K. Failing to maintain patients' information confidentially.

L. Using profanity and/or verbal and physical abuse in the classroom, campus lab, or clinical area.

M. Repeated violations of the dress code.

N. Any activity that would jeopardize the health safety, and/or welfare of the patient, the hospital staff, the instructor, students and self.

O. Being under the influence of mind-altering drugs, use of illegal drugs, and/or the use of alcohol while in class, the clinical area, or representing the University or program in public.

P. Misappropriation of supplies, equipment, and drugs.

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University of Arkansas Fort Smith Radiography Program 2026-2027 Policy and Procedures Manual Q. Leaving a clinical assignment without properly advising appropriate personnel and instructor.

R. Discriminating in the rendering of services as it relates to the human rights and dignity of the individual.

S. Committing an act that a reasonable and prudent student would not perform at his/her level in the program.

T. Omitting an act that a reasonable and prudent student would be expected to perform at his/her level in the program.

U. Failure to disclose errors to the hospital's responsible party and clinical instructor.

V. Conduct detrimental to the public interest.

W. While caring for a patient, engaging in conduct with a patient that is sexual or may be interpreted as sexual, or in any verbal behavior that is seductive or sexually demeaning to a patient, or engaging in sexual exploitation of a patient.

X. Violating the Social Media Policy.

Y. Violating the Cell Phone/Electronic Device Policy. This policy includes the use of electronic devices such as Smart Watches, tablets, and laptops.

Z. Exhibiting the inability to work respectfully with faculty, staff, and/or other health care personnel in the classroom, campus lab, or clinical agencies.

AA. Engaging in conduct that is damaging to a faculty member, staff, or another student’s reputation. (i.e., slander, defamation) These actions will result in a written warning and may be subject to progressive disciplinary action.

BB. Bullying.

CC. Failing to disclose any clinical error to the instructor and/or appropriate clinical personnel.

DD. Violating clinical affiliate policies and procedures.

EE. Violating the UAFS Student Handbook Code of Conduct.

NOTE: This list represents examples of unprofessional conduct and is not an exhaustive list of unprofessional behaviors. Disciplinary steps to be imposed will be guided by the extent of the unprofessional conduct. Disciplinary action is documented.

Disciplinary Action Students in the radiography program are required to strive to do their best and to display the professional attitude necessary to promote a positive image of radiography to patients, fellow students, technologists, physicians, the university, and the public. However, if a student fails to abide by the policies and procedures of this manual, they have failed to promote a positive image of their would-be profession and thus may become subject to probation and/or dismissal.

Removal from a Clinical Education Center

A student may be removed from a clinical education center at the request of the clinical instructor and the administrative director of the affiliate. The request must be in writing and must contain the following items: A. Objective reason(s) for the request.

B. Documentation of efforts to correct the situation.

C. The results of these efforts, and D. Any other information supporting the request.

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University of Arkansas Fort Smith Radiography Program 2026-2027 Policy and Procedures Manual The following reason(s) may be considered grounds for removal from a clinical affiliate: A. B. C. D. E.

The student has received three incident reports while at the clinical education center.

The student has demonstrated flagrant abuse of hospital policies and procedures.

Alcohol and drug abuse while at the clinical site will also result in dismissal from the program.

Irreconcilable differences.

Chronic poor performance which may be characterized by an excessive repeat rate, failure to progress, poor listening, and communication skills, and/or consistent failure to follow directions and departmental routines, excessive absences, or F. Any other circumstances which demonstrate poor student performance overall.

Probation Guidelines

A student may be placed on probation if an infraction of any of the various manual policies occurs. An “Unsatisfactory Performance Contract” (probation form) will be completed by the student, the faculty, the clinical coordinator, the Executive Director of Imaging Sciences, and the clinical instructor (if applicable). (See the Forms section of this manual). Probation will extend to the length of time designated on the contract and/or the satisfaction of the conditions of the contract agreed upon by the parties above.

The following infractions will cause the student to be placed on probation: A. The student receives less than a “C” in a course in the radiography curriculum not containing a RISP prefix.

1. Probation will extend one semester during which time the student must repeat the course (or its equivalent) and earn a “C” or better.

B. The student receives less than 75% on two of the Clinical Performance Evaluations for the clinical semester grade.

1. Probation will extend through the following semester and the completion of the subsequent semester’s clinical rotation evaluation of 75% or above.

C. A student is removed from one clinical affiliate due to unsatisfactory performance at the request of the clinical instructor and the administrative director (request must be made in writing).

1. Probation will extend until completion of the radiography program in this instance.

D. A student is performing below standards in one or more areas of his/her training academically or clinically, which includes but is not limited to the student’s clinical rotation evaluations and annual student evaluations.

1. Probation will be applied and extended at the discretion of the clinical coordinator and/or program director.

E. Chronic poor performance in either the clinical or didactic aspects of a student’s education which may include: 1. Unprofessional behavior 2. Excessive absenteeism 3. Poor communication skills 4. Lack of respect toward program faculty, university faculty and staff, clinical staff, patients, and fellow classmates 5. Or other circumstances which inhibit successful completion of the program.

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University of Arkansas Fort Smith Radiography Program 2026-2027 Policy and Procedures Manual Dismissal A student may be dismissed from the program for violations of this manual, which include but are not limited to: (1) academic dishonesty (2) failing to abide by the substance abuse policy (3) a breach of applicable code of ethics (4) unprofessional conduct (5) violation of the Supervision policy (6) student receives a grade of less than a “C” in any course in the radiography program with an RISP prefix (7) failure to earn a grade of “C” or better in a radiography curriculum course (not a RISP prefix) on the second attempt (8) violation of the Energized On-Campus Radiography Laboratory Usage Policy (9) violating Radiation Safety policy The faculty member requesting disciplinary action will follow the following steps when seeking to discipline a student for a violation of the program manual. In addition, students facing discipline from program staff, faculty, and administration will be given notice and an opportunity to be heard. The faculty member and the student may resolve the matter informally. However, the student may request the matter be resolved through the procedure below by submitting written notice to the faculty member at any point prior to resolution. Whether the matter is resolved via the informal process or the process below, the faculty member initiating the proceedings will, by a preponderance of the evidence, demonstrate the student violated the program manual. In cases where a student is dismissed immediately for a serious violation, the student retains the right to request a formal hearing under this policy.

Upon receiving written notice from the student expressing his or her desire to utilize formal disciplinary procedures, the faculty member must notify the Executive Director Imaging Sciences and request that a Hearing Officer be named to serve as the adjudicator of the matter. Within fifteen (15) days, the Executive Director Imaging Sciences must select a Hearing Officer, notify the faculty member and the student facing discipline, and select a pending date and time for a hearing. Any member of the Program faculty may serve as the Hearing Officer. However, the initiating faculty member may not be selected as the Hearing Officer for the matter.

The faculty member initiating the disciplinary process must then prepare a written summary of the violation and any written records of counseling or interventions with the student. These documents must be provided to the student at least fifteen (15) days prior to the date of the hearing. The student may submit a written defense to the Hearing Officer and the initiating faculty member no later than five (5) days prior to the date of the hearing.

At the hearing, both the initiating faculty member and the student will give opening remarks, have an opportunity to refute the allegations of the other party, and provide closing remarks. In the event the faculty member calls on any witness, the student will have an opportunity to question the witness.

Within fifteen (15) days of the conclusion of the hearing, a written decision with the applicable sanctions shall be sent to the student. The student will have five (5) days to appeal that decision to the Executive 26

University of Arkansas Fort Smith Radiography Program 2026-2027 Policy and Procedures Manual Director Imaging Sciences. The Executive Director Imaging Sciences will issue a written decision concerning the appeal within fifteen (15) days from the date the student formally appealed the decision of the hearing officer in writing.

The student will be allowed to continue in class until the appeal is fully adjudicated, unless good cause is shown. Good cause may include but is not limited to posing a danger to oneself, other students, instructors, and patients. In the event a student refuses drug testing or fails to submit test samples in a timely manner, the student may be removed from class and clinical assignments until testing samples are submitted in compliance with the manual.

Any further appeals, to the extent applicable, must conform to the appellate process set by the UAFS Student Handbook. Appeals beyond the Executive Director Imaging Sciences level may only be filed on the following grounds: (1) a procedural error occurred; (2) an objective assessment of the evidence under the preponderance of evidence standard does not support a finding of responsibility, (3) new and significant evidence has been identified after the Board hearing and the evidence was unavailable or could not have been obtained prior to the Board hearing; (4) the sanctions are inconsistent with the Sanction Rubric; or (5) that additional sanctions imposed are excessive.

Disciplinary Steps

A. Step One: A written counseling record is initiated by the faculty member and signed by the student and faculty member. It describes the student's conduct in violation of policy, lists guidelines for correction, and gives a timeframe for correction and the consequences of noncompliance.

B. Step Two: A written warning may follow verbal counseling or be initiated without previous counseling, based on the policy violation. A second documented record that describes student conduct in violation of policy, lists guidelines for correction, gives the timeframe for correction, and the consequences of non-compliance. The faculty and student both sign the written warning.

C. Probation: A written contract with the student specifying the behaviors required to correct conduct that is unprofessional or clinical performance that is unsafe. Failure to meet probationary contract guidelines during the stipulated timeframe will jeopardize the student’s standing in the Radiography program and will result in the student being dismissed from the program.

D. Dismissal: A student may be immediately dismissed from the Radiography program. Any dismissal requires documentation according to the infraction. A student has the right to initiate the formal disciplinary procedures described above.

All steps of disciplinary action are documented and maintained in the student’s file. A copy of the record is provided to the student.

Sanction Rubric Violation Type

Severity

Academic Dishonesty

Minor

Example

Recommended Sanction Copying part of an Written warning, assignment, firstremedial time plagiarism assignment

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Notes/Considerations Document in student file; emphasize academic integrity

University of Arkansas Fort Smith Radiography Program 2026-2027 Policy and Procedures Manual

Patient Safety/Clinical Violation

Substance Abuse

Major

Cheating on exams, repeated plagiarism

Dismissal from Program

Minor

Failure to follow non-critical protocol

Major

Jeopardizing health safety of patient, staff, instructor or self/others.

HIPAA breach, misappropriation of supplies, equipment, or drugs, etc.

Off-duty use detected, no impairment during clinical Impairment during clinical or lab

Counseling, additional training, probation Immediate dismissal or clinical suspension

Minor

Major

Unprofessional Conduct

Minor

Major

Code of Ethics Violation

Minor Major

Tardiness, inappropriate language, etc (see Unprofessional Conduct for more).

Harassment, discrimination, repeated unprofessional behavior, etc. (see Unprofessional Conduct for more) Minor breach in reporting or communication Falsifying patient records, serious ethical violation

Counseling, probation

Academic dishonesty undermines professional and ethical standards; zerotolerance policy applied No immediate patient harm Patient safety risk; immediate reporting required

Offer support; documented in file

Immediate dismissal

Threat to patient and student safety; may require legal reporting Verbal or written Documented; behavior warning, correction plan counseling

Probation or dismissal

Documented and reviewed by Executive Director; disciplinary actions follow established due process.

Warning, mentorship

Reinforce professional standards

Dismissal

Legal and professional implications; document thoroughly

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University of Arkansas Fort Smith Radiography Program 2026-2027 Policy and Procedures Manual Violation of Supervision Policy

Major

Grade Below “C” in RISP Course

Major

Failure to Earn “C” or Better on Second Attempt (NonRISP Course) Violation of Energized OnCampus Radiography Lab Policy Violation of Radiation Safety Policy

Major

Minor to Moderate

Major

Student performs radiography procedure without required supervision Student earns below a “C” in any RISP-prefix course

Dismissal from program

Immediate review; ensures patient and student safety

Dismissal from program

Student fails a non-RISP radiography course on second attempt Unauthorized lab use, unsafe handling of equipment

Dismissal from program

Program competency standards require a minimum “C”; no probation or remediation allowed Ensures competency standards are met

Warning, restricted lab access, or probation

Severity depends on risk to self, peers, or equipment

N shielding, making an exposure without protection, failing to follow ALARA principles, or placing others at risk

Immediate dismissal from the program

Zero tolerance; violation of fundamental safety standards with the NRC and NCRP regulations

Grievance Policy If a student believes they have been treated unfairly, arbitrarily, or inconsistently with program or university policies, he/she has the right to have the matter investigated further through informal and formal grievance procedures. Grievance procedures should not be requested frivolously and should be followed in the correct sequence outlined below.

I. Informal Grievance Step 1: Whenever possible, the student should attempt to resolve the issue directly with individual involved (e.g., instructor, staff technologist, or another student).

Step 2: If the issue is not resolved, the student should present the concern to their clinical instructor or faculty member, outlining the situation objectively. The instructor may document the matter and attempt to resolve it.

Step 3: If unresolved, the student may bring the concern to the Clinical Coordinator, who will gather information from all involved parties and document findings as appropriate.

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University of Arkansas Fort Smith Radiography Program 2026-2027 Policy and Procedures Manual Step 4: If the student remains dissatisfied, they may request a meeting with the Executive Director of Imaging Sciences. The Executive Director will document the concern and issue a written response to the student. If the matter remains unresolved after this step, the student may proceed to the Formal Grievance process.

Note: If the grievance involves a course grade, the student should begin the process at the level of the course instructor.

II. Formal Grievance (Due Process) Formal grievance procedures are used when informal procedures have been exhausted or are inappropriate—such as cases involving program dismissal or alleged violations of due process.

Step 1 – Written Request for Hearing The student must submit a written request for a formal hearing to the Executive Director of Imaging Sciences within five (5) working days of the action being grieved. The written request must include: • • • • •

The specific action or injury being appealed, The date(s) the incident occurred, The names of individuals involved, Steps taken by the student to resolve the issue informally, and Any supporting documentation or evidence.

Step 2 – Hearing Process Upon receiving the request: • The Executive Director will select a Hearing Officer, notify the faculty member and the student filing a grievance, and select a pending date and time for a hearing.

The hearing officer may include faculty not directly involved in the incident, ensuring impartiality.

• The student will be given the opportunity to review evidence, present witnesses or documentation, and respond to any statements made. Within fifteen (15) days of the conclusion of the hearing, a written decision with the applicable sanctions shall be sent to the student. The student will have five (5) days to appeal that decision.

Step 3 – Appeal If the student disagrees with the Hearing Officer’s decision, they may submit a written appeal to: A. Dean of the College of Health, Education, and Human Sciences The Dean of the College of Health, Education, and Human Sciences shall review the grievance and issue a written decision within seven (7) working days of receipt of the student’s written request.

B. Chief Operating Officer/Provost If the student wishes to appeal the Dean’s decision, a written appeal must be submitted 30

University of Arkansas Fort Smith Radiography Program 2026-2027 Policy and Procedures Manual to the Provost within three (3) working days of receiving the Dean’s decision. The Provost (or designee) shall issue a written final decision within seven (7) working days of receipt of the appeal. The decision of the Provost is final.

If a student believes that the program is not in compliance with the JRCERT Standards, the student must first follow the established program grievance procedure. If the concern is not resolved after all steps of the grievance and appeals processes have been completed, the student has the right to submit allegations of noncompliance directly to the Joint Review Committee on Education in Radiologic Technology (JRCERT). Current contact information for the JRCERT is provided below.

The JRCERT address is: Joint Review Committee on Education in Radiologic Technology, 20 North Wacker Drive, Suite 2850, Chicago, IL 60606-3182 www.jrcert.org

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University of Arkansas Fort Smith Radiography Program 2026-2027 Policy and Procedures Manual

The Grievance Process INSTRUCTOR

STUDENT

SOURCE

CLINICAL INSTRUCTOR or RADIOGRAPHY FACULTY INFORMAL PROCEDURES

RADIOGRAPHY CLINICAL COORDINATOR

IMAGING SCIENCES EXECUTIVE DIRECTOR

HEARING OFFICER

DEAN - CHEHS Appeal decisions follow the UAFS Student Handbook appellate process.

COO / PROVOST

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FORMAL PROCEDURES: ALL REQUESTS MUST BE IN WRITING

University of Arkansas Fort Smith Radiography Program 2026-2027 Policy and Procedures Manual

Progression To progress through the radiography courses, students must demonstrate competence in both the didactic and clinical components. The curriculum builds upon previous coursework so satisfactory completion of all courses is required for successful completion of the program.

Failing or withdrawing from any one of the semester’s co-requisite courses requires withdrawal from all that semester’s co-requisite courses. Radiography education is a competency-based learning system that combines didactic with clinical coursework. Satisfactory progression in both didactic and clinical courses must be achieved to attain the specific skills required of a Radiographer.

The following apply to successful progression in the radiography program: A. Radiography students must maintain a 2.0 cumulative GPA. B. Students receiving a grade less than a “C” in any radiography course, which carries the RISP prefix, will be dismissed from the program.

C. The Radiography Grading System for all RISP courses, both didactic and clinical is as follows: A = 93 –100 B = 92 – 84 C = 83 – 75 F = Below 75 D. Additional information on grading procedures is included in this manual.

E. If a student fails to progress, withdraws, or discontinues a RISP course for any reason, the student must follow the readmission criteria and procedure. The student’s application will be reviewed by the Radiography Admission Committee to determine if the student is eligible to reenter the program. The Radiography Admission Committee is comprised of all fulltime faculty and the Executive Director for the program.

Withdrawal Procedures

All withdrawals from class must be processed in the Student Advisement Center. Students who wish to withdraw from a class or change classes are governed by the policies outlined in the UAFS Course Catalog NOTE: Withdrawing from one RISP course means automatic withdrawal from the Radiography program. Failure to attend and/or pay tuition does not constitute official withdrawal. It should also be noted that students on financial aid or receiving a scholarship should check with the Financial Aid Office prior to withdrawing from class. Grades will be given in accordance with policies for withdrawal from classes found in the UAFS Academic Catalogs.

Readmission Criteria and Procedure General Information

A student who has withdrawn or received a failing grade in a radiography course may apply for readmission to the program. A student is limited to one re-enrollment into the program. If the student feels there are extenuating circumstances, he/she may request an exception be made. He/she must write a letter to the Executive Director of Imaging Sciences and to the admissions committee asking for special consideration. (The entire radiography faculty acts as the admissions committee).

Each person seeking readmission will be evaluated on a space-available basis. A position is not guaranteed. Students reentering the program are required to follow the sequential structure of the program in the 21-month time frame. Students who successfully completed one full year of the program 33

University of Arkansas Fort Smith Radiography Program 2026-2027 Policy and Procedures Manual before withdrawing might be able to enter the beginning of the second year, provided space is available, time lapsed is not more than 12 months, and approval is granted by the admissions committee. A readmittance examination to evaluate a student’s preparedness and/or level of competency will be required. Students re-entering the program due to failure in one or more courses will be required to repeat all co-reqs within that semester.

If students complete less than one full year, then students must go through the admission process to be reconsidered.

Re-admission Procedure

A person interested in re-entering the program should begin the enrollment process by scheduling a conference with the Executive Director of Imaging Sciences. The director will describe the readmission procedure more fully and answer questions. The individual should then notify the director in writing that he/she does request readmission. The director will then check the student’s file for eligibility for readmission.

Re-admission Requirements

Readmission will be based on the following criteria: A. Academic and clinical performance status at the time of withdrawal.

B. Cumulative GPA at the time of readmission request (minimum of 2.5 GPA).

C. Status of any problems previously identified as interfering with learning.

D. Instructor recommendation.

E. Interview with program faculty or admissions committee.

F. A re-admittance exam to determine student retention of previous learning will be required. The student must show competence (a minimum of 75%) for each category at the level of readmittance.

Acceptance Procedure

The applicant for readmission will receive notification of acceptance or non-acceptance within two weeks of the committee’s decision.

Transfer Students

Transfer students (from a radiography program other than UA Fort Smith’s) will be considered individually. The appropriate advisor will evaluate the general education requirements, and the compatibility of the radiography curriculum will be evaluated by the program director. Transfer students are admitted on a space-available basis. A curriculum specific comprehensive evaluation and/or letter of recommendation by the student’s former program director may be required to help evaluate a transfer student’s level of entry into the UA Fort Smith radiography program.

CHEHS Substance Abuse Policy Introduction

The University of Arkansas – Fort Smith, College of Health, Education, and Human Sciences (CHEHS) recognizes its responsibility to provide a healthy environment within which students may learn and prepare themselves to become members of the healthcare profession. We are committed to protecting the safety, health, and welfare of faculty, staff, students, and people who encounter them during scheduled learning experiences. CHEHS strictly prohibits the illicit use, possession, sale, conveyance, 34

University of Arkansas Fort Smith Radiography Program 2026-2027 Policy and Procedures Manual distribution, and manufacture of illegal drugs, intoxicants, or controlled substances in any amount or in any manner and the abuse of non-prescription and prescription drugs.

Any CHEHS student, who is taking pain or other behavior-altering medications, must provide a medical release from the prescribing physician to the Program Executive Director. Any CHEHS student who exhibits behaviors (as identified on pages 32-38) is subject to testing for cause.

Any CHEHS student who tests positive for illegal, controlled, or abuse-potential substances, and who cannot produce a valid and current prescription for the drug, will be subject to disciplinary action as specified in the Policy for the Prevention and Management of Substance Abuse.

Any CHEHS student who is aware that another CHEHS student is using or is in possession of illegal drugs, intoxicants, or controlled substances is obligated to report this information to a CHEHS faculty member immediately. It is the ethical responsibility of all to ensure that the integrity of the profession and the institution remain in good standing.

The intent of the Policy for the Prevention and Management of Substance Abuse is to identify chemically impaired students. The Policy also attempts to assist the student in the return to a competent and safe level of practice and achieving his/her educational and professional goals. Emphasis is on deterrence, education, and reintegration. All aspects of the policy are to be conducted in good faith with compassion, dignity, and confidentiality.

As a condition of enrollment, each student will sign a Substance Abuse Release Form (page 62) agreeing to adhere to the Policy for the Prevention and Management of Substance Abuse. Failure to adhere to the conditions specified in this policy will result in dismissal from your CHEHS program. This Policy is in alignment with the UAFS Philosophy. See the University Catalog for further information.

Substances-Substance-related disorders are listed in the Diagnostic and Statistical Manual of Mental Disorders, fourth edition, (DSM-IV). Substances of abuse are grouped into eleven classes: alcohol, amphetamines or similarly acting sympathomimetics, caffeine, cannabis, cocaine, hallucinogens, inhalants, nicotine, opioids, phencyclidine (PCP) or similarly acting arylcyclohexylamines and sedatives, hypnotics, or anxiolytics. The CHEHS has the authority to change the panel of tests without notice to include other illegal substances as suggested by local and national reports or circumstances.

Testing Procedures

When Testing May Occur: The CHEHS will require a student to submit to drug testing under any or all of the following circumstances: A. Upon conditional admission to any CHEHS program beginning on or after January 1, 2012.

B. Random testing as required by the clinical agencies.

C. For cause (as identified on pages 37-39).

D. As part of a substance abuse recovery program.

STUDENTS WHO REFUSE TESTING OR DO NOT SUBMIT TO TESTING IN THE 2 HOUR TIME FRAME WILL BE DISMISSED FROM THE CHEHS PROGRAM. The student is responsible for the cost of required drug screens, for MRO (Medical Review Officer) consultation, and/or split sample analysis. The student, if tested for cause, will be required to arrange 35

University of Arkansas Fort Smith Radiography Program 2026-2027 Policy and Procedures Manual for alternate mode of transportation (e.g., family or taxi) rather than self- transport.

Testing Facility: CHEHS has identified Mercy Clinic Occupational Medicine – Regions Park (a SAMHSA2approved laboratory) to perform testing utilizing the agency's policies. The clinic is located at 4300 Regions Park Circle, Fort Smith, AR. The CHEHS will use an MRO who will review and interpret test results and assure (by telephone interview with each donor whose test is lab positive) that no test result is reported as positive unless there is evidence of unauthorized use of substances involved.

Sample Collection: The collection techniques will adhere to the guidelines in accordance with US Department of Transportation 49 CFR Part 40 following chain of custody protocol. An observed specimen will be collected by the designated lab. If warranted (testing for cause or random), the student will submit appropriate laboratory specimens, within a two-hour time frame, in accordance with the University of Arkansas – Fort Smith CHEHS Policy for the Prevention and Management of Substance Abuse. The Program Executive Director will be notified of the results within 48 hours.

Positive Results: Test results will be considered positive if substance levels, excluding caffeine and nicotine, meet or exceed established threshold values for both immuno assay screening and gc/ms confirmation studies, and the Medical Review Officer Verification interview verifies unauthorized use of the substance. Split samples are saved at the original lab and may be sent to another SAMHSA-2-approved lab for additional testing at the student’s expense. If anyone's laboratory is positive for substances classified in the DSM-IV, the decision will be immediate suspension from the program.

Confidentiality

All testing information, interviews, reports, statements, and test results specifically related to the individual are confidential. The Program Executive Director or designee will receive drug test results from the lab, and only authorized persons will be allowed to review this information. Records will be maintained in a safe, locked cabinet and/or password-protected electronic database. While the issues of testing are confidential within the university community, the information regarding substance abuse and rehabilitation may need to be shared with the licensing agency upon application for licensure.

(Reference: Confidentiality issues forbid the CHEHS from disclosing drug/alcohol information about the student according to guidelines of US Department of Transportation 42 CRF Part 2).

Treatment, Referral, & Readmission

The outcome of a positive drug screen will constitute immediate suspension from the CHEHS program.

In cases where a student is dismissed immediately for a serious violation, the student retains the right to request a formal hearing under this policy. The Program Executive Director will refer persons identified as having substance abuse problems for therapeutic counseling for substance withdrawal and rehabilitation. A student will not be denied learning opportunities based on a history of substance abuse. The readmission process for a student who has previously tested positive for substance abuse will include: A. Demonstrated attendance at AA, NA, or a treatment program of choice from a legitimate substance abuse counselor for a one-year period. Evidence of participation must be presented to the CHEHS by the student. Acceptable evidence shall include: a written record with the date of each meeting, the name of each group attended, the purpose of the meeting, and the signed initials of the chairperson of each group attended, plus any pertinent information.

36

University of Arkansas Fort Smith Radiography Program 2026-2027 Policy and Procedures Manual B. Demonstration of at least one year of abstinence immediately before application through random drug screening, including drug of choice.

C. Letters of reference from all employers and sponsors within the last year.

D. A signed agreement to participate in monitoring by random drug screening consistent with the policy of the CHEHS and the clinical agency where assigned client care. The student is required to pay for testing.

E. Abstinence from the use of controlled or abused potential substances (and/or alcohol) except as prescribed by a licensed practitioner from whom medical attention is sought. The student shall inform all licensed practitioners who authorize prescriptions of controlled or abused potential substances of the student's dependency on controlled or abused potential substances, and the student shall cause all such licensed practitioners to submit a written report identifying the medication, dosage, and the date the medication was prescribed. The prescribing practitioners shall submit the report directly to the Program Executive Director or designee within ten (10) days of the date of the prescription.

F. If a student is readmitted to the Radiography program and a positive test for substance abuse is found, the student will be dismissed from the program and will be ineligible to return.

Furthermore, the student will be ineligible to receive a letter of good standing from the CHEHS program. degradation G. Readmission to any CHEHS program will constitute completing the regular admission process to begin any program and acceptance is determined in the same manner as all other students seeking admission.

Appeal Process: An explanation of the Appeal Process can be found in the Academic Policies And Procedures University of Arkansas - Fort Smith - Modern Campus Catalog™

And/or

Student Code of Conduct - University of Arkansas - Fort Smith - Modern Campus Catalog™ Testing For Cause: Any CHEHS student who demonstrates behavioral changes suspected to be related to the use of drugs, including but not limited to alcohol, will be subjected to testing. Student behaviors will be observed on campus, in the clinical agencies, and at program-related community activities. The faculty member’s decision to drug test for cause will be based on: A. Observable phenomena such as direct observation of drug use and/or physical symptoms or manifestations of being under the influence of a drug.

B. Erratic behavior, slurred speech, staggered gait, flushed face, dilated/pinpoint pupils, wide mood swings, deterioration of work performance, or other behaviors as listed in the following table.

C. Information that a student has caused or contributed to an accident that resulted in client injury potentially requiring treatment by a licensed health care professional.

D. Conviction by a court or being found guilty of a drug, alcohol, or controlled substance charge.

Any student found guilty of criminal use of drugs, alcohol, or controlled substance will be suspended from the CHEHS program.

Testing will be conducted using the following policy/procedure:

37

University of Arkansas Fort Smith Radiography Program 2026-2027 Policy and Procedures Manual A. The faculty member will have an additional faculty member or staff confirm the student’s suspicious behavior.

B. The student will be required to leave the area. Accompanied by the faculty member and witness to a location ensuring privacy and confidentiality, a discussion of the situation will ensue. A decision as to whether to a drug test will be made. The discussion and outcome of the discussion will be documented and forwarded to the Program’s Executive Director.

C. If warranted, the student will submit appropriate laboratory specimens, within a two-hour time frame, in accordance with the UAFS CHEHS Policy for the Prevention and Management of Substance Abuse and clinical agency policies. Failure to submit for testing within the two-hour time frame will result in dismissal from the CHEHS Program. In cases where a student is dismissed, the student retains the right to request a formal hearing under this policy.

D. If the clinical agency initiates random or for cause drug screening, the student will follow clinical agency policy on suspected substance abuse.

E. The student will be suspended from all clinical activities until the case has been reviewed by the appropriate personnel or committees, as designated by the Program’s Executive Director or the Dean of the CHEHS. F. If the laboratory test is negative for substances classified in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV), the student will be allowed to return to class without penalty.

Arrangements to make up missed work must be initiated by the student on the first day back to class or clinical (whichever comes first).

G. If anyone laboratory test is positive for substances classified in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV), the student will be immediately suspended from the CHEHS program.

H. Confidentiality will be maintained.

Substance Abuse Behaviors 38

University of Arkansas Fort Smith Radiography Program 2026-2027 Policy and Procedures Manual Academic & Clinical Performance

ALCOHOL

DRUGS

1. Frequently late and/or incomplete paperwork.

2. Unrealistic self-evaluation.

3. Lack of participation in group activities and class.

4. Fails multiple tests.

5. Marginal clinical performance.

1. Transfers to less demanding or more independent or isolated assignments.

2. Does not volunteer for additional or difficult assignments.

Absenteeism

1. Has frequent absences.

2. Calls in last minute.

1. Frequently late and/or incomplete paperwork.

2. Unrealistic self-evaluation.

3. Lack of participation in group activities and class.

4. Fails multiple tests.

5. Marginal clinical performance.

1. Prefers area with high usage of drug choice, decreased patient awareness and lack of supervision, i.e., intensive care unit, orthopedics, anesthesia, nursing homes, or busy surgical units.

2. Volunteers for evening or night clinical rotations.

1. Has frequent absences.

2. Calls in last minute.

Time on Unit

1. Arrives late.

2. Departs early

1. Arrives early; leaves late; skips lunch and breaks; appears at unusual hours.

Disappearances

1. Declines offer for meals or breaks with peers; eats on unit or eats alone.

1. Arrives early; leaves late; skips lunch and breaks; appears at unusual hours.

Decreased Effectiveness

1. Displays inconsistent or erratic performance.

2. Fails to meet deadlines or schedules.

3. Staff complains about student not carrying share of patient assignment.

4. Patients and families complain about student’s job performance.

5. Decreasing ability to make quick judgments or to accomplish routine tasks.

6. Requires more structure for assignments and activities.

7. Experiences difficulty conceptualizing assignments.

1.

Preferences in Assignment

39

Same as alcohol

University of Arkansas Fort Smith Radiography Program 2026-2027 Policy and Procedures Manual ALCOHOL DRUGS Charting and Reporting in Clinical Setting (Nursing Only)

Appearance

Signs of Withdrawal

1. Discrepancies are indicated between the patient's and student’s reports.

2. Administers more medications than other students.

3. Omits documenting interventions.

4. Handwriting noticeably affected.

5. Makes illogical comments, and increased errors or omissions.

6. Fails to report accidents and to complete incident reports.

7. Writes reports which differ from oral reports.

1. Uses mouthwash or strong perfume to cover alcohol odor on breath and clothing.

2. Eyes are red, “bloodshot”, or bleary.

3. Spider veins appear, especially around nose.

4. Face wrinkled, flushed, and puffy.

5. Increasing carelessness about personal appearance.

6. Unkempt; hair lacks luster.

7. Avoids eye contact.

8. Appears older than age.

9. Easily fatigued.

10. Leathery skin.

11. Thin; fat in front with liver enlargement (weight slightly higher on frame than in obesity, which is in lower abdomen, hips, and thighs).

1. Hand tremors.

2. Poor coordination, and gait.

3. Diaphoresis.

4. Headaches, especially in the morning or at the beginning of the shift.

40

Same as Alcohol plus: 1. Charts as administered, but patients complain of incomplete relief from medications given.

2. Records un-witnessed or excessive breakage, waste, or loss.

3. Signs out several PRN medications at one time, i.e., "I'm going to get all my pre-ops ready now."

1. Always wears uniform with pockets.

2. Uses band-aids on hands and arms.

3. Pupils may be constricted (narcotics), or dilated (stimulants), although need to consider multi-drug use.

4. Runny eyes or nose with clear mucous drainage.

5. Malnourished, anorexic, signs of fluid and electrolyte imbalance (edema, dehydration).

1. Abdominal muscle cramps.

2. Diarrhea.

3. Irritable; restless manner.

University of Arkansas Fort Smith Radiography Program 2026-2027 Policy and Procedures Manual ALCOHOL DRUGS Illness and Injury

1. Frequent minor illnesses; vague somatic complaints (flu, virus, backache, toothache).

2. Prone to accidents.

3. Gastrointestinal problems.

4. Cirrhosis; liver malfunction.

5. Peripheral neuropathy.

6. Pancreatitis.

1. Requests drug of choice for frequent injuries which require medication or elective surgery.

2. Demonstrates low tolerance for pain and high tolerance for drugs.

3. Experiences infections, abscesses, or scar tissue from intravenous punctures.

4. Contracts hepatitis from intravenous punctures.

Common Characteristics

1. Altered states of consciousness.

2. Demonstrates wide mood swings.

3. Experiences difficulty in all types of relationships.

4. Is irritable with staff, patients, and family.

5. Acts defensive and suspicious.

6. Blames others.

7. Lies; provides inconsistent information; rationalizes and creates elaborate excuses for behavior.

8. Changing to a younger age group; most often observed in ages 40-45.

9. Socializes only with persons who drink; alcohol focus of all activities; becomes isolated.

10. Demonstrates alcohol tolerance.

11. Experiences blackouts.

12. Drinks early in the day, before parties, alone, and sneak’s drinks; sensitive to comments about drinking.

13. Uses coffee/cigarettes excessively.

14. Prone to auto accidents.

15. May have had driver’s license suspended or revoked.

16. Changing to the 40-50 age group; most often observed in the late 20’s age group.

17. Spends time alone and sleeping, restricted interests.

18. Preoccupied with obtaining and using drugs

Same as alcohol

41

Source: Oklahoma Nurse Assistance Program 6414 No. Santa Fe, Ste. A Oklahoma City, OK 73116 Phone: 405-840-3478

University of Arkansas Fort Smith Radiography Program 2026-2027 Policy and Procedures Manual

Directions to Testing Center There are 0.42 miles between your starting location and the beginning of your driving directions.

A. Start out going east on GRAND AVE. 0.09 miles B. Take the I-540 W ramp. 0.24 miles C. Merge onto I-540 W. 4.42 miles D. Take the AR-255/ZERO ST. exit - exit number 11. 0.19 miles E. Turn LEFT onto AR-255. 0.46 miles F. Turn RIGHT onto Old Greenwood Road 0.1 miles.

G. Turn LEFT onto Regions Park Drive – the facility will be on the right 190 ft.

Total Estimated Time: 8 minutes and Total Distance: 5.41 miles ORIGIN:

5210 Grand Ave. Fort Smith, AR. 72904-7362

DESTINATION:

Mercy Clinic Occupational Medicine 4300 Regions Park Circle Fort Smith, AR 72916 Phone: 479-274-6300

42

University of Arkansas Fort Smith Radiography Program 2026-2027 Policy and Procedures Manual

Cell Phones and Electronic Devices Policy NO CELL PHONES or ELECTRONIC DEVICES (including Smart Watches or devices similar to) in class or clinic. Cell phones and electronic devices such as Smart Watches are to be on vibrate or turned off and must not be audible at any time during class, lab, or clinical. Active use (texting or verbal) of a cell phone or electronic device such as a Smart Watch if in class, lab, or clinical will result in disciplinary action. For the first incident, the student will receive a counseling record and be placed on probation. Subsequent incidents will result in dismissal.

If students need to communicate with someone outside of the class and it is urgent or an emergency situation, please inform the instructor/clinical coordinator so that accommodations to this policy may be made.

Visitors

Learning experiences are designed for students officially enrolled in courses. Visitors (family, friends, children, etc.) cannot be included in scheduled activities or laboratory experiences. The Executive Director of Imaging Sciences or Dean of CHEHS must pre-approve any visitor being a part of an activity with an educational purpose.

PURPOSE

Contingency Plan

In the event of a catastrophic event or pandemic occurring and disrupting the normal learning process, the following contingency guidelines may be implemented.

Since an emergency may be sudden and without warning, these procedures are designed to be flexible to accommodate the contingencies of various types and magnitudes.

A. Unable to continue with in-classroom didactic education.

B. Unable to participate in patients’ exams in the clinical sites.

C. Provide an extension for graduation dates until students can fulfill their didactic and clinical education.

D. Consider delaying admissions to enable the currently enrolled students the opportunity to matriculate.

POLICY

Classroom Education A. Students will be notified immediately that classroom instruction must be altered or discontinued.

B. Faculty will adjust lesson plans to accommodate distance education delivery. Students will need to have reliable access to both the internet and a computer to complete coursework. Classes will be held at the scheduled time/synchronously through Blackboard and students will be required to attend.

C. Students will return to in-person classes when it is deemed safe.

Clinical Education A. Clinical rotations will continue as scheduled if possible.

B. If possible, clinical labs may continue in a controlled environment under the supervision of the faculty member.

C. If clinical rotations are halted, students will be notified immediately. Students will return to clinical sites when the faculty/administration deems it safe.

43

University of Arkansas Fort Smith Radiography Program 2026-2027 Policy and Procedures Manual D. This may mean that students could be reassigned to a different clinical facility or site, or to a nontraditional shift, such as evenings and weekends.

E. The Program will adhere to the supervision policies.

F. The Program will review and possibly revise the clinical education plan to assure that all students are provided equitable learning activities regardless of the type of facility.

The program will work with its affiliates to assure they are aware of the steps being taken to ensure student safety and to keep them apprised of the program’s plan for the students’ education.

Your education is of utmost importance to us. We will do everything in our power to ensure that you graduate on time. However, extenuating catastrophic circumstances may extend the program requirements beyond the expected graduation date. All required clinical competencies and program graduation requirements must be satisfactorily completed prior to program completion, regardless of any disruption to the normal educational process.

Cancellations (Severe Weather) When the University officially cancels classes due to snow or other severe conditions, the students are not required to go into the clinical site that day. If the University is open and the student is unable to reach his/her clinical site, he/she MUST contact program personnel as outlined under the “Attendance Policy”. Any clinical time missed must be made up by the end of the semester. The student will not be penalized if the clinical time is made up.

If the campus closes early and the student is at clinical, faculty will notify the clinical site and the students will be dismissed.

Breaks/Holidays Students will not be required to work during scheduled university breaks/holidays. However, these breaks can and should be, utilized for make-up purposes. Vacations in the radiography program shall be concurrent with the UAFS academic calendar as published in the current university academic catalog.

Students desiring to take a vacation must utilize the university's scheduled periods only. Absences due to other than normally scheduled breaks will be subject to the unexcused absence policy described previously.

Student Employment Due to hospital and/or clinic accreditation standards and the Arkansas Licensure law, students enrolled in an accredited radiography program can be employed in radiography if that student maintains enrollment and is protected under the auspices of the program. UAFS radiography students can be employed by the program’s clinical affiliates in a part-time, limited-capacity position, but are held to the policies and procedures of the radiography program unless the hospital or clinical policies are in direct conflict. At that time the employer’s policies supersede program policies. Violations of program policies and procedures may result in disciplinary actions by the program administration.

The distinction between “on the clock” and “clinical education time” must be strictly adhered to. When on clinical education time, students may NOT be substituted for regular staff or paid for clinical education. Consequently, students employed and “on the clock” may NOT use any of that time as 44

University of Arkansas Fort Smith Radiography Program 2026-2027 Policy and Procedures Manual clinical education time.

Students employed by a clinical affiliate will be required to wear a radiation monitor provided by that facility and may NOT use the UAFS radiography program’s clinical education radiation monitor while working as student employees. UAFS radiation monitoring devices will be worn while assigned to clinical education only.

Students working PRN or Flex for any Medical Imaging (Radiology) Department may NOT skip class or clinical education to work regardless of employer pressure. Violation of this policy may result in immediate probation.

Social Media Policy Purpose

To communicate potential problems and liabilities associated with the use of the Internet and electronic communication (i.e., texting, emails, etc.) systems.

Definitions

Electronic communication (i.e., texting, emails, etc.) systems – websites or web-based services that users may join, view, and/or post information to, including but not limited to weblogs (blogs), internet chat rooms, online bulletin boards, and social networking sites including but not limited to Facebook, MySpace, X, TikTok, iTunes, YouTube, LinkedIn, Flickr, Snapchat, Instagram, etc. Television, newspaper, etc.

Policy

A. Individuals may not share confidential information in violation of HIPAA or FERPA related to UAFS business on electronic communication systems, including but not limited to, personnel actions, internal investigations, research material, or patient/student/faculty information. This includes sharing photos or partial information even when names of patients, students, faculty, or employees of clinical agencies are not used. This includes any activity that would cause UAFS to not be in compliance with state or federal law.

B. Individuals assume personal liability for the information they post on electronic communication systems, including but not limited to personal commentary, medical advice, photographs, and videos. UAFS does not endorse or assume any liability for students’ personal communications.

C. Individuals must exercise appropriate discretion in sharing information, with the knowledge that such communications may be observed by patients, faculty, students, and potential employers.

D. Individuals must not post defamatory information about others, activities, or procedures at UAFS, other institutions, or clinical sites through which they rotate.

E. Individuals must not represent or imply that they are expressing the opinion of UAFS, other institutions, or clinical sites through which they rotate.

F. Individuals must not misrepresent their qualifications or post medical advice.

G. Since information posted on the Internet is public information, UAFS, and other interested parties may review electronic communication systems for content regarding current students.

H. Individuals are prohibited from using TikTok on all state-owned devices and networks across the UA System.

45

University of Arkansas Fort Smith Radiography Program 2026-2027 Policy and Procedures Manual I. Employers, organizations, and individuals may monitor and share information they find posted on electronic communication systems.

J. If potentially inappropriate material has been posted on an electronic communication system, the person who discovered the material should discuss the finding with the Executive Director of Imaging Sciences.

K. Disciplinary actions will occur in compliance with UAFS Radiography Program Professional Conduct. If any agency denies any student the right to complete time in their facility, it is an automatic dismissal from the UAFS Radiography program. In cases where a student is dismissed, the student retains the right to request a formal hearing as outlined under the Student Discipline, Grievance, and Dismissal policy.

Student Health Requirements Students must be able to complete all program requirements and meet the technical abilities of the radiography program physically and emotionally. Students will be responsible for completing all four pages (listed below) of the CHEHS Medical Release Form as documentation that they meet the prescribed abilities for successful completion of the radiography program. It is the responsibility of the student to provide updated forms to the Executive Director that details any changes in student health during enrollment in the Radiography program.

A. Page 1 Student Affirmation B. Page 2 Medical History Questionnaire C. Page 3 Physical Abilities Requirements D. Page 4 Immunizations/Certification Requirements To participate in the clinical education portion of the program, the applicant must possess additional non-academic skills. These technical standards are consistent with the duties of the entry level radiologic technologist. These standards are not limited to but include: A. Must communicate clearly and effectively (oral and written) using the English language and medical terminology with patients, coworkers, and other health care providers.

B. Must be able to hear a patient’s, co-worker’s, or visitor’s request for help; hear instructions from physicians and supervisors.

C. Must be able to distinguish phonetic sounds either mechanically transmitted or from a conversation in order to perform procedures in light-controlled areas (low light).

D. Must be able to read instructions, books, computer screens, technique charts, and patient requisitions with extreme accuracy.

E. Must be able to view images for accuracy and perform necessary imaging procedures.

Involving placement of needles, catheters, etc., into proper anatomy of the patient.

F. Must be able to perform data entry tasks using digital and computer terminals.

G. Must be able to manipulate imaging equipment using the keyboard of a computer and a mouse.

H. Must be able to stand for the majority of the workday.

I. Must be able to maneuver through congested areas or units to perform positioning procedures and transport patients.

J. Must be able to push/pull diagnostic equipment and adjust x-ray tubes to standard distance; transfer patients to and from the unit.

K. Must be able to raise arm(s) while maintaining balance when positioning a patient, reaching over a table, adjusting the x-ray tube, and adjusting diagnostic imaging equipment.

L. Must be able to work with patients and handle and dispose of body secretions, blood, urine, 46

University of Arkansas Fort Smith Radiography Program 2026-2027 Policy and Procedures Manual

stool, etc.

M. Must have adequate behavioral and social skills conducive to professionalism in a college and healthcare environment.

N. Must have the ability to complete tasks or job functions within deadlines.

O. Must complete required tasks/functions under stressful conditions.

P. Must interact appropriately with diverse personalities and populations.

Q. Hear various equipment and background sounds during equipment operations.

The student will submit/upload and have approved the required documentation of immunizations, CPR certification, and completed CHEHS Medical Release Form to his or her PreCheck/SENTRY MD immunization tracker account by the deadline to start the program. All immunizations, CPR certification, and medical releases must remain current throughout the program.

If the required records listed below are not current, the student will not be able to attend the assigned clinical rotations until compliance is met. Anytime missed will be made up and the attendance policy will be followed.

The following records are required: A. CPR certification: must be the American Heart Association Basic Life Support (BLS) for Healthcare Provider’s course. A copy must be front and back of the card, and the card must be signed.

B. Proof of immunization: 1. TST: (mantous tuberculin skin test) - initial testing: 2 step tuberculin skin testing, a blood test, or a chest X-ray (if positive) and annually thereafter.

2. TDaP: (tetanus, diphtheria, and pertussis) - students are required to have TDaP, even if the tetanus and diphtheria is less than 10 years old. TDaP is good for 10 years.

3. HP: (Hepatitis B recombinant vaccine) - three I am doses: initial dose, 2nd dose 4 weeks after the initial dose, 3rd dose 8 weeks after second dose and at least 16 weeks after the first dose.. Waiver must be signed if series is incomplete or refuses vaccine.

4. MMR: (measles, mumps, rubella vaccination) one of the following is required: 2 vaccinations or positive antibody titer for all three components (lab report required) 5. VZV: (Varicella [Chicken Pox] zoster live virus vaccine) one of the following is required: 2 vaccinations, vaccines are given 4 to 8 weeks apart; Positive antibody titer (lab report required).

6. Influenza: must have vaccination annually 7. COVID: This is not a university requirement. However, some clinical affiliates may have specific COVID-19 shot requirements and students are required to adhere to clinical affiliate requirements.

C. THE CHEHS Medical Release Form: this form is to be completed and signed by the student and their health care provider: D. Students are required to submit a completed CHEHS Medical Release Form upon entrance into a CHEHS program as well as: 1. If a student's health status changes at any time during the program, the student is required to submit a new and updated CHEHS Medical Release Form.

2. If a student's medication changes at any time during the program, the student is required to submit a new and updated CHEHS Medical Release Form. This includes adding or discontinuing prescription medications. The CHEHS Medical Release Form must be completed by the provider who prescribes/ updates the medications.

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University of Arkansas Fort Smith Radiography Program 2026-2027 Policy and Procedures Manual E. COVID-19 requirements - some clinical affiliates may have specific COVID-19 requirements students are required to adhere to clinical affiliate requirements.

F. Drug screening - students must remain drug free throughout the program. An annual drug test must be completed to fulfill clinical affiliate requirements. The student is responsible for all fees associated with any components of the drug screening process. All information will be treated as confidential. A positive drug screen will result in revocation of admission, failure to progress, or dismissal from the radiography program. Any student with diluted urine results will be expected to repeat the drug screen.

Extended Illness and Disease

A. Students must notify program faculty as soon as an extended illness (lasting more than one week) or communicable disease is diagnosed.

B. The duration and seriousness of the illness will be evaluated by the program faculty and Executive Director to determine whether the student can continue with the course of study or if a withdrawal is necessary.

C. Students absent due to extended illness or communicable disease must provide medical documentation verifying the condition and indicating when they are cleared to return to class, lab, or clinical settings.

D. Upon return, the student and program faculty will develop an individualized plan to address missed coursework, lab competencies, and clinical assignments. This plan will take into account both academic and clinical progression standards to ensure competency.

E. If the student is unable to return within a reasonable timeframe to meet program learning outcomes or clinical competency requirements, program faculty may recommend withdrawal with the opportunity to reapply or reenter the program, subject to available space and program policy.

Bereavement Leave Up to three (3) days’ bereavement leave may be granted when a death occurs in your immediate family.

Immediate family is defined as: Spouse, children, parents, mother-in-law, father-in-law, brother, sister, stepparent, stepchild, stepsister, stepbrother, grandparent, and grandchild.

One day bereavement leave may be granted when death occurs in your family to include: daughter-inlaw, son-in-law, sister-in-law, brother-in-law, step-parent-in-law, aunt, uncle, cousin, and greatgrandparent.

Clinical Policies Professional Conduct in Clinical The clinical site reserves the right to refuse acceptance of any student who is involved in any activity not considered professional or conducive to proper patient care. Students are expected to conduct themselves in a professional manner at all times. Undue conversation, excessive noise, dirty jokes, gossip, and loitering are unprofessional behaviors and should be avoided. Do not discuss personal problems with patients or staff. No personal telephone calls are to be made or received during clinical hours unless it is an emergency. Do not seek free medical advice for yourself or your family while in clinicals. Do not chew gum while in clinicals.

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University of Arkansas Fort Smith Radiography Program 2026-2027 Policy and Procedures Manual REMAIN BUSY! Take the initiative to find something to do. Cleaning and stocking of the examination rooms are helpful jobs. Be courteous to your patients and staff. Maintain a cooperative and uncomplaining attitude. Professional attitude and behavior are factors considered in recommendations for future employment. Do NOT compare one clinical site to another. Each facility is unique.

All hospital and clinical records are kept confidential. Any request for information concerning a patient should be referred to the clinical instructor. Do not discuss patients and their problems with anyone else unless authorized by the clinical instructor.

The student who is preparing to be a health care professional is expected to conform to certain standards. The following guidelines for professional conduct are expected to be demonstrated by all radiography students.

Each student is expected to: A. Demonstrate responsibility and accountability for decisions and actions.

B. Apply knowledge of legal and ethical concepts in implementing patient care.

C. Seek guidance and assistance when personal limitations are reached.

D. Be responsive to constructive criticism and attempt to improve outcomes.

E. Demonstrate punctuality for both classroom and clinical education.

F. Demonstrate preparedness for both classroom and clinical education.

G. Recognize the patient’s rights to privacy, confidentiality, and dignity.

H. Demonstrate initiative and professional growth through exploration and utilization of available resources.

I. Demonstrate a positive attitude (verbally and nonverbally) in the clinical and academic setting.

J. Perform any exam when “asked” or instructed to do so by the clinical staff under direct or indirect supervision according to the student’s competency level.

K. Demonstrate preservation of health, welfare, and safety of patients, hospital staff, instructors, and all students.

Clinical Participation It is each student’s responsibility to achieve the learning objectives by the end of each semester and all that he/she can do beyond the objectives. Incomplete objectives will result in an incomplete grade for clinical courses. Clinical instructors and many of the staff radiographers are available and willing to teach and answer questions.

Students will not be required to perform, unassisted, any radiologic examination that exceeds their educational or clinical experience. However, it is the philosophy of the program that if a student is ready to expand into an area of radiography, and the clinical instructor believes that the student is capable, the student may undertake more responsibility. Students are encouraged to learn procedures in the hospital as soon as they feel they are capable.

The student’s attitude toward work while in the program will profoundly affect his/her ability to find employment as a radiographer after graduation. For this reason, students will be expected to abide by the following: A. Students must be punctual, attentive, and cooperative in helping the radiology department accomplish its prime objective, providing patient care. Habitual or excessive absenteeism and/or 49

University of Arkansas Fort Smith Radiography Program 2026-2027 Policy and Procedures Manual tardiness reflects poor work habits and is a symptom of negligence or irresponsibility, neither of which is useful in the Radiography profession. Therefore, absences or tardiness must be avoided.

B. Students shall not leave the hospital at the end of a time shift until they have completed the procedure in progress (within reasonable limits) or made arrangements for someone else to take over and oriented them to the department of radiology. Patients are not to be left unattended while examinations are in progress. If you must stay over with a patient, a pink slip may be filled out for the time exceeding 10 minutes. The additional time must be in 5- 5-minute increments.

C. Students must report to the clinical affiliate in a professional manner. This means; being on time, correctly dressed, and not under the influence of drugs or alcohol, nor have them in their possession. Nor shall students sleep during the assigned clinical hours.

D. Students should respect the possessions of others. They shall not remove any articles from the clinical affiliate, other students, or employees of the clinical affiliate or the university.

E. A professional attitude shall be displayed toward the patient, fellow students, physicians, technologists, and faculty. Students are required to abide by the Code of Ethics of the American Registry of Radiologic Technologists found under Appendix A. All UAFS clinical affiliates are nondiscriminatory in nature without regard to color, race, creed, age, sex, religious affiliation, or national origin; however, each clinical affiliate reserves the right to refuse to allow any radiography student in the department who does not practice ethical and professional behavior or who does not consider the patient to be the most important person in each department. No unprofessional conduct will be tolerated.

F. Students must always honor patient confidentiality. All information regarding hospital procedures and patient records is confidential in nature. Any requests for information should be directed to the clinical instructor or chief technologist. Any student revealing confidential information will be subject to disciplinary action and/or DISMISSAL from the program. (Refer to HIPAA guidelines as taught).

G. Students must display initiative in the following areas: 1. Asking questions if they do not understand something.

2. Asking for help when needed.

H. Learning about the equipment.

I. Practicing positioning, critiquing films, studying, and or conducting experiments when there is no patient, AND volunteering to do exams.

J. Students having completed academic and laboratory training and testing and having passed their competency evaluation for a specific examination may not refuse to perform that examination if directed to do so by the clinical instructor or staff.

K. Any student who reports to the clinical affiliate with an improper uniform or without their personal radiation monitor, markers, or name badge will be sent home by the clinical instructor and the time will be made up that same day.

L. Visitors and the use of telephones for personal use should be avoided. Both may be allowed at the discretion of the clinical instructor or the chief technologist. Cell phones must be turned off during clinical time. Smartwatches and other electronic devices (i.e., tablets or laptops) may not be worn and/or used during clinical time.

M. Gum chewing and eating in areas that are not designated shall be avoided.

Violations of the above will result in poor clinical rotation evaluations and may lead to probation and/or dismissal from the radiography program.

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University of Arkansas Fort Smith Radiography Program 2026-2027 Policy and Procedures Manual

Dress Code

Students in the Radiography program are expected to project a professional appearance in all classrooms, laboratory, and clinical sessions. Students are not required to wear their uniform to class or lab; however, students must adhere to the general rules of decency in the classroom and laboratory (e.g., no clothing with profanity, shirts that expose breasts, and short shorts that do not cover buttock cheeks, no pajamas, no sports bras worn as shirts, or no slippers). These items can cause a distraction in the classroom and interfere with the learning of your classmates.

The student uniform is a symbol of the program and is worn with dignity and pride. A student’s personal appearance projects a professional image to patients and persons with whom contact is made.

The following dress code is required for all students while at the clinical site:

Uniform

Scrubs must be clean and wrinkle-free. Students can only wear the color (Royal Blue) and brand that has been selected for the program. A currently approved Imaging Sciences patch must be placed on the left upper arm 3 inches below the shoulder seam. The patch is to be displayed on all tops and lab coats.

A lab jacket must be purchased. It should be a long sleeve with buttons or snaps down the front. The clinical affiliates require the students to wear a lab jacket when rotating through surgery.

A white or black T-shirt (or sleeveless tank top) may be worn under the scrub. A long sleeve T-shirt is permissible; however, if the T-shirt is short-sleeved then the sleeves are not to extend below the scrub top sleeves. Any top worn underneath the scrub cannot extend below the bottom of the scrub.

Shoes

White, gray, or black athletic shoes or white nursing shoes are acceptable. Shoes should be comfortable.

Shoes should be always clean and in good repair. If they are not clean and in good repair, they should be replaced.

Socks

Only white or black socks are to be worn and cannot be visible.

Hair Hair must be clean, neatly arranged, and secured so that it does not fall below the collar or interfere with patient care or equipment operation. Hairstyles and hair colors should reflect a professional appearance appropriate for the radiography setting. Hair color should be natural or neutral in tone to maintain a professional image. Students are expected to avoid hairstyles or colors that are distracting or unprofessional in a clinical environment. Long hair should be secured with a clip, barrette, or other fastener that is neutral and discreet in appearance. Small, plain headbands without ornamentation are permitted. Acceptable headband colors include white, black, gray, or royal blue to match the uniform.

Facial Hair

A mustache or beard is permitted as long as it is kept short and neatly trimmed.

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Fingernails

University of Arkansas Fort Smith Radiography Program 2026-2027 Policy and Procedures Manual

Nails should not extend beyond the fingertips and should be kept clean. No nail polish, artificial nails or nail art may be worn.

Tattoos

Tattoos must be covered at all times while involved in clinical education, community service, or any other activity in which the program is participating.

Jewelry

Jewelry is limited to the following: A. Rings are limited to a wedding band and/or engagement ring.

B. A “non-smart” watch.

C. One small stud earring in each ear. No other visible body piercing will be allowed, including nose, tongue, eyebrow, and lip piercing(s). Also, piercing retainers (even if clear or flesh-colored) are not acceptable and cannot be worn.

D. One necklace, worn close to the neck. Long chains and other dangling jewelry are not allowed.

Cosmetics and Perfumes

Cosmetics must be used sparingly and in a manner consistent with cosmetic practices in professional settings. Students should strive to look professional and career-oriented. In clinical settings, the use of cologne, fragranced hand lotions, and perfumed bath soaps and powders are inappropriate.

Surgery Rotation

Students scheduled in surgery are expected to follow the program dress code when entering or leaving the hospital. Upon arrival, the student must wear surgery attire as provided by the hospital. Students are required to follow the hospital’s surgical protocol when entering, inside, or leaving the surgery suite.

Personal Hygiene

The student is expected to be neat in appearance with a clean uniform and shoes. Daily Personal Hygiene is Required. This will include oral hygiene, daily bathing, and the use of an effective deodorant.

The student’s body must be clean and free from odor.

Students MAY NOT smoke while in their uniforms as the odors cling to the uniform and may be offensive to the patients.

Any deviation is considered improper uniform. If students arrive at the clinical facility with the odor of tobacco or poor personal hygiene or not being in the proper uniform, he/she will be sent home and the time missed will be made up the same day.

Name Badge

The UAFS student photo ID (obtained at the Registrar’s Office in the Campus Center) must be always worn and attached to the left side of the chest. Students will wear their name badges during all clinical experiences. Name badges must not be altered or defaced. Badge reels may be used for name badges, but lanyards are prohibited. If reporting to a clinical site without an ID badge, the student must return home to retrieve it, receive a tardy, and make up for all time missed. If the badge is lost or broken, students must contact a faculty member and they must obtain a new badge from the Registrar’s office before they can return to clinical.

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University of Arkansas Fort Smith Radiography Program 2026-2027 Policy and Procedures Manual

Lead Markers and Initials

Students must purchase a set of right and left lead markers, that have personal initials and position bead indicators (bb’s), before reporting to the first clinical site assigned. Student markers must be placed on each and every image taken in which the student participates. (This includes independent student procedures and those observed). Initialing films aids in identifying and documenting student work. If students do not have the appropriate markers; they will be sent home and unable to attend clinicals until they have the required markers. Any time missed will have to be made up.

Personal Radiation Monitor

Personal radiation monitoring devices will be provided by the program and must be worn during all clinical assignments. Students will not be permitted in the clinical setting without their personal radiation monitor. If the student loses their personal radiation monitor, they will not be allowed to attend clinical until a replacement radiation monitor is obtained.

Radiation Safety Policy and Procedures A. Always wear the personal radiation monitoring device provided to you by the program faculty during clinical. Students must wear the radiation monitoring device during all labs requiring exposure (no exceptions). Never wear anyone else’s monitor. Wear the monitor on your collar and keep it outside a lead apron if one is worn. When not in use, store your monitor in a radiation-free area.

B. Student is required to properly wear their personal radiation monitor. Students WILL NOT be permitted in the clinical setting without their personal radiation monitor (no exceptions).

C. If you suspect, there has been an excessive exposure or radiation incident immediately contact your clinical instructor. This individual should immediately contact the RSO for the facility.

D. Always try to keep your radiation exposure as low as you can. Always be aware of where you are standing and how long you stay in a radiation area. Do not enter or remain in a radiation area unless it is necessary.

E. Under ordinary circumstances, no one should be allowed in the room with the patient during an Xray examination. If other personnel are needed for the examination, they must be wearing monitors and/or protective devices. They must follow safe radiation procedures and shall keep out of the direct beam. Whenever possible, use mechanical or other safe holding devices when a patient or image receptor must be held during exposure. If a person must be selected to hold, select a person who is not pregnant or potentially pregnant, is over the age of 18, and has seldom held a person during x-ray examinations. Students must not hold image receptors during any radiographic procedure.

F. Students should refrain from holding patients during exposure. Students should not hold patients during any radiographic procedure when an immobilization method is the appropriate standard of care. In the event a student has no alternative other than to hold a patient, the student must wear a lead apron during the exposure. Students MUST not hold image receptors during exposure. This is in accordance with JRCERT standards.

G. Students are to never make an exposure unless all personnel or students in the room are properly shielded with appropriate protective devices.

H. Stay in the control booth or other designated “safe” area during each exposure.

I. Always maintain visual and aural contact with the patient.

J. Restrict the x-ray beam to the area of clinical interest. The beam size must not be larger than the image receptor.

K. Do not perform fluoroscopy without the immediate supervision of a physician properly trained in 53

University of Arkansas Fort Smith Radiography Program 2026-2027 Policy and Procedures Manual fluoroscopic procedures.

L. All students in the room during fluoroscopy shall wear a lead apron.

M. Whenever a student is assigned to do a portable exam, he or she shall take along a lead apron to be worn during the exposure.

N. The doors to all radiographic rooms must be closed before an exposure is made.

O. ALL PERSONS, especially children or adults of child-bearing age, SHOULD BE GONDALLY SHIELDED unless it interferes with the study being performed.

P. Any violations of these behaviors will result in a range of actions, from warnings and/or being sent home (attendance policy will be enforced), to dismissal from the program.

The student is responsible for bringing their monitor with them as directed to the campus to exchange them for new monitors.

Current monitor reports will be available to the student within (30) school days following the receipt of the data. The monitor should always be worn at the neck level and outside of the lead apron if one is worn. Accumulated dose reports are maintained permanently on all students.

An overexposure of a personal radiation monitor is considered presumptive evidence of exposure to the individual. An exposure of 100 millirem or more per month, as reported on the Radiation Dosimetry monthly report, will result in an investigation by the Clinical Coordinator and consultation with the student. Documentation of radiation exposure, the student’s response to activities and behavior resulting in the exposure, and faculty counseling will be included in the student’s file. Excessive radiation exposure may result in limited or delayed clinical education.

Although the program provides the initial personal radiation monitor, students losing or damaging their monitor may be required to pay for a replacement.

NOTE: No exposure will be made to human subjects during laboratory or clinical practice without a doctor’s requisition.

Supervision and Repeat Policy Direct Supervision Policy

Until a student achieves and documents competency in any given procedure, all clinical assignments shall be carried out under the direct supervision of qualified radiographers. The parameters of direct supervision are: A. A qualified radiographer reviews the request for examination in relation to the student’s achievement.

B. A qualified radiographer evaluates the condition of the patient in relation to the student’s knowledge.

C. A qualified radiographer is present during the conduct of the examination.

D. A qualified radiographer reviews and approves the radiograph.

E. Students must be directly supervised during all surgical and mobile, including mobile fluoroscopy, procedures regardless of the level of competency.

Indirect Supervision Policy

Once a student successfully completes an exam for competency, they may perform that procedure with indirect supervision.

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University of Arkansas Fort Smith Radiography Program 2026-2027 Policy and Procedures Manual Indirect Supervision is defined as that supervision provided by a qualified radiographer immediately available to assist students regardless of the level of student achievement. Immediately available is interpreted as the presence of a qualified radiographer adjacent to the room or location where a radiographic procedure is being performed. This availability applies to all areas where ionizing radiation equipment is in use including bedside and surgical procedures.

Repeat Policy

In support of professional responsibility for the provision of quality patient care and radiation protection, unsatisfactory radiographs shall be repeated only in the presence of a qualified radiographer under direct supervision, regardless of the student’s level of competency.

Mammography Clinical Rotation Policy Effective January 2018 the University of Arkansas Fort Smith Radiography program has revised its policy regarding the placement of students in clinical mammography rotations to observe and/or perform breast imaging. Additionally, this placement policy may be applied to any imaging procedure performed by professionals who are of the opposite gender of the patient.

Under this policy, all students, male and female, will be offered the opportunity to participate in clinical mammography rotations. The program will make every effort to place a male student in a clinical mammography rotation if requested; however, the program is not in a position to override clinical setting policies that restrict clinical experiences in mammography to female students. Male students are advised that placement in a mammography rotation is not guaranteed and is subject to the availability of a clinical setting that allows males to participate in mammographic imaging procedures. The program will not deny female students the opportunity to participate in mammography rotations if clinical settings are not available to provide the same opportunity to male students.

The change in the program’s policy regarding student clinical rotations in mammography is based on the sound rationale presented in a position statement on student clinical mammography rotations adopted by the Board of Directors of the Joint Review Committee on Education in Radiologic Technology (JRCERT) at its April 2016 Meeting. The JRCERT position statement is available on the JRCERT Website,www.jrcert.org, Programs, and Faculty, Program Resources.

Magnetic Resonance Imaging (MRI) Safety Policy An MRI or Magnetic Resonance Imaging (MRI) is a medical imaging technique that uses a magnetic field and radio waves to create images of the body. All radiography students should be aware of the potential hazards associated with exposure to the magnetic field used in the MRI scanner, as well as understand the consequences of not following proper safety guidelines with the MRI Suite. The magnetic field could potentially be hazardous to students entering the environment if they have specific metallic, electronic, magnetic, and/or mechanical devices. For safety reasons, all students will receive instruction on MRI Safety guidelines and will be screened during orientation prior to starting their clinical experience. Additional information can be found at the MRI Safety. Students must notify the Program Director or Clinical Coordinator of any changes while in the program and a new screening form must be filled out. *Pregnancy notice: A declared pregnancy student should not remain within the MRI Scanning room (Zone IV) during the actual data acquisition or scanning.

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University of Arkansas Fort Smith Radiography Program 2026-2027 Policy and Procedures Manual

MRI Zone Areas: A. Zone 1 – General Public Area B. Zone 2 – Unscreened patents area C. Zone 3 – Screened MR Patients and Control Area D. Zone 4 – Scanning Area In MRI, the magnetic field is ALWAYS on. The student must comply with each clinical site’s policies and procedures pertaining to metallic objects being introduced into the MRI scanning suite. Carrying ferromagnetic objects or introducing them into the MRI scanning area is STRICTLY PROHIBITED. These objects can act as projectiles within the scanning room causing SERIOUS injury, death, or equipment failure.

Items that need to be removed before entering the restricted MRI area include but are not limited to: A. Purse, wallet, money clip, credit cards, or other cards with magnetic strips B. Electronic devices C. Hearing Aids D. Metallic jewelry, watches E. Pens, paperclips, keys, nail clippers, coins, pocketknives F. Hair barrettes, hairpins G. Any article of clothing that has a metallic zipper, buttons, snaps, hooks, or under-wires.

H. Shoes, belt buckles, safety pins To assure that students are appropriately screened for magnetic wave or radiofrequency hazards, students will be screened for certain implants, devices, or objects known to interfere with the MRI unit.

A. All students must complete, sign, and date the MRI screening form. This form will be reviewed by the Clinical Coordinator.

B. Any screening form(s) that have indicated “yes” in any one of the statements will be required to undergo additional screening.

C. Additional screening may consist of further questions, documentation of metal and/or orbit xrays for students with a history of intra-orbital metallic foreign bodies.

D. If a student must complete a screening orbital exam, it will be at their own expense, and they must provide written documentation of a negative exam to the Clinical Coordinator prior to starting clinical rotations.

E. If a student is contraindicated to perform a rotation in the MRI area, the Program Director or Clinical Coordinator will place the student in an alternate rotation to ensure the safety of the student.

The MRI Safety Screening Policy Signature Form is on page 69.

The Magnetic Resonance Imaging (MRI) Safety Policy Acknowledgement Signature Page is on page 70.

Background Check Policy Purpose

The UAFS College of Health, Education, and Human Sciences is committed to producing graduates who go beyond academic excellence, who are productive, self-sufficient citizens of society, who are responsive to the global community, and who maintain high ethical standards in their personal and professional lives. The attainment of this goal is facilitated by partnering with clinical agencies that consent to have faculty and students practice in their facilities.

Students must therefore adhere to all agency policies, such as background checks. The purpose of this 56

University of Arkansas Fort Smith Radiography Program 2026-2027 Policy and Procedures Manual policy is to describe the terms and conditions under which background checks are conducted.

Policy

A criminal background check is required of all students accepted into the UAFS College of Health, Education, and Human Sciences Imaging Sciences, Surgical Technology, Dental Hygiene and School of Nursing Programs. A third-party vendor will conduct the background checks. The student will be responsible for all fees associated with any components of the background check process. All information will be treated as confidential but will be shared with the Imaging Sciences, Surgical Technology, Dental Hygiene or School of Nursing Executive Director and assigned agencies when requested and will be retained in the student’s health file.

Each clinical agency will independently determine if an adverse or negative outcome on the criminal background check will prohibit a student’s practice in their agency. Students unable to practice in clinical agencies because of an adverse or negative background check will be unable to complete program objectives, halting continued progression in the student’s program of study. Failure to complete the background check process before the Friday of the first week of class will result in the student’s inability to complete the program objectives and will therefore halt progression in the student’s program of study.

Students must comply with any additional background checks required by their licensing agency.

General Guidelines: A. Immediately upon acceptance into a College of Health, Education, and Human Sciences Program, the student must authorize the background check by completing the background authorization form provided by the vendor. This form is available to the student upon acceptance into their respective program. The student must also authorize the vendor to send a copy of the results of the background check to their Program Executive Director.

B. The following background checks shall be conducted by the vendor. Additional requests may be made by an agency: 1. Office of Inspector General 2. Sex and violent offender check 3. Social Security Verification 4. Current County of Residence C. If a background check is returned with unfavorable results, the Executive Director will notify the student and the student’s assigned clinical agencies. The clinical agencies will determine if the student will be allowed to practice as a student in their clinical facility.

D. The student has the option to dispute any inaccurate information with the reporting agency, as a right of the Fair Credit Reporting Act. The student will not be able to complete the program objectives, halting their progression in the program of study, until the dispute is resolved.

E. If the background check is favorable, no further action will be taken.

F. All background check results will be retained in the student’s file.

Attendance Policy in Clinical A maximum of 8 hours of clinical absence will be allowed each semester due to personal or immediate family illness. However, ALL clinical times missed will be made up. An absence for any other purpose will result in a one percentage point deduction for each clinical hour missed (extenuating circumstances 57

University of Arkansas Fort Smith Radiography Program 2026-2027 Policy and Procedures Manual may be considered by the Executive Director). Absences to attend interviews, weddings, wedding rehearsals, vacations, etc. will not be an excused absence.

All clinical time missed regardless of the reason must be made up within 2 weeks of the date missed.

Consideration will be given to time missed due to extenuating circumstances by the Executive Director.

If time is not made up within the 2-week time frame, disciplinary action will result in a counseling record and the student will be placed on probation.

If absences exceed the 8-hour limit, ONE percentage point for every one hour of clinical missed will be deducted from the clinical grade at the end of the semester.

Students must call the Program Faculty and Clinical Site each day of absence. Sending a message with another student or a friend does not meet this requirement. Notification should be made at least thirty minutes prior to the start of clinical.

Failure to notify the clinical site and Program Faculty on the morning of the clinical absence will result in two percentage points per hour missed being deducted from the final clinical grade at the end of the semester.

If a student becomes ill and cannot perform his/her duties or may be contagious, then he/she should stay home. If students become ill at the clinical site, they must notify the clinical instructor immediately, BEFORE leaving the facility. Students will make up all time missed due to illness.

NOTE: A. Failure to clock in and out at a clinical assignment will result in a 2-percentage point deduction from the final clinical grade.

B. Failure to clock in or out at a clinical assignment will result in a 1 percentage point deduction from the final clinical grade.

C. Clocking in and/or out on an unapproved electronic device such as a mobile phone, Smart watch, tablet, or laptop will result in a 2-percentage point deduction from the final clinical grade.

D. Students who call in sick on clinical days will not be allowed to come later that day and all the time missed must be made up. (Example: If a student calls in at 7am, that student cannot come in at 1pm)

Tardy Policy in Clinical

Clinical

A tardy at the clinical site is considered any arrival time after the assigned clinical check-in time.

Students arriving after the assigned time will be marked tardy. Failure to notify the clinical instructor and program faculty of a tardy of more than 30 minutes will be treated as an unexcused absence resulting in a deduction of 2 percentage points per hour missed. Students arriving 10 minutes to 1 hour tardy will make up that time at the end of the assigned shift that same day. A tardy that is more than one hour will be made up at a time determined between the student and clinical instructor/clinical coordinator. The third tardy (and each tardy thereafter) within one semester will result in a deduction of two percentage points for each tardy from the final clinical grade at the end of the semester.

Make-up Procedure in Clinical Clinical

Students are expected to complete ALL required clinical hours prior to the end of each semester. Failure 58

University of Arkansas Fort Smith Radiography Program 2026-2027 Policy and Procedures Manual to do this will result in an “incomplete” grade. Unless prior arrangements have been made with the Executive Director, a grade of “incomplete” will become an “F”. At this point, the student will be dropped from the program.

The make-up of clinical time should be arranged through the clinical coordinator. Time must be made up within 2 weeks of the time missed. Clinical time will be made up at the clinical site where clinical education was missed. The amount of time to be made up will be determined by the previous policies found in this handbook. Students cannot make up time when the University is closed. Students may not make up time past 5 p.m.

NOTE: If arrangements have been made for clinical make-up time and the student fails to attend

on that day without calling the appropriate program personnel, he/she will be assessed another unexcused absence.

Incomplete Make-up Time The program faculty at UAFS understands that circumstances beyond a student’s control may interfere with completing certain requirements of this program in the time frame given. If this becomes a stumbling block, students should schedule an appointment with the executive director to discuss possible alternatives. Only under extreme cases will adjustments or other arrangements be made. This decision will rest entirely with the executive director. In the event a student is given additional time to complete make-up clinical time, the program and/or clinical coordinator will complete a probation contract to be agreed upon and signed. If the student is unable to fulfill this contract, he/she will be dropped from the program. A sample of this contract is found in the Academic and Clinical Policies section of this manual.

Advanced Make-up Time

As a general rule, students may NOT accumulate clinical hours in advance for future time off.

The only exceptions to this policy will be: A. Pregnancy – A student may accumulate hours before delivery (see pregnancy policy for additional information on pregnancy).

B. Surgery – If a necessary surgery is scheduled the student can accumulate hours before his/her surgery.

C. Other special circumstances – These will be evaluated on a case-by-case basis by the Executive Director.

If a student qualifies for advanced make-up time, arrangements will be made collaboratively with the student, clinical coordinator, and clinical instructor.

Insurance Coverage and Accidents A. Liability: The University maintains liability insurance for all students and staff while working in the clinical education site.

B. Health: Students are encouraged to carry their own health insurance. The university does not have health insurance available for students.

C. Worker’s Compensation: Students enrolled in the radiography program are not employees of the clinical education site and are, therefore, NOT covered by the Worker’s Compensation Act. 59

University of Arkansas Fort Smith Radiography Program 2026-2027 Policy and Procedures Manual D. Accidents: If a student is injured at the clinical site, he/she must notify the clinical instructor immediately. Students must fill out a written accident report as soon as possible following any accident or injury (see Forms section). In addition, a hospital accident report form should be completed. Since forms vary in the different clinical education sites, the administrative director and the program director must be notified no matter how minor it may seem. Sending a copy of the accident report to the executive director will satisfy this requirement. Students are responsible for any expenses incurred as a result of injury. If an injury results in the student being unable to complete his/her shift, make-up time will be assessed.

E. Emergency Treatment: Hospital policy will prevail. All costs for any treatment received will be borne by the student. Students are prohibited from soliciting free medical advice or service by personnel or clinical sites.

Communicable Disease Policy Students should use surgical gloves for all procedures in which there may be contact with body fluids (urine, blood, excretion, saliva, etc.). Most contacts will be on patients who have not yet been diagnosed and, therefore, the precautionary procedure of wearing gloves is most important. Students will use strict isolation technique if the patient has been diagnosed as having a contagious disease. Students must follow infection control procedures as outlined in the policy manual at the clinical site.

In addition to these precautions, all students are required to have completed the Hepatitis B vaccine series by the spring I semester. This requirement is for the student’s protection and is a result of recent OSHA regulations. Facilities providing the vaccination will be discussed by the program faculty and related to the students. Students are required to provide documentation of vaccination.

If a student has been accidentally exposed to a communicable disease, he/she shall report it immediately to the clinical coordinator and the clinical instructor. Appropriate measures will be taken.

The clinical instructor or clinical coordinator will prepare an Incident Report to be signed by the student.

Each student is required to adhere to the Communicable Disease Policy at the clinical site to which they are assigned.

Accidental Exposure to Blood or Body Fluids

Exposure is defined as a percutaneous injury, contact of mucous membranes, or contact of non- intact skin with blood or other body fluids or tissues that may potentially contain blood borne pathogens.

In the event of accidental exposure, the following steps are to be instituted: 1. Wound Care/First Aid a. Clean wound with soap and water. b. Flush mucous membranes with water or normal saline solution. c. Other wound care as indicated.

2. The exposure will be documented on the incident form that is used by the agency in which the exposure occurred.

3. Any exposure while in the student role will be documented in the student’s file.

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University of Arkansas Fort Smith Radiography Program 2026-2027 Policy and Procedures Manual 4. The student who is exposed to blood or body fluids will be referred for medical care and/or appropriate testing; however, the decision to obtain medical care or testing will rest solely with the person experiencing the exposure.

The health care options available for students or faculty include, but are not limited to: a. The emergency outpatient department of the agency in which the exposure occurred (at personal expense). b. The county health department. c. The private physician of the individual’s choice. d. Arkansas AIDS Foundation. e. NOTE: It is vital the students understand that they are responsible financially for any expenses incurred during treatment or testing. Neither UAFS nor the clinical agency will assume any liability (financial or otherwise), regarding the exposure incident.

5. If the exposed individual chooses to seek medical care and/or testing, all pre- and post-testing counseling will be provided by the healthcare provider conducting the testing.

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Signature Pages Pages 61-69

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University of Arkansas Fort Smith Radiography Program Acceptance of Policy Guidelines I have thoroughly read the policy guidelines for the Radiography program in the manual of the Associate of Applied Science Degree in Radiography at UAFS. I understand my responsibilities concerning the program. I will comply with the policies and guidelines contained in this manual to the best of my ability. In addition, I understand that I must abide by the policies found in the UAFS Academic Catalog and the UAFS Student Handbook & Code of Conduct.

Student Signature

Date

NOTE: Please sign and return this sheet to the Executive Director of Imaging Sciences, UAFS.

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University of Arkansas Fort Smith Radiography Program Health Insurance Coverage Radiography program students must be responsible for any financial coverage if injured in the clinical setting, as there is no worker’s compensation for students.

This requirement is found on page 58 of this Radiography Policy and Procedures Manual.

“All students admitted to the Radiography program are expected to carry personal health insurance.” I am covered by health insurance with the following: Company/Agency: I.D. Number: Policyholder’s Name: I am not covered by health insurance, but I will be responsible for any necessary personal health expenses.

Student Signature

Date

Printed Name

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University of Arkansas Fort Smith Radiography Program Standard Precautions Statement I have been given written and verbal information regarding Standard Precautions. I agree to use Standard Precautions during clinical and simulated laboratory practice.

I understand that my failure to use Standard Precautions may result in exposure to blood borne pathogens including Hepatitis B Virus (HBV) and Human Immunodeficiency Virus (HIV).

In the event that I experience exposure to HBV or HIV as a result of my failure to follow Standard Precautions, I hereby release and hold harmless the University of Arkansas – Fort Smith, its board of visitors, officers, and affiliating agents from any and all liability, responsibility, damage or loss, whether known or unknown, existing or potential, that I may ever claim as a result of any contact or consequence that may arise from my exposure.

Student Signature

Date

Faculty Witness

Date

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University of Arkansas Fort Smith Radiography Program Substance Abuse Release and Acceptance I, , have read and understand the UAFS Substance Abuse Policy and the UAFS CHEHS Radiography Substance Abuse Policy. I understand that I am responsible for the cost of drug screens required due to cause, for MRO (Medical Review Officer) consultation, and/or split sample analysis. I understand, if I’m tested for cause, I am required to arrange for alternate mode of transportation (e.g., family or taxi) rather than self-transport.

I agree that the lab used for drug testing is authorized by me to provide results of the test(s) to the CHEHS Program’s Executive Director. I agree to indemnify and hold the lab harmless from and against any and all liabilities of judgments arising out of any claim related to 1) compliance of the college with federal and state law and 2) the college’s interpretation, use and confidentiality of the test results, except when the lab is found to have acted negligently with respect to such matters.

I understand that an outcome of a positive drug screen will constitute suspension from my CHEHS program. Re-admittance to my program will follow the Program’s Readmission Criteria and Procedures Policy.

I understand that if I’m readmitted to the program and a positive test for substance abuse is found, I will be dismissed from the program and will be ineligible to return. Furthermore, I will be ineligible to receive a letter of good standing.

Student Signature

Date

Executive Director Signature

Date

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University of Arkansas Fort Smith Radiography Program Honor Code The Radiography Program has adopted the following policies. Please read, sign, date, and return this form. This copy will be placed in your student file.

Exam Policy I understand that the content of all examinations is confidential. I agree that I will not divulge any questions on any examination to any individual or entity. I understand that the unauthorized possession, reproduction, or disclosure of any examination questions before, during, or after the examination is in violation of university policy. A violation of this type can result in disciplinary action by the educational institution, including the denial of certification and/or completion of the program.

Sign-in Policy In the event that students must “sign in” to a class, lab, or clinical setting, each student must sign his/her own name. It is unethical and in violation of policy to sign anyone else in for any reason, and to do so will result in disciplinary action. When signing in for class, lab, or clinical after the designated time, it is your responsibility to note the time on the roll next to your name.

Cheating/Plagiarism Policy Cheating in any form, including plagiarism (stealing and passing off as one’s own, the words or ideas of another) is unethical and will result in disciplinary action in accordance with stated university policy. (See UAFS Academic Catalog). To assist another to cheat is equally unacceptable and can result in the same disciplinary actions.

Student Signature

Date

Printed Name

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University of Arkansas Fort Smith Radiography Program HIPAA Statement I have received education regarding the HIPAA regulations. I have been given the opportunity to ask questions. I have been informed and understand the policy on confidentiality. I will be held accountable for practicing within the regulations set forth by HIPAA.

Student’s Signature

Date

Printed Name

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University of Arkansas Fort Smith Radiography Program Magnetic Resonance Imaging (MRI) Screening

WARNING: Certain implants, devices, or objects may be hazardous to you. Do not enter the MRI system room or MRI environment if you have any questions or concerns regarding an implant, device, or object.

The MRI system magnet is ALWAYS on! For safety reasons, anyone who enters the scan room must complete a screening form. All students must complete a screening form before starting clinical rotations.

MRI safety screening forms will be kept in the student’s file.

Do you have or have you ever had any of the following?  Yes  Yes  Yes  Yes  Yes  Yes  Yes  Yes  Yes  Yes  Yes  Yes  Yes  Yes  Yes  Yes  Yes  Yes  Yes  Yes  Yes  Yes  Yes  Yes  Yes  Yes  Yes  Yes  Yes  Yes  Yes  Yes  Yes  Yes

 No  No  No  No  No  No  No  No  No  No  No  No  No  No  No  No  No  No  No  No  No  No  No  No  No  No  No  No  No  No  No  No  No  No

Aneurysm clip(s) Cardiac pacemaker Implanted cardioverter defibrillator Electronic implant or device Magnetically activated implant or device Neurostimulation system Spinal cord stimulator Internal electrodes or wires Bone growth/bone fusion stimulator Cochlear, otologic, or other ear implant Insulin or other infusion pump Implanted drug infusion device Any type of prosthesis (eye, penile, etc.)

Heart valve prosthesis Eyelid spring or wire Artificial or prosthetic limb Wire mesh implant Metallic stent, filter, or coil Shunt (spinal or intraventricular) Vascular access port and/or catheter Radiation seeds or implants Swan-Ganz or thermodilution catheter Medication patch (Nicotine, Nitroglycerine) Any metallic fragment or foreign body Tissue expander (e.g., breast) Surgical staples, clips, or metallic sutures Joint replacement (hip, knee, etc.)

Bone/joint pin, screw, nail, wire, plate, etc.

IUD, diaphragm, or pessary Dentures or partial plates Tattoo or permanent makeup Body piercing jewelry Hearing aid (Remove before entering MRI system room) Other implants

Please List any previous surgeries: I attest that the above information is correct to the best of my knowledge. I read and understand the contents of this form and had the opportunity to ask questions regarding MRI safety/screening. Should any of this information change, I will inform my program director or clinical coordinator before attending the next scheduled clinical day.

Printed Name Student Signature

Date

Faculty Reviewing Form

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University of Arkansas Fort Smith Radiography Program Magnetic Resonance Imaging (MRI) Safety Policy Acknowledgement Please check the box next to each statement you agree with:  I have read the MRI Safety Screening Policy, understand the policy, and have been given the opportunity to ask questions.  I understand and agree to undergo additional screening if I have answered “yes” to specific questions on the MRI Screening form.  I have been counseled by the Clinical Coordinator about the dangers associated with the magnetic field used in MRI and understand the importance of metal screening.  I am refusing to undergo orbit X-rays and understand that I cannot enter the MRI scan room under any circumstances and will be placed in an alternate rotation.  I understand and agree that I am responsible to notify the Program Director or Clinical Coordinator of any changes which impact this screening and may thus compromise safety.

Printed Name Student Signature

Date

Faculty Signature

Date

 I have not identified any contraindications to entering MRI Zone III or IV.  I have identified contraindications to entering the MRI Zone III r IV. I have been advised NOT to progress past MRI Zone III unless screened by an MRI Level II technologist onsite at each clinical facility.

Printed Name Student Signature

Date

Faculty Signature

Date

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University of Arkansas Fort Smith Radiography Program Physical Abilities Requirement University of Arkansas - Fort Smith College of Health, Education, and Human Sciences Imaging Sciences Programs Physical Abilities Requirement Student Name: Semester Applied to Enter:

ABILITIES

R-Regularly

O-Occasionally

MEASURABLE DESCRIPTOR R

Vision: Corrected or Normal

X

Color Vision

X

Hearing

X

Touch Temperature Discrimination

X

Smell

X

Finger Dexterity

X

Intelligible Oral Communication

X

Appropriate Non-Verbal Communication

X

Pushing

X

Pulling Lifting Lifting Floor to Waist Reaching Forward Carrying Standing & Walking Sitting Stooping/Bending Kneeling/Crouching Running Crawling Climbing Stairs (ascending/descending) Turning (head/neck/waist)

X X X X X X X X

Repetitive Arm Movement

X

X X

O Ability to read syringes, labels, instructions and equipment Color coded equipment

X X X X

Ability to hear through some equipment and noisy environments Palpation pulses and discriminate temperature and sensation; Use equipment requiring fine motor skills Differentiate body odors, drainage, skin, and stool odor Manipulation of equipment, dressings, IV and other functions requiring finger dexterity; assessment Communication with clients, staff members, peers and faculty Therapeutic communication with client and health care team Pounds/Foot: 100, equipment, carts with and without clients Pounds/Foot: 50, equipment and client carts Pounds/Foot: 50, clients, equipment and supplies Pounds 75: 3 man lift of patients Moving clients and equipment Pounds 50 Long periods, up to twelve hours Infrequent and short periods, break and lunch Infrequent and short periods; adjusting equipment Infrequent and short periods; adjusting equipment Infrequent, emergency situations Short periods, emergency, adjusting equipment Infrequent, patient care activities Infrequent, emergency situations Frequent extended periods; may position for long periods Key Boards/Computer

I have read, understand, and accept the above working conditions expected of an IS Student in the academic and clinical setting and certify that I am able to meet these requirements.

Student Signature

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Forms

Pages 73-78

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University of Arkansas Fort Smith Radiography Program Counseling Record Form Student Name:

Date:

Faculty Name:

Date:

On , I met with the faculty to evaluate my conduct. The conditions of possible further disciplinary action or the conditions to remain in the program have been discussed with me.

This written statement is a(n): □ Academic Alert  Oral Warning  Written Warning  Critical Incident  Probation Contract Conduct/Violation of Program Policy:

Guidelines to Correct Conduct:

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University of Arkansas Fort Smith Radiography Program 2026-2027 Policy and Procedures Manual Timeframe for correction of conduct to occur:

Consequences of non-compliance with guidelines:

Student Comment:

Student Signature

Date

Faculty Signature

Date

Executive Director Signature

Date

I have satisfactorily met the conditions of this contract. I am aware that I may remain in the program until that time in which I might again fail to meet the objectives and goals of the program.

Student Signature

Date

Faculty Signature

Date

Executive Director Signature

Date

I have not met the conditions of this contract. I am aware that this results in:  placement on probation or □ dismissal from the program.

Student Signature

Date

Faculty Signature

Date

Executive Director Signature

Date 74

University of Arkansas Fort Smith Radiography Program 2026-2027 Policy and Procedures Manual

University of Arkansas – Fort Smith Radiography Program Acknowledgement of Pregnancy Policy I, , have been personally advised of the possible risks and complication due to radiation exposure to my unborn child by the Clinical Coordinator of the Radiography Program. I understand these risks and the radiation precautions I must take in choosing to remain active in the program.

My anticipated due date is:

.

Please initial the following indicating understanding: I understand the recommended radiation dose to my embryo/fetus during my entire pregnancy should not exceed 0.5 rem (5 mSv).

I understand that the NCRP recommends a monthly equivalent dose limit of 0.05 rem (0.5 mSv) to the embryo/fetus.

I understand that I must take measures to limit the dose to my embryo/fetus.

I understand a fetal dosimeter will be ordered by the Clinical Coordinator, and it must be worn at waist height under any lead aprons. I agree to exchange the fetal dosimeter monthly.

I understand that the potential risks associated with clinical education, including radiation exposure, have been explained to me.

I understand that I am responsible for completing all the program’s required clinical assignments.

I understand that I can withdraw my declaration of pregnancy at any time in writing at any point, for any reason, without explanation.

Signature of Student

Date

Clinical Coordinator

Date

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University of Arkansas – Fort Smith Radiography Program Accident Report Form This report is to be used to record ALL details of an accident or mishap involving a student. This report should be completed immediately so that the circumstances surrounding the event will be documented accurately. After completion of this report a copy should be sent to the Executive Director. The clinical site’s Administrative Director and the Executive Director should be notified regardless of how minor it may be.

Date:

Time:

Location:

Description of the Event:

If patient was involved: Patient Name:

Hospital ID:

Patient Age:

Doctor:

Actions take and/or persons notified:

The report was discussed with me: Student Signature

Date

Clinical Instructor Signature

Date

Administrative Director Signature

Date

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University of Arkansas Fort Smith Radiography Program Statement of Medical Options Following Exposure to Body Fluids Complete After Exposure You have been exposed to blood or body fluids. Realizing that several diseases, including HIV and Hepatitis, are transmitted via blood and body fluids, we the faculty of the Radiography Department, strongly recommend that you seek medical care. Medical care options include, but are not limited to: 1. The emergency or outpatient department of the agency in which the exposure occurred (at personal expense).

2. The county health department.

3. The private physician of your choice.

4. The Arkansas AIDS Foundation.

It is vital that you understand that YOU ARE RESPONSIBLE FINANCIALLY FOR ANY EXPENSES INCURRED IN THE COURSE OF TREATMENT OR TESTING. NEITHER UAFS NOR THE CLINICAL AGENCY WILL ASSUME ANY LIABILITY (FINANCIAL OR OTHERWISE) REGARDING THE EXPOSURE INCIDENT. I have read the above and understand the options and financial responsibilities.

Student Signature

Date

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University of Arkansas Fort Smith Radiography Program Documentation of Personal Radiation Monitor of 100 millirem

Student Signature

Date

Clinical Site Personal Radiation Monitor Reading:

millirem for the month of:

If a student’s personal radiation monitor reading is 100 millirem for any month, the following procedure will be followed and documented: 1. Discussion with the Clinical Coordinator concerning possible reasons for overexposure 2. Recommendations made by the Clinical Coordinator to prevent future overexposure 3. Executive Director notified of monitor reading, results of investigation and discussion with student POSSIBLE REASONS & RECOMMENDATIONS:

Student Signature

Date

Clinical Coordinator Signature

Date

Administrative Director Signature

Date

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Evaluations Pages 80-91

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University of Arkansas Fort Smith Radiography Program Student Evaluation of Clinical Instructors

Semester

Year

Clinical Education Site(s)

YES

Needs Improvement

NO

N/A

This questionnaire provides you with the opportunity to anonymously express your view of the clinical instructors. Please utilize the sections provided for additional comments.

1. Were you adequately oriented to the department at the outset of this rotation?

Comments:









2.

Was the opportunity provided for you to achieve all of your clinical objectives?

If not, specify which ones and why. Comments:









3.

Was your clinical instructor available for assistance?

Comments:









Did your clinical instructor provide adequate direction and instruction?

Comments:









4.

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University of Arkansas Fort Smith Radiography Program 2026-2027 Policy and Procedures Manual

YES

Needs Improvement

NO

N/A

University of Arkansas Fort Smith Radiography Program Student Evaluation of Clinical Instructors

a. Periodic one-on-one instruction?









b. Regular opportunities for film critique?









c. Clear, easily understood feedback on your progress?









6.

Did you feel you were graded fairly?

If not, by whom and why (in your opinion)? Comments:









7.

Do you feel the clinical instructor is adequately prepared to teach this setting?

If not, why? Comments:









8.

Did supervision personnel and other staff help you to gain confidence in your abilities?

Comments:









9.

Do you feel that you were treated in a fair and respectful manner by clinical staff?

If not, why? Comments:









10. Did your clinical instructor or other qualified staff oversee all of your repeated









5.

Did your clinical instructor provide:

exams?

If not, explain. Comments:

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University of Arkansas Fort Smith Radiography Program Student Evaluation of Clinical Instructors SUMMARY

Based on the items evaluated, what do you feel are the clinical instructor(s): (If more than one instructor, specify which instructor each comment targets) Greatest Strengths:

Areas needing improvement:

Other Comments:

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University of Arkansas Fort Smith Radiography Program Student Evaluation of Clinical Training Sites

Semester

Year

Please use this form to honestly evaluate the clinical training sites in which you have rotated this semester. Check the blanks to the right of each question and provide answer to comments when requested. Please be as specific as possible and DO NOT SIGN YOUR NAME. CHECK THE CLINICAL TRAINING SITES TO WHICH YOU WERE ASSIGNED THIS SEMESTER. USE THE NUMBERS INDICATED FOR EACH CLINICAL TRAINING SITE IN ANSWERING THE FOLLOWING QUESTIONS: 8. Mercy Clinic Hospital Booneville 9. Mercy Hospital Ozark 10. Mercy Hospital Fort Smith 11. Mercy Hospital Paris 12. Mercy Hospital Waldron 13. Mercy Tower West 14. Washington Regional Medical  11. Mercy Hospital Paris SOMETIMES

      

NO

1. Advanced Orthopedic 2. Arkansas Children's Northwest 3. Baptist Health Fort Smith 4. Baptist Health Van Buren 5. Baptist Health Imaging Center 6. Baptist Health Orthopedics 7 . Mercy Clinic Orthopedics - River Valley

YES

      

1. Did you feel that these clinical rotations were adequate to meet your needs (i.e., able to achieve objectives, perform adequate number of exams)?

Comments:







2.

Were you able to make good use of your time when there were no examinations to perform?

Comments:







Were you allowed to assist the Radiographer with examinations as much as you would have liked?

Comments:







3.

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University of Arkansas Fort Smith Radiography Program 2026-2027 Policy and Procedures Manual

YES

NO

SOMETIMES

Student Evaluation of Clinical Training Sites

4.

Do you feel that you were given too much responsibility?

Comments:







Do you feel that personnel conducted themselves professionally?

Comments:







5.

USE THE SPACE BELOW TO MAKE ADDITIONAL COMMENTS IF NECESSARY

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University of Arkansas Fort Smith Radiography Program Clinical Performance Evaluations of Students This form is used to evaluate the student’s ethical professional behavior. The clinical instructors complete it at the end of the semester. Each completed form will be graded by the clinical coordinator and kept in the student’s file. This score will count as 30% of the student’s clinical grade.

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University of Arkansas Fort Smith Radiography Program Clinical Performance Evaluations of Students Evaluations Totals Evaluation Items PART I PERSONAL APPEARANCE PERSONAL APPEARANCE 0 - Does not adhere to dress code.

1 - Lack of personal hygiene 2 - Occasionally untidy 3 - Professional appearance, neat and clean PART II ATTITUDE COOPERATION 0 - At times arrogant, passive, disrespectful, and/or surly 1 - Occasional conflict with staff and/or peers 2 - Usually cooperative, complains very little 3 - Consistently works well with co-workers and others with various backgrounds SELF-CONFIDENCE 0 - Lacking self-confidence, stands back, hesitant, needs more practice 1 - Overconfident in abilities; does not listen to direction 2 - Satisfactory self-confidence 3 - Consistently self-confident; applies independent judgment ATTITUDE TOWARD SUPERVISION 0 - Takes feedback personally and becomes defensive which includes making excuses 1 - Accepts criticism and feedback in a satisfactory manner but does not show improvement 2 - Willing to learn, usually accepts feedback very well 3 - Cooperates in a positive, acknowledging manner. Tries to use suggestions. Shows respect.

ATTITUDE TOWARD CLINICALS 0 - Shows no interest in profession and/or learning. Avoids work.

1 - Occasionally appears disinterested and/or negative.

2 - Satisfactory attitude toward clinical. Usually strives to improve.

3 - Is enthused about profession and learning. Strives to follow rules and sets a good example.

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PART III DEPENDABILITY

COMPLETES ASSIGNED TASK 0 - Frequently relies on others to complete exams 1 - Unreliable, never completes patient exams 2 - Most of the time follows through with clinical task in a reliable conscientious manner 3 - Always follows through and completes exams or task in a reliable conscientious manner ACCOUNTABILITY 0 - Never reports to assigned area, always roaming 1 - Must be reminded to stay in assigned area, likes to roam 2 - Will not immediately report to assigned area 3 - Always present and punctual in assigned area PART IV PROFESSIONAL BEHAVIOR INTERPERSONAL BEHAVIOR 0 - Lack of or poor interactions with others. Frequently negative comments, poor attitude.

1 - Could be more considerate and tactful. Occasionally argumentative.

2 - Satisfactory working relationship with patients, staff, and peers.

3 - Excellent relationship with patients and staff. Always works in harmony with others.

Is never negative.

ABILITY TO FOLLOW INSTRUCTIONS 0 - Headstrong, ignores instructions 1 - Requires repeated instructions 2 - Satisfactorily follows instructions 3 - Learns rapidly, implements, and retains knowledge INITIATIVE 0 - Wastes time, shows little initiative or interest. Always has to be asked to do exams.

1 - Frequently needs prodding. Does not recognize work to be done. Holds back when insecure. Does not want to perform procedures once competency is completed.

2 - Usually volunteers, assumes responsibility, and uses free time constructively.

Satisfactory amount of interest and enthusiasm.

3 - Volunteers to do their share. Helps out wherever needed. Is enthusiastic. Takes pride in doing work well. Good example to others COMMUNICATION SKILLS 0 - Unable to communicate effectively; has problems expressing themselves.

1 - Does not always communicate well with patient. No patient interaction during positioning of exam.

2 - Satisfactory communication skills.

3 - Excellent communication skills; well organized thoughts, explains exams to patient.

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University of Arkansas Fort Smith Radiography Program 2026-2027 Policy and Procedures Manual

APPROPRIATENESS OF CONVERSATIONS 0 - Discusses inappropriate topics (e.g., other patients, own social activities) in front of patient and/or staff/peers.

1 - Occasionally speaks too loudly outside of room, within hearing distance of patient.

2 - Satisfactory communication within the department with staff and peers.

3 - Always has appropriate conversations with and around patients. Maintains patient confidentiality.

PROFESSIONAL ETHICS 0 - Unethical behavior; ignores rights of others 1 - Attempts professional conduct, usually succeeding, occasionally acts in unethical manner around patients or personnel.

2 - Adheres to professional standards in acceptable manner.

3 - Displays highest level of professional integrity.

PROFESSIONAL BEHAVIOR 0 - Unprofessional, gossips about/around patients or personnel 1 - Inappropriate conversation and volume 2 - Satisfactory professional behavior 3 - Consistently exhibits moral and ethical behaviors PART V QUALITY OF WORK QUALITY OF WORK 0 - Constantly makes careless and repeated errors 1 - Work is inconsistent; does well then makes careless errors 2 - Quality of work acceptable with level of learning 3 - Consistently above average in performance QUANTITY OF WORK 0 - Has to be prodded, works very slow 1 - Slow, just enough to get by 2 - Satisfactory, meets minimum requirements 3 - Superior amount of quality work CARE FOR PATIENTS 0 - Inadequate patient care skills and ignores patient needs 1 - Concentrates on the exam. Frequently leaves patient alone or ignores their needs.

2 - Satisfactory patient care 3 - Anticipates and provides appropriate patient care, safety, and comfort USE AND CARE OF EQUIPMENT 0 - Unfamiliar with most equipment. Inattentive and careless while using equipment.

1 - Ongoing inconsistency in proper equipment manipulation.

2 - Knowledgeable but needs practice with seldom used equipment. Careful with equipment.

3 - Superior skills with all equipment and displays knowledge of its correct use.

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ABILITY TO FORMULATE AND ADJUST TECHNIQUES 0 - Unacceptable, needs constant instruction.

1 - Needs some supervision to set technique and/or make adjustments.

2 - Satisfactory ability to set technique. Usually, accurate.

3 - Efficient at setting exposure factors; able to make appropriate adjustments.

POSITIONING SKILLS 0 - Poor application of knowledge, is slow and inaccurate. Unacceptable for this stage of education. Unable to correct mistakes.

1 - Fair positioning skills. Needs supervision, makes some mistakes.

2 - Satisfactory positioning skills. Average performer.

3 - Excellent and consistently accurate positioning skills. Advanced for this stage of education.

ORGANIZATION OF WORK 0 - Unacceptable; often does not know what to do next.

1 - Occasionally unorganized, works at a slow pace. Recognizes need for improvement.

2 - Acceptable organization, works at a steady pace.

3 - Very efficient; highly productive and organized.

ADAPTABILITY 0 - Student is confounded by change in patient condition or workflow. Rebels against change.

1 - Additional training in adaptability skills is recommended. Does not adapt to department routine and/or not flexible in assignments.

2 - Recognizes change and responds quickly to each new circumstance. Adapts to department routine and very flexible.

3 - Adapts well and responds appropriately to unusual cases.

RADIATION PROTECTION 0 - Needs constant supervision.

1 - Needs some supervision to assure radiation protection requirements are completed.

Lacks confidence in skill.

2 - Performs most radiation protection requirements. Occasionally misses some details.

3 - Performs radiation protection requirements correctly. Is conscientious about patient, public, & personnel protection.

COMPOSURE TO STRESSFUL SITUATIONS 0 - Does not handle stressful situations. Student does not demonstrate the ability to handle stress and does not know how to complete exams under these conditions.

1 - Below average needs work with stress management. Student struggles with the ability to handle stressful situations. Has difficulty completing procedures.

2 - Appropriate response for student at this level. Frequently demonstrates the ability to handle stressful situations. Is working on building skill.

3 - Poised, always demonstrates ability to handle areas of high levels of stress. Effective in getting procedures accomplished efficiently.

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PROBLEM SOLVING SKILLS 0 - Exhibits inadequate problem-solving abilities.

1 - Improving problem solving skills that require modifying standard procedures to accommodate for patient conditions and other variables.

2 - Satisfactory problem-solving abilities.

3 - Proficient at using problem solving skills to modify standard procedures to accommodate for patient conditions and other variables.

CRITICAL THINKING SKILLS 0 - Unable to evaluate radiographic images for appropriate positioning and image quality. Needs help developing critical thinking skills.

1 - Inconsistent in evaluating radiographic images for appropriate positioning and/or image quality.

2 - Satisfactory ability evaluating appropriate positioning and image quality. Occasionally needs help.

3 - Always accurately evaluates radiographic images for appropriate positioning and image quality.

What was your overall opinion of the student’s performance during this evaluation period?

0 - Is not performing as expected. Does not seem to have an interest in improving or lacks motivation.

1 - Is slightly below the performance of their peers but seems to have the ability and attitude to improve.

2 - Is performing at a level with their peers, good attitude.

3 - Is performing at a level with their peers, very positive attitude.

4 - Is performing beyond what is expected, sets example.

Instructions

Student Signature: Student may add signature and/or comments by attaching a postsubmission comment.

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Miscellaneous Pages 93-301

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The Gordon Kelly Academic Success Center The concern of UAFS for the individual student is reflected in the Gordon Kelley Academic Success Center (ASC), which provides programs designed to meet individual student needs not met through the general curriculum. Faculty supplemental materials, free tutoring for many UAFS courses through drop-in tutoring writing center, or Brainfuse Tutoring for online tutoring, motivational programs, and learning programs are all provided to encourage student success.

Time management, self-discipline, and motivational programs are provided for the student who wants to improve study skills and grades. Learning programs focus on specific strategies to understand, retain, and apply new information, as well as traditional study skills techniques.

Learning programs are individually designed to meet student needs and are free to any University student.

An academic coach is available to meet and assist students to set academic goals and enhance academic success. Academic coaching sessions can be held face-to-face on campus or virtually through Blackboard online video chat. The academic coach works individually with students to help examine academic concerns and perceived barriers to success. This provides students with academic support in areas such as time management, self-discipline, procrastination, test preparation, note taking balancing school/work/family, and other effective study strategies.

Contact Information Vines Building Room 202 479-788-7675 asc@uafs.edu

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Appendix A American Registry of Radiologic Technologists - Code of Ethics Preamble The Standards of Ethics of The American Registry of Radiologic Technologists (ARRT) shall apply solely to persons holding certificates from ARRT that are either currently certified and registered by ARRT or that were formerly certified and registered by ARRT (collectively, “Certificate Holders”), and to persons applying for certification and registration by ARRT in order to become Certificate Holders (“Candidates”). Radiologic Technology is an umbrella term that is inclusive of the disciplines of radiography, nuclear medicine technology, radiation therapy, cardiovascular-interventional radiography, mammography, computed tomography, magnetic resonance imaging, quality management, sonography, bone densitometry, vascular sonography, cardiac-interventional radiography, vascular-interventional radiography, breast sonography, and radiologist assistant. The Standards of Ethics are intended to be consistent with the Mission Statement of ARRT, and to promote the goals set forth in the Mission Statement.

Statement of Purpose The purpose of the ethics requirements is to identify individuals who have internalized a set of professional values that cause one to act in the best interests of patients. This internalization of professional values and the resulting behavior is one element of ARRT’s definition of what it means to be qualified. Exhibiting certain behaviors as documented in the Standards of Ethics is evidence of the possible lack of appropriate professional values.

The Standards of Ethics provides proactive guidance on what it means to be qualified and to motivate and promote a culture of ethical behavior within the profession. The ethics requirements support ARRT’s mission of promoting high standards of patient care by removing or restricting the use of the credential by those who exhibit behavior inconsistent with the requirements.

Code of Ethics The Code of Ethics forms the first part of the Standards of Ethics. The Code of Ethics shall serve as a guide by which Certificate Holders and Candidates may evaluate their professional conduct as it relates to patients, healthcare consumers, employers, colleagues, and other members of the healthcare team. The Code of Ethics is intended to assist Certificate Holders and Candidates in maintaining a high level of ethical conduct and in providing for the protection, safety, and comfort of patients. The Code of Ethics is aspirational.

1. The radiologic technologist acts in a professional manner, responds to patient needs, and supports colleagues and associates in providing quality patient care.

2. The radiologic technologist acts to advance the principal objective of the profession to 94

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provide services to humanity with full respect for the dignity of mankind.

3. The radiologic technologist delivers patient care and service unrestricted by the concerns of personal attributes or the nature of the disease or illness, and without discrimination on the basis of race, color, creed, religion, national origin, sex, marital status, status with regard to public assistance, familial status, disability, sexual orientation, gender identity, veteran status, age, or any other legally protected basis.

4. The radiologic technologist practices technology founded upon theoretical knowledge and concepts, uses equipment and accessories consistent with the purposes for which they were designed, and employs procedures and techniques appropriately.

5. The radiologic technologist assesses situations; exercises care, discretion, and judgment; assumes responsibility for professional decisions; and acts in the best interest of the patient.

6. The radiologic technologist acts as an agent through observation and communication to obtain pertinent information for the physician to aid in the diagnosis and treatment of the patient and recognizes that interpretation and diagnosis are outside the scope of practice for the profession.

7. The radiologic technologist uses equipment and accessories, employs techniques and procedures, performs services in accordance with an accepted standard of practice, and demonstrates expertise in minimizing radiation exposure to the patient, self, and other members of the healthcare team.

8. The radiologic technologist practices ethical conduct appropriate to the profession and protects the patient’s right to quality radiologic technology care.

9. The radiologic technologist respects confidences entrusted during professional practice, respects the patient’s right to privacy, and reveals confidential information only as required by law or to protect the welfare of the individual or the community.

10. The radiologic technologist continually strives to improve knowledge and skills by participating in continuing education and professional activities, sharing knowledge with colleagues, and investigating new aspects of professional practice.

11. The radiologic technologist refrains from the use of illegal drugs and/or any legally controlled substances which result in impairment of professional judgment and/or ability to practice radiologic technology with reasonable skill and safety to patients.

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Appendix B Standards for an Accredited Educational Program in Radiography Effective January 1, 2021 Adopted April 2020

Introductory Statement The Joint Review Committee on Education in Radiologic Technology (JRCERT) Standards for an Accredited Educational Program in Radiography are designed to promote academic excellence, patient safety, and quality healthcare. The Standards require a program to articulate its purposes; to demonstrate that it has adequate human, physical, and financial resources effectively organized for the accomplishment of its purposes; to document its effectiveness in accomplishing these purposes; and to provide assurance that it can continue to meet accreditation standards.

The JRCERT is recognized by both the United States Department of Education (USDE) and the Council for Higher Education Accreditation (CHEA). The JRCERT Standards incorporate many of the regulations required by the USDE for accrediting organizations to assure the quality of education offered by higher education programs. Accountability for performance and transparency are also reflected in the Standards as they are key factors for CHEA recognition.

The JRCERT accreditation process offers a means of providing assurance to the public that a program meets specific quality standards. The process not only helps to maintain program quality but stimulates program improvement through outcomes assessment.

There are six (6) standards. Each standard is titled and includes a narrative statement supported by specific objectives. Each objective, in turn, includes the following clarifying elements: •

Explanation - provides clarification on the intent and key details of the objective.

•

Required Program Response - requires the program to provide a brief narrative and/or documentation that demonstrates compliance with the objective.

•

Possible Site Visitor Evaluation Methods - identifies additional materials that may be examined and personnel who may be interviewed by the site visitors at the time of the on-site evaluation in determining compliance with the particular objective. Review of supplemental materials and/or interviews is at the discretion of the site visit team.

Regarding each standard, the program must: • Identify strengths related to each standard • Identify opportunities for improvement related to each standard • Describe the program’s plan for addressing each opportunity for improvement • Describe any progress already achieved in addressing each opportunity for improvement • Provide any additional comments in relation to each standard The self-study report, as well as the results of the on-site evaluation conducted by the site visit team, will determine the program’s compliance with the Standards by the JRCERT Board of Directors.

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Standards for an Accredited Educational Program in Radiography Table of Contents Standard One: Accountability, Fair Practices, and Public Information ................................................. 4 The sponsoring institution and program promote accountability and fair practices in relation to students, faculty, and the public. Policies and procedures of the sponsoring institution and program must support the rights of students and faculty, be well-defined, written, and readily available.

Standard Two: Institutional Commitment and Resources .................................................................... 13 The sponsoring institution demonstrates a sound financial commitment to the program by assuring sufficient academic, fiscal, personnel, and physical resources to achieve the program’s mission.

Standard Three: Faculty and Staff .......................................................................................................... 18 The sponsoring institution provides the program adequate and qualified faculty that enable the program to meet its mission and promote student learning.

Standard Four: Curriculum and Academic Practices ........................................................................... 26 The program’s curriculum and academic practices prepare students for professional practice.

Standard Five: Health and Safety ........................................................................................................... 38 The sponsoring institution and program have policies and procedures that promote the health, safety, and optimal use of radiation for students, patients, and the public.

Standard Six: Programmatic Effectiveness and Assessment: Using Data for Sustained Improvement ..................................................................................................................................................................... 44 The extent of a program’s effectiveness is linked to the ability to meet its mission, goals, and student learning outcomes. A systematic, ongoing assessment process provides credible evidence that enables analysis and critical discussions to foster ongoing program improvement.

Glossary ...................................................................................................................................................... 50 Awarding, Maintaining, and Administering Accreditation .................................................................... 53

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Standard One: Accountability, Fair Practices, and Public Information The sponsoring institution and program promote accountability and fair practices in relation to students, faculty, and the public. Policies and procedures of the sponsoring institution and program must support the rights of students and faculty, be well-defined, written, and readily available.

Objectives: 1.1

The sponsoring institution and program provide students, faculty, and the public with policies, procedures, and relevant information. Policies and procedures must be fair, equitably applied, and readily available.

1.2

The sponsoring institution and program have faculty recruitment and employment practices that are nondiscriminatory.

1.3

The sponsoring institution and program have student recruitment and admission practices that are nondiscriminatory and consistent with published policies.

1.4

The program assures the confidentiality of student educational records.

1.5

The program assures that students and faculty are made aware of the JRCERT Standards for an Accredited Educational Program in Radiography and the avenue to pursue allegations of noncompliance with the Standards.

1.6

The program publishes program effectiveness data (credentialing examination pass rate, job placement rate, and program completion rate) on an annual basis.

1.7

The sponsoring institution and program comply with the requirements to achieve and maintain JRCERT accreditation.

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1.1

The sponsoring institution and program provide students, faculty, and the public with policies, procedures, and relevant information. Policies and procedures must be fair, equitably applied, and readily available.

Explanation: Institutional and program policies and procedures must be fair, equitably applied, and promote professionalism. Policies, procedures, and relevant information must be current, accurate, published, and made readily available to students, faculty, staff, and the public on the institution’s or program’s website to assure transparency and accountability of the educational program. For example, requiring the public to contact the institution or program to request program information is not fully transparent. Policy changes must be made known to students, faculty, and the public in a timely fashion. It is recommended that revision dates be identified on program publications.

At a minimum, the sponsoring institution and/or program must publish policies, procedures, and/or relevant information related to the following:          

admission and transfer of credit policies; tuition, fees, and refunds; graduation requirements; grading system; program mission statement, goals, and student learning outcomes; accreditation status; articulation agreement(s); academic calendar; clinical obligations; grievance policy and/or procedures.

Any policy changes to the above must be made known to students, faculty, and the public in a timely fashion.

In addition, programs must develop a contingency plan that addresses any type of catastrophic event that could affect student learning and program operations. Although the contingency plan does not need to be made readily available to the public, program faculty must be made aware of the contingency plan.

Required Program Response: • Describe how institutional and program policies, procedures, and relevant information are made known to students, faculty, staff, and the public.

• Describe how policies and procedures are fair, equitably applied, and promote professionalism.

• Describe the nature of any formal grievance(s) and/or complaints(s) and their resolution.

• Provide publications that include the aforementioned policies, procedures, and relevant information, including the hyperlink for each.

• Provide a copy of the resolution of any formal grievance(s).

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Possible Site Visitor Evaluation Methods: • Review of institutional and program website • Review of institutional and program materials • Review of student handbook • Review of student records • Review of formal grievance(s) record(s), if applicable • Interviews with institutional administration • Interviews with faculty • Interviews with staff • Interviews with students

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1.2

The sponsoring institution and program have faculty recruitment and employment practices that are nondiscriminatory.

Explanation: Nondiscriminatory recruitment and employment practices assure fairness and integrity. Equal opportunity for employment must be offered to each applicant with respect to any legally protected status such as race, color, gender, age, disability, national origin, or any other protected class. Employment practices must be equitably applied.

Required Program Response: • Describe how nondiscriminatory recruitment and employment practices are assured.

• Provide copies of employment policies and procedures that assure nondiscriminatory practices.

Possible Site Visitor Evaluation Methods: • Review of employee/faculty handbook • Review of employee/faculty application form • Review of institutional catalog • Interviews with faculty

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1.3

The sponsoring institution and program have student recruitment and admission practices that are nondiscriminatory and consistent with published policies.

Explanation: Nondiscriminatory recruitment practices assure applicants have equal opportunity for admission. Defined admission practices facilitate objective student selection. In considering applicants for admission, the program must follow published policies and procedures. Statistical information such as race, color, religion, gender, age, disability, national origin, or any other protected class may be collected; however, the student must voluntarily provide this information. Use of this information in the student selection process is discriminatory.

Required Program Response: • Describe how institutional and program admission policies are implemented.

• Describe how admission practices are nondiscriminatory.

• Provide institutional and program admission policies.

Possible Site Visitor Evaluation Methods: • Review of published program materials • Review of student records • Interviews with faculty • Interviews with admissions personnel, as appropriate • Interviews with students

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1.4

The program assures the confidentiality of student educational records.

Explanation: Maintaining the confidentiality of educational records protects students’ right to privacy. Educational records must be maintained in accordance with the Family Educational Rights and Privacy Act (FERPA).

If educational records contain students’ social security numbers, this information must be maintained in a secure and confidential manner. Space should be made available for the secure storage of files and records.

Required Program Response: Describe how the program maintains the confidentiality of students’ educational records.

Possible Site Visitor Evaluation Methods: • Review of institution’s/program’s published policies/procedures • Review of student academic and clinical records, including radiation monitoring reports • Tour of program offices • Tour of clinical setting(s) • Interviews with faculty • Interviews with clerical staff, if applicable • Interviews with clinical preceptor(s) • Interviews with clinical staff • Interviews with students

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1.5

The program assures that students and faculty are made aware of the JRCERT Standards for an Accredited Educational Program in Radiography and the avenue to pursue allegations of noncompliance with the Standards.

Explanation: The program must assure students and faculty are cognizant of the Standards and must provide contact information for the JRCERT. Any individual associated with the program has the right to submit allegations against a JRCERTaccredited program if there is reason to believe that the program has acted contrary to JRCERT accreditation standards and/or JRCERT policies. Additionally, an individual has the right to submit allegations against the program if the student believes that conditions at the program appear to jeopardize the quality of instruction or the general welfare of its students.

Contacting the JRCERT must not be a step in the formal institutional or program grievance policy/procedure. The individual must first attempt to resolve the complaint directly with institutional/program officials by following the grievance policy/procedures provided by the institution/program. If the individual is unable to resolve the complaint with institutional/program officials or believes that the concerns have not been properly addressed, the individual may submit allegations of noncompliance directly to the JRCERT. Required Program Response: • Describe how students and faculty are made aware of the Standards.

• Provide documentation that the Standards and JRCERT contact information are made known to students and faculty.

Possible Site Visitor Evaluation Methods: • Review of program publications • Review of program website • Interviews with faculty • Interviews with students

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1.6

The program publishes program effectiveness data (credentialing examination pass rate, job placement rate, and program completion rate) on an annual basis.

Explanation: Program accountability is enhanced, in part, by making its program effectiveness data available to the program’s communities of interest, including the public. In an effort to increase accountability and transparency, the program must publish, at a minimum, its most recent five-year average credentialing examination pass rate data, five-year average job placement rate data, and annual program completion rate data on its website to allow the public access to this information. If the program cannot document five years of program effectiveness data, it must publish its available effectiveness data.

The program effectiveness data must clearly identify the sample size associated with each measure (i.e., number of first-time test takers, number of graduates actively seeking employment, and number of graduates).

Program effectiveness data is published on the JRCERT website. Programs must publish a hyperlink to the JRCERT website to allow students and the public access to this information.

Required Program Response: • Provide the hyperlink for the program’s effectiveness data webpage.

• Provide samples of publications that document the availability of program effectiveness data via the JRCERT URL address from the program’s website.

Possible Site Visitor Evaluation Methods: • Review of program website • Review of program publications • Interviews with faculty • Interviews with students

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1.7

The sponsoring institution and program comply with requirements to achieve and maintain JRCERT accreditation.

Explanation: Programs must comply with all JRCERT policies and procedures to maintain accreditation. JRCERT policies are located at www.jrcert.org. In addition, substantive changes must be reviewed and approved by the JRCERT prior to implementation, with the exception of a change of ownership.

JRCERT accreditation requires that the sponsoring institution has the primary responsibility for the educational program and grants the terminal award. Sponsoring institutions may include educational programs established in colleges, universities, vocational/technical schools, hospitals, or military facilities.

The JRCERT does not recognize a healthcare system as the program sponsor. A healthcare system consists of multiple institutions operating under a common governing body or parent corporation. A specific facility within the healthcare system must be identified as the sponsor. The JRCERT requires each program to have a separate accreditation award and does not recognize branch campuses. The JRCERT recognizes a consortium as an appropriate sponsor of an educational program.

The JRCERT requires programs to maintain a current and accurate database. The program must maintain documentation of all program official qualifications, including updated curricula vitae and current ARRT certification and registration, or equivalent documentation. This documentation is not required to be entered into the Accreditation Management System (AMS). Newly appointed institutional administrators, program officials, and clinical preceptors must be updated through the AMS within thirty (30) days of appointment.

No Required Program Response Possible Site Visitor Evaluation Method: Review of a representative sample of program official qualifications

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Standard Two: Institutional Commitment and Resources The sponsoring institution demonstrates a sound financial commitment to the program by assuring sufficient academic, fiscal, personnel, and physical resources to achieve the program’s mission.

Objectives: 2.1

The sponsoring institution provides appropriate administrative support and demonstrates a sound financial commitment to the program.

2.2

The sponsoring institution provides the program with the physical resources needed to support the achievement of the program’s mission.

2.3

The sponsoring institution provides student resources.

2.4

The sponsoring institution and program maintain compliance with United States Department of Education (USDE) Title IV financial aid policies and procedures, if the JRCERT serves as gatekeeper.

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2.1

The sponsoring institution provides appropriate administrative support and demonstrates a sound financial commitment to the program.

Explanation: The program must have sufficient institutional support and ongoing funding to operate effectively. The program’s relative position in the organizational structure helps facilitate appropriate resources and enables the program to meet its mission.

The sponsoring institution should provide the program with administrative/clerical services as needed to assist in the achievement of its mission.

Required Program Response: • Describe the sponsoring institution’s level of commitment to the program.

• Describe the program’s position within the sponsoring institution’s organizational structure and how this supports the program’s mission.

• Describe the adequacy of financial resources.

• Describe the availability and functions of administrative/clerical services, if applicable.

• Provide institutional and program organizational charts.

Possible Site Visitor Evaluation Methods: • Review of organizational charts of institution and program • Review of published program materials • Review of meeting minutes • Interviews with institutional administration • Interviews with faculty • Interviews with clerical staff, if applicable

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2.2

The sponsoring institution provides the program with the physical resources needed to support the achievement of the program’s mission.

Explanation: Physical resources include learning environments necessary to conduct teaching and facilitate learning.

The sponsoring institution must provide faculty with adequate office and classroom space needed to fulfill their responsibilities. Faculty office space should be conducive to course development and scholarly activities. Space must be made available for private student advisement and program meetings.

Classrooms must be appropriately designed to meet the needs of the program’s curriculum delivery methods.

Resources include, but are not limited to, access to computers, reliable and secure Internet service, instructional materials (computer hardware and/or software, technology-equipped classrooms, simulation devices, and other instructional aides), and library resources.

Laboratories must be conducive to student learning and sufficient in size. The sponsoring institution must provide the program with access to a fully energized laboratory. An energized laboratory on campus is recommended. The program may utilize laboratory space that is also used for patient care. In the event patient flow disallows use of the laboratory space, the program must assure that laboratory courses are made up in a timely manner. A mobile unit and/or simulation software cannot take the place of a stationary/fixed energized laboratory.

The JRCERT does not endorse any specific physical resources.

Required Program Response: Describe how the program’s physical resources, such as offices, classrooms, and laboratories, facilitate the achievement of the program’s mission.

Possible Site Visitor Evaluation Methods: • Tour of the classroom, laboratories, and faculty offices • Review of learning resources • Interviews with faculty • Interviews with students

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2.3

The sponsoring institution provides student resources.

Explanation: Student resources refer to the variety of services and programs offered to promote academic success. The institution and/or program must provide access to information for personal counseling, requesting accommodations for disabilities, and financial aid.

The JRCERT does not endorse any specific student resources.

Required Program Response: • Describe how students are provided with access to information on personal counseling, disability services, and financial aid.

• Describe how the program utilizes other student resources to promote student success.

Possible Site Visitor Evaluation Methods: • Tour of facilities • Review of published program materials • Review of surveys • Interviews with faculty • Interviews with students

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2.4

The sponsoring institution and program maintain compliance with United States Department of Education (USDE) Title IV financial aid policies and procedures, if the JRCERT serves as gatekeeper.

Explanation: If the program has elected to participate in Title IV financial aid and the JRCERT is identified as the gatekeeper, the program must: • • • •

maintain financial documents including audit and budget processes confirming appropriate allocation and use of financial resources; have a monitoring process for student loan default rates; have an appropriate accounting system providing documentation for management of Title IV financial aid and expenditures; and inform students of responsibility for timely repayment of Title IV financial aid.

The program must comply with all USDE requirements to participate in Title IV financial aid.

Required Program Response: • Describe how the program informs students of their responsibility for timely repayment of financial aid.

• Provide evidence that Title IV financial aid is managed and distributed according to the USDE regulations to include: o recent student loan default data and o results of financial or compliance audits.

Possible Site Visitor Evaluation Methods: • Review of records • Interviews with administrative personnel • Interviews with faculty • Interviews with students

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Standard Three: Faculty and Staff The sponsoring institution provides the program adequate and qualified faculty that enable the program to meet its mission and promote student learning.

Objectives: 3.1

The sponsoring institution provides an adequate number of faculty to meet all educational, accreditation, and administrative requirements.

3.2

The sponsoring institution and program assure that all faculty and staff possess the academic and professional qualifications appropriate for their assignments.

3.3

The sponsoring institution and program assure the responsibilities of faculty and clinical staff are delineated and performed.

3.4

The sponsoring institution and program assure program faculty performance is evaluated and results are shared regularly to assure responsibilities are performed.

3.5

The sponsoring institution and/or program provide faculty with opportunities for continued professional development.

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3.1

The sponsoring institution provides an adequate number of faculty to meet all educational, accreditation, and administrative requirements.

Explanation: An adequate number of faculty promotes sound educational practices. Full- and part-time status is determined by, and consistent with, the sponsoring institution’s definition. Institutional policies and practices for faculty workload and release time must be consistent with faculty in other comparable health sciences programs in the same institution. Faculty workload and release time practices must include allocating time and/or reducing teaching load for educational, accreditation, and administrative requirements expected of the program director and clinical coordinator.

A full-time program director is required. A full-time equivalent clinical coordinator is required if the program has more than fifteen (15) students enrolled in the clinical component of the program (e.g., the total number of students simultaneously enrolled in all clinical courses during a term). The clinical coordinator position may be shared by no more than four (4) appointees. If a clinical coordinator is required, the program director may not be identified as the clinical coordinator. The clinical coordinator may not be identified as the program director.

A minimum of one clinical preceptor must be designated at each recognized clinical setting. The same clinical preceptor may be identified at more than one site as long as a ratio of one full-time equivalent clinical preceptor for every ten (10) students is maintained. The program director and clinical coordinator may perform clinical instruction; however, they may not be identified as clinical preceptors.

Required Program Response: • Describe faculty workload and release time in relation to institutional policies/practices and comparable health sciences programs within the sponsoring institution.

• Describe the adequacy of the number of faculty and clinical preceptors to meet identified accreditation requirements and program needs.

• Provide institutional policies for faculty workload and release time.

Possible Site Visitor Evaluation Methods: • Review institutional policies for faculty workload and release time • Review of faculty position descriptions, if applicable • Review of clinical settings • Interviews with faculty • Interviews with clinical preceptor(s) • Interviews with students

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3.2

The sponsoring institution and program assure that all faculty and staff possess the academic and professional qualifications appropriate for their assignments.

Position

Qualifications

Program Director

Holds, at a minimum, a master’s degree; For master’s degree programs, a doctoral degree is preferred; Proficient in curriculum design, evaluation, instruction, program administration, and academic advising; Documents three years’ clinical experience in the professional discipline; Documents two years’ experience as an instructor in a JRCERTaccredited program; Holds current American Registry of Radiologic Technologists (ARRT) certification and registration, or equivalent1, in radiography.

Clinical Coordinator

Holds, at a minimum, a bachelor’s degree; For master’s degree programs, holds, at a minimum, a master’s degree; Proficient in curriculum development, supervision, instruction, evaluation, and academic advising; Documents two years’ clinical experience in the professional discipline; Documents one year’s experience as an instructor in a JRCERTaccredited program; Holds current American Registry of Radiologic Technologists (ARRT) certification and registration, or equivalent1, in radiography.

Full-time Didactic Faculty

Holds, at a minimum, a bachelor’s degree; Is qualified to teach the subject; Proficient in course development, instruction, evaluation, and academic advising; Documents two years’ clinical experience in the professional discipline; Holds current American Registry of Radiologic Technologists (ARRT) certification and registration, or equivalent1, in radiography.

Adjunct Faculty

Holds academic and/or professional credentials appropriate to the subject content area taught; Is knowledgeable of course development, instruction, evaluation, and academic advising.

Clinical Preceptor

Is proficient in supervision, instruction, and evaluation; Documents two years’ clinical experience in the professional discipline; Holds current American Registry of Radiologic Technologists (ARRT) certification and registration, or equivalent2, in radiography.

Holds current American Registry of Radiologic Technologists (ARRT) certification and registration, or equivalent2, in radiography.

1 Equivalent: an unrestricted state license for the state in which the program is located.

Clinical Staff

2

Equivalent: an unrestricted state license for the state in which the clinical setting is located.

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Explanation: Faculty and clinical staff must possess academic and professional qualifications appropriate for their assignment. Clinical preceptors and clinical staff supervising students’ performance in the clinical component of the program must document American Registry of Radiologic Technologists (ARRT) certification and registration (or equivalent) or other appropriate credentials. Health care professionals with credentials other than ARRT certification and registration (or equivalent) may supervise students in specialty areas (e.g., Registered Nurse supervising students performing patient care skills, phlebotomist supervising students performing venipuncture, etc.).

No Required Program Response.

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3.3

The sponsoring institution and program assure the responsibilities of faculty and clinical staff are delineated and performed.

Position

Program Director

Clinical Coordinator

Full-Time Didactic Faculty

Adjunct Faculty

Responsibilities must, at a minimum, include: Assuring effective program operations; Overseeing ongoing program accreditation and assessment processes; Participating in budget planning; Participating in didactic and/or clinical instruction, as appropriate; Maintaining current knowledge of the professional discipline and educational methodologies through continuing professional development; Assuming the leadership role in the continued development of the program.

Correlating and coordinating clinical education with didactic education and evaluating its effectiveness; Participating in didactic and/or clinical instruction; Supporting the program director to assure effective program operations; Participating in the accreditation and assessment processes; Maintaining current knowledge of the professional discipline and educational methodologies through continuing professional development; Maintaining current knowledge of program policies, procedures, and student progress.

Preparing and maintaining course outlines and objectives, instructing, and evaluating student progress; Participating in the accreditation and assessment process; Supporting the program director to assure effective program operations; Participating in periodic review and revision of course materials; Maintaining current knowledge of professional discipline; Maintaining appropriate expertise and competence through continuing professional development.

Preparing and maintaining course outlines and objectives, instructing and evaluating students, and reporting progress; Participating in the assessment process, as appropriate; Participating in periodic review and revision of course materials; Maintaining current knowledge of the professional discipline, as appropriate; Maintaining appropriate expertise and competence through continuing professional development.

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Position

Responsibilities must, at a minimum, include:

Clinical Preceptor

Maintaining knowledge of program mission and goals; Understanding the clinical objectives and clinical evaluation system and evaluating students’ clinical competence; Providing students with clinical instruction and supervision; Participating in the assessment process, as appropriate; Maintaining current knowledge of program policies, procedures, and student progress and monitoring and enforcing program policies and procedures.

Clinical Staff

Understanding the clinical competency system; Understanding requirements for student supervision; Evaluating students’ clinical competence, as appropriate; Supporting the educational process; Maintaining current knowledge of program clinical policies, procedures, and student progress.

Explanation: Faculty and clinical staff responsibilities must be clearly delineated and support the program’s mission.

The program director and clinical coordinator may have other responsibilities as defined by the sponsoring institution; however, these added responsibilities must not compromise the ability, or the time allocated, to perform the responsibilities identified in this objective. For all circumstances when a program director’s and/or clinical coordinator’s appointment is less than 12 months and students are enrolled in didactic and/or clinical courses, the program director and/or clinical coordinator must assure that all program responsibilities are fulfilled.

Required Program Response: • Describe how faculty and clinical staff responsibilities are delineated.

• Describe how the delegation of responsibilities occurs to assure continuous coverage of program responsibilities, if appropriate.

• Provide documentation that faculty and clinical staff positions are clearly delineated.

• Provide assurance that faculty responsibilities are fulfilled throughout the year.

Possible Site Visitor Evaluation Methods: • Review of position descriptions • Review of handbooks • Interviews with institutional administration • Interviews with faculty • Interviews with clinical preceptors • Interviews with clinical staff • Interviews with students

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3.4

The sponsoring institution and program assure program faculty performance is evaluated and results are shared regularly to assure responsibilities are performed.

Explanation: Evaluating program faculty, including but not limited to program directors and clinical coordinators, assures that responsibilities are performed, promotes proper teaching methodology, and increases program effectiveness. The performance of program faculty must be evaluated and shared minimally once per year. Any evaluation results that identify concerns must be discussed with the respective individual(s) as soon as possible.

It is the prerogative of the program to evaluate the performance of clinical preceptors who are employees of clinical settings. If the program elects to evaluate the clinical preceptors, a description of the evaluation process should be provided to the clinical preceptors, along with the mechanism to incorporate feedback into professional growth and development.

Required Program Response: • Describe the evaluation process.

• Describe how evaluation results are shared with program faculty.

• Describe how evaluation results are shared with clinical preceptors, if applicable.

• Provide samples of evaluations of program faculty.

• Provide samples of evaluations of clinical preceptors, if applicable.

Possible Site Visitor Evaluation Methods: • Review of program evaluation materials • Review of faculty evaluation(s) • Review of clinical preceptor evaluation(s), if applicable • Interviews with institutional administration • Interviews with faculty • Interviews with clinical preceptor(s), if applicable • Interviews with students

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3.5

The sponsoring institution and/or program provide faculty with opportunities for continued professional development.

Explanation: Opportunities that enhance and advance educational, technical, and professional knowledge must be available to program faculty. Faculty should take advantage of the available resources provided on an institutional campus. Program faculty should not be expected to use personal leave time in order to attend professional development activities external to the sponsoring institution.

Required Program Response: • Describe how professional development opportunities are made available to faculty.

• Describe how professional development opportunities have enhanced teaching methodologies.

Possible Site Visitor Evaluation Methods: • Review of institutional and/or program policies for professional development • Interviews with institutional administration • Interviews with faculty

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Standard Four: Curriculum and Academic Practices The program’s curriculum and academic practices prepare students for professional practice.

Objectives: 4.1

The program has a mission statement that defines its purpose.

4.2

The program provides a well-structured curriculum that prepares students to practice in the professional discipline.

4.3

All clinical settings must be recognized by the JRCERT.

4.4

The program provides timely, equitable, and educationally valid clinical experiences for all students.

4.5

The program provides learning opportunities in advanced imaging and/or therapeutic technologies.

4.6

The program assures an appropriate relationship between program length and the subject matter taught for the terminal award offered.

4.7

The program measures didactic, laboratory, and clinical courses in clock hours and/or credit hours through the use of a consistent formula.

4.8

The program provides timely and supportive academic and clinical advisement to students enrolled in the program.

4.9

The program has procedures for maintaining the integrity of distance education courses.

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4.1

The program has a mission statement that defines its purpose.

Explanation: The program’s mission statement should clearly define the purpose or intent toward which the program’s efforts are directed. The mission statement should support the mission of the sponsoring institution. The program must evaluate the mission statement, at a minimum every three years, to assure it is effective.

The program should engage faculty and other communities of interest in the reevaluation of its mission statement.

Required Program Response: • Describe how the program’s mission supports the mission of the sponsoring institution.

• Describe how the program reevaluates its mission statement.

• Provide documentation of the reevaluation of the mission statement.

Possible Site Visitor Evaluation Methods: • Review of published program materials • Review of meeting minutes • Interviews with institutional administration • Interviews with faculty

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4.2

The program provides a well-structured curriculum that prepares students to practice in the professional discipline.

Explanation: A well-structured curriculum must be comprehensive, current, appropriately sequenced, and provide for evaluation of student achievement. This allows for effective student learning by providing a knowledge foundation in didactic and laboratory courses prior to competency achievement. Continual refinement of the competencies achieved is necessary so that students can demonstrate enhanced performance in a variety of situations and patient conditions. The well-structured curriculum is guided by a master plan of education.

At a minimum, the curriculum should promote qualities that are necessary for students/graduates to practice competently, make ethical decisions, assess situations, provide appropriate patient care, communicate effectively, and keep abreast of current advancements within the profession. Expansion of the curricular content beyond the minimum is required of programs at the bachelor’s degree or higher levels.

Use of a standard curriculum promotes consistency in radiography education and prepares the student to practice in the professional discipline. All programs must follow a JRCERT-adopted curriculum. An adopted curriculum is defined as: • the most recent American Society of Radiologic Technologists (ASRT) Radiography curriculum and/or • another professional curriculum adopted by the JRCERT Board of Directors.

The JRCERT encourages innovative approaches to curriculum delivery methods that provide students with flexible and creative learning opportunities. These methods may include, but are not limited to, distance education courses, part-time/evening curricular tracks, service learning, and/or interprofessional development.

Required Program Response: • Describe how the program’s curriculum is structured.

• Describe the program’s clinical competency-based system.

• Describe how the program's curriculum is delivered, including the method of delivery for distance education courses. Identify which courses, if any, are offered via distance education.

• Describe alternative learning options, if applicable (e.g., part-time, evening and/or weekend curricular track(s)).

• Describe any innovative approaches to curriculum delivery methods.

• Provide the Table of Contents from the master plan of education.

• Provide current curriculum analysis grid.

• Provide samples of course syllabi.

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Possible Site Visitor Evaluation Methods: • Review of the master plan of education • Review of didactic and clinical curriculum sequence • Review of input from communities of interest • Review of part-time, evening and/or weekend curricular track(s), if applicable • Review of course syllabi • Observation of a portion of any course offered via distance delivery • Interviews with faculty • Interviews with students

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4.3

All clinical settings must be recognized by the JRCERT.

Explanation: All clinical settings must be recognized by the JRCERT. Clinical settings must be recognized prior to student assignment. Ancillary medical facilities and imaging centers that are owned, operated, and on the same campus of a recognized setting do not require JRCERT recognition. A minimum of one (1) clinical preceptor must be identified for each recognized clinical setting.

If a facility is used as an observation site, JRCERT recognition is not required. An observation site is used for student observation of equipment operation and/or procedures that may not be available at recognized clinical settings. Students may not assist in, or perform, any aspects of patient care during observational assignments. Facilities where students participate in community-based learning do not require recognition.

Required Program Response: • Assure all clinical settings are recognized by the JRCERT. • Provide a listing of ancillary facilities under one clinical setting recognition.

• Describe how observation sites, if used, enhance student clinical education.

Possible Site Visitor Evaluation Methods: • Review of JRCERT database • Review of clinical records • Interviews with faculty • Interviews with clinical preceptors • Interviews with clinical staff • Interviews with students

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4.4

The program provides timely, equitable, and educationally valid clinical experiences for all students.

Explanation: Programs must have a process in place to assure timely, appropriate, and educationally valid clinical experiences to all admitted students. A meaningful clinical education plan assures that activities are equitable, as well as prevents the use of students as replacements for employees. Students must have sufficient access to clinical settings that provide a wide range of procedures for competency achievement, including mobile, surgical, and trauma examinations. The maximum number of students assigned to a clinical setting must be supported by sufficient human and physical resources. The number of students assigned to the clinical setting must not exceed the number of assigned clinical staff. The student to clinical staff ratio must be 1:1; however, it is acceptable that more than one student may be temporarily assigned to one technologist during infrequently performed procedures.

Clinical placement must be nondiscriminatory in nature and solely determined by the program. Students must be cognizant of clinical policies and procedures including emergency preparedness and medical emergencies.

Programs must assure that clinical involvement for students is limited to not more than ten (10) hours per day. If the program utilizes evening and/or weekend assignments, these assignments must be equitable, and program total capacity must not be increased based on these assignments. Students may not be assigned to clinical settings on holidays that are observed by the sponsoring institution. Programs may permit students to make up clinical time during the term or scheduled breaks; however, appropriate supervision must be maintained. Program faculty need not be physically present; however, students must be able to contact program faculty during makeup assignments. The program must also assure that its liability insurance covers students during these makeup assignments.

Required Program Response: • Describe the process for student clinical placement including, but not limited to: o assuring equitable learning opportunities, o assuring access to a sufficient variety and volume of procedures to achieve program competencies, and o orienting students to clinical settings.

• Describe how the program assures a 1:1 student to radiography clinical staff ratio at all clinical settings.

• Provide current clinical student assignment schedules in relation to student enrollment.

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Possible Site Visitor Evaluation Methods: • Review of published program materials • Review of clinical placement process • Review of course objectives • Review of student clinical assignment schedules • Review of clinical orientation process/records • Review of student records • Interviews with faculty • Interviews with clinical preceptors • Interviews with clinical staff • Interviews with students

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4.5

The program provides learning opportunities in advanced imaging and/or therapeutic technologies.

Explanation: The program must provide learning opportunities in advanced imaging and/or therapeutic technologies. It is the program’s prerogative to decide which advanced imaging and/or therapeutic technologies should be included in the didactic and/or clinical curriculum.

Programs are not required to offer clinical rotations in advanced imaging and/or therapeutic technologies; however, these clinical rotations are strongly encouraged to enhance student learning.

Students assigned to imaging modalities such as computed tomography, magnetic resonance, interventional procedures, and sonography, are not included in the calculation of the approved clinical capacity unless the clinical setting is recognized exclusively for advanced imaging modality rotations.

Once the students have completed the imaging assignments, the program must assure that there are sufficient physical and human resources to support the students upon reassignment to the radiography department.

Required Program Response: Describe how the program provides opportunities in advanced imaging and/or therapeutic technologies in the didactic and/or clinical curriculum.

Possible Site Visitor Evaluation Methods: • Review of clinical rotation schedules, if applicable • Interviews with faculty • Interviews with students

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4.6

The program assures an appropriate relationship between program length and the subject matter taught for the terminal award offered.

Explanation: Program length must be consistent with the terminal award. The JRCERT defines program length as the duration of the program, which may be stated as total academic or calendar year(s), total semesters, trimesters, or quarters.

Required Program Response: Describe the relationship between the program length and the terminal award offered.

Possible Site Visitor Evaluation Methods: • Review of course catalog • Review of published program materials • Review of class schedules • Interviews with faculty • Interviews with students

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4.7

The program measures didactic, laboratory, and clinical courses in clock hours and/or credit hours through the use of a consistent formula.

Explanation: Defining the length of didactic, laboratory, and clinical courses facilitates the transfer of credit and the awarding of financial aid. The formula for calculating assigned clock/credit hours must be consistently applied for all didactic, laboratory, and clinical courses, respectively.

Required Program Response: • Describe the method used to award credit hours for didactic, laboratory, and clinical courses.

• Provide a copy of the program’s policies and procedures for determining credit hours and an example of how such policies and procedures have been applied to the program’s coursework.

• Provide a list of all didactic, laboratory, and clinical courses with corresponding clock or credit hours.

Possible Site Visitor Evaluation Methods: • Review of published program materials • Review of class schedules • Interviews with institutional administration • Interviews with faculty • Interviews with students

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4.8

The program provides timely and supportive academic and clinical advisement to students enrolled in the program.

Explanation: Appropriate academic and clinical advisement promotes student achievement and professionalism.

Student advisement should be both formative and summative and must be shared with students in a timely manner. Programs are encouraged to develop written advisement procedures.

Required Program Response: • Describe procedures for student advisement.

• Provide sample records of student advisement.

Possible Site Visitor Evaluation Methods: • Review of students’ records • Interviews with faculty • Interviews with clinical preceptor(s) • Interviews with students

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4.9

The program has procedures for maintaining the integrity of distance education courses.

Explanation: Programs that offer distance education courses must have processes in place that assure that the students who register in the distance education courses are the same students that participate in, complete, and receive the credit. Programs must verify the identity of students by using methods such as, but not limited to, secure logins, passcodes, proctored exams, and/or video monitoring. These processes must protect the student’s privacy.

Required Program Response: • Describe the process for assuring the integrity of distance education courses.

• Provide published institutional/program materials that outline procedures for maintaining the integrity of distance education courses.

Possible Site Visitor Evaluation Methods: • Review of published institutional/program materials • Review the process of student identification • Review of student records • Interviews with institutional administration • Interviews with faculty • Interviews with students

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Standard Five: Health and Safety The sponsoring institution and program have policies and procedures that promote the health, safety, and optimal use of radiation for students, patients, and the public.

Objectives: 5.1

The program assures the radiation safety of students through the implementation of published policies and procedures.

5.2

The program assures each energized laboratory is in compliance with applicable state and/or federal radiation safety laws.

5.3

The program assures that students employ proper safety practices.

5.4

The program assures that medical imaging procedures are performed under the appropriate supervision of a qualified radiographer.

5.5

The sponsoring institution and/or program have policies and procedures that safeguard the health and safety of students.

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5.1

The program assures the radiation safety of students through the implementation of published policies and procedures.

Explanation: Appropriate policies and procedures help assure that student radiation exposure is kept as low as reasonably achievable (ALARA). The program must monitor and maintain student radiation exposure data. All students must be monitored for radiation exposure when using equipment in energized laboratories as well as in the clinical environment during, but not limited to, simulation procedures, image production, or quality assurance testing.

Students must be provided their radiation exposure report within thirty (30) school days following receipt of the data. The program must have a published protocol that identifies a threshold dose for incidents in which student dose limits are exceeded. Programs are encouraged to identify a threshold dose below those identified in federal regulations.

The program’s radiation safety policies must also include provisions for the declared pregnant student in an effort to assure radiation exposure to the student and fetus are kept as low as reasonably achievable (ALARA). The pregnancy policy must be made known to accepted and enrolled female students, and include: • a written notice of voluntary declaration, • an option for written withdrawal of declaration, and • an option for student continuance in the program without modification.

The program may offer clinical component options such as clinical reassignments and/or leave of absence. Pregnancy policies should also be in compliance with Title IX regulations. The program should work with the Title IX coordinator and/or legal counsel to discuss and resolve any specific circumstances.

Required Program Response: • Describe how the policies and procedures are made known to enrolled students.

• Describe how the radiation exposure report is made available to students.

• Provide copies of appropriate policies.

• Provide copies of radiation exposure reports.

Possible Site Visitor Evaluation Methods: • Review of published program materials • Review of student records • Review of student radiation exposure reports • Interviews with faculty • Interviews with clinical preceptor(s) • Interviews with students

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5.2

The program assures each energized laboratory is in compliance with applicable state and/or federal radiation safety laws.

Explanation: Compliance with applicable laws promotes a safe environment for students and others. Records of compliance must be maintained for the program’s energized laboratories.

Required Program Response: Provide certificates and/or letters for each energized laboratory documenting compliance with state and/or federal radiation safety laws.

Possible Site Visitor Evaluation Methods: • Review of published program materials • Review of compliance records • Interviews with faculty

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5.3

The program assures that students employ proper safety practices.

Explanation: The program must assure that students are instructed in the utilization of imaging equipment, accessories, optimal exposure factors, and proper patient positioning to minimize radiation exposure to patients, selves, and others. These practices assure radiation exposures are kept as low as reasonably achievable (ALARA).

Students must understand basic safety practices prior to assignment to clinical settings. As students progress in the program, they must become increasingly proficient in the application of radiation safety practices.

• • •

Students must not hold image receptors during any radiographic procedure.

Students should not hold patients during any radiographic procedure when an immobilization method is the appropriate standard of care.

Programs must develop policies regarding safe and appropriate use of energized laboratories by students. Students’ utilization of energized laboratories must be under the supervision of a qualified radiographer who is available should students need assistance. If a qualified radiographer is not readily available to provide supervision, the radiation exposure mechanism must be disabled.

Programs must establish a magnetic resonance imaging (MRI) safety screening protocol and students must complete MRI orientation and screening which reflect current American College of Radiology (ACR) MR safety guidelines prior to the clinical experience. This assures that students are appropriately screened for magnetic field or radiofrequency hazards. Policies should reflect that students are mandated to notify the program should their status change.

Required Program Response: • Describe how the curriculum sequence and content prepares students for safe radiation practices.

• Describe how the program prepares students for magnetic resonance safe practices.

• Provide the curriculum sequence.

• Provide policies/procedures regarding radiation safety.

• Provide the MRI safety screening protocol and screening tool.

Possible Site Visitor Evaluation Methods: • Review of program curriculum • Review of radiation safety policies/procedures • Review of magnetic resonance safe practice and/or screening protocol • Review of student handbook • Review of student records • Interviews with faculty • Interviews with clinical preceptor(s) • Interviews with clinical staff • Interviews with students 136

5.4

The program assures that medical imaging procedures are performed under the appropriate supervision of a qualified radiographer.

Explanation: Appropriate supervision assures patient safety and proper educational practices. The program must develop and publish supervision policies that clearly delineate its expectations of students, clinical preceptors, and clinical staff.

The JRCERT defines direct supervision as student supervision by a qualified radiographer who: • reviews the procedure in relation to the student’s achievement, • evaluates the condition of the patient in relation to the student’s knowledge, • is physically present during the conduct of the procedure, and • reviews and approves the procedure and/or image.

Students must be directly supervised until competency is achieved. Once students have achieved competency, they may work under indirect supervision. The JRCERT defines indirect supervision as student supervision provided by a qualified radiographer who is immediately available to assist students regardless of the level of student achievement.

Repeat images must be completed under direct supervision. The presence of a qualified radiographer during the repeat of an unsatisfactory image assures patient safety and proper educational practices.

Students must be directly supervised during surgical and all mobile, including mobile fluoroscopy, procedures regardless of the level of competency.

Required Program Response: • Describe how the supervision policies are made known to students, clinical preceptors, and clinical staff.

• Describe how supervision policies are enforced and monitored in the clinical setting.

• Provide policies/procedures related to supervision.

• Provide documentation that the program’s supervision policies are made known to students, clinical preceptors, and clinical staff.

Possible Site Visitor Evaluation Methods: • Review of published program materials • Review of student records • Review of meeting minutes • Interviews with faculty • Interviews with clinical preceptor(s) • Interviews with clinical staff • Interviews with students

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5.5

The sponsoring institution and/or program have policies and procedures that safeguard the health and safety of students.

Explanation: Appropriate health and safety policies and procedures assure that students are part of a safe, protected environment. These policies must, at a minimum, address campus safety, emergency preparedness, harassment, communicable diseases, and substance abuse. Enrolled students must be informed of policies and procedures.

Required Program Response: • Describe how institutional and/or program policies and procedures are made known to enrolled students.

• Provide institutional and/or program policies and procedures that safeguard the health and safety of students.

Possible Site Visitor Evaluation Methods: • Review of published program materials • Review of student records • Interviews with faculty • Interviews with students

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Standard Six: Programmatic Effectiveness and Assessment: Using Data for Sustained Improvement The extent of a program’s effectiveness is linked to the ability to meet its mission, goals, and student learning outcomes. A systematic, ongoing assessment process provides credible evidence that enables analysis and critical discussions to foster ongoing program improvement.

Objectives: 6.1

The program maintains the following program effectiveness data: • five-year average credentialing examination pass rate of not less than 75 percent at first attempt within six months of graduation, • five-year average job placement rate of not less than 75 percent within twelve months of graduation, and • annual program completion rate.

6.2

The program analyzes and shares its program effectiveness data to facilitate ongoing program improvement.

6.3

The program has a systematic assessment plan that facilitates ongoing program improvement.

6.4

The program analyzes and shares student learning outcome data to facilitate ongoing program improvement.

6.5

The program periodically reevaluates its assessment process to assure continuous program improvement.

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6.1

The program maintains the following program effectiveness data: • • •

five-year average credentialing examination pass rate of not less than 75 percent at first attempt within six months of graduation, five-year average job placement rate of not less than 75 percent within twelve months of graduation, and annual program completion rate.

Explanation: Program effectiveness outcomes focus on issues pertaining to the overall curriculum such as admissions, retention, completion, credentialing examination performance, and job placement.

The JRCERT has developed the following definitions and criteria related to program effectiveness outcomes: Credentialing examination pass rate: The number of graduates who pass, on first attempt, the American Registry of Radiologic Technologists (ARRT) certification examination, or an unrestricted state licensing examination, compared with the number of graduates who take the examination within six months of graduation.

Job placement rate: The number of graduates employed in the radiologic sciences compared to the number of graduates actively seeking employment in the radiologic sciences. The JRCERT has defined not actively seeking employment as: 1) graduate fails to communicate with program officials regarding employment status after multiple attempts, 2) graduate is unwilling to seek employment that requires relocation, 3) graduate is unwilling to accept employment, for example, due to salary or hours, 4) graduate is on active military duty, and/or 5) graduate is continuing education.

Program completion rate: The number of students who complete the program within the stated program length. The program specifies the entry point (e.g., required orientation date, final drop/add date, final date to drop with 100% tuition refund, official class roster date, etc.) used in calculating the program’s completion rate. When calculating the total number of students enrolled in the program (denominator), programs need not consider students who attrite due to nonacademic reasons such as: 1) financial, medical/mental health, or family reasons, 2) military deployment, 3) a change in major/course of study, and/or 4) other reasons an institution may classify as a nonacademic withdrawal.

Credentialing examination, job placement, and program completion data must be reported annually via the JRCERT Annual Report.

No Required Program Response.

Possible Site Visitor Evaluation Methods: • Review of program effectiveness data • Interviews with faculty 140

6.2

The program analyzes and shares its program effectiveness data to facilitate ongoing program improvement.

Explanation: Analysis of program effectiveness data allows the program to determine if it is meeting its mission. This analysis also provides a means of accountability to faculty, students, and other communities of interest.

Faculty should assure all data have been analyzed and discussed prior to sharing results with an assessment committee or other communities of interest. Sharing the program effectiveness data results should take place in a timely manner.

Programs must use assessment results to promote student success and maintain and improve program effectiveness outcomes. Analysis of program effectiveness data must occur at least annually, and results of the evidence-based decisions must be documented.

In sum, the data analysis process must, at a minimum, include: • program effectiveness data that is compared to expected achievement; and • documentation of discussion(s) of data analysis including trending/comparing of results over time to maintain and improve student learning. o If the program does not meet its benchmark for a specific program effectiveness outcome, the program must implement an action plan that identifies the issue/problem, allows for data trending, and identifies areas for improvement. The action plan must be reassessed annually until the performance concern(s) is/are appropriately addressed.

Required Program Response: • Describe examples of evidence-based changes that have resulted from the analysis of program effectiveness data and discuss how these changes have maintained or improved program effectiveness outcomes.

• Provide actual program effectiveness data since the last accreditation award.

• Provide documentation of an action plan for any unmet benchmarks.

• Provide documentation that program effectiveness data is shared in a timely manner.

Possible Site Visitor Evaluation Methods: • Review of aggregated data • Review of data analysis and actions taken • Review of documentation that demonstrates the sharing of results with communities of interest • Review of representative samples of measurement tools used for data collection • Interviews with faculty • Interview with institutional assessment coordinator, if applicable

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6.3

The program has a systematic assessment plan that facilitates ongoing program improvement.

Explanation: A formalized written assessment plan allows programs to gather useful data to measure the goals and student learning outcomes to facilitate program improvement. Student learning outcomes must align with the goals and be explicit, measurable, and state the learning expectations. The development of goals and student learning outcomes allows the program to measure the attainment of its mission. It is important for the program to engage faculty and other communities of interest in the development or revision of its goals and student learning outcomes.

The program must have a written systematic assessment plan that, at a minimum, contains: • goals in relation to clinical competency, communication, and critical thinking; • two student learning outcomes per goal; • two assessment tools per student learning outcome; • benchmarks for each assessment method to determine level of achievement; and • timeframes for data collection.

Programs may consider including additional goals in relation to ethical principles, interpersonal skills, professionalism, etc.

Programs at the bachelor’s and higher degree levels should consider the additional professional content when developing their goals and student learning outcomes.

The program must also assess graduate and employer satisfaction. Graduate and employer satisfaction may be measured through a variety of methods. The methods and timeframes for collection of the graduate and employer satisfaction data are the prerogatives of the program.

Required Program Response: • Describe how the program determined the goals and student learning outcomes to be included in the systematic assessment plan.

• Describe the program’s cycle of assessment.

• Describe how the program uses feedback from communities of interest in the development of its assessment plan.

• Provide a copy of the program’s current assessment plan.

Possible Site Visitor Evaluation Methods: • Review of assessment plan • Review of assessment methods • Interviews with faculty • Interview with institutional assessment coordinator, if applicable

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6.4

The program analyzes and shares student learning outcome data to facilitate ongoing program improvement.

Explanation: Analysis of student learning outcome data allows the program to determine if it is meeting its mission, goals, and student learning outcomes. This analysis also provides a means of accountability to faculty, students, and other communities of interest. Faculty should assure all data have been analyzed and discussed prior to sharing results with an assessment committee or other communities of interest. Sharing the student learning data results must take place in a timely manner.

Programs must use assessment results to promote student success and maintain and improve student learning outcomes. Analysis of student learning outcome data must occur at least annually, and results of the evidence-based decisions must be documented.

In sum, the data analysis process must, at a minimum, include: • student learning outcome data that is compared to expected achievement; and • documentation of discussion(s) of data analysis including trending/comparing of results over time to maintain and improve student learning. o If the program does meet its benchmark for a specific student learning outcome, the program should identify how student learning was maintained or improved and describe how students achieved program-level student learning outcomes. o If the program does not meet its benchmark for a specific student learning outcome, the program must implement an action plan that identifies the issue/problem, allows for data trending, and identifies areas for improvement. The action plan must be reassessed annually until the performance concern(s) is/are appropriately addressed.

Required Program Response: • Describe examples of changes that have resulted from the analysis of student learning outcome data and discuss how these changes have maintained or improved student learning outcomes.

• Describe the process and timeframe for sharing student learning outcome data results with its communities of interest.

• Provide actual student learning outcome data and analysis since the last accreditation award.

• Provide documentation of an action plan for any unmet benchmarks.

• Provide documentation that student learning outcome data and analysis is shared in a timely manner.

Possible Site Visitor Evaluation Methods: • Review of aggregated/disaggregated data • Review of data analysis and actions taken • Review of documentation that demonstrates the sharing of results with communities of interest • Review of representative samples of measurement tools used for data collection • Interviews with faculty • Interview with institutional assessment coordinator, if applicable

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6.5

The program periodically reevaluates its assessment process to assure continuous program improvement.

Explanation: Identifying and implementing needed improvements in the assessment process leads to program improvement and renewal. As part of the assessment process, the program must review its mission statement, goals, student learning outcomes, and assessment plan to assure that assessment methods are providing credible information to make evidence-based decisions.

The program must assure the assessment process is effective in measuring student learning outcomes. At a minimum, this evaluation must occur at least every three years and be documented. In order to assure that student learning outcomes have been achieved and that curricular content is well-integrated across the curriculum, programs may consider the development and evaluation of a curriculum map. Programs may wish to utilize assessment rubrics to assist in validating the assessment process.

Required Program Response: • Describe how assessment process reevaluation has occurred.

• Discuss changes to the assessment process that have occurred since the last accreditation award.

• Provide documentation that the assessment process is evaluated at least once every three years.

Possible Site Visitor Evaluation Methods: • Review of documentation related to the assessment process reevaluation • Review of curriculum mapping documentation, if applicable • Interviews with faculty • Interview with institutional assessment coordinator, if applicable

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Glossary of Terms Academic calendar: the official institutional/program document that, at a minimum, identifies specific start and end dates for each term, holidays recognized by the sponsoring institution, and breaks.

Accreditation status: a statement of the program’s current standing with the JRCERT. Per JRCERT Policies 10.000 and 10.700, accreditation status is categorized as one of the following: Accredited, Probationary Accreditation, and Administrative Probationary Accreditation. The program must also identify its current length of accreditation award (i.e., 8-year, 5-year, 3-year, probation). The JRCERT publishes each program’s current accreditation status at www.jrcert.org.

Administrator: individual(s) that oversee student activities, academic personnel, and programs.

Articulation agreement: a formal partnership between two (2) or more institutions of higher education.

Typically, this type of agreement is formed between a hospital-based program and a community college or a community college and a four (4) year academic institution with the goal of creating a seamless transfer process for students.

Campus: the buildings and grounds of a school, college, university, or hospital. A campus does not include geographically dispersed locations.

Clinical capacity: the maximum number of students that can partake in clinical experiences at a clinical setting at any given time. Clinical capacity is determined by the availability of human and/or physical resources. Students assigned to imaging modalities such as computed tomography, magnetic resonance, interventional procedures, and sonography, are not included in the calculation of the approved clinical capacity unless the clinical setting is recognized exclusively for advanced imaging modality rotations.

Clinical obligations: relevant requirements for completion of a clinical course including, but not limited to, background checks, drug screening, travel to geographically dispersed clinical settings, evening and/or weekend clinical assignments, and documentation of professional liability.

Communities of interest: the internal and external stakeholders, as defined by the program, who have a keen interest in the mission, goals, and outcomes of the program and the subsequent program effectiveness. The communities of interest may include current students, faculty, graduates, institutional administration, employers, clinical staff, or other institutions, organizations, regulatory groups, and/or individuals interested in educational activities in medical imaging and radiation oncology.

Comparable health sciences programs: health science programs established in the same sponsoring institution that are similar to the radiography program in curricular structure as well as in the number of faculty, students, and clinical settings.

Consortium: two or more academic or clinical institutions that have formally agreed to sponsor the development and continuation of an education program. A consortium must be structured to recognize and perform the responsibilities and functions of a sponsoring institution.

Curriculum map (-ping): process/matrix used to indicate where student learning outcomes are covered in each course. Level of instructional emphasis or assessment of where the student learning outcome takes place may also be indicated.

Distance education: refer to the Higher Education Opportunity Act of 2008, Pub. L. No. 110-315, §103(a)(19) and JRCERT Policy 10.800 - Alternative Learning Options.

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Asynchronous distance learning: learning and instruction that do not occur in the same place or at the same time.

Distance education: an educational process characterized by the separation, in time and/or place, between instructor and student. Distance education supports regular and substantive interaction synchronously or asynchronously between the instructor and student through one or more interactive distance delivery technologies.

Distance (Delivery) technology: instructional/delivery methods that may include the use of TV, audio, or computer transmissions (broadcast, closed-circuit, cable, microwave, satellite transmissions); audio, computer, or Internet-based conferencing; and/or methodologies.

Hybrid radiography course: a professional level radiography course that uses a mix of face-to-face traditional classroom instruction along with synchronous or asynchronous distance education instruction. Regardless of institutional definition, the JRCERT defines a hybrid radiography course as one that utilizes distance education for more than 50% of instruction and learning.

Online radiography course: a professional level radiography course that primarily uses asynchronous distance education instruction. Typically, the course instruction and learning is 100% delivered via the Internet. Often used interchangeably with Internet-based learning, web-based learning, or distance learning.

Synchronous distance learning: learning and instruction that occur at the same time and in the same place.

[Definitions based on Accrediting Commission of Education in Nursing (ACEN) Accreditation Manual glossary]

Equivalent: with regards to certification and registration, an unrestricted state license for the state in which the program and/or clinical setting is located.

Faculty: the teaching staff for didactic and clinical instruction. These individuals may also be known as academic personnel.

Faculty workload: contact/credit hours or percentages of time that reflect the manner in which the sponsoring institution characterizes, structures, and documents the nature of faculty members’ teaching and non-teaching responsibilities. Workload duties include, but are not limited to, teaching, advisement, administration, committee activity, service, clinical practice, research, and other scholarly activities.

Gatekeeper: the agency responsible for oversight of the distribution, record keeping, and repayment of Title IV financial aid.

Grievance policy and/or procedure: a grievance is defined as a claim by a student that there has been a violation, misinterpretation, or inequitable application of any existing policy, procedure, or regulation.

The program must have a policy/procedure to provide individuals an avenue to pursue grievances. If the institutional policy/procedure is to be followed, this must be clearly identified and provided to students.

The policy/procedure must outline the steps for formal resolution of any grievance. The final step in the process must not include any individual(s) directly associated with the program (e.g., program director, clinical coordinator, faculty, administrator). The procedure must assure timely resolution. The program must maintain a record of all formal grievances and their resolution. Records must be retained in accordance with the institution’s/program’s retention policies/procedures. Additionally, the program must have a procedure to address any complaints apart from those that require invoking the grievance procedure (e.g., cleanliness of classroom). The program must determine if a pattern of any grievance or complaint exists that could negatively affect the quality of the educational program.

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Master plan of education: an overview of the program and documentation of all aspects of the program.

In the event of new faculty and/or leadership to the program, a master plan of education provides the information needed to understand the program and its operations. At a minimum, a master plan of education must include course syllabi (didactic and clinical courses), program policies and procedures, and the curricular sequence calendar. If the program utilizes an electronic format, the components must be accessible by all program faculty.

Meeting minutes: a tangible record of a meeting of individuals, groups, and/or boards that serve as a source of attestation of a meeting’s outcome(s) and a reference for members who were unable to attend.

The minutes should include decisions made, next steps planned, and identification and tracking of action plans.

Program effectiveness outcomes/data: the specific program outcomes established by the JRCERT. The JRCERT has developed the following definitions and criteria related to program effectiveness outcomes: Credentialing examination pass rate: the number of graduates who pass, on first attempt, the American Registry of Radiologic Technologists (ARRT) certification examination, or an unrestricted state licensing examination, compared with the number of graduates who take the examination within six months of graduation.

Job placement rate: the number of graduates employed in the radiologic sciences compared to the number of graduates actively seeking employment in the radiologic sciences. The JRCERT has defined not actively seeking employment as: 1) graduate fails to communicate with program officials regarding employment status after multiple attempts, 2) graduate is unwilling to seek employment that requires relocation, 3) graduate is unwilling to accept employment due to salary or hours, 4) graduate is on active military duty, and/or 5) graduate is continuing education.

Program completion rate: the number of students who complete the program within the stated program length. The program specifies the entry point (e.g., required orientation date, final drop/add date, final date to drop with 100% tuition refund, official class roster date, etc.) used in calculating the program’s completion rate. When calculating the total number of students enrolled in the program (denominator), programs need not consider graduates who attrite due to nonacademic reasons such as: 1) financial, medical/mental health, or family reasons, 2) military deployment, 3) a change in major/course of study, and/or 4) other reasons an institution may classify as a nonacademic withdrawal.

Program total capacity: the maximum number of students that can be enrolled in the educational program at any given time. Program total capacity is dependent on the availability of human and physical resources of the sponsoring institution. It is also dependent on the program’s clinical rotation schedule and the clinical capacities of recognized clinical settings.

Release time (reassigned workload): a reduction in the teaching workload to allow for the administrative functions associated with the responsibilities of the program director or clinical coordinator or other responsibilities as assigned.

Sponsoring institution: the facility or organization that has primary responsibility for the educational program and grants the terminal award. A recognized institutional accreditor must accredit a sponsoring institution. Educational programs may be established in: community and junior colleges; senior colleges and universities; hospitals; medical schools; postsecondary vocational/technical schools and institutions; military/governmental facilities; proprietary schools; and consortia. Consortia must be structured to recognize and perform the responsibilities and functions of a sponsoring institution.

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Awarding, Maintaining, and Administering Accreditation A.

Program/Sponsoring Institution Responsibilities 1.

Applying for Accreditation The accreditation review process conducted by the Joint Review Committee on Education in Radiologic Technology (JRCERT) is initiated by a program through the written request for accreditation sent to the JRCERT, on program/institutional letterhead.

The request must include the name of the program, the type of program, and the address of the program. The request is to be submitted, with the applicable fee, to: Joint Review Committee on Education in Radiologic Technology 20 North Wacker Drive, Suite 2850 Chicago, IL 60606-3182 Submission of such information will allow the program access to the JRCERT’s Accreditation Management System (AMS). The initial application and self-study report will then be available for completion and submission through the AMS.

2.

Administrative Requirements for Maintaining Accreditation a. Submitting the self-study report or a required progress report within a reasonable period of time, as determined by the JRCERT. b. Agreeing to a reasonable site visit date before the end of the period for which accreditation was awarded. c. Informing the JRCERT, within a reasonable period of time, of changes in the institutional or program officials, program director, clinical coordinator, full-time didactic faculty, and clinical preceptor(s). d. Paying JRCERT fees within a reasonable period of time. Returning, by the established deadline, a completed Annual Report. e. Returning, by the established deadline, any other information requested by the JRCERT. Programs are required to comply with these and other administrative requirements for maintaining accreditation. Additional information on policies and procedures is available at www.jrcert.org.

Program failure to meet administrative requirements for maintaining accreditation will lead to Administrative Probationary Accreditation and potentially result in Withdrawal of Accreditation.

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B.

JRCERT Responsibilities 1.

Administering the Accreditation Review Process The JRCERT reviews educational programs to assess compliance with the Standards for an Accredited Educational Program in Radiography.

The accreditation process includes a site visit.

Before the JRCERT takes accreditation action, the program being reviewed must respond to the report of findings.

The JRCERT is responsible for recognition of clinical settings.

2.

Accreditation Actions Consistent with JRCERT policy, the JRCERT defines the following as accreditation actions: Accreditation, Probationary Accreditation, Administrative Probationary Accreditation, Withholding Accreditation, and Withdrawal of Accreditation (Voluntary and Involuntary).

For more information regarding these actions, refer to JRCERT Policy 10.200.

A program or sponsoring institution may, at any time prior to the final accreditation action, withdraw its request for initial or continuing accreditation.

Educators may wish to contact the following organizations for additional information and materials: Accreditation:

Joint Review Committee on Education in Radiologic Technology 20 North Wacker Drive, Suite 2850 Chicago, IL 60606-3182 (312) 704-5300 www.jrcert.org

Curriculum:

American Society of Radiologic Technologists 15000 Central Avenue, S.E. Albuquerque, NM 87123-3909 (505) 298-4500 www.asrt.org

Certification:

American Registry of Radiologic Technologists 1255 Northland Drive St. Paul, MN 55120-1155 (651) 687-0048 www.arrt.org

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Copyright © 2020 by the JRCERT

Subject to the condition that proper attribution is given and this copyright notice is included on such copies, the JRCERT authorizes individuals to make up to one hundred (100) copies of this work for non-commercial, educational purposes. For permission to reproduce additional copies of this work, please write to: JRCERT 20 North Wacker Drive Suite 2850 Chicago, IL 60606-3182 (312) 704-5300 (312) 704-5304 (fax) mail@jrcert.org (e-mail) www.jrcert.org

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The ASRT Practice Standards for Medical Imaging and Radiation Therapy

©2024 American Society of Radiologic Technologists. All rights reserved. Reprinting all or part of this document is prohibited without advance written permission of the ASRT. Send reprint requests to the 148 ASRT Publications Department, 15000 Central Ave. SE, Albuquerque, NM 87123-3909.

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Table of Contents

Preface .......................................................................................................................................................... 3 Format ....................................................................................................................................................... 3 Definition....................................................................................................................................................... 4 Introduction .............................................................................................................................................. 4 Education and Certification ......................................................................................................................... 10 Introduction ............................................................................................................................................ 10 Medical Imaging and Radiation Therapy Scope of Practice ........................................................................ 16 Standards .................................................................................................................................................... 21 Standard One – Assessment .................................................................................................................... 21 Standard Two – Analysis/Determination ................................................................................................. 25 Standard Three – Education .................................................................................................................... 28 Standard Four – Performance ................................................................................................................. 31 Standard Five – Evaluation ...................................................................................................................... 37 Standard Six – Implementation ............................................................................................................... 40 Standard Seven – Outcomes Measurement............................................................................................ 42 Standard Eight – Documentation ............................................................................................................ 44 Standard Nine – Quality .......................................................................................................................... 47 Standard Ten – Self-Assessment and Professional Development ........................................................... 49 Standard Eleven – Collaboration and Collegiality .................................................................................... 51 Standard Twelve – Ethics ........................................................................................................................ 53 Standard Thirteen – Research, Innovation and Professional Advocacy .................................................. 55 Advisory Opinion Statements ...................................................................................................................... 57 Guidance for the Communication of Clinical and Imaging Observations and Procedure Details by Radiologist Assistants to Supervising Radiologists ................................................................................. 58 Medication Administration in Peripherally Inserted Central Catheter Lines or Ports With a Power Injector*† ................................................................................................................................................ 61 Medication Administration Through New or Existing Vascular Access*† ............................................... 63 Placement of Personnel Radiation Monitoring Devices .......................................................................... 65 Supervision of Contrast Media Administration by Radiologist Assistants ............................................... 67 Use of Postexposure Shuttering, Cropping and Electronic Masking in Radiography.............................. 69 Glossary ....................................................................................................................................................... 72

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Preface The ASRT Practice Standards for Medical Imaging and Radiation Therapy serve as a guide for the medical imaging and radiation therapy profession. These standards define the practice and establish general criteria to determine compliance. Practice standards are authoritative statements established by the profession, through evidentiary documentation, for evaluating the quality of practice, service and education provided by individuals within the profession.

The Practice Standards can be used by individual facilities to develop job descriptions and practice parameters. Those outside the profession can use the standards as an overview of the role and responsibilities of individuals within the profession.

The medical imaging and radiation therapy professional and any individual who is legally authorized to perform medical imaging or radiation therapy must be educationally prepared and clinically competent as a prerequisite to professional practice. The individual should, consistent with all applicable legal requirements and restrictions, exercise individual thought, judgment and discretion in the performance of the procedure. Federal and state statutes, regulations, accreditation standards and institutional policies could dictate practice parameters and may supersede these standards Format The ASRT Practice Standards for Medical Imaging and Radiation Therapy are divided into six sections: • Definition – defines the practice of medical imaging and radiation therapy professionals.

• Education and Certification – describes the minimum qualifications for the education and certification of individuals in addition to an overview of the specific practice.

• Medical Imaging and Radiation Therapy Scope of Practice – delineates the parameters of the specific practice.

• Standards – incorporate patient assessment and management with procedural analysis, performance and evaluation. The Practice Standards define the activities of the individual responsible for the care of patients and delivery of medical imaging and radiation therapy procedures; in the technical areas of performance, such as equipment and material assessment safety standards and total quality management; and in the areas of education, interpersonal relationships, self-assessment and ethical behavior.

• Advisory Opinion Statements – provide explanations of the Practice Standards and are • intended for clarification and guidance for specific practice issues.

Gl d fi d bb i i d h h h P i S d d The Practice Standards are numbered and followed by a term or set of terms that describes the standards. The next statement is the expected performance of the individual when performing the procedure or treatment. A rationale follows and explains why an individual should adhere to the particular standard of performance. Each standard is divided into two parts: the general criteria and the specific criteria. Both general and specific criteria should be used when evaluating performance.

• General Criteria –apply to all medical imaging and radiation therapy professionals.

• Specific Criteria – apply to medical imaging and radiation therapy professionals in PS 3

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specialized modalities.

Definition

Introduction The medical imaging and radiation therapy profession comprises health care professionals identified as a bone densitometry technologist, cardiac-interventional and vascularinterventional technologist, computed tomography technologist, limited x-ray machine operator, magnetic resonance technologist, mammographer, medical dosimetrist, nuclear medicine technologist, quality management technologist, radiation therapist, radiographer, radiologist assistant or sonographer who are educationally prepared and clinically competent as identified by these standards Furthermore, these standards apply to health care employees who are legally authorized to perform medical imaging or radiation therapy and who are educationally prepared and clinically competent as identified by these standards.

Medical imaging and radiation therapy professionals are vital members of a multidisciplinary team that forms a core of highly trained health care professionals, who each bring expertise to the area of patient care. They play a critical role in the delivery of health services as new modalities emerge and the need for medical imaging and radiation therapy procedures Medical imaging and radiation therapy integrates scientific knowledge, technical competence and patient interaction skills to provide safe and accurate procedures with the highest regard to all aspects of patient care. A medical imaging and radiation therapy professional recognizes elements unique to each patient, which is essential for the successful completion of the Medical imaging and radiation therapy professionals are the primary liaison between patients, licensed practitioners and other members of the health care team. These professionals must remain sensitive to the needs of the patient through communication, assessment, monitoring and patient care. As members of the health care team, medical imaging and radiation therapy professionals participate in quality improvement processes and continually assess their professional performance.

Medical imaging and radiation therapy professionals think critically and use independent, professional and ethical judgment in all aspects of their work. They engage in continuing education to include their area of practice to enhance patient care, safety, public education, knowledge and technical competence.

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Bone Densitometry The practice of bone densitometry is performed by health care professionals responsible for the administration of ionizing radiation for diagnostic, therapeutic or research purposes. A bone densitometry technologist performs bone densitometry procedures and acquires and analyzes data needed for diagnosis at the request of and for interpretation by a licensed Bone densitometry technologists independently perform or assist the licensed practitioner in the completion of densitometric procedures. Bone densitometry technologists document medications in accordance with federal and state laws, regulations or lawful institutional policy.

Cardiac-Interventional and Vascular-Interventional The practice of cardiac-interventional and vascular-interventional is performed by health care professionals responsible for the administration of ionizing radiation for diagnostic, therapeutic or research purposes. A cardiac-interventional and vascular-interventional technologist performs radiographic, fluoroscopic and other procedures and acquires and analyzes data needed for diagnosis at the request of and for interpretation by a licensed Cardiac-interventional and vascular-interventional technologists independently perform or assist the licensed practitioner or radiologist assistant in the completion of cardiacinterventional and vascular-interventional procedures. Cardiac-interventional and vascularinterventional technologists prepare, administer and document activities related to medications and radiation exposure in accordance with federal and state laws, regulations, or Computed Tomography The practice of computed tomography is performed by health care professionals responsible for the administration of ionizing radiation for diagnostic, therapeutic or research purposes. A computed tomography technologist performs computed tomography and molecular imaging procedures and acquires and analyzes data needed for diagnosis, interpretation and the performance of interventional and therapeutic procedures at the request of and for interpretation by a licensed practitioner.

Computed tomography technologists independently perform or assist the licensed practitioner or radiologist assistant in the completion of computed tomography and molecular imaging procedures. Computed tomography technologists prepare, administer and document activities related to medications and radiation exposure in accordance with federal and state laws, regulations, or lawful institutional policy.

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Limited X-ray Machine Operator The operation of x-ray equipment in a limited scope is performed by health care employees responsible for the administration of ionizing radiation for diagnostic purposes. A limited x-ray machine operator performs radiographic procedures within the limited scope of practice and acquires and analyzes data needed for diagnosis at the request of and for interpretation by a licensed practitioner.

Limited x-ray machine operators are individuals other than a radiographer who perform static diagnostic radiographic images on selected anatomical sites. Limited x-ray machine operators perform their duties under the direction of a licensed practitioner, radiographer or, when indicated, a medical physicist.

Magnetic Resonance The practice of magnetic resonance is performed by health care professionals responsible for the use of radiofrequencies within a magnetic field for diagnostic, therapeutic or research purposes. A magnetic resonance technologist performs magnetic resonance and molecular imaging procedures and acquires and analyzes data needed for diagnosis at the request of and for interpretation by a licensed practitioner.

Magnetic resonance technologists independently perform or assist the licensed practitioner or radiologist assistant in the completion of magnetic resonance and molecular imaging procedures. Magnetic resonance technologists prepare, administer and document activities related to medications in accordance with federal and state laws, regulations, or lawful Mammography The practice of mammography is performed by health care professionals responsible for the administration of ionizing radiation and multi-frequency sound waves for diagnostic, therapeutic or research purposes. A mammographer performs breast imaging procedures and acquires and analyzes data, including mammographic and sonographic images needed for diagnosis, at the request of and for interpretation by a licensed practitioner.

Mammographers independently perform or assist the licensed practitioner or radiologist assistant in the completion of mammographic and sonographic breast imaging procedures.

Mammographers prepare, administer and document activities related to medications and radiation exposure in accordance with federal and state laws, regulations, or lawful institutional policy.

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Medical Dosimetry The practice of medical dosimetry is performed by health care professionals responsible for designing a treatment plan for use in the administration of ionizing radiation for the purpose of treating diseases, primarily cancer. Medical dosimetrists independently perform duties and complete responsibilities under the supervision of qualified medical physicists and radiation oncologists. Medical dosimetrists generate an optimal treatment plan and ensure the appropriate transfer of data that the radiation therapist will use to treat the patient.

Medical dosimetrists must maintain a high degree of accuracy, thoroughness and safety in treatment planning optimization, treatment techniques and positioning. Medical dosimetrists assist the radiation oncologist in localizing the treatment area, generate a treatment plan and communicate with the radiation oncology team to enable and ensure the appropriate transfer of information.

Nuclear Medicine The practice of nuclear medicine is performed by health care professionals responsible for the administration of ionizing radiation (radioactive material and computed tomography), nonionizing radiation and adjunctive medications for diagnostic, therapeutic, radiotheranostics or research purposes. Radioactive materials, medications and imaging and nonimaging equipment are used in nuclear medicine and molecular imaging to study various organs, body systems and samples to aid in the diagnosis, treatment, radiotheranostics and treatment planning of various pathological conditions. A nuclear medicine technologist performs nuclear medicine and molecular imaging procedures, radiotheranostics or therapies, and acquires and analyzes data at the request of and for interpretation by a licensed practitioner and under the s per ision of an a thori ed ser N clear medicine technologists also administer the Nuclear medicine technologists independently perform or assist the licensed practitioner or radiologist assistant and authorized user in the completion of nuclear medicine and molecular imaging procedures, radiotheranostics and treatments. Nuclear medicine technologists prepare, administer and document activities related to ionizing radiation (radioactive material and computed tomography), nonionizing radiation, medications and radiation exposure in accordance with federal and state laws, regulations, or lawful institutional policy.

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Quality Management The practice of quality management is performed by health care professionals responsible for the identification, measurement, control and improvement of the various core processes that will ultimately lead to improved medical imaging and radiation therapy department Today’s medical imaging and radiation therapy departments involve multiple modalities, creating an interdisciplinary team. The quality management technologist is a member of the health care team, which includes clinicians, management, support staff and Quality management has four main components: quality planning, quality control, quality assurance and quality improvement. Quality management focuses on the means to achieve image and service quality. A quality management technologist combines all of these components to ensure efficient and effective patient care.

Quality management technologists independently perform or assist the medical physicist in the completion of quality control procedures. Quality management technologists prepare, administer and document activities related to all facets of quality management in accordance with federal and state laws, regulations, or lawful institutional policy.

Radiation Therapy The practice of radiation therapy is performed by health care professionals responsible for the administration of high doses of ionizing radiation for the purpose of treating diseases, primarily cancer. A radiation therapist acquires and analyzes data in preparation for patient treatment, uses various imaging technologies to localize the treatment area, participates in treatment planning and performs radiation therapy procedures as prescribed and supervised by a radiation oncologist. Radiation therapists perform procedures in accordance with federal and state laws regulations or lawful institutional policy Radiation therapists are the primary liaison between patients and other members of the radiation oncology team. They also provide a link to other health care providers, such as social workers and dietitians. Radiation therapists must remain sensitive to the needs of the patient through communication, patient assessment, patient monitoring and patient care skills.

Radiation therapy often involves daily treatments extending over several weeks using highly sophisticated equipment It requires thorough initial planning as well as constant patient care Radiography The practice of radiography is performed by health care professionals responsible for the administration of ionizing radiation for diagnostic, therapeutic or research purposes. A radiographer performs a full scope of radiographic and fluoroscopic procedures and acquires and analyzes data needed for diagnosis at the request of and for interpretation by a licensed practitioner.

Radiographers independently perform or assist the licensed practitioner or radiologist assistant in the completion of radiographic and fluoroscopic procedures. Radiographers prepare, administer and document activities related to medications and radiation exposure in accordance with federal and state laws, regulations, or lawful institutional policy.

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Radiologist Assistant A radiologist assistant practices under the supervision of a radiologist and enhances patient care in radiology services. As a member of the radiologist-led team, the radiologist assistant performs invasive and noninvasive procedures at the request of and for interpretation by a Radiologist assistants act as liaisons between patients, radiographers, radiologists and other members of the health care team. Radiologist assistants remain sensitive to the physical, cultural and emotional needs of patients through communication, comprehensive patient assessment, continuous patient monitoring and advanced patient care skills.

Radiologist assistants maintain their radiographer credentials; therefore, both the radiologist assistant and radiography sections of the Practice Standards should be consulted when seeking practice information for the radiologist assistant. The clinical activities are delegated by the supervising radiologist in accordance with federal and state laws, regulations, or lawful institutional policies.

Sonography The practice of sonography is performed by health care professionals responsible for the administration of multi-frequency sound waves and other techniques for diagnostic, therapeutic or research purposes. A sonographer performs sonographic and molecular imaging procedures and acquires and analyzes data needed for diagnosis at the request of and for interpretation by a licensed practitioner.

Sonographers independently perform or assist the licensed practitioner or radiologist assistant in the completion of sonographic and molecular imaging procedures. Sonographers prepare, administer and document activities related to medications in accordance with federal and state laws, regulations, or lawful institutional policy.

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Education and Certification Introduction Medical imaging and radiation therapy professionals must be educationally prepared and clinically competent as a prerequisite to professional practice. Only medical imaging and radiation therapy professionals who have completed the appropriate education and training as outlined in these standards should perform medical imaging and radiation therapy procedures. Individuals working in more than one modality must meet these requirements in the specific modalities they are responsible to perform.

Medical imaging and radiation therapy professionals should be registered by certification agencies recognized by the ASRT. Individuals performing diagnostic or therapeutic procedures in more than one modality will adhere to the general and specific criteria for each area of practice To maintain certification(s), medical imaging and radiation therapy professionals must complete appropriate continuing education requirements to sustain their expertise and awareness of changes and advances in practice.

Medical imaging and radiation therapy professionals performing multimodality hybrid procedures should meet certification requirements for the diagnostic or therapeutic portion of the procedure and must be educationally prepared and clinically competent in the specific modality for which they perform attenuation correction or anatomical localization.

Medical imaging and radiation therapy professionals performing multimodality hybrid procedures should be registered by certification agencies recognized by the ASRT in the modality for the diagnostic or therapeutic portion of the procedure. Individuals performing multimodality hybrid procedures will adhere to the specific criteria for the diagnostic or therapeutic portion of the procedure.

Medical imaging and radiation therapy professionals performing multimodality hybrid procedures should complete continuing education requirements in the modality used for the diagnostic or therapeutic portion of the procedure and maintain education and clinical competence in the modality used for attenuation correction or anatomical localization.

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Bone Densitometry Only medical imaging and radiation therapy professionals who have completed the appropriate education and obtained certification(s) as outlined in these standards should perform bone densitometry procedures.

Bone densitometry technologists prepare for their roles on the interdisciplinary team by meeting postprimary examination eligibility criteria as determined by the ARRT. Those who have passed the ARRT bone densitometry postprimary examination use the additional credential (BD).

The ISCD is another certifying agency. Individuals with a primary medical imaging or radiation therapy certification who have passed the ISCD certified bone densitometry technologist examination use the additional credential CBDT. Cardiac-Interventional and Vascular-Interventional Only medical imaging and radiation therapy professionals who have completed the appropriate education and obtained certification(s) as outlined in these standards should perform cardiac- interventional and vascular-interventional procedures.

Cardiac-interventional and vascular-interventional technologists prepare for their roles on the interdisciplinary team by meeting postprimary examination eligibility criteria as determined by the ARRT or CCI. Those who have passed the ARRT cardiac-interventional, cardiovascular-interventional or vascular-interventional radiography postprimary examinations use the additional credentials (CI), (CV) or (VI), respectively.

CCI is another certifying agency. Individuals with primary certification in radiography who have passed the CCI cardiovascular invasive specialist examination as a postprimary certification use the additional credential RCIS. Computed Tomography Only medical imaging and radiation therapy professionals who have completed the appropriate education and obtained certification(s) as outlined in these standards should perform computed tomography and molecular imaging procedures.

Computed tomography technologists prepare for their roles on the interdisciplinary team by meeting postprimary examination eligibility criteria as determined by the ARRT or NMTCB. Those who have passed the ARRT or NMTCB computed tomography postprimary examination use the additional credential (CT).

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Limited X-ray Machine Operator Limited x-ray machine operators prepare for their roles on the interdisciplinary team in several ways. Various education and training programs for limited x-ray machine operators exist throughout the United States.

Many states require the completion of a program of study prior to administering a state licensure exam for limited x-ray machine operators. Several states use some or all of the Limited Scope of Practice in Radiography state licensing exams developed by the ARRT. States that administer an exam and issue a license or certification may use various terminologies to designate a limited x- ray machine operator. Limited x-ray machine operators shall only perform ionizing radiation procedures within their limited scope of practice.

Magnetic Resonance Only medical imaging and radiation therapy professionals who have completed the appropriate education and obtained certification(s) as outlined in these standards should perform magnetic resonance and molecular imaging procedures.

Magnetic resonance technologists prepare for their roles on the interdisciplinary team by meeting primary or postprimary examination eligibility criteria as determined by the ARRT. Those who have passed the ARRT magnetic resonance primary examination use the credential R.T.(MR).

Those who have passed the ARRT magnetic resonance postprimary examination use the additional credential (MR).

Mammography Only medical imaging and radiation therapy professionals who have completed the appropriate education and obtained certification(s) as outlined in these standards should perform mammography and breast sonography procedures.

Mammographers prepare for their roles on the interdisciplinary team by meeting postprimary examination eligibility criteria as determined by the ARRT. Those who have passed the ARRT mammography postprimary examination use the additional credential (M).

Those who have passed the ARRT breast sonography postprimary examination use the additional credential (BS).

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Medical Dosimetry Only medical imaging and radiation therapy professionals who have completed the appropriate education and obtained certification(s) as outlined in these standards should perform medical dosimetry procedures.

Medical dosimetrists prepare for their roles on the interdisciplinary team by meeting the examination eligibility criteria established by the MDCB. Those who have passed the medical dosimetry examination use the credential Nuclear Medicine Only medical imaging and radiation therapy professionals who have completed the appropriate education and obtained certification(s) as outlined in these standards should perform nuclear medicine and molecular imaging procedures, radiotheranostics or therapies.

Nuclear medicine technologists prepare for their roles on the interdisciplinary team by meeting examination eligibility criteria as determined by the ARRT or NMTCB. Those who have passed the ARRT examination use the credential R.T.(N).

Those who have passed the NMTCB examination use the credential CNMT. Those who have passed the NMTCB nuclear cardiology, positron emission tomography or radiation safety specialty examinations use the additional credentials NCT, PET or NMTCB (RS), respectively.

Quality Management Only medical imaging and radiation therapy professionals who have completed the appropriate education and obtained certification(s) as outlined in these standards should perform quality management procedures.

Quality management technologists prepare for their roles on the interdisciplinary team by meeting postprimary examination eligibility criteria as determined by the ARRT. Those who have passed the ARRT quality management postprimary examination use the additional credential (QM).

HQCC is another certifying agency. Individuals with a primary medical imaging or radiation therapy certification who have passed the Certified Professional in Healthcare Quality examination use the additional credential CPHQ.

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Radiation Therapy Only medical imaging and radiation therapy professionals who have completed the appropriate education and obtained certification(s) as outlined in these standards should perform radiation therapy procedures.

Radiation therapists prepare for their roles on the interdisciplinary team by meeting examination eligibility criteria as determined by the ARRT. Those who have passed the ARRT radiation therapy examination use the credential R.T.(T).

Radiography Only medical imaging and radiation therapy professionals who have completed the appropriate education and obtained certification(s) as outlined in these standards should perform radiographic and fluoroscopic procedures.

Radiographers prepare for their roles on the interdisciplinary team by meeting examination eligibility criteria as determined by the ARRT. Those who have passed the ARRT radiography examination use the credential R.T.(R).

Radiologist Assistant Only radiographers who have completed the appropriate education and obtained certification(s) as outlined in these standards should perform radiologist assistant procedures.

Radiologist assistants prepare for their roles in medical imaging by meeting examination eligibility criteria as determined by the ARRT. Those who have passed the registered radiologist assistant examination use the additional credential R.R.A.

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Sonography Only medical imaging and radiation therapy professionals who have completed the appropriate education and obtained certification(s) as outlined in these standards should perform sonographic and molecular imaging procedures.

Sonographers prepare for their roles on the interdisciplinary team by meeting primary or postprimary examination eligibility criteria as determined by the ARDMS, ARRT or CCI. Those who have passed the ARDMS examination(s) use the credentials RDCS, RDMS, RMSKS or RVT. Those who have passed the ARRT primary examination use the credential R.T.(S) or R.T.(VS).

Those who have passed the CCI examination(s) use the credentials RCCS, RCS, RPhS or RVS. Those who have passed the ARRT breast sonography, sonography or vascular sonography postprimary examinations use the additional credentials (BS), (S) or (VS), respectively.

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Medical Imaging and Radiation Therapy Scope of Practice Scopes of practice delineate the parameters of practice and identify the boundaries for practice. A comprehensive procedure list for the medical imaging and radiation therapy professional is impractical because clinical activities vary by the practice needs and expertise of the individual. As medical imaging and radiation therapy professionals gain more experience, knowledge and clinical competence, the clinical activities may evolve.

The scope of practice of the medical imaging and radiation therapy professional • Administering medications enterally, parenterally, through new or existing vascular access or through other routes as prescribed by a licensed practitioner.*† • Administering medications with an infusion pump or power injector as prescribed by a licensed practitioner.*† • Administering oxygen as prescribed by a licensed practitioner.

• Applying, implementing and monitoring AI. • Applying principles of ALARA to minimize exposure to patient, self and others.

• Applying principles of patient safety during all aspects of patient care.

• Assisting in maintaining medical records while respecting confidentiality and adhering to HIPAA and established policy.

• Corroborating a patient’s clinical history with the procedure and ensuring information is documented and available for use by a licensed practitioner.

• Educating and monitoring students and other health care providers.* • Evaluating images for proper positioning and determining if additional images will • improve the procedure or treatment outcome.

• Evaluating images for technical quality and ensuring proper identification is recorded.

• Identifying and responding to emergency situations.

Identifying, calculating, compounding, preparing or administering medications as • prescribed by a licensed practitioner.*† • Performing ongoing quality assurance activities.

• Performing point-of-care testing as prescribed by a licensed practitioner.† • Performing venipuncture as prescribed by a licensed practitioner.*† • Postprocessing data.

• Preparing patients for • procedures. Providing education.

Providing input for equipment and software purchase and supply decisions when • appropriate or requested.

• Providing optimal patient care.

Receiving, relaying and documenting verbal, written and electronic orders in the patient’s • medical record.

Selecting the appropriate protocol and optimizing technical factors while maximizing • patient safety.

Starting, maintaining and/or removing intravenous access as prescribed by a licensed • practitioner.*† * Excludes limited x-ray machine operator † Excludes medical dosimetry

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• Verifying informed consent for applicable procedures.* Bone Densitometry • Performing bone densitometry procedures as prescribed by a licensed practitioner.

• Performing and monitoring quality control procedures for bone densitometry Cardiac-Interventional and Vascular-Interventional • Assisting a licensed practitioner or radiologist assistant with fluoroscopic and specialized interventional radiography procedures.

• Maintaining intra-arterial access as prescribed by a licensed practitioner.

• Panning the procedure table during image production.

• Participating in physiologic monitoring of patients.

• Performing diagnostic/interventional procedures as prescribed by a licensed • practitioner. Performing manual and mechanical hemostasis, including the use of vascular closure devices, as prescribed by a licensed practitioner.

• Performing noninterpretive fluoroscopic procedures as prescribed by a licensed practitioner.

• Placing, maintaining and removing peripherally inserted central catheters as prescribed b li d titi Computed Tomography • Assisting a licensed practitioner or radiologist assistant with interventional computed tomography procedures.

• Performing computed tomography and molecular imaging procedures as prescribed by a licensed practitioner.

Limited X-ray Machine Operator • Assisting a licensed practitioner or radiographer during static radiographic • procedures. Performing diagnostic radiographic procedures within the limited scope of practice as prescribed by a licensed practitioner.

Magnetic Resonance • Applying principles of magnetic resonance safety to minimize risk to patient, self and others.

• Assisting a licensed practitioner or radiologist assistant with magnetic resonance interventional procedures.

• Performing magnetic resonance and molecular imaging procedures as prescribed by a licensed practitioner.

• Selecting appropriate pulse sequences with consideration given to established protocols and other factors influencing data acquisition parameters.

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Mammography • Assisting a licensed practitioner or radiologist assistant with interventional breast procedures.

• Imaging pathologic breast specimens as prescribed by a licensed practitioner.

• Performing breast ultrasound procedures as prescribed by a licensed practitioner.

• Performing mammographic procedures per facility policy or as prescribed by a licensed practitioner.

• Performing or assisting with clinical breast examination Medical Dosimetry • Designing and generating optimal treatment plans in collaboration with a radiation oncologist.

• Evaluating treatment plans for accuracy.

• Monitoring doses to normal tissues within the irradiated volume to ensure tolerance levels are not exceeded.

• Obtaining and incorporating patient data from medical imaging procedures or manual methods to be used in simulation, treatment planning, treatment delivery and quality assurance.

• Participating in brachytherapy treatment planning and delivery.

• Participating in simulation under the supervision of a radiation oncologist.

• • Performing dosimetric calculations.

Performing or assisting with the fabrication of patient immobilization and other • treatment devices. f dd l d d d l Nuclear Medicine • Applying principles of magnetic resonance safety to minimize risk to patient, self and others when performing PET-MR. • Assembling, calibrating, maintaining, eluting and administering radiopharmaceuticals from the radionuclide infusion system and the generator while complying with standards and as prescribed by a licensed practitioner and under the supervision of an authorized user.

• Performing hybrid imaging, including PET-CT, PET-MR and SPECT-CT for emission, transmission, attenuation correction, anatomical location and for use in radiation therapy treatment planning when performed within hybrid imaging as prescribed by a licensed practitioner and under the supervision of an authorized user.

• Performing nuclear medicine and molecular imaging procedures, radiotheranostics or therapies as prescribed by a licensed practitioner and under the supervision of an • authorized user.

Procuring, identifying, calculating, preparing and/or administering ionizing radiation (radioactive material and computed tomography) and nonionizing radiation as

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Quality Management • Coordinating, performing and monitoring quality control procedures for all types of equipment.

• Creating policies and procedures to meet regulatory, accreditation and fiscal requirements.

• Ensuring adherence to accreditation, federal, state and local regulatory requirements.

• Facilitating change through appropriate management processes.

• Facilitating performance improvement processes.

• Facilitating the department’s quality assessment and improvement plan.

• Monitoring exposure factors and/or procedural protocols in accordance with ALARA principles and age-specific considerations.

• Performing physics surveys independently on general radiographic and fluoroscopic • equipment, with medical physicist oversight.

Providing assistance to staff for image optimization, including patient positioning, • proper equipment use and image critique.

• Providing practical information regarding techniques and tools for process • improvement. Serving as a resource regarding regulatory, accreditation and fiscal Radiation Therapy • Constructing/preparing immobilization, beam directional and beam-modification • devices. Delivering radiation therapy treatments as prescribed by a radiation oncologist.

• Detecting and reporting significant changes in patients’ conditions and determining when to withhold treatment until the radiation oncologist is consulted.

• Monitoring doses to normal tissues within the irradiated volume to ensure tolerance levels are not exceeded.

• Participating in brachytherapy procedures.

• Participating in superficial radiation therapy procedures as prescribed by a licensed practitioner.

• Performing simulation, localization, treatment planning procedures and dosimetric calculations as prescribed by a radiation oncologist.

• Using imaging technologies for the explicit purpose of simulation, treatment planning dt t t d li ib d b di ti l it Radiography • Assisting a licensed practitioner or radiologist assistant with fluoroscopic and specialized radiologic procedures.

• Performing diagnostic radiographic and noninterpretive fluoroscopic procedures as prescribed by a licensed practitioner.

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Radiologist Assistant • Assessing, monitoring and managing patient status, including patients under minimal and moderate sedation.

• Assisting with data collection and review for clinical trials or other research.

• Communicating the supervising radiologist’s report to the appropriate health care provider consistent with the ACR Practice Guidelines for Communication of Diagnostic Imaging Findings.

• Completing patient history and physical.

• Emphasizing patient safety and verifying procedure appropriateness by analyzing and incorporating evidenced-based practices for optimal patient care.

• Evaluating images for completeness and diagnostic quality and recommending additional images.

• Identifying and administering radioactive materials as prescribed by a supervising • radiologist and under the supervision of an authorized user.

Identifying variances that may influence the expected outcome through preprocedural • evaluation as part of the radiologist-led team.

Obtaining images necessary for diagnosis and communicating initial observations to the supervising radiologist. The radiologist assistant does not provide image interpretation • as defined by the ACR. • Participating in or obtaining informed consent.

• Participating in quality assurance activities within the radiology practice.

Performing or assisting with invasive or noninvasive procedures as delegated by the radiologist who is licensed to practice and has privileges for the procedure • being performed by the radiologist assistant.

Sonography • Collaborating with a licensed practitioner or radiologist assistant in the performance of sonographic interventional procedures.

• Ensuring equipment parameters for diagnostic and interventional procedures are of optimal technical and administrative quality as requested by a licensed practitioner.

• Performing diagnostic, interventional and molecular imaging sonographic procedures as prescribed by a licensed practitioner or during appropriate educational activities.

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Standards Standard One – Assessment The medical imaging and radiation therapy professional collects pertinent data about the patient, procedure, equipment and work environment.

Rationale Information about the patient’s health status is essential in providing appropriate imaging and therapeutic services. The planning and provision of safe and effective medical services relies on the collection of pertinent information about equipment, procedures and the work The medical imaging and radiation therapy professional: General Criteria • Assesses and maintains the integrity of medical supplies and medications, properly disposing when indicated.

• Assesses any potential patient limitations or factors that may affect the procedure.

• Assesses patient lab values, medication list and risk for allergic reaction(s) prior to procedure and administration of medication.*† • Confirms that equipment performance, maintenance and operation comply with the manufacturer’s specifications.

• Determines that services are performed in a safe environment, minimizing potential hazards.

• Maintains restricted access to controlled areas.

• Obtains and reviews relevant previous procedures and information from all available • resources.

• Recognizes signs and symptoms of an emergency.

Verifies appropriateness of the requested or prescribed procedure, in compliance with • the clinical indication and protocol.

Verifies parameters when using AI to ensure patient safety in accordance with ALARA • principles.

• Verifies patient identification.

Verifies that protocol and procedure manuals include recommended criteria and are • reviewed and revised.

• Verifies that the patient has consented to the procedure.

Specific Criteria Bone Densitometry • Assesses patient compliance with prescribed treatment as it relates to the • procedure. Confirms all required quality control tests are performed. * Excludes limited x-ray machine operator † Excludes medical dosimetry

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Cardiac-Interventional and Vascular-Interventional Refer to general criteria.

Computed Tomography • Verifies that a registered technologist is physically present at the CT console to perform a remote CT procedure.

Limited X-ray Machine Operator • Develops and maintains standardized exposure technique guidelines for all • equipment. Maintains and performs quality control on radiation safety equipment.

Magnetic Resonance • Assesses patient for factors that may contribute to anxiety or claustrophobia.

• Identifies and removes items that may affect safety, damage the equipment or affect the image quality.

• Screens patient and others for potential magnetic resonance contraindications, either within the body or on their person, prior to entering the magnet room.

• Verifies that a registered technologist with MR Level 2 Personnel training is physically present at the MR console throughout a remote MR procedure Mammography • Assesses the need for alternative procedures based on the patient’s age, hormonal or lactation status and the presence of surgical implants.

• Confirms all required quality control tests are performed.

Medical Dosimetry • Assesses the patient’s need for information and • reassurance. Reviews patient history for previous

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Nuclear Medicine • Complies with regulations and federal and state laws to minimize radiation exposure levels.

• Maintains and performs quality control on radiation safety equipment, radionuclide infusion systems and generators according to regulatory agencies.

• Identifies and removes items that may affect safety, damage the equipment or affect the image quality when performing PET-MR. • Performs area monitoring and surveys to assess radiation exposure levels and contamination sites.

• Reviews theranostic protocol criteria and assesses contraindications and conditions that may affect the therapy.

• Screens patient and others for potential magnetic resonance contraindications, either within the body or on their person, prior to entering the magnet room when • performing PET-MR. • Verifies the patient’s lactation or breastfeeding status. f ’ Quality Management • Assesses policies, protocols and guidelines to improve safety, efficiency and patient care, and identify the potential impact to the facility.

• Identifies the customers served by medical imaging and radiation therapy.

• Identifies the processes used in customer service.

Radiation Therapy Assesses the patient’s need for information and reassurance.

Identifies and removes objects that could interfere with prescribed treatment.

Inspects beam modifying and immobilization devices prior to use.

Monitors and assesses patients throughout the treatment course and follow-up visits.

Monitors doses to normal tissues.

Monitors side effects and reactions to treatment.

Monitors treatment unit operation during use.

Recognizes the patient’s need for referral to other care providers, such as a social worker, nurse or dietitian.

• Reviews beam shaping devices prior to treatment delivery.

• Reviews treatment protocol criteria and assesses conditions affecting treatment • d li R i t t t d i t t t t i l ti Radiography • • • • • • • •

• Develops and maintains standardized exposure technique guidelines for all • equipment. Maintains and performs quality control on radiation safety equipment.

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Radiologist Assistant Assesses the patient’s level of anxiety and pain and informs the supervising radiologist.

Interviews patient to obtain, verify and update medical history.

Observes and assesses a patient who has received minimal and moderate sedation.

Performs a history and physical examination, analyzes data, and reports findings as part of a radiologist-led team.

• Performs area monitoring and surveys to assess radiation exposure levels and contamination sites.

• Verifies the patient's lactation or breastfeeding status • • • •

Sonography • Verifies that a registered sonographer operates the offsite equipment during a remote procedure.

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Standard Two – Analysis/Determination The medical imaging and radiation therapy professional analyzes the information obtained during the assessment phase and develops an action plan for completing the Rationale Determining the most appropriate action plan enhances patient safety and comfort, optimizes diagnostic and therapeutic quality and improves efficiency.

The medical imaging and radiation therapy professional: General Criteria • Consults appropriate medical personnel to determine an action plan.

• Determines that all procedural requirements are in place to achieve a quality procedure.

• Determines the appropriate type and dose of contrast media to be administered based on established protocols.*† • Determines the course of action for an emergent situation.

• Determines the need for and selects supplies, accessory equipment, shielding, positioning and immobilization devices.

• Develops methods for minimizing hazards associated with medical imaging and radiation therapy procedures.

• Employs professional judgment to adapt procedures to improve diagnostic quality or therapeutic outcomes.

• Evaluates and monitors services, procedures, equipment and the environment to determine if they meet or exceed established guidelines and develops the action plan.

• Selects the most appropriate and efficient action plan after reviewing all pertinent data d i h i ’ bili i d di i Specific Criteria Bone Densitometry Refer to general criteria.

Cardiac-Interventional and Vascular-Interventional • Analyzes and determines action plans in conjunction with the cardiovascular Computed Tomography • Reviews the patient’s medical record and the licensed practitioner’s request to determine optimal scanning protocol for clinical indication.

* Excludes limited x-ray machine operator † Excludes medical dosimetry

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Limited X-ray Machine Operator • Develops, maintains and makes available optimal exposure technique guidelines for all radiographic equipment.

Magnetic Resonance • Reviews the patient’s medical record and licensed practitioner’s request to determine optimal protocol and imaging parameters for clinical indications.

• Selects appropriate imaging coil.

Mammography • Monitors the patient’s need for information and reassurance throughout the • procedure. Selects appropriate equipment and imaging techniques to optimize the Medical Dosimetry • Gathers and analyzes pertinent data relevant to the treatment planning and delivery process.

• Participates in reviewing patient treatment parameters and dose records to ensure treatment does not exceed the prescribed dose or normal tissue tolerances.

• Recommends the appropriate immobilization devices and positioning aids for simulation and treatment.

• Recommends when to hold treatment until a radiation oncologist is notified.

• Reviews the treatment record and verifies calculations before and/or after treatment delivery.

• Verifies the treatment summary and the mathematical accuracy of the prescription Nuclear Medicine • Determines radiopharmaceutical dosage based on protocol, patient’s age, weight, medical and physical status.

• Evaluates results of quality control testing on radioactive material.

• Reviews the patient’s medical record and the examination request to determine optimal procedure parameters for clinical indications.

• Selects appropriate data acquisition equipment and accessories to perform the Quality Management • Assesses and prioritizes the current processes to improve quality while focusing on issues needing immediate response.

• Assesses proposed changes to minimize organizational disruption during • implementation. Clarifies current steps in a process to minimize redundancy, reordering and improving service flow.

• Creates an effective action plan after reviewing all pertinent data while assessing possible options, fiscal impact and ease of implementation.

• Develops monitoring metrics.

• Establishes benchmarks and quality indicators to assess quality management issues PS 26

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• Monitors and develops methods to improve customer Radiation Therapy • Determines when to contact the radiation oncologist or licensed practitioner regarding patient side effects or questions.

• Determines when to withhold treatment until a radiation oncologist is contacted.

• Ensures the appropriate imaging technique is chosen for image-guided radiation therapy procedures.

• Participates in decisions about appropriate simulation techniques and treatment • positions. Reviews doses daily to ensure that treatment does not exceed prescribed dose, normal tissue tolerance or treatment protocol constraints.

• Reviews and verifies patient treatment plan and prescription prior to initial treatment delivery.

• Reviews and evaluates patient treatment records prior to each treatment for • prescription or treatment procedure changes.

Reviews treatment record, calculations and/or treatment plan for accuracy prior to • treatment delivery.

• Reviews verification images prior to treatment.

• Verifies machine quality assurance has been performed.

• Verifies the mathematical accuracy of the prescription and the daily treatment Radiography • Develops, maintains and makes available optimal exposure technique guidelines for all radiographic and fluoroscopic equipment.

Radiologist Assistant • Reviews the patient’s medical record and the licensed practitioner’s request to determine optimal imaging procedure for clinical indications.

Sonography • Monitors the patient’s need for information and reassurance throughout the • procedure. Selects appropriate equipment and imaging techniques to optimize the

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1

Standard Three – Education The medical imaging and radiation therapy professional provides information about the procedure and related health issues according to protocol; informs the patient, public and other health care providers about procedures, equipment and facilities.

Rationale Education and communication are necessary to establish a positive relationship, promote safe practices and provide quality patient care.

The medical imaging and radiation therapy professional: General Criteria • Educates the patient, public and other health care providers about procedures, the associated biological effects and radiation protection.

• Elicits confidence and cooperation from the patient, the public and other health care providers by providing timely communication and effective instruction.

• Explains effects and potential side effects of medications.*† • Provides accurate explanations and instructions at an appropriate time and at a level the patient and their care providers can understand; addresses questions and concerns regarding the procedure.

• Provides information about the role of AI. • Provides information on certification or accreditation to the patient, other health care providers and the public.

• Provides information to patients, health care providers, students and the public • concerning the role and responsibilities of individuals in the profession.

• Provides pre-, peri- and post-procedure education.

R f i b di i i li d ii Specific Criteria Bone Densitometry Refer to general criteria.

* Excludes limited x-ray machine operator † Excludes medical dosimetry

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Cardiac-Interventional and Vascular-Interventional Refer to general criteria.

Computed Tomography Refer to general criteria.

Limited X-ray Machine Operator Refer to general criteria.

Magnetic Resonance • Provides magnetic resonance safety Mammography • Displays all certification and accreditation documents of compliance.

• Educates the patient about the need for adequate compression to achieve a quality mammogram and instructs the patient to communicate if the compression becomes intolerable.

• Educates the patient about the risk factors for breast cancer and the benefits of early detection.

• Educates the patient about the value and use of additional projections and alternative breast imaging procedures.

• Provides mammography consumer information in accordance with federal and state regulations and guidelines Medical Dosimetry • Explains the role and function of the medical dosimetrist in the overall treatment • course. Reviews the treatment plan with the patient as requested by a radiation Nuclear Medicine • Ensures radiation safety instruction information and limitations are provided to the patient and others during and following radiotheranostics and therapeutic • procedures. Provides instruction to the patient and others regarding the reduction of radiation exposure during and after the procedure.

• Provides magnetic resonance safety education when performing PET-MR. Quality Management Refer to general criteria.

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Radiation Therapy • Anticipates a patient’s need for information and provides it throughout the treatment course.

• Instructs patient in the maintenance of treatment markings.

• Provides information and instruction on proper skin care, diet and self-care • procedures. Provides pre-, peri- and post-procedure instructions to the patient for simulation and treatment.

Radiography Refer to general criteria.

Radiologist Assistant • Provides precare and postcare instructions to the patient as part of the radiologistled team.

Sonography • Educates patients and other health care professionals of the potential exposure risks associated with nonmedical entrepreneurial or entertainment 2D/3D/4D sonographic procedures.

• Educates patients and other health care professionals that the use of 2D/3D/4D sonography for nonmedical entrepreneurial or entertainment purposes is an unethical practice.

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Standard Four – Performance The medical imaging and radiation therapy professional performs the action plan and quality assurance activities, including modifications when needed.

Rationale Quality patient services are provided through the safe and accurate performance of a deliberate plan of action. Quality assurance activities provide valid and reliable information regarding the performance of equipment, materials and processes.

The medical imaging and radiation therapy professional: General Criteria • Adheres to radiation safety rules and standards.

• Administers contrast media and other medications only when a licensed practitioner is immediately available to ensure proper diagnosis and treatment of adverse events.*† • Administers first aid or provides life support.† • Applies principles of aseptic or sterile technique.

• Assesses and monitors the patient’s physical, emotional and mental status.

• Consults with medical physicist or engineer in performing and documenting quality control tests and in reviewing of quality assurance.

• Explains to the patient each step of the action plan as it occurs and elicits the cooperation of the patient.

• Immobilizes patient for procedure.

• • Implements an action plan.

• Maintains current information on equipment, materials and processes.

Modifies the action plan according to changes in the clinical situation, equipment or • environment.

• Monitors the patient for reactions to medications.*† • Participates in ALARA, patient and personnel safety and risk management activities.

• Performs ongoing quality assurance activities and quality control testing.

• Performs procedural timeout.

• Positions patient for anatomic area of interest, respecting patient ability and comfort.

• Supports and implements the safe use of new technologies and procedures.

• Uses accessory equipment.

• Uses an integrated team approach.

• Uses personnel radiation monitoring devices as indicated by the RSO or designee.

Works aseptically in the appropriate environment while preparing compounding and

* Excludes limited x-ray machine operator † Excludes medical dosimetry

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Specific Criteria Bone Densitometry • Applies the concepts of accuracy and precision in bone • densitometry. Confirms patient position matches the selected scan • parameters.

Cardiac-Interventional and Vascular-Interventional • Coordinates and manages the collection and labeling of tissue and fluid specimens.

• Monitors ECG, blood pressure, respiration, oxygen saturation, level of consciousness and pain pre-, peri- and post-procedure.

Computed Tomography Adheres to protocol scan length to optimize patient dose.

Confirms patient position matches the selected scanning orientation parameters.

Coordinates and manages the collection and labeling of tissue and fluid specimens.

Determines optimum placement of ECG electrodes and correctly identifies ECG wave trigger.

• Optimizes technical factors to minimize radiation exposure to the patient while maintaining diagnostic image quality.

• Performs a remote CT procedure when a registered technologist is physically present with the patient.

• Uses radiation shielding devices.

• Utilizes isocentering of the anatomy of interest to optimize dose Limited X-ray Machine Operator • • • •

• Reviews patient exposure records and reject analyses as part of the quality assurance program.

• Uses appropriate uniquely identifiable pre-exposure radiopaque markers for anatomical and procedural purposes.

• Uses pre-exposure collimation and proper field-of-view selection.

Magnetic Resonance • Ensures that anyone who is pregnant is not in the magnetic resonance scanner bore or scan room during actual data acquisition or scanning, unless medically necessary.

• Identifies appropriate cardiac or respiratory triggers.

• Monitors the patient’s specific absorption rate and other factors related to patient • heating. Performs a remote MR procedure when a registered technologist with MR Level 2 Personnel training is physically present with the patient.

• Positions imaging coil.

• Provides hearing protection to patient and others.

• Uses appropriate positioning and/or insulation materials to protect the patient from excessive heating and burns PS 32

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Mammography • Applies appropriate radiopaque markers to the breast to indicate anatomic landmarks, including nipples, scars and lumps.

• Coordinates and manages the collection and labeling of tissue and fluid specimens.

• Ensures correct annotation of images.

• Ensures sonographic correlation to mammographic findings.

• Exercises clinical judgment in the application of adequate compression to acquire a quality mammographic image.

• Recognizes sonographic appearance of normal and abnormal breast tissue Medical Dosimetry • Adheres to established best practice protocols, guidelines and radiation oncologist directives.

• Calculates treatment unit parameters and doses to treatment volumes and points of interest.

• Collaborates with the radiation therapist, medical physicist and radiation oncologist regarding the simulation and treatment processes and procedures.

• Demonstrates safe handling, storing and disposal of brachytherapy sources.

• Develops a treatment plan as prescribed by a radiation oncologist.

• Ensures an independent machine-setting check is completed before treatment is delivered.

• Makes the recommendation to discontinue patient treatment until equipment is • operating properly.

• Prepares or assists in preparing brachytherapy sources and equipment.

Reviews treatment planning data for accuracy and appropriateness prior to input into

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Nuclear Medicine • Administers radioactive material enterally, parenterally or through new or existing vascular access devices or through other routes as prescribed by a licensed practitioner and under the supervision of an authorized user.

• Coordinates and manages the collection and labeling of tissue and fluid specimens, including radiolabeling.

• Demonstrates safe handling, receipt, storage and disposal of radioactive materials.

• Determines optimum placement of ECG electrodes and correctly identifies ECG wave trigger and/or pattern.

• Ensures that anyone who is pregnant is not in the magnetic resonance scanner bore or scan room during actual data acquisition or scanning, unless medically necessary when performing PET-MR. • Follows aseptic technique in the appropriate environments while preparing, compounding, dispensing and repackaging sterile and nonsterile radiopharmaceuticals • in compliance with USP and FDA standards.

• Follows appropriate USP standards for beyond-use date and vial puncture standard.

• Follows USP standards for immediate use of sterile radiopharmaceuticals.

Maintains security of radioactive material to reduce radiation exposure to patients, • personnel and general public.

• Manipulates a radiopharmaceutical unit dose and performs dose pooling.

Monitors for internal exposure when applicable including bioassays, blood and urine • collection as directed by RSO or designee.

• Monitors shielding effectiveness.

• Provides hearing protection to patient and others when performing PET- MR. Uses appropriate positioning and/or insulation materials to protect the patient • from excessive heating and burns when performing PET-MR. • Uses radiation detecting equipment.

• Uses radiation shielding devices Quality Management • • • • •

Assesses process flow.

Collects and analyzes data using standard tools.

Identifies variables and implements changes to improve performance.

Investigates adverse events and continuously monitors outcomes to minimize risk. Uses knowledge to modify current practices.

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Radiation Therapy • Achieves precision patient alignment using imaging and external markings.

• Acquires and manages simulation and verification images.

• Assists the radiation oncologist in determining the optimum treatment field to cover the target volume.

• Calculates monitor units and treatment times.

• Demonstrates safe handling, storage and disposal of brachytherapy sources.

• Exports data to treatment planning systems.

• Makes the decision to discontinue patient treatment until equipment is operating • properly. Monitors the patient visually and aurally during treatment.

• Monitors the treatment console during treatment.

• Obtains radiation oncologist’s approval of images prior to initiation of treatment.

• Performs clinically indicated treatment imaging and motion management techniques.

• Performs quality assurance checks on simulator, treatment unit and appropriate • equipment.

• Prepares or assists in the preparation of brachytherapy sources and equipment.

Uses knowledge of biological effects of ionizing radiation on tissue to minimize radiation • dose to normal tissues.

• Uses radiation shielding devices.

Verifies that only the patient is in the treatment room prior to initiating treatment or any Radiography • Coordinates and manages the collection and labeling of tissue and fluid specimens.

• Reviews patient exposure records and reject analyses as part of the quality assurance program.

• Uses appropriate uniquely identifiable pre-exposure radiopaque markers for anatomical and procedural purposes.

• Uses pre-exposure collimation and proper field-of-view selection.

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Radiologist Assistant Administers medications as approved by the supervising radiologist.

Administers minimal and moderate sedation as prescribed by the supervising radiologist. Collects and documents tissue and fluid specimens.

Demonstrates safe handling and disposal of radioactive materials.

Maintains security of radioactive material to reduce radiation exposure to patients, personnel and general public.

• Monitors patient’s physical condition during the procedure and responds to changes in patient vital signs, hemodynamics and level of consciousness.

• Participates in quality reporting measures for the purpose of improved patient care.

• Recognizes and responds to medical emergencies, activates emergency response systems and provides advanced life support intervention.

• • Uses radiation detecting equipment.

U di ti hi ldi d i h h dli di h ti l Sonography • • • • •

Adheres to evidence-based practices to mitigate work-related musculoskeletal disorders.

Coordinates and manages the collection and labeling of tissue and fluid specimens.

Ensures correct annotation of images.

Performs a remote procedure when a registered technologist is physically present with the patient.

• Recognizes sonographic appearance of normal and abnormal tissue structures and physiological data • • • •

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Standard Five – Evaluation The medical imaging and radiation therapy professional determines whether the goals of the action plan have been achieved, evaluates quality assurance results and establishes an appropriate action plan.

Rationale Careful examination of the procedure is important to determine that expected outcomes have been met. Equipment, materials and processes depend on ongoing quality assurance activities that evaluate performance based on established guidelines.

The medical imaging and radiation therapy professional: General Criteria • Communicates the revised action plan to appropriate team members.

• Completes the evaluation process in a timely, accurate and comprehensive manner.

• Confirms data is accurate and complete.

• Develops a revised action plan to achieve the intended outcome.

• Evaluates discrepancies and variances when using AI. • Evaluates images for optimal demonstration of anatomy of interest.

• Evaluates quality assurance and quality control results.

• Evaluates the patient, equipment and procedure to identify variances that might affect the expected outcome.

• Identifies exceptions to the expected outcome.

• Measures the procedure against established policies, protocols and benchmarks.

• V lid t lit t l t ti diti d lt Specific Criteria Bone Densitometry • Evaluates and identifies unexpected bone mineral density • changes. Reviews previous scan(s) and reanalyzes as necessary.

• Reviews T-scores and Z-scores to modify the action plan.

Cardiac-Interventional and Vascular-Interventional • Evaluates access site for complications requiring intervention or further Computed Tomography Refer to general criteria.

Limited X-ray Machine Operator • Evaluates images for the purpose of monitoring radiation exposure.

• Evaluates images to determine the use of appropriate imaging parameters.

• Verifies that exposure indicator data for digital radiographic systems has not been altered or modified and is included in the DICOM header and on images exported to PS 37

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Magnetic Resonance Refer to general criteria.

Mammography • Collaborates with the lead interpreting physician and medical physicist to maintain quality and comply with federal and state regulations and guidelines.

Medical Dosimetry • Acquires data necessary to perform accurate patient protocol plans and participates in implementation of the plan.

• Ensures treatment parameters have been transferred correctly to the oncology information system.

• Reviews treatment calculations and ensures the validity of the treatment plan.

• Reviews treatment variances and assists in determining possible causes and Nuclear Medicine • Consults with a licensed practitioner to confirm procedural completeness.

• Reviews procedure to determine if additional images or data will enhance the diagnostic value.

Quality Management • Evaluates customer satisfaction.

• Evaluates measured processes and results against established policies, protocols, guidelines and benchmarks.

• Evaluates adverse events to minimize risk.

Radiation Therapy • • • • • • • •

Checks treatment calculations or treatment plan, or both when applicable.

Compares verification images to reference images.

Evaluates the patient daily for any side effects, reactions and therapeutic responses.

Performs treatment chart checks.

Reviews treatment discrepancies, determines causes and assists with the action plan. Reviews verification images for quality and accuracy.

Verifies the accuracy of the patient setup prior to treatment delivery.

Verifies treatment console readouts and settings prior to initiating treatment and upon termination of treatment

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Radiography • Evaluates images for the purpose of monitoring radiation exposure.

• Evaluates images to determine the use of appropriate imaging parameters.

• Verifies that exposure indicator data for digital radiographic systems has not been altered or modified and is included in the DICOM header and on images exported to Radiologist Assistant Refer to general criteria.

Sonography Refer to general criteria.

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Standard Six – Implementation The medical imaging and radiation therapy professional implements the revised action plan based on quality assurance results and achievement of goals from the action plan.

Rationale It may be necessary to implement a revised action plan to promote safe and effective The medical imaging and radiation therapy professional: General Criteria • Adjusts imaging parameters, patient procedure or additional factors to improve the outcome.

• Bases the revised plan on the patient’s condition and the most appropriate means of achieving the expected outcome.

• Implements the revised action plan.

• Implements appropriate health care provider notification when immediate clinical response is necessary, based on procedural findings and patient condition.

• Obtains assistance to support the quality assurance action plan.

• Resolves discrepancies and variances with AI. • Takes action based on patient and procedural variances Specific Criteria Bone Densitometry Refer to general criteria.

Cardiac-Interventional and Vascular-Interventional Refer to general criteria.

Computed Tomography Refer to general criteria.

Limited X-ray Machine Operator Refer to general criteria.

Magnetic Resonance Refer to general criteria.

Mammography Refer to general criteria.

Medical Dosimetry • Develops additional treatment plans to achieve an optimal dose

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• Ensures accuracy in the transfer and documentation of treatment parameters, according to departmental policies.

• Reviews and implements treatment field changes indicated on simulation or verification images as directed by a radiation oncologist.

Nuclear Medicine • Employs devices to minimize radiation levels.

• Manages radioactive contamination and uses decontamination • procedures. Performs additional images or data collections as needed.

Quality Management • Develops policies, protocols and guidelines in collaboration with other health care providers.

Radiation Therapy • Collaborates with radiation oncologists, medical physicists and medical dosimetrists to make adjustments ensuring treatment accuracy.

• Establishes congruence between verification images and reference images.

• Formulates recommendations for process improvements to minimize treatment discrepancies.

• Implements treatment plan or treatment field changes as directed by the radiation oncologist.

• Reports deviations from the standard or planned treatment Radiography Refer to general criteria.

Radiologist Assistant • Manages radioactive contamination and uses decontamination Sonography Refer to general criteria.

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Standard Seven – Outcomes Measurement The medical imaging and radiation therapy professional reviews and evaluates the outcome of the procedure according to quality assurance standards.

Rationale To evaluate the quality of care, the actual outcome is compared to the expected outcome. Outcomes assessment is an integral part of the ongoing quality management action plan to enhance services.

The medical imaging and radiation therapy professional: General Criteria • Assesses the patient’s physical, emotional and mental status prior to • Evaluates the process and recognizes opportunities for future changes.

• Measures and evaluates the results of the appropriate action plan.

• Reviews all data for completeness and accuracy.

• Reviews and evaluates quality assurance processes and tools for • effectiveness. Reviews the implementation process for accuracy and validity.

• Uses evidence-based practice to determine whether the actual outcome is within established criteria Specific Criteria Bone Densitometry Refer to general criteria.

Cardiac-Interventional and Vascular-Interventional Refer to general criteria.

Computed Tomography Refer to general criteria.

Limited X-ray Machine Operator Refer to general criteria.

Magnetic Resonance Refer to general criteria.

Mammography Refer to general criteria.

Medical Dosimetry Refer to general criteria.

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Nuclear Medicine Refer to general criteria.

Quality Management • • • • • •

Assesses differences between expected and actual outcomes.

Assesses implemented changes for improvement.

Develops methods to demonstrate continuous improvement.

Develops strategies for maintaining improvement.

Evaluates the effectiveness of and supports changes to processes Performs procedural analysis

Radiation Therapy • Monitors patient status during procedures, throughout the treatment course and for follow-up care.

Radiography Refer to general criteria.

Radiologist Assistant • Performs follow-up patient evaluation and communicates findings to the supervising radiologist.

Sonography Refer to general criteria.

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Standard Eight – Documentation The medical imaging and radiation therapy professional documents information about patient care, procedures and outcomes.

Rationale Clear and precise documentation is essential for continuity of care, accuracy of care and quality assurance.

The medical imaging and radiation therapy professional: General Criteria • Archives images or data.

• Documents diagnostic, treatment and patient data in the medical record in a timely, accurate and comprehensive manner.

• Documents medication administration in patient’s medical record.*† • Documents procedural timeout.

• Documents unintended outcomes or exceptions from the established criteria.

• Maintains documentation of quality assurance activities, procedures and results.

• Provides pertinent information to authorized individual(s) involved in the patient’s • care. Records information used for billing and coding procedures.

• Reports any out-of-tolerance deviations to the appropriate personnel.

• Verifies patient consent is documented Specific Criteria Bone Densitometry Refer to general criteria.

Cardiac-Interventional and Vascular-Interventional • • • • •

Documents administered medications.

Documents or assists in documenting patient medical history related to the procedure. Documents radiation exposure parameters and initiates further action as needed.

Documents use of sedation.

Computed Tomography • Archives or documents radiation exposure.

• Documents the use of shielding devices and proper radiation safety Limited X-ray Machine Operator Documents radiation exposure.

• Documents the use of shielding devices and proper radiation safety •

* Excludes limited x-ray machine operator † Excludes medical dosimetry

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Magnetic Resonance Refer to general criteria.

Mammography • Documents quality assurance and quality control outcomes and necessary corrective action according to established guidelines.

• Records interval changes in breast sonographic findings compared to previous Medical Dosimetry • Reports any treatment variances in accordance with departmental, institutional and national quality assurance guidelines.

Nuclear Medicine • Documents dose and route of administered radiopharmaceutical or radionuclide therapy in the patient medical record.

• Documents instrumentation quality testing procedures and maintains results for • review. Documents radioactive materials quality testing procedures and maintains results for inspection.

• Documents the implementation, evaluation and modification of the radiation safety plan under the authority of the RSO. • Maintains records of the receipt administration and disposal of radioactive materials Quality Management Documents goals and outcomes based on data analysis.

Documents process flow variances and justifies exceptions.

Documents steps used to improve processes.

Updates institutional policies, protocols and guidelines to ensure continuous compliance with regulatory requirements.

• Provides reports as required by institutional policy, accrediting bodies and federal and state regulations • • • •

Radiation Therapy • Maintains imaging and treatment records according to institutional • policy. Reports treatment discrepancies and variances to appropriate Radiography • Documents fluoroscopic time.

• Documents radiation exposure.

• Documents the use of shielding devices and proper radiation safety

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Radiologist Assistant Communicates and documents radiologist’s order to other health care providers.

Documents a history and physical examination in the patient record.

Documents administration of medications.

Documents and assists radiologist in quality reporting measures for the purpose of improved patient care.

• Documents dose and route of administered radiopharmaceutical in the patient medical record.

• Documents the implementation, evaluation and modification of the radiation safety plan under the authority of the RSO. • Documents use of minimal and moderate sedation.

• Reports clinical and imaging observations and procedure details to the supervising radiologist Sonography • • • •

• Documents initial impressions and technical data for interpretation by a licensed practitioner.

• Records interval changes in sonographic findings compared to previous imaging.

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Standard Nine – Quality The medical imaging and radiation therapy professional strives to provide optimal Rationale Patients expect and deserve optimal care during diagnosis and The medical imaging and radiation therapy professional: General Criteria • Adheres to standards, policies, statutes, regulations and established • guidelines. Anticipates, considers and responds to the needs of a diverse • patient population. Applies professional judgment and discretion while • performing the procedure. Assists with establishing required quality assurance • and quality control criteria. Collaborates with others to elevate the quality of • care.

• Establishes the parameters of AI and develops quality assurance activities.

• Maintains ALARA principles while utilizing integrated AI technology Specific Criteria Bone Densitometry • Advocates that facilities determine precision error and calculate the least significant change.

• Advocates that facilities have at least one practicing technologist with a bone densitometry certification as recognized by the ASRT. Cardiac-Interventional and Vascular-Interventional Refer to general criteria.

Computed Tomography • Advocates that facilities performing remote CT require a registered technologist be physically present with the patient.

Limited X-ray Machine Operator Refer to general criteria.

Magnetic Resonance • Advocates the need for a minimum of one registered magnetic resonance technologist and one additional MR Level 2 Personnel as the standard for safe and efficient delivery of magnetic resonance procedures.

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Mammography • Assists in setting policy and procedures in the facility to meet certification and accreditation standards specific to breast imaging.

• Prepares the annual medical outcomes audit and provides results to the lead interpreting physician.

• Reviews the annual MQSA inspection, medical outcomes audit and medical physicist’s reports to assess the quality of the breast imaging equipment’s performance and the facility’s quality assurance program Medical Dosimetry Refer to general criteria.

Nuclear Medicine • Performs procedures in accordance with the NRC or in agreement with state Quality Management • Verifies the achievement of goals and identifies exceptions.

Radiation Therapy • Maintains all elements of best practice when performing superficial radiation therapy procedures under the direction of a licensed practitioner.

• Promotes patient safety by performing external beam treatments with a minimum of two registered radiation therapists.

Radiography Refer to general criteria.

Radiologist Assistant • Performs procedures in accordance with the NRC or in agreement with state Sonography Refer to general criteria.

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Standard Ten – Self-Assessment and Professional Development The medical imaging and radiation therapy professional evaluates personal performance and maintains professional growth.

Rationale Self-assessment is necessary for personal growth and professional development. This can direct education necessary to maintain current knowledge and advancements in the profession to provide optimal patient care.

The medical imaging and radiation therapy professional: General Criteria • Advocates for and participates in continuing education related to area of practice to maintain and enhance clinical competency.

• Advocates for and participates in vendor-specific applications training to maintain clinical competency.

• Assesses personal work ethics, behaviors and attitudes.

• Evaluates performance, applies personal strengths and recognizes opportunities for educational growth and improvement.

• Maintains credentials and certification related to practice.

• Maintains knowledge of the most current practices and technology used to optimize patient exposure while producing quality images.

• Recognizes hazards associated with their work environment and takes measures to mitigate them Specific Criteria Bone Densitometry Refer to general criteria.

Cardiac-Interventional and Vascular-Interventional • Maintains competency in the use of diagnostic and interventional Computed Tomography Refer to general criteria.

Limited X-ray Machine Operator • Investigates avenues to continue progress to become a registered Magnetic Resonance Refer to general criteria.

Mammography Refer to general criteria.

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Medical Dosimetry Refer to general criteria.

Nuclear Medicine Refer to general criteria.

Quality Management Refer to general criteria.

Radiation Therapy Refer to general criteria.

Radiography Refer to general criteria.

Radiologist Assistant Refer to general criteria.

Sonography Refer to general criteria.

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Standard Eleven – Collaboration and Collegiality The medical imaging and radiation therapy professional promotes a positive and collaborative practice atmosphere with other members of the health care team.

Rationale To provide quality patient care, all members of the health care team must communicate effectively and work together efficiently.

The medical imaging and radiation therapy professional: General Criteria • Develops and maintains collaborative partnerships to enhance quality and • efficiency. Informs and instructs others about radiation safety.

• Promotes understanding of the profession.

• Shares knowledge and expertise with others.

Specific Criteria Bone Densitometry Refer to general criteria.

Cardiac-Interventional and Vascular-Interventional Refer to general criteria.

Computed Tomography Refer to general criteria.

Limited X-ray Machine Operator Refer to general criteria.

Magnetic Resonance Refer to general criteria.

Mammography Refer to general criteria.

Medical Dosimetry Refer to general criteria.

Nuclear Medicine Refer to general criteria.

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Quality Management Refer to general criteria.

Radiation Therapy Refer to general criteria.

Radiography Refer to general criteria.

Radiologist Assistant Refer to general criteria.

Sonography Refer to general criteria.

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Standard Twelve – Ethics The medical imaging and radiation therapy professional adheres to the profession’s accepted ethical standards.

Rationale Decisions made and actions taken on behalf of the patient are based on a sound ethical foundation.

The medical imaging and radiation therapy professional: General Criteria • Accepts accountability for decisions made and actions taken.

• Acts as a patient advocate.

• Adheres to the established ethical standards of recognized certifying agencies.

• Adheres to the established practice standards of the profession.

• Delivers equitable and inclusive patient care and service free from bias or • discrimination. Identifies and implements standards and ethics applicable to AI. • Promotes radiation safety standards.

• Provides health care services with consideration for a diverse patient population.

• Reports unsafe practices to the RSO, regulatory agency or other appropriate authority.

• Respects the patient’s right to privacy and confidentiality Specific Criteria Bone Densitometry Refer to general criteria.

Cardiac-Interventional and Vascular-Interventional Refer to general criteria.

Computed Tomography Refer to general criteria.

Limited X-ray Machine Operator Refer to general criteria.

Magnetic Resonance Refer to general criteria.

Mammography Refer to general criteria.

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Medical Dosimetry Refer to general criteria.

Nuclear Medicine Refer to general criteria.

Quality Management Refer to general criteria.

Radiation Therapy Refer to general criteria.

Radiography Refer to general criteria.

Radiologist Assistant Refer to general criteria.

Sonography • Participates in diagnostic sonographic procedures for the sole purpose of education, treatment or interpretation in accordance with the tenets of ethical

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Standard Thirteen – Research, Innovation and Professional Advocacy The medical imaging and radiation therapy professional participates in the acquisition and dissemination of knowledge, advocacy and the advancement of the profession.

Rationale Participation in professional organizations and scholarly activities advances the The medical imaging and radiation therapy professional: General Criteria • Adopts new best practices.

• Advocates for an ergonomically safe work environment based on evidence-based practices.

• Improves patient care and clinical outcomes through integration and dissemination of evidence-based research and practice.

• Investigates innovative methods for application in practice.

• Investigates relevant AI uses to enhance the science of the profession.

• Monitors changes to federal and state law, regulations and accreditation standards affecting areas of practice.

• Participates in data collection.

• Participates in professional advocacy efforts.

• • Participates in professional societies and organizations.

• Pursues lifelong learning.

• Reads and evaluates research relevant to the profession.

Specific Criteria Bone Densitometry Refer to general criteria.

Cardiac-Interventional and Vascular-Interventional • Advocates for a safe working environment to mitigate the occupational risk related to fluoroscopically-guided interventional procedures.

Computed Tomography Refer to general criteria.

Limited X-ray Machine Operator Refer to general criteria.

Magnetic Resonance Refer to general criteria.

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Mammography Refer to general criteria.

Medical Dosimetry Refer to general criteria.

Nuclear Medicine Refer to general criteria.

Quality Management Refer to general criteria.

Radiation Therapy Refer to general criteria.

Radiography Refer to general criteria.

Radiologist Assistant Refer to general criteria.

Sonography • Advocates for an ergonomically safe working environment, based on evidencebased practices, to mitigate the risk of work-related musculoskeletal disorders.

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Advisory Opinion Statements Advisory opinion statements provide explanations of the Practice ASRT issues advisory opinions to clarify what constitutes appropriate practice and offer guidance for specific practice issues.

The profession holds medical imaging and radiation therapy professionals responsible and accountable for rendering safe, effective clinical services to patients and for judgments exercised and actions taken in the course of providing those services. The advisory opinion statements assist medical imaging and radiation therapy professionals in safe practice.

The medical imaging and radiation therapy professional’s performance should be evidencebased and consistent with federal and state laws, regulations, established standards of practice and facility policies and procedures.

The ASRT recognizes the use of GRADE for measuring the quality of evidence and strength in recommendations for the development of advisory opinion statements.

Each medical imaging and radiation therapy professional must exercise prudent judgment when determining whether the performance of a given act is within the scope of practice for which the individual is licensed, if applicable within the jurisdiction in which the person is employed, educationally prepared and clinically competent to perform.

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Guidance for the Communication of Clinical and Imaging Observations and Procedure Details by Radiologist Assistants to Supervising Radiologists After research of evidentiary documentation, the ASRT issued opinions contained Advisory Opinion It is the opinion of the ASRT based on evidentiary documentation and where federal or state law and/or institutional policy permits that: 1. Communication of clinical and imaging observations and procedure details by the radiologist assistant to the supervising radiologist is an integral part of radiologist assistant practice. Without clear, consistent and appropriate communication between members of the radiology team, there is a possibility of inadequate patient care, incomplete reports and diminished departmental productivity. To create a safe and productive radiology environment, communication between the radiologist assistant and supervising radiologist must be free-flowing, consistent and relevant to the patient examination or procedure. This communication can take many forms, including verbal, written and electronic correspondence. These communications may be included and taken into consideration by the radiologist in creating a final report. However, initial clinical and imaging observations and procedure details communicated from the radiologist assistant to the radiologist are only intended for the radiologist’s use and do not substitute for the final report created by the radiologist. These communications 2. should be considered and documented as “initial clinical and imaging observations or procedure details.”

While assisting radiologists in the performance of imaging procedures or during the performance of procedures under radiologist supervision, the radiologist assistant must be able to communicate and document procedure notes, observations, patient responses and other types of information relevant to the radiologist’s interpretation and creation of the final report. Radiologist assistants do not independently “report findings” or “interpret” by dictation or by any other means; and to avoid any confusion, these terms should not be used to refer to the activities of the radiologist assistant.

However, radiologist assistants may add to the patient record, (following the policies and procedures of the facility), in a manner similar to any other dependent nonphysician practitioner. Radiologist assistants who are authorized to communicate initial observations to the supervising radiologist using a voice recognition dictation system or other electronic means must adhere to institutional protocols ensuring that initial observations can be viewed or accessed only by the supervising radiologist. Initial clinical or imaging observations or procedure details created by the radiologist assistant li f h di l i i ’ i l i h f f h GRADE: Strong Definitions See glossary.

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Evidentiary Documentation Current Literature Not applicable Curricula • Radiologist Assistant Curriculum (ASRT, 2020) QUALITY OF EVIDENCE: High Certification Agency Entry-Level Clinical Activities • Registered Radiologist Assistant Entry-Level Clinical Activities (ARRT, 2023) The document states that radiologist assistants may “Review imaging procedures, make initial observations, and communicate observations ONLY [emphasis added] to the radiologist; record initial observations of imaging procedures following radiologist approval; communicate radiologist’s report to appropriate health care provider consistent with the ACR Practice Parameter for Communication of Diagnostic Imaging Certification Agency Content Specifications Not applicable QUALITY OF EVIDENCE: High Scopes of Practice and Practice Standards Reference • Scope of Practice – (radiologist assistant only) o Communicating the supervising radiologist’s report to the appropriate health care provider consistent with the ACR Practice Guidelines for Communication of Diagnostic Imaging Findings. o Evaluating images for completeness and diagnostic quality and recommending additional images. o Obtaining images necessary for diagnosis and communicating initial observations to the supervising radiologist. The radiologist assistant does not provide image interpretation as defined by the ACR. o Providing follow-up patient evaluation.

• The ASRT Practice Standards for Medical Imaging and Radiation Therapy o Performs a history and physical examination, analyzes data, and reports findings as part of a radiologist-led team. (Standard One, radiologist assistant only) o Performs follow-up patient evaluation and communicates findings to the supervising radiologist. (Standard Seven, radiologist assistant only) o Documents diagnostic, treatment and patient data in the medical record in a timely, accurate and comprehensive manner. (Standard Eight, General Criteria) o Maintains documentation of quality assurance activities, procedures and results.

(Standard Eight, General Criteria) o Communicates and documents a radiologist’s order to other health care providers.

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o Documents and assists radiologist in quality reporting measures for the purpose improved patient care. (Standard Eight, radiologist assistant o Reports clinical and imaging observations and procedure details to the radiologist. (Standard Eight, radiologist assistant only) QUALITY OF EVIDENCE: High Federal and State Statute References Not applicable Other Not applicable 1

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Medication Administration in Peripherally Inserted Central Catheter Lines or Ports With a Power Injector*† After research of evidentiary documentation, the ASRT issued the opinions contained Advisory Opinion It is the opinion of the ASRT based on evidentiary documentation and where federal or state law and/or institutional policy permits that: Medical imaging and radiation therapy professionals can access and/or use an FDA approved: 1. Peripherally inserted central catheter (PICC) line by inserting an approved connective device. The PICC line must be designated for use with power injectors. Manufacturer guidelines regarding infusion rate and pressure must be followed.

2. Port by inserting an approved non coring needle. The port must be designated for use with power injectors. Manufacturer guidelines regarding infusion rate and pressure must be followed.

GRADE: Strong Definitions See glossary.

Evidentiary Documentation Current Literature Not applicable Curricula • Computed Tomography Curriculum (ASRT, 2023) • Magnetic Resonance Curriculum (ASRT, 2020) • Nuclear Medicine Technology Competency-Based Curriculum Guide (SNMMI, 2022) • Radiography Curriculum (ASRT, 2022) • Radiologist Assistant Curriculum (ASRT, 2020) QUALITY OF EVIDENCE: High 1

Certification Agency Content Specifications • Components of Preparedness (NMTCB, 2020) • Computed Tomography (ARRT, 2022) • Positron Emission Tomography (PET) Specialty Examination Content Outline (NMTCB, 2023) • Vascular-Interventional Radiography (ARRT, 2023) QUALITY OF EVIDENCE: High

* Excludes limited x-ray machine operator † Excludes medical dosimetry

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Scopes of Practice and Practice Standards Reference • Scope of Practice o Administering medications enterally, parenterally, through new or existing vascular access or through other routes as prescribed by a licensed practitioner.*† o Administering medications with an infusion pump or power injector as prescribed by a licensed practitioner.*† o Identifying, calculating, compounding, preparing or administering medications QUALITY OF EVIDENCE: High Federal and State Statute References Not applicable Other Not applicable 1

* Excludes limited x-ray machine operator † Excludes medical dosimetry

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Medication Administration Through New or Existing Vascular Access*† After research of evidentiary documentation, the ASRT issued the opinions contained Advisory Opinion It is the opinion of the ASRT based on evidentiary documentation and where federal or state law and/or institutional policy permits that: 1. It is within the scope of practice for medical imaging and radiation therapy professionals to access and administer medications through new or existing vascular access by an approved method of administration (e.g., hand injection, power injection, slow push, bolus infusion) as prescribed by a licensed practitioner GRADE: Strong Definitions • access – The process of inserting an approved connective device through the access point of an existing vascular access device to deliver intravenous (IV) fluids or • medication. existing vascular access – Peripheral or central vascular implanted devices or external access lines that include, but are not limited to, peripherally inserted central catheter Evidentiary Documentation Current Literature • ACR Committee on Drugs and Contrast Media. ACR Manual on Contrast Media.

American College of Radiology; 2023.

• American College of Radiology. ACR-SPR practice parameter for performing and interpreting diagnostic computed tomography (CT). Revised 2022.

• American College of Radiology. ACR practice parameter for performing and interpreting magnetic resonance imaging (MRI). Revised 2022.

• American College of Radiology. ACR-SPR practice parameter for the use of intravascular contrast media. Revised 2022.

• Rockwell D. A competency for central line use in radiology. J Radiol Nurs. 2008;27(2):84. doi:10 1016/j jradnu 2008 04 016 QUALITY OF EVIDENCE: High Curricula • Cardiac-Interventional and Vascular-Interventional Curriculum (ASRT, 2019) • Computed Tomography Curriculum (ASRT, 2023) • Magnetic Resonance Curriculum (ASRT, 2020) Mammography • Curriculum (ASRT, Revised 2023) • National Education Curriculum for Sonography (JRC-DMS, 2016)

* Excludes limited x-ray machine operator † Excludes medical dosimetry

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• • • •

Nuclear Medicine Technology Competency-Based Curriculum Guide (SNMMI, 2022) Radiation Therapy Curriculum (ASRT, 2019) Radiography Curriculum (ASRT, 2022) Radiologist Assistant Curriculum (ASRT, 2020)

QUALITY OF EVIDENCE: High Certification Agency Content Specifications • Components of Preparedness (NMTCB, 2020) • Computed Tomography (ARRT, 2022) • Examination Overview: Registered Cardiovascular Invasive Specialist (CCI, 2022) • Magnetic Resonance Imaging (ARRT, 2020) • Nuclear Medicine Technology (ARRT, 2022) • Positron Emission Tomography (PET) Specialty Examination Content Outline (NMTCB, 2023) • Radiography (ARRT, 2022) • Registered Radiologist Assistant (ARRT, 2023) • Vascular Interventional Radiography (ARRT 2023) QUALITY OF EVIDENCE: High Scopes of Practice and Practice Standards Reference • Scope of Practice o Administering medications enterally, parenterally, through new or existing vascular access or through other routes as prescribed by a licensed practitioner.*† o Identifying, calculating, compounding, preparing or administering medications as prescribed by a licensed practitioner.*† o Performing venipuncture as prescribed by a licensed practitioner.*† o Starting, maintaining and/or removing intravenous access as prescribed by a licensed practitioner.*† QUALITY OF EVIDENCE: High Federal and State Statute References Not applicable Other Not applicable

* Excludes limited x-ray machine operator † Excludes medical dosimetry

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Placement of Personnel Radiation Monitoring Devices After research of evidentiary documentation, the ASRT issued the opinions contained Advisory Opinion It is the opinion of the ASRT based on evidentiary documentation and where federal or state law and/or institutional policy permits that: 1. Radiation workers wear a personnel radiation monitoring device outside of protective apparel with the label facing the radiation source at the level of the collar.

2. In specific cases, a whole-body monitor may be indicated. This monitor should be worn at the waist inside of protective apparel, with the label facing the radiation source GRADE: Strong Definitions See glossary.

Evidentiary Documentation Current Literature • Bushong S. Occupational radiation dose management. In: Radiologic Science for Technologists: Physics, Biology, and Protection. 12th ed. Elsevier; 2020: 547 - 549. By • standards number: 1910.1096(d)(3)(i) – ionizing radiation. Occupational Safety and Health Administration website.

• Gilmore D, Watersham-Rich K. Radiation safety in nuclear medicine. In: Nuclear Medicine and PET/CT: Technology and Technique. 8th edition. Elsevier; 2016:116.

• Statkiewicz-Sherer MA, Visconti PJ, Ritenour ER, Welch-Haynes K. Radiation monitoring. In: Radiation Protection in Medical Radiography. 9th ed. Elsevier; 2022:7287 QUALITY OF EVIDENCE: High Curricula • Bone Densitometry Curriculum (ASRT, Revised 2023) Limited • X-ray Machine Operator Curriculum (ASRT, 2020) • Nuclear Medicine Technology Competency-Based Curriculum Guide (SNMMI, 2022) • Radiation Therapy Curriculum (ASRT, 2019) • Radiography Curriculum (ASRT, 2022) Radiologist • Assistant Curriculum (ASRT, 2020)

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QUALITY OF EVIDENCE: High Certification Agency Content Specifications • Cardiac-Interventional Radiography (ARRT, 2023) • Components of Preparedness (NMTCB, 2020) • Limited Scope of Practice in Radiography (ARRT, 2023) • Nuclear Medicine Technology (ARRT, 2022) • Radiation Therapy (ARRT, 2022) Radiography • (ARRT, 2022) • Registered Radiologist Assistant (ARRT, 2023) • Vascular-Interventional Radiography (ARRT 2023) QUALITY OF EVIDENCE: High Scopes of Practice and Practice Standards Reference • Uses personnel radiation monitoring devices as indicated by the RSO or designee, (Standard Four, General Criteria) Federal and State Statute References • § 19.12 Instruction to Workers (NRC, 2021) • § 20.1208 Dose Equivalent to an Embryo/Fetus (NRC, 2021) • § 20.1502 Conditions Requiring Individual Monitoring of External and Internal Occupational Dose (NRC, 2021) • Regulatory Guide 8.34: Monitoring Criteria and Methods to Calculate Occupational Radiation Doses (NRC, 2022) • Regulatory Guide 8.36: Radiation Dose to the Embryo/Fetus (NRC, 2017) • Regulatory Guide 8.7: Instructions for Recording and Reporting Occupational Radiation Exposure Data (NRC 2018) QUALITY OF EVIDENCE: High Other • AAPM Report No. 58: Managing the Use of Fluoroscopy in Medical Institutions.

Appendix A: Radiation Safety/Quality Assurance Program QUALITY OF EVIDENCE: High

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Supervision of Contrast Media Administration by Radiologist Assistants After research of evidentiary documentation, the ASRT issued the opinions contained Advisory Opinion It is the opinion of the ASRT based on evidentiary documentation and where federal or state law and/or institutional policy permits that radiologist assistants are qualified to: 1. Supervise the administration of contrast media for medical imaging and radiation therapy procedures, as members of the radiologist-led team. The radiologist assistant must be able to consult with their supervising physician.

2. Recognize and respond to medical emergencies resulting from the administration of contrast media, in accordance with their advanced cardiac life support certification.

3 Administer medications and other interventions under a standing orders or GRADE: Strong Definitions See glossary.

Evidentiary Documentation Current Literature • ACR Committee on Drugs and Contrast Media. ACR Manual on Contrast Media.

American College of Radiology; 2023.

• American College of Radiology. Statement from Drugs and Contrast Media Committee on Supervision of Contrast Material Administration. Accessed February 26, 2024. https://www.acr.org/-/media/ACR/Files/Clinical-Resources/FINAL_Statementfrom-Drugs-and-Contrast-Media-Committee-on-Supervision-of-ContrastAdministration.pdf Curricula • Radiologist Assistant Curriculum (ASRT, 2020) QUALITY OF EVIDENCE: High Certification Agency Entry-Level Clinical Activities • Registered Radiologist Assistant Entry-Level Clinical Activities (ARRT, 2023) The document states that radiologist • Administer contrast agents and radiopharmaceuticals as prescribed by the supervising radiologist.

• Administer medications (EXCLUDING contrast agents and radiopharmaceuticals) as prescribed by a licensed practitioner and approved by the supervising radiologist.

• Administer oxygen as prescribed.

• Monitor patient for side effects or complications of the pharmaceutical(s).

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• Recognize and respond to medical emergencies (e.g., drug reactions, cardiac arrest, hypoglycemia) and activate emergency response systems, including notification of the supervising radiologist.

Certification Agency Content Specifications • Registered Radiologist Assistant (ARRT, 2023) QUALITY OF EVIDENCE: High Scopes of Practice and Practice Standards Reference • Scope of Practice (radiologist assistant only) o Completing patient history and physical.

• The ASRT Practice Standards for Medical Imaging and Radiation Therapy o Administers medications as approved by the supervising radiologist. (Standard Four, radiologist assistant only) o Monitors patient’s physical condition during the procedure and responds to changes in patient vital signs, hemodynamics and level of consciousness.

(Standard Four, radiologist assistant only) o Recognizes and responds to medical emergencies, activates emergency response systems and provides advanced life support intervention. (Standard Four, radiologist assistant only) o Documents administration of medications. (Standard Eight, radiologist assistant o only) Reports clinical and imaging observations and procedure details to the ii di l i t (St d d Ei ht di l i t i t t l ) QUALITY OF EVIDENCE: High Federal and State Statute References Not applicable Other Not applicable

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Use of Postexposure Shuttering, Cropping and Electronic Masking in Radiography After research of evidentiary documentation, the ASRT issued the opinions contained Advisory Opinion It is the opinion of the ASRT based on evidentiary documentation and where federal or state law and/or institutional policy permits that: 1. It is within the scope of practice of a radiologic technologist to determine and apply appropriate pre-exposure collimation to individual projections of examinations to comply with the principle of ALARA. Postexposure shuttering, cropping, electronic collimation or electronic masking to eliminate the visibility of large regions of brightness are acceptable, where automatic processing fails to do so.

2. It is outside of the scope of practice of a radiologic technologist to use postexposure shuttering, cropping, electronic collimation or electronic masking to eliminate any anatomical information. This information is a part of the patient’s permanent medical record and should therefore be presented to the licensed practitioner to determine whether the exposed anatomy obtained on any image is significant or of diagnostic 3. value.

It is outside the scope of practice of a radiologic technologist to use postexposure shuttering, cropping, electronic collimation or electronic masking to duplicate and use any acquired image for more than one prescribed view or projection on any exam.

Facilities acquiring digital images are legally required to retain information in the DICOM information of each image that identifies the selected view or projection at the time of image acquisition. Using the same acquired image to represent two different GRADE: Strong Definitions See glossary.

Evidentiary Documentation Current Literature • American College of Radiology. ACR-AAPM-SIIM-SPR practice parameter for digital radiography. Revised 2022.

• Bomer J, Wiersma-Deijl L, Holscher HC. Electronic collimation and radiation protection in paediatric digital radiography: revival of the silver lining. Insights Imaging.

2013;4(5):723-727. doi:10.1007/s13244-013-0281-5 • Carroll QB. Radiography in the Digital Age. 3rd ed. Charles C Thomas; 2018. Carter • C, Vealé B. Digital Radiography and PACS. 4th ed. Elsevier; 2023.

• Chalazonitis AN, Koumarianos D, Tzovara J, Chronopoulos P. How to optimize radiological images captured from digital cameras, using the Adobe Photoshop 6.0 program. J Digit Imaging. 2003;16(2):216-229.

• DeMaio DN, Herrmann T, Noble LB, et al; American Society of Radiologic Technologists.

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• Don S, Macdougall R, Strauss K, et al. Image Gently campaign back to basics initiative: ten steps to help manage radiation dose in pediatric digital radiography. AJR Am J Roentgenol. 2013;200(5):W431-W436. doi:10.2214/AJR.12.9895 • Fauber TL, Dempsey MC. X-ray field size and patient dosimetry. Radiol Technol.

2013;85(2):155-161.

• Fauber TL. Radiographic Imaging and Exposure. 6th ed. Elsevier; 2020:120 and 176.

• Goske MJ, Charkot E, Herrmann T, et al. Image Gently: challenges for radiologic technologists when performing digital radiography in children. Pediatr Radiol.

2011;41(5):611-619. doi:10.1007/s00247-010-1957-3 • Lo WY, Puchalski SM. Digital image processing. Vet Radiol Ultrasound. 2008;49(1 suppl 1):S42-S47. doi:10.1111/j.1740-8261.2007.00333.x • Russell J, Burbridge BE, Duncan MD, Tynan J. Adult fingers visualized on neonatal intensive care unit chest radiographs: what you don’t see. Can Assoc Radiol J. 2013;64(3):236-239. doi:10.1016/j.carj.2012.04.004 • • Seeram E. Digital Radiography: An Introduction. Cengage Learning; 2011.

Uffmann M, Schaefer-Prokop C. Digital radiography: the balance between image quality and required radiation dose. Eur J Radiol. 2009;72(2):202-208.

• doi:10.1016/j.ejrad.2009.05.060 Willis CE. Optimizing digital radiography of children. Eur J Radiol. 2009;72(2):266-273.

• doi:10.1016/j.ejrad.2009.03.003 Zetterberg LG, Espeland A. Lumbar spine radiography—poor collimation practices after implementation of digital technology. Br J Radiol. 2011;84(1002):566-9.

QUALITY OF EVIDENCE: High Curricula • Limited X-ray Machine Operator Curriculum (ASRT Board Approved, 2020) • Radiography Curriculum (ASRT, 2022) Certification Agency Content Specifications • Limited Scope of Practice in Radiography (ARRT, 2023) • Radiography (ARRT, 2022) Scopes of Practice and Practice Standards Reference • Scope of Practice o Applying principles of ALARA to minimize exposure to patient, self and others. o Selecting the appropriate protocol and optimizing technical factors while maximizing patient safety.

• The ASRT Practice Standards for Medical Imaging and Radiation Therapy o Employs professional judgment to adapt procedures to improve diagnostic quality or therapeutic outcomes. (Standard Two, General Criteria) o Adheres to radiation safety rules and standards. (Standard Four, General Criteria)

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o Participates in ALARA, patient and personnel safety and risk management activities (Standard Four, General Criteria) o Positions patient for anatomic area of interest, respecting patient ability and comfort. (Standard Four, General Criteria) o Uses pre-exposure collimation and proper field-of-view selection. (Standard Four, limited x-ray machine operator and radiography only) o Evaluates images for optimal demonstration of anatomy of interest. (Standard Five, General Criteria) o Evaluates images to determine the use of appropriate imaging parameters.

(Standard Five, limited x-ray machine operator and radiography only) o Verifies that exposure indicator data for digital radiographic systems has not been altered or modified and is included in the DICOM header and on images exported to o media. (Standard Five, limited x-ray machine operator and radiography only) Adheres to the established practice standards of the profession. (Standard Twelve, QUALITY OF EVIDENCE: High Federal and State Statute References Not applicable Other Not applicable

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Glossary The glossary is an alphabetical list of defined terms or words specifically found in the ASRT Practice Standards for Medical Imaging and Radiation Therapy. The terms or words have meaning that might not be general knowledge. The definitions are formulated using evidentiary documentation and put into place following extensive review and subsequent approval. The glossary is not all-inclusive. New terms and new usage of existing terms will emerge with time and advances in technology AAPM – American Association of Physicists in Medicine ACR – American College of Radiology adverse event – Any undesirable experience associated with the use of a medical product in a patient.

AI – artificial intelligence ALARA – Acronym for “as low as (is) reasonably achievable,” which means making every reasonable effort to maintain exposures to radiation as far below the dose limits as practical, consistent with the purpose for which the licensed activity is undertaken, while taking into account the state of technology, the economics of improvements in relation to state of technology, the economics of improvements in relation to benefits to the public health and safety and other societal and socioeconomic considerations, and in relation to the use of nuclear energy and licensed materials in the public interest. The ASRT recognizes the concept of ALARA to include energies used for magnetic resonance and sonographic imaging. anatomic (anatomical) landmarks – Bones or other identifiable points that are visible or palpable and indicate the position of internal anatomy. appropriate action plan – Encompasses the initial, current or revised action plan. archive (archival) –The storage of data in either hard (film) or soft (digital) form.

ARDMS – American Registry for Diagnostic Medical Sonography ARRT – American Registry of Radiologic Technologists artifact – Extraneous information on the image that interferes with or distracts from image quality.

ASRT – American Society of Radiologic Technologists authorized user – A physician, dentist or podiatrist who meets the requirements as defined by the United States Nuclear Regulatory Commission. beam-modification devices – Devices that change the shape of the treatment field or distribution of the radiation at (tissue) depth. brachytherapy – A method of treatment that involves the temporary or permanent placement of radiation source(s) (isotopic or electronic) inside or immediately adjacent to a tumor-bearing region

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change management – Systematic approach to preparing for, implementing and sustaining a change in process. clinical – Pertaining to or founded on actual observations and treatments of patients. clinically competent – The ability to perform a clinical procedure in a manner that satisfies the demands of a situation, as assessed and documented by a qualified individual. compounding medication – The combining, mixing, pooling or otherwise altering of a conventionally manufactured drug in response to or anticipation of a medication order. compounding radiopharmaceutical – The combining, mixing, pooling or otherwise altering of a conventionally manufactured radiopharmaceutical or synthesizing/formulating a radiopharmaceutical from bulk drug substances and radionuclides. contrast media – A substance administered during a medical imaging procedure for the purpose of enhancing the contrast between an internal structure or fluid and the surrounding tissue. cropping – The process of selecting and removing a portion of the image. custom blocks – Devices designed to shape the radiation field.

DICOM – Acronym for “Digital Imaging and Communications in Medicine.” The DICOM standards are a complex set of instructions to exchange and present medical image information. dose distribution – Spatial representation of the magnitude of the dose produced by a source of radiation. It describes the variation of dose with position within an irradiated volume. dose pooling – Combining unit doses of a radiopharmaceutical to meet the dosage requirements of a single patient. dosimetric calculations – Computation of treatment unit settings, monitor units, treatment times and radiation doses to anatomical areas of interest.

ECG – electrocardiogram educationally prepared – The successful completion of didactic and clinical education necessary to properly perform a procedure in accordance with accepted practice standards. electronic masking – Electronic collimation or cropping of the digital radiographic image that occurs during postprocessing of the acquired image and does not alter the size of the irradiated field.

FDA – U.S. Food and Drug Administration GRADE – Grading of Recommendations Assessment, Development and Evaluation HIPAA – Health Insurance Portability and Accountability Act of 1996 HQCC – Healthcare Quality Certification Commission hybrid imaging – The combination of imaging technologies that allows information from diff t d liti t b t d i l t fi PS 73

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imaging technologies – Technologies using ionizing and nonionizing radiation to visualize physiological processes, internal structures and fiducial markers, both anatomical and nonanatomical. immediate use – Dose preparation, including one made using appropriate and necessary deviation, and/or the dispensing of a sterile radiopharmaceutical specific for a single patient. immobilization device – Device that assists in maintaining or reproducing the position while limiting patient movement. initial observation – Assessment of technical image quality with pathophysiology correlation communicated to a radiologist. interpretation – The process of examining and analyzing all images within a given procedure and integration of the imaging data with appropriate clinical data in order to render an impression or conclusion set forth in a formal written report composed and signed by a licensed practitioner. interventional procedures – Invasive medical imaging guidance methods used to diagnose and/or treat certain conditions.

ISCD – International Society for Clinical Densitometry JRC-DMS – Joint Review Committee on Education in Diagnostic Medical Sonography least significant change ‒ The least amount of bone mineral densitometry change that can be considered statistically significant. licensed practitioner – A medical or osteopathic physician, chiropractor, podiatrist or dentist who has education and specialist training in the medical or dental use of radiation and is deemed competent to perform independently or supervise medical imaging or radiation therapy procedures by the respective state licensure board.

MDCB – Medical Dosimetrist Certification Board medical physicist – An individual who is competent to practice independently in the safe use of x-rays, gamma rays, electron and other charged particle beams, neutrons, radionuclides, sealed radionuclide sources, ultrasonic radiation, radiofrequency radiation and magnetic fields for diagnostic and therapeutic purposes. An individual is considered competent to practice in the field of medical physics if the individual is certified by the appropriate recognized certification organization. medication – Any chemical substance intended for use in the medical diagnosis, cure, treatment or prevention of disease. minimal sedation (anxiolysis) – A drug-induced state during which patients respond normally to verbal commands. Although cognitive function and coordination may be impaired, ventilatory and cardiovascular functions are unaffected. moderate sedation – A drug-induced depression of consciousness during which patients respond purposefully to verbal commands, either alone or accompanied by light tactile stimulation. No interventions are required to maintain a patent airway, and spontaneous PS 74

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characterization and measurement of biologic processes at the molecular and cellular levels.

Molecular imaging techniques may be applied to computed tomography, magnetic resonance, nuclear medicine, optical imaging, PET-CT, sonography and spectroscopy. monitor units – Unit of output measure used for linear accelerators, sometimes indicated with the abbreviation MU. Accelerators are calibrated so that 1 MU delivers 1 cGy for a standard reference field size at a standard reference depth at a standard source to calibration point.

MQSA – Mammography Quality Standards Act MR Level 2 Personnel – Individuals who have completed more extensive education in broad MR safety issues related to all MR energy fields.

NECS – National Education Curriculum for Sonography NMTCB – Nuclear Medicine Technology Certification Board noninterpretive fluoroscopic procedures – Use of fluoroscopic imaging under the direction of a licensed practitioner for purposes other than interpretation. normal tissue tolerance – Radiation tolerance levels of healthy organs near or within the radiation treatment fields.

NRC – U.S. Nuclear Regulatory Commission panning – Movement of the procedure table during image production to maintain visualization of an anatomic region of interest. personnel radiation monitoring devices – Devices designed to be worn or carried by an individual for the purpose of measuring the dose of radiation received. physics survey – Performing equipment testing, evaluating the testing results and completing a formal written report of results. The written survey report, validated by a medical physicist, contains sufficient information to document that each test was conducted according to local, federal or state requirements and includes an assessment of corrective actions and recommendations for improvements. point-of-care testing – Medical diagnostic testing performed outside the clinical laboratory in close proximity to where the patient is receiving care (e.g., blood sugars, creatinine). postprocessing – Computerized processing of data sets after acquisition to create a diagnostic or therapeutic image. procedure – Specific course of action intended to result in an imaging study, treatment or other outcome. processing – Manipulation of the raw data just after acquisition. protocol – The plan for carrying out a procedure, scientific study or a patient’s treatment regimen. quality assurance – Activities and programs designed to achieve a desired degree or grade of care in a defined medical, nursing or health care setting or program. Sometimes indicated with the abbreviation QA. PS 75

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the interpretation of data regarding equipment function and confirmation that corrective actions are/were taken. Sometimes indicated with the abbreviation QC. radiation oncologist – A physician who specializes in using radiation to treat cancer. radiation protection – Prophylaxis against injury from ionizing radiation. The only effective preventive measures are shielding the operator, handlers and patients from the radiation source; maintaining appropriate distance from the source; and limiting the time and amount of exposure. radioactive material – A substance composed of unstable atoms that decay with the spontaneous emission of radioactivity. Includes radiopharmaceuticals, unsealed sources (open, frequently in liquid or gaseous form) and sealed sources (permanently encapsulated, frequently in solid form). radiobiology – The study of the effects of radiation on living organisms. radiography – The process of obtaining an image for diagnostic examination using x-rays. radiotheranostics – The use of radionuclides for the paired imaging and therapy agents. remote procedure – Operator control of image acquisition from a physical location that is different from the patient.

RSO – Radiation Safety Officer scholarly activity – Activities that systematically advance the teaching, research and practice of the medical imaging and radiation therapy profession through scientific investigation, presentation, and publication. setup – Arrangement of treatment parameters used in preparation for delivering radiation therapy; includes patient positioning data, field alignment information and equipment configurations. shuttering – A postprocessing technique that may be used to eliminate ambient light around an image for the sole purpose of improving the quality of the displayed image. It should not be used as a substitute for insufficient collimation of the irradiated field. simulation – A process using imaging technologies to plan radiation therapy so that the target area is precisely located and marked; the mockup procedure of a patient treatment with medical imaging documentation of the treatment portals.

SNMMI – Society of Nuclear Medicine and Molecular Imaging static – Any medical image that is fixed or frozen in time. superficial radiation therapy – Treatment with x-rays produced at potentials ranging from 40150 kV. supervising radiologist – A board-certified or board-eligible radiologist who oversees duties of the radiologist assistant and has appropriate clinical privileges for the procedure performed by the radiologist assistant. theranostics – The systematic integration of targeted diagnostics and therapeutics. timeout – Preprocedural pause to conduct a final assessment that the correct patient, site and 223 procedure are identified.

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tolerance levels (doses) – The maximum radiation dose that may be delivered to a given biological tissue at a specified dose rate and throughout a specified volume without producing an unacceptable change in the tissue. treatment calculations – See dosimetric calculations. treatment field (portal) – Volume of tissue exposed to radiation from a single radiation beam. treatment planning – The process by which dose delivery is optimized for a given patient and clinical situation. It encompasses procedures involved in planning a course of radiation treatment, including simulation through completion of the treatment summary. treatment record – Documents the delivery of treatments, recording of fractional and cumulative doses, machine settings, verification imaging and the ordering and implementation of prescribed changes.

T-score – Number of standard deviations the individual’s bone mineral density is from the average bone mineral density for gender-matched young normal peak bone mass.

USP – United States Pharmacopeia vascular access device – Apparatus inserted into the peripheral or central vasculature for diagnostic or therapeutic purposes. vascular closure device ‒ Active or passive medical devices used to achieve hemostasis after a cardiovascular or endovascular procedure that requires catheterization. venipuncture – The transcutaneous puncture of a vein by a sharp rigid stylet or cannula carrying a flexible plastic catheter or by a steel needle attached to a syringe or catheter. verification images – Images produced to confirm accurate treatment positioning and accurate treatment portals.

Z-score – Number of standard deviations the individual’s bone mineral density is from the average bone mineral density for age- and gender-matched reference group.

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The ASRT Practice Standards for Medical Imaging and Radiation Therapy

©2024 American Society of Radiologic Technologists. All rights reserved. Reprinting all or part of this document is prohibited without advance written permission of the ASRT. Send reprint requests to the ASRT Publications Department, 15000 Central Ave. SE, Albuquerque, NM 87123-3909.

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Table of Contents

Preface .......................................................................................................................................................... 3 Format ....................................................................................................................................................... 3 Definition....................................................................................................................................................... 4 Introduction .............................................................................................................................................. 4 Education and Certification ......................................................................................................................... 10 Introduction ............................................................................................................................................ 10 Medical Imaging and Radiation Therapy Scope of Practice ........................................................................ 16 Standards .................................................................................................................................................... 21 Standard One – Assessment .................................................................................................................... 21 Standard Two – Analysis/Determination ................................................................................................. 25 Standard Three – Education .................................................................................................................... 28 Standard Four – Performance ................................................................................................................. 31 Standard Five – Evaluation ...................................................................................................................... 37 Standard Six – Implementation ............................................................................................................... 40 Standard Seven – Outcomes Measurement............................................................................................ 42 Standard Eight – Documentation ............................................................................................................ 44 Standard Nine – Quality .......................................................................................................................... 47 Standard Ten – Self-Assessment and Professional Development ........................................................... 49 Standard Eleven – Collaboration and Collegiality .................................................................................... 51 Standard Twelve – Ethics ........................................................................................................................ 53 Standard Thirteen – Research, Innovation and Professional Advocacy .................................................. 55 Advisory Opinion Statements ...................................................................................................................... 57 Guidance for the Communication of Clinical and Imaging Observations and Procedure Details by Radiologist Assistants to Supervising Radiologists ................................................................................. 58 Medication Administration in Peripherally Inserted Central Catheter Lines or Ports With a Power Injector*† ................................................................................................................................................ 61 Medication Administration Through New or Existing Vascular Access*† ............................................... 63 Placement of Personnel Radiation Monitoring Devices .......................................................................... 65 Supervision of Contrast Media Administration by Radiologist Assistants ............................................... 67 Use of Postexposure Shuttering, Cropping and Electronic Masking in Radiography.............................. 69 Glossary ....................................................................................................................................................... 72

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Preface The ASRT Practice Standards for Medical Imaging and Radiation Therapy serve as a guide for the medical imaging and radiation therapy profession. These standards define the practice and establish general criteria to determine compliance. Practice standards are authoritative statements established by the profession, through evidentiary documentation, for evaluating the quality of practice, service and education provided by individuals within the profession.

The Practice Standards can be used by individual facilities to develop job descriptions and practice parameters. Those outside the profession can use the standards as an overview of the role and responsibilities of individuals within the profession.

The medical imaging and radiation therapy professional and any individual who is legally authorized to perform medical imaging or radiation therapy must be educationally prepared and clinically competent as a prerequisite to professional practice. The individual should, consistent with all applicable legal requirements and restrictions, exercise individual thought, judgment and discretion in the performance of the procedure. Federal and state statutes, regulations, accreditation standards and institutional policies could dictate practice parameters and may supersede these standards Format The ASRT Practice Standards for Medical Imaging and Radiation Therapy are divided into six sections: • Definition – defines the practice of medical imaging and radiation therapy professionals.

• Education and Certification – describes the minimum qualifications for the education and certification of individuals in addition to an overview of the specific practice.

• Medical Imaging and Radiation Therapy Scope of Practice – delineates the parameters of the specific practice.

• Standards – incorporate patient assessment and management with procedural analysis, performance and evaluation. The Practice Standards define the activities of the individual responsible for the care of patients and delivery of medical imaging and radiation therapy procedures; in the technical areas of performance, such as equipment and material assessment safety standards and total quality management; and in the areas of education, interpersonal relationships, self-assessment and ethical behavior.

• Advisory Opinion Statements – provide explanations of the Practice Standards and are • intended for clarification and guidance for specific practice issues.

Gl d fi d bb i i d h h h P i S d d The Practice Standards are numbered and followed by a term or set of terms that describes the standards. The next statement is the expected performance of the individual when performing the procedure or treatment. A rationale follows and explains why an individual should adhere to the particular standard of performance. Each standard is divided into two parts: the general criteria and the specific criteria. Both general and specific criteria should be used when evaluating performance.

• General Criteria –apply to all medical imaging and radiation therapy professionals.

• Specific Criteria – apply to medical imaging and radiation therapy professionals in PS 3

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specialized modalities.

Definition

Introduction The medical imaging and radiation therapy profession comprises health care professionals identified as a bone densitometry technologist, cardiac-interventional and vascularinterventional technologist, computed tomography technologist, limited x-ray machine operator, magnetic resonance technologist, mammographer, medical dosimetrist, nuclear medicine technologist, quality management technologist, radiation therapist, radiographer, radiologist assistant or sonographer who are educationally prepared and clinically competent as identified by these standards Furthermore, these standards apply to health care employees who are legally authorized to perform medical imaging or radiation therapy and who are educationally prepared and clinically competent as identified by these standards.

Medical imaging and radiation therapy professionals are vital members of a multidisciplinary team that forms a core of highly trained health care professionals, who each bring expertise to the area of patient care. They play a critical role in the delivery of health services as new modalities emerge and the need for medical imaging and radiation therapy procedures Medical imaging and radiation therapy integrates scientific knowledge, technical competence and patient interaction skills to provide safe and accurate procedures with the highest regard to all aspects of patient care. A medical imaging and radiation therapy professional recognizes elements unique to each patient, which is essential for the successful completion of the Medical imaging and radiation therapy professionals are the primary liaison between patients, licensed practitioners and other members of the health care team. These professionals must remain sensitive to the needs of the patient through communication, assessment, monitoring and patient care. As members of the health care team, medical imaging and radiation therapy professionals participate in quality improvement processes and continually assess their professional performance.

Medical imaging and radiation therapy professionals think critically and use independent, professional and ethical judgment in all aspects of their work. They engage in continuing education to include their area of practice to enhance patient care, safety, public education, knowledge and technical competence.

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Bone Densitometry The practice of bone densitometry is performed by health care professionals responsible for the administration of ionizing radiation for diagnostic, therapeutic or research purposes. A bone densitometry technologist performs bone densitometry procedures and acquires and analyzes data needed for diagnosis at the request of and for interpretation by a licensed Bone densitometry technologists independently perform or assist the licensed practitioner in the completion of densitometric procedures. Bone densitometry technologists document medications in accordance with federal and state laws, regulations or lawful institutional policy.

Cardiac-Interventional and Vascular-Interventional The practice of cardiac-interventional and vascular-interventional is performed by health care professionals responsible for the administration of ionizing radiation for diagnostic, therapeutic or research purposes. A cardiac-interventional and vascular-interventional technologist performs radiographic, fluoroscopic and other procedures and acquires and analyzes data needed for diagnosis at the request of and for interpretation by a licensed Cardiac-interventional and vascular-interventional technologists independently perform or assist the licensed practitioner or radiologist assistant in the completion of cardiacinterventional and vascular-interventional procedures. Cardiac-interventional and vascularinterventional technologists prepare, administer and document activities related to medications and radiation exposure in accordance with federal and state laws, regulations, or Computed Tomography The practice of computed tomography is performed by health care professionals responsible for the administration of ionizing radiation for diagnostic, therapeutic or research purposes. A computed tomography technologist performs computed tomography and molecular imaging procedures and acquires and analyzes data needed for diagnosis, interpretation and the performance of interventional and therapeutic procedures at the request of and for interpretation by a licensed practitioner.

Computed tomography technologists independently perform or assist the licensed practitioner or radiologist assistant in the completion of computed tomography and molecular imaging procedures. Computed tomography technologists prepare, administer and document activities related to medications and radiation exposure in accordance with federal and state laws, regulations, or lawful institutional policy.

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Limited X-ray Machine Operator The operation of x-ray equipment in a limited scope is performed by health care employees responsible for the administration of ionizing radiation for diagnostic purposes. A limited x-ray machine operator performs radiographic procedures within the limited scope of practice and acquires and analyzes data needed for diagnosis at the request of and for interpretation by a licensed practitioner.

Limited x-ray machine operators are individuals other than a radiographer who perform static diagnostic radiographic images on selected anatomical sites. Limited x-ray machine operators perform their duties under the direction of a licensed practitioner, radiographer or, when indicated, a medical physicist.

Magnetic Resonance The practice of magnetic resonance is performed by health care professionals responsible for the use of radiofrequencies within a magnetic field for diagnostic, therapeutic or research purposes. A magnetic resonance technologist performs magnetic resonance and molecular imaging procedures and acquires and analyzes data needed for diagnosis at the request of and for interpretation by a licensed practitioner.

Magnetic resonance technologists independently perform or assist the licensed practitioner or radiologist assistant in the completion of magnetic resonance and molecular imaging procedures. Magnetic resonance technologists prepare, administer and document activities related to medications in accordance with federal and state laws, regulations, or lawful Mammography The practice of mammography is performed by health care professionals responsible for the administration of ionizing radiation and multi-frequency sound waves for diagnostic, therapeutic or research purposes. A mammographer performs breast imaging procedures and acquires and analyzes data, including mammographic and sonographic images needed for diagnosis, at the request of and for interpretation by a licensed practitioner.

Mammographers independently perform or assist the licensed practitioner or radiologist assistant in the completion of mammographic and sonographic breast imaging procedures.

Mammographers prepare, administer and document activities related to medications and radiation exposure in accordance with federal and state laws, regulations, or lawful institutional policy.

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Medical Dosimetry The practice of medical dosimetry is performed by health care professionals responsible for designing a treatment plan for use in the administration of ionizing radiation for the purpose of treating diseases, primarily cancer. Medical dosimetrists independently perform duties and complete responsibilities under the supervision of qualified medical physicists and radiation oncologists. Medical dosimetrists generate an optimal treatment plan and ensure the appropriate transfer of data that the radiation therapist will use to treat the patient Medical dosimetrists must maintain a high degree of accuracy, thoroughness and safety in treatment planning optimization, treatment techniques and positioning. Medical dosimetrists assist the radiation oncologist in localizing the treatment area, generate a treatment plan and communicate with the radiation oncology team to enable and ensure the appropriate transfer of information.

Nuclear Medicine The practice of nuclear medicine is performed by health care professionals responsible for the administration of ionizing radiation (radioactive material and computed tomography), nonionizing radiation and adjunctive medications for diagnostic, therapeutic, radiotheranostics or research purposes. Radioactive materials, medications and imaging and nonimaging equipment are used in nuclear medicine and molecular imaging to study various organs, body systems and samples to aid in the diagnosis, treatment, radiotheranostics and treatment planning of various pathological conditions. A nuclear medicine technologist performs nuclear medicine and molecular imaging procedures, radiotheranostics or therapies, and acquires and analyzes data at the request of and for interpretation by a licensed practitioner and under the supervision of an authorized user. Nuclear medicine technologists also administer the prescribed radionuclide therapy to the patient at the request and under the supervision of an authorized user.

Nuclear medicine technologists independently perform or assist the licensed practitioner or radiologist assistant and authorized user in the completion of nuclear medicine and molecular imaging procedures, radiotheranostics and treatments. Nuclear medicine technologists prepare, administer and document activities related to ionizing radiation (radioactive material and computed tomography), nonionizing radiation, medications and radiation exposure in accordance with federal and state laws, regulations, or lawful institutional policy.

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Quality Management The practice of quality management is performed by health care professionals responsible for the identification, measurement, control and improvement of the various core processes that will ultimately lead to improved medical imaging and radiation therapy department Today’s medical imaging and radiation therapy departments involve multiple modalities, creating an interdisciplinary team. The quality management technologist is a member of the health care team, which includes clinicians, management, support staff and Quality management has four main components: quality planning, quality control, quality assurance and quality improvement. Quality management focuses on the means to achieve image and service quality. A quality management technologist combines all of these components to ensure efficient and effective patient care.

Quality management technologists independently perform or assist the medical physicist in the completion of quality control procedures. Quality management technologists prepare, administer and document activities related to all facets of quality management in accordance with federal and state laws, regulations, or lawful institutional policy.

Radiation Therapy The practice of radiation therapy is performed by health care professionals responsible for the administration of high doses of ionizing radiation for the purpose of treating diseases, primarily cancer. A radiation therapist acquires and analyzes data in preparation for patient treatment, uses various imaging technologies to localize the treatment area, participates in treatment planning and performs radiation therapy procedures as prescribed and supervised by a radiation oncologist. Radiation therapists perform procedures in accordance with federal and state laws, regulations, or lawful institutional policy.

Radiation therapists are the primary liaison between patients and other members of the radiation oncology team. They also provide a link to other health care providers, such as social workers and dietitians. Radiation therapists must remain sensitive to the needs of the patient through communication, patient assessment, patient monitoring and patient care skills.

Radiation therapy often involves daily treatments extending over several weeks using highly sophisticated equipment. It requires thorough initial planning as well as constant patient care and monitoring.

Radiography The practice of radiography is performed by health care professionals responsible for the administration of ionizing radiation for diagnostic, therapeutic or research purposes. A radiographer performs a full scope of radiographic and fluoroscopic procedures and acquires and analyzes data needed for diagnosis at the request of and for interpretation by a licensed practitioner.

Radiographers independently perform or assist the licensed practitioner or radiologist assistant in the completion of radiographic and fluoroscopic procedures. Radiographers prepare, administer and document activities related to medications and radiation exposure in accordance with federal and state laws, regulations, or lawful institutional policy.

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Radiologist Assistant A radiologist assistant practices under the supervision of a radiologist and enhances patient care in radiology services. As a member of the radiologist-led team, the radiologist assistant performs invasive and noninvasive procedures at the request of and for interpretation by a Radiologist assistants act as liaisons between patients, radiographers, radiologists and other members of the health care team. Radiologist assistants remain sensitive to the physical, cultural and emotional needs of patients through communication, comprehensive patient assessment, continuous patient monitoring and advanced patient care skills.

Radiologist assistants maintain their radiographer credentials; therefore, both the radiologist assistant and radiography sections of the Practice Standards should be consulted when seeking practice information for the radiologist assistant. The clinical activities are delegated by the supervising radiologist in accordance with federal and state laws, regulations, or lawful institutional policies.

Sonography The practice of sonography is performed by health care professionals responsible for the administration of multi-frequency sound waves and other techniques for diagnostic, therapeutic or research purposes. A sonographer performs sonographic and molecular imaging procedures and acquires and analyzes data needed for diagnosis at the request of and for interpretation by a licensed practitioner.

Sonographers independently perform or assist the licensed practitioner or radiologist assistant in the completion of sonographic and molecular imaging procedures. Sonographers prepare, administer and document activities related to medications in accordance with federal and state laws, regulations, or lawful institutional policy.

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Education and Certification Introduction Medical imaging and radiation therapy professionals must be educationally prepared and clinically competent as a prerequisite to professional practice. Only medical imaging and radiation therapy professionals who have completed the appropriate education and training as outlined in these standards should perform medical imaging and radiation therapy procedures. Individuals working in more than one modality must meet these requirements in the specific modalities they are responsible to perform.

Medical imaging and radiation therapy professionals should be registered by certification agencies recognized by the ASRT. Individuals performing diagnostic or therapeutic procedures in more than one modality will adhere to the general and specific criteria for each area of practice.

To maintain certification(s), medical imaging and radiation therapy professionals must complete appropriate continuing education requirements to sustain their expertise and awareness of changes and advances in practice.

Medical imaging and radiation therapy professionals performing multimodality hybrid procedures should meet certification requirements for the diagnostic or therapeutic portion of the procedure and must be educationally prepared and clinically competent in the specific modality for which they perform attenuation correction or anatomical localization.

Medical imaging and radiation therapy professionals performing multimodality hybrid procedures should be registered by certification agencies recognized by the ASRT in the modality for the diagnostic or therapeutic portion of the procedure. Individuals performing multimodality hybrid procedures will adhere to the specific criteria for the diagnostic or therapeutic portion of the procedure.

Medical imaging and radiation therapy professionals performing multimodality hybrid procedures should complete continuing education requirements in the modality used for the diagnostic or therapeutic portion of the procedure and maintain education and clinical competence in the modality used for attenuation correction or anatomical localization.

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Bone Densitometry Only medical imaging and radiation therapy professionals who have completed the appropriate education and obtained certification(s) as outlined in these standards should perform bone densitometry procedures.

Bone densitometry technologists prepare for their roles on the interdisciplinary team by meeting postprimary examination eligibility criteria as determined by the ARRT. Those who have passed the ARRT bone densitometry postprimary examination use the additional credential (BD).

The ISCD is another certifying agency. Individuals with a primary medical imaging or radiation therapy certification who have passed the ISCD certified bone densitometry technologist examination use the additional credential CBDT. Cardiac-Interventional and Vascular-Interventional Only medical imaging and radiation therapy professionals who have completed the appropriate education and obtained certification(s) as outlined in these standards should perform cardiac- interventional and vascular-interventional procedures.

Cardiac-interventional and vascular-interventional technologists prepare for their roles on the interdisciplinary team by meeting postprimary examination eligibility criteria as determined by the ARRT or CCI. Those who have passed the ARRT cardiac-interventional, cardiovascular-interventional or vascular-interventional radiography postprimary examinations use the additional credentials (CI), (CV) or (VI), respectively.

CCI is another certifying agency. Individuals with primary certification in radiography who have passed the CCI cardiovascular invasive specialist examination as a postprimary certification use the additional credential RCIS. Computed Tomography Only medical imaging and radiation therapy professionals who have completed the appropriate education and obtained certification(s) as outlined in these standards should perform computed tomography and molecular imaging procedures.

Computed tomography technologists prepare for their roles on the interdisciplinary team by meeting postprimary examination eligibility criteria as determined by the ARRT or NMTCB. Those who have passed the ARRT or NMTCB computed tomography postprimary examination use the additional credential (CT).

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Limited X-ray Machine Operator Limited x-ray machine operators prepare for their roles on the interdisciplinary team in several ways. Various education and training programs for limited x-ray machine operators exist throughout the United States.

Many states require the completion of a program of study prior to administering a state licensure exam for limited x-ray machine operators. Several states use some or all of the Limited Scope of Practice in Radiography state licensing exams developed by the ARRT. States that administer an exam and issue a license or certification may use various terminologies to designate a limited x- ray machine operator. Limited x-ray machine operators shall only perform ionizing radiation procedures within their limited scope of practice.

Magnetic Resonance Only medical imaging and radiation therapy professionals who have completed the appropriate education and obtained certification(s) as outlined in these standards should perform magnetic resonance and molecular imaging procedures.

Magnetic resonance technologists prepare for their roles on the interdisciplinary team by meeting primary or postprimary examination eligibility criteria as determined by the ARRT. Those who have passed the ARRT magnetic resonance primary examination use the credential R.T.(MR).

Those who have passed the ARRT magnetic resonance postprimary examination use the additional credential (MR).

Mammography Only medical imaging and radiation therapy professionals who have completed the appropriate education and obtained certification(s) as outlined in these standards should perform mammography and breast sonography procedures.

Mammographers prepare for their roles on the interdisciplinary team by meeting postprimary examination eligibility criteria as determined by the ARRT. Those who have passed the ARRT mammography postprimary examination use the additional credential (M).

Those who have passed the ARRT breast sonography postprimary examination use the additional credential (BS).

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Medical Dosimetry Only medical imaging and radiation therapy professionals who have completed the appropriate education and obtained certification(s) as outlined in these standards should perform medical dosimetry procedures.

Medical dosimetrists prepare for their roles on the interdisciplinary team by meeting the examination eligibility criteria established by the MDCB. Those who have passed the medical dosimetry examination use the credential Nuclear Medicine Only medical imaging and radiation therapy professionals who have completed the appropriate education and obtained certification(s) as outlined in these standards should perform nuclear medicine and molecular imaging procedures, radiotheranostics or therapies.

Nuclear medicine technologists prepare for their roles on the interdisciplinary team by meeting examination eligibility criteria as determined by the ARRT or NMTCB. Those who have passed the ARRT examination use the credential R.T.(N).

Those who have passed the NMTCB examination use the credential CNMT. Those who have passed the NMTCB nuclear cardiology, positron emission tomography or radiation safety specialty examinations use the additional credentials NCT, PET or NMTCB (RS), respectively.

Quality Management Only medical imaging and radiation therapy professionals who have completed the appropriate education and obtained certification(s) as outlined in these standards should perform quality management procedures.

Quality management technologists prepare for their roles on the interdisciplinary team by meeting postprimary examination eligibility criteria as determined by the ARRT. Those who have passed the ARRT quality management postprimary examination use the additional credential (QM).

HQCC is another certifying agency. Individuals with a primary medical imaging or radiation therapy certification who have passed the Certified Professional in Healthcare Quality examination use the additional credential CPHQ.

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Radiation Therapy Only medical imaging and radiation therapy professionals who have completed the appropriate education and obtained certification(s) as outlined in these standards should perform radiation therapy procedures.

Radiation therapists prepare for their roles on the interdisciplinary team by meeting examination eligibility criteria as determined by the ARRT. Those who have passed the ARRT radiation therapy examination use the credential R.T.(T).

Radiography Only medical imaging and radiation therapy professionals who have completed the appropriate education and obtained certification(s) as outlined in these standards should perform radiographic and fluoroscopic procedures.

Radiographers prepare for their roles on the interdisciplinary team by meeting examination eligibility criteria as determined by the ARRT. Those who have passed the ARRT radiography examination use the credential R.T.(R).

Radiologist Assistant Only radiographers who have completed the appropriate education and obtained certification(s) as outlined in these standards should perform radiologist assistant procedures.

Radiologist assistants prepare for their roles in medical imaging by meeting examination eligibility criteria as determined by the ARRT. Those who have passed the registered radiologist assistant examination use the additional credential R.R.A.

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Sonography Only medical imaging and radiation therapy professionals who have completed the appropriate education and obtained certification(s) as outlined in these standards should perform sonographic and molecular imaging procedures.

Sonographers prepare for their roles on the interdisciplinary team by meeting primary or postprimary examination eligibility criteria as determined by the ARDMS, ARRT or CCI. Those who have passed the ARDMS examination(s) use the credentials RDCS, RDMS, RMSKS or RVT. Those who have passed the ARRT primary examination use the credential R.T.(S) or R.T.(VS).

Those who have passed the CCI examination(s) use the credentials RCCS, RCS, RPhS or RVS. Those who have passed the ARRT breast sonography, sonography or vascular sonography postprimary examinations use the additional credentials (BS), (S) or (VS), respectively.

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Medical Imaging and Radiation Therapy Scope of Practice Scopes of practice delineate the parameters of practice and identify the boundaries for practice. A comprehensive procedure list for the medical imaging and radiation therapy professional is impractical because clinical activities vary by the practice needs and expertise of the individual. As medical imaging and radiation therapy professionals gain more experience, knowledge and clinical competence, the clinical activities may evolve.

The scope of practice of the medical imaging and radiation therapy professional • Administering medications enterally, parenterally, through new or existing vascular access or through other routes as prescribed by a licensed practitioner.*† • Administering medications with an infusion pump or power injector as prescribed by a licensed practitioner.*† • Administering oxygen as prescribed by a licensed practitioner.

• Applying, implementing and monitoring AI. • Applying principles of ALARA to minimize exposure to patient, self and others.

• Applying principles of patient safety during all aspects of patient care.

• Assisting in maintaining medical records while respecting confidentiality and adhering to HIPAA and established policy.

• Corroborating a patient’s clinical history with the procedure and ensuring information is documented and available for use by a licensed practitioner.

• Educating and monitoring students and other health care providers.* • Evaluating images for proper positioning and determining if additional images will • improve the procedure or treatment outcome.

• Evaluating images for technical quality and ensuring proper identification is recorded.

• Identifying and responding to emergency situations.

Identifying, calculating, compounding, preparing or administering medications as • prescribed by a licensed practitioner.*† • Performing ongoing quality assurance activities.

• Performing point-of-care testing as prescribed by a licensed practitioner.† • Performing venipuncture as prescribed by a licensed practitioner.*† • Postprocessing data.

• Preparing patients for • procedures. Providing education.

Providing input for equipment and software purchase and supply decisions when • appropriate or requested.

• Providing optimal patient care.

Receiving, relaying and documenting verbal, written and electronic orders in the patient’s • medical record.

Selecting the appropriate protocol and optimizing technical factors while maximizing • patient safety.

Starting, maintaining and/or removing intravenous access as prescribed by a licensed • practitioner.*† * Excludes limited x-ray machine operator † Excludes medical dosimetry

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• Verifying informed consent for applicable procedures.* Bone Densitometry • Performing bone densitometry procedures as prescribed by a licensed practitioner.

• Performing and monitoring quality control procedures for bone densitometry Cardiac-Interventional and Vascular-Interventional • Assisting a licensed practitioner or radiologist assistant with fluoroscopic and specialized interventional radiography procedures.

• Maintaining intra-arterial access as prescribed by a licensed practitioner.

• Panning the procedure table during image production.

• Participating in physiologic monitoring of patients.

• Performing diagnostic/interventional procedures as prescribed by a licensed • practitioner. Performing manual and mechanical hemostasis, including the use of vascular closure devices, as prescribed by a licensed practitioner.

• Performing noninterpretive fluoroscopic procedures as prescribed by a licensed practitioner.

• Placing, maintaining and removing peripherally inserted central catheters as prescribed b li d titi Computed Tomography • Assisting a licensed practitioner or radiologist assistant with interventional computed tomography procedures.

• Performing computed tomography and molecular imaging procedures as prescribed by a licensed practitioner.

Limited X-ray Machine Operator • Assisting a licensed practitioner or radiographer during static radiographic • procedures. Performing diagnostic radiographic procedures within the limited scope of practice as prescribed by a licensed practitioner.

Magnetic Resonance • Applying principles of magnetic resonance safety to minimize risk to patient, self and others.

• Assisting a licensed practitioner or radiologist assistant with magnetic resonance interventional procedures.

• Performing magnetic resonance and molecular imaging procedures as prescribed by a licensed practitioner.

• Selecting appropriate pulse sequences with consideration given to established protocols and other factors influencing data acquisition parameters.

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Mammography • Assisting a licensed practitioner or radiologist assistant with interventional breast procedures.

• Imaging pathologic breast specimens as prescribed by a licensed practitioner.

• Performing breast ultrasound procedures as prescribed by a licensed practitioner.

• Performing mammographic procedures per facility policy or as prescribed by a licensed practitioner.

• Performing or assisting with clinical breast examination Medical Dosimetry • Designing and generating optimal treatment plans in collaboration with a radiation oncologist.

• Evaluating treatment plans for accuracy.

• Monitoring doses to normal tissues within the irradiated volume to ensure tolerance levels are not exceeded.

• Obtaining and incorporating patient data from medical imaging procedures or manual methods to be used in simulation, treatment planning, treatment delivery and quality assurance.

• Participating in brachytherapy treatment planning and delivery.

• Participating in simulation under the supervision of a radiation oncologist.

• • Performing dosimetric calculations.

Performing or assisting with the fabrication of patient immobilization and other • treatment devices.

Transferring and documenting treatment planning data according to departmental policy.

Nuclear Medicine • Applying principles of magnetic resonance safety to minimize risk to patient, self and others when performing PET-MR. • Assembling, calibrating, maintaining, eluting and administering radiopharmaceuticals from the radionuclide infusion system and the generator while complying with standards and as prescribed by a licensed practitioner and under the supervision of an authorized user.

• Performing hybrid imaging, including PET-CT, PET-MR and SPECT-CT for emission, transmission, attenuation correction, anatomical location and for use in radiation therapy treatment planning when performed within hybrid imaging as prescribed by a licensed practitioner and under the supervision of an authorized user.

• Performing nuclear medicine and molecular imaging procedures, radiotheranostics or therapies as prescribed by a licensed practitioner and under the supervision of an • authorized user.

Procuring, identifying, calculating, preparing and/or administering ionizing radiation (radioactive material and computed tomography) and nonionizing radiation as

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Quality Management • Coordinating, performing and monitoring quality control procedures for all types of equipment.

• Creating policies and procedures to meet regulatory, accreditation and fiscal requirements.

• Ensuring adherence to accreditation, federal, state and local regulatory requirements.

• Facilitating change through appropriate management processes.

• Facilitating performance improvement processes.

• Facilitating the department’s quality assessment and improvement plan.

• Monitoring exposure factors and/or procedural protocols in accordance with ALARA principles and age-specific considerations.

• Performing physics surveys independently on general radiographic and fluoroscopic • equipment, with medical physicist oversight.

Providing assistance to staff for image optimization, including patient positioning, • proper equipment use and image critique.

• Providing practical information regarding techniques and tools for process • improvement. Serving as a resource regarding regulatory, accreditation and fiscal Radiation Therapy • Constructing/preparing immobilization, beam directional and beam-modification • devices. Delivering radiation therapy treatments as prescribed by a radiation oncologist.

• Detecting and reporting significant changes in patients’ conditions and determining when to withhold treatment until the radiation oncologist is consulted.

• Monitoring doses to normal tissues within the irradiated volume to ensure tolerance levels are not exceeded.

• Participating in brachytherapy procedures.

• Participating in superficial radiation therapy procedures as prescribed by a licensed practitioner.

• Performing simulation, localization, treatment planning procedures and dosimetric calculations as prescribed by a radiation oncologist.

• Using imaging technologies for the explicit purpose of simulation, treatment planning and treatment delivery as prescribed by a radiation oncologist.

Radiography • Assisting a licensed practitioner or radiologist assistant with fluoroscopic and specialized radiologic procedures.

• Performing diagnostic radiographic and noninterpretive fluoroscopic procedures as prescribed by a licensed practitioner.

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Radiologist Assistant • Assessing, monitoring and managing patient status, including patients under minimal and moderate sedation.

• Assisting with data collection and review for clinical trials or other research.

• Communicating the supervising radiologist’s report to the appropriate health care provider consistent with the ACR Practice Guidelines for Communication of Diagnostic Imaging Findings.

• Completing patient history and physical.

• Emphasizing patient safety and verifying procedure appropriateness by analyzing and incorporating evidenced-based practices for optimal patient care.

• Evaluating images for completeness and diagnostic quality and recommending additional images.

• Identifying and administering radioactive materials as prescribed by a supervising • radiologist and under the supervision of an authorized user.

Identifying variances that may influence the expected outcome through preprocedural • evaluation as part of the radiologist-led team.

Obtaining images necessary for diagnosis and communicating initial observations to the supervising radiologist. The radiologist assistant does not provide image interpretation • as defined by the ACR. • Participating in or obtaining informed consent.

• Participating in quality assurance activities within the radiology practice.

Performing or assisting with invasive or noninvasive procedures as delegated by the radiologist who is licensed to practice and has privileges for the procedure • being performed by the radiologist assistant.

Sonography • Collaborating with a licensed practitioner or radiologist assistant in the performance of sonographic interventional procedures.

• Ensuring equipment parameters for diagnostic and interventional procedures are of optimal technical and administrative quality as requested by a licensed practitioner.

• Performing diagnostic, interventional and molecular imaging sonographic procedures as prescribed by a licensed practitioner or during appropriate educational activities.

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Standards Standard One – Assessment The medical imaging and radiation therapy professional collects pertinent data about the patient, procedure, equipment and work environment.

Rationale Information about the patient’s health status is essential in providing appropriate imaging and therapeutic services. The planning and provision of safe and effective medical services relies on the collection of pertinent information about equipment, procedures and the work The medical imaging and radiation therapy professional: General Criteria • Assesses and maintains the integrity of medical supplies and medications, properly disposing when indicated.

• Assesses any potential patient limitations or factors that may affect the procedure.

• Assesses patient lab values, medication list and risk for allergic reaction(s) prior to procedure and administration of medication.*† • Confirms that equipment performance, maintenance and operation comply with the manufacturer’s specifications.

• Determines that services are performed in a safe environment, minimizing potential hazards.

• Maintains restricted access to controlled areas.

• Obtains and reviews relevant previous procedures and information from all available • resources.

• Recognizes signs and symptoms of an emergency.

Verifies appropriateness of the requested or prescribed procedure, in compliance with • the clinical indication and protocol.

Verifies parameters when using AI to ensure patient safety in accordance with ALARA • principles.

• Verifies patient identification.

Verifies that protocol and procedure manuals include recommended criteria and are • reviewed and revised.

• Verifies that the patient has consented to the procedure.

Specific Criteria Bone Densitometry • Assesses patient compliance with prescribed treatment as it relates to the • procedure. Confirms all required quality control tests are performed. * Excludes limited x-ray machine operator † Excludes medical dosimetry

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Cardiac-Interventional and Vascular-Interventional Refer to general criteria.

Computed Tomography • Verifies that a registered technologist is physically present at the CT console to perform a remote CT procedure.

Limited X-ray Machine Operator • Develops and maintains standardized exposure technique guidelines for all • equipment. Maintains and performs quality control on radiation safety equipment.

Magnetic Resonance • Assesses patient for factors that may contribute to anxiety or claustrophobia.

• Identifies and removes items that may affect safety, damage the equipment or affect the image quality.

• Screens patient and others for potential magnetic resonance contraindications, either within the body or on their person, prior to entering the magnet room.

• Verifies that a registered technologist with MR Level 2 Personnel training is physically present at the MR console throughout a remote MR procedure.

Mammography • Assesses the need for alternative procedures based on the patient’s age, hormonal or lactation status and the presence of surgical implants.

• Confirms all required quality control tests are performed.

Medical Dosimetry • Assesses the patient’s need for information and • reassurance. Reviews patient history for previous

PS 22

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Nuclear Medicine • Complies with regulations and federal and state laws to minimize radiation exposure levels.

• Maintains and performs quality control on radiation safety equipment, radionuclide infusion systems and generators according to regulatory agencies.

• Identifies and removes items that may affect safety, damage the equipment or affect the image quality when performing PET-MR. • Performs area monitoring and surveys to assess radiation exposure levels and contamination sites.

• Reviews theranostic protocol criteria and assesses contraindications and conditions that may affect the therapy.

• Screens patient and others for potential magnetic resonance contraindications, either within the body or on their person, prior to entering the magnet room when • performing PET-MR. • Verifies the patient’s lactation or breastfeeding status.

Verifies the patient’s menstrual cycle.

Quality Management • Assesses policies, protocols and guidelines to improve safety, efficiency and patient care, and identify the potential impact to the facility.

• Identifies the customers served by medical imaging and radiation therapy.

• Identifies the processes used in customer service.

Radiation Therapy Assesses the patient’s need for information and reassurance.

Identifies and removes objects that could interfere with prescribed treatment.

Inspects beam modifying and immobilization devices prior to use.

Monitors and assesses patients throughout the treatment course and follow-up visits.

Monitors doses to normal tissues.

Monitors side effects and reactions to treatment.

Monitors treatment unit operation during use.

Recognizes the patient’s need for referral to other care providers, such as a social worker, nurse or dietitian.

• Reviews beam shaping devices prior to treatment delivery.

• Reviews treatment protocol criteria and assesses conditions affecting treatment • delivery. Reviews treatment record prior to treatment or simulation.

Radiography • • • • • • • •

• Develops and maintains standardized exposure technique guidelines for all • equipment. Maintains and performs quality control on radiation safety equipment.

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Radiologist Assistant Assesses the patient’s level of anxiety and pain and informs the supervising radiologist.

Interviews patient to obtain, verify and update medical history.

Observes and assesses a patient who has received minimal and moderate sedation.

Performs a history and physical examination, analyzes data, and reports findings as part of a radiologist-led team.

• Performs area monitoring and surveys to assess radiation exposure levels and contamination sites.

• Verifies the patient's lactation or breastfeeding status.

• • • •

Sonography • Verifies that a registered sonographer operates the offsite equipment during a remote procedure.

PS 24

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Standard Two – Analysis/Determination The medical imaging and radiation therapy professional analyzes the information obtained during the assessment phase and develops an action plan for completing the Rationale Determining the most appropriate action plan enhances patient safety and comfort, optimizes diagnostic and therapeutic quality and improves efficiency.

The medical imaging and radiation therapy professional: General Criteria • Consults appropriate medical personnel to determine an action plan.

• Determines that all procedural requirements are in place to achieve a quality procedure.

• Determines the appropriate type and dose of contrast media to be administered based on established protocols.*† • Determines the course of action for an emergent situation.

• Determines the need for and selects supplies, accessory equipment, shielding, positioning and immobilization devices.

• Develops methods for minimizing hazards associated with medical imaging and radiation therapy procedures.

• Employs professional judgment to adapt procedures to improve diagnostic quality or therapeutic outcomes.

• Evaluates and monitors services, procedures, equipment and the environment to determine if they meet or exceed established guidelines and develops the action plan.

• Selects the most appropriate and efficient action plan after reviewing all pertinent data and assessing the patient’s abilities and condition.

Specific Criteria Bone Densitometry Refer to general criteria.

Cardiac-Interventional and Vascular-Interventional • Analyzes and determines action plans in conjunction with the cardiovascular Computed Tomography • Reviews the patient’s medical record and the licensed practitioner’s request to determine optimal scanning protocol for clinical indication.

* Excludes limited x-ray machine operator † Excludes medical dosimetry

PS 25

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Limited X-ray Machine Operator • Develops, maintains and makes available optimal exposure technique guidelines for all radiographic equipment.

Magnetic Resonance • Reviews the patient’s medical record and licensed practitioner’s request to determine optimal protocol and imaging parameters for clinical indications.

• Selects appropriate imaging coil.

Mammography • Monitors the patient’s need for information and reassurance throughout the • procedure. Selects appropriate equipment and imaging techniques to optimize the Medical Dosimetry • Gathers and analyzes pertinent data relevant to the treatment planning and delivery process.

• Participates in reviewing patient treatment parameters and dose records to ensure treatment does not exceed the prescribed dose or normal tissue tolerances.

• Recommends the appropriate immobilization devices and positioning aids for simulation and treatment.

• Recommends when to hold treatment until a radiation oncologist is notified.

• Reviews the treatment record and verifies calculations before and/or after treatment delivery.

• Verifies the treatment summary and the mathematical accuracy of the prescription.

Nuclear Medicine • Determines radiopharmaceutical dosage based on protocol, patient’s age, weight, medical and physical status.

• Evaluates results of quality control testing on radioactive material.

• Reviews the patient’s medical record and the examination request to determine optimal procedure parameters for clinical indications.

• Selects appropriate data acquisition equipment and accessories to perform the Quality Management • Assesses and prioritizes the current processes to improve quality while focusing on issues needing immediate response.

• Assesses proposed changes to minimize organizational disruption during • implementation. Clarifies current steps in a process to minimize redundancy, reordering and improving service flow.

• Creates an effective action plan after reviewing all pertinent data while assessing possible options, fiscal impact and ease of implementation.

• Develops monitoring metrics.

• Establishes benchmarks and quality indicators to assess quality management issues.

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• Monitors and develops methods to improve customer Radiation Therapy • Determines when to contact the radiation oncologist or licensed practitioner regarding patient side effects or questions.

• Determines when to withhold treatment until a radiation oncologist is contacted.

• Ensures the appropriate imaging technique is chosen for image-guided radiation therapy procedures.

• Participates in decisions about appropriate simulation techniques and treatment • positions. Reviews doses daily to ensure that treatment does not exceed prescribed dose, normal tissue tolerance or treatment protocol constraints.

• Reviews and verifies patient treatment plan and prescription prior to initial treatment delivery.

• Reviews and evaluates patient treatment records prior to each treatment for • prescription or treatment procedure changes.

Reviews treatment record, calculations and/or treatment plan for accuracy prior to • treatment delivery.

• Reviews verification images prior to treatment.

• Verifies machine quality assurance has been performed.

• Verifies the mathematical accuracy of the prescription and the daily treatment Radiography • Develops, maintains and makes available optimal exposure technique guidelines for all radiographic and fluoroscopic equipment.

Radiologist Assistant • Reviews the patient’s medical record and the licensed practitioner’s request to determine optimal imaging procedure for clinical indications.

Sonography • Monitors the patient’s need for information and reassurance throughout the • procedure. Selects appropriate equipment and imaging techniques to optimize the

PS 27

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1

Standard Three – Education The medical imaging and radiation therapy professional provides information about the procedure and related health issues according to protocol; informs the patient, public and other health care providers about procedures, equipment and facilities.

Rationale Education and communication are necessary to establish a positive relationship, promote safe practices and provide quality patient care.

The medical imaging and radiation therapy professional: General Criteria • Educates the patient, public and other health care providers about procedures, the associated biological effects and radiation protection.

• Elicits confidence and cooperation from the patient, the public and other health care providers by providing timely communication and effective instruction.

• Explains effects and potential side effects of medications.*† • Provides accurate explanations and instructions at an appropriate time and at a level the patient and their care providers can understand; addresses questions and concerns regarding the procedure.

• Provides information about the role of AI. • Provides information on certification or accreditation to the patient, other health care providers and the public.

• Provides information to patients, health care providers, students and the public concerning the role and responsibilities of individuals in the profession.

• • Provides pre-, peri- and post-procedure education.

Refers questions about diagnosis, treatment or prognosis to a licensed practitioner.

Specific Criteria Bone Densitometry Refer to general criteria.

* Excludes limited x-ray machine operator † Excludes medical dosimetry

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Cardiac-Interventional and Vascular-Interventional Refer to general criteria.

Computed Tomography Refer to general criteria.

Limited X-ray Machine Operator Refer to general criteria.

Magnetic Resonance • Provides magnetic resonance safety Mammography • Displays all certification and accreditation documents of compliance.

• Educates the patient about the need for adequate compression to achieve a quality mammogram and instructs the patient to communicate if the compression becomes intolerable.

• Educates the patient about the risk factors for breast cancer and the benefits of early detection.

• Educates the patient about the value and use of additional projections and alternative breast imaging procedures.

• Provides mammography consumer information in accordance with federal and state regulations and guidelines.

Medical Dosimetry • Explains the role and function of the medical dosimetrist in the overall treatment • course. Reviews the treatment plan with the patient as requested by a radiation Nuclear Medicine • Ensures radiation safety instruction information and limitations are provided to the patient and others during and following radiotheranostics and therapeutic • procedures. Provides instruction to the patient and others regarding the reduction of radiation exposure during and after the procedure.

• Provides magnetic resonance safety education when performing PET-MR. Quality Management Refer to general criteria.

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Radiation Therapy • Anticipates a patient’s need for information and provides it throughout the treatment course.

• Instructs patient in the maintenance of treatment markings.

• Provides information and instruction on proper skin care, diet and self-care • procedures. Provides pre-, peri- and post-procedure instructions to the patient for simulation and treatment.

Radiography Refer to general criteria.

Radiologist Assistant • Provides precare and postcare instructions to the patient as part of the radiologistled team.

Sonography • Educates patients and other health care professionals of the potential exposure risks associated with nonmedical entrepreneurial or entertainment 2D/3D/4D sonographic procedures.

• Educates patients and other health care professionals that the use of 2D/3D/4D sonography for nonmedical entrepreneurial or entertainment purposes is an unethical practice.

PS 30

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Standard Four – Performance The medical imaging and radiation therapy professional performs the action plan and quality assurance activities, including modifications when needed.

Rationale Quality patient services are provided through the safe and accurate performance of a deliberate plan of action. Quality assurance activities provide valid and reliable information regarding the performance of equipment, materials and processes.

The medical imaging and radiation therapy professional: General Criteria • Adheres to radiation safety rules and standards.

• Administers contrast media and other medications only when a licensed practitioner is immediately available to ensure proper diagnosis and treatment of adverse events.*† • Administers first aid or provides life support.† • Applies principles of aseptic or sterile technique.

• Assesses and monitors the patient’s physical, emotional and mental status.

• Consults with medical physicist or engineer in performing and documenting quality control tests and in reviewing of quality assurance.

• Explains to the patient each step of the action plan as it occurs and elicits the cooperation of the patient.

• Immobilizes patient for procedure.

• • Implements an action plan.

• Maintains current information on equipment, materials and processes.

Modifies the action plan according to changes in the clinical situation, equipment or • environment.

• Monitors the patient for reactions to medications.*† • Participates in ALARA, patient and personnel safety and risk management activities.

• Performs ongoing quality assurance activities and quality control testing.

• Performs procedural timeout.

• Positions patient for anatomic area of interest, respecting patient ability and comfort.

• Supports and implements the safe use of new technologies and procedures.

• Uses accessory equipment.

• Uses an integrated team approach.

• Uses personnel radiation monitoring devices as indicated by the RSO or designee.

Works aseptically in the appropriate environment while preparing, compounding and

* Excludes limited x-ray machine operator † Excludes medical dosimetry

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Specific Criteria Bone Densitometry • Applies the concepts of accuracy and precision in bone • densitometry. Confirms patient position matches the selected scan • parameters.

Cardiac-Interventional and Vascular-Interventional • Coordinates and manages the collection and labeling of tissue and fluid specimens.

• Monitors ECG, blood pressure, respiration, oxygen saturation, level of consciousness and pain pre-, peri- and post-procedure.

Computed Tomography • • • •

Adheres to protocol scan length to optimize patient dose.

Confirms patient position matches the selected scanning orientation parameters.

Coordinates and manages the collection and labeling of tissue and fluid specimens.

Determines optimum placement of ECG electrodes and correctly identifies ECG wave trigger.

• Optimizes technical factors to minimize radiation exposure to the patient while maintaining diagnostic image quality.

• Performs a remote CT procedure when a registered technologist is physically present with the patient.

• Uses radiation shielding devices.

• Utilizes isocentering of the anatomy of interest to optimize dose.

Limited X-ray Machine Operator • Reviews patient exposure records and reject analyses as part of the quality assurance program.

• Uses appropriate uniquely identifiable pre-exposure radiopaque markers for anatomical and procedural purposes.

• Uses pre-exposure collimation and proper field-of-view selection.

Magnetic Resonance • Ensures that anyone who is pregnant is not in the magnetic resonance scanner bore or scan room during actual data acquisition or scanning, unless medically necessary.

• Identifies appropriate cardiac or respiratory triggers.

• Monitors the patient’s specific absorption rate and other factors related to patient • heating. Performs a remote MR procedure when a registered technologist with MR Level 2 Personnel training is physically present with the patient.

• Positions imaging coil.

• Provides hearing protection to patient and others.

• Uses appropriate positioning and/or insulation materials to protect the patient from excessive heating and burns.

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Mammography • Applies appropriate radiopaque markers to the breast to indicate anatomic landmarks, including nipples, scars and lumps.

• Coordinates and manages the collection and labeling of tissue and fluid specimens.

• Ensures correct annotation of images.

• Ensures sonographic correlation to mammographic findings.

• Exercises clinical judgment in the application of adequate compression to acquire a quality mammographic image.

• Recognizes sonographic appearance of normal and abnormal breast tissue t Medicalt Dosimetry • Adheres to established best practice protocols, guidelines and radiation oncologist directives.

• Calculates treatment unit parameters and doses to treatment volumes and points of interest.

• Collaborates with the radiation therapist, medical physicist and radiation oncologist regarding the simulation and treatment processes and procedures.

• Demonstrates safe handling, storing and disposal of brachytherapy sources.

• Develops a treatment plan as prescribed by a radiation oncologist.

• Ensures an independent machine-setting check is completed before treatment is delivered.

• Makes the recommendation to discontinue patient treatment until equipment is operating properly.

• • Prepares or assists in preparing brachytherapy sources and equipment.

Reviews treatment planning data for accuracy and appropriateness prior to input into ’

PS 33

257

Nuclear Medicine • Administers radioactive material enterally, parenterally or through new or existing vascular access devices or through other routes as prescribed by a licensed practitioner and under the supervision of an authorized user.

• Coordinates and manages the collection and labeling of tissue and fluid specimens, including radiolabeling.

• Demonstrates safe handling, receipt, storage and disposal of radioactive materials.

• Determines optimum placement of ECG electrodes and correctly identifies ECG wave trigger and/or pattern.

• Ensures that anyone who is pregnant is not in the magnetic resonance scanner bore or scan room during actual data acquisition or scanning, unless medically necessary when performing PET-MR. • Follows aseptic technique in the appropriate environments while preparing, compounding, dispensing and repackaging sterile and nonsterile radiopharmaceuticals • in compliance with USP and FDA standards.

• Follows appropriate USP standards for beyond-use date and vial puncture standard.

• Follows USP standards for immediate use of sterile radiopharmaceuticals.

Maintains security of radioactive material to reduce radiation exposure to patients, • personnel and general public.

• Manipulates a radiopharmaceutical unit dose and performs dose pooling.

Monitors for internal exposure when applicable including bioassays, blood and urine • collection as directed by RSO or designee.

• Monitors shielding effectiveness.

• Provides hearing protection to patient and others when performing PET- MR. Uses appropriate positioning and/or insulation materials to protect the patient • from excessive heating and burns when performing PET-MR. • Uses radiation detecting equipment.

• Uses radiation shielding devices.

Quality Management • • • • •

Assesses process flow.

Collects and analyzes data using standard tools.

Identifies variables and implements changes to improve performance.

Investigates adverse events and continuously monitors outcomes to minimize risk. Uses knowledge to modify current practices.

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Radiation Therapy • Achieves precision patient alignment using imaging and external markings.

• Acquires and manages simulation and verification images.

• Assists the radiation oncologist in determining the optimum treatment field to cover the target volume.

• Calculates monitor units and treatment times.

• Demonstrates safe handling, storage and disposal of brachytherapy sources.

• Exports data to treatment planning systems.

• Makes the decision to discontinue patient treatment until equipment is operating • properly. Monitors the patient visually and aurally during treatment.

• Monitors the treatment console during treatment.

• Obtains radiation oncologist’s approval of images prior to initiation of treatment.

• Performs clinically indicated treatment imaging and motion management techniques.

• Performs quality assurance checks on simulator, treatment unit and appropriate • equipment.

• Prepares or assists in the preparation of brachytherapy sources and equipment.

Uses knowledge of biological effects of ionizing radiation on tissue to minimize radiation • dose to normal tissues.

• Uses radiation shielding devices.

Verifies that only the patient is in the treatment room prior to initiating treatment or any Radiography • Coordinates and manages the collection and labeling of tissue and fluid specimens.

• Reviews patient exposure records and reject analyses as part of the quality assurance program.

• Uses appropriate uniquely identifiable pre-exposure radiopaque markers for anatomical and procedural purposes.

• Uses pre-exposure collimation and proper field-of-view selection.

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Radiologist Assistant Administers medications as approved by the supervising radiologist.

Administers minimal and moderate sedation as prescribed by the supervising radiologist. Collects and documents tissue and fluid specimens.

Demonstrates safe handling and disposal of radioactive materials.

Maintains security of radioactive material to reduce radiation exposure to patients, personnel and general public.

• Monitors patient’s physical condition during the procedure and responds to changes in patient vital signs, hemodynamics and level of consciousness.

• Participates in quality reporting measures for the purpose of improved patient care.

• Recognizes and responds to medical emergencies, activates emergency response systems and provides advanced life support intervention.

• • Uses radiation detecting equipment.

Uses radiation shielding devices when handling radiopharmaceuticals.

Sonography • • • • •

Adheres to evidence-based practices to mitigate work-related musculoskeletal disorders.

Coordinates and manages the collection and labeling of tissue and fluid specimens.

Ensures correct annotation of images.

Performs a remote procedure when a registered technologist is physically present with the patient.

• Recognizes sonographic appearance of normal and abnormal tissue structures and physiological data.

• • • •

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Standard Five – Evaluation The medical imaging and radiation therapy professional determines whether the goals of the action plan have been achieved, evaluates quality assurance results and establishes an appropriate action plan.

Rationale Careful examination of the procedure is important to determine that expected outcomes have been met. Equipment, materials and processes depend on ongoing quality assurance activities that evaluate performance based on established guidelines.

The medical imaging and radiation therapy professional: General Criteria • Communicates the revised action plan to appropriate team members.

• Completes the evaluation process in a timely, accurate and comprehensive manner.

• Confirms data is accurate and complete.

• Develops a revised action plan to achieve the intended outcome.

• Evaluates discrepancies and variances when using AI. • Evaluates images for optimal demonstration of anatomy of interest.

• Evaluates quality assurance and quality control results.

• Evaluates the patient, equipment and procedure to identify variances that might affect the expected outcome.

• Identifies exceptions to the expected outcome.

• • Measures the procedure against established policies, protocols and benchmarks.

Validates quality control testing conditions and results.

Specific Criteria Bone Densitometry • Evaluates and identifies unexpected bone mineral density • changes. Reviews previous scan(s) and reanalyzes as necessary.

• Reviews T-scores and Z-scores to modify the action plan.

Cardiac-Interventional and Vascular-Interventional • Evaluates access site for complications requiring intervention or further Computed Tomography Refer to general criteria.

Limited X-ray Machine Operator • Evaluates images for the purpose of monitoring radiation exposure.

• Evaluates images to determine the use of appropriate imaging parameters.

• Verifies that exposure indicator data for digital radiographic systems has not been altered or modified and is included in the DICOM header and on images exported to PS 37

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Magnetic Resonance Refer to general criteria.

Mammography • Collaborates with the lead interpreting physician and medical physicist to maintain quality and comply with federal and state regulations and guidelines.

Medical Dosimetry • Acquires data necessary to perform accurate patient protocol plans and participates in implementation of the plan.

• Ensures treatment parameters have been transferred correctly to the oncology information system.

• Reviews treatment calculations and ensures the validity of the treatment plan.

• Reviews treatment variances and assists in determining possible causes and solutions.

Nuclear Medicine • Consults with a licensed practitioner to confirm procedural completeness.

• Reviews procedure to determine if additional images or data will enhance the diagnostic value.

Quality Management • Evaluates customer satisfaction.

• Evaluates measured processes and results against established policies, protocols, guidelines and benchmarks.

• Evaluates adverse events to minimize risk.

Radiation Therapy • • • • • • • •

Checks treatment calculations or treatment plan, or both when applicable.

Compares verification images to reference images.

Evaluates the patient daily for any side effects, reactions and therapeutic responses.

Performs treatment chart checks.

Reviews treatment discrepancies, determines causes and assists with the action plan. Reviews verification images for quality and accuracy.

Verifies the accuracy of the patient setup prior to treatment delivery.

Verifies treatment console readouts and settings prior to initiating treatment and upon termination of treatment.

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Radiography • Evaluates images for the purpose of monitoring radiation exposure.

• Evaluates images to determine the use of appropriate imaging parameters.

• Verifies that exposure indicator data for digital radiographic systems has not been altered or modified and is included in the DICOM header and on images exported to Radiologist Assistant Refer to general criteria.

Sonography Refer to general criteria.

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Standard Six – Implementation The medical imaging and radiation therapy professional implements the revised action plan based on quality assurance results and achievement of goals from the action plan.

Rationale It may be necessary to implement a revised action plan to promote safe and effective The medical imaging and radiation therapy professional: General Criteria • Adjusts imaging parameters, patient procedure or additional factors to improve the outcome.

• Bases the revised plan on the patient’s condition and the most appropriate means of achieving the expected outcome.

• Implements the revised action plan.

• Implements appropriate health care provider notification when immediate clinical response is necessary, based on procedural findings and patient condition.

• Obtains assistance to support the quality assurance action plan.

• Resolves discrepancies and variances with AI. • Takes action based on patient and procedural variances.

Specific Criteria Bone Densitometry Refer to general criteria.

Cardiac-Interventional and Vascular-Interventional Refer to general criteria.

Computed Tomography Refer to general criteria.

Limited X-ray Machine Operator Refer to general criteria.

Magnetic Resonance Refer to general criteria.

Mammography Refer to general criteria.

Medical Dosimetry • Develops additional treatment plans to achieve an optimal dose

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• Ensures accuracy in the transfer and documentation of treatment parameters, according to departmental policies.

• Reviews and implements treatment field changes indicated on simulation or verification images as directed by a radiation oncologist.

Nuclear Medicine • Employs devices to minimize radiation levels.

• Manages radioactive contamination and uses decontamination • procedures. Performs additional images or data collections as needed.

Quality Management • Develops policies, protocols and guidelines in collaboration with other health care providers.

Radiation Therapy • Collaborates with radiation oncologists, medical physicists and medical dosimetrists to make adjustments ensuring treatment accuracy.

• Establishes congruence between verification images and reference images.

• Formulates recommendations for process improvements to minimize treatment discrepancies.

• Implements treatment plan or treatment field changes as directed by the radiation oncologist.

• Reports deviations from the standard or planned treatment.

Radiography Refer to general criteria.

Radiologist Assistant • Manages radioactive contamination and uses decontamination Sonography Refer to general criteria.

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Standard Seven – Outcomes Measurement The medical imaging and radiation therapy professional reviews and evaluates the outcome of the procedure according to quality assurance standards.

Rationale To evaluate the quality of care, the actual outcome is compared to the expected outcome. Outcomes assessment is an integral part of the ongoing quality management action plan to enhance services.

The medical imaging and radiation therapy professional: General Criteria • Assesses the patient’s physical, emotional and mental status prior to • Evaluates the process and recognizes opportunities for future changes.

• Measures and evaluates the results of the appropriate action plan.

• Reviews all data for completeness and accuracy.

• Reviews and evaluates quality assurance processes and tools for • effectiveness. Reviews the implementation process for accuracy and validity.

• Uses evidence-based practice to determine whether the actual outcome is within established criteria.

Specific Criteria Bone Densitometry Refer to general criteria.

Cardiac-Interventional and Vascular-Interventional Refer to general criteria.

Computed Tomography Refer to general criteria.

Limited X-ray Machine Operator Refer to general criteria.

Magnetic Resonance Refer to general criteria.

Mammography Refer to general criteria.

Medical Dosimetry Refer to general criteria.

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Nuclear Medicine Refer to general criteria.

Quality Management • • • • • •

Assesses differences between expected and actual outcomes.

Assesses implemented changes for improvement.

Develops methods to demonstrate continuous improvement.

Develops strategies for maintaining improvement.

Evaluates the effectiveness of and supports changes to processes. Performs procedural analysis.

Radiation Therapy • Monitors patient status during procedures, throughout the treatment course and for follow-up care.

Radiography Refer to general criteria.

Radiologist Assistant • Performs follow-up patient evaluation and communicates findings to the supervising radiologist.

Sonography Refer to general criteria.

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Standard Eight – Documentation The medical imaging and radiation therapy professional documents information about patient care, procedures and outcomes.

Rationale Clear and precise documentation is essential for continuity of care, accuracy of care and quality assurance.

The medical imaging and radiation therapy professional: General Criteria • Archives images or data.

• Documents diagnostic, treatment and patient data in the medical record in a timely, accurate and comprehensive manner.

• Documents medication administration in patient’s medical record.*† • Documents procedural timeout.

• Documents unintended outcomes or exceptions from the established criteria.

• Maintains documentation of quality assurance activities, procedures and results.

• Provides pertinent information to authorized individual(s) involved in the patient’s • care. Records information used for billing and coding procedures.

• Reports any out-of-tolerance deviations to the appropriate personnel.

• Verifies patient consent is documented.

Specific Criteria Bone Densitometry Refer to general criteria.

Cardiac-Interventional and Vascular-Interventional • • • • •

Documents administered medications.

Documents or assists in documenting patient medical history related to the procedure. Documents radiation exposure parameters and initiates further action as needed.

Documents use of sedation.

Computed Tomography • Archives or documents radiation exposure.

• Documents the use of shielding devices and proper radiation safety Limited X-ray Machine Operator Documents radiation exposure.

• Documents the use of shielding devices and proper radiation safety •

* Excludes limited x-ray machine operator † Excludes medical dosimetry

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Magnetic Resonance Refer to general criteria.

Mammography • Documents quality assurance and quality control outcomes and necessary corrective action according to established guidelines.

• Records interval changes in breast sonographic findings compared to previous Medical Dosimetry • Reports any treatment variances in accordance with departmental, institutional and national quality assurance guidelines.

Nuclear Medicine • Documents dose and route of administered radiopharmaceutical or radionuclide therapy in the patient medical record.

• Documents instrumentation quality testing procedures and maintains results for • review. Documents radioactive materials quality testing procedures and maintains results for inspection.

• Documents the implementation, evaluation and modification of the radiation safety plan under the authority of the RSO. • Maintains records of the receipt, administration and disposal of radioactive materials.

Quality Management Documents goals and outcomes based on data analysis.

Documents process flow variances and justifies exceptions.

Documents steps used to improve processes.

Updates institutional policies, protocols and guidelines to ensure continuous compliance with regulatory requirements.

• Provides reports as required by institutional policy, accrediting bodies and federal and state regulations • • • •

Radiation Therapy • Maintains imaging and treatment records according to institutional • policy. Reports treatment discrepancies and variances to appropriate Radiography • Documents fluoroscopic time.

• Documents radiation exposure.

• Documents the use of shielding devices and proper radiation safety

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Radiologist Assistant Communicates and documents radiologist’s order to other health care providers.

Documents a history and physical examination in the patient record.

Documents administration of medications.

Documents and assists radiologist in quality reporting measures for the purpose of improved patient care.

• Documents dose and route of administered radiopharmaceutical in the patient medical record.

• Documents the implementation, evaluation and modification of the radiation safety plan under the authority of the RSO. • Documents use of minimal and moderate sedation.

• Reports clinical and imaging observations and procedure details to the supervising radiologist.

Sonography • • • •

• Documents initial impressions and technical data for interpretation by a licensed practitioner.

• Records interval changes in sonographic findings compared to previous imaging.

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Standard Nine – Quality The medical imaging and radiation therapy professional strives to provide optimal Rationale Patients expect and deserve optimal care during diagnosis and The medical imaging and radiation therapy professional: General Criteria • Adheres to standards, policies, statutes, regulations and established • guidelines. Anticipates, considers and responds to the needs of a diverse • patient population. Applies professional judgment and discretion while • performing the procedure. Assists with establishing required quality assurance • and quality control criteria. Collaborates with others to elevate the quality of • care.

• Establishes the parameters of AI and develops quality assurance activities.

• Maintains ALARA principles while utilizing integrated AI technology.

Specific Criteria Bone Densitometry • Advocates that facilities determine precision error and calculate the least significant change.

• Advocates that facilities have at least one practicing technologist with a bone densitometry certification as recognized by the ASRT. Cardiac-Interventional and Vascular-Interventional Refer to general criteria.

Computed Tomography • Advocates that facilities performing remote CT require a registered technologist be physically present with the patient.

Limited X-ray Machine Operator Refer to general criteria.

Magnetic Resonance • Advocates the need for a minimum of one registered magnetic resonance technologist and one additional MR Level 2 Personnel as the standard for safe and efficient delivery of magnetic resonance procedures.

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Mammography • Assists in setting policy and procedures in the facility to meet certification and accreditation standards specific to breast imaging.

• Prepares the annual medical outcomes audit and provides results to the lead interpreting physician.

• Reviews the annual MQSA inspection, medical outcomes audit and medical physicist’s reports to assess the quality of the breast imaging equipment’s performance and the facility’s quality assurance program.

Medical Dosimetry Refer to general criteria.

Nuclear Medicine • Performs procedures in accordance with the NRC or in agreement with state Quality Management • Verifies the achievement of goals and identifies exceptions.

Radiation Therapy • Maintains all elements of best practice when performing superficial radiation therapy procedures under the direction of a licensed practitioner.

• Promotes patient safety by performing external beam treatments with a minimum of two registered radiation therapists.

Radiography Refer to general criteria.

Radiologist Assistant • Performs procedures in accordance with the NRC or in agreement with state Sonography Refer to general criteria.

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Standard Ten – Self-Assessment and Professional Development The medical imaging and radiation therapy professional evaluates personal performance and maintains professional growth.

Rationale Self-assessment is necessary for personal growth and professional development. This can direct education necessary to maintain current knowledge and advancements in the profession to provide optimal patient care.

The medical imaging and radiation therapy professional: General Criteria • Advocates for and participates in continuing education related to area of practice to maintain and enhance clinical competency.

• Advocates for and participates in vendor-specific applications training to maintain clinical competency.

• Assesses personal work ethics, behaviors and attitudes.

• Evaluates performance, applies personal strengths and recognizes opportunities for educational growth and improvement.

• Maintains credentials and certification related to practice.

• Maintains knowledge of the most current practices and technology used to optimize patient exposure while producing quality images.

• Recognizes hazards associated with their work environment and takes measures to mitigate them.

Specific Criteria Bone Densitometry Refer to general criteria.

Cardiac-Interventional and Vascular-Interventional • Maintains competency in the use of diagnostic and interventional Computed Tomography Refer to general criteria.

Limited X-ray Machine Operator • Investigates avenues to continue progress to become a registered Magnetic Resonance Refer to general criteria.

Mammography Refer to general criteria.

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Medical Dosimetry Refer to general criteria.

Nuclear Medicine Refer to general criteria.

Quality Management Refer to general criteria.

Radiation Therapy Refer to general criteria.

Radiography Refer to general criteria.

Radiologist Assistant Refer to general criteria.

Sonography Refer to general criteria.

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Standard Eleven – Collaboration and Collegiality The medical imaging and radiation therapy professional promotes a positive and collaborative practice atmosphere with other members of the health care team.

Rationale To provide quality patient care, all members of the health care team must communicate effectively and work together efficiently.

The medical imaging and radiation therapy professional: General Criteria • Develops and maintains collaborative partnerships to enhance quality and • efficiency. Informs and instructs others about radiation safety.

• Promotes understanding of the profession.

• Shares knowledge and expertise with others.

Specific Criteria Bone Densitometry Refer to general criteria.

Cardiac-Interventional and Vascular-Interventional Refer to general criteria.

Computed Tomography Refer to general criteria.

Limited X-ray Machine Operator Refer to general criteria.

Magnetic Resonance Refer to general criteria.

Mammography Refer to general criteria.

Medical Dosimetry Refer to general criteria.

Nuclear Medicine Refer to general criteria.

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Quality Management Refer to general criteria.

Radiation Therapy Refer to general criteria.

Radiography Refer to general criteria.

Radiologist Assistant Refer to general criteria.

Sonography Refer to general criteria.

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Standard Twelve – Ethics The medical imaging and radiation therapy professional adheres to the profession’s accepted ethical standards.

Rationale Decisions made and actions taken on behalf of the patient are based on a sound ethical foundation.

The medical imaging and radiation therapy professional: General Criteria • Accepts accountability for decisions made and actions taken.

• Acts as a patient advocate.

• Adheres to the established ethical standards of recognized certifying agencies.

• Adheres to the established practice standards of the profession.

• Delivers equitable and inclusive patient care and service free from bias or • discrimination. Identifies and implements standards and ethics applicable to AI. • Promotes radiation safety standards.

• Provides health care services with consideration for a diverse patient population.

• Reports unsafe practices to the RSO, regulatory agency or other appropriate authority.

• Respects the patient’s right to privacy and confidentiality.

Specific Criteria Bone Densitometry Refer to general criteria.

Cardiac-Interventional and Vascular-Interventional Refer to general criteria.

Computed Tomography Refer to general criteria.

Limited X-ray Machine Operator Refer to general criteria.

Magnetic Resonance Refer to general criteria.

Mammography Refer to general criteria.

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Medical Dosimetry Refer to general criteria.

Nuclear Medicine Refer to general criteria.

Quality Management Refer to general criteria.

Radiation Therapy Refer to general criteria.

Radiography Refer to general criteria.

Radiologist Assistant Refer to general criteria.

Sonography • Participates in diagnostic sonographic procedures for the sole purpose of education, treatment or interpretation in accordance with the tenets of ethical

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Standard Thirteen – Research, Innovation and Professional Advocacy The medical imaging and radiation therapy professional participates in the acquisition and dissemination of knowledge, advocacy and the advancement of the profession.

Rationale Participation in professional organizations and scholarly activities advances the The medical imaging and radiation therapy professional: General Criteria • Adopts new best practices.

• Advocates for an ergonomically safe work environment based on evidence-based practices.

• Improves patient care and clinical outcomes through integration and dissemination of evidence-based research and practice.

• Investigates innovative methods for application in practice.

• Investigates relevant AI uses to enhance the science of the profession.

• Monitors changes to federal and state law, regulations and accreditation standards affecting areas of practice.

• Participates in data collection.

• Participates in professional advocacy efforts.

• • Participates in professional societies and organizations.

• Pursues lifelong learning.

• Reads and evaluates research relevant to the profession.

Specific Criteria Bone Densitometry Refer to general criteria.

Cardiac-Interventional and Vascular-Interventional • Advocates for a safe working environment to mitigate the occupational risk related to fluoroscopically-guided interventional procedures.

Computed Tomography Refer to general criteria.

Limited X-ray Machine Operator Refer to general criteria.

Magnetic Resonance Refer to general criteria.

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Mammography Refer to general criteria.

Medical Dosimetry Refer to general criteria.

Nuclear Medicine Refer to general criteria.

Quality Management Refer to general criteria.

Radiation Therapy Refer to general criteria.

Radiography Refer to general criteria.

Radiologist Assistant Refer to general criteria.

Sonography • Advocates for an ergonomically safe working environment, based on evidencebased practices, to mitigate the risk of work-related musculoskeletal disorders.

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Advisory Opinion Statements Advisory opinion statements provide explanations of the Practice ASRT issues advisory opinions to clarify what constitutes appropriate practice and offer guidance for specific practice issues.

The profession holds medical imaging and radiation therapy professionals responsible and accountable for rendering safe, effective clinical services to patients and for judgments exercised and actions taken in the course of providing those services. The advisory opinion statements assist medical imaging and radiation therapy professionals in safe practice.

The medical imaging and radiation therapy professional’s performance should be evidencebased and consistent with federal and state laws, regulations, established standards of practice and facility policies and procedures.

The ASRT recognizes the use of GRADE for measuring the quality of evidence and strength in recommendations for the development of advisory opinion statements.

Each medical imaging and radiation therapy professional must exercise prudent judgment when determining whether the performance of a given act is within the scope of practice for which the individual is licensed, if applicable within the jurisdiction in which the person is employed, educationally prepared and clinically competent to perform.

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Guidance for the Communication of Clinical and Imaging Observations and Procedure Details by Radiologist Assistants to Supervising Radiologists After research of evidentiary documentation, the ASRT issued opinions contained Advisory Opinion It is the opinion of the ASRT based on evidentiary documentation and where federal or state law and/or institutional policy permits that: 1. Communication of clinical and imaging observations and procedure details by the radiologist assistant to the supervising radiologist is an integral part of radiologist assistant practice. Without clear, consistent and appropriate communication between members of the radiology team, there is a possibility of inadequate patient care, incomplete reports and diminished departmental productivity. To create a safe and productive radiology environment, communication between the radiologist assistant and supervising radiologist must be free-flowing, consistent and relevant to the patient examination or procedure. This communication can take many forms, including verbal, written and electronic correspondence. These communications may be included and taken into consideration by the radiologist in creating a final report. However, initial clinical and imaging observations and procedure details communicated from the radiologist assistant to the radiologist are only intended for the radiologist’s use and do not substitute for the final report created by the radiologist. These communications 2. should be considered and documented as “initial clinical and imaging observations or procedure details.”

While assisting radiologists in the performance of imaging procedures or during the performance of procedures under radiologist supervision, the radiologist assistant must be able to communicate and document procedure notes, observations, patient responses and other types of information relevant to the radiologist’s interpretation and creation of the final report. Radiologist assistants do not independently “report findings” or “interpret” by dictation or by any other means; and to avoid any confusion, these terms should not be used to refer to the activities of the radiologist assistant.

However, radiologist assistants may add to the patient record, (following the policies and procedures of the facility), in a manner similar to any other dependent nonphysician practitioner. Radiologist assistants who are authorized to communicate initial observations to the supervising radiologist using a voice recognition dictation system or other electronic means must adhere to institutional protocols ensuring that initial observations can be viewed or accessed only by the supervising radiologist. Initial clinical or imaging observations or procedure details created by the radiologist assistant li f h di l i i ’ i l i h f f h GRADE: Strong Definitions See glossary.

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Evidentiary Documentation Current Literature Not applicable Curricula • Radiologist Assistant Curriculum (ASRT, 2020) QUALITY OF EVIDENCE: High Certification Agency Entry-Level Clinical Activities • Registered Radiologist Assistant Entry-Level Clinical Activities (ARRT, 2023) The document states that radiologist assistants may “Review imaging procedures, make initial observations, and communicate observations ONLY [emphasis added] to the radiologist; record initial observations of imaging procedures following radiologist approval; communicate radiologist’s report to appropriate health care provider consistent with the ACR Practice Parameter for Communication of Diagnostic Imaging Certification Agency Content Specifications Not applicable QUALITY OF EVIDENCE: High Scopes of Practice and Practice Standards Reference • Scope of Practice – (radiologist assistant only) o Communicating the supervising radiologist’s report to the appropriate health care provider consistent with the ACR Practice Guidelines for Communication of Diagnostic Imaging Findings. o Evaluating images for completeness and diagnostic quality and recommending additional images. o Obtaining images necessary for diagnosis and communicating initial observations to the supervising radiologist. The radiologist assistant does not provide image interpretation as defined by the ACR. o Providing follow-up patient evaluation.

• The ASRT Practice Standards for Medical Imaging and Radiation Therapy o Performs a history and physical examination, analyzes data, and reports findings as part of a radiologist-led team. (Standard One, radiologist assistant only) o Performs follow-up patient evaluation and communicates findings to the supervising radiologist. (Standard Seven, radiologist assistant only) o Documents diagnostic, treatment and patient data in the medical record in a timely, accurate and comprehensive manner. (Standard Eight, General Criteria) o Maintains documentation of quality assurance activities, procedures and results.

(Standard Eight, General Criteria) o Communicates and documents a radiologist’s order to other health care providers.

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o Documents and assists radiologist in quality reporting measures for the purpose improved patient care. (Standard Eight, radiologist assistant o Reports clinical and imaging observations and procedure details to the radiologist. (Standard Eight, radiologist assistant only) QUALITY OF EVIDENCE: High Federal and State Statute References Not applicable Other Not applicable 1

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Medication Administration in Peripherally Inserted Central Catheter Lines or Ports With a Power Injector*† After research of evidentiary documentation, the ASRT issued the opinions contained Advisory Opinion It is the opinion of the ASRT based on evidentiary documentation and where federal or state law and/or institutional policy permits that: Medical imaging and radiation therapy professionals can access and/or use an FDA approved: 3. Peripherally inserted central catheter (PICC) line by inserting an approved connective device. The PICC line must be designated for use with power injectors. Manufacturer guidelines regarding infusion rate and pressure must be followed.

4. Port by inserting an approved non coring needle. The port must be designated for use with power injectors. Manufacturer guidelines regarding infusion rate and pressure must be followed.

GRADE: Strong Definitions See glossary.

Evidentiary Documentation Current Literature Not applicable Curricula • Computed Tomography Curriculum (ASRT, 2023) • Magnetic Resonance Curriculum (ASRT, 2020) • Nuclear Medicine Technology Competency-Based Curriculum Guide (SNMMI, 2022) • Radiography Curriculum (ASRT, 2022) • Radiologist Assistant Curriculum (ASRT, 2020) QUALITY OF EVIDENCE: High 1

Certification Agency Content Specifications • Components of Preparedness (NMTCB, 2020) • Computed Tomography (ARRT, 2022) • Positron Emission Tomography (PET) Specialty Examination Content Outline (NMTCB, 2023) • Vascular-Interventional Radiography (ARRT, 2023) QUALITY OF EVIDENCE: High

* Excludes limited x-ray machine operator † Excludes medical dosimetry

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Scopes of Practice and Practice Standards Reference • Scope of Practice o Administering medications enterally, parenterally, through new or existing vascular access or through other routes as prescribed by a licensed practitioner.*† o Administering medications with an infusion pump or power injector as prescribed by a licensed practitioner.*† o Identifying, calculating, compounding, preparing or administering medications QUALITY OF EVIDENCE: High Federal and State Statute References Not applicable Other Not applicable 1

* Excludes limited x-ray machine operator † Excludes medical dosimetry

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Medication Administration Through New or Existing Vascular Access*† After research of evidentiary documentation, the ASRT issued the opinions contained Advisory Opinion It is the opinion of the ASRT based on evidentiary documentation and where federal or state law and/or institutional policy permits that: 1. It is within the scope of practice for medical imaging and radiation therapy professionals to access and administer medications through new or existing vascular access by an approved method of administration (e.g., hand injection, power injection, slow push, bolus, infusion) as prescribed by a licensed practitioner.

GRADE: Strong Definitions • access – The process of inserting an approved connective device through the access point of an existing vascular access device to deliver intravenous (IV) fluids or • medication. existing vascular access – Peripheral or central vascular implanted devices or external access lines that include, but are not limited to, peripherally inserted central catheter Evidentiary Documentation Current Literature • ACR Committee on Drugs and Contrast Media. ACR Manual on Contrast Media.

American College of Radiology; 2023.

• American College of Radiology. ACR-SPR practice parameter for performing and interpreting diagnostic computed tomography (CT). Revised 2022.

• American College of Radiology. ACR practice parameter for performing and interpreting magnetic resonance imaging (MRI). Revised 2022.

• American College of Radiology. ACR-SPR practice parameter for the use of intravascular contrast media. Revised 2022.

• Rockwell D. A competency for central line use in radiology. J Radiol Nurs. 2008;27(2):84. doi:10.1016/j.jradnu.2008.04.016 QUALITY OF EVIDENCE: High Curricula • Cardiac-Interventional and Vascular-Interventional Curriculum (ASRT, 2019) • Computed Tomography Curriculum (ASRT, 2023) • Magnetic Resonance Curriculum (ASRT, 2020) Mammography • Curriculum (ASRT, Revised 2023) • National Education Curriculum for Sonography (JRC-DMS, 2016)

* Excludes limited x-ray machine operator † Excludes medical dosimetry

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• • • •

Nuclear Medicine Technology Competency-Based Curriculum Guide (SNMMI, 2022) Radiation Therapy Curriculum (ASRT, 2019) Radiography Curriculum (ASRT, 2022) Radiologist Assistant Curriculum (ASRT, 2020)

QUALITY OF EVIDENCE: High Certification Agency Content Specifications • Components of Preparedness (NMTCB, 2020) • Computed Tomography (ARRT, 2022) • Examination Overview: Registered Cardiovascular Invasive Specialist (CCI, 2022) • Magnetic Resonance Imaging (ARRT, 2020) • Nuclear Medicine Technology (ARRT, 2022) • Positron Emission Tomography (PET) Specialty Examination Content Outline (NMTCB, 2023) • Radiography (ARRT, 2022) • Registered Radiologist Assistant (ARRT, 2023) • Vascular-Interventional Radiography (ARRT, 2023) QUALITY OF EVIDENCE: High Scopes of Practice and Practice Standards Reference • Scope of Practice o Administering medications enterally, parenterally, through new or existing vascular access or through other routes as prescribed by a licensed practitioner.*† o Identifying, calculating, compounding, preparing or administering medications as prescribed by a licensed practitioner.*† o Performing venipuncture as prescribed by a licensed practitioner.*† o Starting, maintaining and/or removing intravenous access as prescribed by a licensed practitioner.*† QUALITY OF EVIDENCE: High Federal and State Statute References Not applicable Other Not applicable

* Excludes limited x-ray machine operator † Excludes medical dosimetry

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Placement of Personnel Radiation Monitoring Devices After research of evidentiary documentation, the ASRT issued the opinions contained Advisory Opinion It is the opinion of the ASRT based on evidentiary documentation and where federal or state law and/or institutional policy permits that: 4. Radiation workers wear a personnel radiation monitoring device outside of protective apparel with the label facing the radiation source at the level of the collar.

5. In specific cases, a whole-body monitor may be indicated. This monitor should be worn at the waist inside of protective apparel, with the label facing the radiation source.

GRADE: Strong Definitions See glossary.

Evidentiary Documentation Current Literature • Bushong S. Occupational radiation dose management. In: Radiologic Science for Technologists: Physics, Biology, and Protection. 12th ed. Elsevier; 2020: 547 - 549. By • standards number: 1910.1096(d)(3)(i) – ionizing radiation. Occupational Safety and Health Administration website.

• Gilmore D, Watersham-Rich K. Radiation safety in nuclear medicine. In: Nuclear Medicine and PET/CT: Technology and Technique. 8th edition. Elsevier; 2016:116.

• Statkiewicz-Sherer MA, Visconti PJ, Ritenour ER, Welch-Haynes K. Radiation monitoring. In: Radiation Protection in Medical Radiography. 9th ed. Elsevier; 2022:7287 QUALITY OF EVIDENCE: High Curricula • Bone Densitometry Curriculum (ASRT, Revised 2023) Limited • X-ray Machine Operator Curriculum (ASRT, 2020) • Nuclear Medicine Technology Competency-Based Curriculum Guide (SNMMI, 2022) • Radiation Therapy Curriculum (ASRT, 2019) • Radiography Curriculum (ASRT, 2022) Radiologist • Assistant Curriculum (ASRT, 2020)

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QUALITY OF EVIDENCE: High Certification Agency Content Specifications • Cardiac-Interventional Radiography (ARRT, 2023) • Components of Preparedness (NMTCB, 2020) • Limited Scope of Practice in Radiography (ARRT, 2023) • Nuclear Medicine Technology (ARRT, 2022) • Radiation Therapy (ARRT, 2022) Radiography • (ARRT, 2022) • Registered Radiologist Assistant (ARRT, 2023) • Vascular-Interventional Radiography (ARRT, 2023) QUALITY OF EVIDENCE: High Scopes of Practice and Practice Standards Reference • Uses personnel radiation monitoring devices as indicated by the RSO or designee, (Standard Four, General Criteria) Federal and State Statute References • § 19.12 Instruction to Workers (NRC, 2021) • § 20.1208 Dose Equivalent to an Embryo/Fetus (NRC, 2021) • § 20.1502 Conditions Requiring Individual Monitoring of External and Internal Occupational Dose (NRC, 2021) • Regulatory Guide 8.34: Monitoring Criteria and Methods to Calculate Occupational Radiation Doses (NRC, 2022) • Regulatory Guide 8.36: Radiation Dose to the Embryo/Fetus (NRC, 2017) • Regulatory Guide 8.7: Instructions for Recording and Reporting Occupational Radiation Exposure Data (NRC, 2018) QUALITY OF EVIDENCE: High Other • AAPM Report No. 58: Managing the Use of Fluoroscopy in Medical Institutions.

Appendix A: Radiation Safety/Quality Assurance Program QUALITY OF EVIDENCE: High

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Supervision of Contrast Media Administration by Radiologist Assistants After research of evidentiary documentation, the ASRT issued the opinions contained Advisory Opinion It is the opinion of the ASRT based on evidentiary documentation and where federal or state law and/or institutional policy permits that radiologist assistants are qualified to: 4. Supervise the administration of contrast media for medical imaging and radiation therapy procedures, as members of the radiologist-led team. The radiologist assistant must be able to consult with their supervising physician.

5. Recognize and respond to medical emergencies resulting from the administration of contrast media, in accordance with their advanced cardiac life support certification.

6. Administer medications and other interventions under a standing orders or GRADE: Strong Definitions See glossary.

Evidentiary Documentation Current Literature • ACR Committee on Drugs and Contrast Media. ACR Manual on Contrast Media.

American College of Radiology; 2023.

• American College of Radiology. Statement from Drugs and Contrast Media Committee on Supervision of Contrast Material Administration. Accessed February 26, 2024. https://www.acr.org/-/media/ACR/Files/Clinical-Resources/FINAL_Statementfrom-Drugs-and-Contrast-Media-Committee-on-Supervision-of-ContrastAdministration.pdf Curricula • Radiologist Assistant Curriculum (ASRT, 2020) QUALITY OF EVIDENCE: High Certification Agency Entry-Level Clinical Activities • Registered Radiologist Assistant Entry-Level Clinical Activities (ARRT, 2023) The document states that radiologist • Administer contrast agents and radiopharmaceuticals as prescribed by the supervising radiologist.

• Administer medications (EXCLUDING contrast agents and radiopharmaceuticals) as prescribed by a licensed practitioner and approved by the supervising radiologist.

• Administer oxygen as prescribed.

• Monitor patient for side effects or complications of the pharmaceutical(s).

• Perform examinations and procedures including contrast media administration when appropriate and operation of imaging equipment.

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• Recognize and respond to medical emergencies (e.g., drug reactions, cardiac arrest, hypoglycemia) and activate emergency response systems, including notification of the supervising radiologist.

Certification Agency Content Specifications • Registered Radiologist Assistant (ARRT, 2023) QUALITY OF EVIDENCE: High Scopes of Practice and Practice Standards Reference • Scope of Practice (radiologist assistant only) o Completing patient history and physical.

• The ASRT Practice Standards for Medical Imaging and Radiation Therapy o Administers medications as approved by the supervising radiologist. (Standard Four, radiologist assistant only) o Monitors patient’s physical condition during the procedure and responds to changes in patient vital signs, hemodynamics and level of consciousness.

(Standard Four, radiologist assistant only) o Recognizes and responds to medical emergencies, activates emergency response systems and provides advanced life support intervention. (Standard Four, radiologist assistant only) o Documents administration of medications. (Standard Eight, radiologist assistant o only) Reports clinical and imaging observations and procedure details to the supervising radiologist. (Standard Eight, radiologist assistant only) QUALITY OF EVIDENCE: High Federal and State Statute References Not applicable Other Not applicable

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Use of Postexposure Shuttering, Cropping and Electronic Masking in Radiography After research of evidentiary documentation, the ASRT issued the opinions contained Advisory Opinion It is the opinion of the ASRT based on evidentiary documentation and where federal or state law and/or institutional policy permits that: 1. It is within the scope of practice of a radiologic technologist to determine and apply appropriate pre-exposure collimation to individual projections of examinations to comply with the principle of ALARA. Postexposure shuttering, cropping, electronic collimation or electronic masking to eliminate the visibility of large regions of brightness are acceptable, where automatic processing fails to do so.

2. It is outside of the scope of practice of a radiologic technologist to use postexposure shuttering, cropping, electronic collimation or electronic masking to eliminate any anatomical information. This information is a part of the patient’s permanent medical record and should therefore be presented to the licensed practitioner to determine whether the exposed anatomy obtained on any image is significant or of diagnostic 3. value.

It is outside the scope of practice of a radiologic technologist to use postexposure shuttering, cropping, electronic collimation or electronic masking to duplicate and use any acquired image for more than one prescribed view or projection on any exam.

Facilities acquiring digital images are legally required to retain information in the DICOM information of each image that identifies the selected view or projection at the time of image acquisition. Using the same acquired image to represent two different GRADE: Strong Definitions See glossary.

Evidentiary Documentation Current Literature • American College of Radiology. ACR-AAPM-SIIM-SPR practice parameter for digital radiography. Revised 2022.

• Bomer J, Wiersma-Deijl L, Holscher HC. Electronic collimation and radiation protection in paediatric digital radiography: revival of the silver lining. Insights Imaging.

2013;4(5):723-727. doi:10.1007/s13244-013-0281-5 • Carroll QB. Radiography in the Digital Age. 3rd ed. Charles C Thomas; 2018. Carter • C, Vealé B. Digital Radiography and PACS. 4th ed. Elsevier; 2023.

• Chalazonitis AN, Koumarianos D, Tzovara J, Chronopoulos P. How to optimize radiological images captured from digital cameras, using the Adobe Photoshop 6.0 program. J Digit Imaging. 2003;16(2):216-229.

• DeMaio DN, Herrmann T, Noble LB, et al; American Society of Radiologic Technologists.

Best practices in digital radiography. Published 2019.

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• Don S, Macdougall R, Strauss K, et al. Image Gently campaign back to basics initiative: ten steps to help manage radiation dose in pediatric digital radiography. AJR Am J Roentgenol. 2013;200(5):W431-W436. doi:10.2214/AJR.12.9895 • Fauber TL, Dempsey MC. X-ray field size and patient dosimetry. Radiol Technol.

2013;85(2):155-161.

• Fauber TL. Radiographic Imaging and Exposure. 6th ed. Elsevier; 2020:120 and 176.

• Goske MJ, Charkot E, Herrmann T, et al. Image Gently: challenges for radiologic technologists when performing digital radiography in children. Pediatr Radiol.

2011;41(5):611-619. doi:10.1007/s00247-010-1957-3 • Lo WY, Puchalski SM. Digital image processing. Vet Radiol Ultrasound. 2008;49(1 suppl 1):S42-S47. doi:10.1111/j.1740-8261.2007.00333.x • Russell J, Burbridge BE, Duncan MD, Tynan J. Adult fingers visualized on neonatal intensive care unit chest radiographs: what you don’t see. Can Assoc Radiol J. 2013;64(3):236-239. doi:10.1016/j.carj.2012.04.004 • • Seeram E. Digital Radiography: An Introduction. Cengage Learning; 2011.

Uffmann M, Schaefer-Prokop C. Digital radiography: the balance between image quality and required radiation dose. Eur J Radiol. 2009;72(2):202-208.

• doi:10.1016/j.ejrad.2009.05.060 Willis CE. Optimizing digital radiography of children. Eur J Radiol. 2009;72(2):266-273.

• doi:10.1016/j.ejrad.2009.03.003 Zetterberg LG, Espeland A. Lumbar spine radiography—poor collimation practices after implementation of digital technology. Br J Radiol. 2011;84(1002):566-9.

QUALITY OF EVIDENCE: High Curricula • Limited X-ray Machine Operator Curriculum (ASRT Board Approved, 2020) • Radiography Curriculum (ASRT, 2022) Certification Agency Content Specifications • Limited Scope of Practice in Radiography (ARRT, 2023) • Radiography (ARRT, 2022) Scopes of Practice and Practice Standards Reference • Scope of Practice o Applying principles of ALARA to minimize exposure to patient, self and others. o Selecting the appropriate protocol and optimizing technical factors while maximizing patient safety.

• The ASRT Practice Standards for Medical Imaging and Radiation Therapy o Employs professional judgment to adapt procedures to improve diagnostic quality or therapeutic outcomes. (Standard Two, General Criteria) o Adheres to radiation safety rules and standards. (Standard Four, General Criteria)

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o Participates in ALARA, patient and personnel safety and risk management activities (Standard Four, General Criteria) o Positions patient for anatomic area of interest, respecting patient ability and comfort. (Standard Four, General Criteria) o Uses pre-exposure collimation and proper field-of-view selection. (Standard Four, limited x-ray machine operator and radiography only) o Evaluates images for optimal demonstration of anatomy of interest. (Standard Five, General Criteria) o Evaluates images to determine the use of appropriate imaging parameters.

(Standard Five, limited x-ray machine operator and radiography only) o Verifies that exposure indicator data for digital radiographic systems has not been altered or modified and is included in the DICOM header and on images exported to o media. (Standard Five, limited x-ray machine operator and radiography only) Adheres to the established practice standards of the profession. (Standard Twelve, QUALITY OF EVIDENCE: High Federal and State Statute References Not applicable Other Not applicable

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Glossary The glossary is an alphabetical list of defined terms or words specifically found in the ASRT Practice Standards for Medical Imaging and Radiation Therapy. The terms or words have meaning that might not be general knowledge. The definitions are formulated using evidentiary documentation and put into place following extensive review and subsequent approval. The glossary is not all-inclusive. New terms and new usage of existing terms will emerge with time and advances in technology AAPM – American Association of Physicists in Medicine ACR – American College of Radiology adverse event – Any undesirable experience associated with the use of a medical product in a patient.

AI – artificial intelligence ALARA – Acronym for “as low as (is) reasonably achievable,” which means making every reasonable effort to maintain exposures to radiation as far below the dose limits as practical, consistent with the purpose for which the licensed activity is undertaken, while taking into account the state of technology, the economics of improvements in relation to state of technology, the economics of improvements in relation to benefits to the public health and safety and other societal and socioeconomic considerations, and in relation to the use of nuclear energy and licensed materials in the public interest. The ASRT recognizes the concept of ALARA to include energies used for magnetic resonance and sonographic imaging. anatomic (anatomical) landmarks – Bones or other identifiable points that are visible or palpable and indicate the position of internal anatomy. appropriate action plan – Encompasses the initial, current or revised action plan. archive (archival) –The storage of data in either hard (film) or soft (digital) form.

ARDMS – American Registry for Diagnostic Medical Sonography ARRT – American Registry of Radiologic Technologists artifact – Extraneous information on the image that interferes with or distracts from image quality.

ASRT – American Society of Radiologic Technologists authorized user – A physician, dentist or podiatrist who meets the requirements as defined by the United States Nuclear Regulatory Commission. beam-modification devices – Devices that change the shape of the treatment field or distribution of the radiation at (tissue) depth. brachytherapy – A method of treatment that involves the temporary or permanent placement of radiation source(s) (isotopic or electronic) inside or immediately adjacent to a tumor-bearing region

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change management – Systematic approach to preparing for, implementing and sustaining a change in process. clinical – Pertaining to or founded on actual observations and treatments of patients. clinically competent – The ability to perform a clinical procedure in a manner that satisfies the demands of a situation, as assessed and documented by a qualified individual. compounding medication – The combining, mixing, pooling or otherwise altering of a conventionally manufactured drug in response to or anticipation of a medication order. compounding radiopharmaceutical – The combining, mixing, pooling or otherwise altering of a conventionally manufactured radiopharmaceutical or synthesizing/formulating a radiopharmaceutical from bulk drug substances and radionuclides. contrast media – A substance administered during a medical imaging procedure for the purpose of enhancing the contrast between an internal structure or fluid and the surrounding tissue. cropping – The process of selecting and removing a portion of the image. custom blocks – Devices designed to shape the radiation field.

DICOM – Acronym for “Digital Imaging and Communications in Medicine.” The DICOM standards are a complex set of instructions to exchange and present medical image information. dose distribution – Spatial representation of the magnitude of the dose produced by a source of radiation. It describes the variation of dose with position within an irradiated volume. dose pooling – Combining unit doses of a radiopharmaceutical to meet the dosage requirements of a single patient. dosimetric calculations – Computation of treatment unit settings, monitor units, treatment times and radiation doses to anatomical areas of interest.

ECG – electrocardiogram educationally prepared – The successful completion of didactic and clinical education necessary to properly perform a procedure in accordance with accepted practice standards. electronic masking – Electronic collimation or cropping of the digital radiographic image that occurs during postprocessing of the acquired image and does not alter the size of the irradiated field.

FDA – U.S. Food and Drug Administration GRADE – Grading of Recommendations Assessment, Development and Evaluation HIPAA – Health Insurance Portability and Accountability Act of 1996 HQCC – Healthcare Quality Certification Commission hybrid imaging – The combination of imaging technologies that allows information from diff t d liti t b t d i l t fi PS 73

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imaging technologies – Technologies using ionizing and nonionizing radiation to visualize physiological processes, internal structures and fiducial markers, both anatomical and nonanatomical. immediate use – Dose preparation, including one made using appropriate and necessary deviation, and/or the dispensing of a sterile radiopharmaceutical specific for a single patient. immobilization device – Device that assists in maintaining or reproducing the position while limiting patient movement. initial observation – Assessment of technical image quality with pathophysiology correlation communicated to a radiologist. interpretation – The process of examining and analyzing all images within a given procedure and integration of the imaging data with appropriate clinical data in order to render an impression or conclusion set forth in a formal written report composed and signed by a licensed practitioner. interventional procedures – Invasive medical imaging guidance methods used to diagnose and/or treat certain conditions.

ISCD – International Society for Clinical Densitometry JRC-DMS – Joint Review Committee on Education in Diagnostic Medical Sonography least significant change ‒ The least amount of bone mineral densitometry change that can be considered statistically significant. licensed practitioner – A medical or osteopathic physician, chiropractor, podiatrist or dentist who has education and specialist training in the medical or dental use of radiation and is deemed competent to perform independently or supervise medical imaging or radiation therapy procedures by the respective state licensure board.

MDCB – Medical Dosimetrist Certification Board medical physicist – An individual who is competent to practice independently in the safe use of x-rays, gamma rays, electron and other charged particle beams, neutrons, radionuclides, sealed radionuclide sources, ultrasonic radiation, radiofrequency radiation and magnetic fields for diagnostic and therapeutic purposes. An individual is considered competent to practice in the field of medical physics if the individual is certified by the appropriate recognized certification organization. medication – Any chemical substance intended for use in the medical diagnosis, cure, treatment or prevention of disease. minimal sedation (anxiolysis) – A drug-induced state during which patients respond normally to verbal commands. Although cognitive function and coordination may be impaired, ventilatory and cardiovascular functions are unaffected. moderate sedation – A drug-induced depression of consciousness during which patients respond purposefully to verbal commands, either alone or accompanied by light tactile stimulation. No interventions are required to maintain a patent airway, and spontaneous PS 74

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characterization and measurement of biologic processes at the molecular and cellular levels.

Molecular imaging techniques may be applied to computed tomography, magnetic resonance, nuclear medicine, optical imaging, PET-CT, sonography and spectroscopy. monitor units – Unit of output measure used for linear accelerators, sometimes indicated with the abbreviation MU. Accelerators are calibrated so that 1 MU delivers 1 cGy for a standard reference field size at a standard reference depth at a standard source to calibration point.

MQSA – Mammography Quality Standards Act MR Level 2 Personnel – Individuals who have completed more extensive education in broad MR safety issues related to all MR energy fields.

NECS – National Education Curriculum for Sonography NMTCB – Nuclear Medicine Technology Certification Board noninterpretive fluoroscopic procedures – Use of fluoroscopic imaging under the direction of a licensed practitioner for purposes other than interpretation. normal tissue tolerance – Radiation tolerance levels of healthy organs near or within the radiation treatment fields.

NRC – U.S. Nuclear Regulatory Commission panning – Movement of the procedure table during image production to maintain visualization of an anatomic region of interest. personnel radiation monitoring devices – Devices designed to be worn or carried by an individual for the purpose of measuring the dose of radiation received. physics survey – Performing equipment testing, evaluating the testing results and completing a formal written report of results. The written survey report, validated by a medical physicist, contains sufficient information to document that each test was conducted according to local, federal or state requirements and includes an assessment of corrective actions and recommendations for improvements. point-of-care testing – Medical diagnostic testing performed outside the clinical laboratory in close proximity to where the patient is receiving care (e.g., blood sugars, creatinine). postprocessing – Computerized processing of data sets after acquisition to create a diagnostic or therapeutic image. procedure – Specific course of action intended to result in an imaging study, treatment or other outcome. processing – Manipulation of the raw data just after acquisition. protocol – The plan for carrying out a procedure, scientific study or a patient’s treatment regimen. quality assurance – Activities and programs designed to achieve a desired degree or grade of care in a defined medical, nursing or health care setting or program. Sometimes indicated with the abbreviation QA. PS 75

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the interpretation of data regarding equipment function and confirmation that corrective actions are/were taken. Sometimes indicated with the abbreviation QC. radiation oncologist – A physician who specializes in using radiation to treat cancer. radiation protection – Prophylaxis against injury from ionizing radiation. The only effective preventive measures are shielding the operator, handlers and patients from the radiation source; maintaining appropriate distance from the source; and limiting the time and amount of exposure. radioactive material – A substance composed of unstable atoms that decay with the spontaneous emission of radioactivity. Includes radiopharmaceuticals, unsealed sources (open, frequently in liquid or gaseous form) and sealed sources (permanently encapsulated, frequently in solid form). radiobiology – The study of the effects of radiation on living organisms. radiography – The process of obtaining an image for diagnostic examination using x-rays. radiotheranostics – The use of radionuclides for the paired imaging and therapy agents. remote procedure – Operator control of image acquisition from a physical location that is different from the patient.

RSO – Radiation Safety Officer scholarly activity – Activities that systematically advance the teaching, research and practice of the medical imaging and radiation therapy profession through scientific investigation, presentation, and publication. setup – Arrangement of treatment parameters used in preparation for delivering radiation therapy; includes patient positioning data, field alignment information and equipment configurations. shuttering – A postprocessing technique that may be used to eliminate ambient light around an image for the sole purpose of improving the quality of the displayed image. It should not be used as a substitute for insufficient collimation of the irradiated field. simulation – A process using imaging technologies to plan radiation therapy so that the target area is precisely located and marked; the mockup procedure of a patient treatment with medical imaging documentation of the treatment portals.

SNMMI – Society of Nuclear Medicine and Molecular Imaging static – Any medical image that is fixed or frozen in time. superficial radiation therapy – Treatment with x-rays produced at potentials ranging from 40150 kV. supervising radiologist – A board-certified or board-eligible radiologist who oversees duties of the radiologist assistant and has appropriate clinical privileges for the procedure performed by the radiologist assistant. theranostics – The systematic integration of targeted diagnostics and therapeutics. timeout – Preprocedural pause to conduct a final assessment that the correct patient, site and 300 procedure are identified.

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tolerance levels (doses) – The maximum radiation dose that may be delivered to a given biological tissue at a specified dose rate and throughout a specified volume without producing an unacceptable change in the tissue. treatment calculations – See dosimetric calculations. treatment field (portal) – Volume of tissue exposed to radiation from a single radiation beam. treatment planning – The process by which dose delivery is optimized for a given patient and clinical situation. It encompasses procedures involved in planning a course of radiation treatment, including simulation through completion of the treatment summary. treatment record – Documents the delivery of treatments, recording of fractional and cumulative doses, machine settings, verification imaging and the ordering and implementation of prescribed changes.

T-score – Number of standard deviations the individual’s bone mineral density is from the average bone mineral density for gender-matched young normal peak bone mass.

USP – United States Pharmacopeia vascular access device – Apparatus inserted into the peripheral or central vasculature for diagnostic or therapeutic purposes. vascular closure device ‒ Active or passive medical devices used to achieve hemostasis after a cardiovascular or endovascular procedure that requires catheterization. venipuncture – The transcutaneous puncture of a vein by a sharp rigid stylet or cannula carrying a flexible plastic catheter or by a steel needle attached to a syringe or catheter. verification images – Images produced to confirm accurate treatment positioning and accurate treatment portals.

Z-score – Number of standard deviations the individual’s bone mineral density is from the average bone mineral density for age- and gender-matched reference group.

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