Home
School of Health Science MSc DIAGNOSTIC RADIOGRAPHY (Pre-registration)

School of Health Science MSc DIAGNOSTIC RADIOGRAPHY (Pre-registration)

School of Health Science MSc DIAGNOSTIC RADIOGRAPHY (Pre-registration)

MANAGEMENT OF CLINICAL EDUCATION - HANDBOOK

CLINICAL EDUCATION FOR STUDENTS OF DIAGNOSTIC RADIOGRAPHY

INTRODUCTION

Clinical education placements have a theoretical as well as a practical focus. They provide clear opportunities for students to develop, evaluate, organise and build upon academic learning in a progressive fashion. They enable integration of theory with practice and the safe, effective assimilation of the student into the multidisciplinary health care team.

Clinical and academic blocks are integrated programme elements and should not be viewed as standing alone. Lecturers, Clinical Tutors, Student Liaison Officers, Assessors, Supervisors and all members of the multidisciplinary department teams facilitate continuous linking of theory with practice and provide sound student support. Clinical education for students of diagnostic radiography is delivered from imaging departments in Ayr Hospital,Ayr; Crosshouse Hospital, Kilmarnock; Borders General Hospital, Melrose; Forth Valley Royal, Larbert; Leith Community Treatment Centre; Queen Margaret Hospital, Dunfermline; Roodlands Hospital, Haddington; Royal Infirmary of Edinburgh; Royal Hospital for Sick Children, Edinburgh; St John’s Hospital, Livingston; Stirling Royal Infirmary; Victoria Hospital, Kirkcaldy; Western General Hospital, Edinburgh; Perth Royal Infirmary, Perth and Ninewells Hospital, Dundee. Information regarding staffing and available modalities may be found in the Clinical Placement Handbook.

These organisations provide guided experiential learning through supervised direct patient contact and allow opportunities to develop personal confidence and professional competence. They facilitate the acquisition of clinical judgment skills and the expertise required to become a competent practitioner and effective member of the multidisciplinary health care team.

The clinical education programme includes elements of clinical supervision, clinical workshops, tutorials and clinical assessment and, with emphases on communication and reflection, enables students to acquire the clinical competencies required for registration by the Health Professions Council. Students will also acquire the investigative and analytical skills necessary to enhance the knowledge base of the profession.

Quality Assurance in Clinical Education

Clinical Placements

To ensure the quality and effectiveness of practice placements all new and current placements are required to be approved. The module coordinator or a member of the Diagnostic Radiography team will complete a clinical monitoring report, in conjunction with a named representative from each clinical placement (Appendix A). Placements will be monitored on an annual basis, unless there is a major change within the placement provision, or there is cause for concern.

The following individuals have key roles and defined responsibilities with regard to implementing, coordinating and monitoring clinical education programmes.

Module Coordinator

The module coordinator has responsibility for placing students appropriately to ensure achievement of learning outcomes, organising workshops for students, supervisors and assessors as well as coordinating, implementing and supervising the assessment systems. A key aspect of the role of this individual is effective collaboration with managers and clinicians to ensure that common aims and outcomes are established and achieved. Close liaison with clinical tutors / liaison officers is essential to plan and monitor clinical education appropriately. The individual must interact effectively with the students to encourage development of skills in self-appraisal and reflective practice.

Lecturers / Clinical Tutors / Student Liaison Officers

In addition to providing pastoral care and support, lecturers / clinical tutors / student liaison officers have responsibility for management and education of students on clinical placement and must adopt a key role in collaborating with practitioners to ensure equity of student experience and learning opportunity. They will contribute to the continuous evaluation and development of clinical education and will establish effective relationships with members of the multi-professional team.

Clinical Supervisors

Radiographers are responsible for the teaching and effective supervision of the student on a daily basis as well as monitoring their performance and progress. They have a key role within the continuous assessment scheme, being responsible for the daily appraisal of performance and the provision of continuous feedback to students. All clinical supervisors should undergo training with periodic updates.

Clinical Assessors

Radiographers, having undergone appropriate training, who are responsible for planning, implementing and conducting staged assessments in partnership with the module coordinator, lecturers and clinical tutors.

Notification of Concern

Any supervisor or assessor who has concerns about student performance levels in any of the domains of clinical practice has a clear responsibility to notify the module coordinator. A reporting proforma is available for staff completion (Appendix B). After completion, the individual will notify the module coordinator who will arrange a meeting to discuss their concerns and explore possible actions

Academic Staff Areas of Clinical Liaison

Catherine McClintick; Module Coordinator: All Areas

Alanah Kirby; Senior Lecturer: Ayrshire and Tayside

Alison Scott; Lecturer: Lothian

Dawn Walker; Lecturer: Forth Valley and Fife

Simon Holmes; Lecturer Borders

Contacting the University

Details of the clinical programme including practice educator training, QMU staff contact details, QMU Practice Placement Handbook, clinical documentation and communication forms are located on the QMU Practice Educator Website

When an incident occurs outside of normal working hours, and there is an urgent requirement to contact the University, please telephone (0131) 474 0000. When prompted, ask for reception.

Clinical Education Framework

Practice Based Learning 1

The student undertakes 6 weeks of clinical placement. The student begins to develop knowledge and skills in general radiography, by closely integrating theory with practice. The learner commences the safe, effective integration process into the multidisciplinary team and starts to develop a profile of professional identity.

Practice Based Learning 2

The student undertakes 11 weeks of clinical placement. The learner continues to develop their general radiographic expertise and further integrates into the multidisciplinary team. Theory is closely related to practice through critical reflection.

Practice Based Learning 3

The student undertakes 5 weeks of clinical placement. Close integration of theory with practice is facilitated with experience of specialised radiodiagnostic imaging modalities.

Practice Based Learning 4

The student undertakes 17 weeks of clinical placement. The learner continues the safe, effective and efficient integration into the multidisciplinary health care team whilst consolidating a general knowledge and skills base. The development of high level skills in problem-solving, critical analysis, evaluation and appraisal will prepare the student for continuing professional development and life-long learning in a multi-professional environment. An elective placement enables the student to expand their analytical and evaluation skills in a new environment, which broadens the experience and enables recognition of individual approaches to clinical practice (Appendix C).

FITNESS TO PRACTISE

The University has an obligation to ensure that graduates from its pre-registration healthcare programmes are fit to practise. This means we need to consider whether students:

have a long-term health condition or disability which could prevent them from practising safely without supervision;
have any criminal convictions or cautions which could make them unsuitable for registration;
have demonstrated that they can maintain the standards of conduct expected of a health professional.

The students’ behaviour on placement and in private life has the potential to affect their suitability for registration. If the University becomes aware of an issue regarding a student’s behaviour it may initiate Fitness to Practise proceedings. Where there are serious concerns, a Fitness to Practise panel may be convened. The Fitness to Practise panel has the authority to impose a range of sanctions, including requiring a student to suspend study or even to leave the programme.

For more information, see the QMU Fitness to Practise Policy (Table 1).

The Health and Care Professions Council (HCPC) publishes guidance for students and registrants about Fitness to Practise (Table 1).

Health and Disability

Students should keep their Personal Academic Tutor or Programme Leader informed of any changes to their health or disability status. The University will seek to put in place measures to support students with health problems or disabilities so far as is practical. It is essential that you discuss any concerns you might have with staff as early as possible.

To protect patient safety, you must inform your placement supervisor immediately if you contract a communicable disease.

Conduct

Concerns may arise about a student’s fitness to practise if any of the following situations occur:

conviction of a criminal offence, particularly one involving dishonesty or violence;
found in breach of the student discipline code, e.g., for your behaviour towards other students or for cheating in an exam / plagiarism;
behave in an unethical or unprofessional manner on placement;
breach of patient confidentiality.

The above list is not exhaustive. Each case will be dealt with according to the individual circumstances.

Radiography is a profession regulated by the HCPC and therefore statutory requirements exist for the regulation of practice to protect patients and their carers. The titles ‘Radiographer’ and ‘Diagnostic Radiographer’ are legally protected and may only be used by individuals who have completed an approved course of study and are subsequently registered by the HCPC. Students can access the following resources; the first is considered essential reading.

Links to essential documents

Guidance on Conduct and Ethics for Students	Confidentiality - Guidance for Registrants
Guidance on Health and Character	QMU guidance on Fitness to Practise
Standards of Education and Training guidance	HCPC Guidance on Fitness to Practise

[ Broken links ]

APPEARANCE AND DRESS CODE

It is important for the student to develop the personal discipline and professional attitudes necessary for successful clinical practice. Patients attach great importance to the appearance of hospital staff and a high standard of personal hygiene and appearance should be maintained. Students should therefore dress in a manner which is likely to inspire public confidence and appropriate steps should be taken to minimise the risks of infection and cross contamination for patients and the public.

During clinical placement, students are required to wear the stipulated uniform. Name badges and dosimeters must be worn.

Duty shoes will be soft-soled, closed toe in black, navy or white. Fashion footwear or canvas shoes are not permitted.

Uniform and footwear MUST NOT be worn outside the hospital.

Hair must be clean and tied up, the hair must not touch the uniform collar

Nails should be short, clean, well manicured and devoid of nail polish. False nails are not permitted.

With the exception of small stud earrings and plain wedding bands, no hand, wrist or neck jewellery is permitted. One set of earrings are permitted. Facial piercings are considered to be inappropriate in the clinical environment. Visible tattoos which might be perceived as being offensive should be covered.

Students are permitted to wear short sleeve t-shirts under their uniforms. T-shirts should be black, white or navy in colour.

Consideration must be given to the cultural and religious requirements of students.

In addition, students must adhere to any local and national dress code and uniform policy.

Mobile phones must not be used or taken into the clinical environment. Mobile phone can be used in designated rest / staff rooms only.

ATTENDANCE

Prior to clinical placement, the student will be given a timetable illustrating weekly clinical placements. These may not, except under exceptional circumstances and after discussion with the module coordinator, be altered.

For the 38 weeks of clinical placement in Practice Based Learning 1, 2, 3 and 4 100% attendance is required. All absence MUST be notified to the module coordinator and the clinical supervisor. A medical certificate is required for absence of more than 5 working days, this must be submitted to the module coordinator. All sick leave will be re-timetabled appropriately to ensure 100% attendance. Occasional absence of a day may be recovered by foregoing study half days; this must be negotiated with the module coordinator. Requests for consideration of extenuating circumstances should be made according to the QMU regulations.

Students who require time off for legitimate reasons such as health related appointments (General Practitioner or Dentist, for example) and personal issues must negotiate with QMU programme leader or module coordinator. Reported attendance/absence is recorded for each student for future reference.

The student must have complied satisfactorily with the conditions attached to all clinical placements and assessments prior to recommendation for the award of MSc in Diagnostic Radiography.

The student will follow the normal work pattern of clinical staff and will typically work from 09.00 until 17.00 with 30 minutes for lunch. Morning coffee breaks are normally of 20 minutes duration and all breaks are negotiated with the clinical supervisors.

If a student needs to leave placement early, before 17,00hrs, this should be discussed with the module coordinator in the first instance.

The student must be prepared to alter any part-time working hours to suit a particular clinical placement situation and to perform periods of clinical experience out with ‘normal’ working hours.

One half day during each clinical week is allowed for study and reflection and is either specified by the module coordinator or is negotiated with the clinical supervisor. If a statutory holiday falls within the clinical placement, this half-day is not allowed. The student will work until 13.00hrs.

The programme team is concerned that students demonstrate appropriate professional behaviour and prospective employers frequently request information regarding attendance as part of reference information.

CLINICAL EDUCATION STANDARDS

Prior to Clinical Placement

In Year1, prior to clinical placement, students are required to complete a Practice Education Passport (Appendix B). The passport has been developed in conjunction with placement providers to ensure students are aware of their responsibilities within the practice setting and take an active role in practice placement preparation. Failure to complete any element of the Practice Education Passport precludes the student from attending practice placement.

Students are required to take a copy of the completed passport and PVG certificate to placement. If a student is unable to produce their passport or PVG they may be asked to leave the placement.

The Module Coordinator will provide a timetable indicating the students’ location for each placement week.

Teaching schedules for each semester and learning outcomes for each placement will be provided to enable clinical staff to support students appropriately.

The Module Coordinator will collaborate with the clinical staff and ensure relevant, current site information is available to the student.

Clinical Tutors, Liaison Officers, Practice Assessors, Practice Educators and Supervisors will indicate their availability and agree tutorial times with the student.

The Clinical Tutors, Liaison Officers, Assessors, Educators and Supervisors will discuss and agree personal learning outcomes for the student at the start of every placement.

The student is responsible, at the beginning of a placement, for notifying the Clinical Tutor or Clinical Assessor that an assessment is due. The Clinical Tutor or Assessor is responsible for ensuring sufficient preparation precedes the assessment process.

During Clinical Placement

The student’s identity is verified on the first day of each placement week. The student is required to present their matriculation card to the practice educator / supervisor responsible for their training. If the matriculation card is not available another suitable form of identification (i.e. driving licence or passport) will suffice. The practice educator is asked to sign the front page of the student’s clinical assessment sheets to confirm identification.

The Clinical Tutors, Liaison Officers, Assessors and Supervisors will discuss and agree personal learning outcomes for the student at the start of every placement.

The Clinical Supervisor is responsible for obtaining, according to local protocol, patient consent prior to a student observing, assisting with or performing a procedure.

The Clinical Supervisor is responsible for supervising the student and ensuring safe and successful completion of all procedures.

The Clinical Supervisor is responsible for taking over the examination if it becomes apparent that the student is experiencing difficulty or is placing the patient at risk. The Clinical Supervisor will subsequently have a reflective discussion with the student regarding the reasons for this action.

The Clinical Supervisor and the student are jointly responsible for completion of the Continuous Assessment forms and will have a reflective discussion both at the mid point and at the end of the placement.

Any supervisor or assessor who has concerns about student performance levels in any of the domains of clinical practice has a clear responsibility to notify the module coordinator (Appendix C). After completion, the individual will notify the module coordinator who will arrange a meeting to discuss their concerns and explore possible actions.

On occasion a student may have concerns about the clinical placement experience they are having. If this cannot be rectified through communication and negotiation with the radiography team or they feel there may be a risk of them failing a component of their assessment then they must notify the module coordinator.

If a student is involved in a radiation incident, or near miss, the supervisor and the student must advise the module coordinator and the QMU Radiation Protection Supervisor (RPS) as soon as possible (Appendix E). The student is required to complete a radiation incident form and email the completed form to the module coordinator and the RPS within 48hours of the incident occurring (Appendix F).

If during placement the student has concerns about their well being or the well being of patients there is a support network in place to ensure the situation is dealt with quickly and efficiently (Appendix G).

During Clinical Placement

The Clinical Tutors, Liaison Officers, Assessors and Supervisors will discuss and agree personal learning outcomes for the student at the start of every placement.

The Clinical Supervisor is responsible for obtaining, according to local protocol, patient consent prior to a student observing, assisting with or performing a procedure.

The Clinical Supervisor is responsible for supervising the student and ensuring safe and successful completion of all procedures.

Any supervisor or assessor who has concerns about student performance levels in any of the domains of clinical practice has a clear responsibility to notify the module coordinator (Appendix C). After completion, the individual will notify the module coordinator who will arrange a meeting to discuss their concerns and explore possible actions.

After the Clinical Placement

The student will submit Continuous Clinical Assessment Documentation (Section 14) to the assignment drop-box outside the school office in accordance with the assessment timetable published on the Hub. Penalties will be incurred for late or non-submission of this material according to QMU regulations.

At the conclusion of each clinical placement block, the module coordinator will verify attendance and schedule additional clinical experience as required under the attendance regulations (Section 4).

At the end of every clinical week, the student will complete the Clinical Placement Evaluation Form (attached to the Continuous Assessment pack), which is returned to the module coordinator. The form will be detached from the continuous assessment document to assure anonymity and for collation of site reports. This information is made available to the clinical placement providers.

The student must return their dosimeter as soon as possible to the designated return point when the dosimeter expires or at the end of the clinical placement, whichever date is first.

INSURANCE

Due to professional requirements, students on Nursing, Allied Health Profession and Healthcare Science qualifying programmes are required to hold professional indemnity insurance as a pre- condition of progressing to placement. This is most easily gained through the joining of the appropriate professional body, and information on this will be provided during the induction process into your programme.

If a student chooses to travel overseas for an elective placement, the overseas placement provider should insure the student for public liability insurance as a minimum. The University has in place travel insurance, the student should notify the Finance Office that they are going on placement where and when and obtain Insurance Policy Number and Emergency Contact information. Details can found on the Finance area of the intranet: (broken link)

COMPLAINTS

The University has a Complaints Handling Procedure which can be found here: [broken Link] The Procedure has three stages: frontline resolution, investigation and external review.

If a student has a complaint, they should discuss this with someone in the area which the student wishes to complain about (for example, for a complaint relating to speech and hearing sciences, this should be discussed with the Programme Leader or Module Coordinator for the module concerned).

The complaint will be considered under frontline resolution (unless complex) and a response will usually be given within 5 working days. If the complaint is complicated, it is the student’s choice to take it to investigation stage immediately or it may be referred to the investigation stage by the person the student determined to discuss the complaint with at frontline resolution. Should the complaint be considered under the investigation stage, a response will normally be received within 20 working days.

Any queries about the complaints procedure or any complaints written on the Complaints Form may be emailed to Complaint Email Address

GENERIC LEARNING OUTCOMES

By the end of Practice Based Learning 1, the student will be able to:

identify the key components of X-ray tubes, tables and accessories and describe their operation;

identify the display components of generator control consoles and demonstrate their functions;

demonstrate safe and effective handling and positioning of X-ray tubes;

demonstrate safe and effective use of collimation devices;

Describe and demonstrate correct utilisation of moving and stationary secondary radiation grids, erect buckys and cassette holders;

make X-ray exposures safely whilst implementing radiation safety measures for patients and staff;

identify and demonstrate the correct use of radiation protection and safety devices;

identify and differentiate between different image receptors for CR and DR systems in general use;

demonstrate correct patient reception and positive identification;

demonstrate effective communication interaction with the patient;

demonstrate application, where relevant, of pregnancy check and 28/10 day rule according to local protocol in a courteous manner with consideration for patient confidentiality;

demonstrate the use of moving and handling techniques safe for patients and staff;

demonstrate awareness of and discuss the reasons for local policies for disposal of waste;

describe the location of emergency equipment and emergency procedures for fire and cardiac arrest;

select the appropriate image receptor for each examination and demonstrate its correct use;

demonstrate correct use of anatomical markers and legends;

describe and demonstrate correct technique for routine general examinations specified for the clinical placement by:

identifying and examining the patient correctly;

selecting and utilising the correct equipment and accessories;

positioning the patient, X-ray tube and image receptor correctly;

selecting correct exposure technique;

applying radiation protection protocols correctly;

demonstrating appropriate standards of care of the patient, before, during and after the procedure;

completing documentation correctly as per local protocol.

evaluate radiographic images for:

correct patient identification;

evidence of collimation and, where appropriate, gonad protection;

quality of patient positioning

quality of image contrast, density and exposure index;

radiographic appearances and the presence or absence of pathology;

further action required.

By the end of Practice Based Learning 2, in addition to the above, the student will be able to:

describe the type and specification of imaging equipment in use;

describe and demonstrate correct utilisation of moving and stationary secondary radiation grids, erect buckys and cassette holders;

demonstrate effective communication with carers, relatives and members of the multi-professional team;

describe and utilise correct technique for all procedures specific to the placement; demonstrate and discuss modification of routine general techniques to accommodate traumatic, congenital and pathological conditions;

discuss the capabilities and limitations of image recording systems used locally;

demonstrate an awareness for the special care required for patients with intravenous access devices and surgical drains;

describe and demonstrate the use and routine care of oxygen and suction apparatus;

describe location, types, distribution and checking procedure for drugs in the X-ray department;

discuss and demonstrate an awareness of local policies.

By the end of Practice Based Learning 3, in addition to the above, the student will be able to:

discuss the capabilities and limitations of the equipment and its suitability for use;

demonstrate safe, effective and efficient operation of imaging equipment and accessories;

demonstrate appropriate and safe patient preparation, positioning and aftercare for the examinations specific to the placement;

discuss the use of alternative and additional imaging modalities appropriate for the demonstration and differentiation of pathology and disease;

demonstrate effective and appropriate communication with patient, relatives, carers and members of the multidisciplinary team to facilitate clear understanding, instill confidence, obtain informed consent and encourage cooperation and compliance;

demonstrate appropriate care to patients with traumatic, congenital, pathological and post-operative conditions;

discuss preparation, care and aftercare of patients having ultrasound, cardiovascular, CT, MRI and RNI examinations and procedures;

critically evaluate radiographic images for normal and abnormal anatomical appearances and identify requirements for additional, supplementary or repeat imaging;

discuss the use and dosage of contrast media and radiopharmaceuticals used in imaging;

demonstrate and discuss local departmental quality assurance procedures.

By the end of Practice Based Learning 4, in addition to the above, the student will be able to:

demonstrate competence in performing all specified examinations;

critically evaluate radiographic images to distinguish the normal from the abnormal, discuss possible causes of abnormality and identify diagnostic and clinical significance;

demonstrate the ability to offer total patient care;

analyse the needs of patients and demonstrate competence in supporting them, their relatives and carers both physically and psychologically;

integrate with the multi-disciplinary team, give professional advice and act as an informed source of expertise;

discuss and evaluate the physical and technological principles of all imaging modalities; analyse and critically evaluate the capabilities, strengths and weaknesses and hazards of all imaging modalities;

reflect on the physical and emotional impact of preparation and procedure upon the patient;

evaluate and discuss quality control procedures in imaging;

synthesise the factors affecting modality and technique selection in relation to the needs and condition of the patient as well as the anatomy, physiology and disease processes to be demonstrated.

SPECIFIC LEARNING OUTCOMES – ROUTINE RADIOGRAPHY

Radiography in the Imaging Department, Wards and Operating Theatres

By the end of Practice Based Learning 1 the student will be able to:

demonstrate the ability to perform correctly and in their entirety, routine projections of:

fingers and hand;
wrist and carpal bones;
forearm;
elbow;
humerus;
shoulder girdle;
toes and tarsal bones;
ankle and tibia and fibula;
knee.

demonstrate the ability to perform correctly and in their entirety, routine projections of:

femur and hip;
pelvis and sacroiliac joints;
thorax.

demonstrate the ability to perform correctly and in their entirety, routine examinations of:

thoracic contents;
abdominal contents;
kidneys, ureters and bladder.

demonstrating and describing appropriate methods of radiation protection;

By the end of Practice Based Learning 2, in addition to the above, the student will be able to:

demonstrate the ability to perform correctly and in their entirety, additional and alternate projections of:

fingers and hand;
wrist and carpal bones; forearm;
elbow;
humerus;
shoulder girdle;
toes and tarsal bones;
ankle and tibia and fibula;
knee.

demonstrate the ability to perform correctly and in their entirety, additional and alternate projections of:

femur and hip;
pelvis and sacroiliac joints; thorax;
cervical spine;
thoracic spine;
lumbar spine, sacrum and coccyx;
skull and facial bones;

discuss the reasons for the modifications to the routine techniques for the above procedures and identify the criteria for assessing the diagnostic quality of the resultant images;

discuss and evaluate the specific radiation risks associated with radiography of the abdomen, chest and ribs;

discuss and demonstrate the correct procedure for examination of the chest and abdomen on a non- ambulant, acutely unwell, patient;

demonstrate correct management of patients cared for under barrier and reverse barrier nursing conditions along with those in high dependency, intensive and coronary care units;

describe and discuss the care required and the modifications to basic technique needed by patients with traumatic or acute conditions in the X-ray department, wards and operating theatres;

describe, discuss and demonstrate additional and alternate projections of the chest and abdomen;

describe the techniques used for open reduction and internal fixation of fractures;

demonstrate safe handling and operation of the dedicated skull unit and orthopantomograph / cephalostat.

By the end of Practice Based Learning 4, in addition to the above, the student will be able to:

select, prioritise and demonstrate, under supervision, examinations for patients with multiple traumatic injuries;

demonstrate the ability to contribute fully as a member of the multi-professional team in Accident and Emergency;

list the sequence of radiographs taken for examination of multiple trauma and discuss the reasons for this sequence;

list, describe and discuss the various skeletal surveys performed and the clinical reasons for them;

discuss the management of patients with disruptive behaviour patterns;

describe and critically evaluate patient care in the Accident and Emergency department, the appearance and treatment of shock, the application of sterile dressings, plaster of paris and splints;

participate fully in department emergency duty and out of hours working, shadowing and assisting the duty radiographer in single handed work situations;

demonstrate the ability to perform the administrative duties required outwith normal working hours;

demonstrate the ability to locate, precisely, fixators in trauma theatre.

Radiography Using Contrast Media

By the end of Practice Based Learning 2 the student will be able to:

identify and verify the expiry date and condition of contrast media;

under supervision, prepare contrast media for administration and discuss contraindications for use;

identify and discuss the indications and contraindications for intravenous urography and contrast examination of the biliary system, upper and lower gastrointestinal tracts;

demonstrate the ability to produce, according to local protocol and the required diagnostic standard, radiographs for intravenous urography;

demonstrate the ability to produce, according to local protocol and the required diagnostic standard, radiographs for contrast studies of the biliary system, upper and lower gastrointestinal tracts;

assist in total patient care before, during and after contrast media examinations;

initiate emergency procedures, according to local protocol, should adverse reaction occur.

By the end of Practice Based Learning 3, in addition to the above, the student will be able to:

describe and demonstrate the technique required for radiographic procedures with contrast of:

- genito-urinary system;
- biliary system;
- gastro-intestinal system;
- cardio-vascular system;
- central nervous system.

assist with radiographic examinations of the central nervous system;

state and describe the contrast media used and the reasons for their selection;

prepare the equipment and contrast for the examination;

demonstrate disposal of contaminated material and ‘sharps’ correctly according to local protocol;

discuss and evaluate therapeutic interventional techniques such as angioplasty, embolisation and stenting;

demonstrate correct operation of imaging equipment and PACS.

Administrative Processes

By the end of Practice Based Learning 1 the student will be able to:

receive patients at reception and register them correctly using the local administrative systems and procedures;

process request forms correctly according to local protocol;

obtain previous reports, images and records as appropriate;

describe the department appointment systems;

describe and discuss local patient information documents and preparation instructions.

Image Processing

By the end of Practice Based Learning 1 the student will be able to:

demonstrate correct identification of the radiographic image;

identify, describe and demonstrate the function and controls of computerised and digital image processors.

By the end of Practice Based Learning 2, in addition to the above, the student will be able to:

demonstrate the care of computerised and digital image receptors;

demonstrate the range of functions of computerised and digital processing systems, describing the unloading, loading and processing cycles in full;

compare and contrast image processing systems;

participate in the routine care, maintenance and quality assurance of image processing systems.

By the end of Practice Based Learning 4, in addition to the above, the student will be able to:

discuss and participate in departmental quality assurance procedures for image processors;

critically evaluate results with regard to quality standards and consistency;

analyse inconsistencies, identify causes and formulate solutions;

assess the contribution of quality assurance programmes to achieving and maintaining quality standards in the imaging department.

SPECIFIC LEARNING OUTCOMES - SPECIAL IMAGING TECHNIQUES

Mammography

By the end of Practice Based Learning 3 the student will be able to:

describe the differences between conventional X-ray and Mammographic equipment and discuss the reasons for these;

state the advantages of image processors and viewers and discuss the merits of an ongoing quality assurance programme in the mammography department;

state the type of image receptor used for mammography and identify reasons for maintenance of scrupulously clean equipment;

state the routine projections performed and describe patient positioning;

describe normal mammographic appearances and differentiate normal from abnormal for a range of age groups;

discuss care levels and communications skills required for this patient group;

demonstrate correct operation of imaging equipment and PACS.

Shock Wave Lithotripsy

By the end of Practice Based Learning 3 the student will be able to:

state the reasons for and the advantages of hemi-KUB and collimated renal radiographs;

identify the reasons for performing a full KUB radiograph;discuss the reasons for using either ultrasound or radiography as a locating tool;

describe the effect of shock wave lithotripsy on calculi;

identify the procedures performed in endourology theatre and discuss the role of the radiographer;

state the reasons for stenting and nephrostomy and describe their functions;

describe normal abdominal appearances and differentiate normal from abnormal images;

demonstrate correct operation of imaging equipment and PACS.

Ultrasound

By the end of Practice Based Learning3 the student will be able to:

discuss the principles of ultrasound and state the standard frequencies used;

describe equipment used for obstetric and general ultrasound and discuss its uses and limitations;

describe the preparation required for a patient undergoing obstetric ultrasound examination and demonstrate the ability to offer total care;

identify the measurements that are made in routine examination of the foetus;

describe the preparation and care of the patient undergoing abdominal, vascular and musculo- skeletal ultrasound;

describe normal abdominal appearances and differentiate normal from abnormal images;

demonstrate correct operation of imaging equipment and PACS.

Computed Tomography

By the end of Practice Based Learning 3 the student will be able to:

describe the operating principles of CT;

discuss the clinical indicators for CT;

participate effectively with all CT examinations;

describe and demonstrate, with assistance, the preparation and positioning of patients undergoing CT of the head, spine, chest and abdomen in routine and acute situations;

state the contrast media and discuss the methods of administration used in CT of the head, spine, pelvis, chest and abdomen;

identify and describe normal and abnormal anatomical, pathological and trauma appearances on CT images of the head, spine, pelvis, chest and abdomen;

participate as an active member of the multi-disciplinary team in caring for the patient before, during and after CT examinations with and without contrast media;

demonstrate the ability to perform, under supervision, standard CT head examinations;

demonstrate correct operation of imaging equipment and PACS.

Magnetic Resonance Imaging

By the end of Practice Based Learning 3 the student will be able to:

discuss the physical principles of magnetic resonance imaging and state the standard field strengths used for imaging;

state the safety precautions required;

discuss the clinical indicators for magnetic resonance imaging;

describe the preparation of and the positioning required for patients undergoing magnetic resonance imaging of the head, abdomen, spine, pelvis and extremity;

state the contrast media and methods of administration used in magnetic resonance imaging;

identify anatomical structures demonstrated on magnetic resonance imaging of the head, abdomen,spine and extremity;

demonstrate correct operation of image recording equipment;

demonstrate the preparation of and the positioning required for patients undergoing magnetic resonance imaging of the head, abdomen, spine, pelvis and extremity along with the ability to offer total care;

participate as an active member of the multi-disciplinary team in caring for the patient before, during and after magnetic resonance imaging using contrast media;

discuss the anatomy demonstrated in cross section by magnetic resonance imaging and differentiate normal from abnormal appearances;

critically analyse the use of magnetic resonance imaging and debate the utilisation of alternative cross sectional imaging methods.

Radionuclide Imaging

By the end of Practice Based Learning 3 the student will be able to:

describe the components of equipment used in RNI;

discuss the clinical indicators for RNI;

describe the preparation of and the positioning required for patients undergoing RNI of the chest, skeleton and abdomen along with the ability to offer total care;

state the common radionuclides and methods of administration used in RNI;

identify anatomical structures demonstrated during RNI, discuss the anatomy demonstrated and differentiate normal from abnormal appearances;

discuss the physical principles of radionuclide dispensing and imaging and the safety precautions necessary;

participate as an active member of the multi-disciplinary team in caring for the patient before, during and after radionuclide imaging;

critically analyse the use of radionuclide imaging and debate the utilisation of alternative cross sectional imaging methods;

demonstrate correct operation of image recording equipment and PACS.

Cardiovascular, Angiography and Interventional Radiology

By the end of Practice Based Learning 3 the student will be able to:

describe the components of equipment used in cardiovascular imaging and interventional radiology;

discuss the clinical indicators for cardiovascular and interventional procedures;

describe the preparation of and the positioning required for patients undergoing cardiovascular and interventional procedures;

state the contrast media and methods of administration in cardiovascular and interventional procedures;

participate as an active member of the multi-disciplinary team in caring for the patient before, during and after cardiovascular imaging and interventional procedures;

critically analyse the use of angiography and debate the utilisation of alternative imaging methods;

identify and discuss anatomical structures demonstrated and differentiate normal from abnormal appearances;

demonstrate correct operation of image recording equipment and PACS.

CLINICAL EDUCATION

Practice Based Learning 1

The focus for the Practice Based Learning 1 is the acquisition of foundation skills in general radiography and fluoroscopy as well as the building of a knowledge base in patient care, department administration and image processing.

Placements will offer the following learning opportunities:

radiography of the skeleton, chest, abdomen, genito-urinary, gastrointestinal and biliary systems;

where possible, attachment to department nursing staff;

where possible, attachment to department administrators;

Placements will be arranged via:

general and fluoroscopic imaging facilities in teaching hospitals, district general hospitals and community treatment centres;

accident and emergency departments;

mobile radiography and fluoroscopy in wards and operating theatres.

Practice Based Learning 2

The focus for Practice Based Learning 2 is the continued development of general skills in routine radiography and fluoroscopy, as well as integrating further into the Health Care Team.

Placements will be arranged via:

general and fluoroscopic imaging facilities in teaching hospitals, district general hospitals and community treatment centres;

accident and emergency departments;

orthopaedic departments;

paediatric departments;

mobile radiography and fluoroscopy in wards and operating theatres.

Practice Based Learning 3

The focus for Practice Based Learning 3 is the building of a foundation knowledge in the specialist imaging areas of paediatrics, dental, mammography, ultrasound, shock wave lithotripsy, computed tomography, magnetic resonance imaging, radionuclide imaging and cardiovascular and interventional radiology.

Placements will be arranged via:

specialist imaging facilities in teaching hospitals, district general hospitals and community treatment centres.

Practice Based Learning 4

The focus for Practice Based Learning 4 is the consolidation of general skills in radiography and the achievement of ‘competence to practice’ as a radiographer. The Elective Placement is a required element of Practice Based Learning 4 and an exemption can be given only by the Module Coordinator or Programme Leader. Students will undertake an Elective Placement of four weeks duration to encourage the development of their practical, analytical and evaluative skills. The placements are arranged by the student and can be world-wide. Students will arrange the elective placement in Semester 7. Students who do not complete the continuous or staged assessment in Practice Based Learning 4 would not undertake the elective placement.

Placements will be arranged via:

general, fluoroscopic and specialist imaging facilities in teaching hospitals, district general hospitals and community treatment centres;

accident and emergency departments, to include ‘out of hours’ working;

orthopaedic X-ray departments;

mobile radiography and fluoroscopy in wards and operating theatres;

eporting radiographers and radiologists.

Feedback

Feedback will be given to the student throughout their placement by clinical tutors, liaison officers and supervisors whose common goal is to make the experience as informative and interesting as possible. Students will be required to utilise ePortfolio to record reflective accounts of their experiences. Students will submit their ePortfolio to the module coordinator for formative feedback according to the published schedules. Students will also be asked to give written, anonymous, feedback to the departments via the module coordinator with regard to their experiences

The student will collate the ratings received from the continuous assessment scheme on the continuous assessment spreadsheet; this enables the student to generate their own feedback regarding their clinical strengths and weaknesses. The student will attend a clinical appraisal review with the module coordinator after each module to review progress and address any concerns. The module coordinator, or the student, can request a meeting at any time if there are any causes of concern.

Tutorials and Clinical Workshops

Tutorials, workshops and online discussions will be available at appropriate intervals during clinical practice. Tutorials may be formal or informal and must be recorded in and reflected upon, in terms of the key elements of learning, in the ePortfolio.

CLINICAL ASSESSMENT

Introduction

The technologies employed in the practice of diagnostic radiography are diverse and complex, the range of procedures undertaken is vast and the risks associated with the application of ionising radiation well known. It is necessary therefore that the student be supervised, observed and monitored through all the stages of clinical education that underpin clinical practice; safe application of ionising radiations, appropriate examination and care of the patient and adherence to the legal requirements of radiography practice.

The clinical assessment programme provides a flexible and robust record of achievement and progress through Practice Based Learning 1, 2, 3 and 4. The programme strives to encourage personal responsibility for learning and development.
The scheme has three fundamental elements, continuous clinical assessment, staged clinical assessment (which assesses competency) and e-portfolio.
It will:

be a valuable learning and educational tool for the student;
improve the students’ expertise through systems of performance appraisal;
allow self-assessment and encourage reflective practice;
encourage involvement and input by clinical practitioners in teaching and assessment processes;
enhance patient care and raise patient awareness of the role of the radiographer in health care management.

Management of Assessment

The clinical module coordinator manages systems of assessment and is responsible for:

equitable application of the scheme across the student body;
consulting with department managers regarding selection of clinical assessors;
training for assessors and supervisors;
submitting data to the Boards of Examiners as required.

Clinical Assessment Methods

Practice Based Learning 1

Continuous Assessment. Pass/Fail

Staged Clinical Assessment Pass/Fail

ePortfolio Pass/Fail

Practice Based Learning 2

Continuous Assessment Pass/Fail

Staged Clinical Assessments Pass/Fail

ePortfolio 30% weighting

Discussion 70% weighting

Practice Based Learning 3

Continuous Assessment Pass/Fail

ePortfolio Pass/Fail

Practice Based Learning 4

Continuous Assessment Pass/Fail

Competence to Practice Clinical Assessment Pass/Fail

ePortfolio 30% weighting

Viva Voce Examination 70% weighting

STAGED CLINICAL ASSESSMENT

Format for Practice Based Learning 1 and 2

A total of four clinical staged assessments are required in Practice Based Learning 1 and 2:

During the examination, the Clinical Assessor completes the performance indicator proforma and gives feedback on performance at the end of the process (Appendix H). The Academic Assessor will verify the 'pass' awarded.

Prior to assessment of the images, the student completes the examination data proforma. Together, the Clinical Assessor and student will critique the images. All data protection and patient confidentiality issues must be considered. All students' work for QMU must take into consideration professional codes of conduct. The student must not remove any images or information from the clinical environment which could identity the patient. Failure to comply with this will result in that piece of work being marked as a fail grade.

Practice Based Learning 1 and 2; Clinical Assessments

First assessment: routine examination of the Chest or Abdomen to be completed in Semester 2, Weeks 37–39.

Second assessment: routine examination of an appendicular joint: wrist, elbow, knee or ankle, completed in Semester 2, Weeks 40–1.

Third Assessment: routine examination of the cervical, thoracic or lumbar spine, completed in Semester 2, Weeks 45–1.

Fourth Assessment: mobile examination, typically a chest, completed in Semester 2, Weeks 45–1.

Practice Based Learning 1 and 2; Clinical Assessor Guidance

The student must have received appropriate tuition and have been observed to have performed similar examinations unaided.

The student must be recently familiar with the equipment and accessories available.

The student must not have access to the performance indicator pack during the examination.

The Assessor has a duty to closely observe the student throughout the examination, it is essential therefore that they are not disturbed for the duration of the process.

Throughout the examination, the student must clearly indicate verbally their actions.

If, during the assessment, the Assessor deems the patient to be unsuitable due to their clinical or psychological condition, the process is halted and declared null and void. The student may rearrange the assessment without penalty.

The Assessor must terminate the assessment if the student clearly cannot cope or is placing the patient at risk. This is recorded as a failed assessment and the Assessor notifies the module coordinator at the earliest opportunity. After appropriate counselling by the academic team, further clinical practice as required, and approval from the Convener of the Board of Examiners, the student will arrange a second diet assessment as soon as is practicable.

The Assessor must terminate the assessment and take over the procedure if any SECOND REPEAT radiographs are required. This is recorded as a failed assessment and the Assessor notifies the module coordinator at the earliest opportunity. After appropriate counselling by the academic team, further clinical practice as required, and approval from the Convener of the Board of Examiners, the student will arrange a second diet assessment as soon as is practicable.

In the event of termination of assessment, the student MUST be told that the Assessor is taking over along with the reasons associated with this decision. The patient must be informed that the examination will continue with qualified staff and assured of a satisfactory outcome.

In the event of termination of assessment, the student will be counseled by Clinical Tutor, Lecturer or Programme Leader as appropriate and a repeat assessment arranged.

In the event of failure of the clinical assessment according to the marking criteria, the student must receive immediate feedback from the Assessor. The assessor must immediately inform the module coordinator who will meet with the student. The module coordinator will retain all documentation and will consult with the Convener of the Board of Examiners; after appropriate action, the student will arrange a second diet assessment.

Permission to repeat a failed element of the assessment will be sought from the Convener of the Board of Examiners. Possible actions include;

- repeat following feedback and further instruction,
- allowing mark to stand in the event of unusual contributory factors.

The student may repeat a staged assessment element once only. This repeat will be recorded as a second diet attempt with a maximum of 40% being awarded for the module. Failure of an assessment at second diet is referred to the Board of Examiners.

Format for Practice Based Learning 4

The ‘Competence to Practice’ clinical assessment is required during semester 5.

The aim of the assessment is to ensure individual competence to practice as a registered radiographer. The student will manage a practical clinical session of a minimum of 2 hours during which the clinical assessor completes a performance indicator proforma for each examination / procedure conducted (Appendix I). At the end of the session, the assessor will collate the results and feed back to the student. An error rate of 5% or less is required to pass this element.

Format for Practice Based Learning 4; Clinical Examination

Competence to Practice: practical general clinical session for two hours, to be completed in Semester 5, Weeks 45 - 1.

Format for Practice Based Learning 4; Clinical Assessors Guide

The Competence to Practice clinical assessment requires that between eight (minimum) and 12 (maximum) varied examinations or procedures be completed in order that technical and managerial competence in a normal working situation may be assessed. In the event of low activity or lack of procedural variety, the assessment may be extended. The assessor will not however specially select the patients for the student nor will they stipulate the types of procedures to be undertaken. For example, it is not a requirement that the student undertake a multiple trauma examination as this facility is not available in all assessing departments.

The student must have received appropriate tuition and have performed similar examinations unaided.

The student must be allowed to negotiate location(s) with the assessor, with the period being divided between areas if appropriate. For example, an assessment conducted between an Accident and Emergency room and a general room will allow the student to demonstrate a variety of skills and techniques.

The student must be recently familiar with the equipment and accessories available.

The student MUST NOT have access to the assessment pack during the examination.

The Assessor has a duty to closely observe the student throughout the examination, it is essential therefore that they are not disturbed for the duration of the process.

Throughout the examination, the student must effectively communicate their actions and decisions to the Assessor although a running commentary is not required.

If, during the session, the Assessor deems a patient to be unsuitable, the process is halted and that examination declared null and void. The assessment may then proceed.

The Assessor must terminate the assessment if the student clearly cannot cope or is placing the patient at risk. This will result in failure of the clinical element.

The Assessor must terminate the assessment and take over the procedure if any second repeat images are required. This will result in failure of the clinical element.

Permission to repeat a failed element of the assessment will be sought from the Convener of the Board of Examiners. Possible actions include:

- repeat following feedback and further instruction;
- allowing mark to stand in the event of unusual contributory factors.

The Role and Responsibilities of the Student

The student will:

seek and identify appropriate opportunities for clinical assessment and negotiate with Clinical Tutors and Assessors;

prepare appropriately for assessment;

ensure the assessment documentation has been completed correctly;

It is the responsibility of the Clinical Tutor or Clinical Assessor to ensure that the student is prepared for the assessment procedure. However, the student has a responsibility for indicating the following points prior to commencement of the examination:

the student feels that the patient selected by the Assessor is unsuitable;

the student feels that, during this clinical block, they have had insufficient experience of the examination and/or the equipment.

These points cannot be used as mitigating factors in the event of failure of the assessment unless identified prior to the start of the assessment process. The student must immediately notify the module coordinator of any grievance.

The Clinical Assessor

Will be employed by the clinical placement provider as a Radiographer or by the University as a Lecturer.

Will have been practicing clinically for at least 18 months.

Will have received training in clinical assessment procedures and systems from staff of the University.

Will attend or complete online or face-to-face a training refresher activity every two years.

Roles and Responsibilities of the Clinical Assessor

The Clinical Assessor will:

identify a suitable patient for the clinical assessment;

arrange a suitable date for assessment of competence to practice;

arrange appropriate location for the examination(s);

obtain patient(s) consent to participate;

observe the procedure(s);

complete the performance indicator pack according to the agreed criteria;

manage appraisal of the radiographs produced;

provide immediate feedback to the student on completion of the assessment;

inform the Lecturer responsible for clinical education immediately following termination or failure of an assessment.

Selecting the Patient

Unless specified as part of the assessment criteria and excluding the assessment of competence to practice, the patient should be cooperative and mobile.

With the exception of the mobile and assessment of competence to practice, examinations should be a ‘routine’ as possible. Students in Practice Based Learning 1 and 2 should not be required to make complex decisions regarding non-standard techniques or projection modification.

In Practice Based Learning 1 and 2, supplementary and additional projections are NOT included in the assessment process.

In Practice Based Learning 1, a single patient must be used for ONE assessment only. If, for example, a patient is referred for examination of the knee and spine, they may NOT be used for assessment in both categories.

In the assessment of competence to practice, the student should manage and prioritise the workload of the area in which the assessment is taking place. Although expected to work unaided, the student is required to ask for and direct assistants as required to reflect a ‘real’ working situation. Consultation with colleagues and texts with regard to technique is permitted and, again, reflects ‘real’ work practices.

Equality of Assessment

To minimise potential for personality clashes and perceptions of unfairness or inequality:

Each hospital will, in addition to the Student Liaison Officer / Clinical Tutor, have several Clinical Assessors. All students have extensive clinical placement rotations and it is therefore unlikely that the same Clinical Assessor will be used twice;

Student Liaison Officers / Clinical Tutors must ensure that as many individuals as possible are involved in assessing students during the MSc programme.

OPERATION OF THE CLINICAL ASSESSMENT

Clinical Assessor

The cover sheet records student, hospital, Assessor and examination information and should be completed by the student before examination starts.

Section 1 must be completed before the start of the examination with the Clinical Assessor completing the patient consent and pregnancy check appropriateness categories.

The student must indicate each point in section 1 verbally.
An automatic fail results if 1a) and 1b) carries a NO response and the assessment is terminated.

The student must be able, under 1e), to discuss the implications of patient sex, age and condition upon dose limitation.

In section 2 and 3, care must be taken not to tick the boxes as a matter of routine and without due consideration.

An automatic fail results if 3b) carries a NO response and the assessment is terminated. A clear, positive identity must be given by the patient or established by following local protocol.

An automatic fail results if 3g) carries a NO response and the assessment is terminated. Pregnancy check, if required, must be carried out according to local protocol.

Failure is the result of a total of three NO responses in sections 1e) and 5b) and 5h). Feedback is given to the student at the end of the assessment.

Failure is the result of NO responses in any 3 categories of section 4 and feedback is given to the student at the end of the assessment.

In sections 4-6, care must be taken not to tick the boxes as a matter of routine and without due consideration.

The student should complete the Examination Data Record immediately after the examination is complete and prior to discussing the radiographs with the Assessor.

If a pack is returned incomplete, the Module Coordinator will contact the Clinical Assessor for discussion.

Reason for repeat must be given by the Clinical Assessor and NO student can be permitted more than one repeat of an examination.

If however a repeat was due to genuine equipment malfunction, the student should not be penalised.

CT HEAD COMPETENCY

Students in Practice Based Learning 3 are required to demonstrate competency in CT Head imaging. To evidence completion of this competency the CT Head Checklist should be completed (Appendix J). Only one checklist is required to be completed. The individual elements of the checklist can be completed as the student develops their skills throughout the placement week. To pass the assessment the checklist should evidence ‘Acceptable’ in all elements and the supervisor must confirm the student has completed, under supervision, five unaided CT Head examinations.

If the student does not attain ‘Acceptable’ in all elements, or does not complete the 5 unaided CT Head examinations, the student can still progress to Practice Based Learning 4. The student will be provided with a second opportunity in Practice Based Learning 4 to successfully complete the assessment.

OPERATION OF THE ASSESSMENT OF COMPETENCE TO PRACTICE

In Practice Based Learning 4, theory is integrated with practice to provide a sound framework for the competent clinical practitioner. The development of high level skills in problem-solving, critical analysis, evaluation and appraisal will prepare the student for continuing professional development and life-long learning in a multi-professional environment.

An extended, more comprehensive assessment of a students’ competence to practice at the end of their course of study is therefore required.

During the second clinical practice block in semester 5, the student will be required to ‘become a radiographer’ for a period of two hours when all aspects of their performance will be appraised. An error rate of 5% or less is required to pass the clinical practice session.

Clinical Assessor

Individuals performing Competence to Practice clinical assessment will be experienced Clinical Assessors who have received the necessary training and updates from the University. They will:

arrange a suitable time slot for the competence to practice assessment;

agree appropriate location(s) for the examinations;

obtain patients’ consent to participate;

observe the procedures;

complete the performance indicator proforma according to the agreed criteria;

facilitate discussion and critique of the images.

CONTINUOUS CLINICAL ASSESSMENT

Introduction

The Continuous Clinical Assessment Programme will enable the student to develop from observer through participant to competent practitioner. The programme will demonstrate a clear pathway from the novice who is able to perform single tasks or discrete elements of a task to a competent member of the multi-disciplinary team who is able to apply a range of skills and knowledge to a wide range of situations. Evaluation of this progression is supported by continuous formative assessment (Appendix J), ePortfolio of clinical practice and progress mapping.

Continuous Clinical Assessment utilises progressive achievement levels in domains of diagnostic radiographic practice, providing quantitative analysis and qualitative assessment of competence through evaluation and monitoring of the development of clinical, technical and professional skills. Feedback to the student encourages reflection on experiences within clinical environments and the setting of personal objectives. Students will also be asked to give written feedback to the departments with regard to their experiences.

Learning Outcomes

The programme will:

enhance the learning experience for the student by providing feedback on clinical performance;

ensure continued high level input and involvement of clinical staff in teaching and assessment;

encourage the integration and application of theoretical concepts into practice;

allow the student to develop into a proactive practitioner via reflection, appraisal and critical analysis;

determine levels of student achievement;

introduce principles of performance review and appraisal.

Achievement Levels

As a student proceeds through the course and gains knowledge and experience, they progress through levels of clinical achievement. The Continuous Clinical Assessment Programme is designed to describe and monitor these levels of skill and achievement across the students’ range of activity.

PBL1, the student starts in clinical practice as a ‘novice’ with minimal clinical experience but some academic knowledge who will observe clinical activity and attempt to link these observations to existing knowledge. As PBL 1 progresses, the learner will gain enough clinical expertise to allow supervised and directed practice. To achieve a pass in PBL 1 the student must demonstrate a minimum rating of ‘C’ overall. Those who do not achieve the minimum required standard will have results presented to the Board of Examiners and may be timetabled appropriately to enable retrieval.

PBL2, the student continues to build on their initial practical experience linking activities and elements together to be able to consistently perform routine general radiographic examinations. Students will extend their skills to enable modification and adaptation of routine examinations. As PBL 2 progresses the students will demonstrate increased levels of expertise thus requiring minimal support. To achieve a pass in PBL 2 the student must demonstrate a minimum rating of ‘C’ overall. Those who do not achieve the minimum requiredstandard will have results presented to the Board of Examiners and may be timetabled appropriately to enable retrieval.

PBL3, the student will develop a knowledge and skills base in specialist areas to enable participation in specialist procedures. To achieve a pass in PBL 3, a minimum rating of ‘D’ for specialist placements in MRI, CT or Ultrasound, for example, is required. Those who do not achieve the minimum required standard will have results presented to the Board of Examiners and may be timetabled appropriately to enable retrieval.

PBL4, students learn to adapt their skills to enable the performance of procedures in routine, non-routine and complex situations. They will be able to plan, organise and prioritise multiple clinical events appropriately. The student will arrange an elective placement to broaden their clinical expertise and versatility.
These skills should be considered as elements of clinical competence. As the individual gains experience and knowledge, the basic skills are combined and integrated into overall professional competence which will enable the graduate to apply their skills in a flexible manner whilst responding imaginatively to new and unfamiliar situations. To achieve a pass in PBL4, the student must demonstrate a minimum rating of ‘C’ overall. Those who do not achieve the minimum required standard will have results presented to the Board of Examiners and may be timetabled appropriately to enable retrieval. Elective placements do not form part of the continuous assessment process, but 100% attendance is required.

Domains of Practice

In order to evaluate and monitor competence in Diagnostic Radiography it is necessary to identify the elements of competent practice. The application of domains of practice allows recognition of professional skills, which are essential components of clinical, technical and interpersonal competence. Using levels of achievement allows for progressive evaluation of developing skills. It facilitates formative assessment and performance monitoring in Practice Based Learning throughout the programme thus helping and encouraging the student to expand their professional expertise.

The domains of practice in which students are assessed are:

TECHNICAL SKILL

TS1 DIAGNOSTIC PROCEDURE

PBL 1: the student can perform routine radiographic examinations of the appendicular skeleton, chest and abdomen.

PBL 2: the student can perform routine examinations; modifying and adapting technique for trauma, pathology and congenital abnormalities as required.

PBL3: the student can assist before, during and after specialised imaging procedures.

PBL4: the student can consistently produce high quality images, adapting technique as required to meet individual patient’s needs and capability.

TS2 EVALUATION OF IMAGES

PBL 1: the student can identify normal and abnormal appearances on radiographic images.

PBL2: the student can evaluate radiographic images for technical accuracy, pathological appearances and identify the need for additional and supplementary projections.

PBL3: the student can critically evaluate image quality, differentiate between normal and abnormal appearances.

PBL4: the student can critically appraise diagnostic images: describe abnormalities, identify possible causes of abnormalities and discuss their diagnostic and clinical significance.

TS3 OPERATION OF IMAGING EQUIPMENT

PBL 1: the student will be able to operate imaging equipment and accessories safely, effectively and

efficiently whilst observing local rules for radiation protection.

PBL 2: the student will be able to manoeuvre and manipulate imaging equipment to compensate for patient condition and disability and the effects of trauma, pathology and congenital abnormality.

PBL 3: the student can, with assistance, manoeuvre the imaging equipment during specialised procedures.

PBL 4: the student can competently use imaging equipment in a variety of clinical settings, and demonstrate competence in the selection and manipulation of exposure factors, minimising patient dose.

APPLIED KNOWLEDGE

AK1. INTEGRATION OF THEORY AND PRACTICE

PBL 1: the student demonstrates good background knowledge of routine radiographic techniques, including centring points.

PBL 2: the student is able to apply theoretical knowledge to routine and complex situations.

PBL 3: the student is able to apply theoretical knowledge to specialist imaging modalities.

PBL 4: the student is able to justify their clinical practice based on a sound knowledge of theory, polices and procedures.

AK2. INQUIRY AND RESEARCH

PBL 1: the student critically reflects on their clinical knowledge and skills.

PBL 2: the student has read and can apply: local infection control, health and safety, equality and diversity, radiation protection policies and procedures to their clinical practice.

PBL 3: the student can initiate discussion and utilise relevant literature and research.

PBL 4: the student will initiate inquiry and discussion and will seek and use relevant literature and research materials to improve their practice.

PATIENT MANAGEMENT

PM1 EMERGENCY PROCEDURES

All students must know the local protocol for emergency telephone numbers, call procedures, fire alarms, extinguishers, emergency exits and evacuation procedures. Orientation should be performed by the department Health and Safety Representative or by the Clinical Tutor.

PM2 RECOGNITION AND ALLEVIATION OF PAIN AND DISCOMFORT

PBL 1: the student demonstrates an awareness of the patient’s physical condition throughout the radiographic examination.

PBL 2: the student demonstrates compassionate care and initiates appropriate care strategies for routine patients, patients in pain or patients with limited physical capabilities.

PBL 3: the student can respond quickly and use appropriate techniques to minimise pain and discomfort.

PBL 4: the student demonstrates a patient centred care approach, modifying technique, communication and providing support as required.

PM3 PSYCHOLOGICAL AND EMOTIONAL SUPPORT

PBL 1: the student demonstrates courtesy and patience, does not show distaste or disapproval.

PBL 2: the student recognises the signs of emotional distress and anxiety, assists with alleviation measures and is supportive towards patients undergoing investigation and treatment.

PBL 3: the student can assist in maintaining patient dignity and minimise anxiety via appropriate care strategies.

PBL 4: the student anticipates sources of general distress and those related to specific procedures, using appropriate patient care measures to minimise stress whilst adopting a supporting role.

COMMUNICATION SKILLS

CS1 COMMUNICATING WITH RADIOLOGY DEPARTMENT STAFF

PBL 1: the student communicates appropriately with supervisors and asks appropriate questions in a professional manner.

PBL 2: the student can receive, record and convey verbal and electronic information accurately.

PBL 3: the student communicates effectively and constructively with the radiology department team.

PBL 4: the student is able to communicate effectively and constructively, making a valuable contribution to department operations.

CS2 COMMUNICATING WITH THE MULTIDISCIPLINARY TEAM

PBL 1: the student is aware of their role within the radiodiagnostic multidisciplinary team and can communicate effectively with other team members.

PBL 2: the student communicates effectively with members of the radiodiagnostic multidisciplinary team to promote team working.

PBL 3: the student communicates effectively with members of the multidisciplinary team to promote patient care and support.

PBL 4: the student is able to function as an effective and efficient member of the multidisciplinary team promoting patient care and optimum service delivery.

CS3 COMMUNICATING WITH PATIENTS, RELATIVES AND CARERS

PBL 1: the student is able to provide clear instructions to patients and carers before, during and after diagnostic imaging.

PBL 2: the student demonstrates the ability to respond appropriately to patients and carers’ questions.

PBL 3: the student communicates clearly with regard to preparation for, experience during and consequences of specialist imaging procedures.

PBL 4: the student responds to individuals’ need for information and can use verbal and non-verbal skills effectively.

ORGANISATIONAL SKILLS

OS1 PERSONAL PRESENTATION

All students must comply with QMU, local and national requirements as specified in the module handbooks.

OS2 TIME MANAGEMENT

PBL 1: the student makes good use of unstructured time by using quieter times for study, reflection and role-play.

PBL 2: the student makes effective use of programmed and unstructured time to develop skills and knowledge and ensuring that assigned tasks are completed on schedule.

PBL 3: the student has awareness of how to manage time effectively and how the workload is prioritised .

PBL 4: the student demonstrates the ability to prioritise clinical workload.

OS3 GENERAL ORGANISATION

PBL 1: the student can establish and confirm the pre-examination information required for justification, authorisation, patient identification and consent.

PBL 2: the student can establish a safe working environment by adhering to infection control, radiation safety and manual handling polices and procedures.

PBL 3: the student demonstrates an organised approach to imaging procedures and administration processes.

PBL 4: the student demonstrates demonstrates proficient organisational skills and can complete assigned tasks efficiently and to a high standard.

PROFESSIONALISM

PR1 INTEREST AND MOTIVATION

PBL1: the student willingly participates in all aspects of the department routine, including cleaning.

PBL2: the student initiates discussions with supervisors to enhance their learning and proactively engages in all aspects of the department workload.

PBL3: the student proactively makes use of departmental resources to enhance their learning.

PBL 4: the student proactively seeks learning opportunities: attends MDT meetings, arranges reporting sessions and participates in quality assurance tests/clinical audits.

PR2 RESPONSIBILITY

PBL 1: the student is able to introduce themselves to patients and carers in a professional manner.

PBL 2: the student accepts responsibility for routine and more complex examinations, and asks for assistance when required.

PBL 3: the student accepts responsibility for aspects of specialist examinations, and asks for assistance when required.

PBL 4: the student knows their limitations and will ask for appropriate assistance.

PR3 PROFESSIONAL JUDGEMENT

PBL 1: the student is willing to learn and can set their own learning objectives.

PBL 2: the student demonstrates an understanding of the justification process and the procedure to deal with incomplete/inappropriate referrals.

PBL 3: the student demonstrates a problems solving approach to professional or examination issues.

PBL 4: the student demonstrates the ability to assess professional/clinical problems and deal with the problem based on their acquired knowledge and experience.

PR4 PUNCTUALITY AND PROFESSIONALISM

All students are ready to start work on time and return from rest breaks promptly.

All students act in a professional manner at all times.

The students’ abilities in these areas are assessed during each clinical placement, collated by the module coordinator and are appraised by the module coordinator / lecturers at the end of each module (Appendix K).

OPERATION OF CONTINUOUS CLINICAL ASSESSMENT SCHEME

The Continuous Clinical Assessment Scheme operates via the placement report proforma (Appendix L,M, N and O), found in the Module Handbooks. Commencement and mid placement discussions are vital to explore the practitioners’ expectations of the student, to identify issues that may hinder progress and to give an opportunity to offer positive reinforcement and two-way feedback.

Student ability in the domains of clinical practice are assessed during placement and appraised by the module coordinator throughout the year.

The overall rating for Clinical Appraisal is achieved by rating the elements of each domain on a six-point scale. In each element of each domain the rating is awarded according to the students’ level of achievement in the specified learning outcomes.

It is the responsibility of the supervising radiographer to be aware of the outcomes in the performance report and to rate each student objectively and equitably. The ratings are:

The overall rating for Clinical Appraisal is achieved by rating the elements of each domain on a six-point scale on the final day of placement. In each element of each domain the rating is awarded according to the student’s level of achievement in the specified learning outcomes.

A The student is consistently performing well above the level of the learning outcome.

B The student is performing above the level of the learning outcome.

C The student is performing at the level of the learning outcome.

D The student is performing below the level of the learning outcome, support is still required. Continued development of knowledge, skills or confidence required.

E The student is performing well below the level of the learning outcome, constant support is required. Significant development of knowledge, skills or confidence required.

F The student’s performance is unsatisfactory: lack of engagement, no effort has been made to meet the learning outcome.

The rating will take into account any factors or constraints which have affected the student’s ability to perform effectively.

The Clinical Supervisor will:

complete the daily/weekly report component of the continuous clinical assessment proforma;

discuss the assessment with the student;

identify and agree the students’ strengths and areas for improvement.

The Clinical Supervisor:

responsible for completing the daily/weekly report will be one of a team within a placement or will be the member of staff with responsibility for students within that placement.

IMPORTANT NOTES

If during the week the student’s performance indicates that they will be awarded an ‘F’, the supervisor must discuss the situation with the student and record details of the discussion on the continuous assessment sheets. If there is no improvement the subsequent day(s) the supervisor must contact the Module Coordinator, and complete a cause for concern form (Appendix C).

If on the final day of placement the student scores an ‘F’ in any of the categories, immediate contact with the Module Coordinator is required.

Each case will be considered individually and appropriate remedial action taken.

A student will have a range of skills levels in different areas at the same time. They will be competent in some techniques and still be novice in others. Areas in which the student receives limited experience require specific objectives.

COLLATION AND MARKING SCHEME

Achievement levels from all outcomes, of every domain, of clinical practice are entered by the student onto the continuous Assessment Spreadsheet. The spreadsheet will automatically calculate and map the inputted data to the appropriate rating. The previous sheet provides examples of the ratings obtained from various combinations. The Module Coordinator will check the student marking and collate achievement levels.

Collation and Marking Process:

the student downloads the spreadsheet from the Hub;
the student inputs their attendance, entering ‘Y’ or ‘N’, the overall attendance will be automatically calculated. The half day study should be recorded as ‘N’;
the student inputs the data from the continuous assessment sheets into the spreadsheets using the codes A, B, C, D, E, F or Y, N for yes/no responses;
- any missing or incomplete data – leave the cell blank

the numerical values attached to each of the codes are:

A 6.5
B 5.5
C 4.5
D 3.5
E 2.5
F1.5 N1.5

Y does not have a numerical value as the student should be consistently working at the level of the learning outcome, the final rating will not be affected. If a student is rated N, the student’s rating will have a detrimental effect on the rating for the week, the domain of practice and the overall rating.

the spreadsheet automatically calculates the weekly, overall block and module domain ratings, this provides the student with feedback to evaluate their current status and progression throughout the module;

to calculate the final weekly, overall block and module rating the following minimal values must be attained

6.0 - A

5.0 - B

4.0 - C

3.0 - D

2.0 - E

1.5 - F

by the specified dates, the student will enter the completed spreadsheets to the Hub drop box;

continuous assessment documentation should be given to the Module Coordinator at the appropriate tutorial;
the Module Coordinator will verify data entry, to ensure consistency and accuracy of data entry.

Levels required for a ‘pass’ are:

PBL1	General	C	Specials	None
PBL2	General	C	Specials	None
PBL3	General	C	Specials	D
PBL4	General	C	Specials	None

CLINICAL ACTIVITY LOG

During each clinical placement experience the student is required to complete and record a number of patient episodes using the appropriate proforma supplied by the module coordinator. The purpose of the clinical log is to ensure the student gains a wide clinical experience. The clinical log will be utilised during the student appraisal to discuss placement provision and the student’s participation in clinical procedures.

Although a guide to the minimum number of procedures may be specified, as many and as wide a variety of techniques as possible should be recorded. To pass the continuous assessment, the student must demonstrate a participation in a wide variety of examinations, and attain the minimum numbers in accordance with their clinical rotation. Changes to clinical practice and protocol may impact upon the availability of some examinations, for example skull and fluoroscopy.

The student’s clinical experience is classified under the following three headings:

Observed - the student observes the examination, they are not actively involved in the examination process;

Aided - the student undertakes the examination with support or assistance from the supervisor;

Unaided - the student, under supervision, completes the examination without assistance from the supervisor.

Practice Based Learning 1

By the end of PBL1 the student should have documented the following minimum numbers of procedures:

Procedure	Observed	Aided	Unaided
Upper Limb	5	10	10
Lower Limb	5	10	10
Shoulder Girdle	5	10	10
Pelvis and Hip	10	10
Spine	10	10
Skull and Face *	10	10
Thorax and Contents	5	15	20
Abdomen	10	10	5

* It is acknowledged that, due to changes in clinical management skull radiography is diminishing. Facial bone examinations are plentiful however in Accident and Emergency departments. Allowances for these changes will be made by the module coordinator.

Practice Based Learning 2

By the end of PBL2 the student must have documented the following minimum numbers of procedures:

Procedure	Observed	Aided	Unaided
Upper Limb		10	10
Lower Limb		10	10
Shoulder Girdle		10	10
Pelvis and Hip		10	10
Spine		10	10
Skull* and Face Dental	3	15	10
Paediatric Skeletal		10	5
Paediatric		10	5
CXR/AXR
Paediatric Fluoro etc	15	5
Thorax and Contents		10	25
Abdomen	10	10	5
Ward Radiography	5	10	5
Upper GI Contrast *		10	5
Lower GI Contrast		10	5
Urinary System *		10	5
Biliary System *		3	3

* It is acknowledged that, due to changes in clinical management, the use of skull radiography is diminishing. Facial bone examinations are plentiful however in Accident and Emergency departments. Due to changes in imaging practice, GI and Biliary examinations are being replaced by endoscopy and IVU by CT and MRI. Allowances for these changes will be made by the module coordinator.

Practice Based Learning 3

By the end of PBL3 the student must have documented the following minimum numbers of procedures:

Procedure	Observed	Aided	Unaided
Urinary System *		10	10
Biliary System *		3	3
Ultrasound Ob/Gyn	20
Ultrasound General	20
Mammography ^	10	5
Lithotripsy	5
CT Head	10	5	5
CT Other	10
MRI Head/Spine	15	5
Cardio / Intervent	10
RNI	10	5

^ Mammography placements in the Breast Unit are for females only.
All students will experience an assessed CT placement and at least two additional 'specials'.
Students who do not achieve the CT scan outcomes for the head in PBL 3 will be placed in CT in PBL4.

Practice Based Learning 4

By the end of PBL 4 the student must have documented the following minimum numbers of procedures:

Procedure	Aided	Unaided
Upper Limb		25
Lower Limb		25
Shoulder Girdle		20
Pelvis and Hip		20
Spine		20
Mobile CXR/AXR	20	10
Mobile Skeletal *	10	10
Theatre Skeletal	10	10
Skull and Face ^	5	20
Thorax and Contents		40
Abdomen	5	15
Fluoro Procedures *	30	10
Urinary System *	5	20

*Modern methods in treatment of fractures have reduced the requirement for mobile, examinations of the skeleton. Due to changes in imaging practice, GI and Biliary examinations are being replaced by endoscopy and IVU by CT and MRI. Allowances for these changes will be made by the module coordinator.

^ It is acknowledged that, in modern clinical practice, use of examination of the skull is diminishing. Facial examinations should however be plentiful in Accident and Emergency departments.

Students who did not achieve the CT scan outcomes for the head in PBL 3 will be placed in CT in PBL 4.

ePORTFOLIO

As part of the Continuous Clinical Assessment strategy, the student is required to maintain an electronic portfolio of clinical practice and professional development using QMU ePortfolio (Pebble+). This will give the student opportunities to reflect upon clinical practice, learning and performance and to provide evidence of clinical experience and progress. It will form the foundation for continuing professional development and will be maintained and developed throughout the programme.

The ePortfolio will require collection and collation of information from a wide range of sources to provide evidence of competence, learning and understanding.

The ePortfolio will also include elements of personal reflection from individual clinical experiences.

Guidelines: See also ePortfolio Handbook

Use QMU ePortfolio which is accessed from the home page via the student IT login. A structural template is available through a gateway for students to utilise if they wish.

For each week of clinical practice in PBL1, 2 and 3 a full, reflective account of at least one procedure, experience or critical incident should be recorded using the appropriate proforma or blog. The student should also make the key elements of their learning on placement specific; this commentary should make reference to the learning outcomes stated in the handbook.

In PBL4 the students are required to critically reflect and provide evidence of clinical learning and development linked to six core, and two specific dimensions of the Knowledge and Skills Framework.

Additional and supplementary evidence of extended learning must be included and its relevance referred to explicitly in the writing.

Tutorials and discussions must be recorded and key elements of learning reflected upon.

The ePortfolio must contain a personal learning and development plan linked to the Knowledge and Skills Framework.

In PBL 4, a Curriculum Vitae is a mandatory element of the ePortfolio.

Appendix A

School of Health Sciences
Radiography
Clinical Placement Initial and Continuous Monitoring Report

[FORM PAGE 47]

Appendix B

[FORM]

Appendix D

SCHOOL OF HEALTH SCIENCES RADIOGRAPHY

MSc Diagnostic Radiography (Pre-registration)

RECORD OF ELECTIVE PLACEMENT

[FORM]

Appendix F

[form]

Appendix G

[form]

APPENDIX G

[form]

APPENDIX H

[form]

APPENDIX I

[form]

APPENDIX K

[form]

APPENDIX L

[form]

APPENDIX M

[form]

APPENDIX N

[form]