clinical objectives technical affective skills

Clinical ObjectivesClinical Objectives

Technical and Affective SkillsTechnical and Affective Skills

Patient InteractionsPatient Interactions

Interacts with the patient in a courteous, Interacts with the patient in a courteous, professional manner by:professional manner by:


Treating All Patients EquallyTreating All Patients Equallydoes not discriminate on the basis of sex, age, does not discriminate on the basis of sex, age, race, creed or religionrace, creed or religion

cares for patients with communicable diseasescares for patients with communicable diseases

Patient InteractionsPatient InteractionsCommunicating With Patients in a Polite and Communicating With Patients in a Polite and

Reassuring MannerReassuring Manneraddresses adult patients by surnameaddresses adult patients by surnamemaintains a positive demeanormaintains a positive demeanorresponds to patient requests and inquiries responds to patient requests and inquiries promptlypromptlylistens and responds to patient concernslistens and responds to patient concernsdirects attention to the patientdirects attention to the patientanswers patient questions to best of abilityanswers patient questions to best of ability

“Hey, I only work here.”


Maintaining Confidentiality of Patient Maintaining Confidentiality of Patient InformationInformationonly discusses patient information in a only discusses patient information in a professional contextprofessional context


Maintaining Patient Comfort and ModestyMaintaining Patient Comfort and Modestyprovides patient blanket, pillow, etc. as needed provides patient blanket, pillow, etc. as needed and appropriateand appropriate

covers patient to maintain modestycovers patient to maintain modesty

uses table pads, sponges, etc. as appropriate to uses table pads, sponges, etc. as appropriate to increase patient comfortincrease patient comfort

“I didn’t have time.”

Peer InteractionsPeer Interactions

Interacts with peers in a courteous, Interacts with peers in a courteous, professional manner by:professional manner by:


Conducting Professional and Courteous Conducting Professional and Courteous Conversations in the Work AreaConversations in the Work Arealistens and responds to inquiries and commentslistens and responds to inquiries and comments

addresses individuals by name and/or titleaddresses individuals by name and/or title

“No Dr., it is actually my second day here.”


Using Proper Telephone EtiquetteUsing Proper Telephone Etiquetteupon answering the telephone identifies self and upon answering the telephone identifies self and departmentdepartment

listens and responds to inquirieslistens and responds to inquiries

ask permission before placing caller on holdask permission before placing caller on hold

verify that transferred calls reach intended verify that transferred calls reach intended recipientrecipient

“I just assumed that I transferred the call to the right place.”

Peer InteractionsPeer InteractionsMaintaining a Positive Attitude That Is Maintaining a Positive Attitude That Is

Supportive Of Other StudentsSupportive Of Other Studentsdirects concerns to proper authoritydirects concerns to proper authoritycomplaints are of a reasonable naturecomplaints are of a reasonable natureabides by due process guidelines abides by due process guidelines assists other students when not busyassists other students when not busydoes not talk about other students in a does not talk about other students in a negative waynegative way

“I think that other student put barium in my soda!”

Initiative/DependabilityInitiative/Dependability

Displays initiative and dependability by:Displays initiative and dependability by:


Completing Assigned TasksCompleting Assigned Tasksonce begun, completes examinationonce begun, completes examination

carries out assigned tasks expeditiouslycarries out assigned tasks expeditiously


Seeking Instruction and Guidance When Seeking Instruction and Guidance When NecessaryNecessaryasks for help when unsure of selfasks for help when unsure of self

has radiographs checked by proper authority has radiographs checked by proper authority before releasing patientbefore releasing patient

“But everyone was busy!”

Initiative/DependabilityInitiative/DependabilityPerforming Radiographic Examinations with Performing Radiographic Examinations with

Appropriate SupervisionAppropriate Supervisionhas a technologist directly supervise exams prior has a technologist directly supervise exams prior to competency testingto competency testing

has a technologist indirectly supervise exams has a technologist indirectly supervise exams following competency testingfollowing competency testing

has a technologist directly supervise all repeatshas a technologist directly supervise all repeats

has a technologist approve all radiographs taken has a technologist approve all radiographs taken regardless of the level of competenceregardless of the level of competence

“They said that I should be able to do portables alone.”

Initiative/DependabilityInitiative/DependabilityPerforming Non-Patient Tasks On Own Performing Non-Patient Tasks On Own

InitiativeInitiativemaintains room supply of accessory itemsmaintains room supply of accessory itemskeeps assigned room clean and neatkeeps assigned room clean and neatassists in ancillary areas (i.e. film library, assists in ancillary areas (i.e. film library, patient escort) when patient examinations patient escort) when patient examinations are not availableare not availabledoes not use the internet for entertainment does not use the internet for entertainment purposespurposes “But MySpace threatened to

close my account, I have to clean up my blog!”


Remaining In Vicinity of Assigned AreaRemaining In Vicinity of Assigned Areais immediately available to participate in exams is immediately available to participate in exams performed in assigned roomperformed in assigned room

let others know when you are leaving the let others know when you are leaving the departmentdepartment

Initiative/DependabilityInitiative/DependabilitySeeking Opportunities for Clinic PracticeSeeking Opportunities for Clinic Practice

volunteers to perform patient examinationsvolunteers to perform patient examinations

asks questions pertinent to examinations asks questions pertinent to examinations performedperformed

practices positioning when patient examinations practices positioning when patient examinations are not availableare not available

practices equipment manipulation when patient practices equipment manipulation when patient examinations are not availableexaminations are not available

“But, I already comped on that.”

Acceptance of Constructive Acceptance of Constructive CommentaryCommentary

Acknowledges constructive commentary Acknowledges constructive commentary by:by:

Acceptance of Constructive Acceptance of Constructive CommentaryCommentary

Accepting Comments Graciously and Uses Them Accepting Comments Graciously and Uses Them to Improve Performanceto Improve Performancelistens politely to commentslistens politely to commentsallows comments to be completed before allows comments to be completed before respondingrespondingresponds to comments in a professional mannerresponds to comments in a professional mannerconsults appropriate authority for mediation of consults appropriate authority for mediation of problem areasproblem areasnotes areas needing improvingnotes areas needing improvingwhile in clinic attempts to improve areas of while in clinic attempts to improve areas of weaknessweakness

AppearanceAppearance

Maintains a proper, professional Maintains a proper, professional appearance by:appearance by:

Adhering To the Uniform Policy As Outlined Adhering To the Uniform Policy As Outlined In the Student HandbookIn the Student Handbook

AppearanceAppearance

Keeping Uniforms and Shoes Clean and Keeping Uniforms and Shoes Clean and NeatNeatshoes are cleanshoes are clean

uniform is freshly laundereduniform is freshly laundered

AttendanceAttendance

Acknowledges the need for responsible Acknowledges the need for responsible clinic attendance by:clinic attendance by:


Minimizing AbsenteeismMinimizing Absenteeismis absent no more than three days in any one is absent no more than three days in any one semestersemester

PPS grade begins to lower after 1 to 2 absencesPPS grade begins to lower after 1 to 2 absences


Reporting To Clinic on Time Reporting To Clinic on Time is not late to clinical siteis not late to clinical site

PPS grade begins to lower after 1 to 2 tardiesPPS grade begins to lower after 1 to 2 tardies

Remember…..your attendance record is the Remember…..your attendance record is the most inquired about attribute by future most inquired about attribute by future employersemployers

QualityQuality

Produces radiographs of diagnostic quality Produces radiographs of diagnostic quality by:by:

QualityQuality

Preparing the Radiographic Room Prior To Preparing the Radiographic Room Prior To Patient ArrivalPatient Arrivalhas appropriate number of IRshas appropriate number of IRs

has prepared contrast media / consent forms if has prepared contrast media / consent forms if applicableapplicable

has enough lead shielding availablehas enough lead shielding available

has anatomic markers, sponges, grids, tape, etc.has anatomic markers, sponges, grids, tape, etc.

QualityQuality

Placing Proper Anatomic Marker and Patient Placing Proper Anatomic Marker and Patient Identification Information on the FilmIdentification Information on the Filmright/left marker is visible and not in pertinent right/left marker is visible and not in pertinent anatomyanatomy

date, patient name and number are visibledate, patient name and number are visible

QualityQuality

Setting Appropriate Technical FactorsSetting Appropriate Technical Factorsmeasure SID – no “guessing”measure SID – no “guessing”

mAs and kVp to produce optimum contrast and mAs and kVp to produce optimum contrast and densitydensity

focal spot size used to produce optimum detailfocal spot size used to produce optimum detail

measures patient and consults technique chartmeasures patient and consults technique chart

selects appropriate AEC cellselects appropriate AEC cell

QualityQuality

Following Department Protocol for the Exam Following Department Protocol for the Exam RequestedRequestedseeks to memorize departmental protocolsseeks to memorize departmental protocols

correct projections are taken for each correct projections are taken for each examinationexamination

“I don’t need to write it down.”

QualityQuality

Maintaining a Repeat Rate That Is Consistent Maintaining a Repeat Rate That Is Consistent With Level of Knowledge and SkillWith Level of Knowledge and Skillpositioning patient properlypositioning patient properly

aligning the x-ray tube, patient and image aligning the x-ray tube, patient and image receptor device appropriatelyreceptor device appropriately

adjusting routine protocol for patient limitationsadjusting routine protocol for patient limitations

QuantityQuantity

Maintains a high level of active Maintains a high level of active participation by:participation by:

QuantityQuantity

Performing Examinations in an Organized Performing Examinations in an Organized MannerMannertakes radiographs in a logical sequence that takes radiographs in a logical sequence that minimizes patient discomfortminimizes patient discomfort

prioritizes tasks to improve efficiencyprioritizes tasks to improve efficiency

QuantityQuantity

Assisting Others When Not BusyAssisting Others When Not Busyvolunteers to help othersvolunteers to help others

“But, I’m not going to be a file room clerk when I graduate.”

QuantityQuantity

Performing Tasks at a Speed Consistent Performing Tasks at a Speed Consistent With Level of EducationWith Level of Educationspeed at which successfully tested competency speed at which successfully tested competency exams are performed gradually increases with exams are performed gradually increases with added practiceadded practice

QuantityQuantity

Seeking Opportunities for Clinic ExperienceSeeking Opportunities for Clinic Experiencevolunteers to assist othersvolunteers to assist others

continues to practice previously completed continues to practice previously completed competencies to increase skillcompetencies to increase skill

with assistance, attempts exams not yet with assistance, attempts exams not yet competency testedcompetency tested

“But, I already have enough comps for the semester.”

Radiation Protection/General Radiation Protection/General SafetySafety

Provides radiation/general protection for Provides radiation/general protection for patients, others and self by:patients, others and self by:


Asking Female Patients of Child Bearing Asking Female Patients of Child Bearing Age about the Possibility of PregnancyAge about the Possibility of Pregnancycompletes institutional pregnancy questionnairecompletes institutional pregnancy questionnaire

seeks appropriate action when possibility of seeks appropriate action when possibility of pregnancy existspregnancy exists


Shielding PatientsShielding Patientsshields all patients of childbearing ageshields all patients of childbearing age

may shield all patients upon request by patient may shield all patients upon request by patient or facilityor facility

places shield appropriately for each projection places shield appropriately for each projection takentaken


Limiting the X-Ray Field to the Area of Limiting the X-Ray Field to the Area of InterestInterestuses the smallest IR possible uses the smallest IR possible

collimates to the partcollimates to the part


Using Appropriate Radiation Safety Methods Using Appropriate Radiation Safety Methods for Self and Othersfor Self and Othersremoves all unnecessary persons from the room removes all unnecessary persons from the room prior to making the exposureprior to making the exposureensures all persons, other than the patient, in ensures all persons, other than the patient, in the room during radiographic exposure wear the room during radiographic exposure wear protective apparelprotective apparelwears a personnel radiation monitoring deviceswears a personnel radiation monitoring devicespractices the principles of time and distance to practices the principles of time and distance to reduce exposurereduce exposure


Transporting Patients without Accident or Transporting Patients without Accident or InjuryInjurylocking wheels on wheelchair before assisting locking wheels on wheelchair before assisting patient in or outpatient in or out

driving transport vehicles safelydriving transport vehicles safely

checking for tubing, lines, etc. before moving the checking for tubing, lines, etc. before moving the patientpatient

“I’m sorry nurse, I didn’t mean to pull out that IV line that took you two hours to put in.”


Transferring Patients without Accident or Transferring Patients without Accident or InjuryInjuryproviding step stools for the patientproviding step stools for the patient

physically assisting the patient as neededphysically assisting the patient as needed

obtaining sufficient lifting help to transfer obtaining sufficient lifting help to transfer stretcher patientsstretcher patients


Positioning the Patient and Equipment without Positioning the Patient and Equipment without Causing Further Injury to the PatientCausing Further Injury to the Patientprovides pads, cushions etc. for patient comfort and provides pads, cushions etc. for patient comfort and safetysafetymoves x-ray tube away from the table before assisting moves x-ray tube away from the table before assisting patient on and offpatient on and offprovides hand grips for the patient when availableprovides hand grips for the patient when availablecautions patient about grasping the edges of the tablecautions patient about grasping the edges of the tablegives clear instructions to the patientgives clear instructions to the patient

Equipment ManipulationEquipment Manipulation

Properly and safely manipulating the Properly and safely manipulating the radiographic and ancillary equipment by:radiographic and ancillary equipment by:


Driving and Maneuvering Mobile EquipmentDriving and Maneuvering Mobile Equipmentdrives mobile units safelydrives mobile units safely

maneuvers mobile units in and out of patient maneuvers mobile units in and out of patient rooms or OR suitesrooms or OR suites


Operating Ancillary EquipmentOperating Ancillary Equipmentturns oxygen on and off as necessaryturns oxygen on and off as necessary

prepares suction machine for usageprepares suction machine for usage


Processing Radiographs ProperlyProcessing Radiographs Properlyfeeds film into the processor correctlyfeeds film into the processor correctly

processes radiographs properlyprocesses radiographs properly

secures film bin before leaving darkroomsecures film bin before leaving darkroom

produces copies of radiographsproduces copies of radiographs

DR/CR/PACSDR/CR/PACShas understanding of software, image has understanding of software, image manipulation, and exposure protocol (S#, EI, etc.)manipulation, and exposure protocol (S#, EI, etc.)

Patient CarePatient Care

Courteously provides patient care and Courteously provides patient care and comfort by:comfort by:


Properly Identifying the PatientProperly Identifying the Patientchecks patient wristbandchecks patient wristband

questions the patient to ascertain identityquestions the patient to ascertain identity

matches patient information to examination matches patient information to examination requestrequest


Assisting the PatientAssisting the Patienthelps patient with clothing changeshelps patient with clothing changes

assists patient on and off x-ray tableassists patient on and off x-ray table

provides patient help with bathroom needsprovides patient help with bathroom needs


Collecting Pertinent Clinical DataCollecting Pertinent Clinical Datacompletes any required institutional formscompletes any required institutional forms


Providing Patient EducationProviding Patient Educationexplains examination preparationexplains examination preparation

explains examination procedureexplains examination procedure

answers patient questions to best of abilityanswers patient questions to best of ability

“Oh, it’s just a little injection, no big deal.”


Talking In a Voice That Is Appropriate In Talking In a Voice That Is Appropriate In Tone and VolumeTone and Volumevoice tone and volume are adequate for hearing voice tone and volume are adequate for hearing under normal circumstancesunder normal circumstances

Senior studentsSenior students

meet with me when you are ready to meet with me when you are ready to begin modality rotationsbegin modality rotations

1.1. comps are completedcomps are completed

2.2. approval of rotations by site / Pima approval of rotations by site / Pima

3.3. no more than four weeks at a timeno more than four weeks at a time

HarborviewHarborview

4 week rotations4 week rotationsparking: pay in garage, take bus, locate parking: pay in garage, take bus, locate street parking (limited)street parking (limited)expectations: be aggressive, be proactive, expectations: be aggressive, be proactive, learn to adapt to patient learn to adapt to patient condition/limitations quicklycondition/limitations quicklycan earn compscan earn compsturn in completed trauma objectives and turn in completed trauma objectives and evaluationevaluation

Children’sChildren’s

2 week rotations2 week rotationsparking: whale garage, lower levels (at least for parking: whale garage, lower levels (at least for first day)first day)radiology is located on the 4radiology is located on the 4 thth floor floorexpectations: observe first day or so, earn expectations: observe first day or so, earn confidence from techs, let them know that you confidence from techs, let them know that you are ready to try somethingare ready to try somethingcan earn comps: let clinical instructor know can earn comps: let clinical instructor know which area you want more time in (x ray, fluoro, which area you want more time in (x ray, fluoro, OR)OR)no objectives or evaluations to be completedno objectives or evaluations to be completed

clinical objectives technical affective skills

Education

patient interactions

patient examinations

patient comfort

patient concerns

patient escort

patient arrival

patient blanket

patient requests