Clinical Practice in Diagnostic Imaging 3 Learning Outcome : General Learning Outcome

QMU Clinical Practice in Diagnostic Imaging 3 Learning Outcome : General Learning Outcome

Clinical Practice in Diagnostic Imaging 2 (CP3) is the continued development of general skills in routine radiography.

By the end of CP 3, in addition to achieving the ICP and CP 2 outcomes, the student will be able to:

  • describe the type and specification of imaging equipment in use;
  • discuss the capabilities and limitations of the equipment and its suitability for use;
  • demonstrate safe, effective and efficient operation of imaging equipment and accessories;
  • discuss the capabilities and limitations of image recording systems used locally;
  • describe and utilise correct technique for all procedures specific to the placement;
  • demonstrate appropriate and safe patient preparation, positioning and aftercare for the examinations specific to the placement;
  • modify and adapt techniques and procedures in consideration of traumatic, congenital and pathological conditions which may limit patient cooperation;
  • 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;
  • critically evaluate radiographs for normal and abnormal anatomical appearances and identify requirements for additional, supplementary or repeat imaging;
  • discuss preparation, care and aftercare of patients having ultrasound, cardiovascular, CT, MRI and RNI examinations and procedures;
  • discuss the use of alternative and additional imaging modalities appropriate for the demonstration and differentiation of pathology and disease;

describe and demonstrate correct technique for all 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.

SPECIFIC LEARNING OUTCOMES –

ROUTINE RADIOGRAPHY

Radiography in the Imaging Department, Wards and Operating Theatres

By the end of CP 3, in addition to achieving the ICP and CP2 outcomes, the student will be able to:

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

  • cervical spine;
  • thoracic spine;
  • lumbar spine, sacrum and coccyx
  • pelvis and hip

discuss the rationale for the modifications to the routine techniques for the above areas and identify the criteria for assessing the diagnostic quality of the resultant radiographs;

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

discuss and evaluate the specific radiation risks associated with radiography of the abdomen and thorax, demonstrate and describe effective and appropriate methods of radiation protection;

discuss and demonstrate the procedure for the 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 in addition to those in high dependency and intensive and coronary care facilities;

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;

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

describe and perform the total care required for patients who have incurred a spinal injury, who have kyphoscoliosis and who have undergone surgery for femoral neck fracture;

describe and discuss the care required and the modifications to basic technique for patients with traumatic conditions in the x-ray department, wards and operating theatres;

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;

Radiography Using Contrast Media

By the end of CP 3, in addition to achieving the Level 2 outcomes, the student will be able to:

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

  • genito-urinary system;
  • biliary system;
  • gastro-intestinal system;
  • cardiovascular system;
  • central nervous system (CT brain).

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 analyse the differences between digital and conventional vascular examinations;

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

demonstrate correct operation of imaging equipment and PACS.

Image Processing

By the end of CP 3, in addition to achieving the ICP and CP2 outcomes 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;

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

SPECIFIC LEARNING OUTCOMES – SPECIAL IMAGING TECHNIQUES

Mammography

By the end of CP 3 the student will be able to:

  • describe the differences between conventional X-ray and Mammographic tubes 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 he 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;
  • discuss care levels and communications skills required for different patient groups;
  • demonstrate correct operation of imaging equipment and PACS.

Shock Wave Lithotripsy

By the end of CP 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.
  • demonstrate correct operation of imaging equipment and PACS.

Ultrasound

By the end of CP 3 the student will be able to:

  • discuss the principles of ultrasound and state the standard frequencies used
  • describe the equipment used for obstetric and general ultrasound and discuss its uses and limitations;
  • describe the preparation required for an obstetric patient having ultrasound and demonstrate the ability to offer total care;
  • identify the measurements that are made in routine examinations of the foetus;
  • describe the preparation and care of the patient undergoing abdominal, vascular and musculo-skeletal ultrasound;
  • demonstrate correct operation of imaging equipment and PACS.

Computed Tomography (CT)

By the end of CP 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 cute situations;
  • state the contrast media and discuss methods of administration used in CT of the head, spine, chest, pelvis and abdomen;
  • identify and describe normal and abnormal anatomical, pathological and trauma appearances on CT images of the head, spine, chest, pelvis and abdomen;
  • participate as an active member of the multi-disciplinary team in caring for the patient before, during and after computed tomography using contrast media;
  • demonstrate the ability to perform, under supervision, standard CT head examinations;
  • demonstrate correct operation of imaging equipment and PACS.
Magnetic Resonance Imaging (MRI)
By the end of CP 3 the student will be able to:
  • discuss the physical principles of MRI and state the standard field strengths used for imaging;
  • state the safety precautions required;
  • discuss the clinical indicators for MRI;
  • describe the preparation of and the positioning required for patients undergoing MRI of the head, abdomen, spine, pelvis and extremity;
  • state the contrast media and methods of administration used in MRI;
  • identify anatomical structures demonstrated on MRI of the head, abdomen, spine, pelvis and extremity;
  • demonstrate correct operation of image recording equipment;
  • demonstrate the preparation of and the positioning required for patients undergoing MRI 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 MRI 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;
  • demonstrate correct operation of image recording equipment and PACS.

Radionuclide Imaging (RNI)

By the end of CP 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 CP 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.

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