Computed Tomography (CT)

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CT-Specific Handbook

Program Description

See the CT Homepage, About the Profession and Our Program for complete descriptions of the Computed Tomography Practicum.

Accreditation

The Computed Tomography Practicum is offered as an advanced option under the Radiography Program and is not a separately accredited program. The Radiography Program is accredited by the Joint Review Committee on Education in Radiologic Technology (JRCERT).

For more information on JRCERT, please use the contact information below: Joint Review Committee on Education in Radiologic Technology (JRCERT) 20 North Wacker Drive, Suite 2850 Phone: 312.704.5300 Chicago, IL 60606-3182 Website: www.jrcert.org

Program-Specific Policies & Procedures

All CT students will be required to sign the Student Responsibility Statement.

Supervision of Students

Clinical Supervision of Students: All MITS students must have adequate and proper supervision during all clinical assignments as specified by individual institutional, program, and accreditation policies. The following policies and procedures apply to UNMC clinical assignments for students, technologists, and evaluators.

CT Procedure: A registered technologist will provide direct supervision for procedures performed. The student will transition from observation to active participation during the curriculum. Initially, the staff technologist will provide direct one-on-one supervision regardless of the exam or its degree of difficulty. Ultimately the student will transition to a more active role in the completion of an exam. After adequate didactic and clinical instruction and exam competency has been established, the supervising technologist may take on more of an indirect role. The supervising technologist will always remain available to the student.

Procedure for Clinical Evaluations

1. Clinical evaluations include the three domains of learning: cognitive (knowledge), affective (professional behaviors), and psychomotor (technical skills).
2. The student will receive a minimum of two evaluations for affective, psychomotor, and cognitive areas in the practicum.
3. Clinical instructor and staff feedback will be used in the evaluation process.

Academic Probation

Students who perform at a non-acceptable level as defined by the program, in any of the three domains, may be placed on immediate academic probation. Students who do not show immediate rectification of the problems will be put on academic probation.

1. Students will be notified of the nature of the problem and discuss ways to improve.
2. The length of the probationary period will be clearly defined on an individual basis.
3. At a defined time the student will receive another evaluation. If improvement is not demonstrated, the student will be removed from clinic and a failing grade can be issued for the clinical course. A committee of program directors in the MITS department will assess and determine if dismissal from the program will be recommended.
4. If improvement is shown, the student may either be removed from probation or probation may be continued for a defined time.
5. If the behavior is noted again at any time during the remainder of the practicum, the student will immediately receive a failing grade for the course and be recommended for dismissal.

Clinical Compliance

Accidents/Incidents: As general policy, MITS students will comply with the policies and procedures with the clinical site at which they are assigned. It is the policy that there be written reports of all unusual incidents/accidents. An incident is an unusual occurrence which is not consistent with the routine operation of the institution or clinical rotation which may or did cause harm, involves possible negligence, requires some immediate consideration or action by a supervisor.

A student enrolled in a program in the Department of Medical Imaging and Therapeutic Sciences is expected to provide prompt, complete and accurate written documentation of the details related to any accidents/incidents, thus enabling corrective actions and/or programs for prevention. The program adheres to the Infection Control Policy for University Hospitals and Clinics. Students with signs and symptoms of an infectious process should report immediately to the program director for appropriate referral.

All accidents/incidents must immediately be reported to the technical supervisor or immediate person in charge. Proper report forms must be completed.

Equipment Use and Operation: The professions in Medical Imaging and Therapeutic Sciences employ the use of highly specialized equipment. Any equipment failure or equipment that is not in proper working order must be reported immediately to the technical supervisor. Do not place any calls to equipment representatives. Do not attempt to repair.

Blood Borne Pathogens Exposure Plan for Students

Campus Blood Borne Pathogen Exposure (on and off campus): Students must call the Medical Communication Center at 402-559-6824 or the OUCH pager at 402-888-6824 (24 hours a day, 7 days a week) ASAP and report to the nearest emergency room for appropriate blood borne pathogen procedures. On the next work day, please call the Student Health office at 402-559-5158 with information regarding your ER visit.

Radiation Protection

It is each student’s responsibility to adhere to the following guidance for radiation protection:

1. Students must practice safe radiation and protection criteria and practice the principles of ALARA at all times. These are found in the UNMC Radiation Safety Manual available online at www.unmc.edu/CRSO .
2. The principles of decreased time and increased distance and shielding shall be employed when working with radiation.
3. The spread of any accidental contamination from radioactive materials will be decreased by frequent personnel monitoring and hand washing.
4. Radiation exposure is measured by personnel monitoring device; therefore, they must be worn at all times within the department. Personnel monitoring devices are to be worn at the collar. It is the student’s responsibility to exchange badges on a quarterly basis with person designated by the RSO for each program.
5. If your personnel monitoring device is lost or left where it can be exposed unknowingly, contact the respective program director immediately.
6. In accordance with the philosophy of keeping exposures ALARA (As Low As Reasonably Achievable), the Radiation Safety Office has established levels at which the dosimetry company will provide immediate notification of a higher than normal reading. These notification levels are presently as follows:

Dose Type	Evaluation Level	Investigation Level
DDE (whole body)	300 mrem	600 mrem
LDE (lens of eye)	900 mrem	1500 mrem
SDE (skin or extremity)	900 mrem	2000 mrem
Declared Pregnant Woman	40 mrem	50 mrem

ALARA DOSE LIMITS (PER MONITORING PERIOD)

Any doses above the ALARA Evaluation Level require that the Radiation Safety Officer review the circumstances pertaining to this dose and determine if additional actions need to be taken or if further investigation is required. An investigation requires that the Radiation Safety Officer investigate the cause of the dose and steps that may be required to prevent this dose level in the future with consideration of cost and scientific impact. All doses above the ALARA action levels will be reported to the Radiation Safety Committee.

The Radiation Safety Committee may alter these values based on regulatory or departmental concerns. When an individual exceeds any one of these levels, a follow-up survey may be conducted to determine if a reduction in dose can be reasonably achieved.

For further information regarding personnel monitoring of ionizing radiation, refer to the UNMC Radiation Safety Manual or contact the Radiation Safety Office.

Students are responsible for bioassays for the presence of I-125 or I-131 in the thyroid at appropriate times during their clinical experiences (Nuclear Medicine Technology).

If a student becomes pregnant, she is encouraged to voluntarily consult with the program director concerning the most appropriate procedure to assure that exposure to the fetus is less than 0.5 rem (refer to Pregnancy Policy below).

Pregnancy

The pregnancy policy is a voluntary program intended to provide safety for pregnant students and their fetus who are considered occupationally exposed to ionizing radiation. In the event of a suspected or confirmed pregnancy, it is the responsibility of the student to advise her program director in writing of her condition. Pregnancy will not affect the student’s enrollment in the academic courses in the program. However, due to the physical requirements placed upon the student in the clinical courses and assignments, and in order to comply with 180 NAC 004.13 (10 CFR Part 20.1208) to keep the radiation exposure to the fetus as low as reasonably achievable (no more than 500 mrem during the entire gestation period), the following procedures will apply:

1. The student may voluntarily report suspected or confirmed pregnancy to the program director. At that time the UNMC/The Nebraska Medical Center policies and procedures and the MITS Student Policies and Procedures Manual pregnancy policy will be reviewed with the student. Once the student has elected to declare suspected or confirmed pregnancy, the student should:
2. Complete the “UNIVERSITY of NEBRASKA MEDICAL CENTER DECLARATION OF PREGNANCY” form and forward it to the Radiation Safety Office.
3. The Radiation Safety Office will determine the estimated radiation dose from time of conception to the date of declaration based on dosimetry records and calculate the permissible remaining dose to the embryo/fetus for the remainder of the pregnancy. (See form).
4. Upon review of the findings and recommendations of the Radiation Safety Officer or Medical Radiation Physicist, clinical assignments will be reviewed. Clinical assignments will only be altered if the fetus received the maximum permissible dose as stated by 180 NAC 004.13 (10 CFR Part 20.1208). Any clinical competencies not completed for reasons related to pregnancy must be successfully completed prior to graduation.
5. Provide the program director with written indication of intent to:
   1. continue in the program, or
   2. take a medical leave of absence with intent to complete the program (form available from CAHP Academic & Student Affairs), or
   3. withdraw from the program (form available from CAHP Academic and Student Affairs).
6. The student should provide the program director with written consent from her physician providing medical advice for:
   1. continuing in the program as a full-time student, and/or
   2. any limitations placed upon the student while enrolled in the program.
7. A student may also voluntarily withdraw their declaration of pregnancy at any time. (See form.)

MITS Dress Code Policy

All students will dress in a professional manner, appropriate to the situation and according to the following guidelines:

1. All MITS students will wear Caribbean Blue scrubs with or without a Caribbean Blue lab jacket for both class and clinic.
2. The uniform top will have the UNMC/Nebraska Medicine logo on upper left chest. All uniforms should be purchased online here.
3. A solid white or gray shirt may be worn under the scrub top and must be tucked into the scrub pant.
4. Flat, enclosed-toe, neutral colored shoes are acceptable. Socks must be worn at all times.
5. Proper UNMC photo ID and personnel monitoring devices must be worn at all times. The ID must be visible at all times to identify student status.
6. Simple jewelry may be worn with the uniform, i.e., small earrings, wedding rings, and watches.
7. Students assigned to a surgery rotation will follow the surgical dress code policy of the clinical facility in which he or she is rotating.

Students are held responsible for their appearance and will be dismissed from clinic if inappropriately attired, groomed, or adorned per faculty standards. (Ex: artificial fingernails are not allowed, hair worn longer than shoulder length must be pulled back, etc.). If a student is sent home from clinic due to a dress code violation, the amount of time missed from clinic will be deducted from the student comp time allotment.

Use of Technology

1. Personal phone calls during clinic hours must be kept to a minimum.
2. No personal long distance calls are permitted on department telephones.
3. Personal technology such as iPods and cell phones may not be carried or used during clinic or class. Technology used for educational purposes may be used as approved by class instructors.
4. Computer use is permitted for the purpose of academic endeavors only with supervisor approval.

Student Leave Time

Personal Time

Students enrolled in the Division of RSTE are given 16 hours of leave time for personal affairs each semester. It is intended to provide necessary time for planned or unplanned events without jeopardizing the student’s attendance record. Regarding the use of student leave time, the following guidelines must be followed:

1. Unused time allotted is not transferrable to a successive semester.
2. Allotted hours may be used for such things as illness, funerals, medical and dental appointments, job interviews, or vacations.
3. All leave time for reasons other than illness must have prior approval of the program director.
4. Students taking more than the allotted number of hours will be required to make up the time according to the discretion of the program director.
5. Unauthorized absenteeism may result in disciplinary actions.
6. A student may be required to furnish satisfactory medical proof of illness, disability or dental work.
7. Students must contact the person in charge of the assigned clinical area and/or the program director 30 minutes prior to time assigned for arrival if they are unable to attend the scheduled day unless directed otherwise by their program director.
8. It is recommended that suspected and confirmed pregnancy be reported to the program director. Time lost due to pregnancy must be made up according to the decision of the program director based on the Radiation Protection and Pregnancy Policies contained in this document.
9. Full time students may request up to 5 days of funeral/bereavement leave in the event of a death of an immediate family member. Documentation may need to be provided upon request.

Compensation Time Guide

Provision of compensation time is intended to ensure fair, uniform, and impartial treatment for all students. Students may voluntarily choose to spend additional authorized time participating in clinic procedures over and above their scheduled hours as long as the student continues to perform in the student capacity, including direct supervision and holding only student clinical responsibilities.

Student Employment Guidelines

Opportunities for student employment may exist in the clinic departments and may be initiated and/or discontinued as dictated by manpower needs.

1. Students may not take the place of regular staff in the clinical areas to which they are assigned. It is appropriate, however, for students to assume the responsibility for performing defined activities and tasks, with adequate direction and supervision, after demonstration of clinical competencies.
2. Students may be employed in a clinical setting outside regular educational hours, provided this work does not interfere with their academic responsibilities. In addition, student employment in the clinical setting is non-compulsory and is subject to standard employee policies.

Personal Property

UNMC, the Department of Radiology or Radiation Oncology or your respective programs are not responsible for your valuable possessions. All valuables and money should be monitored closely by each individual.

Inclement Weather Policy

Official cancellations of clinical assignments and/or RSTE classes at UNMC due to inclement weather will be concurrent with that announced on the radio and TV for UNO. In the event of cancellation during the day because of weather, students will be notified by their program director. In situations other than official UNO closings, students electing not to travel due to inclement weather conditions must contact their program director (or designee) and time will be deducted from their personal leave bank. Students that are at distance education sites will follow local community college or university cancellations.