Radiation Therapy (RTT)

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RTT-Specific Handbook

Program Description

See our homepage, About the Profession, and Our Program for complete descriptions of the Radiation Therapy program.

Program-Specific Policies & Procedures

All Radiation Therapy 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/ therapists, and evaluators. Supervision of Radiation Therapy Students: Direct supervision of radiation therapy students is provided by a qualified practitioner who reviews the procedure in relation to the student’s achievement, evaluates the condition of the patient in relation to the student’s knowledge, is present during the procedure, and reviews and approves the procedure.

Procedure:

1. A certified radiation therapist is responsible for determining the degree of student participation in procedures using external beam equipment, simulator, and brachytherapy radioactive sources and provides direct supervision throughout the procedure.
2. A dosimetrist and/or physicist are responsible for determining the degree of student participation in dosimetry procedures and provide direct supervision throughout the procedure.
3. A staff radiation therapist, nurse, or radiation oncologist is responsible for determining the degree of student participation in consult, physical examination, patient care, and follow-up procedures and provides direct supervision throughout the procedure.

Procedure for Clinical Evaluations

1. Clinical evaluations include the three domains of learning: cognitive (knowledge), affective (professional behaviors), and psychomotor (technical skills).
2. 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. See CAHP academic probation policy.

Student Grievance

Purpose: The MITS Department strives to promote an educational environment that values fair and equitable treatment among students, faculty, and staff. Despite this goal, differences among individuals may occasionally lead to conflicting circumstances that require a process for resolution to take place. The purpose of the Student Grievance Policy is to provide a framework to effectively resolve any justified complaint or grievance without retaliation.

Examples or Types of Grievances (but not limited to):

• Acts or threats of intimidation
• Acts or threats of physical aggression
• Acts of bias or unfair treatment by a fellow student, faculty or staff member which adversely effects the learning process
• Violation of student rights and responsibilities

Procedure:

1. Informal Process - Ideally, grievances can be resolved informally among the parties involved. Therefore, before a formal grievance process takes place, the student is encouraged to meet with the individual whose behavior warranted the grievance. If this action is not feasible, the student should contact the program director for possible resolution. A final option for informal resolution is to utilize an Ombudsperson. The Ombudsperson identified for students on the UNMC campus is located in the Student Counseling Department. The informal meeting must take place within two weeks of the occurrence that caused the grievance.
2. Formal Process - If the student is not satisfied with the results of the informal process, or an informal resolution is not possible then he/she should initiate the formal process within 30 days of the occurrence.
   1. A formal statement of the grievance must be presented in writing to the MITS Department Associate Director within the timeframe specified. (If the Associate Director is the individual involved, then the formal statement should be submitted to the Associate Dean of the College of Allied Health Professions). The formal statement must include the following items: A) Full name, address, and telephone number of the person(s) making the charge; B) Full name of each person being charged, location of employment, and work telephone number; C) A concise and factual description of the specific incident(s) surrounding the grievance violation (the description should include a timeline of events); D) A proposed resolution.
   2. The Associate Director (or Associate Dean, if applicable) will review the facts surrounding the grievance. If there is justified evidence that a grievance exists, then the grievance will be forwarded to the CAHP Student Grievance Committee.
   3. Within two weeks after receiving the alleged grievance, the committee members will review the statement, convene to discuss the issues at hand, hear testimony, and consider all other facts pertaining to the grievance.
   4. Both parties will have the right to present testimony, evidence, and witnesses. Each party shall have the right to seek legal counsel in the preparation of statements concerning the grievance; however, they may not be represented by counsel in discussions with the committee. Each party shall have the right to hear all testimony surrounding the grievance. The hearing will be closed to the public.
   5. In all proceedings where the complaint touches upon questions of policies, rules and regulations, the CAHP Student Grievance Committee shall be guided by written policies, rules and regulations. The committee will make a decision on the grievance charge after reviewing all facts, testimony, and documentation. The committee’s decision or resolution will be made within two weeks following the hearing. Both parties involved will be notified of the decision in writing. A summary record of the proceedings will be maintained in a confidential file.

The student may appeal the decision of the Student Grievance Committee, to the Office of the Associate Dean. The Associate Dean will review all documents surrounding the grievance, and make a decision within two weeks of receiving the appeal. Both parties involved will be notified of the decision in writing. The decision by the Associate Dean will be final.

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 (As Low As Reasonably Achievable) at all times. These are found in the UNMC Radiation Safety Manual.
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 (e.g., radiation badge) and finger TLD rings, (Radiation Therapy, Nuclear Medicine Technology and CVIT); therefore, they must be worn at all times within the department. Radiation badges are to be worn at the collar, and finger TLD rings on the dominant hand. When wearing a lead apron the monitoring device must on the outside of the apron. It is the student’s responsibility to exchange badges and rings on a quarterly basis with person designated by the Radiation Safety Office (RSO) for each program.
5. If your personnel monitoring device or finger TLD ring is lost or left where it can be exposed unknowingly, contact the respective program director immediately.
6. If a student becomes pregnant, she is encouraged to voluntarily consult with the program director concerning the most appropriate procedure to ensure that exposure to the fetus is less than 500 mrem (5 mSv) for the entire gestation period. In addition to the radiation badge worn on the outside collar, a radiation badge is worn on the front abdomen area under the lead apron. For a student on the fetal monitoring program both badges are exchanged on a monthly basis.
7. In accordance with the philosophy of keeping exposures ALARA, the RSO 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 (3 mSv)	600 mrem (6 mSv)
LDE (lens of eye)	900 mrem (9 mSv)	1500 mrem (15 mSv)
SDE (skin or extremity)	900 mrem (9 mSv)	2000 mrem (20 mSv)
Declared Pregnant Woman	40 mrem (0.4 mSv)	50 mrem (0.5 mSv)

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.

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 form “UNIVERSITY of NEBRASKA MEDICAL CENTER DECLARATION OF PREGNANCY” and forward it to the Radiation Safety Office. (See form.)
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.) 
8. 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.

MITS Dress Code Policy

All students will dress in a professional manner, appropriate for 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. Pant hemlines should not touch or drag on the ground.
5. Simple jewelry may be worn with the uniform, i.e., small earrings, wedding rings, and watches.
   1. Visible piercings and transdermal implants must be removed or covered except ear piercings.
   2. Ear gauges must be plugged with flesh colored plugs while in clinic.
   3. Earrings must be small and not touching the neck.
   4. Bandanas are not permitted.
6. Visible tattoos that are larger than 2” x 2” or clearly offensive, including but not limited to anything hateful, violent, profane and/or containing nudity, must be completely covered.
7. Flat, enclosed-toe, neutral colored shoes are acceptable. Socks must be worn at all times.
8. Students assigned to a surgery rotation will follow the surgical dress code policy of the clinical facility in which he or she is rotating.
   1. Students are to wear from home their uniform or proper street clothing and then change into clean scrubs after they arrive at the hospital/clinic. At the end of the shift, the students are to change back into their uniform or proper street clothing.
   2. All scrub clothing provided by the hospital/clinic may not be removed from the property. Scrubs must not be worn outside of the hospital/clinic buildings.
9. 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.

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. Only department computers may be used for documenting clock in and clock out procedures via Trajecsys. Personal cell phones may not be used for this function.
5. Computer use is permitted for the purpose of academic endeavors only with supervisor approval.

Student Leave Time

Personal Time

Students enrolled in the Department of MITS 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.

Personal time for professional meetings: The MITS Department supports participation in professional organizations relevant to the student’s professional growth and development. Therefore, students may qualify for time for documented attendance and involvement in these activities. See program director for more information.

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.

Policy for Authorship of Student/Scientific Papers and/or Presentations

It is a tradition and common accepted practice amongst academic institutions that scientific papers and posters submitted for consideration of publication or presentation include as an author the student’s advisor, program director, professor, department chairperson, or any other similar individual that had a direct relationship to the student and the material being presented.

Dean’s List Policy

The Dean's List policy is in the Academic_Policies_and_Procedures section 1.15.

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.