Department of Allied Health Professions / Diagnostic Imaging

Clinical Placement Handbook.

Advanced Diagnostic Imaging Studies

Year 3

Name…………………………………

Cohort…………………………………

Placement……………….……………

University of the West of England, Bristol

CLINICAL PLACEMENTS:

Clinical placements are organised by the clinical co-ordinator, who will also monitor student progress in conjunction with Practice Educators (PE) and Link tutors.

Academic staff will undertake the role of Link tutors and visit you on clinical placement. Primarily the role is to provide academic guidance and support for students ensuring that effective communication links between the University and Clinical departments are maintained.

PLACEMENT OUTLINE

As part of the Advanced Professional Studies Module, you are once again required to undertake a clinical placement. This will allow you to consolidate your knowledge and gain the required clinical experience. This takes the form of a 14-week clinical block, which begins on 12.09.16 and ends on 16.12.16.

Students will be entitled to 1 study session per week for academic study during the 14 weeks, the timing of these study sessions must be agreed with the placement and cannot be accumulated.

Please note all students will be required to work a 37.5 hour week in-line with qualified staff working hours.

During this placement you will be allocated to the following areas:

-1 or 2* weeks in Fluoroscopy (to include Digital and Angiography if available).

-4 weeks in Accident and Emergency to include all patient groups e.g. paediatrics, elderly and those with special needs.

-2 or 3* weeks in General rooms

-3 weeks on Mobiles / Theatre

-1 or 2* weeks in CT

-1 week in chosen “specialist” modality (MRI, RNI or US)

-1 week in other modalities (1/2 week in each of the non-selected modalities MRI, RNI, US)

* Extra week at the discretion of the placement and dependent upon which appraisal is to be undertaken:

  • if undertaking Fluoroscopy/Angiography room management appraisal then 2 weeks in Fluoroscopy and 2 weeks in General
  • if undertaking General room management appraisal then 3 weeks in General and 1 week in Fluoroscopy
  • if undertaking a CT room management appraisal then 2 weeks in CT and 1 weeks in Fluoroscopy.

SICKNESS REPORTING

If for any reason you are unable to attend your practice placement please call or email:

  1. Your Practice Placement – as near to the start of your shift as possible. Advise them if you are sick or unable to attend placement for any other reason. Note: for infection control purposes, if you have diarrhoea or sickness you will be required to remain off placement for 48 hours following the last “episode”.
  2. Your Link Lecturer or Clinical Coordinator – as near to the start of your shift as possible.

If your period of sickness is likely to substantial and therefore affect your ability to complete the requirements of your practice placement, you mustinform your link lecturer and/or clinical co-ordinator as soon as possible. If your period of sickness is likely to affect your ability to submit by the assessment deadline, you must fill in an EC1 form within 5 days of assessment date.

ATTENDANCE RECORD

The CoR regards an attendance of 90%in the planned clinical practice component of the course as being the desirable minimum. This is to enable students to meet professional requirements satisfactorily.

Any absence that is not reported as sickness or approved leave will be recorded as unauthorised - you are advised that this may be detrimental to your employment reference.

If there is a personal situation that requires you to seek compassionate leave please discuss with the Clinical Coordinator or Personal Tutor or Link Lecturer.

REPORTING SESSION

The requirement is for all 3rd year students to arrange themselves to sit in on at least one reporting session with either a radiologist or a reporting radiographer. This session is to take place during the students half day study period and within their allocated clinical placement.

Allreporting sessions attended are to be recorded in the log book on the relevant page.

OUT OF HOURS EXPERIENCE

During this placement all 3rd year students will undertake a dedicated 1 week of ‘out of hours’ experience, the model for this week will be decided by each placement and students informed accordingly. The recommendation is that this week should be during an A/E or General week.

All ‘out of hours’ experience gained is to be recorded in the log book on the relevant page.

APPRAISAL DETAILS

During the Clinical Placement you MUST complete the following appraisals:

Room Management Session

Theatre Case

Accident and Emergency Case

CT Continuous Appraisal

You will be assigned to each of the above specific areas for clinical experience. The Room Management Session will be negotiated with the department and will either be in a General, Fluoroscopy, Angiography, CT or A/E room. You can undertake your appraisal at any time during this period if, after discussion, the Practice Educator (PE) feels you are ready to do so.

Please note that if you do a CT Room Management appraisal you still have to do the CT Continuous appraisal. The same applies if you do an A/E Room Management appraisal you still have to do an A/E Trauma appraisal.

GENERAL APPRAISAL GUIDELINES

Each of the four Year 3 appraisals has very specific guidelines. There will however, have to be some flexibility to allow for differences in departmental procedure. These are discussed in more detail under each appraisals specific heading. There are however, some general guidelines, which apply to all Year 3 appraisals.

Mock appraisals

The facilitation of mock appraisals is very difficult and would result in PE’s workload becoming unmanageable. As a compromise, during your placement in a specific area, you should be allowed to shadow the team leader in preparation for the actual appraisal. You MUST only attempt the appraisal at the discretion of the Practice Educator (PE), after BEING IN THE RELEVANT PLACEMENT AREA FOR A MINIMUM OF 1 WEEK.

Referral in an appraisal

If you fail at the first opportunity you may only be granted a second opportunity at the discretion of the award board.

Administration

You will be issued with one form for each appraisal. Further copies are available on request from the Clinical co-ordinator.The forms are triplicate. The copies, once completed should be separated,

  • The White copy is retained by you
  • The Pink copy is retained by the Practice Educator
  • TheYellow copy is forwarded (as soon as possible) to the Clinical Co-ordinator (Radiography) at the School of Allied Health Professions.

The white copies must be submitted with the completed portfolio at the end of the placement and they will be returned to you following the assessment of the portfolio.

Marking of the Appraisals

The appraisal marking criteria has five levels of competency for each section; a recent change to the marking criteria is the introduction of a number of automatic fails and an element of negative marking.

F Non completion of task as deemed a dangerous act and an

automatic failure of assessment opportunity.

-5. Objective not completed. (0 where applicable)

1. Required assistance

2. Worked unassisted but lacked proficiency

3. Worked proficiently (including an acceptable time frame)

The appraisal can be halted at any point if the student is deemed to be performing in a dangerous or unprofessional manner.

The year 3 appraisals do not contain a formalised discussion element however; it is envisaged that the Practice Educator will have to question you during the appraisal so that they can award the appropriate mark to each section. It may even be necessary to question you after the appraisal has finished in order to clarify some issues.

At this level it has been agreed that there should be an element of negative marking. It is with this in mind that the forms have been designed so that if omitted, the areas of practice, which should be “second nature”, can be penalised. This will mean that if you fail to carry out one of the elements in the appraisal you will either incur an automatic failure or a deduction in marks depending on the nature of the omission.

The pass mark for year 3 appraisals is 70%.

Logbook

You must produce evidence in your logbook to show that you have completed sufficient relevant examinations before the appraisal is carried out.

A table outlining the minimum unassisted examination numbers required by the end of the 3rd year placement is included in the front of the logbook.

Failure to record / achieve these numbers may result in a referral in the portfolio componentand the academic award board will decide if you are granted a second opportunity.

Please note for all general radiographic examinations you are required to record the exposure given in your logbook.

Clinical Portfolio

For a pass to be achieved, the student must demonstrate satisfactory progress. In the event of an area being identified as “BELOW REQUIRED STANDARD FOR THIS STAGE OF TRAINING.” and scored as a 1, an ACTION PLAN needs to be produced. There is the option to use an action plan at any stage of the 14 weeks if the practice educator feels that the student is not performing at the required level for that week.

The Action Plan

This plan will be a negotiated between the student and the clinical supervisor and will aim to redress the identified shortcoming.

If this is not achieved within the agreed time frame, the link lecturer/clinical coordinator will intervene.

Students scoring a ‘1’ in any of the Clinical Competencies in the last 2 weeks of placement may fail the clinical placement

SPECIFIC APPRAISAL GUIDELINES

Room Management Session

This appraisal has been designed to test your management skills. The rationale behind its design was to investigate how well the student would cope with the day to day running of a General/Fluoroscopy/Angiography / CT or A/E Room rather than one isolated case.

It is envisaged that you will co-ordinate the running of the room in question for either a morning or an afternoon session. The length of time each individual student will be under appraisal conditions will vary. However, the session time should be between 2-3 hours to allow for sufficient variety in workload and departmental procedures.

The idea is that you will take over the role of team leader for that particular room. You will liaise with staff and manage the workload and the staff working in the room, to ensure the smooth running of the room. You will be required to make decisions and liaise with staff whilst following normal working procedures.

The guidelines as to what type of room should be used will be deliberately vague to allow for departmental variation.It is envisaged that there be a minimum of 2 staff working there, (1 of these staff can be the student). You should undertake the examinations of some but not all of the patients that are imaged during the session.

Assessment Forms

The front sheet of this appraisal form (L3/Man/1) records the general particulars for the appraisal and the pre-requisite objectives.

Form L3/Man/2 is specific to the sessional appraisal and should be marked as per marking criteria depending on overall performance.

Form L3/Man/3 deals with questions that relate to the patients that are imaged during the session. Failure to carry out any of these tasks will result in an automatic failure. Section 3 is specific to the sessional appraisal and should be marked as outlined in the marking of appraisals section depending on overall sessional performance.

L3/Man/4 is specific to the sessional appraisal and marked as per marking guidelines. There is also a final mark form similar to those used in year 1 and 2 appraisals.

L3/Man/5 and 6 allows the Practice Educator and the student to reflect and comment on the session similar to those used in year 1 and 2.

Clinical Appraisal Level Three- Room Management Session

Name of Hospital…………………………………………………………………….

Name of Practice Educator.……………………………..

Name of Student………………………………….

Please indicate session type: General / Fluoroscopy/ CT/ other……………...

------

Do not proceed with the appraisal if the following pre-requisite has not been met.

Has the student spent a minimum of one week in the area prior to

this appraisal?

------

Session details

Date…………………………………..

Number of patients during assessment session……………………

Range of type of patient………………………………………………

Range of examinations performed during the session………………………

Number of staff in the room………………………………………

Time period under assessment……………………………………

Time started……………………………….. Time finished……………

NB The appraisal can be halted and an automatic failure recorded if: -

a) The Practice Educator deems that the student is committing a dangerous act.

b) If the answer to any question marked * in section 2 is “NO”

YES=1 mark

L3/Man/1

MARKING GUIDE (Using the log book definitions of assisted and unassisted):

F. NON COMPLETION OF THIS TASK * IS DEEMED A DANGEROUS ACT AND IS AN
AUTOMATIC FAILURE OF THIS ASSESSMENT OPPORTUNITY
-5. Not completed (0 where applicable)
1. Required assistance
2. Worked unassisted but lacked proficiency
3. Worked proficiently
Section 1
Prior to the session to what level did the student:-
-5 / 1 / 2 / 3
F
F
TOTAL

a)Prepare the room / area?

b)Prepare the relevant equipment?

c)Check the emergency equipment?

d)Ensure sufficient supply of consumables?

e)Carry out forward planning of the session?

f)Correctly identify the procedures that will be carried out?

g)Wash/gel hands?

L3/Man/2

Section 2
Did the student ensure that the following checks were carried out for the imaging session?

YES=1 mark

NO=Automatic failure

YES / NO
SUB-TOTAL

i)* Possibility of patient pregnancy.

ii)*Request forms were completed in accordance with departmental protocol (E.g. verified by signature)

iii)* Positive identity checks were carried out for all patients

iv)*Examinations were justified with regards to IRMER.

v)* The viewing of previous images or reports were considered (even when images/reports are not available).

Section 3

During the session

To what level did the student :- / -5 / 1 / 2 / 3
Manage the transport of patients
Prioritise duties to be performed
Delegate duties to be performed
Liaise/communicate with other staff
Ensure radiation protection measures were carried out for staff/patients including the use of markers when required. / F
Anticipate any difficulties/problems
Deal with any difficulties
Manage their time
Manage the workload of other staff
Ensure that doses were recorded and monitored
Ensure a high standard of patient care / F
TOTAL

L3/Man/3

Section 4

After the examinations

To what level did the student:- / -5 / 1 / 2 / 3
Ensure patients aftercare
Ensure that the patients knew how to get their results.
Manage patient transport
Ensure correct image post processing and image transfer.
Ensure the room and equipment was cleaned in accordance with infection control protocols.
TOTAL

APPRAISAL SCORE

PASS MARK = 70% = 52/74

Section number / 1 / 2 / 3 / 4
SCORE / 21 / 5 / 33 / 15
TOTAL SCORE

APPRAISAL SCORE %

[Total / 74 X 100]

/ 74

L3/Man/4

Evaluation and Feedback

Practice Educator’s feedback on student’s overall performance (including areas for development and relevant details of patient condition)

Practice Educator’s signature...... Date......

Practice Educator’s name……………......

L3/Man5

Student’s comments and reflection on appraisal performance

Student’s signature… ……………………………. Date…………….

L3/Man/6

Theatre Case

The rationale behind this appraisal is to assess your performance as a radiographer undertaking a theatre case.

You will be required to make decisions and liaise with other theatre staff whilst following normal working procedures.

Obviously this appraisal will be very difficult to standardise throughout the region, however, it is envisaged that the case will relate to an operation done in an operating theatre under sterile conditions, requiring screening using an Image Intensifier in two planes. Examples of suitable cases include: Dynamic Hip Screw, operative cholecystography, any plate/pinning procedure.

.

Assessment Forms

The front sheet of this appraisal form (L3/Theatre/1) records the general particulars for the appraisal and the pre-requisite objectives. The “Bail Option” is there to allow the Practice Educator to take over the procedure from you if they consider it necessary as a result of factors outside your control. You will not be penalised if this happens.

Form L3/Theatre/2 relate to the general elements of the appraisal including preparation of the equipment and patient prior to imaging. It also has the mandatory questions, which carry an automatic failure if the tasks are not completed correctly. This is similar to those in the 1st and 2nd years.

Form L3/Theatre/3 allows the Practice Educator to rate your performance in section 3 during the operation. Sterile conditions relate to the observation and maintenance of any sterile field determined by the surgeon or other theatre staff and your ability to manoeuvre radiographic equipment safely in that environment. The marks awarded follow the format outlined in the “marking of appraisal guidelines”.

Form L3/Theatre/4, section 4, allows for the assessment of your actions after the operation. The final marking grid is also on this page

L3/Theatre/5. This is similar to those used in year 1 and 2 appraisals, and allows the Practice Educator and the student to comment on the session. The Practice Educator is encouraged to feedback on the quality of the resultant images.

Clinical Appraisal Level Three – Theatre case

NB. This assessment must be conducted on a single theatre case, which is performed under sterile conditions using an Image Intensifier

Name of Hospital……………………………………………………………………

Name of Practice Educator………………………………

Name of Student…………………………………

Do not proceed with the appraisal if the following pre-requisite has not been met