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Practice Foundations (M1)

Module description

*Please note that Degree Apprenticeship programmes have variable start dates and modules are taught across the full year.

This module provides a practical learning environment in which you will apply theory in practice. In this module you will experience clinical and technical aspects involved in a range of modalities including both ionising and non-ionising radiation. You will learn about safe practice and the use of contrast media in these areas. You will also learn about common pathologies encountered in the clinical environment and the relative roles of the various modalities for demonstrating these conditions.

The module commences with an attendance block at the University of Exeter with an emphasis on face-to-face learning. The module then runs over a 12 month period with two further block attendances across the year for further face-to-face learning. In the non-block weeks there will be protected ‘off the job’ learning (one day (7.5 hours) per week) supported by e-learning materials provided by the academic team. The full calendar of activities and assessment will be made available via the handbook. Annual leave may be booked in accordance with the requirements laid out in the handbook.

Module aims - intentions of the module

The aim of this work-based module is to enable you to develop knowledge of the essential applied science and technology that underpins medical imaging modalities in the practice setting.

This work based module provides practical experiences that will directly support the further development of your underpinning knowledge base. You will apply the theoretical knowledge you are gaining in RADM101DA and RADM102DA within the practice setting. You will apply the physics knowledge so as to understand the wide range of modalities used in medical imaging, including equipment and room design and safe practice. You will learn how quality assurance processes are used to ensure safe practice. You will apply your knowledge of pathology to identify common abnormalities on medical images and will gain understanding of comparative imaging. 

Intended Learning Outcomes (ILOs)

ILO: Module-specific skills

On successfully completing the module you will be able to...

• 1. Evaluate and explain systems and processes in place to ensure acceptably functioning equipment and quality management in imaging departments
• 2. Evaluate and explain equipment design and room layout for general radiography, fluoroscopy, DXA, dental, mammography, MRI, RNI, US, CT
• 3. Evaluate and explain the scope of applications, constraints, and legislative framework for the use of both ionising and non-ionising radiation in medicine
• 4. Identify normal, developmental and anatomical variant anatomy on medical images and demonstrate understanding of how image appearances influence the patient pathway for common pathologies and foreign objects (implanted devices and foreign bodies) and how to escalate in case of unexpected findings
• 5. Evaluate and explain how to adapt level of patient care to patient need, including assessment of patient, and providing information at an appropriate level in a suitable format

ILO: Discipline-specific skills

On successfully completing the module you will be able to...

• 6. Demonstrate ability to further develop skills and knowledge by reflecting on clinical experience and identify strengths and areas for further learning
• 7. Use patient records from a range of sources to ensure appropriate choice of imaging

ILO: Personal and key skills

On successfully completing the module you will be able to...

• 8. Contribute positively to the placement department, working in partnership with service users, work effectively with other professions and professionals, support staff and others, ensure effective management of caseload and resources
• 9. Practice within limits of own competence seeking advice as appropriate, accepting responsibility for decisions made
• 10. Solve problems using knowledge, experience and personal initiative

Syllabus plan

Whilst the module’s precise content may vary from year to year, an example of an overall structure is as follows:

It is expected that apprentices will undertake basic life support, manual handling, fire safety and other annual Trust requirements as part of their employment contract, and as such these requirements are not, therefore, stipulated here. As a condition of employment, apprentices must abide by their employers’ policies and procedures and as such this is not stipulated within the syllabus.

QUALITY MANAGEMENT
• QA tests typically undertaken in medical imaging departments
• Recognise when x-imaging equipment is not functioning accurately / within specification and take appropriate action
• Role of audit and review in quality management including appropriate outcome measures
• Participate in departmental audit and review (quality management)
• Participate in reject analysis

EQUIPMENT AND TECHNOLOGY
• Techniques and equipment used in basic level x-radiography and fluoroscopy
• Techniques and equipment used in image formation, including the basis of exposure factor selection (kVp, mA, mAs, and collimation) and image optimisation
• Room and equipment design in relation to radiation protection

SCOPE OF APPLICATIONS AND RADIATION PROTECTION
• Scope of use of general x-radiography and fluoroscopy including impact of imaging on patient care and treatment
• Local and national imaging policies and procedures relating to general x-radiography and fluoroscopy
• Legislative framework and local rules for safe working with ionising radiation as applied in the practice setting
• The role of the radiographer in relation to radiation protection of self, patients and other personnel
• Constraints placed upon practice to ensure optimal use of ionising radiation
• Personnel monitoring
• Lead protection – design, uses, quality assurance

2D techniques – range of techniques, advantages, limitations, relative role and basic image evaluation
• Dual energy x-ray absorption (DXA)
• Fluoroscopy
• Mammography
• Dental
• Interventional including treatment

3D techniques (ionising) – range of techniques, advantages, limitations, relative role and basic image evaluation
• Computed Tomography (CT)

Other modalities - range of techniques, advantages, limitations, relative role and basic image evaluation
• Radionuclide Imaging (RNI), 2D, 3D
• Positron Emission Tomography (+/- CT)
• Ultrasound
• Magnetic Resonance Imaging (MRI)

RADIATION PROTECTION AND SAFETY IN IMAGING MODALTIES
• Potential hazards and the design, systems and governance in practice for safe working in all imaging modalities

RADIOGRAPHIC ANATOMY
Normal human anatomy as demonstrated on medical images:
• Axial skeleton: joints, associated musculature and other tissues
• Appendicular skeleton: joints, associated musculature and other tissues
• Head, thorax and abdomen: principal internal organs and associated structures
• Evaluation and assessment of images
Development and change of normal human anatomy as demonstrated on medical images:
• Axial skeleton
• Appendicular skeleton
Anatomical variations of human anatomy as demonstrated on medical images:
• Axial skeleton: joints, associated musculature and other tissues
• Appendicular skeleton: joints, associated musculature and other tissues
• Head, thorax and abdomen: principal internal organs and associated structures

RADIOGRAPHIC PATHOLOGY
• Identify common pathologies on medical images found in practice
• Patient pathway in relation to common pathologies and foreign objects (implanted devices and foreign bodies) found on medical images in practice e.g. clinical indications, associated complications, cause of image appearances, typical treatments
• Relative role of modalities in relation to common pathologies and foreign objects (implanted devices and foreign bodies) found on medical images in practice
• Under guidance, undertake and record patient assessment when appropriate (undertaking observations, applying national early warning score systems, escalating concerns as appropriate)
• Effective communication in practice
• Dementia, LDA and autism awareness
• Process for escalation in case of unexpected findings

PATIENT CARE
• Undertake and record patient assessment
• Prepare and provide information about medical imaging procedures, in a range of formats, appropriate to the needs of a diverse patient population

CONTINUING PROFESSIONAL DEVELOPMENT
• Reflection on clinical experience and identifying personal strengths and areas for further learning.
• Reflection on own impact on others
• Begin a personal and professional portfolio as a basis for future CPD

INFORMATON AND COMMUNICATION TECHNOLOGIES
• Information and communication technologies available to view images, retrieve and record patient information
• Patient history retrieval from a range of software applications and paper records (clinical records, prior imaging, test results and dose records) to ensure appropriate choice of imaging

PROFESSIONALISM
• Work in partnership with service users
• Work effectively with other professions and professionals, support staff and others

SCOPE OF PRACTICE
• Practice within limits of own practice
• Seek advice as appropriate

PROBLEM SOLVING SKILLS
• Justification of decisions taken in relation whether to initiate, continue, modify or cease medical imaging examinations
• Resolution of problems by using knowledge, experience and personal initiative - under guidance

Learning activities and teaching methods (given in hours of study time)

Details of learning activities and teaching methods

Formative assessment

Summative assessment (% of credit)

Details of summative assessment

Details of re-assessment (where required by referral or deferral)

Re-assessment notes

All assessment components must be passed at 50% or above.  Each component of this module must be passed. Reassessment should be of the original assessment with additional preparation made to bring performance up to passing standard. The referred assessment will be capped at the pass mark. The module mark will not be capped. If any component is not passed at the final referral attempt, the module is capped at 49%.

This programme runs to a non-standard timetable; assessment weeks and Assessment, Progression & Awarding Committees (APACs) for both initial and deferred assessments are held as per the programme’s published timetable.  

Apprentices who are referred / defer the assessment for this module may be permitted to progress onto the next year of the programme but must achieve the credits for this module at the referred exam board in order to remain on the programme. 

Indicative learning resources - Basic reading

• Carlton R.R. and Adler A.M. (2013), Radiographic Imaging Concepts and Principles (5^th edition), Delmar, ISBN 1473720524
• Graham D.T., Cloke P. and Vosper M. (2012), Principles and Applications of Radiological Physics (6^th edition), Churchill Livingstone, ISBN 9780702052156 electronic version also available
• McQuillen Marten (2019) Radiographic Image Analysis 5^th edition ISBN 978-0-323-52281-6
• McQuillen Marten (2019) Radiographic Image Analysis workbook ISBN 978-0-323-54463-4

ELE – College to provide hyperlink to appropriate pages

Indicative learning resources - Web based and electronic resources

• UK Statutory Instruments (2017), Ionising Radiation Regulations 2017, The Stationary Office, Available from https://www.legislation.gov.uk/uksi/2017/1075/contents/made
  
• UK Statutory Instruments (2017), The Ionising Radiation (Medical Exposure) Regulations 2017, The Stationery Office, Available from http://www.legislation.gov.uk/uksi/2017/1322/made
• UK Statutory Instruments (2018), The Ionising Radiation (Medical Exposure) (Amendment) Regulations 2018, The Stationary Office, Available from http://www.legislation.gov.uk/uksi/2018/121/contents/made 
• The Health & Safety Executive (2018), Work with Ionising Radiation. Ionising Radiations Regulations 2017: Approved Code of Practice and Guidance, HSE Books, ISBN 9780717666621

Indicative learning resources - Other resources

• Carter C. and Veale B. (2013), Digital Radiography and PACS (2nd edition), Mosby Elsevier, ISBN 978-0323086448
• Blake G., Wahner H.W. and Fogelman I. (1998), The Evaluation of Osteoporosis: Dual Energy X-ray Absorptiometry in Clinical Practice (2nd edition), CRC Press, ISBN 978-1853174728
• R Kowalczyk N. and Mace J.D. (2017), Radiographic Pathology for Technologists (7th edition), Mosby, ISBN 9780323675765, electronic version also available
• Kim, E. (2012), Handbook of nuclear medicine and molecular imaging: principles and clinical applications, World Scientific, ISBN 9789814366236
• Kremkau F.W. (2016), Sonography: Principles and Instruments (9th edition), Saunders, ISBN 978-0323322713
• McRobbie D.W. et al. (2017), MRI from Picture to Proton (3rd edition), Cambridge University Press, ISBN 9781107706958
• Powsner R.A. Palmer M.R. and Powsner E.R (2013), Essentials of Nuclear Medicine Physics (3rd edition)., Wiley Blackwell,  ISBN 978-0470905500
• Society and College of Radiographers (2019), Safety in Magnetic Resonance Imaging, Society and College of Radiographers, ISBN 978-1-909802-31-5
• Westbrook C. (2018), MRI in Practice (5th edition), Wiley Blackwell, ISBN 978-1-119-39196-8
• Johns C. (2013), Becoming a Reflective Practitioner (4th edition), Wiley-Blackwell, ISBN 9780470674260
• Code of Professional Conduct, College of Radiographers (2013), Society and College of Radiographers, https://www.sor.org/  
• Principles for continuing professional development and lifelong learning in health and social care, Society and College of Radiographers, https://www.sor.org/
• The Scope of Practice 2013, Society and College of Radiographers, https://www.sor.org/
• Obtaining consent: a clinical guideline for the diagnostic imaging and radiotherapy workforce,  Society and College of Radiographers, https://www.sor.org/  
• Guidance on mental capacity decisions in diagnostic imaging and radiotherapy, Society and College of Radiographers https://www.sor.org/ 

Key words search

Medical Imaging, Image, Procedures, Interventional, Radiology, Control, Qualities, Detail, Interpretations, Technology. MRI US RNI