ASSESSMENT OF THE PERSPECTIVE AND ATTITUDE OF RADIOLOGY STAFF TO RADIOGRAPHY STUDENTS FOR CLINICAL TRAINING IN THE RADIOLOGY DEPARTMENT (A CASE STUDY OF UNTH, ESUTH AND NOHE)

 

CHAPTER 1

INTRODUCTION

When allied health students complete an educational program, a vital component of that education occurs in a clinical setting.  “A clinical component of education is essential for students pursuing careers as health care providers… Clinical education provides an integral experience for students to apply, develop, and extend their knowledge and skills from their classroom and lab experiences” (Fortsch, 2007, p. 1).

In the clinical setting, the students put theory into practice.  Students get an opportunity to practice didactic theories and concepts using scenarios in supervised lab settings or on real patients in real clinical settings (Fortsch, 2007; Giordano, 2008; Giordano & Harris, 2012; Hart, 2009).  The clinical setting supplements the classroom educational experience (Giordano &

Harris, 2012).

All Joint Review Committee on Education in Radiologic Technology (JRCERT) accredited radiologic technology programs must provide a clinical component in the educational curriculum and follow the curriculum guidelines as set forth by the American Society of Radiologic Technologists (ASRT) (JRCERT, 2010).  The ASRT curriculum requires that students are instructed in “…the essential clinical skills that employers expect of graduates…” (American Society of Radiologic Technologists, 2012, p. 3).  ASRT (2012) states the design of the clinical experiences of radiography students should:

…sequentially develop, apply, critically analyze, integrate, synthesize and evaluate concepts and theories in the performance of radiologic procedures.  Through structured, sequential, competency-based clinical assignments, concepts of team practice, patientcentered clinical practice and professional development are discussed, examined and evaluated. (p.6)

Graduates of a JRCERT accredited program are encouraged to take the licensing examination as administered by the American Registry of Radiologic Technologists (ARRT).  Before graduates can take the ARRT examination in Radiography, they must fulfill certain didactic educational requirements, clinical competencies, and patient care tasks and must adhere to the ARRT standards of ethics (ARRT, 2014d).  The educational requirements include completing a JRCERT accredited program and studying topics of radiation protection, equipment operation and quality control, imaging procedures, patient care and education, and image acquisition and evaluation (ARRT, 2010a). The clinical competencies include a list of six specific patient care tasks, 46 total imaging procedures as a combination of 31 mandatory examinations and 15 electives from a list of 35, one elective head procedure, and two elective fluoroscopy procedures (ARRT, 2010b).

As the students enter the clinical educational portion of their curriculum, they will work with and learn from various members of the imaging team in the respective clinical facility (Campos, 2013).   Campos (2013) described students working with clinical instructors (CIs) as well as clinical staff (CS) in the clinical setting.  The program’s clinical coordinator (CC) will coordinate and evaluate the clinical materials as well as connect the clinical materials to didactic competencies (JRCERT, 2010).  The program director (PD) oversees the entire process (JRCERT, 2010).  The program director must also safeguard that the CIs are educating and assessing the students’ clinical performance effectively (Giordano, 2008).

The CI is a vital component of the clinical education process (Campos, 2013; Fortsch,

2007; Giordano & Harris, 2012; Ingrassia, 2011).  The CI is usually an expert practitioner in his or her field (Campos, 2013; McLeod et al., 2009).  Although CIs display competence in the practice of their craft, that competence does not automatically transfer to the area of clinical instruction.  “A unique aspect of teaching radiologic sciences is the need to be didactically and clinically proficient” (Giordano, 2004, p. 471).  McLeod et al. (2009) described clinical instructors as having practical “how to do it’ knowledge of teaching but few understand the basic principles, theories and concepts of the teaching and learning process or the ‘why’ of pedagogic behaviours” (p. 117).  Giordano (2008) described how oftentimes clinical instructors mold their own teaching style and activities after their experiences as students because most CIs obtain little formal preparation on effective instruction which could explain why Giordano and Harris (2012) found variations that exist in clinical instructors’ effectiveness from facility to facility.  McLeod et al. (2009) indicated that CIs believe that gaining an understanding of pedagogical principles would enhance instructional effectiveness.

Fortsch (2007) recommended future research using a qualitative study of technologists and clinical instructors’ educational preparation and professional experience related to instructing radiography students in the clinical setting. “Do they have the necessary skills and knowledge to facilitate student supervision, instruction, and evaluation while balancing patient care and negotiating interpersonal relationships? … Knowing more about students, faculty, clinical instructors, and technologists will help identify potential barriers to the learning process” (Fortsch, 2007, p. 227).

Statement of the Problem

Radiologic technologists who transition into the role of clinical instructors are usually expert practitioners but may lack knowledge of best practices regarding student instruction and evaluation.

Purpose of the Study

The purpose of this study was to investigate how CIs experience the transition from practitioner to educator and what knowledge or education of best practices of instruction and evaluation they bring to the position.

Research Questions

1. How are CIs prepared for their role as a radiography clinical instructor?
2. What experiences or education has provided CIs with the necessary skills, expertise, and knowledge of best practices to instruct and evaluate students?
3. What do the CIs perceive would adequately prepare someone to transition from registered radiologic technologist to radiography clinical instructor?

Significance of the Study

The information obtained from this study will improve orientation and training programs for CIs, thereby better preparing new CIs in the areas of student instruction and evaluation.

Limitations and Delimitation

This study is limited by the following:

1. Participants of this study were a sample of convenience and only represent clinical instruction in one community college radiography program in the southeast.
2. Results of this particular study may not be transferrable to other geographic regions.
3. The responses were collected during one interview session per participant and only represent participants’ perceptions at that snapshot in time.

This study was delimited to clinical instructors practicing at affiliated clinical facilities in one community college associate degree radiography program.  To be included in the study, the participants must be registered radiologic technologists by the American Registry of Radiologic

Technologists (ARRT) and recognized as a current clinical instructor by the Joint Review

Committee on Education in Radiologic Technology (JRCERT).

The researcher assumed that all participants understood the significance of the study and the interview questions.  The researcher also assumed that the participants answered openly and honestly to all questions presented.

Definitions of Terms

For the purpose of this study, the following terms are defined as follows:

Accreditation:assures students and graduates that an accredited educational program will “…provide them with the requisite knowledge, skills, and values to competently perform the range of professional responsibilities expected by potential employers nationwide… requires programs to teach the entire curriculum developed by the … American Society of Radiologic

Technologists” (JRCERT, 2014a, para. 1)

American Registry of Radiologic Technology (ARRT): “…the world’s largest credentialing organization that seeks to ensure high quality patient care in medical imaging….  We test and certify technologists and administer continuing education and ethics requirements for their annual registration” (American Registry of Radiologic Technologists, 2014a, para. 1). American Society of Radiologic Technologists (ASRT): “…the premier professional association of people working in medical imaging and radiation therapy” (American Society of Radiologic

Technologists, 2013b, para. 1).

Clinical Coordinator (CC):  Someone who “correlates clinical education with didactic education, evaluates students, participates in didactic and/or clinical instruction, supports the program director to help assure effective program operation, coordinates clinical education and evaluates its effectiveness” (JRCERT, 2010, p. 43).

Clinical Facility (also referred to as Clinical Setting):  A JRCERT approved clinical educational site for an accredited Radiography program.  For this study, the facilities were all hospital settings.

Clinical Instructor (CI): An ARRT registered radiologic technologist with at least two years of experience and recognized by the JRCERT as an instructor in the clinical setting for student radiographers currently enrolled in an accredited educational program in Radiography or Radiologic Technology.

Clinical Staff (CS):  Any ARRT registered radiologic technologist employed by a JRCERT approved clinical facility affiliate with an accredited radiography or radiologic technology program who works directly with the students of that educational program within the clinical educational experience to perform some instruction and complete competency evaluations of students as they perform the day-to-day patient care and radiographic procedure requirements of their employment.

Joint Review Committee on Education in Radiologic Technology (JRCERT): “The JRCERT is the only agency recognized by the Nigeria Department of Education (USDE) and the Council for Higher Education Accreditation (CHEA), for the accreditation of traditional and distance delivery educational programs in radiography, radiation therapy, magnetic resonance, and medical dosimetry” (Joint Review Committee on Education in Radiologic Technology, 2014b, para. 1).

Program Director (PD):  “Assures effective program operations, oversees ongoing program assessment, participates in budget planning, maintains current knowledge of the professional discipline and educational methodologies through continuing professional development, and assumes the leadership role in the continued development of the program” (JRCERT, 2010, p.

43).

Registered Technologist (Radiography) (RT(R)):A “…designation of individuals who have completed the prescribed classroom and clinical education, passed the appropriate exam, and met the ethics requirements” for Radiographers (American Registry of Radiologic Technologists,

2014b, “And ARRT-registered R.T.s,” para. 2).

 

ASSESSMENT OF THE PERSPECTIVE AND ATTITUDE OF RADIOLOGY STAFF TO RADIOGRAPHY STUDENTS FOR CLINICAL TRAINING IN THE RADIOLOGY DEPARTMENT (A CASE STUDY OF UNTH, ESUTH AND NOHE)

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