Standards applied to clinical practice

The Standards are the foundation of the JRCERT mission to promote excellence in education and enhance the quality and safety of patient care through the accreditation of educational programs. Program compliance with the Standards is an important component in achieving the JRCERT mission. However, program compliance depends on both academic and clinical activities. By becoming aware of and following JRCERT Standards, clinical education settings and their employees will contribute greatly to achieving the excellence in education that leads to good and safe patient care.     

Planning for the future

Revising the strategic plan was the beginning of a multiyear initiative that will determine the path of the JRCERT. The key word in the preceding statement is beginning. The strategic plan is an ever-changing document. Although some components, such as the values statements, will stand over time, other components will change as accreditation and educational arenas change. That is the paradox of strategic planning: Remaining true to the vision, values and mission statements requires knowing when to change to keep the JRCERT aligned with the responsive to its communities of interest.     

Teaching technology to technologists

CONTEXT: The field of radiologic technology is in a transition period between the traditional film-based model and the digital-based model. OBJECTIVE: To determine the extent to which educational programs accredited by the Joint Review Committee on Education in Radiologic Technology (JRCERT) are providing digital imaging-specific education. METHODS: A survey regarding digital imaging instruction was administered electronically to program directors of 289 JRCERT-accredited educational programs in the United States. RESULTS: One hundred forty-four responses were received, for a response rate of 50%. The survey revealed that the majority of educational programs (73.6%) have added, modified or are already covering digital imaging topics, while other programs (21.5%) were in the planning stages of preparing coursework.     

Program director satisfaction with leadership skills

CONTEXT: Educators in radiologic technology help students mature into health care professionals; however, not all educators receive formal training in education. The majority of radiologic technology educators train first as practitioners and later become educators. OBJECTIVE: Identify areas for professional development and effective methods to learn leadership skills. METHODS: Radiologic technology program directors from Joint Review Committee on Education in Radiologic Technology (JRCERT) accredited programs were surveyed and interviewed to determine their level of satisfaction with their leadership skills. RESULTS: Results indicate program directors are satisfied with most of their leadership skills. Budget and resources, conflict resolution and communication were identified as areas for improvement. Program directors identified workshops and lectures as their preferred method of learning leadership skills. SUMMARY: Program directors need to use a variety of skills for the successful operation of their programs. Even though results from this study indicate that radiologic technology program directors were satisfied overall with their leadership skills, there were areas that could use improvement.     

We will be champions: Leaders' confidence in ‘us’ inspires team members' team confidence and performance

The present research examines the impact of leaders' confidence in their team on the team confidence and performance of their teammates. In an experiment involving newly assembled soccer teams, we manipulated the team confidence expressed by the team leader (high vs neutral vs low) and assessed team members' responses and performance as they unfolded during a competition (i.e., in a first baseline session and a second test session). Our findings pointed to team confidence contagion such that when the leader had expressed high (rather than neutral or low) team confidence, team members perceived their team to be more efficacious and were more confident in the team's ability to win. Moreover, leaders' team confidence affected individual and team performance such that teams led by a highly confident leader performed better than those led by a less confident leader. Finally, the results supported a hypothesized mediational model in showing that the effect of leaders' confidence on team members' team confidence and performance was mediated by the leader's perceived identity leadership and members' team identification. In conclusion, the findings of this experiment suggest that leaders' team confidence can enhance members' team confidence and performance by fostering members' identification with the team.     

Imaging Appearances of Congenital Thoracic Lesions Presenting in Adulthood

Many congenital lesions of the thorax are detected for the first time in adulthood when they can simulate a wide range of pathologies, including infection and neoplasia. They can be broadly classified into tracheobronchial, parenchymal, vascular, and combined parenchymal/vascular abnormalities. An awareness of their typical imaging features enables a confident diagnosis and helps direct appropriate patient management.     

Admission requirements for radiography programs

CONTEXT: Radiography program applicants far outnumber available class capacity in many programs. Educational accountability requires that programs justify their admission practices, work to retain all qualified students and evaluate their attrition rates. Thus, radiography programs are interested in identifying the best candidates for admission. PURPOSE: The purpose of this small survey study was to document admission requirements of entry-level programs in radiography accredited by the Joint Review Committee on Education in Radiologic Technology (JRCERT) in Oklahoma and Texas. METHODS: A 14-question survey was sent to 45 JRCERT-accredited entry-level radiography programs in Oklahoma and Texas. The survey included questions concerning program demographics, admission criteria and admission practices. RESULTS: Cumulative grade point average, interviews, successful completion of math and science courses, and performance on standardized tests were the most commonly used admission criteria, although no criteria were used by all of the programs surveyed. CONCLUSION: The current study is the first step toward identifying the most effective admission criteria for radiography programs. Future research should examine the correlation of specific admission criteria with program success (ie, program retention, program completion and professional certification).     

Painful sclerosis of the medial end of the clavicle

Pain and swelling of the medial end of the clavicle may be associated with radiographic sclerosis. The commonest causes are osteoarthritis, infection and condensing osteitis of the clavicle. Distinguishing between these clinically and radiologically can be difficult but computed tomography (CT) and magnetic resonance imaging (MRI) are often useful for their differentiation. In this review, the typical imaging features of these conditions are presented with an emphasis on the CT and MRI appearances. These are correlated with clinical features, which together should enable a confident diagnosis to be made.     

Renal angiomyolipoma: typical and atypical features

Renal angiomyolipoma is an uncommon lesion, well-known to the radiologists as one of the few lesions for which a specific diagnosis can be achieved on the basis of radiological findings. It contains variable amounts of adipose tissue, smooth muscle and vessels. It usually grows as single lesion, and it can be isolated or associated with tuberous sclerosis or with the more rare lymphangioleiomyomatosis. From a radiological point of view there are typical aspects that allow a confident diagnosis, whereas more rarely there are atypical aspects that make the diagnosis more controversial. In this review the clinical, macro and microscopic morphological aspects of angiomyolipoma are presented as well as the therapeutic approaches that can be adopted in different circumstances. The most frequent and the atypical characteristics that can be appreciated with diagnostic imaging are described as well.     

Hypersensitivity pneumonitis: patterns on high-resolution CT

Hypersensitivity pneumonitis, also known as extrinsic allergic alveolitis, is caused by inhalation of specific environmental organic antigens. This disease may have typical high-resolution CT findings that, in the appropriate clinical setting, can be sufficiently characteristic to allow a confident diagnosis without the need for a lung biopsy. In this pictorial essay, the high-resolution CT patterns of hypersensitivity pneumonitis are illustrated. The authors emphasize the correlation among the radiologic presentation, functional abnormalities, and pathologic findings.     

Sternberg双重任务测验效度检验及文化因素影响分析

探讨Ｓｔｅｒｎｂｅｒｇ双重任务测验对飞行能力的评价意义及不同教育程度对评价效果的影响，为航天员心理选拔研究提供有效的指标，１１２名现役歼击机，强击机，运输机及轰炸机飞行员，完成Ｓｔｅｒｎｂｅｒｇ双重任务测验和飞行技术水平多效标系统评价。结果显示：Ｓｔｅｒｎｂｅｒｇ双重任务测验主要用于评价飞行员快速反应能力和实际操纵能力，在评价时效考虑年龄和文化程度因素的影响，尤其是歼击机，强击机飞行员，结论：Ｓｔ     

An integrated model of learning

Worldwide, most educational systems are based on three levels of education that utilize the pedagogical approaches to learning. In the 1960s, scholars formulated another approach to education that has become known as andragogy and has been applied to adult education. Several innovative scholars have seen how andragogy can be applied to teaching children. As a result, both andragogy and pedagogy are viewed as the opposite ends of the educational spectrum. Both of these approaches have a place and function within the modern educational framework. If one assumes that the goal of education is for the acquisition and application of knowledge, then both of these approaches can be used effectively for the attainment of that goal. In order to utilize these approaches effectively, an integrated model of learning has been developed that consists of initial teaching and exploratory learning phases. This model has both the directive and flexible qualities found in the theories of pedagogy and andragogy. With careful consideration and analysis this educational model can be utilized effectively within most educational systems.     

Use of hearing protection on military operations

Noise Induced Hearing Loss (NIHL) continues to be a significant source of morbidity for UK service personnel. The Personal Interfaced Hearing Protection (PIHP) system was procured as an Urgent Operational Requirement primarily to provide a connection to the Personal Role Radio. Through its custom- mould design it was also expected to act as Personal Protective Equipment (PPE) against NIHL in a method that had not been possible previously. The aim of this paper was to evaluate user opinion of the four current methods of hearing protection including PIHP. 108 service personnel serving in a Forward Operating Base in Afghanistan were questioned anonymously using a paper-based questionnaire. The response rate was 78%, reflecting the difficulties in anonymous data collection in an environment such as this. PIHP was perceived to be more practical for use on the ranges or patrolling than the standard methods of hearing protection. Although only 4% were routinely wearing PIHP on patrol, this was related to understandable reluctance in wearing a new system that had only been issued immediately prior to this deployment. Early design problems highlighted by our study, such as changes in the design of the ear-piece to improve retention, have already been implemented. Compliance will be improved through a dedicated educational programme to explain its relevance. Despite the logistical difficulties in providing custom- made ear moulds, the PIHP system must be delivered to all service personnel early in their career so they are confident in its use long before operational deployment. Future research is required to ascertain the effectiveness of PIHP as a method of PPE in reducing the incidence of NIHL.     

The injured child

Pre-hospital immediate care for seriously injured children is rarely required, but when it is, the response must be prompt and effective. The key to an effective and confident approach to injured children lies in understanding the age related anatomical and physiological differences between adults and children. These differences are most exaggerated in the first few years of life and excellent training courses and materials are available to help practitioners develop their confidence and skills in this age group. An easy to use length based aide memoire and a set of equipment packed according to size are essential to ensure safe management in the pre-hospital environment. Care of the seriously ill child, emergency childbirth and neonatal resuscitation are beyond the scope of this article. Nonetheless, pre-hospital practitioners should develop an understanding of assessment of ill children and normal delivery and be prepared to assist with emergency childbirth and neonatal resuscitation. Excellent educational material, courses and web based resources are available to achieve this (54). This is the sixth article in the add on series in pre-hospital care. The series is edited by Maj R Mackenzie. Maj RC Sutcliffe is a general practitioner and regimental medical officer. Maj R Mackenzie is a Specialist Registrar in Accident and Emergency Medicine and an immediate care doctor. While every effort has been made to ensure correct drug dosages are quoted, readers should always check these before use.     

Practical solutions for staff recruitment & retention

There are three essential topics for radiology managers to consider in light of persistent staffing shortages: support of the profession and educational programs, perks as recruitment tools and incentives as retention tools. Some activities that can help support departments and educational programs for radiologic technologists are job shadowing, training for volunteer services, advanced placement for school applicants, sponsoring an educational program or clinical training site, creating a positive work environment and supporting outreach projects geared to local high schools. Traditional perks used in recruitment efforts have included relocation assistance, travel and lodging expenses during the interview process, loan repayment, scholarships and sign-on bonuses. Some common incentives for retaining employees are tuition reimbursement, cross training, availability of educational resources, continuing education opportunities, professional development and incremental increases in salary. There are many other tools that can be used, such as career ladders, creating an environment conducive to teamwork or a more personal atmosphere and showcasing talents of various staff members. There is much overlap among these suggestions in support of the profession and educational programs, recruitment and retention of qualified staff radiologic technologists. Radiology managers can and should be creative in developing different programs to build loyalty and commitment to a radiology department.     

Visual detection of commencement of aircraft takeoff runs

Among other things, airport control towers should be sited so that controllers can readily detect whether an aircraft cleared for takeoff has commenced its takeoff run. The detection of movement is not well enough understood to enable confident prediction that a particular site for a tower will enable commencement of takeoff run to be easily observed. A field study was undertaken to establish detection times for commencement of takeoff run by groups of trained and trainee air traffic controllers and untrained observers. It was found that the mean response of observers occurs when the aircraft is displaced about 5' of arc, a value essentially independent of observer experience, observation distance, aircraft velocity, and the clarity with which the aircraft can be seen. Binoculars reduce the mean response time and response variability, although not as much as might be expected. Domains within which control towers can be located to enable detection of takeoff runs within 2 s and 4 s are defined.     

The changes seen on high-resolution ultrasound in orchitis

Orchitis and epididymitis are increasingly common lesions encountered in general practice. The clinical diagnosis of inflammation of the testis can be difficult as 10% of neoplasms present acutely with features of inflammation or torsion. The radiological diagnosis is also difficult as the changes seen on ultrasound, whether diffuse or focal, acute or chronic, have to be differentiated from the changes seen with tumours of the testis. The purpose of this review is to describe and illustrate the evolving changes seen in orchitis with reference to the anatomy and pathophysiology of testicular inflammation. We hope that recognition of this pattern may lead to a more confident diagnosis and appropriate management decisions.     

Diagnostic accuracy of thin-section CT and chest radiography of pediatric interstitial lung disease

OBJECTIVE: We assessed the accuracy of thin-section CT and chest radiography to diagnose pediatric interstitial lung disease. MATERIALS AND METHODS: We identified 20 infants, boys, and girls (age range, 1 month to 14 years) with histopathologic confirmation of interstitial lung disease. Six boys and girls without interstitial lung disease were also included. Two observers independently assessed chest radiograph and CT images. The observers stated the most likely diagnosis and a differential diagnosis. We evaluated individual CT features and their distribution. RESULTS: Observers' diagnoses on CT images were correct (first choice or differential) in 66% of observations versus 45% on chest radiographs (p < 0.025). Correct diagnoses were made on first choice in 61% of CT observations versus 34% on chest radiographs (p < 0.005). Observers were confident (versus uncertain) in 42% of the CT observations versus 18% on chest radiographs; of the confident diagnoses made on CT, 91% were correct. CT interpretations were most accurate in the diagnosis of pulmonary alveolar proteinosis, congenital lymphangiectasia, and idiopathic pulmonary hemosiderosis. All healthy patients examined with CT were correctly identified as such. We noted a distinctive CT pattern in three patients with nonspecific interstitial pneumonitis and one patient with desquamative interstitial pneumonitis; the CT pattern consisted of upper zone predominant honeycombing on a background of ground-glass attenuation. CONCLUSION: A higher proportion of pediatric interstitial lung diseases can be diagnosed on thin-section CT than on chest radiographs. In our study, confident and correct diagnoses were made more frequently with CT than with chest radiographs.     

The impact of COVID-19 upon student radiographers and clinical training

IntroductionTo investigate student clinical placement concerns and opinions, during the initial COVID-19 pandemic outbreak and to inform educational institution support planning.MethodsBetween mid-June to mid-July 2020, educational institutions from 12 countries were invited to participate in an online survey designed to gain student radiographer opinion from a wide geographical spread and countries with varying levels of COVID-19 cases.Results1277 respondents participated, of these 592 had completed clinical placements during January to June 2020. Accommodation and cohabiting risks were identified as challenging, as was isolation from family, travel to clinical placements, and to a lesser extent childcare. Students stated they had been affected by the feeling of isolation and concerns about the virus whilst on placement. Overall 35.4% of all respondents were ‘Not at all worried’ about being a radiographer, however, 64.6% expressed varying levels of concern and individual domestic or health situations significantly impacted responses (p ≤ 0.05). Year 4 students and recent graduates were significantly more likely to be ‘Not worried at all’ compared to Year 2 and 3 students (p ≤ 0.05). The need for improved communication regarding clinical placements scheduling was identified as almost 50% of students on clinical placements between January to June 2020 identified the completion of assessments as challenging. Furthermore, only 66% of respondents with COVID-19 imaging experience stated being confident with personal protective equipment (PPE) use.ConclusionStudent radiographers identified key challenges which require consideration to ensure appropriate measures are in place to support their ongoing needs. Importantly PPE training is required before placement regardless of prior COVID-19 imaging experience.Implications for practiceAs the next academic year commences, the study findings identify important matters to be considered by education institutions with responsibility for Radiography training and as students commence clinical placements during the on-going global COVID-19 pandemic.     

Landing in netball: effects of taping and bracing the ankle

OBJECTIVES: To investigate the effect of bracing and taping on selected electromyographic, kinematic, and kinetic variables when landing from a jump. METHODS: Fifteen netball players performed a jump, so as to land on their dominant limb on a force plate. Electromyographic activity was recorded from the gastrocnemius, tibialis anterior, and peroneus longus muscles. Subjects were also filmed and measures of rearfoot motion were derived. RESULTS: Significantly less electromyographic activity (p<0.007) was observed from the gastrocnemius and peroneus longus muscle groups when subjects were braced. No other significant electromyographical findings were observed. Peak vertical ground reaction force and time to peak for vertical ground reaction force were not affected by bracing and taping, nor were the rearfoot and Achilles tendon angles at foot strike. CONCLUSIONS: The effect of bracing and taping on the selected biomechanics variables associated with landing was specifically limited to a reduction in muscle action, particularly for the braced condition. Netball players can be confident that the biomechanics of their landing patterns will not be altered whether they choose to wear a brace or tape their ankle joints.