careers in radiologic technology radiologic technologist –radiographer –x-ray technologist...

CAREERS IN RADIOLOGIC CAREERS IN RADIOLOGIC TECHNOLOGYTECHNOLOGY

RADIOLOGIC RADIOLOGIC TECHNOLOGISTTECHNOLOGIST– RADIOGRAPHERRADIOGRAPHER– X-RAY X-RAY

TECHNOLOGISTTECHNOLOGIST

“ “ TECHNICIAN”TECHNICIAN”

RADIOLOGISTRADIOLOGIST

What does aWhat does a Radiologic Radiologic TechnologistTechnologist

do? do?

A “Radiologic Technologist” A “Radiologic Technologist” (or (or RadiographerRadiographer))

medical professionalmedical professional

trained to safely use x-ray radiation to trained to safely use x-ray radiation to image different parts of patients’ bodies image different parts of patients’ bodies

Provide diagnostic images so the Provide diagnostic images so the physician can make a diagnosis physician can make a diagnosis

Medical Radiographer Medical Radiographer (X-ray Technologist)(X-ray Technologist)

use sophisticated imaging equipment to image use sophisticated imaging equipment to image parts of the human bodyparts of the human body challenging fieldchallenging fieldassist physicians by producing images of assist physicians by producing images of diagnostic qualitydiagnostic qualityresponsibility to explain the process to the responsibility to explain the process to the patientspatientsposition them and the equipment correctly position them and the equipment correctly and adhere to the principles of radiation and adhere to the principles of radiation protection. protection. know how to maintain equipment, process know how to maintain equipment, process images and keep patient records. images and keep patient records.

Radiologic TechnologistRadiologic Technologist

R.T.R.T.Dawn Charman, M.Ed., RT (R)(M), CRT(R)(F)Dawn Charman, M.Ed., RT (R)(M), CRT(R)(F)Kelly Clark, M.S.R.T. RT (R)(CT), CRT(R)(F)Kelly Clark, M.S.R.T. RT (R)(CT), CRT(R)(F)Mina Colunga, B.S.R.T. RT (R), CRT(R)(F)Mina Colunga, B.S.R.T. RT (R), CRT(R)(F)

ARRT – R.T.ARRT – R.T.State of California– C.R.T.State of California– C.R.T.

Radiologic TechnologistRadiologic Technologistis a licensed professionalis a licensed professional

This program here is for an entry level into the This program here is for an entry level into the professionprofession

Both Radiation Therapy and Nuclear Medicine would Both Radiation Therapy and Nuclear Medicine would require additional educationrequire additional education

Certification/licensesCertification/licenses

ARRT—ARRT— American Registry of Radiologic American Registry of Radiologic TechnologiesTechnologies– Provides national certificationProvides national certification– After taking the examAfter taking the exam

CRT--CRT-- California Registered TechnologistCalifornia Registered Technologist– After completing ARRT exam you pay a fee and get your After completing ARRT exam you pay a fee and get your

California license to practiceCalifornia license to practice– A separate test is taken for fluoroscopyA separate test is taken for fluoroscopy

Radiologic Technologists All types of EXAMS & PEOPLE

PATIENTS ARE:• INFANTS • ELDERLY• ALL CLASSES• ALL ETHICITY• ALL BACKGROUND

• HEAD TO TOES• TRAUMA• SPECIAL

PROCEDURES• CRITICAL PATIENTS• WALK INS• SURGERY

FIG. 4–2 Radiologic science professionals must use advanced critical thinking skills when handling all patient care situations.

Elsevier items and derived items © 2007, 2003 by Saunders, an imprint of Elsevier Inc.

Radiologic Technologist

•Must be able to COMMUNICATE EFFECTIVELY with

•PATIENTS, STAFF & PEERS

•Must use GOOD JUDGEMENT & CRITICAL THINKING SKILLS

Critical ThinkingCritical Thinking

• Involves sound, professional judgement

• Applied with high ethical standard

• And integrity

Critical ThinkingCritical Thinking

• Analysis

• Synthesis

• Evaluation

• Critique

• Achieved through• Role Playing• Lab experiments• Case Studies

Patient CommunicationPatient Communication

• Interacting with the patient

• Interacting with family and friends

• Methods of Effective Communication

• Age as a factor in Patient Interactions

Communication & AdaptingCommunication & Adaptingto Special Condition Patientsto Special Condition Patients

• Traumatized Patients

• Visually Impaired Patients

• Speech and Hearing Impaired Patients

• Non-English Speaking Patients

• Mentally Impaired Patients

• Substance Abusers

Education in the Radiologic Sciences

DIDACTIC – CurriculumSpecifically describes the objectives What the students will learn ….. Instructional Activities – LECTURE

CLINICAL - HospitalSee and do ….

Types of Types of Diagnostic ExamsDiagnostic Exams

CHESTCHEST

EXTREMITIESEXTREMITIES

SKULL / FACIALSKULL / FACIAL

SPINESPINE

GASTROINTESTINALGASTROINTESTINAL

INTERVENTIONALINTERVENTIONAL

RADIOGRAPHYRADIOGRAPHY

LEARNING

COGNITIVE – thought / knowledge

PSYCHOMOTOR – physical actions

AFFECTIVE – guided by feelings

FIG. 5–1 The articulation of didactic, laboratory, and clinical instruction.

(From Ford C, ed: Clinical education for the allied health professions, St Louis, 1978, Mosby.)

RT ProgramsDidactic and Clinical Education

Some studies of spinal trauma have recorded a missed injury rate as high as 33%.

communitedOpen fracture

ELDERLY

INFANTS & CHILDREN

SURGERY

Fluoroscopy

TECHNOLOGIST

• FLUOROSCOPY

• Dawn Charman RT (R), (F)

• CONTRAST MEDIA (X-RAY DYE)

ARRT Standards ARRT Standards Accrediting AgenciesAccrediting Agencies

Joint Review Committee on Educational Joint Review Committee on Educational Programs in Programs in Nuclear MedicineNuclear Medicine Technology Technology (JRCNMT) (JRCNMT) Committee on Accreditation of Allied Health Committee on Accreditation of Allied Health Education Programs (CAAHEP)  in collaboration Education Programs (CAAHEP)  in collaboration with the Joint Review Committee on Education with the Joint Review Committee on Education in in Diagnostic Medical SonographyDiagnostic Medical Sonography (JRC-DMS) (JRC-DMS) Regional Institutional Accrediting Agencies Regional Institutional Accrediting Agencies (degree-granting divisions) (degree-granting divisions) WSACWSACConjoint Accreditation Services of the Conjoint Accreditation Services of the Canadian Canadian Medical Association Medical Association Australian Australian Institute of Radiography Institute of Radiography

Accrediting AgenciesAccrediting Agencies

SCHOOLS/PROGRAMSSCHOOLS/PROGRAMSJoint Review Committee on Education in Joint Review Committee on Education in Radiologic Technology (JRCERT) Radiologic Technology (JRCERT)

HOSPITAL ACCREDITATIONHOSPITAL ACCREDITATION – – JCAHOJCAHOJoint Commission on Accreditation ofJoint Commission on Accreditation ofHealthcare (Hospital) OrganizationsHealthcare (Hospital) Organizations

“Alphabet Soup”NATIONAL & STATE LICENSES

ARRT = (R.T.)American Registry of Radiologic TechnologyR.T. – Certification in Radiologic Technology

CRT – Certified Radiologic Technology State of California, Dept of Health - Radiation Health Branch– Licensing to practice in California

C.R.T. (R) (F) (M)Radiography, Fluoroscopy, Mammography

5 Primary Exams5 Primary Exams

  Radiography (R)Radiography (R)Nuclear Medicine Technology (NM)Nuclear Medicine Technology (NM)Radiation Therapy (T)Radiation Therapy (T)Sonography (US) (RDMS)Sonography (US) (RDMS)Magnetic Resonance Imaging (MR)Magnetic Resonance Imaging (MR)

candidates must have successfully completed a formal educational candidates must have successfully completed a formal educational program in the respective discipline that is accredited by a mechanism program in the respective discipline that is accredited by a mechanism

acceptable to ARRTacceptable to ARRT..

Post PrimaryPost Primary

Cardiovascular-Cardiovascular-Interventional Interventional Radiography (Note: No Radiography (Note: No longer available for new longer available for new candidates) candidates) Mammography Mammography Computed Tomography Computed Tomography Magnetic Resonance Magnetic Resonance Imaging (Note: Both a Imaging (Note: Both a primary and post-primary primary and post-primary track) track) Quality Management Quality Management

Sonography (Note: Both Sonography (Note: Both a primary and post-a primary and post-primary track) primary track) Bone Densitometry Bone Densitometry Vascular Sonography Vascular Sonography Cardiac-Interventional Cardiac-Interventional Radiography Radiography Vascular-Interventional Vascular-Interventional Radiography Radiography Breast Sonography Breast Sonography Registered Radiologist Registered Radiologist AssistantAssistant

“Alphabet Soup”KNOW THESE!

J.R.C.E.R.T - Joint Review Committee on Education in

Radiologic Technology

J.C.A.H.O – Joint Commission of Accreditation of

Healthcare Organizations

A.R.R.T-American Registry of Radiologic Technologists

Beyond Diagnostic Beyond Diagnostic RadiographyRadiography

Advanced ModalitiesAdvanced Modalities

ADVANCED SKILL LEVELS• CAT SCAN (CT) • MRI (MR)• ANGIOGRAPHY (CIT) (CV)• RADIATION THERAPY (T)• MAMMOGRAPHY (M)• Bone Densitometry (BD)• ULTRASOUND (RDMS)• NUCLEAR MEDICINE(NM)

– PET– SPECT

• MANAGEMENT (BS)• EDUCATION (BS,MEd, PhD EDD)

MAMMOGRAPHY

Dawn Charman, RT (M)

RADIOGRAPHIC IMAGING OF THE

BREAST Dx for breast cancer

Bone Densitometry

“low dose

Radiation”

BONE DENSITOMETRY

• JOE RUIZ, RT (R) (BD)

• POST PRIMARY EXAM BEGAN IN JANUARY 2001

• ??? May also have certification w/o RT ????

• MEASURING MINERAL CONTENT AND DENSITY OF BONES

FIG. 1–7 A nuclear medicine technologist performs procedures requiring the use of radioactive substances.

(Courtesy of Philips Medical Systems.)

CAT SCAN & MRI

Computed Tomography

• Kelly Clark, RT (R) (CT)

• 1995 began post primary exam

FIG. 1–9 A computed tomographic technologist uses a computerized x-ray system to produce sectional anatomic images of the body.

(Courtesy of Philips Medical Systems.)

CT SCANNER

• USES• RADIATION – AND A

COMPUTER • TO RECONSTRUCT• IMAGES

• 3-D

C T SCANNER

Electron BeamTomography

EBT

WHOLE BODY

SCANNER

Risk factor

• HIGH DOSES ?

• WHAT YOU DON’T• KNOW …….

• ‘FALSE POSITIVE’S”• NOW THAT YOU KNOW – WHAT ARE

YOU GOING TO DO ABOUT IT? =

Radiation Dose

• EBT scans expose the patient to about 1/5th the radiation of a multi-slice CT scanner.

• OR so they tell you..• $$$$$$$$

Magnetic Resonance Imaging

• RT (R) (MRI) or

• RT (T) (MRI) or (N) (MRI)

• 1995 ARRT began post primary exams

MRI SIGNAL PRODUCTION

• Images are crated by interaction of Magnet field, radio waves with tissue

• Atoms – Nucleus – Electrons

MRI SAFETY

USE NON MAGNETIC MATERIALS

CAN CAUSE HARM TO PATIENT & PERSONELL

1 REPORTED DEATH FROM O2 TANK & 6YO PATIENT

MRI

• NOT IONIZING RADIATION

• USES MAGENTIC RESONANCE

• (RADIO WAVES)

• Jane Schultz, R.T. (MR)

RADIOGRAPHY VS MRI

BONE vs Soft Tissue

PET Scan & SPECT Scan

• PET = Positron Emission Tomography

• Single Photon Emission Computed Tomography

• X-rays/MRI with Radioisotopes

• PET Scan showing diffuse spread of prostate cancer to bone. PET has the advantage over traditional bone scanning in its ability to differentiate active from dormant disease.

ANGIOGRAPHY/ CARDIOVASCULAR INTERVENTIONAL

TECHNOLOGY

is a specialized radiographic examination where the images of the blood vessels of the body are demonstrated by injection of contrast media.

CARDIAC-INTERVENTIONAL RADIOGRAPHY

• Mike Smith, RT (R) (CI)

• POST PRIMARY EXAM BEGAN IN JANUARY 2003

INTERVENTIONALRADIOGRAPHY

• ANGIOGRAPHY

• CARDIAC CATH

• + MANY OTHERS

• RT (CV) (CIT) (CVIT)

ANGIOGRAPHY is a specialized radiographic examination where the images of the blood

vessels of the body are demonstrated by injection

of contrast media

Cardiovascular Interventional Radiography

• Jane Smith, RT (R) (CVI)

• Angiography

• 1991 began post primary exam for CVIT Radiographers

Angiography

VASCULAR-INTERVENTIONAL RADIOGRAPHY

• JOE CAR, RT (R) (VI)

• POST PRIMARY EXAM BEGAN IN JANUARY 2003

NUCLEAR

MEDICINE

use radioactive isotopes to make images

Nuclear Medicine

• RT (NM)

• ARRT or NMTCB

NM – Images collected afterinjections of a RADIOISOTOPE

The tracer travels into the blood vessels until it arrives to the

bone

PET Scan & SPECT Scan

• PET = Positron Emission Tomography

• Single Photon Emission Computed Tomography

Prostate cancer metastasized in bones

PET NUCLEAR MED + CT or MRI- co-registration

RADIATION THERAPY

R.T.(T)• 2 YRS ADDITIONAL EDUCATION

• CITY OF HOPE

• LLU

• CAL STATE LONG BEACH

• The branch of Radiology that involves the treatment of disease by means of high energy x-rays or radioactive substances

RADIATION THERAPY

• branch of Radiology that involves the treatment of disease by means of high energy x-rays (GAMMA) or radioactive substances

Radiation Therapy

• RT (T) = Registered technologist in radiation therapy technology

• Medical dosemetrists are involved in treatment planning and dose calculations

• 1-4 year program

ULTRASOUND

uses a technique similar to Navy SONAR to produce diagnostic images.

ULTRASOUNDCypress CollegeOrange Coast

LLU1 – 2 years

Diagnostic Medical Sonographers

• RT (R) (S) or RT (S) or (RDMS)

• American Registry of Diagnostic Medical Sonographers

• ARRT in 1999 began post primary exam

• ARRT in 2005 began primary exam

Determines depth

Ultrsound beam is transmitted and reflected – as special crystal at the end of the transducer candetermine the type of tissue

Uses SOUND WAVES (NOT X-RAYS)

“real time” images

ULTRASOUND

uses a technique similar to Navy SONAR to produce diagnostic images.

2D vs. 3D/4D

U/S & the “real thing”

Breast Sonography

• Post Primary Exam

• Valuable for Technologists that specialize in Mammography

VASCULAR ULTRASOUND

New - RA• Radiology Assistant (Like PA)

• Weber State (On line – Utah)

• LLU

• 3 others in US (2007 – more)

• $$$$ NEW GRADS = 100 K/YEAR (?)

• PART OF RADIOLOGIST GROUP

• As of 2007 – NOT APPROVED BY STATE to Work as RA in California

Additional OpportunitiesAdditional Opportunities

EducationEducation

AdministrationAdministration

Management (QM)Management (QM)

CommercialCommercial

Radiologist Radiologist Assistant = RAAssistant = RA

RADIOLOGY ASSISTANT RA

• LLU • 2 YRS RT• BA DEGREE

• WEBER STATE• 6YR RT

OTHER PATHWAYS

• SALES

• APPLICATIONS SPECIALIST

• INDUSTRIAL X-RAY

• MANAGEMENT (DEGREE)

• EDUCATON

TRAVELING TECHNOLOGIST = SEE THE WORLD AND GET $$$

Other working Other working opportunities…opportunities…

►Registry (local)Registry (local)

►Registry (out of Registry (out of state)state)

►X rays taken X rays taken around the around the world !!world !!

Variety of Work Settings• physicians offices,• • clinical outpatient facilities,

• free standing imaging centers,

• mobile imaging centers

• portable services to rehabs

• Mammo’s to under privileged areas

• Urgent care

SALARY RANGES RT’s

• NEW R.T. = $ 25 -$38 PER HOUR• ON-CALL + O.T. $45,000 – $60,000 YR

• ADVANCE SPECIALTIES• $ 30 - $50 PER HOUR

• A GREAT SHORTAGE IN ALL HEALTH CARE – A GREAT NEED TO AQUIRE NEW TECHNOLOGIST TO THIS AREA

Professional Organizations

• ASRT – American Society of Radiologic Technologis

• CSRT – California SocietySociety of Radiologic Technologists

• RTEC – Radiologic Technology Educators of California

• International Societies, other state societies, other modalities