DOCUMENT RESUME 08 Buatti, A.; Rich, D. Nuclear Medical ...presented, followed by a bibliography. Essentials of an Accredited Educational Program for the Nuclear Medical Technologist

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DOCUMENT RESUME

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AUTHOR Buatti, A.; Rich, D.TITLE Nuclear Medical Technology. Curriculum for a Two Year

Program. Final Report. .

INSTITUTION Middlesex Community Coll., Middletown, Conn.SPONS AGENCY Bureau of Occupational and Adult Education(DHEW/OE),

Washington, D.C.; Connecticut Vocational EducationResearch and Planning Unit, Hartford.

PUB DATE \ Jun 77NOTE \ 52p.; Parts of appendixes may be marginally4eqible

due to pr int quality of the document - A

LIIS'PRICE MF-$0.83 HC-$3.50 Plus Postage.DESCRIPTORS Associate Degrees; Community Colleges; *Cooperative

Programs; *Core Curriculum; Course Descriptions;.Curriculum Design; *Curriculum Development; *HealthOccupations Education; Hospital Personnel; Hospitals;Interinstitutional Cooperation; *MedicalTechnologists; Paraprofessional Personnel; PostSecondary Education; *Radiologic Technologists

ABSTRACTObjectives of the project briefly described here were

(1) to develop curriculum for a two-year nuclear medical technologyprogram based on a working relationship between three institutions(c cimmunity college, university, health center, and hospital) and (2) .

to develop procedures fcr the operation of a medical imaging andtaliation technology core program for radiologic, nuclear medicine,ultrasound, radiotherapy, and biomedical technology. Methods used inthe interinstitutional cooperative curriculum development effort aresummarized, followed by a general description of the curriculum, acurriculum outline, and brief descriptions of the courses. A timeschedule for students and an outline of student hours are presented.Twenty,pages of instructional objectives for each course areprovided, followed by recommended texts, laboratory manuals, andreferences. A general description of the medical imaging andradiation technology core program is included, along with anexplanation of the cooperative relationship of the core program withthe' community college and hospitals. Conclusions and recommendationsregarding the cooperative curriculum development-effort arepresented, followed by a bibliography. Essentials of an AccreditedEducational Program for the Nuclear Medical Technologist areappended. An outline of Naval training programs for nuclear medicinetechnician, x-ray techniCian, x ray technique, clinical nuclearmedicine technician, and radioactive isotope techiician is alsoappended. (BL)

Documents acquired by ERIC include many informal unpublished materials not available from other sources. ERIC makes everyeffort to obtain the best copy available. Nevertheless, items of marginal reproducibility are often encountered and this affects thequality of the microfiche and hardcopy reproductions ERIC makes available via the ERIC Document Reproduction Service (EDRS).EDRS is not responsible for the quality of the original document. Reproductions supplied by EDRS are the best that can be made'fromthe original.

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NUCLEAR MEDICAL TECHNOLOGY

CURRICULUM FOR A TWO YEAR PROGRAM

"PERMISSION TO REPRODUCE THISMATERIAL HAS BEEN GRANTED BY

gederIck L. 14adttal

TO THE EDUCATIONAL RESOURCESINFORMATION CENTER (ERIC) ANDTHE ERIC SYSTEM CONTRACTORS"

FINAL REPORT

BEST COPY AVAILABLE

A. BuattiMiddlesex Community College

100 Training Hill RoadMiddletown, Conn. 06457

D. RichHartford Hospital80 Seymour St.

Hartford, Conn. 06115

JUNE 1977

U S DEPARTMENTOF HEALTH.

EDUCATION &WELFARENATIONAL INSTITUTE OF

EDUCATION

THIS DOCUMENTHAS BEEN REPRO.

DUCED EXACTLY AS RECEIVED FROMTHE PERSON OR ORGANIZATION ORICAN

AT MO IT POINTS OF VIEW OR OPINIONS

STATED DO NOT NECESSARILY REPRE-

SENT OF FICiAL NATIONAL iNSTiTuTE OF

EDUCATION POSITION OR POLiC't

Po\4ts of view or opinions stated do not necessarily representofficial opinion or policy of state of federal governmentalagencies, as the writers are encouraged to express freelytheir professional judgement in the conduct of the project.

CONNECTICUT STATE DEPARTMENT OF DUCATIONDIVISION OF VOCATIONAL EDUCATION

RESEARCH AND PLANNING UNITJIARTFORD, CONNECTICUT

L. 2

PREFACE'

This curriculum study was made.possible by aresearch grant from the Connecticut State Department ofEducation, Division of Vocational Education, Research andPlanning Unit. The study was performed under the purviewof Dr. Frederick L. Haddad, Consultant, Research and,Planning Unit whom we wish to thank for his guidance andhis assistance.

.

This work is a result of the foresight and theimpetus of Dr. Richard Spencer, Professor and Headof Nuclear Medicine at the University of Connecticut/Health Center who more than two years ago undertook toestablish an educational training-prpgram in nuclearmedical technology. Dr. John Sziklas, Director ofClinical Nuclear Medicine, Hartford Hospital workedwith Dr. Spencer and with the authors to establish arelationship that could offer students a two yeartraining program in nuclear medical technology as acooperative effort-between three institutions; The UConnHealth Center, Hartford Hospital, and Middlesex CommunityCollege.

The College will administer this program as a .

specialty under a Medical Imaging and RadiationTechnology Degreed program which will encompass severalimaging modalities for diagnosis and the application ofradiation for therapy. The MIRT program will be a corefrom which students, in their second year, will elect tospecialize in any one of the options.

'The practice of* nuclear medicine includes the utilizationof radioactive materials for therapeutic and diagnostic,"in-vivo" and"in-vitro" procedures and any combination thereof.The skills of the nuclear medical technologist shall complementthose of the nuclear medicine physician and other professionalsin the field. The nuclear medicine technologist' must be ableto perform effectively in three major areas of responsibility:1)patient care, 2)technical skills, and 3)administrative functions.(Reference 1).

SummaryBackgroundMethodsCurriculum

TABLE OF CONTENTS

General DescriptionCourse Patterns and DescriptionsStudent's Schedule and HoursInstructional ObjectivesRecommended Materials

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34

581030

Medical Imaging and Radiation Technology Core ProgramGeneral Description 33Cooperative Relationships 35

ConclusionsReferencesBibliography

and Recommendations 37

Appendices A.B.

C.D.

3839

Abstract of Mini Grant ProposalEssentials of an AMA Accredited Programfor the Nuclear Medical TechnologistVOICE Program, SNMMilitary (Navy) Programs in Nuclear Medicine

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SUMMARY

This report contains the curriculum materials for a two yeartraining program in nuclear medical technology. The materialswere written based 'on a working relationship between threeinstitutions which could offer the student the academic trainingfor the first year of study (Middlesex Community College), and thedidactic training (The University of Conn. Health Center) andclinical training. (Hartford Hospital) during the second year ofstudy. In addition, the student will earn an Associate inScience degree from the college, and he will be qualified andpermitted to sit for the Registry examination.

The training program in nuclear medical technology will be aspecialty of a Medical Imaging and Radiation Technology program-which will be administered by the Community College. The MIRTprogram will contain a core of basic courses which all studentswill be required to take while 'at the college. During theirsecond year they will specialize in any one of the options_in theimaging modalities or in the application of radiation for therapy.This program will also provide upward mobility for radiologictechnologists who wish to become certified in nuclear medicaltechnology.

The objectives of this study were to develop the curriculumfor the NMT training program, and to develop the procedures for th(operation of the MIRT core program. The first objective wascompleted in detail, -and an operating framework was developed'forthe second objective.

Much of the research work completed for the project consistedof literature searches in the academic and medical libraries atseveral colleges and hospitals in the central Connecticut area.In addition, both authors interviewed and discussed with manyprofessionals working in Connecticut and in New England. Thoseprofessionals included physicians, physicists, researchers,technologists, hospital administrators, and college faculty andadministrators. It was deemed of first importance to gather theinformation from and the opinions of professionals currentlyworking in the field.

Based on the experience of producing these material's and theexperienqes of other programs operating as cooperative effortsbetween colleges and hospitals, it is believed that such programsare not only beneficial for students, but, necessary. Neithercolleges nor hospitals can afford to offer to students a completerange of academic and clinical experiences, and all agree thatstudents should have both of these' experiences. Each organizationhas what the other needs, and cooperative efforts will be moreefficient than unnecessary duplication. In nuclear medicaltechnology this is esPeciaIly true due to the extensive use ofand the training required for large scale, complex, and veryexpensive medical electronic equipment.

The expansion of the cooperative efforts to includeaffiliations with more than one hoSpital in an effort to serveother related fields such as radiologic technology, ultrasound,and radiotherapy is a logical expansion of this concept and-willadd the dimension of flexibility and rotation. 'Although theoperation of such a program will be more cumbersome due to thenumber of cooperating institutions involved, it is b-elieved to beoverall more efficient from the standpoint of sharing facilitiesand services, and willirfcrease communications and cooperationin this field.

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BACKGROUND

Dr. Richard Spencer, Professor Head of 1Thclear Medicine atthe University of Connecticut Health Center intiated the work ona program in nuclear medical technology to be affiliated witha large community hospital (Hartford Hospital) and ,a communitycollege (Middlesex). Survey conducted by his staff in Connecticutduring the latter part of 1975 indicated that there w s a needto train more technologists than were available. Studi sproduced by the Conn. Institute for Health Manpower Reso rces, inthat same year, indicated (Reference 2) that there was a eed foradditional technologists and training programs in this fiel4 inConnecticut. Reference3 indicated that there were only aboutwelve two year Associate in Science Degrced programs nationwideand that the move to increase hospital and community collegeaffiliations was increasing.

This inforMation in addition to that 'supplied by the Society_of Nuclear Medicine confirmed the need to establish such a -

program in Cqnnucticut. This program would be established inaddition to and in cooperation with an existing program at Yale/New Haven hospital in which Dr. Spencer was instrumental inestablishing while he was there.

Dr. John Sziklas, Director of Cli?iical Nuclear Medicine atHartford Hospital and the authors joined with Dr. Spencer inworking on the establishment of a program. The curriculummaterials written were based not only on the technocaIraspectsof the field, but also on this three way cooperation betweeninstitutions. It was the intent of the initiators to prbducethis program with existing staff, equipment, and facilities. .

To that end the curriculum materials were designed based on thecurrent services of each institution. The behavioral objectivesfor students in nuclear medical technology are set down inAppendix B, and it was the job of this study to organize anddefine currently existing services in each organization in sucha way as to meet the requirements of the Essentials, the CommunityCollege, the Health Center, and the Community Hospital.

The staff at the UConn Health Center was committed tosuppling the didactic work, the staff at Hartford Hospital theclinical work, and the staff at Middlesex Community College theacademic work. In addition, it was,the college's intention toestablish the NMT-program as a model option under ii-core programin Medical Imaging and Radiation Technology around which it couldcluster an existing program in Radiologic Technology, and newprograms to be developed such as ultrasound, radiotherapy, andbiomedical technology. The academic offerings in the first yearare general rather than specific in order to cover the materialsrequired by students specializing in several imaging fieldsas well as radiotherapy. Specialization is accomplished duringthe second year in the clinical phase.

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METHODS

The methods used in establishing the materials consistedof searching, defining, and organizing the services, pelsonnel,and facilities at all three institutions which would be involvedin the operation of this program. The search was accomplishedsimply by contacting staff members in the organizations whobelonged to departments whose involvement was obvious. Allcontacts were cordially received often with enthusiasm and veryseldom with reluctance which was caused by the fear that studentswould interfere with the work and the efficiency of a department.

Literature searches were performed at the libraries ofarea colleges and hospitals and with the cordial assistance ofthe staff of the Society of Nuclea'r Medicine.' Existing programswere investigated, not only for the two year A.S. degree type,but also the one_year_hospital based program, four year B.S.d-egree programs, and specialized upper division programs inthe Radiologic Sciences. Assistance with this last catagorywas offered by Scott Gregory and Eleanora Coates of the Departmentof Radiologic Sciences, Quinnipiac College.

The requirements of the AMA and the professional societiesand registries were searched as well as the educational requiremen'established by the Conn. Commission for Higher Education.Interviews and discussions were held with many working professiona:either at their hospitals or at monthly grand rounds or at Societymeetings in Connecticut and in New England. Also, manufacturersand suppliers were contacted to obtain company educational orpromotional materials in attempts to document existing equipmentand supplies currently in use and those in the research andtesting stages. Discussions with hospital and college staffmembers involved in similar or related programs were held tounearth the difficulties in hospital-college programs.

Letters were sent to magazine and text book publishersand to professional societies requesting lists of books anddocuments which were later purchased. Much oC the technicalmaterial was based on these reference's in addition totthediscussions held with working professionals. The latter groupcontributed tremendously in the area of procedures and studenthandling and familiarization, and in the areas where' variousorganizations might conflict.

All of the mate ,.ials were compiled and organized, and thenpresented for review by the staff members of the three organizatiolThe science department and the professional staff approved theprogram as did the Board of Trustees for the ConnecticutCommunity Colleges. The department heads at the Health Centerand at Hartford Hospital also approved the technicalsontentand the procedural aspects of the program.

In regard to the actual operation of the program, this isnot yet possible since it must lastly be approved for licensure bythe Commission for Higher Education and the AMA's Council onMedical Education.

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GENERAL DESCRIPTION OF THE CURRICULUM

This curriculum will require 27 months to complete and.starts in June of one year and is completed in September twoyears later. Students will attend classes at the CommunityCollege during their first year of study and during the summerspreceding and following that year. The next year is spentessentialy full time in the clinical setting at the CommunityHospital; however, they will spend one morning per week at theHealth Center for their didactic work.

The program requires more than twentyfive hundred hqursto be spent, in the academic and clinical settings during thetwentyseven month extent of the program. More than eightconhundred hours_of that time are spent during the second yearin the Clinical setting.

Students in their first year of study take basic-coursesin mathematics and sSience, and in psychology and sociology.Two elective courses at the college during the second summeroffer the students an opportunity to broaden their liberaleducation, or to further pursue the sciences, or to make upwork notes completed during theirfirst year. The summer coursesduring the second summer also add to the exposure that studentshave to the hospital setting prior to their full time involvement.They also take a course in hospital- orientation which meetsone friday morning per month during the academic year, and onefriday monling for six weeks during the. summer preceding thesecond yeai, in the clinical phase of training. The last threemonths of the program include full time performance in theclinical area in preparatiOn for the Regi.stry examination.

The academic courses in the first year offer a basicfoundation general enough to satisfy the needs of students inthe related options of radiologic technology, ultrasound, .

radiotherapy, and, perhaps, biomedical technology. Of course,the work in the second year is very specific and demands thespecialized behavioral objectives pertinent to each field.Students in other options will go to other departments orhospitals for thir training.

A course pattern for the nuclear medical technology optionsis presented, and, for each course there is given a briefcourse description, instructional objectives designed tosatisfy the behavioral obj =ctives stated in the Essentials,and a list of recommended texts, lab manuals, and references.Also, a students schedule and 'lours are given.

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COURSE PATTERN

MEDICAL IMAGING AND RADIATION TECHNOLOGY PROGRAM(Nuclear Medical Technology)

(June) 1st Summer:(MxCC)

(Sept) 1st Year:(MxCC)

Eng.. 101 3 Cr*Math 105 3 Cr 6 Cr

Fall Spring

Bio 103 4 Cr Bio 104 4 CrChem 103 3 Chem 104 3Physics 103 3 Physics 104 3*Psych 100 3 *Soc 100 3Hosp. Orient. 0 Hosp. Orient. 0

13 13 26 Cr

(June) 2nd Summer:(MxCC)

Elective 3 CrElective 3Hosp. Orient. 0

6 6 Cr

(Sept) 2nd Year:, (Hospital)//

Fall Spring

Nuc. Med. Tech 101 3 Cr NMT 105 3 CrNMT 102 . 3 NMT 106 3NMT 103 3 NMT 107 3NMT 104 3 NMT 108 3

12 12 24 Cr

(June Sept) 3rd Summer:(Hospital)

NMT 109 3 CrNMT 110 3

*Minimum requirements

6 Cr

TOTAL: 68 Cr.

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BRIEF COURSE DESCRIPTIONS*(Offered at Middlesex Community College)

English 101 Basic Composition 3 CreditsPractice and analysis of techniques used'in exposition.Emphasis on the fundamentals of sentences and paragraphs.Prerequisite: satisfactory placement.scores, completionof English 99, or permission.

Math 105 Applied Mathematics I 3 CreditsTopics in arithmetic, algegra, and coordinate geometry.Emphasis on applying concepts to such subjects asmarketing, computers, and sciences.

Biology 103 - 104 Anatomy-Physiology #4-4 CreditsThe structural organization and functioning of the humanbody. Laboratory work includes comprehensive studyof the cell, tissues, skeletal and muscular systems,blood cell morphology, and internal anatomy.

Chemistry 103 - 104 Introductory Chemistry 3-3 CreditsRecommended for students with minimal chemistry ormathematics background. A concise introduction to thefundamental concepts of chemistry which covers abroad range of topics: nomenclature, measurement,bonding, stoichiometry, equilibrium, organic chemistry,and biochemistry. Lab activities included.

Physics 103 104 Physics for the Medical Sciences 3-3 CreditsA survey of the introductory concepts of physics withemphasis on applications to the medical sciences., Labactivities and lectures at area hospitals included.Course approved by MxCC. Not yet listed in catalog.

Psychology 100 Selected Issues 3 CreditsSelected contemporary issues in psychology--forexample, personality, motivation, learning, and drugs.Recommended for students who do not intend a baccalaureatemajor in the behavioral sciences.

Sociology 100 Introduction to Sociology: 3 CreditsContemporary Social Problems

A systematic analysis of major contemporary socialproblems, such as mental illness, crime, poverty, andracial and ethnic conflicts, with emphasis on theirorigins.

*Printed in the 1976-78 Middlesex Community College Catalog.

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BRIEF COURSE DESCRIPTIONS(Offered at the University of ConnecticutHealth Center and Hartford Hospital)

Hospital OrientationAn introduction to the hospital setting and to the fieldof medical imaging. Students will observe in. theworking areas, and will attend lectures on ethics,patient care, emergency procedures, and medical imaging '

procedures.

Nuclear Medical Technology 101 - 102 Introduction to 3-3 CreditsRadiophysics and Radiobiology

A survey of the basic concepts and definitions of radiationphysics and radiobiology, and the interactions of radiationwith matter are presented. Radiation safety, the managementand handling of radioactive materials, and hospital andgovernmental regulations are covered. In the clinicalsetting, a review of terminology, ethics, and radiationprotection are covered as well as observation and assistingin clinical procedures.

Nuclear Medical Technology 103 - 104 Introduction to 3-3 CreditsRadiation Detection and Radio Pharmacy

A purvey of radiation detectors, dose calibrators andnuclear medical instrumentation to include their use andtheir principles of operation. An introduction to thepreparation and utilization of radiopharmaceuticals. Inthe clinical setting, hands-on experience with detectorsand survey equipment, and observation of the use ofradiopharmaceuticals and nuclear medical instrumentation.

Nuclear Med. 105 - 106 Clinical Nuclear Medicine 3-3 Creditsand Nursing Procedures I

A study of the use and detection of radioactive materialsin vivo. Includes the anatomical, physiological, andradiopharmaceutical aspects of in vlvo diagnostic

tiexaminations. Particular attenon'is paid to techniquesand nursing procedures.

Nucleal. Med. 107 - 108 Clinical Nuclear Medicine 3-3 Creditsand Nursing Procedures II

A study of the use and detection of radioactive materialsin vitro. Includes competitive binding studies, and thephysical and _chemical principles of radioimmunoassay.A continuation of the study of nursing procedures.

Nuclear Med. 109 - 110 Clinical Nuclear Medicine 3-3 CreditsPracticum

A practicum laboratory course in the use and detectionof radioactive materials in the in vivo and in vitrophases designed to prepare the sTridea-for the Registryexam.

TIME SCHEDULE FOR STUDENTS

1st Year--at Middlesex Community College

Summer: Course work at Middlesex.

Fall: Course work at,Middlesex primarily. A non-credithospital orientation course. One Friday morningper month at Hartford Hospital or U.Conn. HealthCenter for tours and general introduction.

Spring: Same as fall, except that Friday mornings atU.Conn should include didactic work in healthphysics and radiation protection.

Summer: Two courses at the college. One HospitalOrientation course will include Friday morningseach week for six weeks. (About the middle ofJune to the end of July.)

Student Vacations:Christmas--three weeks -- Christmas to middle ofJanuary.Spring- -three weeks--Middle of May to middle ofJune.Summer--three weeks--Last three weeks in August.

2nd Year--Clinical Phase at Hartford Hospital and U.C6nn.Health Center - 12 Month Program

Fall and Spring: Full time clinical work at Hartford(l8wks) (l8wks) Hospital plus one Friday morning per

weekat U.Conn. Health Center.Courses to be completed are NMT 101thru 108.

Summer: Full time clinical work at Hartford Hospital;June to September. Courses to be completedare NMT 109 and 110.

Vacations--one week at Christmas; one week in MayHolidays--Five days observed by Hartford HospitalSick Days--Eight days allowed. Fifteen dads maximum

Rotations:In-Vivo Labs 6 months (one month each

instrument)In-Vitro Labs 3 months (two students at

a time)Research Rotation(UConn) 2 months (two students at

a time)Vacations, Holidays,Sick days 1 month

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1st Summer2MicCEng 101 '3CrMath 105 3

1st Year-Fall-MxCCBio 105 4 CrChem 103 3Phys 103 3PsSrch 100 3

*+Hosp. O. 0

1st' Year-Spring-MxCCBio 104 4 CrChem 104 3Phy :104 3Soc 100 3

*+Hosp. 0. 0

2nd Year-Summer-MxCCElective 3 CrElective 3

*+Hosp. O.

'2nd.Year-Fall-Hospital

NMT- l01 3 LrNMT 102 -3NMT 103 3NMT 1014 3

STUDENT HOURS

Lecture

2nd Year-Spring-HospitalNMT 105 3 Cr

NMT 107 3NMT 108 3

. 72 hr.

6wksX8hr.6 X 8

96hr.

16wksX3hr.16 X 316 X 316 X 3

192 hr.

Lab. Practicum

0 0

16X216X116X1

(4 visitsX4hr)64 hr. 16 hr.

16 X 3 16X216 X 3 16X116 X 3 16X116 X 3

TV

.

(4'visltsX4hr)192 hr 3,74Er 16 hr.

6wksX8hr.6 X

(6 -visitsX4hr)6 hr 0 24 hr.

Didactic

18wks.X1hr.*18 X 118 X.118 X 172 hr.

18wksX1hr.*18 X 118 X 118 X 1

5rh, Summer - Hospital .

NMT 109NMT 110

Coll.e.gs"-Hours Totals

Clinical

18 X 818 X 8:18 X 818 X 8576 hr.

18 X 818 X 818 X 818 X 8576 hr.

12wksX2Ohr.12wksX2Ohr.

480 hr.

Liure + Lab. + Practicum576 hrs. + I2 0 = 704hourr,

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Hospital Hours Totals Didactic Clinical1 , C; 2Q0 hrs. + 1632 hrs = 1832hours

'Minimum hospital hours '(ninus twenty sick days and----.. i -holidays) = -1672hours

Grand Totals . 2536hours*Hospital lectures to be given every Fiidaimorning at the. Worm Health Center.- .':

+Hours credited towards didactic work139

(INSTRUCTIONAL OBJECTIVES IN MATHEMATICS 4

A. Arithmetic - Review of addition, subtraction, multiplicationand division of whole-numbers,.fractions, mixednumbers, and decimals._ Determination ofpercents and ratios.

B. Algebra - Addition, subtraction, Multiplication, and divisionof monomials. Solutions of algebraic equationsand operations with exponential numbers.Application of algebraic expresbions.

C. Significant Figures

D. Scientific Notation

- The rules for rounding off. Thedanger of rounding off.

- The metric system and the power of ten.Conversion of whole numbers, fractions,and decimals to scientific notation.Arithmetic and algebraic operations withnumbers given in ,scientific notation.

E. ',logarithms - Operations lit/common and natural logarithms toinclude multiplication, division, andexponentiation. Applications of logarithms.

F. Geometry - Review of basic concepts in geometry and applicationof principles to problems.

G. Trigonometry - Operations with trigonometric functionsand the use of tables. Application of trigfunctions.

H. Graphing -

I. Slide Rule

Construction, application, and analysis ofgraphs for linear and exponential functions.

- Operation of the slide rule for multiplication,-division, proportions, and dxponents.

J. Pocket Calculators - Operation of calculators forarithmetic, algebraic, trignometric, andlogarithmic problems.

K. Computers - Introduction to computers and data processing.Operation of basic programs..

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INSTRUCTIONAL OBJECTIVES IN ENGLISH

A. Purpose ofCommunications - Primarily for exposition, but to include

inquiry, information, and persuasion.

B. Methods ofCommunications - Primarily written, but to include oral

and visual communications.

C. Written Communications - Of a formal and informal natureencompassing articles, memos, letters,and reports. Emphasis on grammar,organization, and style of thevarious forms of written .communications

D. Oral and VisualCommunications - Based on improvement of delivery on a

person to person level, primarily and on a-person to group level, secondarily.

'E. Library use - To cover classification systems, references,periodicals, publications, and research work.

F. F.: ivey of .

Reading Skills - To include analysis of written communications.Intensive reading plus techniques forskimming and scanning.

G. Survey of Writing - Technical reports written in the scientificstyle, and writing in the third personpast tense. Importance of accuracy andhonesty in the observation and recordingof technical data.

H. Review of Various Materials - Reports, articles, and journalsin the scientific and medicalfields.

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INSTRUCTIONAL OBJECTIVES IN PHYSICS.

A. ,ThenScientific.

Method - Measurements, accuracy, precision, significant figures,and methods.

B. Mathematics Review - Algebra, trigonometry, geometry,.logarithms, graphing, scientific notation,the metric system, and conversion of units.

C. Motion - Equations of motion and graphs. Coneepta of mass,weight, density; gravity, equilibrium, friction, andtorques. Clinical applications of forces, motion,and torque.

D. Energy and Work - Principles of conservation, equations forwork, energy and momentum. Calculationsfor problems applied to simple machines andanalogies in the human body.it

E. States of Matter -3Gases, liquids, and solids. Atomic andmolecular structures and laws governing thestates. Problems applied to fluids in thebody in the respiratory and circulatorysystems.

F. Temperature and Heat - Definitions of temperature, heat,specific heat; heat of reaction,temperature scales, and units.Calculations to include determination oftemperatures and conversion of units;and the determinations of heat quantitiesProblems applied to the physiologicalimplications of heat transfer.

G. Electricity andmagnetism - Introduction to the electrical nature of matter,

electric charge and flow, definition of units,calculations, and instruments and machines.Problems and examples applied to bioelectricity inthe human body and its measurement.

H. Electrical Circuitsand Instruments - Definitions of the calculations for voltage,

current, resistance, energy and power. Basic .

components; resistors, capacitors, inductors,transformers, etc. Survey of basic instrumentamplifiers, computers, display devices,.etc.Examples of medical instruments such as EKG,EEG, ENG, and x-ray, ultrasound and gammadetectors.

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I. Sound andWave Motion - Definitions of elasticity, periodic motion,

transverse and longitudinal waves, dopplereffect, and interference. Examples appliedto the ear and human hearing, and to the useof ultrasound in diagnostics.

J. Light andModern Physics - Review of atomic structure and electronic

configutdtion. Electromagnetic spectrumand the various forms of energy. Quantumtheory. Problems applied to vision,vision Correction, color, and opticalinstruments.

K. Atomic andNuclear Radiations - Radioactivity_tAcay_l_and-half life.

---Det-edt-ibria radiation and biologicaleffects. Examples applied to radioisotopeEand the detection of x-ray and gamma rays.

L. Laboratory Exercises - To be planned to reinforce the conceptspresented in the classroom. Examplesare well documented in standard textsand laboratory manuals.

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INSTRUCTIONAL OBJECTIVES IN CHEMISTRY

A. Mathematics - Review of fractions, percents, ratios, significantfigures, scientific notation, logarithms,algebra, graphing, and Conversion of units.

B. Metric System - Review of metric units, measurements, andequivalents in the english system.

O. Basic Conceptsof Matter - Atomic structure, electronic configuration, the

periodic table, nomenclature, formulas, and thegram mole?

D. States of Matter -

E. Chemical Bonding -

Gases, .liquids, and solids., Calculationsof density, and., the gas -laws.

The nature of chemical bonds,energy in bonding, formulas,ionic and covalent bonding.

concepts ofvalence,

F. 'Solutions - Preparation, calculation of concentrations,properties, suspensions, colloids and emulsions.Examplesiapplied to fluids in the body.

G. Equations and Stoichiometry -yritIng and- balancing_ equations, and stoichiometric

calculations.

H. Acids, Bases,and Salts - Ionization concentration, ph, buffers, and

equilibrium calculations. Problems applied tobody fluids.

I. Oxidation-Reduction - Balancing equations, and importance cifsuch reactions in the body.

J. Introduction toOrganic Chemistry - Survey of organic structures, classificatiot

of hydrocarbons and the,IUPAC namingsystem, important reactions, aliphaticaromatic, and heterocyclic compounds.

K. Introduction toBiochemistry - Survey of carbohydrates, fats, and proteins;

also, enzymes, body fluids, vitamins,hormones, and metabolism.

L. Laboratory Exercises - To be planned to reinforce experiencesand concepts covered in the classroom.Examples are well documented instandard texts and laboratory manuals.

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INSTRUCTIONAL OBJECTIVES IN ANATOMY AND PHYSIOLOGY6

A. Applications from Chemistryand Physics - Review of the metric system and application of

basic chemical and physical concepts to livingorganiews.

B. Cells and Tissue - Definitions of terms and description oforganization, structure, reproduction, andthe various tissues. .

Definition of terms, body regions, and genera:Ianatomical orientation. Description, locationand function of organs.

Basic elements, building blocks, divisions,and 'overview of components and functions.Cortical systems and general sensory systems.

C. General Anatomy .-,

D. Nervous System -

E. Sensory Systems -

F. Skeletal Motor

The general, viseral, special sensory, andproprioceptor 'systems. To include motorsystems_and evaluationy of injury and .

abnormalities.'1 $

System - Components, structure, function, and development ofbone, and disorders, and diseases. Structures,classifications, diseases of joints. Identificationand physiology, properties, and responsiveness ofmuscles.

G. ReproductiveSystem - Male and female systems, and birth control.

H. CirculatorySystem - Body fluids, anatomy, and functions of the components

of this system. Blood and lymph fluids, pressureexchange of nutrients and wastes. Interractiorthwith the respiratory system and diseases and disorders

I. Respriatory System - Components, mechanisms, and functions.Exchange of gasses, capacity, disease anddisorders.

J. Nutrition Digestionand Elimination - Components, functions, and chemistry.

Absorption of nutrients and elimination ofwastes. Principals of metabolism, carbohy-drates, proteins, fats, vitamins, minerals,and caloric requirements. Organs andfunctions of the excretory system.

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K. General Endocrinology General concepts, regulation ofhormones, and the glands.

L. Body Defenses - Nonimmunological and immunological processes,drugs and hypersensitivity.

M. Laboratory Exercises.- Totbe planned to reinforce theconcepts presented in the classroom.Examples are well documented instandard texts and lab manuals.

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INSTRUCTIONAL OBJECTIVES IN PSYCHOLOGY

A. Behavior - Situational, environmental, and organic factorswhich j!:fluence behavior. Situational factorssuch ao location, interractions with people, andactivity toutines. Environmental factors such asphysical and emotional environment'and socialenvironment. Organic factors to include generalhealth, heredity, censitivi ;y, intelligence,interests and motivation. Interactions betweenperson and situation.

B. Behavior ProblemSolutions - Correction of situation or environment which

creates pressure.__Education_for_modification ofatfitUdes and motivation, and establishment ofgrievance procedures. Investigation and solutionof problems with life style, social and economicpressures, and emotion.

C. Motivation -.Physical, social, emotional, and psycnolcgd..calneeds as human needs. Priority of needs, andmotivational "and maintenance needs. Moti-vationalincentives.

D. Frustration - Pressures, failures, interference, end levels.Aggression, regression, resignation, defenees,

-and mental illness. Solutions such .7.sacceptance, variability, and substitution.Therapy such as catharsis, attitudinal correction,role playing, and counseling.

E. Insights andCommunications - Awareness of discontent, and identification

of causes. Supportive leadership, higher-needs, motivation, recognition and otherrewards, balance of values, and encouragementof creativity. Group decision methods,grievance communications, and job rotationsand enrichment.

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21

INSTRUCTIONAL OBJECTIVES IN SOCIOLOGY

A. Social Attitudes - Definitions, terms, evaluation, interpreta-tion, justification, and frames of reference.

B. Factors InfluencingAttitudes - Physical condition, emotions, rationalization,

experience, personality, group identities, socialpressure, education, environment, income, and age.

C. Effects onAttitudes - Influence on behavior creation of prejudices,

determination of meaning, and reconciliationof contradictions.

D. Improvement ofAttitudes - Development of communication skills, role

playing, exposition of problems and feelings,and efforts to correct sources of pressure.

E. Human Relations - History, meaning, and current approaches.Basic concepts of individuality, motivation,ego, dignity, and individual differences.Interactions and relationships betweenindividuals and groups, in familial, social,educational, and professional situations.

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22

INSTRUCTIONAL OBJECTIVES IN ELECTIVE COURSES

There are three intended purposes for requiring theelective courses in the second summer. They are to offerthe student the opportunity to:

a. Broaden his education in the humanities, socialsciences, or mathematics and science,

b. add depth to his studies in mathematics or science, and

c. make up course work not completed during the first year.

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23

INSTRUCTIONAL OBJECTIVES IN HOSPITAL ORIENTATION

A. Ethics andProfessionalism - Definitions, need and value, confidential

information, relationships with patients andother hospital personnel, and legal aspects.

B. Hospital Employment - Your position as a technologist andrelationships with other personnel in thedepartment. Work duties and deparmentalmanagement and procedures. Relationshipswith business offices, personnel, andother administrative or service depart-ments. Hospital rules and regulations,medical-social-educational benefits,vacation-hdliday-sick day benefits,salary and position improvement, andunions and contracts. Job huntingand registration with professionalSocieties. Writing resumes, fillingout applications, and appearance andgrooming for interviews. Hospitalemergency procedures for fires, naturaldisasters, and mass casualties.

C. Introduction toNuclear Medical Technology - History of nuclear medicine and

description of the field. In-vivoand in-vitro labs, the medicallab, x-ray department, radiopharmacra,dotherapy, and other areasutilizing radiation. Radiationsafety and the biological effectsof radiation exposure. The use ofradioactivity for clinical studies,diagnostics, and therapy.

D. Hospital Sepsis andCommunicable Diseases - Definitions and identifications.

Responsibility for controlling diseaseand preventive measures. Etiology,manifestations, transmission, preventionbarriers, and decontamination fordisease.

E. Nursing Procedures - Patient handling while lifting or movingof unencumbered patients and those incasts and traction, and those with I.V.,catheter or drainage bag in place.Equipment, techniques, and problems withI.V.'s and vena punctures. Signs andsymptoms of emergency complications.Vital signs and CPR.

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24

INSTRUCTIONAL OBJECTIVES IN NUCLEAR MEDICAL TECHNOLOGY 101-102

A. Radiation Physics - Concepts and relationships between mass,energy, and atomic structure are defined aswell as the system of units used to describefor electromagnetic forms of radiation aswell as-particulate forms. Radioactivity itdescribed in terms of nuclear disintegratio,processes as isomer and isobaric transiti.and altha decay. Calculations for half lif.mean life, parent-daughter relationships,and decay curves are performed.Definitions of units of radiation such asthe Roentgen, RAD, REM, and RBE are coveredAtomic interactions such as absorption,ionization, photoelectric affect, Comptorscattering, and others are described. Thebasic factors in radiation dosimetry and th.'physical characteristics of commonly usedradiopharmaceuticals are introduced.

B. Radiation Safety - Calculations for radiation exposure areperformed for simple geometries and commonlyused units. Definitions for dowse equivalentthe Curie, specific activity are covered andthe relationship between activity and doserate are explored. Radiation protectionguidelines as defined by the National Councion Radiation Protection, the NationalRegulatory Council (formerly the AEC), andstate, local, and hospital guidelines arediscussed. Radiation survey methods arecovered to include personnel monitoring,area surveys, and acceptable levels. Recordkeeping and periodic surveying are emphasizeThe safe handling of radioactive materials,management of radioactive wastes, and recordof radionuclide accountability are discussedDecontamination techniques and emergencyprocedures are covered.

C. Radiobiology - The characteristics of the cell and thespecialization of tissues in organs are covered.Effects on the cell due to radiation interactior )are discussed as well as the factors affectingthe differential sensitivity of cells.Interpretation of data and the factors influencithe survival ofdrradhted cells are presented.The concepts of genetics and the effects ofradiation levels required to produce them, andeffects which may occur at a later time. Doserate calculations are expanded to includeinternal sources, concepts Of biological halflife, and the factors be considered forcritical organs.

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D. Clinical Aspects - In the clinical setting a survey of admin-istrative procedures for the hospital andthe department are covered with emphasison the functional and organizationalstructure, and relationships between personnand departments. Emphasis is given toethics, professionalism, and the legal aspecof the profession. Nursing procedures areintroduced and observed in regard to patientmoving and handling, reviewing charts,techniques used to obtain vital signs,and procedures used in emergency situations.Medical terminology is emphasized to reviewbasics of anatomy and physiology and tointroduce common and unusual terms usedin nuclear medicine as well as those usedspecifically for radiopharmaceutice.s,instruments, and procedures. The variousimaging procedures performed are presentedand observed while students are requestedto assist in moving patients and deliveringpaperwork and materials. Students areintroduced to photographic techniques,film processinG, and dark room procedures,and are requested to assist in dark roomproduction. Radiation protection and themanagement of radioactive materials arecovered and students are expected toobserve and to assist in surveying,decontamination, and record keepingprocedures.

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INSTRUCTIONAL OBJECTIVES IN NUCLEAR.MEDICAL TECHNOLOGY 103 - 104

A. Radiation Detection - Principleg of-gas filled, and liquidand sol4d: scintillation counters arepresented. Area survey and personnelmonitoring devices are described, andthe principles nuclear medical instrumenand detection system electronic componenare introduced. Counting efficiency toinclude physical as well as geometrical

4 effects are covered which includes thetheory and the application ofstatistics of counting data.

B. Nuclear MedicalInstruments - A survey of the principles of scanners and

imaging systems, collimation, photographic andmagnetic tape recording, and the use of computerfor analysis and display. Static and dynamicimaging systems are included, and the effectsof such parameters as resolution, uniformity,'linearity, and overall quality control arediscussed.

C. Radiopharmaceuticals - The basic concepts of radiochemistryare discussed in regard to radio-chemical separations, generator systemsand the production and preparation ofradiopharmaceuticals, Taggingcompounds, tracer concepts, localizatioof radionuclides, and quality control omaterials are presented. Toxicologyand the pyrogenitity and sterilitytesting of commonly used materialsare discussed. The in vitro useof radiopharmaceuticals in radio-immunoassay, and the therapeutic useof these materials are introduced.

Clinical Aspects - Observation of the calibrion and use ofarea survey and personnel monitoring devitcand student assistance in pefOrming

.

periodic surve s, decontaminations, recordkeeping, and pr aration of materials andfacilities for h spite], and NRC inspectionsObservation and assistance with recordkeeping for procedures, radiation 'safety,radionuclide accountability, instrumentperformance, and inventory. Observation ofand practice with measurements andcalculations of counter efficiency,statistics, and dose rates. Use of pointand line sources and phantoms-are covered.Observation of the use of scanners and imagsystems with emphasis on patient positionand instrument operation as well as thephotog25 raphic or magnetic tape recording.

27

C

Observation of the use of the computer indata storage and analysis. Observationand assistance with quality controlprocedures, and the processing ofphotographic materials in the darkroom.Observation °I the storage, preparation,and the adMinistrationof radiopharmaceu-ticals for imaging as well as their usefor :n -vitro testing and for therapy.

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23

INSTRUCTIONAL OBJECTIVES IN NUCLEAR MEDICAL TECHNOLOGY 105 - 106

A. Clinical Aspects - Students will assist and perform underclose supervision the clinical proceduresrequired for a nuclear medical examination.These will include simple therapeuticprocedures and in-vitro testing, and asmany of the different imaging exams thatthe department, routinely performs, eg;skeletal and soft tissue exams, cardio-vascular,' pulmonary, gastrointestinal,neurological, renal, endocrine, andhematological exams. Students will assistand perform under close supervision thepreparation and the administration ofradiopharmaceuticals, the record keepingrequired for supplies, accountability,safety, and exposure, the performance ofdarkroom procedures, radiation safety survprecautions, and record keeping, and theprocedures and testing required to assurequality control of instrumentation.Students will perform calculations andexperiments designed to determine counterefficiency statistics, effects ofcollimation, resolution, full width athalf maximum, and other procedures deemedimportant by the department for aparticular piece of equipm9nt or examinaticStudents will assist and perform under cloysupervision the nursing proceduresinvolved with handling, moving, and I

positioning patients who are unencumberedor attached to oxygen supply, IV's,catheters or drainage bags, preparationand handling of the patient chart,measurements of vital signs, medicationorders, and precautions to insure against .

the Epread of disease.

.B. Imaging Studies - The in-vivo imaging studies performed(Didactic) statically or dynamically, by scanners or

static imaging devices are covered. Althouithe material is presented on a general leve.attempts to correlate lecture work tospecific instruments, hopefully those usedin the clinical setting, will be made.Correlation of the didactic and clinicalphases are important, and less time is spentin lecture and more time devoted to discuss:of procedures and operations of instrumentsencountered in the clinical setting.Instrument operation and quality control artstressed in attempts to produce the bestimages possible. Determination andpreparation of doses and radiopharmaceuticaare presented.

2529

Anatomy, physiology, and pathology arereviewed for specific clinical studies,eg; those listed above under A, andhopefully, those actually performed inthe clinical area.

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30

INSTRUCTIONAL OBJECTIVES IN NUCLEAR MEDICAL TECHNOLOGY 107 - 108

A. Clinical Aspects - The therapeutic use of radiopharmaceuticalsand the performance of competitive bindingassays are stressed as allowed by the labfacilities in the clinical and didacticareas. Review of anatomy, physiology, andpathology and the use of radiopharmaceuticafor thyroid and malignant hematological,disorders, and for intracavitary use arepresented. Students observe and assist, asallowed by department or hospital policy,in the administration of therapeutic doses,preparation and handling of the materialsas well as calculations for dose ratesand record keeping.Review of radiochemistry and radiopharmacyas applied to in-vitro testing withradionuclides. Procedures are presentedfor as much in-vitro work as occurs in theclinical setting, and hopefully a rotationthrough the medical lab for several monthscan be accomplished. Competitive bindingassays are covered, egi thyroxine, T3 andT4, TSH, B12, digoxin and digitoxin,angiotensin I, II, insulin, etc. Studentsobserve and assist, as allowed bydepartment or hospital policy, 'in theprocedures used for testing, radionuclideor kit preparation, measurement andinterpretation of _data, and operation ofequipmeht.

B. Therapeutic Use andIn-Vitro Testing - The theoretical aspects of the use of

(Didactic) s radionuclide for therapeutic use is coveredand includes concepts from radiophysica andradiobiology. Discussion of the effects ofradiation on tissue and the success ratepreviously documented for climinating diseaAnatomy, physiology, and pathology arereviewed. Clinical procedures, safetyprecautions, and record keeping are discussin regard to procedures performed in theclinical setting. Correlation of lecturesand discussions concerning clinicalexperiences are important.The theoretical aspects of the use ofradionuclides for in-vitro testing willinclude basic concepts from radiochemistryand radiopharmacy. Discussion in generalterms of,:all widely performed in-vitrotesting being performed by students in theclinical area Correlation of lectures anddiscussions concerning clinical experiencesare important.

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BEHAVIORAL OBJECTIVES IN NUCLEAR MEDICAL TECHNOLOGY 109 - 110

A. Clinical Practicum - Students perform under loose supervisionthe in-vivo and in-vitro testing, and thetherapeutic use of radionuclides thatwere previously observed and performe:01.under close supervision. Those tests' orprocedures not previously covered should,be.done so at this time.

B. Nursing andAdministration - All routine nursing and administrative

procedures are to be performed independentlyby students. This includes all phases ofpatient handling, record - 'keeping andemergency procedures, and all phases ofdepartmental operation including radiationsafety, record keeping, and department andhospital procedures.,

C. In-Vivo Imaging - All routine imaging procedures includingstatic and dynamic studies performed byscanners and imaging devices. Studentchecklists are prepared to insure that allstudents have completed the routine tests.Critiques of student performance will besconducted. If possible, observation andstudent assistance for more complex,experimental, or research studies will beaccomplished. Discussions of latesttechniques and equipment will be held.'Pathology will be discussed. Emphasis willbe based on independent student performance.Group discussions for preparation for the"registry exam will be conducted.

D. In-Vitro Testing - All routine competitive binding assays willbe performed, and student check lists willbe prepared to insure that all studentshave completed the routine tests. Critiquc.of performance will be held. Pathologyand 'the latest techniques, materials, andinstruments will be discussed. Ifpossible, obserVation and studentassistance for more complex, experimentalor research studies will be accomplished.Emphasis will be based on independentstudent performance. Group discussionsfor preparation for the registry examwill be conducted.

E. Therapeutic Use ofRadiopharmaceuticals - All routine procedures for preparing

and administering therapeutic doses, a;alloWed by department or hospitalregulations, will be performed by

2students. Critiques of performance

32

will be held. Anatomy, physiology, andpathology reviewed: The latest.techniques and materials will bediscussed, and, if possible, studentswill observe or assist with experiment&or research work.

F. Radiopharmacy - Students will perform procurement, storage,and the administration- of-radionuclides.Radiation safety-and-quality_contralprocedures will be performed and recordskept of reports and accountability. Independe)student action is expected and performancewill be critiqued. Discussions will beheld to discuss the newest materials andpreparation procedures, and preparationfor the registery exam.

G. PhotographicTechniques - Students are expected to indepenaently perform

the routine procedures, including dark roomwork, required to produce photographic records.A student's performance is discussed.

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RECOMMENDED TEXTS, LABORATORY MANUALS REFERENCES

English - Writing in-college, Kerrigan; Harcourt, Brace andJovanovichWriting to the Point, Kerrigan; H.B.J.Principles of Speech, Monroe; Scott, ForesmaniSpeech Communication, Ross; Prentice HallHandbook of Current English, Perrin et al; Scott,ForesmanEffective English: A_Guide for Writing, Canavan;Dickenson PublishingReport Writing, Graves and Hoffman; Prentice HallTechniques of Reading, Jodson et al; H.B.J.Reference Books: A Brief Guide, Parton and Bell;Enoch7Websters or Heritage Dictionary, Pratt Free Library

Math - Supercalifragilistic, Furgale; XeroxElementary Algebra, Stephans; RienhartIntermediate Algebra, Leithold; MacMillanModern Elementary Statistics, Freund; Prentice HallBasic Mathematical Skills, Gossage; McGraw HillEssentials of Mathematics, Person; WileyIntroduction to Technical Mathematics, Washington, Cummings

Chemistry - Basic Chemistry for the Life Sciences, Helmpracht andFriedman; McGraw - HillChemistry, L. Wasserman; WadsworthChemistry Laboratory Manual, Wasserman; WadsworthChemistry for the Health Sciences, Sacheim andSchultz; MacMillanC!.emistry and the Living Organism, Bloomfield; WileyLaboratory Experiments for Chemistry and thelLivingOrganism, Bauer and Bloomfield; WileyEssentials of General, Organic, and Biochemistry,Routh et al; SaundersExperiments in General, Organic, and Biochemistry,Routh et al; Wiley

Physics - Physics for the Life Sciences, Crowell; McGraw HillLaboratory Manual for Physics for the Life Sciences,Crowell; McGraw HillPhysics for the Health Sciences, Have and Nave; SaundersPhysics for Biology and Pre-Med Students, Greenberg;SaundersLaboratory Phyeics.for the Life Sciences, Hayden; 'SaundersThe Clinical Applications of Physics of Radiation andNuclear Science, Bogardus; Green, Inc.Experiments in Nuclear Science, Chase; Burgess.

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Anatomy and Physiology - Basic Anatomy and Physiology, McClinticcWileyHuman Anatomy and"Aysiology, Hartenstein;Van NostrandAnatomy and Physiology, Evans; PrenticeHallStructure of the Human Body, Gardner andOsbournei SaundersIntergrated Science for Health Students,Lankyord;tRestonAnatomy and Physiology, Anthony; MosbyLab Manual; Anatomy and Physiology,Anthony; MosbyLab Manual of Mammalian Anatomy andPhysiology, Grollman, MacmillanLab Manual; Introductory Physiology andAnatomy, Haupt et al, Macmillan

Sociology - Social Problems,_ McKee; Random HouseSocial Problems, Scarpitti, HRWIntroduction to Sociology, Denisoff; MacmillanFuture Shock, Toffler; Random HouseHuman Behavior at Work, Davis; McGraw HillHuman Relations, Ellenson; Prentice Hall

Psychology - Psychology in Action, McKenney; MacmillanIntroduction to Psychology, Hilgard; Harcourt, Brace,and JovanovichReadings in Human Development, Roe; DushkinAbnormal Behavior, McMahon, Prentice HallI'm OK...You're OK., Harris; Harper and RoePsychology in Industrial Organizations, Maier;Houghton MifflinMotivation and Personality, Maslow; Harper & How

Hospital Orientation - Nuclear Medicine, Wagner; HP PublishingLearning Medical TErminology, Young andBarger; MosbyNuclear Medicine for Technicians, Lange;Year Book MedicalTechnology for Patient Care, Bronzino; MosbyThe Dynamics of Health Care, French;McGrew HillNursi:ig of Adults, Smith and Germaine;LippimcottTaber's Cyclopedic Medical Dictionary,Thomas; DavisPractical Nurses Medical Dictionary,Schmidt; ThomasYour Body and Radiation, USAECRadiological Health Handbook, USEPA

31 35

Nuclear MedicalTechnology Courses - Nuclear Medicine for Technicians, Lange;

Year Book Medical PublishersNuclear Medicine Technology, Early et al;

. Mosby0 Basic Science Principles of Nuclear Medicine,

Boyd and Dalrymple; MosbyPrinciples of Radioisotope Methodology,Chase and Rabiaowitz; BurgessRadioactive Nuclides in Medicine and Biology,Quimby et al; Lea and FebigerClinical Nuclear Medicine, Maynard; Lea &Febiger-Radiopharmacy, Tubis and Wolf; WileyRadiopharmaceuticals, Subramanian et al; SNMFundamentals of Radiobiology, Bacq andAlexander; PergamonMedical Radiation Biology, Dalrymple et al;SaundersIntroduction to Health P sics, Cember;PergamonRadiological Health Ha ook; Bureau ofRadiological HealthRadiation Biophysics, Andrews; Prentice Hall

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MEDICAL IMAGING AND RADIATION TECHNOLOGY CORE PROGRAMGENERAL -DESCRIPTION

A two year associate in science degree program was designedto satisfy the needs for training for radiologic, nuclearmedical, ultrasound, radiotherapy, and biomediCal technologists.A survey of existing_literature_(Reterences 117, 8, 9) indicatedthat enough similarity existed between all of the diagnostic andthe therapeutic .specialties to allow for a common core of basiccourses which could satisfy the preparatory academic requirements-of each specialty. While this report presents, the two yearcurriculum for a nuclear medical technology option only, it wasthe intent of the study to have the course selections for thefirst year specified for the NMT option satisfy the requirementsfor the specialties listed above. Other specialties such asthermography, mammography, xeroradiography, electron radiography,special procedures, and floroscopy which are currently beinghandled by radiologic technology should, at this time, remainthere, as did nuclear medicine and ultrasound, until they toohave grown in the numbers and types of procedures and servicesoffered to warrant special attention and specialized educationalprograms. Perhaps that time is 'not too far off as in the caseof Nosimetry and radiation therapy. However, if and when aseparation dJ5es occur it is believed that, these specialties toecan enter the family_of programs 'offered to imaging and therapytechnologists and share in the offerings of a core program.

A core of related programs has so much to offer students,professionals, organizations, and the profession. With a coreprogram that has several specialized options, there exists theflexibility to change the number of entering students in any one-specialty so as to adjust to local or regional changes in the jobmarket and the technology. This flexibility offers the studentthe opportunity to change his specialization prior to hissecond year_based onhis increased awareness of the field gainedduring his first year; to the college the ability to adjustnumbers of students in individual options while maintaining asignificant number of total students in the entire program towarrant the offering of specialized courses and services thattheae students will need; to hospitals the opportunity to moreeasily change the number of students presently in an option basedon near future projections of the need for technologists, and theopportunity to fill more easily vacancies in other departments frothe larger number of students present in the total program; and tothe profession increased communication and cooperation betweendepartments and hospitals who are really trying to do their bestby offering the best medical services possible. Perhaps a newcommunity spirit will grow amongst the members of diagnostic andtherapeutic professions.

Students in each option will take all of the courses in theirfirst year, and then go off in groups ranging from four to eightstudents to different hospitals or to different departments inone hospital to' continue with their studies 'in the clinical anddidactic phases of their training.

Not all options need to be twentyseven months long as is theNMT option, but for students who are recent high school graduatesor who have no previous medical experience at least twentyfourmonths is required. 33

37

For professionals who have previously worked in the field,and who have accredited and certified medical training, aminimum of twelve months clinical training would be required tosatisfy AMA requriements, and perhaps an additional course ortwo as a refresher.

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COOPERATIVE RELATIONSHIPS

The core program was designed as a cooperative relationshipbetween a community college and several hospitals. The intentwas to give the college the responsibility for administeringthe program and the granting of the degree of Associate inScience. There are about twelve programs of this nature(Reference 3).n the country, most of which consist of such anaffiliation, but for usually only one program or perhaps two.Several programs have multiple specialties, and references 3 and 4describe those programs at Denver Community College and atthe British Columbia .lastitute of 1Schnology.

Affiliation agreements and contracts between colleges andhospitals have been documented in the literature, eg; Reference 11contains the contract between Springfi.eld Technical CommunityCollege and Wesson Memorial Hospital. Such contracts which donot have exclusivity clauses can be signed between a college andseveral hospitals, and will add to the relationships throughincreased communications and sharing of resources and facilities,

Much can be gained from such relationships if a spirit dfcooperation and friendly competition is maintained. Studentsin various programs will have the advantage of rotations todifferent hospitals, be they public or private institutionsserving small or large communities or perhaps even institutionsinvolved in research and higher education. Exposure of thestudent to such diverse hospital environments will offer a widebreadth of experiences which can only increase his cosmopolitanand communal senses. Professional and social acquaintencesor relationships will add to the profession more friendly, cordial,and respectful attitudes. Job hunting will be much simpler, aswill the selection of new employees as the word circulates as towhich organization does what better and which prospect wouldbe best for a particular organization. In addition, from thetechnical point of view there will be more sharing of information,procedures, and, perhaps, services and personnel. Rotation ofclinical instructors, as an example or perhaps computer analysts,may be possible so as to reduce unnecessary duplication of effortsfor educational programs which usually have small enrollments.AS-nib restrictions on hospital costs increase, and the ability ofhospitals to purchase expensive equipment decreases, the rotationmethod may be the only way in which students can be exposedto expensive machinery such as computers, CAT scanners, wholebody scanners, linear accelerators, etc.

The disadvantages of such a program for students centersaround their need to travel to different institutions and thefamiliarization with the facility, the staff, and the proceduresfor each. Of course, they will be evaluated by many more people,which may or may not be a disadvantage, and they will certainlybe held responsible for much more knowledge of a technical andprocedural nature.

For hospitals the disadvantages will deal mostly withfamiliarization of new groups of students several times a year.However, since the groups may be as small as two or four at atime, individual departmental staff members should be able tofacilitate the handling and the familiarization of the new studentwithout disruptions in the daily work schedule of the department.

3539

For the college the core program will need more personnel,staff, and support when compared to programs in nonclinicalareas which service about the same number of students. Separateapplications, procedures,, arrangements, and accreditations maybe necessary for each hospital. However, there is really noalternative if colleges wish to service the needs of andcooperate with the medical community. Clinical programs such asthese usually demand small numbers of students, and when thiscore program is compared to the operation of separate programsin each area the cost factors favor the core. If collegesattempt to cut their costs and increase their efficiency byincreasing the number of students, cooperation from the hospitalswill cease and perhaps the entire program. Hospitals cannottolerate large numbers of students in their workiiig areas, norwill they be able to employ upon completion of the program thelarger numbers forced by the college. Therefore, the clusteringof several small programs around a core appears to be overallless costly, more efficient, and broader educationally thanthe operation of several separate programs.

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4

CONCLUSIONS AND RECOMMENDATIONS

The cooperation for educational programs between colleges andhospitals has been growing in recent years in the general'field ofthe radiologic sciences, and the associations have been cordial,efficient and beneficial to all concerned (References 4, 5)

While there has been a relatively large growth (comparedto employment opportunities) in the ,field of radiologic technologythere has been a low growth rate for'programs in nuclear medicaltechnology '(again compared to employment opportunities).Employment opportunities documented in references 2 and 6indicate that employment and career oppOrtunitios for NMT's havebeen growing at a very great ratein recent years; a rate whichhas out paced the establishment of career programs and thedelivery of trained-technologists.

The growth rate in NMT offers to trained radiologic tech-nologists an expansion into a related area that they could easilyenter and become certified. It was the intention of this studyto allow registered technologists the opportunity to enter theprogram in the second year.

A review of Connecticut Community College catalogs such .asreference 10 and proposed curricula (references 5, 11) indicatesthat most colleges offer all of the basic academic coursesrequired as prerequisites to the various specialties in theradiologic sciences, and that core programs make sense from anacademic or technical point of view, but pose problems in liaisonand coordination.

The core program presented can serve as a model for otherclinical or specialized programs which deal with more than oneinstitution in several areas where enrollments for any one areamight, of necessity, be small. However, startup of theseprograms are difficult, for each option in such a clusterrequires the same amount of research, production, coordination,liaison, approval, and administration of procedures as a fulltime program.Studies such as this presented for the NMT option wilbe repented for ultrasound, radiotherapy, and biomedical7,echnology.

It became clear daring the course of this work that theoverall recommendation was to encourage continued cooperationbetween colleges and outside institutions in the developmentof career training programs for students.' This cooperation isessential if educational organizations are to be able to presentviable training programs which are of use to industry and employer

The cluster concept for educational programs needs supportfor the startup and the coordination and the liaison necessaryfor such programs. Without such support there may be littlecontact, lack of communication, and often bad feelings generatedbetween institutions. The continued involvement of staff membersin the operations of other organizations is essential to thesuccess of such a program.

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REFERENCES

1. Essentials of an AMA Accredited Educational Program for theNuclear Medical Technologist, Revised June 1976, AMACouncil on Medical Education.

2. Studies of Educational Programs and Employment Opportunitiesin Health, Connecticut Institute for Health ManpowerResources, Commission for Higher Education.

3. Allied Medical Education Directory, AMA;Development ofCareer Opportunities for BMET's, TERC.

4. A Case Study of the History and Development of an NMTEducational Program, Technical Education Research Centers.

5. Triton Community College; Nuclear Medical Technology Program6. Development of Career Opportunities for NMT's, TERC.?. Essentials of an Accredited Educational Program for the

Radiation Therapy Technologist, Revised Dec. 1976, AMA.8. Essentials of an Accredited Educational Program for Radiologic

Technologists, Revised Dec. 1969, AMA.9. Currioulum Guide for Programs in Radiologic Technology,

Sept 1976, American Society of Radiologic Technologists.10. Middlesex Community College Catalog, 1976.11. A Suggested Post Secondary Curriculum in Nuclear Medical

Technology, TERC.

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BIBLIOGRAPHY

1. Essentials of an AMA Accredited Educational Program for theNuclear Wedical Technologist, AMA Council on Medical Educatio:

2. Programs in Radiologic Technology, Curriculum Guide, AmericanSociety of Radiologic Technologists,

3. Textbook of Nuclear Medicine Technology, Early et al; Mosby4. Nuclear Medicine for Technicians, Lange; Year Book Medical

Publishers5. Principles of RadioisOtope Methodology, Chase and Rabinowity;

Burgess6. Radioactive Nuclides in Medicine and Biology, Quimby et al;

Lea & Febiger7. Basic Science Principles of Nuclear Medicine, Boyd; Mosby8. Medical Radiation Biology, Dalrymple et al; Saunders9. Radiation Biology, Casarett; Prentice Hall10. Exercises in Diagnostic Radiology, Vol. 6 Nuclear Radiology,

44 Vol. 8 Diagnostic Ultrasound; Squire, Saunders11. Experiments in Nuclear Science, Chase et al; Burgess Publishinf

. 12. Introductioa to Health Physics, Qembes; Pergamon13. FundamentaLs of Radiobiology, Bacq and Alexander; Pergamon14. Clinical Nuclear Medicine, Maynard; Lea E.nd Febiger15. Radiopharmacy, Tubis and Wolf; Wiley Interscrene16. Radiologic Science for Technologists, Bushong; Mosby17. Intro to Physics for Radiologic Technologists, Graham and

Thomas; Saunders18. The Physics of Radiography, Ridgeway and Thumm; Addison Wesley19. Radiation Biophysics, Andrews; Prentice Hall20. Ultrasonic Biophysics, Dunn and O'Brien; Halstead21. National Nuclear Medicine Seminar, Squibb Co.22. Nuclear Medicine Technology, Technical Education Research

Center23. Development of Career Opportunities for NMT's, TERC24. Career Ladder Concept in Nuclear Medical Technology, TERC25. Workshop Manual for Quality Control of Scintillation

Cameras in Nuclear Medicine, Bureau of Radiological Health26. Nuclear Medical Technology Program, Triton Community College,

Chicago_27. Technology for Patient Care, Bronzino; Mosby28. Biomedical Equipment Technology, Technical Education Research

Centers29. Basic Electronics for Scientists, Brophy; McGraw Hill30. Medical Instrumentation for Health Care, Cromwell et al;

Prentice Hall31. Biomedical Instrumentation and Measurements, Cromwell et al;

Prentice Hall32. An Introduction to Biomedical Instrumentation, Dewhurst;

Pergamon33. Image Reconstruction From Projections, Scientific American,

Sept. 197534. Biophysical Aspects of the Medical Use of 99mTc, Keriakes,

American Association of Physicists in Medicine, 197735. Scintillation Camera with 11 inch Crystal, Hal Anger, USAEC

Report.36. Proceedings of 6

thSymposium, Society of Nuclear Medicine

37. Semiconductor Detectors, SNM38. Tomographic Imaging in Nuclear Medicine, SNM39. Computer Processins of Dynamic Images, SNM40. Radiophartaceuticals, SNM

39 43

APPENDIX AABSTRACT

title of Project: Curriculum Development For Nuclear MedicineTechnology

Project Director: Albert Buatti, Associate Professor In Science

Applicant Organization: Middlesex Community College, Middletown,Connecticut

Total Project Funds: $6672 (State/Federal: $3340 Local: $3332Inkind)

Beginning Date: January 14, 1977 Ending Date: June 30, 1977

Objectives: To develop the curriculum and the proceduresfor the clinical phase of training for NuclearMedicine Technologists.

To develop a procedure for the operation of aMedical Radiation Technology core program whichwill encompass a cluster of five related diagnosticand therapeutic technologies:

1. Radiologic Technology,2. Nuclear Medicine Technology,3. Ultrasound Technology,4. Radiotherapy Technology,5. Biomedical Technology.

Procedures: The project director will spend one day per week forsix months working at Hartford Hospital for thepuropse of producing curriculum materials for theNuclear Medicine Technology program.

Also, he will consult with the staff at the Universityof Connecticut Health Center and at Yale-New HavenHospital to observe the latest clinical techniquesand to develop the procedures for the coordinationof several programs at these hospitals.

Contribution to Education:

Nuclear Medicine Technology is a new and emergingcareer for which educational materials must bedeveloped.

The development of a core program that can service asmany as five career programs will help to relieve theproblem that occurs in health programs due to theconflicting needs of the cooperating institutions;Colleges need many students in a program - Hospitalscan handle only a few.

The Curriculum materials developed may be used insimilar programs at other colleges and hospitals.

The core program in Me cal Radiation Technology canserve as a model for Pialre core programs.

Essentials of an Aciredited Educational Programfor the Nuclear Medicine Technologist(Robed ban% MOEstablished byAMERICAN MEDICAL ASSOCIATIONCOUNCIL ON MEDICAL EDUCATIONin collaboration withAMERICAN COLLEGE OF RADIOLOGYAMERICAN SOCIETY FOR MEDICAL TECHNOLOSYAMERICAN SOCIETY OF CLINICAL PATHOLOGISTSAMERICAN SOCIETY OF RADIOLOGIC TECHNOLOGISTSSOCIETY OF NUCLEAR MEDICINE

The organizations indicated above have obvious interest andconcern in the development of educational programs designed to .

prepare the nuclear medicine technologist. To organize their con-cerns and provide an orderly mechanism for, both program evalua--'ion and preparation of recommendations on accreditation status,`these organizations have established a Joint Review Committee onEducational Programs in Nuclear Medicine Technology. As theagent' of the five sponsoring organizitions and of the Council onMedical Education in matters relating to educational programs innuclear medicine technology, the Joint Review Committee is dedi-cated to the maintenance of high standards of education. Its mem-bership is comprised of representatives from each of the sponsoringorganizations.

The education and health professions cooperate in establishingand maintaining standards of appropriate quality for educations/programs in nuclear medicine technology and in providing recogni-tion for educational programs that meet or exceed the minimumstandards outlined in these Essentials. These standards are to beused as a guide by the Joint Review Committee and programdirectors. -

DESCRIPTION OF l'IlE OCCUPATIONThe practice of nuclear medicine includes the utilization 'of

raciioaaive materials for therapeutic and dilly:I:66c, "in vivo" and"hi vitro" procedures and any combination thereof. The skills ofthe nuclear medicine techria ogiv shall complement those of thenuclear medicine physician other professionals in the field.

The nuclear medicine to hnologist mast be able to performeffectively in three major areas of responsibility:A. Patient Care

I. Must understand and relate to the patients' concerns andfears about their illnesses and pending diagnostic proceduresor therapy.

2. Must recognize emergency patient conditions and initiatelife-saving first aid prior to the wivel of a physician.

B. Technical Skills ...

I. Prepares and manages quality control of radiopharmaceuti-cals n patients by intravenous, intramuscular, subcutane-ous, and oral methods.

2. Understands and utilizes radiation detection devices andother laboratory equipment that measure the quantity anddistribution of radionuclides deposited in the patient or apatient specimen.

3. Performs "in vivo" and 'in vitro" procedures, understand-ing these tasks sufficiently well to supplement selectedexaminations and procedures for the benefit of the patientand to improve the diagnostic quality of the data produced.

4. Utilizes his knowledge of radiation physics and safety regu-lations to practice radiation safety, thereby limiting theexposure to the patient. the public, and fellow radiation"workers to acceptable, minimal levels of radiation.

S. Is aware of quality control techniques and applies themappropriately to all procedures and products in the laborato-ry.

6. Participates in research activities that demand a thoroughknowledge of the many facets of nuclear medicine.

C. Adolidetrative FunctionsI. May supervise other nuclear Medicine technologists, labora-

tory assistants, and other personnel.2. Participates in the procurement of supplies and instrumenta-

tion required to operate the facility.3. Records all operations of the laboratory including the receipt

and disposition of radioactive materials, instrument andprocedural nuality control data, patient procedures, andundies! recotds..

REQUIREMENTS FOR ACCREDITATION

I. INSTITUTIONS THAT MAY EST'AELISHPROGRAMSA. Junior and Senior Colleges, Universities, and Technical. Vocational InstitutesB. Hospitals and ClinicsC. Medical Schools '

The institution must be accredited or otherwise acceptable to theCouncil on Medical Education of the American Medical Associa-tion. Colleges, universities, and technical vacationist instituteswithout clinical facilities must have appropriate clinical affiliations.

45

II. INSTRUCTIONAL FACILITIESA. General - Adequate classrooms, laboratories, and clini-

id facilities must be provided.B. Laboratory - Appropriate modem equipment ihd

supplies for directed experience must be availabk insufficient quantities for full participation by the indi-vidual student.

C. Library - A library must be readily accessible and con;thin an adequate supply of current reference volumes,periodicals, and other material related to the curriculum.

MI. CLINICAL FACILITIESA. The Clinical phase of the educational program must be

conducted in a broad clinical setting under competentmedical direction.

B. In the clinical teaching environment, an effective ratio ofstudents to clinical instructors must be maintained.

C. The type and quantity of nuclear medicine proceduresmust be adequate for the clinical training of the student.

D. The clinical facility must have adequate quantity andvarieties of nuclear medicine instumentation to allowfor student instruction.

E. Where classroom and clinical instruction are not pro-vided in the same institution, accreditation will begranted lo the sponsoring institution, as identified byestablished AMA criteria. However, responsibilityfor quality of the total teaching program most beshared by both institutions involved (i.e., collegeand hospital).

IV. FINANCESA. Financial resources for continued operation of the educe-

tional program must be assured through regular budgets.B. The institution shall not charge excessive student fees.

C. The sponsoring institution or its clinical affiliates mustnot substitute students for paid personnel to conduct thework of the clinical faculty.

V. ADMINISTRATORS AND FACULTYA. Edacatioaal Directors

The educational direction shall be assumed by a physi-cian, nuclear medicine technologist, or. other alliedhealth personnel (i.e., physicist, professional educator).

Every program must have a qualified medical directorand nuclear medicine technologist director responsiblefor the clinical training, program coordination and for theorganization, administration, periodic review, continueddevelopment, and general effectiveness of the program.

B. Medial DirectorThe medical director must be a physician qualified in theuse of radionuclides and a diplomate of the AmericanBoard of Nuclear Medicine, Nuclear Radiology, a sub-specialty of the American Board of Radiology, orRadioisotopic Pathology, a subspecialty of the Ameri-can Board of Pathology; or have qualifications accepta-ble to the Council on Medical Education.

The medical director of the program shall providecompetent direction for the clinical instruction and forclinical relationships with other health and medical edit-CatiOliii programs and should develop the understandingand support of practicing physicians.

C. Tedoologist VL'ectorThe technologist director shal) devote full time to thelaboratory where the educational program is conducted.The technologist must be certified in nuclear medicinetechnology by the American Society of ClinicalPathologists Board of Registry or the American Registryof Radiologic Technologists. This technologist musthave at least three years of experience at a combination ofstaff and senior nuclear medicine technologist levels andshall have education and experience embracing methodsof instruction, educational psychology, and human rela-tions.

D. Faculty AppointmentsIf the clinical facility is not an integral part of the institu-tion initiating the program (i.e., university: technicalvocational institution), the physician, technologist direc-tor, and instructors shall be members of the faculty orstaff of the sponsoring institution.

E. Change of DirectorIf any of the directors of the educational program arenewly appointed, immediate notification must be sent tothe AMA Department of Allied Health Evaluation. Thecurriculum vitae of the new directors, which shouldinclude details of training, education, and experience inthe field, must be submitted. If the new director's cre-dentials are satisfactory, accreditation of the programwill be continued.

F. Teaching StaffThe instructional staff must be qualified throughacademic preparation and experience to teach the sub-jects assigned. Faculty shall have adequate and appro-priate training in the areas of curriculum design andteaching techniques. The staff shall include at kart oneinstructor who is certified in nuclear medicine tech-nology and actively engaged in the clinical practice ofnuclear medicine lechnol ogy.. A planned progrim for thecontinued education for the faculty shall be provided.

G. Advisory CouunitteeFor programs involving mow than a single institution, anadvisory committee must be appointed to assist the dime-

ton in continuous* program development and evaluation,in faculty coordination. and in ensuring effective clinicalrelationships. Programs having minimal or no extra-institutional activities shall provide for periodic reviewand updating of program standards and curriculum con-tent by the director and institutional staff.

VI. STUDENTSA. Selection -In colleges. universities, and technical voca-

tional institutes. Election of students shall be made inaccordance with the generally accepted practice of theinstitution. Directors of the clinical aspects of the pro-gram shall be involved in the selection. In hospital-sponsored Prognosis, selection of students must be madeby an admissions committee of individuals responsiblefor the program. Admissions data shall be on fik at alltimes in colleges, universities, or hospitals sponsoringthe Minot

B. Admission Requirements - Persons admitted into nu-clear medicine technology programs shall have com-pleted high school or its equivalent and have completedpostsecondary courses in the following areal.:

Anatomy told Physiology2. Basic Physics3. Basic Mathematics4. Medical Terminology5. Oral le Written Communications6. General Chemistry7. Psychology and Sociology8. Medical Ethics and Jurisprudence

Under unusual circumstances some of the prerequisitesmay be completed during the year of nuclear medicinetraining.

Qualified medical technologists, M.T. (ASCP) oreligible. ndioloagic technologists, R.T. (ARRT) or eli-gible, and registered nurses. R.N. are presumed to havethe necessary crtedentials to meet the entrance require-ments.

Educational institutions such as junior colleges, uni-versities, and technical vocational institutes may providethese prerequisite courses as pan of an integrated pro.gram in nuclear medicine technology (i.e.. 2 to 4 years).In these programs educational institutions are encour-aged to provide such basic elements of a general educa-tion as are necessity to qualify the students for an as-sociate or bachelors degree.Health - Applicants shall be required to submit evidence

3of good health. Student health service shall be availablefor evaluation and maintenance of the student's health.When students are learning in a clinical setting or ahospital. the hospital or clinic shall provide students withthe protection of the same physical examinations andimmunizations as are provided to hospital employeesworking in the Name institution.

VII. STUDENT RECORDSSatisfactory records of student performance in the educa-tional program thal I be maintained. Monthly and annualrepqns of the department must be prepared and available forreview. Records shit!!! include the following:A. Transcripts of high school and college credits and other

pre-admission credentials.B. Certification by A phpscian as to the ...mind:nes good

lealth upon admission'Record of class and laboratory participation and ac-

-'-cosnpliatment of each student in accordance with re-quirements of the institution.

D. Attendance and grades.E. Record of clinical performance under supervision.

46

VIII. 'PROFESSIONAL CURRICULUMA. Length

1. General - The Structure of the curriculum shall bebased on not less than one calendar year of full-timestudy. This is to provide didactic content ofappropri-ate scope and depth as well as clinical experience ofsufficient variety to develop needed knowledge andskills.

2. Innovative Programs - Performance objectives forall phases of curriculum and for graduation shall beclearly defined in terms of measurable behavior.Therefore, the curriculum may also be structured toallow students to-progtess at an individual pace. Thiswill provide an opportunity for students to meet per-formance standards specified for graduation in lessthan normal cumculum length as well as provide anopportunity for students who require more time toextend the length of their instructional program. Stu-dents completing the program in less than oneyear ',rust be advised of current requirements ofnational certifying bodies.

B. Structure - Instruction should follow a planned outlinewhich includes:I. Assignment of appropriate instructional material.2. Classroom pizsentations, discussions, and demonstra-

tions.3. Supervised clinical experience.4. Examinations, oral and written, for didacticand clin-

ical aspects of the program.C. Content

a. Patient Careb. Nuclear Physicsc. Instrumentation and Statisticsd. Health Physicse. Biochemistryf. Immunologyg. Radionuclide Chemistryh. RadiopharmacyI. Administrationj. Radiation Biologyk. Clinical Nuclear Medicine - "in vivo" and "in

vitro" studiesI. Radionuclide Therapym. Introduction to Computer Application/operation or

data manipulationD. Records - Complete curriculum shall be kept on file

including rotation of assignment., lists of instructionalaids used to augment the learning experience of thestudent, copies of the ccarse outlines, and classschedules. Directed experience and teaching plans shallbe kept on file and available for review. Copies of thepractical and wntten examinations should be maintainedand continually rc-evaluated.

IX. EDUCATIONAL OBJECTIVESAfter participation in the program, each student must beexpected to have attained a certain level of knowledge andunderstanding that is consistent with specific performanceobjectives. Following is a minimal list of objectives.A. Physical ScierKe. The technologist must demonstrate a

fundamental knowledge and understanding of the fol-lowing:I. elementary aspests of the structure of matter with

special emphasis on the composition, stability. andenergy levels of atomic nuclei.

2. modes of radioactive decay with special emphasis onbeta decay. electron capture. metastable states, andinternal comer:Am

3 particle and photon radiation accompanying radioac-tive decafwith special emphasis on photon radiation.

4. interactions of radiation with matter. with special

47

emphasis on photoelectric and Compton interactions.S. radiation detectors with special emphasis on scintilla-

tion and semi-conductor detectors for photons.6. collimated radiation detectors with special emphasis

on the characteristics of/flat-field, focused, parallel-hole diverging, and pier:hole collimators in responseto point, line, and plane sources.

7. electronic instruments such as amplifiers, pulse-height analyzers, scalers, count-rate meters, andcomputers.

8. statistics of counting random events.9. mathematical operations including logarithms and

exponential functions.B. Radiation biology and protection. The technologist must

demonstrate a fundamental knowledge and understand-ing of:1. the biologic effects of radiation exposure.2. administrative and technical means of reducing un-

necessary radiation exposure to patients, personnel,and environment.

3. techniques of measuring levels of raoioactive con-tamination and techniques of decontamination.

4. government regulations regarding exposure and ma-terial handling.

C. Radiophamtaceuticals. The nuclear medicine technol-ogist must be able to demonstrate knowledge and under-standing of radiopharmaceuticals in the followingspecific areas:I. production of radionuclides by reactors and particles

accelerators, the use of radionuclide generators, theconcept of specific activity ter± the special chemicalcharacteristics of the carrier-free state.

2. formulation of radi.,pharmaccuticals including gen-eral techniques of preparing agents used in the nucle-ar medicine labbrutory, quality control proceduresincluding tests for radiochemical purity, quantitativeassay. sterility and pyrogens.

3. operation of electronic equipment appropriate forradioassay and quality control.

4. understanding of biochemical and physiologicalproperties or radlopharmaceuticals including themechanism of localization.

D. "In vivo" procedures (imaging and "in vivi," labortF"tory work). The technologist must demo strate knowl-edge and understanding of s,I. stationary and moving radionuclide imaging devices.2. stationary imaging include: imaging of brain, cereb-

ral spinal fluid spaces, thyroid,_lung, heart_liver,spleen, kidney, bones, and other organ systems.

3. the use of single and multiple detectors for time-dependent studies such as cerebral bood flow, thyroiduptake, cardiac output, differential renal function.

4. body composition teats such as blood volume, redblood cell volume.

5. erythrokinetic studies including red cell productionand deszuction and quantification of blood loss.

6. gastrointestinal absorption studies of substances suchas iron, vitamin 1312.

7. gastrointestinal loss studies such as proteins, blood.E. "In vitro" procedures. The technologist must demon-

strate knowledge and understanding of:I. the hazards of working with toxic chemicals, infecti-

ous biologic materials, and radionuclides, and beespecially aware of the proper handling and disposalof such materials.

2. common laboratory instruments and equipment in-eluding pipets, centnfuges, pH meters, analyticalbalances. calculators, and scintillation counters.

3. the pnnciples of saturation analysis and competitiveprotein binding assays in order to follow a protocol,

with an appreciation of the indications for and limita-tions of the technique including procedures such asprinciples of physiology and biochemistry pertainingto specimen collection and analyses.

4. good laboratory quality assurance program, how toset up such a program, and an appreciation of thenecessity of maintaining adequate laboratory records.

F. Therapeutic uses of radionuclides inc. Ading knowledgeand understanding ofI. ,he more common therapeutic applications of

radionuclides, dose ranges for each indication, andproper techniques for calculating quantities of ad-ministered radiopharmaceuticals.

2. special problems of patient care, radiation safety, andfollow-up.

3. special problems of handling excreta from such pa-tients.

X. ADMINISTRATIONA. Catalog - An official publication including g description

of the curriculum shall be issued at least biennially. Itshall include information regarding the org.mization ofthe program, a brief description of required courses,names and academic rank of faculty, entrance require-ments, tuition and fees, and information concerning hos-pitals and facilities used for directed experience. Thecatalog must also include information about the currentaccreditation status of the program.

B. Accreditation - Evaluation,, including survey team vis-its, of a program of study can only be initiated by theaxpres, invitation of the chief administrator of the spon-soring institution or his officially designated representa-tive.

C. Withdrawal - The institution may withdraw its requestfor initial accreditation at any time (even after evalua-tion) prior to final action. The AMA Council on MedicalEducation and collaborating organizations may with-draw accreditation whenever the educational program isnot maintained in accordance with the standards unlinedabove, or when there are no students in the program fortwo consecutive years. Accreditation may be revokedonly after notice in time to review and respond has beengiven to the chief administrative officer of the sponsoringinstitution and program director indicating that such ac-tion is contemplated and providing reasons therefor.

D. Re-evaluation and Review - The program director andchief adminisoative officer are given the opportunity tobecome acquainted with the factual part of the report.prepared by the visiting team and to comment on itsaccuracy before final action-is taken: At-the request ofthe institution, a resurvey may be made. Accreditationdecisions may be appealed by letter to the Council onMedical Education of the American Medical Associa-tion.

4

E. Reports - An annual report must be mackto the AMACouncil on Medical Education and collaborating orpni-zations through the Joint Review Committee on Educa-tional Programs in Nuclear Medicine Technology., Areport form is provided and should be completed, signedby the director of the educational program, and re/timedpromptly.

F. Resurvey - The AMA and collaborating organizationswill periodically resurvey educational programs for con-sultation and evaluation.

APPLICATIONS AND INQUIRIESA. Accreditation

Application for accreditation of a program shall be made to:DEPARTMENT OF ALLIED HEALTH

EVALUATIONDivision of Medical EducationAmerican Medical Association535 N. Dearborn StreetChicago, Illinois 60612

B. CareersInquiries regarding career information should be addressed to:

AMERICAN COLLEGE OF RADIOLOGY20 North Wacker Drive .

Chicago, Illinois 60610AMERICAN SOCIETY FOR MEDICAL

TECHNOLOGY5555 West Loop South, Suite 200Bellaire, exits 77401AMER AN SOCIETY OF CLINICAL

PA HOLOGISTS2100 West Harrison StreetChicago, Illinois 60612

AMERICAN SOCIETY OF RADIOLOGICTECHNOLOGISTS

500 North Michigan Avenue, Suite 836Chicago, Illinois 60610SOCIETY OF NUCLEAR MEDICINE475 Park Avenue South ,New York, New York 10017

10,C. Registration Certification

Inquiries regarding registration or certification of qualifiedgraduates of the accredited program shall be addiessed to:

AMERICAN REGISTRY OF RADIOLOGICTECHNOLOGISTS /

2600 Wayzata BoulevardMinneapolis, Minnesota 55405

BOARD OF REGISTRYAmerican Society of Ciihical Pathologists2100 West Harrison StreetChicago, Illinois 60612

-1

APPENDIX CSociety of Nuclear Medicine

VOICE GENERAL INFORMATION

What is VOICE? VOICE (Verification of Involvement inContinuing Education) is a continuing education accountingprogrAm developed and offered by the Technologist Section ofthe Society of Nuclear Medicine. This program offers apermanent, official computerized record of continuing educationactivities related to nuclear medicine tecnnology. VOICEawards points for participation in a variety of activities.Persons who accumulate a total of 150 points in a 2 yearperiod are awarded a Cerficate of Continuing Education.

Why did the Technologist Section develop the VOICEro am? The rapid change in nuclear me icine equipmentana clinical procedures, and the concern of the public forquality health care and radiation safety, require that today'snuclear medicine technologists continue their educationalinvolvement beyond basic training. Continuing educationis also being considered as a popular alternative to certificationby examination. VOICE offers the technologist a method ofmaintaining a comprehensive, permanent record of all educationalexperiences. The VOICE program has been in existance sinceJune, 1976.

What kind of credits are earned?CEU - Continuing Education Units

The CEU is the nationally accepted measure of continuingeducation in a forL,a1 setting. The CEU is definedby the National Task force on Continuing Educationas'follows: "One CEU is 10 contact hours ofparticipation in an organized continuing educationexperience under responsible sponsorship, capabledirection, and qualified instruction. The CEU -

s educational value, is recognized nationally,and promotes high quality educational programswhich may lead to an increased professionaldevelopment of individuals".CEU courses sponsored by the Technologist Sectionmust-be-at-least 5 hours in length and may beoffered within a single session or over a longerperiod of time. CEU credit is only awarded toattendees who successfully complete.an evaluationexamination or project at the end of an accreditedcourse.(100 points are ewarded for 1.0 CEU. At least1.0 CEU is requii.ed for the Certificate)

VUE - Verified Unit of EducationVUE creditis awarded to persons having successfullycompleted the evaluation examination or programof a CEU course, so accredited by an organizationother than the Technologist Section.(100 points are awarded for 1.0 VUE. However, only50 points can be used towards the Certificate)

Technologist Section

49

PAR - Professional Activities RecognitionThis category recognizes educational experiences,which although relevant and of equivalent qualitycontent, do not meet the criteria for CEU or VUEcredits: attendance at professionally relatedlectures, symposia, and workshops (2 points perhour), publication of articles, books, etc.,(10 points per publication), presentation ofscientific papers, exhibits, and lectures (10 pointsper presentation), and service in professionalorganizations as an officer or committee member(5 points per year of service). (A maximum of 20points can be. used towards ne Certificate)

Who can spin VOICE? Membership in the VOICE programis open to all persons interested in maintaining a recordof continuing education activities. Members of the TechnologistSection of the Society of Nuclear Medicine are offered VOICEmembership at a lower cost than non-members.

VOICE membership details: The VOIC" program membershipyear is June 1 to the following June 1. Applications areaccepted at any time during the year, but it is recommendedthat technologists apply early on to take full advantage ofthe program. The membership fee remains consistant throughoutthe year: members of the SNM Technologist Section pay $7.00,non-members of thepAIM Technologist Section pay $15.00, andpersons applying simultaneously to the Technologist Sectionand VOICE pay $7.00 (this $7.00 does npt included the SNMor Section application fee).

Receipt of VOICE dues initiates computer docuthentationof continuing education activities.

Credit is not retroactive.There is no billing for VOICE dues] Eventually billing

will be computerized. Until that tithe, a check or moneyorder made payable to the Society of Nuclear Medicine mustaccompany the membership application.

A VOICE card will be sent within three weeks of receiptof the membership application, indicating the member's fullname, VOICE identification number, and card expiration date.

VOICE membership i§orenewed annually, preferably inApril or May.

50

APPENDIX D

NAVAL TRAINING PROGRAMS

NV-0705-0004

NUCLEAR MEDICINE TECHNICIAN(Nuclear Medicine Technic)Course Number: B-322-0010Location: Submarine Medical Center, Groton, CT.Length: 12 weeks (355-398 hours).Dates: 1/63 - Present.Objectives: TD train enlisted personnel in radiation

monitoring and surveys.Instruction:. Lectures and practical exercises in radiation

monitoring and surveys, including' radiological administration,mathematics, physics, reactor plant technology, radiobiology,and dosimetry.

Credit Recommendation: In the vocational certificatecategory, 6 semester hours in algebra, 6 in physics, andcredit in nuclear medical technology, radiology or occupationalsafety and health on the basis of'institutional examination(7/74); in the upper-division bacalaureate category, 6 semesterhours in algebra, 6 in physics, and credit in nuclearmedical technology, radiology, occupational safety and healthon the basis of institutional examination (7/74).

NV-0705-0003

X-RAY TECHNIQUE(X-Ray Technician, Class C)(X-Ray Technic)Course Number: B-313-26; B-313-27; B-313-28; B-313-29;

B-313-30; 3-313-31; B-313-32; B-313-33; B-313-34Location: Naval Hospital, Bethesda, MD; Naval Hospital,

Portsmouth, VA; Naval Hospital, San Diego, CA; Naval Hospital,St. Albans, NY; Naval Hospital, Cp. Pendleton, CA; NavalHospital, Chelsea, MA; Naval Hospital, Great Lakes, IL;Naval Hospital, Oakland, CA; Naval Hospital, P:Iiladelphia, PA.

Length: 52 weeks (2080-2087 hours).Dates: 1/54 - Present.Objectives: To train technicians to operate medical

x-ray equipment, to produce and process diagnostic radiographs,to assist in the application of radiation therapy, and to .

assist in fluoroscopic examinations.Instruction: Lectures on mathematics and electricity;

clinical application of radiologic and fluoroscopic techniques;photodosimetry and radiation safety; film, screen, and darkroomprocedures; and radiation' therap..

Credit Recommendation: In the vocational certificatecategory, 12 semester hours in radiologic technology, 2 inradiation therapy, 3 in physical science and mathematics, andadditional credit in radiologic technology on the basis of

Ia

institutional examination (2/74); in the lower-divisionbaccalaureate/associate degree category, 12 semester hoursin radiologic technology, 2 in radiation therapy., 3 inphysical science and mathematics, and additional credit inradiologic technology on the basis of institutional examination(2/74); in the upper-division baccalaureate category, 12semester hours in radiologic technology, 2 in radiation therapy,3 in physical science and mathematics, and additional creditin radiologic technology on the basis of institutional examination(2/74).

NV-0705-0002

1. CLINICAL NUCLEAR MEDICINE TECHNICIAN(Clinical Nuclear Medicine Technique)

2. RADIOACTIVE ISOTOPE TECHNICIAN, CLASS C(Radioactive Isotope Technic)Course Number: All versions: B-311-16. Version 2: B-311-17Location: All versions: National Naval Medical Center,

Bethesda, MD. Version 2: Naval Hospital, San Diego, CA.Dates: Version 1: 3/72 - Present. Version 2: 1/58 - 2/72.Objectives: To train personnel-to operate and maintain

radioisotope therapy apparatus and to assist medical officerein- radioisotope therapy.

Instruction: Lectures on mathematicst general chemistry,nuclear physics, radiation safety, radiochemistry, clinicalpractice, and laboratory procedures.

Credit Recommendation: Version 1: In the vocationalcertificate category. 3 semester hours in algebra, 6 in physics,6 in physiology, and 3 in.hematology (7/74); in the lower-division baccalaureate/associate degree category, 3 semesterhours in algebra, 6 in physics, 6 in physiology, and 3 in

/ hematology (7/74). Version 2: In the vocational certificatecategory, 4 semester hours in general chemistry, 3 inmathematics, 8 in radioisotope technology, 4 in physicalscience, and ,additional credit in radioisotope technology onthe basis of institutional examination (2/74); in the lower-division baccalaureate/associate degree category, 4 semesterhours in general chemistry, 3 in mathematics, 8 in radioisotopetechnology, 4 in physical science, and additional credit inradioisotope technology on the basis of institutionalexamination (2/74); in the upper-division baccalaureateceAgory, 3 semester hours in general chemistry (12/68).