Introductory X-ray Operator Course - Queensland Health · This course aims to provide participants with the knowledge and skills to perform diagnostic chest and ... anatomy and pathology

Introductory X-ray Operator Course Self-directed Learning Application package

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Name of publication Introductory X-ray Operator Course | Application package Version 3.01 Approved July 2020 First published November 2018 Prepared by Kate Ryan Published by Cunningham Centre PO Box 405 Toowoomba Queensland 4350 Australia t. +61 7 4699 8195 e. [email protected]

This document is licensed under a Creative Commons Attribution Non-Commercial No Derivatives 3.0 Australia licence. To view a copy of this licence visit http://creativecommons.org/licenses/by-nc-nd/3.0/au/ © Darling Downs Hospital and Health Service (The State of Queensland) 2018. This work is copyright. In essence you are free to copy and communicate the work in its current form for non-commercial purposes, in accordance with the Copyright Act 1968, as long as you attribute the Darling Downs Hospital and Health Service (State of Queensland) and abide by the licence terms. You may not alter or adapt the work in any way. For permissions beyond the scope of this licence, copyright inquiries should be addressed to:

Cunningham Centre PO Box 405 Toowoomba Queensland 4350 [email protected]

Disclaimer Darling Downs Hospital and Health Service has made every effort to ensure that the information in this resource, at the time of publication is correct. The information in this resource will be kept under review and future publications will incorporate any necessary amendments. The information in this resource does not constitute clinical advice and should not be relied upon as such in a clinical situation. The information is provided solely on the basis that readers will be responsible for making their own assessment of the matters presented herein and readers are advised to verify all relevant representations, statements and information. Specialist advice in relation to the application of the information presented in this publication must be sought as necessary to ensure the application is clinically appropriate. In no event, shall Darling Downs Hospital and Health Service be liable (including negligence) for any claim, action, proceeding, demand, liability, costs, damages, expenses or loss (including without limitation, direct, indirect, punitive, special or consequential) whatsoever brought against it or made upon it or incurred by Darling Downs Hospital and Health Service arising out of or in connection with a person’s use of information in this publication.

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Course information This application package contains information relevant to applicants, their Facility Managers and Radiographic Advisors1 (RAs). It is essential for all parties to read this application package carefully and understand their responsibilities before an application is submitted. All parties should also be familiar with the Department of Health’s X-ray Operator Services Guideline (QH-GDL-363:2015) which outlines initial and ongoing training and supervision recommendations. All parties should also review the requirements pertaining to X-ray Operators (XOs) within their HHS specific Radiation Safety and Protection Plan (RSPP). Ongoing financial and time costs, as well as workload capacity, for XOs and RAs should be considered before an application is submitted.

Course objectives This course aims to provide participants with the knowledge and skills to perform diagnostic chest and extremity radiography within a rural or remote service. Successful participants will be eligible to apply for a trainee chest and extremity licence from Radiation Health. Upon successful completion of all course components, participants will be able to:

• understand the properties of X-rays and develop the skills and knowledge required to safely operate plain X-ray equipment, including their local facility equipment

• understand and apply the principles of radiation protection for the patient, themselves (as a licensee), staff and members of the public

• understand the responsibilities relevant to holding a Radiation Use Licence under the Radiation Safety Act 1999, including duty of care and consequences of poor radiography

• apply knowledge of common radiographic terminology, anatomy and pathology • interpret and evaluate an X-ray request form • appropriately use image processing and ancillary equipment • perform routine diagnostic radiographs of the fingers, thumb, hand, wrist, forearm, elbow,

humerus, toes, foot, ankle, lower leg, knee, femur and chest, with remote supervision if required • perform diagnostic radiographs of the chest and extremities for various patient presentations, with

remote supervision if required • understand how imaging faults and artefacts occur, affect image quality and how to correct them • review and evaluate radiographs for clinical value and technical proficiency.

1 RA – a radiographer who agrees to support the XO trainee with face-to-face and remote training and supervision.

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Eligibility To be eligible for this course the applicant must: • work in a rural or remote health facility within Queensland • work at an XO-only facility or facility with 1-2 radiographers requiring additional support • demonstrate they meet the course prerequisites including:

— relevant mandatory training completed — basic skills in IT, communication, literacy and numeracy, patient care — basic level of physical mobility — general employability skills e.g. self-awareness, initiative, time management, flexibility,

teamwork, independence. Please note that Radiation Health suggests applicants should be considered from a clinical background in the first instance, e.g. allied health professions and assistants, medical, nursing, paramedics. Where this is not possible (e.g. due to staff turnover, existing responsibilities of clinical staff) non-clinical applicants may be considered i.e. from administrative or operational backgrounds. Note that Radiation Health requires Executive support from the HHS2 to justify the selection of a non-clinical participant. Cost (ex. GST) 1 July 2020-30 June 2021

Tier 1 Payment by Queensland Health work unit $ 2,008 per participant

Tier 3 Payment by external participant/private organisation $ 2,420 per participant3

Applications will only be accepted with a completed Payment Form (refer to Application Form).

Payments are only processed after the applicant has been offered and accepted a place in the course.

Additional costs to be factored in: • offline time for the XO to complete learning and assessment tasks (approximately 60 - 72 hours

for theory work, plus a three-day practical workshop) • costs for the practical workshop (see p5) • Videoconference (VC) capability for the X-ray room (see p5) • annual use licence fees (per QH-POL-209) and dosimeter fees • ongoing supervision, training and assessment costs (refer to QH-GDL-363:2015 or HHS policy) • RA support – a fee for service arrangement may need to be negotiated with the RA’s facility.

2 Refer to section 4.2 of the X-ray Operator Services Guideline 3 Including GST

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Practical workshop Attendance at the three-day practical workshop is mandatory for participants who have successfully completed all theory components. Morning tea and lunch is provided during the workshop, and participants will be provided with personalised lead markers. The participant’s facility is responsible for costs associated with participant’s wages, travel and accommodation. Workshop dates will be confirmed once sufficient participants have completed the theory components of the course. The following factors should be considered for workshops located outside of Toowoomba: • workshops require a minimum of three participants

• reasonable patient throughput is needed to ensure sufficient opportunities for participants to assist with medical imaging examinations, e.g. an average of 10 examinations per day

• access is required to a dedicated X-ray room and fully functioning fixed X-ray machine

• access is required to a training room/space separate to the X-ray room to perform role play with a mobile X-ray unit and a patient trolley with a drawer or tray for an image receptor

• availability of ancillary equipment, e.g. grids, foam

• access to PACS or RIS system may need to be granted to the Cunningham Centre facilitator

• access is required to a PC, the Queensland Health network and a projector or large screen (e.g. VC unit screen)

• a single invoice will be issued to the host facility to recover the additional costs of Cunningham Centre facilitator travel, accommodation, incidentals, travel time and courier costs for resources

• Facility Manager (of requested location) approval to be provided in writing. Videoconferencing in the X-ray Room • Installing VC capability in the X-ray room is strongly recommended as it allows:

— course participants to link with Cunningham Centre facilitators via VC — the RA or XO Support team to dial in if participants need assistance for the practical activities

or facility specific queries — existing XOs to access remote RA supervision at the point of care i.e. during an examination.

As demonstrated in the Teleradiography Project (2012), VC capabilities in the X-ray room offers benefits to the patient and XOs; further information can be found in the following article: http://onlinelibrary.wiley.com/doi/10.1002/jmrs.229/full

• VC capability in the X-ray room can be achieved by: — utilising an existing wireless VC unit — moving an existing VC unit into the X-ray room after activating a port in the X-ray room, or — installing a webcam and Cisco Jabber software onto a PC in the X-ray room (see Queensland

Health Online IT store). Ensure headset/speakers and 10m Ethernet cable are purchased.

Enrolment changes We recognise that adult learners may encounter unexpected circumstances which could disrupt their progress in the course. In the first instance, please contact the course facilitators at the earliest convenience to discuss the situation, as we will endeavour to provide as much support and flexibility as practical to assist participants.

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Course facilitators can provide the relevant form to be completed, which will need to be submitted to [email protected], and cc’d to the Facility Manager and RA. An administration fee ($ 300) will be charged for any approved requests, unless extenuating circumstances are demonstrated. Cunningham Centre guidelines for enrolment changes can be found at: https://www.health.qld.gov.au/cunninghamcentre/forms-guidelines

Withdrawals Refunds are unable to be granted once the course has commenced (ie. Access granted to online/hard copy resources). A refund, minus an administration fee, will be considered where the applicant makes this request in writing before online access is granted.

Transfers If a participant withdraws prior to access being granted to Cunningham Centre resources, and the facility has identified a replacement candidate, a transfer of enrolment may be requested. An administrative fee is charged if approved, and an application for the new participant must be submitted within one week.

Course completion Participants must complete the theory components within 6 months of enrolment. They will then need to attend a three-day practical workshop to complete the course.

Re-enrolment Where a participant does not complete a previous course and wishes to re-enrol in a subsequent cohort, they should contact the course facilitator who can advise what information needs to be submitted and what previously completed activities can be recognised as prior learning. The enrolment fee will be determined on a case-by-case basis dependent on what activities are yet to be undertaken to facilitate re-entry and successfully complete the course.

Practical workshop attendance Once a participant confirms their attendance at a practical workshop, any approved request to attend an alternate workshop date may be accompanied by an administrative fee.

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Requirements of applicants, their Facility Managers and RAs Application During the application process, the: • Facility Manager assesses radiographic workload4, seeks candidates through an EOI process5

and liaises with RA to select appropriate candidate/s with consideration of workload, availability and capacity to complete the training. Candidate/s ongoing ability to perform imaging examinations within their primary role should be carefully considered.

Please note: as a general benchmark, most XOs are best able to maintain their skills to an acceptable standard if they have opportunity to perform at least 50 radiographic examinations per year. Where an XO performs fewer examinations, it is likely they will need to spend additional time at a Radiographer facility with reasonable throughput and/or require an increased amount of remote RA support.

• applicant, Facility Manager and RA thoroughly discuss the course application, plan the required offline time (including RA site visit to candidate’s facility) and determine what additional support will be provided to the applicant during the course.

• applicant/s and RA meet in person or via VC, complete and submit a Supervision Agreement. One Supervision Agreement can be completed for all applicants from the same facility (with the same RA).

• applicant and Facility Manager complete the application form, and submit with all supporting documentation by the closing date. The XO Support team will acknowledge receipt of all applications within three business days. Incomplete applications will not be accepted.

• applicant retains copies of all submitted documentation. • applicant regularly checks their nominated email account for emails from the XO Support team.

Pre-course requirements Upon acceptance into the course but prior to the commencement of week 1, the: • participant and manager organise IT resources, rostered offline time for the completion of study

and assessment tasks • participant completes online enrolment form, required to organise access to course materials • participant and Facility Manager ensure any local training relevant to the course is up-to-date,

e.g. VC training, incident reporting, mandatory clinical training. Please note: non-clinical participants will now need to undertake some of the mandatory clinical training, e.g. Basic Life Support, Child Protection, Infection Control.

• participant undertakes pre-course activities outlined in Study Guide, e.g. Patient ID and Procedure Matching module; pre-reading; basic anatomy quiz.

• RA completes Local Facility Guide and provides to participant.

During the course the: • manager provides agreed offline time for study and assessment tasks (approximately 60 - 72

hours for required tasks), RA site visit and practical workshop (see Course Outline). Please note: Participants must be on their local roster for each of the practical workshop days to ensure they are covered in case of an incident. Funding for any travel or accommodation for the workshop is also the responsibility of the participant’s facility.

4 Refer to section 4.1 of the X-ray Operator Services Guideline 5 Refer to section 4.2 the X-ray Operator Services Guideline

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• RA undertakes a site visit to the participant’s facility to assist the participant to become familiar with the local X-ray equipment and processes, complete the practical activities and local facility assignment. This must be completed prior to attending the 3-day workshop.

• RA and experienced local XOs assist participant to complete the Examination Log. • participant submits all assessment tasks within 6 months of commencing the course (course

commencement will be once online access has been issued) . If an assessment item is unable to be completed in this timeframe, the participant contacts the XO Support team as soon as possible to request an extension. Failure to do so prior to the end of the 6-month period may result in the participant being withdrawn from the course.

• participant is entitled to a maximum of three submission attempts for any one assessment task. All assessment tasks must be passed to progress through the course. Failure to successfully complete assessments within the three submissions may result in participants being withdrawn from the course.

• participant takes responsibility for their learning needs, and liaises with their RA, manager and/or the XO Support team if challenges arise which may affect course completion.

• participant completes the Radiation Health application form and organises required identification documentation and brings to the practical workshop. Facility Manager approves payment of Use Licence fees6

Please note: — Participants will not be permitted to progress to the practical workshop until all theory

assessments have been satisfactorily completed. — Participants are not permitted to perform radiographic examinations on patients until they have

received their trainee Radiation Use Licence from Radiation Health. — Refer to Academic progress Guideline and Assessment Guideline for more information on

Cunningham Centre processes and student responsibilities: https://www.health.qld.gov.au/cunninghamcentre/forms-guidelines

Post course Upon successful completion of the practical workshop and assessments, participants will be issued with a Statement of Attainment to be submitted to Radiation Health with their trainee licence application. Once trainees receive their licence it is expected that the: • trainee, their Facility Manager and RA fulfil the requirements of the Supervision Agreement, e.g.

review RA feedback of examinations performed; attend training with RA; attend VC in-services. • RA and Facility Manager actively support the trainee to utilise the trainee licence period to

consolidate and expand on knowledge and skills • trainee actively participates in training and supervision opportunities provided to them • trainee organises a mandatory competency assessment with a Radiation Health Endorsed

Radiographer a few months prior to licence expiry • Facility Manager provides funding and offline time to attend the annual competency assessment

process • RA and Facility Manager discuss whether there is a need for a Rural and Remote - Extended

licence (trainee first needs to be deemed competent during their Chest and Extremities licence assessment process before moving to an extended scope licence).

6 According to Policy 209 https://www.health.qld.gov.au/__data/assets/pdf_file/0039/395868/qh-pol-209.pdf

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Key dates7

Applications open May 2020

Applications close -

Pre-course activities due Before commencement of Module 1 activities

Introductory VC Tutorial (VC1) TBC

RA Site Visit (to be organised with your RA) 1-2 days

Practical workshops (tentative dates*) TBC

*Please keep these dates available where possible. Practical workshop dates and locations will be confirmed as soon as practical. Key contacts Please direct any queries to the XO Support team on 4699 8097 or email [email protected] Application submissions A completed application form, Supervision Agreement (Appendix 1) and Course Payment Form (https://www.health.qld.gov.au/__data/assets/pdf_file/0032/966551/payment-2020-tier1.pdf ) should be submitted to the XO Support team via email: [email protected] at your earliest convenience.

Page 10 is an ‘example course outline’ for those participants who prefer structed learning.

7 These key dates may be subject to change

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Example Course Outline

* Participants will require offline time to complete the pre-course activities. **The RA site visit may be scheduled any time, depending on RA availability, with pre-reading and pre-recorded videos to be reviewed by XO trainees prior to completing the associated assessment and activities with the RA. Most beneficial when undertaken after at least the first 3 modules have been completed.Please note: some participants may require additional time to complete the assessment items, particularly those without a background in health sciences. In such cases, it is recommended to provide the participants with an additional day of offline time for each module.

Module Task Required Time Evidence Evidence Due

PRE-COURSE ACTIVITIES

Pre-Course*

Mandatory Training 1-2h Upload Patient ID and Procedure Matching Certificate

Prior to start of course

Pre-reading 8h Refer to Study Guide

Familiarisation with local facility ½ h Upload Local Facility Guide (from your RA)

Basic Anatomy 1-8h Basic Radiographic Anatomy Quiz

Introductory VC 1-2h Mandatory Attendance TBC

THEORY COMPONENT

1

VC Tutorial 1

8-12h

Online N/A

Principles of radiographic imaging Principles of Radiographic Imaging Quiz

2

VC Tutorial 2

8-12h

Online N/A

Radiobiology and Radiation Safety Radiation Protection Quiz

3 VC Tutorial 3

8-12h

Online N/A

Equipment, Artefacts, Exposures Equipment and Artefacts Quiz

Radiographic Advisor (RA) Site Visit* 8h

Practical Activity Assignment Local Facility Assignment Image Processing and Informatics Checklist Examination Log (10 examinations)

4 VC Tutorial 4

8-12h

Online N/A

Radiography of the upper limb Upper Limb Quiz

5 VC Tutorial 5

8-12h Online N/A

Radiography of the lower limb Lower Limb Quiz

6 VC Tutorial 6

8-12h Online N/A

Radiography of the chest Chest Quiz

PRACTICAL WORKSHOP

Face-to-face workshop/s held at Medical Imaging Department (dates and location/s TBA)

3 days

Assessment of practical performance – examinations, role play Statement of Attainment issued to successful participants

Supervised Practice with RA support 12 months – follow Supervision Agreement

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Introductory X-ray Operator Course | Application form Privacy disclaimer: Cunningham Centre is collecting this information in accordance with the National Vocational Education and Training Regulator Act 2011 in order to meet your needs as a client and ensure records are maintained for accreditation purposes. Some of this information may be given to an external agency for the purpose of meeting contractual reporting arrangements. Your information will not be given to any other person or organisation unless authorised or required by law.

Applicant

Name Position Title

Discipline Facility

Email Telephone

Facility Manager

Name Facility

Email Telephone

Workplace information

How many X-ray operators and/or radiographers work at this facility? XOs: Rads:

Does your facility have any visiting radiographers? Yes No

If yes, how often do they visit your facility?

How many X-ray examinations are performed annually at this facility?

If the number of examinations per year averages less than 50 per XO, please provide some brief details around the need for additional XOs, e.g. succession planning, service needs.

Is VC functionality currently available in the X-ray room at this facility? If yes, please describe what type, e.g. wireless, fixed, movi/webcam.

Will the applicant perform imaging at any other facilities? If yes, where?

Support for applicant to complete coursework Does the applicant have readily available access to VC and a Queensland Health PC with internet access?

Yes No – specify what access is limited/unavailable

Comments:

How many hours per fortnight of offline time to complete the coursework will the applicant be provided with? (8-12 hours per fortnight recommended. Note that attendance at practical workshop is in addition to this)

8-10hrs 10-12hrs 12-14hrs As much time as the applicant requires

Comments:

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If an RA is unavailable to provide all required on-site support (e.g. orientating applicant to local equipment; involving applicant in examinations; assisting with practical activities), will existing experienced XOs be rostered with the applicant, and provided with time to assist?

Yes No

Comments (include name/s of existing experienced XOs):

The applicant possesses: basic IT/VC skills good communication and literacy skills self-awareness, initiative and ability to follow instructions (to ensure duty of care performed) skills in time management, flexibility, teamwork & independence (to ensure efficient imaging service) base level of mobility – a number of physical activities are inherent in radiography e.g. squatting to

check cassette placement, handling large pieces of equipment, including above shoulder height.

Comments:

Has the applicant held any type of Radiation Use Licence previously? Yes No If yes, please provide details (licence type, dates of licensing):

Declaration By signing below the applicant and Facility Manager agree that: • both parties have read this application package and are aware of the time commitment required for all

course components to be successfully completed. • the manager will provide adequate offline time, IT/telehealth resources and funding for the applicant to

complete coursework, assessment activities and the practical workshop. • both parties are aware of the ongoing (i.e. post course) training and supervision required to maintain

and develop quality XO skills, as outlined in the X-ray Operator Services Guideline. • the applicant is up-to-date with relevant clinical mandatory training, e.g. BLS, Child Protection, Cultural

Awareness, Infection Control, Patient Centred Care, Patient Manual Handling. • the information provided in this application and the supporting documents is accurate • both parties agree to the terms and conditions of Cunningham Centre activities and have read and

understand the Academic Guidelines:https://www.health.qld.gov.au/cunninghamcentre/forms-guidelines

Applicant’s signature Date

Facility Manager’s signature Date

Non-clinical applicants only Radiation Health requires Executive support for a non-clinical applicant (see page 4 for further details). Please provide reasons for selection of non-clinical participant:

HHS Executive’s name

HHS Executive’s signature Date Email application form, Course Payment Form and Supervision Agreement to [email protected]

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Appendix 1 – Supervision Agreement A supervision agreement is required prior to the applicant being accepted into the Introductory X-ray Operator Course. Complete this agreement in conjunction with the Radiographic Advisor (RA). This agreement allows all parties to be aware of the time and cost commitment involved with training as an X-ray operator (XO). Ongoing supervision is based on the best practice recommendations from the X-ray Operator Services Guideline (QH-GDL-363:2015). One supervision agreement can be created for all applicants from the same facility, provided that there is one RA. Include all applicant names on the agreement. An example of entries is provided immediately following this form to assist with creation of an agreement. Ensure that the agreement form has been updated/altered to satisfy individual XO, RA and HHS requirements. If you have any queries completing this agreement, please contact 4699 8097 or [email protected] Facility

Applicant name/s

Start date (Today) Review date 9-12 months from start date

Objective Supervision/training requirement Format Frequency

During XO course VC session (mandatory)

Attendance at Introductory VC. (RAs also welcome.)

VC 1 only (on commencement of course)

RA site visit (mandatory)

RA (or delegate) visits XO facility to assist participant with practical activities, Local Facility Assignment and any other concerns (e.g. PACS, RIS, radiation safety, equipment troubleshooting, etc.)

Face-to-Face

Once, ideally during Modules 3-6 of XO course Tentative date scheduled:

During Trainee licence Teleradiology (VC) supervision

XO to contact RA to request VC supervision at time of examination: If VC is unavailable, phone advice is provided.

Remote image review

RA will review imaging and contact XO to discuss any non-diagnostic examinations. XO to review all written advice from RA.

Image review sessions

XO and RA meet (face-to-face or remotely) to discuss XO’s imaging examinations in depth, especially consistent errors or problems.

Attend in-service training

Improve skills around challenging examinations

XO to attend RA’s hospital for: Face-to-Face

Refresher training/extend on introductory techniques

XO to attend: Face-to-Face

RA site visit RA (or delegate) visits XO facility to assist with any local concerns or trouble shooting

Face-to-Face

Competency assessment

Attend a training & assessment workshop or locate an endorsed radiographer to conduct assessment.

Face-to-Face

Attend 3 months prior to licence expiry. (Organise at least 6 months prior to licence expiry)

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Additional comments:

Radiographic Advisor to complete

RA Name RA Facility

RA Email Telephone

RSO Name RSO Position Title Has the relevant RSO approved for this applicant to complete the Introductory X-ray Operator Training Course?

Yes No – please comment

Additional comments:

Declaration By signing below all parties agree that: • they agree to the completion of all activities listed above in the appropriate time frames • completion of the above activities will assist to support the mandatory competency assessment at the end of

the trainee licence period • the Facility Manager will provide adequate offline time, IT/telehealth resources and funding for the applicant

to complete these activities (including travel/accommodation where required) • the information provided in this agreement is accurate.

Applicant’s signature Date

RA’s signature Date

Facility Manager’s name

Facility Manager’s signature Date

Email completed application form, Course Payment Form (available here) and Supervision Agreement to [email protected]

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Appendix 2 – Example of Completed Supervision Agreement Example entries (bold and italics below) are provided to assist with creation of an agreement, but should be altered to satisfy individual XO, RA and HHS requirements. If you have any queries completing this agreement, please contact 4699 8097 or [email protected]

Facility

Applicant name/s

Start date (Today) Review date 9-12 months from start date

EExxaammppllee OOnnllyy

Objective Supervision/training requirement Format Frequency

During XO course VC sessions (mandatory)

Attendance at Introductory VC. (RAs also welcome.) VC 1 only (on commencement of

course)

RA site visit (mandatory)

RA (or delegate) visits XO facility to assist participant with practical activities, Local Facility Assignment and any other concerns (e.g. PACS, RIS, radiation safety, equipment troubleshooting, etc.)

Face-to-face Once, ideally during Modules 3-6 of XO course

During Trainee licence

Teleradiology (VC) supervision

XO to contact RA to request VC supervision at time of examination for new or challenging examinations. If VC is unavailable, phone advice is provided.

Movi/VC

Each examination until RA decides XO is competent in certain regions e.g. after 2 months XO can perform selected examinations without contacting RA

Remote image review

RA will review imaging and contact XO to discuss any non-diagnostic examinations. XO to review all written advice from RA.

PACS

RA reviews images 3 times/wk and rates or comments via the 'study comment' facility on PACS; XO checks comments weekly

Image review sessions

XO and RA meet (face-to-face or remotely) to discuss XO’s imaging examinations in depth, especially consistent errors or problems.

Phone & screen share PACS via Outlook Lync

Fortnightly for first 3-6 months

Attend in-service training

Register for Cunningham Centre monthly in-services (recordings available on Yammer)

VC/webinar/Yammer

Every other month (depending on XO availability)

Improve skills around challenging examinations

XO to attend RA’s hospital for 2 days to focus on any identified problem areas and refresh examinations not done since initial training

Face-to-face Within 1-3 months of XO receiving licence

Refresher training / extend on introductory techniques

XO to attend a 2-day workshop OR attend RA's hospital for 2 days to consolidate and further extend on knowledge and skills; and perform supervised practical examinations

Face-to-face Within 4-6 months of receiving licence

RA site visit RA (or delegate) visits XO facility to assist with any local concerns or trouble shooting Face-to-face Within 5-9 months of trainee

receiving licence

Competency assessment

Attend a training & assessment workshop or locate an endorsed radiographer to conduct assessment.

Face-to face Attend 3 months prior to licence expiry. (Organise at least 6 months prior to licence expiry)