Professional Documents
Culture Documents
Introduction
The discovery of x-ray radiation by Wilhelm Conrad Roentgen had paved the way for
medical imaging system. In its early days in Europe and the United States, x-rays were
used by surgeons to guide them in their work. Today, x-rays had helped radiographic
examination improved the quality of health care services. It is now widely used in
medical field to examine internal structures of patient for any diseases, illness or injuries
for early diagnosis and immediate treatment. Doctors require their patient to go through
radiographic examination for clearer and liable information of any irregularities that may
or may not be present within the patients body for prevention and cure and also to
follow the course of a disease already diagnosed and/or treated . X-ray based
examinations and ultrasonography are very crucial in terms of all levels of medical
settings and health care due to some instances that it may affect the current condition of
the patient. Berger and Luckman (1966) explained the way in which radiography has
this thesis because it is radiographys position within the field of medicine that has
worked to marginalize the specialization and reduce the power of the radiographers
voice. This is due to radiography having been seen as a technological process used by
with the history of radiology and it is not possible to understand an entity such as rural
produced.
1
The World Health Organization said that in United States of America (2015),
radiographic examination can result to effective decisions depend on clear and correct
conditions, the use of medical imaging services are best in confirming, correctly
assessing and documenting the progression of the disease as well as in evaluating its
response to treatment. This was supported by the survey taken by the American Society
of Radiologic Technologist (2011), the total number of medical imaging studies rose
students who are studying Radiologic Technology due to the demand of more
radiographic technologist that are equipped with enough knowledge and skills to
In the journal written by S.M. Lundgren, M. Lunden & B.T. Andersson entitled
(2015), all radiography students' exemplified radiography with statements related to the
practical level although some of them also identified radiography at an abstract level, as
emerged, which is an attribute on the abstract level. The practical level was described
by four attributes: Mastering Medical Imaging, To accomplish images for diagnosis and
the years of studying the Radiologic Technology course, trained students will be fortified
on the practical and proper ways to do the radiographic examination, most especially on
2
how patients certain part of the body must be positioned. However in New Zealand,
Ben O'Sullivan wrote in his article about Plain Radiography or X-ray (2009), he said that
X-rays are a form of radiation similar to visible light, radiowaves and microwaves. X-
radiation is special because it has a very high energy level that allows the X-ray beam
exposed at an early stage as first year to have actual experience on the radiographic
techniques and allowed to view various imaging modalities as provided in its mother
hospital Medical Center Manila to stimulate and sustain the interest of the students. The
college, aside from its laboratory equipment was also provided with radiograph
unit/clinic located within the campus for community patients in need of diagnostic
services where our students integrate immediately and gradually confirms learned skills
and knowledge. This was also supported by Commission on Higher Education (CHEd)
on its CHEd Memorandum Order No. 18 Series of 2006, the program is designed to
centers, community health agencies or industrial concerns where radiation is used for
quality control. Moreover, the radiologic technologists in the Philippines have the same
perspective with other radiographers across the globe about the radiographic
examination. Therefore, the researchers of this study pursue to uncover more valuable
knowledge for the students who are in a field of radiologic technology to become an
efficient and skillful radiologic technologists that serves quality health care to
3
community. Health care provider that is professional enough to produce liable and
students who are in the field of Radiology to gain more knowledge regarding the field.
So as with the radiologic technologist, this study wanted to bring quality service to
patient and also for the improvement of the medical imaging. It is conducted to help
examination. This serves as basis to answer some questions of curious individuals and
to satisfy them.
The output of this research seeks to contribute and expand the knowledge in the
the student to be well trained in order to become an efficient and skilful radiologic
technologist that provides excellent health care services towards other people.
The researchers of this study believe that this output can provide information and
learning paradigm to the following students, radiologic technologists, society and to the
researchers.
It is designed to help students who are practicing Radiologic Technology for their
academic purposes and development of skills and for awareness about radiographic
4
examination to be able to become an efficient radiologic technologist in the future. To the
knowledge and skills about radiographic examination that are useful in their profession.
To the Society. The study will also redound to the benefit of the society considering that
the field of radiology plays an important role in individuals health in terms of diagnosing
and treating diseases so as the course of a disease already diagnosed and/or treated..
The output of this study is for the betterment of everyone. To the Researchers. In the
process of doing the study, the researchers would gain information for the improvement
of knowledge and technical skills. This information will surely have a valuable
Theoretical Lens
This study was anchored on the theory of Nicholas A. Koontz1 and Richard B.
Gunderman the Gestalt Theory: Implications for Radiology Education (2008). For the
variety of grouping principles (the laws of closure, proximity, similarity, common region,
continuity, and symmetry) are ubiquitous in daily work, not to mention in art and
personal life.By considering the applications of these principles and the stereotypical
ways in which humans perceive visual stimuli, a radiology learner may incur fewer
Gestalt theory, identify examples of these principles in widely recognizable fine art, and
highlight their implications for radiology education. However for radiographers, Studies,
mainly from the United Kingdom, have described a role extension for radiographers into
new professional areas, mainly tasks and responsibilities formerly belonging to the
5
medical field. This involves interpretation of images and conducting examinations
things that were previously done by the radiologists and which have been included in
policies (Kelly,Hogg & Henwood, 2008; Ford, 2010; Reeves, 2008; Kelly, Piper &
Nightingale, 2008; Hardy M & Culpan, 2007).In medical imaging some of the
techniques instead. This means, in practice, that examinations traditionally carried out
and Ultrasound. CT and MRI are by tradition carried out by radiographers inSweden.
This means that the majority of radiological examinations in Sweden are carried outby
Methods, Theory and Applications, that Radiography uses X-rays to view a non-
uniformly composed material such as the human body and displays areas of different
density and composition. In this book, the authors present current research in the study
of the methods, theory and applications of radiography. Topics discussed include super-
This theory was widely used for students who are studying in the field of radiology.
6
Moreover, the Monash course reflects a strong commitment to the experiential Learning
Theory first espoused by Dewey and his notion of reflective thinking later re-defined by
theorists such as Kolb [54] in terms of a learning cycle and Schn in terms of reflective
practice [24]. It acknowledges the contextual learning theory espoused by Coles [55]
and, just as importantly, mental schema theory from cognitive psychology [56-57].
Attention is also paid to the insights educators have gained from the critical theory
associated with Habermas [58] and constructivism with its origins attributed to Kant,
Piaget and the pragmatic school of philosophy [59-60]. The clinical assessment tools
used within the clinical studies units are congruent with the novice to expert model of
skill development associated with Dreyfus and Dreyfus [61] and introduced into nursing
by Patricia Benner.
Research Questions
The research questions that led to the study were the following:
Definition of Terms
The following key terms in the study were to be subsequently defined in order to
7
radiography (Introduction to Radiologic Technology with Science, Technology and
Imaging (MRI) scans and Computed Tomography (CT) scans. They are responsible for
accurately positioning patients and ensuring that a quality diagnostic image is producing
complementary health services or any or all of the enumerated services or any other
the way the students and radiologic technologist saw about the radiographic
examination. These opinions were articulated in their answers to the question given
The proposed study was follows a qualitative research; this involves identifying
examination. The respondents of this study are 10 Radiologic Technology students from
Davao Doctors College and 5 licensed Radiologic Technologist who are also part-time
8
The respondents were given questionnaires and were interviewed by the
researchers. Other information gathered was collected through the internet, published
journals, articles and books. The assembled data were used to support and to
9
CHAPTER II
This Chapter contains a review of related literature and studies which have bearing on
the present study. These related readings taken from material are very necessary in
According to the U.S. Food and Drug Administration (2014), medical radiography
is a broad term that covers several types of studies that require the visualization of the
internal parts of the body using x-ray techniques. For the purposes of this page
radiography means a technique for generating and recording an x-ray pattern for the
purpose of providing the user with a static image(s) after termination of the exposure. It
discussed elsewhere. Radiography may also be used during the planning of radiation
therapy treat is used to diagnose or treat patients by recording images of the internal
structure of the body to assess the presence or absence of disease, foreign objects,
passed through the body. A portion of the x-rays are absorbed or scattered by the
internal structure and the remaining x-ray pattern is transmitted to a detector so that an
image may be recorded for later evaluation. The recoding of the pattern may occur on
10
images to diagnose an injury or disease. Radiographers have to be registered with the
regulatory Body, the Health Professions Council (HPC) to practice in the United
Kingdom. Radiologists are registered medical practitioners with the General Medical
Council and use imaging to diagnose, treat and monitor various disease processes.
Following the discovery of X-Rays by Rntgen in 1895 there was much interest in
the application of the new rays in diagnosing and treating disease. Non-medical and
medical workers were soon to engage with the new technology and initially there were
1983). This was soon to change and the role of non-medical radiographers was
role boundary between the professions was established in 1924 after much discussion
and bitter argument (Larkin, Price 2001). The argument largely centered on the practice
practitioners. This practice was challenged by radiologists who wished to establish the
new discipline of radiology with consultant status within medicine. To do this they went
to great lengths to stress their difference from radiographers (Larkin, 1983). In the
dispute regarding who had the right to report, radiologists questioned radiographers
ability and competence to perform such tasks, even though some had performed such
tasks satisfactorily for a number of years. Following the conclusion of the dispute over
the division of labor between Radiologists and radiographers the boundaries between
the two professions remained unchanged for approaching seventy years, with
radiologists concerned primarily with the interpretation of the image and radiographers
with its production. Within that period there are instances of radiologists position being
11
strengthened, for example, Furby (1944), a radiographer, stated that the primary
function of the radiographer was to be of utmost service to the radiologist and the
are standard procedures and involve almost no preparation from the patient. Depending
on the area under review, you may want to wear loose, comfortable clothing that you
can easily move around in. You may also be asked to change into a hospital gown for
the test. You will be instructed to remove any jewelry and other metallic items from your
body before the X-ray is taken. You should always tell your doctor if you have any metal
implants from prior surgeries. These can block the X-rays from passing through your
body. If your test requires contrast dye, a doctor or nurse will give it to you as an
injection, an edema, or a pill to swallow before the test. If your X-ray is examining your
intestines, your doctor may tell you to fast for a certain amount of time beforehand, or to
clear out your bowels. He also tackled about how x-ray is performed. X-rays can be
diagnostic procedures. Once you are fully prepared, a radiologist (X-ray technician) will
tell you how he or she needs you to be positioned in order to get the right view. The
technician will most likely require you to lie, sit, or stand in several positions during the
test. Some images may be taken while you stand in front of a specialized plate that
contains X-ray film or sensor. In some cases, the technician will move a large camera
connected to a steel arm over your body. This can capture the X-ray images of your
body using film or sensors held in the table. You will have to hold your breath and
remain still while the images are being taken. This provides the clearest images
12
possible. The test is finished as soon as your radiologist is satisfied with the images
gathered.
well as strive to keep patient dose to an absolute minimum. Radiographer must follow
the ALARA Principle (As low as reasonably achievable) as they carry out their tasks.
The Radiologic facility must undergo appropriate Radiation surveys. Staff must be
proper oriented and regular in service education on radiation safety must take Place.
radiation is when primary photon intercept an object and undergo a change in direction.
(B) Grid both stationary and moving, function to remove a large percentage of scattered
(primary Compton) radiation from the remnant beam before it reaches the image
scattered radiation from the patient, particularly in fluoroscopy, where the use of high
voltage results in energetic Compton Scattering emerging from the patient and posing a
Radiation one meter from the patient is about 0.1% of the intensity of the primary beam.
That is why in term of radiation protection the patient is considered the most important
source of scatter. Other Scattering object includes the x-ray table. The bucky-slot cover/
types of x-rays are responsible for the optical density and contrast on a radiograph
13
those that pass through the patient without interacting and those that are scattered
within the patient through Compton interaction X-ray that exist from the patient are
remnant x-ray and those that exit and interact with the image receptor are called image-
forming x-rays. Proper collimation of the x-ray beam has the primary effect of reducing
patient dose by restricting the volume of irradiated tissue. Proper collimation also
improves image contrast. Ideally, only those x-rays that do not interact with the patient
should reach the image receptor. As scattered radiation increase the radiograph loses
contrast and appears grey and dull. Three primary factors influence the relative intensity
of scatter radiation that reaches the image receptor: Kvp, field size, and patient
thickness. Control of scatter radiation , effect of scatter radiation on image control One
of most important characteristic of image quality is contrast, the visible different between
the light and dark areas of an image contrast is the degree of difference in OD between
areas of radiographic image. Contrast resolution is the ability to image and distinguish
soft tissue. Even under the most favourable condition, must remnant x-ray are
scattered.
decrease the area of the x-ray beam. Proper beam restriction will reduce the amount of
primary photons emitted from the tube and collimator thereby reducing the dose to the
patient. Also, beam restriction will keep the total amount of tissue irradiated to a
minimum so fewer scattered photons are created consequently the image quality will be
beam. As kVp is increased, fewer atoms interact with the tissue, and more pass through
14
to end up on the image receptor. In radiography, kilovoltage is selected based
more scatter will result unless it is accompanied by a reduction in mAs thereby reducing
scatter and the dose to the patient. Thus beam restriction along with technical factors
are very important aspects of radiation protection by reducing the patient dose and
piece of lead containing a hole in the center that attaches to the x-ray tube port. The
opening can be made in any size or shape, but rectangular is the most common. The
main advantages of aperture diaphragms are there simple design, low cost, and ease of
use. The main disadvantage is the increase in the unsharpness around the periphery of
the image known as penumbra. Other disadvantages include off-focus radiation and no
light field for use in positioning. Aperture diaphragms are used in special procedure
angiography studies.
regulatory Body, the Health Professions Council (HPC) to practise in the United
Kingdom. Radiologists are registered medical practitioners with the General Medical
Council and use imaging to diagnose, treat and monitor various disease processes.
15
The exclusion of radiographers from reporting remained unchallenged for nearly
fifty years until the debate around the potential for radiographers to develop and extend
their role was prompted by Swinburne (1971). He recognised the potential for
workloads and in the face of a chronic shortage of radiologists. Swinburne (ibid) also
commented upon the fact that radiographers seemed to function below their full
potential and on this point he compared radiographers with laboratory technicians who
accepted greater professional responsibilities by reporting the findings of their work. His
opinion was that radiography should have graduate status which would improve
considered it was time that official recognition was made of the fact that radiographers
all over the world assisted in the interpretation of x-ray films. He recognized the
interdependency of radiology and radiography and his view was that under the best
conditions there was no need for boundary disputes. Swinburne (ibid) had proposed a
training program and a system of working which were radical and ahead of their time.
increasing radiological workload and the shortage of radiologists. The British Journal of
Radiology (1975) published an editorial Must radiologists do all the reporting? and in
the same edition a letter was published from a leading general practitioner (Emrys-
Roberts, 1975) who thought that it was a waste of time for radiologists to attempt to
report every image. The editorial and the letter prompted a number of responses
including those from two radiologists, Aberdour (1975) and McLachlan (1975) who
16
It was not until the 1980s that the work of the radiographer began to diversify
when ultrasound imaging signaled a new role for radiographers. This included providing
interpretational data (Witcombe and Radford, 1986). There remained no sign of any
return to plain film reporting by radiographers but the work of Berman, DeLacy, Twomey,
Welch and Eban (1985) and Cheyne, Field-Boden, Wilson and Hall (1987) on the
accident and emergency (A&E) departments at two hospitals in the London area. This
became known as the red dot system which involved a radiographer placing a coloured
paper dot onto a film which was determined to be abnormal in an attempt to alert
medical staff to the presence of trauma and/or pathology. Interest in the feasibility of
radiographers playing a role in abnormality detection grew and in the early 1990s
Renwick, Butt, and Steele (1991) conducted a study to investigate how well
this appeared to be a variation of the red dot system. Radiographers were asked to
place films in one of four categories; normal, abnormal, insignificantly abnormal and
could offer useful advice on radiographs to casualty officers, because of a high false
positive rate they could not perform to the required level of accuracy to extend their role.
The results were perhaps not surprising given that the radiographers had not
undergone any training, and the study was criticised for this fact by Nawrocki and
17
abnormality detection and should undergo a short period of training for the task. In
response, Renwick (1991) agreed that radiographers were an under utilised resource
and believed that they should be given the opportunity of extra training and that his
Department was seeking funding for such an initiative. The red dot system gained
momentum and by 1991 a study reported 25% of major casualty departments had
adopted some form of flagging system (James, Bracegirdle and Yates, 1991).
radiologist is a specialist medical doctor who has had specific postgraduate training in
treatments that involve the use of xray, ultrasound, and magnetic resonance imaging
equipment.
become a radiologist takes several years. Four years of college are followed by four
more of medical school (some universities offer combined bachelor's and medical
After graduating from medical school, radiologists spend another five years in a
residency program. Radiologists must pass several tests along the way, including the
MCATS from college into medical school, and exams administered by the National
their patients by making a diagnosis and providing treatment using medical imaging.
Radiologists have the medical knowledge to understand and explain your medical
18
problem or symptom through the images or pictures that are taken of various parts of
(PET) and Nuclear imaging. Radiologists generally work behind the scenes analyzing
studies, making diagnoses and consulting with physicians. In some cases, they get
involved in the procedure in order to help prepare the patient or outline further
practice. They are there to help other doctors diagnose and treat illness. They do this by
about a symptom, disease, injury or treatment, etc., and also when imaging is unlikely to
be helpful. If an imaging test is needed, radiologists know which test is likely to be the
best one to answer the question, or, if more than one test is needed, in which order the
tests should be done to get the best result. When a radiologist receives a request for a
tests available, considers the risks and benefits of the different ways of obtaining
imaging to assist in answering the question, and determines what test or treatment to do
19
Radiologists communicate the results of diagnostic and interventional imaging to
the doctor who has sent you for the test or procedure, by a written report sent to your
doctor. Sometimes, the radiologist will discuss the report verbally (e.g. over the
Radiologists work as part of the clinical team taking care of you so that they can
participate actively in decision making about imaging tests that your doctor is
regarding your clinical problem, helps the radiologist best understand how to answer
your doctors question(s). Your doctor and the radiologist will communicate through the
written referral your doctor gives you to take to the hospital or radiology practice. Your
doctor may talk with the radiologist to discuss how best to answer a question using
imaging, or to clarify information about your problem before the radiologist can make a
diagnosis based on the imaging (pictures) you have had taken at the hospital or
radiology practice.
(CT), magnetic resonance imaging (MRI), ultrasound and nuclear medicine imaging
techniques to obtain images that are then interpreted to aid in the diagnosis of
equipment. Interventional radiologists may sub-specialise further so that they only treat
20
elsewhere in the body (angiointervention) Interventional radiology is a minimally
procedures, usually done with tiny instruments and thin plastic tubes called catheters
radiation therapy. These specialists are not called radiologists, but radiation oncologists,
even though they belong to the Royal Australian and New Zealand College of
Radiologists.
Not all diagnostic and interventional radiology tests and procedures are
many specialise first in internal medicine. Vascular (blood vessel) surgeons may
perform ultrasound, angiography (taking pictures of the blood vessels using X-rays and
contrast medium) and interventional procedures on the arteries and veins using X-ray
equipment like radiologists. Some obstetricians perform their own ultrasound, and some
practice to this area. Cardiologists perform ultrasound on the heart and are increasingly
involved in MRI and CT scanning of the heart as well. You may be referred to have a
departments, some work in public hospitals or private practice, and some do all or a
mixture of these.
21
Physicians who thrive on intellectual stimulation find radiology an
especially rewarding area of practice. Because the field advances so rapidly, there is
always something new and exciting to learn. These specialists are among the first to
laboratories. Radiologists also enjoy the challenge of interpreting complex studies and
Though most radiologists still work in hospitals and outpatient diagnostic centers,
now practice in any location equipped with a computer, high-resolution monitor and
units obtain emergency consultations after hours and also promotes consultation among
experts around the globe.Unlike most other physicians, radiologists have limited patient
diagnoses.Radiologists who work in the hospital work long, irregular shifts that include
nights, weekends and holidays. Those employed by outpatient centers are more likely
Pre-medicine students may major in any subject but need to meet prerequisites in math,
biology, organic and inorganic chemistry, physics and the humanities. Students can
conducting scientific research and achieving high scores on the Medical College
22
Admission Test (MCAT). Many four-year colleges and universities have pre-med
compete for available residencies. They will also benefit from top scores on Steps I and
II of the United States Medical Licensing Examination (USMLE). During the final year of
medical school, students should apply for a four-year diagnostic radiology residency
through the National Resident Matching Program (NRMP). Residents work an average
of 60 hours per week and spend some nights on call. Upon completion, some
interventional radiology.
Effective 2013, this will require passage of a two-part examination covering medicine,
residencies is fierce, students seeking to enter this field must be top academic
performers with excellent test scores. More so than other medical specialties, radiology
advance, many choose a more comfortable lifestyle over pay increases. This usually
takes the form of fewer nighttime, weekend and holiday shifts. Other radiologists
advance their careers by gaining new skills and expertise. It is not uncommon for an
23
interventional radiologist to be the only professional in the region performing certain
cutting-edge procedures. This allows the person to command a higher income and may
opportunities, take teaching positions or move into health care administration. According
to the Bureau of Labor Statistics, the job outlook for physicians in general is strong, with
growth of 18% expected between 2012 and 2022. This is faster than average growth.
Radiologists in particular may find their job prospects better than other physicians as
O*Net projects the growth rate of radiology positions to be 15-21% between 2012
and 2022. The American College of Radiologists (ACR) conducted a 2013 survey of
radiologists nationwide and concluded that job growth would remain stable and provide
jobs for the number of new radiologists projected to look for work through the year 2016
(the extent of their survey). Their study did conclude, however, that while overall growth
was projected to be adequate for job candidates, those candidates might need to be
Description (2006), Radiologic Technologists, also known as Rad Tech's or RT's, assist
the Radiologist physician with the process of imaging and diagnosing illness. Radiologic
Technologist job descriptions include tasks such as: capturing the image, obtaining the
best quality image, and ensuring the patients are comfort and safe. The RT; however,
24
does not do the actual diagnosing as this is the function of the physician or Radiologist
M.D. The Rad Tech must be able to effectively explain the procedure to the patient and
be sure that they are comfortable and at ease during the procedure; however, it is very
important that they do what is necessary to obtain a high quality image that will be
sufficient for thorough examination by the physician and allow for correct diagnosis.
known among RT's that patient positioning can be challenging for a number of reasons.
The patients may be sick and at different levels of severity of illness. They may have
trouble maintaining the position needed to get the best quality image because of their
illness or simply because they are elderly or handicapped. Other reasons include
patient anxiety or even anger about the possibility that they have an illness. A major part
through these challenges with the patient in a calm, compassionate, and professional
demeanor. After all, it is in the best interest of the patient to get the best quality images
taken to aid in their road to recovery. As an RT, you will have a full understanding of the
protocols and requirements of positioning depending on what the specific case warrants
will use protective devices such as lead shields. The amount of radiation you exposure
yourself to is documented and tested on an ongoing basis to ensure that there will be no
adverse side effects to you. Patients are of course, also protected from radiation
exposure and there are strict protocols for the amount of radiation used depending on
the type of procedure being performed. Different organs and tissues within the body
25
have various levels of sensitivity to radiation. Rad Tech's are trained to understand this
info.org.
facility. Jobs are available most commonly in hospitals and medical imaging centers, but
also in physician offices, veterinary offices, and dental practices. The types of
procedures performed are many and the radiologic technologist job description may
vary depending upon the size and scope of the facility. Some of the most common
26
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