progression a free for all to practicing physicians to the minimally educated office assistant or

Transcription

1 JW 4 1 Describe the evolution of basic science requirements as they have existed in education for medical radiology technologists the last several decades (1950, 1960, 1970, 1980, 1990, 2000). The Evolution of Basic Science Requirements in the Radiography Curriculum In more than a century, the practice of radiology has progressed from an unregulated field of science to a highly respected practice. The first three decades from its inception in 1895 saw progression a free for all to practicing physicians to the minimally educated office assistant or nurse (Harris, 1995). Education in radiology was unmonitored and vastly different from one institution to another. Even radiology workers had different methods of performing examinations and were often unwilling to share their secret. By 1910, the need to further delineate the role and responsibilities of the practicing radiologist was addressed (Harris, 1995). Some felt that professionals working with radiation needed knowledge and appreciation of equipment mechanics, principles of creating a radiograph (or radiologic technique), the human body, theurapeutic uses of radiation, and dangers of radiation. College courses on radiology were offered as postgraduate work and included electrophysics, equipment mechanics, and radiographic positioning. Fellowships were also available. No matter the route taken to obtain knowledge about radiology, there was a lack of curriculum oversight, scope and uniformity. Practicing physicians could also simply take a brief course from an x-ray department or shadow a radiologist. Radiology became more commonplace and physicians began feeling overburdened with the technical aspects of the field, allowing for less patient interaction (Harris, 1995). In the early part of the decade, office assistants began producing the radiographs, a duty also performed by

2 JW 4 2 nurses. However, they had little to no education in human anatomy, and their purpose was to operate and maintain the equipment: The role of the technician as an x-ray operator or manipulator might be best compared to that of the military conscript enlisted without warning, and often without choice if they cared to continue receiving a paycheck suddenly thrust into a duty that was foreign and, even for the trained nurse, somewhat frightening. (Harris, 1995, p.20) Eddy C. Jerman, a salesman, electrician, and experimenter, became the leading force in establishing an educational standard for radiology professionals (Harris, 1995). In 1920, he founded what is now known as the nationally recognized American Society of Radiologic Technologists (ASRT), and he was also a leader of the American Registry of Radiologic Technologists (ARRT), or Registry. The Registry, established in 1923, is still the route to certification within the radiography profession. Even though a method for certification existed, candidates who sought this status did not have to complete a formal educational program. By the end of 1923, 89 radiographers earned their certification through ARRT. This number grew to 290 by 1925, when the ASRT announced the requirement of member certification. This move was made to promote the profession and to establish educational standards for the profession. In the early 1930 s, the Council on Education and Registration in conjunction with the Radiological Society of North America (RSNA) was formed to identify the standards and qualifications for radiographers (Harris, 1995). They were also charged with establishing a curriculum. The committee evaluated the current Registry practice and discovered that examination questions could easily be obtained by candidates, thus compromising the integrity of the system.

3 JW 4 3 The RSNA first made recommendations for Registry candidates and education requirements in 1933 (Harris, 1995). Candidates were expected to fully devote one year study, and they were not to be employed elsewhere during this time. The curriculum included courses in anatomy and osteology, physiology, physics/electricity, equipment mechanics, x-ray tubes and production, darkroom chemistry, radiation exposure, bedside unit, protection and biology, andpositioning. With emergence of World War II, the Army saw the need for additional radiologists and radiographers in the field (Harris, 1995). Initially, they presented short courses for radiologists ranging from two-weeks to four-weeks, but the program did not meet the approval of their civilian counterparts. The United States also put out a call for radiographers, but turned down many applicants who they felt were not qualified. Ultimately, they Army developed a 90-day training course for radiographers in which students had to assemble and disassemble the x-ray equipment in order to pass. By 1943, the program s length increased to 120 days and there was a greater emphasis on research projects. The civilian sector was concerned that many of these radiographers were not adequately prepared or had interest in the profession. Neither the Army nor civilian radiographers were happy with each other s standards. By 1944, the American Medical Association (AMA) accepted the challenge to identify and oversee approved radiography schools (Harris, 1995). This oversight allowed educational standards to be set and enforced. In 1940, there were 90 accredited schools. This number grew to 150 by Even though college education was not required, radiographers who had this background were in greater demand than those who did not.

4 JW 4 4 It was not until 1952 that a standardized curriculum was proposed and approved by the ASRT (Harris, 1995). This curriculum included studies in positioning and clinical practice, physics, anatomy and physiology, x-ray technique, special procedures nursing procedures, radiation safety, office procedures, department administration, ethic, medical terminology, and film critique. This curriculum was mandated to be no less than one year in length and recommended to be two years. The ASRT published the first edition of a radiography curriculum in Even though the curriculum was endorsed by the ASRT, radiography schools did not have to follow this curriculum to be accredited. In 1959, there was a push for a two-year curriculum, a move which had the support of the American College of Radiology (American Society of -Ray Technicians, 1960). This resulted in the second edition of the curriculum and teacher s guide in The curriculum stated that successful applicants needed a background, or at least high school course, in physics, chemistry, mathematics, and typing. Students who made poor grades in high school were generally not successful. It is believed, however, that unless a student is well-grounded in the basic principles involved in x-ray technology, he may not only fail to understand the fundamentals of what he is learning to do with his hands and his mind, but he may also be handicapped in his development as a professional assistant to his radiologist and in his ministrations to the patients whom both serve. (Harris, 1995, p.1) The next substantial revision to the standardized curriculum did not come until the 1970 s (American Society of Radiologic Technologists [ASRT], 1978). The ASRT developed a task force to identify the essential curriculum components. A review of the 1966 curriculum outline and the addendum to the 1976 curriculum shows that some of the courses were eliminated and others were restructured and better defined. One of the bigger differences was the division of

5 JW 4 5 radiation safety into radiation protection and radiation biology. The addendum also included a glossary of terms. The curriculum undergoes a revision about every decade, with the newest technology added but nothing eliminated. The radiography curricula over the past decades promoted general education courses, but did not mandate it. This might have been so because most radiography programs were hospitalbased, but the option existed to affiliate with a university or college so that students could receive general education courses and a degree. The 1996 Articulation Agreement model required students to complete the following general education courses in the following areas: sciences, arts and humanities, social sciences, English, mathematics, health, and state-required courses (ASRT, 1996a). The degree-awarding institution and radiography program determined the amount of courses. In the articulation agreement model provided by the ASRT, the following courses were to be completed: communications, microbiology, anatomy and physiology, physics, psychology, and English. The ASRT identified three levels of radiographers in the early 1990 s: entry level, professional level and primary care level (ASRT, 1996b). Entry-level students are in a radiography program preparing for the profession and for the Registry examination. These students either earn an associate degree or certificate of completion. They can be based either in a hospital or college setting. Students enrolled in a hospital program may have the option to earn a degree if there is an articulation agreement in place. The ASRT recommends that entry-level students complete course work in the following content areas: anatomy & physiology, pathology, medical terminology, oral and written communication, computer literacy, math, medical ethics and law, basic sciences, liberal arts, interpersonal relationships, psychology, psychosocial

6 JW 4 6 aspects of health care, and culture diversity. Basic science is defined as physics, chemistry, and biology. In 2002, a list of general education topics was recommended: mathematics/logical reasoning, communications, arts & humanities, information systems, social/behavioral sciences, and natural sciences (ASRT, 2002). The natural science recommendations were to allow students the opportunity to gain an understanding to the scientific method, be informed about scientific topics and learn science related terms and definitions. This list of was identified as required in the 2007 revision (ASRT, 2007). Beginning in 2015, an associate degree, baccalaureate degree, or graduate degree will be required for candidates of the ARRT. This degree requirement does not have to be based in radiologic sciences, and can be a degree earned prior to beginning the radiologic science professional program. The purpose of this change is to ensure that candidates have a solid general education background of communication skills, sociological and psychological understanding. The ARRT believes this requirement will elevate the standard of patient care. Radiography curriculum s general education requirements, specifically science, have wavered over the decades. In the beginning, there were no educational or practice standards in the profession. Not until practicing radiologists became overworked was there a need to develop some sort of educational program. Even then, programs were not standardized and did what they wanted. Jerman started the very slow process to standardize the radiography curriculum by identifying and promoting the need. In the early ASRT curricula, the importance of chemistry and physics was understood, yet these courses were not mandated. Specific general education courses were not recommended until the 21 st century, and then only in the most recent

7 JW 4 7 curriculum required. The upcoming professional requirement change deems a background in science courses as unimportant. In this aspect, the profession s educational standards have gone backwards. In a profession which is described as being an art and a science, general science courses will play a minimal role.

8 JW 4 8 References American Society of Radiologic Technologists. (1978). Addendum to curriculum guide for programs in radiography. American Society of Radiologic Technologists. (1996a). Articulate agreement model toward degrees in the radiologic sciences. American Society of Radiologic Technologists. (1996b). Final report of the national educational consensus conference in the radiologic sciences. American Society of Radiologic Technologists. (2002). Radiography curriculum. American Society of Radiologic Technologists. (2007). Radiography curriculum. Retrieved from American Society of -Ray Technicians. (1960). Curriculum and teacher s syllabus for schools of x-ray technology. A teaching guide (2 nd ed.). Harris, L. (1995). The shadowmakers. A history of radiologic technology. Retrieved from

9 JW 4 9 Appendix A Comparison of Radiography Curricula Orientation/Elementray Rad Protection Fundamentals of Rad Sci & Health Care Intro to Rad Tech Office Procedures Departmental Administration Professional Ethics Medical Ethics Ethics & Law Med Terminology A & P Physics Darkroom Chemistry & Technique Radiographic Processing Imaging & Processing Technqiue of fluoroscopy x-ray Technique Prin of Rad Exposure I Prin of Rad Exposure II Digital Image Acquistion & Display Film-Screen Image Acquistion & Processing Imaging Imaging Equipment Roentgen Apparatus & Mechanics Bedside Unit

10 JW Ray Tube & Production of -rays Rad Production & Characteristics Basic Prin of CT Rad Positioning/Procedures Intraoral Radiography Pediatric Radiography Rad Procedures using CM Pharmacology & Drug Administration Special Rad Procedures Topographic Anatomy Nursing Procedures Patient Care Electrical and Rad Dangers/Protection; Troubleshooting Radiation Safety Rad Protection Rad Biology Rad Therapy Suvey of Medical Surgical Diseases/Pathology Radiographic Pathology Calibration of Machines Equipment Maintenance Intro to Quality Assurance Intro to Computer Literacy Computers in Rad Sci Film Critiques Weekly Rad Film Evaluation Image Analysis Human Diversity Clinical Practice

11 JW 4 11 Mathematical/Logical Reasoning Communication Arts & Humanities Information Systems Social/Behavioral Sciences Natural Sciences Psychology Medical Use of Radioisotopes Photography Principles of Teaching Research in Relation to the -Ray Tech Technical Writing Rad Mathematics Civil Defenct (Rad Monitoring) Recommended Required Recommended Required Recommended Required Recommended Required Recommended Required Recommended Required

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