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Vanderbilt-Ingram Cancer CenterVanderbilt-Ingram Cancer Center

 

Clinical Education

Students who have been admitted to the Vanderbilt Department of Radiation Oncology Program in Radiation Therapy and have at least three years experience in a cancer center, working as a full-time radiation therapist, may elect to challenge the clinical component of the program after being formally admitted to the program.

Students seeking to challenge the clinical curriculum must demonstrate competency in all areas established in the plan for clinical education in the Program in Radiation Therapy Clinical Curriculum Guide. All clinical competencies must be demonstrated in all areas prior to the second clinical rotation to successfully complete the challenge. The clinical competencies and review of case studies must be scheduled through and performed by the Program Director and/or Program Clinical Coordinator. The competencies may not be completed at an outside clinical setting. Failure to complete or demonstrate competency in any area of the clinical curriculum will result in an unsuccessful challenge. In this case, the student must complete a regularly scheduled plan of clinical education as outlined by the program officials.

Applicants who successfully challenge the clinical portion of the curriculum will be exempt from the clinical education component of the program, with the exception of practical didactic labs. The student successfully challenging the clinical component is still responsible for the successful completion of the didactic component of the curriculum.

Clinical Education

Clinical Attendance

The student is required to attend clinical practicum for not more than 40 hours per week. The Program Administrative Staff will assign students to a clinical unit. The schedule will reflect equal experience for all students enrolled in the program.

Clinic rotations on the treatment units, simulator, nursing area and dosimetry area will be determined by the Program Administrative staff with input and approval by the Clinical Education Supervisors, to ensure experience for the students in all areas.

The appropriate Clinical Education Supervisor must directly approve any change in the clinical attendance schedule for a student. The Program Clinical Coordinator is then to be advised of the change.

Students are required to document clinical attendance with the Clinical Education Supervisor, or his/her designate, at the end of each week. If the person designated to document attendance is not present, the student should have the Clinical Coordinator or his/her representative initial the attendance sheet and inform the Clinical Education Supervisor as soon as possible. The Clinical Education Supervisor will inform the students of the designate and required sign-in procedure. Non-adherence to sign in procedures will result in no credit being given to clinical assignments done during that time. That time would have to be made up in accordance with review by the appropriate program official.

Anticipated tardiness should be reported whenever possible so that the supervisor knows the reason for the delay. Students are not allowed to leave the clinical department without permission of the Clinical Education Supervisor.

The student will be excused for a period of time as arranged through the Program Director, Program Clinical Coordinator, or Clinical Education Supervisor in the event of the death of an immediate family member. The student must promptly inform the Program Director or Clinical Education Supervisor of the need for time off so that the appropriate arrangements may be made.

Clinical Objectives and Assignments

The Clinical Educational Supervisor Clinical Coordinator or Program Director, when appropriate, will explain all objectives and assignments to the student at the beginning of each clinical rotation.

The clinical assignments will be primarily monitored and graded by the Clinical Education Supervisor or Program Clinical Coordinator. Occasionally, group or committee review will be utilized.

Specific requirements for each rotation will vary according to the department in which the student is assigned. Each student will be assigned to work with a registered therapist or other professional depending on the area rotation.

Clinical Mastery Competency

As a requirement for graduation, each student will successfully perform the skills required by an entry-level radiation therapist. This is measured by a mandatory clinical mastery competency evaluation conducted during the last clinical rotation by the Program Director and Program Clinical Coordinator. Successful completion of the competency is achieved by scoring 80% or better.

Dress Code

The following is the required dress code for all therapy students during clinical rotations:

Women:

Scrub shirt and pants, with white lab coat (solid white tennis shoes allowed) or street clothes (e.g. khakis) with white lab coat.

Men:

Scrub shirt and pants, with white lab coat (solid white tennis shoes allowed) or street clothes (e.g. khakis) with white lab coat.

In addition:

  1. Shoes and clothing are to be neat, clean and pressed at all times.
  2. Hair longer than shoulder length should be fastened in some way.
  3. Beards must be neatly trimmed.
  4. Cosmetics are to be subtle and conservative.
  5. Fingernails must be neatly trimmed - if painted, must be of conservative color.
  6. Multiple rings and bracelets are not allowed. All jewelry must be free of sharp surfaces, which could scratch a patient.
  7. Denim, tee-type shirts, and tight stretch fabric slacks are not permitted for clinical attire.

Identification badges and film badges are also considered a part of the student's uniform and must be worn at all time. Any variance from these standards is cause to send student home with time away documented as a clinical absence.

Emergency Medical Care

The Vanderbilt University Medical Center or assigned Clinical Education Setting will provide emergency medical care for enrolled students during program hours at the student's expense. The Program makes no provisions for student personal medical coverage. Students are required to carry their own health insurance coverage to defray the cost of any medical service rendered. The program is not responsible for any costs incurred by the student.

Clinical Evaluation

The student will receive an evaluation for each area of rotation within the clinical module. All professional staff that has had the opportunity to work with the student will be asked to provide input in the student's written evaluation.

The student will review the evaluation with the Clinical Education Supervisor. The student will, upon request, have an opportunity to meet with the specific evaluators. This process is intended to promote open discussion of the student's clinical progress. Frequent feedback to the student is a vital part of his/her professional growth.

During each clinical rotation, the student will have a mid-point evaluation filled out by the Clinical Instructor. This evaluation will not be counted for a grade. The mid-point evaluation is to be given to the Clinical Education Supervisor to review clinical progress with the student.

Each student will be requested to complete a general evaluation of the clinical instructor at the end of each clinical rotation. This will provide valuable feedback to the appropriate personnel within the institution.

Clinical Competencies

The student must perform a number of clinical competency examinations per rotation after observing and assisting in the corresponding procedure listed on the checklist. In the course of clinical education, the student will operate as many units as is feasible and necessary to achieve the required clinical competencies. Clinical competencies for treatment and simulation may only be supervised and evaluated by a registered therapist.

A competency checklist/evaluation for each category and/or a course grade is used to assess student performance. Students must meet clinical competencies in all categories to be eligible for program completion. Students may start to attempt clinical competencies after the first clinical rotation.

All students of The Vanderbilt Department of Radiation Oncology Program in Radiation Therapy are required to complete a specific number of clinical competencies by the end of each clinical rotation (2-8); competency completion makes up a part of the clinical grade. If the required number of clinical competencies is not completed in the specified time frame, the student will be placed on clinical probation. At that point the student must successfully complete the next three rotations. Only one clinical probation period is allowed for each student during his/her tenure as a student.

Grading

The Program Clinical Coordinator, with input from other appropriate personnel, is responsible for submitting the final grade for each evaluation and rotation. This final grade will be based on the performance evaluation, clinical assignments (competencies and case studies), clinical logbook completion, and overall professional conduct as referred to in that section of the student handbook.

The individual performance evaluations will be used to determine the grade for each rotation.

Grading information is available to the students at the beginning of each rotation along with the objectives. The clinical evaluation is composed of technical skills and professional attributes. The performance evaluation is graded based on clinical performance and successful competency completion.

The number and types of competencies are outlined in the clinical curriculum guide.

If a student fails a clinical rotation evaluation, the student is placed on clinical probation for a period of three months. During the probationary period, the student must successfully pass all clinical rotation evaluations and meet all clinical objectives to be reinstated into "good standing". If the student fails a clinical rotation during a clinical probationary period, the student is immediately dismissed from the program without recourse.

If a student fails a clinical rotation with less than three months remaining prior to graduation, the three-month probationary period may extend the overall length of the clinical education. In this scenario, the student would still need to successfully complete the three-month probation to successfully complete the program. The student will not be certified as having completed the program until these mandates have been fulfilled; he/she may not be able to take the ARRT examination in Radiation Therapy until satisfactory completion of said mandates.

The Clinical Education Supervisor, upon consultation with the Program Clinical Coordinator, has the prerogative to alter the clinical grade if the student's behavior and attitude is not in compliance with the professional conduct guidelines listed or if the student does not adhere to other clinical policies.

Clinical Policies

Personal Phone Calls

The student is expected to limit incoming and outgoing personal phone calls to an absolute minimum while in the clinic. Such phone calls disrupt concentration on patient care and can have serious implications towards patient safety. Department personnel are instructed to take a message for the student receiving an incoming non-emergency personal call.

Electronic Pagers and Cellular Phones

While in the clinical setting, personal electronic pagers and cellular telephones are not to be used by students. Any incoming personal call should be directed to the student through the clinical facility phone system.

Radiation Monitoring

State laws require that all radiation workers be monitored for radiation exposure in the clinical setting. Upon acceptance into the Program, the student will receive a film badge application form. The environmental safety office will issue a film badge for each student. This badge must be worn at all times while in the clinic and care must be taken not to damage the badge.

All standard radiation safety practices must be strictly adhered to for the safety of personnel and patients. A cumulative exposure record is available to the student from the radiation safety officer and/or Clinical Education Supervisor.

Professional Liability Insurance

The Program, upon admitting a student, will require professional liability insurance for that student during the entire length of the professional program at the student's expense.

Patient Related Incidents

Students enrolled in the program will report patient related incidents in the following manner:

  1. Any incident, which would warrant an incident report for a staff therapist, would be considered an incident for students with the following inclusion. Failing to report an incident warranting a report constitutes a major infraction.
    1. Remarks deemed unprofessional by Clinical Instructors
    2. Any complaint lodged by a patient concerning student's conduct in the presence of patients
  2. The student will stay in the assigned area until the clinical instructor fills out an incident report. The Clinical Education Supervisor and Program Clinical Coordinator will be made immediately aware of the incident.
  3. The student will give an oral report to the Clinical Education Supervisor and Program Clinical Coordinator and if necessary to the Attending Physician as well.
  4. The Program Director will decide, based on the incident report and the student's oral report, whether there was an infraction of rules and if any action is to be taken.
  5. If a patient related incident occurs as a result of infraction of program rules, the student will be on clinical probation for the remainder of the academic year. Another patient related incident during the probationary period will be grounds for dismissal.

Technical Standards

The Vanderbilt Department of Radiation Oncology Program in Radiation Therapy has established technical standards that must be met by all students in the program. Each student must be able to perform and maintain the following throughout tenure in the program:

  1. Reach overhead up to six (6) feet off the floor
  2. Communicate both verbally and in writing in a clear and concise manner to people in various departments
  3. Read and apply appropriate instructions in treatment charts, notes and records
  4. Lift thirty (30) pounds of weight (for example, treatment cones, blocks or immobilization devices) up and over head level
  5. Move immobile patients from stretcher to treatment table with assistance from departmental personnel
  6. Push standard wheel chair from waiting area to treatment room
  7. Understand and apply clinical instructions given from departmental personnel
  8. Utilize computer keyboard and monitor for inputting clinical data into treatment console and computers
  9. Visually monitor patients in dimmed light and visually monitor patients via video monitors during treatment
  10. Monitor patients via audio monitor during treatment
  11. Hear and distinguish between various equipment and background sounds during equipment operations.

Students who have disabilities requiring accommodations should discuss these with the Program Director prior to the start of the program. Documentation is required to verify disabilities.

Pregnant Students

The Program abides by the National Council on Radiation Protection (NCRP) recommendation concerning fetal exposure. This recommendation advises to keep the whole of the nine-month exposure within 5 mSv. Declared pregnant students will be given an additional fetal radiation monitor to be worn at all times while in the clinical setting.

In the event of a declared student pregnancy, the Program Director will cooperate by placing the pregnant student in a clinical rotation area having a low probability of any personal radiation exposure, if this is administratively possible without disrupting clinical rotation schedules of the program and does not prevent the student from achieving her clinical objectives. Declaration of pregnancy is voluntary and requires written notification by the student to the Program Director. At any time the student may withdraw the declaration, understanding that fetal monitoring will cease.

The student may elect to take a leave of absence and return after pregnancy to start at the beginning of the term when she left. The student will receive credit for all completed courses and clinical rotations. The Program Director and declared pregnant student will negotiate sick leave for the pregnant student exceeding the allotted days if needed.

Student Hours

  • The hours for students are not to exceed 40 hours per week; hours may fluctuate throughout the academic year as necessary. No night or weekend call is required.
  • The morning and afternoon breaks are 15 minutes during the clinical rotations. Only 15 minutes are permitted.
  • The lunch period is one (1) hour long. Lunch may be taken in the cafeteria, employee lounge, or off premises.
  • When the students are not in their assigned clinical area, it is required that they let the clinical education instructor/supervisor or Program Clinical Coordinator/Program Director know where they are.
  • The Program Director/Program Clinical Coordinator/Clinical Education Supervisor shall be notified of any absence from the department. Students are not permitted to leave early without authorization from a Program official. Non-adherence to this will result in disciplinary action.
  • Students are not to ask the clinical instructors for permission to leave their assigned areas early or to go to the classroom to study. However, if the therapists are finished with the daily patient treatments, they may refer the student to the appropriate Program official for possible early dismissal.

Student Supervision

All clinical experience in Radiation Therapy shall be under direct supervision. The Joint Review Committee on Education in Radiologic Technology defines direct supervision as "a registered radiation therapist being present while any treatment is being administered". The supervising professional must check all student activities (e.g. set-ups, calculations, etc.) before the treatment is given. Students must not accept responsibility for administering radiation therapy treatments. The clinical experience of the student is a planned part of the educational program. The clinical experience of the student is governed by sound clinical objectives and the progress of the student is evaluated and the results used in the overall evaluation of the students.

Students Working in Radiation Therapy

Students may not take the place or responsibility of qualified staff. Students may be employed in the field of study outside of regular educational hours provided the work does not interfere with regular academic responsibilities. The work must be non-compulsory, paid, and subject to employee regulations.