N.D. Admin. Code tit. 33.1, art. 33.1-10, ch. 33.1-10-06, app H
Students must meet the prerequisite requirements of item 1 of subparagraph b of paragraph 2 of subdivision a of subsection 1 of section 33.1-10-06-03 and complete the training requirements of this appendix.
Training requirements have been divided into two sections, didactic instruction and clinical experience/supervision. Upon completion of didactic training, the individual must complete the clinical experience requirements of either subdivision a or b of subsection 2 and demonstrate competence for examinations listed in appendix I. Records must be maintained to demonstrate compliance with these requirements.
1. Didactic instruction section: Individuals shall complete a minimum of eighty hours of didactic training at a single course providing the minimum hours of instruction in the subjects below. Correspondence coursework cannot exceed twenty percent of the eighty-hour course (sixteen hours maximum). The course content should approximate the outline below. The eighty-hour course is subject to department approval. Individuals must also complete the three-hour self study course designed by the state health department. An examination is required to demonstrate successful completion of a course.
a. | Basic X-Ray Physics | 12 hrs. |
- General description of production of x-rays | ||
- Function of filtration and effects it has on x-ray beam | ||
- Collimation | ||
- Types and function of beam-limiting devices | ||
- Design, features, and function of x-ray tube | ||
b. | Radiobiology | 1 hr. |
- Effects of ionizing radiation to the human body | ||
- Factors that cause somatic and genetic damage | ||
c. | Radiation Protection | 6 hrs. |
- ALARA concept | ||
- Shielding materials | ||
- Radiation quantity and units of measurement | ||
- Basic interactions of x-ray with matter | ||
- Primary and secondary scatter | ||
- Importance of time, distance, shielding | ||
- Maximum permissible dose-occupational/public | ||
- Latency period | ||
- Patient protection | ||
d. | Principles of Exposure | 15 hrs. |
- Factors that control and influence radiographic quality | ||
- Properties of x-rays | ||
- Size distortion caused by geometric parameters | ||
- Parameters which cause shape distortion | ||
- Technique factor selection | ||
- 15% rule, mAs and kVp relationship | ||
- Grid-types, ratios, and how they affect image quality | ||
- Intensifying screens | ||
- X-ray film | ||
- Artifacts | ||
- Inverse square law | ||
e. | Darkroom Procedure and Processing | 4 hrs. |
- Film storage and handling | ||
- Film processing and troubleshooting | ||
- Design, features, and function of a processor | ||
- Silver recovery | ||
- Quality assurance/quality control | ||
f. | Anatomy and Positioning | |
1. Chest | 4 hrs. | |
2. Abdomen | 4 hrs. | |
3. Extremity | 8 hrs. | |
4. Spine | 8 hrs. | |
5. Skull | 8 hrs. | |
g. | Pediatric | 2 hrs. |
h. | Rules and Regulations | 1 hr. |
2. Clinical experience/supervision section. Individuals must complete either a or b below. If the individual is unable to demonstrate clinical competence in a procedure due to a lack of opportunity, the student shall complete the three prerequisite examinations required by appendix J using simulation for subdivisions a through k of subsection 1 of appendix J. Final demonstration of competence in subdivisions a through s of subsection 1 of appendix J should be completed as soon as there is a patient requiring the procedure. No individual may perform an unsupervised procedure for which they have not successfully completed the final demonstration of competence.
a. The individual must complete three months of clinical training during which time they may perform x-ray examinations only under direct supervision.
(1) Direct supervision and evaluation of competence shall be performed by a general diagnostic operator or a limited x-ray machine operator with two years' experience.
(2) The individual shall utilize proper procedure as indicated in appendix J.
(3) The individual shall be evaluated on procedure, performance, and competency on forms provided by the department for each of the examinations listed in appendix I; or
b. Individuals must complete at least one hundred twenty hours of clinical training at a facility where there is routinely fifty or more limited diagnostic x-ray examinations performed per week. During this time they may perform x-ray examinations only under direct supervision. After completing the one hundred twenty hours of training, the individual must complete an additional three-month probationary training period as outlined in number 4 of this part.
(1) Direct supervision and evaluation of competence shall be performed by a general diagnostic operator or a limited x-ray machine operator with two years' experience.
(2) The individual shall utilize proper procedure as indicated in appendix J.
(3) The individual shall be evaluated on procedure, performance, and competency on forms provided by the department for each of the examinations listed in appendix I.
(4) Upon completion of one hundred twenty clinical hours and demonstration of competence in accordance with appendix J for limited x-ray machine operator examinations:
(a) Individuals must complete a three-month probationary training period during which time they may independently perform limited x-ray machine operator examinations for the procedures which they have successfully demonstrated competence.
(b) During the three-month probationary training, a general diagnostic operator, or a limited x-ray machine operator with two years' experience, or a radiologist must evaluate all films and conduct at least six hours of direct supervision on a weekly basis and give feedback on any needed improvements.
[1] All films, including repeat and waste films, must be kept for evaluation.
[2] Evaluation must be done on forms supplied by the department.
N.D. Admin Code tit. 33.1, art. 33.1-10, ch. 33.1-10-06, app H