Radiation Therapy (RTT)

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Program Description

See our homepage, About the Profession, and Our Program for complete descriptions of the Radiation Therapy program.

Program-Specific Policies & Procedures

All Radiation Therapy students will be required to sign the Student Responsibility Statement.

Supervision of Students

Clinical Supervision of Students: All Radiation Therapy students must have adequate and proper supervision during all clinical assignments as specified by individual institutional, program, and accreditation policies. The following policies and procedures apply to UNMC clinical assignments for students, technologists/ therapists, and evaluators. Supervision of Radiation Therapy Students: Direct supervision of radiation therapy students is provided by a qualified practitioner who reviews the procedure in relation to the student’s achievement, evaluates the condition of the patient in relation to the student’s knowledge, is present during the procedure, and reviews and approves the procedure.

Procedure:

1. A certified radiation therapist is responsible for determining the degree of student participation in procedures using external beam equipment, simulator, and brachytherapy radioactive sources and provides direct supervision throughout the procedure.
2. A dosimetrist and/or physicist are responsible for determining the degree of student participation in dosimetry procedures and provide direct supervision throughout the procedure.
3. A staff radiation therapist, nurse, or radiation oncologist is responsible for determining the degree of student participation in consult, physical examination, patient care, and follow-up procedures and provides direct supervision throughout the procedure.

Procedure for Clinical Evaluations

1. Clinical evaluations include the three domains of learning: cognitive (knowledge), affective (professional behaviors), and psychomotor (technical skills).
   1. The student will receive a minimum of two evaluations for affective, psychomotor, and cognitive areas in the program before the midpoint of the clinical component of the program. Any ongoing issues will be identified immediately, discussed, and verbal counseling will be documented.
2. Students who perform at a non-acceptable level as defined by the program, in any of the three domains, may be placed on immediate academic probation. Students who do not show immediate rectification of the problems will be put on academic probation.
   1. Students will be notified of the nature of the problem and discuss ways to improve.
   2. The length of the probationary period will be clearly defined on an individual basis.
   3. At a defined time the student will receive another evaluation. If improvement is not demonstrated, the student will be removed from clinic and a failing grade can be issued for the clinical course. A committee of program directors in the division will assess and determine if dismissal from the program will be recommended.
   4. If improvement is shown the student may either be removed from probation or probation may be continued for a defined time.
   5. If the behavior is noted again at any time during the remainder of the program, the student will immediately receive a failing grade for the course and be recommended for dismissal.

Student Grievance

Purpose: The MITS Department strives to promote an educational environment that values fair and equitable treatment among students, faculty, and staff. Despite this goal, differences among individuals may occasionally lead to conflicting circumstances that require a process for resolution to take place. The purpose of the Student Grievance Policy is to provide a framework to effectively resolve any justified complaint or grievance without retaliation.

Examples or Types of Grievances (but not limited to):

• Acts or threats of intimidation
• Acts or threats of physical aggression
• Acts of bias or unfair treatment by a fellow student, faculty or staff member which adversely effects the learning process
• Violation of student rights and responsibilities

Procedure:

1. Informal Process - Ideally, grievances can be resolved informally among the parties involved. Therefore, before a formal grievance process takes place, the student is encouraged to meet with the individual whose behavior warranted the grievance. If this action is not feasible, the student should contact the program director for possible resolution. A final option for informal resolution is to utilize an Ombudsperson. The Ombudsperson identified for students on the UNMC campus is located in the Student Counseling Department. The informal meeting must take place within two weeks of the occurrence that caused the grievance.
2. Formal Process - If the student is not satisfied with the results of the informal process, or an informal resolution is not possible then he/she should initiate the formal process within 30 days of the occurrence.
   1. A formal statement of the grievance must be presented in writing to the MITS Department Associate Director within the timeframe specified. (If the Associate Director is the individual involved, then the formal statement should be submitted to the Associate Dean of the College of Allied Health Professions). The formal statement must include the following items: A) Full name, address, and telephone number of the person(s) making the charge; B) Full name of each person being charged, location of employment, and work telephone number; C) A concise and factual description of the specific incident(s) surrounding the grievance violation (the description should include a timeline of events); D) A proposed resolution.
   2. The Associate Director (or Associate Dean, if applicable) will review the facts surrounding the grievance. If there is justified evidence that a grievance exists, then the grievance will be forwarded to the CAHP Student Grievance Committee.
   3. Within two weeks after receiving the alleged grievance, the committee members will review the statement, convene to discuss the issues at hand, hear testimony, and consider all other facts pertaining to the grievance.
   4. Both parties will have the right to present testimony, evidence, and witnesses. Each party shall have the right to seek legal counsel in the preparation of statements concerning the grievance; however, they may not be represented by counsel in discussions with the committee. Each party shall have the right to hear all testimony surrounding the grievance. The hearing will be closed to the public.
   5. In all proceedings where the complaint touches upon questions of policies, rules and regulations, the CAHP Student Grievance Committee shall be guided by written policies, rules and regulations. The committee will make a decision on the grievance charge after reviewing all facts, testimony, and documentation. The committee’s decision or resolution will be made within two weeks following the hearing. Both parties involved will be notified of the decision in writing. A summary record of the proceedings will be maintained in a confidential file.

The student may appeal the decision of the Student Grievance Committee, to the Office of the Associate Dean. The Associate Dean will review all documents surrounding the grievance, and make a decision within two weeks of receiving the appeal. Both parties involved will be notified of the decision in writing. The decision by the Associate Dean will be final.

Clinical Compliance

Accidents/Incidents: As general policy, MITS students will comply with the policies and procedures with the clinical site at which they are assigned. It is the policy that there be written reports of all unusual incidents/accidents. An incident is an unusual occurrence which is not consistent with the routine operation of the institution or clinical rotation which may or did cause harm, involves possible negligence, requires some immediate consideration or action by a supervisor.

A student enrolled in a program in the Department of Medical Imaging and Therapeutic Sciences is expected to provide prompt, complete and accurate written documentation of the details related to any accidents/incidents, thus enabling corrective actions and/or programs for prevention. The program adheres to the Infection Control Policy for University Hospitals and Clinics. Students with signs and symptoms of an infectious process should report immediately to the program director for appropriate referral.

All accidents/incidents must immediately be reported to the technical supervisor or immediate person in charge. Proper report forms must be completed.

Equipment Use and Operation: The professions in Medical Imaging and Therapeutic Sciences employ the use of highly specialized equipment. Any equipment failure or equipment that is not in proper working order must be reported immediately to the technical supervisor. Do not place any calls to equipment representatives. Do not attempt to repair. Blood Borne Pathogens Exposure Plan for Students Campus Blood Borne Pathogen Exposure (on and off campus): Students must call the Medical Communication Center at 402-559-6824 or the OUCH pager at 402-888-6824 (24 hours a day, 7 days a week) ASAP and report to the nearest emergency room for appropriate blood borne pathogen procedures. On the next work day, please call the Student Health office at 402-559-5158 with information regarding your ER visit.

Radiation Protection

It is each student’s responsibility to adhere to the following guidance for radiation protection:

1. Students must practice safe radiation and protection criteria and practice the principles of ALARA at all times. These are found in the UNMC Radiation Safety Manual.
2. The principles of decreased time and increased distance and shielding shall be employed when working with radiation.
3. The spread of any accidental contamination from radioactive materials will be decreased by frequent personnel monitoring and hand washing.
4. Radiopharmaceuticals must be kept in lead shields until placed in a syringe shield for injection into the patient (Nuclear Medicine Technology).
5. Radiation exposure is measured by personnel monitoring device and finger TLD rings, (Radiation Therapy, Nuclear Medicine Technology and CVIT); therefore, they must be worn at all times within the department. Personnel monitoring devices are to be worn at the collar, and finger TLD rings on the dominant hand. It is the student’s responsibility to exchange badges and rings on a quarterly basis with person designated by the RSO for each program.
6. If your personnel monitoring device or finger TLD ring is lost or left where it can be exposed unknowingly, contact the respective program director immediately.
7. In accordance with the philosophy of keeping exposures ALARA (As Low As Reasonably Achievable), the Radiation Safety Office has established levels at which the dosimetry company will provide immediate notification of a higher than normal reading. These notification levels are presently as follows:

Dose Type	Evaluation Level	Investigation Level
DDE (whole body)	300 mrem	600 mrem
LDE (lens of eye)	900 mrem	1500 mrem
SDE (skin or extremity)	900 mrem	2000 mrem
Declared Pregnant Woman	40 mrem	50 mrem

ALARA DOSE LIMITS (PER MONITORING PERIOD)

Any doses above the ALARA Evaluation Level require that the Radiation Safety Officer review the circumstances pertaining to this dose and determine if additional actions need to be taken or if further investigation is required. An investigation requires that the Radiation Safety Officer investigate the cause of the dose and steps that may be required to prevent this dose level in the future with consideration of cost and scientific impact. All doses above the ALARA action levels will be reported to the Radiation Safety Committee.

The Radiation Safety Committee may alter these values based on regulatory or departmental concerns. When an individual exceeds any one of these levels, a follow-up survey may be conducted to determine if a reduction in dose can be reasonably achieved.

For further information regarding personnel monitoring of ionizing radiation, refer to the UNMC Radiation Safety Manual or contact the Radiation Safety Office.

Students are responsible for bioassays for the presence of I-125 or I-131 in the thyroid at appropriate times during their clinical experiences (Nuclear Medicine Technology).

If a student becomes pregnant, she is encouraged to voluntarily consult with the program director concerning the most appropriate procedure to assure that exposure to the fetus is less than 0.5 rem (refer to Pregnancy Policy below).

Pregnancy

The pregnancy policy is a voluntary program intended to provide safety for pregnant students and their fetus who are considered occupationally exposed to ionizing radiation. In the event of a suspected or confirmed pregnancy, it is the responsibility of the student to advise her program director in writing of her condition. Pregnancy will not affect the student’s enrollment in the academic courses in the program. However, due to the physical requirements placed upon the student in the clinical courses and assignments, and in order to comply with 180 NAC 004.13 (10 CFR Part 20.1208) to keep the radiation exposure to the fetus as low as reasonably achievable (no more than 500 mrem during the entire gestation period), the following procedures will apply:

1. The student may voluntarily report suspected or confirmed pregnancy to the program director. At that time the UNMC/The Nebraska Medical Center policies and procedures and the MITS Student Policies and Procedures Manual pregnancy policy will be reviewed with the student. Once the student has elected to declare suspected or confirmed pregnancy, the student should:
2. Complete the form “UNIVERSITY of NEBRASKA MEDICAL CENTER DECLARATION OF PREGNANCY” and forward it to the Radiation Safety Office. (See form.)
3. The Radiation Safety Office will determine the estimated radiation dose from time of conception to the date of declaration based on dosimetry records and calculate the permissible remaining dose to the embryo/fetus for the remainder of the pregnancy. (See form).
4. Upon review of the findings and recommendations of the Radiation Safety Officer or Medical Radiation Physicist, clinical assignments will be reviewed. Clinical assignments will only be altered if the fetus received the maximum permissible dose as stated by 180 NAC 004.13 (10 CFR Part 20.1208). Any clinical competencies not completed for reasons related to pregnancy must be successfully completed prior to graduation.
5. Provide the program director with written indication of intent to:
   1. continue in the program, or
   2. take a medical leave of absence with intent to complete the program (form available from CAHP Academic & Student Affairs), or
   3. withdraw from the program (form available from CAHP Academic and Student Affairs).
6. The student should provide the program director with written consent from her physician providing medical advice for:
   1. continuing in the program as a full-time student, and/or
   2. any limitations placed upon the student while enrolled in the program.
7. A student may also voluntarily withdraw their declaration of pregnancy at any time. (See form.)