Clinical Policies and Procedures

Clinical Observations

The student will be observed by the clinical instructor and/or the clinical coordinator approximately twice during each quarter during scheduled clinical site visits.  An observation evaluation will be written or entered in Trajecsys.  This observation comprises 30% of the quarterly clinical practice grade for first and second year students.

Students are evaluated on technical, personal and professional skills. Observations are completed using the following rating system: 5=Outstanding, 4=Exceeds Expectations, 3=Meets expectations, 2=Needs Improvement and 1=Unsatisfactory. NA=Not Applicable

Observation Criteria

  • Focus on task at hand
  • Participate in tasks at appropriate level of performance
  • Demonstrate critical thinking & problem solving skills
  • Explain procedures to clinical coordinator
  • Identify patient diagnosis & treatment plan
  • Identify treatment area & structures on film/CT
  • Performs ancillary duties as needed/instructed
  • Accurately performs technical procedures
  • Demonstrate appropriate communication skills
  • Follow verbal and/or written instructions
  • Exhibit good patient rapport
  • Is neatly & appropriately dressed
  • Exhibit safe & ethical practices
  • Works as a team member (appropriate to level of education)
  • Successfully completed prescribed procedures for level of education
  • Attendance & logs up to date

Clinical Evaluations

Twice each quarter (mid-quarter and end of quarter), the student will be evaluated by the clinical preceptor (staff therapist). Criteria for clinical performance are listed below. Clinical evaluations comprise 60% of the quarterly clinical practice grade for the first year, and 60% of the grade in the second year. *note: The 60% is based on two evaluations which are the midterm and final. The only exception is for Clinical Practice I when the evaluation counts only 40% of the grade due to the initial orientation period. At designated mid-quarter and end of quarter dates, the clinical preceptor completes the evaluation form and reviews it with the student. Since evaluations are part of the student grade, the student is responsible for his or her evaluations. This may require politely reminding the clinic preceptor to complete the evaluation in Trajecsys.

After the student has signed the evaluation, the evaluation will be reviewed by the clinical coordinator in Trajecsys. Signing the evaluation is required to demonstrate that the student has received the evaluation. Signing the evaluation does not mean that the student agrees with the evaluation.

If for any reason the student disagrees with the evaluation, the form should be signed and an explanation added.

Clinical Outcomes and Goals

The student is responsible for reviewing the outcomes for each quarter. The student will work with the clinical preceptor to align personal goals with corresponding outcomes for each clinical course. The student is responsible for entering his or her personal goals into Trajecsys each quarter. The purpose of the lesson plan is to track and assess completion of set personal goals and determination of met outcomes. Personal goals for the quarters 2- 8 should be completed during the second week of clinic.  The student should get feedback from the instructors or clinical preceptor regarding these personal goals. All clinical days missed for unpreparedness will be made up at the end of the quarter.

Second Year Competencies

During the second year, students will begin completing two types of competencies required for graduation. The two types of competencies are Treatment and CT Simulation. The competencies are governed by the ARRT Didactic and Clinical Competency Requirements. A copy of these competencies can be found by following the link:

ARRT Didactic and Clinical Competency Requirements

Recomps

Additionally, the clinical preceptor, clinical supervisor or instructor may require a student to perform a “recomp” which is a repeat of a previously completed competency at any given time. The request of a recomp is at the discretion of a clinical preceptor, clinical instructor, clinical coordinator or program chair of the Radiation Therapy Program.

Required Discussion Questions

Due to a State requirement that has added a one hour a week discussion session to all clinical classes students are required to participate in weekly discussion questions in CANVAS for all eight clinical courses (Radon 111-114 and Radon 211-214).

Discussions

Discussions will open in CANVAS on Wednesday and close Sunday at midnight. No points will be granted past the due date. Points are awarded for participation and based on the number of questions answered. Student can expect questions regarding patient treatments from the following categories: Set up and Treatment Techniques, Pathology, Side effects, Total Dose and Organs at Risk, Dose Distribution and Beam Arrangement, Motion Tracking or Management Techniques and Radiation Safety.

Grading for Clinical Practice Courses

Evaluation grades are located in Trajecsys, our electronic clinical tracking system. Observation scores are given to student during on site conference. Discussion question points are awarded in CANVAS.

Factors Determining Clinical Practice Grades:

With the exception of first quarter, the weighting for all clinical courses is: Evaluations 60%, Observations 30% and Discussions 10% for a total of 100%

*Radon 111 (first quarter) weighting: Final Evaluation 40%, Final Observation 30%, Discussions 10% and Orientation Quiz 20% for a total of 100%

Criteria for Clinical Performance Year One and Two

Students are evaluated on technical, personal and professional skills. Evaluations are completed in Trajecsys using the following rating system: 5=Outstanding, 4=Exceeds Expectations, 3=Meets expectations, 2=Needs Improvement and 1=Unsatisfactory. NA=Not Applicable

Clinical Practice Grading Criteria Year One

Clinical Practice Grading Criteria Year Two

Clinical Assignments

Each quarter, students will be assigned to specific clinical education settings (hospitals and clinics) by the Clinical Coordinator.  Clinical assignments are determined by the educational needs of each student.  No student will be assigned to a clinic in which a significant other or relative is employed in the radiation therapy department. 

The College has contracts with each of the clinical education settings.  To intern at a clinical education setting, a student must be registered for the appropriate clinical practice course (e.g. RADON 111,112, 113, 114. 211, 212, 213, 214.) Students must be registered for the specific Clinical Practice course prior to attending that course at the clinical education setting.

If a student attends a clinical practice course, and is not currently registered for that course, the student will be asked to leave the clinical education setting until that student is properly registered.

Clinical education experience will be obtained in many areas to include:

  • Linear Accelerators
  • Patient Transportation
  • Electron Block Fabrication
  • Tumor Boards
  • New Patient & Follow-up Visits
  • CT Scanning
  • Simulators
  • Record and Verify Software
  • Brachytherapy
  • Medical Oncology
  • Nuclear Medicine
  • New technologies when available

Whenever a student is in the clinical area, he/she is to be under the direct supervision of a radiation therapist or other appropriate clinical personnel.

First quarter students are not allowed to beam on.  Second and third quarter students may be allowed to beam on with the permission of the clinical coordinator and clinical preceptor at their clinical education center.

Students may operate the treatment console only under the direct supervision of the radiation therapist. The student must receive permission from the therapist to generate a beam of radiation for each patient field treated.  The therapist must check the MU setting, timer setting, treatment mode, energy setting, and wedge interlocks prior to permitting a student to generate a beam of radiation.

A student generating a beam of radiation for a patient treatment without following the above procedure is subject to dismissal from the program.

Students will be assigned to each area by the clinical coordinator or the clinical preceptor. The presence of students in the clinical facility must in no way alter the routine work or schedule of the department or inconvenience the patient or staff.  Dependability, punctuality and performing at a clinically acceptable pace by the student are essential for the successful completion of the clinical education assignment.

Current Clinical Education Settings in Washington State

  • Confluence Health Central Washington Hospital
  • Evergreen Hospital Medical Center
  • Fred Hutch Cancer Center – Lake Union (formerly Seattle Cancer Care Alliance)
  • Fred Hutch Cancer Center – Peninsula
  • Fred Hutch Cancer Center – Proton
  • Kadlec Tri Cities Cancer Center
  • Kaiser Permanente (formerly Group Health Cooperative of Puget Sound)
  • Multicare Tacoma General Hospital
  • Overlake Hospital Medical Center
  • Peace Health St. John Cancer Center
  • Peninsula Radiation Oncology Center – TVROC
  • Providence Radiant Care Centralia
  • Providence Radiant Care Oncology – Lacy
  • Providence Regional Cancer Partnership Everett
  • Swedish Cancer Institute at First Hill
  • Swedish Cancer Institute at Edmonds
  • Swedish Cancer Institute at Issaquah
  • Tacoma/Valley Radiation Oncology Center – Puyallup, WA
  • Tacoma/Valley Radiation Oncology Center – St Joseph
  • University of WA Medical Center
  • Virginia Mason Franciscan Health
  • VM-FH St. Anne Burien
  • VM-FH St. Michael’s Radiation Oncology

Travel and Parking at the Clinical Education Settings

Travel to and from the clinical education settings and/or travel between didactic classes and clinical education settings is the responsibility of the student.  Any costs incurred for transportation to and from the clinics are the responsibility of the student.

Bellevue College provides reduced fare bus passes to BC students. Go to the following link for more info: https://www.bellevuecollege.edu/location/bus/

Metro bus routes provide service for Seattle and the Eastside. Additional METRO Bus information may be obtained at: http://metro.kingcounty.gov/schedules/

Parking

Some clinical affiliates provide free parking for students. Check with your clinical preceptor regarding parking availability.  Parking at many of the clinical settings is difficult and expensive; at such sites, students are encouraged to use public transportation.

Attendance for Clinical Practice Courses

  • Each student will receive a clinical assignment schedule and a schedule of clinical instruction hours at the beginning of each academic quarter
  • Time Records: Each student is responsible for maintaining a time record. Time records for each quarter are provided in Trajecsys, the clinical electronic records portal. Students must either sign in/clock into Trajecsys from a PC at the institution or on their smart phone once the student arrives at the institution. If the student uses their smart phone, GPS must be enabled so that the geographical location is recognized. If GPS is not enabled on the smart phone then the student is advised to log in from a PC.
  • Missed Time Entries: If a student has a missed time entry, the student is responsible for manually entering the missed arrival or departure time. Additionally, the student is responsible for asking their clinical preceptor to approve of the manual entry.

   Only the clinical preceptor may give the student permission to leave early.

  • The student must sign in and out for the actual hours at the treatment unit or clinical assignment.

Examples:

Student “A” arrives at the clinic at 7:50 a.m. and reports to the treatment unit ready to work at 8 a.m. The student leaves the treatment unit at 4:30 p.m. and leaves the clinic at 4:35 p.m.  Student “A” signs in at 8 a.m. and signs out at 4:30 p.m.

Student “B” arrives at the treatment unit at 8:10 a.m. and because of a dental appointment leaves the treatment unit to go home at 4 p.m. Student “B” signs in at 8:10 a.m.. and signs out at 4 p.m..

  • LUNCH and Breaks: In general, during a scheduled clinic day, students should receive a 30 minute lunch period and two 15 minute breaks for a total of 1 hour per clinical day.
  • JRCERT Standard 1.4

 The 10 Hour Rule:

Limit requires clinical assignments for students to not more than 10 hours per day.

Explanation: This limitation helps assure that students are treated ethically.  For the safety of students and patients, not more than ten (10) clinical hours shall be scheduled in any one day. Hours exceeding these limitation must be voluntary on the student’s part.

A PDF Copy of 2021 JRCERT Standards for an Accredited Educational Program is available at http://www.jrcert.org/programs-faculty/jrcert-standards/ (Information is found under 2021 Radiation Therapy Standards – Standard Four, Objective 4.4.)

  • During the summer months (June, July, and August) when there are no didactic classes scheduled, the students may be permitted to arrange their clinical schedules to conform to the hours of operation at the clinical education center (e.g., 4-day week 7:45 a.m. – 6:15 p.m.). It is emphasized that this will be at the option of both the student and the clinical preceptor.

In general total clinical hours are as follows but may change depending upon the academic calendar for each year:

QuarterFirst YearSecond Year
Fall96240
Winter160240
Spring160240
Summer400400

Clinical hours subject to change due to BC academic calendar. Attendance at clinical labs is required.

Punctuality

  • Each student is required to be at the clinical area at the assigned time, ready to perform educational assignments.
  • A student who enters the clinic late or who fails to return on time from lunch or scheduled breaks may be sent home at the discretion of the clinical preceptor.  A student sent home for the above reason will be required to make up a full clinical day.
  • Excessive tardiness is cause for dismissal from the program.

Holidays, No Class and Snow Days

  • The Radiation Therapy Program normally follows the College’s schedule of holidays and No Class days per the published academic calendar.
  • Students cannot be in clinic If the College is closed for a Holiday
  • Students cannot be in clinic if the College is closed due to inclement weather.
  • Students cannot be in clinic on College “No Class” days.
  • Students do not need to make up missed days due to inclement weather
  • The College is open for classes; however the area of the Clinical Site could have inclement weather.

For example, there is no snow in Bellevue and College is open; however there is 12 inches of snow in Olympia.

We cannot have a rule regarding the situation above.  However we urge all students to assess the situation and follow the principle of Safety First.

Question: College is open and there is a lot of snow at the clinical site so I did not go to clinic because of driving conditions.  Will I need to make-up the day?

Answer: This will be decided on an individual basis by the Clinical Coordinator and Program Chair.

School delays or early closures:

If Bellevue College announces a 2 hour delayed start, students may arrive at the clinic 2 hours later than usual. Please inform the clinic preceptor of your arrival time.

If you are at the clinic and the weather is deteriorating, please use your best judgment to decide if you should leave early to get home safely. Please discuss the situation with your preceptor and inform the clinical coordinator and program chair by email.

Clinical Absences

  • In case of absence, the student must notify the clinical preceptor within the first hour of the clinic’s working day (normally 8:00 a.m.) via email, followed by a phone call and email to the clinical coordinator and the program chair. It is students responsibility to make time exceptions for missed clinical days in Trajecsys by choosing the absence option and specifying the reason for absence in the comment box (For example, sick, inclement weather, or personal reason)
  • Any student absent due to illness for three or more consecutive days must notify the clinical coordinator to receive permission to return to the clinical education center.
  • Each student shall be granted two (2) excused absences in the form of two (2) “sick days” per academic year (an academic year comprises the start of the year in Fall through Winter, Spring, and Summer quarter).  The student shall be excused from clinic, and shall not be required to make up the clinical hours for these missed “sick days”.
  • Sick days are not cumulative, and the student shall only have two (2) excused sick day absences available per academic year (regardless of whether they were used the previous year or not).  While a student may experience an illness which prevents them from being in clinic for longer than two (2) days, exceptions beyond two (2) excused sick days will not be made, and any days after the two (2) will be considered unexcused, and must be made-up, in order to ensure student success and that the student achieves the clinical work hours required of the program.
  • During a quarter, if a student has more than four days of absence (that have not yet been made up by the end of that quarter) that student will receive an “Incomplete” grade until those days are made up.
  • Missed clinical education time must be made up prior to graduation from the program. The 40-hour rule still applies in this situation.
  • First year students may not make up clinical time on days that second year students are assigned to the clinics.  Second year students may not make up clinical time on days that first year students are assigned to the clinics.
  • Students may not make up clinical time during hours assigned for academic classes. Furthermore, students may not make up clinical time on a National or State Holiday or on “No Class days” (which are the College’s non-instructional days as listed on Bellevue College’s Academic/Student Calendar)
  • No student will be absent from the clinical area for the purpose of studying for examinations except with the permission of the clinical coordinator or program chair.
  • A pattern of excessive absence is cause for dismissal from the Radiation Therapy Program.

Clinical Make Up Time

The student is responsible for scheduling make up time with the clinical supervisor. In general, make up time should be made up at the same clinic where the time was missed. Make up time can be done during college breaks and must be approved by the clinical preceptor and/or clinical coordinator.

Banking of clinical hours is only permitted under extraordinary circumstances and must be approved by the clinical coordinator prior to accumulation of hours.

Jury Duty

Students are encouraged to ask for deferment for jury duty requests while in the program. The purpose of the deferment is to provide consistency in academic and clinical progress ensuring student success.

Other Credit for Clinical Time

Qualifiers: Job interviews, and conferences – both must be related to radiation therapy

Examples: Job interview for second year student nearing graduation, ASRT conference

Specifics:

  • Half Day/Full day: If less than four hours must make up half day. Five hours or more counts as a full day.
  • Local versus Out of State

Out of State: Interview will count as one full day credit but travel time needs to be made up.

  • If conference or interview falls on regular scheduled clinic day, log on time sheet for same day. If event falls on non-clinical day then absence is excused but cannot be counted as clinical. Student is responsible for informing all instructors (clinical and didactic) of reason for absence (see absence policy).
  • If conference is held on a Saturday or Sunday, time is counted towards clinical. The rationale behind this is most institutions would reimburse you for your time regardless of which day the conference falls on.
  • If conference does not fall on a scheduled clinic day, guidelines are as follows since banking of clinical hours is not permitted:

Attendance in lieu of clinic must be applied to the corresponding academic quarter. For example, if attending a conference at the end of an academic quarter, student must take time off during same quarter rather than banking the hours for the next quarter.

Limitations:

Maximum Interview per quarter: 3
Maximum Conference per academic year: 1

Special Note for Conferences:

Verification of attendance is required for clinic time. Conference registration and/or receipt are valid forms that may be used for verification.

Documentation:

Manually record qualifying clinical time on the student electronic time record in Trajecsys with an explanation. Send an email to clinical coordinator for approval of manual entry.

Dress and Hygiene Policy

Students are required to follow the dress code and proper hygiene for the clinical education setting to which they are assigned.  Hygiene includes proper care of hair, fingernails and skin. Please check with your clinical preceptor for the specific code requirements.

The student must wear a Bellevue College ID tag or ID tag provided by the clinical education center. The ID tag should be worn so that it may easily be seen.

A student who reports to a clinical education center not in proper attire may be sent home at the discretion of the clinical preceptor.  The student will be required to make up the lost clinical time.

While not every clinical education center may require the use of lab coats or scrubs, it is highly recommended that the student wear lab coats or scrubs. Lab coats can aid in the protection of street clothes.

During certain clinical education assignments, such as block fabrication, it is recommended that the student wear appropriate protective clothing (e.g. gloves, goggles, protective apron, etc.).

While working with patients, some procedures may require the student to use personal protective equipment (PPE) such as gloves or masks. Students are responsible for following institutional procedures where they are assigned.

Smoking and Use of Electronic Cigarettes Policy

Smoking is prohibited at all clinical education settings.  Check with clinical preceptor at the individual settings for specific policies regulating smoking.

Smoking is prohibited on most of the BC campus. Please see the BC Policies and Procedures for details regarding the campus smoking policy.

http://www.bellevuecollege.edu/policies/id-6350/

Ethical Expectations

Students are expected to maintain a high standard of ethical behavior in the clinical education settings and in the classroom.

  • Students must abide by the standard rules and regulations of the College and the clinical education setting
  • Students must respect the patient’s right to privacy and keep confidential the information relating to the patient. Students are expected to comply with HIPAA regulations. Failure to do so can result in dismissal from the Program.

When preparing case studies for classroom presentations or other reports, etc., it is mandatory that the student receive permission of the clinical preceptor to make copies of any patient-related material. Any copies of reports or films used for presentations must have the patient’s name and clinical number (or any other identifying information) covered. This helps to ensure the patients right to confidentiality.

Behavior in the Clinic Area for Students and Therapists

  • Whenever a student is in the clinical area, he/she is to be under the direct supervision of a radiation therapist or other appropriate clinical personnel.
  • During clinical assignments students should be viewed as members of the Radiation Therapy Treatment Team and be provided with the opportunity to perform tasks within their level of ability. It must always be remembered that the clinical assignments are for educational purposes. Students are not to replace paid personnel during any portion of the clinical education program. In addition to participating in direct patient care, students may be asked to perform other therapist-related tasks such as assisting in transportation of patients, processing films, filing charts and film, and keeping the treatment rooms neat and well stocked.
  • Set-ups performed by the student must be checked by the supervising therapist before the patient is treated. This includes patient positioning and all beam parameters.
  • Students may operate the treatment console only under the direct supervision of the radiation therapist. The student must receive permission from the therapist to generate a beam of radiation for each patient field treated. The therapist must check the MU setting, timer setting, treatment mode, energy setting, and wedge interlocks prior to permitting a student to generate a beam of radiation.

A student generating a beam of radiation for a patient treatment without following the above procedure is subject to dismissal from the program.

When entering a linear accelerator room, student must ensure that staff is aware of his/her presence in that room.

  • Students should be encourage to operate the record and verify system under direct supervision of a radiation therapist.
  • Any behavior on the part of a student which results in an unsafe condition for the patient, staff or student should be immediately corrected by the supervising therapist.
  • Discussion of patient set-ups by the student and therapist should not take place in front of the patient. This includes student questions regarding therapists correction of student.
  • Any injuries involving a student during the clinical assignment should be documented and must be reported to the clinical preceptor and clinical coordinator/program chair.
  • All problems which cannot be resolved by discussion between the therapist and the student should be first communicated to the clinical preceptor and then to the program chair.
  • The students will clock in and clock out every clinic day in Trajecsys.  The clinical preceptor will approve the student time log in Trajecsys. The student is responsible for maintenance of time records.
  • Students will receive two clinical evaluations per quarter in Trajecsys. The midterm evaluation is scheduled halfway through the quarter. The final evaluation is scheduled the last week of the quarter prior to finals week. It is the student’s responsibility to ensure the clinical preceptor has completed his/her evaluation.
  • Students are forbidden to use a mobile phone, or to text, during their clinical practice (except during breaks or emergencies).
  • Any questions that arise as to therapist or student responsibilities should be brought to the attention of the clinical coordinator.

Examples of Inappropriate Behavior

Any student may be disciplined or discharged for just cause which may include, but is not limited to, the following breaches of standards for reasonable conduct:

  • Excessive absenteeism or frequent tardiness.
  • Reporting to school or clinic under the influence of intoxicants or drugs.
  • Harassment or discrimination of employees or students (e.g. sexual, racial, cultural or age).
  • Refusal to accept adjustment of clinical assignment at the direction of the clinical preceptor or program chair.
  • Continued failure to follow safety regulations; gross or willful negligence in the use of radiation or the handling of radioactive substances.
  • Is, by his/her own admission, or has been found guilty of theft.
  • Soliciting of gifts, gratuities or tips. Selling or soliciting in the clinic or hospital.
  • Releasing or failure to prevent the release of confidential information (HIPAA regulations)
  • Abuse, misuse, waste or destruction of hospital or BC property.
  • Unauthorized operation of equipment.
  • Possession of or use of weapons in the hospital or on school premises; or physical violence, threats of harm or abusive conduct.
  • Personality difficulties: inability to get along with employees, other students or with patients.
  • Establishing a social relationship with a patient who is on treatment.
  • Conviction of any felony during the program that would prohibit a person from working in healthcare.
  • Students and staff are not allowed to date superiors and/or subordinates while in the program. Failure to comply with this policy will result in the student being reassigned to a different clinical setting based on availability. If a clinic is not available for reassignment for the remainder of the quarter, then the student is responsible for making up the missed clinical time which may delay their graduation.
  • Texting friends or family during clinical assignment.

BC Student Conduct Code

You may view a copy of the BC Student Conduct Code at:

Bellevue College Policies and Procedures – 2050 Student Code

ASRT Radiation Therapist Code of Ethics

You may view a copy of the Radiation Therapist and Radiologic Technologist Code of Ethics from the ASRT website at:

Radiation Therapist Code of Ethics

Radiologic Technologist Code of Ethics

Health and Safety Policies and Procedures

Last Updated November 2, 2023