Radiography Advisory Meeting Minutes

Nov. 17, 2022, 4 p.m.

Meeting place

Zoom

Facilitator

Janelle Murphy, LLCC Radiography Program Director

Attendees

Members in attendance

Janelle Murphy, LLCC RAD Program Director; Andy Harmon, LLCC RAD Faculty and Clinical Coordinator; Lindsay Whit, LLCC RAD Lab Instructor; Sherri McLaughlin, Jacksonville High School Guidance Counselor; Rebecca Weakley, Memorial Cares, CI; Josh Risse,  Springfield Memorial, CI; Sasha Schaive, Springfield Memorial, CI; Angie Smith, Orthopedic Center, CI; Doug Ferrill, Taylorville Memorial Health, Radiology Manager; Branzley Cantrill, Taylorville Memorial, CI; Joanne VanLeer, Director of Imaging, St. John’s Hospital; Branden Richardson, Director of Imaging, St. John’s Hospital; Shanna Wall, St. John’s Hospital, CI; Charity Mizera, Springfield Clinic, Radiology Operations Manager; Michael Wempen, Springfield Clinic, CI; Trinity Flowers, Hillsboro Area Hospital, Imaging Supervisor; Kayla Kloppe, Jacksonville Memorial Hospital, CI; Danielle Horn, LLCC RAD 2nd year student

Members absent

Dr. Vern Lindquist, LLCC Vice-President of Academic Services; Karen Sanders, LLCC Foundation, Executive Director; Dr. Cynthia Maskey, LLCC Dean of Health Professions; Fabiola Gonzalez, LLCC Student Success Coach; Dr. Curt Settlemoir, Central Illinois Radiologic Associates, Medical Advisor; Marjorie King, Director of Imaging, Springfield Memorial Hospital; Kurt Brauer, Springfield Memorial Hospital, Inpatient Imaging Manager; Jane Johnson, Hillsboro Hospital, CI; Jen Lewis, St. Francis Hospital, Imaging Manager; Lance Malloy, Springfield Memorial Health Outpatient Services Manager; Patti Brown, Director of Imaging, Jacksonville Memorial Health; Shannon Meier, St. Francis Hospital, CI; Brenda Bale, Springfield Clinic, Director of Imaging; Brooklyn Loos, Springfield Clinic, Radiology Operations Manager

Guests

N/A

Agenda

  1. Introductions
  2. Overview of current students
  3. Program effectiveness data
  4. Employer and Graduate survey results
  5. Assessment data 2021-2022, completed cycle 1, June 2021-May 2022
  6. Annual review of program mission statement
  7. Clinical site updates
  8. Miscellaneous
  9. Open forum

Minutes

1. Introductions

  • Everyone was introduced.

2. Overview of current students

  • (Janelle) There are currently 16 first year students and 14 second year students.
  • Second Years, Class of 2023
    • The 2nd year class has had 2 students drop for personal reasons. One withdrew due to a family illness and the other left to start sonography school in Kentucky. This makes the anticipated JRCERT completion rate 14 of 14 or 100%.
    • Current clinical sites: Springfield Memorial (6), St. John’s (5), St. Francis (1), Hillsboro (1), and Taylorville Memorial (1).
  • First Years, Class of 2024
    • We have retained all 16 students.
    • Current clinical sites: Springfield Memorial (6), St. John’s (5), Jacksonville Memorial (2), St. Francis (1), Hillsboro (1), and Taylorville Memorial (1).
  • The application period is currently open for the class that will start in June 2023. Any student who meets the program’s admission requirements can apply until Friday, January 27, 2023, by 5 p.m.

3. Program effectiveness data

  • (Janelle) The LLCC Radiography program is accredited by the Joint Review Committee on Education in Radiologic Technology (JRCERT). The program is required to complete an Annual Report for the JRCERT as an aspect of maintaining accreditation. The 2021 Annual Report was completed and submitted in September 2022. There are 3 pieces of information that are required as data indicating our program’s effectiveness; Credentialing Exam Pass Rate, Program Completion Rate, and Job Placement Rate. This information, as well as almost anything else you’d like to know about our program, can be found on LLCC’s radiography webpage. The data submitted is as follows:
    • ARRT Credentialing Exam Pass Rate – The 5-year average for graduates passing the ARRT exam on the 1st attempt is 98.3%. In the 5-year average, there was one student who did not pass on the 1st attempt. Fortunately, this graduate did pass on the 3rd attempt and is gainfully employed as a radiographer. Janelle also noted that the LLCC graduates have scored higher on the ARRT registry exam than the national average of all programs in the U.S. since 2016. This information was well received by the attendees and there were no additional comments brought forth for discussion. View Credentialing Examination Rate information in the LLCC Radiography Program Effectiveness Data document.
    • Job Placement Rate - The 5-year average for the program’s job placement rate for those graduates seeking active employment within 12 months is 100%. The employers who hired our Class of 2022 graduates were as follows: four hired by Springfield Memorial (Imaging 2, CT 1, and IR 1), three by Memorial ExpressCare, four by HSHS St. John’s (Imaging 3 and Surgery 1); and one by Jacksonville Memorial (Imaging).This information was well received by the attendees and there were no additional comments brought forth for discussion. View the Job Placement Rate information in the LLCC Radiography Program Effectiveness Data document.
    • Program Completion Rate (Attrition) – Per JRCERT requirements, the completion rate is reported annually and not as a 5-year average. The benchmark set by the program is a 75% completion rate and the completion rate for 2022 is 80%. This result meets the set benchmark; however, completion rate continues to be an area of concern for the program, and we are continually seeking ways to improve the outcome. The Class of 2022 started with 16 students, and of those, one dropped for personal reasons in the 1st semester, one was dismissed academically due to a clinical evaluation grade at the end of the 3rd semester, and one was dismissed for abuse of absenteeism at the end of the 4th semester. View the Program Completion Rate information in the LLCC Radiography Program Effectiveness Data document.
  • The program has had an action plan in place to improve its retention rates for quite some time. Strategic pieces of the action plan include:
    1. Change to a Selective Admission process, instituted in 2014
    2. Student Success Plan, instituted in January 2015
    3. Mid-Semester Student Progress Meetings, instituted 2015
    4. Easier access to positioning lab with after hours and weekend availability and the option to sit in on other lab sessions
    5. Change to Clinical Final exam rules, effective June 2018. Since its effective date, 11 students have been able to successfully continue in the program due to this change.
    6. Revision of the positioning lab competency form. Since its effective date of fall 2018, there have been 114 instances of improved scores from the possible base score of 80%. The average comp score for these instances was 89%.
    7. Change to RAD 103 averaged lab competency score. Effective, summer 2019, three students were able to pass RAD 103 who previously would not have.
    8. Proposed change to the Selective Admission Point System form. The program revised the current point system form to include higher points given to potential students who have a previous history of clinical experience. Currently, 0.5 points are given to anyone who is a CNA with certification within the last 5 years or with a current work history. Students who make it into the program with CNA experience always do better clinically and with the patient care courses. The program increased the point for CNA to 1.0 and included CMAs and Radiography Tech Assistants. We also included Paramedics in the extra 1-point group. This change was effective in spring of 2019. Incidentally, out of the current classes, 12 of the 30 students are CNAs. This change seems to be helping with the students who would withdraw from the program due to a lack of healthcare knowledge and/or experience.
    9. Change to student clinical evaluations for 1st year students, effective fall 2021. Dating back to 2015, seven students were dropped from the program due to clinical evaluation scores below 80%. Of those seven, five students were dropped in the first clinical semester. The program discussed this issue at the 2020 Advisory meeting to explore possible resolutions. Based on the Advisory committee’s recommendations, the program formed a small committee to revise the clinical site evaluation for 1st year students. Previously, the same evaluation was used for both 1st and 2nd year students and clinical evaluation scores must be 80% or higher for the student to pass the course and remain in the program. The 2nd year evaluation did not change. The new 1st year evaluation was revised to better correlate to 1 st year students and their lack of positioning skills, lack of classroom knowledge, and limited clinical time by the time the mid-semester and final evaluations are due. Of the ten total questions, five questions were revised. These five questions related to Organization of Work, Patient Care, Technical Knowledge, Image Assessment, and Adaptability/Critical Thinking. The results of "Revised 1st year clinical evaluation: Results" are as follows:
      1. Fall 2021 mid semester evaluation average = 93.4% vs fall 2020 (old evaluation) = 90.6%
      2. Fall 2021 end of semester average = 93.65% vs fall 2020 (old evaluation) = 91.33%
      3. Spring 2022 mid semester average = 93.4% vs spring 2021 (old evaluation) = 92.3%
      4. Spring 2022 end of semester average = 95.17% vs spring 2021 (old evaluation) = 92.4%
      5. Fall 2021 and 2022 mid semester average = 92.75% vs fall 2019 and 2020 (old evaluation) = 90.46%
      6. Average increase with new first year evaluation = 2.12%

The program is pleased with the results and the attendees were in agreement. There were no additional comments on completion rate improvement.

4. Employer and graduate survey results

Employer survey results

(Janelle) The program waits until about 6 months post-graduation to send surveys to the employers that we know hired our graduates. Based on the results, we appear to be fulfilling our mission of producing competent entry-level radiographers. The survey was sent to 6 different employers of the 12 graduates. View the radiography employer survey of graduated students on the LLCC Radiography Surveys webpage.

OPTIONAL RESPONSES:
  • Please list any topic(s) you believe should be emphasized more in the program that would help us achieve our goals and make graduates even more knowledgeable about radiography, more empathetic towards patients, or better communicators and problem solvers.
    • I don’t know if this can be taught but if it can, teach them to be confident and that it is okay to go directly to the source of their leadership for questions.
    • The program does a good job preparing students.
    • I would like to see the students rotate more through the modalities in general.
  • Please feel free to comment on their ability to provide patient care and high-quality service.
    • This colleague is very good with patients. She has the ability to administer a high level of patient care.
    • This graduate was very prepared for her role. She was a quick learner and is not afraid to advance into higher learning.
    • This graduate has done very well learning the surgery exams. She has adapted very well. I feel she was prepared for her role.
    • This colleague works hard, steps up for any opportunities. She came to us well prepared.
  • Feel free to comment on their ability to perform the specified procedures.
    • She does very well in all areas and works independently.
    • She excels in all of these areas.
    • He is in IR, so the skills are different than what he trained for.
  • Please feel free to comment on their ability to communicate effectively.
    • She works very well with her team. She has good communication skills.
    • She cares about her team and strives to work well with everyone. She has excellent skills with families and patients.
    • Right where he should be for his knowledge of IR.
  • Please feel free to comment on their problem solving and critical thinking skills.
    • Right where he should be.
  • Please feel free to comment on their overall professionalism.
    • This colleague has been very dependable with excellent attendance. Her appearance is very professional.
    • The graduate is very dependable and punctual. Her appearance is professional.
  • Please feel free to comment on their attitude and self-confidence.
    • Colleague joined our department at a time with many openings. The area can be fast paced, and she had adapted well to this. We value her very much.
  • Please feel free to comment on their attitude and self-confidence. 
    • This graduate shows a little frustration when assigned to an area she doesn’t really like or when things are a little overwhelming due to high census.
  • In general, please feel free to comment.
    • Has done well to work in different areas as needed.
    • This graduate is just wonderful. She is ethical in her practices, and we are just so happy she chose to work here. I feel that this graduate has done very well, especially since she took a higher-level position in surgery. She has done very well.
    • The students could use more time in the specialized modalities.
  • Please feel free to comment on how well the program accomplishes its mission.
    • I feel this student was well prepared to enter our work force. She had the skills needed to adapt quickly.
    • LLCC Program Leaders, Janelle and Andy, do a great job. We have been particularly pleased with the interaction and understanding of our clinical directors with the past couple of years of low staffing.
    • All our students have had what they need for their roles here. We are happy they picked us.
Graduate survey results

(Janelle) The program waits until about 6 months post-graduation to send surveys to the graduates who were actively seeking employment. All 12 of the graduates responded to the survey. There are several questions on the survey specific to post-graduate employment. The information gathered from those questions indicates that all 12 of the students’ submitting surveys were employed within 6 months of graduation and all of them had jobs before they graduated. The graduates work in a multitude of locations and often in more than one specific area of the department. Ten graduates are employed in General Radiography, one in IR, and one in Surgery. Nine of the graduates’ work in the hospital setting and three work in an outpatient clinic. Nine of them are employed full-time, one is part-time, and 2 work on a PRN basis. When asked about the length of the orientation process at their place of employment 3 of them indicated a 1-2-week orientation, 5 indicated a 3-6-week orientation, and 4 indicated they had a 7–12-week orientation. View the radiography graduate survey on the LLCC Radiography Surveys webpage.

OPTIONAL RESPONSES:
  • Were you employed in any capacity in Radiology Technology within 6 months of graduation?
    • HSHS St. John’s Surgery
    • Yes. I was hired at Memorial Health six months before I graduated from my Radiology program at LLCC.
  • Please feel free to comment on how long it took you to find employment after you graduated.
    • When the different hospitals came to talk to us, it made it super easy to clarify my decision.
    • Job was lined up 6 months prior to graduation.
    • No time at all.
  • In what specialty have you been employed in since your graduation?
    • Surgery
    • Diagnostic Radiology
    • Also work PRN in Diagnostic X-ray
  • For your first Radiologic Technology job after graduation, how long was the orientation in the imaging department that was provided by your employer?
    • 3 months/90 days
    • I came back for my last two weeks before the program ended so I got most of my training during clinical.
    • Doing clinicals where I was hired at lowered my orientation time.
    • Training in surgery was 2.5 months for me.
    • Paper orientation was only about 6 weeks since I worked as a Tech Assistant. I was quickly left to work on my own, partly due to short staffing.
  • Based on your classes and clinical experience in the program, how well did the program prepare you to perform radiographic and fluoroscopic procedures?
    • I felt ready to start as a tech as soon as I graduated.
    • I felt very prepared.
    • My surgery clinical rotations prepared me well for my job. I think it would have been helpful to have had more time practicing with the c-arm at LLCC prior to our surgical rotation.
    • It prepared me very well. Based on your classes and clinical experience in the program, how well did the program prepare you to provide optimal patient care while delivering excellent patient service?
    • I had a good sense of patient care before entering the program because of my job.
  • Based on your classes and clinical experience in the program, how well did the program prepare you to think critically and solve problems on the job?
    • Most critical thinking skills came from clinical and working with those problems myself in the hospital setting.
    • The trauma positioning lab was very helpful.
  • Based on your experiences since graduation, how would you rate the amount of clinical time you had as a student?
    • I think the clinical time was a lot. Some of the comps that are required and lots of the electives you will never see working as a tech and is just not realistic things that you will do. If you took them off, it would not be hard to get all of your comps with less clinical time.
    • Program Note: The ARRT requires that all students prove competency on 36 mandatory and 15 out of 34 electives before being eligible to apply for exam. If these requirements are not fulfilled, the student will not be able to take the national registry exam.
    • I feel like our clinical sites cold have spent more time on teaching us how to chart/document and interact with the Radiologists. That part of the job was a learning curve when I started my position.
  • How would you rate your satisfaction with the quality of education you received in the Associate Degree Radiography Program?
    • The teachers were amazing and only wanted to see you succeed.
  • Please provide any topics that should have been emphasized more that would have helped you become even more knowledgeable and skilled in radiography, more empathetic towards patients, a better communicator, or a more effective problem solver:
    • I really have no suggestions. I feel like my transition to working was very easy and I felt prepared for my worksite, since I had been there in clinicals. I really enjoyed the program and would recommend it to anyone interested in the field.
    • Going over what images are supposed to look like during lab would help a lot. I would comp in lab but when I would get practices in clinical, I knew my positioning was correct, but I had a hard time knowing if the image looked the way it was supposed to.

5. Assessment data 2021-2022, completed cycle 1, June 2021-May 2022

  • (Janelle & Andy) The June 2021-May 2022 Assessment Plan was presented to everyone. This plan marks the first cycle of a 3-year cycle of assessment. The measurement tools used to correlate the data are various questions on Clinical Evaluations, Clinical Final exams, written papers, oral presentations, and competencies, E*Value time tracking, E*Value procedures tracking reports, skills labs, and embedded test questions. The attendees were provided with a copy of the assessment plan with the invitation to the advisory meeting and were asked to review it in advance of the meeting. Of the 32 benchmarks assessed, 5 of them were not met so the meeting’s assessment discussion was focused on those benchmarks.
    • PLO #2, Students will develop competency in the clinical environment. RAD 200, CLO 4
      • Benchmark - Students will receive a HESI score of 750 (Recommended performance) or higher on the Procedures component of the exam.
      • Analysis - 13 students took the HESI mid-curricular exam, with 12 scoring 750 or higher on the Procedures component of the exam, for a result of 92.3%. The one student who failed to make the cutoff was also very close with a 734. Additionally, the average score of all students on the Procedures component was 1039.7, which is well above the recommended performance. To improve this result and hopefully meet this goal in the next cycle, the instructor will develop several short Canvas assignments covering the different body regions for Radiographic Procedures that the students will be required to complete weekly throughout the course prior to taking the HESI exam.
    • PLO #2, Students will develop competency in the clinical environment. RAD 102, CLO 2
      • Benchmark - Students will receive a passing score (P) on patient transfer skill testing on the first attempt.
      • Analysis - 16 students were tested on both wheelchair and stretcher transfer skills, with only 7 passing on the first attempt for 44%. This result is well below the benchmark, and lower than results from the previous cycle as well. All students did pass on their 2nd attempt, but the most mistakes were made during wheelchair transfers, so these will be emphasized in the future. Additionally, some of the transfer practice time was spent on an interprofessional education session with the Occupational Therapy Assistant program, which may have been less beneficial for practicing the specific skills on which the students were being evaluated. Instructor will plan for a “dry run” of the skills check in future semesters.
    • PLO #3, Students will develop critical thinking skills. RAD 103, CLO 3
      • Benchmark - Average score of > 80% on test questions related to image evaluation and corrective steps.
      • Analysis - 16 students answered test questions related to image evaluation with an average score of 75.6%, which does not meet the benchmark. One student was an outlier with only 23% correct, which probably skewed the data somewhat. Image evaluation is currently mainly taught as in-class group discussion, but some individual asynchronous assignments may be helpful for improving this outcome in cycle 2.
    • PLO #3, Students will develop critical thinking skills. RAD 225, CLO 3
      • Benchmark - Average score of > 80% on image critique assignment.
      • Analysis - 12 students evaluated an AP open mouth C-spine image, with an average score of 76.7%, which does not meet the benchmark. All students correctly identified that the upper incisors were superimposing the dens, but only 5 also noticed that the patient’s head was rotated. When discussing image critique, this upper cervical anatomy will be reviewed as well as a reminder to look for all possible errors, not just the most obvious.
    • PLO #4, Students will develop communication skills. RAD 105, CLO 3
      • Benchmark - Students will respond accurately >90% of the time to positioning questions related to imaging during the lab comp.
      • Analysis - 14 students responded to a total of 82 verbal questions during lab comps with 67.1% accuracy, which falls well below the benchmark. The most frequently missed questions involved why certain breathing instructions and SID are used, as well as which structures are demonstrated on different projections. For future cycles, lecture instructor and lab instructor will work together to create a list of important questions, and students will be prompted to respond to those questions during lab sessions and during lecture review leading up to the comp. 
  • Janelle asked for any additional comments and suggestions and stressed the value of input from the committee on assessment. The group was comfortable with the information that was provided to them. No additional comments were expressed at this time. They were asked to continue to think about the program’s assessment measures and to provide ideas and feedback to Janelle at any time.

6. Annual review of mission statement

All attendees were provided a copy of the current program’s Mission Statement and asked to review it. There were no recommendations for change brought forth.

7. Clinical sites

(Janelle & Andy) The program is looking at various opportunities to potentially accept more students into the program. However, the program is strapped for student placement at our clinical sites as well as by the size of the classroom on campus. The program currently utilizes 13 JRCERT-recognized clinical sites. To take on more students, we need a larger classroom that would have desk space for more students as well as lab space for more students. The current x-ray unit is floor mounted and is within several feet of a wall that inhibits anyone getting access to that side of the unit. If we enlarge class size, we also need a new x-ray unit that possesses an overhead tube so that larger groups of students can be participating in lab at one time. Janelle asked if anyone was getting new equipment and would have a unit with an overhead tube that could be gifted to the program. The unit would need to be in good operating condition. The following are steps we’re taking to find more clinical space:

  • Effective this fall, the program is rotating all 2nd year students through Springfield Clinic. All students will complete a 2-week rotation at main campus as well as a 2-week rotation in the 800 Building orthopedic area. This has proven to be a great experience for the students and is allowing many of them to see more fluoroscopy than at other facilities.
  • Memorial Care in Jacksonville has been recognized as a clinical site and will be an additional rotation for students at JMH.
  • Tentative discussion with HSHS Priority Care as an additional rotation for students at HSHS St. John’s.

Janelle reminded all attendees about JRCERT Standard 4.4 which states “The program provides timely, equitable, and educationally valid clinical experiences for all students.” The JRCERT requires a 1:1 student-to-clinical staff ratio as well as a 1:1 student-to-physical resources ratio. While we recognize that everyone is dealing with staffing issues, this cannot be overlooked. We ask all clinical instructors to please review the scheduling of all students at your clinical site. Andy and Janelle are more than happy to discuss and assist with solutions if this is an issue at your site.

8. Miscellaneous

  • Gifts! The program would like to thank and recognize LLCC for the LEAGUE grant. With this grant we were able to purchase a radiographic leg holder for leg positioning.
  • Wish list! The program is looking for funds to purchase a well-functioning portable x-ray unit that is preferably digital and an x-ray unit with an overhead tube. We would also like to locate a larger classroom that could easily house all students as well as all of our equipment in one location.

10. Open forum

  • All attendees were asked for any additional comments or points of discussion.
    • Trinity Flowers mentioned that she liked the changes that were made to the 1st year student evaluations, as well as the other changes that have been made to help with the program’s completion rate. Thank you to all for your continued support!
  • The Advisory Committee meeting concluded at 5 p.m.