Since X Ray Was Discovered Health And Social Care Essay

Since X ray was discovered by Roentgen in 1895, its medical application has grown to be a fast and dynamic imaging mode. Today ‘s imagination section consists of an impressive array of diagnostic and curative devices from x-ray machines, CT Scan, PET Scan, additive gas pedal, which chiefly use ionising radiation for diagnosing and intervention of unwellnesss ; and with the add-on of ultrasound and MRI that use sound moving ridges and magnets for diagnosing alternatively of X raies. Therefore, radiology is considered as the window of the healthcare establishment and the radiologic engineers are the individuals behind these state-of-the art machines. In the x-ray section, one of the divisions of radiology section, the x-ray machines are used for diagnosings of unwellnesss. For 100 old ages the film-screen system has been the imaging system of pick. This system uses radiographic movie, screen and wet chemical science to bring forth an image merely like conventional picture taking. Every RT ‘s end is to supply high quality images for accurate diagnosing ; hence each measure is really critical. The RT must be equipped with cognition and accomplishments from anatomy, positioning and exposure techniques. One little error can endanger the image and outputs an unacceptable radiogram which entails repetition scrutiny that chiefly means extra radiation dosage to the patient. This is one of the disadvantages of a film-screen system wherein one time the movie has been processed ; there is no manner to change it. What you see is what you get. Fortunately, with the turning engineering of imaging modes came the debut of digital imaginati on which follow the same construct as digital cameras wherein brightness and contrast of the image can be changed and images can now be cropped. Its advantage compared to film-screen is really obvious, since images can be altered, repetition scrutinies, oftentimes is no longer necessary. The engineering is brilliant and its introduction has grown the wonder of every RT whether it is efficient compared to the traditional system. And of class, it is. However, as with every other engineering has its drawback. Since the new engineering chiefly uses computing machine and computer-aided equipments oftentimes do the full occupation. The inquiry lies wherein will the competency of the RT in footings of exposure technique factors be same as utilizing the conventional manner? Several international surveies stated that because of the convenience of the system, the RTs utilizing the machine oftentimes fail to see the criterion protocols in every technique choice because images can be manipulated subsequently. Change of images from clip to clip should non be a day-to-day scenario because use sometimes interfere accurate diagnosing. As of the research workers ‘ cognition, there are no known local related surveies in the diminution of RT ‘s competency in utilizing CR. One of the grounds may be this mode is still in the phase of debut in the Philippines and that its deduction is non yet intensively studied. But this does non halt the research workers to seek of happening out if there is so a diminution in RT ‘s competency with the new system. This survey is a comparative-correlational research in finding the degree of radiographic competency between film-screen system and CR on exposure technique factor choice. The chief aims of the research workers are to compare if there is a important difference in footings of radiographic competency in the RT who uses film-screen from CR and to find if the respondents profile and bureau has a important relationship in footings of radiographic competency. Base on the consequence of the survey, the research workers will be able to measure the indispensable acco mplishments needed for the profession. Technology so has helped us in many ways. However, without the competency of the professional manipulating the equipment is futile. This means that the engineer who has the exclusive duty of manning the state-of-the art equipment should non trust from engineering, alternatively engineering should trust on them.REVIEW OF LITERATUREThis survey chiefly aims to compare the degree of radiographic competency on exposure technique factor choice between film-screen system and computed skiagraphy ( CR ) . Exposure technique factor choice is an of import foundation for these two types of image receptor ( IR ) or imaging system. Image receptor is a device that converts X raies into seeable visible radiation. Competence should non change whether the radiologic engineer ( RT ) is utilizing the conventional or digital system, otherwise, it will get the better of the intensive survey of the exposure techniques during the undergraduate old ages. Furthermore, s upplying appropriate exposure techniques is paramount in the profession since these techniques besides mean radiation dose on the portion of the patient. Harmonizing to Fauber & A ; Johnston ( 2012 ) , the radiographer ‘s actions at the control panel straight determine the nature and the makeup of the x-ray beam. This means that the selected exposure technique factor is straight relative to patient dosage. In add-on, it is the duty of the radiographer to larn the doctrine, factors and methods that minimizes ionising radiation exposure to the patient ( Callaway, 1996 ) . This besides means that an RT is supplying quality patient attention when he/she gives an adequate and necessary sum of radiation to the patient.Competence in Radiologic TechnologistKlemp ( 1980 ) defined competency as â€Å" an implicit in feature of a individual which consequences in effectual and/or superior public presentation on the occupation. † A competent individual is imbued with the right cogni tion, accomplishments and attitude on a peculiar undertaking. Other writers define competency as â€Å" a bunch or related cognition, accomplishments, and attitudes that reflects a major part of one ‘s occupation, which has a relationship in the public presentation on the occupation that can be measured with well-accepted criterions, and that can be improved with preparation and development ( Parry, 1996 ) . † In radiologic engineering, for illustration, an freshly licensed RT already possess cognitive and motor accomplishments at an entry degree, nevertheless, it can merely be enhanced through proper and consistent preparation in a chosen specialised field during the class of his/her work as an RT.Knowledge, Skills, AttitudeAs mentioned, competency is a combination of cognition, accomplishments and attitudes. These constituents are indispensable as a whole because the absence of one constituent greatly affects 1s public presentation. Harmonizing to Dowd ( 1996 ) , cogn ition as portion of competency includes theories and constructs which were gained as a consequence of the experience of executing certain undertakings. Furthermore, in the field of radiologic engineering he added that cognition includes job-specific nomenclature, methods of forming information and an apprehension of rules and generalisations. On the other manus, Hans Reynold in 1928 defined accomplishment as combined mental and physical qualities which make it utile to industry. Knowledge if combined with accomplishments is of import in the workplace. Furthermore, one can non develop a accomplishment without cognition and at higher degrees, cognition are converted to accomplishments ( Klieme, 2004. ) The last constituent that determines competency is the attitude. The attitude such as beliefs, values, traits, and motivations is a portion of competency because it indicates the individual ‘s response to a peculiar event or state of affairs. Attitude refers to the sensitivity or mental province of individuals/users towards a merchandise, thoughts, or attributes. It besides implies on mental preparedness on a peculiar object or his properties toward an object or his penchants. ( Hulse & A ; Dowd, 1996 ) . In the field of radiologic engineering, competency does non merely intend that the RT is equipped with the cognition and accomplishments but RT is besides imbued with the right attitude and judgement to supply each patient with quality attentionOn Radiographic CompetenceIn the field of radiologic engineering, one facet of the profession requires competent accomplishments in radiographic exposure factor technique. The said competency is indispensable particularly in the diagnos tic x-ray imagination, wherein exposure factors are the key to accurate diagnosing and supplying radiation dose to minimum degree. For 100 old ages, film-screen technique has been the method of pick in radiographic imagination ( Bushong 2009 ) . Film-screen system uses radiographic movies, radiographic intensifying screens and wet chemical science to do the image seeable. Furthermore, this conventional system should adhere to the criterions of the darkroom demands. Film-screen system has the same construct as a typical conventional camera. In a film-screen technique, radiologic engineer should be certain on the exposure factors to be applied in a peculiar exposure because improper choice of exposure factors can take to overexposure or underexposure of the movie. Overexposure or underexposure degrades image quality and hence, it can take to rejection of movie, therefore necessitates the demand for repetition scrutiny. Repeat scrutiny provides unneeded dosage to the patient and extra costs to the section. On the other manus, as with the other inventions in engineering, diagnostic imagination has shifted its class from conventional to digital. Computer applications are employed presents in diagnostic imagination modes. An appropriate analogy that is easy for most people to understand is the replacing of typical movie cameras with digital cameras: images can be taken, instantly examined, deleted, corrected, and cropped, and later sent to a web of computing machines. Computed skiagraphy system ( CR ) is an low-cost solution to digital imagination. Alternatively of the movie, CR employs an imaging home base to capture x-rays and makes it seeable when the home base is scanned into a computing machine and digitized it. Once the image is converted to informations, it can be recorded on a optical maser printed movie or can be transmitted and stored digitally. It has particular characteristics like use or sweetening of the image. Its specialised package is used to image sing with enhanced maps similar to film-screen system, such as contrast, brightness, and rapid climb. ( dicomsolutions.com, 2011 ) . Computed skiagraphy has practical proficient advantages compared with conventional techniques, such as broad contrast dynamic scope, post-processing functionality, multiple image screening options, and electronic transportation and file awaying possibilities. In this system, image quality can be achieved because of the post-processing techniques that are non possible with film-screen system. This system is convenient for the engineers because the RT can counterbalance for exposure technique inaccuracies by seting the technique during post-processing stage of the image instead than that clip of exposure. In radiologic engineering field, competency agencies that the RT is equipped with the cognition, accomplishments, attitude and judgement to supply each patient with quality attention. Harmonizing to Olavidez ( 2005 ) , competency is indispensable in the field of Radiologic Technology because RT is a fast growth profession ; RT trades with human lives and most of all, the RT course of study is non plenty to fix the pupils to be equipped with the accomplishments necessary for the profession particularly in the particular Fieldss of radiologic engineering. For an RT to go competent, he/she should hold undergone formal educational background followed by specialised preparation in their chosen field that takes months. As an RT, he/she should hold comprehensive cognition and accomplishments in patient attention, radiologic processs and radiation dose.Exposure Technique FactorsExposure technique factors influence and find the measure and quality of X ray to which the patient is exposed ( Bu shong, 2009 ) . Kilovolt extremum ( kVp ) , milliamperage ( ma ) , exposure clip and source-to-image distance ( SID ) are the chief exposure technique factors. Furthermore, the said factors besides affect image quality. Milliamperage and exposure clip are the exposure factors that affects the measure of radiation. Milliampere is the step of x-ray tubing current, whereas milliampere-second ( ma ) is the green goods of exposure clip and exposure tubing current. They straight affect the optical denseness ( OD ) of the movie. Optical denseness is the overall darkening of the movie. The darker the movie, the higher figure of x-rays is given to the patient. The higher the figure of X raies that are the given to the patients, the greater the radiation dose they receive. Source-to-image receptor distance besides affects the measure of the radiation. The closer the patient is to the x-ray beginning, the higher dose the patient gets. For chest X ray, the standard SID is 72 inches, while for the other x-ray scrutinies, the standard SID is 40 inches. Kilovoltage extremum ( kVp ) , straight affects the quality of radiation. kVp is the maximal electric potency that travels across the x-ray tubing. Since kVp affec ts the quality of the x-ray beam, it besides affects the quality of the radiographic image. Kilovoltage straight affects contrast. Contrast is the fluctuation of densenesss on the movie. The advantage of utilizing higher kVp is that the patient will have lower dose of radiation because it will non be absorbed. However, higher kilovoltage produces more spread radiation, therefore increases the transmittal of X raies to the image receptor and degrades image quality. The best techniques to forestall spread radiation are utilizing beam restrictors such as collimator to filtrate low energy X raies and to cut-off low energy beams utilizing radiographic grids. By using beam restrictors and grid will heighten image contrast because spread radiation will be prevented. Furthermore, spread radiation will besides supply unneeded dosage to the patient. Therefore, exposure technique factor choice is indispensable. To supply quality radiogram and to restrict patients to radiation should be a end for every RT. Harmonizing to Bushong ( 2009 ) , RTs are required to utilize their accomplishments to bring forth the best possible image with individual exposure ( Bushong, 2009 ) . Otherwise, repeat scrutiny will supply unneeded radiation dosage to the patient. Therefore, it is necessary for the RT to be equipped with cognition and accomplishments to pull strings these exposure technique factors to bring forth coveted optical denseness, contrast, and image item on the finished radiogram.RT in Film-Screen SystemIn conventional film-screen system, before each scrutiny, the radiologic engineer must choose the optimal radiographic technique factors- kVp, ma, and exposure clip ( Bushong 2009 ) . There are many considerations to find the value of each factor and they are complexly interrelated. Contrast and Density are the photographic factors of the radiogram and it functions to do the image seeable. Visibility of image is of import so that anatomical image will look for proper diagnosing. After each exposure, there is no manner to pull strings its contrast and denseness and that ‘s what makes film-screen system hard as unequal contrast or denseness entails repetition scrutiny. Since use of the image is non possible in this system, the RT should be certain with the technique factors prior to the exposure ; otherwise, misreckonings can ensue to underexposure or overexposure. In a film-screen system, overexposure and underexposure of the image is considered unacceptable because the of import constructions are non seeable and therefore it is non a tool for proper diagnosing. In other words, image quality is dependent on exposure factors.RT in Computed RadiographyIn CR system, image quality is non dependent on exposure factors. Digital image is unrelated to dose, kVp becomes less of import. Since, image quality is non dep endent on exposure factors, image can be manipulated. In a conventional system, the movie serves as both image acquisition and show medium. With CR, the image home base serves as the acquisition medium but does non expose the image. Since these maps are separate in CR, the digital signal can be altered to counterbalance for underexposure or overexposure and an acceptable image can be displayed on the proctor ( Shephard, 2003 ) . With CR system, post-processing is possible that helps heighten image therefore leting the RT to change image contrast and denseness. Since image can be manipulated or modified, underexposure or overexposure is no longer a job with this system, because it can normally salve fluctuations from the optical technique, whereas proficient mistake with a screen-film system frequently requires a repetition exposure ( Pizzutiello, 1993 ; Cesar, 1997 ) . Therefore, with CR, proficient mistakes are eliminated because of exposure discrepancies that are possible with sal vageable consequences, presuming equal kilovoltage is used ( Ballinger, 1999 ) .On Assessment of RT CompetenceIn order to cognize the competency of a professional, assessment plays a critical function. Assessment is of import so as to measure if the RT is still competent to make the occupation. Since we are in the epoch of rapid engineering, it may come to a point that we will merely set our assurance on computing machines instead than our competency. Harmonizing to Olavidez ( 2005 ) , competency is an discernible ability and it can be measured against set of criterions. Appraisal of competency is a combined cognition, accomplishments, and attitudes that reflect the current work pattern. Furthermore, it can bridge the spread between workplace demands and criterion. Choice of exposure technique factor is of utmost importance because RT trades with exposing patients to radiation. Exposure technique factor is tantamount to the quality and the measure of radiation that exits the patient, hence, the RT should be precise in giving exposure technique factors. Supplying appropriate radiation dosage is necessary to forestall the patients from the jeopardies of the ionizing radiation, hence anterior to the exposure of the patient, accurate exposure techniques should be practiced. The issue of supplying accurate techniques lies in a digital system, wherein images can be manipulated during post-processing. Harmonizing to Fredrick Walker ( medicalimagingmag, 2008 ) , a radiologic engineer at Sharp Rees-Stealy in San Diego, CA, he pointed out if the image is excessively dark, we can pull strings the image utilizing post-processing techniques like windowing or shadowing or to set contrast without holding to reiterate the scrutiny. Furthermore, since image can be manipulated during post-processing, it can promote complacence instead than truth with exposure techniques which can ensue in overexposed or underexposed images ( Medicalxray, 2010 ) . In add-on, harmonizing to Enfinger ( 2012 ) , that it is true that the image can be adjusted, nevertheless, it is non recommended because the natural information from the initial exposure will incorporate information from spread radiation that degrades image quality even if it is manipulated subsequently. Harmonizing to Shephard ( 2003 ) , it is likely that digital imagination will replace conventional screen-film skiagraphy in many modern medical imagination centres in the close hereafter. It has already been stated that even if the image can be manipulated during post-processing, this should non be a pattern because somehow it can deteriorate image quality which consequences in inaccurate diagnosing. One retrospective analysis of patients who had undergone lumbar spinal column radiogram for the diagnosing of osteoporosis comparison diagnostic truth with screen-film versus digital skiagraphy. The writers suspected that bone mineral loss could be more easy seeable with screen-film imaging due to the fact that image contrast can non be adjusted with this mode, whereas CR ( and DR ) images undergo digital post-processing techniques to maximise contrast. This could ensue in misdirecting consequences that confound diagnostic strength in osteoporosis. Therefore, this is a challenge now for the RT to keep their competency amidst the assistance of engineering. Competence of RT is the foundation of supplying quality patient attention by supplying appropriate radiation dosage for accurate diagnosing.SynthesisThe focal point of the literature and surveies cited was the radiographic competency of RT between film-screen system and computed skiagraphy and it is through this survey that the research workers can place and compare whether their competency will differ based on the image receptor that is being used. In add-on, competency in exposure technique factors is indispensable because this will besides intend radiation dosage to the patient. It has already been affirmed that the construct has been there for the past few old ages and hence the present survey is surely non a new construct. Nevertheless, the research workers deemed it necessary to carry on a survey measuring the competency of the RT for the benefit of the establishment whe re they belong because the research worker wants to suggest a professional plan that could beef up the foundation of the RTs ‘ . It is besides of import for the school to offer the plans since about the RT from the different infirmaries in Davao City are merchandises of this establishment. This survey is similar to the other surveies cited in this subdivision because it stated on the effects of digital imagination on the radiographic competency of the RTs. Furthermore, old surveies dealt with the effects of image use on image quality and it indirectly link to the competency of the RTs.Conceptual ModelIn this position, the research workers attempted to measure the degree of radiographic competency of the RTs in footings of cognition, accomplishments and attitude. Through measuring the competency of the RTs, the research workers are able to find the degree of radiographic competency ; their strengths and failing of radiographic techniques. On the other manus, the research workers identified the factors that can impact their competency, such as the respondents ‘ demographic profile in footings of age, sex, figure of old ages in service and educational attainment and the profile of establishment such as bureau and its categorization are besides considered. To hold a graphic image of the survey, Figure 1 served as the research paradigmSCHEMATIC DIAGRAMIndependent Variables Dependent VariablesFactorsRespondents ‘ ProfileAge Number of old ages in serviceAgencyPrivate PublicImage ProcessingFilm-Screen System Computed RadiographyDegree of Radiographic CompetenceCognition Skills AttitudeFigure 1Conventional Diagram demoing the relationship between the independent and dependent variablesSTATEMENT OF THE PROBLEMThe survey aims to compare the degree of radiographic competency in utilizing a film-screen system and computed skiagraphy on exposure technique factor choice ; specifically it aims to reply the undermentioned inquiries: What is the respondents ‘ profile in footings of: Age Number of old ages in service What is the bureau of the health care establishments in footings of: Private Public What is the degree of the respondents ‘ radiographic competency in utilizing film-screen system on exposure technique factor choice in footings of: Cognition Skills Attitude What is the degree of the respondents ‘ radiographic competency in utilizing computed skiagraphy on exposure technique factor choice in footings of: Cognition Skills Attitude Is there a important relationship between the respondents ‘ profile and the degree of radiographic competency in footings of: Cognition Skills Attitude Is there a important relationship between the bureau of health care establishment and the degree of radiographic competency in footings of: Cognition Skills Attitude Is there a important difference in the degree of radiographic competency between film-screen system and computed skiagraphy in footings of: Cognition Skills AttitudeHypothesisThere is no important relationship between the respondents ‘ profile and the degree of radiographic competency in footings of: Age Number of old ages in service There is no important relationship between the bureau of the healthcare establishment and the degree of radiographic competency in footings of: Public Private There is no important difference in the degree of radiographic competency between film-screen system and computed skiagraphy in footings of: Cognition Skills AttitudeDEFINITION OF TERMSAccuracy- refers to the grade of conformance of a measured or calculated value to its existent or specific value. Computed Radiography- is an low-cost solution of digital imagination system that uses a photostimulable phosphor as the image receptor. Digital Radiography- an all-digital technique in which x-ray soaking up is quantified by assignment of a figure to the sum of x-rays making the sensor ; this is besides called as cassetteless system. Exposure- step of ionisation produced in air by X raies or gamma beams. Exposure Factor Selection. It is the factor set by the radiographer ( kVp, and ma ) to bring forth visibleness of constructions in the radiogram. Film Screen System- is the conventional image receptor that uses radiographic movie, radiographic escalating screen and wet chemical science to visualise the image in the radiogram. Image receptor- is a device that converts x-ray beam into seeable image. Degree of Radiographic Competence- refers to the step of the degree of competency of the radiologic engineer in accomplishing ends and aims in supplying quality radiogram with minimal radiation dosage to patients. Private hospital- is a infirmary owned by a net income company or a non-profit organisation and in private funded through payment for medical services by patients themselves. Public hospital- is a infirmary which is owned by the authorities and have authorities support.Significance OF THE STUDYThis survey seeks to find if there is a important difference on the degree of the respondents ‘ radiographic competency in exposure technique factor choice between film-screen system and computed skiagraphy ; and to find if there is a important relationship on the degree of radiographic competency between respondents ‘ profile and bureau. Based on the consequences of this survey, the research workers can place the strengths and failings of the RTs and if it shows important diminution in the competency of the RT in the CR system, the research workers will suggest an enhancement plan for the professionals. The said plan will besides be a portion of the Continuing Professional Education ( CPE ) , and it will be added to the CPE units needed to regenerate RT licences. This survey will be most helpful to the radiology section of the infirmary to heighten Health Care Delivery by restricting radiation dosage to the patients. Furthermore, finding the attitude toward the imagination system will assist the section to reassess the mental and the emotional province of the RT ‘s. Mental and Emotional province of the RT are of import since they are covering with patients. It is the duty of the RT to render quality patient attention by supplying appropriate radiation dosage. Furthermore, this survey will besides be of most helpful to the schools offering radiologic engineering as to escalate the foundation of the pupils in footings of exposure technique factors. Based on the consequence of the survey, there may be a demand to revise the course of study to further escalate the accomplishments of the RT pupils. Computed Radiography is non a portion of the standard RT course of study, and it may be one factor that affects the diminution of competency on the portion of the professional every bit good as the pupils.Chapter 2MethodologyThis part discusses the research design used, the research venue where the survey will be conducted, the description of samples and the sampling technique, the instrument used, the inside informations of process and the statistical analysis to reply the research job.Research DesignThe survey will use a comparative-correlational research. To find the difference between the degree of competency in film-screen system and computed s kiagraphy, comparative survey will be used. Furthermore, to find the relationship between the respondents profile and bureau between the degrees of the radiographic competency, correlational design will be employed.PutingThe survey will be conducted from the selected infirmaries in Davao, Digos and Tagum City using either film-screen system and computed skiagraphy. The infirmaries utilizing film-screen system are the undermentioned: Alexian Brothers Health and Wellness Center, Km. 4, McArthur Highway, Matina, Davao City ; Davao Regional Hospital, located at Apokon, Tagum City 8112 and Davao Del Sur Provincial Hospital which is located at Lapu-lapu St. Digos, City Davao Del Sur. On the other manus, the infirmaries utilizing the computed skiagraphy system are the undermentioned: Davao Doctors Hospital ( DDH ) , E. Quirino Ave. , Davao City ; Southern Philippines Medical Center ( SPMC ) , J.P Laurel Ave. , Bajada, Davao City and Davao Medical School Foundation and Hospital ( DMSF ) , M edical Drive, Bajada, Davao City.ParticipantsThe respondents of the survey are the Registered Radiologic Technologists and Associate X-ray Engineers coming from the selected infirmaries in Davao City using a film-screen and computed skiagraphy system. Furthermore, the qualified respondents should be at least six months in service at the clip of the rating.MeasuresThe research appraisal is composed of four parts. The first portion of the appraisal consists of inquiries refering to the profile of the respondents and infirmary. The 2nd portion consists of inquiries on the respondents ‘ degree of cognition on exposure technique factor choice. The inquiries are specifically structured in such a manner that assesses the respondents ‘ acquired cognition on technique choice. Based on the consequences, the attitude in footings of respondent ‘s response in both film-screen and CR system will be categorized as follows depending on their average mark:Points Obtained Qualitative Description30-25 Very High 20-24 High 15-19 Reasonably High 10- 14 Low 13- 0 Very LowInterpretationThe aforesaid appraisal signifier that will be used as instrument of the survey is constructed and designed by the research workers as to mensurate the basic cognition in exposure technique factor choice regardless of the imagination system used. Its cogency and dependability was attested by experts of the field. Furthermore, the 3rd portion of the appraisal is an existent rating wherein the respondents are observed during x-ray scrutiny. They will be assessed in the existent choice of the exposure technique factor and the result of the image. The said appraisal is a point system ; the appropriate the RT performs in technique factor choice and the acceptable the image, the higher the points. Based on the consequences, the degree of radiographic competency in footings of respondent ‘s accomplishments will be categorized as follows depending on their average mark:Points Obtained Qualitative Description10 Very high degree of radiographic accomplishments 7-9 High degree of radiographic accomplishments 4-6 Reasonably low degree of radiographic accomplishments 1-3 Low degree of radiographic accomplishments Low degree of radiographic accomplishments means that the respondents were non able to execute the appropriate exposure techniques and came up with an unacceptable radiogram. Reasonably low degree of radiographic accomplishments means that they were non able to execute appropriate exposure techniques and came up with a passable radiogram. High degree of radiographic accomplishments means that they were able to come up with a quality radiogram but did non execute appropriate exposure techniques. Last, really high degree of radiographic accomplishments means that they were able to come up with a quality radiogram and performed appropriate exposure techniques. The appraisal is limited in the x-ray scrutiny of the skull and thorax. Furthermore, the last portion of the appraisal is consists of inquiries sing the attitude of the respondents. The respondents ‘ attitude will be assessed base on their attitudes about the imagination system and its facets. The research workers will use the Likert Scale wherein the respondents are asked to bespeak a grade of understanding and dissension with each of a series of statement. The consequences will be categorized as follows depending on their average mark:Points Obtained Qualitative Description5 Strongly Agree 4 Agree 3 Indifferent 2 Disagree 1 Strongly differ In add-on, the research workers will utilize purposive sampling as to measure up the respondents for the survey.Ethical ConsiderationResearch blessing will be obtained through the research reappraisal section or human resources section from the six infirmaries. To promote voluntary engagement of the RTs ‘ in this survey, the cover missive of the intent and nature of the survey, informations confidentiality, and research support will be attached. The namelessness of the respondents will be ensured.Procedures1. Letter inquiring for permission. 2. After the blessing of the proposal of this survey, the research worker will organize with the human resource section and the radiology section caputs. Once approved by radiology caputs, the research workers will get down the rating procedure. The research workers will aim two months in assemblage of informations get downing October 1- November 1. Based on the consequence, the research workers will so place the area/s of troubles by the respondents and so proposed an enhancement plan for the professional concentrating on the failings identified.Datas AnalysisThe undermentioned statistical methods will be utilized for the analysis of the informations and reading of the consequences:To reply the undermentioned jobs, obtaining Frequency, Mean and Percentage will be employed.What is the respondents ‘ profile in footings of: Age Number of old ages in service What is the bureau of infirmary in footings of: Private Public 3. What is the degree of the respondents ‘ radiographic competency in utilizing film-screen system on exposure technique factor choice in footings of: Cognition Skills Attitude 4. What is the degree of the respondents ‘ radiographic competency in utilizing computed skiagraphy on exposure technique factor choice in footings of: Cognition Skills AttitudeThe Pearson Product-Moment Coefficient of Correlation will be used to correlate the respondents ‘ degree of radiographic competency and the ( 1 ) respondents ‘ profile and ( 2 ) profile of the healthcare establishment. It seeks to reply the undermentioned jobs:5. Is there a important relationship between the respondents ‘ profile and the degree of radiographic competency in footings of: Cognition Skills Attitude Is there a important relationship between the bureau of health care establishment and the degree of radiographic competency in footings of: Cognition Skills AttitudeLast, T-test will be used to compare the degree of respondents ‘ competency between film-screen system and computed skiagraphy:Is there a important difference in the degree of competency between film-screen system and computed skiagraphy in footings of: Cognition Skills Attitude The processing will be done with the usage of SPSS.Scope and RestrictionThe chief intent of the survey is to find if there is a important difference on the degree of the radiographic competency of radiologic engineers on exposure technique factor choice between film-screen system and computed skiagraphy. Furthermore, the research workers will besides seek to find if there is a important relationship on the degree of radiographic competency between radiologic engineers ‘ profile and bureau. The research workers will use the three competences viz. : Knowledge, Skills and Attitude. The survey is limited merely to six health care establishments in Davao, Digos and Tagum City with the following profile:Name of Hospital Image Receptor AgencyAlexian Brothers Wellness Center Film-Screen System Private Davao Doctors Hospital Computed Radiography Private Davao Del Sur Prov. Hospital Film-Screen System Public Davao Regional Hospital Film-Screen System Public DMSF Computed Radiography Private SPMC Computed Radiography Public Furthermore, the survey is limited to skull and chest scrutiny. Since the survey discusses the quality and measure of radiation, nevertheless, it does non cover the radiation dose the patient receives. The survey merely focuses on the image quality based on the exposure techniques -kVp, ma and SID- selected by the respondents.Appendix 1: Communication LetterRaymund CS. Del Val Davao Doctors Hospital President Thru: Mirasol B. Tiu Director Human Resources Department Beloved Sir/Madam: We would wish to seek permission to carry on our survey in this establishment specifically in the Radiology Department. Our survey is entitled â€Å" Radiographic Competence between Film-Screen System and Computed Radiography on Exposure Technique Factor Selection † . The chief aim of this research is to place the radiographic competency between the radiologic engineers ‘ using film-screen image receptor and computed skiagraphy ( CR ) . Through your engagement, we finally hope to find if competency in exposure technique choice varies or non. We assured that this information will be held in confidential and will be used merely to broaden the position of our survey. Your blessing on this affair will be extremely appreciated. Respectfully Yours,Dannalyn D. Ibanez, RRT Jules King Defensor, RRTResearcher Researcher DDC- RT Department DDC- RT DepartmentTheresa T. Eguia, RRTResearch worker DDC- RT Department Noted By: Joshua P. Sero Dr. Lucila T. Lupo RT Program Chair Head of Research Dept.Appendix 2: COVER LETTERDear Respondent, We are the module of Davao Doctors College- Radiologic Technology Department and soon carry oning a survey entitled â€Å" Radiographic Competence between Film-Screen System and Computed Radiography on Exposure Technique Factor Selection † The chief aim of this research is to place the radiographic competency between the radiologic engineers ‘ using film-screen image receptor and computed skiagraphy ( CR ) . Through your engagement, we finally hope to find if competency in exposure technique choice varies or non. Enclosed with this missive is a brief questionnaire that asks a assortment of inquiries. The questionnaire is composed of five parts. First portion is your personal profile. Second, is your establishments ‘ profile. The 3rd portion is a quiz-type that measures your cognition about exposure factor techniques on skull and chest scrutiny. In the 4th portion, we, the research workers will detect you based on your existent choice of the exposure techniques during the x-ray scrutiny. And in conclusion, we will be inquiring sing your attitudes and positions toward your current occupation as an RT. Your replies and responses are confidential and will be used for research purposes merely. We hope you will take a few proceedingss to finish this questionnaire. Without the aid of people like you, research on radiographic competency could non be conducted. Your engagement is voluntary and there is no punishment if you do non take part. If you have any inquiries or concerns about finishing the questionnaire or about take parting in this survey, you may reach us at 222-0853 local 107 or 09161932693 or you can e-mail us at danna_rrt @ yahoo.com. Sincerely,Dannalyn D. Ibanez, RRT Jules King C. Defensor, RRTResearcher Researcher DDC- RT Department DDC- RT DepartmentTheresa T. Eguia, RRTResearch worker DDC- RT DepartmentAppendix 3: Samples of QuestionnairesDegree of Competence in Exposure Technique Factor SelectionEvaluation FormPart I: Respondent ‘s ProfileName ( Optional ) : ______________________________ Rating: _____________ Sexual activity: ______________________ Date: ______________ Age: _________ Number of Years in Service: ________Part II: Healthcare Institution ‘s Profile:Type of Institution: ( ) Primary ( ) Secondary ( ) Tertiary Type of Imaging System: ( ) Film Screen ( ) Computed RadiographyPart III: CognitionSKULL RADIOGRAPHYThymineFIn skiagraphy of skull, particularly for paediatric and geriatric patients, short exposure clip is required. 2. Use of grid is required in skull skiagraphy 3. In skull skiagraphy, wherein a smaller field size is required exposure factors may hold to be increased. 4. In skull imagination, a 15 % addition in kvp should be accompanied by half decrease in mom. 5. Skull skiagraphy requires a high contrast image, which requires a high kvp choice. 6. When utilizing a grid, it may non be necessary to increase the exposure factor. 7. When exposure factor is done with the usage of bucky, it is of import to see an addition of ma to keep the movie denseness. 8. In skull skiagraphy, the usage of medium kVp and short exposure clip and the highest possible ma is recommended. 9. It is necessary to increase kVp when an x-ray requisition indicates status such as: hydrocephaly, osteochondroma, and Paget ‘s disease. 10. A sidelong skull place will necessitate lesser exposure than PA skull X ray. 11. When tube angulation is applied during skull x-ray, there is an addition in exposure severally. 12. 40 inches distance is used during skull skiagraphy to obtain appropriate degree of denseness. 13. Skull with injuries due to vehicular accident will necessitate lesser exposure factor. 14. ma is the factor of pick for skull process. 15. Skull process with air spreads due to trauma, kVp is the factor of pick.CHEST RADIOGRAPHYThymineF1. Aerated tissue such as lungs require high sum of exposure to enter appropriate degree of denseness. 2. The thickness of the thorax is normally measured with callipers as a usher to the proper ma choice. 3. In portable thorax X ray, the ma value is decreased. 4. Pathological status of the thorax may non be taken into history in gauging the electromotive force value. 5. To find farther the pathology emphysema the usage of lower kVp exposure requires. 6. By and large, kV should be high plenty to ensue in sufficient contrast to show the many sunglassess of grey needed to visualise the finer lung markers. 7. Chest skiagraphy requires the usage of high mas and long exposure clip to minimise the opportunity of gesture and attendant loss of unsharpness. 8. Chest transcending 30cm in thickness requires an addition non merely in ma but besides in kVp 9. In pleural gush, normal thorax technique will ensue in underexposed image. 10. 72 inches distance is officially use during chest skiagraphy to obtain appropriate degree of denseness. 11. In chest x-ray utilizing air spread technique, normally gives lower patient dosage. 12. Chest is considered as a low contrast anatomy. 13. In patients with pneumonia, it is ever appropriate to diminish exposure techniques. 14. In patients with pneumothorax, it is ever appropriate to increase exposure techniques. 15. By and large, as grid ratio additions, patient dosage will diminish.Part IV: SkillsExposure Technique Factor SelectionMarkDid the engineer usage calliper to mensurate the thickness of the portion? ( to use appropriate kVp ) 1 point. 2. Make the engineer suitably use radiographic grids? 1 point. 3. Make the engineer collimate the portion of involvement? ( collimation reduces spread radiation therefore provides high contrast image ) 1 point. 4. Make the engineer usage appropriate source-to-image distance ( SID ) ? 1 point.Radiographic ImageIs the radiogram acceptable in footings of contrast? 2 points. ( 2- acceptable 1- moderate 0- unacceptable ) Is the radiogram acceptable in footings of denseness? 2 points. ( 2- acceptable 1- moderate 0- unacceptable ) Is the image decently collimated? 1 point Is there a presence of image fuzz? ( Long exposure clip contributes to image fuzz ) 1 point.EntirePart V: AttitudeFor Film-Screen user:Film-Screen SystemStrongly AgreeAgreeIndifferentDisagreeStrongly Disagree1. Film-Screen imagination system still is the best mode of pick in bring forthing a quality radiogram. 2. Film-Screen imagination system gives more accurate consequences compared to digital system. 3. Film-Screen imagination system is the most convenient mode in choosing proper exposure technique. 4. Since I can non pull strings the image in a Film-Screen system, I should be precise in choosing kVp and ma in every scrutiny. 5. If the image becomes underexposed, I normally do repeat scrutinies. 6. If the image becomes overexposed, I normally do repeat scrutinies. 7. I normally choose high exposure factors in Film-Screen. 8. Collimation is really of import in Film-Screen. 9. I think film-screen bounds patient radiation dosage. 10. I feel that my competency on exposure technique factor choice is great in film-screen system. For Computed Radiography user:Computed RadiographyStrongly AgreeAgreeIndifferentDisagreeStrongly Disagree1. CR is the best mode of pick in bring forthing a quality radiogram. 2. CR gives more accurate consequences compared to digital system. 3. CR is the most convenient mode in choosing proper exposure technique. 4. Since I can pull strings the image in a CR system, sometimes I am non certain in choice of kVp and ma. 5. If the image becomes underexposed, I normally do repeat scrutinies. 6. If the image becomes overexposed, I normally do repeat scrutinies. 7. I normally choose high exposure factors in CR. 8. There is no demand for collimation since cropping is available during station processing in CR. 9. I think CR bounds patient radiation dosage. 10. I feel that my competency on exposure technique factor choice is lesser in CR.Appendix 4: MentionBooksBallinger, PW, Frank ED: Merill ‘s Atlas of Radiographic Positions and Radiologic Procedures, Volume 3, 9th erectile dysfunction. St. Louis, Mosby-Year Book, 1999 Bloom BJ, erectile dysfunction. Taxonomy of Educational Aims: Cognitive Domain. New York, NY: David McKay Company ; 1956. Bontrager, K, Lampignano, J: Textbook of Radiographic Positioning and Related Anatomy 7th erectile dysfunction. Singapore, Mosby, 2010. Bushong, SC: Radiologic Science for Engineers: Physicss, Biology, and Protection, 9th erectile dysfunction. St. Louis, Mosby-Year Book, 2001. Callaway, W, Gurley, L: Introduction to Radiologic Techology. Mosby-Year Book Inc. 1996. Cesar LJ: Computed skiagraphy: its impact on radiographers. Radiologic Technology 68:225, 1997. Dowd, SB. The profession ‘s hereafter: leading development. Radiologic Technology. 1992 Fauber TL: Radiographic Imaging and Exposure. ST. Louis, Mosby, 2000. Fauber, TL & A ; Johnston, J: Necessities of Radiographic Physics and Imaging. Mosby. 2012. Klieme, E. et al.The Development of National Educational Standards: An Expertness, Berlin: Bundesministerium fur Bildung und Forschung. 2004. Lauer OG. Principles and Practices of the College-Based Radiography Program. St. Louis, Mo: Warren Green Inc ; 1984. More, C. Skill and the English Working Class, 1870-1914, London: Croom Helm. ( 1980 ) Piaget, J. La psychologie de l'intelligence, Paris: Colin.1947. Pizzutiello RJ, Cullinan JE: Introduction to Medical Radiographic Imaging. Rochester, NY, Eastman Kodak Company, 1993. Shephard, C: Radiographic Image Production and Manipulation. Nashville, Tenessee, 2003. Yumul, R. Introduction to Radiologic Technology with Science, Technology and Society. Manila. 2012DiariesSiddiqui, Nazlee & A ; Khandaker, Shahjahan. Comparison of Services of Public, Private and Foreign Hospitals from the Perspective of Bangladeshi Patients. 2007. Balasubramanian, Siva K. and Wagner A. Kamakura, August. â€Å" Measuring Consumer attitudes towards the market topographic point with tailored interview † , Journal of Marketing Research, Vol. 26. 1989.Unpublished ThesissPabunag, Richard et Al. â€Å" Level of Professional Competence of Radiologic Technologist in Davao City on Factor Selection of X-rays of Skull, Extremities and Chest † . Davao City. 2008.Online BeginningsEnfinger, Jeremy. Subjects in Radiography. April 22, 2012 Medicalxray.com.cn July 12/2010 Dicomsolutions.com ( www.discomsolutions/ds-digital-radiology/acquire.html ) . 2011 Dilulio, Renee. CR versus DR: Which is the Techs Choice? ( hypertext transfer protocol: //www.medical imagingmag.com/issues/articles/2008-05_02.asp. May 2008 hypertext transfer protocol: //www.libraryindex.com/pages/1831/Health-Care-Institutions-TYPES HOSPITALS.html † Health Care Institutions – Types of Hospitals.2007Appendix 5: BUDGETARY RequirementBUDGETARY RequirementManpower ( Representation fee/ Burden fee )Statistician 3,000 Research Adviser 4500 ( Proposal, Final ) Validators of Research Instruments ( 3 ) 900 Meals and bites 1500 Subtotal P 9,900Transportation system Allowance:2 Calendar months 5,330 Office Supplies ( booklets, paper, cartridge, ink ) 1000 A? of the Contingency Fund 1,623TOTAL P 17,853