Radiographic Clinical Education II

Course Description

RTE1814L – Radiographic Clinical Education II is a supervised clinical practicum in a hospital or imaging facility, and it carries the most extreme credit-to-contact-hour ratio in the Florida inventory: 2 credits for 256 contact hours. That is not a typographical error and it is not unusual for radiography — each of the clinical courses in the sequence (RTE1804, RTE1814, RTE1824) carries the same ratio.

Clinical education is where a radiography student becomes a radiographer. The laboratory courses teach positioning on phantoms and cooperative classmates; clinical assigns the student to a real department, with real patients who are in pain, immobilized, confused, or uncooperative, and with a work rhythm set by the schedule rather than by the student's readiness. Students work alongside registered technologists, progress from observation to assisted practice to indirect supervision, and are evaluated on performance.

The organizing structure is the ARRT clinical competency requirement. Students must document a defined set of competencies — specific radiographic procedures performed to standard and verified by a qualified evaluator — and completion of the required competencies is a condition of examination eligibility, not merely of passing the course.

Clinical Education II typically builds on the first rotation with expanded procedures, greater independence, and exposure to additional areas: routine radiography across body systems, portable and mobile examinations, surgical imaging, emergency department work, fluoroscopy assistance, and trauma.

Offered at approximately 10 Florida institutions with JRCERT-accredited radiography programs.

Learning Outcomes

Required Outcomes

• Perform radiographic examinations on patients under appropriate supervision.
• Verify patient identity, examination order, and clinical history before imaging.
• Position patients accurately for assigned procedures and adapt for patient condition.
• Select technical factors appropriate to the patient and produce diagnostic images.
• Apply radiation protection to patient, self, and others, including shielding and collimation.
• Evaluate images for diagnostic quality and determine whether a repeat is warranted.
• Recognize and minimize repeat exposures and describe their dose consequences.
• Operate radiographic, mobile, and fluoroscopic equipment safely.
• Perform portable and surgical examinations under supervision.
• Adapt positioning for trauma and non-ambulatory patients without moving the patient.
• Communicate clearly with patients, families, and health care team members.
• Apply infection control, standard precautions, and isolation procedures.
• Transfer and assist patients safely using correct body mechanics.
• Recognize patient distress and respond appropriately, including activating emergency response.
• Document procedures accurately in the radiology information system.
• Apply HIPAA and patient confidentiality requirements in a clinical setting.
• Demonstrate professional conduct, punctuality, and accountability.
• Complete assigned ARRT clinical competencies verified by a qualified evaluator.

Optional Outcomes

• Assist with contrast administration and recognize reactions.
• Rotate through advanced modalities including CT for observation.
• Describe departmental workflow, scheduling, and quality assurance.
• Describe pediatric imaging modifications in practice.
• Participate in image critique with clinical staff.
• Relate clinical experience to ARRT examination content.

Major Topics

Required Topics

• Clinical orientation — site policies, supervision levels, and expectations.
• Supervision requirements — direct versus indirect supervision and the repeat rule.
• Patient identification and order verification — and the consequences of error.
• Routine radiography — chest, abdomen, extremities, spine, and pelvis in practice.
• Technical factor selection — applying technique charts to real patients.
• Image evaluation — diagnostic criteria and repeat analysis.
• Radiation protection — ALARA in practice, shielding, and dosimetry.
• Mobile and portable radiography — technique adjustment and room safety.
• Surgical imaging — C-arm operation and sterile field awareness.
• Emergency and trauma imaging — adapted positioning and pace.
• Fluoroscopy — assisting and dose considerations.
• Patient care — transfer, monitoring, tubes and lines, and comfort.
• Infection control — precautions and isolation in the imaging department.
• Communication — patients, families, nurses, and radiologists.
• Documentation — RIS entry, exam completion, and image markers.
• Professionalism — attendance, appearance, initiative, and accountability.
• Competency completion — the ARRT clinical competency requirements.

Optional Topics

• Contrast administration and reaction recognition.
• Advanced modality observation rotations.
• Departmental operations and quality assurance.
• Pediatric imaging in practice.
• Clinical image critique.
• ARRT examination preparation.

Resources & Tools

• ARRT Radiography Clinical Competency Requirements — free; the document that defines what must be completed and verified. Students should read it themselves rather than relying on summaries.
• The program's clinical handbook — supervision rules, evaluation forms, attendance policy, and competency procedures; the operative document for the course.
• Clinical tracking software — Trajecsys or similar, used to log hours, procedures, and competencies.
• Merrill's Atlas pocket guide or Bontrager's Handbook — carried in a scrub pocket; the reference technologists actually use on shift.
• Dosimeter — issued and required; reading reports is part of professional practice.
• Lead markers — personally assigned and required on every image.
• JRCERT — accreditation standards, including those governing clinical supervision and student-to-technologist ratios.
• Florida Department of Health, Bureau of Radiation Control — student permit and state certification requirements.

Career Pathways

• Radiologic Technologist (SOC 29-2034) — the credential this sequence leads to.
• Hospital and outpatient imaging — AdventHealth, Orlando Health, BayCare, HCA Florida, Baptist Health, Tampa General.
• Surgical, trauma, and mobile radiographer.
• Advanced modality technologist — CT, MRI, mammography, or interventional, via ARRT post-primary certification.
• Clinical instructor — often the same sites students train in.

Clinical rotation is also, functionally, an extended job interview. Florida imaging departments hire students they have trained, and a student's clinical reputation frequently determines their first offer.

Special Information

⚠ Two credits, 256 contact hours — the most extreme ratio in the inventory

Broward College's radiography table states it precisely, and every clinical course in the sequence matches:

In practice, 256 hours over a term means roughly two to three full clinical days per week, scheduled by the facility — frequently including early mornings, and at some sites evenings or weekends. Add travel to the assigned site, which may not be near campus.

The practical consequence: a radiography student cannot reliably hold full-time employment during clinical terms, and programs say so directly. Students who plan a schedule from the credit total — seeing "2 credits" and assuming a light load — are the ones who fail out. Count contact hours.

The ARRT competencies, not the grade, determine examination eligibility

This is the structural fact students most need to grasp. ARRT requires documented completion of a defined set of clinical competencies — specific procedures performed on real patients, verified by a qualified evaluator — before a candidate may sit the certification examination. Passing the clinical course and completing the competencies are related but not identical, and a student who accumulates hours without securing competency verifications can find themselves short at the end of the program. Track them personally, do not assume the program is tracking on your behalf, and pursue opportunities for uncommon procedures actively rather than waiting for them to appear.

Supervision rules are strict, and the repeat rule is the one students violate

ARRT and JRCERT define direct supervision (a qualified technologist present in the room) and indirect supervision (available and immediately reachable). The rule students most often break: any repeat exposure must be performed under direct supervision, regardless of the student's competency level, because a repeat means something went wrong and a second dose is being delivered. Repeating an image alone to avoid embarrassment is a serious violation with real patient-dose consequences. Ask for the technologist, every time.

Clinical is where students are hired — and where they lose offers

Departments observe students for months. Reliability, initiative, willingness to take the unpleasant assignments, and how a student treats patients and support staff are all noted, and Florida imaging managers routinely hire from their student rotations. The corollary is also true: a student who is chronically late, who avoids portables, or who is difficult with staff acquires a reputation that follows them through a small professional community. This is the least academic and most career-determining part of the program.

Clinical clearances and the student permit

Before starting, students need a Level 2 background screening under Chapter 435, F.S., drug screening, immunizations including annual influenza, a physical examination, healthcare-provider CPR, and liability insurance. Florida additionally requires students operating radiographic equipment to hold the appropriate student status with the Bureau of Radiation Control; the program handles the mechanics, but the student is responsible for compliance. A lapse in any clearance suspends clinical attendance, and missed clinical hours must be made up.

Sequence and numbering

The clinical sequence runs RTE1804 → RTE1814 → RTE1824, with additional clinical courses (RTE2805, RTE2862, RTE2905) in the second year at some institutions, carried with and without the L suffix. Programs are cohort-based and sequential, and clinical placement depends on affiliation agreements, so mid-program transfer is rarely practical. SCNS equivalency applies to the same number at the same level, never across numbers.