RADIOLOGY ROTATION
VMB 976 2007-2008
http://vista.ncsu.edu
Introduction
This rotation will provide practical training in the production of quality radiographic
examinations and will help develop interpretation skills in diagnostic radiology. Students are
expected to be familiar with material covered in the third year radiology course (VMB 960)
as it will be incorporated into this rotation. Much of the material for the course will be found
on the VMB 976 Vista site (http://vista.ncsu.edu ).
The radiology rotation is oriented toward teaching and service. Learning experiences result
from a combination of the following:
1. Direct contact with the faculty, residents, technicians, and classmates.
2. Making diagnostic quality radiographs.
3. Participation in the various rounds.
4. Review of assigned material.
5. Independent study.
Course Objectives
At the completion of the rotation, students should be able to:
1. Make quality diagnostic radiographs of commonly performed small animal radiographic
examinations unassisted. Students with an equine interest should be able to perform
common equine radiographic examinations as well.
2. Perform quality control of radiographs and know how to correct any problems.
3. Be able to identify the radiographic findings of common small animal and equine
abnormalities.
4. Be able to generate a reasonable differential diagnosis list for radiographic
findings identified.
5. Understand the pathophysiology of how each differential results in specific radiographic
signs.
6. Be able to make recommendations for additional imaging studies when reviewing
a radiographic exam.
7. Be familiar with all the imaging modalities available at NC State VTH and
indications for their use.
8. Be able to recognize an imaging study of any modality offered at NC State VTH.
Student Responsibilities
First Day of the Rotation:
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Check-in and Orientation
Students are expected in radiology at 8:00AM. Meet in the foyer in front of the
reception desk. A technician will demonstrate how to use the equipment and a short
presentation on positioning and safety will be given. A radiology resident will also
give an orientation and answer any questions you may have about the rotation.
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Vista access
Vista is an integral part of the radiology rotation and it is imperative that you ensure
you can log into Vista and see the VMB976 course on day 1. If you cannot access
the course please email Dr Robertson with your unity id.
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Pharmacy
You need to meet in the Pharmacy at 11am to complete documentation and training
to allow you access to the drug dispensing machines while on the radiology rotation.
Schedule:
There is a bulletin board in radiology with the student rotation schedule posted.
Assignments & Quizzes
Refresher quizzes
There are 5 quizzes on Vista that must be completed by 8am Monday of the second week.
You must obtain an average of 70% in these quizzes to pass the rotation. You can repeat
any quiz once if necessary.
Rounds with Faculty Radiologist: … ‘STUDENT ROUNDS’
Student Rounds with the on duty radiologist typically occur at 8am Tuesday through
Thursday and 1pm on Fridays. Students will present a radiographic study using a format
described below. The radiologist may assign a case (or cases) to each member of the
group. You may be asked questions about a case that is assigned to a classmate and not to
you.
A rounds schedule is posted on the VMB 976 bulletin board. Attendance is MANDATORY.
You will receive a ZERO for the day if you do not attend and have an unexcused absence.
Students are expected to know normal gross and radiographic anatomy of large and
small animals.
YOU ARE EXPECTED TO REVIEW THE TOPIC TO BE COVERED BEFORE ROUNDS
Make use of textbooks and your VMB 960 course notes.
When presenting cases during rounds make sure to include the following information:
 Comment on technique (contrast, detail, artifacts) and positioning and be able to
discuss corrections of any deficiencies if present
 Roentgen signs
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Radiographic findings
Differentials for the radiographic findings
Assessment or summary
What you would do next (imaging, diagnostic test, surgery etc)
Be prepared to discuss the pathophysiology of the disease process present
See the Radiology Notice Board for the rounds topics or access the schedule link on this
site.
Rounds with Radiologist and Radiology Residents …. ‘CLINIC ROUNDS’
Immediately after ‘Student Rounds’, Monday through Thursday at approximately 9am, Clinic
Rounds will begin. You are expected to attend these rounds. Interesting cases from the day
before will be reviewed by the on duty residents and radiologist. Clinic rounds are held in the
radiology conference room. If the clinic is particularly busy you may be asked to leave to
assist with processing patients. On specific days, each student must present one case, for
which they have created a written report – see below.
Generating Reports on Clinical Cases
You are required to create one report on a routine radiographic examination on the following
days of the rotation.
Week 1:
Tuesday, for Wednesday presentation
Wednesday, for Thursday presentation
Friday, for following Monday presentation
Week 2:
Monday, for Tuesday presentation
Tuesday, for Wednesday presentation
Wednesday, for Thursday presentation
While you can chose if it is a large animal or small animal report, the actual case will be
assigned by the duty radiology resident or technician.
Download the Radiology Report Template from the Course Content (home) page of this
Vista site. Save the word document to My Documents of the computer you are using and
name it the Patient ID # of the patient you are reporting on. You may to give the browser
permission to download the file - depending on the computer configuration.
Once a report is generated, upload the report to Vista. Use 'Create Message'. The case
accession # should be the 'Subject'. Copy and Paste your radiology report into the Message
Box.
Information about the exam, (study description, accession number, etc) that needs to be
entered on the report form is available on RIS or the printed radiology order. You will be
given this by the person assigning the case.
You should upload your report to the repository in Vista by 8am the following
morning.
You should print a copy of your report and bring it to the next Clinic Rounds where you will
present your report. Be prepared to discuss any artifacts, how the study could be improved,
roentgen signs, radiographic diagnosis and where applicable a differential list. Be prepared
to discuss the pathophysiology of any disease processes present.
Case Review with Residents: … ‘RESIDENT ROUNDS’
You are required to review in advance a selection of cases for 4 Resident Case Review
Sessions (aka ‘Resident Quiz Review’).
These cases are online in quiz format in Vista and you must complete the Vista quiz
BEFORE each review session. The week one quizzes (1 and 2) are multi-choice. For the
week 2 sessions (3 and 4) rounds, you must write a radiographic diagnosis in the form of a
short answer response. Failure to complete these quizzes before the scheduled time will
result in an incomplete grade being given and additional review material will need to be
covered. SEE NOTICE BOARD FOR REVIEW SCHEDULE.
These cases are also accessible outside Vista via http://cvmimageview.ncsu.edu
Week 1
Review Session 1
Review Session 2
use keyword VMB976R1
use keyword VMB976R2
Week 2
Review Session 3
Review Session 4
use keyword VMB976R3
use keyword VMB976R4
You are encouraged to review the material via this route before taking the quizzes.
FINAL EXAM
You are required to take 2 hour final exam. This exam is closed book and is available from
6am until 6pm on the last clinic day of the rotation.
The exam is a multiple choice exam on Vista using hyperlinks to an image viewer. IT IS IN
YOUR INTEREST TO ENSURE YOU KNOW HOW TO WORK THE IMAGE VIEWER. The
exam is a mixture of both small and large animal cases, with an emphasis on small animal
thorax and abdomen. It is recommended that you take the exam in the computer lab or the
Library.
It is important that your unity profile is correctly configured before taking the exam.
Follow these instructions
Login to a computer in the library (not shuttles) or computer lab.
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Open INTERNET EXPLORER (ONLY) VIA THE NOVELL APPLICATION
LAUNCHER
Go to TOOLS then Internet Options
Click on Security tab
Click on TRUSTED SITES then sites
Add http://*.ncsu.edu and https://*.ncsu.edu to your trusted sites and close .
Click on custom level under trusted sites
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Basically .. Enable everything except popup blocker
Save settings and close.
Close all browsers
Open IE from Novell delivered applications – Unity Applications
Log into Vista and take the practice quiz – ensure the links to the Image Viewer
work.
JUST BECAUSE THE LINKS WORK IN RADIOLOGY DOES NOT MEAN THEY WILL
WORK IN THE STUDENT LAB AND LIBRARY. YOUR UNITY ID HAS TO BE
CONFIGURED ACCORDINGLY.
Only one student should leave the clinic at any one time to take the quiz, if patient load
permits, more can take it at once - this is at the discretion of the radiology supervisor.
Student Evaluations
Students will be graded objectively using quizzes and a final exam and subjectively by the
radiologists and the radiology residents. Input from the technologists will be used to grade
your application of basic radiation safety practices, technical skills, and preparation for
lectures and wet-labs.
A subjective grade will be compiled using the following:
Review quizzes (must get av 70%)
Interaction in Student Rounds
Interaction in Clinic Rounds
Resident Review Session quizzes
Interaction in Resident Rounds
Attitude, aptitude, motivation in clinic
FINAL Exam
Additional Activities
Film/Screen Imaging Lab:
Almost all images are generated digitally. While this is efficient from the hospital’s
perspective, it means that students do not get the opportunity to work with traditional film
screen systems, as you are likely to in practice. To address this, an opportunity to generate
a traditional film/screen technique chart will be given in a ‘wet lab’ to be held in the first week
of the rotation. This lab will also review common artifacts and how to troubleshoot common
radiographic image quality problems. You should take every opportunity to ask about
radiographic technique as it pertains to traditional film screen systems, particularly in rounds.
Contrast Procedures Lecture:
A short presentation on common contrast procedures will be given during the second week.
Review Material:
Interesting cases that you should review have been tagged in RIS. You should review this
material by accessing the SEARCH function in RIS. Type VMB976, and/or VMB960 in the
keyword box.
Technical Duties:
General:
Assisting in the generation of radiographs on clinical cases takes priority over self or
group directed study during business hours. You do not have any after-hours
obligation and should use that time to complete the various assignments.
If all clinical duties are up to date, then you can use any spare time for study, but
clinical duties take priority and you should expect to be interrupted.
Students will work with the radiology technologists to radiograph clinical patients. You are
not taught about the physics of digital imaging in any detail in the junior course as currently
only very few practices have this technology and you have adequate exposure to it in this
rotation. You should discuss with the technologists what factors need to be considered if
one were doing the imaging study using film instead of a digital system, with particular
emphasis on the selection of kVp and mAs.
Studies should be Q/C’d by a technologist, resident or radiologist before being closed. You
should take the opportunity to evaluate the images generated online whenever possible.
Lunch:
Thirty minute lunch breaks will be scheduled by the technologists or radiology manager. Do
not take a lunch break until you are excused by the technologist or radiology
supervisor. Please schedule your lunch time activities so that you return to radiology within
the allotted time period of 30 minutes. Note your name and the time that you leave for lunch
on the radiology schedule board.
Here to Learn!:
Feel free to ask questions, ask for references, use the library in the radiology conference
room. Tell the duty radiologist, residents and technologists your area of interest (ie. species,
imaging modality). Let the technologists know which exams you want to see and try
(this is especially important for students with an equine interest). We will do what we can to
accommodate you. Let us know what you want to learn. You are encouraged to practice
specific interpretation skills when making radiographs.
Emergency & "On-Call" Duties:
After-hours radiographs are made by the Small Animal Emergency Service or in the case of
large animal by the large animal house officers. Small animal ultrasound exams are the
responsibility of the radiology residents. However, students may be required to assist with
emergency duty on occasion. Emergency assistance generally consists of radiographing a
small or large animal patient after 5:00PM during week days. Students will be advised of
possible emergency duty as soon as is known. Be prepared to stay after 5:00PM any day of
the rotation in the event of an emergency or post-operative patient examination.
Radiation Safety:
Radiation badges are located on the wall in the corridor between the ultrasound room and
the conference room. Badges are identified by the student/clinician name. Radiation
badges must be worn at all times in the radiology area during the radiology rotation.
The badge is worn at the thyroid level outside the lead shielding. Badges are to be returned
to the storage area at the end of each day. If you do not have your badge, please see the
radiology supervisor or a technologist for a temporary dosimeter. Students will be evaluated
on their radiation safety skills. It is possible you may receive correspondence from the NC
State Radiation Safety Officer about your radiation exposure record. Failure to comply with
any requests for information will be interpreted as misconduct and handled accordingly.
While hand holding for small animal thorax and abdomen evaluations, sensible precautions
must be taken…. Remember ALARA – As Low As Reasonably Achievable. Make use of the
TIME, DISTANCE and SHIELDING rule.
ONE PERSON HOLDING BOTH THE FORE AND HINDLIMBS OF A PATIENT DURING
ABDOMINAL OR THORACIC RADIOGRAPHY IS UNACCEPTABLE.
Computer Access:
You are welcome to use the computers located throughout radiology, including the rounds
room to access images. Internet browsing should be limited to topics involving imaging or
veterinary medicine ONLY!!! Please be courteous and leave the computers in a state that is
easy for the person who may follow you (eg. close programs, remove CD-ROM etc). Most
Radiology Computers are not ‘locked down’ like the hospital computers. This is necessary to
allow the specialized imaging programs used in radiology to function. This means they are
potentially more vulnerable to hackers and such like. Please refrain from downloading any
.exe (program) files.
Miscellaneous Information
Course Evaluation:
You are requested to complete an assessment of the rotation online via Vista. The
evaluation is configured as a survey and not a quiz. Despite being logged in via your unity
login, your responses are anonymous. This will help us make decisions on activities that
you find useful, as well as change those activities that aren't as productive.
Dress Code:
Students are expected to be neat and clean. Scrubs are acceptable as are jeans without
holes. Shoes with covered toes are mandatory. Jewelry that can become caught on animals
or equipment should not be worn.
Absences:
Planned Excused Absence:
If you have a scheduling conflict and request an excused absence, this must be done and
approved before the block starts. The procedure is documented on Vista. You must
complete an excused absence request form and upload it to Vista. You must ‘makeup’ the
‘same’ lost days during a subsequent rotation.
Emergency Excused Absence:
Attendance is MANDATORY. Excused absences (during the block) will be granted for
emergencies ONLY! A Doctor’s note or other official document is required. During block
absence makeup will be arranged between the student and the course coordinator.
COURSE SUMMARY

DAY 1, WELCOME, POSITIONING LAB, PHARMACY ORIENTATION
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ENSURE YOU CAN LOGIN TO VISTA
See Dr Robertson if there is a problem accessing
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REFRESHER VISTA QUIZZES – Must be done by 8am Monday of week 2
Must get average of 70% to pass – you have 2 attempts
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STUDENT ROUNDS 8AM Tuesday thru Thursday, 11am Friday
Review cases with faculty radiologist. These are ‘unknown cases’.
You should study the topic to be covered.
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CLINIC ROUNDS 9AM Monday thru Thursday (none Friday)
Present a case you have prepared from previously on
Week 1:
Wednesday, Thursday
Week 2:
Monday, Tuesday, Wednesday, Thursday.
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RESIDENT QUIZ REVIEW SESSIONS see notice board for schedule
Must have completed Vista Quiz on these cases before these rounds
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ANALOG FILM WET LAB see notice board for schedule
Run by Christine Schaub
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CONTRAST STUDIES PRESENTATION see notice board for schedule
Presented by Scarlett Robinson
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FINAL EXAM – 2 HOURS – LAST DAY OF ROTATION
Open 6am to 6pm last clinic day of block. One student to leave at a time to take
exam. Exams should be taken in the computer lab or radiology conference room if
computer lab is booked.
Course Coordinator
Any questions or problems with the rotation should be discussed with Dr. Robertson.
Messages should be sent via e-mail to ian_robertson@ncsu.edu . Please place VMB96 in
the subject box.
Radiology Personnel
Radiologists
Dr. J Brown
Dr. J Douglass
Dr. T Pease
Dr. I Robertson
Dr. D Thrall
Residents
Dr. Lisa Jesse
Dr. William Lee
Dr Erica Fields
Dr Sarena Sunico
Technologist Supervisor
Scarlett Robinson
Receptionist/Transciptionist
Anna Benrud
Animal Technicians
Brendy Biggs
Chris Bowman
Technologists
Teri Critcher
Carolyn Greene
Amber Martin
Christine Schaub
Kate Sheehy
(year 3)
(year 3)
(year 1)
(year 1)