VERSION #14 FULL REDRAFT FEBRUARY 2018

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1 VERSION #14 FULL REDRAFT FEBRUARY Board of Medical Imaging Limited X-Ray Machine Operator (LXMO) Permits (1) Applicants for LXMO Permits Qualifications: (a) An applicant for a LXMO permit must be at least 18 years of age, pay an application fee, and have successfully passed a course of instruction that reflects the current Core Module of the "Content Specifications for the Examination for the Limited Scope of Practice in Radiography" published by the American Registry of Radiologic Technologists. The course of instruction must be provided by a school that is approved by the Board and licensed by the Oregon Department of Education, Private Career School Section, or otherwise approved or accredited by the Oregon Department of Higher Education. The curriculum must consist of not less than 52 hours of instruction approved by the Board in the following subjects: (A) Radiation physics; (B) Interaction of radiation with matter; (C) Radiation exposure, monitoring, and radiation units; (D) Principle of the radiographic equipment; (E) Biological effects of radiation; (F) Low-dose technique and minimizing patient exposure; (G) Applicable Federal and State radiation regulations; (H) Darkroom, film processing, and quality assurance; (I) Film and image critique; (J) Personnel protection; (K) Digital and computer-generated radiographic imaging; (L) Developing and using technique charts; and (M) Patient care. (b) Have received a course of instruction in laboratory practice approved by the Board: (A) Meeting the requirements stated in the Board's publication "Overview of Guidelines for Instructors of Courses in Preparation for the Limited Scope Examination in Diagnostic Radiologic Technology dated July 2013 which is incorporated by reference and made a part of this rule; (B) Reflects the current Radiographic Procedure Module(s) of the "Content Specifications for the Examination for the Limited Scope of Practice in Radiography" published by the American Registry of Radiologic Technologists.

2 (C) Taught by a licensed registered technologist specific to each category for which a limited permit is sought and have received the instructor's certification that the applicant has demonstrated all the positions/projections described in the Behavioral Objectives for each category. The minimum hours in each category is as follows: (i) Skull/Sinus, 18 hours; (ii) Spine, 30 hours; (iii) Chest, 12 hours; (iv) Extremities, 60 hours; (v) Podiatric 10 hours. (2) Process and timeframe for obtaining a limited x-ray permit: Language in Red has been renumbered and subdivided for clarity, compared to earlier draft. In addition, this language is proposed to be changed. See document entitled Proposed Revision to the Process for Obtaining a Limited X- Ray Permit for side-by-side comparison with proposed language (a) To qualify to sit for an ARRT limited x-ray examination, a limited x-ray school graduate must have successfully completed a Board-approved Core Module course and must have successfully completed the didactic portion of a Radiographic Procedure Module (Skull/Sinus, Spine, Chest, Extremities, and Podiatric) relative to the anatomical area the graduate wishes to radiograph. (b) Graduate status begins on the date on the student s course completion certificate, and may extend no longer than 24 months from the date on the graduate s course completion certificate. (c) The graduate must pass the ARRT CORE examination within one year from the date on the course completion certificate, measured from the date on the course completion certificate to the date that the graduate sits for the exam. (d) After passing the CORE exam, the graduate has exactly one year to complete all requirements and to apply for a permanent limited permit. For each anatomic area that the graduate completed in school, as reflected on the course completion certificate, graduate status expires the earlier of: (A) 12 months from date that the graduate passed the CORE exam, or (B) Seven days after the graduate completes clinical requirements for a specific anatomic area. Within seven days from when a person has passed the CORE exam and has passed an anatomic exam component, the person is required to apply for a permanent permit in that anatomic component. (e) To qualify to apply to renew a temporary limited permit in an anatomic area, the applicant must provide documentation of having taken the ARRT examination in that anatomic area. If qualified, the temporary permit holder may apply for one six-month temporary permit renewal that will expire the earlier of six months from issuance or 12 months from the date the graduate passed the CORE examination. (f) Up to 30 days prior to course completion, a student may submit an application to the Board for the ARRT examination. The application must include a statement from the school indicating that the applicant is a student in good standing and expected to graduate. The applicant cannot sit for the ARRT examination prior to the date on the applicant s course completion certificate from the limited x-ray school. If the qualified examination applicant passes the CORE section of the ARRT examination with a score of 70 or above, then the examination applicant may apply and will qualify for a six-month initial temporary permit in

3 the anatomic areas that the applicant successfully completed during didactic education, as reflected in the course completion certificate. To be issued a temporary permit, the temporary permit application must include a course completion certificate from the OBMIapproved school indicating the anatomic areas that the applicant successfully completed in school. The applicant must successfully graduate from the educational program to qualify for a temporary permit. (g) The graduate must obtain a temporary permit to successfully complete a practical experience program approved by the Board specific to each category for which the applicant seeks a LXMO permit. The graduate s temporary limited permit can only include the anatomic areas that the applicant successfully completed in school, as reflected in the course completion certificate. The practical experience component must consist of experience with live patients with a supervising practitioner who is a licensed radiographer, radiologist, or license physician, licensed nurse practitioner or licensed physician assistant with adequate training in radiography in accordance with RPS rules OAR (5), (6) and(7), or a person who has been actively taking x-rays under the authority of a permanent limited permit within the immediate previous twelve months in the same anatomic area that is being imaged, present in the room during radiographic exposures. Processed images made by the graduates are evaluated and critiqued by an ARRT-registered, Oregonlicensed radiographer Practical Experience Evaluator. The graduate shall be evaluated for imaging by using either the On-Site or Peer Positioning Practical Experience Evaluation Form developed by the Board. The Practical Experience Evaluator must provide the graduate with a certificate of completion in the categories in which the graduate has successfully completed practical experience. (3) Graduates are allowed three attempts to pass an individual section of the ARRT exam. (4) Limited Scope Examination Fees and application process: (a) The examination fee is $20 for each examination category for which the student is tested, combined with an administration fee set by the American Registry of Radiologic Technologists (ARRT). These fees, together with the necessary certifications and verifications that the applicant has completed Board-approved Core Module course and Radiographic Procedure Module courses, must be submitted to the Board office. On submission and acceptance of the application materials, OBMI shall register the graduate applicant with the ARRT. (b) The Board, upon advance request, may approve a student to submit an application for the examination prior to the timeline specified in section (1)(c), based upon school verification that the student is expected to complete all coursework. Verification must include a preliminary course completion certificate, endorsed by a responsible school official, indicating the courses for which the student is enrolled, expected completion date, and the student s status in each course. The final approved course completion certificate is required as part of the application for a temporary permit. A temporary permit will only be issued for anatomical areas for which the applicant has successfully completed coursework and obtained a passing grade on the ARRT Core examination. (c) The examination shall consist of sections: (A) Core Section (Radiation Use and Safety, Equipment Operation, Quality Control, Image Production, Image Evaluation, and Patient Care); and (B) Specific Radiographic Procedures (positioning and techniques) in the category or categories (Skull/Sinus, Spine. Chest, Extremities, and Podiatric).

4 (C) A score of 70 percent constitutes a minimum passing score for each section of the limited scope examination; (D) Limited scope examinations will be administered at computer-based testing sites identified by ARRT. The graduate is subject to rules regarding test administration at the testing site. (E) The application fee for the LXMO permit examination is non-refundable. (5) A permanent limited x-ray permit will only be issued to graduates who have passed the ARRT CORE exam, and will only be issued in anatomic areas for which the graduate has passed the respective ARRT exam and completed clinical experience requirements. (6) To add an anatomic area to an existing permit: Once a permanent LXMO permit holder completes an approved educational program to add an anatomic area to their permit, the applicant may apply to OBMI for a temporary permit to complete practical experience requirements in that anatomic area. The applicant has one year from the date on the course completion certificate to complete practical experience requirements as specified in rule for that specific anatomic area, pass the ARRT examination for that anatomic area, and notify OBMI to add the anatomic area to their permanent permit. The applicant is eligible for one six-month temporary permit, which may be renewed one time and which can extend no later than 12 months from course completion. To qualify for a temporary permit renewal, the applicant must show that they have taken the ARRT exam in the relevant anatomic area. A permanent limited permit holder does not need to pass the CORE exam to add an anatomic area. (7) Bone densitometry permit application process: (1) An applicant for a limited permit in x-ray bone densitometry must be at least 18 years of age, pay an application fee set by the Board, and have successfully passed a Board approved 24 hour course of instruction which includes not less than 20 hours of radiation protection, equipment operation and quality control specific to x-ray bone densitometry, and meets the didactic and practical experience requirements stated in the Board's publication "Behavioral Objectives and Teaching Guide Bone Densitometry Equipment Operators dated October 01, 2008 which is incorporated by reference and made a part of this rule. (2) Graduate status will continue for one year from the date of completion of the "Bone Densitometry Equipment Operators Examination" given by the American Registry of Radiologic Technologists. Graduate status expires at the end of the one-year period specified above; or seven days after the date on which an applicant becomes eligible for a permanent bone densitometry permit. (3) Except for a person who has a radiography license from OBMI or who is exempted from OBMI s licensure requirements, every person who performs bone densitometry procedures must have passed the ARRT Bone Densitometry Equipment Operators Examination and be in possession of an active bone densitometry limited permit from OBMI Requirements for LXMO Permit Program Sponsors (1) Instructors, program directors, or authorized school officials of Core Module or Radiographic Procedure Module classes must provide the Board with the names of all students who have successfully completed the didactic portions of the LXMO permit program. The list must indicate the specific didactic portion(s) of the LXMO permit program the student has successfully completed and the completion date.

5 (2) Retention of Student Records: instructors, program directors, or authorized school officials of Core Module or Radiographic Procedure Module classes and practical experience evaluators must retain student grades and attendance records for a period of two years. (3) LXMO permit program sponsors must annually submit to the Board for review an outline of the LXMO permit program. The outline along with the names of all instructors teaching in the program must be submitted to the Board office no later than July 1 each year. The plan must include details on the respective school s compliance with Paragraph (5). In addition to a written outline, and as a condition of Board approval, each LXMO permit program site shall be inspected every two years or as needed by a Board member or an authorized representative of the Board. The site visit shall include an inspection of the physical premises on which LXMO permit programs are conducted as well as interviews with students currently enrolled in the LXMO permit program. Additionally, the Board may obtain a list of students and their clinical experience sites from each school, and may make inquiries or site visits to clinical experience sites to assure that temporary permit holders are being properly trained and supervised. (4) Each LXMO permit program must provide oversight of the clinical experience component for a specific number of exams for each anatomic area in which the student completed and passed coursework at an approved school. For any anatomic area in which the temporary licensee is permitted to perform under supervision, the following minimum number of exams must be included. The minimum number of exams must include at least one of each of the required exams as specified in the Board s most recent approved version of the Clinical Demonstration Checklist. Each exam must include the minimum diagnostic series, established in accordance with the January 2018 edition of the Board of Medical Imaging s Practical Experience Evaluation Requirements: Required Exams Total of all exams to be completed: (Must include at least one of every required exam and any combination of required and elective exams) Chest 1 exam (incl. 2 views) 5 Extremities 11 exams (25 views) 15 Skull/Sinus 4 exams (11 views) 8 Spine 3 exams (9 views) 10 Podiatric 4 exams (9 views) 10 (5) The clinical experience component must have a designated clinical coordinator who will minimally fulfill the following functions: a) Complete clinical experience agreement for each student, formalizing the responsibilities of the school, the student, and the clinical experience site; b) Provide orientation to students regarding clinical experience requirements and expectations; c) Placement of students in clinical experience sites, for students who are not already employed at their clinical experience site; d) Assure proper supervision of temporary permit holders during clinical procedures, in compliance with OBMI statutes and rules; and e) Assure proper evaluation of practical experience requirements. (6) A resource library shall be maintained at the program site and the resource materials shall be made available to students.

6 (7) Prior to the first class meeting, Board-approved LXMO permit programs must provide students with clear statements describing the course and program policies. These must include but are not necessarily limited to information regarding the following: (a) Student costs including tuition, books, lab fees, LXMO permit examination fees, LXMO permit application and renewal fees; (b) Tuition refund policies; (c) How the practical experience requirement will be fulfilled including a clear explanation of the responsibilities to be assumed by the program and the responsibilities that will be assumed by the student; (d) Employment guarantees, if any; (e) Course outlines and minimum hourly requirements for each section of the course; (f) The LXMO permit examination process including applications, deadlines for filing for the examination, and examination fees; (8) Failure by the LXMO permit program sponsor to submit the outline required under this section or to cooperate in the site visit procedure shall constitute grounds for the Board's refusal to approve the program. (9) If the Board's inspection of a LXMO permit program site reveals that corrective action needs to be taken, the Board or its representative will so notify the program director. The program director shall respond in writing to the Board within 20 days of receiving the information. The response shall consist of a description of the corrective action that will be taken. (10) Any LXMO Permit course of instruction, approved by the Board in order to satisfy the Board's requirement for didactic and clinical experience portions of the LXMO Permit course of instruction, shall be made generally available to the public for purposes of enrollment in and completion of the course, unless the Board, for good cause, decides otherwise.

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