When you lie down for an X-ray as the technologist scans your body, the image it produces tells an intricate story.

If done incorrectly, that image can lead to a slew of possible misdiagnoses and can damage a patient’s trust in the health care system.

“Our job as radiologic technologists is to image anatomy and image it correctly,” said Chad Hensley, director of the radiography program inside the UNLV’s School of Integrated Health Sciences. “We have to build trust and confidence with our patients. You can have the best orthopedic surgeon in the world, but the first thing that surgeon is going to do is look at that X-ray.”

Learning the proper way to position a patient is the foundation of Radiographic Procedures Skill Laboratory (RAD 371), a class critical enough that it requires two full semesters to complete.

During their first semester of the program, students are taught how to properly position the chest and abdomen, upper and lower extremities, and the gastro/intestinal tract. In the second semester, they position for the urinary system, spine, skull, and boney/thorax, more commonly known as the ribs and sternum.

Students are also in lab every Thursday afternoon practicing these lessons on one another to hone their skills before working with actual patients on their clinical rotations.

The intensity of the labs, complemented by an equally important lecture (RAD 370), is paramount to educating these future radiological technologists.

“I tell the students that our job looks easy when you become good at it,” Hensley said. “The patients shouldn’t know how much schooling you’ve gone through to understand what’s going on. Once you are confident, it’s going to look like it’s an easy job when the reality is that there’s a lot that goes into it to make sure that it’s done correctly.”

The Course: Radiographic Procedures Skill Laboratory

RAD 371 is the anatomy and positioning lab taught in conjunction with RAD 370 for radiography students working in X-ray. There are specific ways radiologic technologists need to position patients so they are able to correctly see the human anatomy during a scan. In RAD 371, students learn to provide proper patient care by practicing on each other to feel for landmarks on the human body.

Why is the skills laboratory taught?

“If you don’t represent the anatomy correctly, you run the risk of not telling the patient’s story. For X-rays, it’s giving the opportunity to tell the story of that patient where the human eye just can’t see,” Hensley said. “Take heart size, for example. Heart size can be measured on an X-ray to make sure it’s not enlarged. If there is poor positioning or poor technique for getting that image, the heart can appear larger than it actually is, which can inadvertently create a bad diagnosis.”

Simply put, an incorrect image can be catastrophic. That is why students must attend their six-hour, hands-on lab every Thursday.

Who is taking this class?  

This class is taken by first-year radiography students. The radiography program is part of the Department of Health Physics and Diagnostic Sciences, housed within the School of Integrated Health Sciences. Since these students have yet to gain any clinical experience, RAD 371 prepares them to be more comfortable working with patients once they begin their clinicals.

Who is teaching this class?

Chrissie Choa, a radiological technologist and an alumna of the radiography program. After graduating from the School of Integrated Health Sciences in 2015, Choa worked as a technologist in different hospitals across the Las Vegas Valley before returning to her alma mater to teach.

“Since I’ve already gone through the program, I feel like I can provide more insight for the current students,” she said. “I graduated eight years ago, and I can still remember the emotions that I felt going through the program — like feeling overwhelmed from learning all the different positioning parameters or feeling anxious during exams or stressed out from radiation physics. As I teach this course, I share study tips that I used or study tips that I wish I knew as a student, such as memorizing vs. understanding.”

Choa also shares her  personal experiences working in the field with her radiography students to help better prepare them for a career after UNLV.

“Some of those experiences were good, some of them were not so good, and some were definitely embarrassing,” she said. “I share my experiences so that hopefully the students can learn from them, but more importantly, to show that they are not alone and that everyone makes mistakes.”

What is something that students might be surprised to learn in this class?

According to Hensley, some students are genuinely surprised by how much hands-on experience the job requires.

“From the outside, many people think that radiologic technologists just stand behind a wall, bark instructions, and push a button,” he said. “But we are intimately involved in patient care, and in order to do things correctly, you have to put your hands on a patient.”

Is there anything that the layperson should know from this course?

Hensley emphasizes the importance of the impact that radiological technologists make on our health care system. The image is the first thing a physician looks at when meeting with a patient, and the technologists are responsible for creating that image.

“The reality is that medicine doesn’t continue without imaging,” he said. “We’re not necessarily the ones who are always talked about, but it’s expected that we’re going to do our job so the patient can have a diagnosis and the doctor can prescribe treatments. But the doctors are going to come back to that X-ray to see what’s going on because we are the eyes to the inside of the body.”

The intensity of the curriculum requires strict knowledge of the intricacies within the human body, which is why it takes two full semesters to learn how to position the entire body correctly.

Where do students go next?

Radiography students’ first year in the program is foundational, practicing positioning before starting clinics in the summer where they work 40 hours each week.

In the second year of the program, students are in clinics for 24 hours each week while taking some on-campus courses. They maintain the same schedule for the spring semester. The final summer, their educational experience culminates with 40-hour weeks in the clinic before graduating in July.

Is there a reading/movie list about radiography that the layperson could benefit from?

“It’s hard because radiological technologists aren’t necessarily looked on as being as important as some of the other health care professions, and there is a lot of misrepresentation about who we are and what we do,” Hensley said. “But the show Bones is a fairly decent representation of what we do. They have imaging, and most of the time they are fairly accurate in regards to what they are talking about.

"Too many times, Hollywood will feature X-rays that are upside down, or they’ll talk about something that just doesn’t make sense. It drives me crazy, but I know I can spot it a lot easier than most.”