Training activity information
Details
Perform a diagnostic reference level (DRL) audit for a selection of nuclear medicine and CT or hybrid procedures
Type
Developmental training activity (DTA)
Evidence requirements
Evidence the activity has been undertaken by the trainee.
Reflection on the activity at one or more time points after the event including learning from the activity and/or areas of the trainees practice for development.
An action plan to implement learning and/or to address skills or knowledge gaps identified.
Considerations
- ARSAC DRLs and adjustments
- National and local CT diagnostic reference level
- Audit cycle
- Optimisation
Reflective practice guidance
The guidance below is provided to support reflection at different time points, providing you with questions to aid you to reflect for this training activity. They are provided for guidance and should not be considered as a mandatory checklist. Trainees should not be expected to provide answers to each of the guidance questions listed.
Before action
- What is your understanding of the purpose of DRLs in optimising radiation dose to patients, and what specific methodology will you use to collect and access the required dose data for the procedures you are auditing?
- What specific insights do you hope to gain regarding how your department’s current dose levels compare to national DRLs, and what do you expect to learn about the process of identifying areas for potential dose optimisation?
- What do you already know about how DRLs are established and the various factors—such as equipment settings or patient demographics—that can influence the final patient dose?
- Have you discussed the training activity with your training officer to gain a clarity of understanding regarding the audit’s scope, the specific procedures to be included, and the expected analysis methods?
- What possible challenges might you face—such as difficulty accessing data or dealing with incomplete records—and how have you planned to handle or mitigate these issues in the moment?
- How do you feel about embarking on this activity, and do you feel technically and emotionally prepared to handle the complex data analysis involved in a DRL audit?
In action
- Pay attention to your actions.
- How are you collecting and analysing the dose data for the DRL audit? Why are you choosing this method?
- What decisions are you making about which data to include and how to compare it to existing DRLs?
- What aspects of data collection and analysis feel intuitive, and what requires more conscious effort (e.g., understanding units, normalisation factors)?
- How effective are your methods for collecting the necessary data?
- What challenges are you facing in accessing the data or interpreting the relevant parameters?
- What can you learn about typical dose levels in different procedures as the audit unfolds?
- How does this activity connect to your understanding of dose optimisation?
- Are there alternative approaches you could take if data is missing or inconsistent?
- What support or guidance might you need if you are unsure about how to interpret the data in relation to national DRLs?
- Are you ensuring your audit aligns with the principles of IRMER regarding dose optimisation?
On action
- Which nuclear medicine and CT or hybrid procedures did you include in your DRL audit?
- What data did you collect for each procedure to perform the audit?
- What were the calculated DRLs for the procedures you audited?
- How did the departmental levels compare to national or recommended DRLs?
- Were there any significant variations in doses for the same procedure across different patients or equipment?
- What did you learn about the concept and importance of Diagnostic Reference Levels (DRLs)?
- How does a DRL audit contribute to the optimisation of radiation dose to patients?
- What factors might influence the radiation dose received by patients during these procedures?
- Did you identify any procedures where the departmental levels were above or significantly below recommended DRLs? What might be the reasons for this?
- How does this activity relate to the IRMER principle of optimisation?
- How will your understanding of DRLs influence how you approach imaging protocols and patient doses in the future?
- What recommendations would you make based on your audit findings?
- How can you contribute to the ongoing monitoring and review of patient doses in your department?
- What further learning or resources would be beneficial to enhance your knowledge of dose optimisation and DRLs?
Beyond action
- How has revisiting your initial reflections and the audit report deepened your understanding of DRL purposes and methodologies since completing the task?
- Have you compared your findings with national or local standards? Has engaging in discussion with senior colleagues provided you with new insights into how your results might influence departmental changes?
- How has this audit influenced your awareness of patient radiation doses, and in what ways has it informed your ability to advocate for ALARP principles (As Low As Reasonably Practicable) during discussions with practitioners?
- How has this practical experience of dose review prepared you for observed in-person assessments, such as Case-based Discussions or Observed Communication Events involving the interpretation of IRMER legislation?
- What transferable skills did you develop, and how will these support your involvement in future service improvement projects or the maintenance of patient safety?
- What specific actions have you identified to ensure you continue to refine your expertise in dose optimisation and the audit process?
Relevant learning outcomes
| # | Outcome |
|---|---|
| # 1 |
Outcome
Interpret, apply and audit adherence to the Ionising Radiation (Medical Exposures) Regulations (IRMER) and related guidance in the Nuclear Medicine environment. |