Penn State Greater Allegheny Campus
Radiological Sciences Program
Applicants to the Penn State University Radiological Sciences Program must submit this completed form as evidence that they have observed the following procedures/scenarios with the radiologic technologist or student in a hospital environment at one of the program’s clinical affiliates. Shadowing for 8 hours is a requirement of admission to the Rad Sci program.
Purpose: Meeting the following objectives will provide meaningful insight into the field of Radiology that will aid in a career choice for the applicant.
Please check all of the following that the student observed while shadowing:
- General Diagnostic Radiography (Example: chest, abdomen, shoulder, or pelvis and extremity radiographs)
_____ Observed, _____ Did not Observe, ______ Not Applicable
Please list the general diagnostic procedures observed ___________________________________________________________________________________________________________________________________________________________________________________________________ - Fluoroscopic Procedures (Example: barium enema, UGI, small bowel studies, etc.)
_____ Observed, _____ Did not Observe, ______ Not Applicable
Please list the fluoroscopic procedures observed ____________________________________________________________________________________________________________________________________________________________________________________________________ - Inpatient Radiography (Example: exams done on in-patients who are typically more ill than out-patients)
_____ Observed, _____ Did not Observe, ______ Not Applicable
Please list the inpatient radiography procedures observed ___________________________________________________________________________________________________________________________________________________________________________________________________ - Exams in other Modalities (Example: exams done in CT, MRI, Ultrasound, Special Procedures, Nuclear Medicine or other modalities)
_____ Observed, _____ Did not Observe, ______ Not Applicable
Please list the exams in other Modalities observed ____________________________________________________________________________________________________________________________________________________________________________________________________
Discussion with Attending Technologists or Student: The shadowing student should discuss the following topics with the attending technologist or student, and record acquired information below.
- How long has the attending radiographer or student been in the field of Radiologic Technology?
___________________________________________________________________________________________________________________________________________________________________________________________________ - What are the professional credentials of the attending radiographer?
___________________________________________________________________________________________________________________________________________________________________________________________________ - In what types of employments settings has the attending radiographer worked?
___________________________________________________________________________________________________________________________________________________________________________________________________ - What, if any, further career aspirations does the student have?
__________________________________________________________________________________________________________________________________________________________________________________________________ - What are the positive aspects of this career?
__________________________________________________________________________________________________________________________________________________________________________________________________ - What are the negative aspects of this career?
__________________________________________________________________________________________________________________________________________________________________________________________________
Signature of attending radiologic technologist/student:
____________________________________________________________________________________
Date:___________________________________________________________
Signature of Student:
____________________________________________________________________________________
Date:___________________________________________________________
Name of clinical affiliate where student shadowed___________________________________________
Date of shadowing_________________________________________
Start time:_____________ Verifying signature:____________________________________________
End time:_______________ Verifying signature:____________________________________________