X-ray Operator Introductory Course

In rural and remote Queensland where a radiographer is not readily available, limited scope radiography may be performed by appropriately licensed health service employees, who are called X-ray operators.

This blended delivery course provides participants with the knowledge and skills to apply for a trainee X-ray operator chest and extremities licence from the Radiation Health Unit, Queensland, the regulatory body that administers the Radiation Safety Act 1999 and radiation use licences. This course has been endorsed by the Radiation Health Unit, Queensland, as well as similar regulatory bodies in other jurisdictions.

This course also aligns with the recommendations of the Department of Health's X-ray Operator Services Guideline and Education and Training Framework for X-ray Operators.

Upon successful completion of all course components, participants will be able to:

• understand the properties of X-rays and develop the skills and knowledge required to safely operate plain X-ray equipment, including their local facility equipment
• understand and apply the principles of radiation protection for the patient, themselves (as a licensee), staff and members of the public
• understand the responsibilities relevant to holding a Radiation Use Licence under the Radiation Safety Act 1999, including duty of care and consequences of poor radiography
• apply knowledge of common radiographic terminology, anatomy and pathology
• interpret and evaluate an X-ray request form
• appropriately use image processing and ancillary equipment
• perform routine diagnostic radiographs of the fingers, thumb, hand, wrist, forearm, elbow, humerus, toes, foot, ankle, lower leg, knee, femur and chest, with remote supervision if required
• perform diagnostic radiographs of the chest and extremities for various patient presentations, with remote supervision if required
• understand how imaging faults and artefacts occur, affect image quality and how to correct them
• review and evaluate radiographs for clinical value and technical proficiency.

This course is open to rural and remote health service employees from a variety of backgrounds, however clinical staff (i.e. Aboriginal and Torres Strait Islander health practitioners, allied or oral health professionals, clinical assistants, doctors, nurses or paramedics) may be prioritised where course demand exceeds capacity.

Careful consideration of the capability, capacity and interest of applicants ensures best use of financial and human resources. It is important for applicants, managers and Radiographic Advisors to consider how an applicant might fit the ongoing role requirements of an X-ray operator, some of which include:

• workload flexibility to perform X-ray examinations when clinically required, as well as undertake mandatory annual X-ray training and assessment
• good communication, interpersonal and teamwork skills
• ability to work autonomously within a defined scope of practice
• accountability for work performance and willingness to accept constructive feedback.

Applicants must also be willing to complete all the online, self-paced theory component (approx. 50-75 hours) within two months of enrolling; and be able to attend the scheduled practical workshop.

If an applicant does not meet the above criteria but a need exists for this training, please contact the Allied Health Education and Training (AHET) radiographers directly to discuss.

To be eligible for admission to the course applicants must meet the following prerequisites:

• work in a rural or remote health facility or service
• work at a facility with X-ray operators or a sole radiographer
• have  support from the local Radiographer Advisor, Radiation Safety Officer, Facility Manager and health service Executive (or Possession Licensee).

The applicant must also:

• be up to date with relevant mandatory training
• have (or be supported locally to acquire) basic skills in IT to navigate online platforms, digital equipment and software systems, use videocall technology and manage accurate data input
• have (or be supported locally to acquire) basic skills in patient care, understanding of duty of care to the patient, privacy and confidentiality obligations
• have an appropriate level of functional mobility to perform X-ray examinations e.g. squatting, kneeling, using both arms above head height, moving beds and large equipment
• possess adequate literacy skills to read, understand and apply instructions in technical manuals, organisational policies and clinical procedural documents; write incident reports or log equipment faults; correspond via email
• understand and be able to apply basic mathematical skills such as arithmetic, decimals and fractions, measurement and geometry, statistics and inverse square laws
• be able to learn and apply a basic level of X-ray optics, atomic and radiation physics
• be willing to adhere to the requirements of their local Radiation Safety and Protection Plan (RSPP) or equivalent
• review and adhere to the Cunningham Centre’s Academic Guidelines.

It is also strongly recommended for potential applicants to spend 1-2 days work shadowing the local Radiographic Advisor prior to applying for this course, so that they are aware of the practical and ongoing requirements of the role.

As part of the X-ray Operator Support program, this course is coordinated by the Allied Health Education and Training team at the Cunningham Centre.

The Allied Health Education and Training radiographers deliver the training and conduct assessment processes. Radiographic Advisors (RAs) are involved in orientating participants to local equipment, systems and processes. RAs may also be involved in co-facilitating training where the practical workshop is held at the participants’ local health service.

An average timeframe to complete the theory component is 50-75 hours; please see the Course outline for further details, noting that minor changes to the course requirements can occur from one cohort to the next. The amount of offline time required to complete this course may vary depending on the participant's:

• professional background, work and study experiences
• IT skill level navigating the online platform
• support provided by the local manager,  Radiographic Advisor and experienced X-ray operators
• existing level of familiarity with local X-ray service and systems.

The theory component is undertaken as self-directed learning, supplemented with learning activities to be supervised by radiographers or local XOs. The online learning platform contains recorded tutorials and interactive learning resources. Remote support is provided by the Allied Health Education and Training team via phone, email or videocall. If delivery of the theory component via live videocall tutorials is required, please email the team requesting a quote for this additional support.

Participants must successfully complete the entire theory component within 2 months. Participants are then required to attend a (minimum) 3-day face-to-face practical workshop, which focuses on a variety of clinical and practical areas pertaining to limited licence radiography and includes small group tutorials, simulated tasks and performing supervised radiographic examinations in a hospital setting. The workshop allows participants to consolidate the theoretical knowledge gained and develop practical radiographic technique in a supervised clinical environment.

Practical workshops are delivered in Toowoomba throughout the year. Workshops can also be held at other rural or regional locations; further details can be requested by contacting the AHET team directly.

Learning materials for this course are accessed through the Cunningham Centre’s online learning management system (LMS). These courses have been tested on the Queensland Health standard operating environment. As of March 2022 this is Microsoft Windows 10 20H2 and Microsoft Edge 64bit v92.

The following software are recommended:

• Microsoft Windows 10 or 11
• Microsoft Edge Browser
• Adobe Acrobat Reader

Please be aware that:

• Apple Mac computers running the latest version of macOS and the Safari web browser should work without issue, but are not specifically tested or supported by the Cunningham Centre.
• Mobile devices such as iPads, iPhones or Android devices are not recommended or supported.
• For best results, software should have any updates applied.
• Some computers may be running additional software that affects the features and functionality of that computer. This may include, but is not limited to, anti-virus software and web browser plug-ins.
• A broadband internet connection is required to use the LMS. Some files, including videos, may be large; please ensure that you have sufficient data allowance to download and upload data from and to the LMS.
• If a technical issue is reported that is affecting your ability to access online materials, we will attempt to replicate the issue in the Windows 10 environment. If the issue cannot be replicated in this way, then it will be assumed that the issues lies with your computer or internet connection and responsibility for resolution will lie with you.

Assessment activities are interspersed throughout the theory component and may include tasks such as:

• online quizzes
• short answer assignments
• local facility activities (in conjunction with radiographer or an existing X-ray operator)
• reflection activities.

At the end of the practical workshop participants are assessed when performing simulated tasks and supervised radiographic examinations. Feedback from the participant's Radiographic Advisor may also be incorporated into the assessment results.

All assessment tasks must be successfully completed to pass the course. Participants are entitled to a maximum of three submission attempts for any assessment task. Failure to successfully complete any task may result in being withdrawn from the course.

^ Tier 2 and Tier 3 includes GST.

Additional costs to be considered:

• offline time for the participant to complete learning and assessment tasks (approximately 50-75 hours for theory)
• costs associated with attending the 3-day (minimum) practical workshop  e.g. participant wages and travel
• videoconference capability for the X-ray room  (more details under “Will there be any additional resources required?”)
• Radiographic Advisor support – a fee for service arrangement may need to be negotiated
• use licence application fees | Policy QH-POL-209
• personalised lead side markers
• ongoing annual fees for licensing, dosimeters, training and assessment should also be considered | Guideline QH-GDL-363:2015.

Please refer to our fees and payments page for more detail on our pricing model, payment options, fees and refund guidelines.

A quote and single payment (in lieu of individual payment forms) can be requested where payment for more than five applicants will come from the same cost centre. Please contact the team to discuss.

Queensland Health X-ray operators may be entitled to have any fees for Radiation Use Licences and Annual Training and Assessment Workshops either paid for by their workplace or reimbursed.

Please refer to the following documents for further information:

• X-ray Operator Services | Guideline QH-GDL-363:2015
• Radiation Safety Act 1999 - Application and Licence Fees - 'Use' Licences | Policy QH-POL-209

Your health service will need to provide you with:

Theory component

• offline time to complete learning and assessment activities, including time with the local radiographer and experienced X-ray operators
• a device with internet access and webcam
• access to a printer and scanner
• access to the local X-ray room
• access to the local medical imaging systems (e.g. PACS and RIS).

Practical workshop

• offline time for workshop
• travel and accommodation
• approval for the Radiation Health Unit licence and application fees.

Videocall capability in the X-ray room
Establishing VC capability in the X-ray room is strongly recommended as it:

• allows course participants to link with the X-ray Operator Support team or their Radiographic Advisor
• enables VC based annual assessments for existing XOs
• enables existing XOs to access remote radiographer supervision at the time of examination. As outlined in the Teleradiography Project (2012), this benefits the patient  and XO (Local advice may need to be sought regarding privacy and security where patients are involved.)
• can be achieved using a variety of existing devices and software
• may be considered as a prioritisation criterion for course entry when demand is high.

Local resources

• personalised side markers
• dosimeters
• training sessions with your Radiographic Advisor.

Upon successful completion of the course, participants will have gained the knowledge and skills outlined under “What is this course about?” and be able to apply to the Radiation Health Unit for a trainee chest and extremity use licence.

Participants will be provided with a hard copy Positioning Manual which can be used as an ongoing radiographic reference.

A Radiation Health Unit Statement of Attainment and a Cunningham Centre Certificate of Completion will be issued to participants who have successfully completed all components of the course.

Participation in this professional development activity may contribute to continuing professional development (CPD) requirements for the purposes of registration and/or professional association membership. Please refer to the specific CPD requirements of your registration board and/or professional association to confirm

Once the coursework has been successfully completed, you will need to:

• apply for a trainee licence with the Radiation Health Unit
• not perform any patient imaging until a trainee use licence is received from the Radiation Health Unit
• adhere to your local Radiation Safety and Protection Plan
• undertake the agreed ongoing training activities in your supervision agreement
• aim to perform at least 50 examinations per year. Where facility examination numbers are low, this may require the XO to attend a radiographer site with increased throughput to conduct additional supervised examinations
• organise an annual competency assessment at least 3 months prior to licence expiry.

Applications for this course are currently closed.

Applicants need to review all the information on this webpage and complete the following documentation:

• Applicant submission including x-ray observation log
• Supervision agreement with RA input

Applicants will need to forward these documents to their Facility Manager, who will need to complete:

• Cunningham Centre payment form
• Online Facility Manager application

All above documentation will need to be uploaded into this form.

A summary can be found in the course process.

If demand for the course exceeds capacity, applications may be prioritised based on details of clinical service provision needs, the ratio of X-ray operators to facility radiographic workload, distance from another X-ray facility, support provided to applicants or appropriateness of applicant.

If a health service has 6 participants looking to complete this training and are interested in a workshop being held at their location, please contact the team directly to discuss.

If there is an urgent clinical need, Facility Managers or Radiographic Advisors are welcome to contact the XO Support radiographers to discuss.

Please refer to our fees and payments page for the full conditions of enrolment prior to proceeding. Refunds and transfers are generally unable to be granted once the participant has commenced the course.

For further information regarding this course, contact:

X-ray Operator Support, Allied Health Education and Training
t. 07 4699 8097
e. X-ray-Operator-Support@health.qld.gov.au

For further information regarding radiation use licensing, or the Radiation Safety Act 1999, contact the Radiation Health Unit.

• X-ray Operator Annual Training