We started ROC to provide radiation safety and technical service to those doing general radiographic procedures. These services placed us on-site where persons who had no training in the production of radiographs were performing x-ray procedures. Training for these individuals was intended to improve their patient care and radiation safety practices. About the same time Nebraska passed a law requiring all operators of x-ray equipment to pass a competency-based exam. We knew we could help.


The live course was developed as an evening class to accommodate our typical student who is a full-time employee in an office or clinic. He/she is already licensed in some other allied health area and is seeking this as a second license at the request of the employer. Many times this person will backup an RT to allow continuity of service when that RT has time off.

Later, the home study course was developed to provide a training opportunity to those who live in remote areas. For the home study course we partner with facilities that provide an RT, a Licensed Practitioner or Licensed Limited Operator to supervise these students. Although the content is not delivered on-line, the home study materials are very user-friendly.The Course Manual coordinates all the materials and directs the student step by step.

To be successful in our course we recommend that you have a health care background which could include but is not limited to nursing, medical assisting, medical laboratory, surgical technology, or respiratory therapy. (In fact, sometimes this course will be acceptable for CE credits for those holding other licenses.) Also, we recommend working with a local RT who will supervise your practice of procedure units. You need to be self-motivated and able to work independently.

The Limited Radiography course includes a comprehensive presentation of radiography fundamentals including procedures and techniques as well as methods of minimizing radiation exposure to patients and personnel. Procedures covered in this course include chest and thorax, extremities, and spine. 

The course begins by covering the basics of terminology in the field and encouraging the student to correctly name and operate the x-ray equipment in their own facility with the appropriate supervision. We provide him/her with certain exercises that can be done using water phantoms, again, in their own facility. These exercises can be done with film/screen or digital x-ray equipment. There are videos that demonstrate both types of imaging. We discuss how to describe the image with correct terms and how to manipulate kVp, mA, time and other factors to influence how the image appears and/or to control the dose to the patient.

Then we proceed to anatomy and the principles of patient and part positioning, starting with the exam most commonly performed by the limited operator, the chest. The next procedures are the distal extremities, hand, foot, etc. After that we discuss the proximal extremities (e.g., shoulder and knee). The last set of procedures we discuss is the spine. The unit on skulls includes a workbook and a PowerPoint materials. There is a unique method provided in the workbook for practicing skull positioning.

Next, we move into the science of producing x-rays, how they interact with human tissue, the risks associated with radiation and how to maximize the benefits and reduce the risks to patients and personnel. We place this discussion at the end of the course rather than the beginning for two reasons. First, it allows the student more time to practice procedures and evaluate images during the course. Secondly, since the science content includes more test eligible theory, it is the last thing the student has studied before taking the exam. We've found this approach encourages the student to participate in the course more effectively from the beginning and results in more students completing the entire course successfully.