Rethink Imaging

EP 31 • November 6, 2025

Teaching Moral Courage in Radiology: Why Soft Skills Matter as Much as Technical Training

Featured Guest

Dr. Kristin Beinschroth, PhD, MPH, BSRS, R.T.(R)

Program Director, Radiologic Technology • Carrington College

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Host Chris St. John talks with Dr. Kristin Beinschroth, a radiologic technologist, educator, and researcher whose doctoral dissertation measured the relationship between moral courage, professional confidence, and academic achievement in radiologic sciences students. Her data showed that students with higher moral courage tended to earn stronger program and clinical GPAs, while students with higher professional confidence sometimes scored slightly lower, often because finishing competencies early bred complacency. The two dig into what moral courage looks like on the job: telling a surgeon no when they lack the fluoroscopy license California requires, or pulling an IV after contrast because scope of practice says it cannot stay.

The second half turns to how educators build courage before students reach the clinic. Dr. Beinschroth teaches it through modeling, scenario-based learning, and reflective discussion, and she defends the See One, Do One, Teach One method as deliberate practice under pressure rather than trial by fire for its own sake. She explains why California law requires 1,800 to 1,850 clinical hours, why students must master 38 mandatory and 15 elective competencies, and why admissions should weigh observation hours and mentorship alongside GPA. She also names the bind educators face now: heavy pressure to graduate more technologists while short-staffed hospitals can only supervise so many students.

Host

Chris St. John

Host, Rethink Imaging • Imalogix

Featured Guest

Dr. Kristin Beinschroth, PhD, MPH, BSRS, R.T.(R)

Program Director, Radiologic Technology • Carrington College

Watch the Episode

Key Takeaways

Moral courage beats confidence as a predictor of success. Students with higher moral courage held stronger program and clinical GPAs, while some higher-confidence second-years backed off after completing most of their competencies early.
Ethical dilemmas are routine, not rare. In California, technologists must refuse fluoroscopy to a physician who lacks the supervisor and operator license, and must remove a contrast IV after the exam, because it is the technologist’s license on the line.
Courage can be taught. Modeling by faculty and preceptors matters most, since students are always watching how mentors handle pressure, backed by scenario-based learning and reflective discussion.
Hours build resilience. California law requires 1,800 to 1,850 clinical hours, and students must prove competence on 38 mandatory plus 15 elective competencies, on patients of any age, size, or condition.
The pipeline squeeze is real. Demand for new technologists collides with direct supervision ratios: a hospital staffed at 50 percent can only take 50 percent of the students.

Full Transcript

[00:00:00] Kristin Beinschrot: There are two departments that are hated in health care. So, like, radiology and lab, everybody hates us. And for good reason, you have to wait on us to move forward with treatment plans and get answers on your patients, and over seventy percent of patients will get some type of imaging or laboratory exam, and our results are critical for health care providers doing the rest of their job. And so we’re always being rushed. Always, always. We can never move fast enough, and it took me, I’m not kidding, two days as a student to be like, oh, everybody hates us.

[00:00:31] Chris St John: Welcome to Frame by Frame Rethink Imaging, a podcast by Imologix. Here, we explore the intricate world of medical imaging, aiming to dissect the field and inspire both professionals and curious minds alike. I’m your host, Chris St. John. Today on Frame by Frame Rethink Imaging, I’m thrilled to be joined by doctor Kristin Beinschroft, a radiologic technologist, educator, and researcher whose recent dissertation explored the connection between moral courage, confidence, and success among radiology students. With students logging nearly double the clinical hours of their nursing counterparts, Kristin asked what really prepares technologists to step into practice, whether it’s technical skill or strength of character? Today, we’re gonna talk about what moral courage looks like in imaging, why confidence doesn’t always predict achievement, and how to better prepare the next generation of techs. Kristen, welcome to Frame by Frame.

[00:01:27] Kristin Beinschrot: Thank you so much. I’m so excited to be here.

[00:01:29] Chris St John: We’re super excited to have you today, and we’re super stoked to dig into the subject matter with you. And so just, like, brief overview, do you mind just, like, giving a little bit of an intro on yourself to our listeners and a little bit of a high level overview of your dissertation?

[00:01:46] Kristin Beinschrot: Absolutely. So I’m a radiologic technologist, and I have been for almost fifteen years now. I went into higher education in radiologic sciences program shortly after graduation, so I’ve been an educator for twelve of those years. And in being in academia, education is really important. I’m a forever student, so I recently completed my PhD, and my dissertation was really important to me. It’s it’s very foundational whenever you’re in an a doctoral program. But I wanted I knew I wanted to study radiologic sciences, and I also wanted to look at soft skills because soft skills are something that I saw my students struggling with more today than when I started. So I looked at moral courage, and I wanted to see I didn’t just wanna measure it because that’s kind of, like, tacky and silly, and anybody can do that. I wanted to see like, I wanted to measure it comparing us to our counterparts in other professions, but I also wanted to see, like, why does it matter? You know? Does it make you more successful as a student? And then future research is does it make you more successful as a technologist?

[00:02:49] Chris St John: Hell, yeah. And so just when you’re talking about the term moral courage, what exactly do you mean in the context of of imaging education?

[00:02:56] Kristin Beinschrot: Yeah. So I like, come out of my personal definition is the courage to do what is right even when it doesn’t necessarily feel right. Mhmm. So there’s there’s multiple authors that kind of describe it different ways. The the kind of foundational author that has really published a lot of moral courage research, her name is miss Newmanen. She defined it in 2017 as acting within one’s right and wrong value system despite criticism. Some other authors have defined it as acting with inner strength according to moral and ethical principles. So it’s really just kind of like it’s it’s courage. It’s having the the confidence to kind of do something that you feel uncomfortable with, but it particularly pertains to doing what’s right. And moral courage can be anywhere, but a lot of the literature really pertains to your job. So it’s doing what’s right at your job even if it’s hard or difficult or doesn’t feel right or has repercussions.

[00:03:52] Chris St John: Right. And, like, has that that socialized pressure attached to it in in some capacity. Right?

[00:03:59] Kristin Beinschrot: Very much societal and social pressure, and also just the pressures of the workplace. We’re doing more with less people and lots more expectations. And so it’s kind of standing up to say, no. I can’t do that. That’s not safe for patients or it’s not safe for me. That’s one of the big areas I see it in radiology is, you know, standing up for patients when maybe there’s something that’s ordered that isn’t correct or isn’t appropriate. That’s a pretty big barrier for us.

[00:04:26] Chris St John: Yeah. And so you found that students with higher moral courage tended to have stronger GPAs, while those with higher professional confidence sometimes showed slightly lower GPAs. What do you attribute that pattern to?

[00:04:39] Kristin Beinschrot: So I think that students who have higher moral courage step up in scenarios where maybe other counterparts don’t necessarily step up, which shows initiative. It shows drive. It shows will and determination. And when you have those things and your preceptors recognize it or your faculty recognize it, sometimes you’re given other opportunities. Like, hey. You acted extremely professional in this difficult scenario. I’d like to give you the opportunity to come to one of our faculty meetings and tell about the story or something like that. So I think that moral courage really helps you step up in scenarios, and that’s the thing that the expectation when you come to a radiology program is that the you’re always gonna say yes because we’re asking you to do things that we know are for your growth even though they’re difficult. So we want you to say yes. We want you to step right in and do it. There’s no time to dilly dally. There’s no time to double think it.

[00:05:32] Chris St John: Right.

[00:05:32] Kristin Beinschrot: The professional confidence side, I thought was really interesting. So students with higher professional confidence had slightly lowered academic GPAs, both academically and clinically, because I kind of separated them as well and evaluated them. And I think that that comes from as a second year radiologic sciences student, you have completed many of the things that you need to graduate. We call them competencies. And so you tend to just get a little bit lazy. Mhmm. You know? Like, I’ve already done everything I need to do, and so I’m just gonna kind of, like, back off a little bit. Um, and I think that that just honestly, you just lose points in your clinical grade. I think it also comes from the, I don’t need to do that anymore. I’m a second year. I don’t need to take every chest x-ray, and that’s a really negative kind of environment. So some of the other parts of it is, like, moral courage is positively correlated in the literature with moral resilience and professionalism in nursing students. So moral resilience is your ability to bounce back when you have to come into a moral or ethical dilemma. I think that’s important. I think that that gives you better academic success if you’re able to bounce back after a bad score. In EMT students, moral courage is associated with self actualization, which is the highest level on Maslow’s hierarchy of needs, risk taking, and defending the right. And so I think professional confidence kind of gets in the way leading students to think, oh, I don’t need to do that. Not my job. Not my monkeys. Not my circus type of thing.

[00:07:01] Chris St John: Right.

[00:07:01] Kristin Beinschrot: And, you know, like, you have to be willing because when you go from being a second year student, you’re kinda big man on campus, people look up to you, to being an entry level radiographer, you go back to being straight at the bottom again. So you can’t go into it with too much, but it’s definitely a delicate balance between the two.

[00:07:19] Chris St John: And so, you know, we’re you’re talking about moral courage, professional confidence, moral resilience. How were you measuring those? Or, like, how how are you quantifying those?

[00:07:29] Kristin Beinschrot: Yeah. So moral courage and Newman, actually, she made moral courage instrument. So it’s asking questions. It’s scenario type questions and then using a five point Likert scale to say your level of confidence in that area. So from no confidence to complete confidence, how would you feel in taking on this scenario? And so that’s kind of a future research area too is adapting that moral courage instrument that was created for nurses to be more reflective of radiologic sciences. A lot of the scenarios are fairly general health care scenarios, but some of them, you know, we could definitely add to that with radiology specific ones.

[00:08:06] Chris St John: Going from that, you know, like, the theoretical, like, self measuring of these two actual ethical dilemmas in a clinical setting, right, What does that moral courage to you look like in practice? Do you do you have any examples of something that stood out in your research or your teaching?

[00:08:22] Kristin Beinschrot: Yeah. So in California, where I live, we have a very limited scope of practice. It’s more limited than we would be nationally. So my national registry certification gives me the ability to work within this scope of practice, and we can do things like catheterize patients. We can inject intramuscular. In California, that’s very limited. And so one of the things that is a difficult area for ethical dilemma is venipuncture. We have to take a course and receive a certificate that says we’re competent in starting IVs in patients. But we can only start an IV in the upper extremity for the purpose of contrast, so injecting contrast for an exam, and we have to take it out afterwards. Many times, if you start an IV, you wanna keep that in because I’m not trying to poke a patient again. But the truth is that it’s our ethical responsibility and our license is on the line to remove it. So I actually used to put that in an ethical scenario paper for my students is that if a physician asked you to do something that you knew was outside of your scope, what would you do about it? And I would tell them there’s no right or wrong answer because ethics is gray. Everything’s gray in ethics. There is no right and wrong. There’s more right and less wrong, but, truly, it comes down to, do I do what’s best for the patient, or do I do what’s best for me and my license? So I think that that’s one of the areas is that we are very much our scope of practice is not well known among other professionals. They don’t necessarily know what we can and cannot do. It’s our responsibility to know that and to practice that. So there are many times where we even in California, we have to have a separate license for fluoroscopy. We’re the only state that requires it. And even under that license, the physician in the room has to have a higher level of license called a supervisor operator. So, for example, if you go to surgery and there’s a surgeon who wants to use fluoroscopy like a c arm, the portably Right. If they don’t have a license, you have to tell them no. That’s not easy to look a doctor in the face and be like, no. You can’t have what you need for this patient’s surgery. But the truth is, it’s your license on the line if they don’t have it. So we come up with, I mean, we encounter ethical issues all the time in radiology. And I know that we also experience those things in other areas, but we have plenty of opportunities to make bad choices and and to face consequences. Yeah. So it’s, you know, it’s something that I thought about. I was like, oh my gosh. Like, we’ve been practicing moral courage forever. Like, day one day one as a student, you recognize there are two departments that are hated in health care. So, like, radiology and lab, everybody hates us. And and for good reason, you have to wait on us to move forward with treatment plans and get answers on your patients. And and and, you know, over seventy percent of patients will get some type of imaging or laboratory exam, and our results are critical for health care providers doing the rest of their job. And so we’re always being rushed. Always, always. We can never move fast enough, and it took me, I’m not kidding, two days as a student to be like, oh, everybody hates us. And and so I think that we actually are uniquely positioned to practice moral courage because we’re faced with it all the time. And, you know, it’s just being courageous and saying, like, hey. Realistically, we’re already three and a half hours behind. You ordered at stat, but this patient is much more critical than that patient, and I’m making an executive decision and a triage decision to go do this person first even if you don’t like it.

[00:11:55] Chris St John: Right.

[00:11:56] Kristin Beinschrot: You know? And that happens all the time. All the time.

[00:11:59] Chris St John: Kristen, how much of moral courage do you think is innate, and how much can programs proactively teach or nurture this habit?

[00:12:07] Kristin Beinschrot: It’s funny. I think that there is an innate quality in that some people are based on adversity in their life, based on their experiences in life. They may be more likely to be a little bit more firm in their convictions or a little bit more confident in saying no to something. But I think it’s actually our responsibility as educators to teach it, and I think that the best way you teach it is through modeling and doing it yourself. So if you’re a preceptor or a clinical faculty, your students are constantly watching you to see what to do. And I always say you can learn something from everybody even if it’s what not to do, but it’s also the scenario based learning. So simulations are the forefront of health care education right now. We want students to simulate an environment before they go and practice so that they have some skills. We debrief. We prebrief. We give tons of discussion, and we can make moral courage simulations where it’s just you and a faculty member, and the faculty member is acting as a provider. And you’re a technologist, and you have to stand up to that provider and just have that that instant feedback mechanism. The difficulty is that we have so many technical aspects that have to be covered because they’re on the registry exam and because you’re gonna need it to practice that it’s hard to fit it in, but you can fit it in in simple things. You can fit it in in a homework assignment, in an ethical you know, we cover ethics. We have to cover ethics. You can fit moral courage into an ethics homework assignment. You can fit it into a discussion. You can share stories of it. You know, I always tell students, I’m like, I wanna hear all your stories, first of all, because you don’t always tell the administrators at the hospital what’s going on, and it’s important for us to know if things are going beyond your back. But, you know, it’s just behind the scenes. So, you know, I always tell students, usually, I start especially if it’s been a week since I saw them, I I start off, like, what did you face at clinical this week that, like, really threw you for a loop? And a lot of times, some of it is technical. Oh, I had this really difficult patient that had this condition. But a lot of times, it’s like, oh, well, I was working with this technologist, and then they got pulled, and then I was alone in that surgery room. And I’m not competent yet. I don’t have my competency. I I don’t feel comfortable doing that. So you know? And just kind of, like, guiding them through it. I think that one of the biggest things too is, you know, because we know we’re hated, we kind of have to know how to kill them with kindness and, like, turn that off. Like, be so likable that they can’t even stand you. That’s always been, like, my perspective is I’m gonna go and I’m gonna make stupid small talk and make corny jokes just so that when I have to ask a favor or when I have to push back and be like, hey. You’re wrong in different words. But, like, hey. You’re wrong. Even though you’re niggling better than me, you’re wrong. And I just share a lot of that in the classroom. Like, I usually start off with a truly embarrassing story, and it just cuts that weirdness and that awkwardness. Like, yes, there’s a professional boundary. Yes, I’m your professor and not your friend. However, I want you to know I’m just like you.

[00:15:19] Chris St John: Right.

[00:15:19] Kristin Beinschrot: So there’s lots of ways that we can teach it. What we do need is more evidence based, tested simulation with guided materials that we can provide, you know, through a national professional organization or through a teaching organization that helps people. Because I think, you know, this is not something that I learned in my education. It was something that I just randomly found when I was looking up some information for a different presentation. So first, it’s training us on what it is, and then it’s figuring out how do we train others on what it is and how to practice it. So still a lot of work to be done, but there’s there’s a lot to it, and I think that much of it can be taught if we have the right tools.

[00:16:01] Chris St John: It’s so funny. You get my mind reeling about this, and, like, this particular set of soft skills is such a lifelong practice that there is, like like, to some degree, everybody enrolling in the program is starting at zero with a lot of the technology and the competencies and all of that. Like, there’s, like, a relatively even playing field. But for those social barriers and practices, it is so wild to think about, like, the massive disparity in people’s ability to be honest, direct, and comfortable communicating their needs, others’ needs, whatever, especially, like, within the context of this moral courage conversation.

[00:16:45] Kristin Beinschrot: Even more so today with newer generations than past generation. Yeah. Yep.

[00:16:51] Chris St John: Absolutely. Yeah. I mean, it’s it’s crazy. Even just you know, I used to work in restaurants. Even just working in restaurants, like, the different abilities of people to handle a difficult customer. It is so wild. Like, once people are put on the spot, like, the flight, fright, freeze response takes over in such a crazy way. And so, yeah, I mean, it’s just it’s super interesting to think about it within this context.

[00:17:18] Kristin Beinschrot: Yes. And we kind of I’m just gonna transition into the next one because I kinda have a thought about it. But

[00:17:24] Chris St John: Oh, yeah. That’s that’s where yeah. It’s where I was going.

[00:17:26] Kristin Beinschrot: Yeah. We have kind of been practicing moral courage all along with not without knowing it. So it’s a very well known kind of practice that we do in radiology programs. It’s called see one, do one, teach one. And there is, basically, you you do it once and then or you watch it once, then you are expected to perform at the second time. By the third time, you should know it so well that you’re willing to teach it, and you can teach it to somebody else. And so we do that a lot. We throw you directly into the fire sometimes because we recognized over the decades that we’ve had radiology education that the more you stand outside and you don’t step in and you think about something, you are more likely to just make mistakes that are silly. And so if we just throw you in there and do it first of all, you wouldn’t do that on your own, so we force you to do it. But it breeds confidence when you do it okay. Because that’s the other thing is being a clinical faculty or a clinical preceptor, one of our responsibilities is to recognize when our students are competent and when they’re not, when they’re ready to jump into the scenario and when they’re not. And I may have two students side by side in the same scenario, and I’d throw one in. I wouldn’t throw the other one in. But that is and that’s kind of how this dissertation came to be. As I was having a conversation with my husband, we were talking about doing something difficult, and we’re like, oh, why do we have such bad anxiety about this? We’ve done way more difficult things in our lives. We’re just going to a new place. Why are we anxious? And then we said, well, how did we get here where we’re doing all of these things and speaking in front of thousands of people? Like, we’re that’s not who we are. We’re introverts. And, ultimately, it came down to being a little bit of a people pleaser and saying yes when I didn’t necessarily wanna say yes. But I was given these opportunities that required courage, and I felt in the moment that I wanted to say yes, and so I said yes, or maybe I felt like I needed to say yes. And then on the the back end of it, I survived, and I said, oh, oh, oh, oh, okay. Maybe I can do that, and it gave me confidence. Right? So doing courageous things gives you confidence. We have been doing that for a long time, c one, do and teach one. We’ve been forcing courageousness on our students, and, you know, that is that’s where it comes from. And I think that that is the the kind of the first step in how radiology programs move forward in fostering moral courage in our students.

[00:19:50] Chris St John: Yeah. And so let’s keep moving with there are so many clinical hours required to become a tech. Right? I I think it’s between 1,600 1,800. Yep. Nearly double what nursing students complete. Do you see that intensity building resilience? Or sometimes, like, is it possible that it’s, like, chipping away at their confidence a little bit?

[00:20:14] Kristin Beinschrot: Yeah. I think so, you know, in California, we actually have a law from the nineteen eighties that says students have to complete eighteen hundred eighteen hundred and fifty hours of clinical. And so there is pretty great variability, but there are some research studies that show that most programs fall anywhere between 1,600 up to 3,600, but the majority of them are about 16 to 1,800. It’s a lot of hours. A nursing program will do anywhere between 600 and maybe 1,200 depending on an associate’s versus a BSN. In the beginning, I think that it does erode the confidence because we throw you into a scenarios. But I think over time, it is what breeds resilience, and purely just the number of hours actually helps us. And as a it’s hard because as an associate’s degree, it’s supposed to be around 60 units. Just the clinical aspect when you have eighteen hundred and fifty hours, just the clinical aspect is already 30 units. I can’t possibly fit in all of the educational values and different things that we have to teach in the other 30 units. So what we end up having is about 80 to 90 unit associate’s degrees. That doesn’t look good to education. That doesn’t look good to a student. If I’m doing all those extra hours, I should get something extra, and I get it. But having been an educator for so long, I also know it’s a practice makes perfect. So we have 38 as of today, and and this changes January 1. But we have 38 mandatory competencies do we have to get, and then we have 15 elective competencies. You don’t get a competency the first time you do a chest x-ray. You get a competency when you are competent to perform a chest x-ray on any patient of any varying condition, age, size, status, whatever. And so it takes a lot of time. Practice makes perfect. In nursing, there are certain skills that have to be acquired, starting an IV, catheterizing a patient, titrating medications, and and things like that, but there are not as many competencies as we have. Mhmm. So I think that that’s one area where we’re really different. And I think that because we have so much more experiential training, we could actually come out with a lot higher moral courage than a nurse graduate because we have scenarios real life scenarios. We’re in the hospital watching these things happen for a much longer period of time. We also have hospital required skills. So, basically, like, you cannot go through a program and only rotate through an outpatient center because some of these have to be done in a hospital setting. I think that’s also really important. A hospital is really different from an outpatient center. The stakes are higher. The equipment is different. The patients’ conditions are much more grave. And I think that it does make us kind of I say, like, grown ups. Like, a first year radiology student is still very nervous. A second year radiology student is a totally different person. Like, they literally grow up.

[00:23:16] Chris St John: You were talking about the differences. Right? In what ways are you talking about? What in like, what are these differences that you’re you’re talking about?

[00:23:24] Kristin Beinschrot: Our job is very practice make perfect. It takes a long time. You have to do a ton of chest x rays before you’re really competent. And because we have 45 plus competencies, you have to be really good at 45 different things in order to get that, and you have to have those things to graduate. Whereas nursing, it is more knowledge based. Mhmm. It’s understanding pathophysiology. It’s assessments, but that’s very much a a thoughtful process rather than an active process. It’s not necessarily doing these things. It’s being able to analyze data. There she goes again. Analyzing data is something that you can grow in time and do on your own, but ours is so hands on. We don’t do a ton of assessments and analyses. We we have a very technical job. So that’s one of the ways that we are different is that we do those hours are important. As much as I would love to cut some of those hours to make my units lower and make it easier on all of us, I really don’t think we ever will because it takes that long.

[00:24:26] Chris St John: Especially now with such a shortage of text too. It’s like it’s it’s this it’s like this fascinating amalgam of, like, you have the speed of see one, do one, teach one, right, and this framework that is about, you know, moving quickly, learning fast, staying on your toes, but then within the larger context of this massive amount of time, this huge time commitment. But then, societally, we’re like, no. No. We need text. Like, let’s go. It’s crazy.

[00:24:57] Kristin Beinschrot: Yeah. We need techs so bad right now, and there’s a ton of pressure to graduate more techs, but there are limitations. We wanna make sure it’s a quality education. And if your hospital is 50% staffed, you can only take 50% of the students because we have a direct supervision ratio that we have to contend with. So we’re in a tough spot right now as educators. There’s a lot of pressure to put out new techs, but to also make them fantastic.

[00:25:25] Chris St John: Also make them And

[00:25:25] Kristin Beinschrot: you just can’t get that without time.

[00:25:27] Chris St John: Yeah. You also described effective learning, values, attitudes, beliefs as harder to teach but, you know, equally as critical. How do you approach weaving that into a curriculum that is already so technically PAX? Like, I mean, it’s like we’re talking about.

[00:25:42] Kristin Beinschrot: It’s crazy. A lot of this is kind of reflective questions. So these are kind of homework. We may not have a whole lot of time to reflect on it in class, but I do a lot of homework that is very not necessarily based on points. Right? You can’t get it right or wrong. I just wanna know your perspective. I want you to think through this process. It’s a lot of scenarios. And there is quite a bit of literature that’s focused on effective domain now because those soft skills are what clinical sites are saying. Your students are not coming with the soft skills that they used to. So we are putting more of a focus on professionalism, showing up on time, making sure your scrubs are not wrinkly, like simple things that, you know, prior generations, it was kind of a known, but it’s less known now. But you’ve you really have to figure out a way to weave it into your curriculum and to kind of revisit patient care in every single lecture. Patient care is usually one class, but the truth is that patient care is is it’s in everything. It’s communication. It’s ethics. It’s actual patient care, hands on technical. It’s also understanding, like, work related body mechanics and making sure that you’re protecting yourself. So pretty much and I actually have a colleague who says, like, patient care is in every class. I’m like, yeah. No. You’re totally right. You have to implement it everywhere. And I think that discussions safe discussions in a safe space, like, in the classroom instead of clinical, where students can be honest and open and say, like, shoot, sometimes they cry. Sometimes they get really angry. Sometime you know, like, those vulnerable environments are where we kind of open our minds and hearts to learn from each other and we and then bringing in our clinical partners. So having the hospital staff that’s complaining about the soft skills, like, having them come in and say, hey. Great. Would you wanna help us with that? Maybe we can do something productive, and maybe we can do something proactive. And and having them be a part of it, I think, is really important. It’s just tough. Soft skills and effective domain have always been the hardest. It’s also really hard to hold students accountable and not be subjective. So our assessments, we have to ensure objectivity in our assessment so that we’re not discriminating against any student or group. And at the same time, like, soft skills are subjective. Like, your definition of professionalism could be very different from my definition of professionalism. I’m a professional who has a whole lot of tattoos, and there are other professionals that thinks that yeah. Exactly. There are other professionals that think tattoos are unprofessional. Absolutely. You know what I mean?

[00:28:10] Chris St John: Yes.

[00:28:10] Kristin Beinschrot: And that’s, like, that’s a current struggle that I have in that my clinical sites require that you cover your tattoos. But to tell you the truth, I could care less. Your tattoos don’t make me who you are. You know? And it’s 2025. Who cares about tattoos? So, yeah, it’s policies having policies in place that foster professionalism and and teach students. We cannot expect them to come in. Just because they’re adults does not mean that they’re fully developed. Most of our students are about twenty to twenty two when they enter the program. Mhmm. And as we know, the frontal lobe is not fully developed until 24 to 26. Yeah. See? Males are 25 to 26. Females are 24 to 25 biologically. So, you know, I think a lot of it too is we have we think by having really strict admissions criteria, we’re gonna get the best of the best, and these are gonna be little grown ups coming into the classroom. And the truth is that they’re not, and I can’t expect them to be. Yeah. This is one of the things I will often kind of butt heads with fellow program directors on is, well, they just need to learn it. I was like, no. We actually have to teach them. Like, we have to take responsibility for that. So it’s it’s changing the expectations, and then it’s also reexamining our emissions criteria. And it’s trying to just, first of all, just being open to it. Just saying, like, hey. We could do better, which is also difficult to say, but we can do better, and then being open to figuring out how.

[00:29:30] Chris St John: Yeah. You were talking about admissions criteria. And if admissions criteria continue to focus almost exclusively on GPA and test scores, what qualities do you think we are overlooking that could predict successful students?

[00:29:45] Kristin Beinschrot: We’re overlooking well roundedness when we’re overlooking critical thinking. So the way education is based is that we have to have these objective assessments that don’t necessarily tell us about subjective domains like soft skills. So the admissions criteria, there is there’s a few studies that tried to say, like, what of all of these different admissions criteria, which one of them is most likely to show student success? And the way we gauge student success is the first time pass rate of the registry exam after they graduate. And, basically and it’s actually some of my colleagues that did one of those studies. They found that nothing is a good predictor outside of maybe to a small degree prerequisite science courses. So having worked at I I started a community college, then I worked at a private university, and now I’m kind of in a proprietary area. So I feel like I have a good experiential workload in this area. And what I have found is that many community colleges, because we are and especially public institutions, we are required to be objective at a higher level than a private institution. So a lot of those programs do lottery systems, where once you meet the minimum criteria, you are placed into a lottery system, and we just choose at random. I think that has gotta stop because we’re setting students up for failure that may not necessarily be prepared. We’ve tried admissions, like placement testing, like general education, math, science knowledge, English knowledge. Those have not been good predictors of student success. Interviews are too subjective, and our accreditors are not big fans of interviews for that reason. So I do think that we have to find other ways. I think one of the ways that’s most helpful is having students do required observation hours and to require them to have a mentor before the program. So either requiring that they interview a working tech or that they do observation hours as a volunteer in a hospital based program. So many students don’t have any idea what they’re getting into. Yeah. I love TikTok. I’m gonna say that. I love TikTok. It’s very fun for silly cat videos. One of the negatives that has come out of it is that very wonderful TikTok influencers that I very much like have paid transparency and salary transparency, and they say, look how much money I made with a two year degree. And so now we have this rapid, I mean, thousands of increases in interest. So we have all these people applying to these programs, and the truth is the radiology is not for everybody. We deal with feces. We deal with vomit. We deal with blood. We deal with guts. We are in the room when a trauma comes in. People are not prepared for that. So immersion learning and having a mentor that can evaluate you, I think, is the future of how we improve our admissions admissions criteria.

[00:32:44] Chris St John: Yeah. And and how how do those mentors or role models, clinical instructors, faculty, peers influence whether or not students are finding their voices as they’re moving through these programs?

[00:32:58] Kristin Beinschrot: Great question. I think that modeling it, practice what you preach type of thing, modeling it, sharing your failures, sharing your failures. Tell people when you fail because people look up to you and they think, oh, they would never do that. No. I’ve done it all. Let me tell you. I have been fired from a job. I have failed a class at community college, and lo and behold, it happened to be one of the ones that transferred, of course. You know, it wasn’t one of non transfer class. It was the transfer class. But, you know, like, mentors first of all, it is our responsibility. I’ve always taken mentorship as part of my job. That is part of my job to not just when I was an educator, but just even as an advocate. I’m very active with legislation and advocacy in our profession, and that came from having fantastic mentors in the program that I went to. So taking responsibility to be a mentor is how we prepare people better because collectively, then we teach as a community, not just from teachers in the classroom. You know, everybody taking a little bit of responsibility, personal responsibility for outcomes, you know, that definitely helps, and then ownership of we’re the expert.

[00:34:10] Chris St John: Mhmm.

[00:34:10] Kristin Beinschrot: So walking into that surgery room, and if they try to push you around and say, no. Don’t do it that way. Don’t do it this way. Like, standing up and saying, respectfully, I’m the expert in this one domain. You’re the expert in a lot of other domains, but I’m the expert in this one, and I need you to trust me on this. And that’s, again, just practicing moral courage and saying, you know because the truth is, like, radiation you don’t learn about radiation. You don’t learn about it in high school. You don’t learn about it in medical school. In PA school, they get one lecture, usually. In medical school, they usually get a couple classes. But the truth is that radiology is still very much an unknown. We’re doing better. We have a national campaign called the Be Seen campaign through our national organization, the American Society of Radiologic Technologists, and we’re getting we’re getting bigger and better. But the truth is that people don’t necessarily know what we do, what we can’t do, what we should do, and we don’t necessarily take ownership of it. Some people, not me, but some people, and maybe not my friends, but some people are. I’m just saying, some people get into radiology for the money. And let me tell you, the money’s good, but it’s not that good. And we deal with really hard stuff. I watched a coworker die. I’ve watched I’ve held people when they died. I’ve watched babies die. I’ve x rayed dead babies. I’ve done things that would break people. Right? And you do learn to compartmentalize it and do it because it’s your job, but you need to know that going in. And so sharing the transparent TikTokers, I love you, share the bad.

[00:35:42] Chris St John: Yeah. Share

[00:35:42] Kristin Beinschrot: the bad also. Share the good. Share the bad. And then mentor others and help them understand. At the end of the day, I still love my job. Fifteen years later, I truly can sell my job like a ketchup popsicle to a woman in white gloves on a hot summer day. However, I recognize that there are things I don’t miss about outside.

[00:36:00] Chris St John: Yeah.

[00:36:01] Kristin Beinschrot: There are things that I’m happy to be in the classroom instead of in a hospital. But and also just interprofessional education, getting nursing students and surgical tech students and radiology students together before they go work together so they can learn from each other and we can share these experiences. I think that’s part of the future is interprofessional education, having some evidence based tools to be able to use to foster moral courage and being open to the fact that we’re not perfect and we still gotta do better.

[00:36:34] Chris St John: Yeah. And so this may be, like, a a silly little outgoing question. But if you could make any proactive change to tech education, just you know, you could just snap your fingers, what would you change?

[00:36:50] Kristin Beinschrot: Ugh. ARRT. You’re not gonna like this, but remove circuitry. Like, there are so like, we learn about electricity and circuits, and the truth is I’m never gonna pop open a generator and go do that thing. Right? Like, I can understand to some degree, but there’s a lot of technical aspects that we just do not use, and we teach them because they’re on the exam. I love you, ARRT. I’m meeting with you tomorrow. I love you. But please take away all these technical aspects because there is not a whole lot of room for the things that are most important to a clinical site, which is soft skills when we have to teach so many nitty gritty details that are not part of the job. It’s part of the knowledge. It’s part of the overall field. It’s not part of the job. So I love you, ARRT. I’m sorry.

[00:37:39] Chris St John: Well, with that with that lovely dismissal of ARRT, thank you so much to doctor Kristin Beintraub. Kristin, thank you so much for joining us today on Frame by Frame. It’s been delightful having you today.

[00:37:53] Kristin Beinschrot: Likewise. I’ve had a great time, and thank you so much for having me. What a great experience.

[00:37:58] Chris St John: Absolutely. I’ll talk to you

[00:38:00] Kristin Beinschrot: soon. Sounds good.

[00:38:03] Chris St John: Frame by Frame Rethink Imaging is brought to you by Imalogix. Here, you’ll find engaging interviews with thought leaders, experts, and patients sharing stories that showcase the transformative power of medical imaging. To discover how Imologix is rethinking imaging in health care, visit imologix.com. Be sure to subscribe to Frame by Frame Rethink Imaging on Apple podcasts, Spotify, or wherever you listen. And from all of us here at Emalogics, thanks for tuning in.

Questions from This Episode

Why does moral courage predict academic success better than confidence?
In Dr. Beinschroth’s study, students with higher moral courage stepped up in scenarios where peers held back, which showed initiative, drive, and determination that faculty and preceptors rewarded with more opportunity. Students with higher professional confidence sometimes had slightly lower academic and clinical GPAs, often because finishing most competencies early in the second year led them to coast.
What do ethical dilemmas look like in day-to-day radiology practice?
They show up as scope of practice boundaries. In California, a technologist can only start an IV in the upper extremity for contrast and must remove it afterward, and a surgeon who wants to use a C-arm without the required fluoroscopy license has to be told no. Either way, it is the technologist’s license at stake.
How can educators teach moral courage before students enter the clinical environment?
By modeling it, since students constantly watch how faculty and preceptors handle pressure, then reinforcing it with scenario-based learning and reflective discussion. The See One, Do One, Teach One progression pushes students to act early and often, which builds both competence and the resilience to speak up.