1. Page 1 Examination of nurse practitioner educational preparation to appropriately Nurse practitioner educational preparation in imaging Title of study: Examination of nurse practitioner educational preparation to appropriately order and interpret radiological imaging tests The purpose of this study is to explore educational needs for nurse practitioners in the area of radiology. You are being asked to complete an anonymous brief survey, online via SurveyMonkey. This should take approximately 5­10 minutes. There are no risks or benefits involved in this study. There is no compensation for participating in this study. Your identity will be kept confidential to the extent provided by law. Your responses will be held in confidence, and you will never be identified as a participant. No identifying information will be collected. Your IP address (a numerical identification tied to your Internet service provider) will not be known to the researchers, and will not be collected with your answers. Your participation in this study is completely voluntary. There is no penalty for not participating. You have the right to withdraw from the study at any time without consequence. If you have questions about the study, contact Roberta Logsdon post­master's DNP student, University of Florida College of Nursing (blogsdon@ufl.edu, 904­403­4904) or Dr. Robyn Gleason, Project Chair (rgleason@ufl.edu, 352­284­2123). If you have any questions or concerns about your rights as a research participant in the study, contact the IRB02 office (PO Box 112250, Gainesville, FL 32611, 352­392­0433). By proceeding and responding to the questions in this survey, I am agreeing to the following statement: I voluntarily agree to participate in this study, I have read the study information above, and I am at least 18 years of age. By clicking the provided link and proceeding in the survey I am giving my informed consent to participate in this study. Problem Statement With the increasing use of radiologic imaging procedures and the resultant rise of exposure to ionizing radiation, there is a need for providers to become aware of appropiate use of radiologic imaging based on guidelines and the appropriateness criteria scale developed by the American College of Radiology.

2. Page 2 Examination of nurse practitioner educational preparation to appropriately * 1. Program of Nurse Practitioner Education    Family    Adult or Adult­Gero Primary Care    Adult or Adult­Gero Acute Care    Geriatric    Dual Adult Primary/Acute Care    Pediatric Primary Care    Pediatric Acute Care    Dual Pediatric Primary/Acute Care    Women's Health/Nurse Midwifery    Psych/Mental Health * 2. From what University did you receive your ARNP degree? * 3. How many years have you practiced as an ARNP? Please answer in number format. * 4. In what state (or country) was the program located where you completed your NP education? * 5. What is the highest educational degree that you have completed, in any field? * 6. In what field or major is your highest degree?

3. Page 3 Examination of nurse practitioner educational preparation to appropriately 7. Which of the following best describes the setting of your current practice as an NP? Competency in ordering diagnostic imaging for common conditions seen in my specialty.   Not all Prepared    Minimally Prepared    Adequately Prepared    Well Prepared    N/A  Competency in determining when to use ultrasound, MRI, nuclear or radiographic imaging for common conditions seen in my specialty.        Understanding of the risks of radiation exposure Competency in interpreting diagnostic reports and determining follow up treatment based on results of Ultrasound, MRI, Nuclear or radiographic imaging for common conditions seen in my specialty.        Competency in determining when it is necessary to order contrast with radiographic imaging.        Competency in ordering the diagnostic test that it is appropriate for what you are trying to rule in or rule out. ( Eq. Looking for a foreign body such as glass in a foot, would radiograph be appropriate? Would a chest xray­ be appropriate for pulmonary embolus?)         Acute care clinic    Adult health/internal medicine    Emergency department    Family practice clinic    Inpatient unit    Pediatric clinic    Public health clinic    School/college clinic    Women's health clinic    I am currently not practicing Other (please specify) * 8. Rating of educational preparation for radiological imaging and interpretation upon graduation from nurse practitioner educational program:

4. Page 4 Examination of nurse practitioner educational preparation to appropriately * 9. What methods were utilized in your academic curriculum to educate you on ordering appropriate diagnostic imaging tests ? * 13. How often do you consult with a radiologist when ordering diagnostic imaging?         Integrated into other course work         A course dedicated solely to Radiological Imaging         As part of a course that covered various radiological imaging used in advanced nursing practice         Was never presented in program Other (please specify) * 10. Are you familiar with the American Radiology College Appropriateness Criteria (ACR) when ordering diagnostic imaging?    No * 11. Do you utilize the guidelines presenting by the American Radiology College Appropriateness Criteria (ACR) when ordering diagnostic imaging?    No 12. Are you aware that ACR guidelines have different recommendations when ordering radiologic imaging on children?    No    Never    Rarely    Occasionally    Usually    Always

5. Page 5 Examination of nurse practitioner educational preparation to appropriately * 14. How often do you order diagnostic imaging because of liability concerns, when it is not clinically indicated in accepted guidelines ? * 15. How confident are you in ordering radiological imaging by type:   Head and Neck Breast Pulmonary Cardiologic Vascular Gastrointestinal Genitourinary Musculoskeletal Neurologic Nuclear Molecular Pediatric Interventional Radiology   Very Confident    Confident    Somewhat confident    Not Confident    N/A  * 16. How often have you ordered an imaging test and been informed that additional or different imaging was needed?    Never    Rarely    Occasionally    Often    Never    Rarely    Occasionally    Often

6.  CT scans Page 6 Examination of nurse practitioner educational preparation to appropriately * 17. Which of the following diagnostic imaging tests do you commonly order in your practice? Plain Radiographs­ Chest ­ Xray   Area not covered    Minimally Prepared    Somewhat prepared    Generally well prepared    Very well prepared  Plain Radiographs­ Extremities        Nuclear Imaging PET scans Mammography CT scans Ultrasound MRI                Plain Radiographs­chest­xray         Plain Radiographs­ Extremities         Nuclear Imaging         PET scans         Mammography         Ultrasound         MRI Other (please specify) * 18. Upon completing your basic NP education, how prepared were you for actual NP practice in each of the following clinical areas? Other (please specify) * 19. Would it be beneficial for nurse practitioner programs to have a dedicated clinical rotation in diagnostic imaging and testing?         No Other (please specify)

7. Page 7 Thank you for taking the time to respond to this survey. Thank you! Examination of nurse practitioner educational preparation to appropriately * 20. Would you like to have continued education on radiological imaging best practices?    No