Strategies for Inclusive Medical Imaging Environments for Sexual and Gender Minority Patients and Radiographers: An Integrative Literature Review

An assessment of radiation safety practices for transgender and gender non-binary patients in Irish radiology departments

INTRODUCTION

Studies indicate there may be inadequate care given to transgender and non-binary (TGNB) patients in healthcare environments, with radiology departments not being equipped to cater for this group. There is currently a deficit in research concerning the use of radiation safety measures for TGNB patients. The purpose of this research was to examine opinions of Irish Radiation Safety Experts (RSE) on current status of radiation safety protocols and techniques in place for TGNB patients and consider any changes necessary.

METHODOLOGY

Ten semi-structured interviews were conducted with RSEs from eight Irish hospitals, including five radiation protection officers (RPO) and five medical physicists. Question included: current radiation safety protocols for TGNB patients, potential issues and challenges with current practice, and recommendations of new measures. Coding was used to facilitate content analysis for interpretation of findings.

RESULTS

No reference to TGNB patients in local policies or guidelines was evident. Interviews established key radiation safety risks including inadvertent exposure of the foetus and insensitive patient care. Prominent categories identified included additional education, gender identification at patient registration and consideration of current policies and guidelines. The extent to which RSEs promoted the implementation of further measures to radiology departments varied.

CONCLUSIONS

A clear lack of guidance and instruction for radiation safety for TGNB patients is evident. Whilst there are few TGNB patients in Irish hospitals, participants believed that inclusive changes should be made concurrent with Ireland's evolving culture and in the interest of equality of patient safety.

IMPLICATIONS FOR PRACTICE

Inclusive changes should be made to radiology departments concurrent with Ireland's evolving culture. However, barriers to implementing such measures include a lack of available resources, investment, and instruction from authoritative bodies.

Diagnostic radiography students' perspectives on cultural competence and safety

INTRODUCTION

Cultural competency and safety are essential components to consider in the provision of person-centred equitable healthcare. Therefore, student radiographers' learning should include the necessary knowledge, skill sets and competence to recognise the patient's unique characteristics to enable culturally competent and safe medical imaging services. Therefore, this study explored undergraduate and postgraduate diagnostic radiography students' perspectives on cultural competency and safety.

METHODS

A qualitative phenomenological design with a hermeneutic phenomenological approach was followed to explore student perspectives. Student radiographers (second and third-year undergraduate and first and second-year postgraduate) from the study site were purposively and conveniently recruited to participate in focus group interviews. Fifteen focus group interviews were conducted, recorded and transcribed verbatim before undergoing thematic analysis.

RESULTS

Thematic analysis identified two themes. Theme one centred around the cultural competence and safety learnt by student radiographers at university and the second theme cultural competence and safety learnt in workplace learning.

CONCLUSION

This study demonstrated the importance of cultural competence and safe practice in examining patients of different cultures. It highlights the importance of creating awareness among students of their own abilities and capabilities of cultural sensitivity and safe practice as part of their learning. Future health professionals should be empowered to address and respond to patients' unique needs in a competent, safe and professional manner to reduce health disparities.

IMPLICATIONS FOR PRACTICE

Cultural competence and safety are integral to person-centred care. Including these concepts in radiography education is therefore vital to ensure optimal patient outcomes.

Experiences of embedding gender and sexuality diversity workshops in an undergraduate medical imaging curriculum

This commentary describes some of the reported challenges of health participation for the gender- and sexuality-diverse (GSD) population, particularly related to medical imaging practice. The approach and student feedback of an undergraduate education initiative to support students in the delivery of culturally competent care are described. The experiences of delivery over a three-year period are reported, including the 2020 online delivery due to COVID-19 precautions. Student feedback demonstrates positive outcomes from the workshops and activities.

Implementation of transgender and gender diverse curriculum in medical imaging programs: A review of the literature

INTRODUCTION

Sexual and gender minority patients experience significant inequities when accessing health care. Transgender and non-binary patients are at an even greater risk of experiencing health disparities due to their specialized health care needs. In the discipline of medical imaging, limited cultural competence, social stigma, and cis-heteronormative environments are barriers for these patients. There is an urgent need to improve medical imaging care for transgender and non-binary people; inclusion of sexual and gender minority content in medical imaging curriculum is one strategy to begin to address this need.

METHOD

A review of the literature was undertaken to explore implementation of sexual and gender minority content in the curricula of medical imaging programs.

RESULTS/DISCUSSION

Three main themes were identified: 1) educators' acknowledgement of the importance and value of adding sexual and gender minority content to healthcare curriculum; 2) educators' lack of a sense of preparedness, experience, and knowledge to adequately teach this content: and 3) lack of resources and institutional support to help develop curriculum.

CONCLUSION

Including content in the curriculum related to the needs of transgender and non-binary patients will help ensure entry-to-practice Medical Radiation Technologists are better prepared to provide inclusive care.