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Diaby LF, Debess J, Teli M. Clinical decisions-making within diagnostic radiography - A scoping review. Radiography (Lond) 2024; 30:1136-1143. [PMID: 38820676 DOI: 10.1016/j.radi.2024.05.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2024] [Revised: 05/13/2024] [Accepted: 05/16/2024] [Indexed: 06/02/2024]
Abstract
OBJECTIVES To describe and synthesise literature on clinical decision-making within diagnostic radiography, to uncover the important elements, and to identify knowledge gaps for further investigation. The scoping review question was: How do diagnostic radiographers make clinical decisions? KEY FINDINGS Radiographers make clinical decisions before, during and after examinations. The primary source of information radiographers use is the clinical request, however, if they doubt something, they rely on their colleague's points of view rather than evidence-based practice. Many elements must be considered in the clinical decision-making process; however, lack of autonomy, sparse information on the clinical requests, and lack of time affect the process, which can lead to a barrier to effective decision-making. CONCLUSION Clinical decisions are made based on many different elements before, during, and after examinations in combination with different types of knowledge, as well as technical and organisational aspects within radiography clinical practice. IMPLICATION FOR PRACTICE There is a need to focus on giving more attention to developing the decision-making elements. In addition, there must be more focus on improving intra-professional work between radiographers and radiologists to facilitate radiographers' opportunities to act on their clinical decisions.
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Affiliation(s)
- L F Diaby
- Radiography Education, University College of Northern Denmark, Denmark; Department of Sustainability and Planning, Aalborg University, Denmark.
| | - J Debess
- Radiography Education, University College of Northern Denmark, Denmark.
| | - M Teli
- Department of Sustainability and Planning, Aalborg University, Denmark.
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Makanjee CR, Zhang J, Bergh AM. Roles and Responsibilities in the Transition to Working Independently: A Qualitative Study of Recently Graduated Radiographers' Perspectives in Australia. J Multidiscip Healthc 2023; 16:2471-2483. [PMID: 37664802 PMCID: PMC10473244 DOI: 10.2147/jmdh.s416510] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Accepted: 07/11/2023] [Indexed: 09/05/2023] Open
Abstract
Background Medical imaging features along the entire healthcare continuum and is known for its fast-paced technological evolution which enables it to keep up with the demands of the healthcare system to provide safe, quality services. The overall efficacy and efficiency of the system depends on practitioners' clinical competence, achieved through professional education and continuous professional development. Recent studies have revealed concerns regarding newly graduated healthcare professionals' preparedness and readiness to handle actual practice. Methods We conducted qualitative face-to-face and telephonic interviews with a convenient and purposive sample of 23 participants consisting of recently graduated radiographers (n=14), radiography students (n=5) and supervising radiographers (n=4) in Australia. Verbatim transcriptions were analyzed inductively to identify themes pertaining to perspectives and experiences of the work readiness of novice radiographers. Results The findings of our study suggest that the workplace immersion and transitioning of recently graduated radiographers into their professional roles requires a process of experiential learning and honing of knowledge and skills if they are to function efficiently and independently in a team-oriented workplace. Radiographic services are spread across various levels of care and are an integral part of the organizational structure of a healthcare system. Maladaptive transitions to the workplace may be the result of low self-confidence, a lack of support, uncertainty in inter-collegial interactions, or unrealistic performance expectations. The overarching themes of communication and interaction emerged clearly as recently graduated radiographers navigated the four roles of coordinator, collaborator, mediator, and advocate. Conclusion The application of radiographic skills is embedded in a workplace culture of communication and safety. Transitioning to independent practice takes place in a complex, multifaceted environment and is accompanied by internal and external expectations. Because each workplace has a unique context, system and culture, no novice radiographic professional can ever be fully prepared through pre-service training and workplace induction.
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Affiliation(s)
- Chandra R Makanjee
- Department of Medical Radiation Sciences (MI), University of Canberra, Bruce, Australian Capital Territory, Australia
| | - Julie Zhang
- Division of Diagnostic Radiology, Princess Alexandra Hospital, Brisbane, Queensland, Australia
| | - Anne-Marie Bergh
- Research Centre for Maternal, Fetal, Newborn and Child Health Care Strategies, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
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O'Regan T, Robinson L, Newton-Hughes A, Strudwick R. A review of visual ethnography: Radiography viewed through a different lens. Radiography (Lond) 2019; 25 Suppl 1:S9-S13. [PMID: 31481188 DOI: 10.1016/j.radi.2019.06.007] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2019] [Revised: 06/25/2019] [Accepted: 06/27/2019] [Indexed: 11/29/2022]
Abstract
INTRODUCTION The objective of this article is to provide a short review of the research methodology 'visual ethnography'. METHOD The review article will provide a summary of the foundations of visual ethnography, outline the key debates and refer to some of the main authors working in this field. RESULTS Visual Ethnography is both a methodology and a method of research. It should be selected for research in radiography when research questions seek to focus upon aspects or elements of a culture. A research plan that is designed using a visual ethnographic approach should be flexible and take into account the requirements of the researcher and research participants. Visual methods of research include the use of various images, for example, photographs, collage, film or drawings. Visual methods are commonly employed together with interviews, conversations and observation. The approach enables researchers to generate new and unique insights into cultures. CONCLUSION This review of visual ethnography provides background information that informs an introduction to the methodology. It demonstrates a methodology with the potential to explore culture and expand knowledge of radiography practice. IMPLICATIONS FOR PRACTICE The authors suggest that for future studies visual ethnography is a methodology that can expand the paradigm of radiography research.
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Affiliation(s)
- T O'Regan
- The Society and College of Radiographers, 207 Providence Square, Mill Street, London, SE1 2EW, UK.
| | - L Robinson
- University of Salford, Allerton Building, Salford, M5 4WT, UK.
| | - A Newton-Hughes
- University of Salford, Allerton Building, Salford, M5 4WT, UK.
| | - R Strudwick
- University of Suffolk, Waterfront Building, Neptune Quay, Ipswich, IP4 1QJ, UK.
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Rawashdeh M, McEntee MF, Zaitoun M, Abdelrahman M, Brennan P, Alewaidat H, Lewis S, Saade C. Knowledge and practice of computed tomography exposure parameters amongst radiographers in Jordan. Comput Biol Med 2018; 102:132-137. [PMID: 30278337 DOI: 10.1016/j.compbiomed.2018.09.020] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2018] [Revised: 09/20/2018] [Accepted: 09/24/2018] [Indexed: 02/03/2023]
Abstract
OBJECTIVE To investigate the knowledge and practice of computed tomography (CT) radiographers working in Jordan. MATERIALS AND METHODS This Institutional Review Board (IRB) approved study disseminated a questionnaire via social media and recruited 54 Jordanian CT radiographers. The questionnaire comprised 36 questions divided into four sections: demographics; an evaluation of knowledge regarding CT exposure; modifications to CT exposure for paediatric patients; dose units and diagnostic reference levels (DRLs). Descriptive and inferential statistics including Chi-square tests, Mann-Whitney U tests, independent samples t-tests and Kruskal-Wallis H tests were employed. Statistical significance was considered below p < 0.05. RESULTS The 54 participants had various qualifications, with the majority holding a Bachelor's degree (n = 35, 64.8%) and the rest holding a Diploma (n = 19, 35.2%). In order to pass the questionnaire, participants needed to score 13 correct answers. The overall number of radiographers who correctly passed the questionnaire was 48 (88.9%). None of the participants correctly stated all the DRL values for chest, abdomen and brain CT. However, four out of 54 respondents (7.4%) knew the chest DRL value, three (5.6%) participants correctly estimated the abdominal DRL value but only two (3.7%) knew the DRL for the brain. CONCLUSION Good general knowledge was found amongst radiographers regarding the relationship of each exposure parameter to the image quality and patient dose. However, there was poor knowledge of diagnostic reference levels and the order of the organ radiation sensitivity. The need for CT radiographers to undertake further education that focuses on radiation exposure in CT is highlighted.
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Affiliation(s)
- Mohammad Rawashdeh
- Faculty of Applied Medical Sciences, Jordan University of Science and Technology, Irbid, 22110, Jordan.
| | - Mark F McEntee
- Medical Image Optimisation and Perception Group (MIOPeG), Brain and Mind Centre, Faculty of Health Sciences, The University of Sydney, Sydney, New South Wales, Australia
| | - Maha Zaitoun
- Faculty of Applied Medical Sciences, Jordan University of Science and Technology, Irbid, 22110, Jordan
| | - Mostafa Abdelrahman
- Faculty of Applied Medical Sciences, Jordan University of Science and Technology, Irbid, 22110, Jordan
| | - Patrick Brennan
- Medical Image Optimisation and Perception Group (MIOPeG), Brain and Mind Centre, Faculty of Health Sciences, The University of Sydney, Sydney, New South Wales, Australia
| | - Haytham Alewaidat
- Faculty of Applied Medical Sciences, Jordan University of Science and Technology, Irbid, 22110, Jordan
| | - Sarah Lewis
- Medical Image Optimisation and Perception Group (MIOPeG), Brain and Mind Centre, Faculty of Health Sciences, The University of Sydney, Sydney, New South Wales, Australia
| | - Charbel Saade
- Department of Diagnostic Radiology, American University of Beirut Medical Center, Beirut, Lebanon
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Makanjee CR, Bergh A, Hoffmann WA. Distributed decision making in action: diagnostic imaging investigations within the bigger picture. J Med Radiat Sci 2018; 65:5-12. [PMID: 29130645 PMCID: PMC5846027 DOI: 10.1002/jmrs.250] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2017] [Accepted: 09/20/2017] [Indexed: 01/21/2023] Open
Abstract
INTRODUCTION Decision making in the health care system - specifically with regard to diagnostic imaging investigations - occurs at multiple levels. Professional role players from various backgrounds are involved in making these decisions, from the point of referral to the outcomes of the imaging investigation. The aim of this study was to map the decision-making processes and pathways involved when patients are referred for diagnostic imaging investigations and to explore distributed decision-making events at the points of contact with patients within a health care system. METHOD A two-phased qualitative study was conducted in an academic public health complex with the district hospital as entry point. The first phase included case studies of 24 conveniently selected patients, and the second phase involved 12 focus group interviews with health care providers. Data analysis was based on Rapley's interpretation of decision making as being distributed across time, situations and actions, and including different role players and technologies. RESULTS Clinical decisions incorporating imaging investigations are distributed across the three vital points of contact or decision-making events, namely the initial patient consultation, the diagnostic imaging investigation and the post-investigation consultation. Each of these decision-making events is made up of a sequence of discrete decision-making moments based on the transfer of retrospective, current and prospective information and its transformation into knowledge. CONCLUSION This paper contributes to the understanding of the microstructural processes (the 'when' and 'where') involved in the distribution of decisions related to imaging investigations. It also highlights the interdependency in decision-making events of medical and non-medical providers within a single medical encounter.
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Affiliation(s)
| | - Anne‐Marie Bergh
- South African Medical Research Council Unit for Maternal and Infant Health Care StrategiesUniversity of PretoriaPretoriaSouth Africa
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Hayre C, Blackman S, Eyden A. Do general radiographic examinations resemble a person-centred environment? Radiography (Lond) 2016. [DOI: 10.1016/j.radi.2016.07.001] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Matilainen K, Ahonen SM, Kankkunen P, Kangasniemi M. Radiographers' perceptions of their professional rights in diagnostic radiography: a qualitative interview study. Scand J Caring Sci 2016; 31:139-145. [PMID: 27164407 DOI: 10.1111/scs.12335] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2015] [Accepted: 01/04/2016] [Indexed: 11/30/2022]
Abstract
BACKGROUND Considering the ethics of each profession is important as inter-professional collaboration increases. Professional ethics creates a basis for radiographers' work, as it includes values and principles, together with rights and duties that guide and support professionals. However, little is known about radiographers' rights when it comes to professional ethics. THE AIM The aim of this study was to describe radiographers' perceptions and experiences of their professional rights. The ultimate aim was to increase the understanding of professional ethics in this context and support radiographers' ethical pondering in diagnostic radiography. METHODOLOGY A qualitative method was used. Semistructured group interviews with 15 radiographers were conducted in spring 2013 at two publicly provided diagnostic imaging departments in Finland. Data were analysed by inductive content analysis. All the participants were women, and they had worked as radiographers for an average of 18 years. FINDINGS Based on our analysis, radiographers' professional rights consisted of rights related to their expertise in radiography and the rights related to working conditions that ensured their wellbeing. Expertise-based rights included rights to plan, conduct and assess radiological care with patient advocacy. Radiographers have the right to contribute to a culture of safe radiation in their organisation and to use their professional knowledge to achieve their main target, which is the safe imaging of patients. Radiographers also have right to work in conditions that support their well-being, including the legal rights stated in their employment contract, as well as their rights concerning resources at work. CONCLUSIONS Radiographers' professional rights are an elementary and multidimensional part of their clinical practice. In future, more theoretical and empirical research is needed to deepen the understanding of their rights in the clinical practice and support radiographers on issues related to this aspect of their work.
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Affiliation(s)
- Kati Matilainen
- Department of Nursing Science, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland
| | - Sanna-Mari Ahonen
- Faculty of Medicine, Institute of Health Sciences, University of Oulu, Oulu, Finland
| | - Päivi Kankkunen
- Department of Nursing Science, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland
| | - Mari Kangasniemi
- Department of Nursing Science, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland
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Williams R, Morton D. Knowledge of practising radiographers of the supraspinatus outlet projection for shoulder impingement syndrome in the Eastern Cape, South Africa. Radiography (Lond) 2016. [DOI: 10.1016/j.radi.2015.10.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Hayre C. ‘Cranking up’, ‘whacking up’ and ‘bumping up’: X-ray exposures in contemporary radiographic practice. Radiography (Lond) 2016. [DOI: 10.1016/j.radi.2016.01.002] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Hayre CM. WITHDRAWN: Are Diagnostic Radiographers Image Acquisition Experts Within the General Radiographic Environment? J Med Imaging Radiat Sci 2016. [DOI: 10.1016/j.jmir.2016.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Breast compression – An exploration of problem solving and decision-making in mammography. Radiography (Lond) 2015. [DOI: 10.1016/j.radi.2014.11.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Griffiths M. Creating the Hybrid Workforce: Challenges and Opportunities. J Med Imaging Radiat Sci 2015; 46:262-270. [PMID: 31052132 DOI: 10.1016/j.jmir.2015.06.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Marc Griffiths
- Faculty of Health and Applied Sciences, University of the West of England, Bristol, UK.
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Makanjee CR, Bergh AM, Hoffmann WA. Healthcare provider and patient perspectives on diagnostic imaging investigations. Afr J Prim Health Care Fam Med 2015; 7:801. [PMID: 26245604 PMCID: PMC4666288 DOI: 10.4102/phcfm.v7i1.801] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2014] [Revised: 04/05/2015] [Accepted: 02/13/2015] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Much has been written about the patient-centred approach in doctor-patient consultations. Little is known about interactions and communication processes regarding healthcare providers' and patients' perspectives on expectations and experiences of diagnostic imaging investigations within the medical encounter. Patients journey through the health system from the point of referral to the imaging investigation itself and then to the post-imaging consultation. AIM AND SETTING: To explore healthcare provider and patient perspectives on interaction and communication processes during diagnostic imaging investigations as part of their clinical journey through a healthcare complex. METHODS A qualitative study was conducted, with two phases of data collection. Twenty-four patients were conveniently selected at a public district hospital complex and were followed throughout their journey in the hospital system, from admission to discharge. The second phase entailed focus group interviews conducted with providers in the district hospital and adjacent academic hospital (medical officers and family physicians, nurses, radiographers, radiology consultants and registrars). RESULTS Two main themes guided our analysis: (1) provider perspectives; and (2) patient dispositions and reactions. Golden threads that cut across these themes are interactions and communication processes in the context of expectations, experiences of the imaging investigations and the outcomes thereof. CONCLUSION Insights from this study provide a better understanding of the complexity of the processes and interactions between providers and patients during the imaging investigations conducted as part of their clinical pathway. The interactions and communication processes are provider-patient centred when a referral for a diagnostic imaging investigation is included.
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Affiliation(s)
- Chandra R Makanjee
- Faculty of Health Sciences, Department of Radiography, University of Pretoria.
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Winter PD, Linehan MJ. Bernstein's theory of pedagogic discourse as a theoretical framework for educators studying student radiographers' interpretation of normality vs. abnormality. Radiography (Lond) 2014. [DOI: 10.1016/j.radi.2013.09.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Professionals' experiences of imaging in the radiography process – A phenomenological approach. Radiography (Lond) 2014. [DOI: 10.1016/j.radi.2013.10.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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