Interprofessional working in diagnostic radiography

Workplace factors impacting the wellbeing of diagnostic radiographers in clinical practice: A literature review

INTRODUCTION

The Coronavirus (COVID-19) pandemic resulted in an emphasis on external factors affecting the wellbeing of staff within the National Health Service. There is a national shortage of diagnostic radiographers in the United Kingdom, so maintaining the health and satisfaction of the current radiographic workforce is important. The aim of this literature review is to determine workplace-related factors affecting the wellbeing of diagnostic radiographers in their clinical practice.

METHODS

An interpretive phenomenological approach was selected to gain an insight of wellbeing from the perspective of radiographers and radiology managers. A systematic literature search was conducted, resulting in 10 core articles which were then thematically analysed.

RESULTS

Five themes were identified: Initial waves of COVID-19, Workload and Working Patterns, Mental Health, Sources of Support, and Recognition and Development.

DISCUSSION

COVID-19 has had a short and long-term impact on the working practices of radiographers, leading to a risk of burnout. Radiographers appreciated different forms of recognition from managers and support within their team but felt a lack of professional recognition outside the radiology department. Radiographers displayed resilience during the pandemic, using various strategies to cope with emotional challenges. A variety of external support was available to radiographers, but this was often self-directed, with in-person support difficult to access due to working patterns.

CONCLUSION

This review highlights the lack of tailored support addressing radiographers' unique experiences. As imaging modalities have different workloads and varying emotional involvement with patients, further research to provide evidence-based interventions to improve radiographers' mental health is advised.

Attitudes and barriers to interprofessional collaboration among radiographers: A multi-country perspective

INTRODUCTION

To promote effective interprofessional collaboration (IPC), it is crucial to understand the attitudes of healthcare workers towards IPC and identify any barriers they may face. This is particularly important in the radiography profession where IPC is vital for providing holistic care and ensuring radiation protection and safety. However, there is limited research available on the attitudes and barriers to IPC specifically among radiographers. Therefore, this study aimed to assess the attitudes and barriers to IPC among radiographers from multiple countries.

METHODS

A quantitative descriptive cross-sectional online survey was conducted using the adapted attitudes toward healthcare teams scale (ATHCT) and barriers scale towards IPC. Data analysis was performed using descriptive statistics, Wilcoxon rank-sum, Kruskal-Wallis tests, and exploratory factor analysis.

RESULTS

A total of 233 radiographers across the globe participated in this survey. The study found that the overall mean score on the ATHCT scale was 54.68 (SD = 5.75). Although not statistically significant, radiographers with over 15 years of experience tended to strongly agree with all the statements, indicating a more positive attitude towards IPC. The study also identified three subscales related to IPC: quality of care, team efficiency, and time constraint. The top three barriers to IPC reported by radiographers include i. a lack of clearly defined, shared, and measurable purpose, ii. poor communication, and iii. a lack of commitment from team members.

CONCLUSIONS

The findings highlight the need for interventions and programs that promote effective communication and establish a shared vision among healthcare team members.

King of the castle: organisational influences on authority gradients between network controllers and other team members

The rail system relies on the effective coordination of multiple disciplines and teams situated within an operational hierarchy to meet a single operational objective-the safe and timely movement of rail traffic. Power and status dispersals across these teams and the various roles within them impact interaction and communication. This study drew on the perceptions of network controllers, to identify organisational factors influencing power imbalances that generate authority gradients between network controllers and other team members. Network controllers (N = 55) across eight Australasian organisations engaged in interviews using the Scenario Invention Task Technique to explore perceptions of risk. Thematic analysis revealed relationships between teams were affected by: (1) the accountability mechanisms adopted by organisations; (2) the way power was vested in roles; and (3) the status attached to roles. This insight into organisational power hierarchies and the generation of authority gradients provides opportunities for understanding teamwork error.Practitioner summary: Communication is impaired by authority gradients across teams in rail and is a contributing factor in incidents occurring on the network. This paper explores the organisational influences on power hierarchies across teams from the perspective of the network controller, pointing to an adversarial culture, resulting in tribalism impeding team interactions.

Exploring the experiences of the team members in the interprofessional socialization process for becoming a interprofessional Collaborator

BACKGROUND

The current study aimed to explore the team members' experiences in the socialization process for becoming a collaborator in an interprofessional team.

METHOD

This qualitative study is conducted using an inductive qualitative content analysis approach. Participants consisted of 32 physicians (n = 16) and nurses (n = 16) who participated by purposeful sampling. Data were collected through in-depth semi-structured interviews and analyzed by Graneheim and Lundman approach.

RESULTS

In the study, "the perceived confrontation between interprofessional professionalism and uni-professionalism in the interprofessional socialization process" is explored as the theme, including two categories: "interprofessional professionalism commitment" as a facilitator and "uni-professional centrism" as a barrier.

CONCLUSION

A reciprocal dimension in interprofessional socialization was explored. Interprofessional professionalism adherence and team-centered accountability among team members were explored as a facilitator. The uni-professional culture and immature interprofessional collaboration competencies of team members disrupted the interprofessional socialization process.

Interprofessional practice in the Intensive Treatment Unit during the Covid-19 pandemic; the reflections of an Advanced Practitioner Radiographer

Background

The onset of the Covid-19 pandemic in March 2020 posed significant challenges to the National Health Service (NHS) in the United Kingdom (UK). Existing workforce shortages were further exacerbated with staff absence, and the need to redeploy staff into frontline clinical areas became a necessity.

Purpose

The exploration of the experiences of an Advanced Practitioner Radiographer volunteering in the Intensive Treatment Unit (ITU) during the Covid-19 pandemic.

Method

Interview using Microsoft Teams© involving one participant facilitated by two researchers using a semi-structured interview schedule.

Discussion

Redeployment to ITU has allowed individuals to work outside of their normal scope of practice. The non-hierarchical structure within teams, focussed minds and demonstrated interprofessional collaboration at its best, ensuring the best patient care was delivered to those critically affected by the virus.

Conclusion

The interprofessional practice demonstrated in ITU during the pandemic should be applied to future learning and training opportunities, to develop individuals and prepare for future pandemics.

The value of referral information and assessment - a cross sectional study of radiographers' perceptions

Background

Radiology professionals are frequently confronted with referrals containing insufficient clinical information, which hinders delivery of safe and quality medical imaging services. There is however lack of knowledge on why and how referral information is important for radiographers in clinical practice. This study explores what purposes referral information is used/ useful for the radiographers, and the benefits of involving them in assessing referrals.

Methods

A cross sectional study was conducted of radiographers recruited through the International Society of Radiographers and Radiological Technologists (ISRRT) networks. A questionnaire was developed and distributed consisting of 5-point Likert scale questions on a) use/usefulness of referral information for 12 listed purposes and b) the benefits of radiographers assessing referrals for 8 possible reasons. The questionnaire was validated using a test–retest reliability analysis. Kappa values ≥0.6 were accepted. SPSS software was used for data analysis and chi-square tests to determine associations between using referral information and background variables.

Results

Total respondents were 279 (n = 233 currently in clinical practice and n = 46 in other positions). The participants in clinical practice ranked high all 12 listed purposes for use of referral information, and all except one received ≥60% ‘frequent’/‘very frequent’ responses. Use for patient identification purposes received the highest score (97% ‘frequently’/‘very frequently’ responses), followed by ensuring imaging of the correct body region (79% ‘very frequently’ responses). Radiographers not currently working in clinical practice ranked the ‘usefulness’ of listed items similarly. Significant associations between frequent use of referral information and education level were not observed, and only three items were significantly associated with modality of practice. All items on benefits of radiographers assessing referrals received ≥75% ‘agree’/‘strongly agree’ scores. The items ranked highest were promotes radiographers’ professional responsibility and improves collaboration with radiologists and referring clinicians, with 72 and 67% strongly agreed responses, respectively.

Conclusion

Radiographers use referral information frequently for several purposes. The referral information is needed for justifying and optimising radiological procedures, hence crucial for ensuring patient safety and high-quality services. This further emphasis why radiographers perceive several benefits of being involved in assessing the referral information.

Interdisciplinary interprofessional education using an online learning environment called values exchange: A qualitative investigation

Introduction

Interprofessional education (IPE) is implemented throughout the curricula of student healthcare professions as it is understood to provide positive impact on patient outcomes in the clinical environment. There are different methods to provide IPE such as through online learning or traditional face‐to‐face methods. However, there is a lack of research surrounding the use of Online Learning Environments (OLEs) to teach IPE.

Methods

In a pilot study, seventy‐one undergraduate radiography students and twenty Master of Pharmacy students engaged in an ethical scenario using the OLE, Values Exchange (Vx). Following the activity, students were invited to complete an open‐ended response question. Fourteen students responded and these data were used for qualitative analysis.

Results

A thematic analysis of the students' open‐ended responses found the emergence of three major themes, namely; understanding the roles of other healthcare professionals, developing self‐reflection skills and, preparing for the clinical environment. Students suggested that additional time allocated for undertaking the study would benefit their engagement in the activity. Students would benefit from added engagement in the Vx task in both the short and long term for IPE.

Conclusion

Students are receptive in utilising contemporary approaches such as OLEs in furthering their IPE. Positive interpretations and suggestions by both radiography and pharmacy students in this study demonstrate how Vx as an OLE teaching tool can be used effectively. OLEs can overcome barriers that exist in face‐to‐face education experiences. OLEs should be considered for greater use within academic curricula of healthcare professions, but only if they have been evaluated for effectiveness.

Interprofessional research teams in radiography - where the magic happens

Based on publications and professional experiences, this article, intended for academic and clinical therapy/diagnostic radiographers, considers conducting research in interprofessional teams, including its values and how to go about achieving it. Whilst there is a growing number of journal papers published by interprofessional teams, almost nothing is published about how best to build interprofessional research relationships or harness the potential of the different professional experience to deliver novel research within the radiography literature. Thus, this article draws heavily on our experiences of creating, working within and leading interprofessional teams which have a specific focus on conducting radiography-related research. Suggestions are proposed about how to create an interprofessional research team and how to get the best out of it. Values of working within an interprofessional research team, to self, to research quality and to the end users of the research are considered.

Diagnostic radiographers' experiences when interacting with the custodians of paediatric patients presenting for general radiographic imaging

INTRODUCTION

Radiographic imaging of children presents several complexities, one of which includes their reliance on an adult to take care of them. Literature reports on investigations that focused on interactions of healthcare professionals with children and their parents or guardians in the healthcare setting, but little is known about radiographers' interactions with different custodians of paediatric patients. This study sought to explore and describe the experiences of radiographers with the different custodians of paediatric patients and assess how these custodians contribute to the outcomes of radiographic examinations.

METHODS

A qualitative, exploratory descriptive design was undertaken. Purposive sampling was used to select 25 radiographers from four health institutions in the Tshwane region of South Africa. Semi-structured interviews, audiotapes and field notes were used to collect data. Qualitative content analysis was used to analyse the transcribed data.

RESULTS

The following three themes emerged, namely; a) communication with different custodians, b) a radiographer's role in suspected physical abuse (SPA) and c) radiographers' responsibilities and associated radiation concerns.

CONCLUSION

Radiographers experienced different communication and interaction challenges in the imaging department with various custodians of paediatric patients. These impacted service deliveries. The paediatric patient's reaction in the imaging room might further affect the interaction between the radiographer and the custodian.

IMPLICATIONS FOR PRACTICE

There is a need for further studies that explore the concerns that radiographers have regarding their limited role in SPA. In addition, the study also adds to increasing awareness of both health professionals and the general public on radiation protection and safety.

Experiences of radiographers working alone in remote locations: A Far North Queensland non-participant observational study

INTRODUCTION

Radiographers employed in remote locations such as Far North Queensland (FNQ) can face unique sets of challenges as they often perform radiographic and sonographic diagnostic imaging without onsite radiologists' services. Additionally, the majority of patients presenting to these sites are Indigenous for whom English may be their third language. This non-participant observational study observed two FNQ radiographers' interactions with patients and interprofessional staff, and the radiographers' ability to fit into the Indigenous community during routine radiographic and sonographic examinations which to date have received little attention.

METHODS

Non-participant observations and semi-structured interviews with radiographers were held at two FNQ hospitals. Consecutive radiographer-patient interactions were observed and recorded on checklists. Interviews were audio recorded and transcribed for thematic analysis.

RESULTS

Across both remote sites, 24 patients were observed as they underwent diagnostic imaging examinations, with the majority being Aboriginal or Torres Strait Islanders (n = 17/24 (70.8%). In total, eleven general radiography and sixteen ultrasound examinations were observed. Semi-structured interviews highlighted complex issues such as the need for radiographer communication in local dialect, ongoing interprofessional collaborations, overcoming the lack of radiologists' onsite support by providing radiographic reports directly to referring doctors and midwives, and isolation with regard to professional development opportunities.

CONCLUSIONS

Radiographers working in remote hospitals need to be culturally competent, navigate local indigenous languages and possess excellent interprofessional skills as well as thorough knowledge of imaging pathology to convey findings to referring doctors and allied health professionals. These findings have implications for the entry to practice curriculum.

IMPLICATIONS FOR PRACTICE

This study provides evidence that culturally competent radiographers are capable of undertaking reporting roles to facilitate patient management in the absence of timely radiologists' reports at remote sites.

Perceptions of Iranian emergency department directors of interprofessional leadership: an interview study

The aim of this study was to explore the viewpoints of Iranian health-care team directors regarding factors that are influential in leading an interprofessional team in the emergency department. The study was conducted using in-depth individual interviews and inductive content analysis. The study took place in the emergency departments of three teaching hospitals in Tehran. We used purposeful criterion sampling and interviewed 15 health-care team directors including 12 emergency medicine specialists and 3 nursing directors. Each interview lasted 60 to 90 minutes. All interviews were recorded and transcribed verbatim. Participants' statements were used to freely generate the initial data codes (open coding). Then, the initial codes were arranged into subcategories, which were later grouped together into categories. Finally, by comparing and contrasting categories, three main categories were identified: (a) effectiveness of the team-based leadership, (b) strategies of advancing interprofessional collaboration, and (c) weakness in overcoming team challenges. In the present study, the main factors that affected developing interprofessional collaboration in the Iranian emergency department were the development and support of leadership at the team and organizational levels, and implementation of staff development strategies at the individual and team levels.

A review of visual ethnography: Radiography viewed through a different lens

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.

A review of peer-assisted learning to deliver interprofessional supplementary image interpretation skills

BACKGROUND

Peer-assisted learning provides a means through which individuals can learn from one another through a reciprocal process. Radiographic image interpretation skills are fundamental to both diagnostic radiography students and medical students due to their shared role in preliminary evaluation of conventional radiographic images. Medical students on graduation, may not be well prepared to carry out image interpretation, since evidence suggests that they perform less well than radiographers in e.g. Accident and Emergency situations.

METHOD

A review of literature was conducted exploring the application of peer-assisted learning within diagnostic radiography and health education more widely as well as the practice of initial image interpretation. An extensive and systematic search strategy was developed which provided a range of material related to the areas.

FINDINGS

An overview was obtained of the effectiveness of peer-assisted learning and the issues associated with development of image interpretation skills and a degree of discrepancy was identified between the two cohorts regarding their interpretative competence and confidence. This inconsistency may create an opportunity to apply peer-assisted learning, better preparing both disciplines for the practical application of image interpretation skills.

CONCLUSION

The review identified the lack of a substantial evidence base relating to peer-assisted learning in radiography. Peer-assisted learning is not widely embraced in an interprofessional context. Multiple positive factors of such an intervention are identified which outweigh perceived negative issues. Student teacher and learner may benefit as should the clinical service from enhanced practitioner performance. The findings justify further research to develop the evidence base.

Radiographers' perceptions of their professional rights in diagnostic radiography: a qualitative interview study

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.