A qualitative study of perceptions of professionalism amongst radiography students

Features of and barriers to effective teamwork at university and on clinical placement: The student radiographer perspective

INTRODUCTION

Radiography departments require effective teamwork in order to deliver high standards of safe and efficient patient care. The aim of this study was to explore the features of and barriers to effective teamwork as experienced by pre-registration BSc and MSc diagnostic radiography students at university and during clinical placement.

METHOD

This qualitative study used semi-structured interviews and the thematic analysis approach of Braun and Clark to investigate the views of diagnostic radiography students on BSc and MSc pre-registration programmes from one university in the Northwest of England.

RESULTS

Barriers to teamwork were identified in a main theme, acceptance into the team and two subthemes, theory-practice gap and trying on the professional self. Features of effective teams were identified in two main themes, positive experiences of teamwork and an ideal team. Students highlighted caring for the team, as equally as important as caring for the patient, and another main theme, a caring team, described both the barriers to, and features of, effective teams.

CONCLUSION

Students had a developed understanding of the features of effective teams and equated a team that cares for each other, as one able to provide the best care to patients. This study provides an insight into the impact of teamwork on radiography students experiences of university and clinical placement. Barriers to teamwork affect students' sense of belonging and overall professional development in a clinical environment.

IMPLICATIONS FOR PRACTICE

This study can better inform university and clinical staff regarding improvements to teamworking education and practice for students. It may also provide insights which may influence the teamworking practice of clinical staff.

Radiography community involvement in the professional socialisation of diagnostic radiography students

INTRODUCTION

Professional socialisation entails acquisition and internalisation of knowledge, skills, and values necessary to become members of a chosen profession. In the healthcare professions, the process is initiated during undergraduate academic and clinical learning, with clinical learning considered as more significant. This suggests that clinical radiographers play a key role in socialising students into the radiography profession. Based on communities of practice, a theory of social learning, professional socialisation of diagnostic radiography students would involve different members of the radiography community. Limited knowledge exists on the professional socialisation of diagnostic radiography students.

AIM

This study aimed to explore how diagnostic radiography students are socialised in the clinical environment with a focus on the role of communities of practice.

METHODS

Qualitative, exploratory, and descriptive research was conducted. Data was collected through unstructured interviews and focus groups. Interview recordings were verbatim transcribed, and framework analysis was used to analyse data.

FINDINGS

Data analysis resulted in the identification of a key theme, radiography community involvement, with four subthemes: shared responsibility for learning and teaching, critical reflection and lifelong learning, interpersonal skills, and empathy and consideration for students.

CONCLUSION

Effective professional socialisation of diagnostic radiography students is essential to develop radiography knowledge, skills, and values. The findings presented in this paper highlight the importance of the radiography community involvement in the professional socialisation of students because the various members of this community have valuable knowledge to share and a role to play.

IMPLICATIONS FOR PRACTICE

The findings can guide development of initiatives to support radiography community members in their role as facilitators of student professional socialisation, which in turn will enable effective professional socialisation for the students.

Alumni, radiographers, clinical placement tutors and industry insights about current radiographers practice, competences and autonomy in western Switzerland

INTRODUCTION

Radiographers' profession is constantly evolving, which demands adaptation of education and training programs to build up medical imaging and radiation therapy professionals (MIRTPs) that provide healthcare to improve patient experience and outcomes. This study aimed to map radiographers' practices, competences, and autonomy level in Western Switzerland.

METHODS

Data was collected by 2 cross-sectional online surveys targeting Alumni, radiographers, clinical placement tutors and medical imaging equipment specialists from industry, with opened and closed-end questions. Descriptive statistics and thematic analysis were used to analyse the data.

RESULTS

81 Alumni and 93 Chief-Radiographers, clinical tutors, practitioner-radiographers and industry answered the questionnaires. The competences considered as the most "acquired or completely acquired" by the Alumni were: adopt a reflective posture on practice (90.1 %; 73/81), adopt ethical behaviour (90.1 %; 73/81), carrying out and providing radiological services for diagnostic, therapeutic and preventive purposes (81.5 %; 68/81), adapting communication to the other surrounding persons (81.5 %; 66/81), and check compliance of procedures with standards (69.1 %; 56/81). Similar results were referred by Employers. The autonomy of the participant radiographers was considered as average, and it focuses only the preparation of the patient and the protocol optimisation. The development and integration of research is weak as well as the application of competences regarding professionalism.

CONCLUSIONS

A better link between educational institutions and clinical practice can help on the integration of research and evidence-based on practice, necessary to progress the radiographers' profession in Western Switzerland. The autonomy needs to be further developed and leadership courses must be integrated in the curricula to facilitate the implementation of new approaches to reinforce radiographer's profession.

IMPLICATIONS FOR PRACTICE

Practice must be revised to integrate evidence-based; to facilitate research development, the managers need to increase support.

Perception of professionalism in clinical practice among clinical year radiography students in a tertiary institution in Ghana

INTRODUCTION

Professionalism describes the positive attitudes, conduct, aims, values, skills, and behaviours that characterize a profession or a group of professionals. The steady professional growth of radiographers, which begins during undergraduate training, continues to be significantly influenced by education. As professional traits are ingrained in radiography students through official clinical instruction and observations, research on professionalism is necessary to monitor the perception of the subject matter. However, no study on Ghanaian radiography students on professionalism has been conducted. The goal of this study was to determine how clinical radiography students at a higher education facility in Ghana viewed the professionalism of radiography practice.

METHODS

Sixty-four consenting Level 300 (3rd year) and Level 400 (4th year) students in the University of Ghana School of Biomedical and Allied Health Sciences' BSc Diagnostic Radiography and BSc Therapy programmes completed the Pennsylvania State College of Medicine Professionalism Questionnaire (PSCOM-PQ) which was used to determine the impacts and challenges to professionalism. Version 23.0 of the Statistical Package for Social Science program (SPSS 23.0) was used to analyze the collected data.

RESULTS

A good sense of professionalism in clinical practice was held by the majority of clinical radiography students. More than 56% of them observed professional practice among the majority of radiographers, contrary to 40.6% of them who witnessed it among only a few radiographers. The students observed both positive and negative effects on the professionalism of radiography practice. As a result, 77.9% of the students said that it was difficult to exhibit professionalism in radiography during their clinical training.

CONCLUSION

The students agreed that professionalism impacted positively and negatively on radiography practice, and consequently identified to need to address the mitigating challenges to improve the level of professionalism. By this, most of the clinical year students had a better understanding of perceptions of the professionalism of radiography practice.

IMPLICATION FOR PRACTICE

According to the study's findings, clinical students' radiography practice is affected either positively or negatively by their conceptions of professionalism and their adherence to them during the entire training period.

Compassionate communication: Keeping patients at the heart of practice in an advancing radiographic workforce

INTRODUCTION

Compassion is a poorly understood concept in diagnostic and therapeutic radiography, but an increase in its focus was recommended in the Francis Report (2013). Much of the healthcare literature including policy and protocol has focussed on benchmarking and individualising compassion. Two separately conducted doctoral research projects, one therapeutic and one diagnostic, aimed to conceptualise compassion in order to understand its meaning and behavioural expression.

METHODS

A constructivist approach was taken with appropriate ethical approval. Patients and carers, student radiographers and radiographers took part in interviews and focus groups and tweets were harvested from a Twitter journal club discussion between radiographers of the second author's published literature review. Data were transcribed and analysed thematically.

FINDINGS

Key aspects of communication are fundamental to giving compassionate patient-centred care. These include verbal and non-verbal cues, actively listening and engaging and establishing rapport with the patient. Specific skills associated with these are also identified in these studies.

CONCLUSION

Keeping the patient as a person at the centre of radiographic practice in the rapidly evolving technical and cultural environment in which it exists requires timely and appropriate behavioural expressions of compassion from radiographers deploying a range of highly specific communication and interpersonal skills.

IMPLICATIONS FOR PRACTICE

When undertaking reflective practice, radiographers could consider key aspects of how they communicate with patients, including: verbal (in particular the language they use with patients and their tone of voice); non-verbal (especially eye contact and smiling and their body language). They could also usefully explore and develop skills in reading their patients' body language as well as their own in order to pick up subtle or hidden cues that might suggest a patient is suffering emotionally or psychologically. Finally, they could think about the sort of targeted questions they could ask of patients when welcoming them into the x-ray or treatment room that would both facilitate the procedure and leave the patient feeling that their radiographer had taken a genuine interest in them and their situation. These reflections could then be used to possibly modify their existing communications with their patients.

Unprofessional practice and student professionalism dilemmas: What can radiography learn from the other health professions?

OBJECTIVE

Professionalism in radiography is a complex, multidimensional concept seldom investigated. During clinical placements, students may observe or be involved in unprofessional practice/professionalism lapses which result in professionalism dilemmas. Establishing what constitutes a professionalism dilemma and what action to take may be challenging for students and also practitioners. This is due to unclear reporting pathways and fear of retribution, both deterrents to raising concerns. The aim of this integrative literature review was to investigate how and why professionalism dilemmas occur. In addition, to explore the types of dilemma students experience during clinical placement and to contextualise and reflect on these findings within radiography. Ovid MEDLINE, PubMed, Google Scholar and the grey literature were reviewed, analysed and themed.

KEY FINDINGS

Twenty-eight papers (published between 2004 and 2020) were analysed and summarised. Four themes emerged, and were discussed within the radiography context; the nature of professionalism lapses (mistreatment, verbal abuse, exclusion and intimidation), reasons for professionalism lapses (burnout and poor role modelling), student response at the time of the professionalism dilemma (accept, resist or report) and long-term impacts on students (moral/emotional distress, professional development and choice of career).

CONCLUSION

Professionalism dilemmas are not reported in the radiography literature but are cited in radiology and other health professions studies. Student experiences of such dilemmas can be profound and long lasting. Thus, research is required to investigate specifically the professional dilemmas experienced by radiography students in the unique environment in which they develop their clinical skills.

IMPLICATIONS FOR PRACTICE

The literature review findings can be used to support the development of strategies to enhance future teaching and modelling of professionalism and develop related research in radiography.

Patient centred care in diagnostic radiography (Part 3): Perceptions of student radiographers and radiography academics

INTRODUCTION

Awareness is growing of the importance of patient centered care (PCC) in diagnostic radiography. PCC is embedded within professional body publications and guidance documents, but there is limited research evidence exploring the perceptions of student radiographers and radiography academics.

METHODS

This paper reports Stage 1 and Stage 2 of the project from the perspective of radiography academic and student radiographer participants, and compares these to the perspectives of service users, clinical radiographers and radiography managers reported previously. Stage 1 used an online survey tool to gauge participant agreement with a series of attitudinal statements. Stage 2 used situational vignettes to promote discussion and debate about PCC approaches.

RESULTS

Response rates to the Stage 1 survey were above the minimum threshold, with 50 responses from student radiographers and 38 responses from radiography academics. Stage 1 participants were asked to participate in Stage 2 on a voluntary basis. As with service users and service deliverers, care communication, event interactions and control over environment were the key influences on PCC. However, students highlighted differences between reported and observed levels of PCC.

CONCLUSION

There is some way to go to embed PCC in diagnostic radiography practice. As impartial observers of radiography practice, student radiographers highlight the difference between service users and service deliverer's perceptions of PCC. Whilst the focus of clinical radiographers remains on efficiency, it is difficult for student radiographers to challenge the accepted norm. Role models are required to promote PCC behaviours and a holistic approach in radiography practice.

IMPLICATIONS FOR PRACTICE

A package of educational support and audit tools will be made available to support both service deliverers and student radiographers to deliver PCC.

A comparative study about motivations, expectations and future plans for professional development in four European radiography programs

INTRODUCTION

This study aims to compare motivations, expectations and work plans of students and teaching-staff from four different European radiography programs, it aims also to explore areas that could be included to advance post graduate studies.

METHODS

Two different questionnaires (open- and closed-end questions) were applied to key-informants, students who had just completed their bachelor thesis and teaching-staff, to collect data regarding motivations, expectations, challenges and potentials for radiography education and, plans for further work. Descriptive statistics and thematic analysis were performed according to the nature of the questions.

RESULTS

The response rates were 45% (students) and 68% (teaching-staff). The motivations to study radiography were similar between students: to work in a healthcare-service, helping people, manipulating high-end technologies, providing service while combining different knowledge (physics, patient-care, physiology, anatomy). 75% of the students did not reach all their expectations due to the lack of focused and updated content for some areas. The teaching-staff were expecting an extension of the radiographers' role. The development of advance studies in computed tomography and magnetic resonance was highlighted as important by students. Future work plans included: self-improvement, continuation of studies, specialization, research and collaborations.

CONCLUSIONS

This study increased the understanding of radiography education and provides insights into future perspectives. Participants have similar motivations, expectations and future plans. Improvements in education should focus on technological developments and meeting job market demands. Further studies should be performed to identify approaches that acknowledge the specific needs of each country, while also providing strategies to harmonize radiography education in Europe.