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

Diagnostic radiography clinical resources in a workplace-based learning setting

INTRODUCTION

Workplace-based learning (WBL) is a method that combines theoretical knowledge with practical experience, promoting learner autonomy. Diagnostic radiography students in South Africa face challenges due to inconsistencies in clinical resources from the public and private sectors. Insufficient clinical resources can negatively impact students' competence and confidence in their skills. This study explored diagnostic radiography students' understanding of clinical resources.

METHODS

A qualitative exploratory-descriptive and contextual study with 21 participants at a single Higher Education institution (HEI) in South Africa was conducted through one-on-one semi-structured interviews on Microsoft Teams. The data collection tool was an interview guide. Students' narratives were transcribed and analysed using thematic analysis.

RESULTS

Thematic analysis revealed four themes: Theme one: Defining clinical resources in WBL; Theme two: Experiences with clinical resources in WBL; Theme three: Accessibility of clinical resources in WBL and Theme four: Defining clinical resources in WBL.

CONCLUSION

Clinical resources are essential for radiography learning, promoting skills development and independent work. Balancing these resources with other activities is crucial for a comprehensive WBL experience. However, unequal access can hinder learning. Alternative solutions should be explored for specialised imaging techniques. Integrating simulation and collaborative practice between clinical practices and HEIs can enhance students' preparedness for real-world scenarios.

Australian radiographer roles in the emergency department; evidence of regulatory compliance to improve patient safety - A narrative review

OBJECTIVES

Using a narrative approach, this paper aims to determine the extent of Australian radiographers' regulatory compliance to improve patient safety when performing appendicular X-ray and non-contrast brain computed tomography (CT) in the Emergency Department (ED).

KEY FINDINGS

A narrative review explored relevant literature and key regulatory policy. Ten documents were identified, three main themes were developed related to the radiographer roles in X-ray request justification, dose optimisation and preliminary image evaluation (PIE). Radiographers were equally aware of justification and optimisation pre and post the introduction of a Medical Code of Practice. The collective PIE accuracy of radiographers remained unaffected by changes in mode of PIE delivery and regulatory factors but varied based on the anatomical region.

CONCLUSION

While current Australian regulations mandate radiographer request justification, dose optimisation and PIE, the degree of compliance by Australian radiographers remains uncertain. Current literature provides evidence that radiographers can improve patient care and safety through justification, optimisation, and PIE delivery. Change in workplace practice, supported by key stakeholders including radiologists, is essential to integrate radiographers' functions into routine ED clinical practice. Further research is required to audit radiographers' regulatory compliance to improve patient safety.

IMPLICATIONS FOR PRACTICE

Patient safety in ED can be improved with timely and accurate diagnosis provided by radiographers. Radiographers have a professional obligation to adhere to the capabilities and standards for safe medical radiation practice defined by Australian regulations. Therefore, radiographers must justify the X-ray request, optimise the radiation dose where appropriate and communicate urgent or unexpected findings to the referrer.

Exploring peer tutoring from the peer tutor's perspective

INTRODUCTION

Changing working practices, student numbers, workforce demands, and deficits, have created a need to consider new ways of radiography student training. One suggestion could be to implement Peer Assisted Learning (PAL) during clinical placements. PAL utilises social constructivist theories, where peer tutors teach lower or same level tutees, reinforcing and practicing material formally taught. The aim of this study was to trial an intervention of PAL, co-designed between the university and students and evaluated to identify opportunities and challenges.

METHODS

Using participatory action research 8 final year student volunteers trialled a 3-week intervention, where they delivered PAL to first years, tutoring on first year radiographic clinical practice. Focus groups were held pre and post intervention to gather qualitative data.

RESULTS

Focus group discussions were transcribed and collectively thematically analysed. Two students and the primary researcher took part in the analysis.

CONCLUSION

Students identified benefits and challenges to PAL. Issue around preparing for and being a peer tutor are also discussed. Further study involving experiences of first year students and clinical colleagues is required.

IMPLICATIONS FOR PRACTICE

Peer-tutoring has potential benefits to students to facilitate the development of skills related to image analysis and critique as well as radiographic anatomy and patient positioning.

Accuracy of radiographer preliminary clinical evaluation of skeletal trauma radiographs, in clinical practice at a district general hospital

INTRODUCTION

Error in interpretation of trauma radiographs by referrers is a problem which has detrimental effects on the patient and causes unnecessary repeat attendances. Radiographers can reduce errors by offering their opinion at the time of imaging. The Society and College of Radiographers have a longstanding recommendation that Red Dot (RD) schemes should be replaced by Preliminary Clinical Evaluation (PCE). The purpose of the study was to evaluate radiographer interpretation of skeletal trauma radiographs in clinical practice, determine if there was any difference in ability to interpret appendicular and axial studies, and evaluate appropriateness of PCE implementation.

METHODS

A convenience sample of 23 self-selecting radiographers provided RD and PCE on 762 examinations. Each case was compared against the verified report and assigned a true negative/positive or false negative/positive value. Accuracy, sensitivity and specificity were calculated and performance measures between RD versus PCE, and appendicular versus axial were compared using Two-sample Z-Tests. Error analysis was performed and inter-observer consistency determined.

RESULTS

Overall RD and PCE accuracy, sensitivity and specificity for the study were 90%, 72% and 97% (RD), and 92%, 80% and 97% (PCE) respectively. Significant difference was demonstrated for sensitivity with PCE more sensitive than RD (p-value 0.03) and appendicular more sensitive than axial (RD p-value <0.02, PCE p-value <0.0001). Most errors were false negatives. Inter-observer consistency was evaluated by review of 128 cases and no difference between reviewers was established.

CONCLUSION

Radiographers without specific training were able to provide RD and PCE to a high standard. Radiographers interpreted positive findings more accurately using PCE than RD, and positive findings on appendicular cases were interpreted more accurately than those on axial cases.

IMPLICATIONS FOR PRACTICE

This study supports local PCE implementation, contributes to the wider evidence base to justify transition towards PCE and identifies the necessity for local axial image interpretation training.

Radiography students' perceptions of Peer assisted learning

INTRODUCTION

Peer Assisted Learning (PAL) is collaborative learning in which students from the same or different academic levels learn from each other. It is meant to support the regular teaching and learning process. Learning in PAL can be explained by constructive social learning theories and has many advantages such as, students' perception of it and the ease of discussion between peers. This study aims to measure students' perception of PAL in the context of radiography education.

METHODS

A PAL programme was implemented in one module taught to second year radiography students. A questionnaire was then distributed to the participating students (n = 28) to measure their perception of PAL; the questionnaire consisted of 13 questions with a Likert scale of 5 (1 = strongly disagree to 5 = strongly agree). The results were analysed using SPSS to calculate the percentages, means, standard deviations, and factorial analysis.

RESULTS

Twenty-six students responded to the questionnaire (92.8%). The range of agreement in all questionnaire items ranged from 79.9% to 92.3%. The factor analysis revealed two main factors affecting students' acceptability. PAL enriched students' learning experience and helped them in preparation for exams.

CONCLUSION

The use of PAL is highly acceptable by students in context of radiography education.

IMPLICATIONS FOR PRACTICE

More studies are necessary to confirm the best methods of using PAL. These may involve both students and educators, and pre- and post-methods.