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Oliveira C, Barbosa B, Couto JG, Bravo I, Hughes C, McFadden S, Khine R, McNair HA. Advanced practice in radiotherapy across Europe: stakeholders' perceptions of implementation and evolution. Radiography (Lond) 2024; 30:896-907. [PMID: 38608565 DOI: 10.1016/j.radi.2024.03.013] [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: 11/03/2023] [Revised: 03/09/2024] [Accepted: 03/25/2024] [Indexed: 04/14/2024]
Abstract
INTRODUCTION Adapting radiotherapy services with workforce innovation using skills-mix or task-shifting optimises resources, supporting current and future demands. Advanced practitioners (APs) work at a different level of practice (beyond initial registration) across four pillars: clinical practice, leadership and management, education, and research. There is limited cross-country research on the advanced therapeutic radiographers/radiation therapists (TR/RTTs), particularly in Europe. This study aimed to investigate European radiotherapy stakeholders' perceptions regarding current and future advanced practice (AP). METHODS From June to September 2022, one-to-one online semi-structured interviews were conducted in English, and audio and video were recorded. Full verbatim audio files were independently transcribed and checked by interviewer and interviewees. Braun and Clarke's seven steps guided the thematic analysis (using NVivo). RESULTS Thirty-three interviewees working or studying in 16 European countries represented practitioners (n=14), managers (n=6), educators (n=4), professional bodies (n=4), students (n=3), and regulators (n=2). Four overarching themes emerged: "AP drivers and outcomes", "AP challenges vs enablers", "Current vs future AP", "Becoming and being advanced practitioner". Participants identified research as the neglected AP pillar due to a lack of protected time, limited staff skills, no research culture, no funding, workload, and clinical priorities. Interviewees highlighted the importance of consistency in job titles, harmonisation of education models and curricula, definition of AP requirements, and support for all AP pillars through job plans and workforce planning. CONCLUSION Neither the profession nor education of TR/RTTs are harmonised across Europe, which is highly reflected in advanced-level practice. Advanced TR/RTTs should work across all pillars, including research, and these should be embedded in master's programmes, including leadership. IMPLICATIONS FOR PRACTICE This study highlights a policy gap in the education and practice of APs in radiotherapy.
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Affiliation(s)
- C Oliveira
- Radiotherapy Department, Instituto Português de Oncologia do Porto (IPO Porto), Portugal; Escola Internacional de Doutoramento, Universidad de Vigo, Spain.
| | - B Barbosa
- Radiotherapy Department, Instituto Português de Oncologia do Porto (IPO Porto), Portugal; Escola Internacional de Doutoramento, Universidad de Vigo, Spain; Medical Physics, Radiobiology Group and Radiation Protection Group, IPO Porto Research Centre (CI-IPOP), Instituto Português de Oncologia do Porto (IPO Porto), Portugal.
| | - J G Couto
- Radiography Department, Faculty of Health Sciences, University of Malta, Malta.
| | - I Bravo
- Medical Physics, Radiobiology Group and Radiation Protection Group, IPO Porto Research Centre (CI-IPOP), Instituto Português de Oncologia do Porto (IPO Porto), Portugal.
| | - C Hughes
- School of Health Sciences, Ulster University, United Kingdom.
| | - S McFadden
- School of Health Sciences, Ulster University, United Kingdom.
| | - R Khine
- European Federation of Radiographer Societies, Utrecht, Netherlands; Institute of Health Sciences Education, Faculty of Medicine & Dentistry, Queen Mary, University of London, United Kingdom.
| | - H A McNair
- European Federation of Radiographer Societies, Utrecht, Netherlands; The Royal Marsden NHS Foundation Trust, Radiotherapy and the Institute of Cancer Research, Surrey, United Kingdom.
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Bailey DS, Harding D. Professional identity and role perception of Radiographers and Clinical Technologists in Nuclear Medicine - An exploratory qualitative study. Radiography (Lond) 2024; 30:73-79. [PMID: 37871368 DOI: 10.1016/j.radi.2023.10.002] [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: 06/22/2023] [Revised: 09/13/2023] [Accepted: 10/02/2023] [Indexed: 10/25/2023]
Abstract
INTRODUCTION An awareness of Professional Identity (PI), an individual's identity in relation to their professional group, and Role Perception (RP), an individual's view of their specific role, may enable safe and effective practice by providing an understanding of professional boundaries, behaviours and activities. This research aimed to explore and gain an understanding of the PI and RP of Radiographers and Clinical Technologists working as Nuclear Medicine Technologists (NMT's). METHODS 10 NMT's were recruited from a large National Health Service (NHS) Trust. Utilising the established methodology of Qualitative Description, data was obtained using semi-structured interviews and analysed using inductive thematic analysis. RESULTS Four themes were identified: "Becoming the Unexpected" which detailed various training pathways; "Caring with Science" which described the NMT's role and defined their PI; "Same View, Different Lens" which portrayed how Radiographers and Clinical Technologists practise as team of NMT's; and "Confirmation of Professional Self" which presented how individuals view their professional status. CONCLUSION The study showed that the NMT role is highly specialised, multi-faceted and patient-centred. Their professional status is based on the nature of their role and their university level education and training. They work together under the umbrella title of NMT with a dual professional identity of "provider of care" and "user of science and technology". However, they may have an individual identity of Radiographer or Clinical Technologist that is determined by their training pathway. IMPLICATIONS FOR PRACTICE This research has provided valuable understanding of the PI and RP of NMT's. By highlighting the differences in the regulatory status of this workforce, an insight into the future implications in the context of national healthcare planning has been provided, highlighting potentially significant issues that may impact on the manner in which NMT's can practice.
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Affiliation(s)
- D S Bailey
- Workforce, Education & Professional Development Lead, Department of Nuclear Medicine, Guy's and St Thomas' NHS Foundation Trust, Great Maze Pond, London SE1 9RT, UK.
| | - D Harding
- Centre for Allied Health, St George's University of London, Cranmer Terrace, London SW17 0RE, UK.
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Leslie K, Bourgeault IL, Carlton AL, Balasubramanian M, Mirshahi R, Short SD, Carè J, Cometto G, Lin V. Design, delivery and effectiveness of health practitioner regulation systems: an integrative review. HUMAN RESOURCES FOR HEALTH 2023; 21:72. [PMID: 37667368 PMCID: PMC10478314 DOI: 10.1186/s12960-023-00848-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Accepted: 07/23/2023] [Indexed: 09/06/2023]
Abstract
BACKGROUND Health practitioner regulation (HPR) systems are increasingly recognized as playing an important role in supporting health workforce availability, accessibility, quality, and sustainability, while promoting patient safety. This review aimed to identify evidence on the design, delivery and effectiveness of HPR to inform policy decisions. METHODS We conducted an integrative analysis of literature published between 2010 and 2021. Fourteen databases were systematically searched, with data extracted and synthesized based on a modified Donabedian framework. FINDINGS This large-scale review synthesized evidence from a range of academic (n = 410) and grey literature (n = 426) relevant to HPR. We identified key themes and findings for a series of HPR topics organized according to our structures-processes-outcomes conceptual framework. Governance reforms in HPR are shifting towards multi-profession regulators, enhanced accountability, and risk-based approaches; however, comparisons between HPR models were complicated by a lack of a standardized HPR typology. HPR can support government workforce strategies, despite persisting challenges in cross-border recognition of qualifications and portability of registration. Scope of practice reform adapted to modern health systems can improve access and quality. Alternatives to statutory registration for lower-risk health occupations can improve services and protect the public, while standardized evaluation frameworks can aid regulatory strengthening. Knowledge gaps remain around the outcomes and effectiveness of HPR processes, including continuing professional development models, national licensing examinations, accreditation of health practitioner education programs, mandatory reporting obligations, remediation programs, and statutory registration of traditional and complementary medicine practitioners. CONCLUSION We identified key themes, issues, and evidence gaps valuable for governments, regulators, and health system leaders. We also identified evidence base limitations that warrant caution when interpreting and generalizing the results across jurisdictions and professions. Themes and findings reflect interests and concerns in high-income Anglophone countries where most literature originated. Most studies were descriptive, resulting in a low certainty of evidence. To inform regulatory design and reform, research funders and governments should prioritize evidence on regulatory outcomes, including innovative approaches we identified in our review. Additionally, a systematic approach is needed to track and evaluate the impact of regulatory interventions and innovations on achieving health workforce and health systems goals.
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Affiliation(s)
- Kathleen Leslie
- Athabasca University, Athabasca, Canada.
- Canadian Health Workforce Network, Ottawa, Canada.
| | - Ivy Lynn Bourgeault
- University of Ottawa, Ottawa, Canada
- Canadian Health Workforce Network, Ottawa, Canada
| | - Anne-Louise Carlton
- Royal Melbourne Institute of Technology (RMIT) University, Melbourne, Australia
| | - Madhan Balasubramanian
- College of Business, Government and Law, Flinders University, Adelaide, Australia
- Menzies Centre for Health Policy and Economics, The University of Sydney, Sydney, Australia
| | - Raha Mirshahi
- University of Ottawa, Ottawa, Canada
- Canadian Health Workforce Network, Ottawa, Canada
| | | | - Jenny Carè
- University of Technology Sydney, Sydney, Australia
| | | | - Vivian Lin
- University of Hong Kong, Hong Kong, China
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Flood T, O Neill A, Oliveira CM, Barbosa B, Soares AL, Muscat K, Guille S, McClure P, Hughes C, McFadden S. Patients' perspectives of the skills and competencies of therapy radiographers/radiation therapists (TRs/RTTs) in the UK, Portugal and Malta; a qualitative study from the SAFE Europe project. Radiography (Lond) 2023; 29 Suppl 1:S117-S127. [PMID: 36959043 DOI: 10.1016/j.radi.2023.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Revised: 02/08/2023] [Accepted: 03/02/2023] [Indexed: 03/25/2023]
Abstract
INTRODUCTION The role of the Therapy Radiographer/Radiation Therapist (TR/RTT) is to provide radiotherapy to patients with a cancer diagnosis. This includes, not only administration of treatment, but also management of side-effects and provision of support/care. Despite this role being consistent throughout Europe, there is currently no standardisation of education for TRs/RTTs. The SAFE EUROPE project aims to standardize TR/RTT education to enable 'safe and free exchange' of TRs/RTTs across Europe. Consequently, this study aims to explore patients' perspectives regarding the current skills and competencies of TRs/RTTs. METHODS From May 2021 to February 2022, semi-structured interviews were conducted with patients who had recently received radiotherapy in the UK, Malta and Portugal. Ethical approval for this study was granted by the NHS Research Ethics Committee with additional local approvals obtained. RESULTS Forty-eight participants from the UK (n = 18), Portugal (n = 19), and Malta (n = 11) completed interviews. Participants described high satisfaction with TRs'/RTTs' competence and skills in all three countries. The main theme arising from the analysis was the importance of trust building with TRs/RTTs. Six factors were identified as influencing levels of trust: communication; side-effect management; team consistency; relational skills; patient dignity; and competence. A small number of patients reported feeling rushed and not having their physical and emotional needs met by TRs/RTTs. CONCLUSION This multicentre study demonstrated that patients perceive TRs/RTTs in the UK, Malta and Portugal as highly competent and skilled. Practical recommendations are provided to address identified deficits in practice, which can be addressed through adaptation of TR/RTT education/training and clinical practice. IMPLICATIONS FOR PRACTICE Recommendations arising from this study are important to ensure that TRs/RTTs have transferable skills that provide consistently high quality care to patients throughout Europe.
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Affiliation(s)
- T Flood
- Lecturer in Radiotherapy and Oncology, Ulster University Northern Ireland, UK.
| | - A O Neill
- Ulster University, Northern Ireland, UK.
| | - C M Oliveira
- Radiotherapy Department, Instituto Português de Oncologia Do Porto (IPO Porto), R. Dr. António Bernardino de Almeida 865, 4200-072 Porto, Portugal.
| | - B Barbosa
- Radiotherapy Department, Instituto Português de Oncologia Do Porto (IPO Porto), R. Dr. António Bernardino de Almeida 865, 4200-072 Porto, Portugal.
| | - A L Soares
- Medical Physics Service,Portuguese Oncology Institute of Porto, Porto, Portugal.
| | - K Muscat
- University of Malta, MSD 2080, Malta.
| | - S Guille
- Ulster University, Northern Ireland, UK.
| | - P McClure
- Ulster University, Northern Ireland, UK.
| | - C Hughes
- School of Nursing and School of Health Sciences, Ulster University, Northern Ireland, UK.
| | - S McFadden
- Senior Lecturer, Ulster University, Northern Ireland, UK.
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Oliveira C, Barbosa B, Couto JG, Bravo I, Hughes C, McFadden S, Khine R, McNair HA. Advanced practice roles amongst therapeutic radiographers/radiation therapists: A European survey. Radiography (Lond) 2023; 29:261-273. [PMID: 36608396 DOI: 10.1016/j.radi.2022.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Revised: 11/24/2022] [Accepted: 12/04/2022] [Indexed: 01/06/2023]
Abstract
INTRODUCTION Advanced Practice (AP) roles in Radiotherapy (RT) over time are variable, often locally developed and not underpinned by professional standards which leads to conceptual and practical gaps. This study aimed to assess AP roles amongst Therapeutic Radiographers/Radiation Therapists (TR/RTTs) and identify educational gaps for this level across Europe. METHODS An anonymous online survey was designed, validated, and distributed across Europe. Convenience sampling was used to recruit advanced TR/RTTs practitioners or TR/RTTs working in AP roles. Descriptive analysis from closed questions and thematic analyses from open questions are reported. RESULTS A total of 272 responses were obtained, of which 189 eligible participations were from 21 European countries. 42% of respondents acknowledged additional education required to perform AP, and 25% reported a minimum of five years of RT practice to perform AP roles/tasks. There is a trend to work more on the clinical practice domain with a low percentage of working time allocated to research. Inconsistency was found in job titles, scopes of practice, and educational backgrounds across and even within countries. Education needs regarding knowledge about image-guided and adaptive RT, multimodal imaging and technologies, and advanced treatment planning were found. Training needs on leadership and management skills and clinical site-specific expertise were identified. CONCLUSION This study clearly shows a gap in education support, a need for standardisation in job titles and scopes of practice across Europe. IMPLICATIONS FOR PRACTICE As the first large-scale assessment of current AP roles and educational support amongst TR/RTTs across Europe, this study recommends the establishment of governance structure and role regulation. It also informs the curricula for master programmes to align the education with current and future practice.
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Affiliation(s)
- C Oliveira
- Radiotherapy Department, Instituto Português de Oncologia do Porto (IPO Porto), R. Dr. António Bernardino de Almeida 865, 4200-072 Porto, Portugal; Escola Internacional de Doutoramento, Universidad de Vigo, Circunvalación ao Campus Universitario, 36310 Vigo, Pontevedra, Spain.
| | - B Barbosa
- Radiotherapy Department, Instituto Português de Oncologia do Porto (IPO Porto), R. Dr. António Bernardino de Almeida 865, 4200-072 Porto, Portugal; Escola Internacional de Doutoramento, Universidad de Vigo, Circunvalación ao Campus Universitario, 36310 Vigo, Pontevedra, Spain; Medical Physics, Radiobiology Group and Radiation Protection Group, IPO Porto Research Centre (CI-IPOP), Instituto Português de Oncologia do Porto (IPO Porto), R. Dr. António Bernardino de Almeida 865, 4200-072 Porto, Portugal.
| | - J G Couto
- Radiography Department, Faculty of Health Sciences, University of Malta, Msida, MSD2080, Malta.
| | - I Bravo
- Medical Physics, Radiobiology Group and Radiation Protection Group, IPO Porto Research Centre (CI-IPOP), Instituto Português de Oncologia do Porto (IPO Porto), R. Dr. António Bernardino de Almeida 865, 4200-072 Porto, Portugal.
| | - C Hughes
- School of Health Sciences, Ulster University, Shore Road Newtownabbey Co, Antrim, BT37 0QB, United Kingdom.
| | - S McFadden
- School of Health Sciences, Ulster University, Shore Road Newtownabbey Co, Antrim, BT37 0QB, United Kingdom.
| | - R Khine
- European Federation of Radiographer Societies, Utrecht, Netherlands; School of Health Care and Social Work, Buckinghamshire New University, Buckinghamshire, United Kingdom.
| | - H A McNair
- European Federation of Radiographer Societies, Utrecht, Netherlands; The Royal Marsden NHS Foundation Trust, Radiotherapy and the Institute of Cancer Research, Surrey, SM2 5PT, United Kingdom.
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Bockhold S, McNulty J, Abdurakman E, Bezzina P, Drey N, England A, Flinton D, Khine R, McEntee M, Mekiš N, Precht H, Rainford L, Sá Dos Reis C, Santos A, Syrgiamiotis V, Willis S, Woodley J, Beardmore C, Harris R, O'Regan T, Malamateniou C. Research ethics systems, processes, and awareness across Europe: Radiography research ethics standards for Europe (RRESFE). Radiography (Lond) 2022; 28:1032-1041. [PMID: 35964488 DOI: 10.1016/j.radi.2022.07.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Revised: 06/29/2022] [Accepted: 07/02/2022] [Indexed: 10/31/2022]
Abstract
INTRODUCTION The Radiography Research Ethics Standards for Europe (RRESFE) project aims to provide a cross-sectional snapshot of current research ethics systems, processes, and awareness of such, across Europe together with identifying the associated challenges, education, and training needs. METHODS A cross-sectional online survey targeting radiography researchers in Europe was conducted. Data collection took place between April 26 and July 12, 2021, using a snowball sampling approach. Descriptive and analytical statistics were used to identify trends in research ethics frameworks across Europe. RESULTS 285 responses were received across 33 European and 23 non-European countries. Most (n = 221; 95%) European respondents stated ethics approval is required before commencing research in their country. Requirements around research ethics approval and awareness of such requirements varied by European region (X2 (2, n = 129) = 7.234, p = 0.013) and were found to differ depending on the type of research participant and study design. Additionally, European respondents reported ethics approval is a national requirement more often than their non-European counterparts (X2 (1, n = 282) = 4.316, p = 0.049). Requirements for ethics approval were also associated with the undergraduate programme duration (2-year vs. 3-year vs. 3.5 year vs. 4-year vs. multiple programme durations; X2 (4, n = 231) = 10.075, p = 0.016) and availability of postgraduate training (postgraduate training available vs. postgraduate training not available; X2 (1, n = 231) = 15.448, p = <0.001) within respondents' country. CONCLUSION Respondents from countries with longer programme durations/availability of multiple programme lengths, availability of postgraduate training, and establishment of European Qualifications Framework Level 6 were generally associated with less uncertainty and more comprehensive research ethics requirements. IMPLICATIONS FOR PRACTICE Results are informative of the current status of research ethics within evidence-based radiography.
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Affiliation(s)
- S Bockhold
- Radiography and Diagnostic Imaging, School of Medicine, University College Dublin, Ireland.
| | - J McNulty
- Radiography and Diagnostic Imaging, School of Medicine, University College Dublin, Ireland.
| | - E Abdurakman
- Division of Midwifery and Radiography, School of Health Sciences, City University of London, United Kingdom
| | - P Bezzina
- Radiography, Faculty of Health Sciences, L-Università ta' Malta, Malta
| | - N Drey
- Division of Nursing, School of Health Sciences, City University of London, United Kingdom
| | - A England
- Discipline of Medical Imaging and Radiation Therapy, School of Medicine, University College Cork, Ireland
| | - D Flinton
- Division of Midwifery and Radiography, School of Health Sciences, City University of London, United Kingdom
| | - R Khine
- School of Health Care and Social Work, Buckinghamshire New University, United Kingdom
| | - M McEntee
- Discipline of Medical Imaging and Radiation Therapy, School of Medicine, University College Cork, Ireland
| | - N Mekiš
- Medical Imaging and Radiotherapy, Faculty of Health Sciences, University of Ljubljana, Slovenia
| | - H Precht
- Diagnostic and Treatment and Radiography Education, Health Sciences Research Centre, UCL University College, Denmark
| | - L Rainford
- Radiography and Diagnostic Imaging, School of Medicine, University College Dublin, Ireland
| | - C Sá Dos Reis
- Radiological Medical Imaging Technology, School of Health Sciences, University of Applied Sciences and Arts Western Switzerland, Lausanne, Switzerland
| | - A Santos
- Medical Imaging and Radiotherapy, ESTESC-Coimbra Health School, Instituto Politécnico de Coimbra, Portugal
| | - V Syrgiamiotis
- CT-MRI Department, General Children's Hospital of Athens Agia Sophia, and University of West Attica, Greece
| | - S Willis
- Health Education England, National Health Service, London, United Kingdom
| | - J Woodley
- School of Health and Social Wellbeing, Faculty of Health and Applied Sciences, University of the West of England, Bristol, United Kingdom
| | - C Beardmore
- Society and College of Radiographers, London, United Kingdom
| | - R Harris
- Society and College of Radiographers, London, United Kingdom
| | - T O'Regan
- Society and College of Radiographers, London, United Kingdom
| | - C Malamateniou
- Division of Midwifery and Radiography, School of Health Sciences, City University of London, United Kingdom.
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Bockhold S, McNulty J, Abdurakman E, Bezzina P, Drey N, England A, Flinton D, Khine R, McEntee M, Mekiš N, Precht H, Rainford L, Sá Dos Reis C, Santos A, Syrgiamiotis V, Willis S, Woodley J, Beardmore C, Harris R, O'Regan T, Malamateniou C. Research ethics training, challenges, and suggested improvements across Europe: Radiography research ethics standards for Europe (RRESFE). Radiography (Lond) 2022; 28:1016-1024. [PMID: 35939960 DOI: 10.1016/j.radi.2022.07.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 06/14/2022] [Accepted: 07/07/2022] [Indexed: 10/31/2022]
Abstract
INTRODUCTION The Radiography Research Ethics Standards for Europe (RRESFE) project aimed to provide a cross-sectional view of the current state of radiography research ethics across Europe. This included investigating education and training in research ethics, and identifying the key challenges and potential improvements associated with using existing research ethics frameworks. METHODS This cross-sectional online survey targeting radiography researchers in Europe was conducted between April 26 and July 12, 2021. Descriptive and analytical statistics were used to identify research ethics education and training trends. Content analysis of qualitative responses was employed to identify significant challenges and proposed improvements in research ethics frameworks of practice. RESULTS There were 232 responses received across 33 European countries. Most (n = 132; 57%) respondents had received some research ethics training; however, fewer participants had received training on safeguarding vulnerable patients (n = 72; 38%), diversity and inclusivity (n = 62; 33%), or research with healthy volunteers (n = 60; 32%). Training was associated with a greater perceived importance of the need for research ethics review (p = 0.031) and with the establishment of EQF Level 6 training (p = 0.038). The proportion of formally trained researchers also varied by region (p = <0.001). Time-to-ethics-approval was noted as the biggest challenge for professionals making research ethics applications. CONCLUSION Early and universal integration of research-oriented teaching within the radiography education framework which emphasises research ethics is recommended. Additionally, study findings suggest research ethics committee application and approval processes could be further simplified and streamlined. IMPLICATIONS FOR PRACTICE The survey contributes to a growing body of knowledge surrounding the importance of education and training in research ethics for assuring a high standard of research outputs in Radiography and has identified hurdles to obtaining research ethics approval for further investigation and address.
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Affiliation(s)
- S Bockhold
- Radiography and Diagnostic Imaging, School of Medicine, University College Dublin, Ireland.
| | - J McNulty
- Radiography and Diagnostic Imaging, School of Medicine, University College Dublin, Ireland
| | - E Abdurakman
- Division of Midwifery and Radiography, School of Health Sciences, City University of London, United Kingdom
| | - P Bezzina
- Radiography, Faculty of Health Sciences, L-Università ta' Malta, Malta
| | - N Drey
- Division of Nursing, School of Health Sciences, City University of London, United Kingdom
| | - A England
- Discipline of Medical Imaging and Radiation Therapy, School of Medicine, University College Cork, Ireland
| | - D Flinton
- Division of Midwifery and Radiography, School of Health Sciences, City University of London, United Kingdom
| | - R Khine
- School of Health Care and Social Work, Buckinghamshire New University, United Kingdom
| | - M McEntee
- Discipline of Medical Imaging and Radiation Therapy, School of Medicine, University College Cork, Ireland
| | - N Mekiš
- Medical Imaging and Radiotherapy, Faculty of Health Sciences, University of Ljubljana, Slovenia
| | - H Precht
- Diagnostic and Treatment and Radiography Education, Health Sciences Research Centre, University College Lillebælt, Vejle, Denmark
| | - L Rainford
- Radiography and Diagnostic Imaging, School of Medicine, University College Dublin, Ireland
| | - C Sá Dos Reis
- Radiological Medical Imaging Technology, School of Health Sciences, University of Applied Sciences and Arts Western Switzerland, Lausanne, Switzerland
| | - A Santos
- Medical Imaging and Radiotherapy, ESTESC-Coimbra Health School, Instituto Politécnico de Coimbra, Portugal
| | - V Syrgiamiotis
- CT-MRI Department, General Children's Hospital of Athens Agia Sophia, and University of West Attica, Greece
| | - S Willis
- Health Education England, National Health Service, London, United Kingdom
| | - J Woodley
- School of Health and Social Wellbeing, Faculty of Health and Applied Sciences, University of the West of England, Bristol, United Kingdom
| | - C Beardmore
- Society and College of Radiographers, London, United Kingdom
| | - R Harris
- Society and College of Radiographers, London, United Kingdom
| | - T O'Regan
- Society and College of Radiographers, London, United Kingdom
| | - C Malamateniou
- Division of Midwifery and Radiography, School of Health Sciences, City University of London, United Kingdom
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Chevalier S, Colombat P, Lejeune J, Guglielmin B, Bouquet M, Aubouin-Bonnaventure J, Coillot H, Fouquereau E. Recognition of radiographers in the workplace: Why it matters. Radiography (Lond) 2022; 28:648-653. [DOI: 10.1016/j.radi.2022.05.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Revised: 04/25/2022] [Accepted: 05/02/2022] [Indexed: 11/16/2022]
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Barbosa B, Bravo I, Oliveira C, Antunes L, Couto JG, McFadden S, Hughes C, McClure P, Dias AG. Digital skills of therapeutic radiographers/radiation therapists - Document analysis for a European educational curriculum. Radiography (Lond) 2022; 28:955-963. [PMID: 35842952 DOI: 10.1016/j.radi.2022.06.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Revised: 06/14/2022] [Accepted: 06/23/2022] [Indexed: 11/25/2022]
Abstract
INTRODUCTION It is estimated that around 50% of cancer patients require Radiotherapy (RT) at some point during their treatment, hence Therapeutic Radiographers/Radiation Therapists (TR/RTTs) have a key role to play in patient management. It is essential for TR/RTTs to keep abreast with new technologies and continuously develop the digital skills necessary for safe RT practice. The RT profession and education is not regulated at European Union level, which leads to heterogeneity in the skills developed and practised among countries. This study aimed to explore the white and grey literature to collate data on the relevant digital skills required for TR/RTTs practice. METHODS An exhaustive systematic search was conducted to identify literature discussing digital skills of TR/RTTs; relevant grey literature was also identified. A thematic analysis was performed to identify and organise these skills into themes and sub-themes. RESULTS 195 digital skills were identified, organised in 35 sub-themes and grouped into six main themes: (i) Transversal Digital Skills, (ii) RT Planning Image, (iii) RT Treatment Planning, (iv) RT Treatment Administration, (v) Quality, Safety and Risk Management, and (vi) Management, Education and Research. CONCLUSION This list can be used as a reference to close current gaps in knowledge or skills of TR/RTTs while anticipating future needs regarding the rapid development of new technologies (such as Artificial Intelligence or Big Data). IMPLICATIONS FOR PRACTICE It is imperative to align education with current and future RT practice to ensure that all RT patients receive the best care. Filling the gaps in TR/RTTs skill sets will improve current practice and provide TR/RTTs with the support needed to develop more advanced skills.
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Affiliation(s)
- B Barbosa
- Radiotherapy Department, Instituto Português de Oncologia do Porto (IPO Porto), R. Dr. António Bernardino de Almeida 865, 4200-072 Porto, Portugal; Escola Internacional de Doutoramento, Universidad de Vigo, Circunvalación ao Campus Universitario, 36310 Vigo, Pontevedra, Spain; Medical Physics, Radiobiology and Radiation Protection Group, IPO Porto Research Center (CI-IPOP), Porto Comprehensive Cancer Center (Porto.CCC) & Rise@CI-IPOP (Health Research Network), R. Dr. António Bernardino de Almeida 865, 4200-072 Porto, Portugal.
| | - I Bravo
- Medical Physics, Radiobiology and Radiation Protection Group, IPO Porto Research Center (CI-IPOP), Porto Comprehensive Cancer Center (Porto.CCC) & Rise@CI-IPOP (Health Research Network), R. Dr. António Bernardino de Almeida 865, 4200-072 Porto, Portugal.
| | - C Oliveira
- Radiotherapy Department, Instituto Português de Oncologia do Porto (IPO Porto), R. Dr. António Bernardino de Almeida 865, 4200-072 Porto, Portugal; Escola Internacional de Doutoramento, Universidad de Vigo, Circunvalación ao Campus Universitario, 36310 Vigo, Pontevedra, Spain.
| | - L Antunes
- School of Health, Polytechnic Institute of Porto, Rua Dr. António Bernardino de Almeida 400, 4200-072 Porto, Portugal.
| | - J G Couto
- Radiography Department, Faculty of Health Sciences, University of Malta, Msida MSD2080, Malta.
| | - S McFadden
- Institute of Nursing and Health Research, School of Health Sciences, Ulster University, Jordanstown, United Kingdom.
| | - C Hughes
- Institute of Nursing and Health Research, School of Health Sciences, Ulster University, Jordanstown, United Kingdom.
| | - P McClure
- Institute of Nursing and Health Research, School of Health Sciences, Ulster University, Jordanstown, United Kingdom.
| | - A G Dias
- Medical Physics, Radiobiology and Radiation Protection Group, IPO Porto Research Center (CI-IPOP), Porto Comprehensive Cancer Center (Porto.CCC) & Rise@CI-IPOP (Health Research Network), R. Dr. António Bernardino de Almeida 865, 4200-072 Porto, Portugal; Medical Physics Department, Instituto Português de Oncologia do Porto (IPO Porto), R. Dr. António Bernardino de Almeida 865, 4200-072 Porto, Portugal.
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10
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Sousa F, Somoano M, Jourani Y, Van Gestel D. Qualitative evaluation of the role of RTTs IGRT specialists and their influence on treatment delivery. Tech Innov Patient Support Radiat Oncol 2022; 22:9-15. [PMID: 35425870 PMCID: PMC9003568 DOI: 10.1016/j.tipsro.2022.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Revised: 03/02/2022] [Accepted: 03/15/2022] [Indexed: 11/24/2022] Open
Abstract
Radiation Therapists specialised in image-guided radiation therapy (RTT spIGRT) experience their role positiveltly. The RTT spIGRT role is perceived to have a positive influence on radiotherapy treatment delivery. A legal framework to provide formal RTT training and continuous education in order to increase radiotherapy treatment quality is of utmost importance.
Purpose The study aims to investigate qualitatively how Radiation Therapist IGRT specialists (RTT spIGRTs) experience their role and whether they have an impact on the treatment delivery. Methods Eleven RTTs, i.e. six RTT spIGRTs and five RTTs not specialised in IGRT (RTTs noIGRT) were interviewed during October and November 2020. RTTs noIGRT having knowledge of the daily practice before and after the creation of this RTT spIGRT role, served as control group capable of weighing its impact on the work environment. A qualitative method using face-to-face semi-structured questionnaires was used. Interviews lasted approximately 10–20 min, and were after coded and analysed for thematic content. Results Five themes and twelve sub-themes were drawn from the analysis. RTT spIGRTs experience their role positively, despite the limited role perception and different work experiences. The implemented role increased autonomy and facilitated decision-making and Radiotherapy (RT) treatment delivery. Interviewees considered the new role useful to very useful. The raised concerns are related to a bigger role involvement and improvement, with focus on visibility, regular meetings and training. Interviewees considered the RTT spIGRT role to have an influence on the treatment delivery when properly carried out. Conclusion RTT spIGRTs experience their role positively. Their knowledge confidence seems to rely on the training received. The RTT spIGRT role is perceived to have a positive influence on the treatment delivery. Continuous follow up and training were amongst the suggested solutions to improve the RTT spIGRT’s role. This study stresses the urgent need for a legal framework to provide formal RTT training and continuous education in order to increase RT treatment quality.
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Affiliation(s)
- Filipa Sousa
- Radiation Oncology Department, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
- Inholland University of Applied Sciences, School of Health, Haarlem, The Netherlands
- Corresponding author.
| | - Monica Somoano
- Radiation Oncology Department, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
| | - Younes Jourani
- Medical Physics Department, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
| | - Dirk Van Gestel
- Radiation Oncology Department, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
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11
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Törnroos S, Pasanen M, Leino-Kilpi H, Metsälä E. Identification of research priorities of radiography science: A modified Delphi study in Europe. Nurs Health Sci 2022; 24:423-436. [PMID: 35289482 PMCID: PMC9314951 DOI: 10.1111/nhs.12938] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Revised: 03/02/2022] [Accepted: 03/02/2022] [Indexed: 01/01/2023]
Abstract
Radiography science is a new discipline among health sciences. It is a discipline that investigates phenomena in medical imaging, radiation therapy, and nuclear medicine. It has merged from the need to provide research evidence to support these services. The domain of the discipline needs clarification and more research should be focused on its paradigmatic issues. Radiography research priorities have been previously charted on a national level in different countries but the viewpoint has been that of the needs of the profession, not of the discipline. This study aimed to identify the priorities of the discipline. The method chosen was a modified version of the Delphi technique with two rounds. The expert panel consisted of 24 European radiography researchers with long professional experience. This study shows that the research priorities in radiography science are related to the phenomena of radiographers' profession, clinical practices, and the safe and high-quality use of radiation and technology for medical imaging, radiotherapy, and nuclear medicine. Identifying these priorities can help focus research onto most important topics and clarify disciplinary perspective.
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Affiliation(s)
- Sanna Törnroos
- Department of Nursing Science, University of Turku and Metropolia University of Applied Sciences, Turku, Finland
| | - Miko Pasanen
- Department of Nursing Science, University of Turku, Turku, Finland
| | - Helena Leino-Kilpi
- Department of Nursing Science, University of Turku and Turku University Hospital, Turku, Finland
| | - Eija Metsälä
- Department of Nursing Science, University of Turku and Metropolia University of Applied Sciences, Turku, Finland
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12
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Sousa F, Vaandering A, Couto JG, Somoano M, Van Gestel D. Barriers in education and professional development of Belgian medical imaging technologists and nurses working in radiotherapy: A qualitative study. Radiography (Lond) 2022; 28:620-627. [PMID: 35567804 DOI: 10.1016/j.radi.2022.04.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Revised: 03/15/2022] [Accepted: 04/13/2022] [Indexed: 11/27/2022]
Abstract
INTRODUCTION Radiotherapy (RT) professionals are not officially recognised or have formal education in many countries, with RT being often a very short component of a broader programme. This study aims to investigate Belgian stakeholders' perpectives regarding existing barriers and solutions for the education and professional development of Radiation therapists (RTT) which regroups medical imaging technologists (MIT) and nurses working in RT. METHODS Nine experts with vast experience in RT were invited to be interviewed; eight participated (4 heads of the RT departments, 2 school representatives, 2 national society's representatives). A semi-structured questionnaire was used. The first two authors open-coded all interviews using thematic analysis. RESULTS Five themes and eleven sub-themes were drawn from the analysis. Belgian MIT and nurses in RT perform the same roles, but have different educational backgrounds. The barriers in education and professional development are related to law, education landscape, economics, social-cultural context, politics and professional identity. The main difference between the French and Dutch-speaking parts of the country were at the education level. The proposed solutions included modifying the legislative framework surrounding the RTT profession, setting up financial support, formalizing the educational requirements and increasing professional awareness. Future strategies might include the development of advanced roles and responsibilities. CONCLUSIONS Current law, educational landscape and lack of economic support were the main barriers identified. Except for the educational background, no fundamental differences were found between nurses and MIT in the French and Dutch-speaking parts. Perspectives for both professional groups are linked to future legislative and financial actions, the stakeholders involved and a clear strategic vision. In the upcoming years, increased responsibilities and the creation of a master's degree should be foreseen. IMPLICATIONS FOR PRACTICE Regulation of RTT profession and education and an increase in RT-specific training must be implemented in Belgium to ensure professional development and optimized treatment delivery.
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Affiliation(s)
- F Sousa
- Radiation Oncology Department, Institut Jules Bordet - Université Libre de Bruxelles, Brussels, Belgium; Inholland University of Applied Sciences, School of Health, Haarlem, the Netherlands.
| | - A Vaandering
- Radiation Oncology Department, Cliniques Universitaires Saint Luc, Belgium; Center of Molecular Imaging, Radiotherapy and Oncology (MIRO), Institut de Recherche Expérimentale et Clinique (IREC), Université Catholique de Louvain, Brussels, Belgium
| | - J G Couto
- Radiography Department, Faculty of Health Sciences, University of Malta, Msida, MSD2080, Malta
| | - M Somoano
- Radiation Oncology Department, Institut Jules Bordet - Université Libre de Bruxelles, Brussels, Belgium
| | - D Van Gestel
- Radiation Oncology Department, Institut Jules Bordet - Université Libre de Bruxelles, Brussels, Belgium
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13
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Oliveira C, Barbosa B, Couto JG, Bravo I, Khine R, McNair H. Advanced practice roles of therapeutic radiographers/radiation therapists: A systematic literature review. Radiography (Lond) 2022; 28:605-619. [PMID: 35550932 DOI: 10.1016/j.radi.2022.04.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Revised: 04/06/2022] [Accepted: 04/19/2022] [Indexed: 12/27/2022]
Abstract
INTRODUCTION Advances in Radiotherapy (RT) technology and increase of complexity in cancer care have enabled the implementation of new treatment techniques. Subsequently, a greater level of autonomy, responsibility, and accountability in the practice of Therapeutic Radiographers/Radiation Therapists (TR/RTTs) has led to Advanced Practice (AP) roles. The published evidence of this role is scattered with confusing terminology and divergence regarding the perception of whether a specific role represents AP internationally. This study aims to establish an international baseline of evidence on AP roles in RT to identify roles and activities performed by TR/RTTs at advanced level practice and to summarise the impact. METHODS A systematic PRISMA review of the literature was undertaken. Thematic analysis was used to synthesise the roles and associated activities. Six RT external experts validated the list. The impact was scrutinised in terms of clinical, organisational, and professional outcomes. RESULTS Studies (n = 87) were included and categorised into four groups. AP roles were listed by clinical area, site-specific, and scope of practice, and advanced activities were organised into seven dimensions and 27 sub-dimensions. Three most-reported outcomes were: enhanced service capacity, higher patient satisfaction, and safety maintenance. CONCLUSION Evidence-based AP amongst TR/RTTs show how AP roles were conceptualised, implemented, and evaluated. Congruence studies have shown that TR/RTTs are at par with the gold-standard across the various AP roles. IMPLICATIONS FOR PRACTICE This is the first systematic literature review synthetisising AP roles and activities of TR/RTTs. This study also identified the main areas of AP that can be used to develop professional frameworks and education guiding policy by professional bodies, educators and other stakeholders.
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Affiliation(s)
- C Oliveira
- Radiotherapy Department, Instituto Português de Oncologia do Porto (IPO Porto), R. Dr. António Bernardino de Almeida 865, 4200-072, Porto, Portugal; Escola Internacional de Doutoramento, Universidad de Vigo, Circunvalación Ao Campus Universitario, 36310, Vigo, Pontevedra, Spain.
| | - B Barbosa
- Radiotherapy Department, Instituto Português de Oncologia do Porto (IPO Porto), R. Dr. António Bernardino de Almeida 865, 4200-072, Porto, Portugal; Escola Internacional de Doutoramento, Universidad de Vigo, Circunvalación Ao Campus Universitario, 36310, Vigo, Pontevedra, Spain; Medical Physics, Radiobiology Group and Radiation Protection Group, IPO Porto Research Centre (CI-IPOP), Instituto Português de Oncologia do Porto (IPO Porto), R. Dr. António Bernardino de Almeida 865, 4200-072, Porto, Portugal.
| | - J G Couto
- Radiography Department, Faculty of Health Sciences, University of Malta, Msida, MSD2080, Malta.
| | - I Bravo
- Medical Physics, Radiobiology Group and Radiation Protection Group, IPO Porto Research Centre (CI-IPOP), Instituto Português de Oncologia do Porto (IPO Porto), R. Dr. António Bernardino de Almeida 865, 4200-072, Porto, Portugal.
| | - R Khine
- European Federation of Radiographer Societies, PO Box 30511, Utrecht, 3503, AH, Netherlands; School of Health Care and Social Work, Buckinghamshire New University, Buckinghamshire, United Kingdom.
| | - H McNair
- European Federation of Radiographer Societies, PO Box 30511, Utrecht, 3503, AH, Netherlands; The Royal Marsden NHS Foundation Trust, Radiotherapy and the Institute of Cancer Research, Surrey, SM2 5PT, United Kingdom.
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14
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Holmström A, Haavisto E, Talman K. Student selection in radiography education. A narrative review. Radiography (Lond) 2022; 28:838-847. [PMID: 35241373 DOI: 10.1016/j.radi.2022.02.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Revised: 01/10/2022] [Accepted: 02/07/2022] [Indexed: 10/19/2022]
Abstract
OBJECTIVES Due to effects on study success, radiography student selection has a major impact on higher education institutions and applicants. However, there is very little research to demonstrate which selection methods and contents are most successful in radiography education. This study aimed to describe the methods and contents used in radiography student selection and factors related to study success. KEY FINDINGS A narrative review was undertaken. A computerized search in four databases limited to studies published between January 2000 and June 2021. Ten quantitative, mainly retrospective, studies were included. The review identified 23 selection methods; of these, interview (n = 4), Scholastic Aptitude Test (n = 3), American College Test (n = 2) and reference letter (n = 2) were used more than once in radiography student selection. The content of the selection methods was identified in four categories including 44 factors. The most often assessed content was category of learning skills while the least often assessed concerned categories of social skills, personality traits and career choice. Regarding study success, factors of learning skills, namely mathematics, physics, biology, anatomy, physiology, natural sciences, a composite of factors comprising electronics and a composite of factors comprising mechanics predicted study success. Factors of social skills, personality traits and career choice were not related to study success. CONCLUSION The methods used and contents assessed vary greatly in radiography student selection. The results suggest using the content in the four categories in the selection of radiography students. IMPLICATIONS FOR PRACTICE Further research is needed to clarify the methods, with knowledge of the reliability and validity and the contents for the suggested categories, and to demonstrate their relationship to study success and identify the core content of radiography student selection especially in European context.
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Affiliation(s)
- A Holmström
- Oulu University of Applied Sciences, 90220 Oulu, Finland.
| | - E Haavisto
- Tampere University, Department of Health Sciences, Arvo Ylpön katu 34, 33520 Tampere, Finland.
| | - K Talman
- Metropolia University of Applied Sciences, 00079 Metropolia, Finland.
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15
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Couto JG, McFadden S, McClure P, Bezzina P, Beardmore C, Hughes C. Competency level in radiotherapy across EU educational programmes: A cross-case study evaluating stakeholders' perceptions. Radiography (Lond) 2021; 28:180-186. [PMID: 34728137 DOI: 10.1016/j.radi.2021.10.015] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Revised: 10/08/2021] [Accepted: 10/17/2021] [Indexed: 12/20/2022]
Abstract
INTRODUCTION The education of Therapeutic Radiographers (TRs) is regulated in some countries but is not standardised across the EU, leading to differences in competencies between and within member states. This study aimed to explore stakeholders' perceptions regarding underdeveloped competencies of TRs practising on the linear accelerator, identified in a previous study by the same research team. METHODS Interviews with stakeholders from four countries (selected based on the characteristics of their degrees) were performed as part of this cross-case study. Stakeholders were asked to provide their perception regarding the least developed competencies identified in a previous study. RESULTS The 27 stakeholders confirmed that Pharmacology, Quality Assurance (QA), Management and Leadership, Research (from the previous study) were underdeveloped and identified Image Verification and Critical Thinking as additional underdeveloped competencies. Suggested causes included: lack of regulation of required competencies at the national level, lack of training dedicated to radiotherapy (RT) (taught within generic modules) and lack of time within the degree programme. The ideal academic level to develop these competencies and whether they are essential varied between country and stakeholder. CONCLUSION It is essential to regulate learning outcomes at the national level to ensure a high level of care is provided to all RT patients and, ideally, standardise it across Europe. Education institutions should review their curricula to ensure that sufficient time is dedicated to RT and that the essential competencies are developed. Due to time constraints within some programmes, some competencies must be developed after graduation. IMPLICATIONS FOR PRACTICE Lack of regulation of learning outcomes (at European level and national level in many countries) and lack of RT-specific training lead to underdeveloped competencies that may compromise patient care.
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Affiliation(s)
- J G Couto
- Radiography Department, Faculty of Health Sciences, University of Malta, Msida, MSD2080, Malta.
| | - S McFadden
- School of Health Sciences, Ulster University, Newtownabbey, Co. Antrim, BT37 0QB, Ireland.
| | - P McClure
- School of Health Sciences, Ulster University, Newtownabbey, Co. Antrim, BT37 0QB, Ireland.
| | - P Bezzina
- Radiography Department, Faculty of Health Sciences, University of Malta, Msida, MSD2080, Malta.
| | - C Beardmore
- Society and College of Radiographers, London, UK; European Federation of Radiography Societies, Lievegem, Belgium.
| | - C Hughes
- School of Health Sciences, Ulster University, Newtownabbey, Co. Antrim, BT37 0QB, Ireland.
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Foley S, Paulo G, Vassileva J. Large differences in education and training of radiographers in Europe and Central Asia: Results from an IAEA coordinated study. Radiography (Lond) 2021; 28:48-54. [PMID: 34404576 DOI: 10.1016/j.radi.2021.07.016] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Revised: 06/30/2021] [Accepted: 07/22/2021] [Indexed: 10/20/2022]
Abstract
INTRODUCTION Education and training of radiographers is known to be diverse between countries and regions. Under an IAEA project, this work collected data on radiographer education for the Europe and Central Asia region with a particular focus on radiation protection gaps and potential actions. METHODS Following piloting, an electronic questionnaire was distributed to all national counterparts for the IAEA Technial Coopearation (TC) Europe region (n = 33 countries) and nominated national representatives. Contacts were additionally invited to a virtual workshop to discuss and rank common problems in education and training of radiographers and to propose potential solutions. RESULTS Responses were received from 31 countries, including 14 from the European Union. Just over half of countries reported radiographer education being in higher education with 71% having program durations more than 3 years (range: 1 month-4 years). Programs included a spectrum of both clinical training and radiation protection hours with ten-fold variations noted across the region. Inclusion of core radiation protection topics within curricula varied similarly, as did radiographers' clinical involvement in both justification and optimisation between countries. Workshop participants identified five common training problems, namely education availability, lack of standardisation, radiation protection course quality, teamwork problems and lack of equipment. CONCLUSION Radiographer education in the IAEA Europe region is heterogeneous with substantial differences in duration and quality of training programs between countries, which likely impact on quality of patient care delivered. Common problems have been identified and potential solutions proposed to focus quality improvement initiatives. IMPLICATIONS FOR PRACTICE Radiographer education and training is diverse throughout the IAEA TC Europe region, with likely impacts on radiation protection practices applied. Clinical involvement of radiographers in justification and optimisation differs, potentially limiting adherence to radiation protection principles.
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Affiliation(s)
- S Foley
- Radiography & Diagnostic Imaging, School of Medicine, University College Dublin, Ireland.
| | - G Paulo
- Medical Imaging and Radiotherapy Department, Instituto Politécnico de Coimbra ESTESC - Coimbra Health School, Coimbra, Portugal
| | - J Vassileva
- Radiation Protection Unit, International Atomic Energy Agency, Vienna, Austria
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McNulty JP, England A, Shanahan MC. International perspectives on radiography practice education. Radiography (Lond) 2021; 27:1044-1051. [PMID: 33934944 DOI: 10.1016/j.radi.2021.04.004] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Revised: 04/08/2021] [Accepted: 04/12/2021] [Indexed: 10/21/2022]
Abstract
INTRODUCTION The radiography profession is built upon strong educational foundations which help ensure graduate radiographers have the required knowledge, skills, and competence to practise safely and effectively. Changing clinical practices, service needs, technological developments, regulatory changes, together with our growing professional evidence-base, all contribute to the need for our curricula to responsive and continually reviewed and enhanced. This study aims to explore similarities and differences in training curricula and follows a 2012 global survey on radiography education and more recent surveys undertaken by the European Federation of Radiographer Societies (EFRS). METHODS An online questionnaire, based on previous EFRS education and clinical education surveys, which comprised of open and closed questions and consisted of sections designed to ascertain data on: type, level and duration of education programmes leading to an initial or pre-registration qualification in radiography/medical radiation practice, pre-clinical skill development and clinical placement within programmes. The survey was distributed via social media channels and through an international network of professional societies. Descriptive statistics are reported for most analyses while open questions were analysed thematically. RESULTS Responses were received from 79 individuals from 28 identified countries across four continents. This represented a total of 121 different pre-registration/entry level programmes offered across these institutions. While dedicated diagnostic radiography programmes were most common (42/121), almost one-third of programmes (40/121) offered two or more areas of specialisation within the curriculum. The average of total hours for clinical placement were 1397 h for diagnostic radiography programmes; 1300 h for radiation therapy programmes; 1025 h for nuclear medicine programmes; and 1134 h for combined specialisation programmes, respectively. Institutions provided a range of physical and virtual systems to support pre-clinical skills development. CONCLUSION Around the world, radiography programmes vary considerably in terms of their level, duration, programme type, pre-clinical and clinical training, use of simulation, and also in terms of class sizes, student/staff ratios, and graduate employment prospects. The ability of graduates to work independently in areas covered within their programmes varied considerably. While some changes around simulation use were evident, given the impact of COVID-19 it would be beneficial for future research to investigate if pre-clinical and clinical education hours or use of simulation resources has changed due to the pandemic. IMPLICATIONS FOR PRACTICE The heterogeneity that exists between radiography programmes presents a significant challenge in terms of the mutual recognition of qualifications and the international movement of the radiographer workforce.
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Affiliation(s)
- J P McNulty
- Radiography and Diagnostic Imaging, School of Medicine, University College Dublin, Ireland.
| | - A England
- School of Allied Health Professions, Keele University, Staffordshire, UK.
| | - M C Shanahan
- Discipline of Medical Radiation Science, Faculty of Health, University of Canberra, Bruce, ACT, Australia.
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Couto JG, McFadden S, McClure P, Bezzina P, Camilleri L, Hughes C. Evaluation of radiotherapy education across the EU and the impact on graduates' competencies working on the linear accelerator. Radiography (Lond) 2020; 27:289-303. [PMID: 32943354 DOI: 10.1016/j.radi.2020.08.010] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Revised: 08/21/2020] [Accepted: 08/26/2020] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Regulation and education of the professionals administering radiotherapy treatments in the linear accelerator varies across the EU. However, how different programme characteristics affect the level of competency of these professionals has never been studied before. This study also aimed to assess which are the least and most developed competencies in radiotherapy across the EU. METHODS An online questionnaire was distributed to academic staff teaching radiotherapy across the EU. Staff were asked to identify the characteristics of the course programmes and to classify the level of competency of graduates regarding linear accelerator tasks. RESULTS Fifty respondents from 19 EU countries answered the questionnaire. The least developed competency theme was pharmacology followed by equipment quality assurance and management and leadership. The most developed competency was positioning and immobilisation, followed by radiotherapy treatment delivery and professional and ethical practice. Some competencies are developed at the same level across EU countries, while others vary considerably between member-states. Longer programmes, with more placements, and larger proportions of radiotherapy in the programme showed significant increase in the development of some competencies. Longer placements in skills labs was correlated with a decrease in competency. CONCLUSION There is no harmonisation of radiotherapy eduction across the EU and the differences in programme characteristics are reflected in differences in competency levels of radiotherapy radiographers. This may hinder movement of professionals and create disparities in the level of care offered across the EU. IMPLICATIONS FOR PRACTICE Longer programmes, with longer clinical practice and adequate proportion of radiotherapy in the course are essential to ensure that these professionals are competent at similar levels across the EU and to ensure patient safety.
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Affiliation(s)
- J G Couto
- Radiography Department, Faculty of Health Sciences, University of Malta, Msida, MSD2080, Malta.
| | - S McFadden
- School of Health Sciences, Ulster University, Room 14J15, Shore Road Newtownabbey Co, Antrim, BT37 0QB, UK.
| | - P McClure
- School of Health Sciences, Ulster University, Room 01B113, Shore Road Newtownabbey Co, Antrim, BT37 0QB, UK.
| | - P Bezzina
- Department of Radiography, Faculty of Health Sciences, University of Malta, Msida, MSD2080, Malta.
| | - L Camilleri
- Statistics & Operations Research, Faculty of Science, University of Malta, Msida, MSD2080, Malta.
| | - C Hughes
- School of Health Sciences, Ulster University, Room 01B118, Shore Road Newtownabbey Co, Antrim, BT37 0QB, UK.
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England A, McNulty JP. Inclusion of evidence and research in European radiography curricula. Radiography (Lond) 2020; 26 Suppl 2:S45-S48. [PMID: 32444326 DOI: 10.1016/j.radi.2020.04.018] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Revised: 04/29/2020] [Accepted: 04/30/2020] [Indexed: 11/30/2022]
Abstract
PURPOSE To provide a short reflective article discussing the extent to which evidence and research are included within radiography training curricula and whether there is a need for change and greater standardisation. FINDINGS Great steps have been taken to harmonise aspects of radiography training programmes across Europe, however, variations do exist, especially in the areas of clinical practice, training hours and inclusion of specific curriculum topics. Limited evidence exists regarding the inclusion of evidence and research; thus, diversity is likely. The majority of training curricula follow the Bologna cycle and both research and evidence components are likely to be included within teaching and assessment. Wider questions exist regarding maintaining and developing the research and evidence culture within the radiography profession. Education institutions will play an important role in this process. CONCLUSION Limited evidence exists regarding the inclusion of 'evidence' and 'research' themes within European radiography training curricula. Undoubtedly, there is a need for these themes, but this must be balanced with other demands on the curriculum and how research is likely to evolve within the profession. IMPLICATIONS FOR PRACTICE Greater clarity is needed on how evidence and research are to be included within radiography training curricula. A single model is unlikely to be suitable for all, curricula should focus on the requirements for the newly qualified graduate and the radiography profession as a whole.
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Affiliation(s)
- A England
- School of Health & Society, University of Salford, UK; European Federation of Radiographer Societies, Utrecht, the Netherlands.
| | - J P McNulty
- European Federation of Radiographer Societies, Utrecht, the Netherlands; School of Medicine, University College Dublin, Dublin, Ireland
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Couto J, McFadden S, McClure P, Bezzina P, Hughes C. Competencies of therapeutic radiographers working in the linear accelerator across Europe: A systematic search of the literature and thematic analysis. Radiography (Lond) 2020; 26:82-91. [DOI: 10.1016/j.radi.2019.06.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2019] [Revised: 05/15/2019] [Accepted: 06/09/2019] [Indexed: 12/31/2022]
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Characterization of breast imaging education and insights from students, radiographers and teaching staff about its strengths, difficulties and needs. Radiography (Lond) 2019; 25:e1-e10. [PMID: 30599840 DOI: 10.1016/j.radi.2018.07.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2018] [Revised: 07/05/2018] [Accepted: 07/14/2018] [Indexed: 11/21/2022]
Abstract
INTRODUCTION The study aimed to characterize breast imaging education and identify its strengths, difficulties and needs across five European countries according to student, radiographer and teaching staff perspectives. METHODS An observation grid was used to collect data regarding breast imaging education and three questionnaires targeted to key-participants were developed/applied to collect data on strengths, difficulties and needs. Descriptive statistics and thematic analysis were performed according to the nature of the questions. RESULTS Breast imaging curricula varied within and between countries. Response rate for questionnaires also varied (13-100%). More than one-third of the teaching staff (37.5%) was involved in breast research projects. This was identified as the main strength in breast imaging education followed by collaborations between hospitals and academia. Difficulties with their education program identified by the 97 students surveyed included teaching issues (45), breast positioning (18), variety of image evaluation strategies (10) and human interaction (6). The need to provide an explanation to the patient about the role of the student in the mammography setting, and performing exams and teaching at the same time (22.6%) was identified as difficult by radiographers. The need for education and training in communication, practice and technological developments was identified. CONCLUSIONS A bridge between academia and clinical practice is extremely important in order to overcome recognized gaps between theory and practice. The development of a European education program covering the needs identified by the participants could be a possible solution to improve knowledge and access, and also to harmonize education and training across Europe.
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Sá Dos Reis C, Pires Jorge JA, York H, Flaction L, Johansen S, Mæhle S. A comparative study about motivations, expectations and future plans for professional development in four European radiography programs. Radiography (Lond) 2018; 24:e91-e97. [PMID: 30292519 DOI: 10.1016/j.radi.2018.05.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2018] [Revised: 05/17/2018] [Accepted: 05/21/2018] [Indexed: 02/06/2023]
Abstract
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.
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Affiliation(s)
- C Sá Dos Reis
- Department of Medical Radiation Sciences, Curtin University, Perth, Western Australia, Australia; Escola Superior de Tecnologia da Saúde de Lisboa/Instituto Politécnico de Lisboa (ESTeSL/IPL), Portugal.
| | - J A Pires Jorge
- Haute École de Santé Vaud/University of Applied Sciences and Arts Western Switzerland (HES-SO), Switzerland
| | - H York
- University of Hertfordshire, Hatfield, UK
| | - L Flaction
- Haute École de Santé Vaud/University of Applied Sciences and Arts Western Switzerland (HES-SO), Switzerland
| | - S Johansen
- Oslo Metropolitan University (OMU), Oslo, Norway; Department of Oncology (AKB), Division of Cancer Medicine, Surgery and Transplantation (KKT), Oslo University Hospital (OUS), Norway
| | - S Mæhle
- Oslo Metropolitan University (OMU), Oslo, Norway
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