The global impact of the COVID-19 pandemic on clinical radiography practice: A systematic literature review and recommendations for future services planning

The COVID-19 Pandemic's Effect on Preventive Imaging

Introduction

This study assessed the effect of the COVID-19 pandemic on preventive care imaging and potential disparities because preventive care may be perceived as nonurgent. The objective was to identify the associations between the COVID-19 pandemic and changes in preventive imaging volumes for patients in general and as affected by race and ethnicities.

Methods

The authors performed a retrospective observational study by extracting the weekly volumes of all imaging studies between January 7, 2019 and May 1, 2022 from a radiology data warehouse at a tertiary care medical center (n=92,105 preventive imaging studies and 3,493,063 total radiology imaging studies) and compared preshutdown with postshutdown periods using a 2-sample t-test. Additional comparisons stratified by race and ethnicity were performed for mammograms and bone density examinations using interrupted time series models with negative binomial error distribution to assess the immediate level change and trends over time of preventive imaging volumes after shutdown.

Results

The authors found a significant decrease in bilateral mammograms, bone density examinations, and aortic ultrasound examinations in the postshutdown period compared with those in the preshutdown period (p<0.001, p=0.003, and p=0.001, respectively). There were no significant changes in low-dose computed tomography chest examinations (p=0.46). The shutdown was associated with a significant immediate decrease in mammograms in the Hispanic and Latino group to approximately three quarters of its preshutdown level (p=0.04). For bone density examinations, postshutdown weekly volumes tripled compared with the preshutdown volumes for Hispanic or Latino patients and doubled for non-Hispanic Black patients (p<0.0001 for both). In comparison, a significant decrease was seen for Other patients (reduced to nearly a fifth of preshutdown volume) (p<0.0001).

Conclusions

There was a significant decrease in overall volume of bilateral mammograms, bone density examinations, and aortic ultrasound examinations after pandemic shutdown. For mammograms, some of this decreasing trend was already seen before shutdown (such as for patients with Other race), so the shutdown was only specifically associated with an immediate decrease in mammogram levels in the Hispanic and Latino group. For bone density examinations, the shutdown was unexpectedly associated with an increase in volumes for Hispanic or Latino patients and non-Hispanic Black patients, which was countered by a significant steep decrease in volumes only for patients of Other race. Health systems should carefully explore their preventive screening examination volumes to determine which patients should be actively engaged to assure catch up on recommended care.

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

INTRODUCTION

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

METHODS

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

RESULTS

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

DISCUSSION

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

CONCLUSION

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

Lived experiences of radiology caregivers during a health crisis: A COVID-19 case analysis

Background

Health crises have been linked with the exacerbation of pre-existing difficulties and the emergence of unique challenges, as evidenced by the impact of coronavirus disease 2019 (COVID-19) on health caregivers worldwide. Baseline data allow for reflection and preparation for any future health emergencies therefore giving impetus to phenomenological enquiries among the experiencers.

Aim

This study aimed to explore the lived experiences of the eThekwini district frontline radiology caregivers during the COVID-19 pandemic.

Setting

The study was conducted in public and private radiology departments in the eThekwini district of KwaZulu-Natal, South Africa.

Methods

A qualitative, interpretative phenomenological analysis methodology was adopted in a multi-method data-collection context comprising semi-structured interviews and focus group discussions (FGDs) among 24 radiologists, radiographers, and radiology nurses obtained by non-probability sampling. Data were transcribed verbatim and analysed using an interpretative phenomenological approach.

Results

Three superordinate themes emerged, namely: (1) duties and roles during the COVID-19 pandemic, (2) work-related challenges, (3) personal challenges.

Conclusion

Frontline radiology caregivers experienced increased workload, staff shortages, salary cuts, personal protective equipment (PPE) shortages, non-recognition, poor managerial support, disrupted social relations, and poor work-life balance. This necessitates the need for the radiology departments to address staffing, infection prevention and control deficits, and invest in support interventions to assist frontline radiology caregivers during health crises.

Contribution

The findings comprise baseline information that can be used for reflection and guiding radiology departments in preparing for any future health crises.

Medical education during the coronavirus disease 2019 pandemic: an umbrella review

Background

The coronavirus disease 2019 (COVID-19) pandemic affected many aspects of lifestyle and medical education during the recent years. We aimed to determine the impacts of COVID-19 pandemic on medical education to provide an overview of systematic reviews on it.

Methods

We searched PubMed, Scopus, Web of Science, Cochrane library, Google Scholar, and medRxiv, with the following keywords: "SARS-CoV-2," "COVID-19," "Medical Education," "E-learning," "Distance Education," "Online Learning," "Virtual Education," "systematic review," and "meta-analysis," up to 15 April 2023. Studies were included if they were systematic reviews assessing the impacts of the COVID-19 pandemic on medical sciences students. We used A MeaSurement Tool to Assess systematic Reviews 2 (AMSTAR-2) checklist for quality assessment.

Results

A total of 28 systematic reviews were included. The eligible reviews included between five and 64 primary studies, ranging from 897 to 139,381 participants. Technology-enhanced learning and simulation-based learning were the most frequently used strategies. Virtual teaching has several drawbacks like technical difficulties, confidentiality problems, lower student involvement, connection problems, and digital fatigue. The overall satisfaction rate for online learning was above 50%. Also, favorable opinions about perception, acceptability, motivation, and engagement were reported. The quality of 27 studies were critically low and one was low.

Conclusion

There were reduced clinical exposure and satisfaction for medical students during the pandemic. Further high-quality systematic reviews are required.

The environmental sustainability implications of contrast media supply chain disruptions during the COVID-19 pandemic: A document analysis of international practice guidelines

INTRODUCTION

Travel restrictions implemented during the acute phases of the COVID-19 pandemic disrupted supply chain for critical radiology consumables including contrast media (CM) leading to shortages. Consequently, some departments had to restructure their clinical workflows in accordance to recommended guidelines to ensure safe continuity of patient care. This study aimed to summarise the temporary crisis-driven recommendations with implicit environmental sustainability essence and to analyse how these measures might inform the development of a more sustainable, long-term clinical guideline for safer and cost-effective CM usage without compromising diagnostic quality.

METHODS

Documents were obtained through an electronic database search together with a relevant manual search in Google Scholar and relevant reference lists. The selected documents were subjected to a pre-defined eligibility criteria for inclusion. The READ approach was employed for document analysis and a thematic analysis of the obtained data was conducted.

RESULTS

Of the 17 documents included, 70% (n = 12) emanate from the United States of America. The summary of the findings relate to minimising CM usage through strategic clinical approaches including optimisation of CM volumes, prioritisation of non-contrast imaging and/or alternative imaging depending on patient need without compromising diagnostic quality.

CONCLUSION

Critical lessons of sustainability essence are implicitly embedded in the policy guidelines issued during the periods of acute CM shortage in the COVID-19 pandemic. These lessons were themed around CM conservation based on: type and priority of medical imaging investigation, kind of imaging modality and use of smaller vials over multi-dose vials packaging.

IMPLICATIONS FOR PRACTICE

The temporary crisis-driven strategies may offer critical lessons for post-pandemic service delivery to enhance patient safety while saving cost and promoting greener practice via strategic clinical and operational monitoring of CM through policy renewal, education and training and collaboration with industry partners.

Towards an improved dementia care experience in clinical radiography practice: A state-of-the-art review

INTRODUCTION

The increasing global incidence rate of dementia and associated co/multimorbidity has consequently led to a rise in the number of people with dementia (PwD) requiring clinical radiography care services. This review aims to explore and integrate findings from diverse settings with a focus on the experiences of PwD and stakeholders, towards the development of a holistic approach for dementia care and management within the context of radiography services.

METHOD

An electronic search was performed across the following databases: PUBMED, CINAHL, Medline, SCOPUS, and ScienceDirect for articles published from January 2009 and June 2023. Articles were included if they fulfilled a predefined criteria mainly focused on experiences of PwD and/or other stakeholders when using the radiography services. Data obtained from the included studies were analysed using a result-based convergent synthesis.

RESULT

Eleven studies from diverse settings met the inclusion criteria. A mix of both positive and negative experiences of PwD and stakeholders were reported following visits to radiology and radiotherapy departments were highlighted across settings. The findings were themed around the need for: person-centred care, effective communication, attitudinal changes of staff, specialised and improved clinical environment and inclusion of caregivers for the care of PwD.

DISCUSSION

This study emphasise the critical importance of adopting holistic approaches to caring for PwD. This involves adopting a person-centred approach, actively involving caregivers, effective communication, and adequate training for radiographers to provide quality services, all in dementia-friendly environments.

CONCLUSION

The experiences of various stakeholders highlight the need for a more holistic approach and strategy for the care and management of PwD within the context of the radiography services. This calls for an urgent need for a comprehensive strategy that includes awareness creation of staff to enhance the quality of care and the overall experience for PwD using the radiography services.

Research and evidence-based practice in clinical radiography: A systematic review of barriers and recommendations for a new direction

INTRODUCTION

Existing literature provides valuable insight into the application of evidence-based practice (EBP) in Radiography; however, it primarily focuses on localised, context-specific scenarios within individual countries or institutions. This review aims to systematically explore the barriers to EBP and research implementation in clinical Radiography practice internationally.

METHODOLOGY

A mixed-method systematic review was implemented to obtain data from primary studies of qualitative, quantitative and mixed-methods designs. Articles were searched between June and July 2023 from the following scientific databases: PubMed, Medline, CINAHL, Science Direct and manual search dating from 2003 to July 2023. The reviewed studies were subjected to data extraction and results-based convergent synthesis.

RESULTS

A total of 376 articles were identified through electronic database search and citation screening after the removal of duplicates. Thirty-one studies met the predetermined inclusion criteria and were included for this review. The challenges to EBP implementation in clinical Radiography are broadly themed around professional and personal obligations, motivation and organisational culture, knowledge and skill gaps, resources and opportunities, and institutional governance.

CONCLUSION

Globally, clinical radiographers perceived a high level of motivation and interest towards research activities. However, numerous barriers were reported such as insufficient time allocation for research, lack of resources, lack of research culture and inadequate research-related skills and knowledge. A transition towards greater evidence-based practice precipitates the quality of clinical Radiography services, augmenting efficiency in the workflow process and enriching patient experience.

IMPLICATIONS FOR PRACTICE

Radiography managers must develop strategies that aim to stimulate radiographers to initiate research projects. Beyond allocation of protected time, managers should inspire staff participation in research activities through implementation of effective departmental level culture and governance for quality service delivery and improved patient care.

Radiographers' knowledge, attitude and adherence to standard COVID-19 precautions and the policy implications: a national cross-sectional study in Nigeria

BACKGROUND

We investigated the knowledge of COVID-19 pathogenesis and prevention, attitude, and adherence to safe clinical practices among radiographers during the pandemic and made some informed policy recommendations.

MATERIALS AND METHODS

The study was an online cross-sectional survey. The questionnaire captured data on respondents' demographics, knowledge of COVID-19, attitudes, practices, and standard precaution adherence during the pandemic. Data were analysed using descriptive statistics, Pearson's correlation and one-way ANOVA tests.

RESULTS

Of the 255 respondents, 17.3% were actively involved in the management of COVID-19 cases. Participants had high scores regarding their knowledge of COVID-19 pathology (82.46 ± 8.67%), prevention (93.43 ± 7.11%) and attitude (74.11 ± 11.61%), but low compliance to safety precautions (56.08 ± 18.56%). Knowledge about COVID-19 prevention strategies differed significantly across educational qualifications, F(3, 251) = 4.62, p = .004. Similarly, levels of compliance with safety precautions differed across educational qualification (F[3, 251] = 4.53, p = .004) and years-in-practice (F[4, 250] = 4.17, p = .003).

CONCLUSION

Participants' adherence to standard COVID-19 precautions was low. The level of professional qualification influenced participants' knowledge and safe practices during the pandemic. Upgrading the aseptic techniques and amenities in practice settings and broadening the infectious diseases modules in the entry-level and continuous professional education may improve radiographers' response to COVID-19 and future pandemics.Key messagesRadiographers whose qualifications were lower than a bachelor's degree had significantly less knowledge of COVID-19 prevention.Generally, radiographers had a positive attitude towards safe practices during the pandemic, but inadequate education, standard operational guidelines and resources affected their level of adherence.Apart from the shortage of personal protective equipment, poor infrastructural design and inadequate hygienic facilities such as handwashing stations, running water and non-contact hand sanitizer dispensers hampered adherence to COVID-19 precautions in low-resource settings.

Considerations for environmental sustainability in clinical radiology and radiotherapy practice: A systematic literature review and recommendations for a greener practice

INTRODUCTION

Environmental sustainability (ES) in healthcare is an important current challenge in the wider context of reducing the environmental impacts of human activity. Identifying key routes to making clinical radiology and radiotherapy (CRR) practice more environmentally sustainable will provide a framework for delivering greener clinical services. This study sought to explore and integrate current evidence regarding ES in CRR departments, to provide a comprehensive guide for greener practice, education, and research.

METHODS

A systematic literature search and review of studies of diverse evidence including qualitative, quantitative, and mixed methods approach was completed across six databases. The Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines and the Quality Assessment Tool for Studies with Diverse Designs (QATSDD) was used to assess the included studies. A result-based convergent data synthesis approach was employed to integrate the study findings.

RESULTS

A total of 162 articles were identified. After applying a predefined exclusion criterion, fourteen articles were eligible. Three themes emerged as potentially important areas of CRR practice that contribute to environmental footprint: energy consumption and data storage practices; usage of clinical consumables and waste management practices; and CRR activities related to staff and patient travel.

CONCLUSIONS

Key components of CRR practice that influence environmental impact were identified, which could serve as a framework for exploring greener practice interventions. Widening the scope of research, education and awareness is imperative to providing a holistic appreciation of the environmental burden of healthcare.

IMPLICATIONS FOR PRACTICE

Encouraging eco-friendly travelling options, leveraging artificial Intelligence (AI) and CRR specific policies to optimise utilisation of resources such as energy and radiopharmaceuticals are recommended for a greener practice.

Effectiveness of online trainings on radiation protection in the context of the COVID-19 pandemic

Over 212 healthcare professionals from the country have used the online trainings on radiation protection conducted during the COVID-19 pandemic. Each training, lasting up to 10 working days, is accompanied by mandatory Google Form-based questionnaires, which includes topic key questions about each lecture as well as pre- and post-training tests and provided to participants. In addition, the ability to conduct a dialogue with patients about radiation risks, group discussions, as well as a special module for radiation protection officers were assessed online. The trainings also allow participants to focus on the most important issues from their point of view in their daily work, indicating them in pre-tests, allowing the trainers to conduct lectures more adequately for each group of participants. Analysis of the tests have shown that online training is not inferior in efficiency to face-to-face training and national regulatory body received an improved opportunity to indirectly assess this efficiency.

Pandemic preparedness of diagnostic radiographers during COVID-19: A scoping review

INTRODUCTION

As chest imaging is a tool for detecting coronavirus disease 2019 (COVID-19), diagnostic radiographers are a key component of the frontline workforce. Due to its unforeseen nature, COVID-19 has challenged radiographers' preparedness in combating its effects. Despite its importance, literature specifically investigating radiographers' readiness is limited. However, the documented experiences are prognostic of pandemic preparedness. Hence, this study aimed to map this literature by addressing the question: 'what does the existing literature reveal about the pandemic preparedness of diagnostic radiographers during COVID-19?'.

METHODS

Using Arksey and O'Malley's framework, this scoping review searched for empirical studies in MEDLINE, Embase, Scopus, and CINAHL. Consequently, 970 studies were yielded and underwent processes of deduplication, title and abstract screening, full-text screening, and backward citation searching. Forty-four articles were deemed eligible for data extraction and analysis.

RESULTS

Four themes that reflected pandemic preparedness were extrapolated: infection control and prevention, knowledge and education, clinical workflow, and mental health. Notably, the findings highlighted pronounced trends in adaptation of infection protocols, adequate infection knowledge, and pandemic-related fears. However, inconsistencies in the provision of personal protective equipment, training, and psychological support were revealed.

CONCLUSION

Literature suggests that radiographers are equipped with infection knowledge, but the changing work arrangements and varied availability of training and protective equipment weakens their preparedness. The disparate access to resources facilitated uncertainty, affecting radiographers' mental health.

IMPLICATIONS FOR PRACTICE

By reiterating the current strengths and weaknesses in pandemic preparedness, the findings can guide clinical practice and future research to correct inadequacies in infrastructure, education, and mental health support for radiographers in the current and future disease outbreaks.

Knowledge, perceptions, and expectations of Artificial intelligence in radiography practice: A global radiography workforce survey

BACKGROUND

Artificial Intelligence (AI) technologies have already started impacting clinical practice across various settings worldwide, including the radiography profession. This study is aimed at exploring a world-wide view on AI technologies in relation to knowledge, perceptions, and expectations of radiography professionals.

METHODS

An online survey (hosted on Qualtrics) on key AI concepts was open to radiography professionals worldwide (August 1st to December 31st 2020). The survey sought both quantitative and qualitative data on topical issues relating to knowledge, perceptions, and expectations in relation to AI implementation in radiography practice. Data obtained was analysed using the Statistical Package for Social Sciences (SPSS) (v.26) and the six-phase thematic analysis approach.

RESULTS

A total of 314 valid responses were obtained with a fair geographical distribution. Of the respondents, 54.1% (157/290) were from North America and were predominantly clinical practicing radiographers (60.5%, 190/314). Our findings broadly relate to different perceived benefits and misgivings/shortcomings of AI implementation in radiography practice. The benefits relate to enhanced workflows and optimised workstreams while the misgivings/shortcomings revolve around de-skilling and impact on patient-centred care due to over-reliance on advanced technology following AI implementation.

DISCUSSION

Artificial intelligence is a tool but to operate optimally it requires human input and validation. Radiographers working at the interface between technology and the patient are key stakeholders in AI implementation. Lack of training and of transparency of AI tools create a mixed response of radiographers when they discuss their perceived benefits and challenges. It is also possible that their responses are nuanced by different regional and geographical contexts when it comes to AI deployment. Irrespective of geography, there is still a lot to be done about formalised AI training for radiographers worldwide. This is a vital step to ensure safe and effective AI implementation, adoption, and faster integration into clinical practice by healthcare workers including radiographers.

CONCLUSION

Advancement of AI technologies and implementation should be accompanied by proportional training of end-users in radiography and beyond. There are many benefits of AI-enabled radiography workflows and improvement on efficiencies but equally there will be widespread disruption of traditional roles and patient-centred care, which can be managed by a well-educated and well-informed workforce.

Clinical audit and research in radiography practice: An exploration of the English landscape

BACKGROUND

Research and clinical audit are central to the quality improvement (QI) process in healthcare; whereas research produces new knowledge, clinical audit establishes if practice is meeting set standards. Thus, radiographers have responsibility to engaging in these QI activities. This study aimed to explore radiographers' understanding, attitudes and level of involvement in clinical research and audit across England.

METHODS

A cross-sectional survey using an online questionnaire for data collection over a 6-week period was employed. The questionnaire consisted of open and closed ended questions. Participants were recruited through social media. The quantitative data obtained was analysed using Statistical Package for Social Sciences (SPSS) Version 26 (IBM Inc, Armonk, NY) whilst content analysis was used to analyse the free-response data.

RESULTS

A total of 100 valid responses were obtained after exclusion of 45 partial and/or incomplete responses. Radiographers showed a positive attitude towards involvement in research and audit with overall mean score of 3.85 (SD 0.80) and 4.01 (SD 0.80), respectively. Of the respondents, 35.7% (n = 35/98) were currently involved in clinical audit projects whilst 78.6% (n = 77/98) have previously been involved. Radiographers with postgraduate degrees were significantly more likely to have initiated research, 61.5% (n = 16/26) (p = 0.01) and to have previously been involved with research, 80.8% (n = 21/26) (p = 0.02). A significant association between radiographers' role and implementation of changes, following an audit (p = 0.03) was noted. Similarly, a significant association was noted between radiographers' role and initiation of research (p = 0.05).

CONCLUSION

Clinical radiographers in England showed a positive attitude towards research and audit. However, this did not translate into actual participation in research and audit activities.

IMPLICATIONS FOR PRACTICE

The need to stimulate clinical radiographers' interest in clinical audit and research is highlighted. Additionally, the findings support the rationale for managers to give more support including protected time to radiographers to engage in QI activities.

A cross-sectional student survey of the impact of the Covid-19 lockdowns on clinical placement in England

INTRODUCTION

Clinical placement is an essential aspect of student radiographers' training. The Covid-19 pandemic proved challenging for diagnostic radiography students disrupting clinical placements. This study aims to explore the impact of Covid-19 on first and second year student diagnostic radiographers' in clinical practice during the Covid-19 lockdown periods and Covid-19 waves in England.

METHOD

A cross-sectional online survey was used to attain quantitative attitudinal 5-point Likert and qualitative free-text response data. Descriptive and inferential statistics data analysis applied the Mann-Whitney U test and Kruskal-Wallis H test. The qualitative data were thematically coded and analysed for patterns of reoccurring themes.

RESULTS

There were n = 85 responses from n = 9 different counties within England. Students reported missing between n = 1-14 weeks of placement. There was a lack of (41%; n = 35) or limited radiography staff (21%; n = 18) in the clinical departments and a lack of a range of X-ray examinations available (67%; n = 57) during the Covid-19 lockdowns, which affected completing practice assessments. Negative effects included stress, anxiety and worry (68%; n = 58); positive effects included team working (16.4%; n = 14), learning to work under pressure (12.9%; n = 11), and preparation for qualifying (8.2%; n = 7).

CONCLUSIONS

This study identified that students needed more support in this critical aspect of their training. There were both positive and negative responses; notably, the results highlight how the Covid-19 lockdowns have strained the National Health Service (NHS) and adversely affected radiography students.

IMPLICATIONS FOR PRACTICE

The findings underscore the need for university educators and student liaison radiographers within hospitals to have an awareness of the mental health and practical learning needs of the students they are instructing post-Covid-19 lockdown.

The impact of performance feedback reports on physician ordering behavior in the use of computed tomography pulmonary angiography (CTPA)

PURPOSE

The increased utilization, and potential overutilization, of computed tomography pulmonary angiography (CTPA) is a well-recognized issue within emergency departments (EDs). The objective of this study is to determine the impact of performance feedback reports on CTPA ordering behavior among ED physicians.

METHODS

We conducted a prospective study of the impact of individualized performance feedback reports on the ordering behavior of physicians working at two high-volume community EDs in Ontario, Canada. We generated individualized reports (or "Dashboards") for each ED physician containing detailed feedback and peer comparison for each physician's CTPA ordering. Our baseline pre-intervention period was January 1 to December 31, 2018, and our intervention period was January 1, 2019, to December 31, 2021. We tracked individual and group ordering behavior through the study period. Our primary outcomes are impact of feedback on (1) overall group ordering rate and (2) overall diagnostic yield. Secondary analysis was done to determine the impact of the intervention on those physicians with the highest CTPA utilization rate.

RESULTS

There was no statistically significant difference in the diagnostic yield of the included physicians in either of the years of the intervention period. There was a statically significant increase in the utilization rate for CTPA from 2018 to 2020 and 2021 from 5.9 to 7.9 and 11.4 CTPAs per 1000 ED visits respectively (p < 0.5).

CONCLUSION

Our study found no consistent significant impact of individualized feedback and peer comparison on physician ordering of CTPAs. This points to a potentially greater impact of environmental and institutional factors, as opposed to physician-targeted quality improvement measures, on physician ordering behavior.

TWO YEARS ON AND FOUR WAVES LATER- JOHANNESBURG DIAGNOSTIC RADIOGRAPHERS’ EXPERIENCES OF COVID-19

Introduction

At the onset of COVID-19 diagnostic radiographers from Gauteng, South Africa, shared their experiences of the new workflow and operations, their well-being and their resilience during this time. They experienced emotional, physical and financial fatigue. It is now over two years later, and South Africa has experienced four waves of COVID-19. Therefore, this study explored diagnostic radiographers' experience of COVID-19 after two years and four waves.

Methods

A qualitative explorative, descriptive and contextual study was conducted collecting data through nine virtual individual in-depth interviews. Responses from the diagnostic radiographers in Johannesburg, Gauteng South Africa, underwent thematic analysis.

Results

Thematic analysis revealed two themes and related categories. Theme one: participants shared synchronistic experiences with the four COVID-19 waves, the heterogeneous vaccination ideologies and their support and coping skills. Theme two: lessons learnt and the way forward.

Conclusion

Participants shared feeling overwhelmed at the onset of COVID-19 and feared infecting their family, friends and colleagues. However, their anxiety and fear decreased with time. They experienced the Delta variant as the worst and felt supported by their colleagues more than by management. They recounted observations of vaccine hesitancy but acknowledged that vaccination had alleviated some of the fear and anxiety. Participants' coping skills varied, and reflecting on their experience, they shared the lessons learnt and the way forward.

Assessment of job satisfaction, lifestyle behaviors, and occupational burnout symptoms during the COVID-19 pandemic among radiologic technologists in Saudi Arabia

INTRODUCTION

Radiologic technologists (RTs) are among the healthcare staff negatively impacted by job dissatisfaction, occupational stress, and unhealthy lifestyle behaviors, especially during the COVID-19 pandemic. The aim of this study was to assess job satisfaction, lifestyle behaviors, occupational burnout symptoms, and associated factors among RTs in Saudi Arabia.

METHODS

A survey study was conducted from January 2021 to February 2022 using a self-administered questionnaire. The questionnaire gathered socio-demographic information, answers to the Minnesota Satisfaction Questionnaire, lifestyle behaviors, and frequency of occupational burnout symptoms. Data were analyzed to obtain descriptive and inferential statistics.

RESULTS

A total of 261 RTs completed the survey. Participants were predominantly male and most were working in public hospitals. The overall mean score for job satisfaction was 3.77 (of 5), indicating moderate job satisfaction, with two items showing low satisfaction- compensation (3.33) and advancement (3.28). The overall mean score for lifestyle behaviors was 2.00 (of 3), indicating moderate lifestyle behaviors, with the lowest scores reported in sleep quality (1.92), healthy diet (1.85), and relaxing and unwinding (1.86). For burnout symptoms, the overall mean score was 2.30, indicating moderate burnout level, with the highest score reported in experiencing physical symptoms (2.72). There were significant relationships between job satisfaction, lifestyle behaviors and burnout symptoms. A positive and moderate relationship, r = 0.53 (p < 0.05), was found between job satisfaction and healthy lifestyle behaviors. The burnout relationships with job satisfaction, r = -0.615 (p < 0.05), and healthy lifestyle behaviors, r = -0.524 (p < 0.05), were negative and moderate relationships CONCLUSION: The interrelationships between job satisfaction, lifestyle behaviors, and occupational burnout symptoms suggest that improving lifestyle behaviors and managing burnout symptoms could contribute to higher job satisfaction.

IMPLICATIONS FOR PRACTICE

Policymakers should focus their efforts in the workplace health promotion programs to play essential roles in promoting healthy lifestyle behaviors and occupational stress management, as well as, improvements of RTs career advancement and compensation.

The Impact of COVID-19 on the Clinical Experience and Training of Undergraduate Student Radiographers internationally: The Clinical Tutors' perspective

INTRODUCTION

The impact on the clinical training and education of healthcare students by COVID-19 has been documented. However, the thoughts and experiences of clinical tutors (CTs) about radiography students attending for clinical training and education during this now elongated period beyond first recognition of the virus has not been explored. This paper will discuss data collected from CTs in the UK Devolved Nations (UKDN) and the United Arab Emirates (UAE) who were compared because of their similarities in delivery based on individual 'rules of engagement' devised by their various health departments.

AIM

The purpose of this study was to examine the clinical tutors' thoughts and experiences of supervising radiography students attending clinical placement during the COVID-19 pandemic.

METHODS

The UK Devolved Nations (UKDN) and the United Arab Emirates (UAE) were selected for comparison on an international level as they are geographically distinct with a comparable population and education accredited/acknowledged by the Society and College of Radiographers (SCoR). Data was collected data from CTs across the UKDN and the UAE. The study used an online questionnaire (Google Forms) with closed questions in four themes including: students' experiences, impact on students' clinical placement, attitude of the clinical staff and the potential effects of COVID-19 on future graduates' skills and competencies. Further data was gathered on the experience of CTs mentoring students during the COVID-19 pandemic.

RESULTS

Data were collected from 59 CTs (81%, n = 48) from UKDN and (19%, n = 11) UAE. Twenty-seven (46%) respondents reported that COVID-19 had a negative impact on clinical practical experience. However, 32 (54%) identified that COVID-19 had no impact on student supervision/feedback or on clinical achievements. Eleven (19%) respondents thought that students should not have been on clinical placement during the pandemic but a further 51% (n = 30) were happy with the students on placement and expressed willingness to delegate work to students. Interestingly, 58% (n = 34) of CTs suggested that future graduates may need a longer preceptorship after they graduate due to receiving decreased clinical experience during the pandemic. Overall, 78% (n = 46) of respondents thought that students improved their clinical confidence by working directly with COVID-19 positive patients.

CONCLUSION

The current study has identified conflicting opinions across CTs in different clinical departments. Whilst some felt that students should not be in the hospital during the pandemic, others reported that working directly with COVID-19 patients had a positive impact on students as it improved their clinical confidence. Despite the challenges presented by COVID-19, CTs were able to provide direct clinical supervision and feedback to students on clinical placement throughout the pandemic. Nevertheless, future graduates may need a longer preceptorship period due to decreased clinical experience during the pandemic.

IMPLICATIONS FOR PRACTICE

Clinical placements should continue during subsequent COVID-19 waves of infection or future pandemics to ensure development of skills in resilience and adaptability. Underdeveloped skills due to a decreased range of examinations can be rectified when any wave of the infection subsides by providing tailored training based on individual student's needs.

Towards describing the global impact of the COVID-19 pandemic on clinical radiography education: A systematic review

INTRODUCTION

The sudden onset of the COVID-19 pandemic has brought significant and rapid changes to the traditional ways of providing radiography education, including adaptations to teaching and learning styles as well as disruptions to students' clinical placement. This review explored the impact of the pandemic on clinical radiography education globally.

METHODS

A systematic literature search was conducted on relevant databases, including PubMed, Science Direct, CINAHL (Cumulative Index of Nursing and Allied Health Literature, and SCOPUS. All relevant articles were critically appraised for quality and subjected to information extraction and results-based convergent synthesis.

RESULTS

A total of 17 articles met the inclusion and exclusion criteria for this review. The key findings are themed around challenges and benefits with the introduction of new teaching and learning approaches and resilience exhibited by students during the pandemic to overcome: inadequate support and mentorship while transitioning to fully qualified professionals, challenges with PPE usage, and impact on personal and academic life.

CONCLUSIONS

Globally, radiography students experienced several challenges, especially during the initial acute phase of the pandemic. The pandemic-related challenges identified in this review could negatively influence the radiography student attrition rates, consequently worsening the existing radiography workforce shortage. Thus, urgent institutional level support systems and interventions would be necessary to mitigate the pandemic impact and improve the students' learning experience.

The changing role of pre-admission work experience (clinical visits) in therapeutic radiography, diagnostic radiography and operating department practice: Academic perspectives (part 2)

Introduction

A clinical visit (work experience) provides an opportunity for prospective students, prior to registration, to visit a clinical department to observe health professionals in practice. The Covid-19 pandemic interrupted access to clinical visits; this article explores the value of clinical visits and the alternatives implemented as a response to Covid-19 restrictions from an academic perspective.

Methods

This article reports the quantitative phase of a three-phase mixed methods study. A survey was distributed to Higher Education Institution (HEI) education leaders for onward distribution to academics supporting recruitment for diagnostic radiography, therapeutic radiography and operating department practice programmes. Qualtrics online survey software was used to administer the survey which was launched in October 2020. Descriptive statistics summarised the data.

Results

Representing 37.7% (n = 18/49) of eligible universities, 34 responses from 18 HEIs across England and Wales were received Seventy-eight percent of respondents strongly agreed that they are vital in confirming career choices. Prior to the Covid-19 pandemic, 64% of respondents’ programmes had a clinical visit requirement, yet with improvements in simulation and online learning alternatives, 48% agreed that in the longer-term clinical visits will become obsolete.

Conclusion

Requirements for clinical visits vary between professions and HEIs; academics welcome an opportunity to standardise work experience. Regardless of prospective student background and selected profession/university, all should have equitable and easily available access to high quality resources to support career decision-making.

Implications for practice

The enforced withdrawal of clinical visits may impact upon subsequent attrition associated with ‘misinformed career choice’. Alternatives to clinical visits, while less onerous for students, admissions staff and clinical colleagues alike, need to be carefully evaluated to ensure they offer prospective students a realistic understanding of the profession.

The Impact of COVID-19 Crisis on the Control and Management of Radiography Practice in the United Arab Emirates

The present study aimed to assess the impact of the COVID-19 crisis on radiology practices in Abu Dhabi, UAE. An electronic survey (Google form) was distributed among Abu Dhabi government and private hospitals. The survey included general X–ray services, which were only provided in the radiology departments. The diagnostic radiographers who reported changes in the number and type of radiology procedures (37%) reported that the changes reached 61–80% compared to the number of procedures being conducted prior to the outbreak of COVID-19. While infection control was challenging due to the shortage of personal protective equipment (PPE), 51.2% of the participants were affected. The healthcare workers in the radiology departments in Abu Dhabi are exposed to a high number of COVID-19–infection patients, which increases their chances of contracting the disease. A total of 90% of employees were infected with COVID-19 during the crisis. COVID-19 has resulted in changes in clinical working patterns, such as the type and number of procedures performed daily. Additionally, PPE shortages, staff infection during the pandemic, an increase in workplace–related difficulties, and staff well–being are common consequences of the pandemic. It is vital to enhance coping strategies in order to support staff well–being. However, the psychological effects caused as a result of the pandemic should not be ignored, and providing professional support to workers is recommended.

The risk of burnout in academic radiographers during the COVID-19 pandemic

Introduction

The COVID-19 pandemic created major challenges across society, healthcare provision and also for those delivering healthcare education programmes. Clinical placements were disrupted and, in many incidences cancelled. Higher education institutions were required to move completely to online delivery methods with little notice. This created significant additional workload, stress and the need to learn new skills at a time of great uncertainty. This study explored the risks of burnout in academic radiographers during the first 12 months of the pandemic.

Methods

A survey was circulated using SurveyMonkey™ via personal, national and international networks, including the European Federation of Radiographer Societies (EFRS), to reach as many academic radiographers as possible. Disengagement and exhaustion were measured using the Oldenburg burnout inventory. Descriptive statistics and a one-way ANOVA were used to analyse the quantitative data using STATA V16 (Statacorp, TA).

Results

533 academic radiographers responded to the survey from 43 different countries. Mean disengagement was in the medium range and exhaustion was high for the total dataset. In a subset of countries with 10 or more responses, there was significant variation between countries, with the UK having highest mean exhaustion score and the UK, Ireland and France sharing the highest mean disengagement score. In the total dataset, 86% agreed workload had increased during the pandemic and 35% had considered leaving academia in the last year.

Conclusion

These data demonstrate the stark reality of the impact of the COVID-19 pandemic on academic radiographers’ workload, wellbeing, and intention to leave their roles.

Implications for practice

COVID-19 has had a significant impact on academic radiographers and this study highlights the urgent need for remedial measures to better support academic radiographers in order to ensure a sufficient, and sustainable workforce.

COVID-19 vaccine hesitancy concerns: Findings from a Ghana clinical radiography workforce survey

INTRODUCTION

Vaccination is a key global strategy to mitigate the clinical impact of the COVID-19 virus. As part of local efforts to manage the outbreak, the government of Ghana announced its intention to vaccinate its population starting with essential and high-risk workers including radiographers. However, there were reports of hesitance to receiving the vaccine among the radiography workforce. This study was undertaken prior to the intended vaccination exercise to assess the willingness and concerns of radiographers to undergo the COVID-19 vaccination and to suggest recommendations to improve the vaccine uptake.

METHODS

An ethically-approved online survey strategy was employed for this cross-sectional study conducted between 24th-28th February 2021. The survey employed quantitative questions and open text response options. Quantitative and open text responses were analysed using statistical and thematic analyses, respectively.

RESULTS

There were 108 responses (response rate of 46.3%). The majority (n = 64, 59.3%) were willing to have the vaccine, however, some (n = 44, 40.7%) were not. The main reason behind their willingness to have the vaccine was its ability to reduce the spread of infections and lower mortality (n = 35, 54.7%). However, doubts about the vaccine's efficacy and side effects (n = 26, 56.8%), conspiracy theory concerns about its effects on the Ghanaian race (n = 4, 9.1%), and fertility concerns (n = 2, 4.5%) were some reasons for their hesitance to receive the vaccine. The open text commentary further revealed that the vaccine was thought of as a lifesaving medication, however, clinical safety concerns, lack of education/information and religious beliefs were affecting peoples' willingness to be vaccinated.

CONCLUSION

Our findings demonstrate the need for an urgent public health educational intervention to address the COVID-19 vaccine hesitancy concerns raised by radiographers to help increase the vaccine uptake.

IMPLICATION FOR PRACTICE

The study provides pertinent information to improve COVID-19 vaccine uptake among radiographers to limit the spread of infections.

Usefulness of ultrasound in the diagnosis of nosocomial maxillary sinusitis in patients with severe Covid-19 pneumonia: a retrospective study

Purpose

Severe Covid-19 pneumonia frequently presents with infective complications as bacterial and fungal infections, nosocomial maxillary sinusitis is one of them. We describe the role of ultrasonography in the diagnosis of nosocomial maxillary sinusitis in patients undergoing mechanical ventilation due to severe Covid-19 pneumonia.

Methods

Patients with severe pneumonia due to Covid-19 requiring mechanical ventilation and had maxillary sinus occupation by ultrasonography were retrospectively enrolled at intensive care unit of Sanatorio De los Arcos, Buenos Aires, Argentina, between March 2020 and May 2021.

Results

We evaluated a total of 171 patients with severe Covid-19 pneumonia requiring mechanical ventilation during the study period. We included 26 patients that had maxillary sinus occupation by ultrasonography (15.2%). Out of the 26 patients, in 17 the diagnosis was confirmed by surgical drainage of the maxillary sinus with positive cultures with a positive predictive value of 85%. In 34.6% of the cases the maxillary sinus disease was unilateral and in 38.4% bilateral. A sinus computed tomography (CT) was performed in 30.7% of the patients. Most of the patients underwent to surgical drainage without a CT scan (66.7%).

Conclusions

Ultrasonography is a useful tool for the detection of maxillary sinus infection in patients with severe Covid-19 pneumonia and avoids to perform a CT scan and, therefore, unnecessary transfers.

Impact of the Covid-19 pandemic on clinical radiography education: Perspective of students and educators from a low resource setting

Introduction

The COVID-19 pandemic has had significant impact on clinical radiography educational activities including teaching, research, and clinical placement. The study aimed to investigate the impact of the COVID-19 pandemic on clinical radiography education in a low-resource setting from the perspectives of students and educators.

Methods

A cross-sectional online survey was conducted between December 2020 and March 2021. Participants included student radiographers and educators from six clinical radiography training institutions in Ghana. Conventional descriptive statistics, frequency, and thematic text analysis were undertaken.

Results

291 valid responses were received involving 277 students and 14 educators. Most of the respondents, predominantly students did not find the online platforms for learning user-friendly. Key challenges to clinical radiography training during the pandemic included poor internet connectivity (73.8%), inadequate time for academic discussions (50.9%), and the reluctance of health facilities to accept students for clinical placement (51%). Challenges with data collection and the provision of supervision were issues associated with research activities.

Discussion

The findings suggest the COVID-19 pandemic has had significant impact on clinical radiography education in Ghana and other countries of similar resource availability.

Conclusion

Clinical radiography training institutions need to customize approaches to education. Adopting blended learning approaches as well as the use of simulation to augment practical placement opportunities are new modes of instruction that will maximize learning experience.

Experiences of diagnostic radiographers through the Covid-19 pandemic

Introduction

Diagnostic Radiography plays a major role in the diagnosis and management of patients with Covid-19. This has seen an increase in the demand for imaging services, putting pressure on the workforce. Diagnostic radiographers, as with many other healthcare professions, have been on the frontline, dealing with an unprecedented situation. This research aimed to explore the experience of diagnostic radiographers working clinically during the Covid-19 pandemic.

Methods

Influenced by interpretative phenomenology, this study explored the experiences of diagnostic radiographers using virtual focus group interviews as a method of data collection.

Results

Data were analysed independently by four researchers and five themes emerged from the data. Adapting to new ways of working, feelings and emotions, support mechanisms, self-protection and resilience, and professional recognition.

Conclusion

The adaptability of radiographers came across strongly in this study. Anxieties attributed to the provision of personal protective equipment (PPE), fear of contracting the virus and spreading it to family members were evident. The resilience of radiographers working throughout this pandemic came across strongly throughout this study. A significant factor for coping has been peer support from colleagues within the workplace. The study highlighted the lack of understanding of the role of the radiographer and how the profession is perceived by other health care professionals.

Implications for practice

This study highlights the importance of interprofessional working and that further work is required in the promotion of the profession.