First year student radiographers' perceptions of a one-week simulation-based education package designed to increase clinical placement capacity

Diagnostic radiography workforce expectations of learners against the 2023 HCPC standards of proficiency: Results of a UK Delphi study

INTRODUCTION

The UK Health and Care Professions Council revised the Standards of Proficiency for diagnostic radiographers in 2023 to reflect modern practices and service needs. This will impact on the training and assessment of learners throughout their programmes in order to support them to meet the threshold standards.

METHODS

A Delphi survey was distributed to UK diagnostic radiographers to ascertain the stage of training in which they expect each standard of proficiency to be demonstrated by the learner.

RESULTS

Ninety-four diagnostic radiographers responded to the survey and 58.5% (n = 55) completed the second round of the survey. Participants agreed on the stage of pre-registration training that 74.9% of standards should be met. However, for 19.6% of standards there was no consensus. In 5.5% of standards participants expected these to be met one year post qualification.

CONCLUSION

Agreement of when three quarters of the new Standards would be expected to be met during pre-registration training could support practice placement learning and assessment. However, there is some uncertainty around the Standards and the ability to provide appropriate resources, support, and expertise to enable learners to meet them.

IMPLICATIONS FOR PRACTICE

The consensus of expectations could inform stage appropriate learning opportunities aligned to the 2023 HCPC Standards within practice placements, and a standardised assessment, should the appetite be established. However, the UK diagnostic radiography profession still has some work to do in aligning expectations with the statutory regulatory body requirements and preparing all staff to support learners to meet all threshold standards at point of qualification.

The effect of different patient-based learning models on student perceptions of empathy, engagement, knowledge, and learning experience

BACKGROUND

Problem-based learning is used widely in pharmacy and medical programmes, incorporating realistic patient scenarios into regular teaching as a way of linking theory to practice. Routine case-based learning lessons ranges from real patient involvement, scripted patient scenarios, digital simulations (avatars) as well as through media such as Zoom. The existing literature has explored the extensive benefits of using patients in clinical education, but fewer studies have directly compared the efficacy of each model as learning tools.

AIM

To compare student perceptions of patient-based learning models to elicit student empathy, increase engagement, improve knowledge, and enrich learning experience.

METHODS

A questionnaire was distributed to second-year pharmacy students in Swansea University to gather their perceptions on the nine different patient-based learning models in their routine teaching (SUMS RESC 2023-0011). Students were asked to rank their experience of the models explicitly against each other, based on the four pillars of (1) eliciting student empathy, (2) increasing engagement, (3) improving knowledge and (4) enriching the learning experience. Students were also asked to rate the significance of realism (i.e. knowing the patient demographics/having a visual representation of the patient) to their experience.

RESULTS

Altogether, 31 student rankings of the nine learning models were weighted (9 = highest rank; 1 = lowest ranked). The data showed clear preferences for real-patient involvement over fictional cases, especially for eliciting empathy. Interestingly, scripted scenarios were rated highly for both engagement and learning experience only when avatars were involved, which suggests a role of animated visual representation of the patient in facilitating these outcomes.

CONCLUSION

Whilst it is useful to have multiple patient-based learning models, this study serves as a guide for educators in preparing case-based learning sessions for achieving the desired outcomes of any of the four pillars above.

What do the revised UK standards of proficiency mean for diagnostic radiography training? A regional radiographer focus group study

INTRODUCTION

Revisions to the UK Health and Care Professions Council (HCPC) standards of proficiency for diagnostic radiographers came into effect on September 1st 2023. Changes include an increase of proficiencies in CT and extended to MRI imaging. As workforce support the development of learners to meet stage outcomes in practice, this study aimed to understand the radiographers' expectations of future learners' training to meet the new standards of proficiency.

METHODS

Snowball sampling was used to invite practice educators/student supervisors and department leads within the 21 NHS Trusts in the North East and Yorkshire region providing diagnostic radiography practice placements. Online focus groups used a semi structured topic guide to explore the expectations of student performance during different stages of their training, and on different types of pre-registration programmes. Participants views were sought on considerations for appropriate assessment. Thematic analysis was supported by NVivo software.

RESULTS

Fifteen diagnostic radiographers across 11 NHS trusts participated in 5 focus groups in November 2022. The findings showed consistency in expectations of student performance in projectional radiography, patient care and communication. Participants felt some standards of proficiency were beyond threshold competency, or current practices were a barrier in supporting learning. Participants felt assessment over a period and range of examinations in the clinical environment gave a fairer picture of student performance.

CONCLUSION

There is uncertainty and perceived barriers in supporting future diagnostic radiography training in the practice setting.

IMPLICATIONS FOR PRACTICE

Further work will be needed to identify and support appropriate learning opportunities and stage outcomes if learners are to meet the breadth of HCPC standards of proficiency with some consistency.

'Gear up and get ready': Collaborative curriculum for radiographers supporting percutaneous nephrolithotomy in the operating theatre

INTRODUCTION

Newly qualified radiographers often find working in the operating theatre (OT) challenging and intimidating. These perceptions, which inhibit confidence, may hinder their effectiveness in interprofessional teamwork, which may in turn adversely affect patient outcomes. A collaborative education programme was designed, building upon the foundations of competency-based education (CBE) and simulation-based mastery learning (SBML) to examine its potential in mitigating these perceptions. The objective of this research was to assess participants' experience and level of competency after attending the curated collaborative educational programme.

METHODS

The programme was developed based on the Analysis, Design, Development, Implementation, and Evaluation (ADDIE) model and comprises two teaching and learning phases: educational session and simulation. A collaborative approach was undertaken to develop an assessment checklist for the interprofessional simulation. Requirements for the simulation, such as scenario design, information and storyboard, task trainer, logistics, and learners' briefing, debrief, and feedback, were identified and assembled. The radiographers' performance was recorded using a practical skills assessment checklist and a theory assessment.

RESULTS

Twelve radiographers participated and showed improvement in their self-rating of learning objectives before and after the programme. The median (interquartile range) score achieved in the theory assessment, out of a possible of 11, was 9.00 (7.75-9.50). The median (interquartile range) score achieved in the simulation component, out of a possible of 16, was 15.00 (14.00-15.00). There was statistically significant difference in self-perceived performance in all learning objective domains.

CONCLUSION

The findings from the programme were promising. The use of simulation and an assessment checklist proved to be useful learning tools in preparing newly qualified radiographers for work in the OT.

IMPLICATIONS FOR PRACTICE

Assessment checklists are valuable tools that should be considered to facilitate teaching and learning. The use of interprofessional simulation activities can support radiographers in developing knowledge, professional skills, and clinical competency. It should be conducted in a timely manner to facilitate the introduction to role understanding and effective communication.

An exploration of simulation-based education from other health professionals, to create an informed and effective simulation delivery in a new diagnostic radiography programme

INTRODUCTION

The recent validation of three Diagnostic Radiography programmes in the south of England involved a rigorous approval process with multiple Professional and Statutory Regulatory Bodies (PSRB's). Part of the validation process was evidencing that approximately 50% of each programme is spent undertaking practice-based learning. As well as clinical placements, practice-based learning includes simulation-based education (SBE).

METHODOLOGY

From May 2022 to June 2022, a questionnaire was sent to all 22 simulation education facilitators from health courses belonging to the University School Simulation Group. Ethical approval was reviewed and approved by the Learning and Teaching Hub Research Ethics Panel.

RESULTS

Of the initial 22 participants invited, the response rate was 59% (13 participants). The main themes arising from the analysis was the use of a theoretical or conceptual framework, a breakdown of the simulation session components and the role of simulation training.

CONCLUSION

This questionnaire study demonstrated that there was a need for a standardised guide on how to deliver SBE. There is also a lack of feedback, training, and reassurance for facilitators. However, facilitators would welcome training or further training and HEE and the University have taken steps to prioritise SBE.

IMPLICATIONS FOR PRACTICE

The study highlighted how health professionals are delivering SBE within their subjects in innovative and creative ways. These ideas have helped to structure SBE within the new diagnostic radiography courses at the University.

Time for a simulation strategy?

This editorial evaluates the role of virtual reality alongside traditional simulation learning environments for radiography education. With such rapid uptake in recent years, is it time to consider how simulation can be implemented more strategically?

Radiographers' perceptions of first year diagnostic radiography students' performance following implementation of a simulation-based education model

INTRODUCTION

Simulation-based education (SBE) partially replaced the clinical placement learning for a cohort of first year students on a BSc (Hons) Diagnostic Radiography programme. This was in response to the pressures on hospital-based training caused by increasing student numbers and following increased capability and positive outcomes for student learning in delivering SBE as a result of the COVID-19 pandemic.

METHODS

A survey was distributed to diagnostic radiographers, across five NHS Trusts, involved in the clinical education of first year diagnostic radiography students at one UK university. The survey sought radiographers' perception of student performance in undertaking radiographic examinations, safety procedures, knowledge of anatomy, professionalism, and the impact of embedding simulation-based education through multichoice and free text questions. Descriptive and thematic analysis of the survey data was undertaken.

RESULTS

Twelve survey responses from radiographers across four Trusts were collated. Responses indicated the majority of radiographers perceived students to require the expected level of assistance in undertaking appendicular examinations, applying infection control and radiation safety measures, and had the expected level of radiographic anatomy knowledge. Students also interacted appropriately with service users, demonstrated increased confidence in coming into the clinical environment and were receptive to feedback. Some variation was noted, particularly in professionalism and engagement, though not always attributed to SBE.

CONCLUSION

Replacement of clinical placement with SBE was perceived to have provided appropriate learning opportunities and some additional benefits, however it was felt by some radiographers that SBE could not replace the experience of the real imaging environment.

IMPLICATIONS FOR PRACTICE

Embedding simulated-based education requires a holistic approach and close collaboration with placement partners to ensure complimentary learning experiences in the clinical placement setting, and support achievement of the learning outcomes.

An exploratory study on recently qualified Australian radiographers' expectations and experiences in emergency and trauma imaging

BACKGROUND

Radiographers provide imaging services in multiple healthcare settings, including emergency and trauma. Transitioning to a qualified radiographer is already a time of vulnerability - with the increasing complexity and unpredictable nature of the emergency and trauma healthcare environment, recently qualified radiographers may experience this environment distinct from other service delivery areas.

OBJECTIVE

The study explored recently qualified radiographers' expectations and experiences in emergency and trauma imaging service delivery.

METHODS

An inductive qualitative phenomenological approach with a purposive sampling technique recruited recently qualified radiographers (n=19) involved in the delivery of emergency and trauma imaging services. Transcribed semi-structured individual interviews were thematically analysed.

RESULTS

Two themes and related categories were identified: 1. The multiplexity of diagnostic emergency and trauma imaging service delivery and 2. Approaching the complex nature of emergency and trauma imaging.

CONCLUSION

The expectations and experiences of emergency and trauma imaging varied, aligned to previous exposure to emergency and trauma imaging. Even though emergency and trauma imaging was challenging, the fast pace, patient dynamics and multidisciplinary deliverance; the experience was considered rewarding and an opportunity to improve skills. Participants coped through debriefing and calming strategies; however, radiology-specific debriefing was recommended to further foster the recently qualified radiographers' well-being.

Can simulation-based education or other education interventions replace clinical placement in medical radiation sciences? A narrative review

OBJECTIVES

In response to increasing student enrolment and workload pressures from the Covid-19 pandemic, a recent focus on health student preparation programs has been on curricula adaptations and replacement of clinical placement time with alternative education activities. The aim of the narrative review was to explore the current evidence relating to education activities in Medical Radiation Sciences (MRS) used to replace clinical placements or part of clinical placements. Medline, CINAHL and Web of Science databases were used to search for articles published between 2017 and 2022. Data from the literature was summarised into (1) planning and development of clinical replacement learning activities in MRS, (2) evaluation of clinical replacement activities, and (3) benefits and challenges of clinical replacement in MRS.

KEY FINDINGS

Planning and development of clinical replacement learning activities in MRSrequires support from a wide range of stakeholders, and evidence from activities already implemented exists. Activities largely encompass an institution-specific focus. Developed clinical replacement activities use a blended approach, with simulation-based education (SBE) as a main teaching platform. Evaluation of clinical replacement activities are largely focused on students' achievement of learning objectives relating to practical and communication skills. Emerging evidence based on small student samples shows that clinical and clinical replacement activities provide similar results in terms of learning objectives.

CONCLUSION

Benefits and challenges of clinical replacement in MRS are similar to those presented in the other health professions. The balance between quality and quantity of teaching and learning experiences for clinical skill development in MRS needs to be further investigated.

IMPLICATIONS FOR PRACTICE

To meet the dynamic challenges of the health care environment and MRS profession, a major goal in the future will be to affirm the benefit of clinical replacement activities for MRS students.

Survey of clinical placements within pre-registration diagnostic radiography programmes in the UK and Ireland

INTRODUCTION

Placement capacity is a challenge in supporting the clinical education of diagnostic radiography students within the UK at a time where growth in the workforce is required if service delivery needs are to be met. COVID-19 has been one of the catalysts in the growth of innovative and simulated clinical placement models. This survey seeks to understand the current picture of clinical education models and the drivers for it.

METHODS

A short online MS Forms survey with mixed question types was distributed to higher education institutions (HEIs) delivering pre-registration diagnostic radiography programmes in the UK and Ireland. Descriptive and thematic analysis of data was undertaken to gain insight into the clinical placement models used.

RESULTS

Responses related to 24 programmes from 17 HEIs were collated. Capacity issues, increased student numbers and ability to achieve the learning outcomes were the drivers for the model and arrangement of clinical placements. Clinical practice hours varied widely across programmes as did the proportion of simulation-based education. Respondents felt an increase in the use of placements in modalities and other settings could further increase training capacity.

CONCLUSION

Opportunities to further change the clinical placement model have been identified which may alleviate some pressure points on capacity. Guidance around clinical practice hours may facilitate a sustainable approach to workforce training. Innovative placement models will require assessment strategies that align in order that students demonstrate relevant capabilities in a range of settings and value varied learning opportunities.

IMPLICATIONS FOR PRACTICE

The collective engagement and innovation of higher education institutions and service providers will be needed to create sustainable quality models of clinical training and assessment to meet diagnostic radiography workforce requirements.

Virtual Reality in Health Science Education: Professors’ Perceptions

Virtual reality (VR) is a simulated experience in a three-dimensional (3D) computer-simulated world. Recent advances in technology position VR as a multipurpose technology in the healthcare sector and as a critical component in achieving Health 4.0. In this article, descriptive and correlationally quantitative research is carried out on the assessments made by Latin American health sciences university professors on the didactic use of virtual reality technologies. The main objective was to analyze the differences in the perceptions expressed by the public or private tenure of the universities where the professors teach. In addition, gender and age gaps were identified in the assessments obtained from each of the types of universities. The results reveal that Latin American health science professors at private universities have a higher selfconcept of their digital skills for the use of virtual reality in the lectures. This greater selfconcept also leads to a reduction in the gender and age gaps in the participating private universities with respect to the public counterparts. It is advisable to increase both faculty training in the didactic use of virtual reality and funding for its use, mainly in public universities.