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

Research culture, barriers and facilitators within the radiography workforce in the UK - results of a national survey

INTRODUCTION

Research is vital for diagnostic and therapeutic radiographers, providing the evidence base for disease diagnosis, screening, surveillance, radiotherapy planning, delivery, and treatment. Despite its benefits in improving patient outcomes and imaging services, little is known about the research culture barriers and facilitators within the UK radiography workforce.

METHODS

An online survey with three sections was created, including demographic questions and a validated research and development culture index to measure research capacity, equality, diversity, and inclusivity. The survey was distributed between May and October 2023 to radiographers and nuclear medicine technologists via email and social media. Mixed methods analysis was performed using statistical analysis (R version 4.2.2) and qualitative analysis utilising a coding framework for open-ended responses.

RESULTS

A total of 970 completed surveys were returned: 629 diagnostic radiographers, 306 therapeutic radiographers and 35 nuclear medicine technologists (∼3 % of the UK workforce). Of respondents, 47.4 % had completed or were undertaking a postgraduate qualification and 41.1 % had engaged in research. The barriers to research yielded similar trends over all the radiographers. 'Lack of protected time at work', 'other roles taking priority' and 'lack of funding' being key barriers. The only enablers that scored less than 90 % agreement were 'research encouraged by manager', 'experienced external colleagues able to supervise', and the 'desire to prove a theory or hunch' and 'research written into the role description'.

CONCLUSION

Research remains underdeveloped in UK radiography roles. This national survey highlights that currently less than half of the UK radiographers have experience in research within their role. Protected time, funding, managerial support, and supervision access are crucial to embedding research into practice.

IMPLICATIONS FOR PRACTICE

Greater support is needed for radiographers and managers to overcome barriers and promote radiographer-led research.

The role of MRI research radiographers in clinical research: Responsibilities, challenges, and future directions a UK perspective

BACKGROUND

The role of MRI research radiographers has transformed over the past decade, evolving from a focus on diagnostic imaging to active contributions in clinical research. MRI research radiographers now engage in protocol development, participant safety management, and emerging technologies, highlighting their importance in multidisciplinary research teams.

AIM

This professional review explores the responsibilities, challenges, and future directions of MRI research radiographers in the UK, with a focus on their evolving role in clinical research settings.

METHODS

A narrative review methodology was utilised to synthesise peer-reviewed literature, professional guidelines, and expert opinions. Findings were categorised into three main themes: core responsibilities, challenges and barriers, and opportunities for future professional growth.

KEY FINDINGS

MRI research radiographers play a crucial role in managing participant safety, ethical considerations, and advanced imaging technologies. Challenges such as resource constraints, interdisciplinary communication gaps, and ethical dilemmas (e.g., incidental findings) pose barriers to effective practice. Future opportunities include integrating artificial intelligence, establishing standardised professional frameworks, and expanding global collaborations. Enhanced training in advanced imaging techniques, research ethics, and governance is also essential for their continued contribution to both research and clinical practice.

CONCLUSION

This review highlights the critical and evolving role of MRI research radiographers in advancing clinical research and participant care. By addressing current challenges and leveraging emerging opportunities, MRI research radiographers can remain at the forefront of technological innovation and enhance their impact on healthcare research and delivery.

A survey of Swedish radiographer's need for knowledge at advanced level

INTRODUCTION

There are uncertainties about whether current advanced-level courses provide the knowledge needed to develop the profession for radiographers in Sweden. The aim of this study was to investigate Swedish radiographers' perceived need for additional post-registration knowledge in their profession and their need for education at advanced level.

METHODS

Swedish radiographers were invited to participate in a national electronic survey between November and December 2022. The survey encompassed demographics and 22 inquiries covering domains concerning radiographer's educational needs and motivations, educational type, and the employer's influence on radiographers' higher education pursuits. The pilot-tested survey used both open-ended questions and questions answered with a 10-point Likert scale. Analysis was performed using linear regression and ANOVA, as well as latent content analysis.

RESULTS

In total, 326 respondents participated in the survey, representing all 21 county councils in Sweden. The highest ranked reasons for desiring increased knowledge were to increase patient safety and increase the quality of examinations. Radiographers preferred to study during paid working hours, in university/college, with the possibility to undertake a master's degree in radiography; however, staff shortages hampered this development. Moreover, women expressed a greater desire to pursue further studies than men.

CONCLUSION

Swedish radiographers expressed a high concern for enhancing the quality of examinations and patient safety, and to succeed, they wanted to study during paid working hours at university/college with the possibility of taking a master's degree in radiography.

IMPLICATIONS FOR PRACTICE

The requirement by law of regulated modality-based specialization positions for radiographers, leading to a demand for advanced-level courses at universities/colleges for all current methods in radiology departments, would increase the quality of examinations and treatments, as well as patient safety.

Research and fellowship funding perspectives: A collective NIHR experience of a community of pre- and post-doctoral radiographers

OBJECTIVES

This paper harnesses a comprehensive overview and the collective experience of a community of pre- and post-doctoral Radiographers in successfully securing grants to demonstrate what is required as part of an NIHR fellowship application.

KEY FINDINGS

Developing a research fellowship application requires individuals to expose themselves to critique to improve the content, design and structure of the proposed piece of work. The scale of the project should be carefully considered when developing applications, with the research plan accurately and realistically proposing a suitable amount of work to be undertaken within the timeframe. All fellowship applications comprise several key elements which must be meticulously crafted to address the requirements of the specific call. This is critical because every section of the application undergoes scrutiny by review panels to ensure the funding achieves its maximum impact. The key elements requiring detailed information are themed around Project, Person, Place, Patient and public involvement and engagement (PPIE), the surrounding People, and a training plan. However, a golden thread highlighting inclusive research that is people-centred is required to run through the entire application.

CONCLUSION

NIHR fellowships are an important pathway to enable dedicated clinically relevant research projects for patient/family benefit to be combined with the advancement of an individual's clinical and academic skills. These dedicated funding streams are tailor-made to enable a wide range of healthcare professionals, including Radiographers, to develop into research leaders of the future.

IMPLICATIONS FOR PRACTICE

Maximising research training opportunities, including research fellowships for the Radiography profession, will offer the completion of clinically relevant research projects alongside the development of the research leaders of the future.

Factors of importance for the development of evidence-based practice amongst radiographers in public healthcare

INTRODUCTION

Research evidence suggests that radiographers often rely on previous training, traditional practices, work experience and protocols developed within the department rather than up-to-date research-based evidence in their daily practice. The aim of the study was to investigate factors that might impact the development of evidence-based practice amongst radiographers in clinical public settings in the Nordic countries.

METHODS

An online survey was performed amongst 640 radiographers in four Nordic countries. Multivariate logistic regression was performed to investigate the odds ratio (OR) of facilitators for and barriers to radiographers' development of evidence-based practice.

RESULTS

A reflective approach in everyday practice and being aware of the current research evidence were significant facilitators for radiographers' development of evidence-based practice (OR ≥ 3.10, p < 0.001). Discussing research with colleagues and managers was associated with engagement in the utilisation of evidence (OR 7.21, p < 0.001). Difficulties in evaluating research evidence represented the only significant barrier (OR 1.84, p 0.009).

CONCLUSION

A critical approach amongst radiographers in their performance of healthcare in diagnostic imaging, and the development of their academic skills to improve awareness of the available research evidence are important factors for developing evidence-based practice in radiography. Leadership is crucial for the engagement of radiographers in the development of evidence-based practice. Management should facilitate the development of a learning culture within diagnostic imaging.

IMPLICATIONS FOR PRACTICE

The results provide suggestions for the development of a learning culture, proactive and person-centred leadership, and strategic management for the provision of research infrastructure, all of which contribute to the further integration of evidence-based practice in radiography. Also, the study results suggest the importance of shared responsibility for creating a critical fellowship in diagnostic imaging.

Research active medical imaging professionals in Australian metropolitan health services embrace opportunities and can overcome obstacles to engage in research: A mixed methods study

INTRODUCTION

A minority of medical imaging professionals within Australian metropolitan healthcare services are engaging in research activity as part of an emerging research culture. This study aimed to explore the characteristics and experience of medical imaging professionals who engage in research to identify contextual and individual factors that empower them to participate in research.

METHODS

A mixed methods observational study consisting of quantitative (survey) and qualitative (semi-structured interview) components using an interpretative description approach was completed with research active medical imaging professionals (radiographers, nuclear medicine technologists and sonographers). Thematic analysis was performed on qualitative data and triangulation of qualitative and quantitative data provided an in-depth synthesis.

RESULTS

Fifteen participants completed the survey. Participants had moderate levels of research interest (median 4 points, interquartile range (IQR) 3-4), and higher confidence and experience than a general cohort of medical imaging professionals. Interviews (n = 14) found an overall theme that participants embraced opportunities and could overcome challenges related to research. This was driven by personal characteristics including a motivation to solve clinical problems. They overcame issues related to competing clinical and research demands and identified that support from research mentors was critical and pivotal to fuelling emerging research culture.

CONCLUSION

Research active medical imaging professionals are interested in developing research skills and exhibit personal characteristics and drive that help them overcome common barriers to research participation when adequate support is provided.

IMPLICATIONS FOR PRACTICE

This study identified enablers to research in medical imaging departments including the importance of research support, especially research mentors. Findings from this study may support the development of research skills and culture among staff in medical imaging departments to ensure optimal care for patients.

Navigating challenges in radiography research: radiographers' perspectives in Saudi Arabia

Introduction

Radiography is a crucial healthcare specialty that requires ongoing research to advance imaging technologies and techniques. Despite this, radiographers are faced with obstacles such as time constraints, lack of resources, and the need for training on new technologies, which can discourage their research involvement. This study aims to provide a more representative understanding of the radiography research culture in Saudi Arabia, building upon previous studies.

Methods

Following the approval of an ethics committee at Taibah University (2024/173/302 DRD), a cross-sectional survey was conducted from January to March 2024 among registered radiographers in Saudi Arabia. An online questionnaire was distributed via social media platforms using a snowball sampling strategy to reach a diverse group of radiographers across different regions and institutions. Participants provided informed consent before completing the questionnaire. The questionnaire, originally in English, was translated into Arabic and validated by two bilingual academics. It included sections on demographics, previous research experience, barriers to research involvement, factors encouraging research engagement, and self-assessment of research competencies. Descriptive statistics and Cronbach's alpha were used to analyze the data.

Results

A total of 105 radiographers participated in the study, with 41% having prior research involvement. Among those engaged, the most common activity was data collection (65%), followed by preparation of scientific articles (49%). Challenges such as the lack of a research-focused culture (48%), insufficient awareness of opportunities (36%), and time constraints (34%) were prominent barriers to research participation. Encouraging factors included the need for research training (63%), support from research groups (51%), and allocated research time (50%). Respondents assessed their research skills, with confidence varied across skills, with 50% feeling capable of initiating research and 51% of participating, yet a significant proportion expressed uncertainties, especially in statistical knowledge and research methodology.

Conclusion

Most of the surveyed radiographers did not engage in research. However, there is a substantial interest in enhancing research involvement, with training, collaborative groups, and organizational support identified as key factors encouraging participation. The findings suggest that addressing these barriers can foster a more robust research culture, leading to improved diagnostic practices.

Iodinated contrast media waste management in hospitals in central Norway

INTRODUCTION

The demand for iodine has increased in the last years, among other factors due to increased medical use. There is no consensus regarding iodinated contrast media (ICM)'s damaging impact on the environment and therefore the producers encourage collecting and recycling ICM waste. The aim of the study was to investigate the ICM waste management in hospitals in Central Norway and to explore the radiographers' attitudes regarding ICM recycling and possible causes of suboptimal waste management.

METHODS

The link to the electronic survey was sent to all radiographers working with computed tomography within the Central Norway Regional Health Authority. Descriptive and inferential statistics were performed.

RESULTS

Results reported from 100 radiographers from eight hospitals show that ICM leftovers are recycled or reused in most cases (26% collect them for recycling and 38% use them for oral administration) while 25% send them to the pharmacy together with other pharmaceutical waste and 8% discard them in the sink or the garbage bin. 25% reported that they are not familiar with their department's procedures related to ICM waste. 84% were concerned about the consequences of ICM waste for the environment.

CONCLUSION

There were considerable differences in the management of ICM waste amongst the hospitals and also internally within the hospitals. Improper practices, likely caused by lack of disposal plans and/or suboptimal information flow, were reported to a low extent.

IMPLICATIONS FOR PRACTICE

Local ICM waste management guidelines which are easily available for radiographers may increase both reuse and recycle rates. Including ICM waste management in the educational curriculum for radiographers can provide early understanding of the rationale behind the procedures and their environmental impact.

Sonographers' perspectives on research - A worldwide online questionnaire study

INTRODUCTION

Research has been performed by sonographers (also known as ultrasound reporting radiographers) for many years for improving diagnosis of disease, developing new imaging approaches, and enhancing patient outcomes. Despite this, sonographers' perspectives on research have not been well studied. To understand the views of sonographers is essential, as they have an important role in the successful implementation of research outcomes during their daily work. The study aimed to explore sonographers' perspectives on research.

METHODS

This cross-sectional online questionnaire was developed, and pilot tested, before distribution on social media platforms by the research group to sonographers or reporting radiographers in ultrasound worldwide. The questionnaire included 21-items. The link was open for 8 weeks in the spring of 2023. A mix of closed, open and scale questions were used. Informed consent was mandatory, and information about the study and anonymity was presented.

RESULTS

A total of 165 sonographers participated in the questionnaire of which 66.1 % were from Europe (n = 109), 6.1 % from North America (n = 10), 0.6 % from South America (n = 1), 2.4 % from Asia (n = 4), 13.3 % from Africa (n = 22) and 11.5 % from Oceania (n = 19). A total of 32 % of the participants had performed research. Also, 68.5 % would like to become more involved in research.

CONCLUSION

Most sonographers work in large hospitals, and half of them have obtained academic level 7 education. A limited number of sonographers have published peer reviewed papers. Many sonographers expressed an interest in research. This suggests a potential for future development of the sonographers' role in research.

IMPLICATIONS FOR PRACTICE

The findings for this study provide insight that could be used to improve research practice for sonographers.

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.