Professionalism in radiography

Alumni, radiographers, clinical placement tutors and industry insights about current radiographers practice, competences and autonomy in western Switzerland

INTRODUCTION

Radiographers' profession is constantly evolving, which demands adaptation of education and training programs to build up medical imaging and radiation therapy professionals (MIRTPs) that provide healthcare to improve patient experience and outcomes. This study aimed to map radiographers' practices, competences, and autonomy level in Western Switzerland.

METHODS

Data was collected by 2 cross-sectional online surveys targeting Alumni, radiographers, clinical placement tutors and medical imaging equipment specialists from industry, with opened and closed-end questions. Descriptive statistics and thematic analysis were used to analyse the data.

RESULTS

81 Alumni and 93 Chief-Radiographers, clinical tutors, practitioner-radiographers and industry answered the questionnaires. The competences considered as the most "acquired or completely acquired" by the Alumni were: adopt a reflective posture on practice (90.1 %; 73/81), adopt ethical behaviour (90.1 %; 73/81), carrying out and providing radiological services for diagnostic, therapeutic and preventive purposes (81.5 %; 68/81), adapting communication to the other surrounding persons (81.5 %; 66/81), and check compliance of procedures with standards (69.1 %; 56/81). Similar results were referred by Employers. The autonomy of the participant radiographers was considered as average, and it focuses only the preparation of the patient and the protocol optimisation. The development and integration of research is weak as well as the application of competences regarding professionalism.

CONCLUSIONS

A better link between educational institutions and clinical practice can help on the integration of research and evidence-based on practice, necessary to progress the radiographers' profession in Western Switzerland. The autonomy needs to be further developed and leadership courses must be integrated in the curricula to facilitate the implementation of new approaches to reinforce radiographer's profession.

IMPLICATIONS FOR PRACTICE

Practice must be revised to integrate evidence-based; to facilitate research development, the managers need to increase support.

Assessing the barriers and enablers to the implementation of the diagnostic radiographer musculoskeletal X-ray reporting service within the NHS in England: a systematic literature review

INTRODUCTION

The United Kingdom (UK) government's healthcare policy in the early 1990s paved the way adoption of the skills mix development and implementation of diagnostic radiographers' X-ray reporting service. Current clinical practice within the public UK healthcare system reflects the same pressures of increased demand in patient imaging and limited capacity of the reporting workforce (radiographers and radiologists) as in the 1990s. This study aimed to identify, define and assess the longitudinal macro, meso, and micro barriers and enablers to the implementation of the diagnostic radiographer musculoskeletal X-ray reporting service in the National Healthcare System (NHS) in England.

METHODS

Multiple independent databases were searched, including PubMed, Ovid MEDLINE; Embase; CINAHL, and Google Scholar, as well as journal databases (Scopus, Wiley), healthcare databases (NHS Evidence Database; Cochrane Library) and grey literature databases (OpenGrey, GreyNet International, and the British Library EthOS depository) and recorded in a PRISMA flow chart. A combination of keywords, Boolean logic, truncation, parentheses and wildcards with inclusion/exclusion criteria and a time frame of 1995-2022 was applied. The literature was assessed against Joanna Briggs Institute's critical appraisal checklists. With meta-aggregation to synthesize each paper, and coded using NVivo, with context grouped into macro, meso, and micro-level sources and categorised into subgroups of enablers and barriers.

RESULTS

The wide and diverse range of data (n = 241 papers) identified barriers and enablers of implementation, which were categorised into measures of macro, meso, and micro levels, and thematic categories of context, culture, environment, and leadership.

CONCLUSION

The literature since 1995 has reframed the debates on implementation of the radiographer reporting role and has been instrumental in shaping clinical practice. There has been clear influence upon both meso (professional body) and macro-level (governmental/health service) policies and guidance, that have shaped change at micro-level NHS Trust organisations. There is evidence of a shift in culturally intrenched legacy perspectives within and between different meso-level professional bodies around skills mix acceptance and role boundaries. This has helped shape capacity building of the reporting workforce. All of which have contributed to conceptual understandings of the skills mix workforce within modern radiology services.

Tensions in ethnographic observation: overt or covert?

Purpose

The purpose of this paper is to reflect on the tensions between being covert and overt during ethnographic observations. The example of an ethnographic study of the culture in a diagnostic imaging department will be used to provide examples.

Design/methodology/approach

This paper is a reflection on an ethnographic study, focussing on the participant observation.

Findings

This paper discusses the author’s reflections on the covert and overt nature of ethnographic observation.

Originality/value

The discussion is of value to all ethnographic researchers who experience this tension.

Letter in response to 'The role of research for advanced practitioners'

This letter to the Editor is in response to the paper 'Conceptualisation of the characteristics advanced practitioners in the medical radiation professions' by Smith et al. and the subsequent letter from Jenny Sim. The writers agree that research should be explicitly listed in the conceptual model of advanced practice, and provide some evidence and viewpoints from over a decade of advanced practice work in Canada.

Nurses', physicians' and radiographers' perceptions of the safety of a nurse prescribing of ionising radiation initiative: A cross-sectional survey

BACKGROUND

A new initiative was introduced in Ireland following legislative changes that allowed nurses with special training to prescribe ionising radiation (X-ray) for the first time. A small number of studies on nurse prescribing of ionising radiation in other contexts have found it to be broadly as safe as ionising radiation prescribing by physicians. Sociological literature on perceptions of safety indicates that these tend to be shaped by the ideological position of the professional rather than based on objective evidence.

OBJECTIVES

To describe, compare and analyse perceptions of the safety of a nurse prescribing of ionising radiation initiative across three occupational groups: nursing, radiography and medicine.

DESIGN

A cross-sectional survey design.

SETTINGS

Participants were drawn from a range of clinical settings in Ireland.

PARTICIPANTS

Respondents were 167 health professionals comprised of 49 nurses, 91 radiographers, and 27 physicians out of a total of 300 who were invited to participate. Non-probability sampling was employed and the survey was targeted specifically at health professionals with a specific interest in, or involvement with, the development of the nurse prescribing of ionising radiation initiative in Ireland.

METHODS

Comparisons of perspectives on the safety of nurse prescribing of ionising radiation across the three occupational groups captured by questionnaire were analysed using the Kruskal-Wallis H test. Pairwise post hoc tests were conducted using the Mann-Whitney U test.

RESULTS

While the majority of respondents from all three groups perceived nurse prescribing of ionising radiation to be safe, the extent to which this view was held varied. A higher proportion of nurses was found to display confidence in the safety of nurse prescribing of ionising radiation compared to physicians and radiographers with differences between nurses' perceptions and those of the other two groups being statistically significant.

CONCLUSION

That an occupational patterning emerged suggests that perceptions about safety and risk of nurse prescribing of ionising radiation are socially constructed according to the vantage point of the professional and may not reflect objective measures of safety. These findings need to be considered more broadly in the context of ideological barriers to expanding the role of nurses.

The research agenda and the role of the therapeutic radiographer: The College of Radiographers perspective

This article reflects on the influences on current radiotherapy practice and the key role that Therapeutic Radiographers have in the management of cancer care and the delivery of treatments. In particular the Cancer Reform Strategy is discussed which clearly highlights the many challenges related to cancer. Changes in societal and scientific understanding will demand that the most appropriate and evidence-based care is provided for patients, underscoring the need for evidence through research, to underpin every aspect of daily work if patient outcomes are to continue to improve. In October 2005, the Society and College of Radiographers published: ‘Research and the Radiography Profession—A Strategy and Five Year Plan’. This is an ambitious document, which sets out expectations for the appreciation and use of substantiated research involvement at all levels of practice. Sections of this document and the relevance to radiotherapy practice are discussed. Alongside this, the career progression model for radiography continued to be driven forward with support from the Department of Health. This model describing higher levels of practice for radiographers, at advanced and consultant levels, clearly identified research as a key requirement for the profession. The guidance document in 2006, from the Society and College of Radiographers ‘Positioning Therapeutic Radiographers within Cancer Services: Delivering Patient Centred Care’, further articulated these expert roles, in response to the changing drivers within cancer and across the radiotherapy pathway. In conclusion, research must become a fundamental component of everyday radiotherapy practice as it will verify professional standards of care and sustain the future of the profession. To contribute to the wider cancer agenda it is imperative that all therapeutic radiographers, from practitioner to consultant level, participate in and lead research.

The scholarly radiation therapist. Part one: charting the territory

As radiation therapy practice evolves with advancing treatment and planning technologies, merging of imaging modalities, changing working models and the advancement to higher education, radiation therapists are frequently finding themselves on the frontline of translating new knowledge into practice. To a large degree, this growing involvement in self-directed original research, with associated dissemination of completed results, has led to an increasing number of therapists being encouraged to pursue an academic path in addition to a clinical career. In Canada, radiation therapists are being appointed as faculty to university departments for the first time. It is heartening that such opportunities are increasing; therapists are able to play a profound role in developing an evidence-based professional body of knowledge while at the same time being recognised for scholarly endeavours. However, despite these many positive steps, barriers and challenges to the development of a scholarly culture for radiation therapists still exist. Part one of this two-part series explores the history of the profession and the subsequent development of a scholarly culture.