Ethical issues for radiographers: general observations and a pilot qualitative study

Unprofessional practice and student professionalism dilemmas: What can radiography learn from the other health professions?

OBJECTIVE

Professionalism in radiography is a complex, multidimensional concept seldom investigated. During clinical placements, students may observe or be involved in unprofessional practice/professionalism lapses which result in professionalism dilemmas. Establishing what constitutes a professionalism dilemma and what action to take may be challenging for students and also practitioners. This is due to unclear reporting pathways and fear of retribution, both deterrents to raising concerns. The aim of this integrative literature review was to investigate how and why professionalism dilemmas occur. In addition, to explore the types of dilemma students experience during clinical placement and to contextualise and reflect on these findings within radiography. Ovid MEDLINE, PubMed, Google Scholar and the grey literature were reviewed, analysed and themed.

KEY FINDINGS

Twenty-eight papers (published between 2004 and 2020) were analysed and summarised. Four themes emerged, and were discussed within the radiography context; the nature of professionalism lapses (mistreatment, verbal abuse, exclusion and intimidation), reasons for professionalism lapses (burnout and poor role modelling), student response at the time of the professionalism dilemma (accept, resist or report) and long-term impacts on students (moral/emotional distress, professional development and choice of career).

CONCLUSION

Professionalism dilemmas are not reported in the radiography literature but are cited in radiology and other health professions studies. Student experiences of such dilemmas can be profound and long lasting. Thus, research is required to investigate specifically the professional dilemmas experienced by radiography students in the unique environment in which they develop their clinical skills.

IMPLICATIONS FOR PRACTICE

The literature review findings can be used to support the development of strategies to enhance future teaching and modelling of professionalism and develop related research in radiography.

Multiprovider and Patient Perspectives on Conveying Diagnostic Imaging Investigation Results in a South African Public Health Care System

INTRODUCTION

This study explored interaction processes in conveying messages about the results of diagnostic imaging investigations in a public hospital complex in South Africa from the perspective of health care providers and patients.

METHODS

The study was part of a qualitative inquiry into the interaction and communication processes relating to diagnostic imaging investigations in the public health care system. Data collection included individual interviews with 24 patients and 62 health care providers (ie, medical practitioners, specialists, radiologists, registrars, radiographers, and nurses). In addition, 12 focus group interviews were conducted with health care providers. The transcribed data were coded and analysed to identify categories and themes.

RESULTS

Three main themes emerged from the study. The first theme deals with the medical territory, specifically who should interpret and convey the diagnostic results to the patient. The second theme highlights the role of radiographers and nurses in communicating parts of the diagnostic results. The last theme focuses on patient experience, interpretation, and comprehension in the provider-patient communication process.

CONCLUSIONS

The findings provide a multidimensional view about the disclosure of imaging results to patients by medical and nonmedical health care providers. Further research is needed on the role of nonmedical providers in the context of ethical and moral obligation toward patients and the professional restrictions inherent in their scope of practice.

Investigation of qualitative and quantitative factors related to radiological exposure to nursing staff during computed tomography examinations

Radiologists or nurses intermittently stay in computed tomography rooms during computed tomography examinations; these actions are defined as “entrance actions.” The qualitative and quantitative factors related to radiological exposure to computed tomography nursing staff were investigated to identify the protective measures against entrance actions. A questionnaire survey was used to investigate the frequency, motives, and causalities of entrance actions. Individual and area monitoring were simultaneously performed. The mean frequency of entrance actions was 1.2 times mo(−1). The primary motive for entrance actions was to dispel anxieties regarding collateral accidents during computed tomography. The nursing staff particularly engaged in close supervision to help the patients cope with contrast media extravasation. The average personal dose equivalent [Hp(10)] to the nurses was 0.21 mSv mo(−1). The ambient dose equivalent [H*(10)] rate was 1.4–3.7 mSv min(−1) at a distance of 1 m from CT gantry centre. Avoidance of entrance actions and collateral accidents would decrease the occupational exposures to nurses.