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Cordrey T, Thomas A, King E, Gustafson O. Evaluating the perceived impact and legacy of master's degree level research in the allied health professions: a UK-wide cross-sectional survey. BMC MEDICAL EDUCATION 2024; 24:750. [PMID: 38997702 PMCID: PMC11241887 DOI: 10.1186/s12909-024-05582-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Accepted: 05/21/2024] [Indexed: 07/14/2024]
Abstract
BACKGROUND Post graduate master's degree qualifications are increasingly required to advance allied health profession careers in education, clinical practice, leadership, and research. Successful awards are dependent on completion of a research dissertation project. Despite the high volume of experience gained and research undertaken at this level, the benefits and impact are not well understood. Our study aimed to evaluate the perceived impact and legacy of master's degree training and research on allied health profession practice and research activity. METHODS A cross-sectional online survey design was used to collect data from allied health professionals working in the United Kingdom who had completed a postgraduate master's degree. Participants were recruited voluntarily using social media and clinical interest group advertisement. Data was collected between October and December 2022 and was analysed using descriptive statistics and narrative content analysis. Informed consent was gained, and the study was approved by the university research ethics committee. RESULTS Eighty-four responses were received from nine allied health professions with paramedics and physiotherapists forming the majority (57%) of respondents. Primary motivation for completion of the master's degree was for clinical career progression (n = 44, 52.4%) and formation of the research dissertation question was predominantly sourced from individual ideas (n = 58, 69%). Formal research output was low with 27.4% (n = 23) of projects published in peer reviewed journal and a third of projects reporting no output or dissemination at all. Perceived impact was rated highest in individual learning outcomes, such as improving confidence and capability in clinical practice and research skills. Ongoing research engagement and activity was high with over two thirds (n = 57, 67.9%) involved in formal research projects. CONCLUSION The focus of master's degree level research was largely self-generated with the highest perceived impact on individual outcomes rather than broader clinical service and organisation influence. Formal output from master's research was low, but ongoing research engagement and activity was high suggesting master's degree training is an under-recognised source for AHP research capacity building. Future research should investigate the potential benefits of better coordinated and prioritised research at master's degree level on professional and organisational impact.
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Affiliation(s)
- Terry Cordrey
- Oxford Allied Health Professions Research and Innovation Unit, Oxford University Hospitals NHS Foundation Trust, Oxford, OX3 9DU, UK.
- Centre for Movement, Occupational, and Rehabilitation Sciences, Oxford Brookes University, Oxford, OX3 0BP, UK.
| | - Amanda Thomas
- Barts Health NHS Trust, Royal London Hospital, London, E1 1BB, UK
| | - Elizabeth King
- Oxford Allied Health Professions Research and Innovation Unit, Oxford University Hospitals NHS Foundation Trust, Oxford, OX3 9DU, UK
- Centre for Movement, Occupational, and Rehabilitation Sciences, Oxford Brookes University, Oxford, OX3 0BP, UK
| | - Owen Gustafson
- Oxford Allied Health Professions Research and Innovation Unit, Oxford University Hospitals NHS Foundation Trust, Oxford, OX3 9DU, UK
- Centre for Movement, Occupational, and Rehabilitation Sciences, Oxford Brookes University, Oxford, OX3 0BP, UK
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Oliveira C, Barbosa B, Couto JG, Bravo I, Hughes C, McFadden S, Khine R, McNair HA. Advanced practice in radiotherapy across Europe: stakeholders' perceptions of implementation and evolution. Radiography (Lond) 2024; 30:896-907. [PMID: 38608565 DOI: 10.1016/j.radi.2024.03.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Revised: 03/09/2024] [Accepted: 03/25/2024] [Indexed: 04/14/2024]
Abstract
INTRODUCTION Adapting radiotherapy services with workforce innovation using skills-mix or task-shifting optimises resources, supporting current and future demands. Advanced practitioners (APs) work at a different level of practice (beyond initial registration) across four pillars: clinical practice, leadership and management, education, and research. There is limited cross-country research on the advanced therapeutic radiographers/radiation therapists (TR/RTTs), particularly in Europe. This study aimed to investigate European radiotherapy stakeholders' perceptions regarding current and future advanced practice (AP). METHODS From June to September 2022, one-to-one online semi-structured interviews were conducted in English, and audio and video were recorded. Full verbatim audio files were independently transcribed and checked by interviewer and interviewees. Braun and Clarke's seven steps guided the thematic analysis (using NVivo). RESULTS Thirty-three interviewees working or studying in 16 European countries represented practitioners (n=14), managers (n=6), educators (n=4), professional bodies (n=4), students (n=3), and regulators (n=2). Four overarching themes emerged: "AP drivers and outcomes", "AP challenges vs enablers", "Current vs future AP", "Becoming and being advanced practitioner". Participants identified research as the neglected AP pillar due to a lack of protected time, limited staff skills, no research culture, no funding, workload, and clinical priorities. Interviewees highlighted the importance of consistency in job titles, harmonisation of education models and curricula, definition of AP requirements, and support for all AP pillars through job plans and workforce planning. CONCLUSION Neither the profession nor education of TR/RTTs are harmonised across Europe, which is highly reflected in advanced-level practice. Advanced TR/RTTs should work across all pillars, including research, and these should be embedded in master's programmes, including leadership. IMPLICATIONS FOR PRACTICE This study highlights a policy gap in the education and practice of APs in radiotherapy.
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Affiliation(s)
- C Oliveira
- Radiotherapy Department, Instituto Português de Oncologia do Porto (IPO Porto), Portugal; Escola Internacional de Doutoramento, Universidad de Vigo, Spain.
| | - B Barbosa
- Radiotherapy Department, Instituto Português de Oncologia do Porto (IPO Porto), Portugal; Escola Internacional de Doutoramento, Universidad de Vigo, Spain; Medical Physics, Radiobiology Group and Radiation Protection Group, IPO Porto Research Centre (CI-IPOP), Instituto Português de Oncologia do Porto (IPO Porto), Portugal.
| | - J G Couto
- Radiography Department, Faculty of Health Sciences, University of Malta, Malta.
| | - I Bravo
- Medical Physics, Radiobiology Group and Radiation Protection Group, IPO Porto Research Centre (CI-IPOP), Instituto Português de Oncologia do Porto (IPO Porto), Portugal.
| | - C Hughes
- School of Health Sciences, Ulster University, United Kingdom.
| | - S McFadden
- School of Health Sciences, Ulster University, United Kingdom.
| | - R Khine
- European Federation of Radiographer Societies, Utrecht, Netherlands; Institute of Health Sciences Education, Faculty of Medicine & Dentistry, Queen Mary, University of London, United Kingdom.
| | - H A McNair
- European Federation of Radiographer Societies, Utrecht, Netherlands; The Royal Marsden NHS Foundation Trust, Radiotherapy and the Institute of Cancer Research, Surrey, United Kingdom.
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Kuczawski M, Ablard S, Sampson F, Croft S, Sutton-Klein J, Mason S. Exploring advanced clinical practitioner perspectives on training, role identity and competence: a qualitative study. BMC Nurs 2024; 23:185. [PMID: 38500131 PMCID: PMC10946138 DOI: 10.1186/s12912-024-01843-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Accepted: 03/04/2024] [Indexed: 03/20/2024] Open
Abstract
BACKGROUND Advanced Clinical Practitioners (ACPs) are a new role that have been established to address gaps and support the existing medical workforce in an effort to help reduce increasing pressures on NHS services. ACPs have the potential to practice at a similar level to mid-grade medical staff, for example independently undertaking assessments, requesting and interpreting investigations, and diagnosing and discharging patients. These roles have been shown to improve both service outcomes and quality of patient care. However, there is currently no widespread formalised standard of training within the UK resulting in variations in the training experiences and clinical capabilities of ACPs. We sought to explore the training experiences of ACPs as well as their views on role identity and future development of the role. METHODS Five online focus groups were conducted between March and May 2021 with trainee and qualified advanced clinical practitioners working in a range of healthcare settings, in the North of England. The focus groups aimed to explore the experiences of undertaking ACP training including supervision, gaining competence, role identity and career progression. Thematic analysis of the focus group transcripts was performed, informed by grounded theory principles. RESULTS Fourteen advanced clinical practitioners participated. Analysis revealed that training was influenced by internal and external perceptions of the role, often acting as barriers, with structural aspects being significant contributory factors. Key themes identified (1) clinical training lacked structure and support, negatively impacting progress, (2) existing knowledge and experience acted as both an enabler and inhibitor, with implications for confidence, (3) the role and responsibilities are poorly understood by both advanced clinical practitioners and the wider medical profession and (4) advanced clinical practitioners recognised the value and importance of the role but felt changes were necessary, to provide security and sustainability. CONCLUSIONS Appropriate structure and support are crucial throughout the training process to enable staff to have a smooth transition to advanced level, ensuring they obtain the necessary confidence and competence. Structural changes and knowledge brokering are essential, particularly in relation to role clarity and its responsibilities, sufficient allocated time to learn and practice, role accreditation and continuous appropriate supervision.
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Affiliation(s)
- Maxine Kuczawski
- Centre for Urgent and Emergency Care Research (CURE), Sheffield Centre for Health and Related Research (ScHARR), The University of Sheffield, S1 4DA, Sheffield, UK.
| | - Suzanne Ablard
- Centre for Urgent and Emergency Care Research (CURE), Sheffield Centre for Health and Related Research (ScHARR), The University of Sheffield, S1 4DA, Sheffield, UK
| | - Fiona Sampson
- Centre for Urgent and Emergency Care Research (CURE), Sheffield Centre for Health and Related Research (ScHARR), The University of Sheffield, S1 4DA, Sheffield, UK
| | - Susan Croft
- Centre for Urgent and Emergency Care Research (CURE), Sheffield Centre for Health and Related Research (ScHARR), The University of Sheffield, S1 4DA, Sheffield, UK
- Emergency Department, Northern General Hospital, S5 7AU, Sheffield, UK
| | - Joanna Sutton-Klein
- Centre for Urgent and Emergency Care Research (CURE), Sheffield Centre for Health and Related Research (ScHARR), The University of Sheffield, S1 4DA, Sheffield, UK
- Manchester Royal Infirmary, Oxford Rd, M13 9WL, Manchester, UK
| | - Suzanne Mason
- Centre for Urgent and Emergency Care Research (CURE), Sheffield Centre for Health and Related Research (ScHARR), The University of Sheffield, S1 4DA, Sheffield, UK
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House S, Snaith B, Sevens T. Expectations of radiographer reporting roles: A multimethod evaluation across a single imaging network. Radiography (Lond) 2023; 29:1070-1076. [PMID: 37751640 DOI: 10.1016/j.radi.2023.09.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Revised: 08/23/2023] [Accepted: 09/06/2023] [Indexed: 09/28/2023]
Abstract
INTRODUCTION Prior studies have demonstrated inconsistent development and utilisation of radiographers in the reporting of radiographs, and there is ongoing consideration of the level at which such radiographers should be educated to and operating at. This study aimed to explore and evaluate expectation and utilisation of radiographers currently, or training in, reporting in projection radiography across one integrated care system (ICS). METHODS A multi-method approach was utilised, with document analysis of projection radiography reporting role job descriptions and person specifications and an online survey of managers and clinical leads. A single ICS in the north of England formed the setting for the study. RESULTS This study demonstrated variation in implementation and utilisation of the role across trusts within the ICS. Inconsistencies in scope, expected underpinning education and role activity were identified. Radiographers autonomously reporting in projection radiography were titled advanced practitioners, however are not expected to achieve national educational standards for such roles and are not empowered to work at this level of practice by their employers. It was acknowledged that staffing pressures hinder appropriate role utilisation and reporting capacity. CONCLUSION Inconsistent development and utilisation of radiographers in such roles may hamper collaboration and service delivery across a network. Identifying variation and working towards role standardisation could promote cross-organisational working and improve career progression opportunities. IMPLICATIONS FOR PRACTICE Scoping the reporting radiographer workforce may assist and guide future imaging service and workforce planning.
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Affiliation(s)
- S House
- The Rotherham NHS Foundation Trust, UK.
| | - B Snaith
- University of Bradford, UK; Mid Yorkshire Teaching NHS Trust, UK
| | - T Sevens
- South Yorkshire and Bassetlaw Integrated Care System, UK
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Wood AF, Hyde R. Advanced Clinical Practitioners (ACPs) have a significant impact on patient outcomes and healthcare services. Evid Based Nurs 2023:ebnurs-2023-103725. [PMID: 37321801 DOI: 10.1136/ebnurs-2023-103725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/02/2023] [Indexed: 06/17/2023]
Affiliation(s)
- Alison F Wood
- Division of Nursing and Paramedic Science, Queen Margaret University, Musselburgh, UK
| | - Robin Hyde
- Department of Nursing, Midwifery & Health, Northumbria University, Newcastle upon Tyne, UK
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Evidence of expert clinical practice among nuclear medicine non-medical staff: a scoping review. Nucl Med Commun 2023; 44:169-177. [PMID: 36729427 DOI: 10.1097/mnm.0000000000001650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE This scoping review concerns expertclinical practice (ECP) by nuclear medicine practitioners (NMP), encompassing radiographers, technologists and nurses. ECP is typically demonstrated by clinical skills with higher levels of autonomy and responsibility traditionally fulfilled by physicians. The Advanced Clinical Practice (ACP) framework by Health Education England (2017) specifies ECP as one aspect of advanced role progression. This scoping review aims to identify and categorise the extent and type of the existing NMP ECP evidence to support the establishment of Nuclear Medicine ACP. METHODS PubMed, Cumulative Index to Nursing and Allied Health Literature, and Ovid Medline were searched for peer-reviewed literature published between 2001 and 2021 using extended and advanced practice as key terms alongside nuclear medicine and each NMP profession. Due to the sparsity of results, conference abstracts from prominent international societies were also searched. Studies were independently reviewed and graded for inclusion by four NMP. RESULTS Of the 36 studies that met the inclusion criteria, 80.6% were conference abstracts and 66.7% were single-centres studies. Commonly reported NM ECP activities included image interpretation, cardiac stressing and therapies. Less reported activities include ordering complementary diagnostic procedures, invasive procedures and physical examinations. The United Kingdom presented itself at the forefront of NMP ECP publications. CONCLUSION This study demonstrates evidence of NMP ECP across a variety of clinical roles. The dominance of conference abstracts highlights NMP ECP as an emerging area of role extension and a potential preference for information dissemination by NMP. Greater research into specific NMP ECP activities is required particularly studies of greater sample size and robusticity.
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Wang H, English M, Chakma S, Namedre M, Hill E, Nagraj S. The roles of physician associates and advanced nurse practitioners in the National Health Service in the UK: a scoping review and narrative synthesis. HUMAN RESOURCES FOR HEALTH 2022; 20:69. [PMID: 36109746 PMCID: PMC9479410 DOI: 10.1186/s12960-022-00766-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Accepted: 09/07/2022] [Indexed: 05/17/2023]
Abstract
BACKGROUND Mid-level practitioners (MLPs), including physician associates (PAs) and advanced nurse practitioners (ANPs), have emerged to address workforce shortages in the UK and perform specific roles in relation to population needs. This has resulted in new ways of working and changes to established professional hierarchies. We conducted a study to investigate the career development, competencies, effectiveness, perceptions, and regulation of PAs and ANPs, with the aim of understanding ways to effectively integrate MLPs into the NHS workforce. METHODS We conducted a systematic scoping review following PRISMA guidelines. Embase, Medline, the Cochrane database, Pubmed, and CINAHL databases were searched, using terms relating to PAs and ANPs in the UK. A total of 128 studies (60 on PAs and 68 on ANPs) were included in the final analysis. A narrative synthesis, guided by the pre-defined themes and emerging themes, was conducted to bring together the findings. RESULTS PAs are educated on a medical model with basic medical skills but lack formal professional regulation and do not have prescribing rights. ANPs are educated on a nurse model with enhanced skills that depend on roles within specific specialities, and their governance is mostly employer-led. PAs are primarily employed in secondary care. ANPs are employed widely in both primary and secondary care. No defined career progression exists for PAs. In contrast, becoming an ANP is a form of career progression within nursing. Both roles were regarded as cost-effective in comparison to doctors performing simple tasks. PAs were less understood compared to ANPs and received a mixed reception from colleagues, which sometimes undermined their professional identity, whereas ANPs were mostly welcomed by colleagues. CONCLUSIONS Potential ways to better integrate PAs and ANPs into the NHS workforce include further initiatives by regulatory bodies and the NHS to create more awareness and clearer role definitions for MLPs, outline potential for career progression, offer transparency with regard to remuneration, and introduction of prescribing rights. Future research might include more cadres of MLPs and explore the international literature.
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Affiliation(s)
- Hanyu Wang
- Nuffield Department of Medicine, Oxford Centre for Global Health Research, University of Oxford, Oxford, UK.
| | - Mike English
- Nuffield Department of Medicine, Oxford Centre for Global Health Research, University of Oxford, Oxford, UK
- KEMRI-Wellcome Trust Research Programme, KEMRI-Wellcome Trust, Nairobi, Kenya
| | - Samprita Chakma
- Nuffield Department of Medicine, Oxford Centre for Global Health Research, University of Oxford, Oxford, UK
| | | | - Elaine Hill
- Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Shobhana Nagraj
- Nuffield Department of Medicine, Oxford Centre for Global Health Research, University of Oxford, Oxford, UK
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The Advanced Practitioner Certification in Clinical Nutrition Provides Opportunities for Validation and Career Advancement for Registered Dietitians. TOP CLIN NUTR 2021. [DOI: 10.1097/tin.0000000000000250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Khine R, Stewart-Lord A. An examination of Advanced Clinical Practice: Qualitative insights from therapeutic radiography advanced and consultant practitioners based in England. Tech Innov Patient Support Radiat Oncol 2021; 17:97-101. [PMID: 34007914 PMCID: PMC8110936 DOI: 10.1016/j.tipsro.2020.12.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2020] [Revised: 12/16/2020] [Accepted: 12/17/2020] [Indexed: 11/30/2022] Open
Abstract
INTRODUCTION Therapeutic radiographers play a vital and changing role in the delivery of radiotherapy services treating patients with cancer. Advanced Practitioners (AP) and Consultant Practitioners (CP) in radiotherapy have developed advanced clinical skills and specialisms, enhancing the ability of the profession to offer a greater depth of cancer services and ease pressure elsewhere in the system.The aim of this study was to define the opportunity and potential for Advanced Clinical Practice (ACP) roles in oncology services. Specific objectives were to explore local profiles, role development and opportunities for standardisation of ACPs in therapeutic radiography and to determine resource requirements to roll out and ensure continuation of the existing and new roles. MATERIAL AND METHODS The research was addressed through a qualitative study design using focus groups. Convenience sampling was used to recruit therapeutic radiography advanced and consultant practitioners (N = 36) from the respective radiotherapy departments in England to participate in regional focus groups. Four regional areas were identified for inclusion. Data generated was analysed thematically. RESULTS The findings are presented in four themes: ownership of professional identity, desire for standardisation and guidance, drivers of role development and self-directed educational routes. CONCLUSION Key findings from the focus groups indicated the need for standardisation in job descriptions, roles and responsibilities and a key understanding of career progression. The professional identity of the AP is acknowledged by independent, autonomous working; however, this can only be facilitated if the correct training is undertaken and the necessary support structures are in place to enable career progression. Challenges associated with role development are 1) lack of career and pathway guidance, 2) lack of clear educational routes, 3) lack of standardised roles.
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Affiliation(s)
- R.N.M. Khine
- School of Health Sciences, City, University of London, UK
| | - A. Stewart-Lord
- School of Health and Social Care, London South Bank University, UK
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