Towards the development of a reflective radiographer: challenges and constraints

The effect of non-immersive virtual reality radiographic positioning simulation on first-year radiography students' image evaluation performance

INTRODUCTION

Optimal radiographic image quality is critical because it affects the accuracy of the reporter's interpretation. Radiographers have an ethical obligation to obtain quality diagnostic images while protecting patients from unnecessary radiation, including minimizing rejected and repeated images. Repeated imaging due to positioning errors have increased in recent years.

METHODS

This study evaluated the effectiveness of non-immersive virtual reality (VR) simulation on first-year students' evaluation of positioning errors on resultant knee and lumbar spine images. Crossover intervention design was used to deliver radiographic image evaluation instruction through traditional lecture and guided simulation using non-immersive VR to 33 first-year radiography students at a single academic institution located across four geographic program locations. Pre- and post-test knowledge assessments examined participants' ability to recognize positioning errors on multiple-choice and essay questions.

RESULTS

Raw mean scores increased on multiple choice questions across the entire cohort for the knee (M = 0.82, SD = 3.38) and lumbar spine (M = 2.91, SD = 3.69) but there was no significant difference in performance by instructional method (p = 0.60). Essay questions reported very minimal to no raw mean score increases for the knee (M = 0.27, SD = 2.78) and lumbar spine (M = 0.00, SD = 2.55), with no significant difference in performance by instructional method (p = 0.72).

CONCLUSION

Guided simulation instruction was shown to be as effective as traditional lecture. Results also suggest that novice learners better recognize image evaluation errors and corrections from a list of options but have not yet achieved the level of competence needed to independently evaluate radiographic images for diagnostic criteria.

IMPLICATIONS FOR PRACTICE

Non-immersive VR simulation is an effective tool for image evaluation instruction. VR increases access to authentic image evaluation practice by providing a simulated resultant image based off the students' applied positioning skills.

Writing for reflection: Radiography students' experiences with reflective journaling

INTRODUCTION

Reflective journaling is a widely recognised method of engaging in reflective practice, whereby individuals document their critical analysis of past experiences or actions, focusing on the implications and lessons learned for future application. In radiography and other healthcare professions, reflective practice is considered essential for professional development and should be cultivated during training. This study aimed to explore the experiences of senior radiography students in utilising the reflective journal as a clinical learning tool.

METHODS

This study employed a phenomenological research design, with the study participants being third and fourth-year radiography students. Data collection took place after the introduction of reflective journaling, with nineteen participants having utilised the reflective journal daily, for a minimum of eight months. Individual interviews were conducted after obtaining the participants' consent. The collected data were analysed using Atlas. ti (version 9.3), guided by the content analysis framework.

RESULTS

The study revealed that participants experienced adaptation, characterised by reflective adaptation and process adaptation when utilising the reflective journal. Participants also encountered reflective barriers, including personal expression bias, inconsistent feedback, rumination overload, and impulsive practice dominance.

CONCLUSION

The findings demonstrate the benefits of reflective journaling in promoting critical thinking and reflective practice among radiography students. It is therefore recommended that this practice be fully embraced as a standard clinical component. Additionally, the frequency of reflections should be reviewed to ensure effectiveness and consistent feedback should be provided to enhance skills development.

IMPLICATIONS FOR PRACTICE

The findings contribute further evidence to support the incorporation of reflective journaling in clinical training to promote critical thinking and reflective practice.

Evaluating the use of exposure indicators in digital x-ray imaging system: Gauteng South Africa

INTRODUCTION

Exposure indicators (EIs) are the only indicator of correct exposure technique in digital x-ray imaging systems but the use of such indicators remains largely unexplored in a South African setting. With exposure creep in the digital radiography age being a worldwide phenomenon, the study investigated radiographers' familiarity and use of EIs, providing insight into current exposure technique practices in this setting.

METHODS

An explorative and descriptive quantitative study was conducted at 10 randomly selected radiography clinical training facilities in Gauteng, South Africa. The study used a questionnaire consisting of 26 questions based on familiarity with and use of EIs and radiographers' attitude to ionising radiation.

RESULTS

A response of rate of 49.3% was achieved. Results show a low number of respondents (54.3%) had a perfectly correct understanding of the exposure indicator (EI) and only 55.7% of respondents made correct use of the EI.

CONCLUSION

Observable lack of familiarity and use of the EI suggests that improvements could be made to the training radiographers receive on digital imaging systems. Moreover radiographers need to be vigilant against making decisions in digital radiography using knowledge that may relate exclusively to analogue radiography.

Clinical educators' attitudes towards the use of technology in the clinical teaching environment. A mixed methods study

Introduction

In healthcare, there is ongoing flux in expectations for students and practitioners. Establishing integrated systems of monitoring and evidencing students’ development is imperative. With current trends towards the use of technology in tertiary education, online learning environments (OLEs) could constitute more effective evidencing of student progress in the clinical environment. However, there is little research exploring clinical educators' experiences with implementing technology in clinical education.

The research aimed to:

Examine clinical educators’ attitudes towards technology and its use in clinical education.

Explore clinical educators’ experiences of implementing technologies in a clinical environment.

Methods

A mixed methods approach was taken to explore the aims. A previously validated technology attitude survey (TAS) was used with slight modifications, as well as open‐ended qualitative responses. These explored clinical educators’ experiences of the implementation of one specific OLE (PebblePad™) in their clinical environments. The survey was sent to clinical educators involved in the supervision of Medical Imaging students on clinical placement.

Results

Clinical educators play pivotal roles in students’ professional development and, given current trends in tertiary education, are under increasing pressure to utilise OLEs. This poses particular challenges in clinical environments. Irrespective of the challenges, successful implementation of technology in any environment is dependent on the attitudes of the users.

Conclusions

Clinical environments have specific challenges when implementing technology such as access to computers and time constraints on practitioners. Even with positive attitudes towards technology, a change in pedagogical outlook when using technology in clinical teaching is necessary.

Oncology patients' experience of a routine surveillance CT examination: Relationships and communication

INTRODUCTION

The question of radiographers' capacity to establish short time relationships as well as decoding patients' needs and expectations simultaneously with performing high technological examination frequently arises in the clinical practice. Additionally, the constant focus on technology and the fact that radiographers work in high productive departments accentuates the issue. Patients' experiences with radiology seem to be a neglected area of research and may help to identify areas for improvement in this highly technological and productive field. The purpose of the study was to explore oncology patients' experiences of a routine surveillance CT examination and their need for relationships and communication with the radiographer as part of the CT examination.

METHODS

The study included patients diagnosed with cancer and in need of a CT examination as part of their course of treatment, and 21 semi-structured interviews were conducted. The interviews were analysed using qualitative content analysis. Themes were constructed and narratively reported. To increase validity, the themes were identified, discussed and formulated by the author group.

RESULTS

Four themes were constructed based on the analysis: 1: The professional radiographer, 2. Disease and treatment, 3. The examination environment and 4: While waiting.

CONCLUSION

The lack of focus on radiographers' capacity to establish relations, to consider each patient as an individual human being and being able to show sincere interest and empathy were highlighted. Findings illuminated the patient's need for relationship and communication with the radiographer as part of a CT examination.

A comparative study about motivations, expectations and future plans for professional development in four European radiography programs

INTRODUCTION

This study aims to compare motivations, expectations and work plans of students and teaching-staff from four different European radiography programs, it aims also to explore areas that could be included to advance post graduate studies.

METHODS

Two different questionnaires (open- and closed-end questions) were applied to key-informants, students who had just completed their bachelor thesis and teaching-staff, to collect data regarding motivations, expectations, challenges and potentials for radiography education and, plans for further work. Descriptive statistics and thematic analysis were performed according to the nature of the questions.

RESULTS

The response rates were 45% (students) and 68% (teaching-staff). The motivations to study radiography were similar between students: to work in a healthcare-service, helping people, manipulating high-end technologies, providing service while combining different knowledge (physics, patient-care, physiology, anatomy). 75% of the students did not reach all their expectations due to the lack of focused and updated content for some areas. The teaching-staff were expecting an extension of the radiographers' role. The development of advance studies in computed tomography and magnetic resonance was highlighted as important by students. Future work plans included: self-improvement, continuation of studies, specialization, research and collaborations.

CONCLUSIONS

This study increased the understanding of radiography education and provides insights into future perspectives. Participants have similar motivations, expectations and future plans. Improvements in education should focus on technological developments and meeting job market demands. Further studies should be performed to identify approaches that acknowledge the specific needs of each country, while also providing strategies to harmonize radiography education in Europe.

Curricula, attributes and clinical experiences of radiography programs in four European educational institutions

INTRODUCTION

The aim of this study was to compare radiography curricula, teaching/learning strategies, skill development, clinical practice outcomes and research development delivered by four European educational institutions.

METHODS

This study was carried out in two phases: the first focused on curricula analysis; the second involved online questionnaires to ascertain data from two key-informants: students who had recently completed their bachelor thesis and teaching-staff. Questionnaires were designed to capture teaching and learning strategies, skill acquisition and outcomes of clinical practice and research. Descriptive statistics and thematic analysis were performed according to the nature of the questions.

RESULTS

The European Credits Transfer System dedicated per core subject area (natural sciences, clinical practice, research, imaging technology, humanities) differed between institutions. Students classified technical, practical and communication skills as the most important, teaching-staff highlighted also critical thinking. The students defined as "very good" their experience in radiography (58.5%) and computed-tomography (45%). Magnetic resonance imaging practice was considered "Average" by 53% of the UK-students and "Good" by the other European students (40%). According to 71% (55/78) of the students, research work contributed to the development of critical/reflective thinking.

CONCLUSIONS

The four radiography programs presented variations in curricula, contact-hours, clinical experience and outcomes. Research units allowed the participant-students to develop their critical thinking capabilities. The outcomes from clinical practice differ across the institutions, mainly due to differences in background and access to specialities. Further work is necessary to assess the real impact of different radiography programs on professional and academic mobility across Europe.

Dichotomy between theory and practice in chest radiography and its impact on students

Introduction

It is important that theory is synchronous with clinical practices that students engage in. Lack of congruence between theory and practice presents serious problems to students. This study was therefore conducted to determine if there was a theory–practice gap in chest radiography during clinical rotations, and any associated causes and effects on radiography students.

Method

A descriptive survey design was used to conduct this study from 2 February to 27 July 2014. A semi‐structured questionnaire consisting of open‐ and close‐ended questions was used to purposively collect data from 26 radiography students in Ghana who had completed theory lessons in chest radiography and had either completed or were undertaking clinical rotations in chest radiography.

Results

Twenty‐five (96%) respondents indicated the presence of theory–practice gap in chest radiography during clinical rotations, where differences between theory and clinical practice were observed. Lack of working materials 16 (62%), heavy workload 14 (54%), equipment breakdowns 14 (54%) and supervisory factors 11 (43%) were identified as the causes. Many students (81%) experienced diverse adverse effects such as confusion 10 (38%), poor performance during clinical examinations 6 (23%) and entire loss of interest in the professional training 1 (4%) of this dichotomy.

Conclusion

Dichotomy between theory and practice found in chest radiography has diverse adverse effects on students. Regular feedback on the quality of clinical practice received by students should be encouraged to determine the existence of any gaps between theory and practice in order to promote effective clinical rotation programmes in radiography.

Radiographers' professional knowledge regarding parameters and safety issues in plain radiography: a questionnaire survey

OBJECTIVE

To review the knowledge of radiographers and examine the possible sociodemographic and situational contributors to this knowledge.

METHODS

A questionnaire survey was devised and distributed to a cohort of 120 radiographers. Each questionnaire contained two sections. In the first section, background data, including sex, age, highest academic level, grade point average (GPA), length of time from graduation, work experience as a radiographer and the status of previous refresher course(s), were collected. The second section contained 17 multiple-choice questions concerning radiographic imaging parameters and safety issues.

RESULTS

The response rate was 63.8%. In univariate analytic model, higher academic degree (p < 0.001), higher GPA (r(2) = 0.11; p = 0.001), academic workplace (p = 0.04) and taking previous refresher course(s) (p = 0.01) were significantly associated with higher knowledge score. In multivariate analytic model, however, higher academic degree (B = 1.62; p = 0.01), higher GPA (B = 0.50; p = 0.01) and taking previous refresher course(s) (B = -1.26; p = 0.03) were independently associated with higher level of knowledge. Age, sex, length of time from graduation and work experience were not associated with the respondents' knowledge score.

CONCLUSION

Academic background is a robust indicator of a radiographer's professional knowledge. Refresher courses and regular knowledge assessments are highly recommended.

ADVANCES IN KNOWLEDGE

This is the first study in the literature that examines professional knowledge of radiographers in terms of technical and safety issues in plain radiography. Academic degree, GPA and refresher courses are independent predictors of this knowledge. Regular radiographer professional knowledge checks may be recommended.