Radiographers' opinions on radiography research in Norway – A national survey

ObjectiveThe objective of the Norwegian Radiography Research Group is to establish a strategy for radiography research in Norway. A survey investigating radiographers' opinions on research was conducted to establish a basis for this strategy.MethodsA questionnaire was sent to all members of the Norwegian Society of Radiographers using the society's e-mail list from May 2014 (n = 2273). The respondents, 31% (n = 697), were divided into six groups; general radiographers (n = 392), specialised radiographers (n = 124), managers (n = 74), radiation therapists (n = 59), professors (n = 13), and others (n = 35). The questionnaire included four parts: introduction, participation in research, research performed at the respondent's work place, and opinions on radiography research. The first parts consisted of close-ended questions, while the fourth part also included a Likert scale.ResultsAmong all respondents, 63% respondents agreed that there is a need for radiography research and 50% agreed that general radiographers/radiation therapists should be the principal investigators of such research. However, only 19% reported participation in a research project during the last five years, and of those, 50% knew how the results of their research had been communicated.ConclusionThe majority of radiographers agreed that there was a need for radiography research and that radiographers/radiation therapists should take a leading role in such work. The results indicate that radiographers/radiation therapists would benefit from training in informal and formal research skills.     

Benchmarking of Emotional Intelligence in radiography students within KwaZulu- Natal,South Africa

IntroductionEmotional Intelligence (EI) is an important skill within the various health care professions, and a higher level of EI is associated with better patient care, communication, empathy and teamwork. Within the Republic of South Africa, there is limited literature on EI within the health care sector, and specifically within radiography.MethodsThe Trait EI Questionnaire Short Form (TEIQue-SF) was used to record the EI scores of 247 BHSc Radiography students in all four disciplines over the four years of study at the selected University of Technology (UoT) in Kwazulu-Natal (KZN), South Africa. The TEIQue-SF yields a Global EI score and the four factors of EI.ResultsThe study benchmarked the TEI scores of the radiography cohort.The male participants scored significantly higher in Global EI (p = 0.020 and 0.029) and the Self-control factor (p = 0.000) of EI compared to the female participants. The younger participants scored significantly higher in three of the five factors of TEI, namely: Global EI (p = 0.003), Well-being (p = 0.003) and Self-control (p = 0.010), which was an unexpected finding and against the norm. Racially (0.010 and 0.009) and culturally (P = 0.022 and 0.026), the Black participants and the Zulu participants scored significantly higher in the Self-control factor of TEI.ConclusionThis study benchmarked the TEI scores of radiography students within KZN and compared these TEI scores to the demographic variances of the students with interesting results. This study has highlighted the TEI level of the students at a selected UoT, which can be used to ensure that better prepared, well-rounded and employable graduates enter the workplace. This can be achieved by the implementation of the recommendations, which includes the levels of EI to be developed and relevant EI training required. Further research is required within the field of TEI and Radiography in the South African context to strengthen this study's findings.Implication for practiceThis study has highlighted the EI scores of a cohort of radiography students. The results of this study have made the institution more aware of the students’ TEI which will allow the institution to ensure students are better prepared and are employable graduates within their chosen profession by including EI training within the health faculty curriculum.     

An evaluation of the educational requirements to practise radiography in the European Union

IntroductionRadiography is practised world wide, however, the definition of the profession varies across countries. As there is no regulation of the profession or education at EU level, different national regulations might result in educational differences that can compromise the movement of professionals or the safety of patients. The aim of this study was to identify the commonalities and discrepancies in national regulation of radiography.MethodsNational competent authorities from all EU countries where the profession is regulated (n = 27) were invited to identify the legal requirements to practise radiography and the data was analysed using thematic analysis.ResultsOne country does not regulate the profession in the EU. Although, a single profession is regulated in 83% of the cases, 21% regulate separate professions for different specialisms (diagnostic radiography, radiotherapy and nuclear medicine). All countries (n = 27) define education as requirement to practise, however, the academic level varies from secondary school to Master's degree with required programmes varying from 2 to 4 years and from 120 to 240 ECTS. In addition, the subjects covered in the education programme showed great heterogeneity. These subjects were not identified by 35% of the respondents (n = 23) and only 26% define the subjects in terms of competencies.ConclusionEducation is a requisite to practise all over the EU, however, the lack of EU-wide regulation leads to a variation of national regulations. These differences may lead to inhomogeneity of competencies being developed, compromising the movement of professionals across Europe and patient safety.     

Clinical placement challenges associated with radiography education in a low-resource setting: A qualitative exploration of the Ethiopian landscape

IntroductionClinical placements (CP) are of paramount importance in the learning and the acquisition of key competencies in terms of knowledge, skill and professional attributes required for clinical radiography practice. This study explored the challenges faced by radiography students and educators in relation to clinical placement and training in Ethiopia.MethodsA qualitative approach using focus group discussion and interviews were used to explore the experiences of students and educators, respectively, pertaining to challenges encountered in relation to the clinical placement of students across four university affiliated hospitals. Data obtained was analysed using a structured three step framework and the coding approach employed in a thematic analysis.ResultsParticipants comprise of third- and fourth-year undergraduate radiography students (n = 14) and educators [academic faculty (n = 7) and clinical practice educators (n = 8)]. Four main themes were identified, which relate to deficiencies of an existing training curriculum and its implementation strategies, inadequate resource and infrastructure within the CP environments and absence of advanced training opportunities.ConclusionThis research showed that there are many and varied challenges encountered by both students and educators in relation to CP and training of radiography students in Ethiopia. These challenges could potentially affect the future performance of students/practitioners and/or the appropriate application of the core clinical radiography skills and competencies in the world of work.Implications for practiceClinical radiography training in resource-limited settings will require urgent attention and support with modern infrastructure including simulation to augment their clinical development to acceptable standards.     

The impact of 3D virtual reality radiography practice on student performance in clinical practice

IntroductionSimulation-based learning plays an integral role in preparing students for clinical practice. This study investigated the impact of immersive three-dimensional (3D) virtual reality (VR) simulation-based learning on first-year radiography students’ performance in the clinical setting.MethodsA retrospective analysis of first-year radiography clinical assessments was carried out to compare performance pre-and post-introduction of VR. The stage one cohort with no VR education was considered the control group (n = 93). The VR group (n = 98) had seven hours of practice in the immersive VR suite (Virtual Medical Coaching). Experienced clinical tutors assessed first-year students performing an extremity radiographic examination in the clinical setting. Assessment criteria were ranked on a 5-point Likert scale from poor to excellent. Mann Whitney U Tests were applied to compare performance across cohorts.ResultsStudents trained with VR performed better across 20 of the 22 assessment criteria. VR-trained students performed significantly better (more ranked as ‘very good’ or ‘excellent’) than the control group in the following criteria; positioning patients for X-rays (19% difference) (U = 3525, z = ?2.66, p < 0.05), selecting exposure factors (12% difference) (U = 3680, z = ?3.13, p < 0.05), image appraisal of patient positioning (27% difference) (U = 3448, z = ?2.9, p < 0.05) and image appraisal of image quality (18% difference) (U = 3514, z = ?2.6, p < 0.05). Their comprehension of clinical indications, equipment set up and explanation of the procedure was also significantly better (p < 0.05).ConclusionThis is the first study to investigate the translation of VR learning into radiography clinical practice. VR learning had a positive impact on the performance of first-year students in their clinical assessment, especially with respect to patient positioning, exposure parameter selection and image appraisal.Implications for practiceVR is a valuable educational tool in preparing novice radiography students for clinical practice. It is particularly useful to enhance student knowledge in the areas of patient positioning, exposure factor selection and radiographic image appraisal.     

Large differences in education and training of radiographers in Europe and Central Asia: Results from an IAEA coordinated study

IntroductionEducation and training of radiographers is known to be diverse between countries and regions. Under an IAEA project, this work collected data on radiographer education for the Europe and Central Asia region with a particular focus on radiation protection gaps and potential actions.MethodsFollowing piloting, an electronic questionnaire was distributed to all national counterparts for the IAEA Technial Coopearation (TC) Europe region (n = 33 countries) and nominated national representatives. Contacts were additionally invited to a virtual workshop to discuss and rank common problems in education and training of radiographers and to propose potential solutions.ResultsResponses were received from 31 countries, including 14 from the European Union. Just over half of countries reported radiographer education being in higher education with 71% having program durations more than 3 years (range: 1 month-4 years). Programs included a spectrum of both clinical training and radiation protection hours with ten-fold variations noted across the region. Inclusion of core radiation protection topics within curricula varied similarly, as did radiographers’ clinical involvement in both justification and optimisation between countries. Workshop participants identified five common training problems, namely education availability, lack of standardisation, radiation protection course quality, teamwork problems and lack of equipment.ConclusionRadiographer education in the IAEA Europe region is heterogeneous with substantial differences in duration and quality of training programs between countries, which likely impact on quality of patient care delivered. Common problems have been identified and potential solutions proposed to focus quality improvement initiatives.Implications for practiceRadiographer education and training is diverse throughout the IAEA TC Europe region, with likely impacts on radiation protection practices applied. Clinical involvement of radiographers in justification and optimisation differs, potentially limiting adherence to radiation protection principles.     

Assistant radiographer practitioners: Creating capacity or challenging professional boundaries?

IntroductionOver the last 2 decades the assistant radiographer practitioner (ARP) role has been introduced into NHS diagnostic imaging departments as a strategy to expand the workforce and create capacity. This skill mix initiative has not been implemented in a standardised way and there is limited knowledge of the current role scope within general radiography (X-Ray).MethodAn electronic survey of ARPs working within UK diagnostic imaging departments was conducted. Both open and closed questions sought information regarding basic demographic data (age category; gender; geographic region), scope of practice (patient groups; anatomical regions; imaging outside of the diagnostic imaging department), limitations placed on practice, supervision and additional roles.ResultsA total of 108 responses, including 13 trainees, were received. Most sites employ three or less ARPs in general radiography (n = 43/66; 65.2%), although 11 sites have five (range 1–15). The majority undertake imaging of both adults and children (n = 85/108; 78.7%), although limitations on age were described. Their scope of practice covers a broad anatomical range and included some non-ambulant patients. The level of supervision varied with some sites empowering ARPs to check the referral prior to examination (n = 25) or images post acquisition (n = 32) (both n = 20/66; χ² = 16.003; 1df; p = 0.000).ConclusionARPs are helping to maintain capacity in imaging departments but we suggest there is further scope for expansion. The practice described by the post holders suggests that many are working beyond the scope envisaged by the radiography professional body.     

Radiographers as doctors: A profile of UK doctoral achievement

IntroductionRadiography aspires to be a research active profession, but there is limited information regarding the number of individuals with, or studying for, a doctoral award. This study aims to profile UK doctoral radiographers; including their chosen award, approach and employment status.MethodThis was a prospective cohort study utilising an electronic survey. No formal database of doctoral radiographers existed therefore a snowball sampling method was adopted. The study sample was radiographers (diagnostic and therapeutic) based in the UK who were registered with the Health and Care Professions Council (HCPC) and who held, or were studying for, a doctoral award.ResultsA total of 90 unique responses were received within the timescale. The respondents comprised 58 females (64.4%) and the majority were diagnostic radiographers (n = 71/90; 78.9%). The traditional PhD was the most common award, although increasing numbers were pursuing Education or Professional Doctorates. An overall increase in doctoral studies is observed over time, but was greatest amongst those working in academic institutions, with 63.3% of respondents (n = 57/90) working solely within a university, and a further 10% employed in a clinical–academic role (n = 9/90).ConclusionThis study has demonstrated that radiography is emerging as a research active profession, with increasing numbers of radiographers engaged in study at a doctoral level. This should provide a platform for the future development of academic and clinical research.     

The effects of stroboscopic balance training on cortical activities in athletes with chronic ankle instability

ObjectivesTo investigate the effect of a 6-week stroboscopic balance training program on cortical activities in athletes with chronic ankle instability.DesignRandomized controlled trial. Setting: Single-center.ParticipantsThirty-nine participants were assigned to the strobe group (SG, n = 13), non-strobe group (NSG, n = 13), and control group (CG, n = 13).Main outcome measuresCortical activity and balance velocity were evaluated while the athletes were on the HUBER balance device. Electroencephalographic measurements of cortical activity were made at the transition from bipedal stance to single-leg stance.ResultsThe SG showed significant increases in Cz theta and alpha values and COP-v (center of pressure velocity) between pretest and posttest (p < 0.001, p = 0.003, p < 0.001). Posttest Cz theta was significantly higher in the SG compared to the CG (p = 0.009) and posttest Cz alpha was significantly higher in the SG compared to the NSG (p = 0.039) and CG (p = 0.001). Posttest COP-v was significantly higher in the SG than in the CG (p = 0.031) and NSG (p = 0.03).ConclusionsStroboscopic training may be clinically beneficial to improve balance parameters in athletes with CAI, and may have utility in sport-specific activity phases of rehabilitation to reduce visual input and increase motor control.     

Student selection in radiography education. A narrative review

ObjectivesDue to effects on study success, radiography student selection has a major impact on higher education institutions and applicants. However, there is very little research to demonstrate which selection methods and contents are most successful in radiography education. This study aimed to describe the methods and contents used in radiography student selection and factors related to study success.Key findingsA narrative review was undertaken. A computerized search in four databases limited to studies published between January 2000 and June 2021. Ten quantitative, mainly retrospective, studies were included. The review identified 23 selection methods; of these, interview (n = 4), Scholastic Aptitude Test (n = 3), American College Test (n = 2) and reference letter (n = 2) were used more than once in radiography student selection. The content of the selection methods was identified in four categories including 44 factors. The most often assessed content was category of learning skills while the least often assessed concerned categories of social skills, personality traits and career choice. Regarding study success, factors of learning skills, namely mathematics, physics, biology, anatomy, physiology, natural sciences, a composite of factors comprising electronics and a composite of factors comprising mechanics predicted study success. Factors of social skills, personality traits and career choice were not related to study success.ConclusionThe methods used and contents assessed vary greatly in radiography student selection. The results suggest using the content in the four categories in the selection of radiography students.Implications for practiceFurther research is needed to clarify the methods, with knowledge of the reliability and validity and the contents for the suggested categories, and to demonstrate their relationship to study success and identify the core content of radiography student selection especially in European context.     

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

BackgroundResearch and clinical audit are central to the quality improvement (QI) process in healthcare; whereas research produces new knowledge, clinical audit establishes if practice is meeting set standards. Thus, radiographers have responsibility to engaging in these QI activities. This study aimed to explore radiographers’ understanding, attitudes and level of involvement in clinical research and audit across England.MethodsA cross-sectional survey using an online questionnaire for data collection over a 6-week period was employed. The questionnaire consisted of open and closed ended questions. Participants were recruited through social media. The quantitative data obtained was analysed using Statistical Package for Social Sciences (SPSS) Version 26 (IBM Inc, Armonk, NY) whilst content analysis was used to analyse the free-response data.ResultsA total of 100 valid responses were obtained after exclusion of 45 partial and/or incomplete responses. Radiographers showed a positive attitude towards involvement in research and audit with overall mean score of 3.85 (SD 0.80) and 4.01 (SD 0.80), respectively. Of the respondents, 35.7% (n = 35/98) were currently involved in clinical audit projects whilst 78.6% (n = 77/98) have previously been involved. Radiographers with postgraduate degrees were significantly more likely to have initiated research, 61.5% (n = 16/26) (p = 0.01) and to have previously been involved with research, 80.8% (n = 21/26) (p = 0.02). A significant association between radiographers' role and implementation of changes, following an audit (p = 0.03) was noted. Similarly, a significant association was noted between radiographers’ role and initiation of research (p = 0.05).ConclusionClinical radiographers in England showed a positive attitude towards research and audit. However, this did not translate into actual participation in research and audit activities.Implications for practiceThe need to stimulate clinical radiographers’ interest in clinical audit and research is highlighted. Additionally, the findings support the rationale for managers to give more support including protected time to radiographers to engage in QI activities.     

Injury risk profile of amateur Irish women soccer players and players’ opinions on risk factors and prevention strategies

ObjectiveTo explore injury profile, opinions on risk factors and injury prevention, among Irish amateur women soccer players.DesignA cross-sectional online survey. Setting: Irish amateur winter league.ParticipantsActive players ≤18 years of age.Main outcomesDifferences were found between injured and uninjured groups, and risk factors that significantly predict soccer injury were identified.Results168 injuries were reported by 83 respondents during the winter season. An increased prevalence of competition anxiety was observed in (53.8%:n = 85 of respondents) compared to other risk factors. There was a negative association between injuries and players' general health state (OR = 0.820, 95% CI 0.7–0.9, p = 0.007). Players’ knowledge about some risk factors including playing position, joint hypermobility, and playing during menses contradicts current evidence. 50%; n = 67 of the respondents had not received any education on injury risk or prevention.ConclusionThis study identified that Irish amateur women soccer players that responded have different characteristics, prevalence of risk factors and injury profiles to women players from different levels and countries. The findings suggest that some players may not be aware of the existing evidence base pertaining to common risk factors for injury. Further research is required to confirm the findings and explore the implementation of injury prevention strategies.     

Insights into the methodology of radiography science

IntroductionThe aim of this article is to give an insight into radiography as a science and a discipline from the viewpoints of knowledge interest and methodological approach and design.MethodsOriginal articles published in Radiography (n = 184) and the Journal of Clinical Radiography and Radiotherapy (n = 10) at the timeline 2015 to 3/2017 were reviewed for research focus and the methodology used. To abstract the results, thematisation analysis was used.ResultsOut of 194 studies analysed, 99 (50%) were found to have a technical, 80 (42%) a practical and 15 (8%) a critical interest of knowledge. The research methodologies used did not rigorously fit into the methodological approach expected on the basis of the interest of knowledge.ConclusionRadiography as a science seems to have mostly a technical and practical interest of knowledge, but somewhat critical research is also being made. It seems to be a remarkably open and flexible science when it comes to the use of research methodologies. More discussion and research on the science name and paradigm is needed in order to strengthen the scientific status of radiography.     

The effect of a digital training tool to aid chest image interpretation: Hybridising eye tracking technology and a decision support tool

IntroductionEye tracking technology, checklists and search strategies have been demonstrated as useful aids in image interpretation. A training tool was developed, by the research team, which included these features. This study aimed to evaluate the effect of the training tool on participant image interpretation performance.MethodsThe study was carried out with reporting radiographers who had either commenced training in chest image interpretation (n = 12) or were trained in musculoskeletal image interpretation (n = 23) (total n = 35). Participants were allocated to a control or intervention group. Participants completed an initial assessment at recruitment and re-attended nine months later for a follow-up assessment. The intervention group were given unlimited access to a digital training tool.During assessments participants interpreted 20 chest images whilst using eye tracking technology (total of 1400 images were interpreted). A confidence level was obtained from participants on their diagnosis and a questionnaire, to obtain demographic data, was completed following the assessment.ResultsImprovements were seen in the confidence of intervention group participants (p < 0.05). False Positive (FP) scores decreased for both the control and intervention group (p < 0.05), this decrease was from 4.20 to 3.20 for the control group and from 5.87 to 3.27 for the intervention group. True Negative (TN) scores increased, from 5.13 to 6.73 for the intervention group (p < 0.05). Mean decision time decreased for both the control and intervention group.ConclusionThe tool led to positive effects on participant performance and could be a useful aid in chest image interpretation learning.Implications for practiceImprovements in performance were observed with a digital tool. The tool could improve image interpretation methods and training.