Radiography and research: A United Kingdom perspective

In the past two decades radiography has experienced a wealth of changes, involving the teaching site, learning methods, curriculum, professional status, educational funding, and public expectations. Consequently this period witnessed the transition of radiography from a mainly hospital-linked to a mainly university-linked degree, from a knowledge-based discipline to an evidence-based practice. The early 1990s saw the establishment of graduate programs, the role expansion of radiographers, the technological advancements in medical imaging, the participation of the Radiography Schools in Research Assessment Exercise (RAE) schemes.Given the educational, technological and social advancements the engagement of radiographers in research is emphasized as a priority that will bring the profession forward and help to maintain high standards of patient care.Research in radiography is a requirement, as by definition professions are expected to contribute to the body of knowledge necessary for a profession to progress. Funding, ethical considerations, mentorship, proficiency in research methodology, commitment, and ability to work in a multi-disciplinary team are just a few of the requirements for high quality radiography research.There has been a definite increase in the number of radiographers who are research aware and active as well as in the number of radiographers who pursue purely academic and research careers. However intensification of personal efforts and formulation of strategic decisions are required so that research forms an integral part of the profession. Recent developments in strengthening the research base of radiography are encouraging.     

The role of the radiotherapy treatment review radiographer

Purpose: The aim of the study was to describe and interpret the role of the radiotherapy treatment review radiographer.Method: A qualitative, phenomenological methodology was employed to gain an understanding of the role of the treatment review radiographer by in-depth interviews with three practitioners who had different lengths of experience, from 6 months to 3 years. Comparative content analysis was undertaken to reveal the process of development and the essence of the role.Results: The analysis disclosed the process of development from a safe, carefully controlled, task-oriented, delegated role to a professionally mature, new, radiographic role with considerable autonomy and an enhanced role in the cancer care team. Fully exploited, the role has resulted in improved patient care and added value to the provision of cancer services.Conclusions: The study concludes that this demanding new role better serves the needs of people having radiotherapy treatment, provided that it is properly supported educationally and clinically. It points to the potential for further role development by therapeutic radiographers who can take their rightful place as skilled practitioners in the interprofessional cancer care team. The requirement for strong professional leadership is noted.     

Mentoring assistant practitioners – The radiographer’s perspective

PurposeThe aim of this study was to evaluate the experiences of diagnostic and therapeutic radiographers as they mentored trainee assistant practitioners undertaking an educational programme. The evaluation study describes the challenges and benefits the radiographers experienced as mentors as well as giving their insights into the introduction of assistant practitioners in their departments.MethodThe mentors’ opinions were sought by a questionnaire which formed part of the evaluation of the respective diagnostic imaging and therapeutic educational programmes run by two colleges.ResultsThe response rate was 54% (22/41). Mentors described personal and professional benefits for themselves from undertaking this role. Although mentoring had provided a number of challenges including an increase in workload, the experience had also enhanced their teaching and mentoring skills and contributed to their Continuing Professional Development (CPD). Whilst the role was more time consuming than initially expected this had not impacted generally on their ability to undertake CPD or deliver patient care. In relation to the wider impact of the programmes some negative impact was reported on the speed of service delivery but not on the quality of practice. Mentors felt that the programmes had a positive effect on teamworking and had been beneficial for patient care. Some difficulties were noted in balancing the mentoring of trainee assistant practitioners and radiography undergraduates.ConclusionThe mentors strongly endorsed the educational programmes and their roles and responsibilities in their delivery. Protected time to carry out mentoring duties and establishing good communication with the colleges providing the theoretical teaching were identified as means of further improving the mentoring process.     

The radiographer and role expansion in nuclear medicine

With the introduction and wide application of Clinical Governance to all clinical areas, all healthcare professionals including radiographers/technologists working in Nuclear Medicine need to gain skills required for implementation. New professional and legal obligations demand that relevant expertise is developed. This article examines the potential for role expansion of radiographers/technologists in Nuclear Medicine with emphasis on the training and development aspects. The key areas addressed include clinical audit, risk management, research, management and continuing professional development.     

Preparticipation examination (screening): practical issues as determined by sport: a United Kingdom perspective.

OBJECTIVES: Pre-participation examination, screening and health surveillance are part of the job specification for many roles within Sports Medicine. The type and scope of this activity varies enormously, with little consensus as to best evidence-based practice. The purpose of this work was to explore and understand the practical approaches to pre-participation examination, screening and health surveillance in two contrasting sport scenarios. DATA SOURCE: Team physicians for British Triathlon and Manchester United Football Club. DATA SYNTHESIS/METHODS: Information was gathered under the headings: why screen, screening objectives, practical issues and constraints? RESULTS: The systems evolved within these two sports reflect their respective opportunities and constraints. Different systems, each with merit, have evolved with some generalizable concepts across sport. CONCLUSIONS: A perfect system for pre-participation examination, screening and health surveillance across all sport does not exist, however, within specific sport scenarios examples of good practice are demonstrated.     

The Chernobyl reactor accident: the impact on the United Kingdom

I had originally thought that by this time, nearly 1 year after the Chernobyl reactor accident, I would be in a position to describe fully its impact on the UK in terms of radiation doses, economics and future emergency planning. However, only one of these is reasonably clear-the radiological impact. We shall continue our measurements, particularly those of activity in persons, and doubtless we shall refine our estimates of collective dose, but they are unlikely to change significantly. We can therefore be certain that the radiological impact on the UK was small and that the health effects will not be detectable. Predictions of the consequences of accidental releases of radionuclides have in the past, perforce, relied upon models of environmental transfer. Data on which the models are based were obtained from investigations of weapons fallout and of routine releases from nuclear facilities. The Chernobyl accident provided a situation of activity deposition that was well characterised in time and in geographical distribution, and measurements along environmental pathways will allow us to validate or refine our models. This accidental deposition reinforced the importance of some effects that we knew about-such as the importance of wet deposition-and will cause us to consider the need to take account of specific situations that we had not considered previously in adequate detail-in particular, the behaviour of radionuclides in upland ecosystems. The overall economic impact is not yet clear and, unfortunately, is unlikely to become so until all restrictions on the movement and slaughter of sheep are removed and the farmers have received compensation. The effect on international trade may never be quantified. Some international agencies are evaluating the consequences of Chernobyl and their reports will become available during 1987. International agreements on intervention levels are also still under discussion and it would be premature to speculate about the need for any fundamental revisions to Emergency Reference Levels and derived quantities. Similarly, we are aware of the need for revision of the national emergency plan, but we are awaiting the government decision on this. One effect of the Chernobyl accident, however, is clear: the public's awareness of radiation issues has reached a new height. Members of the public demand information and advice, and better means of communicating these must be provided. Advice to take some action may provoke unnecessary alarm, but advice that no action is required may be distrusted. We cautiously assume that any dose, no matter how small, has some deleterious effect and yet, in situations of accidental releases, we may tell the public that no actions are required to reduced doses that they may consider appreciable and avoidable. We clearly need to promote a better understanding of the nature and acceptability of the risk of radiation doses in such circumstances and we intend to do so.     

Radiologist perceptions of radiographer role development in Scotland

AimTo survey the perceptions of the Scottish radiology community in relation to radiographer role development.MethodsA postal questionnaire was sent to all consultant radiologists recorded on the NHS Scotland database of consultants.ResultsResponse rate was 63%. (i) Respondents considered increased professional standing of radiographers, best use of manpower resources, reduced pressure on the service and improved recruitment and retention, as positive advantages of radiographer development. (ii) The potential impact on radiology specialist registrar training, lack of clear medico-legal responsibilities and radiographers recognising the limitations of their abilities were identified as the main areas of radiologist anxiety. (iii) Fifty-seven percent did not consider current post-registration radiography education and training resources adequate to underpin the requirement of developed roles. (iv) Barriers to radiographer development were identified as lack of radiography and radiology staff, suitable education, financial constraints, traditional views and resistance to change. (v) Eighty-two percent reported support for radiographer role development and willingness to participate actively in developments.ConclusionDespite reservations Scottish radiologists are supportive of the development of radiography colleagues, however, guidance is required on the medico-legal and accountability aspects of radiographers assuming new roles. Radiologist involvement in education and training for new roles may increase their confidence and trust in radiographers to work within the limitations of their competency and training.     

When disaster strikes; the role of the forensic radiographer

Forensic radiography is a vital tool utilised in the many facets of Forensic Medicine. This paper investigates the role of the forensic radiographer in a mass disaster situation; it also explores the psychological impact of this type of work on radiographers.A literature review indicated that limited work had been documented on the role of the radiographer in mass disasters. This ultimately creates doubt about whether or not the radiographer is acknowledged for the vital role he/she plays and if proper provisions were in place to assess any emotional damage in the aftermath of an emotionally and physically straining situation.A qualitative method of research was used (semi-structured interviews) in order to elicit radiographers' feelings and perceptions. This method is best suited to this research topic because it is a delicate subject.Four interviews were carried out and the responses are presented in themes including emergency versus mass grave experiences (including issues of time and preparation). Other themes include the role of the radiographer and interaction with other members of the team, as well as a discussion of the aftermath of their experiences, including the feelings of pride experienced.     

Suicide by gunshot in the United Kingdom: a review of the literature

This paper reviews the research literature on gunshot suicide in the United Kingdom and the international literature with reference to strategies aimed at preventing gunshot suicides. Trends in gun ownership and changes in firearm legislation in the UK over the past 20 years are described. Most UK gunshot suicides are male, middle-aged and living with a partner and involve the use of shotguns. They are less likely to have current or past mental health problems, or a previous act of self-harm, than people who commit suicide by other methods, and their suicide is more likely to have been precipitated by a relationship dispute. Where alcohol is consumed the amount tends to be large. The international literature provides evidence of a strong association between rates of gun ownership and gunshot suicide, and some evidence of a reduction in firearm suicide rates following the introduction of restrictive firearm legislation. Over the past 20 years the number of gunshot suicides in the UK has declined by over 50% to a little over a hundred deaths per annum. At the same time, firearm legislation has become progressively more restrictive and rates of gun ownership have declined. Measures, which might further reduce the prevalence of gunshot suicides in the UK, are discussed.     

Defining the sports medicine specialist in the United Kingdom: a Delphi study

OBJECTIVE: To define the role and responsibilities of the sports medicine specialist using a recognised research technique. METHODS: A Delphi technique was employed using anonymous postal questionnaires sent to a random sample of 300 members of the British Association of Sport and Exercise Medicine. The questionnaire of 300 putative attributes was developed in a pilot study and the Delphi technique used allowed participants to modify their responses according to the responses of other participants. RESULTS: There was a 53% response to both rounds of the study with 75.6% of the respondents being male, 39% having a higher qualification in sports medicine, and 45.6% being general practitioners. Some 86.3% strongly agreed that sport and exercise medicine should be a recognised speciality and 90% strongly agreed that it should be available on the National Health Service (NHS). The most important specialist attributes were orthopaedic and soft tissue medicine (83.6% strongly agreed) and emergency medical management (79.7% strongly agreed). More than 75% of respondents did not agree that either research or personal playing experience were relevant. CONCLUSION: Sports and exercise medicine is an evolving speciality in the United Kingdom. We believe this is the first systematic attempt to define the role and responsibilities of the sports medicine specialist and the findings are of relevance to the future development of a career pathway.     

The mental health of elite athletes in the United Kingdom

Objectives

The purpose of this study was to investigate the prevalence of signs of anxiety/depression and distress among a sample of elite athletes in the United Kingdom (UK). A secondary aim was to identify the variables associated with signs of anxiety/depression and distress in the same sample.

The current position of cardiac radiology in the United Kingdom

A questionnaire was sent to 39 hospitals, in the United Kingdom, 38 with a cardiosurgical unit and one with a cardiac radiology department. The object was to ascertain the commitment of consultant radiologists to cardiovascular radiology and cardiac radiology in particular and to evaluate training given to non-consultant radiologists in this subspecialty. Thirty-five (90%) departments responded, 33 of which had a cardiac radiology consultant. All but three of the 63 consultant cardiac radiologists report cine angiography. Of the 63, 26 perform one additional imaging technique and 21 perform two or more additional imaging techniques. The remaining 16 consultants only report on cine angiography. Only nine of 21 departments in which some form of cardiac radiology training was given, had a rotation through the subspecialty at registrar or senior registrar level. Twenty-one departments thought that an additional post in cardiac radiology would be sought if trained people were available.     

Civil defence in the United Kingdom

What must be avoided in the nuclear age is wishful thinking. Wishful thinking occurs in an atmosphere of maximum terror (as in Mutual Assured Destruction), and where there is little opportunity for reality testing (as in the East‐West communication barrier). In the small, densely populated island of Britain, the size of today's growing nuclear threat will create responses where delusional thinking can easily dominate. A belief in effective civil defence may induce a sense of false security which may in turn direct attention from the fundamental problem of East‐West mistrust.