First year student radiographers’ perceptions of a one-week simulation-based education package designed to increase clinical placement capacity

IntroductionThe radiography workforce is short-staffed and under increasing pressure to meet service pressures. Combined with the impact of Covid-19, where student face-to-face clinical time was abruptly halted for safety, there is cause to change the pedagogical approach to teaching diagnostic radiography to students, increasing capacity and ensuring the continuance of qualifying radiographers to support the profession. This paper shares the perceptions of first year student radiographers on a one-week simulation-based education package designed to replace one week of clinical placement experience.MethodsTwo cohorts of first-year radiography students engaged in a one-week simulation-based education package. Simulations increased in complexity throughout the week and included conventional imaging techniques, mobile and theatre radiography, and cross-sectional imaging. Thirty-six students consented to the thematic analysis of their reflective blogs.ResultsFive themes emerged from the data: feeling anxious, understanding and skill development, building confidence, communication, and patient-centred care.ConclusionThe simulation package had a positive impact on students learning, no matter the stage at which it was incorporated into their clinical placement block. Students engaged well with the activities and saw value in the experience. The findings indicate that the simulation-based education package is a suitable replacement for one week of clinical placement, supporting skills development in students and providing increased placement capacity.Implications for practiceA successful, engaging simulation-based education package is presented, which first year student radiographers perceived as a suitable replacement for one-week of clinical placement. Further research into the acceptability of use of simulation-based education packages in second- and third-year student radiographers would be a useful next step.     

Visual function assessment of diagnostic radiography students

IntroductionDeterioration of visual acuity (VA) and visual impairment has been linked to age-related subtle changes, gender, and a correlation to socioeconomic status. This study aimed to assess first-year diagnostic radiography students’ visual functional abilities by applying the International Classification of Impairments, Disabilities and Handicaps (ICIDH) recommendations of functional VA screening and health-related quality of life questionnaire (HRQOL).MethodsThe design followed the World Health Organisation (WHO) electronic VA testing of monocular sight using LogMAR charts and binocular vision using Snellen charts, and an HRQOL questionnaire assessing for reduced ability of visual-based tasks in activities of daily living (ADL). The data was evaluated in correlation to the participant's visual correction, age, gender, and socioeconomic background.ResultsSeventy students were recruited, all meeting the WHO standard level for visual ability, with 100% (n = 70/70) met or achieved above normal binocular vision, correlating to expected normal population results from published studies for age. The monocular vision demonstrated 74% (n = 52/70) for the right eye, and 80% (n = 56/70) for the left eye for normal vision levels. The results did not differ significantly between each eye (p = 0.21), gender variations between the left eye (p = 0.27) and the right eye (p = 0.10) results were affected by sample ratio of females (80%; n = 56/70) to males (20%; n = 14/70), the visual correction did not impair binocular VA. The HRQOL assessment indicated no significant functional VA issues in the study sample. The study demonstrated no association between the participant's socioeconomic background that may influence their VA ability.ConclusionThe results provided normative binocular and monocular data on visual function in a sample of student radiographers and indicated that their thresholds align to normal (or near-normal) VA standards.Implications for practiceThe visual health data was reviewed for subgroup comparison and trend analysis, and did not identify risk factors within this sample group that their VA and visual functioning would impact upon radiography clinical placement tasks and activities. The sample is not generalisable to the wider population; further studies are recommended.     

COVID-19 vaccine hesitancy concerns: Findings from a Ghana clinical radiography workforce survey

IntroductionVaccination is a key global strategy to mitigate the clinical impact of the COVID-19 virus. As part of local efforts to manage the outbreak, the government of Ghana announced its intention to vaccinate its population starting with essential and high-risk workers including radiographers. However, there were reports of hesitance to receiving the vaccine among the radiography workforce. This study was undertaken prior to the intended vaccination exercise to assess the willingness and concerns of radiographers to undergo the COVID-19 vaccination and to suggest recommendations to improve the vaccine uptake.MethodsAn ethically-approved online survey strategy was employed for this cross-sectional study conducted between 24th–28th February 2021. The survey employed quantitative questions and open text response options. Quantitative and open text responses were analysed using statistical and thematic analyses, respectively.ResultsThere were 108 responses (response rate of 46.3%). The majority (n = 64, 59.3%) were willing to have the vaccine, however, some (n = 44, 40.7%) were not. The main reason behind their willingness to have the vaccine was its ability to reduce the spread of infections and lower mortality (n = 35, 54.7%). However, doubts about the vaccine's efficacy and side effects (n = 26, 56.8%), conspiracy theory concerns about its effects on the Ghanaian race (n = 4, 9.1%), and fertility concerns (n = 2, 4.5%) were some reasons for their hesitance to receive the vaccine. The open text commentary further revealed that the vaccine was thought of as a lifesaving medication, however, clinical safety concerns, lack of education/information and religious beliefs were affecting peoples' willingness to be vaccinated.ConclusionOur findings demonstrate the need for an urgent public health educational intervention to address the COVID-19 vaccine hesitancy concerns raised by radiographers to help increase the vaccine uptake.Implication for practiceThe study provides pertinent information to improve COVID-19 vaccine uptake among radiographers to limit the spread of infections.     

Radiographer interpretation of trauma radiographs: Issues for radiography education providers

BackgroundThe role of radiographers with respect to image interpretation within clinical practice is well recognised. It is the expectation of the professional, regulatory and academic bodies that upon qualification, radiographers will possess image interpretation skills. Additionally, The College of Radiographers has asserted that its aspiration is for all radiographers to be able to provide an immediate written interpretation on skeletal trauma radiographs by 2010. This paper explores the readiness of radiography education programmes in the UK to deliver this expectation.MethodA postal questionnaire was distributed to 25 Higher Education Institutions in the UK (including Northern Ireland) that provided pre-registration radiography education as identified from the Society & College of Radiographers register. Information was sought relating to the type of image interpretation education delivered at pre- and post-registration levels; the anatomical range of image interpretation education; and education delivery styles.ResultsA total of 19 responses (n = 19/25; 76.0%) were received. Image interpretation education was included as part of all radiographer pre-registration programmes and offered at post-registration level at 12 academic centres (n = 12/19; 63.2%). The anatomical areas and educational delivery methods varied across institutions.ConclusionRadiography education providers have embraced the need for image interpretation education within both pre- and post-registration radiography programmes. As a result, UK education programmes are able to meet the 2010 College of Radiographers aspiration.     

Diagnostic radiography students’ perceptions towards communication with service users who are deaf or hearing impaired

IntroductionCommunication issues can arise when deaf or hearing impaired individuals access National Health Service (NHS) radiology services if reasonable adjustments and inclusive services are not facilitated. This study aims to assess student diagnostic radiographers' attitudes and communication experience with service users who are deaf or hearing impaired.MethodsAn anonymous online survey was conducted on UK undergraduate diagnostic radiography students from a single university. The sample size of students invited to participate in the study was n = 156. The measurement scales and questions included quantitative attitudinal 5-point Likert and qualitative free-response questions. Statistical analysis included the Kruskal–Wallis H test, Mann–Whitney U test, pairwise comparisons of variables and thematic coding of qualitative data.Resultsn=48 students responded. The student's perceptions of communication experiences with deaf or hearing-impaired patients were positive (72.9%) but depended on the amount of experience whilst on clinical placement (first-year students had less clinical placement experience than years two and three). Overall confidence in communicating was 47.9% with no difference by gender (p = 0.87) but variance by age category (p = 0.03), with the 18–29 group less confident and first-year students having less experience to draw upon for responses (p = 0.04). Confidence in gaining consent (56.3%) demonstrated no variation by gender (p = 0.75) or cohort (p = 0.54), but variance by age category (p = 0.03) due to difference in unmatched sample sizes. Participants elaborated on positive service adaptations that can be facilitated for service users who are deaf or hearing impaired and issues that caused negative communication experiences.ConclusionThe study has produced data on the experience of student radiographers interacting with an understudied service user group who are deaf or hearing impaired. Qualitative responses discussed a range of resources to assist clinical practice communication and recommendations for further improvements and training opportunities.Implications for practiceThe findings of this study can help to inform future research, policy, practice, and educational training.     

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.     

Impact of coronavirus disease 2019 (COVID-19) outbreak on radiology research: An Italian survey

PurposeTo understand how COVID-19 pandemic has changed radiology research in Italy.MethodsA questionnaire (n = 19 questions) was sent to all members of the Italian Society of Radiology two months after the first Italian national lockdown was lifted.ResultsA total of 327 Italian radiologists took part in the survey (mean age: 49 ± 12 years). After national lockdown, the working-flow came back to normal in the vast majority of cases (285/327, 87.2%). Participants reported that a total of 462 radiological trials were recruiting patients at their institutions prior to COVID-19 outbreak, of which 332 (71.9%) were stopped during the emergency. On the other hand, 252 radiological trials have been started during the pandemic, of which 156 were non-COVID-19 trials (61.9%) and 96 were focused on COVID-19 patients (38.2%). The majority of radiologists surveyed (61.5%) do not conduct research. Of the radiologists who carried on research activities, participants reported a significant increase of the number of hours per week spent for research purposes during national lockdown (mean 4.5 ± 8.9 h during lockdown vs. 3.3 ± 6.8 h before lockdown; p = .046), followed by a significant drop after the lockdown was lifted (3.2 ± 6.5 h per week, p = .035). During national lockdown, 15.6% of participants started new review articles and completed old papers, 14.1% completed old works, and 8.9% started new review articles. Ninety-six surveyed radiologists (29.3%) declared to have submitted at least one article during COVID-19 emergency.ConclusionThis study shows the need to support radiology research in challenging scenarios like COVID-19 emergency.     

MRI reporting radiographers - A survey assessment of number and areas of practice within the United Kingdom

IntroductionThe aim of this study was to determine a baseline assessment of the national picture of MRI reporting radiographers within the United Kingdom.MethodA questionnaire was utilised using both open and closed questions, the twenty questions were based on four main themes of those in training, those trained, those no longer reporting and post qualification sign off and expectations. The questionnaire was sent out to multiple special interest and MRI specific groups.ResultsResponses were received from 46 trusts (n = 46) between September 2019 and May 2020. The majority of respondents were from English Trusts (n = 40/46). 31 radiographers from 21 different trusts were training in MRI reporting with the majority of those training to report thoraco-lumbar spines and knees. 80 radiographers from 38 trusts had completed training with 77 of those being trained at one south of England University. 57 radiographers from 35 trusts were in practice with the majority of these reporting thoraco-lumbar spines and knees.ConclusionThis survey provides an insight into the current status of MRI reporting radiographers in the UK. Although courses have been available since 2003, numbers are still low and there are significant geographical and working practice variations. Defined standards of practice and the implementation of a central register would benefit both those in practice and those looking to implement a MRI reporting radiographer service.Implications for practiceThis study gives some baseline evidence of the number and scope of practice of MRI reporting radiographers in the UK.     

Graduate radiographers' expectations for role development – The potential impact of misalignment of expectation and valence on staff retention and service provision

PurposeThe purpose of this study was to investigate the role development expectations of graduate radiographers with a view to predicting the potential impact of a misalignment of these expectations and valence on service delivery and staff retention. A final year cohort of radiography students completed a questionnaire designed to explore topics associated with role development opportunities.MethodStructured questionnaires, in the Likert scale format, utilised 20 attitude questions constructed to elicit information in relation to 3 main themes of investigation; expectation, valence and knowledge.ResultsAll participants (n = 37) stated an expectation for role development opportunities with 97.3% (n = 36) indicating that these expectations would be realised within 5 years of graduation and 75.7% (n = 28) within 2 years of graduation. A significant correlation between expectation for role development and job satisfaction was seen (p < 0.05). 81.1% (n = 30) of participants stated turnover intentions in order to meet their expectations.ConclusionThere is an expectation for role development opportunities for new graduates with a valence noted of the intrinsic reward of meeting these expectations. Expectation and valence are seen to be intrinsically linked with job satisfaction suggesting that misalignment of these would have a potentially negative impact on motivation and retention of the future radiography workforce demonstrating a positive correlation with withdrawal behaviours, including turnover intentions. In a relatively small professional group such as radiography the phenomenon of group cohesion may be strong suggesting that withdrawal behaviours may manifest as ‘resignation in post’, impacting on the quality of care and service provision for patients.     

The impact of COVID-19 upon student radiographers and clinical training

IntroductionTo investigate student clinical placement concerns and opinions, during the initial COVID-19 pandemic outbreak and to inform educational institution support planning.MethodsBetween mid-June to mid-July 2020, educational institutions from 12 countries were invited to participate in an online survey designed to gain student radiographer opinion from a wide geographical spread and countries with varying levels of COVID-19 cases.Results1277 respondents participated, of these 592 had completed clinical placements during January to June 2020. Accommodation and cohabiting risks were identified as challenging, as was isolation from family, travel to clinical placements, and to a lesser extent childcare. Students stated they had been affected by the feeling of isolation and concerns about the virus whilst on placement. Overall 35.4% of all respondents were ‘Not at all worried’ about being a radiographer, however, 64.6% expressed varying levels of concern and individual domestic or health situations significantly impacted responses (p ≤ 0.05). Year 4 students and recent graduates were significantly more likely to be ‘Not worried at all’ compared to Year 2 and 3 students (p ≤ 0.05). The need for improved communication regarding clinical placements scheduling was identified as almost 50% of students on clinical placements between January to June 2020 identified the completion of assessments as challenging. Furthermore, only 66% of respondents with COVID-19 imaging experience stated being confident with personal protective equipment (PPE) use.ConclusionStudent radiographers identified key challenges which require consideration to ensure appropriate measures are in place to support their ongoing needs. Importantly PPE training is required before placement regardless of prior COVID-19 imaging experience.Implications for practiceAs the next academic year commences, the study findings identify important matters to be considered by education institutions with responsibility for Radiography training and as students commence clinical placements during the on-going global COVID-19 pandemic.     

An international study of emotional intelligence in first year radiography students: The relationship to age,gender and culture

Emotional intelligence (EI) is an important personality trait in healthcare professionals and students. This study aims to identify gender, age or culture differences in trait EI scores between student radiographers across four countries. The short form of the trait EI questionnaire (TEIQue-SF) was used to collect data from first year radiography students in Australia, Hong Kong, Ireland and the United Kingdom. Global EI and Sociability scores of the first year radiography students were in keeping with published norm data in terms of gender differences, however, Self-Control and Emotionality scores did not follow the gender-based norms. Statistically significant differences in Global EI (p = 0.02), Wellbeing (p = 0.002) and Sociability (p = 0.003) were found with Western versus Asian cultures being a key factor. This study highlights a number of EI findings of importance to health-related professional programmes and the potential impact of cultural background on this key personality trait.     

Stress,a reflective self and an internal locus of control: On the everyday clinical placement experiences of older undergraduate radiographers in the UK

IntroductionExtant evidence indicates that the stresses experienced by younger undergraduate radiographers and their older counterparts vary considerably. Much of this difference has, however, emerged from analyses of the academic component of a radiography degree whereas little work has focused to date upon the specific business of clinical placement. Given this, the research herein reports findings from a qualitative study of how older undergraduate radiography students in the UK assemble their stress and stressors around clinical placement.MethodsAn Interpretative Phenomenological Analysis was employed. N = 6 older undergraduate students undergoing their final year placement were purposively recruited from a variety of hospitals. With full institutional ethical approval, a semi-structured interview was conducted with each participant.ResultsFour superordinate themes emerged. These were: (1) Self-identity and perceived competence; (2) Understaffing, instability and affect; (3) Episodic experience and feeling ‘thrown-in’; (4) Unpreparedness for the challenging patient. Critically, each theme describes an interaction between stressor, experience of stress and self.ConclusionWhile familiar stressors were apparent, the older participating students actively made sense of them in terms of their manageability. This provides a strong contrast with existing literature, which tends to imply a more externalised locus of control among (largely younger) students.Implications for practiceStress in the NHS is a continuing issue and there is a clear rationale for further investigation to ascertain the level of clinical support available and to determine whether further improvements could assist students on clinical placement. Collaboration between academic institutions and clinical sites would allow open discussion around clinical stress experienced by radiography students, with locus of control a potential point of focus, fostering a proactive partnership approach to stress-management and identification of difficulties before they exacerbate.     

Supporting radiography clinical placements in Ireland during the COVID-19 pandemic: The practice educators perspective

IntroductionThe COVID-19 pandemic has significantly impacted healthcare services and the clinical learning environment. Several studies have investigated radiography students' experiences of clinical placement during the pandemic; however, few have investigated the Clinical Practice Educator's (CPEs) perspective. CPEs play a pivotal role in supporting clinical education.MethodA qualitative study was conducted using a purposeful sample of twenty-two CPEs, each working in a different Irish hospital. Four semi-structured focus groups were used to gather data. To maintain reasonable homogeneity, CPEs who were new to the role (n = 8) were assigned a separate focus group from experienced CPEs (n = 14). Inductive thematic analysis was applied.ResultsCPEs experienced role expansion, particularly in managerial and administrative aspects of the role. They described arranging COVID-19 vaccinations locally for radiography students and the complexities of student rostering during the pandemic. CPEs perceived the pandemic to have impacted students' emotional wellbeing with ‘high anxiety levels’ and ‘loneliness’ being reported. They also perceived issues with clinical readiness and the student transition to clinical practice. Many challenges were faced by CPEs including arranging clinical recovery time for numerous students when sites were already at full capacity, fewer learning opportunities due to decreased patient throughput and range of imaging examinations, social distancing constraints, resistance from staff to student placements, and a shortage of staff for student supervision. Flexibility, communication, and multi-level support helped CPEs to fulfil their role.ConclusionThe results provide insight into how CPEs supported radiography clinical placements during the pandemic and into the challenges faced by CPEs in their role. CPEs supported student placement through multi-level communication, teamwork, flexibility, and student advocacy.Implications for practiceThis will aid understanding of the support mechanisms needed by CPEs to provide quality clinical placements.     

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.     

Implementing radiographic CT head reporting: The experiences of students and managers

IntroductionIn the face of growing demand in radiology, skill mix initiatives have sought to improve and expand service provision. Within the UK radiographer reporting is now widespread, although the growth in computerised tomography (CT) head reporting has not been as rapid as anticipated. The literature in this area is limited, but case studies have highlighted the successful implementation of this training through new radiographer roles in practice.MethodA cross-sectional survey was developed to elicit information from radiographers and managers on their experiences before, during and after post-graduate training in CT head reporting.ResultsSeventy one responses were received comprising 48 past students (n = 48/111; 43.2%) and 23 service managers (n = 23/67; 34.3%). Key factors for the development were personal continual professional development for students and departmental need for managers. Challenges during training included a lack of study time due to staff shortages and access to radiologist mentors. Only 48.8% of students responding have gone on to use the new skills in practice cited reasons include staff shortages, resistance from radiologists and increase in radiological staffing.ConclusionsThis qualitative study has demonstrated that those trusts who have implemented CT head reporting have evidenced perceptible benefits for both the department and individuals. Those radiographers who are successfully reporting have shown themselves to be highly motivated and persistent in their development.