Radiographer's confidence in managing patients with claustrophobia during magnetic resonance imaging

IntroductionClaustrophobia is a major problem experienced by some patients referred for magnetic resonance imaging (MRI). This results in significant costs and delays to healthcare service provision due to appointment cancellations or patients' inability to complete MRI examinations. Radiographers may use several strategies to effectively manage patients with claustrophobia during MRI. This study aimed to determine radiographer's confidence in managing patients with claustrophobia and evaluate the perceived effectiveness of the intervention approaches employed.MethodsWith institutional ethical approval, an online survey was conducted (15th September to 9th November 2020) among Kuwaiti MRI radiographers. The survey was designed to obtain information relating to participant demographics and the perceived confidence of radiographers in their use of interventions to manage claustrophobia during MRI procedures. Data obtained were analysed using the Statistical Package for the Social Sciences (v.26).ResultsA total of 144 valid responses were obtained. Of the respondents, 82% (n = 118) were confident that they could support claustrophobic patients during MRI examinations. Almost all respondents (97.9%, n = 141) employed various claustrophobia reduction and relaxation techniques to improve patient experience and increase scan completion rates. There was a significant association between radiographer’s level of education (r_s = +0.18, p = 0.028) and experience (r_s = +0.33, p < 0.001) with their confidence managing claustrophobic patients. While participating radiographers considered lectures and training the most effective methods to improve their skills in managing such patients, educating claustrophobic patients prior to their MRI scan was the most effective technique for facilitating scan completion.ConclusionKuwaiti MRI radiographers are confident in applying different claustrophobic management techniques to improve patient compliance. Patient education, through supportive discussion, prior to their MRI examination was identified as the most effective intervention for managing claustrophobia.Implications for practicePatient education before MRI examination is necessary to enhance their experience and optimise scan completion rates. In addition, it is essential that MR radiographers develop their practical competence in supporting patients with claustrophobia during their scans.     

Occupational stress amongst radiographers: does working in private or public practice make a difference?

Purpose: Nothing is known about the effects of stress amongst radiographers in different clinical settings (hospital and private). We aimed to evaluate the magnitude and impact of this problem.Methods: We conducted a cross-sectional study of public hospital and private radiography departments/practices. A sample of 70 radiographers from hospitals and 75 from private radiography establishments in Sydney, Australia, were asked to complete a self-report questionnaire. Levels of stress, stressors, physical symptoms of stress, and blood pressure were all measured in health care workers with stress-related illness, and details of general socio-demography were collected.Results: The response rate was 71% (n=145). The age range of respondents was (20–66 years) with a mean age of 31, SD=9.68. There was no evidence of gender bias (54% female). Private practice radiographers were almost four times more likely to miss work due to a stress-related illness then those working in a public practice (OR=3.75, 95% CI: 1.51–9.20). Moreover, radiographers in private practice were three times more likely to drink alcohol as a way of relieving stress compared to radiographers in public practice (OR=3.09, 95% CI: 1.46–6.53).Conclusion: Occupational stress is a common occurrence amongst all radiographers. There are no differences in the levels of stress between private and public practices, but there is a difference in the type of stressor(s) in the two clinical settings.     

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.     

Radiographers' commitment to continuing professional development: A single-centre evaluation

PurposeThis study aimed to examine radiographers' commitment to continuing professional development (CPD), and to ascertain what types of activities are preferred so a model for provision of departmental activities could be developed.MethodsAn online survey was used to obtain information from all departmental radiographers regarding their commitment to CPD. Statistical analysis, using Spearman's Rho and Chi-Square test, was utilised to investigate any associations.ResultsAll radiographers (n = 57) were invited via email. A response rate of 67% (n = 38) prevailed. Radiographers feel CPD is important and a positive correlation existed with feelings regarding compulsory CPD (r value = .718, P value = .001). Thirty-four percent had logged the SOR-recommended twelve or more pieces of CPD in the last 2 years. One to three hours a month is the preferred amount of own time radiographers are willing to dedicate. Negative correlations exist between the amount of own time radiographers are willing to commit to CPD activities and their feelings regarding compulsory CPD (r value = −.419, P value = .009), and HCPC audit (r value = −.509, P value .001).ConclusionAlthough radiographers recognise the importance of CPD many spend less than four hours of their own time a month on CPD. Departmental activities should be free, short lasting, lunchtime presentations with theory presentation that encourage interaction and discussion with inclusion of practical elements. Further research investigating the barriers that prevent radiographers from partaking in CPD and the causes for insufficient CPD records is recommended.     

MRI reporting by radiographers: Findings of an accredited postgraduate programme

AimTo analyse the objective structured examination (OSE) results of the first three cohorts of radiographers (n = 39) who completed an accredited postgraduate certificate (PgC) programme in reporting of general magnetic resonance imaging (MRI) investigations and to compare the agreement rates with those demonstrated for a small group of consultant radiologists.MethodForty MRI investigations were used in the OSE which included the following anatomical areas and abnormal appearances: knee; meniscal/ligament injuries, bone bruises, effusions and osteochondral defects; lumbar spine: intervertebral disc morphology, vertebral collapse, tumours (bone and soft tissue), spinal stenosis and/or nerve root involvement; internal auditory meati (IAM): acoustic neuroma. Incidental findings included maxillary polyp, arachnoid cyst, renal cyst, hydroureter, pleural effusion and metastases (adrenal, lung, perirenal and/or thoracic spine). Sensitivity, specificity and total percentage agreement rates were calculated for all radiographers (n = 39) using all reports (n = 1560). A small representative subgroup of reports (n = 27) was compared to the three consultant radiologists' reports which were produced when constructing the OSE. Kappa values were estimated to measure agreement in four groups: consultant radiologists only; radiographers and each of the consultant radiologists independently.ResultsThe sensitivity, specificity and agreement rates for the three cohorts (combined) of radiographers were 99.0%, 99.0% and 89.2%, respectively. For the majority (5/9) of anatomical areas and/or pathological categories no significant differences (p < 0.05) were found between the mean Kappa scores (K = 0.47–0.76) for different groups of observers, whether radiographers were included in the group analysis or not. Where differences were apparent, this was in cases (4/9) where the variation was either not greater than found between radiologists and/or of no clinical significance. These results suggest therefore that in an academic setting, these groups of radiographers have the ability to correctly identify normal investigations and are able to provide a report on the abnormal appearances to a high standard. Further work is required to confirm the clinical application of these findings.     

Intraorbital foreign body detection and localisation by radiographers: A preliminary JAFROC observer performance study

IntroductionThe purpose of this study was to run a preliminary investigation to establish if a short course of learning would increase radiographers' performance in intraorbital foreign body (IOFB) detection and localisation on pre-magnetic resonance imaging (MRI) orbital computed radiographs (CR).MethodA multi-reader multi-case (MRMC) human observer study was performed. Fifteen radiographers from 5 hospitals participated. Each radiographer reviewed a pre- and post-training image bank and was instructed to identify the presence or absence of IOFBs, indicating the lesion location on each case whilst scoring the detection using a confidence index on a 5-point scale, for 30 orbital radiographs. The results were analysed using a Jackknife free-response receiver operating characteristic (JAFROC2 equal weighted) methodology.ResultsThe performance of the radiographers demonstrated a statistically significant difference after a short period of training in the detection of IOFBs on orbital radiographs (F (1,14) = 12.99, df = 14.0, p = 0.0029). The JAFROC2 analysis averaged figure of merit (FOM) for the radiographers was 0.818 (95% CI 0.769, 0.867) pre-training and 0.920 (95% CI 0.891, 0.950) post-training.ConclusionThese results suggest that with a short programme of learning in image interpretation for IOFBs in orbital radiographs, radiographers should be able to achieve a high level of accuracy in the identification and localisation of IOFBs prior to MRI examination.     

A survey on the research awareness and readiness among radiographers in Singapore General Hospital (SGH)

AimResearch is a key component of evidence-based medical imaging. Good knowledge and attitude towards research is important in implementing the paradigm shift from the traditional model of practice to evidence-based practice. The aim of this study was to ascertain the attitude, level of awareness and knowledge of radiographers about research. Potential barriers might also be identified so that programmes and schemes could be developed to raise the profile of research in clinical practice.MethodsA 20-item scale self-completion questionnaire was designed and distributed to radiographers in the Department of Diagnostic Radiology, SGH. The questionnaire consisted of questions pertaining to years of working experience, specialization of practice, role/involvement in any research, training needs and identification of potential barriers to research.ResultsThe final response rate was 67% (N = 114). Although the involvement in research is 39% (N = 44), the radiographers strongly believed that it is essential for them to participate in research to develop themselves and the profession, as well as to improve the quality of care delivered to patients. The main identified perceived barriers to research included lack of time, resources and heavy clinical workload. Sixty-four percent (N = 73) of participants indicated that provision of courses would improve their research skills, such as research methodology, biostatistics, literature critique, and a lack of these could be some of the reasons for low research involvement among radiographers.ConclusionsThe data suggest that positive attitudes, institutional support and provision of research related courses are needed to increase radiographers' involvement in research.     

A FROC analysis of radiographers performance in identification of distal radial fractures

The aims of the study are to measure the performance of radiographers in detecting the presence of a distal wrist fracture; to determine whether the number of years clinical service impacts on radiographers' performance and progresses further to compare the performance of the radiographer, untrained in reporting, to that of published data on the performance of consultant radiologists.

Method

A Free-response Receiver Operating Characteristic (FROC) study was carried out on radiographers to assess their performance. 19 experienced radiographers untrained in image interpretation were shown 30 wrist radiographs, 15 of which had distal radial fractures, 15 did not. The results of the FROC, false positive and false negative data were assessed.

Results

The study showed that for AUC values radiographers scored 0.877 (0.087) on average. A trend of increased performance with increased experience was seen amongst the radiographers.

Conclusions

Radiographers AUC scores of 0.87 demonstrates that there is potential for radiographers to recognise fractures with some accuracy. There is a trend of increasing performance with increasing experience. When this was compared to published data it is seen that radiologists outscored radiographers and a difference in performance exists between the groups. The radiologists as a whole and the MSK specialists scored a significantly higher than the radiographers with and AUC value of 0.92 (p ≤ 0.05) and 0.96 (p ≤ 0.001) respectively. Radiologists had fewer false positives than radiographers (P ≤ 0.007), however there was no difference was found in the false negatives (p ≤ 0.11). Further image interpretation training of radiographers should now be carried out and this experiment should be repeated     

Consultant radiographers: Profile of the first generation

AimThe aim of this research is to examine the profile of first generation consultant radiographers: their demographics, educational backgrounds, qualifications and training, career experience and progression, teaching, lecturing and research activities.MethodParticipant recruitment was drawn from the Society and College of Radiographers consultant radiographer group. Data collection involved a self-administered paper based and web based questionnaire.ResultsParticipant response rate of 55% (n = 11).ConclusionsThe profile of the first consultant radiographer cohort reflects a diverse and eclectic mix. While some aspects of their development such as educational background, clinical training and skills enhancement are comparable to nurse consultants, clinical experience and employment history show some differences. Commitment to development of expert clinical skills is evident within the profile of the first generation cohort of consultant radiographers however research and leadership training are not strong features.     

Cognisance of magnetic resonance imaging-induced vertigo and supported care: A study among a cohort of MRI radiographers in a country in West Africa

IntroductionMagnetic resonance imaging (MRI) can induce vertigo in patients undergoing such examinations. The severity of the vertigo is thought to increase with higher magnetic field strengths and could cause a patient to fall.The study assessed the awareness levels on MRI-induced vertigo among a cohort of MRI radiographers and their perspectives on the care that should be administered to patients post MRI examinations.MethodsThe study utilized a quantitative cross-sectional research design and a questionnaire. Out of a total of 40 MRI-radiographers identified nationwide, 31 participated in the study. Statistical Package for Social Sciences v.21.0 was used to analyse the data.ResultsMost participants (n = 21, 67.7%) were aware of MRI-induced vertigo. Many knew that patients (able and weaker) need to be assisted off the couch (n = 28, 90.3%) and escorted to the changing rooms post MRI examinations (n = 31,100%). There were statistically significant associations between the size of magnetic field strength used by the participants and their level of awareness about MRI-induced vertigo (r = 0.691, p = 0.003), appreciation of the needed support for patients post MRI examinations (r = 0.530, p = 0.041) and the frequency of occurrence of MRI-induced vertigo among their patients (r = 0.530, p = 0.001).ConclusionThe radiographers were mostly cognisant of MRI-induced vertigo and the supported care they were supposed to administer to their patients. The size of magnetic field strength used by the participants correlated with their level of awareness about MRI-induced vertigo and their appreciation of the needed support for patients post MRI examinations.Implication for practiceThe study highlights the need for a refresher training to expand the knowledge-base of a few of the radiographers who were not very cognisant about MRI-induced vertigo.     

Radiographers’ knowledge and attitudes toward dementia

IntroductionDementia is a syndrome associated with a decline in brain function, impacting how we speak, think, feel, and behave. Misunderstanding of dementia and how it affects patients and their carers is common. There is limited research on how radiographers provide adequate care to those with dementia. Radiographers with knowledge and positive attitudes can reduce stigma and fear, improving the quality of care. This study aimed to assess radiographers’ knowledge and attitudes towards dementia.MethodsA cohort of registered radiographers in Ireland participated in an online survey. Two pre-existing validated questionnaires: The Alzheimer's Disease Knowledge Scale (ADKS) and the Dementia Attitudes Scale (DAS), assessed radiographers' knowledge and attitudes towards dementia and people with dementia. Scores were compared across variables such as gender, age, grade, qualification, work setting, and the number of years qualified.ResultsA total of 123 radiographers responded. Knowledge scores did not significantly differ across demographic groups (p > 0.05). Total knowledge scores ranged from 60% to 100%. Total attitude scores ranged from 50% to 100%. Participants with a BSc, MSc, and other post-graduate degrees scored higher on the attitude scale than those with a diploma qualification (p = 0.027). Those with less than 20 years’ experience scored higher than those with more. Knowledge had little correlation with attitude (r = 0.0522; p = 0.5667).ConclusionFindings indicate variations in attitudes linked to age and experience, and some misconceptions can be observed across varying groups. Interventions to improve attitudes and raise awareness are needed.Implications for practiceThere is a need for further research and education on dementia care in the imaging department. We have identified areas requiring further education.     

RadBench: Benchmarking image interpretation skills

PurposeThe key aim of this research was to develop an objective, accurate assessment tool with which to provide regular measurement and monitoring of image interpretation performance. The tool was a specially developed software program (RadBench) by which to objectively measure image interpretation performance en masse and identify development needs.MethodTwo test banks were generated (Test 1 & Test 2), each containing twenty appendicular musculoskeletal images, half were normal, half contained fractures. All images were double reported by radiologists and anonymised. A study (n = 42) was carried out within one calendar month to test the method and analysis approach. The participants included general radiographers (34), reporting radiographers (3), radiologists (2) (all from one UK NHS Trust) and medical imaging academics (3).ResultsThe RadBench software generated calculations of sensitivity, specificity, and accuracy in addition to a decision making map for each respondent. Early findings highlighted a 5% mean difference between image banks, confirming that benchmarking must be related to a specific test. The benchmarking option within the software enabled the user to compare their score with the highest, lowest and mean score of others who had taken the same test. Reporting radiographers and radiologists all scored 95% or above accuracy in both tests. The general radiographer population scored between 60 and 95%.ConclusionsThe evidence from this research indicates that the Radbench tool is capable of providing benchmark measures of image interpretation accuracy, with the potential for comparison across populations.     

Accuracy of appendicular radiographic image interpretation by radiographers and junior doctors in Ghana: Can this be improved by training?

IntroductionAccess to image interpretation in Ghana remains a challenge with the limited number of radiologists. Radiographers with the right skills and knowledge in image interpretation could help address this challenge. The aims of the study were to determine and compare the ability (accuracy, sensitivity and specificity) of radiographers and junior doctors in interpreting appendicular trauma radiographs both before and after training.MethodsAn action research study involving a pre and post training test was carried out to determine the level of accuracy, sensitivity and specificity in abnormality detection by radiographers after undergoing training when compared to junior doctors. Eight radiographers and twelve junior doctors were invited to interpret an image bank of 30 skeletal radiographs, both before and upon completion of an educational program. The participants’ tests were scored against a reference standard provided by an experienced radiologist. Pre and post-test analysis were carried out for comparison.ResultsPost training mean accuracy (radiographers 83.3% vs 68.8%, p = 0.017; doctors 81.9% vs 71.6%, p = 0.003), sensitivity (radiographers 83.3% vs 69.2%, p = 0.042; doctors 77.2% vs 67.8% p = 0.025) and specificity (radiographers 83.3% vs 68.3%, p = 0.011; doctors 86.7% vs 75.6% p = 0.005) of both groups significantly improved. No significant differences were recorded between the radiographers and doctors after the training event.ConclusionThe study revealed that, with a well-structured training program, radiographers and junior doctors could improve on their accuracies in radiographic abnormality detection and commenting on trauma radiographs.     

Assessment of diagnostic radiographers’ knowledge of work-related health problems and associated effects: A multicentre study in Ghana

IntroductionWork-related health problems (WRHPs) are health conditions peculiar to a group of people or occupations including radiography in a specific work setting. These WRHPs occur as a result of prevailing work conditions which predispose workers to risks of physical or psychological distress.AimThis study assessed the knowledge of WRHPs among practicing radiographers in Ghana and evaluated the sources, causes, effects and preventive measures of WRHPs.MethodsA prospective cross-sectional design incorporating a quantitative data collection approach was used. A questionnaire was used to assess the knowledge and evaluate the effects of WRHPs among two cohorts of 31 practicing radiographers at a regional hospital (RH) and a teaching hospital (TH).ResultsAn average score of 4.2 (SD = 0.4) out of 5 (84.8%) obtained on the knowledge scale indicated very good knowledge of WRHPs among the radiographers. Physical work demands, ergonomic issues, increased workload and stress levels on on-duty radiographers due to sick absence by colleagues, large numbers of daily cases, and extra work without incentives were reported as WRHPs effects mostly experienced by the radiographers. The study also showed no significant difference between gender groups (p = 0.313), years of professional practice experience level (p = 0.319), and academic qualifications (p = 0.287) on knowledge of WRHPs.ConclusionRadiographers working in some referral and teaching hospitals in Ghana demonstrated very good knowledge of WRHPs and identified several effects of WRHPs on professional practice.Implication for practiceThe study concludes that WRHPs predispose radiographers to adverse health conditions, and administrative protocols are required to prevent or mitigate the burden.     

Longitudinal changes in extended roles in radiography

Purpose: The purpose of this research was to identify the extent and scope of changes to radiography practice. Method: Questionnaires were sent to radiology managers at acute National Health Service (NHS) hospitals in 2000 as a follow-up to an initial survey conducted in 1998. Information was sought on region, teaching/non-teaching status, the nature of extended role tasks undertaken and the year in which these tasks were first undertaken. Results: Some 172 questionnaires were returned from a total of 253 dispatched (68%). In 161 hospitals radiographers administered intravenous injections and performed barium enemas in 119 hospitals, while a red-dot system was in operation in 141 hospitals. Reporting by radiographers had increased since 1998. Replies indicated that, at 124 hospitals, radiographers were reporting in ultrasound. Skeletal reporting was the second most-frequently-reported activity, with 63 hospitals indicating that radiographers reported in this modality, while barium enemas were reported by radiographers in 34 hospitals. Reporting was also undertaken by radiographers in mammography, nuclear medicine, paediatrics and chest radiography in a small minority of hospitals. There was no statistically significant difference between the adoption of tasks in non-teaching and teaching hospitals with the exception of radiographer-performed barium enemas (P=0.014) and red-dot systems (P=0.05). Radiographers were more likely to undertake both of these activities at non-teaching hospitals than in teaching hospitals. Regional differences were apparent in reporting, with a greater prevalence in the English regions than Northern Ireland, Scotland and Wales. Conclusion: The study provided data that demonstrated the extent to which hospitals are utilizing the developing skills of radiographers. This has important implications for future education and training needs for radiographers and for delivery of imaging services.     

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.