Radiographers Research Articles

An Institutional Approach to Fight Technologist Burnout: Radiologist Contribution to National Radiologic Technology Week and Other Efforts

Radiologic technologists are an integral part of the function of the radiology department and are at risk of burnout with increasing volumes and demands. Integration of the technologists into departmental wellness efforts may prove to be important to technologist retention and job satisfaction. We describe a single institution's efforts to support the technologists in our department, which started as a spontaneous thank you note drive and has grown into an annual effort to celebrate National Radiologic Technology Week and a broader inclusion of the technologists in departmental wellness.

Radiation Safety Awareness and Practice among Radiology Staff in Kabul National Specialty Hospitals

In the world, more than ten million photographs and hundreds of thousands of nuclear medicine operations are performed daily. The exposure of such a large population even at the low dose levels used in diagnostic radiology due to definite effects and the possibility of ionizing radiation has caused public concern. This study aimed to determine the awareness of radiology staff from X-Rays adverse effects and the extent of use of safety measures in their practice in Kabul National hospitals. Methodology: A cross-sectional descriptive study was conducted among 60 radiology staff in national specialty hospitals of Kabul Afghanistan. A structured multiple-choice questionnaire was used. Data were coded and analyzed using the statistical package for social science (SPSS) software. Results: 83.3% of participants were male. 71% of the participants had >40 years old and the mean age of them was 41 years old. The type of job of participants was radiology technician. The mean of the years of job experience was 16 years. The knowledge or awareness of 95.0 % of participants was weak and 5.0% was intermediate. 96.7% of participant's practice was good and 3.3 % was intermediate. Conclusion: The level of awareness of 95.0 % of radiology staff was very poor. This is of concern as technologists are the first point of contact with the patients and they should be adequately trained to answer common patient questions and concerns. The level of practice of 3.3 % of the staff was intermediate and 96.7% was good. Based on our results, a conscientious effort to provide a more robust education and acquire greater knowledge in these matters is required.

Assessment of effective dose and radiation-induced cancer risk in CT-KUB

Background and objectivesAmong the various imaging techniques employed for disorders related to the renal and urinary tract systems, computed tomography of kidneys, ureters, and bladder (CT-KUB) is considered the gold standard. The study evaluated effective dose and organ equivalent dose and estimated cancer risk for patients undergoing CT-KUB scans. MethodsScans of 110 patients (76 males, 31 females; mean age 45 years) were completed using a calibrated GE Light Speed 64-slice multi-slice CT (MSCT) scanner. CT exposure parameters were recorded, including tube current, pitch factor tube potential, volume CT dose index (CTDIvol) and dose-length product (DLP), and the National Cancer Institute dosimetry system for computed tomography (NCICT) was used to calculate the effective dose for each patient. Patient organ doses for colon, breast, stomach, bladder, prostate, and ovaries were calculated and converted to estimate cancer risk, based on the Biological Effects of Ionizing Radiation (BEIR) VII report. ResultsCTDIvol, DLP, and effective dose reported mean values of 9.9 mGy, 483.57 mGy cm, and 5.8 mSv, respectively. Lifetime cancer risk ranged from 0.01% to 0.08%, with a mean of 0.03% per 100,000 CT-KUB procedures. For younger individuals, the level of risk was higher for females than for males. While male patients are at higher risk than females for colon cancer, with close risk for both genders regarding stomach and bladder cancers. A statistically significant positive correlation was observed between effective dose and body mass index (p < 0.011, r > 0.4), AP diameter (p < 0.01, r > 0.4), and transfer diameter (p < 0.01, r > 0.5). ConclusionsAlthough the reported effective doses fall within the standard limits, there is significant potential to reduce the radiation dose for patients undergoing CT-KUB. Possible options include low dose protocols and ultrasonography, depending on patient characteristics and clinical condition. Appropriate education and training of radiologic technologists can help to ensure radiation dose optimization.

How radiography educators teach the concept of caring to undergraduate radiography students

IntroductionCaring is a key part of a radiographers work and the education of student radiographers. Despite recent literature highlighting the importance of putting the patient at the centre of care and being caring, research describing the educational approaches used by radiography educators to facilitate the teaching of caring is lacking. The aim of this paper is to explore the teaching and learning strategies used by radiography educators to facilitate the development of caring in students. MethodsA qualitative, exploratory research design was used. Purposive sampling was used to select radiography educators (n = 9). This was followed by quota sampling to ensure all four radiography disciplines, namely diagnostic radiography, diagnostic ultrasound, nuclear medicine technology and radiation therapy were represented in the sample. Data was analysed thematically and themes were identified. ResultsThe findings indicated that radiography educators use teaching strategies such as peer role play, learning through observation and role modelling to facilitate teaching and learning of caring. ConclusionThe study suggested that although radiography educators know the teaching strategies that facilitate caring, aspects such as clarification of professional values and the refinement of reflection seems to be lacking. Implications for practiceThe teaching and learning approaches that can assist students in developing as caring radiographers can add to the evidence-based pedagogies that shape the teaching of caring in the profession.

MRI Safety Matters: Assessing the Knowledge of Radiologic Technologists and Nurses for Safe Imaging Practices

BackgroundConsiderable immediate safety risks are intrinsic to the magnetic resonance imaging (MRI) environment and must be acknowledged and prevented. PurposeThe purpose of this study was to analyze the impact of health professionals' characteristics on the mean knowledge in MRI safety domains and identify significant predictors for knowledge in these domains. Materials and MethodsA convenience sample of 433 participants was recruited from hospitals representing the four major health sectors in the country. The questionnaire consisted of questions about the demographics of the participants and their knowledge of the main domains of MRI safety. ResultsKnowledge of the main MRI safety domains and their associated subdomains varied among participants. MRI technologists, workers in private hospitals, and those who had courses/training had higher mean scores in all domains of MRI safety knowledge compared to their counterparts. ConclusionA statistically significant difference in the participants’ knowledge in the four main MRI safety domains based on participants’ characteristics.

How do Trained and Prospective Physiotherapists and Radiologic Technologists Face Knee Joint Effusion Profession-Specifically and Interdisciplinary?-A Cross-Sectional Study

Objective: Knee osteoarthritis (OA) is often accompanied by joint effusion that requires accurate detecting and diagnosing. In an interprofessional evidence-based practice (EBP) approach to this, physiotherapists (PTs) and radiologic technologists (RTs) should be included. While researchissults regarding the 1st pillar (external clinical evidence) and the 2nd (patients´side) pillar of EBP are available, these are still missing concerning the 3rd pillar (clinical experts´ side). Therefore, the aim of this study is to investigate how PTs and RTs deal with knee joint effusion detection in the course of knee OA patients’ profession-specifically as well as how they rate the other occupational group´s competencies. Methods: An online survey consisting of open and closed questions was conducted in the period from 31st of January 2023 till 6th of March 2023 to collect data. PTs, RTs as well as physiotherapy students (PTSs) and radiologic technology students (RTSs) were defined as target groups. A structuring content analysis was used to evaluate open questions. Descriptive and inferential statistics were used to analyses closed questions. Results: PTs and PTSs determined at least one of the cardinal symptoms of inflammation, inspection, palpation, the patellar tap test, and circumference measurement as knee effusion detection possibilities in patients´ with knee OA. In contrast, the modified stroke test and the bulge sign were hardly mentioned. The majority of RTs and RTSs stated that MRI was the first-choice imaging to detect effusion followed by sonography. Focusing on specific signs in radiologic imaging modalities fluid on T2 sequences in MRI, hypoechoic area on sonography, swelling on conventional radiography, fluid accumulation on CT and radionuclide uptake on scintigraphy were frequently mentioned. Among all 4 participating occupational groups, PTs and RTs were among the top 5 mentioned professions that have knee effusion detection competencies. There is no significant difference regarding the other occupational group´s knee effusion detection competencies. The participants rated them consistently as “rather competent” most frequently. Conclusion: The authors study results indicate that there are some discrepancies among PTs, PTSs, RTs and RTSs in regard to the 1st and 3rd pillar of EBP. All occupational groups show partly contradictory or lack of in-depth knowledge regarding frequently applied and suggested diagnostic procedures in literature. Implementing relevant training formats should be considered in the future.

Evaluating the role of the diagnostic radiographer in identifying child safeguarding concerns: A knowledge, attitude and practice survey approach

IntroductionChild safeguarding and the appropriate identification of suspected victims represents a global phenomenon. Diagnostic imaging is acknowledged as a contributory diagnostic service but the role of the radiographer in the identification and escalation process is less well understood. MethodA Knowledge, Attitude and Practice (KAP) survey was constructed to evaluate knowledge base in the context of the patient–radiographer interaction, the shaping of attitude towards child safeguarding and attitudes held towards their role plus the actual practical experiences of managing child safeguarding concerns. ResultsRespondents demonstrated a inconsistent knowledge base with respect to physical, social and radiographic signs and symptoms of child safeguarding concern. A positive attitude towards the role of the radiographer in child safeguarding was demonstrated but one that was shaped more by experience than pre-registration education.Assessment of concerns was chiefly influenced by clinical history and appreciation of aetiology. Practically, radiographers have infrequent involvement with the identification and escalation of concerns. Whilst some statistically significant relationships between responses and demographics did exist, these were either sporadic or argued to be a result of natural variation. ConclusionAssessment of physical and social signs of child safeguarding concern are argued to be becoming more challenging. Radiological signs continue to be visible to radiographers but with increasing use of other imaging modalities these signs are becoming more varied in nature and are providing new challenges. Radiographers are capable of escalation when required to do so. Implications for practiceTo maximise the contribution of the profession, education needs to account for imaging modality worked with, in combination with an understanding of related aetiology. Previously existing concerns with respect to escalating processes are no longer in evidence and radiographers are both willing and able to contribute to that process.

An exploration of simulation-based education from other health professionals, to create an informed and effective simulation delivery in a new diagnostic radiography programme

IntroductionThe recent validation of three Diagnostic Radiography programmes in the south of England involved a rigorous approval process with multiple Professional and Statutory Regulatory Bodies (PSRB's). Part of the validation process was evidencing that approximately 50% of each programme is spent undertaking practice-based learning. As well as clinical placements, practice-based learning includes simulation-based education (SBE). MethodologyFrom May 2022 to June 2022, a questionnaire was sent to all 22 simulation education facilitators from health courses belonging to the University School Simulation Group. Ethical approval was reviewed and approved by the Learning and Teaching Hub Research Ethics Panel. ResultsOf the initial 22 participants invited, the response rate was 59% (13 participants). The main themes arising from the analysis was the use of a theoretical or conceptual framework, a breakdown of the simulation session components and the role of simulation training. ConclusionThis questionnaire study demonstrated that there was a need for a standardised guide on how to deliver SBE. There is also a lack of feedback, training, and reassurance for facilitators. However, facilitators would welcome training or further training and HEE and the University have taken steps to prioritise SBE. Implications for practiceThe study highlighted how health professionals are delivering SBE within their subjects in innovative and creative ways. These ideas have helped to structure SBE within the new diagnostic radiography courses at the University.

An exploration of communication skills development for student diagnostic radiographers using simulation-based training with a standardised patient: UK-based focus-group study

IntroductionCommunication is an essential skill for all healthcare professionals but is particularly challenging for diagnostic radiographers since their role involves conveying extensive information within a relatively short amount of time. One method to develop communication skills in radiography is through simulation-based training using high fidelity simulation activities. The use of video recording for reflection and debriefing are also important elements that can be utilised to enhance learning. The aim of this project was to explore student radiographers’ experiences of a simulation-based activity utilising a standardised patient designed to aid development of communication skills. MethodsFifty-two undergraduate 3rd year diagnostic radiography students at a single Higher Education Institution undertook a simulation roleplay exercise with an expert by experience (EBE) who acted in an anxious manner in order to challenge the student's communication skills following the simulation, students received a debrief session where detailed feedback was provided from the EBE and an academic. Students were also able to watch their video of the simulation and reflect. Students were invited to participate in a focus group to discuss their experience and the learning they had developed and 12 students participated. Transcribed material from the focus groups was thematically analysed to deduce themes of learning developed and ways to improve for future simulations. FindingsSix main themes were identified from the thematic analysis of the transcripts from 12 diagnostic radiography students. These were patient care, radiographer's role and responsibilities, personal development, feelings, fidelity, and pedagogy. The themes represented the key learning points expressed by students and also aspects of the simulation which could be improved.Overall, the simulation provided a positive learning experience for the students. Having a video recording of the scenario was regarded as beneficial to enable a depth of reflection on non-verbal communication skills, which would be beneficial in future simulation scenarios. Students were aware that even though they used appropriate language their overall manner affected the interaction with the expert by experience more significantly. Students also considered methods to improve their communication if they encountered a similar patient interaction in their future practice. ConclusionThere is great potential for simulation-based training in developing communication skills for diagnostic radiography students. EBEs are a vital addition to simulation and educational activities in Higher Education Institutions and should be involved with the design of simulation activities also, as they can bring unique patient insight.

Radiation Safety Awareness and Practice among Radiology Staff in Kabul National Specialty Hospitals

Background and Aim: In the world, more than ten million photographs and hundreds of thousands of nuclear medicine operations are performed daily. The exposure of such a large population even at the low dose levels used in diagnostic radiology due to definite effects and the possibility of ionizing radiation has caused public concern. This study aimed to determine the awareness of radiology staff from X-Rays adverse effects and the extent of use of safety measures in their practice in Kabul National hospitals. Methodology: A cross-sectional descriptive study was conducted among 60 radiology staff in national specialty hospitals of Kabul Afghanistan. A structured multiple-choice questionnaire was used. Data were coded and analyzed using the statistical package for social science (SPSS) software. Results: 83.3% of participants were male. 71% of the participants had &gt;40 years old and the mean age of them was 41 years old. The type of job of participants was radiology technician. The mean of the years of job experience was 16 years. The knowledge or awareness of 95.0 % of participants was weak and 5.0% was intermediate. 96.7% of participant's practice was good and 3.3 % was intermediate. Conclusion: The level of awareness of 95.0 % of radiology staff was very poor. This is of concern as technologists are the first point of contact with the patients and they should be adequately trained to answer common patient questions and concerns. The level of practice of 3.3 % of the staff was intermediate and 96.7% was good. Based on our results, a conscientious effort to provide a more robust education and acquire greater knowledge in these matters is required.

Life Saver in Diagnostic Radiography (X-RAY)

Life Saver in Diagnostic Radiography (X-RAY)

Analysing the Diagnostic Radiography (DR) undergraduate's infection control practical session lesson plan from the lens of educational theories

Analysing the Diagnostic Radiography (DR) undergraduate's infection control practical session lesson plan from the lens of educational theories

Anatomy education during COVID-19 pandemic: Perceptions and opinions of Diagnostic Radiography students

Anatomy education during COVID-19 pandemic: Perceptions and opinions of Diagnostic Radiography students

Qualitative study on the pilot of Diagnostic Radiography Entrustable Professional Activity in Singapore

Qualitative study on the pilot of Diagnostic Radiography Entrustable Professional Activity in Singapore

Radiologists’ perceptions of knowledge and training required by radiographers in the interpretation of radiographic images: An explorative study in KwaZulu-Natal province, South Africa

IntroductionThe health sector of South Africa is burdened by the shortage of radiologists leading to the under-reporting of radiographic images and ultimately mismanagement of patients. Previous studies have recommended training of radiographers in radiographic image interpretation in order to improve the reporting. There is paucity of information regarding the knowledge and training required by radiographers to interpret radiographic images. The purpose of this study was therefore to explore the knowledge and training required by diagnostic radiographers, according to radiologists, for the interpretation of radiographs. MethodA qualitative descriptive study employing criterion sampling to select qualified radiologists practicing in the eThekwini district of the KwaZulu Natal province, was conducted. One-on-one and in-depth, semi-structured interviews were used to collect data from three participants. The interviews were not carried out face to face as a result of the Covid 19 pandemic and the regulation of social distancing. This did not permit engagement with research communities. The data from the interviews were analysed using Tesch's eight steps for analysing qualitative data. ResultsFindings revealed that radiologists supported the interpretation of radiographic images by radiographers in rural settings, and for the radiographer's scope of practice to be restructured to include the reporting of chest and the musculoskeletal system images. The themes that emerged from the analysis included knowledge, training, clinical competencies and medico-legal responsibilities required by radiographers in the interpretation of radiographic images. ConclusionAlthough the radiologists support the training of radiographers in the interpretation of radiographic images, radiologists think that the scope of practice should be limited to the interpretation of the chest and musculoskeletal systems in rural areas only.

A model to facilitate critical thinking of radiography students.

Critical thinking is a much-needed skill required by radiography students, across disciplines, when they graduate. The facilitation of critical thinking is a task that radiography educators are faced with in order to produce graduates who can apply these skills in the clinical setting, for the best care of the patient. The development of critical thinking skills is challenging, and currently there is no radiography-specific model which has been implemented and evaluated as a framework of reference for radiography educators. The aim of this article is to present a critical thinking model as a framework of reference that was implemented and evaluated by diagnostic radiography educators. A theory-generating qualitative, exploratory, descriptive and contextual design was used for the development of a model to facilitate critical thinking skills of diagnostic radiography students in a South African setting. A theory-generation model to facilitate critical thinking skills for radiography students was developed. The model was implemented and evaluated by radiography educators. Three themes emerged from the evaluation of the model after implementation. The results indicated the implementation of the model provided a platform for radiography educators to collaborate and purposefully tailor activities to incorporate critical thinking into their teaching. Through the implementation of the model, radiography educators felt empowered by using a framework of reference to facilitate critical thinking skills of radiography students.

EVALUATION AND STATISTICAL ANALYSIS OF THE USE OF INDIVIDUAL DOSIMETER BY RADIOLOGY PROFESSIONALS IN THE MUNICIPALITY OF GOIANIA BY DECREE SVS/MS Nº 453/1998

Occupational exposure can induce a stochastic effect with no dose limit. This means that small doses, even those below the limits, can induce them. Cancer and genetic effects are examples of such effects. Radiology professionals are exposed to small doses of radiation throughout their professional lives, so they must use dosimeters correctly and monitor the doses they receive. Thus, we evaluated the use of personal dosimeters by radiology professionals in Goiania. Through field research, with a descriptive character and a quantitative approach. Using the technique of collecting information based on observation and a questionnaire with closed questions, we sought to assess knowledge of dosimeter use. The subjects of this research were radiology technicians working in Goiania. Five questions were asked of 79 radiology technicians, and they showed that only 37% of the professionals monitored the values of the monthly doses. And 67% knew that they should use it on the lead apron, while in practice, 62% used it correctly. Correct usage of the lead apron is important for estimating the dose equivalent of exposed, unshielded parts. The survey also revealed that 79% of technicians know where to put it after hours. And half of the interviewees use the dosimeter in the most exposed region of the trunk. Thus, we conclude that the use of dosimeters is flawed and that continuing education of professionals exposed to ionizing radiation is necessary to improve the safety of services.

Blood and Hand Surface Lead in Veterinary Workers Using Lead Shielding During Diagnostic Radiography.

The objectives are to compare lead blood concentrations in veterinary workers using lead shielding with concentrations in a control population, to measure hand surface lead before and after use of shielding, and to compare hand surface lead with and without the use of disposable gloves worn under hand shielding. Blood and hand wipe samples were analyzed for lead using inductively coupled plasma mass spectrometry. There was no difference in blood lead between exposed and control groups. After lead glove use, 69% (18/26) of hand surface lead samples from workers not using disposable gloves were greater than 500 μg, 42% (11/26) were greater than 1000 μg, and 12% (3/26) were greater than 2000 μg. If lead shielding use is unavoidable, disposable gloves should be worn, and skin should be decontaminated after use.

Magnetic Resonance Imaging in Patients with Cochlear Implants without Magnet Removal: A Radiology-Administered Protocol to Enhance Operational Efficiency and Improve Workflow.

To describe the development, implementation, and validation of a radiology-administered protocol to obtain magnetic resonance imaging (MRI) in patients with cochlear implants and auditory brainstem implants without magnet removal. Retrospective review and description of novel care pathway. A radiology-administered protocol was designed based on careful input from the radiology safety committee and neurotology. Radiology technologist training modules, consent instructions, patient educational material, clinical audits, and other safeguards were implemented, with samples provided in this report. The primary outcomes measured included instances of magnet displacement during MRI and premature termination of MRI studies secondary to pain. Between June 19, 2018, and October 12, 2021, 301 implanted ears underwent MRI without magnet removal, including 153 devices housing diametric MRI-conditional magnets, and 148 implants with conventional axial (i.e., nondiametric) magnets. Among cases with diametric MRI-conditional magnets, all studies were completed without magnet dislodgement or need to terminate imaging early due to pain. Among cases with conventional axial (nondiametric) magnets, 29 (19.6%) MRI studies were stopped prematurely secondary to pain or discomfort; the overall rate of this event was 9.6% (29 of 301) among the entire study cohort. In addition, 6.1% (9 of 148) experienced confirmed magnet displacement despite headwrap placement; the overall rate among all cases was 3.0% (9 of 301). Eight of these patients received successful external magnet reseating through manual pressure on the external scalp without surgery, and one required surgical replacement of the magnet in the operating room. There were no documented instances of hematoma, infection, device or magnet extrusion, internal device movement (i.e., gross receiver-stimulator migration), or device malfunction in this cohort related to MRI. We present the successful implementation of a radiology-administered protocol designed to streamline care for cochlear implant and auditory brainstem implant recipients who require MRI and ease clinical demands for otolaryngology providers. Examples of resources developed, including a process map, radiology training modules, consent instructions, patient educational materials, clinical audit, and other procedural safety measures are provided so interested groups may consider adapting and implementing related measures according to need.

Promotion of research culture among radiographers in one UK NHS trust through journal club activities – An autoethnographic study

IntroductionThe poor research culture within the radiography profession can be addressed through initiatives such journal club activities. The role of a research radiographer is best suited to drive achievement of journal club outcomes for research culture improvement; however, the cultural environment of healthcare providers presents challenges. This is an autoethnographic account of a research radiographer in promoting research culture among diagnostic radiographers in a single UK NHS trust through journal club activities. MethodsThe study adopts an analytical autoethnography methodology to critically analyse reflective accounts of the research radiographer's experiences and the interplay with the cultural environment in which the experiences occurred. The reflective accounts are supported by locally collected data during a 10-month period of the journal club and published literature. ResultsThe establishment of the journal club received encouraging support from the senior management, university academics, library services and radiography professionals. There are initial signs of research culture improvement among participants of the journal club as observed through engagement in research related activities. However, cultural challenges including lack of time to explore gaps in research evidence, and prioritisation of clinical duties over research related activities, may have affected the achievement of expected outcomes of the club. ConclusionThe research radiographer is well placed to encourage research culture within the clinical imaging department through targeted initiatives such as journal clubs. The long-term contributions of such initiative to departmental efficiency and quality service delivery should encourage optimum support to actualize expected outcomes. Implications for practiceEncouragement of journal clubs as a means of improving research culture within clinical radiography teams, driven by research radiographers. Encouragement of management support for the achievement of set outcomes of journal clubs.