Developing CT workforce competencies: What knowledge and skills should we expect of an early career radiographer?

INTRODUCTION: Individual professions seek to define their professional practice through competencies which describe the behaviours and technical attributes to perform effectively within role. Professional body and regulatory frameworks define universal standards for radiography but there is limited evidence of the technical competencies expected of the workforce in Computed Tomography (CT). This study aimed to address this gap by agreeing the essential competencies for the early career radiography workforce who have CT as part of their clinical responsibilities. This is the first step in developing a competency framework for CT across all radiography expertise levels. METHODS: A modified e-Delphi study was used to identify and gain agreement on essential practice competencies for this group. Structured surveys over two rounds were completed by an expert panel with CT knowledge and experience. Participants were asked to rate the essentiality of competencies for the novice CT workforce. Structured feedback was provided between surveys for consensus building, defined by the content validity ratio (CVR). RESULTS: Survey responses were received from 34 participants across different diagnostic imaging roles and settings. A total of 56 competency statements were agreed as essential for the early career CT workforce, including some appropriate to assistant radiographer practitioner roles. Competencies could be divided into those that were relevant to diagnostic radiography but could be applied to the CT setting (n = 32) and technical attributes unique to the CT context (n = 24). CONCLUSION: CT competencies for this group centre around understanding technical concepts of image formation and image quality optimisation; patient preparation and contrast media administration. IMPLICATIONS FOR PRACTICE: The competencies presented in this research represent the agreed minimum standards for the workforce in CT. Further work is required to validate competencies in practice.

Current Diagnostic Techniques for Pneumonia: A Scoping Review.

Community-acquired pneumonia is one of the most lethal infectious diseases, especially for infants and the elderly. Given the variety of causative agents, the accurate early detection of pneumonia is an active research area. To the best of our knowledge, scoping reviews on diagnostic techniques for pneumonia are lacking. In this scoping review, three major electronic databases were searched and the resulting research was screened. We categorized these diagnostic techniques into four classes (i.e., lab-based methods, imaging-based techniques, acoustic-based techniques, and physiological-measurement-based techniques) and summarized their recent applications. Major research has been skewed towards imaging-based techniques, especially after COVID-19. Currently, chest X-rays and blood tests are the most common tools in the clinical setting to establish a diagnosis; however, there is a need to look for safe, non-invasive, and more rapid techniques for diagnosis. Recently, some non-invasive techniques based on wearable sensors achieved reasonable diagnostic accuracy that could open a new chapter for future applications. Consequently, further research and technology development are still needed for pneumonia diagnosis using non-invasive physiological parameters to attain a better point of care for pneumonia patients.

Enablers and barriers to delivering person centred dementia care: Perceptions and experiences of diagnostic and therapeutic radiography practitioners.

INTRODUCTION: There is a lack of evidence about the experiences of radiographers providing care to people living with dementia (PLWD). This study explored the perceptions and experiences of radiography practitioners when delivering person-centred dementia care (PCDC) in both diagnostic imaging and radiotherapy departments. METHODS: A two-phase qualitative multi-method study was conducted. For phase 1, fifteen diagnostic and two therapeutic radiography practitioners from across the UK participated with online focus group discussions. For phase 2, four key stakeholders involved with the development of the UK Society of College of Radiographers Caring for People with Dementia practice guidelines for diagnostic and therapeutic radiography practitioners took part with individual semi-structured interviews. RESULTS: Participants from both phases identified enablers and barriers to providing person-centred care to individuals living with dementia. Three themes were identified that were linked to (1) Time and workload pressures in delivering person-centred dementia care, (2) Workplace practice and norms, and (3) Areas for improvement in delivering person-centred dementia care. DISCUSSION: Delivering PCDC can be challenging in practice. This is often due to workplace cultures where time and resources linked to productivity and waiting lists are the norms and impact on the delivery of PCDC. Leaders and managers of departments were thought to not always value a culture of PCDC but were seen as key influencers in supporting change and impact in delivering PCDC. Radiography practitioners were not always aware that a patient had dementia prior to their attendance in the department making it difficult to prepare ahead of appointments. Care partners were identified as having the potential to help alleviate some challenges radiographers faced. Findings also suggest a need for more education and training linked to dementia awareness. Further research is warranted in this area.

International student mobility in diagnostic radiography: Benefits and pitfalls.

INTRODUCTION: International student mobility (ISM) is increasingly utilised in higher education to allow students the opportunity to engage authentically with cultures outside their own, providing an opportunity for self-growth. These growth opportunities often extend skills such as cultural competency, academic learning and self-efficacy, all of which are important skills for diagnostic radiography graduates. This study explores the motivations, benefits and pitfalls of an ISM program and highlights key considerations for academics considering organising a program within their own university. METHODS: This study utilised a combination of individual and small group interviews to collect data about diagnostic radiography students' motivations, perceived benefits and pitfalls of undertaking ISM. Data were analysed using reflexive thematic analysis and overarching themes were developed. RESULTS AND DISCUSSION: Three themes were developed from the data, challenges and uncertainty, personal growth, and support. Participants undertaking ISM faced challenges such as cultural differences, as well as feelings of uncertainty. Additionally, they highlighted the importance of organisation in mitigating these challenges. Despite the challenges faced, participants reported significant personal growth and success as a result of the program, integral to this success was the support of their peers and academic advisors. CONCLUSION: ISM programs may lead to enhanced employability of diagnostic radiography graduates, with integral skills such as teamwork, communication cultural competence being enhanced in participants. The role of support during ISM is integral to the success of the program. It is imperative for academics organising ISM programs at their institutions to deliberately consider the way in which radiography students are supported both before and during the program to enhance the experience and ensure outcomes are maximised.

Factors Affecting Gonadal Shielding Use Among Technologists in California.

PURPOSE: To assess the patient gonadal shielding practices of radiologic technologists in the state of California. METHODS: A survey invitation was sent via email to registered radiologic technologists in California to collect data to determine whether there were significant associations between gonadal shielding practices and various categorical variables, including patient sex, patient age, body part, availability of gonadal shielding protocols, availability of gonadal shields, and supervisor encouragement. RESULTS: There was a significant association between gonadal shielding protocol availability and supervisor encouragement of using gonadal shielding (P = .005) and between gonadal shielding availability and supervisor encouragement of using gonadal shielding (P < .001). Contrary to other studies in the literature, there was a significant difference between patient sex and the likelihood of gonadal shielding use, with participants indicating that they shield girls and women more often than they shield boys and men (P < .001). DISCUSSION: There was a sex-based difference in the frequency of gonadal shielding usage among the sample in this study. Also, supervisors providing accessible protocols and encouraging gonadal shielding can increase technologists' use of gonadal shielding. CONCLUSION: Gonadal shielding is the current Code of Federal Regulations standard, although most professional and scientific organizations support discontinuing shielding during abdominal and pelvic radiography examinations. Shielding of these areas is more likely to occur with the availability of gonadal shielding, supervisory encouragement, protocols mandating shielding, and state regulations.

The role of the radiographer in promoting health: A qualitative examination of diagnostic radiographer perspectives at a Scottish Major Trauma hospital.

INTRODUCTION: Publication of Government directives and initiatives have signalled a shift in healthcare priorities, with growing emphasis on prevention and early intervention. In comparison to other allied health professions, perceptions of Diagnostic Radiographers of their contribution to addressing these initiatives and role in promoting health, has not been explored. There is limited evidence on current practices, knowledge and confidence in providing health promotion advice to patients within this professional group. This study aimed to investigate the perceptions of Diagnostic Radiographers of their role in promoting health. METHODS: Semi-structured focus groups were conducted with 20 Diagnostic Radiographers recruited via convenience sampling from a Scottish Major Trauma Hospital. Focus groups were transcribed and analysed using thematic analysis. RESULTS: Findings demonstrated a lack of awareness and understanding of government initiatives and professional body recommendations surrounding health promotion. Diagnostic radiographers felt ill-equipped to provide appropriate and impactful health promotion advice and reported lack of time as a barrier to contributing to such activities. CONCLUSION: Diagnostic Radiographers noted a willingness to undertake additional training to enable them to participate and were able to identify areas where they could adopt health promotion activities in their clinical practice. Addressing the barriers to participation is essential to empower Diagnostic Radiographers to contribute to the health promotion agenda. IMPLICATIONS FOR PRACTICE: There is a need to address profession specific education at pre-registration and post-qualification levels, to ensure Diagnostic Radiographers are equipped with the knowledge, skills and confidence to promote health to their patients. Strong leadership is essential for creating a positive environment to facilitate education, training and the acceptance of health promotion as a key part of a diagnostic radiographer's role.

Clinical preparedness programme as perceived by first-year diagnostic radiography students in South Africa.

INTRODUCTION: There is an increasing emphasis on exploring ways to improve students' transition from the classroom into the clinical environment. Diagnostic radiography (DR) students undergo rigorous theoretical and practical training before they are exposed to the clinical environment. It has been found that when DR students commence clinical learning in the workplace for the very first time, they experience difficulties in this transition. At the site of investigation, a newly integrated and dedicated clinical preparedness (CP) programme was offered; however, little is known about the DR students' perceptions of this programme. METHODS: A qualitative approach coupled with a self-developed, cross-sectional research tool was employed. First-year DR students were purposefully sampled against the inclusion and exclusion criteria. The principle of voluntary participation was upheld throughout the data collection process. The data were analysed using Braun and Clarke's six steps of thematic analysis. RESULTS: Forty-two responses were collected. Following a thematic analysis, two overarching themes were developed, namely: (1) reflections on the CP programme and (2) suggestions for future CP programmes. CONCLUSION: This study demonstrated the need for effective CP programmes as an approach to ease the transition of first-year DR students from the classroom into the clinical environment. Several suggestions, for example, an extended CP programme and a clinical information pack were made for the offering of similar programmes in the future.

Impostor phenomenon traits in radiography students: Findings from a UK pilot survey.

INTRODUCTION: Impostor Phenomenon (IP) includes feelings of being a fraud, which can be associated with high anxiety levels. Research suggests healthcare students on clinical placement report high levels of anxiety. This study aimed to explore radiography students' (diagnostic and therapeutic) IP traits within the United Kingdom (UK). METHODS: The pilot study used a mixed-method online survey, applying the Clance Impostor Phenomenon Scale (CIPS). Internal student recruitment used the university virtual learning environment (VLE), and external UK recruitment used social media with a convenience sampling method. The survey included demographic questions (gender, age, year of study, course). The statistical analysis used the Kruskal-Wallis test for the quantitative responses and content analysis of the qualitative responses. RESULTS: The survey received n = 92 responses; 77% were found to have frequent or intense IP traits. No significant differences were identified by age (p = 0.46) or radiography programme (diagnostic or therapeutic) (p = 1.00). The year of study demonstrated a significant difference (p = 0.01), with second-year students scoring a higher CIPS score (78.56) than first and third years (72.41 and 66.17, respectively). There was also a significant difference between males and females surveyed (p = 0.001). The thematic analysis highlighted that the clinical placement environment, prior IP knowledge, feelings of not belonging, and being an older/mature student increased IP feelings. CONCLUSION: Both therapeutic and diagnostic students returned a high CIPS score >70, demonstrating that IP traits were present in the sample of survey responses. Although being an older/mature student was a subtheme in qualitative responses, the quantitative data displayed no statistical difference amongst the CIPS scores by age. A significant difference between males and females surveyed (p = 0.001) and year of study (p = 0.01) was found with second years students scoring higher (mean CIPS score of 75.56) than first and third-year students (72.41 and 66.17, respectively). The qualitative responses further suggested as clinical placement experiences increased, feelings of IP decreased. IMPLICATIONS FOR PRACTICE: Educational intervention methods such as workshops may assist radiography students in identifying and coping with IP traits before their first clinical placement.

July 2021 civil unrest: South African diagnostic radiography students' experiences.

Background: South Africa (SA), in 2021, experienced a wave of civil unrest following political events that led to mass looting and the destruction of property. Civil unrests, among other disruptions, have been seen to cause ripple effects on healthcare education, particularly for radiography students who undergo work integrated learning within hospitals and universities, even during these times of unrest. Aim: This study aimed to explore and describe the undergraduate diagnostic radiography students' experience of the civil unrest that occurred in SA in 2021. Setting: The study was conducted across five universities in South Africa, offering the diagnostic radiography programme. Methods: A qualitative, interpretive phenomenological design was employed as it enabled the researchers to facilitate focus group interviews to gain insight into the lived experiences of the students during this time. Results: Four themes emerged from the study data, namely: (1) Negative effects on students' emotional and psychological well-being, (2) Academic and clinical support mechanisms during disruptions, (3) The influence of disruptions on clinical training, (4) Recommendations to support students for future disruptions. Conclusion: The participants from this study described the negative effects that the civil unrest had on their emotional and mental well-being. There is a need for increased support mechanisms during times of disruptions from universities across South Africa. Contribution: The findings highlight the ripple effects that disruptions, such as civil unrests, have on radiography students. This can assist universities to relook at their institutional support structures, in order to enhance the current support given to students across universities in times of disruptions.

Clinical indications for plain abdominal radiographs: A survey study among radiographers.

Background: Abdominal pain is a common complaint in the Emergency Department. Radiographers' knowledge and practices regarding clinical indications for performing abdominal examinations are crucial in the results radiographs produced. Aim: To determine the knowledge and practices of radiographers regarding the clinical indications for performing radiographic examinations of the abdomen. Setting: Four public hospitals in the Eastern Cape province, South Africa. Methods: A cross-sectional study was conducted, using a convenience, all-inclusive sample of n = 85 radiographers. A hard copy self-administered questionnaire was distributed between February and June 2020. Descriptive (mean and standard deviations) and inferential (chi² test) statistics were generated using IBM® SPSS® version 26.0 software package. Results: Knowledge of clinical indications had a mean of 59.41. All four demographics (age, years of experience, attended a short course and attended pattern recognition course) were significantly associated with overall knowledge. Additionally, short course attendance was significantly associated with most practice items, and two knowledge items (which views are done for perforation; and which view(s) demonstrate a stab abdomen). Pattern recognition was significantly associated with one knowledge item (which views are regarded as an acute abdomen). Conclusion: Despite the lack of short courses and pattern recognition courses, radiographers' knowledge of clinical indications was good (>50%). Continuous training, accessible protocols for performing clinical indications for plain abdominal radiographic examinations for radiographers, audit, feedback and reminders to enhance protocol adherence are recommended. Contribution: The study findings could be used to enhance knowledge and practices regarding clinical indications for plain abdominal radiographic examinations among radiographers.

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

INTRODUCTION: The 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). METHODOLOGY: From 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. RESULTS: Of 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. CONCLUSION: This 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 PRACTICE: The 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.

Australian graduate radiographers' perspectives and experiences of work readiness.

INTRODUCTION: Graduate radiographers entering their qualified positions need to orientate and familiarise themselves with a rapidly changing work environment to deliver a high standard of diagnostic imaging services. During this transitional phase, these newcomers also strive to meet self-expectations and workplace expectations. This study was performed to understand the work readiness perspectives and initial experiences of graduate radiographers on beginning their newly qualified roles. METHODS: The study used a qualitative phenomenological approach to collect data through individual semi-structured in-depth telephone interviews with 14 purposively sampled undergraduate and postgraduate radiographers. The rich data were transcribed verbatim and then thematically analysed. RESULTS: Four major themes emerged: (1) preparing to be 'work-ready', (2) initial encounters as qualified radiographers, (3) personal and professional challenges and (4) support strategies and advice for new graduates. CONCLUSIONS: New graduate radiographers face many personal and professional challenges but agree that they thrive in supportive collegial environments. Most participants had a high perspective of their work readiness strongly related to their clinical placements as students, workplace familiarity, support networks and coping strategies. Further review into individual workplace orientations by organisation leaders may benefit the immersion and enhancement of graduate radiographers' initial experiences in their new role.

Optimising care and the patient experience for people living with dementia: The perceptions of radiography practitioners.

INTRODUCTION: Despite abundant literature on the diagnosis of dementia, limited research has explored the lived experiences by radiography practitioners when delivering care to people living with dementia (PLWD). This study explored the perceptions and compatibility of current professional guidance by both radiography practitioners and key stakeholders involved in developing the Society and College of Radiographers clinical practice guideline document for caring for people with dementia. METHODS: This was a two-stage qualitative multi-method study. Fifteen diagnostic and two therapeutic radiography practitioners from across the UK participated with three asynchronous online discussion forums. One core member and three members from the key stakeholder group participated with individual semi-structured interviews. Data analysis included narrative and thematic analysis. RESULTS: Participants from both stages identified enablers and barriers to providing person-centred care (PCC) to PLWD. Three superordinate themes were identified linked to (1) Challenges in delivering person-centred care to people living with dementia, (2) The need for role specific education and training, and (3) Partnership working with carers. Challenges in delivering care included time and resource pressures. The lack of dementia specific education compounded these difficulties. Care partners were seen as an asset to providing care. CONCLUSION: Providing PCC to meet the individual needs of PLWD can be challenging in practice. This is often due to time and resource implications. There were also issues with the identification of PLWD prior to their attendance in the department. Carers could help to alleviate some challenges. There is a need for profession specific education and dementia awareness training to support the provision of PCC to PLWD. IMPLICATIONS FOR PRACTICE: Dementia training needs to be specifically tailored for radiography practitioners to bridge the gap between guidelines and clinical practice rather than being generalised from other disciplines.

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

INTRODUCTION: Communication 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. METHODS: An 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. RESULTS: n=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. CONCLUSION: The 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 PRACTICE: The findings of this study can help to inform future research, policy, practice, and educational training.

Exploring current undergraduate student perspectives on the introduction of the degree apprenticeship scheme in diagnostic radiography - a single institution study.

INTRODUCTION: The first degree apprenticeship programme in diagnostic radiography was launched in March 2020. This route into radiography runs in parallel with 'conventional' pre-registration programmes where students apply to a higher education institution (HEI) and undertake discrete clinical placements. The aim of this study was to explore the perspectives of pre-registration students on the diagnostic radiographer degree apprenticeship route. METHODS: A qualitative approach (online questionnaire) gathered attitudes and opinions of pre-registration students from a single HEI, regarding the degree apprenticeship programme. Participants were pre-registration medical imaging students from all stages of the programme (n = 204). Braun and Clarks's thematic analysis was employed for data analysis. RESULTS: A response rate of 21% (n = 44) was recorded. Four themes emerged from data analysis: (1) misunderstandings surrounding the degree apprenticeship, (2) financial implications and (3) practical experience associated with both degree courses and (4) the experience the pre-registration degree has to offer. CONCLUSION: There was an apparent lack of understanding regarding the degree apprenticeship leading students to misinterpret aspects of the course. Additionally, students highlighted the earning aspect of the apprenticeship to be an advantage in comparison to student debts associated with the traditional pre-registration programmes. Furthermore, students emphasised the advantage of the clinical focus practice associated with the degree apprenticeship. Nevertheless, students who have selected the HEI route still value what the traditional pre-registration degree offers. IMPLICATIONS FOR PRACTICE: As degree apprenticeship programmes become widely available, a greater awareness should, therefore, follow. In the interim, there is scope for HEIs to seek to raise awareness of degree apprenticeship provision. HEIs should seek to allay any concerns and highlight the benefits of having this alternative route into the profession.

Qualitative content analysis of image interpretation education in UK pre-registration diagnostic radiography programmes.

INTRODUCTION: Image interpretation is a required capability for all UK pre-registration programmes in diagnostic radiography to meet the needs of graduate practice. It also provides a potential educational foundation for future advanced clinical practice. The aim of this study was to explore how image interpretation education is designed, delivered, and assessed within contemporary UK pre-registration diagnostic radiography programmes. METHODS: Qualitative content analysis of open-source image interpretation curriculum data extracted from UK Higher Education Institute (HEI) websites. RESULTS: Extracted search data was initially coded and three overarching themes emerged, image interpretation education vision, operationalisation, and delivery and assessment. CONCLUSION: This study identified significant heterogeneity in all aspects of UK pre-registration image interpretation education which may suggest an equal heterogeneity can be expected in the image interpretation knowledge, skill, confidence between newly registered practitioners. IMPLICATIONS FOR PRACTICE: There may be a need for clearer expectations on HEIs by professional and regulatory bodies to ensure consistency in pre-registration image interpretation education.

Opportunities to develop leadership skills in the undergraduate diagnostic radiography program: Insights from students at an Australian university.

INTRODUCTION/BACKGROUND: Leadership is defined as the ability to influence others to work towards common visions and goals. A key principle of the Australian Health Leadership Framework is that it applies to all leaders and potential leaders, who are at any place in the system. Hence, leadership is everyone's responsibility, including health profession students. In this short communication, we discuss the concept of leadership development in the undergraduate diagnostic radiography (DR) program through experiential learning. Examples from students' and academics' perspectives are presented, with the intention of providing a broad context to the range of opportunities that support development of leadership skills in DR students. DISCUSSION: Experience and experiential learning are fundamental and natural means of learning. Experiential learning has a positive effect on leadership because of its impact on personal, attitudinal, moral, social, and cognitive outcomes. Undergraduate DR students value opportunities to develop leadership skills during their university education. Four opportunities to develop and reflect on leadership skills are discussed. Two of the opportunities, clinical placements and honours programs, form part of the curricula, whilst others, such as mentoring and profession-specific social groups, are not. Through experience-based learning, students may benefit from transformational effects in their individual skills, which may ultimately benefit the organisation or community in which the individual participates. CONCLUSION: Commitment from clinical and academic educators to enable leadership development in DR students is essential. Through implementation of obligatory and optional experiential learning opportunities, it is anticipated that leadership skills will be cultivated in DR students, enabling students to exercise effective leadership in their current student roles and establish essential skills for their future professional roles.

Teaching evidence-based practice: Case study of an integrated assessment task for diagnostic radiography students.

INTRODUCTION: A core competency for all health care professionals is evidence-based practice (EBP). An understanding of research skills are key to diagnostic radiographers adopting EBP, and should be taught and assessed in curricula leading to eligibility to register and practice. This paper focuses on the design, implementation and initial evaluation of an assessment task in the Diagnostic Radiography (DR) curriculum at an Australian university, which aimed to facilitate students' skills to identify and interpret research methods and output as a foundation for EBP by combining with EBP and DR theoretical content. METHODS: An integrated assessment task was introduced across two units of study, requiring student groups to produce a single literature review incorporating learning objectives from each distinct unit of study. This approach recognised and incorporated themes of student choice, negotiation of group membership, and scholarly writing as inherent components. RESULTS: Student feedback showed that students valued the integration of content knowledge and research principles across two units of study to better reflect their depth and breadth of learning. Students also commented on the value of team or group work in developing their communication and cooperation skills, which are essential skills in the DR workplace. DISCUSSION: A literature review assessment task integrated across two previously separate units of study provided an innovative approach to assessment of EBP in the DR curricula. CONCLUSION: It is anticipated that DR graduates, who are prepared with knowledge and skills in EBP prior to graduation, will become leaders and drive future innovation in EBP.

Factors affecting chiropractor requests for full-length spinal radiography: A scoping review.

Chiropractors often refer their patients for full-length (three- to four-region) radiographs of the spine as part of their clinical assessment, which are frequently completed by radiographers in medical imaging practices. Overuse of spinal radiography by chiropractors has previously been reported and remains a contentious issue. The purpose of this scoping review was to explore the issues surrounding the utilisation of full-length spinal radiography by chiropractors and examine the alignment of this practice with current evidence. A search of four databases (AMED, EMBASE, MedLine and Scopus) and a hand search of Google was conducted using keywords. Articles were screened against an inclusion/exclusion criterion for relevance. Themes and findings were extracted from eligible articles, and evidence was synthesised using a narrative approach. In total, 25 articles were identified, five major themes were extracted, and subsequent conclusions drawn by authors were charted to identify confluent findings. This review identified a paucity of literature addressing this issue and an underrepresentation of relevant perspectives from radiographers. Several issues surrounding the use of full-length spinal radiography by chiropractors were identified and examined, including barriers to the adherence of published guidelines for spinal imaging, an absence of a reporting mechanism for the utilisation of spinal radiography in chiropractic and the existence of a spectrum of beliefs amongst chiropractors about the clinical utility and limitations of full-length spinal radiography. Further investigation is required to further understand the scope of this issue and its impacts for radiation protection and patient safety.

Diagnostic radiography students' perceptions of working in the clinical environment: A focus on emotional challenges.

INTRODUCTION: Diagnostic radiography (DR) students experience situations that affect their emotional wellbeing during clinical placements. This study aimed to investigate factors that contribute to students' reduced wellbeing on clinical placements, and to identify responses to situations that are considered challenging. METHODS: An online survey was employed to collect data from five cohorts in the undergraduate (UG) and graduate entry masters (GEM) DR programs (n = 461 enrolled students). Questions related to experiences with health professionals, clinical work area or patient presentations that were considered to reduce wellbeing. Data on personal reactions to challenging situations, and strategies that could better prepare students for coping were also collected. Quantitative and qualitative data were analysed using descriptive statistics and thematic analysis respectively. RESULTS: 155 completed surveys were returned (33.6% response rate). Regarding health professionals, 21.4% of participants (33/154) indicated either 'agree' or 'strongly agree' that a prior interaction with a radiographer had contributed to reduced wellbeing. The highest agreement for work area was emergency department (23/66, 34.8%). For patient presentations, 78.1% (n = 121/155) of responses related to 'patients in suffering', with differences between UG and GEM students (p = 0.027). The majority of responses to challenging situations was 'focused on the task of imaging' (n = 103/155, 66.5%), and 58.7% (n = 91/155) of participants indicated that listening to other students' personal experiences would assist them in the future. Four main themes emerged from the qualitative data: 'student role and expectations', 'emotional impact of a patient's presentation', 'interaction with radiographers' and 'personal experience'. CONCLUSION: Emotional challenges exist in the clinical environment. Experiences affecting wellbeing in the clinical setting are diverse among DR students, and students may lack preparedness to deal with them. IMPLICATIONS FOR PRACTICE: Support strategies and educational interventions are recommended in order to support students' wellbeing.