Patient, public and practitioner partnership within imaging and radiotherapy: An exploration of the implementation and use of the college of radiographers guiding principles.

INTRODUCTION: In 2014 the National Health Service (NHS) in England released the Five Year Forward plan1, envisioning a shift in power from health professionals to patients and the public. In response the Society and College of Radiographers (SCoR) produced the "Patient, Public and Practitioner Partnership within Imaging and Radiotherapy: Guiding Principles" (P4) document which was implemented within four domains of radiography practice; service delivery, service development, education and research2. This project explored how these guidelines were implemented; and whether improvement to the quality and scope were needed, leading to making recommendations for updating the document. METHODS: A mixed methods design was adopted with two phases. Phase 1 - a survey exploring use of the P4 document's guiding principles. There was no maximum number of participants to ensure inclusivity. Phase 2 - one focus group and four one-to-one interviews from the four domains3. RESULTS: 626 participants completed the phase 1 survey. 18.85% (n=118) of participants were aware of the document and used it as a reference tool for practice, teaching, and research. 81.15% (n=508) of participants stated they were unaware of the document. Themes from phase 2; importance of service user involvement in service delivery and evaluation, resources to ensure service user involvement, suggestions to update the P4 document and use of the P4 document in radiographer education. Participants acknowledged guidance in the document was best practice. They reported more awareness of patients' needs and the effect this has on radiographers in supporting their needs. CONCLUSION: Participants recommended the document be given greater visibility. The voices of patients and the public must be heard within radiography practice. IMPLICATIONS FOR PRACTICE: Feedback from this study can be used for the future development of the P4 document.

Exploring UK sonographers' views on the use of professional supervision in clinical practice - Stage one findings of a mixed method study.

INTRODUCTION: Professional Supervision has been described across multiple professional groups, however to date, minimal research has been conducted exploring the use of professional supervision within the United Kingdom (UK) sonographer workforce. METHODS: An online self-administered survey was conducted to explore UK sonographers views on the use of professional supervision in practice. The survey was open to sonographers, consultant or clinical specialist sonographers, ultrasound managers and professional body officers. Multiple choice questions were utilised to obtain quantitative data on the provision of support mechanisms, with free text questions allowing qualitative data to be elicited further to explore thoughts of participants. RESULTS: A total of 112 participants completed the survey in full and response rates varied across the subgroups. Varying support mechanisms were in place for sonographers. However only 55.4 % of sonographers felt supported in the clinical workplace. Thematic analysis of qualitative data highlighted that workload pressures, staffing and retention of sonographers, were key concerns that professional supervision could improve. It was highlighted that time to undertake professional supervision could be challenging, however if training for professional supervision was in place then this could provide improved quality of care and staff support. CONCLUSION: Participants highlighted the challenges faced by UK sonographers and the positive impact that professional supervision could have on retention and staff support. There are limited support mechanisms in place for UK sonographers and this is impacting on how participants felt they were being supported in the workplace. Stage 2 of this research project will explore sonographers' views in more detail. IMPLICATIONS FOR PRACTICE: The approach to support mechanisms for sonographers should be considered to support improvement of professional wellbeing and retention of the sonographic workforce.

An exploration of values-based radiography from the perspective of the service user.

INTRODUCTION: This article presents the patient outcomes of a CoRIPS funded study which investigated the values of patients in both a diagnostic and therapeutic setting. Little work has been conducted to ascertain patient values and these have previously been presumed. METHOD: The study used focus groups, conducted by two experienced researchers, to allow participants the opportunity to discuss their values during imaging examinations and therapeutic treatments. The resultant discussions were audio recorded and transcribed before a thematic analysis was conducted. A sample of the data was reviewed by both researchers to demonstrate credibility and confirmability. RESULTS: The main themes identified were related to radiographer professional skills, communication and compassion. Both diagnostic and therapeutic participants shared values despite the difference in their examinations and treatments. They valued being seen as an individual and felt that radiographer communication contributed to this. Patients value being able to access information to help them prepare for their examination or treatment. During the examination they value the skills of the radiographer which they assumed. The patients also value the radiographer taking their time over the examination as they relate this the quality of the examination or treatment. After the imaging or treatment they valued being able to see their images and have their questions answered. Patient responses suggested that their values were not always met in practice. CONCLUSION: The values of the patients were successfully explored using focus groups. Patient values relate to radiographer professional skills, communication and compassion. Patients do not always have their values met during their examinations and treatments. Radiographers in practice should be mindful that patients value being treated as individuals and be provided with information throughout their imaging and treatment. Recommendations for practice were identified.

Identification of factors associated with diagnostic performance variation in reporting of mammograms: A review.

OBJECTIVES: This narrative review aims to identify what factors are linked to diagnostic performance variation for those who interpret mammograms. Identification of influential factors has potential to contribute to the optimisation of breast cancer diagnosis. PubMed, ScienceDirect and Google Scholar databases were searched using the following terms: 'Radiology', 'Radiologist', 'Radiographer', 'Radiography', 'Mammography', 'Interpret', 'read', 'observe' 'report', 'screen', 'image', 'performance' and 'characteristics.' Exclusion criteria included articles published prior to 2000 as digital mammography was introduced at this time. Non-English articles language were also excluded. 38 of 2542 studies identified were analysed. KEY FINDINGS: Influencing factors included, new technology, volume of reads, experience and training, availability of prior images, social networking, fatigue and time-of-day of interpretation. Advancements in breast imaging such as digital breast tomosynthesis and volume of mammograms are primary factors that affect performance as well as tiredness, time-of-day when images are interpreted, stages of training and years of experience. Recent studies emphasised the importance of social networking and knowledge sharing if breast cancer diagnosis is to be optimised. CONCLUSION: It was demonstrated that data on radiologist performance variability is widely available but there is a paucity of data on radiographers who interpret mammographic images. IMPLICATIONS FOR PRACTICE: This scarcity of research needs to be addressed in order to optimise radiography-led reporting and set baseline values for diagnostic efficacy.

Allied health professionals: A promising ally in the work against health inequalities- A rapid review.

Objectives: Allied Health Professionals (AHPs) have a crucial role in reducing health inequalities. However, there is a lack of evidence regarding the ways they can fulfil this role. This rapid review explores the ways in which AHPs can decrease health care or health outcome inequalities; address inequalities in the social determinants of health; and support disadvantaged groups at an individual, organisational and system level. Study design: Rapid review following Cochrane criteria and narrative synthesis. Methods: MEDLINE, EMBASE, CINAHL, Web of Science and AMED were searched combined with grey literature, to identify quantitative or qualitative review articles published between January 2010 and February 2021. Results: From 8727 references, 36 met the inclusion criteria. The methodological quality of the studies was assessed with the AMSTAR tool and was generally low. Meta-analysis was not possible due to the heterogeneity of the studies, and a narrative synthesis was produced. Three themes emerged at patient and organisational level: 1) access to AHP services; 2) quality of care; and 3) social determinants of health. Two themes emerged at system level: 1) unequal workforce distribution and 2) lack of inclusive clinical guidelines. Conclusions: This rapid review offers a broad range of evidence on the ways AHPs can contribute to the reduction of inequalities in health care, both in terms of access and quality of care and in health outcomes. More research is needed to further understand the impact of AHPs on inequalities affecting specific groups and their contribution to equitable distribution of social determinants of health.

Experiences of diagnostic radiographers through the Covid-19 pandemic.

INTRODUCTION: Diagnostic Radiography plays a major role in the diagnosis and management of patients with Covid-19. This has seen an increase in the demand for imaging services, putting pressure on the workforce. Diagnostic radiographers, as with many other healthcare professions, have been on the frontline, dealing with an unprecedented situation. This research aimed to explore the experience of diagnostic radiographers working clinically during the Covid-19 pandemic. METHODS: Influenced by interpretative phenomenology, this study explored the experiences of diagnostic radiographers using virtual focus group interviews as a method of data collection. RESULTS: Data were analysed independently by four researchers and five themes emerged from the data. Adapting to new ways of working, feelings and emotions, support mechanisms, self-protection and resilience, and professional recognition. CONCLUSION: The adaptability of radiographers came across strongly in this study. Anxieties attributed to the provision of personal protective equipment (PPE), fear of contracting the virus and spreading it to family members were evident. The resilience of radiographers working throughout this pandemic came across strongly throughout this study. A significant factor for coping has been peer support from colleagues within the workplace. The study highlighted the lack of understanding of the role of the radiographer and how the profession is perceived by other health care professionals. IMPLICATIONS FOR PRACTICE: This study highlights the importance of interprofessional working and that further work is required in the promotion of the profession.

The College of Radiographers Research Strategy for the next five years.

This article outlines the updated College of Radiographers (CoR) Research Strategy. This new research strategy will shape the approach to research from the radiography profession over the next five years. This will apply to all the profession and is aspirational and future thinking. The updated research strategy is the fifth research strategy presented by the CoR. Over the last five years, there have been considerable developments within healthcare and healthcare research. As this article is being written we are still in the middle of a global pandemic (Covid-19) which has influenced all our lives. However, despite the challenges of the last year, we are in a stronger position as a profession with more radiographers working towards and gaining masters and doctoral level qualifications. There are more radiographers working in clinical academic roles and there has been further development of radiographers coordinating and delivering research as well as becoming research leaders. This updated research strategy supports the radiography profession in delivering research-based practice over the next five years offering a framework within which radiographers can develop.

An evaluation of the experiences of academics and practice educators who supported radiography students working on the temporary HCPC register during the COVID-19 pandemic.

INTRODUCTION: The COVID-19 pandemic has had a profound impact on all those residing in the United Kingdom, resulting in unprecedented changes being made to the education and training of healthcare students. Universities and practice partners had to respond quickly and work in close collaboration with Health Education England, to ensure the changes brought in by the Health and Care Professions Council (HCPC) emergency measures were implemented. The aim of this study was to explore the experiences of staff supporting final year diagnostic and therapeutic radiography students who joined the HCPC register early during phase one of the COVID-19 pandemic. METHODS: This study was informed by a phenomenological approach, in which a purposeful sample of eight participants comprising of six practice educators (PEs) and two academics. Semi-structured interviews and focus groups were conducted to collect the data via a virtual platform. RESULTS: The results highlighted three themes, Competence and the transition to registration, Support mechanisms and Communication. Both academics and PEs described how they observed the new registrants gaining confidence and competence during their time on the temporary register and suggested that professional bodies could consider curriculum changes to encompass a final transitional placement similar to their experience. They suggested that having robust support mechanisms and communication in place are essential for the success of this initiative. CONCLUSION: The results provide insight into how PEs and academics supported new registrants to meet the necessary requirements of the HCPC register whilst working during the first phase of the COVID-19 pandemic. They highlight the importance of having robust support mechanisms and good communication in place to achieve this. IMPLICATIONS FOR PRACTICE: Some consideration could be made to changing the curriculum in the future to allow for early temporary registration and paid Band 4 final placements for students working as assistant practitioners.

An evaluation of the experiences of radiography students working on the temporary HCPC register during the COVID-19 pandemic.

INTRODUCTION: The COVID-19 pandemic has changed the world's perspective and had a profound impact on all those residing in the United Kingdom, resulting in unprecedented changes being made to the education and training of healthcare students. Universities and practice partners had to respond quickly and work in close collaboration with their wider system partners, Health Education England and the Department of Health, to ensure the changes made within the Health and Care Professions Council (HCPC) emergency measures were implemented. The aim was to explore the experiences of final year diagnostic and therapeutic radiography students who joined the HCPC temporary register during phase one of the COVID-19 pandemic. METHODS: This study was informed by a phenomenological approach, in which a purposeful sample of seventeen participants comprising of nine students, six practice educators and two academics were chosen to participate. Semi-structured interviews and focus groups were conducted to collect the data via a virtual platform. RESULTS: The results highlighted three themes, professionalism and transition to registration, benefits and challenges of working through a pandemic, and emotional impact. Students described how they gained confidence and competence during their time on the temporary register and suggested that professional bodies could consider curriculum changes to encompass a final transitional placement similar to their experience. They said they had been well supported but felt a sense of loss having been denied the normal rite of passage associated with completion of their course and graduation. CONCLUSION: The results provide insight into how students, practice educators and academics transformed their practice to meet the necessary requirements whilst working during the first phase of the COVID-19 pandemic. They highlight the importance of having good support mechanisms in place and the rewards and challenges for students joining their professional register early. IMPLICATIONS FOR PRACTICE: Some consideration could be made to changing the curriculum in the future to allow for early temporary registration and paid Band 4 final placements for students working as assistant practitioners.

A review of visual ethnography: Radiography viewed through a different lens.

INTRODUCTION: The objective of this article is to provide a short review of the research methodology 'visual ethnography'. METHOD: The review article will provide a summary of the foundations of visual ethnography, outline the key debates and refer to some of the main authors working in this field. RESULTS: Visual Ethnography is both a methodology and a method of research. It should be selected for research in radiography when research questions seek to focus upon aspects or elements of a culture. A research plan that is designed using a visual ethnographic approach should be flexible and take into account the requirements of the researcher and research participants. Visual methods of research include the use of various images, for example, photographs, collage, film or drawings. Visual methods are commonly employed together with interviews, conversations and observation. The approach enables researchers to generate new and unique insights into cultures. CONCLUSION: This review of visual ethnography provides background information that informs an introduction to the methodology. It demonstrates a methodology with the potential to explore culture and expand knowledge of radiography practice. IMPLICATIONS FOR PRACTICE: The authors suggest that for future studies visual ethnography is a methodology that can expand the paradigm of radiography research.

Perceptions and experiences that may influence consideration of breast imaging as a career option.

INTRODUCTION: Staff shortages and increasing workload raises concerns about maintaining breast services. Recruitment and retention of radiographic staff is vital. We explore views of UK undergraduate radiography students and breast radiographers to gauge how training experiences influenced their career choices on graduation. METHOD: Two questionnaires were distributed on line, one to female final year undergraduate radiography students, the second to screening and symptomatic breast units, targeting radiographers in post ≤10yrs. RESULTS: There were 133 student and 126 radiographer responses for analysis. Sixty nine per cent of student respondents were ≤25 yrs. Over 40% of radiographer respondents were ≥36 yrs Seventy five per cent of students and 70% of radiographers had a practice placement in breast imaging (BI), many commenting this should include positioning technique. Experiences during placement were more influential than academic content for career planning. Seventy per cent of students and 50% of radiographers felt BI suitable as a first post. Negative influences came from higher education institution staff and qualified radiographers. Ninety per cent of students intended working in general radiography first, 47% considering BI in future. Sixty nine per cent of radiographers did not choose BI for their first post. Interest and career progression influenced radiographers choosing to subsequently train in mammography. CONCLUSION: Most respondents took a non BI post first with later attractions into BI including interest and career progression. Practice placement was the most influential aspect of training for both groups citing a need for 'hands on' experience and positive engagement from mammographers.

Embracing diversity in radiography: The role of service users.

This article outlines the importance of cultural competence for student radiographers. The UK population is becoming more diverse in terms of ethnicity, the population is also made up of a much wider age range, varying genders and people of different sexual orientation, physical abilities and faiths. Radiographers need to be able to communicate with and care for people of all backgrounds. Radiographers need to be able to build relationships with service users based on mutual respect to provide optimum care despite personal differences. In order to prepare for this, service user involvement in the radiography curriculum is key. This article discussed the way in which service users are involved at one university. All of the strategies used enable students to learn about the different people that they will encounter in their professional role and to develop cultural competence. It is vitally important that student radiographers feel comfortable to interact with and care for service users from different backgrounds and cultures and to be able to demonstrate an awareness of and sensitivity to the range of issues and individual needs of every service user they may encounter in their professional role.

An investigation into breast imaging as part of the undergraduate (UG) education of diagnostic radiography students in the UK.

INTRODUCTION: How mammography is incorporated into undergraduate (UG) radiography training may influence student perception of the speciality and its potential as a future career option. An overview is provided of the academic and clinical content of UG radiography courses relating to mammography across the UK. METHODS: Using mixed methods and an iterative, inductive approach supplying quantitative and qualitative data, we identify any variations and discuss possible causes which may help influence future training strategies. A self-designed questionnaire containing open and closed questions was sent online using SurveyMonkey™ to course leaders of all Higher Education Institutions (HEIs) offering BSc (Hons) Diagnostic Radiography courses in the UK. Responses were analysed for trends which were further explored by semi structured telephone interviews. These were transcribed and evaluated using a thematic analysis, the themes being categorised and coded. RESULTS: 19 of 24 (79%) HEIs responded to the questionnaire. Follow up telephone interviews were conducted with five course leaders to further explore themes. Academic teaching ranged from 3 to 25 h over the 3 year course. Compared to other specialities 10 (53%) HEIs spent less time on mammography with 12 (63%) citing HCPC standards as the reason. 11 (65%) HEIs sent students on mammography placements, 2 (12%) sent females only. Placement times ranged between 2 days and 2 weeks. Influences included availability of expert teaching and relationship with clinical departments. CONCLUSION: There is variation in undergraduate exposure to mammography. Students views should be sought to add validity to these findings.

The role of the World Health Organization in health related aspects of family planning.

PIP: The World Health Organization works in health related aspects of human reproduction, family planning, and population dynamics with an emphasis on the integration of family planning services with basic health services and the strengthening of those services. It is also involved in research, training, health and medical education, and promotion of nursing, midwifery and health auxiliaries. WHO is the central agency responsible for the coordination of internal assistance to family planning programs and it aids in there evaluation.^ieng