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.

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.

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.

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.