Current pressure on the UK imaging workforce deters imaging research in the NHS and requires urgent attention.

Medical imaging is a multidisciplinary specialty, combining clinical expertise from medical physics, radiography, and radiology, and plays a key role in patient care. Research is vital to ensure the care delivered to patients is evidence-based, and is a core component of clinical governance; however, there are pressures on the imaging workforce, which are significantly impeding imaging research. This commentary presents a research gap analysis pertaining to the multidisciplinary imaging workforce on behalf of the National Institute for Health Research (NIHR) Imaging Workforce Group. Data were summarised from membership surveys of the Royal College of Radiologists, Society and College of Radiographers, and Institute of Physics and Engineering in Medicine; national reports; and feedback from NIHR Clinical Research Network Imaging Champions meeting in 2020/2021. Common barriers to delivering research were found across the multidisciplinary workforce. The key issues were lack of staff, lack of time, and lack of funding to backfill clinical services. Given the ongoing workforce shortages and increasing clinical demands on radiologists, diagnostic radiographers, and medical physicists, these issues must be tackled with a high priority to ensure the future of clinical research within the NHS.

AI implementation in the UK landscape: Knowledge of AI governance, perceived challenges and opportunities, and ways forward for radiographers.

INTRODUCTION: Despite the rapid increase of AI-enabled applications deployed in clinical practice, many challenges exist around AI implementation, including the clarity of governance frameworks, usability of validation of AI models, and customisation of training for radiographers. This study aimed to explore the perceptions of diagnostic and therapeutic radiographers, with existing theoretical and/or practical knowledge of AI, on issues of relevance to the field, such as AI implementation, including knowledge of AI governance and procurement, perceptions about enablers and challenges and future priorities for AI adoption. METHODS: An online survey was designed and distributed to UK-based qualified radiographers who work in medical imaging and/or radiotherapy and have some previous theoretical and/or practical knowledge of working with AI. Participants were recruited through the researchers' professional networks on social media with support from the AI advisory group of the Society and College of Radiographers. Survey questions related to AI training/education, knowledge of AI governance frameworks, data privacy procedures, AI implementation considerations, and priorities for AI adoption. Descriptive statistics were employed to analyse the data, and chi-square tests were used to explore significant relationships between variables. RESULTS: In total, 88 valid responses were received. Most radiographers (56.6 %) had not received any AI-related training. Also, although approximately 63 % of them used an evaluation framework to assess AI models' performance before implementation, many (36.9 %) were still unsure about suitable evaluation methods. Radiographers requested clearer guidance on AI governance, ample time to implement AI in their practice safely, adequate funding, effective leadership, and targeted support from AI champions. AI training, robust governance frameworks, and patient and public involvement were seen as priorities for the successful implementation of AI by radiographers. CONCLUSION: AI implementation is progressing within radiography, but without customised training, clearer governance, key stakeholder engagement and suitable new roles created, it will be hard to harness its benefits and minimise related risks. IMPLICATIONS FOR PRACTICE: The results of this study highlight some of the priorities and challenges for radiographers in relation to AI adoption, namely the need for developing robust AI governance frameworks and providing optimal AI training.

UK reporting radiographers' perceptions of AI in radiographic image interpretation - Current perspectives and future developments.

INTRODUCTION: Radiographer reporting is accepted practice in the UK. With a national shortage of radiographers and radiologists, artificial intelligence (AI) support in reporting may help minimise the backlog of unreported images. Modern AI is not well understood by human end-users. This may have ethical implications and impact human trust in these systems, due to over- and under-reliance. This study investigates the perceptions of reporting radiographers about AI, gathers information to explain how they may interact with AI in future and identifies features perceived as necessary for appropriate trust in these systems. METHODS: A Qualtrics® survey was designed and piloted by a team of UK AI expert radiographers. This paper reports the third part of the survey, open to reporting radiographers only. RESULTS: 86 responses were received. Respondents were confident in how an AI reached its decision (n = 53, 62%). Less than a third of respondents would be confident communicating the AI decision to stakeholders. Affirmation from AI would improve confidence (n = 49, 57%) and disagreement would make respondents seek a second opinion (n = 60, 70%). There is a moderate trust level in AI for image interpretation. System performance data and AI visual explanations would increase trust. CONCLUSIONS: Responses indicate that AI will have a strong impact on reporting radiographers' decision making in the future. Respondents are confident in how an AI makes decisions but less confident explaining this to others. Trust levels could be improved with explainable AI solutions. IMPLICATIONS FOR PRACTICE: This survey clarifies UK reporting radiographers' perceptions of AI, used for image interpretation, highlighting key issues with AI integration.

Research ethics systems, processes, and awareness across Europe: Radiography research ethics standards for Europe (RRESFE).

INTRODUCTION: The Radiography Research Ethics Standards for Europe (RRESFE) project aims to provide a cross-sectional snapshot of current research ethics systems, processes, and awareness of such, across Europe together with identifying the associated challenges, education, and training needs. METHODS: A cross-sectional online survey targeting radiography researchers in Europe was conducted. Data collection took place between April 26 and July 12, 2021, using a snowball sampling approach. Descriptive and analytical statistics were used to identify trends in research ethics frameworks across Europe. RESULTS: 285 responses were received across 33 European and 23 non-European countries. Most (n = 221; 95%) European respondents stated ethics approval is required before commencing research in their country. Requirements around research ethics approval and awareness of such requirements varied by European region (X2 (2, n = 129) = 7.234, p = 0.013) and were found to differ depending on the type of research participant and study design. Additionally, European respondents reported ethics approval is a national requirement more often than their non-European counterparts (X2 (1, n = 282) = 4.316, p = 0.049). Requirements for ethics approval were also associated with the undergraduate programme duration (2-year vs. 3-year vs. 3.5 year vs. 4-year vs. multiple programme durations; X2 (4, n = 231) = 10.075, p = 0.016) and availability of postgraduate training (postgraduate training available vs. postgraduate training not available; X2 (1, n = 231) = 15.448, p = <0.001) within respondents' country. CONCLUSION: Respondents from countries with longer programme durations/availability of multiple programme lengths, availability of postgraduate training, and establishment of European Qualifications Framework Level 6 were generally associated with less uncertainty and more comprehensive research ethics requirements. IMPLICATIONS FOR PRACTICE: Results are informative of the current status of research ethics within evidence-based radiography.

Research ethics training, challenges, and suggested improvements across Europe: Radiography research ethics standards for Europe (RRESFE).

INTRODUCTION: The Radiography Research Ethics Standards for Europe (RRESFE) project aimed to provide a cross-sectional view of the current state of radiography research ethics across Europe. This included investigating education and training in research ethics, and identifying the key challenges and potential improvements associated with using existing research ethics frameworks. METHODS: This cross-sectional online survey targeting radiography researchers in Europe was conducted between April 26 and July 12, 2021. Descriptive and analytical statistics were used to identify research ethics education and training trends. Content analysis of qualitative responses was employed to identify significant challenges and proposed improvements in research ethics frameworks of practice. RESULTS: There were 232 responses received across 33 European countries. Most (n = 132; 57%) respondents had received some research ethics training; however, fewer participants had received training on safeguarding vulnerable patients (n = 72; 38%), diversity and inclusivity (n = 62; 33%), or research with healthy volunteers (n = 60; 32%). Training was associated with a greater perceived importance of the need for research ethics review (p = 0.031) and with the establishment of EQF Level 6 training (p = 0.038). The proportion of formally trained researchers also varied by region (p = <0.001). Time-to-ethics-approval was noted as the biggest challenge for professionals making research ethics applications. CONCLUSION: Early and universal integration of research-oriented teaching within the radiography education framework which emphasises research ethics is recommended. Additionally, study findings suggest research ethics committee application and approval processes could be further simplified and streamlined. IMPLICATIONS FOR PRACTICE: The survey contributes to a growing body of knowledge surrounding the importance of education and training in research ethics for assuring a high standard of research outputs in Radiography and has identified hurdles to obtaining research ethics approval for further investigation and address.

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.

Artificial Intelligence: Guidance for clinical imaging and therapeutic radiography professionals, a summary by the Society of Radiographers AI working group.

INTRODUCTION: Artificial intelligence (AI) has started to be increasingly adopted in medical imaging and radiotherapy clinical practice, however research, education and partnerships have not really caught up yet to facilitate a safe and effective transition. The aim of the document is to provide baseline guidance for radiographers working in the field of AI in education, research, clinical practice and stakeholder partnerships. The guideline is intended for use by the multi-professional clinical imaging and radiotherapy teams, including all staff, volunteers, students and learners. METHODS: The format mirrored similar publications from other SCoR working groups in the past. The recommendations have been subject to a rapid period of peer, professional and patient assessment and review. Feedback was sought from a range of SoR members and advisory groups, as well as from the SoR director of professional policy, as well as from external experts. Amendments were then made in line with feedback received and a final consensus was reached. RESULTS: AI is an innovative tool radiographers will need to engage with to ensure a safe and efficient clinical service in imaging and radiotherapy. Educational provisions will need to be proportionately adjusted by Higher Education Institutions (HEIs) to offer the necessary knowledge, skills and competences for diagnostic and therapeutic radiographers, to enable them to navigate a future where AI will be central to patient diagnosis and treatment pathways. Radiography-led research in AI should address key clinical challenges and enable radiographers co-design, implement and validate AI solutions. Partnerships are key in ensuring the contribution of radiographers is integrated into healthcare AI ecosystems for the benefit of the patients and service users. CONCLUSION: Radiography is starting to work towards a future with AI-enabled healthcare. This guidance offers some recommendations for different areas of radiography practice. There is a need to update our educational curricula, rethink our research priorities, forge new strong clinical-academic-industry partnerships to optimise clinical practice. Specific recommendations in relation to clinical practice, education, research and the forging of partnerships with key stakeholders are discussed, with potential impact on policy and practice in all these domains. These recommendations aim to serve as baseline guidance for UK radiographers. IMPLICATIONS FOR PRACTICE: This review offers the most up-to-date recommendations for clinical practitioners, researchers, academics and service users of clinical imaging and therapeutic radiography services. Radiography practice, education and research must gradually adjust to AI-enabled healthcare systems to ensure gains of AI technologies are maximised and challenges and risks are minimised. This guidance will need to be updated regularly given the fast-changing pace of AI development and innovation.

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.

Poppy tea drinking in East Anglia.

Poppy tea drinking was a widespread traditional practice in the Fenlands of East Anglia during the nineteenth century. The subsequent social changes which led to greater integration of the area with the rest of the country may have contributed to a decline in the practice. In recent years poppy tea drinking has been revived within the illicit drug using community and a survey using a self-report questionnaire was carried out among patients attending the Cambridge Drug Dependency Unit. Forty-three patients admitted to drinking poppy tea, usually during the summer months and on an intermittent basis. The potency of the infusion varied and was unpredictable but in general was low. Although poisoning from herbicides and pesticides was seen as the main risk, it is in the main perceived by drug users as a harmless secondary activity existing alongside the more regular and more potent drugs of misuse.