Incorporating Reflective Learning Practices In Medical Imaging Curriculum.

PURPOSE: To provide an overview of the reflective learning cycle, as well as common reflective learning models, as a means of informing future implementation of reflective learning assignments in medical imaging curriculum. METHODS: Journal articles were searched for in Google Scholar, ScienceDirect, and ResearchGate, as well as the university's library databases using the keywords reflective learning, Kolb's model of learning, reflective learning practices in health care, and reflective learning in radiography. Out of 19 articles found, 12 articles were selected based on inclusion and exclusion criteria. RESULTS: The literature search yielded results in health care education, nursing, medicine, medical imaging and radiography, pharmacy, physical therapy, and occupational therapy. DISCUSSION: Studies have shown that reflection is an integral aspect of learning and has substantial implications for learners' clinical practice. Reflection is a cognitive process that facilitates learning, assists in the understanding and application of knowledge to clinical situations, and develops new clinical knowledge in student radiographers. When reflective activities, such as journaling, portfolios, and problem-based learning, are scaffolded throughout the curriculum, students develop critical reflection skills that positively affect their clinical practice. CONCLUSION: Reflective learning practices can positively affect student learning, clinical decision-making skills, and patient outcomes. When reflective learning activities are incorporated throughout the curriculum, students are more effectively able to bridge the gap between theoretical knowledge and clinical practice. In addition, the reflective learning process allows learners to examine their clinical experiences while providing context for application and future clinical practice and continued learning.

Student Observations Reveal Gaps Between Chest Imaging Theory and Practice.

PURPOSE: To assess whether first-year radiography students observed differences between what they were taught in didactic and laboratory courses and how technologists perform chest imaging procedures during clinical experiences. METHODS: This study used a mixed-methods approach with a cross-sectional survey, consisting of 11 quantitative and 11 qualitative items, during the fall 2020 semester. The survey asked participants to evaluate survey statements based on their observations of radiographers' behaviors during chest imaging procedures in relation to the 11 American Registry of Radiologic Technologist clinical competency areas. Participants rated their evaluations based on the degree to which they agreed or disagreed with statements regarding radiographers' behaviors using a 5-point Likert scale, ranging from strongly disagree (1) to strongly agree (5). For each statement, a follow-up, open-ended question asked participants to provide reasons why they thought technologists did or did not exhibit certain behaviors. Data were analyzed quantitatively with differential statistics and qualitatively by thematically categorizing open-ended responses. RESULTS: A total of 19 first-year radiography students (N = 19) completed the survey. Most participants somewhat agreed or strongly agreed with 8 out of the 11 competency statements based on their observations of technologists when performing chest imaging procedures: room preparation (73.7%), patient identity verification (89.5%), examination order verification (79%), patient assessment (79%), equipment operation (52.6%), patient management (100%), technique selection (73.6%), and image evaluation (94.7%). Most participants somewhat disagreed, strongly disagreed, or were neutral with 3 out of the 11 categories: patient positioning, radiation safety, and image processing. Qualitatively, participants responded that technologists only provided lead shielding for pediatric patients, were not instructing patients to take 2 inspirations before making an exposure, and were cropping their images electronically before submitting them for diagnoses. DISCUSSION: Participants reported inconsistencies between what they were taught and what they saw technologists doing during chest imaging procedures related to patient positioning, radiation safety, and imaging processing. Participants' responses stated that these inconsistencies might be because of an increase in technologist responsibilities, patient volumes, and fear of not including relative anatomy on their images. CONCLUSION: Participants reported the most disagreement with radiation safety during chest imaging procedures. Although lead shielding for abdominal and pelvic procedures is no longer recommended, shielding patients during chest imaging procedures is still recommended. Radiography programs can educate students that inconsistency between task order does not mean there is a gap between theory and practice.

[Clinical Validation of Chest X-ray Educational Content for Radiography Students Using Gaze Information].

PURPOSE: Radiography training for students in colleges of radiology should be based on real clinical situations. The purpose of this study was to verify the clinical validity of our originally developed scenarios for chest X-ray training and the instructional contents using gaze information of experienced radiology technologists (RTs). METHODS: We divided 8 RTs with different experiences into an evaluator group (3 RTs) and a subject group (5 RTs). The evaluator group created a validation model consisting of 31 items, a chest X-ray scenario, instructional contents, and gaze attention objects during the scenario. The subject group simulated chest X-ray wearing an eye tracker. The evaluator group evaluated fit rates of the validation model to subjects' procedures based on gaze information to verify the clinical validity of the validation model. RESULTS: The subject group procedures did not deviate from the scenario. We obtained a fit rate of 91.6±6.70%. CONCLUSION: Our validation model showed more than 90% fitting with the chest X-ray techniques of five RTs with different backgrounds. This result suggested that the scenario and instructional contents in this study had clinical validity.

Virtual Technology in Radiologic Technology Classrooms: Educational Effect of the COVID-19 Pandemic.

PURPOSE: To investigate the educational effect of the COVID-19 pandemic on virtual technology use in the radiologic technology classroom by comparing virtual technology use and perceived barriers for use from before the COVID-19 pandemic through the spring 2021 semester. METHODS: An explanatory mixed-method, cross-sectional survey design was used to evaluate radiologic technology educators' integration of virtual technology and continuance intention to use (CITU) virtual technology in the radiologic technology classroom. A pseudoqualitative component also was used to add meaning to the quantitative data. RESULTS: A total of 255 educators completed the survey. Educators with associate degrees scored significantly lower in CITU compared with participants with master's degrees (P = .04) and doctoral or professional degrees (P = .01). Virtual technology use significantly increased from before COVID-19 to spring 2021 (P < .001). Educators' perceptions of barriers to technology integration significantly decreased from before COVID-19 to spring 2021 (P < .001). In this report, radiologic technology educators indicated intentions for increased virtual technology use in the future compared with their use during the spring 2021 semester (P = .001). DISCUSSION: Virtual technology use was low before COVID-19, and although it increased during the spring 2021 semester, it remained relatively low. Future intentions for virtual technology use indicate an increase from spring 2021, suggesting a change in future delivery of radiologic science education. Instructors' levels of education had a significant effect on CITU scores. Cost and funding was consistently the highest reported barrier to virtual technology use, whereas student resistance to technology was consistently the lowest reported barrier. Narratives of participants' challenges, current and future use, and rewards related to virtual technology also added pseudoqualitative meaning to the quantitative findings. CONCLUSION: The educators in this study demonstrated low virtual technology use before the COVID-19 pandemic, increased virtual technology use because of the pandemic, and significantly positive CITU scores. Radiologic science educators' responses regarding their challenges, current and future use, and rewards might be helpful in facilitating more effective technology integration.

Evaluating Current Tuition Trends in Radiography Programs.

PURPOSE: To identify current tuition trends among types of radiography programs; compare tuition rates; and provide prospective students, educators, and professionals with a comprehensive cost analysis for postsecondary education planning, recruitment, and retention. METHODS: Radiography program tuition data were collected from the Joint Review Committee on Education in Radiologic Technology (JRCERT) website. National tuition rates were obtained from the National Center for Education Statistics website. Tuition fees for JRCERT-accredited programs were sorted by degree level and state. The data were evaluated for each pathway to determine tuition range, median cost, cost effectiveness, and comparison with national rates. RESULTS: The range of annual tuition costs for JRCERT-accredited radiography programs was $750 to $51 769. Results were not normally distributed, and the median annual tuition rate for all programs was $5005. Broken down by program type, the median tuition rate was $4861 for a certificate, $4556 for an applied associate of science degree, $5959 for an associate of science degree, and $10 075 for a bachelor of science degree. The overall mean for radiography tuition was $7875, compared with the national average of $13 016 for all undergraduate institutions nationally. DISCUSSION: Radiography program tuition rates vary widely. Prospective students' use of research and financial strategies to determine the best value is recommended. The applied associate of science degree in radiography was found to be the most cost-effective type of program. Bachelor's degrees in radiography were the most expensive option, but according to the literature, a bachelor's degree could yield additional benefits such as increased employment, advanced career opportunities, and higher return on investment. CONCLUSION: An education in radiography is a competitive option compared with the national average for undergraduate programs. To achieve a favorable outcome, prospective students should evaluate educational costs, educational value, and informed decision-making strategies when investing in their postsecondary education.

Radiologic Technologists' Perceptions of Imaging Appropriateness in Radiography, CT, and Mammography.

PURPOSE: To determine U.S.-based radiologic technologists' perceptions of imaging appropriateness by imaging modality and to examine relationships between descriptive variables and perception of imaging appropriateness scores. METHODS: A cross-sectional survey was used to collect data and guide testing of the hypotheses. Radiologic technologists working in radiography, computed tomography, and mammography were eligible to participate in the study. The survey instrument items were evaluated for validity and reliability. Categorical and descriptive data were calculated, and 1-way analysis of variance tests were used to analyze hypotheses. RESULTS: Survey results found that the radiologic technologists perceived that 16% to 30% of completed examinations were inappropriate, with the primary reasons being fear of lawsuits and patient expectations. Technologists indicated that imaging ordering should be based on the effect that an imaging procedure can have on the patient's diagnosis or treatment. The study found 6 main effects with mean differences between groups for the perception of imaging appropriateness score, including primary employed imaging modality (P < .001), shift length (P < .001), work shift (P < .001), primary practice facility (P < .001), primary patient population (P = .009), and level of education (P = .044). Employment status, primary role, age, years of experience, number of imaging credentials, gender, and practice location were not significant at the level of P ≤ .05. DISCUSSION: Study findings demonstrate the complexity and interconnectedness of imaging appropriateness, the potential reasons driving ordering practices, and the importance of increasing radiologic technologists' familiarity with appropriate use criteria. Further, the results show the importance of using clinical decision support mechanisms and ensuring that potential risk from ionizing radiation exposure remains a core component of the decision-making process when choosing among imaging examinations of similar diagnostic value. CONCLUSION: Further research needs to be conducted to better understand perceptions of imaging appropriateness, how perceptions align or deviate from appropriate use criteria, and improvements in imaging appropriateness from enhanced radiologic technologist-provider collaboration.

Intrapersonal and Institutional Influences On Overall Perception of Radiation Safety Among Radiologic Technologists.

PURPOSE: The purpose of the study was to examine mean differences between intrapersonal and institutional variables and the overall perception of radiation safety (OPRS) among U.S. radiologic technologists. The study also sought to demonstrate the applicability of the socioecological model for radiation safety decision-making. METHODS: A quantitative, cross-sectional design with the Radiation Actions and Dimensions of Radiation Safety survey instrument was used to collect data and guide hypotheses testing. The 425 research participants included radiologic technologists working in radiography, mammography, computed tomography, and radiology management. Categorical and descriptive data were calculated, and 1-way analysis of variance tests were used to analyze hypotheses. RESULTS: Seven main effects demonstrated mean differences between groups for the OPRS, including age (F5,419 = 2.55, P = .03), years of experience (F5,419 = 4.27, P = .001), primary employed imaging modality (F2,422 = 9.04, P < .001), primary role (F2,422 = 4.58, P = .01), shift length (F3,421 = 10.33, P < .001), primary practice facility (F4,404 = 5.00, P = .001), and work shift (F3,405 = 4.14, P = .007), with shift length having the largest effect. Level of education, employment status, number of imaging credentials, gender, patient population, and practice location were not significant at the level of P ≤ .05. DISCUSSION: Radiation safety culture is a multidimensional topic that requires consideration of several intervening influences, making the socioecological model well aligned when considering radiation safety culture and radiation safety perception in medical imaging. Previous research on radiation safety perception among radiologic technologists demonstrated that leadership actions, teamwork across imaging stakeholders, organizational learning, and questioning behavior are drivers of OPRS. However, this study's findings demonstrate that radiologic technologist scheduling practices and primary employed imaging modalities also should be considered when seeking to improve OPRS. CONCLUSION: This study presents an extensive examination of intrapersonal and institutional variables on OPRS among U.S.-based radiologic technologists and provides findings to support radiation safety culture decision-making in medical imaging, particularly for shift length considerations.

Evaluation of the quality of mammographic breast positioning: a quality improvement study.

BACKGROUND: Although there are concerns that inadequate breast positioning in mammographic examinations may lead to cancers being missed, few studies have examined the quality of breast positioning, especially in the Canadian context. Our objective was to assess the quality of breast positioning in mammographic examinations in a Quebec-wide representative sample of technologists. METHODS: This quality improvement study was part of a professional inspection launched by the Ordre des technologues en imagerie médicale, en radio-oncologie et en électrophysiologie médicale du Québec among its members. The inspection was conducted between May and July 2017 on a proportionate stratified random sample of all active technologists certified in mammography in Quebec. Each technologist provided images from 15 consecutive mammographic examinations they performed in the previous 6 months. The quality of positioning was then evaluated by senior technologists using a quality assessment tool specifically developed for this inspection. A technologist was deemed to have failed the professional inspection when at least 7 of the 15 mammographic examinations were scored as critical failures. Proportions were calculated accounting for sampling weights and correction for finite population. RESULTS: Among the 520 technologists certified in mammography in Quebec, 76 technologists (14.6%) were randomly selected for the professional inspection and contributed images from 1127 mammographic examinations. Thirty-eight technologists (weighted percentage 50.3%, 95% confidence interval [CI] 37.6% to 63.0%) failed the professional inspection. Overall, 492 mammographic examinations (43.7%, 95% CI 38.6% to 48.8%) had at least 1 image scored as a critical failure. INTERPRETATION: Half of the technologists performing mammographic examinations in Quebec who participated in this study failed the inspection, and a substantial proportion of their mammographic examinations demonstrated critical failures in breast positioning. Overall, our findings are concordant with those of previous studies and highlight the need for additional investigations assessing the quality of breast positioning in mammographic examinations in other jurisdictions.

[Source blocking in HDR brachytherapy: Practical situation and experience feedback at the Eugène Marquis-Rennes]. / Blocage de source en curiethérapie de haut débit de dose : mise en situation pratique et retour d'expérience au centre Eugène Marquis- Rennes.

At the Eugene Marquis Center, high dose rate brachytherapy is part of the care offering. The risk analysis and the national experience feedback linked to the use of high activity sources show that blocking the source outside its storage position, during treatment, would be the main risk of exposure of ionizing radiation. In a process of radiation protection of patients and workers, and to limit the consequences of such an accident, the Eugene Marquis Center has set up periodic training with practical experience for all brachytherapy professionals. This article describes the experience feedback from this training by brachytherapy technicians.