Fostering a culture of interprofessional education for radiation therapy and medical dosimetry students

A less-studied aspect of radiation therapy and medical dosimetry education is experiential learning through attendance at interprofessional conferences. University of North Carolina radiation therapy and medical dosimetry students regularly attended morning conferences and daily pretreatment peer review, including approximately 145 hours of direct interaction with medical attending physicians and residents, medical physicists, and other faculty. We herein assessed the effect of their participation in these interprofessional conferences on knowledge and communication. The students who graduated from our radiation therapy and medical dosimetry programs who were exposed to the interprofessional education initiative were compared with those who graduated in the previous years. The groups were compared with regard to their knowledge (as assessed by grades on end-of-training examinations) and team communication (assessed via survey). The results for the 2 groups were compared via exact tests. There was a trend for the examination scores for the 2012 cohort to be higher than for the 2007 to 2011 groups. Survey results suggested that students who attended the interprofessional education sessions were more comfortable speaking with attending physicians, residents, physicists, and faculty compared with earlier students who did not attend these educational sessions. Interprofessional education, particularly vertical integration, appears to provide an enhanced educational experience both in regard to knowledge (per the examination scores) and in building a sense of communication (via the survey results). Integration of interprofessional education into radiation therapy and medical dosimetry educational programs may represent an opportunity to enrich the learning experience in multiple ways and merits further study.     

Interprofessional work in early detection of breast cancer: An integrative review

Objectives

To identify the roles of health care staff in interprofessional work related to breast cancer detection and diagnosis.

Phenomena of radiography science - A scoping review

IntroductionThe purpose of the study is to clarify the domain of radiography science. The main goal of science is building knowledge and developing ideas and theories that explain, predict, understand or interpret the phenomena investigated. Each discipline has its own perspective to view and study the phenomena of interest. The disciplinary perspective enables researchers in radiography science to reason and conceptualize phenomena, but it can also restrict them. The aim of this review was to investigate phenomena that are at the core of the discipline of radiography science.MethodsThis study used a scoping review as the method. A systematic search was carried out in the databases: Science Direct, Pubmed, Cinahl, and Scopus. The selection of articles was conducted by predetermined inclusion and exclusion criteria for the title, abstract and full text. After the exclusion process, fourteen articles were selected for a final review. The articles were analyzed with inductive content analysis.ResultsFrom the articles, 117 research interests were identified; these were merged into 17 categories and further into six main categories. The main categories represent the phenomena radiography science investigates. The phenomena are: the radiographers’ profession, clinical practices in diagnostic and therapeutic patient pathways, safe and high quality use of radiation, radiographic technology, discipline, management and leadership of radiography professionalsConclusionsRadiography science has a conceptual structure of its own that needs more investigation. Radiography science researches distinctive phenomena and specialized knowledge, common to researchers from different traditions and subspecialties thus justifying its existence.Implications for practiceInvestigating the core phenomena of interest in radiography science can support researchers in the field to focus their research and to develop the concepts of radiography.     

International audit of simulation use in pre-registration medical radiation science training

IntroductionSimulation-based education (SBE) can replicate the challenging aspects of real-world clinical environments, while providing a safe and less intimidating setting. Literature supports its use within medical radiation science (MRS) training for safe practice of psychomotor skills, development of problem solving, team working, interpersonal and decision-making skills and embedding awareness of patient safety. This project aimed to quantify usage of SBE resources and activities internationally and to evaluate how this changed during COVID-19 restrictions.MethodsAn anonymous online survey tool gathered data relating to programme demographics, simulation resources, simulation activities and future plans. A link to the survey was distributed to programme leads via social media, professional bodies and national networks.ResultsA total of 72 responses were received from a range of countries and representing a range of programme structures. Most respondents reported up to 100 h of SBE per student per year with low fidelity resources and image viewing software featuring most prominently. There was low reported engagement of service users within simulation activities. Respondents also indicated that COVID-19 had been a trigger for rapid uptake of simulation resources.ConclusionSBE forms an important aspect of MRS training internationally with low-fidelity resources being widely deployed. Where available, high fidelity virtual reality and specialised profession-specific resources were used heavily. There was a low level of reported engagement with service users or expert patients in simulation activities. Future research will identify whether the rapid uptake of SBE during COVID-19 continues and clarify the role of service users in SBE provision.Implications for practiceIncreased collaboration between MRS education providers may help to improve parity of SBE provision and identify additional opportunities to engage service users within SBE.     

Problem based learning in radiography education: A narrative review

ObjectivesRadiography practice is fast developing with new imaging updates and challenging scenarios to deal with on a frequent basis. There is a need to equip students with the skill to be independent learners and develop critical thinking skills, so they can change their practice as the profession evolves. Problem Based Learning (PBL) has widely been adopted in medical and nursing training worldwide as a result of its desirable benefits. In order to ascertain the efficacy of the technique, this paper presents a review of the essential aspects of PBL, such as the theories, process, key roles and implication for radiography education and practice.Key findingsThe use of a defined model provides a useful structure to the PBL exercise with the addition of reflection, which is a pertinent inclusion within the process. The role of the facilitator in PBL is significant to students' learning as they help guide the students to the learning outcomes and provide support to the group; however, their skills development is an important factor to consider in PBL.ConclusionThis teaching approach has key benefits in radiography education and training in particular, its impact on preparing students for autonomous clinical practice.Implications for practiceThe application of PBL in developing students' critical thinking and decision-making abilities support the narrowing of the spoon-feeding expectation of students and render it a useful pedagogical implementation within radiography programmes.     

Barriers in education and professional development of Belgian medical imaging technologists and nurses working in radiotherapy: A qualitative study

IntroductionRadiotherapy (RT) professionals are not officially recognised or have formal education in many countries, with RT being often a very short component of a broader programme. This study aims to investigate Belgian stakeholders’ perpectives regarding existing barriers and solutions for the education and professional development of Radiation therapists (RTT) which regroups medical imaging technologists (MIT) and nurses working in RT.MethodsNine experts with vast experience in RT were invited to be interviewed; eight participated (4 heads of the RT departments, 2 school representatives, 2 national society's representatives). A semi-structured questionnaire was used. The first two authors open-coded all interviews using thematic analysis.ResultsFive themes and eleven sub-themes were drawn from the analysis. Belgian MIT and nurses in RT perform the same roles, but have different educational backgrounds. The barriers in education and professional development are related to law, education landscape, economics, social-cultural context, politics and professional identity. The main difference between the French and Dutch-speaking parts of the country were at the education level. The proposed solutions included modifying the legislative framework surrounding the RTT profession, setting up financial support, formalizing the educational requirements and increasing professional awareness. Future strategies might include the development of advanced roles and responsibilities.ConclusionsCurrent law, educational landscape and lack of economic support were the main barriers identified. Except for the educational background, no fundamental differences were found between nurses and MIT in the French and Dutch-speaking parts. Perspectives for both professional groups are linked to future legislative and financial actions, the stakeholders involved and a clear strategic vision. In the upcoming years, increased responsibilities and the creation of a master's degree should be foreseen.Implications for practiceRegulation of RTT profession and education and an increase in RT-specific training must be implemented in Belgium to ensure professional development and optimized treatment delivery.     

Methods employed for chest radiograph interpretation education for radiographers: A systematic review of the literature

ObjectivesThis systematic review aimed to determine the strength of evidence available in the literature on the effect of training to develop the skills required by radiographers to interpret plain radiography chest images.Key findingsThirteen articles feature within the review. Sample size varied from one reporting radiographer to 148 radiography students/experienced radiographers. The quality of the articles achieved a mean score of 7.5/10, indicating the evidence is strong and the quality of studies in this field is high. Investigative approaches included audit of participants' performance in clinical practice post formal training, evaluation of informal training and the impact of short feedback sessions on performance.ConclusionAll studies demonstrated positive attributions on user performance. Using a combination of training techniques can help maximise learning and accommodate those with different preferred learning types.     

Changes in graduate medical education: A view from radiation oncology

The accreditation process of graduate medical education is changing. This change presents new challenges to teachers of radiation oncology. With the help of the ACR and other institutions, radiation oncology is well positioned to meet this challenge.     

A review of the impact of the COVID-19 pandemic on pre-registration medical radiation science education

ObjectiveThe COVID-19 pandemic has changed traditional ways to provide pre-registration medical radiation science (MRS) (medical imaging and radiation therapy) education. This literature review explores the published pre-registration MRS education curriculum adaptations implemented in response to the pandemic and effects of the adaptations on stakeholders.Key findingsEleven articles were identified through a systematic literature search. The included articles covered the pre-registration MRS curriculum adaptations implemented in response to the pandemic in 12 countries of five continents. Through changing content delivery and assessment modes from face-to-face to online, non-practical classes and academic assessments could continue without significant interruptions. However, cancellation/postponement of practical classes and clinical placements was common during COVID-19 lockdown. Simulated learning was used by some institutions to replace some practical classes and placements. Among the stakeholders of MRS education (students, academics and clinical educators), the students were most affected. The main impacts were negative psychological effects and learning experiences. For the academics, they had common concerns about online learning quality and assessment integrity.ConclusionThis review of the early publications in the first year of the pandemic provides an illustration of the MRS curriculum adaptations implemented in five continents covering both English and non-English speaking countries and their effects on the stakeholders as yet. It is expected that more articles on this area will be published over time and hence allowing a more comprehensive review in the future.Implications for practiceThe included articles show provision of wellbeing support, good planning of online content delivery based on sound pedagogical approaches, implementation of computer-based simulation tools suitable for home-based learning environment and use of authentic online assessments would address the impacts on the students and academics.     

Evaluation of use of e-Learning in undergraduate radiology education: A review

PurposeThe aim of this review is to investigate the evaluative outcomes present in the literature according to Kirkpatrick's learning model and to examine the nature and characteristics of the e-Learning interventions in radiology education at undergraduate level.Materials and methodsFour databases (PubMed, MEDLINE, Embase, Eric) are searched for publications related to the application of e-Learning in undergraduate radiology education. The search strategy is a combination of e-Learning and Mesh and non Mesh radiology and undergraduate related terms. These search strategies are established in relation to experts of respective domains. The full text of thirty pertinent articles is reviewed. Author's country and study location data is extracted to identify the most active regions and year's are extracted to know the existing trend. Data regarding radiology subfields and undergraduate year of radiology education is extracted along with e-Learning technologies to identify the most prevalent or suitable technologies or tools with respect to radiology contents. Kirkpatricks learning evaluation model is used to categorize the evaluative outcomes reported in the identified studies.ResultsThe results of this analysis reveal emergence of highly interactive games, audience response systems and designing of wide range of customized tools according to learner needs assessment in radiology education at undergraduate level. All these initiatives are leading toward highly interactive self directed learning environments to support the idea of life-long independent learners. Moreover, majority of the studies in literature regarding e-Learning in radiology at undergraduate level are based on participant satisfaction followed by participant results or outcomes either before or after an intervention or both. There was no research particularly demonstrating performance change in clinical practice or patient outcome as they may be difficult to measure in medical education. Thus clinical competences and performances are highly affected by pretentious learning environments.     

Patient safety in medical imaging: A joint paper of the European Society of Radiology (ESR) and the European Federation of Radiographer Societies (EFRS)

The fundamental professional roles of radiographers and radiologists are focused on providing benefit to patients with our skills, while maintaining their safety at all times. There are numerous patient safety issues in radiology which must be considered. These encompass: protection from direct harm arising from the techniques and technologies we use; ensuring physical and psychological well-being of patients while under our care; maintaining the highest possible quality of service provision; and protecting the staff to ensure they can deliver safe services. This paper summarises the key categories of safety issues in the provision of radiology services, from the joint perspectives of radiographers and radiologists, and provides references for further reading in all major relevant areas. This is a joint statement of the European Society of Radiology (ESR) and the European Federation of Radiographer Societies (EFRS), published simultaneously in Insights into Imaging [DOI: https://doi.org/10.1186/s13244-019-0721-y] and Radiography [DOI: https://doi.org/10.1016/j.radi.2019.01.009].     

Embracing service user involvement in radiotherapy education: A discussion paper

AimThere is currently a drive within cancer services to incorporate user involvement in delivery and education, as such the aim of this article is to investigate the potential role of service users in pre-registration education and how this could impact on radiotherapy programmes.MethodKey databases were searched for terms: patient participation, service user involvement, health care education, student assessment, patient involvement, pre-registration education and training. Suitable literature was reviewed and references within all articles and documents were investigated to ensure as broad and an inclusive search possible.ResultsThere is little published literature indicating user involvement in radiotherapy education but many studies in nursing, medicine and other allied health professions indicate a rationale for user involvement.DiscussionThere are benefits of involving service users, i.e. gaining insight from patients and carers perspectives, challenges stereotypes and assumptions. Disadvantages include the quality of the feedback from users in assessment, resources required, and the ethical considerations.ConclusionInclusion of service users in radiotherapy education is recommended in line with cancer care policy, they provide a unique perspective to learning and involvement should be encouraged.     

The use of simulation and moulage in undergraduate diagnostic radiography education: A burns scenario

IntroductionThere is a national drive to increase allied health professions simulation training. However, there is a paucity of literature within diagnostic radiography in relation to clinical simulation. No research could be found regarding the impact of simulation in radiography with complex clinical burns scenarios.This research aims to explore the perceptions of radiography undergraduate students regarding their preparedness for the complex care requirements in imaging examinations of clinical burns cases using a mixed methods approach.MethodA small-scale simulation-based teaching session was developed in a Scottish HEI, using role play and moulage to create realism. Twenty-eight undergraduate student radiographers participated in the scenario. Students completed pre and post-scenario questionnaires using Likert scale and free response data. Focus groups were undertaken three months after the simulation to obtain rich qualitative data. Common themes were identified via a process of initial coding and a 6-phase thematic analysis.ResultsThematic analysis demonstrated a marked increased perception of preparedness post-scenario; students felt more prepared to undertake their role in the imaging of complex care patients (Likert scoring increased with both mode and median post-scenario). Common themes that were identified were patient centeredness, realism and learning.ConclusionWithin this limited pilot project, the use of simulation was an effective means of preparing students to understand their role within the complex care setting (with respect to the traumatic realism of burns) in preparedness for professional practice. Additionally, students related to the practical understanding of the complexity of human factors that exist within clinical practice.     

Osteochondritis (osteochondrosis) dissecans: A review and new MRI classification

Osteochondritis (osteochondrosis) dissecans (OCD) is a common condition in children, adolescents, and young adults. Describing OCD together with osteochondral fractures and epiphyseal ossification disturbances and considering these three conditions as one entity has caused much confusion. Age distribution and localization combined with the radiologic and surgical presentation distinguishes these conditions. Osteochondritis dissecans represents an osseous lesion with secondary involvement of the overlying cartilage. Beginning as avascular osteonecrosis, OCD forms a transitional zone that harbors the potential of restoration with complete healing or progression to an osseous defect. Mechanical and traumatic factors are etiologically dominant in OCD, but a predisposition seems to be a contributing factor in some patients. Osteochondritis dissecans is generally diagnosed by conventional radiology. Its therapy is determined by the stage of the lesion and MRI will become the method of choice for staging. Intact cartilage, contrast enhancement of the lesion, and absent “cystic” defects are findings of MRI stage I and justify conservative therapy, obviating arthroscopy. Cartilage defect with or without incomplete separation of the fragment, fluid around an undetached fragment, and a dislodged fragment are MRI findings observed in stage II and require arthroscopy with possible intervention. Thus, MRI can noninvasively separate non-surgical from possibly surgical lesions and should replace diagnostic arthroscopy. Received 27 January 1997; Revision received 1 April 1997; Accepted 3 April 1997     

Student selection in radiography education. A narrative review

ObjectivesDue to effects on study success, radiography student selection has a major impact on higher education institutions and applicants. However, there is very little research to demonstrate which selection methods and contents are most successful in radiography education. This study aimed to describe the methods and contents used in radiography student selection and factors related to study success.Key findingsA narrative review was undertaken. A computerized search in four databases limited to studies published between January 2000 and June 2021. Ten quantitative, mainly retrospective, studies were included. The review identified 23 selection methods; of these, interview (n = 4), Scholastic Aptitude Test (n = 3), American College Test (n = 2) and reference letter (n = 2) were used more than once in radiography student selection. The content of the selection methods was identified in four categories including 44 factors. The most often assessed content was category of learning skills while the least often assessed concerned categories of social skills, personality traits and career choice. Regarding study success, factors of learning skills, namely mathematics, physics, biology, anatomy, physiology, natural sciences, a composite of factors comprising electronics and a composite of factors comprising mechanics predicted study success. Factors of social skills, personality traits and career choice were not related to study success.ConclusionThe methods used and contents assessed vary greatly in radiography student selection. The results suggest using the content in the four categories in the selection of radiography students.Implications for practiceFurther research is needed to clarify the methods, with knowledge of the reliability and validity and the contents for the suggested categories, and to demonstrate their relationship to study success and identify the core content of radiography student selection especially in European context.     

Ultrasound clinical teaching capacity in England: A scoping exercise

IntroductionThe United Kingdom has a sonographer shortage. Health Education England are working with stakeholders to address these shortages and increase clinical capacity for sonographer education. The aims of this survey were to ascertain current sonographer staffing levels, estimate staffing requirements in five years’ time and review current clinical placement capacity.MethodsAn on-line survey was used to explore the aims of the study. Questions included current and predicted sonographer staffing requirements and clinical capacity for teaching ultrasound. Free text comments were available for expanding on responses.ResultsOf 72 completed responses the mean sonographer vacancy rate was 2.65 and the predicted number of sonographers needed to provide the service in five years was 4.6. Departments were teaching an average of two sonographers and 2 non-sonographers. A small number of departments had further capacity for sonography student training which was not being utilised for reasons including limited capacity, inadequate staffing levels or competing demands of teaching other health care professionals. Extended working days and weekend training lists were used to increase capacity, along with rolling programmes for teaching sonographers and the use of simulation.ConclusionThe survey supported previous publications that have shown sonographer shortages in England and this is predicted to increase over the next five years. Departments were teaching a similar number of sonographers as other health care professionals. Many experienced competing demands, which challenged their ability to increase clinical capacity.Implications for practiceSuggestions for increasing capacity are provided to help grow the sonography workforce. With the advent of new sonography programmes the departments with spare capacity could be utilised to support clinical practice for sonography students in need of a placement on a direct entry programme.     

CR与屏(铜)-片成像在头颈部肿瘤放疗射野影像验证中的比较应用

目的 评价计算机X线摄影(CR)与屏(铜)-片成像在头颈部肿瘤放疗射野影像验证中的应用价值.资料与方法 40张验证片中,20张采用传统屏(铜)-片摄影,20张采用CR摄影.由4名观察者分别对其进行评价,评价标准参照欧共体提供的影像标准,分"可见"、"再现"及"清晰再现"三级,取其平均百分比.采用SPSS 11.0统计软件包对观察者之间的一致性作方差分析.结果 CR的"可见"率为18.75%,"再现"率为71.25%,"清晰再现"率为10%;屏(铜)-片的"可见"率为71.25%,"再现"率为28.75%,"清晰再现"率为0.对比分析有意义的"再现"率与"清晰再现"率之和,CR组为81.25%,而屏(铜)-片组仅为28.75%.单因素方差分析结果显示观察者之间的一致性无统计学意义(P＞0.05).结论 CR成像在头颈部肿瘤放疗射野影像验证中较屏(铜)-片成像具有更好的显示效果.     

Speaking-up for patient safety: A scoping narrative review of international literature and lessons for radiography in Ghana and other resource-constrained settings

ObjectivesEmployees ‘speaking-up’, or raising concerns about unsafe practices, has gained traction across healthcare, however, the topic has not been widely discussed within radiography generally or within resource-constrained healthcare settings. A systematic scoping narrative review identified the experiences of radiographers in speaking-up about safety concerns, which was extended to healthcare professionals more broadly. The scope of the review was further extended to cover speaking-up in non-healthcare resource-constrained settings in Africa.Key findingsSixty-three studies were included in the review. The majority originated from westernised and/or higher resource health systems, with a dearth of literature from Africa and other resource-constrained settings. Several studies identified barriers and enablers confronting healthcare workers wishing to speak-up. While ‘speaking-up’ as a concept has gained international interest, most studies are, however, focussed on nursing and medical practice contexts, overlooking other healthcare professions, including radiography. The findings are synthesised into a series of key lessons for healthcare and radiography practitioners in Ghana and other resource-constrained settings.ConclusionThe topic has been largely overlooked by policy makers, both within healthcare generally and specifically within radiography in Ghana. This is particularly concerning given the many complexities and risks inherent to radiography. A radiography and a healthcare workforce lacking in voice is poorly positioned to improve workers' safety and patient safety. More generally, promoting speaking up could enhance Ghana's ambitions to deliver a high-quality health care system and Universal Health Coverage (UHC) in the future.Implications for practiceNational and regional policy makers need to implement speaking-up processes and procedures reflecting the lessons of the literature review, such as ensuring no detriment as result of speaking-up and making staff feel that their concerns are not futile. Speaking-up processes should be implemented by individual organisations, alongside staff training and monitoring.     

Computer based simulation in CT and MRI radiography education: Current role and future opportunities

ObjectiveThe use of Computer-based simulation (CBS), a form of simulation which utilises digital and web based platforms, is widely acknowledged in healthcare education. This literature review explores the current evidence relating to CBS activities in supporting radiographer education in CT and MRI.Key findingsJournal articles published between 2010 and 2020 were reviewed (n = 663). The content was evaluated and summarised with the following headings; current utility, overview of CBS types, knowledge acquisition and evaluation, and student perspective.CBS utility in CT and MRI radiography education is limited. Its current use is for pre-registration education, and the interfaces used vary in design but are predominantly used as a preclinical learning tool to support the training of geometric scan planning, image acquisition and reconstruction, and associated technical skills. CBS was positively acknowledged by student radiographers; based on its inherent flexibility, self-paced learning and the ability to practice in a safe environment. Nonetheless, the educational validation of CBS in CT and MRI education pertaining to knowledge and skill acquisition has not been fully assessed through rigorous academic assessments and metrics.ConclusionThe current use of CBS in CT and MRI education is limited. The development of software programmes with functionality and capability that correlates with current clinical practice is imperative; and to enable more research in CBS utility to be undertaken to establish the efficacy of this pedagogical approach.Implications for practiceDue to limited placement opportunities, the use of simulation is increasing and evolving; in line with the approach to design and deliver high quality Simulation Based Education (SBE) in Diagnostic Radiography education. The continued development, utility and evaluation of CBS interfaces to support student radiographers at pre and post registration level is therefore essential.