RPS 2214 - Advancing radiography through education and research: innovations, challenges, and future directions

Author Block: H. L. Spencer¹, K. Williamson², A. Robertson², M. N. K. Anudjo¹, C. Burton³; ¹Bournemouth/UK, ²London/UK, ³Norwich/UK
Purpose: In 2022, the College of Radiographers (CoR) published the fourth edition of their Education and Career Framework (ECF). This essential document provides a professional blueprint for the radiography career trajectory with the overarching aim of improving patient outcomes. However, publication does not guarantee implementation; there often exists a dissonance between policy intent and policy in-action. Therefore, if we are to access the full benefits of the ECF, its implementation requires careful consideration.
Methods or Background: To advance our understanding of the translational gap between policy and practice, this observational mixed-methods study employed Normalisation Process Theory (NPT) as a theoretical frame. Focusing on the diagnostic radiography profession in England, a national consultation survey was deployed, alongside four consultation workshops. The data collection methods were underpinned by NPT. The framework approach was adapted for the qualitative data analysis. The quantitative survey data, meanwhile, was analysed using descriptive and inferential statistics.
Results or Findings: The data collection took place between April-June 2023. In total, 142 survey responses were returned. Each workshop was comprised of 7-11 participants. The findings were deductively interpreted through the lens of NPT, from which five core themes emerged: making sense of complexity (coherence); bringing people together (cognitive participation); being strategic (collective action); evaluating complexity (reflexive monitoring); implementation in the ‘real world’ (barriers and enablers).
Conclusion: By furthering our understanding of the guideline implementation gap, it was then possible to propose recommendations to enhance the ECF’s adoption. The recommendations were study-derived, linked to responsible stakeholders, and grouped into four strategic priorities, aligned with the NPT domains. Through these evidence-based recommendations, it is hoped the ECF can be translated more fully from page to the ‘real world’ for the benefit of the profession and its service users.
Limitations: Nonapplicable.
Funding for this study: This study was undertaken as part of a Clinical Education Improvement Fellowship secondment, supported by NHS England (South East) Workforce, Training, and Education, Canterbury Christ Church University, and the Florence Nightingale Foundation. However, no direct funding was received for this study.
Has your study been approved by an ethics committee? Yes
Ethics committee - additional information: Canterbury Christ Church University Faculty of Medicine, Health, and Social Care Ethics Panel (Reference: ETH2223-0262).

Author Block: L. Bombelli, G. R. Bonfitto, A. Roletto, E. Scaramelli, S. V. Fasulo, D. Catania; Milan/IT
Purpose: The role of radiographers is rapidly evolving, putting them in a key role in a contest of increasing complexities in patient care. With the rising demand for specialized skills, it is crucial to implement structured induction programs for newly qualified radiographers (NQR), also to avoid poor workplace performance and even the dismissal of workers. This study aims to explore the perceptions of NQR who have already experienced an induction programme.
Methods or Background: A survey was distributed to NQR in a large university hospital in Italy. The questionnaire gathered demographic data and by using a 5-point Likert scale assessed 29 sentences concerning issues in their work, including patient management, decision-making, work organization, self-confidence development and relationships with other team members.
Results or Findings: Twenty-two NQR participated in the survey. Among these, 32% (n=7) graduated within the last year and 46% (n=10) reported that they had their first experience in a healthcare setting. Regarding Likert scale evaluation, only 10 out of 29 sentences received scores of 4 or higher, indicating “Agreement”. Participants with prior work experiences reported greater self-confidence in their skills once the induction program has been completed. Conversely, radiographers with no work experience indicated feeling more supported by management.
Conclusion: In conclusion, NQR involved in this study felt adequately prepared for clinical practice after completing the induction program, despite some differences between radiographers with different levels of experiences. A successful induction program for NQR is essential to foster a proactive mindset, promote appropriate work methods, enhance collaboration among team members, reduce radiographers’ stress, turnover and ensure a high quality of patient care.
Limitations: Quantitative study design and limited sample size may have caused limitations.
Funding for this study: No funding for the study.
Has your study been approved by an ethics committee? Not applicable
Ethics committee - additional information: No ethic committe

Author Block: R. M. Strudwick¹, A. Ramlaul², P. Shuttleworth³, C. Fiyebor¹; ¹Ipswich/UK, ²High Wycombe/UK, ³Leeds/UK
Purpose: In 2014 the National Health Service (NHS) 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 or Background: A qualitative methodological framework 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 - six focus groups from the four domains3.
Results or Findings: 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.
Limitations: Small sample size
Funding for this study: Feedback from this study can be used for the future development of the P4 document.
Has your study been approved by an ethics committee? Yes
Ethics committee - additional information: University of Suffolk Ethics committee approval

Author Block: F. Zarb, P. Bezzina, D. Ciantar; Msida/MT
Purpose: To explore patients’ perception of radiographers’ communication skills during planar x-ray imaging examinations at a general hospital in Malta
Methods or Background: A random sample of patients attending for planar x-ray examinations at a medical imaging department at a general hospital in Malta filled out a self-designed questionnaire consisting of demographic data and scored a series of statements on a Likert scale of 1-4, with 1 being ‘Very unsatisfied’, 2 being ‘Unsatisfied’, 3 being ‘Satisfied’ and 4 being ‘Very satisfied’. Data was collected and analysed to identify trends and understand patients’ perception of radiographers’ communication skills. The Friedman test and Kruskal Wallis test were used to analyse the gathered data.
Results or Findings: Mean scores were either 3-Satisfied or 4-Very Satisfied. There were no significant (p>0.05) discrepancies when comparing the different demographics. Females provided significantly (p<0.05) higher mean rating scores than males. Patients’ scores varied the most in the statement ‘Radiographers informed me of what they had to do next’.
Conclusion: This is the first study of its kind performed locally evaluating patients’ perceptions of Radiographers communication skills. The mechanism in place locally for training radiographers in patient communication appears to be effective, as patients are given instructions clearly and without undue discomfort. To make it simpler for patients once they have completed the x-ray and put their minds at ease during their entire stay at the hospital, a clearer pathway should be implemented. Having radiographers with good communication skills improves the patients’ experience when attending for imaging services.
Limitations: Limited sample size, honesty of participants filling the questionnaire and a number of radiographers being foreigners making communication a challenge.
Funding for this study: No funding was received for this study.
Has your study been approved by an ethics committee? Yes
Ethics committee - additional information: Ethical permission for this study was sought and obtained from the Faculty of Health Science Research Ethics Committee (FREC), University of Malta.

Author Block: A. Masperi; Abbiategrasso/IT
Purpose: The aim of this study was to explore student satisfaction with the OPEN project via a survey and to identify factors influencing radiographers' post-graduation decisions.
Methods or Background: Radiography undergraduates face changing career paths, influenced by technology, aspirations, financial gain and post-graduate education choices. In January 2024 the Radiographer bachelor’s degree course at the University of Milan launched the OPEN project aimed at creating a new postgraduate orientation programme.
Following AMEE guidelines, a semi-structured survey was sent to 17 undergraduate students in the OPEN project to identify factors influencing their post-graduation decisions. University of Milan protocols ensured consent, anonymity, and confidentiality. The survey, in three parts with Likert scale questions, showed good internal consistency via Cronbach's alpha.
Results or Findings: Out of 17 participants, 16 consented to participate (94%), with all attending more than 50% of meetings. The internal consistency of the survey was excellent (αC = 0.83551) and results were expressed in terms of median and interquartile range. Students prioritise careers in research-oriented hospitals with opportunities for research and academic advancement. They seek facilities that offer permanent contracts, incentivise clinical activities for salary growth and a balanced working environment.
Conclusion: The Radiography degree programme at the University of Milan has demonstrated the effectiveness of postgraduate orientation programmes that bridge academic and career gaps.
Limitations: It should be noted that the results of this new project are based on a limited cohort of subjects from a single university.
Furthermore, gender preferences were not explored, which could have provided valuable insights to the survey by broadening the field of interview.
Funding for this study: None
Has your study been approved by an ethics committee? Not applicable
Ethics committee - additional information: None

Author Block: K. Brage¹, J. Jensen¹, O. Brage¹, M. W. Kusk², P. L. Hansen¹, M. Roland Pedersen³, H. Precht⁴; ¹Odense/DK, ²Esbjerg/DK, ³Vejle/DK, ⁴Kolding/DK
Purpose: To assess the knowledge, perceptions, and concerns of professionals working with ionizing radiation (IR) regarding their occupational exposure and its implications on their health, fertility, and offspring.
Methods or Background: This cross-sectional survey included European radiographers and students and was distributed via social media and professional bodies (EFRS and Danish Society of Radiographers) from March to July 2024. The questionnaire covered demographics, knowledge of IR, and concerns, using a five-point Likert scale.
Results or Findings: A total of 629 participants from 32 countries were included: 414 women (mean age 34.34 ± 12.18), 208 men (mean age 38.27 ± 11.81), and 7 non-binary or undisclosed individuals. Of these 28.30% were students. Mean exposure time was 10.69 years ± 10.68.
Overall, 29.77% of respondents agreed that their radiation exposure could negatively impact their health, 23.75% expressed concerns about fertility, and 18.59% about their children's health. No significant differences were observed between sex in these responses.
Of the radiographers 0.44% of did not fully understand the occupational risks of IR, 5.77% were dissatisfied with their radiation protection education, and 4.66% felt unqualified to inform patients. Additionally, 1.99% were unsure about self-protection, and 4.00% felt they lacked the necessary protection means. Regarding the International Basic Safety Standard, a total of 28.95% felt not up to date while the number was 12.42% for the National Legislation.
Conclusion: This study highlights concerns regarding IR and related health with up to 30% expressing concerns. While only a minority of respondents felt they needed more education or resources to protect themselves, a third lacked knowledge on the International Basic Safety Standards.
Limitations: Selection bias could be present as this topic may have attracted respondents with greater concerns.
Funding for this study: None
Has your study been approved by an ethics committee? Yes
Ethics committee - additional information: The University of Southern Denmark Research Ethics Committee (23/70920) approved this project on 8 December 2023. Before accessing the questionnaire, participants were informed about the study's purpose and were assured of the confidentiality of their responses. Only those who provided their informed consent proceeded to complete the questionnaire.

Author Block: R. S. T. Ribeiro, C. Schiesser, C. Campeanu, C. S. D. Reis; Lausanne/CH
Purpose: To assess the effectiveness of simulate d CT examinations as an educational intervention for enhancing radiography students' competencies in ultrasound(US).
Methods or Background: A pilot study was conducted with third-year students enrolled in a four-week US module. Participants had prior knowledge of physics but no US practical experience. The educational intervention utilised abdominal CT examinations to enhance competences in US image acquisition, analysis and transducer positioning. A 20 images set comprising abdominal anatomy was administered before and after the module. Assessments were made using a Likert-scale across 4 categories: anatomical identification, anatomical topographical correlation, sectional planes recognition, transducer positioning. Data were analysed using measures of central tendency and dispersion to assess improvements.
Results or Findings: The simulated US based on CT examinations improved students' US competencies. Anatomical Identification scores increased by 49.8%, mainly in the gallbladder (2.30-point increase), liver (1.85-points), and pancreas (1.55-points) . Anatomical Topographical Correlation improved by 34.2%, particularly for the pancreas (1.80-point) and gallbladder (1.50-points), reflecting enhanced spatial understanding. Sectional Planes Recognition was enhanced by 46.5%, for gallbladder (2.40-point) and kidneys (1.86 ), demonstrating better comprehension of cross-sectional anatomy. Transducer Positioning presented a a gain of 66.1%, with improvements for gallbladder (2.60) and kidneys (2.27). Overall, the intervention effectively addressed initial skill gaps, leading to advancements in both specific anatomical structures analysis and hands-on practical competencies in US.
Conclusion: The use of CT examinations proved to be a valuable tool to improve not only anatomical identification but also students’ spatial understanding and practical application skills in US. The greatest improvements were observed in areas that were initially the most challenging, such as pancreas and gallbladder identification and transducer positioning.
Limitations: Only abdominal anatomy was tested. Reduced student panel (5 students)
Funding for this study: Not applicable
Has your study been approved by an ethics committee? Not applicable
Ethics committee - additional information: Not applicable

Author Block: A. Devetti, S. Da Dalt1, F. R. Fabris2, L. Cereser1, M. G. Belgrano2, R. Girometti1, C. Zuiani; 1Udine/IT, 2Trieste/IT
Purpose: This study aimed to evaluate the efficacy of a peer-assessment tool designed to enhance the quality of clinical tutoring experiences for undergraduate students of a Radiographer Bachelor Degree internship program. By collecting student feedback on their tutors' performance, the institution sought to identify strengths, weaknesses, and implement targeted improvement strategies.
Methods or Background: Over three academic years, 940 student evaluations were collected from 180 clinical tutors across four departments (Radiotherapy, Nuclear Medicine, Medical Physics, and Diagnostics). Tutors were evaluated on seven dimensions using a 10-point Likert scale. The reliability of the evaluation tool was assessed using Cronbach's alpha, which consistently yielded values between 0.92 and 0.94.
Results or Findings: The results indicate a high overall level of student satisfaction with the clinical tutoring experience. The mean overall rating was 8.87 out of 10, with a standard deviation of 0.97. While slight variations were observed across departments, these differences were not statistically significant. The high Cronbach's alpha values suggest that the evaluation tool is reliable and internally consistent.
Conclusion: The implementation of a peer-assessment tool has proven to be an effective method for gathering valuable feedback on the quality of clinical tutoring. By providing tutors with individualized feedback, the institution has fostered a culture of continuous improvement. The aggregated data has also allowed for department-wide analysis, enabling the identification of areas where additional training or support may be needed.
Limitations: The evaluation tool was designed specifically for the Radiographer Bachelor Degree internship program and may not be generalizable to other healthcare settings. Additionally, the study relied solely on student perceptions of tutor performance.
Funding for this study: None
Has your study been approved by an ethics committee? Not applicable
Ethics committee - additional information: None