How to Conduct a Qualitative Systematic Review to Guide Evidence-Based Practice in Radiography

In recent years, there has been emphasis on evidence-based practice. Traditionally, systematic reviews of quantitative evidence on randomized clinical trials (RCTs) and the effectiveness of technology in radiography provided the evidence on which to base decisions for patients and policies. However, there has been a recognition that to have in-depth understanding into human behaviour, opinions and experiences also requires evidence-based literature from systematic reviews of qualitative evidence. Unfortunately, there is limited educational literature on how to conduct systematic reviews of qualitative evidence. Therefore, this article provides this information to radiographers, radiography students and other healthcare professionals. This information is applicable in both clinical and educational settings

Developing a Framework Strategy for Supporting Radiographers in the Clinical Supervision of Radiography Students in Zambia: A Mixed Methods Study

BACKGROUND፡ Clinical supervisors of radiography students play a key role in the facilitation of practice-based learning. However, there is a scarcity of evidence-based strategies to support clinical supervisors. This study aimed at exploring the level of support required by radiographers in order to develop a framework strategy for supporting clinical supervisors ofradiography students in Zambia.METHODS: This study used an exploratory sequential mixedmethods approach. The qualitative phase was conducted first, and the findings were used to develop the questionnaire for the quantitative phase. The study population was radiographers working in the Lusaka and Copperbelt provinces of Zambia. For the first phase, data were collected from a purposive sample of 10 clinical supervisors of radiography students. For the survey, data were collected from 120 radiographers using a questionnaire. In the third phase, a group of experts validated the proposed framework using an online questionnaire. Qualitative data were analysed thematically and quantitative data using statistics.RESULTS: Four support areas were identified: training and education in clinical supervision, clinical training resources, human resources and relationships, and quality assurance programmes related to clinical supervision. These findings informed the development of a support framework strategy for clinical supervisors.CONCLUSION: This study has revealed that clinical supervision of radiography students requires coordinated support from stakeholders: schools of radiography, professional body, and radiology and hospital management. It is anticipated that the developed framework, when implemented, will enhance the experiences of clinical supervisors and improve the quality of clinical education

Causes of Reject and Repeat of Digital Radiographic Images: A Literature Review to Guide the Practice of Radiography in Zambia

Background: Radiographers aim at always improving the quality of imaging services through the production of high-quality diagnostic images, whilst minimising the radiation doses to patients and reducing healthcare costs. One strategy used in achieving this is conducting periodical reject and repeat image analysis.Objective: The aim of this study was to review the causes of rejection and repetition of digital radiographic images to guide the practice of radiography in Zambia.Methods: A literature search was conducted in January 2021 in PubMed/MEDLINE and ScienceDirect electronic databases. The search was extended to reference lists of eligible articles and radiography journals.Results: Seven research studies and clinical audits were identified to be relevant and included in this review. Six causes of rejection and repetition of digital radiographic images were identified: patient positioning errors, inappropriate selection of technical exposure factors, patient motion, presence of artefacts, improper collimation of the radiographic beam, and absence of permanent anatomical side markers (ASM). Amongst these factors, patient positioning error was the most common reason for rejecting and repeating digitalimages.Conclusion: The review found the overall image rejection rate to be within the acceptable range in digital radiography. This review's findings can guide the practice of radiography in Zambia as the transition takes place from traditional film-based radiography to digital radiography (DR) imaging systems. Keywords: Digital radiography, Radiographic image, Radiographer, Reject analysi

Barriers to Continuing Professional Development (CPD) in Radiography: A Review of Literature from Africa

Purpose: To review the barriers to continuours professional development (CPD) learning activities in radiography in Africa and propose strategies for supporting radiographers on the continent. Method: A literature search was conducted in four databases: ScienceDirect, PubMed/MEDLINE, CINAHL, and Google Scholar with no time limit. This was supplemented with hand searching to avoid missing relevant literature. All research studies conducted in Africa on this subject were included in the review. Data were synthesised and analysed thematically. Results: Seven research studies were found to be relevant and included in this review. Three main themes on barriers to radiographers’ participation in CPD learning activities were identified: attitudinal, physical, and structural barriers. Attitudinal barriers include a lack of self-motivation and a feeling that topics are irrelevant at study days. The identified physical barriers are time constraints, financial constraints and distance to CPD events, and limited resources. Structural barriers identified include a lack of knowledge about learning opportunities, shortage of staff, poor study days notification and communication, and a lack of support. Conclusion: There are several barriers to radiographers’ participation in CPD learning activities identified in this review. Strategies to support radiographers are proposed. It is anticipated that the implementation of the proposed support strategies will alleviate the barriers and allow active engagement of radiographers in continuing education

Impact and challenges of consultancy role regarding the delivery of breast imaging services in the United Kingdom: consultant breast radiographers' perspective

Background: Breast cancer is the leading cause of death in women worldwide. Imaging and radiographers play an important role in the diagnosis and treatment of breast cancer. With the increase in demand and a shortage of radiologists in the UK, consultant breast radiographers were introduced to perform some roles previously performed by radiologists. However, there is a scarcity of researchto assist other countries, such as Zambia, who are planning to extend the role of radiographers.Objective: To explore the impact and challenges of the radiography consultancy role regarding the delivery of breast imaging services in the United Kingdom.Methods: The study was guided by a qualitative research design. The sample was purposively selected, and semi-structured interviews was used to collect data from consultant breast radiographers in the UK. Data saturation was reached after interviewing eight  participants. Interviews were audio-recorded, transcribed and data analysed thematically.Results:Two themes were identified: the impact and challenges of the radiography consultancy role regarding the delivery of imaging breast services. The creation of consultant posts impacted positively on the service delivery: reduction in patient waiting times, career progression and job satisfaction, and reduction in the workload of radiologists. Participants also faced challenges: increased workload and time pressure, isolation and poor support from colleagues, and animosity from a few radiologists.Conclusion: It is evident that consultant breast radiographers have contributed greatly to improved healthcare delivery. However, consultant breast radiographers encounter challenges in their role as consultants. Radiographers undertaking new roles should be supported to improve the delivery of imaging services. Keywords: breast cancer, consultant radiographer, imaging, radiologist, role extensio

Need for image reporting by radiographers in Zambia

There is a critical shortage of radiologists in Zambia, with only 5 serving the entire population of approximately 17 million. For this reason, most hospitals, especially in rural areas have no radiologist services. This leaves most diagnostic imaging examinations unreported. In order to bring imaging services closer to the families who stand as a point of care, this article addresses the ways and possibilities of having reporting radiographers assisting radiologists in reporting on plain film radiographs. It has further evaluated evidence and research on how this undertaking has worked well in other countries. The article ends by recognising that with postgraduate training in image interpretation and reporting, radiographers (both diploma and degree holders) in Zambia can effectively report on plain film radiographs; thereby improving access to this service for the majority of patients.Keywords: Reporting radiographer, radiologist, role extension, plain film radiograph

Image Interpretation and Reporting by Radiographers in Africa: Findings from the Literature Review and their Application to Zambia

Background: The need for having reporting radiographers has been a part of the discussion in the last decade in Zambia. This is due to  acritical shortage of radiologists, an increase in demand for imaging services, and the radiographers' desire for professional recognition in providing formal reports on radiographic images similar to those they undertake in ultrasonography.Objective: The study aimed at reviewing the evidence relating to image interpretation and reporting by radiographers in Africa and apply the findings to Zambia.Methodology: A literature review was used to bring together studies on image interpretation and reporting by radiographers in Africa. Online databases, radiography journals, cited references, grey literature, and the internet were searched for relevant studies.Results: Thirteen studies were included in this review. The findings revealed that radiographers in Africa have a positive attitude towards image interpretation and reporting. In addition, their accuracy at image interpretation is comparable to radiologists. The main benefit identified by the establishment of reporting radiographers is improved access to imaging reports. The review also found that medical doctors are in support of the establishment of reporting radiographers. However, the main limitations are a lack of postgraduate courses in this speciality and the limitation of their scope of practice.Conclusion: Reporting radiographers contribute significantly to the delivery of quality imaging services by assisting radiologists in  reporting on radiographic images. There is a need for policymakers in Africa, including Zambia, to extend the scope of practice of radiographers and establish postgraduate image interpretation courses

Diagnostic Imaging of Non-Accidental Injury and Percutaneous Foreign Bodies: A Case Report from Zambia

This case report presents the role imagingplayed in the diagnosis and surgical removal of multiple percutaneous foreign bodies in a  5-year-old child who presented with non-accidental injuries (NAI) to medical facilities in Zambia. Children are commonly referred for imaging with suspected accidental foreign bodies, but percutaneous foreign bodies due to NAI are rare. NAI is caused due to child physical abuse and therefore, imaging plays a major role in the diagnosis and provision of legal evidence. In this case report, conventional radiography (plain film) of askeletal survey was the first imaging requested. This was supplemented with a computed tomography (CT) scan of the thorax and abdomen. Lastly, foreign bodies were removed under the guidance of the image intensifier. Although, the cases of NAI reported and presented in medical facilities in Zambia are rare, this case shows that physical child abuse is practiced in our communities. Thus, radiographers and radiologists should pay attention to such cases during imaging and reporting, respectively