Informing radiography curriculum development: the views of UK radiology service managers concerning the ‘fitness for purpose’ of recent diagnostic radiography graduates

Recent years have seen significant changes in the way medical imaging services are delivered, rapid changes in technology and big increases in the number and ranges of examinations undertaken. Given these changes the study aimed to critically evaluate the fitness for purpose of newly qualified diagnostic radiography. The study employed a grounded theory approach to analyse the interviews of 20 radiology managers from a range of medical imaging providers across the UK. Four key themes emerged from the analysis. These were: curriculum content and structure review; diversification in the role of the radiographer; professionalism and coping and the reformation of career structures. The results indicate the role of the radiographer is now quite nebulous and challenge radiology managers and educators to design curricula and career structures which are better matched the role of the radiographer in the very rapidly changing technological, organisational and social contexts of modern society

Soft skills and hard lessons: the future of radiography education in the UK

The diagnostic radiography BSc curriculum has not seen fundamental changes in recent years with the focus of study predominantly centred around the development of competencies within projection/plain radiography accompanied by a limited experience in a range of other imaging modalities. The operation of a modern imaging department now involves the utilisation of a wide variety of imaging modalities many of which have seen large increases in their workload. The study reports of the findings generated from 20 semi-structured interviews undertaken with radiology service managers from across the United Kingdom. An interview schedule was generated which was developed to elucidate: recent changes in working practices within imaging departments; additional training which needs to be provided for recent graduates and the skills required for the future workforce. The results were analysed using a Straussian Grounded Theory approach in which responses were coded and then grouped using thematic analysis. Results showed the current model of education only partly supports the needs of the modern workforce imaging with specific concerns raised regarding the communication skills, professionalism and clinical skills of newly qualified graduates. Managers foresee the continuing development of the four tier structure; further increases in the workload associated with all modalities and the increasing need for ‘specialisation’ at an earlier stage the career of the Radiographer. Projection imaging, mobile and theatre work will continue to play a central part within the imaging department and should be a primary consideration of the development of future curricula though not all graduates may utilise these skills

Challenges and opportunities in educating the medical imaging practitioner workforce

The last two decades have seen unprecedented change in the technologies used within medical imaging. This includes the volume of procedures undertaken, as well as the range and complexity of imaging examinations carried out within radiology and medical physics departments. Against this background, radiography curricula have remained largely static, with a divergence of provision and the creation of silos within the regulatory frameworks which govern the education provision of the medical physics practitioner and the radiography practitioner. Both of these factors have contributed to inefficiency, a lack of undergraduate education provision for the medical physics practitioner and generalised workforce shortages which are currently being experienced within the sector

Patient obesity and the practical experience of the plain radiography professional: on everyday ethics, patient positioning and infelicitous equipment

Patient obesity is increasingly placing significant and multifaceted strain upon medical imaging departments, and professionals, in (particularly Western) healthcare systems. The majority of obesity-related studies in radiology are, however, primarily focused only upon the technical business of collecting diagnostically-efficacious images. This study, using Interpretative Phenomenological Analysis (IPA), qualitatively explores the everyday clinical experiences of eight expert UK diagnosticians working in plain radiography. Focus herein falls particularly upon (a) problems with patient positioning during examination, and (b) challenges arising around available equipment. In line with extant research, participants reported that difficulties with positioning obese patients could have negative impacts on image quality, and that insufficient table weight limits and widths, and inadequate detector sizes, can adversely affect examination. They also raised some more novel issues, such as how the impact of available gown sizes upon a patient’s sense of dignity can cause practical and ethical dilemmas for a clinician in situ. The issue of how one might ‘train’ experience in positioning patients without bony landmarks as a reference point was also made salient, with strong implications for undergraduate radiography curricula. It is finally highlighted how the participating radiographers themselves seldom conceptualised any given problem as a purely ‘technical’ one, instead recurrently recognising the interlinking of material, socio-economic and moral matters in real healthcare contexts. By better understanding such nuance and complexity as lived by real radiographers, it is contended, a more context-sensitive and flexible path to effective training and guideline-production can be mapped

Charting the practical dimensions of understaffing from a managerial perspective: the everyday shape of the UK’s sonographer shortage

Introduction: Across the last two decades, ultrasound services in many healthcare sectors have become increasingly pressurised as a consequence of upsurging demand and difficulties in recruiting viable clinicians. Indeed by 2013, the UK government's Migration Advisory Committee had listed sonography as an official ‘shortage specialty’. Comparatively little research has to date, however, explored the impacts of this situation upon the departments themselves, and the individuals working therein. The core purpose of this study is, thus, to lend qualitative depth to current understandings of the frontline situation in the UK's ultrasound units, many of which are understaffed, from the perspective of their managers. Methods: Using a thematic analysis informed by a Straussian model of Grounded Theory, N=20 extended accounts provided by ultrasound department leads in public (n=18) and private (n=2) units were explored. Results: Four global themes emerged from the analysis of which the first two (the broadly sociological matters) are described in this paper. Theme 1 addresses how a lack of staff in the broader ultrasound economy has created a troublesome migratory system in contemporary UK ultrasound. Theme 2 addresses how this economy works chiefly to the advantage of the most junior and the most senior clinicians, often leaving mid-career professionals in the borderline impossible situation of having to concurrently occupy both junior and senior roles. Conclusions: The findings ideally open up debate on some key practical contingencies of the UK’s sonographer shortage, and reflect upon literature regarding the nuanced aspects of a shifting healthcare workplace constitution