Utilisation of a peer assisted learning scheme in an undergraduate diagnostic radiography module

AcceptedThis is the author's accepted manuscript of an article published in Radiography. Published version available at doi:10.1016/j.radi.2015.08.004Background: Peer to peer support programmes involve students supporting each other in either an educational, social and/or pastoral way. This is now common place in higher education institutes and has been proven to decrease student attrition and improve grades. Aim: To evaluate a peer assisted learning scheme (PALS) within the University of Exeter undergraduate programme, where final year (stage 3) students held extra-curricular teaching sessions in an on-campus X-ray room throughout the academic term to support a first year (stage 1) module introducing basic projectional radiographic examinations, radiation safety, patient care and radiographic equipment. PALS sessions were unstructured and as such could involve roleplaying radiographic examinations, revisiting lecture material and/or discussing hospital placement or pastoral issues. Methods: Brookfield's four lenses of critical reflection were used. 16 of 63 stage 1 students and 9 of 29 stage 3 students were electronically surveyed upon completion of the PALS sessions. Relevant colleagues and educational specialists were also informally interviewed. These were put in context with autobiographical reflections and the existing literature base on PALS. Results: All agreed that the sessions provided a good environment for stage 1 students to improve their practical skills, revise lecture content, and gain confidence for upcoming clinical placements. Stage 3 students gained experience teaching students, an essential role of a graduate radiographer's job. Improvements around recruiting stage 3 peer leaders, sustainability, timetabling and session structure were explored. Conclusion: The PALS proved to be a successful initiative within the undergraduate programme and will be continued into the future

An Evaluation of Service Users as an Educational Resource in an Undergraduate Diagnostic Radiography Module.

Aim: To critically evaluate the PAM2012 “Pathology for Radiographers” module and its “service user session” where around three or four invited SU&Cs living with chronic health conditions discuss their healthcare experiences with small groups of stage 2 students. Methods: Brookfield’s “four lenses of critical reflection” were adopted in order to gain a balanced perspective of key stakeholders, including the students involved (i.e. the “student lens”); medical imaging staff and adopted SU&Cs (the “colleague lens”); and the autobiographical thoughts of the author (the “autobiographical lens”). Evaluation was strengthened by putting these perspectives in context with the literature base (i.e. the “theoretical lens”) [2]. For the “student lens” 12 of 37 (32.4%) students returned an online questionnaire. Four staff and two SU&Cs were also surveyed on their views. Themes such as the benefits, praise, criticisms, barriers and potential improvements for the sessions were identified and explored, along with potential new ways of implementing service users as part of the MI programme

A Review of the Mechanisms, Diagnosis and Preventative Treatment of Osteoporotic Fragility Fractures in Patients With Type 2 Diabetes Mellitus

This is a freely-available open access publication. Please cite the published version which is available via the DOI link in this record.The primary association of both type 2 diabetes mellitus (T2DM) and fragility fractures with age has become cause for concern in the developed world, with T2DM now considered an independent risk factor for an increased risk of fragility fracture. The increased susceptibility to fragility fracture associated with T2DM has wide ranging and increasing socioeconomic, morbidity and mortality effects. As the incidence of T2DM increases, understanding the mechanisms behind why T2DM is a causative risk factor to decreased bone health is an important step. These may be split into two broad categories: those that involve an increased risk of falling, and those mechanisms that make fragility fracture after falling more likely due to detrimental changes to bone strength. The latter is not definitively understood making diagnosis in T2DM populations difficult. Current diagnostic methods do not sufficiently account for the unique endocrinological effects of T2DM on bone. New markers for identifying fragility fracture risk in patients with T2DM are required to overcome the paradoxical increase in bone mineral density (BMD) in these populations, and the shortcomings of predictive algorithms and dual energy X-ray absorptiometry (DXA) in identifying fracture risk in T2DM populations. Earlier identification of patients with T2DM who are at risk of fragility fracture is important, as these patients are not as responsive to current preventative medical interventions as those without T2DM, although there are also adoptive lifestyle changes that can help

Imaging in Osteoporosis

This is the author accepted manuscript. The final version is available from Pavilion Publishing via the link in this record.Osteoporosis is a prevalent metabolic bone disease in the western world, resulting in low trauma fractures and increased morbidity and mortality rates among sufferers. The article describes the common imaging required in the diagnosis and management of osteoporosis. It is important to include imaging within the patient pathway where vertebral fractures are suspected and to use additional imaging modalities such as MRI to aid differential diagnosis where the cause of the fracture is unclear. Radiographers and radiologists reporting imaging examinations may be the first clinicians to suspect the presence of osteoporosis and have a role in helping to ensure that these patients do not get missed so that appropriate treatment can be started. Ideally there should be locally-agreed pathways whereby such patients are automatically referred to the fracture liaison service, regardless of the original requester of the imaging investigation

Computed tomography colonography: Radiographer independent preliminary clinical evaluation for intraluminal pathology

This is the author accepted manuscript; the final version is available from Elsevier via the DOI in this recordIntroduction: We evaluated the reporting competency of radiographers providing preliminary clinical evaluations (PCE) for intraluminal pathology of computed tomography colonography (CTC). Method: Following validation of a suitable tool, audit was undertaken to compare radiographer PCE against radiology reports. A database was designed to capture radiographer and radiologist report data. The radiographer's PCE of intraluminal pathology was given a score, the “pathology discrepancy and significance” (PDS) score based on the pathology present, any discrepancy between the PCE and the final report, and the significance of that discrepancy on the management of the patient. Agreement was assessed using percentage agreement and Kappa coefficient. Significant discrepancies between findings were compared against endoscopy and pathology reports. Results: There was agreement or insignificant discrepancy between the radiographer PCE and the radiology report for 1736 patients, representing 97.0% of cases. There was a significant discrepancy between findings in 2.8% of cases and a major discrepancy recorded for 0.2% of cases. There was a 98.4% agreement in the 229 cases where significant pathologies were present. Conclusion: From a database of 1815 studies acquired over three years and representing work done in a clinical environment, this study indicates a potential for trained radiographers to provide a PCE of intraluminal pathology

Exploring the potential relationships between microvascular haemodynamics and density in bone: a feasibility study utilising near infrared spectroscopy

This is the author accepted manuscript. The final version is available from UKIO2019 via the link in this recordRoyal College of Radiologist

Radiographer-led discharge for emergency care patients, requiring projection radiography of minor musculoskeletal injuries: a scoping review.

This is the final version. Available on open access from BMC via the DOI in this recordAvailability of data and materials: All data used and analysed during this study are included in this published article.BACKGROUND: Pressure on emergency departments (EDs) from increased attendance for minor injuries has been recognised in the United Kingdom. Radiographer-led discharge (RLD) has potential for improving efficiency, through radiographers trained to discharge patients or refer them for treatment at the point of image assessment. This review aims to scope all RLD literature and identify research assessing the merits of RLD and requirements to enable implementation. METHODS: We conducted a scoping review of studies relating to RLD of emergency care patients requiring projection radiography of minor musculoskeletal (MSK) injuries. MEDLINE, Embase and CINAHL, relevant radiography journals and grey literature were searched. Articles were reviewed and the full texts of selected studies were screened against eligibility criteria. The data were extracted, collated and a narrative synthesis completed. RESULTS: Seven studies with varying study designs were included in the review. The small number of studies was possibly due to a generally low research uptake in radiography. The main outcome for four studies was reduced length of stay in ED, with recall and re-attendance to ED a primary outcome in one study and secondary outcome for two other studies. The potential for increased efficiency in the minor MSK pathway patient pathway and capacity for ED staff was recognised. Radiographers identified a concern regarding the risk of litigation and incentive of increased salary when considering RLD. The studies were broadly radiographer focussed, despite RLD spanning ED and Radiology. CONCLUSION: There were a low number of RLD active radiographers, likely to be motivated individuals. However, RLD has potential for generalisability with protocol variations evident, all producing similar positive outcomes. Understanding radiography and ED culture could clarify facilitators for RLD to be utilised more sustainably into the future. Cost effectiveness studies, action research within ED, and cluster randomised controlled trial with process evaluation are needed to fully understand the potential for RLD. The cost effectiveness of RLD may provide financial support for training radiographers and increasing their salary, with potential future benefit of reduction in workload within ED. RLD implementation would require an inter-professional approach achieved by understanding ED staff and patient perspectives and ensuring these views are central to RLD implementation

Correction: Radiographer-led discharge for emergency care patients, requiring projection radiography of minor musculoskeletal injuries: a scoping review

This is the final version. Available on open access from BMC via the DOI in this recordThe article to which this is the correction is available in ORE at http://hdl.handle.net/10871/131862The original article contained errors affecting correct attribution of the citations to their respective references which has since been corrected

Post-acute COVID syndrome (long COVID): What should radiographers know and the potential impact for imaging services

This is the final version. Available on open access from Elsevier via the DOI in this recordOBJECTIVES: The COVID-19 pandemic caused an unprecedented health crisis resulting in over 6 million deaths worldwide, a figure, which continues to grow. In addition to the excess mortality, there are individuals who recovered from the acute stages, but suffered long-term changes in their health post COVID-19, commonly referred to as long COVID. It is estimated there are currently 1.8 million long COVID sufferers by May 2022 in the UK alone. The aim of this narrative literature review is to explore the signs, symptoms and diagnosis of long COVID and the potential impact on imaging services. KEY FINDINGS: Long COVID is estimated to occur in 9.5% of those with two doses of vaccination and 14.6% if those with a single dose or no vaccination. Long COVID is defined by ongoing symptoms lasting for 12 or more weeks post acute infection. Symptoms are associated with reductions in the quality of daily life and may involve multisystem manifestations or present as a single symptom. CONCLUSION: The full impact of long COVID on imaging services is yet to be realised, but there is likely to be significant increased demand for imaging, particularly in CT for the assessment of lung disease. Educators will need to include aspects related to long COVID pathophysiology and imaging presentations in curricula, underpinned by the rapidly evolving evidence base. IMPLICATIONS FOR PRACTICE: Symptoms relating to long COVID are likely to become a common reason for imaging, with a particular burden on Computed Tomography services. Planning, education and updating protocols in line with a rapidly emerging evidence base is going to be essential

Assessment of the multidisciplinary education for a major change in clinical practice; a prospective cohort study

Background: New approaches are often introduced to the neonatal intensive care unit (NICU) and other areas of the health service in either a haphazard or cataclysmic fashion. The needs of staff education are often addressed incompletely or too late. Rarely is education assessed after the introduction of a major change. We changed the basis of our NICU respiratory support. We conducted a major educational and support program before this intervention. This study documented and assessed the educational components of this change in our health service provision. Methods: Senior medical and nursing staff attended training abroad and an education program was applied for one year prior to the change. Multidisciplinary educational support for doctors, nurses and allied health was continued after the change. Assessment was by anonymous questionnaire, prior to change, at one and at nine months. Our hypothesis was that dissatisfaction with education would be greatest at one month. Results: Both theory education and practical education aspects of the new approach were rated as good to very good and this did not change with time. Difficulty of applying the technique was rated as ambivalent initially but decreased significantly over 9 months until it was rated easy to very easy (p < 0.001). Over all, the change was rated by staff as beneficial, both at the end of the education period and at nine months, with no decrease at one month. Conclusion: If education and training reaches all staff, with a system of mutual and continued support, even large changes in clinical practice can be achieved without the dissatisfaction with the educational process that is often otherwise seen