Yes / Research is critical to evidence‐based practice, and the rapid developments in technology provide opportunities to innovate and improve practice. Little is known about the research profile of the medical radiation science (MRS) profession in Australia and New Zealand (NZ). This study provides a baseline of their doctoral activity. A cross‐sectional survey of MRS professionals in Australia and NZ holding a doctorate or undertaking doctoral studies, was performed using an online tool (Bristol Online Survey®, Bristol, UK). A chain‐referral sampling technique was adopted for data collection. An email invitation with a link to the survey was generated and distributed through email and social media. The survey contained questions related to participant demographics, doctoral status, qualification route, funding and employment. There were 63 responses to the survey comprising 50.8% diagnostic radiographers (DRs; n = 32), 23.8% radiation therapists (RTs; n = 15), with the remaining 25.4% (n = 16) equally split between sonographers and nuclear medicine technologists (NMTs). A total of 40 (63.5%) of respondents had completed their doctoral qualification. In NZ, only DRs held a doctoral award constituting 0.3% of DRs and 0.2% of the total registered MRS population. In Australia, there was a greater proportion of doctoral NMTs (n = 8/1098; 0.7%) than RTs (n = 15/2394; 0.6%) and DRs (n = 27/12,001; 0.2%). Similar to other countries, findings show a very small percentage of doctoral MRS professionals in Australia and NZ. Strategies to engage and support individuals in research, up to and beyond doctoral study, need to be embedded in practice.

No / There is limited evidence of the impact of radiographers working in advanced roles beyond task substitution. This study reviews the contribution of advanced (and consultant) practitioner radiographers to service delivery whilst reporting radiographs and demonstrates the impact this has on patients and staff, both internal and external to the imaging department. The study was a prospective exploratory study using activity diaries to allow interval sampling when individuals were rostered to report. Data was coded using a compiled list of activities and recorded in 15-min intervals over the period of one week. Thirteen radiographers who independently report radiographs participated across 6 locations in a busy multisite English National Health Service (NHS) Trust. Radiographers reported the majority of the examinations during the study period (n = 4512/5671; 79.6%). The total number of coded activities recorded over the study period was 1527, equating to 380.5 relative hours. The majority of available time was spent reporting, including dictating and verifying the reports of colleagues or trainees, although 69.5% of reporting time was interrupted. Based upon the hours of reporting there was an average of 19.3 reports (patient episodes) produced per hour. Direct patient care tasks and support for staff in decision making were regularly documented. Supplementary tasks included administrative activity, amendments to rotas, preparing presentations and documenting incidents identified during reporting. This study has demonstrated the breadth and complexity of the activities performed by advanced practice radiographers. The findings confirm their role in supporting service delivery beyond image interpretation.

Yes / Objectives: Many organisations struggle to clearly differentiate the radiographer consultant role from advanced or specialist practice, with newly appointed consultant practitioners often illprepared for working at this level. This article discusses the design, implementation and validation of an outcomes framework for benchmarking competencies for trainee or new-in-post consultant radiographers. Methods: Five experienced radiographers from different clinical specialisms were seconded to a twelve month consultant trainee post, guided by a locally-devised outcomes framework. A longitudinal qualitative study explored, from the radiographers' perspective, the impact of the outcomes framework on the transition to consultant practice and beyond. Data collection included semi-structured interviews (months 1, 6 and 12), validation via a focus group (month 18) and a group interview (5 years). Results: Early interactions with framework objectives were mechanistic, but as participants better understood the role more creative approaches emerged. Despite diverse clinical expertise, the framework facilitated parity between participants, promoting transparency and credibility which was important in how the consultant role was perceived. All participants achieved all framework outcomes and were subsequently appointed to substantive consultant radiographer positions. Conclusion This outcomes framework facilitates experienced radiographers to successfully transition into consultant radiographers, enabling them to meet multiple non-clinical targets while continuing to work effectively within a changing clinical environment. It is the first validated benchmarking tool designed to support the transition to radiographer consultant practice. Adoption of the tool will provide a standardised measure of consultant radiographer outcomes that will promote inter-organisational transferability hitherto unseen in the UK. / Mid Yorkshire NHS Trust Hospitals

Yes / Consultant radiographer numbers remain low despite the ongoing capacity challenges in diagnostic imaging. This is compounded by the limited evidence of how such roles can positively impact on service delivery, particularly in relation to their leadership expectations. Aims: To examine the activities undertaken by consultant radiographers; evidence the impact of the roles, and consider whether the roles encompass the four domains of consultant practice. Method: Six consultant radiographers employed in a single NHS Trust completed an activity diary over a period of 7 days. Interval sampling every 15 minutes enabled the collection of a large volume of complex data. Findings: All consultants worked beyond their contacted hours. The documented activities demonstrate the breadth of the roles and confirmed that the participants were undertaking all four core functions of consultant practice. Conclusion: The impact of the roles stretched beyond the local department and organisation to the health system and wider profession.

No / Accepted definitions and descriptions of advanced practice offer generic ideals for the development of advanced radiographer practitioner roles. However, they fail to specify a development pathway necessary for a clinical practitioner to attain advanced practitioner status and lack of clarity persists around the definition of advanced practice within the context of radiography [Price R. Critical factors influencing the changing scope of practice: the defining periods. Imaging & Oncology 2005;June:6–11.]. This paper will consider the expectations of practitioner and advanced practitioner competencies within the context of radiography practice in the United Kingdom and suggest criteria for an advanced practice development pathway that may be adopted by individual radiographers, or their managers, to assist professional development within any imaging speciality.

Yes / To survey the diagnostic radiography workforce in the United Kingdom (UK) at an organisational level to ascertain the scope of advanced practice and compliance with Health Education England standards for multiprofessional advanced clinical practice (ACP). 174 diagnostic imaging departments were invited to participate in a cross-sectional electronic survey focused upon advanced level practice and their educational and accreditation expectations (October-December 2019). Breast imaging, computed tomography, fluoroscopy, interventional radiology, lithotripsy, magnetic resonance imaging and projectional radiography were included. A total of 97 responses were received, of which 79 were eligible for inclusion (45%). Respondents reported advanced-level practice roles across all imaging modalities, which included clinical reporting, procedural-based and combined roles. Radiograph and mammogram reporting were most prevalent (95 and 67% of Trusts), with fluoroscopy the most frequent procedure-only role (25%). Only 39% of trusts required adherence to the four pillars of ACP within job descriptions, and only 12% requiring a full Masters qualification. Diagnostic radiographer reporting and procedure-based roles in the NHS are varied and widespread. However, inconsistencies in fulfilment against the expected standards for advanced practice exist. Realignment of advanced-level roles to delineate enhanced and advanced clinical practice may ensure consistency between roles and professions. A requirement for accreditation as an advanced (clinical) practitioner with adherence to advanced practice requirements could therefore provide value to accreditation for both individual practitioners and Trusts. Within the UK, diagnostic radiographer roles previously self-identified as advanced-level practice may be termed enhanced practice when not adhering to expected ACP standards.

Yes / Lung cancer remains a major cause of preventable death and early diagnosis is critical to improving survival chances. The chest X-ray (CXR) remains the most common initial investigation, but clinical pathways need to support timely diagnosis through, where necessary, escalation of abnormal findings to ensure priority reporting and early CT scan. This single-centre study included a retrospective evaluation of a rapid lung cancer CXR pathway in its first year of operation (May 2018-April 2019). The pathway was initially designed for primary care referrals but could also be used for any CXR demonstrating abnormal findings. A parallel cross-sectional survey of radiographers explored their understanding, adherence and concerns regarding their role in the pathway operation. Primary care referrals on the rapid diagnostic pathway were low (n = 51/21,980; 0.2%), with 11 (21.6%) requiring a CT scan. A further 333 primary care CXR were escalated by the examining radiographer, with 100 (30.0%) undergoing a CT scan. Overall, 64 of the CT scans (57.7%) were abnormal or demonstrated suspicious findings warranting further investigation. There were 39 confirmed primary lung carcinomas, most with advanced disease. Survey responses showed that most radiographers were familiar with the pathway but some expressed concerns regarding their responsibilities and limited knowledge of CXR pathologies. This baseline evaluation of the rapid lung cancer pathway demonstrated poor referral rates from primary care and identified the need for improved engagement. Radiographer escalation of abnormal findings is an effective adjunct but underlines the need for appropriate awareness, training, and ongoing support. Engagement of the multiprofessional team is critical in new pathway implementation. Rapid diagnostic pathways can enable early diagnosis and the radiographer has a key role to play in their success.

Yes / Prior studies have demonstrated inconsistent development and utilisation of radiographers in the reporting of radiographs, and there is ongoing consideration of the level at which such radiographers should be educated to and operating at. This study aimed to explore and evaluate expectation and utilisation of radiographers currently, or training in, reporting in projection radiography across one integrated care system (ICS). Methods: A multi-method approach was utilised, with document analysis of projection radiography reporting role job descriptions and person specifications and an online survey of managers and clinical leads. A single ICS in the north of England formed the setting for the study. Results: This study demonstrated variation in implementation and utilisation of the role across trusts within the ICS. Inconsistencies in scope, expected underpinning education and role activity were identified. Radiographers autonomously reporting in projection radiography were titled advanced practitioners, however are not expected to achieve national educational standards for such roles and are not empowered to work at this level of practice by their employers. It was acknowledged that staffing pressures hinder appropriate role utilisation and reporting capacity. Conclusion: Inconsistent development and utilisation of radiographers in such roles may hamper collaboration and service delivery across a network. Identifying variation and working towards role standardisation could promote cross-organisational working and improve career progression opportunities. Implications for practice: Scoping the reporting radiographer workforce may assist and guide future imaging service and workforce planning. / The full-text of this article will be released for public view at the end of the publisher embargo on 24 Sep 2024.

Bakgrund: Forskning visar att barn är känsligare för joniserande strålning än vuxna. Röntgenundersökningar får inte utföras i onödan och nyttan med undersökningen skall överstiga dess risker. Det är viktigt att optimera röntgenundersökningar och så långt som möjligt minimera stråldoser utan att påverka det diagnostiska resultatet, då forskning visar att även låga stråldoser kan ge upphov till DNA-skador och i förlängningen orsaka cancer. Syfte: Att beskriva metoder som optimerar röntgenundersökningar och minskar stråldosen till barn vid konventionell röntgen. Metod: Litteraturstudie vars resultat är baserat på 14 vetenskapliga artiklar funna i databaserna PubMed och CINAHL samt via manuell sökning. Resultat: Det fanns ett flertal metoder och tillvägagångssätt som optimerar röntgenundersökningar och minskar stråldosen till barn vid konventionell röntgen. Metoderna berörde åtgärder i undersökningsrummet, parametrar, filtrering och ny teknik. Konklusion: Röntgensjuksköterskor med kunskap om optimering har goda möjligheter att sänka stråldoser till barn vid konventionell röntgen. / Background: Research shows that children are more sensitive to ionizing radiation than adults. X-ray imaging may not be performed unnecessarily and its necessity must exceed the risks. It is important to optimize the imaging and as far as possible minimize the radiation dose without affecting the diagnostic performance negatively. Research shows that even low doses of radiation can cause DNA damage and ultimately induce cancer. Objective: The aim of this paper was to describe methods that optimize the x-ray examination and reduce radiation doses to children in conventional radiography. Method: A literature study whose results are based on 14 scientific articles found in the databases PubMed and CINAHL and manual searches. Results: There were several methods that optimize the x-ray examination and reduce the radiation doses to children in conventional radiography. These methods concern approaches in the examination room, parameters, filtering and new technology. Conclusion: Radiographers’ with knowledge of optimization have good opportunities to lower radiation doses in x-ray examinations of children in conventional radiography.

Ett bra introduktionsprogram är grundläggande för en lång framgångsrik karriär och gör det lättare för den nyexaminerade att lära sig, då övergången från studier till att börja arbeta som en legitimerad röntgensjuksköterska kan vara en stressig period. Syftet med denna studie var att undersöka nyexaminerade röntgensjuksköterskors upplevelse av introduktionen på en ny arbetsplats. Data samlades in till denna studie genom att intervjua nio röntgensjuksköterskor som tagit examen sommaren 2014. Dessa röntgensjuksköterskor arbetar på röntgenkliniker i mellan- och södra Sverige. All insamlad data analyserades med hjälp av innehållsanalys och det resulterade i tre kategorier: Introduktionsprogrammet, Handledarnas kunskap och egenskaper och Sociala relationers betydelse och påverkan. De nyexaminerade röntgensjuksköterskorna upplevde att introduktionen var tillräcklig och bra. Det fanns vissa delar som var mindre bra, till exempel att de blev räknade som en av den ordinarie personalen medan de hade introduktion. Alla informanter ansåg att det blir bäst ifall de har en specifik handledare i början av introduktionen, då det lätt kan bli förvirrande med flera handledare. / A good introduction program is essential for a long successful career and makes it easier for new graduates to learn. As the transition from studies to beginning working as a licensed radiographer can be a stressful period. The purpose of this study was to investigate the new graduate radiographers experience of the introduction at a new workplace. Data was collected for this study by interviewing nine new graduate radiographers who graduated in the summer of 2014. These radiographers are working on radiology departments in central and southern Sweden. All collected data was analyzed using content analysis and it resulted in three categories: Introduction program, The preceptors knowledge and qualities and Social relationships importance and impact. The new graduate radiographers felt that the introduction was sufficient and good. There were some parts that were less good, for example, they were counted as one of the regular staff while they still had the introduction. All the informants believed that it will be best if they have a specific preceptor in the beginning of the introduction, as it can easily become confusing with several preceptors.