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Remote X-Ray Operator Radiography: A Case Study In Interprofessional Rural Clinical PracticeSmith, Anthony Neil January 2006 (has links)
In some rural and remote locations in New South Wales and elsewhere in Australia, a limited range of radiographic examinations may be performed by nurses and general practitioners if there is no radiographer available. These so called remote x-ray operators are licensed under the New South Wales Radiation Control Act 1990. This study aimed to investigate the experiences and perceptions of remote x-ray operator radiography and examine the role of remote operators in New South Wales from the perspective of a cohort of rural radiographers and nurse and GP remote x-ray operators involved in frontline delivery of rural radiographic services. Methodology Semi-structured in-depth interviews were performed with twenty rural radiographers, ten rural nurses and seven rural general practitioners from various rural communities in New South Wales. Interview questions explored the informants’ knowledge, opinions and values, experience and behaviour, and attitudes and feelings in relation to remote x-ray operator radiography. Interviews were tape-recorded and transcribed. Data analysis was subsequently performed using an iterative process based on a modified grounded theory methodology. Data labelling and comparative analysis were carried out in parallel with data collection, allowing progressive modification of the interview theme list to ensure that theoretical saturation was achieved. Results Data analysis led to the emergence of three key concepts, together with their relevant themes and sub-themes. The primary key concept, ‘Dimensions of Practice’, was inclusive of the central precepts of remote x-ray operator radiography. It includes themes titled ‘Licence Conditions and Limitations’, ‘Competency Requirements’ and ‘Image Quality and Practice Standards’. The key concept of ‘Service Provision and Equity of Access’, represents the realities of clinical practice in the rural and remote health care setting. It includes themes of ‘Clinical Management and Decision Making’, ‘Access and Availability’, ‘Patient Expectations’ and ‘Commitment to Service’. The third key concept is ‘Professional Roles and Relationships’, which deals with the interactions that take place between individual practitioners and the factors that influence them. It encompasses the xii themes of ‘Boundary Delineation’, ‘Professional Status and Esteem’ and ‘Interprofessional Conflict and Collaboration’. Relationships between the key concepts, via their themes and sub-themes were also explored. Conclusions Analysis of the data led to the development of a conceptual model and a single story line that represent the perspectives of the study informants. Remote x-ray operator radiography takes place at the intersection of the occupational worlds of rural radiographers, nurses and general practitioners. Remote operators provide a valuable service that prevents rural residents having to travel to access minor radiographic examinations. However, the quality of the radiography they perform is below the standard expected of radiographers. Improvements in collaborative teamwork could improve the quality of service, although interprofessional communication is stifled by status and hierarchical relationships. The remote x-ray operator experience may inform the development of future models of health care. / PhD Doctorate
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