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Yes / Increasing diagnostic capacity is a national priority to expedite the timeliness and appropriateness of patient treatment interventions. Imaging, encompassing a range of technologies including X-ray, Computer Tomography, Magnetic Resonance Imaging and ultrasound, is a key diagnostic service and central to decision making in most, if not all, disease pathways. However, imaging is an expensive discipline accounting for an estimated 3-5% of the annual NHS budget. As a result, it is imperative that we maximize service efficiency while optimizing patient outcomes.

No / Radiography aspires to be a research active profession, but there is limited information regarding the number of individuals with, or studying for, a doctoral award. This study aims to profile UK doctoral radiographers; including their chosen award, approach and employment status. This was a prospective cohort study utilising an electronic survey. No formal database of doctoral radiographers existed therefore a snowball sampling method was adopted. The study sample was radiographers (diagnostic and therapeutic) based in the UK who were registered with the Health and Care Professions Council (HCPC) and who held, or were studying for, a doctoral award. A total of 90 unique responses were received within the timescale. The respondents comprised 58 females (64.4%) and the majority were diagnostic radiographers (n = 71/90; 78.9%). The traditional PhD was the most common award, although increasing numbers were pursuing Education or Professional Doctorates. An overall increase in doctoral studies is observed over time, but was greatest amongst those working in academic institutions, with 63.3% of respondents (n = 57/90) working solely within a university, and a further 10% employed in a clinical–academic role (n = 9/90). This study has demonstrated that radiography is emerging as a research active profession, with increasing numbers of radiographers engaged in study at a doctoral level. This should provide a platform for the future development of academic and clinical research.

Yes / Within medical imaging variations in patient size can generate challenges, especially when selecting appropriate acquisition parameters. This experiment sought to evaluate the impact of increasing body part thickness on image quality (IQ) and effective dose (E) and identify optimum exposure parameters. Methods: An anthropomorphic pelvis phantom was imaged with additional layers (1e15 cm) of animal fat as a proxy for increasing body thickness. Acquisitions used the automatic exposure control (AEC), 100 cm source to image distance (SID) and a range of tube potentials (70e110 kVp). IQ was evaluated physically and perceptually. E was estimated using PCXMC software. Results: For all tube potentials, signal to noise ratio (SNR) and contrast to noise ratio (CNR) deceased as body part thickness increased. 70 kVp produced the highest SNR (46.6e22.6); CNR (42.8e17.6). Visual grading showed that the highest IQ scores were achieved using 70 and 75 kVp. As thickness increases, E increased exponentially (r ¼ 0.96; p < 0.001). Correlations were found between visual and physical IQ (SNR r ¼ 0.97, p < 0.001; CNR r ¼ 0.98, p < 0.001). Conclusion: To achieve an optimal IQ across the range of thicknesses, lower kVp settings were most effective. This is at variance with professional practice as there is a tendency for radiographers to increase kVp as thickness increases. Dose reductions were experienced at higher kVp settings and are a valid method for optimisation when imaging larger patients. / Hashemite University in Jordan, College of Radiographers Industry Partnership (CoRIPS)

Yes / Pelvic radiographs remain an essential investigation in orthopaedic practice. Although it is recognised that acquisition techniques can affect image appearances and measurement accuracy, it remains unclear what variation in practice exists and what impact this could have on decision making. Method: This was a cross sectional survey of UK radiology departments utilising an electronic tool. An introductory letter and link was distributed. Responses were received from 69 unique hospital sites within the specified timeframe, a response rate of 37.9%. Results: There was no consistent technique for the positioning of patients for pelvic radiographs. The distance varied between 90 and 115 cm and 10 different centering points were described. In relation to leg position, the feet are usually internally rotated (65 of 69 [94.2%]). Only 1 teaching hospital (1 of 69 [1.4%]) uses a weight-bearing position as standard. Orthopaedic calibration devices were not in routine use, with only 21 using on pelvic x-rays (30.4%). Further, the type of device and application criteria were inconsistent. Conclusions: To our knowledge this is the first study to directly compare radiographic positioning across hospital sites. Our data demonstrated marked variation in technique for pelvis radiographs with associated implications for clinical decision making. Research is required to determine the standard technique and quality outcome measures to provide confidence in diagnostic interpretation particularly for serial radiographs. / College of Radiographers Industry Partnership Scheme (CoRIPS).

No / The immobilisation and restraint of children to facilitate radiographic examination is a controversial issue that has been relatively ignored by radiography research. The aim of this study was to begin to fill this gap by providing a description of restraint used in a limited number of clinical sites in order to highlight any perceived need for training, policies or guidelines in the use of child immobilisation and restraint. Methods: A cross-sectional survey design using a postal questionnaire was adopted. One hundred and sixty-seven questionnaires were distributed to radiographers employed within six hospital Trusts. Results: A response rate of 83.2% (n=139/167) was achieved. Ninety-three percent (93.5%, n=130/139) of respondents indicated that restraining techniques were used although only 19.2% (n=25/130) had received specific training in safe restraining techniques and 7.9% (n=11/139) in distraction techniques as an alternative to restraint. A need for further guidance and support for clinical staff was evident with 73.3% (n=74/101) of respondents identifying a need for specific guidelines and 84.6% (n=110/130) indicating that further training opportunities were required. Conclusions: The use of restraint in paediatric plain film radiography is an apparently widespread practice and support for clinical radiographers through the development of training opportunities and practice guidelines are seen as essential in order to promote high quality paediatric radiography practices.

Yes / The choice of career and speciality can be a complex process. It is unclear what influences career decisions within undergraduate radiographers and whether the curriculum provides sufficient support. Methods: An online cross-sectional survey was undertaken. All undergraduate diagnostic radiography students within one UK higher education institution were invited to participate. Questions were related to anticipated career choice, motivational factors and influences. Results: The response rate was 67.6% (90/133). The most popular specialist area for career preference was general radiography. The top three motivational factors were work life balance, career development and job satisfaction. The most influential factors on career choice were clinical placements, radiographers on placements and formal teaching. Career guidance was predominantly sourced from the personal academic tutor and was informed by role models. Conclusion: Radiography academic teams and clinical placement providers must work together to ensure that students have access to high quality placements across specialities. The experiences received during undergraduate training are important in specialty choice. Implications for practice: Career guidance is essential and should begin as early as possible. Clinical and academic radiographers need to appreciate the influence they have on students future career plans. / The form of the authors names on the accepted manuscript are: Hackett, Kayleigh and Snaith, Beverly.

Yes / Twitter journal clubs are a relatively new adaptation of an established continuing professional development (CPD) activity within healthcare. The medical radiation science (MRS) journal club 'MedRadJClub' (MRJC) was founded in March 2015 by a group of academics, researchers and clinicians as an international forum for the discussion of peer-reviewed papers. To investigate the reach and impact of MRJC, a five-year analysis was conducted. Tweetchat data (number of participants, tweets and impressions) for the first five years of MRJC were extracted and chat topics organised into themes. Fifth anniversary MRJC chat tweets were analysed and examples of academic and professional outputs were collated. A total of 59 chats have been held over five years with a mean of 41 participants and 483,000 impressions per hour-long synchronous chat. Ten different tweetchat themes were identified, with student engagement/preceptorship the most popular. Eight posters or oral presentations at conferences, one social media workshop and four papers have been produced. Qualitative analysis revealed five core themes relating to the perceived benefits of participation in MRJC: (1) CPD and research impact, (2) professional growth and influencing practice, (3) interdisciplinary learning and inclusion, (4) networking and social support and (5) globalisation. MRJC is a unique, multi-professional, global community with consistent engagement. It is beneficial for both CPD, research engagement, dissemination and socialisation within the MRS community.

Yes / Objectives: Unlike the technological advances in cross-sectional imaging, the adoption of CR and DR has been relatively overlooked in terms of the additional radiographer skills and competences required for optimal practice. Furthermore, projection radiography is often referred to as basic, plain or other words suggesting simplicity or entry-level skill requirements. Radiographers’ professional identity is connected with the discourse expressed via the language used in daily practice and consequently, if the perception of projection radiography is regarded as simple practice not requiring much reflection or complex decision-making, apathy and carelessness may arise. The purpose of this narrative review was to raise projection radiography from its longstanding lowly place and re-position it as a specialist imaging field. Key findings: Danish pre-registration radiography curricula contain little mention of projection radiography and a low proportion (n ¼ 17/144; 11.8%) of Danish radiography students chose to focus on projection radiography within publicly available BSc. theses between 2016 and 2020 as compared to topics related to CT and MRI (n ¼ 60/144; 41.7%). Conclusion: By changing how we as the profession perceive the role and position of projection radiography, we can start to rebuild its lost prestige and demand a greater, more detailed and clinically relevant educational offering from academic partners. For this to commence, the language and terminology we use to describe ourselves and tasks undertaken must reflect the complexity of the profession. Implications for practice: Regardless of imaging modality, every patient should be assured that a radiographer with expertise in acquiring images of diagnostic quality undertakes their examination. Reclaiming the prestige of projection radiography may lead students and radiographers to recognize projection radiography as a demanding specialist field for the benefit of the patients.

Submitted in partial compliance with the requirements for the Master’s Degree in Technology: Chiropractic, Department of Chiropractic, Durban University of Technology, Durban, South Africa, 2016. / Background Literature has shown that clinical and radiological diagnoses do not always correlate in patients with neck pain (Ferrari and Russel, 2003; Peterson and Hsu, 2004). It is not known if this applies to the Chiropractic Day Clinic (CDC) at the Durban University of Technology (DUT) and if the radiological diagnosis leads to a change in the patient’s initial management plan. The impact of cervical spine plain film radiographs will therefore be investigated in the diagnosis and management of patients that presented with neck pain to the CDC at the DUT. It is also not known whether the reason for referral for cervical spine plain film radiographs is always indicated as per the indications in the clinic handbook and radiological referral guidelines. Objectives Objectives were: (1) To determine the suspected pre-radiographic clinical diagnosis and management of the selected clinical records prior to referral for cervical spine plain film radiography; (2) To record the reasoning to send for cervical spine plain film radiographic imaging and to establish whether these are in line with proposed guidelines for referral as found in the literature; (3) To determine the relationship between the suspected pre-radiographic clinical and the radiological diagnoses of patients with neck pain; (4) To determine the number of incidental findings in the selected patients’ plain film radiographs; (5) To determine any change in the pre-radiographic clinical diagnoses and management following radiological reporting of the selected patient’s plain film radiographs. Method This was a quantitative, retrospective, clinical study. The archives at the CDC at the DUT were searched for cervical spine plain film radiographs between 1 January 1997 to 31 December 2013 and these were matched with the corresponding clinical records. After applying the inclusion and exclusion criteria, 73 records were included in the study. The patient’s personal information was coded to ensure confidentiality (Appendix A) and specific clinical and radiological information was recorded (Appendix B). Statistical analysis included the use of frequency counts, percentages, mean, standard deviation and range for the descriptive objectives. Results A total of 73 clinical files and corresponding plain film radiographs were assessed. The mean age of the patients was 44 years. The gender distribution was 64.4% (n=47) females and 35.6% (n=26) males. The most frequent primary radiological diagnosis was loss of lordosis at 41.1% (n=30) followed by cervical spondylosis at 35.6% (n=26) and old cervical spinal trauma at 12.3% (n=9). Sixty four percent (n=47) of patients in this study were sent for cervical spine plain film radiographs after their initial clinical consultation. Reasons that are not considered relevant indications for plain film radiographic referral were present in 46.2% (n=34) of cases; these described non-specific mechanical disorders. The most common reason for plain film radiographic referral was due to positive orthopaedic tests 57.5% (n=42). A total of 27.4% (n=20) of clinical files reviewed had a change in their initial clinical diagnosis and 72.6% (n=53) of these patients had no change in diagnosis. All of the post-radiographic clinical diagnoses were non-specific mechanical conditions. Numerous treatment modalities were utilized by the students with the most common pre-radiographic treatment being soft tissue therapy at 63.0% (n=46). A total of 75% (n=55) of patients had a change of treatment after plain film radiographs were performed and spinal manipulative therapy (SMT) was the main treatment added in 41% of cases. Conclusion Cervical spine plain film radiographs have little impact on the diagnosis of patients with non-specific mechanical neck pain without red flags. It was however found that plain film radiographs had an impact on the management in the majority of cases, especially with an increase in SMT use after plain film radiographs. / M