Published Article / The current master's degree qualification in Diagnostic Radiography at the Central University of Technology, Free State (CUT) is research based and does seemingly not address the need for training in the specialisation fields of Diagnostic Radiography sufficiently. To address this problem, a needs assessment was conducted amongst qualified diagnostic radiographers in Bloemfontein and Kimberley by means of quantitative questionnaires, qualitative interviews and a focus group discussion. The main aim of the needs assessment was to determine the need for a postgraduate qualification for radiographers in the specialised fields. The possible structure of such a program and the preferred mode of delivery were also investigated. The results of the study emphasised the need for a structured postgraduate learning programme in the specialisation fields in Diagnostic Radiography in the region. Responding to this validated need for a structured postgraduate qualification at the CUT, the current master's degree was revised to accommodate the results of the study and it was proposed to the Professional Board for Radiography and Clinical Technology for approval.

No / This case study describes a qualitative investigation of the experiences of 14 experienced mammography radiographers who successfully undertook a formal programme of education and training in stereotactic needle core biopsy (SNCB) of the breast. They now routinely perform SNCB within symptomatic and screening breast services in a variety of NHS hospitals across the country. All 14 radiographers completed a semi-structured postal questionnaire approximately six months after the end of the course. A tentative theory derived from the data suggests that the professional challenge associated with radiographer-performed SNCB builds personal confidence and effects positive change. Three main categories emerging from the data e challenge, confidence and change are underpinned by two main themes e educational, professional and service drivers that promote the realisation of goals and vision; and personal, peer and external motivation sustained by respect, recognition and reward. SNCB role extension as explored in this study is having a positive and transformational impact on patient users of breast diagnostic clinical services and on the professional health carers providing them. The key drivers for this as identified in the study are a formal educational experience, professional role extension opportunities and the NHS modernisation process. The participants experienced positive change as individuals and as professional breast cancer multidisciplinary team members. Academic and financial rewards, respect and recognition from colleagues across professional disciplines and from patients, were key motivators that sustained the process. This study indicates that radiographer-performed SNCB can help deliver the NHS Plan and the NHS Cancer Plan and in doing so has the potential to improve the working lives of health care professionals and ultimately to improve the quality of care for patients.

No / Radiographer abnormality detection schemes (RADS) were first introduced in the United Kingdom (UK) in the mid 1980s with the development of the ‘red dot scheme’. This article establishes the current position of UK RADS practice and provides insight into specific areas for development. Method: A postal questionnaire was distributed to 456 sites, including 270 emergency departments and 186 minor injuries units (MIU). Information was sought relating to: the type of emergency department and radiography service provided; details of RADS operated including any education and audit to support radiographer participation; and the mandatory/voluntary nature of the system adopted. Results: A total of 306 (n = 306/456; 74%) responses were received. The large majority of respondents (n = 284/306; 92.8%) indicated that a RADS was in operation. Of these, 221 sites operated a red dot scheme, 7 sites operated a radiographer comment system, and a further 54 sites operated both a red dot and comment scheme. Two sites indicated that a RADS other than red dot or radiographer commenting was operated. Twenty-one different methods of highlighting abnormal images were identified and eight different commenting methods. The RADS was considered mandatory at 25% of sites. Conclusion: This study confirms the continued widespread contribution of radiographers to the trauma diagnostic process through the use of RADS. The informal nature of the systems, inconsistent approaches to audit and education, and variations in the methods employed are issues which require national guidance.

No / The terms ‘extended’ and ‘advanced’ practice are commonly used to describe clinical practitioner roles. However, these terms have not been clearly defined within the context of modern radiography practice despite their fundamental importance to establishing the 4 tier structure, implementing Agenda for Change and promoting a coherent clinical radiography career structure. This paper discusses the terms ‘extension’ and ‘advancement’ in relation to radiography practice and, using evidence from the debates of other health professions, attempts to offer some clarity to the terminology, presenting one interpretation of its possible application to the radiographer role in the United Kingdom.

Titel: Röntgensjuksköterskans upplevelse av att arbeta med externa granskare under jourtid Syfte: Att undersöka hur röntgensjuksköterskan upplever arbetet med externa granskare under jourtid. Material och metod: Sex stycken röntgensjuksköterskor från två olika sjukhus i mellansverige intervjuades under perioden januari till mars 2017. Inklusionskriterierna för studien var minst två års erfarenhet av yrket samt minst ett års erfarenhet av att arbeta med externa granskare under jourtid. Tillstånd från verksamhetschefer och samtycke från informanterna erhölls innan studien startade. Data samlades in genom en kvalitativ metod med semistrukturerade intervjuer bestående av öppna frågor. Den insamlade datan analyserades med kvalitativ innehållsanalys enligt Graneheim & Lundman. Intervjuerna transkriberades och lästes igenom flera gånger. Därefter identifierades meningsbärande enheter och dessa kondenserades till koder. Genom koderna kunde kategorier och subkategorier identifieras. Resultat: I resultatet framkom fyra kategorier; Teleradiologi – tekniska aspekter, externa granskare jämfört med radiolog på plats, kommunikation och röntgensjuksköterskans kompetenser och egenskaper med tillhörande subkategorier. Konklusion: Informanterna upplever att det tar längre tid att kommunicera med externa granskare (EG) i jämförelse med att ha en radiolog på plats som kan ge svar direkt när röntgensjuksköterskan (RSS) är i behov av vägledning och snabba svar. I kommunikationen upplevs det också finnas språkbarriärer samt bristande kunskap, speciellt hos de sekreterare som tar emot samtal hos EG. Detta leder till frustration och blir ofta ett hinder i akuta situationer då RSS vill prata med en radiolog direkt. Under jourtid upplever RSS att denne får ta ett ökat ansvar samtidigt som förmågan att ta egna initiativ och beslut måste finnas. RSS upplever ingen förändring av bildkvalitén på de bilder som skickas i arbetet med EG. Informanterna upplevde i helhet att arbetet med EG fungerar bra och tillfredsställande under förutsättningarna att tekniken fungerar som den ska samtidigt som arbetsflödet inte ökar för mycket.

Titel: Röntgensjuksköterskans upplevelse av att arbeta med externa granskare under jourtid Syfte: Att undersöka hur röntgensjuksköterskan upplever arbetet med externa granskare under jourtid. Material och metod: Sex stycken röntgensjuksköterskor från två olika sjukhus i mellansverige intervjuades under perioden januari till mars 2017. Inklusionskriterierna för studien var minst två års erfarenhet av yrket samt minst ett års erfarenhet av att arbeta med externa granskare under jourtid. Tillstånd från verksamhetschefer och samtycke från informanterna erhölls innan studien startade. Data samlades in genom en kvalitativ metod med semistrukturerade intervjuer bestående av öppna frågor. Den insamlade datan analyserades med kvalitativ innehållsanalys enligt Graneheim & Lundman. Intervjuerna transkriberades och lästes igenom flera gånger. Därefter identifierades meningsbärande enheter och dessa kondenserades till koder. Genom koderna kunde kategorier och subkategorier identifieras. Resultat: I resultatet framkom fyra kategorier; Teleradiologi – tekniska aspekter, externa granskare jämfört med radiolog på plats, kommunikation och röntgensjuksköterskans kompetenser och egenskaper med tillhörande subkategorier. Konklusion: Informanterna upplever att det tar längre tid att kommunicera med externa granskare (EG) i jämförelse med att ha en radiolog på plats som kan ge svar direkt när röntgensjuksköterskan (RSS) är i behov av vägledning och snabba svar. I kommunikationen upplevs det också finnas språkbarriärer samt bristande kunskap, speciellt hos de sekreterare som tar emot samtal hos EG. Detta leder till frustration och blir ofta ett hinder i akuta situationer då RSS vill prata med en radiolog direkt. Under jourtid upplever RSS att denne får ta ett ökat ansvar samtidigt som förmågan att ta egna initiativ och beslut måste finnas. RSS upplever ingen förändring av bildkvalitén på de bilder som skickas i arbetet med EG. Informanterna upplevde i helhet att arbetet med EG fungerar bra och tillfredsställande under förutsättningarna att tekniken fungerar som den ska samtidigt som arbetsflödet inte ökar för mycket.

Submitted in fulfillment of the requirements for the Degree of Master of Health Sciences in Radiography, Durban University of Technology, 2017. / Background The current scope of practice for diagnostic radiographers, does not allow them to administer intravenous contrast media (IVCM) since there are no formal training guidelines accredited by the Health Professions Council of South Africa (HPCSA) (Koch 2014: 26). In selected countries abroad, radiographers are allowed to administer IVCM and have thus received the necessary and accredited training to do so. In view of this, the South African radiographer’s scope of practice is not on par with the selected countries. The radiologists in South Africa (SA) who are currently responsible for the administration of IVCM have issued a position statement which supports, in principle, the idea of radiographers administering IVCM should they receive the necessary and appropriate training to do so (RSSA 2011: 1-2). The aim of this research study was, therefore, to investigate the radiologists’ perspectives regarding the theoretical knowledge, clinical competencies and medico legal responsibilities required by radiographers in order to effectively administer IVCM. This research study provides input for the development of national training guidelines for radiographers to administer IVCM. Research Methodology A quantitative, descriptive study was conducted by targeting qualified radiologists residing and practicing within the province of KwaZulu Natal (KZN). Ethical approval was obtained from the Durban University of Technology’s (DUT) Institutional Research and Ethics Committee (IREC). All the participants were contacted in their personal capacity. The research tool was an online survey administered through SurveyMonkey which included questions and statements relating to the administration of IVCM and was structured so as to meet the study objectives. The research tool was evaluated and amended by an expert focus group to ensure reliability and validity. Confidentiality was maintained and all the data obtained during this research study was password protected. Results and discussion Fifty-nine radiologists (60.8 percent) participated in this study. Twelve respondents, however, were excluded due to incomplete surveys. The final response rate, therefore, was 48.5 percent (n=47) of which 72.3 percent of the respondents were from the private sector. Results illustrated the radiologists’ agreement regarding the theoretical, clinical/practical and medico legal training components for inclusion in the further training of radiographers to administer IVCM. Most respondents supported the inclusion of three assessments: theoretical (87.2 percent), clinical (93.6 percent) and a record of clinical competencies (95.7 percent). The assessments were considered equally important in terms of percentage weighting. The overall results compared favorably to the current international trends and practice standards of radiographers administering IVCM. Conclusion and Recommendations The study, in providing key data for the development of training guidelines for radiographers to administer IVCM, has demonstrated the importance of higher education (HE) and training in addressing transformation in health services with particular reference to professional scopes of practice. Furthermore, it reinforces the need for local research that will inform HE and training and hence a scope of practice that meets local needs. It was recommended that future studies should include those HE institutions offering training in Radiography as well as their stakeholders for the design and transformation of a national curriculum for radiographers to administer IVCM. / M