Diagnostic radiographers working in the operating theatre: An action research project

Enriching surgical theatre competence through computer-based simulation

INTRODUCTION

Radiographers support the multidisciplinary team by facilitating medical imaging within the operating theatre environment. This project aimed to enhance student readiness for clinical competency in operative theatre imaging by implementing an authentic C-arm simulator for students to use prior to attending clinical placement.

METHODS

This study followed a pre-post, quantitative study design. Medspace.VR© CA is a computer simulation software which allows users to produce radiographic images using a virtual 'C-arm' imaging scanner, within a 3D operating theatre environment. Educational workshops were followed by Likert-scale surveys to ascertain perspectives relating to student satisfaction, engagement, knowledge and skill enhancement, and reflections on behavioral changes following engagement with the simulator.

RESULTS

The post-simulator survey demonstrated favourable scores were favourable in terms of student enjoyment (94 % agreed or strongly agreed), skill development (94 %), anatomical knowledge (63 %), operation of the machine (94 %) and its relevance to the radiographer's role (100 %) and professional capabilities (87 %). Most students found the program's instructions to be straightforward (81 %). Questions relating to confidence also demonstrated favourable results, with students highlighting perceived greater confidence in their abilities (87 %) and the theatre environment (61 %). When asked whether the C-Arm simulator is just as effective as hands-on placement experiences, 50 % of participants disagreed or strongly disagreed with this statement.

CONCLUSION

The C-arm simulator enabled our students to engage in authentic, scenario-based cases within simulated settings, mirroring conditions encountered in clinical practice. Overall, the findings highlight positive levels of perceived development and satisfaction. Future studies should evaluate objective knowledge and skill development within the clinical setting.

IMPLICATIONS FOR PRACTICE

Simulator use in this context prior to clinical placements, has the potential to reduce anxiety, increase satisfaction and expedite skill acquisition.

Interprofessional education and collaborative practice with practicing radiographers: A mixed methods scoping review

INTRODUCTION

There is increasing evidence substantiating the advantages of Interprofessional Education and Collaborative Practice (IPECP) in healthcare. Despite this, global adoption is still in its infancy. Whilst there has been some recognition of the importance of collaborative practice in healthcare, implementation of IPECP programs remain limited in many countries.

METHODS

This scoping review aimed to synthesise global evidence for the implementation and effectiveness of IPECP on practicing radiographers and to further identify the enablers and barriers to the implementation of IPECP within radiography. The JBI guidelines for the conduct of scoping reviews and the PRISMA guidelines for reporting scoping reviews were followed. Databases searched included Medline, CINAHL, Scopus, Embase, Cochrane library, and JBI. Grey literature was searched through Google, Google Scholar, and the ProQuest Dissertations and Theses Global.

RESULTS

Following full text screening, 21 articles were included in the review, and data was extracted onto a custom-developed template. IPECP competencies identified in the included studies were mapped against the Canadian Interprofessional Health Collaborative (CIHC) framework of competencies.

CONCLUSION

Results indicate that while certain factors such as peer support and interprofessional communication facilitated IPECP, numerous barriers impeded its implementation on a wider scale.

IMPLICATIONS FOR PRACTICE

Implications for practice, policy and research include the need to prioritise funding for IPECP initiatives and to establish regulatory frameworks that support interprofessional collaboration.

'Gear up and get ready': Collaborative curriculum for radiographers supporting percutaneous nephrolithotomy in the operating theatre

INTRODUCTION

Newly qualified radiographers often find working in the operating theatre (OT) challenging and intimidating. These perceptions, which inhibit confidence, may hinder their effectiveness in interprofessional teamwork, which may in turn adversely affect patient outcomes. A collaborative education programme was designed, building upon the foundations of competency-based education (CBE) and simulation-based mastery learning (SBML) to examine its potential in mitigating these perceptions. The objective of this research was to assess participants' experience and level of competency after attending the curated collaborative educational programme.

METHODS

The programme was developed based on the Analysis, Design, Development, Implementation, and Evaluation (ADDIE) model and comprises two teaching and learning phases: educational session and simulation. A collaborative approach was undertaken to develop an assessment checklist for the interprofessional simulation. Requirements for the simulation, such as scenario design, information and storyboard, task trainer, logistics, and learners' briefing, debrief, and feedback, were identified and assembled. The radiographers' performance was recorded using a practical skills assessment checklist and a theory assessment.

RESULTS

Twelve radiographers participated and showed improvement in their self-rating of learning objectives before and after the programme. The median (interquartile range) score achieved in the theory assessment, out of a possible of 11, was 9.00 (7.75-9.50). The median (interquartile range) score achieved in the simulation component, out of a possible of 16, was 15.00 (14.00-15.00). There was statistically significant difference in self-perceived performance in all learning objective domains.

CONCLUSION

The findings from the programme were promising. The use of simulation and an assessment checklist proved to be useful learning tools in preparing newly qualified radiographers for work in the OT.

IMPLICATIONS FOR PRACTICE

Assessment checklists are valuable tools that should be considered to facilitate teaching and learning. The use of interprofessional simulation activities can support radiographers in developing knowledge, professional skills, and clinical competency. It should be conducted in a timely manner to facilitate the introduction to role understanding and effective communication.

Simulation-based education for medical radiation students: A scoping review

Simulation-based education is a significant aspect of teaching clinical skills in tertiary medical radiation science programmes, allowing students to experience the clinical setting in a safe environment. As an educational tool, simulation exists in many valid forms including role play, interprofessional simulation and virtual reality simulation. This scoping review looks at the current literature in this field to identify the evidence surrounding simulation-based education for medical radiation students. The purpose of this review is to provide an evidence-based guide for educators, identify gaps in the literature and suggest areas of future research. Data extraction was performed on 33 articles where the interventions could be categorised into either role play simulation, virtual simulation, simulation videos or online learning environments. Most studies demonstrated that simulation could improve clinical competence and increase preparedness and confidence for clinical placement. Student satisfaction remained high throughout the studies; however, it is the view of many that although simulation-based education is a valid and effective tool, it is complementary to and not a replacement for clinical placement.

Diagnostic radiography students' perceptions of working in the clinical environment: A focus on emotional challenges

INTRODUCTION

Diagnostic radiography (DR) students experience situations that affect their emotional wellbeing during clinical placements. This study aimed to investigate factors that contribute to students' reduced wellbeing on clinical placements, and to identify responses to situations that are considered challenging.

METHODS

An online survey was employed to collect data from five cohorts in the undergraduate (UG) and graduate entry masters (GEM) DR programs (n = 461 enrolled students). Questions related to experiences with health professionals, clinical work area or patient presentations that were considered to reduce wellbeing. Data on personal reactions to challenging situations, and strategies that could better prepare students for coping were also collected. Quantitative and qualitative data were analysed using descriptive statistics and thematic analysis respectively.

RESULTS

155 completed surveys were returned (33.6% response rate). Regarding health professionals, 21.4% of participants (33/154) indicated either 'agree' or 'strongly agree' that a prior interaction with a radiographer had contributed to reduced wellbeing. The highest agreement for work area was emergency department (23/66, 34.8%). For patient presentations, 78.1% (n = 121/155) of responses related to 'patients in suffering', with differences between UG and GEM students (p = 0.027). The majority of responses to challenging situations was 'focused on the task of imaging' (n = 103/155, 66.5%), and 58.7% (n = 91/155) of participants indicated that listening to other students' personal experiences would assist them in the future. Four main themes emerged from the qualitative data: 'student role and expectations', 'emotional impact of a patient's presentation', 'interaction with radiographers' and 'personal experience'.

CONCLUSION

Emotional challenges exist in the clinical environment. Experiences affecting wellbeing in the clinical setting are diverse among DR students, and students may lack preparedness to deal with them.

IMPLICATIONS FOR PRACTICE

Support strategies and educational interventions are recommended in order to support students' wellbeing.

Stress, a reflective self and an internal locus of control: On the everyday clinical placement experiences of older undergraduate radiographers in the UK

INTRODUCTION

Extant evidence indicates that the stresses experienced by younger undergraduate radiographers and their older counterparts vary considerably. Much of this difference has, however, emerged from analyses of the academic component of a radiography degree whereas little work has focused to date upon the specific business of clinical placement. Given this, the research herein reports findings from a qualitative study of how older undergraduate radiography students in the UK assemble their stress and stressors around clinical placement.

METHODS

An Interpretative Phenomenological Analysis was employed. N = 6 older undergraduate students undergoing their final year placement were purposively recruited from a variety of hospitals. With full institutional ethical approval, a semi-structured interview was conducted with each participant.

RESULTS

Four superordinate themes emerged. These were: (1) Self-identity and perceived competence; (2) Understaffing, instability and affect; (3) Episodic experience and feeling 'thrown-in'; (4) Unpreparedness for the challenging patient. Critically, each theme describes an interaction between stressor, experience of stress and self.

CONCLUSION

While familiar stressors were apparent, the older participating students actively made sense of them in terms of their manageability. This provides a strong contrast with existing literature, which tends to imply a more externalised locus of control among (largely younger) students.

IMPLICATIONS FOR PRACTICE

Stress in the NHS is a continuing issue and there is a clear rationale for further investigation to ascertain the level of clinical support available and to determine whether further improvements could assist students on clinical placement. Collaboration between academic institutions and clinical sites would allow open discussion around clinical stress experienced by radiography students, with locus of control a potential point of focus, fostering a proactive partnership approach to stress-management and identification of difficulties before they exacerbate.

Simulation of Image-Guided Intervention in Medical Imaging Education

INTRODUCTION/BACKGROUND

Medical imaging education programs across Europe, despite their variability, include clinical practice as a guarantee of quality because learning in a clinical context is more effective and allows for constructive qualification of students. Learning in a clinical simulation context is a strategy to promote simulated clinical experience and assure patient safety. In this work, a learning experience, consisting of simulating a pacemaker implantation, implemented over 3 years with students pursuing the Medical Imaging and Radiotherapy degree at the University of Aveiro was evaluated.

METHODS

A pacemaker implantation simulation with fluoroscopic support was performed with students (third year) pursuing the Medical Imaging and Radiotherapy degree at the Simulation Centre of our institution over 3 years (2016, 2017-2018), addressing all the simulation phases. An operating theater, video recording system, high-fidelity full-body manikin with remote control and monitoring, anesthesia, and fluoroscopic C-arm imaging equipment were used for the simulation. After the simulation activity, students completed a questionnaire evaluated the importance of this learning experience for their educational process.

RESULTS

Overall, the mean score results were consistent, even considering the three independent groups (one for each academic year). Students considered this experience valuable for their education, strongly agreeing that the simulation environment helped their learning process and allowed them to acquire, consolidate, and deepen knowledge. Furthermore, they considered that it impressed on them the necessity to continue to improve their learning, and that they would like to participate in other simulation scenarios.

DISCUSSION/CONCLUSION

This simulation activity was a valuable experience for the learning process of the students because it facilitated the acquisition and consolidation of knowledge. It also allowed the students to be aware of the importance of being engaged in their own education. The results were highly consistent over the 3 years, reinforcing the positive feedback from this experience.

Who's who? Championing the '#TheatreCapChallenge'

Our Developing Perioperative Practice service improvement project, sponsored by the Royal Bournemouth Hospital, addressed whether the remarkably simple idea of putting names and roles on hats in theatre would improve communication and patient care. We were inspired by our own experiences as a group of student Operating Department Practitioners: unfamiliarity with members of the team, wanting to feel included in the work but not out of our depth, and by social media campaigns such as the '#TheatreCapChallenge' and '#hellomynameis', aiming to humanise care and increase patient safety. Researching, clinically trialling and presenting this project gave us a systematic approach to improving the quality of care within the theatre environment.

Motivation of student radiographers in learning situations based on role-play simulation: A multicentric approach involving trainers and students

INTRODUCTION

Role-play simulation is implemented in different radiography institutions. This tool develops Knowledge, Skills and Competences (KSC) in students. The aim of this study was to identify the strategies implemented by trainers in order to encourage student motivational dynamics and to find those that resonate with students.

METHODS

Three role-play simulation sessions using a grid were observed in two different radiography institutions that have a simulation centre (two French institutions and one Swiss). In order to identify explicitly or implicitly the motivational strategies used, four interviews with trainers were conducted. To understand students' opinions about these strategies, seven interviews with radiography students were done.

RESULTS

Defining motivation was not easy. The trainers used various strategies to motivate students, not all of which were verbalized in interviews. Although students said they were stressed prior to participating in role-play simulation, this study shows that such simulation sessions are effective to develop high motivational dynamics for students.

CONCLUSION

This study has identified three main areas of improvement: exploring students' expectations, give importance to patients briefing so that they can fully perform their role and improving the authenticity of the environment. The latter issue can only be addressed through access to up-to-date equipment in training institutions.