The evolution of mandatory continuing professional development (CPD) for diagnostic radiographers in Ireland - A longitudinal study

INTRODUCTION

This longitudinal research study reports on aspects of CPD immediately before and in the years following the simultaneous introduction of state registration and mandatory CPD for diagnostic radiographers in Ireland.

METHODS

Surveys captured information through closed and open questions distributed nationally across various hospital types in hard copy and online formats. Opinion was gathered over 8-years at three time points, prior to the introduction of mandated changes, post-introduction at the end of the first audit cycle, and as society was emerging from a period of pandemic.

RESULTS

Responses were received across age and grade ranges with response rates in keeping with previous surveys. The overall importance with which radiographers held CPD decreased over time, and while small changes were seen, the narrow focus of what radiographers considered CPD had stayed the same, with attendance-based activities remaining the most popular. Respondents indicated that their enthusiasm for undertaking CPD and willingness to undertake CPD outside of working hours had also decreased, with the perceived primary barrier to CPD shifting from funding to time.

CONCLUSIONS

An appetite to undertake CPD amongst the majority is evident; however, addressing issues such as decreasing importance levels and willingness to use personal time for CPD is crucial. While the perceived cost of CPD has lessened as a barrier, lack of time for CPD is now a principal concern. Further research is recommended to explore the broader impacts of time pressures and optimises CPD for radiographers.

IMPLICATIONS FOR PRACTICE

Findings highlight the need for collaborative engagement and support to optimise CPD opportunities for all radiographers in the future.

Recruitment and retention of radiography clinical practice educators

INTRODUCTION

Clinical Practice Educators (CPEs) play a vital role in radiography education, fostering the development of students' clinical competence and creating positive learning experiences. In recent years, there has been a high turnover and difficulties recruiting radiography CPEs in Ireland. This is the first study to explore issues surrounding recruitment and retention of radiography CPEs.

METHOD

A cross-sectional, mixed-method study was conducted to gain a better understanding of the issues surrounding recruitment and retention of radiography CPEs. Current and former CPEs affiliated with undergraduate radiography training in Ireland were recruited. CPEs completed an online questionnaire detailing demographics and career background. Online semi-structured focus groups were conducted with current CPEs and interviews with former CPEs.

RESULTS

Nineteen current CPEs completed the questionnaire and participated in focus groups (95% response rate). Ten CPEs who had resigned within the last five years were interviewed. The main motivators for CPEs were an interest in teaching, inspiration from role models, personal learning goals and the appeal of part-time employment. Job satisfaction was influenced by efficacy in the role, professional growth, autonomy, and relationships with stakeholders. The main disincentives were the CPE grade not being commensurate with work involved, lack of protected time and lack of support from colleagues. A variety of reasons for resignation were provided, many of which related to grading of the CPE post and lack of career progression opportunities in the role.

CONCLUSION

The findings outline the key motivators for radiography CPEs and disincentives relative to recruitment and retention of radiography CPEs in Ireland.

IMPLICATIONS FOR PRACTICE

By understanding the disincentives relative to CPE recruitment and retention, along with the motivators, employers can devise initiatives that reduce turnover and increase CPE retention.

Supporting radiography clinical placements in Ireland during the COVID-19 pandemic: The practice educators perspective

INTRODUCTION

The COVID-19 pandemic has significantly impacted healthcare services and the clinical learning environment. Several studies have investigated radiography students' experiences of clinical placement during the pandemic; however, few have investigated the Clinical Practice Educator's (CPEs) perspective. CPEs play a pivotal role in supporting clinical education.

METHOD

A qualitative study was conducted using a purposeful sample of twenty-two CPEs, each working in a different Irish hospital. Four semi-structured focus groups were used to gather data. To maintain reasonable homogeneity, CPEs who were new to the role (n = 8) were assigned a separate focus group from experienced CPEs (n = 14). Inductive thematic analysis was applied.

RESULTS

CPEs experienced role expansion, particularly in managerial and administrative aspects of the role. They described arranging COVID-19 vaccinations locally for radiography students and the complexities of student rostering during the pandemic. CPEs perceived the pandemic to have impacted students' emotional wellbeing with 'high anxiety levels' and 'loneliness' being reported. They also perceived issues with clinical readiness and the student transition to clinical practice. Many challenges were faced by CPEs including arranging clinical recovery time for numerous students when sites were already at full capacity, fewer learning opportunities due to decreased patient throughput and range of imaging examinations, social distancing constraints, resistance from staff to student placements, and a shortage of staff for student supervision. Flexibility, communication, and multi-level support helped CPEs to fulfil their role.

CONCLUSION

The results provide insight into how CPEs supported radiography clinical placements during the pandemic and into the challenges faced by CPEs in their role. CPEs supported student placement through multi-level communication, teamwork, flexibility, and student advocacy.

IMPLICATIONS FOR PRACTICE

This will aid understanding of the support mechanisms needed by CPEs to provide quality clinical placements.

Optimal exposure parameters for digital radiography of the infant skull: A pilot study

AIM

To determine optimal exposure parameters when performing digital skull radiographs in infants with suspected non-accidental injury (NAI).

METHOD

Anteroposterior and lateral post-mortem skull radiographs of six consecutive infants with suspected NAI were made at six exposure levels for each projection. Entrance surface doses ranged from 75-351 microGy. Exposures were made with a Fuji 5000R computed radiography system onto a standard resolution imaging plate. In three patients exposures were repeated using a high-resolution imaging plate. Hard copy images with an edge-enhancement factor of 0.5 were produced. Six observers assessed and scored the radiographs from 1=poor to 5=excellent for visualization of five criteria. The criteria scored included outer table of skull vault, inner table of skull vault, suture margins, vascular markings and soft tissues of the scalp. Radiographs were then ranked in order of overall image quality. Film density and sensitivity values were recorded. Local research committee approval was obtained.

RESULTS

Current parameters give an average entrance surface dose of 253 microGy and 246 microGy for anteroposterior and lateral radiographs, respectively. The study demonstrated no perceived improvement in image quality above an entrance surface dose of 200 microGy (80% of current dose) or by the use of a high-resolution imaging plate.

CONCLUSION

The potential exists to reduce radiation exposure in infants. A study has commenced to determine the effects of dose reduction on diagnostic accuracy in suspected NAI.

Spodoptera frugiperda pheromone lures to avoid nontarget captures of Leucania phragmatidicola

We confirmed that commercial three- or four-component Spodoptera frugiperda (J.E. Smith) pheromone lures had a high nontarget capture rate for Leucania phragmatidicola Guenée, which compromised monitoring efforts in the northeastern United States. We compiled taxonomic features to distinguish L. phragmatidicola from S. frugiperda, and we compared five new lures. S. frugiperda catch specificity was improved by removing (Z)-11-hexadecen-1-ol acetate (Z11-16:Ac), which attracted L. phragmatidicola. Four lures tracked late-season S. frugiperda immigration, but two of these lures also tracked a bivoltine L. phragmatidicola flight with a second generation coincident with S. frugiperda immigration, and one lure attracted the first, but not the second, generation of L. phragmatidicola. In both low- and high-moth flight conditions, two-component lures had low L. phragmatidicola captures (0.5-1.4%), and although lures with more pheromonal components captured more S. frugiperda, they also had a high percentage of capture of L. phragmatidicola (38-48%). We conclude that although two-component lures captured fewer S. frugiperda, their similar temporal pattern, along with the lower level of L. phragmatidicola, makes them useful for development for monitoring programs in the northeastern United States.

Use of epicardial electrocardiograms for detecting cardiac allograft rejection

Since the advent of cyclosporin A surface electrocardiograms have been unreliable for diagnosing cardiac allograft rejection. Although several noninvasive methods have been proposed, none have been sufficiently accurate to be considered for clinical use. We have studied the use of the QRS complex amplitude, the unipolar peak-to-peak amplitude, recorded from intramyocardial electrodes for detecting rejection. Ten adult mongrel dogs underwent placement of intramyocardial electrodes on each ventricle. After stabilization of signals the hearts were transplanted heterotopically into unmatched recipients receiving cyclosporin A, azathioprine and methylprednisolone. Endomyocardial biopsies were performed after stabilization of unipolar peak-to-peak amplitude, twice weekly thereafter, and when unipolar peak-to-peak amplitude fell significantly. This detected 13 of 14 episodes of rejection. There was one false-positive and one false-negative result. The false-negative study became positive the following day. Thus, analysis of unipolar peak-to-peak amplitude detected all episodes of rejection in a clinically relevant time frame and was able to detect mild forms of rejection and multiple episodes of rejection in the same heart even in the presence of therapeutic levels of cyclosporin A.