The future of radiography: a student discussion

The future of radiography is a highly discussed topic within healthcare. Our profession continues to advance in its practices and scope, adapting and enhancing our diagnostic and therapeutic services in a quest to improve patient outcomes¹.

In 2020, however, our entire healthcare system fell victim to the Covid-19 pandemic. Departments were faced with unprecedented demand, and radiography practices were adapted and evolved to ensure minimal disruption to those in need of care².

This global event left us with many lessons as a profession, but also many experiences. There remains an increasing need for diagnostic services and the staff to run these, but also a desire to streamline our pathways and work efficiently to sustain our workforce. With any growth comes additional pressure, and radiography is growing rapidly³.

Here, we discuss the future of our profession from the perspectives of three pre-registration diagnostic radiography students. Angela Ashcroft is a second-year student at Salford University; Nate Harley is a second-year student at University of Derby; and Kourosh Sadaat is a second-year student at Ulster University.

The group decided to focus on three key topics of discussion: radiography education, radiography practice, and the role of the radiographer. Within these topics, several sub-topics were identified as prominent areas in the future of radiography. These included advancing technologies, expanding roles and opportunities, retention of staff and hybrid learning pathways.

Artificial intelligence (AI)

Nate: From research I have read, I know that AI is now being used to assist with diagnoses. This could make service provision more efficient – we’ve got to do something about NHS waiting lists.

Kourosh: And these technologies could cut down on human error.

Nichola: Do you feel that this might affect the role of the radiographer?

Nate: My hope is that this will give radiographers more time to have a conversation with the patient. I have had the privilege of working in a private department. The difference between being able to have a rich conversation with a patient and having to get them out the door to keep the service running is a complete game-changer.

Angela: Being able to reduce the burden for radiographers and allow them the space to deliver compassionate care will be invaluable.

Imaging modalities

Kourosh: As a student, we are taught in several imaging modalities and we rotate through these different modalities when on clinical placement. However, once we qualify in Northern Ireland, we can only work in plain film until we have been qualified for at least two years. Only then can we apply to work in other modalities, by which time we have built up a significant gap in our training record for these.

Angela: This is not the case in my region. We can rotate into other modalities upon qualification.

Nate: In my placement site, you must remain in plain film for 18 months before moving into other modalities.

Angela: This seems quite difficult and confusing for students and new professionals, as different hospitals across the UK have different systems and pathways in place.

Kourosh: As many modalities are now overlapping in both diagnostic and therapeutic pathways, perhaps it would be beneficial in the future to employ radiographers into multi-modality roles.

Angela: I think a more standardised route would be a positive step.

Apprenticeships

Nate: I think that more and more people will want to follow the apprenticeship route into radiography. It is a lot more hands-on and allows you to work and earn alongside your studies. This is important in the current economic climate, where it is increasingly difficult to undertake a fully academic, intense radiography course in the middle of a cost-of-living crisis.

Angela: Having an apprenticeship may also take away that anxiety around finding a job at the end of your course and allow us to focus on our learning instead. The stigma attached to traditional apprenticeships is definitely changing. It is now seen as an academic, accessible route that offers financial and career security.

Kourosh: Apprenticeships are brilliant, but I am not sure if there is a wider understanding of the teaching involved. Currently, in Northern Ireland, we don’t have this option. There is still a lot of focus on student research and a more academic approach to study.

Nate: It’s still very new for our profession. But I think, with the pandemic affecting delivery of traditional academic pathways, being on site for more practical learning will appeal to a lot of people.

Angela: The pandemic has also increased the number of people considering new careers at a later stage in life, when they have families to support. I can see this really taking off in radiography.

Kourosh: And from a geographical point of view, I can really see there being a benefit in Northern Ireland, where the location of workplaces may be much more accessible than that of the university campus.

Angela: The other important element is the distribution of time spent between university and placement. Being on large placement blocks increases feelings of nervousness, and I find that a significant amount of time is spent at the beginning of each placement block just adjusting and getting back up to speed with practices. Sharing time each week between university and placement would be much more consistent.

Nate: I would imagine that a lot of people would prefer that hybrid approach. It is definitely a positive aspect of future radiography education.

Simulation

Angela: There is much more demand for placement capacity now, and it is only going to get worse, so the use of simulation in education is important. Currently, there are varying degrees of simulation equipment available at universities. We have a simulation suite, and I know some universities use virtual reality headsets, but some students never experience simulation during their training.

Nate: All our degree pathways are different, depending on where we study, but we are all expected to do the same thing when we qualify. How you get to that stage is important.

Angela: It might not work for everybody, however. And if you spend time in simulation, what aspect of your role are you losing out on?

Nichola: That is an interesting question. We have discussed the benefits of AI and advancing technologies in freeing up our radiographers to spend more time delivering compassionate care but, as we use new technologies to train our students, are you feeling that they may potentially spend less time learning how to deliver that care in patient-facing training?

Angela: For younger students who haven’t had public-facing roles before, those early days on placement are so beneficial in learning how to talk to patients. We are dealing with people in their most vulnerable moments. Can technology prepare us for that?

Nichola: Do you feel there is a balance to be struck as we advance our teaching methods?

Nate: The patient doesn’t care if you have the best machine or most advanced program. They care about how they are treated and how they feel under your care. That is what is important.

Angela: We are told we must be professional and learn to communicate well. But how should we communicate? Perhaps radiography education needs to increase focus on the caring aspect of our profession to really reap the benefits of our technological advances.

Reporting

Angela: Increasing the number of reporting radiographers would allow more sharing of workload and would increase round-the-clock care.

Kourosh: Radiographer-led orthopedic services in emergency departments could allow radiographers to assess, scan and report, which would remove some of the burden for already busy doctors.

Angela: More importantly, this could offer more consistency in care for the patient.

Professional profile

Nate: It is my hope that, in the future, the public will know what we mean when we refer to diagnostic radiography.

Angela: We will care for you, and ensure your needs are met, but we are also highly skilled, technical and knowledgeable professionals. I hope the distinction between nurses and allied health professionals will be better understood on a wider level.

Training

Nate: Technology continues to advance, which leaves room to expand our role. Radiography training could be evolved to enhance our care and practices around these advancements.

Prescribing

Angela: Focus on independent prescribing skills will widen the scope of our role, reduce service pressures and improve the patient pathway.

Reporting

Kourosh: As radiographers, we are really coming into our own, with defined, skilled roles. As our responsibility increases, so too does our identity as a profession. Ownership, identity and progression are our future.

Retention

Angela: Departments don’t always feel like a solid base for radiographers. Even as a student, I have seen a high turnover of staff. We need to understand retention better. Is it about pay? Progression? Staff care? We want to go into a profession where we won’t feel we need to look for another job in a few years because it is too difficult to progress in the current system.

Nichola: We have talked a little about role progression, learning opportunities, pay and caring for staff. Do you feel that the concept of worth may be a factor in radiography retention?

Angela: I sense that there is a feeling of there being so many Band 5 radiographers that they can be treated differently to other staff. Often they are allocated undesirable shifts and there is often no consideration given to a work-life balance for the newly qualified workforce. Maybe people want to be seen and treated as individuals, not as their pay band.

Clinical learning

Kourosh: I feel that individualised logbooks would be a positive way to tailor learning to us as individuals. Somewhere to document what you have done, where you are confident and where you need to improve. Facilitators could then prescribe specific tasks, skills and modalities for our next placement to help build our skills. It would also ensure that we are all graduating with the same skillset at the end of our studies.

We need to individualise and employ flexibility in our training structure to fully develop our radiographers. It is about accommodating and valuing people.

Parity

Nate: With so many hospitals taking different approaches to training and progression, people may start to gravitate towards specific sites, leaving gaps in our service provision. This applies to policies that cover overtime, flexible working, role progression and learning opportunities. Without something being set out, which ensures all sites are working to the same principles, it may be difficult to retain staff at certain sites.

Angela: Things need to be more equal across the board, right from when you start your pre-registration training. So many students – even in the same university – have different placement experiences and access to learning opportunities.

Three key themes were identified throughout the course of this student discussion:

1. Balance. It was generally felt that our profession is on a very exciting journey, with new technological advancements allowing the use of AI and simulation in our training and practices. The role of the radiographer is set to evolve and expand significantly in the future. There was a strong feeling in the group that we must maintain focus on the patient and strike a balance in our training pathways to ensure radiographers are being equipped with the skills to deliver the excellent standards of compassionate care to which they aspire.

2. Parity. Much of the discussion centred on the many differences across the UK in the areas of career progression, access to learning and treatment of staff. It was strongly felt that emphasis should be placed on extending the compassionate care of our patients to those responsible for that care. The students felt that a clear set of principles and guidance for development and progression in radiography departments could improve staff retention in the future.

3. Individualised, accessible learning. There was a clear feeling among the students that our society has changed, particularly since the pandemic. Discussions focused on the creation of learning pathways that provide financial stability, career security and equitable access to a standardised structure of learning. Within this structure, it was felt that flexibility should be employed to tailor training to the individual, supporting each radiography learner to achieve the same skillset as their peers.

Overall, the students were positive and enthusiastic about the future of our profession, and showed great drive and leadership in their desire to grow and effect change for the benefit of patients and staff. Kourosh had a final say on the future of radiography, offering this perspective:

“I am excited. A lot of professions are settled into a way of working but radiography is blowing up and expanding constantly. It grows and changes and develops continuously, and it’s an exciting time to be a part of that.”

I am confident that the future of radiography is in great hands.

Nichola Jamison is Students and New Professionals Officer at the Society of Radiographers.

References

1. Knapp KM and Courtie N. The future role of radiographers. Radiography 2021. Volume 27, Supplement 1, S1-S2.

2. Mcfadden S, Flood T, Watson A and Shepherd P. The lessons learned working in diagnostic and therapeutic radiography departments through the COVID-19 pandemic in Northern Ireland, UK. What can we do differently the next time? Radiography 2022. Volume 28, S68-S76.

3. Nightingale J, McNamara J and Posnett J. Challenges in recruitment and retention: Securing the therapeutic radiography workforce of the future. Radiography 2019. Volume 25 (1), 1-3.