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  1. Article ; Online: Assessing the barriers and enablers to the implementation of the diagnostic radiographer musculoskeletal X-ray reporting service within the NHS in England: a systematic literature review.

    Lockwood, P / Burton, C / Woznitza, N / Shaw, T

    BMC health services research

    2023  Volume 23, Issue 1, Page(s) 1270

    Abstract: ... range of data (n = 241 papers) identified barriers and enablers of implementation, which were ...

    Abstract Introduction: The United Kingdom (UK) government's healthcare policy in the early 1990s paved the way adoption of the skills mix development and implementation of diagnostic radiographers' X-ray reporting service. Current clinical practice within the public UK healthcare system reflects the same pressures of increased demand in patient imaging and limited capacity of the reporting workforce (radiographers and radiologists) as in the 1990s. This study aimed to identify, define and assess the longitudinal macro, meso, and micro barriers and enablers to the implementation of the diagnostic radiographer musculoskeletal X-ray reporting service in the National Healthcare System (NHS) in England.
    Methods: Multiple independent databases were searched, including PubMed, Ovid MEDLINE; Embase; CINAHL, and Google Scholar, as well as journal databases (Scopus, Wiley), healthcare databases (NHS Evidence Database; Cochrane Library) and grey literature databases (OpenGrey, GreyNet International, and the British Library EthOS depository) and recorded in a PRISMA flow chart. A combination of keywords, Boolean logic, truncation, parentheses and wildcards with inclusion/exclusion criteria and a time frame of 1995-2022 was applied. The literature was assessed against Joanna Briggs Institute's critical appraisal checklists. With meta-aggregation to synthesize each paper, and coded using NVivo, with context grouped into macro, meso, and micro-level sources and categorised into subgroups of enablers and barriers.
    Results: The wide and diverse range of data (n = 241 papers) identified barriers and enablers of implementation, which were categorised into measures of macro, meso, and micro levels, and thematic categories of context, culture, environment, and leadership.
    Conclusion: The literature since 1995 has reframed the debates on implementation of the radiographer reporting role and has been instrumental in shaping clinical practice. There has been clear influence upon both meso (professional body) and macro-level (governmental/health service) policies and guidance, that have shaped change at micro-level NHS Trust organisations. There is evidence of a shift in culturally intrenched legacy perspectives within and between different meso-level professional bodies around skills mix acceptance and role boundaries. This has helped shape capacity building of the reporting workforce. All of which have contributed to conceptual understandings of the skills mix workforce within modern radiology services.
    MeSH term(s) Humans ; State Medicine ; X-Rays ; England ; Delivery of Health Care ; United Kingdom
    Language English
    Publishing date 2023-11-16
    Publishing country England
    Document type Systematic Review ; Journal Article
    ZDB-ID 2050434-2
    ISSN 1472-6963 ; 1472-6963
    ISSN (online) 1472-6963
    ISSN 1472-6963
    DOI 10.1186/s12913-023-10161-y
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: A pilot study to assess radiographer preliminary clinical evaluation (PCE) introduced for emergency department adult appendicular X-ray examinations: Comparison of trained and untrained radiographers.

    Lidgett, T / Pittock, L / Piper, K / Woznitza, N

    Radiography (London, England : 1995)

    2023  Volume 29, Issue 2, Page(s) 307–312

    Abstract: Introduction: Radiographers are transitioning from using "Red Dot" annotations to flag abnormal emergency X-ray images, to providing written preliminary clinical evaluation (PCE) diagnostic comments. This study explored the impact of local training on ... ...

    Abstract Introduction: Radiographers are transitioning from using "Red Dot" annotations to flag abnormal emergency X-ray images, to providing written preliminary clinical evaluation (PCE) diagnostic comments. This study explored the impact of local training on radiographers' PCE participation and accuracy performance during a trial period.
    Methods: Ten radiographers provided PCE comments for adult appendicular trauma X-ray examinations performed in the Emergency Department of an English public hospital over a 19 week trial period. Five senior radiographers who had received local PCE training and five more recently qualified radiographers, without this local training, participated in the trial. PCE participation rates were recorded and the PCE comments were scored for accuracy compared to the formal radiology report.
    Results: There were 796 eligible examinations, of which 528 (66%) had PCE comments. PCE participation was significantly higher (p < 0.001) for the radiographer group who received the training (80%, 253/316) compared to the untrained group (57%, 275/480). Similar levels of PCE accuracy (90% vs. 89%), sensitivity (86% vs. 82%) and specificity (91% vs. 93%) were found for the trained and untrained cohorts respectively, with no statistically significance difference between these scores.
    Conclusion: Local PCE training was associated with more frequent PCE participation but did not appear to influence PCE accuracy. The accuracy results suggest that radiographers are well equipped to provide PCE comments for adult appendicular X-ray examinations.
    Implications for practice: Local PCE training is likely to be important for consistent PCE scheme participation. Both experienced and recently qualified radiographers appear well equipped to provide accurate PCE for adult appendicular trauma X-ray examinations.
    MeSH term(s) Adult ; Humans ; Clinical Competence ; Emergency Service, Hospital ; Pilot Projects ; Radiology/education ; X-Rays
    Language English
    Publishing date 2023-01-20
    Publishing country Netherlands
    Document type Comparative Study ; Journal Article
    ZDB-ID 1289102-2
    ISSN 1532-2831 ; 1078-8174
    ISSN (online) 1532-2831
    ISSN 1078-8174
    DOI 10.1016/j.radi.2023.01.003
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  3. Article ; Online: Reporting radiographers in Europe survey: An overview of the role within the European Federation of Radiographer Society (EFRS) member countries.

    Pedersen, M R V / Jensen, J / Senior, C / Gale, N / Heales, C J / Woznitza, N

    Radiography (London, England : 1995)

    2023  Volume 29, Issue 6, Page(s) 1100–1107

    Abstract: ... of respondent from United Kingdom (n = 245, 71%) and Denmark (n = 66, 19%). Mean age was 41.9 (S.D 9.8), similar ... in public hospitals (90%). The vast majority of the respondents (n = 270, n = 94%) authored and signed their own ... clinical reports while a minority (n = 18, 6%) stated that their reports were checked by radiologists ...

    Abstract Introduction: Reporting radiographers undertake an important role in healthcare and for the radiographer profession in general. First introduced in the United Kingdom, reporting radiographers are now practicing in several other European countries. Our objective was to investigate the workforce of reporting radiographers across the European Federation of Radiographer Societies (EFRS) community.
    Method and material: A voluntary anonymous 34 item electronic survey was distributed online using social media accounts such as Twitter, Facebook and LinkedIn covering a wide range of topics relating to professional role, advanced practice, education, and seniority. The questionnaire was distributed during a 12-week period in 2022.
    Result: A total of 345 individual responses were received from 15 countries with majorities of respondent from United Kingdom (n = 245, 71%) and Denmark (n = 66, 19%). Mean age was 41.9 (S.D 9.8), similar for females, 42.5 (S.D 9.0) and men 40.9 years (S.D 9.7). Most reporting radiographers worked in public hospitals (90%). The vast majority of the respondents (n = 270, n = 94%) authored and signed their own clinical reports while a minority (n = 18, 6%) stated that their reports were checked by radiologists.
    Conclusion: The survey highlights the scope of practice of reporting radiographers working in Europe. Reporting is becoming a career path for an increasing number of radiographers across Europe and there is assess to academic education and clinical support.
    Implication for practice: Reporting radiographers fulfil an important role within the current demands of healthcare. This demand is likely to increase in the future, and therefore it is vital that there is some form of standardisation in the level of education that this group of healthcare professionals receive.
    MeSH term(s) Male ; Female ; Humans ; Adult ; Europe ; United Kingdom ; Radiologists ; Professional Role ; Workforce
    Language English
    Publishing date 2023-09-25
    Publishing country Netherlands
    Document type Journal Article
    ZDB-ID 1289102-2
    ISSN 1532-2831 ; 1078-8174
    ISSN (online) 1532-2831
    ISSN 1078-8174
    DOI 10.1016/j.radi.2023.09.005
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  4. Article ; Online: Reporting radiographers within the European Federation of Radiographer Society (EFRS) member countries - motivation for becoming a reporting radiographer.

    Jensen, J / Blackburn, P A / Gale, N / Senior, C / Woznitza, N / Heales, C J / Pedersen, M R V

    Radiography (London, England : 1995)

    2024  Volume 30, Issue 3, Page(s) 731–736

    Abstract: Introduction: Radiographer-led reporting originated in the United Kingdom as a strategy to reduce reporting backlog and time taken to report images. The effectiveness of reporting radiographers has been demonstrated, but their motivational factors have ... ...

    Abstract Introduction: Radiographer-led reporting originated in the United Kingdom as a strategy to reduce reporting backlog and time taken to report images. The effectiveness of reporting radiographers has been demonstrated, but their motivational factors have not been thoroughly explored. This survey aims to understand the incentives for radiographers to pursue postgraduate education in reporting radiography across Europe.
    Methods: An online survey was conducted, collecting data across a range of topics such as demographic information, professional role, and job satisfaction. Questions assessing the influence of motivational factors on the decision to become a reporting radiographer are presented in this study. Descriptive statistics characterized the respondents' demographics. The motivational aspects were analysed quantitatively by regression analyses. Thematic analyses were performed for the free text responses on motivational aspects.
    Results: 239 respondents from the UK, Denmark, Norway, Sweden, The Netherlands, Ireland, and Malta completed the survey's motivation section. Increased knowledge and new challenges were the most motivating factors for becoming a reporting radiographer, while less exposure to radiation and less patient contact were the least motivating factors. Job satisfaction was a significant motivator. Gender significantly correlated with the importance of social connections for female reporting radiographers. A cross-country comparison showed that title and position and job security were more important for reporting radiographers from the UK.
    Conclusion: Taking in consideration that a sample of 239 is not generalisable for the role, this survey does provides insights into the motivation behind being a reporting radiographer in Europe. Factors such as increased knowledge, new challenges, and job satisfaction play significant roles. Hindrances experienced by reporting radiographers included lack of time, support, and standards, while aspirations for further professional development were expressed.
    Implications for practice: A thorough understanding of the motivation behind pursuing postgraduate studies in reporting radiography is a valuable tool for managers, aiding in fostering a positive work environment and attracting/keeping qualified personnel. The findings of this study can be employed in the development of strategies to support and enhance the practice of reporting radiographers.
    Language English
    Publishing date 2024-02-29
    Publishing country Netherlands
    Document type Journal Article
    ZDB-ID 1289102-2
    ISSN 1532-2831 ; 1078-8174
    ISSN (online) 1532-2831
    ISSN 1078-8174
    DOI 10.1016/j.radi.2024.02.018
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  5. Article ; Online: Reporting radiographers in Europe survey: Support, role satisfaction, and advanced clinical practice within the European federation of radiographer society (EFRS) member countries.

    Pedersen, M R V / Jensen, J / Gale, N / Senior, C / Woznitza, N / Heales, C J

    Radiography (London, England : 1995)

    2023  Volume 30, Issue 1, Page(s) 87–94

    Abstract: Introduction: Increasing number of radiographers are undertaking image reporting throughout Europe. However, there are variations in practice and experience in European countries. The study aim was to investigate reporting radiographer's perceptions in ... ...

    Abstract Introduction: Increasing number of radiographers are undertaking image reporting throughout Europe. However, there are variations in practice and experience in European countries. The study aim was to investigate reporting radiographer's perceptions in relation to support for their role and workload satisfaction and elements of advanced practice that may also be undertaken.
    Methods: Following institutional ethical approval an online 34 item questionnaire survey was circulated via social media; Twitter, Facebook, and LinkedIn in a 12-week period in 2022 across Europe. The survey data were managed by the online secure database REDCap (Research Electronic Data Capture). Data was collected across a range of questions, of which those relating to support for, and barriers to radiographer reporting, role and job satisfaction, and other role elements are reported here.
    Results: A response level of 345 individual reporting radiographers replied to the survey from 15 European countries; some questions were optional and therefore had a lower response rate. There was consensus about the need for support from radiologists and management, protected time, and funding to support the reporting role. The majority of respondents received additional pay for taking on this role and expressed satisfaction with their role and workload. In relation to elements of advanced practice, the majority of respondents were involved in educational and managerial activities, and there was interest, but limited involvement, in research.
    Conclusion: There was a consensus about the support needed, and perceived barriers to, radiographer reporting, between reporting radiographers from different countries. Whilst there is some commonality in relation to activities such as supervision and education, there was clearer variety in relation to opportunities for research between the respondents, perhaps reflecting the differences between reporting as a standalone role development and reporting as part of an advanced clinical practice role.
    Implications for practice: As there is increasingly an emphasis on advanced clinical practice, reporting radiographers are likely to require support to develop their skills so that they can actively participate in the broader activities associated with this role, including education, leadership, and research.
    MeSH term(s) Humans ; Clinical Competence ; Europe ; Allied Health Personnel ; Personal Satisfaction ; Radiologists
    Language English
    Publishing date 2023-10-21
    Publishing country Netherlands
    Document type Journal Article
    ZDB-ID 1289102-2
    ISSN 1532-2831 ; 1078-8174
    ISSN (online) 1532-2831
    ISSN 1078-8174
    DOI 10.1016/j.radi.2023.10.008
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  6. Article ; Online: Concordance between a gastrointestinal consultant radiologist, a consultant radiologist and qualified reporting radiographers interpreting abdominal radiographs.

    Moth, A / Benning, J / Glover, J / Brown, V / Pittock, L / Woznitza, N / Piper, K

    Radiography (London, England : 1995)

    2023  Volume 29, Issue 2, Page(s) 408–415

    Abstract: ... the consultant radiologist (CR) and RRs when compared to the index radiologist (CR: n = 90/126, 71.4% and RRs: n ... between both groups (CR: n = 23/126, 18.3% and RRs: n = 17/126, 13.5%. p = 0.30).: Conclusion: RRs ...

    Abstract Introduction: Radiographers can accurately report musculoskeletal and chest radiographs, but there is paucity of research comparing the performance of reporting radiographers (RRs) with consultant radiologists when interpreting and reporting abdominal radiographs. This study assessed interobserver agreement in the clinical setting between reporting radiographers and a consultant radiologist compared to an expert gastrointestinal radiologist in a District General Hospital. Major discordant reports affecting patient management were also examined.
    Methods: 126 abdominal radiographs reported by 3 RRs in clinical practice were randomly selected and reported by a consultant radiologist and index gastrointestinal radiologist. The reports of the RRs and consultant radiologist were compared against the reports made by the index radiologist for agreement by a colorectal consultant surgeon. All 126 reports were scored as being in either complete agreement, minor disagreement or major disagreement which would have resulted in a change to patient management.
    Results: There was no significant difference in overall agreement between the consultant radiologist (CR) and RRs when compared to the index radiologist (CR: n = 90/126, 71.4% and RRs: n = 94/126, 74.6%. p = 0.57). Major disagreements were found, but there was no significant difference between both groups (CR: n = 23/126, 18.3% and RRs: n = 17/126, 13.5%. p = 0.30).
    Conclusion: RRs can report abdominal radiographs to a comparable level of agreement as a consultant radiologist in the clinical setting. There was no significant difference in reports deemed to affect patient management.
    Implications for practice: This study addresses the gap in assessing the performance of RRs reporting abdominal radiographs. This small scale study indicates that radiographers could provide additional support in the reporting of abdominal radiographs. This would help to reduce radiologist workload and enhance the role of the reporting radiographer.
    Classification: Agreement between reporting radiographers and radiologists interpreting and reporting abdominal radiographs.
    MeSH term(s) Humans ; Radiology ; Consultants ; Radiography ; Radiography, Abdominal ; Radiologists
    Language English
    Publishing date 2023-02-13
    Publishing country Netherlands
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 1289102-2
    ISSN 1532-2831 ; 1078-8174
    ISSN (online) 1532-2831
    ISSN 1078-8174
    DOI 10.1016/j.radi.2022.12.008
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  7. Article: Radiographer reporting.

    Woznitza, Nick

    Journal of medical radiation sciences

    2014  Volume 61, Issue 2, Page(s) 66–68

    Language English
    Publishing date 2014-05-20
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2734841-6
    ISSN 2051-3909 ; 2051-3895
    ISSN (online) 2051-3909
    ISSN 2051-3895
    DOI 10.1002/jmrs.51
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  8. Article ; Online: COVID-19 in the radiology department: What radiographers need to know.

    Stogiannos, N / Fotopoulos, D / Woznitza, N / Malamateniou, C

    Radiography (London, England : 1995)

    2020  Volume 26, Issue 3, Page(s) 254–263

    Abstract: Objectives: The aim is to review current literature related to the diagnosis, management, and follow-up of suspected and confirmed Covid-19 cases.: Key findings: Medical Imaging plays an important auxiliary role in the diagnosis of Covid-19 patients, ...

    Abstract Objectives: The aim is to review current literature related to the diagnosis, management, and follow-up of suspected and confirmed Covid-19 cases.
    Key findings: Medical Imaging plays an important auxiliary role in the diagnosis of Covid-19 patients, mainly those most seriously affected. Practice differs widely among different countries, mainly due to the variability of access to resources (viral testing and imaging equipment, specialised staff, protective equipment). It has been now well-documented that chest radiographs should be the first-line imaging tool and chest CT should only be reserved for critically ill patients, or when chest radiograph and clinical presentation may be inconclusive.
    Conclusion: As radiographers work on the frontline, they should be aware of the potential risks associated with Covid-19 and engage in optimal strategies to reduce these. Their role in vetting, conducting and often reporting the imaging examinations is vital, as well as their contribution in patient safety and care. Medical Imaging should be limited to critically ill patients, and where it may have an impact on the patient management plan.
    Implications for practice: At the time of publication, this review offers the most up-to-date recommendations for clinical practitioners in radiology departments, including radiographers. Radiography practice has to significantly adjust to these new requirements to support optimal and safe imaging practices for the diagnosis of Covid-19. The adoption of low dose CT, rigorous infection control protocols and optimal use of personal protective equipment may reduce the potential risks of radiation exposure and infection, respectively, within Radiology departments.
    MeSH term(s) COVID-19 ; Coronavirus Infections/diagnosis ; Coronavirus Infections/diagnostic imaging ; Coronavirus Infections/epidemiology ; Female ; Humans ; Infection Control/methods ; Infectious Disease Transmission, Vertical/prevention & control ; Male ; Occupational Health ; Pandemics ; Patient Safety ; Patient-Centered Care/organization & administration ; Pneumonia, Viral/diagnosis ; Pneumonia, Viral/diagnostic imaging ; Pneumonia, Viral/epidemiology ; Radiography, Thoracic/methods ; Radiography, Thoracic/statistics & numerical data ; Radiologists/organization & administration ; Radiology Department, Hospital/organization & administration ; Safety Management ; Sensitivity and Specificity ; Severe Acute Respiratory Syndrome/diagnostic imaging ; Severe Acute Respiratory Syndrome/epidemiology ; Tomography, X-Ray Computed/methods ; Tomography, X-Ray Computed/statistics & numerical data ; Ultrasonography, Doppler/methods ; Ultrasonography, Doppler/statistics & numerical data
    Keywords covid19
    Language English
    Publishing date 2020-06-04
    Publishing country Netherlands
    Document type Journal Article ; Research Support, Non-U.S. Gov't ; Review
    ZDB-ID 1289102-2
    ISSN 1532-2831 ; 1078-8174
    ISSN (online) 1532-2831
    ISSN 1078-8174
    DOI 10.1016/j.radi.2020.05.012
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  9. Article ; Online: Diagnostic radiographer advanced clinical practice in the United Kingdom - A national cross-sectional survey.

    Woznitza, Nick / Pittock, Lisa / Elliott, James / Snaith, Bev

    BJR open

    2021  Volume 3, Issue 1, Page(s) 20210003

    Abstract: Objectives: To survey the diagnostic radiography workforce in the United Kingdom (UK) at an organisational level to ascertain the scope of advanced practice and compliance with Health Education England standards for multiprofessional advanced clinical ... ...

    Abstract Objectives: To survey the diagnostic radiography workforce in the United Kingdom (UK) at an organisational level to ascertain the scope of advanced practice and compliance with Health Education England standards for multiprofessional advanced clinical practice (ACP).
    Methods: 174 diagnostic imaging departments were invited to participate in a cross-sectional electronic survey focused upon advanced level practice and their educational and accreditation expectations (October-December 2019). Breast imaging, computed tomography, fluoroscopy, interventional radiology, lithotripsy, magnetic resonance imaging and projectional radiography were included.
    Results: A total of 97 responses were received, of which 79 were eligible for inclusion (45%). Respondents reported advanced-level practice roles across all imaging modalities, which included clinical reporting, procedural-based and combined roles. Radiograph and mammogram reporting were most prevalent (95 and 67% of Trusts), with fluoroscopy the most frequent procedure-only role (25%). Only 39% of trusts required adherence to the four pillars of ACP within job descriptions, and only 12% requiring a full Masters qualification.
    Conclusions: Diagnostic radiographer reporting and procedure-based roles in the NHS are varied and widespread. However, inconsistencies in fulfilment against the expected standards for advanced practice exist. Realignment of advanced-level roles to delineate enhanced and advanced clinical practice may ensure consistency between roles and professions. A requirement for accreditation as an advanced (clinical) practitioner with adherence to advanced practice requirements could therefore provide value to accreditation for both individual practitioners and Trusts.
    Advances in knowledge: Within the UK, diagnostic radiographer roles previously self-identified as advanced-level practice may be termed enhanced practice when not adhering to expected ACP standards.
    Language English
    Publishing date 2021-06-24
    Publishing country England
    Document type Journal Article
    ISSN 2513-9878
    ISSN (online) 2513-9878
    DOI 10.1259/bjro.20210003
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  10. Article ; Online: COVID-19: A case series to support radiographer preliminary clinical evaluation.

    Woznitza, N / Nair, A / Hare, S S

    Radiography (London, England : 1995)

    2020  Volume 26, Issue 3, Page(s) e186–e188

    MeSH term(s) Aged ; COVID-19 ; COVID-19 Testing ; Clinical Laboratory Techniques/methods ; Coronavirus Infections/diagnosis ; Coronavirus Infections/diagnostic imaging ; Coronavirus Infections/pathology ; Decision Support Systems, Clinical/standards ; Female ; Humans ; Pandemics ; Pneumonia, Viral/diagnostic imaging ; Pneumonia, Viral/pathology ; Practice Guidelines as Topic/standards ; Radiography, Thoracic/methods ; Radiography, Thoracic/standards ; Radiologists/standards ; Severe Acute Respiratory Syndrome/diagnostic imaging ; Severe Acute Respiratory Syndrome/pathology ; Societies, Medical ; Tomography, X-Ray Computed/methods ; Tomography, X-Ray Computed/standards ; United Kingdom
    Keywords covid19
    Language English
    Publishing date 2020-04-11
    Publishing country Netherlands
    Document type Case Reports ; Journal Article ; Review
    ZDB-ID 1289102-2
    ISSN 1532-2831 ; 1078-8174
    ISSN (online) 1532-2831
    ISSN 1078-8174
    DOI 10.1016/j.radi.2020.04.002
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