- Email: [email protected]
Radiographers meet ‘old’ challenge
RAD
RAPHERS
Radiography
GUEST
(1998)
4,237-238
EDITORIAL
Radiographers
meet ‘old’ challenge
New technology has no respect for traditions and its impact on practice ensures that professional boundaries are continually shifting. The forces for change within radiology, including demands for time consuming interventional procedures, have been discussed by Chapman [I]. One consequence of such increasing demands is that in some accident and emergency departments radiographs are never seen by a radiologist [I]. In trying to address this problem, radiographers (and in some instances, nurse practitioners) are developing their role to include plain film reporting. The case for radiographers to provide reports is a strong one. Many radiographers, radiologists and accident and emergency consultants support these developments, but there are those who are cautious and some even opposed to reporting by radiographers. Such polarized views will ensure that reporting remains controversial, at least in the short-term, but nevertheless, a growing number of radiographers are providing reports and a number of education centres are offering postgraduate programmes to support this work. The recent interest in radiographer reporting, however, is not new. Radiographers are rediscovering the skills of their predecessors, who, in the first quarter of the century, issued reports as routine. The boundary dispute between radiographers and radiologists in the formative years of the two professions split the Society of Radiographers and ended with radiographers foregoing their right to issue reports, albeit reluctantly. What are the views of the professional bodies today? The College of Radiographers state in their Code of Conduct [2] that radiographers should provide a written report to the referring clinician. In their vision document [3], the position is strengthened by stating that a report by a radiographer is not an option for the future but a requirement. The Royal College of Radiologists has stated that all radiographs require a written report but recognise that there are insufficient radiologists to report all examinations and have explored 1078-8174/98/040237+02
$18.0010
alternative ways of providing plain radiographs [a]. However, the Royal College views reporting by radiographers as contentious but does set out advice for radiologists when participating in such schemes [5]. There is no statutory impediment to prevent radiographers from issuing reports and the most important information for radiographers is contained within the Statement of Conduct issued by the Radiographers Board [6]. The Statement goes so far as to set out the conditions under which radiographers can provide reports. To many radiographers, reclaiming a lost role would seem a logical extension of their practice. However, the question of education and training needs serious consideration. Whatever the sentiments of history, the reality is that new skills have to be acquired and additional responsibilities recognised. The majority of radiographers embarking on, what is for them, a new journey understand the implications of such demands. However, early course developments some 3 years ago were taking place in isolation and consequently difficulties were encountered in this politically sensitive subject. Nationally, there was no awareness of what was going on in local situations and evidence and outcomes from the educational process or from practice were not being disseminated or debated sufficiently. *To try and overcome these difficulties the Special Interest Group in Radiographic Reporting (SIGRR) was established in 19% to provide a national forum for parties with an interest in radiographic reporting. Currently, the SIGRR is based upon local groups with an interest in radiographic reporting. The group is multidisciplinary and has ‘a number of broad aims. These include advancing the debate on radiographic reporting, disseminating evidence of practice based upon audit and research and seeking to promote national and transferable standards in radiographic reporting. The last point is especially important and is providing an important focus for the SIGRR. It is imperative that those who are 0 1998
The College
of Radiographers
Price
238
reporting have a qualification that is recognised by their employer and by the profession. The pattern of education and training that has emerged (although not exclusively) is the development of postgraduate reporting courses, in response to approaches from NHS Trusts. Radiographers and radiologists are working in partnership with universities to develop and deliver accredited programmes which recognise that an individual’s competence is built upon education as well as training and that ’ competence does not only describe the ‘skill’ but includes underpinning knowledge and understanding. Clearly matters have moved on since the early years of the century, but once again the role of radiographers in reporting is being acknowledged. Time will tell whether radiographers are performing effectively. While there are radiologists and radiographers who doubt the wisdom of radiographers reporting [7], it is not clear how they have formed their opinions because the early evidence is to the contrary. Reports from hospitals in Manchester, Leeds and Luton have been presented at national meetings in 1998 and have demonstrated clear benefits to patients and to the NHS. Since the establishment of the SIGRR 2 years ago the debate has moved on. It is no longer about who should report but about the standard of reports and their impact on patient management,
What is there to prevent radiographers looking forward and claiming that radiographic reporting is no longer controversial, but is an indispensable and beneficial part of the service to our patients? Richard C. Price Chair, Special Interest Group in Radiographic Reporting, Department of Radiography, Faculty of Health and Human Sciences, University of Herlfordshire, College lane, Hatfield Herts, U.K.
References 1.
Chapman AH. Changing
work patterns. Lntrcet 1997; 350:
581-83. 2. 3.
4.
5.
6.
The College of Radiographers. Professional Code of Conduct. London: The College of Radiographers, 1994. The College of Radiographers. Reporting by radiographers: a vision paper. London: The College of Radiographers, 1997. Royal College of Radiologists. Statement on reporting in departments of clinical radiology. London: Royal College of Radiologists, 1995. Royal College of Radiologists. Advice on delegation of tasks in departments of clinical radiology. London: Royal College of Radiologists, 1996. The Radiographers Board. Statement of Conduct. London: The Council for Professions Supplementary to Medicine, 1995.
7.
Cunningham DA. Special interest group reporting. Br ] Radio/ 1997; 70: 873-4.
in radiographer
RAPHERS
Radiography
GUEST
(1998)
4,237-238
EDITORIAL
Radiographers
meet ‘old’ challenge
New technology has no respect for traditions and its impact on practice ensures that professional boundaries are continually shifting. The forces for change within radiology, including demands for time consuming interventional procedures, have been discussed by Chapman [I]. One consequence of such increasing demands is that in some accident and emergency departments radiographs are never seen by a radiologist [I]. In trying to address this problem, radiographers (and in some instances, nurse practitioners) are developing their role to include plain film reporting. The case for radiographers to provide reports is a strong one. Many radiographers, radiologists and accident and emergency consultants support these developments, but there are those who are cautious and some even opposed to reporting by radiographers. Such polarized views will ensure that reporting remains controversial, at least in the short-term, but nevertheless, a growing number of radiographers are providing reports and a number of education centres are offering postgraduate programmes to support this work. The recent interest in radiographer reporting, however, is not new. Radiographers are rediscovering the skills of their predecessors, who, in the first quarter of the century, issued reports as routine. The boundary dispute between radiographers and radiologists in the formative years of the two professions split the Society of Radiographers and ended with radiographers foregoing their right to issue reports, albeit reluctantly. What are the views of the professional bodies today? The College of Radiographers state in their Code of Conduct [2] that radiographers should provide a written report to the referring clinician. In their vision document [3], the position is strengthened by stating that a report by a radiographer is not an option for the future but a requirement. The Royal College of Radiologists has stated that all radiographs require a written report but recognise that there are insufficient radiologists to report all examinations and have explored 1078-8174/98/040237+02
$18.0010
alternative ways of providing plain radiographs [a]. However, the Royal College views reporting by radiographers as contentious but does set out advice for radiologists when participating in such schemes [5]. There is no statutory impediment to prevent radiographers from issuing reports and the most important information for radiographers is contained within the Statement of Conduct issued by the Radiographers Board [6]. The Statement goes so far as to set out the conditions under which radiographers can provide reports. To many radiographers, reclaiming a lost role would seem a logical extension of their practice. However, the question of education and training needs serious consideration. Whatever the sentiments of history, the reality is that new skills have to be acquired and additional responsibilities recognised. The majority of radiographers embarking on, what is for them, a new journey understand the implications of such demands. However, early course developments some 3 years ago were taking place in isolation and consequently difficulties were encountered in this politically sensitive subject. Nationally, there was no awareness of what was going on in local situations and evidence and outcomes from the educational process or from practice were not being disseminated or debated sufficiently. *To try and overcome these difficulties the Special Interest Group in Radiographic Reporting (SIGRR) was established in 19% to provide a national forum for parties with an interest in radiographic reporting. Currently, the SIGRR is based upon local groups with an interest in radiographic reporting. The group is multidisciplinary and has ‘a number of broad aims. These include advancing the debate on radiographic reporting, disseminating evidence of practice based upon audit and research and seeking to promote national and transferable standards in radiographic reporting. The last point is especially important and is providing an important focus for the SIGRR. It is imperative that those who are 0 1998
The College
of Radiographers
Price
238
reporting have a qualification that is recognised by their employer and by the profession. The pattern of education and training that has emerged (although not exclusively) is the development of postgraduate reporting courses, in response to approaches from NHS Trusts. Radiographers and radiologists are working in partnership with universities to develop and deliver accredited programmes which recognise that an individual’s competence is built upon education as well as training and that ’ competence does not only describe the ‘skill’ but includes underpinning knowledge and understanding. Clearly matters have moved on since the early years of the century, but once again the role of radiographers in reporting is being acknowledged. Time will tell whether radiographers are performing effectively. While there are radiologists and radiographers who doubt the wisdom of radiographers reporting [7], it is not clear how they have formed their opinions because the early evidence is to the contrary. Reports from hospitals in Manchester, Leeds and Luton have been presented at national meetings in 1998 and have demonstrated clear benefits to patients and to the NHS. Since the establishment of the SIGRR 2 years ago the debate has moved on. It is no longer about who should report but about the standard of reports and their impact on patient management,
What is there to prevent radiographers looking forward and claiming that radiographic reporting is no longer controversial, but is an indispensable and beneficial part of the service to our patients? Richard C. Price Chair, Special Interest Group in Radiographic Reporting, Department of Radiography, Faculty of Health and Human Sciences, University of Herlfordshire, College lane, Hatfield Herts, U.K.
References 1.
Chapman AH. Changing
work patterns. Lntrcet 1997; 350:
581-83. 2. 3.
4.
5.
6.
The College of Radiographers. Professional Code of Conduct. London: The College of Radiographers, 1994. The College of Radiographers. Reporting by radiographers: a vision paper. London: The College of Radiographers, 1997. Royal College of Radiologists. Statement on reporting in departments of clinical radiology. London: Royal College of Radiologists, 1995. Royal College of Radiologists. Advice on delegation of tasks in departments of clinical radiology. London: Royal College of Radiologists, 1996. The Radiographers Board. Statement of Conduct. London: The Council for Professions Supplementary to Medicine, 1995.
7.
Cunningham DA. Special interest group reporting. Br ] Radio/ 1997; 70: 873-4.
in radiographer