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Radiographers’ Professional Competence: Development of a context-specific instrument
Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science.
2012 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Aims: The overall aim of this thesis was to explore and describe radiographers‟ professional competence based on patients‟ and radiographers‟ experiences and to develop a context-specific instrument to assess the level and frequency of use of radiographers‟ professional competence.

Methods: The design was inductive and deductive. Both qualitative and quantitative methods were used. The data collection methods comprised interviews (Studies I-II) and questionnaires (Studies III-IV). The subjects were patients in study I and radiographers in studies II-IV. In study I, 17 patients were interviewed about their experiences of the encounter during radiographic examinations and treatment. The interviews were analysed using qualitative content analysis. In study II, 14 radiographers were interviewed to identify radiographers‟ areas of competence. The critical incident technique was chosen to analyse the interviews. Studies III and IV were based on a national cross-sectional survey of 406 randomly selected radiographers. Study III consisted of two phases; designing the Radiographer Competence Scale (RCS) and evaluation of its psychometric properties. A 42-item questionnaire was developed and validated by a pilot test (n=16) resulting in the addition of 12 items. Thus the final RCS comprised a 54-item questionnaire, which after psychometric tests was reduced to 28 items. In study IV, the 28-item questionnaire served as data. The level of competencies was rated on a 10-point scale, while their use was rated on a six-point scale.

Results: In study I, the female patients‟ comprehensive understanding was expressed as feelings of vulnerability. The encounters were described as empowering, empathetic, mechanical and neglectful, depending on the radiographers‟ skills and attitudes. Study II revealed two main areas of professional competence, direct patient-related and indirect patient-related. The first focused on competencies in the care provided in close proximity to the patient and the second on competencies used in the activities of the surrounding environment. Each of the two main areas was divided into four categories and 31 sub-categories that either facilitated or hindered good nursing care. In study III the analysis condensed the 54-item questionnaire in two steps, firstly by removing 12 items and secondly a further 14 items, resulting in the final 28-item RCS questionnaire. Several factor analyses were performed and a two factor-solution emerged, labelled; “Nurse initiated care” and “Technical and radiographic processes”. The psychometric tests had good construct validity and homogeneity. The result of study IV demonstrated that most competencies in the RCS received high ratings both in terms of level and frequency of use. Competencies e.g. „Adequately informing the patient‟, „Adapting the examination to the patient‟s prerequisites and needs‟ and „Producing accurate and correct images‟ were rated the highest while „Identifying and encountering the patient in a state of shock‟ and „Participating in quality improvement regarding patient safety and care‟ received the lowest ratings. The total score of each of the two dimensions had a low but significant correlation with age and years in present position. The competence level correlated with age and years in present position in both dimensions but not with the use of competencies in the “Nurse initiated care” dimension.

Conclusion: This thesis has shown that professional competence is important in the encounter between patient and radiographer. It has also demonstrated that radiographers‟ self-rated professional competence is based on nursing, technological and radiographic knowledge. From a radiographer‟s perspective, „Nurse initiated care‟ and „Technical and Radiographic processes‟ are two core dimensions of Radiographer Competence Scale. The 28-item questionnaire regarding level and frequency of use of competence is feasible to use to measure radiographers‟ professional competence.

Place, publisher, year, edition, pages
Jönköping: School of Health Sciences , 2012. , 100 p.
Series
Hälsohögskolans avhandlingsserie, ISSN 1654-3602
Keyword [en]
Professional competence, Radiographer perspective, Patient perspective, Nursing, Radiography, Instrument development, Self-assessment, Psychometric evaluation, RCS
National Category
Nursing
Identifiers
URN: urn:nbn:se:hj:diva-19717ISBN: 978-91-85835-33 (print)OAI: oai:DiVA.org:hj-19717DiVA: diva2:563503
Public defence
2012-11-09, Forum Humanum, Barnarpsgatan 39, 553 18, Jönköping, 13:00
Opponent
Supervisors
Available from: 2012-10-30 Created: 2012-10-30 Last updated: 2012-11-13Bibliographically approved
List of papers
1. Female patients' encounters with the radiographer in the course of recurrent radiographic examinations – a qualitative study
Open this publication in new window or tab >>Female patients' encounters with the radiographer in the course of recurrent radiographic examinations – a qualitative study
2012 (English)Article in journal (Refereed) Submitted
National Category
Nursing
Identifiers
urn:nbn:se:hj:diva-19697 (URN)
Available from: 2012-10-26 Created: 2012-10-26 Last updated: 2012-10-30Bibliographically approved
2. Radiographers' areas of professional competence related to good nursing care
Open this publication in new window or tab >>Radiographers' areas of professional competence related to good nursing care
2008 (English)In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 22, no 3, 401-409 p.Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Radiographers' ability and competence is a matter of vital importance for patients. Nursing care is an integral part of the radiographer's work. The demand for high competence in clinical activities has increased in diagnostic radiology and has had an impact on the development of the profession.

AIM: The aim was to describe the radiographer's areas of professional competence in relation to good nursing care based on critical incidents that occur in the course of radiological examinations and interventions.

METHOD: A descriptive design with a qualitative approach, using the Critical Incident Technique was employed. Interviews were conducted with a strategic sample of registered radiographers (n = 14), based at different hospitals in Sweden.

ETHICAL ISSUES: The appropriate ethical principles were followed. All the participants provided informed consent, and formal approval for conducting the research was obtained according to national and local directives.

RESULTS: The data analysis resulted in two main areas; direct and indirect patient-related areas of competence, which describe the radiographers' skills that either facilitate or hinder good nursing care. In the direct patient-related area of competence, four categories emerged, which illustrate good nursing care in the patient's immediate surroundings. In the indirect patient-related area of competence, four categories illuminated good nursing care that is provided without direct contact with the patient.

CONCLUSIONS: The study highlights the different areas of the radiographer's unique professional competence. The findings provide insight into the radiographer's profession, on one hand as a carer and on the other as a medical technologist as well as highlighting the importance of each role. The radiographer's work encompasses a variety of components--from caring for the patient to handling and checking the technical equipment.

Keyword
competence, Critical Incident Technique, good nursing care, knowledge, radiographer, radiological nurse
National Category
Nursing
Identifiers
urn:nbn:se:hj:diva-7022 (URN)10.1111/j.1471-6712.2007.00543.x (DOI)
Available from: 2008-12-12 Created: 2008-12-10 Last updated: 2012-10-30Bibliographically approved
3. Development and psychometric evaluation of the radiographers’ competence scale
Open this publication in new window or tab >>Development and psychometric evaluation of the radiographers’ competence scale
2012 (English)In: Open Journal of Nursing, ISSN 2162-5336, Vol. 2, no 2, 85-96 p.Article in journal (Refereed) Published
Abstract [en]

Assessing the competence of registered radiographers’ clinical work is of great importance because of the recent change in nursing focus and rapid technological development. Self-assessment assists radiographers to validate and improve clinical practice by identifying their strengths as well as areas that may need to be developed. The aim of the study was to develop and psychometrically test a specially designed instrument, the Radiographers Competence Scale (RCS). A cross sectional survey was conducted comprising 406 randomly selected radiographers all over Sweden. The study consisted of two phases; the development of the instrument and evaluation of its psychometric properties. The first phase included three steps: 1) construction of the RCS; 2) pilot testing of face and content validity; and 3) creation of a web-based 54-item questionnaire for testing the instrument. The second phase comprised psychometric evaluation of construct validity, internal consistency reliability and item reduction. The analysis reduced the initial 54 items of the RCS to 28 items. A logical two-factor solution was identified explaining 53.8% of the total variance. The first factor labelled “Nurse initiated care” explained 31.7% of the total variance. Factor 2 labelled “Technical and radiographic processes” explained 22.1% of the total variance. The scale had good internal consistency reliability, with a Cronbach’s alpha of 0.87. The RCS is a short, easy to administer scale for capturing radiographers’ competence levels and the frequency of using their competence. The scale was found to be valid and reliable. The self-assessment RCS can be used in management, patient safety and quality improvement to enhance the radiographic process.

Keyword
Competence Scale, Instrument Development, Management, Nursing, Psychometric Evaluation, Radiographer, RCS
National Category
Nursing
Identifiers
urn:nbn:se:hj:diva-19707 (URN)10.4236/ojn.2012.22014 (DOI)
Available from: 2012-10-29 Created: 2012-10-29 Last updated: 2012-11-13Bibliographically approved
4. Radiographers' self-assessed level and use of competencies: a national survey
Open this publication in new window or tab >>Radiographers' self-assessed level and use of competencies: a national survey
Show others...
2012 (English)In: Insight into Imaging, ISSN 1869-4101, Vol. 3, no 6, 635-645 p.Article in journal (Refereed) Published
Abstract [en]

OBJECTIVES: To describe radiographers' self-assessed level and use of competencies as well as how sociodemographic and situational factors are associated with these competencies, particularly related to work experience.

METHODS: A cross-sectional design was employed. Radiographers (n = 406) completed the self-administered 28-item questionnaire encompassing two dimensions: 'Nurse-initiated care' and 'Technical and radiographic processes'. The level of competencies was rated on a 10-point scale and the frequency of use on a 6-point scale.

RESULTS: Most competencies received high ratings both in terms of level and frequency of use. In 'Nurse-initiated care' the competency 'Adequately informing the patient' was rated the highest, while 'Identifying and encountering the patient in a state of shock' and 'Participating in quality improvement regarding patient safety and care' received the lowest ratings. In 'Technical and radiographic processes' the highest rated competencies were 'Adapting the examination to the patient's prerequisites and needs' and 'Producing accurate and correct images'. The lowest frequency of use was 'Preliminary assessment of images'.

CONCLUSION: The main findings underline the radiographers' high competency in both 'Nurse-initiated care' and 'Technical and radiographic processes'. The lower rated competencies emphasise the importance of continuous professional education and quality improvement.

MAIN MESSAGES :

• Assessing radiographers' clinical competencies is fundamental for ensuring professional standards.

• Most competencies received high ratings both in the nursing and in the radiographic dimensions.

• The highest rated competencies focussed on information and adaptability to the patients needs.

• The lowest rated competencies focussed on encountering the patient in shock and image assessments.

• Age, years in present position and work place only explained a relatively small part of competency.

Keyword
Competence, Assessment, Cross-sectional, Radiography, Nursing
National Category
Nursing
Identifiers
urn:nbn:se:hj:diva-19708 (URN)10.1007/s13244-012-0194-8 (DOI)23079730 (PubMedID)
Available from: 2012-10-29 Created: 2012-10-29 Last updated: 2013-01-11Bibliographically approved

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