Design-based research for the development of a flexible learning environment

Background: Students enrolled for the Bachelor of Radiography degree at the Central University of Technology Free State in Bloemfontein, South Africa, spent many weeks off campus at hospitals during workplace learning. A design-based research approach was applied to analyse an educational problem, namely that students apparently fail to apply the theory of radiation safety regulations to protect themselves and patients. Aims: The purpose of the study was to develop authentic activities and assessment for radiation safety requirements, to provide flexible learning in a blended environment to students off campus. Setting: The second-year radiography students of 2016 and 2017 responded off campus to the QuestionPro survey. Method: Authentic learning and assessment opportunities were contextualised and compiled to align with learning outcomes of the safety regulations as confirmed during a Delphi process. Flexible learning opportunities were delivered via electronic mail (email) and WhatsApp. Assessment responses from the students were received via mobile phones with a Web-based software tool, QuestionPro. Results: Of the 117 students, 92.3% responded to the QuestionPro survey. From the incorrect responses, learning areas that needed revision were identified, as well as the areas in the X-ray departments of the hospitals showing non-compliance with the requirements for radiation safety. Conclusion: The three outcomes of this design-based research included the formulation of design principles, a designed product in the form of a Website and professional development of the researcher. The design-based research principles that were tested involved the use of knowledge in real life and measuring if students were effective performers with acquired knowledge

Medical doctors' awareness of radiation exposure in diagnostic radiology investigations in a South African academic institution

Background: Diagnostic investigations using radiation have become a critical feature of medical practice in recent times. However, the possibility of doctors' underestimation of risks of over-exposure of patients to diagnostic radiation still warrants further evaluation. Objectives: To investigate doctors' awareness of diagnostic radiation exposure at Dr George Mukhari Academic Hospital, South Africa. Methods: This was a cross-sectional, analytical investigation of the awareness of doctors about radiation exposure in diagnostic radiology investigations. A cluster sampling technique was employed to recruit 217 participants. Consent and approval of the participants were sought and obtained before questionnaire administration during departmental meetings between October 2017 and March 2018. Results: Of the participants, 80% had no formal training on radiation exposure and 33.8% of them correctly estimated natural background radiation. Correct estimates of the effective dose from a single-view abdominal X-ray (AXR) were expressed by 7.5%, quantity of radiation of a single-phase computed tomography (CT) abdomen by 30.3% and dosage from a two-view unilateral mammogram by 29.1% of the participants. More than 75% of participants agreed that children are more sensitive to radiation, but only 10.5% suggested medical termination of pregnancy for a woman who had CT abdomen and pelvis with contrast. Dosage and risk of inducing fatal cancer from common but more complex imaging procedures were poorly understood. Only the doctors of the radiology department showed a statistically significant (p< 0.0001) association with regards to their radiation awareness. Conclusion: Because of the high rate of poor awareness of radiation risks observed in this study, it is important to initiate, early in the medical curriculum for medical students, the need for a rotation in the Department of Radiology, similar to such rotations in other medical specialties

Determination of X-ray shielding thickness in two tertiary hospitals in Kano metropolis, Nigeria

Background: Radiation dose depends on the total workload (Wtot) which is affected by the number of patients, tube potential, and tube current. Despite the increment in patients visiting the X-ray units under study and X-ray tube revolutions, changes have not been made in the shielding material to suit the current situation. Aims: This study aims to evaluate the thickness of X-ray shielding barriers in two tertiary hospitals in Kano Metropolis using XRAYBAR software. Materials and Methods: This was a prospective, cross-sectional study and was undertaken from March 2017 to October 2017. A purposive sampling technique was employed to select two hospitals out of five. The two were named A and B, respectively. The minimum required thickness in each barrier was determined by XRAYBAR software. Results: The Wtot (workload) for room I, II and III was found to be 199.9, 146, and 149.1 mA-min per week. The shielding barrier thickness required to reduce the unshielded radiation dose to the design dose limit for wall 1, 2, 3, 4, and operating console of the Room I was found to be 17.5, 5.5, 0.2, 0.00, 3.3 cm, that of wall 1, 2, 3, and 4 of room II was found to be 9.1, 3.4, 0.02, 2.3 cm, while for the wall 1, 2, 3, 4, and operating console of room III was found to be 12.3, 4.8, 3.8, 3.2, and 26.5 cm, respectively. Conclusion: The calculated shielding barrier thickness from XRAYBARR code when compared to the design barrier thickness was found to be adequate

Interventionalists' perceptions on a culture of radiation protection

Background: Occupational exposure to ionising radiation poses potential health risks to radiation workers unless adequate protection is in place. The catheterisation laboratory is a highly contextualised workplace with a distinctive organisational and workplace culture. Objective: This study was conducted to understand the culture of radiation protection (CRP). Methods: This study was a qualitative study and data were collected through 30 in-depth and 6 group interviews with 54 purposively selected South African interventionalists (interventional radiologists and cardiologists). The participants included a diversity of interventionalists who varied in sex, geographic location and years of experience with fluoroscopy. The transcribed data were analysed thematically using a deductive and inductive approach. Results: 'Culture of radiation protection' emerged as a complex theme that intersected with other themes: 'knowledge and awareness of radiation', 'radiation safety practice', 'personal protective equipment (PPE) utilisation' and 'education and training'. Conclusion: Establishing and sustaining a CRP provides an opportunity to mitigate the potentially detrimental health effects of occupational radiation exposure. Education and training are pivotal to establishing a CRP. The time to establish a culture of radiation in the catheterisation laboratory is now

Attitudes et connaissances des chirurgiens-dentistes sénégalais sur la radioprotection

Introduction : Bien que les doses de rayonnements rencontrés en radiologie dentaire soient faibles, elles peuvent entraîner des effets stochastiques, qui sont, un phénomène de tout-ou-rien. L'objectif de cette étude était d'évaluer le niveau de connaissances et les attitudes des chirurgiens-dentistes sénégalais en radioprotection. Matériels et méthodes : Des questionnaires auto-administrés ont été distribués afin de recueillir les informations relatives à : l'importance de la radiologie dans la pratique quotidienne, l'équipement en appareil radiologique, la fréquence de prescription des examens radiologiques, moyens de radioprotections, le niveau de risque des rayons X. Les données ont recueilli et analysé avec le logiciel Epi info 3.4.3. Le niveau de significativité est fixé à p≤0,05. Résultats : 132 chirurgiens-dentistes ont répondu aux questionnaires. 91,14% des chirurgiens-dentistes déclaraient être équipés d'un appareil de radiographie et 64% d'entre eux faisaient des radiographies systématiques lors de la première consultation. Les radiographies retro alvéolaires étaient les plus prescrites 81,68% suivies par les radiographies panoramiques 16,03%. les films argentiques étaient plus utilisés (75%) que les récepteurs numériques (25%). Seuls 16,35% déclaraient avoir un dispositif de radioprotection, contre 83,65%. Les moyens de radioprotection utilisés dans les structures bucco-dentaires étaient constitués de collimateur (1,7%), de collier à plomb (5,7%), de tablier à plomb (8,62%), de mur plombé (0,86%). Les examens radiographiques étaient réalisés dans, 80% chez les enfants sans dispositif de radioprotection et 50% chez les femmes enceintes. Conclusion : une minorité de chirurgiens-dentistes est conscient de l'existence des règles de radioprotection. Des formations continues en radioprotections est nécessaires pour meilleure usage des examens radiographiques

Évaluation des connaissances des praticiens sur la radioprotection des patients au Burkina Faso

Objectif : Évaluer les connaissances des praticiens sur la radioprotection des patients au Burkina Faso.Méthodes : Étude descriptive transversale multisites du 1er mars au 31 mai 2015 dans trois structures sanitaires auprès des prescripteurs chez qui un questionnaire comportant plusieurs items en rapport avec les connaissances sur la radioprotection a été administré.Résultats : Le questionnaire a été soumis à 164 médecins : 123 (75%) ont accepté de le remplir ; 82,9% prenaient en compte le rapport bénéfice-risque ; 60% informaient le patient sur les risques des rayonnements ionisants ; 26,9% avaient une bonne connaissance sur les objectifs de la radioprotection et 17,9% sur les principes de la radioprotection ; 83,7% étaient informée de l'existence du risque de cancer radio-induit ; 80% reconnaissaient l'exposition médicale comme source d'irradiation et 36,6% considéraient l'IRM comme une technique irradiante. Conclusion : Notre étude a montré une faible connaissance des principes, des objectifs de la radioprotection par les praticiens bien que l'existence du risque de cancer radio-induit lors de la réalisation de certains examens radiologiques n'était pas ignorée

Radiation Protection Practices of Staff During Extra-Corporeal Shock Wave Lithotripsy at Okada, Nigeria

Background: The study was designed to find out the radiation protection practices of radiologists and other staff involved in the first extra-corporeal shock wave lithotripsy in Nigeria, performed at Igbinedion Hospital and Medical Research Centre, Okada. Methodology: Some members of staff who were present when the extra-corporeal shock wave lithotripsy (ESWL) was used in the hospital at Okada were interviewed between November 2002 and August 2003. Radiology records of the hospital were studied. Literature search involved available publication on the procedure in local and international journals with interest in precautions to reducing radiation exposure. Results: Only lead apron and lead gloves were used by the radiologists for radiation protection and shielding during fluoroscopy procedures. The fluoroscopy was the screen type with TV monitor. Multiple sessions were used in several patients with multiple pre- and post- treatment radiographic studies including contrast studies with average of two sessions per patient. All the patients were adults aged between 26 and 65 years with mean age of 42.5 years. 627-6000 shock waves were delivered over 45-135 minutes at intensity of 143-19KV depending on patients build and the size of the stones. The sizes of the patients varied from very obese with large bulk to slim built. Radiation monitoring of the staff and patients was not done. Staff believed that radiation effect from the lithotripsy procedure was low therefore adequate radiation monitoring and radiation reducing alteration in the procedure was rarely adopted. Conclusion: Extended fluoroscopy time, multiple fluoroscopy examinations, multiple treatment sessions and multiple x-ray examinations which increased both the patients/' and staff/'s radiation exposures were noted. Proper radiation protection and monitoring of patients and staff are necessary to avoid the risks from low-level exposure to radiation such as in ESWL