International perspectives on radiography practice education.

INTRODUCTION: The radiography profession is built upon strong educational foundations which help ensure graduate radiographers have the required knowledge, skills, and competence to practise safely and effectively. Changing clinical practices, service needs, technological developments, regulatory changes, together with our growing professional evidence-base, all contribute to the need for our curricula to responsive and continually reviewed and enhanced. This study aims to explore similarities and differences in training curricula and follows a 2012 global survey on radiography education and more recent surveys undertaken by the European Federation of Radiographer Societies (EFRS). METHODS: An online questionnaire, based on previous EFRS education and clinical education surveys, which comprised of open and closed questions and consisted of sections designed to ascertain data on: type, level and duration of education programmes leading to an initial or pre-registration qualification in radiography/medical radiation practice, pre-clinical skill development and clinical placement within programmes. The survey was distributed via social media channels and through an international network of professional societies. Descriptive statistics are reported for most analyses while open questions were analysed thematically. RESULTS: Responses were received from 79 individuals from 28 identified countries across four continents. This represented a total of 121 different pre-registration/entry level programmes offered across these institutions. While dedicated diagnostic radiography programmes were most common (42/121), almost one-third of programmes (40/121) offered two or more areas of specialisation within the curriculum. The average of total hours for clinical placement were 1397 h for diagnostic radiography programmes; 1300 h for radiation therapy programmes; 1025 h for nuclear medicine programmes; and 1134 h for combined specialisation programmes, respectively. Institutions provided a range of physical and virtual systems to support pre-clinical skills development. CONCLUSION: Around the world, radiography programmes vary considerably in terms of their level, duration, programme type, pre-clinical and clinical training, use of simulation, and also in terms of class sizes, student/staff ratios, and graduate employment prospects. The ability of graduates to work independently in areas covered within their programmes varied considerably. While some changes around simulation use were evident, given the impact of COVID-19 it would be beneficial for future research to investigate if pre-clinical and clinical education hours or use of simulation resources has changed due to the pandemic. IMPLICATIONS FOR PRACTICE: The heterogeneity that exists between radiography programmes presents a significant challenge in terms of the mutual recognition of qualifications and the international movement of the radiographer workforce.

A pilot study investigating two dose reduction techniques for AP lumbar spine radiography using direct dosimetry and Projection VR.

INTRODUCTION: The purpose of this study was to compare radiation dose measurements generated using a virtual radiography simulation with experimental dosimeter measurements for two radiation dose reduction techniques in digital radiography. METHODS: Entrance Surface Dose (ESD) measurements were generated for an antero-posterior lumbar spine radiograph experimentally using NanoDOT™, single point dosimeters, for two radiographic systems (systems 1 and 2) and using Projection VR™, a virtual radiography simulation (system 3). Two dose reduction methods were tested, application of the 15% kVp rule, or simplified 10 kVp rule, and the exposure maintenance formula. The 15% or 10 kVp rules use a specified increase in kVp and halving of the mAs to reduce patient ESD. The exposure maintenance formula uses the increase in source-to-object distance to reduce ESD. RESULTS: Increasing kVp from 75 to 96 kVp, with the concomitant decrease in mAs, resulted in percent ESD reduction of 59.5% (4.02-1.63 mGy), 60.8% (3.55-1.39 mGy), and 60.3% (6.65-2.64 mGy), for experimental systems 1 and 2, and virtual simulation (system 3), respectively. Increasing the SID (with the appropriate increase in mAs) from 100 to 140 cm reduced ESD by 22.3% 18.8%, and 23.5%, for experimental systems 1 and 2, and virtual simulation (system 3), respectively. CONCLUSION: Percent dose reduction measurements were similar between the experimental and virtual measurement systems investigated. For the dose reduction practices tested, Projection VR™ provides a realistic alternate of percent dose reduction to direct dosimetry.