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Executive Summary

i. Background

An audit was undertaken to identify the current Information Management and Technology (IM&T) knowledge and skills of the radiography workforce on behalf of The Society and College of Radiographers (SCoR). An on-line survey was completed by radiographers, academics, educators and radiography managers, primarily employed in the NHS, the independent sector or higher education in the United Kingdom (UK). A response rate of 1443 was achieved.

ii. Engagement in clinical systems

Radiography has become dependent on many IM&T systems to improve workflow within a clinical care setting. The advent of Picture Archive and Communication Systems (PACS) and its continuing development to facilitate the electronic patient record (EPR) has undoubtedly improved the efficiency of clinical communication and decision making. There remain challenges however, to integrate all IM&T systems and to ensure their usability. Among those challenges is ensuring that all radiographers possess the appropriate skills and to make sure that there is adequate training to cope with new technological advances.

When informants were asked about their confidence in using clinical applications, they reported high confidence for applications that were used daily (e.g. PACS, HIS, RIS, patient management record systems). Conversely where applications were only rarely used, confidence was much lower, for example using on line test results applications. When considering confidence, this also appeared to be dependent on Agenda for Change bandings with those at bands 8 or above showing greater confidence than those in the lower bandings. It was likely that this confidence had developed from the level and degree of engagement, since those in higher bandings demonstrated greater usage than those in the lower bandings. Additionally, those informants in the higher bandings are required to manage and solve problems associated with IM&T, have responsibilities to train others and are more likely to have management responsibilities requiring greater engagement in audit and databases. Whilst most radiographers rated their IM&T skills as good to excellent, there were some radiographers who felt under confident and that they lacked the ability to carry out their roles efficiently. This may be linked to a reported lack of formal training, with most skills being self-taught.

The study demonstrated that some radiographers were unaware of issues relating to data protection and governance, there is therefore a requirement to make sure that all radiographers are fully competent in data governance issues in the near future.

iii. Engagement in general Information Technology systems

Engagement in general IM&T systems was found to be varied with applications such as email, internet, intranet and word processing being the most commonly used. There was recognition that IM&T plays an important role in the workplace, although there was evidence that IM&T is not fully exploited in terms of CPD. When asked about their level of confidence in using IM&T, the majority of informants felt they were fairly confident, with only 1.5% indicating they were not confident at all and 9.5% indicating they were very confident The findings show that there is high confidence for applications where there was high usage (e.g. weekly or more) namely e mail, internet, intranet and word processing. There was a wider distribution of confidence levels for applications such as PowerPoint and databases which were not used as frequently. Some IM&T applications were not widely used in a clinical setting, such as PowerPoint. The majority of informants (742) had no qualifications in IM&T, had not received any formal training in general IM&T applications and were primarily self taught. Since a certificate of attendance is not recognised as an award ECDL was the qualification held by the most informants.

iv. Conclusions

One of the main themes that emerged from this study was the lack of structured training accessible to informants. Indications were that this mainly related to staff being released from departments, individuals own clinical workloads and financing. When general IM&T training did take place this was primarily at an introductory level and took place in a group which matched with the preferred format for this type of application. The other significant point to note is that when training did take place for clinical applications it was mainly informal / ad hoc, except for HIS and RIS where informants had participated in small group training or one to one training. It appears from the findings that this kind of ad hoc training is appropriate for applications that are used on a daily basis as long as ongoing support and advice are available. However for applications that are not used frequently it appears ad hoc training was not sufficient. Some informants did express a need for more high level training so that they could understand the systems more fully and would be able to troubleshoot problems arising. The preferred method of training for most applications was one to one or group training. Specialist training was only requested by a small number of informants. In addition remote learning was not rated as a popular method to learn.

v. Recommendations

IM&T is an evolving discipline in radiography, the scope of practice ranges from general IM&T skills to in-depth knowledge of specialist clinical applications. Therefore the workforce needs to be adaptable to change and IM&T skills need to be acquired and updated. In order to enhance the skills of the workforce and improve patient care there needs to be more IM&T training. There is a need for a standardised form of training involving generic and radiography specific IM&T skills, integrated into undergraduate radiography courses initially but also maintained by the NHS in ongoing specialised training. IM&T skills for new graduates need to be identified, and these skills should be explicit within undergraduate curricula, at least to ECDL level. Educational placements offering IM&T experiences need to be identified for higher education students, with in-service education required for HIS, RIS and PACs. More work and investment is needed to support a clinical and cultural change. It is acknowledged radiographers require basic IM&T skills (at least the ECDL) but they need to be encouraged to achieve at least a basic level of competence. The benefits to an organisation of staff training, education and qualifications in IM&T should be acknowledged and addressed with adequate resources to ensure radiographers are equipped with the necessary IM&T skills to ensure optimum service delivery and patient care. Further work is required to map IM&T competencies across bands and specialties and where necessary, accredited courses developed. Key staff must understand how IM&T can benefit patient care in terms of efficiency, effectiveness and safety, and how to apply knowledge and skills within their area of expertise. In the future advanced IM&T skills may need to be recognised as an area of role development / advanced practice. Generally informants also felt that they would prefer training in small groups or one to one training delivered on site. In addition, although the use of Smartcard technology was found to be low, transmission of data was widespread within trusts and therefore IM&T training must incorporate data governance and security issues. Clinical systems must be integrated more efficiently to enhance the flow of work, particularly as IM&T crosses different boundaries and there is a greater sharing of patient data.

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