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Chapter 2: Results

2.1 Informants

Approximately 19,250 qualified radiographers were members of the Society of Radiographers during 2007-2008. 1443 valid responses to this survey were received within the time limit. This represents approximately 7.5% of the total (SoR) membership. Of these 1232 (85.4%) described their discipline as diagnostic and 211 (14.6%) as therapeutic.

As indicated by responses to Questions 1-3 the majority of informants, as anticipated, were members of the Society of Radiographers (98%) and female (78.9%). Informants represented the full range of age categories presented in the questionnaire (20 years - 60+ years) with most (67.4%) being aged over 40 years. 97.7% of informants were located in the UK with the largest number (14.2%) located in the south east of England and working in the NHS (83%). 92 (6.4%) worked in independent / private sectors.

Most informants were in bands 7 (32.6%) and 6 (31.9%) with 343 (23.8%) of informants employed in general radiography, 152 (10.5%) in ultrasound and 129 (8.9%) in management. 88 (6.1%) were employed in higher education, 85 (5.9%) in accident and emergency / trauma radiography, 82 in breast imaging and 74 (5.1%) in radiotherapy treatment. Other informants worked in a wide range of diagnostic and therapeutic areas such as MRI, CT, radioisotopes/ nuclear medicine, radiotherapy pre-treatment and IM&T.

The main specialties of the consultant radiographer informants were breast (3) reporting (3), ultrasound (3) with 2 informants describing themselves as working in advanced practice. The remaining 11 consultants who participated worked in 11 differing specialties namely ‘Brachytherapy, Abdominal and gynae, DXA bone densitometry , Emergency Care, GI /Urology , Head and Neck Oncology, Imaging Specialist , Macmillan, Mammography, Palliative Radiotherapy, Vascular and general Abdominal’.

103 (7.1%) of informants worked in a university with the majority (39%) employed as lecturers and 30.5% engaged as senior lecturers in a post-92 university (i.e. an institution created after 1992). Since university employed staff formed a small percentage of the total informants and the aims of the study focused on IM&T in the clinical setting this group will not be considered separately. However the findings may be considered in a separate report.

The highest level of qualification informants commonly held was a bachelor’s degree (24.8%), with others identifying their highest qualification as diploma (20.9%), postgraduate diploma (18.6%), postgraduate certificate (15.1%), master’s degree (15%) and doctorate (1.1%).

Only 184 (12.8%) were primarily employed or required, to undertake a specific IM&T role in their job/specification.

2.2 Information Management and Technology: Ability

Informants rated their level of ability on a scale of 1 – 6 where 1 described a Beginner and 6 described an Expert. The majority (1005 / 70%) rated their ability as 4 and above (Table 1). When cross tabulated with age, it was evident that 73% under 40 yrs rated their ability as 4 and over, compared to 69% in the 40-59 yr age group. When the 60+yrs age group results were added to the 40-59 yr age group, the figure dropped slightly to 68%.

 

    Level of IM&T ability
    Beginner 2 3 4 5 Expert Total
Age 20-29 6 9 31 82 40 3 171

30-39 7 12 61 127 81 9 297
  40-49 11 28 120 195 126 19 499
  50-59 7 25 95 201 77 12 417
  60+ 0 4 15 19 12 2 52
  Total 31 78 322 624 336 45 1436

Table 1: Level of IM&T ability and age

When considering IM&T ability and Agenda for Change (AfC) band, 80% at band 8 and above rated their ability at over 4 compared to 66% at bands 5 and 6, and 67% at band 7. Those in the higher bandings (8a and over) considered themselves to have greater aptitude than those in bands 5 to 7 (Table 2).

 

  Level of IM&T ability
  Beginner 2 3 4 5 Expert Total
Band 5 6 14 40 69 42 3 174
Band 6 3 25 104 163 81 10 386
Band 7 12 20 92 172 90 9 395
Band 8a and higher 3 8 34 110 57 13 225
Other 0 1 3 10 7 1 22
Total 24 68 273 524 277 36 1202

Table 2: Level of IM&T ability and band 

2.3 Information Management and Technology: Confidence

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. There was no difference in confidence levels in the use of IM&T in general between those employed in the NHS and the private sector.

 

    Confidence in using IM&T
    Not
Confident
2 3 4 5 Very
Confident
Total
Age 20-29 4 10 27 55 59 14 169

30-39 6 19 48 103 84 36 296
  40-49 7 29 101 167 146 49 499
  50-59 5 28 98 150 103 33 417
  60+ 0 3 15 17 13 4 52
  Total 22 89 289 492 405 136 1433

Table 3: Confidence in using IM&T vs. age

 

Age Group % demonstrating confidence
20-29 76
30-39 79
40-49 72
50-59 68
60+ 65

Table 4: Percentage of Age Groups demonstrating Confidence in using IM&T

 Typically across the age groups most informants indicated they were generally confident in IM&T. When looking at specific age groups versus confidence in using IM&T a higher percentage of those in the 30-39 age group demonstrated confidence. Similarly when compared to other age groups a higher proportion of those the 30-39 age group indicated they were very confident in their use of IM&T.

    Confidence in using IM&T
    Not
confident
2 3 4 5 Very
confident
Total
Band Recode Band 5 3 16 35 54 53 11 172
  Band 6 2 26 84 136 106 31 385
  Band 7 8 29 79 144 92 43 395
  Band 8a and higher 3 9 34 78 72 29 225
  Other 0 0 5 6 7 4 22
  Total 16 80 237 418 330 118 1199

Table 5: Confidence in using IM&T vs. band

 When considering band versus confidence, informants at bands 6 and above tended to rate themselves as fairly confident to very confident (Table 5). Training, confidence and time were considered to be the main issues as one informant highlighted:

‘Lack of time and priority given to adequate training at different levels i.e. the least competent need to be given more training. Government targets mean that staff are kept in the department rather than being given time for training.’

There was also a number of comments concerning age related fears and confidence for example.

‘Older members of staff lack confidence and have missed out on the essential building blocks of knowledge needed to build a strong foundation on which to build further skills.’

'Older radiographers are reluctant to learn new skills.’

‘Older staff don’t like change.’

While these comments provide a further insight into radiographers perceptions they were not substantiated by the data provided by informants.

2.4 Information Management & Technology: Work Applications

2.4.1 Importance

The majority of informants believed that IM&T applications in the work place were very important (37%) and 33% felt they were important. Only 0.4% considered IM&T not to be important. There were no particular differences relating to age and band.

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Graph 1: Applications used as part of work

E mail had the most widespread use in work being used by 1409 (98.1%) informants. Of these 78.3% used this application on a daily basis (Graph1). Internet usage received a similar response with a reported use by 1403 (98%) of informants. Of these 67.6% (967) used the internet on a daily basis. The intranet was used by 1386 (97.6%) of informants and on a daily basis by 875 (61.6%). Work use of word processing (e.g. Word) received a similar response being used by 1290 (97%) of informants. Of these 591 (41.2%) used this application daily. 63% of informants regularly used IM&T for CPD purposes. Other applications were used less widely. When considering work usage of applications by the various groups, bands 8a and above showed greatest involvement in all major applications used such as word processing, Excel, databases, e mail and internet.

The use of presentation applications was minimal but bands 8A and above showed greater involvement than other bands. There was little difference in usage across the age groups. Internet work usage on a weekly basis by the 20-29 age group was 5% less than the lowest figure for the other age groups.

2.4.2 Email

For e mail all age groups tended to use e mail for work purposes weekly or more. In each of the age groups over 90% of the informants used e mail weekly or more (Graph2).

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Graph 2: E mail usage related to age

When looking at e mail usage versus band (Graph3) it appears that all groups tend to engage in e mail communication weekly or more. The use of e mail as a means of communication increases inrelation to the increase in the banding levels. 90% of all informants in each band used e mail weekly or more often.

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Graph 3: E mail usage related to bands

2.4.3 Internet

Findings relating to age and use of the internet (Graph 4) are similar to those for engagement with e mail, over 90% of informants in each of the bands using the internet weekly or more. The 40-49 age group demonstrated highest usage on a weekly basis. When considering weekly and occasional use, the 30-39 age group showed the greatest engagement. Use of the internet across the bands was similar to e mail usage, the higher the band the greater the number of informants who used the internet (Graph 5).

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Graph 4: Internet usage related to age

 

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Graph 5: Internet usage related to bands

2.4.4 Word

When looking at age and usage for word processing the majority of users tend to be the 40-49 (377) age group closely followed by the 50-59 (326) age group. There is limited usage (40) in the 60 and above group (Graph 6).

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Graph 6: Word usage related to age

Those in bands 7 (296) and 8a (220) indicated greater use of word processing than those in other bands. 67 informants in band 5 and 67 at band 6 reported they rarely / never used word processing in work (Graph 7).

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Graph 7: Word usage related to bands

Informants were also asked how confident they felt using a range of generalised / educational IM&T applications. (Graph 8) 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.

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Graph 8: Confidence in using General IM&T Applications

2.5 Information Management & Technology: Home Applications

2.5.1 Engagement

Informants were asked about their engagement in IM&T in the home as well as the work place. The rationale for this was to consider their overall IM&T engagement, taking into consideration that many informants may use IM&T relating to work at home. It was also thought that informants may consider themselves to be inept in IM&T in the workplace but demonstrate confidence in its use at home.

Informants were also asked about their own personal IM&T use. In particular which IM&T applications they have at home and which are for work or personal usage.

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Graph 9: Home based IM&T Applications

From the above it appears that informants have a good range of IM&T applications at home and that they tend to use them for both personal use and work related activities. Of particular note are the dual use of word processing, email and the internet. It appears that databases, spreadsheets, and presentation applications are used for work place activities more than the other applications. When asked about the importance of IM&T in the home the majority (30.1%) felt IM&T was fairly important and 24.4% considered IM&T to be important.

2.5.2 Access to the Internet

The majority of informants (88.5%) had access to broadband in the home as indicated in Table 6 below.

Type of access to the Internet % of Informants
Dial-up 3.1%
Broadband cable 31%
Broadband (fixed land line) 57.5%
USB modem 6.6%
Other 1.8%

Table 6: Internet Access at home

2.6 Clinical Applications

2.6.1 Engagement

Informants were asked which clinical systems they used and how often.

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Graph 10: Usage of IM&T Applications

For daily use, the most popular applications were RIS (66.4%), PACS (65.2%), HIS (36.6%), electronic patient records (33.6%) and electronic booking systems 30.2%.

When considering the therapy clinical systems and accounting for the number of therapy informants (n=211), 25% were engaging daily in radiotherapy treatment planning systems, 43% engaging daily in radiotherapy treatment verification systems and 56% engaging daily in radiotherapy patient management record systems. Clinical systems, used less frequently, included virtual training systems (once a month 7%), remote reporting (daily 9.6%), on line test results (daily 16.9%) and e –prescribing (rarely 2%).

As indicated in Graph 10, PACS, RIS, and HIS, were the most frequently used clinical applications. Engagement with these applications has been considered separately for diagnostic and therapeutic informants.

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Graph 11: Percentage of Diagnostic Radiography Informants engagement with PACS, RIS & HIS

Results indicated that of the three main diagnostic clinical applications HIS was used less frequently. RIS was the application used most frequently by diagnostic informants on a daily basis (75.6%) followed by PACS (72.6%) with HIS only used by 37.9%.In comparison 59.5% of therapeutic informants were engaged with HIS, 56.9% of those engaged with PACS and 27.9% engaged with RIS (23.2% on a daily basis).
 

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Graph 12: Percentage of Therapeutic Informants’ engagement with PACS, RIS & HIS

It is suggested the differences noted between diagnostic and therapeutic radiographers engagement with these three systems is indicative of the nature of the daily tasks each group undertakes.

When considering therapeutic informants engagement with radiotherapy specific applications it can be seen that most engagement takes place with radiotherapy patient management and least engagement with radiotherapy treatment planning. Use of radiotherapy treatment verification lies between the two (Graph 13).

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Graph 13: Percentage of Therapeutic Informants’ engagement with main Radiotherapy Specific Applications

2.6.2 Confidence

Informants were asked how confident they felt using specialised radiographic / clinical IM&T applications (Graph 14). For the systems that were used daily, informants felt very confident with PACS (33.1%), RIS (38.8%) and HIS (19.7%). For applications that were not being used frequently the responses were much more widely spread, for electronic booking systems 15.9% were confident, 12.6% fairly confident and 5% not confident. The findings were similar for electronic remote reporting, on line test results and e-prescribing. For the therapy applications (n= 211) 15% were confident in using radiotherapy treatment planning systems, 10% were not very confident, however the majority (68%) were fairly confident. For radiotherapy treatment verification systems 42% were very confident, with only 11% feeling not very confident. For radiotherapy patient management record systems again the majority (45%) were very confident. These results indicate that if the application is used frequently informants tend to feel more confident in using them.

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Graph 14: Confidence using IM&T applications

As indicated in Graph 15 diagnostic informants indicated most confidence when using PACS, HIS and RIS applications with greatest confidence demonstrated in RIS.

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Graph 15: Diagnostic Informants Confidence in using PACS, RIS & HIS

When considering therapeutic informants’ confidence in the same applications (PACS, RIS and HIS), the proportion who indicated they were very confident was not as great as their diagnostic counterparts (Graph 16). However therapeutic informants showed greater confidence in the use of radiotherapy specific clinical applications as indicated in Graph 17.

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Graph 16: Therapeutic Informants Confidence in using PACS, RIS & HIS

 

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Graph 17: Therapeutic Informants Confidence in using Radiotherapy Specific Applications

When considering age versus confidence, Graph 18 shows that few informants in the 60+ age group feel very confident using radiography specific systems i.e. PACS, RIS and HIS. Closer analysis of the percentage of informants per age group indicating a score of 5 or more i.e. high level of confidence, reveals that there are minimal differences between the age groups in relation to confidence of using these systems, as can be seen in Graph 19.

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Graph 18: Confidence using PACS, RIS and HIS vs Age

 

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Graph 19: Percentage of age group indicating a score of 5 or 6 (very confident) using PACS, RIS and HIS

When looking at band versus confidence in using radiography specific systems i.e. PACS, RIS and HIS, the majority rate themselves as being confident to very confident (Graph 20). In fact there was little difference between the scores of 5 or more for confidence in using these systems (Graph 21).

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Graph 20: Confidence using PACS, RIS and HIS vs Band

 

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Graph 21: Percentage of bands scoring 5 or 6 (very confident) in using PACS RIS and HIS

For the responses relating to radiotherapy specific applications, Graph 22 shows that there is a high confidence level for each age group, although the numbers corresponding to the 60+ age group was low. Closer analysis of the scores of 5 or more (very confident) shows that there is a slight decline in the percentage indicating a high level of confidence as age increases (Graph 23).

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Graph 22: Confidence levels of using radiotherapy applications versus age

 

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Graph 23: Percentage of age group indicating a score of 5 or 6 (very confident) in using radiotherapy applications

Analysis of the effect of band on confidence levels of using radiotherapy applications can be seen in Graph 24. Again the results show a large proportion of each band being confident in using these applications. Graph 25 shows that there is minimal difference between the bands for scores of 5 or more in relation to confidence in using these systems.

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Graph 24: Confidence levels of using radiotherapy applications versus band

 

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Graph 25: Percentage of band indicating a score of 5 or 6 (very confident) in using radiotherapy applications

 

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Graph 26: Diagnostic Informants use of PACS vs Confidence

As demonstrated in Graph 26 diagnostic radiographers’ confidence in using PACS increased as their usage increased. However as indicated in Graph 27 therapeutic informants’ confidence using PACS does not increase at a similar rate to their diagnostic counterparts but reported greater confidence in the applications used most frequently.

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Graph 27: Therapeutic Informants Use of PACS: Use vs. Confidence

 

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Graph 28: Informants Confidence vs. Use of on line test results application

When considering on line test results those demonstrating least confidence rarely used this application (Graph 28). Confidence increases as engagement with an application (use) increases.

2.6.3 NHS versus Independent Private Sector

On the whole when investigating confidence levels in using the major specialist radiographic applications (PACS/HIS/RIS and main radiotherapy applications) dependent upon place of employment, there is little difference between those informants who work in the NHS and those in the Independent/Private sector. However as can be seen in Graphs 29 and 30, the confidence of informants in using PACS and RIS is much higher for those working in the NHS than in the Independent/Private sector, where nearly twice as many NHS radiographers feel very confident in using these applications.

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Graph 29: NHS vs. Independent / Private Sectors Comparison of Confidence in using PACS

 

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Graph 30: NHS vs. Independent / Private Sectors Comparison of Confidence in using RIS NHS

2.7 Data Transmission and Storage

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Graph 31: Authority to send/transmit data

1078 (75%) of informants always (that is in all instances) had the authority to send / transmit data internally within the department with only 3.7% (53) never having this authority (Graph 31).

Authority to transmit was reduced when recipients were external to the department and as restrictions diminished. 65.6% (947) always had the authority to transmit data internally within the trust or equivalent with 5.7% (82) never having this authority. Transmission of data externally with some restrictions was always possible for only 34% of informants and never for 15.5%. External transmission without restrictions was always possible for only 260 (18.8%) and never for 37.8% (545).

When considering the Data Protection Act 83.6% of informants were aware of their responsibilities, 14.3% were unsure and 2.0% were unaware. When these results are examined for diagnostic and therapeutic radiography informants (Graph 32) there is little difference between the two groups.

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Graph 32: Awareness of Responsibilities under the Data Protection Act

The use of Smartcards was not widespread with only 9.1% indicating they used this technology, 75.1% indicating no involvement and for 15.9% the question was not applicable.
 

2.8 Barriers to the use of Information Management and Technology

Training was the main issue identified as a barrier to the use of IM&T. Others are indicated in Table 7 below.

Barriers Informants
Training 183
Confidence/Technophobia 85
Time constraints 70
Adequacy of equipment 54
Access 51
Cost/Finance 46
Age 45
Lack of support 12
Advancements in technology/practice 8
Confidentiality 5
Security 4
Complexity 5
Data protection 4
Elitism 2
Management 1
Pay 1

Table 7: Barriers to the use of IM&T

2.9 Education and Training

2.9.1 Qualifications

IM&T Qualifications held Number of Responses
None 742
Certificate of Attendance 338
ECDL 222
Internal work based certificates of attainment 196
CLAiT 112
Other 109
GCSE or equivalent 78
NVQ 20

Table 8: IM&T Qualifications

The majority of informants (742) had no qualifications in IM&T. Since a certificate of attendance is not recognised as an award ECDL was the qualification held by the most informants. The 32 other qualifications cited by 93 informants covered a wide spectrum including advanced ECDL (n=2), part ECDL (n=12), City and Guilds (n=9), A level (n=6), Advanced courses in PACS and RIS (6), HND/HNC (6), RSA (6) and BTEC (3). The ECDL is an internationally recognised qualification which enables individuals to demonstrate their competence in computer skills. It is designed specifically for those wishing to gain a benchmark qualification in computing to enable them to develop their IT skills and enhance their career prospects (British Computer Society 2008). The ECDL syllabus covers the key concepts of computing, its practical applications and their use in the workplace and society. It comprises seven modules, each of which must be passed before an ECDL certificate is awarded.

The seven modules that make up the ECDL are:

  1. Basic concepts of IT
  2. Using the computer and managing files
  3. Word processing
  4. Spreadsheets
  5. Database
  6. Presentation
  7. Information and Communication

The modules may be taken in any order and over any period of time up to three years which makes this a flexible option for those in clinical practice where access to a computer during the normal working day may be problematic. This flexibility and the relatively low cost to the department or learner (approximately £150) may contribute to the popularity of this qualification amongst informants.

2.9.2 General Information Management & Technology Training

In relation to the type of general IM&T training undertaken, the informants indicated a variety of methods (Graph 33) and it was evident that a combination of training methods had been experienced for the various applications. The majority of responses however indicated a lack of formal training, with the number of informants having experienced external training being very small. Indeed, this represented 13% of all responses received for this question. Similarly, informants had a low experience of informal training, with only 16% of responses indicating that they had received any kind of internal training. Of the formal training which had taken place most of this was at an introductory level (3370 responses) compared to advanced type of training (1030 responses). Ad hoc training accounted for 14% of the responses, whilst the majority of responses (57%) indicated that the informants were self-taught or had no experience of training.

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Graph 33: Type of general IM&T training undertaken

For most informants the training had taken place in a group for all applications. For training in word and spreadsheets the second highest form of training was distance/remote learning, the third one to one and the fourth specialist (e.g. vendor) training. For all other applications one to one was the second highest form, with remote learning taking third place and specialist (vendor) training taking fourth.

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Graph 34: Training Format General Applications

When considering preferences (Graph 35), training received in a group was identified as the preferred format for all applications except for statistics where one to one was marginally preferred (41%) to group training (38%). The second most preferred method for all other applications was one to one except for e mail and internet training where self taught came second to group training. Specialist (vendor) training was the least preferred method of training for all applications.

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Graph 35: Preferred format General IM&T Applications

 

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Graph 36: Clinical Applications IM&T training undertaken (Diagnostic & Therapeutic Informants

 

Participation in advanced training courses was minimal for all clinical applications. Internal introductory level courses were those most used for PACS (n=552), RIS (n=551), HIS (n=434), electronic patient records (n=284), electronic booking systems (n=283) and online test results (n=172). Informal / ad hoc training was the next most frequent undertaken for PACS (n=439), RIS (n=385), HIS (n=375), electronic booking systems (n=350), electronic patient records (n=308) and online test results (n=266). None / self taught was the response for on line test results (n=230), virtual training systems (n=197), HIS (n=194), electronic patient record records (n=174), electronic booking systems (n=166), PACS (n=138) and RIS (n=134). Not applicable was the highest response for all other applications. Very few (11%) had undertaken advanced radiography specific IM&T systems training. This type of training was seen to be mostly self taught or ad hoc (52% of responses) and introductory level training (37% of responses), represented in Graph 36. The format of the training reported was mainly in one to one or group format (89% of responses), which again is the preferred format (84% of responses) for most of the informants (Graph 39). As anticipated diagnostic radiographers training in radiotherapy specific applications was minimal. As indicated in Graph 37 for diagnostic informants PACS and RIS were the applications where most training had taken place and where internal training was prevalent. For other applications ad hoc training dominated.

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Graph 37: Clinical Applications Training (Diagnostic Informants)

A contrast between diagnostic and therapeutic informants can be seen in Graphs 37 and 38. Training in radiotherapy verification, management, electronic booking and treatment planning had been undertaken by more therapeutic informants than training in other clinical applications. For these applications internal training was prevalent and self taught training minimal, although more self taught training took place in other applications.

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Graph 38: Clinical Applications Training (Therapeutic Informants)

 

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Graph 39: Preferred Format of Clinical Applications Training (Diagnostic and Therapeutic Informants)

In Graph 39 informants preferred a group format of training for most applications. For those who had undergone training in clinical applications, group training was preferred by 48% for HIS, 45% for RIS and 42% for PACS. One to one was the preferred method for radiotherapy treatment planning (47%), radiotherapy verification (44%) and remote reporting (43%). A similar pattern emerges for diagnostic and therapeutic preferences independently.

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Graph 40: Preferred Format of Clinical Applications Training (Diagnostic Informants)

For the application used most frequently by diagnostic informants (RIS) group training was the preferred method (45.4%). When considering PACS there was little preference demonstrated by diagnostic informants between one to one (42.8%) and group training (42.9%). For HIS and RIS, results were similar where the preferred format of training was in a group. Group training was the preferred method by diagnostic informants for all other applications except for remote reporting where one to one was preferred.

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Graph 41: Preferred Format of Therapy Clinical Applications Training (Therapeutic Informants)

When considering therapeutic informants, Graph 41 demonstrates one to one training was the preferred method for radiotherapy treatment planning (49.3%) and radiotherapy verification (46.9%). Group training was the preferred method for all other therapeutic applications.

Graph 42 below provides a comparison between the preferred format of training for diagnostic and therapeutic informants. Of note is that for the main diagnostic applications, group training was preferred whilst for the main radiotherapy applications one to one was the preferred method.

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Graph 42: Diagnostic & Therapeutic Informants Preferred Format of Training

2.9.4 Barriers to Information Management & Technology Training

Barrier to IM&T Training Number of Responses
Time 339
Funding/Costs 169
Staffing 86
Training Quality 44
Skills/Training 39
Attitudes 38
Access/Availability 35
Resources 27
Fear/Age 21
IM&T Resources/Issues 17
Not part of Job 2
Patient Care/Service Delivery 3

Table 9: Barriers to IM&T Training

 

The main barrier identified was that of time. This related to time to be released from the department in terms of clinical load and the availability of staff to cover absences. Informants felt that ad-hoc training in the work place was not sufficient and that staff needed to be released to undergo formal training. They recognised that this could not happen without adequate funding, which needed to be invested in quality training courses and also to release staff from their ordinary work.

‘There is never enough time to learn anything in the NHS. We are too busy dealing with our own work load.’

‘Staff shortages often result in people not be able to go on training courses.’

Radiographers also commented that IM&T training was not valued by many departments as one informant commented:

‘A computer is still viewed by the people who lead as a play thing for geeks. As such it I not considered a worthy cause to spend the training budget on.’

Others felt that formal training was not always necessary and that it was possible to learn from others in the work place but that you needed time to reflect and practice the skills for the learning to be meaningful.

‘The presumption is that training is always necessary. If staff had the time facilities and resources and encouragement (protected study time) then ICT skills would increase substantially.’

2.10 IM&T: The Future

When considering the future, only 228 informants were able to identify future aspect of IM&T which they thought might be useful or would like to see in practice. Responses were varied with no consensus demonstrated. 24 suggested they would like to see an increase in functionality of RIS/ PACS.

11 identified training in virtual systems while a further eleven identified the need for better integration of these systems:

‘The joining together of the many systems currently in use. To be able to do what I currently do, I need at least 10 passwords.’

Radiographers were asked to comment on which IM&T skills they considered to be necessary for the future. While not all responses can be classified as skills they do provide an insight into the areas where training needs to be focused although the low response rate for this question provides an indication of the difficulty in predicting the future in imaging and radiotherapy.

A general knowledge of word processing and data management was the skill which predominantly featured being identified by 138 of the 531 informants. Other skills which informants identified are included in the table below.

Future Skills Numbers responding
General knowledge of word processing, graphs, data management, 138
ECDL 63
PACS/RIS/HIS/Networking 55
All 44
Keyboard Skills 23
Databases 22
Excel 17
Better understanding of how things work 13
Computer literate 13
Email 12
Internet/Intranet 11
Advanced skills in computing 11

Table 10: Future Skills (n=531)

A range of other skills (43) were identified including ‘as many as possible’ and ‘lots’ with a comment made by one informant:

‘Becoming essential to the role in increasing computerized image acquisition retrieval / data management systems role development by E KSF.’

‘To be computer literate, the basics of which are presumably covered by the national curriculum.’

An interesting finding was that 63 informants suggested that the ECDL or higher might need to be a requirement for the job in the future.

Connecting for Health, in England, has developed the Essential IT Skills (EITS) Programme following a national consultation with NHS stakeholders to supersede the ECDL Service. This programme has been designed to provide local NHS organisations with eLearning tools to ensure NHS staff are prepared for NPfIT systems training rollouts.

The programme will initially focus on the delivery of two qualifications. NHS ELITE (NHS eLearning IT Essentials) an eLearning package for improving candidate’s essential IT skills and NHS Health (NHS eLearning for Health Information Systems), designed to improve individual’s knowledge of the basic principles relating to information governance and patient safety when using health information systems.

The need for organised training was highlighted by several informants whose comments included:

‘Unfair and unrealistic to expect radiographers to pick up IM&T skills by self teaching and picking up hints and tips from other staff members.’

‘We have so many computer illiterate staff that it is detrimental to the efficient service that we strive to provide.’

Radiographers also commented that they would need ongoing training and education as technology moved on very quickly:

‘Image acquisition, processing communication with wards and outside referrers will all eventually go to electronic all round skill is therefore required and are also essential for CPD.’

‘As technology grows very fast it is important to keep ourselves up to date in skills and technology which will help radiographers and other related medical professionals to share, transfer information (data /images in a fast and easy way.’

Other areas that were mentioned were ‘higher level skills’, for example knowing how things work so that they could trouble shoot computer problems when they occurred.

‘It should feature as a regular item on a departments CPD program (i.e. small building block approach ) For example background information on how computers networks function specific tailored small group activities on essential work elements (e.g. RIS PACS operational general elements (e.g. word Excel) which are available to NHS staff).’

‘Nice to have some knowledge of what to do when the systems we use daily do not work, it would empower radiographers….’

When asked to identify any future aspects of IM&T which may be useful to radiographers or that they would like to see in practice, 62 of the 221 responses related to training. Several indicated a need for increased access to training in IM&T at varying levels as the following quotes illustrate:

‘(Need) At least basic computer literacy training. I started radiography in the days when you still dipped your films into fixer and developers.’

‘I think it would be a good idea if the HPC could play a role in assessing radiographers IT skills so as to ensure they have a pre-determined competence in order to practice.’

‘More thorough organised training, where individuals reach a known and quantifiable level of skill rather than ad hoc training.’

‘Perhaps SCoR could produce on-line training sessions.’

However there were also some conflicting views:

‘It’s just record keeping and communication; it doesn’t need complicating beyond that.’

‘We don’t need formal training for every single bit of software. If radiographers can take the initiative and do a Google search to find out how to use some package rather than say ‘we need training’. Confidence building is needed.’

The hypothetical nature of this question resulted in a varied response with radiographers perhaps talking more personally about how they see the future need for IT training / skills affecting them rather than the profession. However several conclusions may be drawn.

Radiographers do perceive that the range and level of IM&T in the workplace will increase and they will need training to cope with this, particularly in the general IT area and with specialist clinical systems. They feel a need for progression in training from understanding the basics at entry level to having greater higher order skills as they move through their career. There is also a feeling that training should be more structured and that there should be greater recognition for the training undertaken.

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