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Chapter 3: Conclusions

This research, commissioned by the Society and College of Radiographers (SCoR) has provided a wealth of data on the Information Management and Technology (IM&T) knowledge, skills, engagement and education of radiographers, managers and educators in Clinical Imaging and Radiotherapy. A response rate of 1443 was achieved. Although not fully representative of the 19,250, (approximate) members of the SCoR, compared to other on-line surveys commissioned this is a high response rate. This response rate was achieved through widespread publicity and a prize draw. The option to complete a paper based questionnaire was also given, although this was only taken up by 2 informants. It has to be recognised that one of the limitations of this research could be that the opinions from people having real difficulties with IM&T may have been missed because of the nature of the data collection process. In addition while some conclusions can be drawn from informants self assessment of their ability and confidence it must be recognised that individuals may be operating within the confines of their own level of ability and unaware of the knowledge and skills that they could achieve in specific applications.

However it is evident that IM&T is a topic which the radiographic workforce consider crucial since 90% rated IM&T in the workplace as important / very important. The high response rate to this survey may be due to the emotive nature of the topic and the difficulties informants are experiencing with the ongoing developments in IM&T.

Informants recognised the importance of IM&T in the workplace with no particular differences relating to age and band. There was engagement with IM&T across the board in a wide variety of applications. The majority (70%) of informants rated their general ability and confidence as fairly high. Those respondents in the higher bands considered themselves to have a higher aptitude for IM&T, the vast majority of those at band 8 and above rated their ability at over 4, significantly higher than those in other bands. Although there were no major differences with age, those under 40 years of age rated their ability higher than those over 40 years. Several informants commented that those in the ‘older’ age group had difficulties with IM&T while those in the younger age groups were more at ease and found applications easier.

Typically across the age groups most radiographers 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 rated themselves as confident. Similarly when compared to other age groups a higher proportion of those the 30-39 age group indicated they were very confident. 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 is suggested that this confidence has developed from the level and degree of engagement, since those in higher bandings demonstrated greater usage than those in the lower bandings. Additionally it is suggested that those in higher bandings will be required to manage and solve problems associated with IM&T and may have responsibilities to train others and are likely to have management responsibilities requiring greater engagement in audit and databases. Informants employed in the NHS showed greater confidence in clinical applications than those employed in independent/private sectors.

Typically E mail, internet, intranet and word processing were the most commonly used applications in the workplace. Others such as Excel, databases, PowerPoint were used less frequently. When considering engagement in clinical applications, for daily use the most applications were RIS, PACS and HIS. For therapeutic radiography informants the greatest engagement was with HIS followed by PACS and HIS. For radiotherapy applications, patient management record systems followed by radiotherapy treatment verification systems were used most widely used. The clinical systems that were used least frequently were virtual training systems and e-prescribing, which are relatively new applications and not yet utilised in every department. When informants were asked about their confidence in using these 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.

Transmission of data within departments and trusts was widespread. As expected the restrictions of data protection meant that few had authorisation to transmit data further a field. It was surprising that few were engaged in the use of SMART cards despite the fact that over 400,000 have been issued to NHS staff and students in England.

The number of informants using IM&T for CPD purposes on a regular basis was less than expected (63%). It is outside the remit of this study to determine whether this reflects engagement with CPD, IM&T or both. This was an unexpected result since the majority of informants were members of the Society of Radiographers and therefore had access to ‘CPD Now’. Lack of confidence is unlikely to be the reason since over half 55% of informants expressed confidence in the use of IM&T for CPD.

Training was identified as the main barrier to the use of IM&T. 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, and individuals own clinical workloads and financing. Despite this 334 informants did have a formal nationally recognised qualification such as the ECDL and CLAiT. The majority of informants had not received any formal training in general IM&T applications and were primarily self-taught. 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.

The main barrier to training in IM&T was identified as time.

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