50 2011


IMAGING & ONCOLOGY


the total picture of how a profession exists and evolves6,7


. They are inextricably linked


in a partnership engaged in the process of developing and applying practice through education, research and collaboration with the aim of ensuring an ongoing drive for excellence. Benson7


indicates that one of the criteria for a profession is that there


must be a professional body which – ‘must set the ethical rules and professional standards which are to be observed by the members’ – thereby acting as a focus for the integration of theory and practice.


Educational programmes develop undergraduates to become members of a profession and, in that process, students will usually undertake work placements within that industry. University departments engage in research, commonly in collaboration with and, indeed, receive funding from the industry with which they are associated. The notion of partnership therefore, if idealistic, is explicit in both educational and research terms.


In radiography, these components all exist, but does the partnership notion really work in the idealistic sense? Anecdotally, it seems that there is often a divide between theory and practice, as if the two were linked in only a tenuous fashion. Undoubtedly, many very effective relationships exist between the clinical and academic sectors, though often this may extend only to limited strata of activity, for example, training of undergraduate students, or linkage for delivery of professional development programmes. This can lead to the perception of a purchaser provider type relationship, rather than a partnership. Whilst it is true that HEIs are obliged to liaise with the clinical sector in the periodic process of developing or reviewing curricula, how often is the clinical sector at ground level, involved in collaborating in research initiatives? How much ownership does the profession have of the development of its evidence base? Current evidence indicates that there is a limited degree of activity in these areas and there are a number of reasons why this may be8


.


For example, radiography has traditionally been seen as a ‘hands on’, practically oriented discipline and this could be considered an ingrained culture; HE sector involvement in radiography education, providing the opportunities for collaboration, is a relatively recent occurrence; the operational linkage with the radiological profession has traditionally been essentially subservient, with much of the practice related research medically dominated; the structure and budgetary mechanisms of the National Health Service do not necessarily facilitate the establishment of department level research initiatives. These factors are general and it would be quite wrong to imply that there are no examples of effective partnerships and collaboration. However, the pervading culture does not readily support the sort of situations that exist more commonly in the wider world.


WHY IS THIS A PROBLEM? In a time of rapid change, adaptation and evolution of the profession have to be driven coherently and strategically. Education should provide practitioners that are not only fit for practice, but fit to take practice forward. The clinical sector should be able to provide a strategic view of what it needs from professional education in the medium term,


bearing in mind that a course developed now will produce its first graduates in at least three years’ time.


Dealing with continuous transition in healthcare delivery and technology means that there is considerable scope for a mismatch of expectation if collaboration is not effective. In this context, it is fair to say that the academic world has a responsibility to have a clear perspective on emerging health policy and technology in order to respond proactively to prospective needs. The danger is, however, that if the ‘cart comes too far before the horse’, then educational effectiveness may be compromised. A largely diagnostic example of balancing such a transition, which could be termed ‘transition stress’, is the move from film-based to entirely digital imaging. This is a situation where HEIs had to shift from one substantial technology to another over a period of time, balancing the needs of students according to the environment in which they were training, in the knowledge that they may then go on to work in a another location where the arrangements were completely different.


The concept of transition stress is a common feature of dealing with change in a multi- factorial environment9


. HEIs need to be ahead of the game, yet aligned to current


reality. They need to be able to work with the clinical sector, yet the shape and culture of that sector may provide its own challenges. Notwithstanding the current economic climate, the projected changes in healthcare structure, delivery and workforce; and the continuing development in technology associated with both imaging and oncology, provide the main challenges to the education sector in both the short and medium term. The scope for change is massive.


CHANGING TECHNOLOGY Imaging and oncology service development is driven by a variety of factors, but there is no doubt that technology is a major component of delivery in both disciplines. Indeed it has been said10


that radiographers are the interface between the equipment and the


patient, ensuring that the two come into contact in the correct way, with the correct outcome. Amongst health practitioners, it can be argued that radiographers occupy an unusual position in terms of how they are ‘linked’ to the equipment they use. This means that evolution in equipment design and function has a fundamental impact on radiographers and the nature of the demands on them in using it.


In the past 30 years at least, developments in computer technology have probably had the greatest impact on the technological aspects of how radiographers practice. Computerised systems are fundamental to how much of modern radiographic equipment functions, relying heavily on computer processing power in order to manage large amounts of digital data. An estimate of the significance of this is demonstrated by Moore’s law11


which, in 1965, predicted a doubling of computer power every two years.


It is believed that the law continues to hold true today, indicating an almost exponential change in processing power that will probably not come as a surprise to radiographers who have been around for a while.


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