reports for decades18,19 head20, mammography21,22
. There are also growing numbers of radiographers who provide clinical reports for CT and MRI examinations23,24
.
Image interpretation as part of the e-Learning for Healthcare program Education for radiographers, both in image interpretation itself and in how to accurately communicate findings to clinicians using appropriate terminology, has been identified as fundamental to radiographers participating in PCE15 16
. Traditionally, image interpretation training for radiographers consisted of workplace learning or
intensive short courses, however growing demand coupled with funding and time pressures meant that a different approach was needed. The Image Interpretation program, an online learning tool, was created to provide a comprehensive educational resource which, in conjunction with local mentorship and work based learning, supports PCE. E-learning, the delivery of education or training flexibly online, is a growing mechanism for the delivery of training, and healthcare is no exception16 25
development for radiographers, and in a drive to improve patient care through the accurate evaluation of radiographic images at time of acquisition, the College of Radiographers and the Department of Health (now Health Education England) developed an interactive, online education resource for image interpretation as a discrete section in the award-winning e-Learning for Healthcare program26
. The complete e-Learning for
Healthcare program is an extensive resource, developed in partnership with a spectrum of academic partners and professional bodies, including the Royal College of Radiologists, Royal College of General Practitioners, and Institute of Physics and Engineering in Medicine, and covers a vast array of healthcare learning. The concept of the Image Interpretation program was developed in 2009, in joint discussions between the College of Radiographers and the Department of Health. Sessions, or small units of learning, have been authored by subject matter experts; senior clinical radiographers, academic radiographers, radiologists, medical physicists, emergency physicians, midwives and other healthcare professionals, using a standardised structure and content to ensure consistency across the program. Modules, comprising multiple sessions grouped by topic, for example obstetric ultrasound, are co-ordinated by module editors who facilitated peer review of every session. This has ensured consistency, accurate content and high quality learning. This rigorous process has produced an acclaimed resource to facilitate image interpretation that is available to all NHS practitioners, not just radiographers, free of charge. The content is highly relevant, not only to radiographers but to all healthcare professionals, who are required to evaluate images in order to deliver appropriate care, such as emergency nurse practitioners, nurse consultants, junior medical staff, anaesthetists, midwives and physiotherapists. These sessions offer an opportunity for new learning for novices or provide a 'refresher' and continuing professional development resource for more experienced staff. The initial Image Interpretation project development consisted of 50 sessions covering plain imaging of the adult axial and appendicular skeleton. Further divided by body region, these sessions provided a comprehensive review of anatomy, mechanisms of injury, image evaluation and pathologic radiographic appearances. These beginnings have now developed into a substantial educational resource on image interpretation, with 284 sessions currently available, growing to more than 300 by July 2015. The entire spectrum of plain imaging has been covered, with 40 sessions covering the paediatric skeleton, 10 sessions on the adult chest, eight sessions
-39-
on the adult abdomen and 14 paediatric chest and abdomen sessions. To facilitate new staff beginning their specialist rotations, introductions to the specialist modalities have been constructed, including CT of the head and cervical spine, MRI of musculoskeletal system and internal auditory meati, and nuclear medicine. Breast imaging has also been covered, with 13 sessions including interpretation of pathology demonstrated on ultrasound, mammograms and MRI, and sessions on screening, quality assurance and anatomy. The e-learning modules can be accessed through the e-Learning for Healthcare Learning Management
. In response to the ever increasing demands of continuing professional
System (e-LfH LMS) or the National Learning Management System. On the e-LfH LMS alone, since the first skeletal modules were launched, more than 20,000 registered users have accessed the training and have spent the equivalent of nearly 900 days engaged in interactive learning. Over 52,000 sessions have been accessed, with skeletal image interpretation accounting for the majority of sessions undertaken (37,000). Adult sessions have proved the most popular, reflecting the majority of the imaging workload of many radiographers, however 3000 sessions covering the paediatric skeleton have also been used. The multidisciplinary reach of the Image Interpretation project, supporting the learning of all health professionals, is demonstrated in the spectrum of professions who have used the program, including medical students, specialist registrars, physiotherapists, nurses, midwives, paramedics, podiatrists as well as radiographers (figure 1). (e-Learning for Healthcare activity data 2010-January 2015).
The importance of imaging in suspected cases of non-accidental injury (NAI) has been reinforced with recent high profile cases27
. In order to support radiographers undertaking such examinations, dedicated modules
covering forensic imaging and non-accidental injury were developed to explain the principles behind these examinations, to reinforce the need for high quality images and to alert radiographers to findings suspicious for NAI when undertaking paediatric x-ray examinations so that appropriate escalation can be instigated. These dedicated sessions have been completed over 1400 times (880 paediatric NAI accesses and 580 for forensic imaging) on the e-LfH LMS. The ultrasound aspect of the program was first launched in 2012 with sessions covering gynaecological and abdominal examinations, men’s health and vascular ultrasound. The scope has further increased in 2013, with content covering obstetric and musculoskeletal applications. This will support not only sonographers expanding their role, but also extended scope physiotherapists and medical staff who require an increasing level of knowledge in their practice. Ultrasound has proved popular with 6500 sessions completed. Obstetrics, gynaecology and abdominal modules are accessed most frequently.
The value of Image Interpretation One of the radiographer specific competencies required upon registration with the Health and Care Professions Council (HCPC) is set out as ‘be able to distinguish disease and trauma processes as they manifest on diagnostic images’28
College of Radiographers29
. This clearly pertains to the evaluation and interpretation of images and, since 2006, the has expected undergraduate education programs for radiographers to ensure that
at qualification radiographers are competent to provide written preliminary comments on specified imaging examinations. This should mean that newly qualified radiographers at the point of registration with the HCPC, now have the underpinning education and training to begin to participate in preliminary clinical evaluation. To support students to meet this professional requirement by the time of qualification, the Image Interpretation
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