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How do technical improvements change radiographers’ practice: a practice theory perspective
Linköping University, Department of Medical and Health Sciences, Division of Radiological Sciences. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Center for Diagnostics, Department of Radiology in Linköping.
Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Health Sciences. (Medicinsk pedagogik)ORCID iD: 0000-0001-5066-8728
Linköping University, Department of Medical and Health Sciences, Division of Radiological Sciences. Linköping University, Faculty of Health Sciences.
2015 (English)In: Radiography, ISSN 1078-8174, E-ISSN 1532-2831, Vol. 21, no 3, 231-235 p.Article in journal (Refereed) Published
Abstract [en]

Introduction: Technical improvements in medical imaging have led to the replacement of two-plane imaging techniques by multidimensional imaging. How this affects radiographers’ professional practice has not been investigated.

Aim: To explore how technical development affects the relations between different actors and their actions in the practice of computed tomography.

Method: A qualitative design was used with data collection by open interviews (n=8) and open observations (n=10) of radiographers during their work with computed tomography. Data was first analysed inductively, resulting in seven preliminary codes. The initial analysis was followed by a phase of abduction, in which the preliminary codes were interpreted theoretically through the lens of practice theory. This resulted in four final themes.

Result: First theme: Changed materiality makes practical action easier. The actual image production has become practically easier. Second theme: New machines cause conflict between the structural arrangements of the work and the patient’s needs. The time required for the scanner to carry out image production is easy to foresee, but information about the patient’s individual status and needs is missing and this leads to difficulties in giving individual planned care. Third theme: Changing materiality prefigures learning. The different apparatus in use and the continuously changing methods of image production are coconstitutive of the practitioner’s activities and learning. Fourth theme: How the connections between different practices lead to moments of practical reasoning in the radiography process with CT. The practice of image production with computed tomography takes account of patient safety in relation to radiation doses and medical security risks. The different professions in CT practice are interconnected through common material objects such as computers and machines. However, the radiographers, who meet the patients, have to check the accuracy of the planned examination in relation to the clinical observed information about patient safety risks during the examination.

Place, publisher, year, edition, pages
Elsevier, 2015. Vol. 21, no 3, 231-235 p.
Keyword [en]
Practice, Radiographer, Radiography, Practice theory
National Category
Radiology, Nuclear Medicine and Medical Imaging
Identifiers
URN: urn:nbn:se:liu:diva-111721DOI: 10.1016/j.radi.2014.12.002OAI: oai:DiVA.org:liu-111721DiVA: diva2:759087
Note

When defending the Ph.D. thesis the status of this article was Manuscript.

Available from: 2014-10-29 Created: 2014-10-29 Last updated: 2017-12-05Bibliographically approved
In thesis
1. Radiographers’ professional practice: a Swedish perspective
Open this publication in new window or tab >>Radiographers’ professional practice: a Swedish perspective
2014 (English)Licentiate thesis, comprehensive summary (Other academic)
Abstract [en]

The general aim of this thesis was to empirically describe the radiographers’ professional scope in diagnostic imaging from the viewpoint of the practitioners and investigate how technical development affects the relations and actions in this practice.

Data was collected by interviews and observations to both studies at the same time with two different aims. Eight radiographers (n=8) were interviewed. The interviews were open in character, were recorded with a digital voice recorder, and transcribed verbatim by the interviewer. The interview guide consisted of four interview questions. The observations of radiographers during their work with Computer Tomography (CT) and Magnetic Resonance Imaging (MRI) were conducted in a middle-sized radiology department in the southern part of Sweden. The observations were ten (n=10) in total.

Two different theoretical perspectives were used: phenomenology (Study I) and practice theory perspective (Study II). Data was analysed with a phenomenological method in Study I. In Study II data was firstly analysed inductively, which resulted in seven codes. Secondly, abduction was made by interpretation of these codes from a practice theory perspective. This led to four themes.

The findings in Study I display the main aspect of the radiographers’ work with image production. Their general tasks and responsibilities can be viewed as a process with the goal of producing images that can be used for diagnosis purposes. The process has three different phases: planning the examination, production of images, and evaluation of the image quality. The radiographers experience the production of images as their autonomous professional area.

The findings in Study II report how technology development affects the relations between different actors and their actions in the practice of Computer Tomography. Four themes were identified; 1) Changed materiality makes the practical action easier. Radiographers’ practica work with image production has become easier when working with CT  compared to conventional techniques because the CT usually performs the image production in one scan. 2) Changed machines cause conflict between the arrangements of the work and the patients` needs. It is difficult to plan the examination individually for each patient because of the arrangements of the CT practice, i.e. they have little information about the patient before the examination. 3) Changing materiality prefigures learning. The radiographers describe a need for constant learning activities because of the changing procedures for image production and new modalities for image production. If not achieved it may affect their relations with the patients. 4) How the connections between different practices lead to times when practical reasoning is required in the radiography process with CT. The connections between the different professions in CT practice mainly occur through material arrangements because physically they work in different areas. The external arrangements in CT practice pre-figure actions for securing accurate radiation level and image quality. But the radiographers, who meet the patients, have to critically judge the intended actions in relation to clinical observed data to ensure patient safety.

Place, publisher, year, edition, pages
Linköping: Linköping University Electronic Press, 2014. 43 p.
Series
Linköping Studies in Health Sciences. Thesis, ISSN 1100-6013 ; 129
Keyword
Radiographer, radiography, practice, technical development, phenomenology, practice theory, patient safety
National Category
Radiology, Nuclear Medicine and Medical Imaging
Identifiers
urn:nbn:se:liu:diva-111722 (URN)10.3384/lic.diva-111722 (DOI)978-91-7519-277-2 (ISBN)
Presentation
2014-11-25, Hagdahl, plan 10, Campus US, Linköpings universitet, Linköping, 09:00 (Swedish)
Supervisors
Available from: 2014-10-29 Created: 2014-10-29 Last updated: 2015-04-01Bibliographically approved

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Lundvall, Lise-LottAbrandt Dahlgren, MadeleineWirell, Staffan

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