BackgroundPatients’ satisfaction arises from their appraisal of experience in hospital services and measuring patients’ satisfaction in hospital has become a global phenomenon. To improve on patients’ satisfaction, radiographers have to imbibe the right ethical attitude in their conduct while discharging duties to patients during radiological examination. The objective of this study is to understand from the patients’ perspective the ethical conduct of radiographers and radiology nurses that constitute factors in patient satisfaction during routine radiological examination. The rationale of (...) the study is to use the findings to improve radiological service delivery and improve on patient satisfaction.MethodsThis is a cross-sectional descriptive study in which 300 respondents in two hospitals were surveyed to ascertain their satisfaction with the ethical conduct of radiographers and services provided by radiology nurses in the department. The data was analyzed using descriptive statistics at 95 % confidence interval for mean scores and Z-values.ResultsThree hundred patients responded to the survey which comprised of 145 patients from the public hospital and 155 patients from the private hospital. Radiographers fell short in some ethical/professional conduct as in informed consent before treatment ; radiographers’ not explaining his/her experience, expectation, knowledge and equipment procedure. However, they did well in some aspects including observation of professional boundaries with patients during treatment and equity in treatment for the patients during the radiological examination. Some services provided by staff members in the department also fell short of patients’ expectation and satisfaction including explanation of what to expect during the exam, whereas they did well in their level of courtesy to patients. There was a significant difference in the satisfaction level experienced by patients at both hospitals in favour of the private hospital.ConclusionsThere is an urgent need for improved ethical/professional conduct of radiographers and general service delivery in the radiology departments of the hospitals where this investigation was carried out to enhance patient satisfaction. Government has to improve the curricular of service providers in radiology service in the university to include ethical/professional conduct and patient/provider relationship. (shrink)

Background The integration of artificial intelligence (AI) in radiography presents transformative opportunities for diagnostic imaging and introduces complex ethical considerations. The aim of this cross-sectional study was to explore radiographers’ perspectives on the ethical implications of AI in their field and identify key concerns and potential strategies for addressing them. Methods A structured questionnaire was distributed to a diverse group of radiographers in Saudi Arabia. The questionnaire included items on ethical concerns related to AI, the perceived impact on (...) clinical practice, and suggestions for ethical AI integration in radiography. The data were analyzed using quantitative and qualitative methods to capture a broad range of perspectives. Results Three hundred eighty-eight radiographers responded and had varying levels of experience and specializations. Most (44.8%) participants were unfamiliar with the integration of AI into radiography. Approximately 32.9% of radiographers expressed uncertainty regarding the importance of transparency and explanatory capabilities in the AI systems used in radiology. Many (36.9%) participants indicated that they believed that AI systems used in radiology should be transparent and provide justifications for their decision-making procedures. A significant preponderance (44%) of respondents agreed that implementing AI in radiology may increase ethical dilemmas. However, 27.8%expressed uncertainty in recognizing and understanding the potential ethical issues that could arise from integrating AI in radiology. Of the respondents, 41.5% stated that the use of AI in radiology required establishing specific ethical guidelines. However, a significant percentage (28.9%) expressed the opposite opinion, arguing that utilizing AI in radiology does not require adherence to ethical standards. In contrast to the 46.6% of respondents voicing concerns about patient privacy over AI implementation, 41.5% of respondents did not have any such apprehensions. Conclusions This study revealed a complex ethical landscape in the integration of AI in radiography, characterized by enthusiasm and apprehension among professionals. It underscores the necessity for ethical frameworks, education, and policy development to guide the implementation of AI in radiography. These findings contribute to the ongoing discourse on AI in medical imaging and provide insights that can inform policymakers, educators, and practitioners in navigating the ethical challenges of AI adoption in healthcare. (shrink)

Previous work has shown that concerns of breast cancer patients after finishing radiotherapy are responsive to conversations with radiographers during the treatment period. This study seeks to further understand radiographer and patient experiences, determine shared priorities for improvement in clinical interaction and develop communication guidelines and training to help radiographers support patients.Methods: Using the principles of Experience-Based Co-Design, semi-structured interviews were held with N = 4 patients and N = 4 radiographers, followed by feedback events to validate (...) findings. Patients and radiographers exchanged experiences in a joint co-design session, agreed with shared priorities and generated ideas for further support. A survey was conducted for process evaluation. To scale up findings, UK-wide representatives from patient networks and radiographers and managerial staff provided consultative input utilizing an iterative, adaptive procedure.Results: Radiographers expressed a need for support with “difficult conversations,” especially those on Fear of Cancer Recurrence, and their appropriate management. Important pointers for reassuring communication were identified, including: being treated like a person, knowing what to expect, and space to ask questions. The co-design process was rated positively by both staff and patients. Thematic collation of findings and mapping these on literature evidence resulted in the “KEW” communication guidelines for radiographers: Know, Encourage, Warmth. National stakeholder consultations validated and helped fine-tune the training model. The resulting training package, included: trigger videos, a simulated patient scenario and interactive handouts on fears of cancer recurrence and the patient pathway.Conclusions: The co-design process captured good practice to help standardize quality in empathic communication in the radiotherapy service. The resulting KEW: Know, Encourage, Warmth guidelines, and training package are user-centered as well as evidence-based. Supplementing single-site co-design with national consultative feedback allows for the development of interventions that are relevant to the clinical practice, even in detail, and helps to generate appropriate buy-in for roll out on a wider scale after evaluation.Trial Registration:www.ClinicalTrials.gov ID: NCT03468881. (shrink)

In 1964 radiographs of an Egyptian mummy displayed by the, then, Gulbenkian Museum of Art and Archaeology in Durham revealed an artificial upper limb attached to a deformed lower forearm. The limb was removed for further study. It concluded that the deformity was due to pre-mortem, amputation above the wrist, the ancient embalmers applying a crude restoration. In 2005 the author undertook a detailed reappraisal of this restored limb. These findings now suggest that this individual exhibits a congenital deformity to (...) the upper limb. Such a proposal prompts a discourse on how deformity was perceived, not only by ancient Egyptian society but by those across the ancient world. Textual sources have been selected to highlight how perfection of the physical body was prized by some cultures, contrasting this with how those who exhibited ‘otherness’,were either accepted or marginalized. (shrink)

Studies in the psychology of visual expertise have tended to focus on a limited set of expert domains, such as radiology and athletics. Conclusions drawn from these data indicate that experts use parafoveal vision to process images holistically. In this study, we examined a novel, as-of-yet-unstudied class of visual experts—architects—expecting similar results. However, the results indicate that architects, though visual experts, may not employ the holistic processing strategy observed in their previously studied counterparts. Participants (n = 48, 24 architects, 24 (...) naïve) were asked to find targets in chest radiographs and perspective images. All images were presented in both gaze-contingent and normal viewing conditions. Consistent with a holistic processing model, we expected two results: (1) architects would display a greater difference in saccadic amplitude between the gaze- contingent and normal conditions, and (2) architects would spend less time per search than an undergraduate control group. We found that the architects were more accurate in the perspectival task, but they took more time and displayed a lower difference in saccadic amplitude than the controls. Our research indicates a disjunctive conclusion. Either architects are simply different kinds of visual experts than those previously studied, or we have generated a task that employs visual expertise without holistic processing. Our data suggest a healthy skepticism for across-the-board inferences collected from a single domain of expertise to the nature of visual expertise generally. More work is needed to determine whether holism is a feature of all visual expertise. (shrink)

The present study examines the work of a group of medical scientists as they identify interpretative ‘pitfalls’ – recurrent sources of error – in the use of a new radiographic technique, formulate suggestions on how these pitfalls can be avoided and communicate their findings in the form of a scientific publication. The analysis focuses on a session in which previously diagnosed cases are discussed, and demonstrates the ways in which a certain source of diagnostic error gradually emerges as a taken-for-granted (...) in the interaction. An increased sense of recognition, recurrence and typicality is discernible in the treatment of the cases. Talk characterized by expansions and elaborations, displays of understanding in the form of reformulations, understanding checks, and so on, leave room for brief typifications and reifications of interpretative difficulties in characteristics of the imaging technique. Topical treatment of perception and interpretation, as well as embodied engagement, become decreasingly salient. It is argued that the abstracted formulations in the published text rely on the case-by-case working up of generality from particularity; from individualized accounts of why ‘I’ interpreted the image in a certain way to proffered generalizations achieved through articulated perceptions of a generalized ‘one’. If these proffers are ratified, a potential ground is established for the consensual formulation of a pitfall. The formulation of novel instructions is consequently made relevant, projecting a re-instructed diagnostic practice. (shrink)

The referral is the key source of information that enables radiologists and radiographers to provide quality services. However, the frequency of suboptimal referrals is widely reported. This research reviews the literature to illuminate the challenges suboptimal referrals present to the delivery of care in radiology departments. The concept of suboptimal referral includes information, that is; missing, insufficient, inconsistent, misleading, hard to interpret or wrong. The research uses the four ethical principles ofnon-maleficence, beneficence, AutonomyandJusticeas an analytic framework.Suboptimal referrals can causeharmby (...) hindering safe contrast-media administration, proper radiation protection by justification of procedures, and compassionate patient care. Suboptimal referrals also hinder promoting patientbenefitsfrom the correct choice of imaging modality and protocol, an optimal performed examination, and an accurate radiology report. Additionally, patientautonomyis compromised from the lack of information needed to facilitate benefit–risk communication. Finally, suboptimal referrals challengejusticebased on lack of reasonable patient prioritising and the unfairness caused by unnecessary examinations.These findings illuminate how suboptimal referrals can inhibit good health and well-being for patients in relation to safety, missed opportunities, patient anxiety and dissatisfaction. The ethical challenges identified calls for solutions. Referral-decision support tools and artificial intelligence may improve referral quality, when implemented. Strategies addressing efforts of radiology professionals are inevitable, including gatekeeping, shared decision-making and inter-professional communication; thereby raising awareness of the importance of good referral quality and promoting commitment to ethical professional conduct. (shrink)

This case study appeared in full in the last issue of Research Ethics Review : 108). It concerned the supervision of Simon Shaw, a senior radiographer undertaking an MSc, whose research focused on the professional and parental response to fetal tissue abnormalities.

Advances in veterinary orthopaedics are assessed on their ability to improve the function and wellbeing of animal patients. And yet historically veterinarians have struggled to bridge the divide between an animal's physicality and its interior experience of its function in clinical settings. For much of the twentieth century, most practitioners were agnostic to the possibility of animal mentation and its implications for suffering. This attitude has changed as veterinarians adapted to technological innovations and the emergence of a clientele who claimed (...) to understand and relate to the subjective experiences of their animals. While visualising technologies and human analogies have shaped the nuts and bolts of veterinary orthopaedic practices, an emerging awareness of the inability of radiographic images to apprehend or correlate to a patient's experience of their function reliably has required veterinarians to place a greater emphasis on the owner's knowledge of the "selves" inhabiting their animals. Rather than simply basing clinical judgments on the "look" of their patients, the indeterminacy in the connection between form and function has compelled veterinarians to put questions regarding particular human-animal relationships near the centre of their practices, not least in orthopaedic surgery. (shrink)

Cet article constitue l'un des éléments d'un dossier comparatif international sur le traitement médiatique de l'attentat survenu à la gare d'Atocha à Madrid en mars 2004. Centré sur la Roumanie et basé sur l'étude d'un corpus de trois quotidiens nationaux, il analyse les orientations du discours développé par la presse de cet état dans les jours qui ont suivi cet événement dramatique. Il montre que le mode de traitement journalistique développe une vision fataliste et tragique de l'événement. Il met en (...) évidence les stratégies «émotionnalisantes» qui sont mises en oeuvre. Axées sur les victimes roumaines de l'attentat, elles sont observables dans les trois journaux tant sur le plan verbal qu'iconique. L'article souligne enfin que l'événement à portée internationale des attentats de Madrid ouvre pour les journalistes roumains l'opportunité de dresser, au plan interne, une radiographie sociopolitique assez sévère, tout en mobilisant des mythes et des archétypes culturels qui confortent les valeurs nationales roumaines.This article is one of a comparative study on the international media coverage of the attack in Atocha train station in Madrid in March 2004. Centered on Romania and based on the study of a corpus of three national newspapers, it analyzes the stand taken by the press of the state in the days that followed this dramatic event. It shows that the method of treatment journalistic develops a fatalistic and tragic event. It highlights strategies "émotionnalisantes" are implemented. Focused on Romanian victims of the attack, they are observable in the three newspapers both verbal qu'iconique. The article stresses that the event of international scope of the Madrid bombings opens to the Romanian journalists the opportunity to develop, internally, a radiograph sociopolitical severe enough, while mobilizing myths and archetypes that reinforce cultural values Romanian national. (shrink)

The purpose of this study was to evaluate recognition of pathologists and radiologists as coauthors in case reports in the field of surgical oncology. The MEDLINE database was searched for all full free text case reports involving human material published from April 1, 2011 until March 31, 2016, using search terms: “case report” + “tumors” + “surgery” + “malignant”. The search strategy identified a total of 1427 case reports of which 907 were included in this analysis. Of 807 articles with (...) histopathological images and/or descriptions, 352 did not acknowledge or include the pathologist as a coauthor. Of 662 case reports with radiographic images and/or their description, 537 did not list the radiologist as coauthor nor acknowledge them. In case reports containing histopathological images, significantly more pathologists were either listed as coauthors or acknowledged compared to those who were not. However, among case reports containing radiographic images, there were significantly less articles either listing radiologists as coauthors or acknowledging them compared to a larger proportion of articles in which radiologists were omitted. In conclusion, pathologists and radiologists are underrecognized as coauthors in surgical oncology case reports in spite of obvious proof of their contribution to manuscript preparation. When involved in research and publishing, all physicians should be aware of fair and honest collaboration with specialists in other clinical and non-clinical disciplines to better serve the scientific community. (shrink)

Background The ideal basis of age estimation is considered to be a combination of clinical, skeletal and dental examinations. It is not easy to determine how forensic physicians take account of evidence-based data obtained from medical journals in their medical decision-making. The question of what is an ethically acceptable probability that adolescents are incorrectly considered to be over 18 has not been answered. Methods In a retrospective study over 1 year (2007), 498 files (for 141 female subjects and 357 male (...) subjects) regarding age assessment requested by the public prosecutor's office for purposes of criminal or asylum proceedings were reviewed. Chronological age was estimated from a combination of physical examination, radiographic examination of the left hand and determination of dental status. Results Estimates of chronological age in 498 subjects claiming to be 9–14 years old were incompatible with the alleged age in 356 (71%) when made by the forensic physician but in only 17 (3%) when based on data from published studies on age estimation in adolescents. Conclusions The present study suggests that in most cases the forensic physician ignores the adolescent's word. Medical mission and ethics imply a need to listen to the claims of persons in custody, whatever the risk of false claims. This situation should prompt forensic physicians to keep up with published data on estimating the age of adolescents. (shrink)

RationaleSurrogates of critically ill patients often have inaccurate expectations about prognosis. Yet there is little research on how intensive care unit clinicians should discuss prognosis, and existing expert opinion-based recommendations give only general guidance that has not been validated with surrogate decision makers.ObjectiveTo determine the perspectives of key stakeholders regarding how prognostic information should be conveyed in critical illness.MethodsThis was a multicenter study at three academic medical centers in California, Pennsylvania, and Washington. One hundred eighteen key stakeholders completed in-depth semistructured (...) interviews. Participants included 47 surrogates of adult patients with acute respiratory distress syndrome; 45 clinicians working in study ICUs, including physicians, nurses, social workers, and spiritual care providers; and 26 experts in health communication, decision science, ethics, family-centered care, geriatrics, healthcare disparities, palliative care, psychology, psychiatry, and critical care.Measurements and main resultsThere was broad support among surrogates for existing expert recommendations, including truthful prognostic disclosure, emotional support, tailoring the disclosure strategy to each family's needs, and checking for understanding. In addition, stakeholders offered suggestions that add specificity to existing recommendations, including: In addition to conveying prognostic estimates, clinicians should help families "see the prognosis for themselves" by showing families radiographic images and explaining the clinical significance of physical manifestations of severe disease at the bedside. Many physicians did not support using numeric estimates to convey prognosis to families, whereas many surrogates, clinicians from other disciplines, and experts believed numbers could be helpful. Clinicians should conceptualize prognostic communication as an iterative process that begins with a preliminary mention of the possibility of death early in the ICU stay and becomes more detailed as the clinical situation develops. Although prognostic information should be initially disclosed by physicians, other members of the multidisciplinary team-nurses, social workers, and spiritual care providers-should be given explicit role responsibilities to reinforce physicians' prognostications and help families process a poor prognosis emotionally.ConclusionsFamily members, clinicians, and experts identified specific communication behaviors that clinicians should use to discuss prognosis in the critical care setting. These findings extend existing opinion-based recommendations and should guide interventions to improve communication about prognosis in ICUs. (shrink)

When education is jointly managed by a workplace and academia, causal mechanisms in the culture, structure and agency of these two contexts may unintentionally generate discourse that conveys conflicting messages for learners regarding some of the priorities of the profession. Using the concepts of culture, structure and agency as they are used in critical realism to analyse the discourse generated in two teaching and learning contexts (a radiography division in a university and a radiography workplace in a large state tertiary (...) academic hospital), this paper attempts (i) to identify possible causal mechanisms that generated discourse concerning the role and value of writing competency for radiographers, such that this discourse possibly influenced learners not to be motivated to improve their writing competency to their lecturers’ satisfaction; and (ii) to suggest what practices and influences might successfully generate an alternative emancipatory discourse. Drawing on Margaret Archer’s (1995) morphogenetic approach, the paper argues that the radiography lecturers have the primary agency to address this unsatisfactory situation, as it is through their interaction – both as a team and with other relevant stakeholders – that an alternative emancipatory discourse may be generated. (shrink)