Experiences of therapy
radiographers in extended
roles.
Angela Eddy
Senior Lecturer- Sheffield Hallam University
Background
Minimal empirical evidence around role
extension/advanced/consultant practice in
therapy.
 Limited evidence around the process of learning
and professional development (Donovan and Manning

2006).
Need to explore perceptions and experiences for
new roles (Probst &Griffiths 2007)
 Functioning in any new role is acknowledged as
difficult and stressful (Johnstone 2007, Gerrish 2000)
 Know that the transition experiences will be
different to the experiences of those established
in roles (Williamson 2006)

Research question:
 What is the developmental process of the neophyte therapy
radiographer working in an extended role?
Aims:
To examine the perceptions of therapy radiographers who
have been working in extended roles for up to 2 years.
 Gain an understanding of their professional development by
exploring the nature and dynamics of the experiences that
inform practice.

Objectives:
Undertake open interviews using grounded theory.
 Develop a substantive theory which explicates the stages and
processes of professional development for extended role
therapy radiographers.

Story so far…10 interviews done
11 to go!
Name
Role/scope of practice
Length of time in
role
Length of time qualified
Participant 1
2.5 months
3 years
Participant 2
Patient assessment and
review.
Clinical trials/research.
3 months
16 years
Participant 3
Site specialist
2 years
34 years
Participant 4
Breast Mark up.
1year
4 years
Participant 5
Site specialist
18 months
2 years
Participant 6
18 months
35 years
Participant 7
Patient assessment and
review.
Site specialist
2 years
14 years
Participant 8
Site specialist
6 months
4 years
Participant 9
Site specialist
2 years
25 years
3 months
20 years
Participant 10 Breast Mark up
Early analysis and initial themes.
Name of code
Sources
References
Confidence
10
67
Mentors and role models
10
50
Frustrations/difficulties/
negative experiences
Transferable skills
10
49
8
45
Job satisfaction
8
32
Educational experience
8
24
Personal
motivation/motivators
Time
8
24
8
16
Positive experiences/enablers
5
15
Communities of Practice
3
12
Working relationships
7
7
Development of Confidence is an
overarching theme.

Links into other themes.
◦ What makes someone confident and how does
that link into the stages and processes of
professional development?

Professional confidence
◦ Task/role orientation and knowledge based skills.

Personal confidence
◦ Interpersonal and communication skills.
◦ Emotional intelligence (Goleman 1997)

Theoretical Framework
◦ Bandura “self efficacy” Framework (1982)
Banduras framework has four
dimensions

What influences the development of
confidence/ self efficacy ?
◦ Enactive mastery of experiences.
 Learning the skills to perform in the role.
◦ Modelling.
 Role models and mentors.
◦ Social persuasion.
 Working environment, communities of practice.
◦ Physiological states.
 Stress, anxiety, and “burn out”
Enactive mastery- skill acquisition

Clinical skills
◦ Development – stage progression to
autonomy. Not having to refer on.
 repetition and having done it time and time again
so if you come across a problem you can recognise
it”
◦ Underpinning knowledge – education
 in the first year not to underestimate the knowledge
required”
 “ Even though I 've got a lot of years experience,
having the M level study to underpin what I do
gives me the confidence and I will argue the toss in
a very confident manner"
Enactive mastery- skill acquisition

Leadership and management
◦ Some peoples leadership skills came from outside the
NHS or from previous experience as Supts.
◦ Learning and developing their own style:
 “learnt not to impose, motivate rather than be dictatorial”

Interpersonal skills – working across boundaries
◦ “communication skills and negotiation”
◦ “ I deliberately don’t have an ego, and make sure I am
seen to not be empire building”
Modeling – role models and
mentors

Who were their role models and
mentors:
◦ Mentorship/task and skill acquisition based
assessments were done by Oncologists.
 Case studies and problem based learning tasks
◦ However most had sought peer support and
review from other professional groups:
 “good ideas from other professions – we can be too
insular”
 “using clinical supervision with a nurse helped me
to find the confidence to deal with difficult
situations and anxious patients
Mentorship – what worked?

Challenging but supportive model in a time
protected environment
◦ Someone who……“Would not stand over you and tut”

Identifying support and learning needs early in
the process, not always easy
◦ " having come from a technical background to a very
patient orientated background was quite a change for
me so…..it was about having someone to talk to, and
reflect on situations"
Social persuasion- developing a
supportive learning community
Supportive working environment Communities of practice
 Established teams in established roles

◦ “I enjoyed it because we could discuss things
and it gave me confidence”
Versus
 Solitary role and a loss of identity

◦ “Feeling of professional isolation”
Social persuasion – group working

Role of MDT’s
◦ “steep learning curve, thrown in at the deep end”
◦ "need to crack this relationship because its how the
medical profession perceive you…its still a patriarchal
system“
◦ Knowing the organisation – getting past
information gatekeepers
◦ “working in a small department means I know
everyone , not sure that’s the same in a bigger place“
◦ “wasted time, a lot of information is not shared – it’s
a power thing”
Physiological states and stress /burn
out
Personal resilience
 In established roles:
◦ “actual transition into the role was
straightforward
 New Roles:
◦ “The first 6 months is a baptism of fire”
◦ “need to grow a second skin”
 Moved along to by the end of the 2 year period
◦ “Not accepting boundaries” but felt burnt
out.

Physiological states and stress /burn
out
Role and scope of practice
 No clear scope of practice… two perspectives:
◦ “that’s a good thing because I can shape the
role” However….
◦ “if you are over ambitious its very easy to try
and be involved in all bits but you cant do
that”
◦ Role boundaries:
◦ “tensions between Superintendents and us as
they cant see where we fit, where their
boundaries finish and ours start”

Physiological states and stress /burn
out

Structure and organisation when implementing the
role.
◦ “ had regular meetings and a structure and a plan
with reviews built in”
◦ “3 months to get it organised and if I did not , it would
be squashed”
◦ “Here is the key to your office, see you!”

Role security and sustainability of role
◦ concerns about long term career plans
◦ “Can this role be done by a nurse”
So…..what are the stages and processes of
professional development for extended role
practitioners?


There maybe trigger points in the process.
Can there be one overarching process?
◦ It may be different depending on the nature of
the role, the dynamics of the organisation and
personal characteristics?
◦ Is there room for the development of a
professional self assessment inventory which may
help identify aspects of personal and professional
development.
◦ Watch this space…………….
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Experiences of neophyte therapy radiographers in extended role