Where did my career go?

June’s blog is by Dr Bev Snaith. Bev is a Clinical Professor of Radiography and the Pathway Lead – MSc ACP (radiography) at the University of Bradford (UK). She also holds a joint appointment with Mid Yorkshire Hospitals NHS Trust.

Suddenly you look back at your career and realise you’ve reached the age that you thought everybody was really ‘old’ when you were a junior radiographer. As such the reflection starts on the choices you made which shaped your career – the knock backs, the opportunities and the external influences. All of these are all so personal, based on experiences, situations and aspirations, but if I was starting again would I choose radiography? Would I aspire to advance practice? Could I ever see myself being an academic?

Career is defined as the job or series of jobs that you do during your working life, especially if you continue to get better jobs and earn more money (1 ) and most of us seek greater earning potential as we get older and our outgoings grow. But this month’s article (2) confirmed financial incentives are not the only factor driving career choices, although the mounting student debts and dwindling bank balances may explain why it was perceived to be more important to final year radiography students . As sociable creatures we thrive when working in an environment where we feel fulfilled, but also where there are opportunities for development. Interestingly, but to us as radiographers perhaps not surprising, prestige was considered the least important factor in Kay’s survey. Is this because of the low profile that radiography still has? Indeed other research has confirmed that many people enter radiography ‘by accident’ as in the recent study on gender diversity in therapeutic radiography by Julie Nightingale et al (3) and Bamba et al’s work (4) confirming that personal contacts were the main source of information about the profession.

When I started radiography 1987, probably before many of you were born, those who had drive and ambition had more limited career options, with management, education or industry the clear expectations. Now opportunities are potentially limitless, and the boundaries of the profession no longer exist. Portfolio careers, experience in different settings, transferable skills acquired through initial and ongoing training, are becoming commonplace. No longer is there a clinical glass ceiling, and students expect role development opportunities, as Anthony Manning-Stanley et al discovered (5). Cross-sectional imaging is popular, as is reporting – although the perception that this equates to specialisation in protectional radiography should be questioned with UK radiographer reporting roles evident across almost all diagnostic modalities and practice areas. It is clear that more research around motivational factors for career planning is emerging and if the profession is to recruit and retain its workforce evidence around the influential factors is critical.

So what has been influential in my career? Certainly other people – colleagues, role models, educators. But also the rejections and failures have probably been more impactful and led me down paths I would never have considered. Spending a year or so outside of radiography made me realise how much patient contact was an important factor and luckily this coincided with the launch of the 4-tier structure in England which then defined my goals. Another influence has been education, I have always found myself one step ahead, mainly due to personal investment and many opportunities would not have been open without that. But, roles did not exist when I started this path, pushing boundaries has been a major factor in my career, sometimes unpopular and it has been difficult to strike a good work-home balance, but I wouldn’t have had it any other way. I remain proud to say I AM A RADIOGRAPHER.

References

1. Cambridge English Dictionary (online). Available from: https://dictionary.cambridge.org/dictionary/english/career [accessed 12 June 2022.
2. Hizzett K, Snaith B. Career intentions, their influences and motivational factors in diagnostic radiography: A survey of undergraduate students. Radiography 2022; 28:162-7.
3. Nightingale J, et al. Gender diversity in therapeutic radiography: A mixed methods exploration of the gender influences impacting on male students’ career choices. Radiography 2022; 28: 258-66.
4. Bamba A, et al. Why do students choose the medical radiation science profession? The Radiographer 2008. Available from https://onlinelibrary.wiley.com/doi/10.1002/j.2051-3909.2008.tb00084.x
5. Manning-Stanley AS, Kirby M. A study to investigate undergraduate diagnostic radiographer preferences and expectations of clinical role development: Quantitative findings. Radiography 2022; 28: 319-24.

Autism friendly MRI: Providing more accessible services, always

This month’s blog for World Autism Awareness and Acceptance Month is by one of the authors of our chosen paper by Stogiannos et al. Autism-friendly MRI: Improving radiography practice in the UK, a survey of radiographer practitioners. Dr. Christina Malamateniou is the Director of Postgraduate Radiography at City, University of London and a Visiting Professor at  HESAV, in Switzerland. She is part of the editorial board of the Journal of Medical Imaging and Radiation Sciences (JMIRS).

Autism awareness month: friend or foe?

April is autism awareness and acceptance month. For people outside autistic life this is a month where they will hear what it means to lead life as an autistic person, from stories shared by autistic people, parents and carers of autistic individuals and allies. Many autistic people though, otherwise very active on social media, may find this month difficult to stomach. Some choose to switch off their social media accounts altogether, as they experience bouts of grief, anxiety and sometimes even online abuse.

This is because for something as important as neurodiversity there should not be only one month to raise awareness; it should be celebrated throughout the year and society should always afford supportive, enabling provisions. There should be no need for reasonable adjustments of services but instead there should be an ever-present variation of approaches and functions to ensure everyone is included and everything is accessible, from healthcare, to education, to housing, to jobs, for all people.

A common theme of inaccessibility

Obstacles to access healthcare and medical imaging are not dissimilar to the challenges autistic people face when trying to use other societal services. Medical imaging, the clinical science that allows for the early investigation and diagnosis of common symptoms and concerns, like headaches, low back pains or even the early treatment after accidents or falls should be a commonly available and easy to access good, right? Not!

How does our study on autism friendly MRI fit in this picture?

Unfortunately, our preliminary work in this paper: “Autism friendly MRI, the UK radiographers’ perspectives” in Radiography journal, has shown that autism is not well understood by healthcare professionals, including radiographers or medical radiation technologists (MRTs).  This is because of scarce or sub-optimal training opportunities and the lack of specific guidelines. Because of this, and despite the best of intentions, radiographers do not always know how to practically help an autistic person when they care for them and they may rely on old stereotypes about autistic people that are unhelpful and often dangerous. These include the ideas that autistic people do not make eye contact, that they are difficult to communicate with, that they are not verbal or have learning disabilities. While these might be true for a minority of autistic people, they do not represent the entirety of autistic patients.

Lack of knowledge leads to poor patient experience

Lack of knowledge is translated into poor service provision and consequently into poor patient and staff experience. Poor choices in communication and environmental adjustments before, during and after the medical imaging examination might result in poor outcomes. Some autistic patients will suffer silently through the process of imaging (either due to sensory sensitivities or anxiety) but they will be so traumatised, they might decide to avoid radiological investigations in the future altogether. Others might become so overwhelmed for similar reasons that the scan has to be stopped or rescheduled, with no guarantee for future success if approaches do not change or informed by evidence. Others might inadvertently move so much during the examination, that the scan will not be useable for clinical decisions. Our early results in another paper show that some autistic individuals might avoid MRI scans because of the fear or lack of knowledge or prior traumatic experience or misinformation and live with chronic pain or other undiagnosed chronic conditions.

Lack of knowledge leads to poor staff satisfaction

Radiographers, like most healthcare professionals, enter this field to help others, to advance knowledge on disease processes and aspire to offer a great experience to their patients. When this is not achieved there might be a drop in staff satisfaction and motivation. It is a vicious circle that we must break.

What is good for autistic people is good for all

So how can radiographers/MRTs help autistic people when they come for an MRI or other imaging examination?

-Make time to listen and to explain; sometime this must be broken down into smaller bites of information to avoid overwhelming people

-Make sure to understand patient preferences and routines and make adjustments in the environment (light, music, noise reduction, comfort) before they visit

-Involve the carers or parents, if they are present and happy to engage

-Follow a thorough risk assessment before the scan to ensure the scan can indeed run without sedation or anaesthesia; some patients will need it

-Educate yourself and others on autism; it is not a disease, or a pathology. It is just a different way of being. There are many reliable courses out there now.

-Understand that, what is good for autistic people, will very likely help other patients’ experience in radiography.

In conclusion, we need to go into this with an open mind and an open heart, to learn and adjust medical imaging processes for all patients.