Maryann Hardy

Introduction The new Health and Care Professions Council (HCPC) Standards of Proficiency for Radiographers have significantly increased the focus on patient care by centralising the role of the service user (HCPC, 2023). However, recent research has found that many barriers exist to patient centred care (PCC) within imaging departments (Hayre et al, 2016; Hyde & Hardy, 2021a; Hyde & Hardy, 2021b; Hyde & Hardy, 2021c), including continued high demand for imaging examinations, departmental pressures for greater efficiency, and budget constraints. To support diagnostic radiographers to take a more PCC approach, a massive open online course (MOOC) was developed in 2021. The MOOC was designed to support clinical radiographers, and other members of the imaging department team, to increase their awareness, and use, of PCC approaches. To assess the impact of the MOOC an evaluation was carried out in the 2022/23 academic year to measure levels of awareness of PCC in a group of diagnostic radiographers in the UK, before and after completing the MOOC. Methods Ethical approval was obtained from University of XXXXX (ETH2223-0177) and University of XXXXX (RETH(S)22/034) for the evaluation. Participants were diagnostic radiographers working in clinical practice in the United Kingdom (UK). Participants were invited to take part in the evaluation and complete the MOOC via email and social media promoted by academic colleagues from four UK Universities who deliver diagnostic radiography education. Survey data were collected using a Microsoft Forms survey tool as advocated by Braun et al. (2020). Data was analysed using thematic analysis methods as advocated by Braun and Clarke (2006, 2019). Once the themes were identified, basic descriptions were developed and repeated phrases that best described the themes were agreed. Results The evaluation was advertised and open for participation for radiographers for eight weeks between February 2023 and April 2023. Twenty-nine diagnostic radiographers completed survey 1 (the pre-MOOC survey) and went on to complete the MOOC. Only six radiographers completed the MOOC and both surveys. Anecdotal feedback from potential participants who did not complete all elements of the evaluation suggested was that this was due to workload pressures, and low morale. Despite the low completion rate, it was felt that the data would be valuable to understand attitudes towards and engagement with PCC. Discussion The response rate to the evaluation was disappointing. Anecdotal feedback from potential participants, and those that started but did not complete the MOOC, suggests that workload pressures and low morale were contributory factors to both the low response and poor completion rate. However, it is important to remember that there was considerable interest in completing the first survey, and that the MOOC has been completed by over 1000 learners (figure correct as of 4th August 2023) to date. This shows that there is an interest in PCC within the UK diagnostic radiography community. The evaluation team are committed to finding ways to reach radiographers who are interested in PCC and supporting them to complete the MOOC. Conclusion Whilst the rate of participation in this evaluation was disappointing, it is heartening to see the number of learners completing the MOOC steadily increasing. The evaluation team will continue to promote the MOOC as a valuable continuing professional development activity for staff working in an imaging department.

Referral practices for upper limb trauma radiography in children vary. Knowledge of the influence of mechanism of injury and functional anatomy on trauma presentation can reduce unnecessary referrals for multiple concurrent radiographic examinations.

Background: Obesity is a global public health concern. Interventions rely predominantly on managing dietary intake and increasing physical activity; however, sustained adherence to behavioral regimens is often poor. The lack of sustained motivation, self-efficacy, and poor adherence to behavioral regimens are recognized barriers to successful weight loss. Avatar-based interventions achieve better patient outcomes in the management of chronic conditions by promoting more active engagement. Virtual representations of self can affect real-world behavior, acting as a catalyst for sustained weight loss behavior. Objective: We evaluated whether a personalized avatar, offered as an adjunct to an established weight loss program, can increase participant motivation, sustain engagement, optimize service delivery, and improve participant health outcomes. Methods: A feasibility randomized design was used to determine the case for future development and evaluation of avatar-based technology in a randomized controlled trial. Participants were recruited from general practitioner referrals to a 12-week National Health Service weight improvement program. The main outcome measure was weight loss. Secondary outcome measures were quality-of-life and self-efficacy. Quantitative data were subjected to descriptive statistical tests and exploratory comparison between intervention and control arms. Feasibility and acceptability were assessed through interviews and analyzed using framework approach. Health Research Authority ethics approval was granted. Results: Overall, 10 men (n=7, 70% for routine care and avatar and n=3, 30% for routine care) and 33 women (n=23, 70% for intervention and n=10, 30% for routine care) were recruited. Participants’ initial mean weight was greater in the intervention arm than in the routine care arm (126.3 kg vs 122.9 kg); pattern of weight loss was similar across both arms of the study in T0 to T1 period but accelerated in T1 to T2 period for intervention participants, suggesting that access to the self-resembling avatar may promote greater engagement with weight loss initiatives in the short-to-medium term. Mean change in participants’ weight from T0 to T2 was 4.5 kg (95% CI 2.7-6.3) in the routine care arm and 5.3 kg (95% CI 3.9-6.8) in the intervention arm. Quality-of-life and self-efficacy measures demonstrated greater improvement in the intervention arm at both T1 (105.5 for routine care arm and 99.7 for intervention arm) and T2 (100.1 for routine care arm and 81.2 for intervention arm). Overall, 13 participants (n=11, 85% women and n=2, 15% men) and two health care professionals were interviewed about their experience of using the avatar program. Conclusions: Participants found using the personalized avatar acceptable, and feedback reiterated that seeing a future self helped to reinforce motivation to change behavior. This feasibility study demonstrated that avatar-based technology may successfully promote engagement and motivation in weight loss programs, enabling participants to achieve greater weight loss gains and build self-confidence. Trial Registration: ISRCTN Registry 17953876; https://doi.org/10.1186/ISRCTN17953876