Assistant Practitioners (APs) in radiography: An exploration of perceptions and experiences related to role development
Introduction
The role of the Assistant Practitioner (AP) in radiography was introduced at the turn of the century to create a supportive workforce within radiography. Staff shortages were responsible for strategic redesign1 of the existing workforce to enable adequate service delivery. Recent studies2 have shown the importance of gathering information from APs to gain insight into the improvements to embed the role of the AP effectively. The configuration of a four-tier structure allowed APs to take on some roles that were previously performed by radiographers.3 The Society and College of Radiographers (SCoR)4, 5, 6, 7, 8, 9 have produced a range of publications that focused on the scope of practice and educational requirements for these new AP roles. However, no studies have explored how these guidelines have informed practice and role development for the AP workforce in radiography, from the perspective of the AP.
Section snippets
Review of literature
A national cross sectional study was conducted in 2007 to investigate the implementation of the four-tier structure across radiography.3 Even though findings were descriptive in nature and focused on the role of the radiographer across the four-tier structure it did highlight the introduction of the AP across the workforce. Recommendations suggested tracking the continuing implementation of the four-tier structure to establish the precise nature and scope of the roles across NHS Trusts and
Aim
To explore APs' perceptions and experiences of their role development and integration into the radiography workforce.
Method
The study was conducted over three phases utilising a mixed methods design. Phase I was a scoping exercise in which n = 112 radiography sites employing APs were identified through telephone contact to map the location of APs across England. A survey in Phase II distributed n = 357 questionnaires with a response rate of n = 167 (47%) to investigate the role of APs in radiography. Phase III utilised n = 38 semi-structured qualitative interviews to extend the findings of phase II and explore
Results
Three main themes and eight sub-themes emerged from the data analyses which are presented below. Interview extracts are presented using direct, anonymous quotations which are presented separately in Table 1, Table 2, Table 3. The anonymous quotations are referred to in the text by means of a numbering system designed by the researcher to enable tracking of data extracts. For example RM14, 11–15: the first two letters (RM) relates to the site of interview, followed by the participant number (14)
Discussion
The original ‘Scope of Practice’ for APs in Clinical Imaging5 and that of Radiotherapy6 was intended as a guidance document that would underline the importance of new roles in the clinical department whilst assisting in service delivery; neither compromising the safety of the patient nor the quality of the care. Guidance5, 6 was released 7 years after the introduction. Assumptions were made that defining work roles in practice were clear-cut. However, findings of the present study revealed the
Recommendations
- (i)
Development of a more defined Scope of Practice for APs in which consideration should be given to areas of practice where skilled and trained APs undertake additional roles and responsibilities.
- (ii)
Current supervision practices need to be adapted according to an updated framework (including direct and indirect supervision) to ensure standardisation for all areas of practice.
- (iii)
Further research is recommended to explore the impact on patient care and patient experience to substantiate the continuing
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