OAR@UM Community:/library/oar/handle/123456789/3242026-05-23T12:15:31Z2026-05-23T12:15:31ZPatients’ perspectives of the skills and competencies of therapy radiographers/radiation therapists (TRs/RTTs) in the UK, Portugal and Malta ; a qualitative study from the SAFE Europe projectFlood, TerryO Neill, A.Oliveira, Celeste M.Barbosa, BarbaraSoares, Ana LuísaMuscat, KyleGuille, SharonMcClure, PatriciaHughes, Ciara M.McFadden, Sonyia L./library/oar/handle/123456789/1462502026-05-08T08:19:24Z2023-01-01T00:00:00ZTitle: Patients’ perspectives of the skills and competencies of therapy radiographers/radiation therapists (TRs/RTTs) in the UK, Portugal and Malta ; a qualitative study from the SAFE Europe project
Authors: Flood, Terry; O Neill, A.; Oliveira, Celeste M.; Barbosa, Barbara; Soares, Ana Luísa; Muscat, Kyle; Guille, Sharon; McClure, Patricia; Hughes, Ciara M.; McFadden, Sonyia L.
Abstract: Introduction: The role of the Therapy Radiographer/Radiation Therapist (TR/RTT) is to provide radiotherapy to patients with a cancer diagnosis. This includes, not only administration of treatment, but also management of side-effects and provision of support/care. Despite this role being consistent throughout Europe, there is currently no standardisation of education for TRs/RTTs. The SAFE EUROPE project aims to standardize TR/RTT education to enable ‘safe and free exchange’ of TRs/RTTs across Europe. Consequently, this study aims to explore patients' perspectives regarding the current skills and competencies of TRs/RTTs.; Methods: From May 2021 to February 2022, semi-structured interviews were conducted with patients who had recently received radiotherapy in the UK, Malta and Portugal. Ethical approval for this study was granted by the NHS Research Ethics Committee with additional local approvals obtained.; Results: Forty-eight participants from the UK (n = 18), Portugal (n = 19), and Malta (n = 11) completed interviews. Participants described high satisfaction with TRs'/RTTs’ competence and skills in all three countries. The main theme arising from the analysis was the importance of trust building with TRs/RTTs. Six factors were identified as influencing levels of trust: communication; side-effect management; team consistency; relational skills; patient dignity; and competence. A small number of patients reported feeling rushed and not having their physical and emotional needs met by TRs/RTTs.; Conclusion: This multicentre study demonstrated that patients perceive TRs/RTTs in the UK, Malta and Portugal as highly competent and skilled. Practical recommendations are provided to address identified deficits in practice, which can be addressed through adaptation of TR/RTT education/training and clinical practice.; Implications for practice: Recommendations arising from this study are important to ensure that TRs/RTTs have transferable skills that provide consistently high quality care to patients throughout Europe.2023-01-01T00:00:00ZEstablishing image quality criteria for lateral knee radiographs/library/oar/handle/123456789/1459022026-04-24T12:50:45Z2025-01-01T00:00:00ZTitle: Establishing image quality criteria for lateral knee radiographs
Abstract: Introduction
Lateral knee radiographs are frequently performed x-ray projections with a high
retake rate. A reason for lateral knee radiograph retakes is inconsistent imaging
protocols. A variation in the literature exists regarding the image quality criteria
required for lateral knee radiographs.
Purpose of the study
The purpose of the study was to establish an image quality criteria list for lateral knee
radiographs. A standardised list would make it easier for radiographers to decide
whether an image should be retaken or not.
Methodology
This study was conducted at a public general hospital in Malta. A prospective
research design was used to collect quantitative data. This study was divided into
three parts. The first part of the study consisted of the collection of 25 lateral knee
radiographs. In the second part, image quality criteria for lateral knee radiographs
were drawn up and validated by experts in the field. The third part of the study
consisted of the distribution of the research tool to radiographers and orthopaedic
surgeons. The participants were asked whether they would keep or retake 25 lateral
knee radiographs according to the established criteria. The extent to which every
criterion was met was rated using a 4-point Likert scale. The Mann-Whitney test was
used to compare mean rating scores provided to every criterion related to image
quality in this study.
Results
A total of 21 participants filled in the research tool. The participants consisted of 16
radiographers and 5 orthopaedic surgeons. Based on the clinical study results, the six
main image quality criteria for lateral knee radiographs, in order of importance,
obtained from this study were the following:
1. The knee joint is seen in the lateral position as evidenced by the
superimposition of the femoral condyles.
2. The patella can be seen in lateral profile with joint space between the
patella and femur well demonstrated.
3. The patella is projected clear of the femur.
4. The proximal tibia slightly superimposes the head of the fibula.
5. The knee joint is in the centre of the collimated field.
6. Fat pad and sharp trabecular markings.
Conclusions
This study identified an image quality criteria list that may assist radiographers when
determining if retakes of lateral knee radiographs are necessary or not. However,
further research is required by using a larger sample size and conducting the study in
different medical imaging departments.
Description: B.Sc. (Hons)(Melit.)2025-01-01T00:00:00ZBenefits and challenges of the new MR Linac service implemented at the local oncology department : a radiographers’ perspective/library/oar/handle/123456789/1459012026-04-24T12:37:15Z2025-01-01T00:00:00ZTitle: Benefits and challenges of the new MR Linac service implemented at the local oncology department : a radiographers’ perspective
Abstract: Purpose: This study aimed to investigate the perception of the radiographers on
the benefits and challenges associated with the introduction of the magnetic
resonance linear accelerator (MR Linac) at the local oncology hospital.
Methodology: All radiographers working at the local oncology department
were invited to complete a self-designed questionnaire consisting mostly of Likert
scale questions ranging from 1 to 5 and some open-ended questions. The
radiographers were asked to rate the benefits and challenges of the MR Linac for
specific areas. In addition, the radiographers were also asked to indicate their
confidence in performing specific tasks, their perceptions on a radiographer-led
workflow, and the additional resources required to improve the services. Finally,
the radiographers were asked to indicate their confidence in performing specific
tasks on the MR Linac and their views on introducing a radiographer-led workflow.
The quantitative data was summarized using descriptive statistics, while the
open-ended questions were analysed using content analysis.
Results: Out of the 26 invited radiographers, 15 completed the questionnaire.
The use of ultra-hypofractionation and the reduction of dose to the healthy OARs
were identified as the main benefits of this technology, while the prolonged
treatment time was identified as the main barrier. The overall level of confidence
using the MR Linac was 2.73 +/- 1.22. The radiographers were least confident in
managing technical and safety issues and most confident in positioning patients.
The majority of the radiographers (53.3%) agreed that a radiographer-led
workflow could improve treatment efficiency, provided that this was introduced
gradually following adequate training. Contouring software based on artificial
intelligence was identified by most radiographers as required to streamline the
workflow.
Conclusion: Despite challenges faced, radiographers expressed optimism about
the integration of this technology in practice. However, more training is required
to improve service delivery and facilitate the introduction of a radiographer-led
workflow.
Description: B.Sc. (Hons)(Melit.)2025-01-01T00:00:00ZLanguage barrier challenges in multi-lingual radiography setting : impact on effective patient communication/library/oar/handle/123456789/1459002026-04-24T12:34:58Z2025-01-01T00:00:00ZTitle: Language barrier challenges in multi-lingual radiography setting : impact on effective patient communication
Abstract: Introduction
Malta’s health-care system now serves a highly multicultural population, with a 2023 net migration
of 20,960 predominantly non-EU newcomers. This linguistic diversity challenges radiographers,
who must obtain accurate histories, give precise procedural instructions, and secure informed
consent within very brief patient encounters. The present dissertation investigated the primary
language-barrier challenges faced by radiographers in a large public hospital, assessed their
perceived impact on communication, and explored demographic and organisational factors that
shape these experiences.
Methods
A validated, cross-sectional questionnaire was distributed to 28 qualified radiographers. The
sample was chiefly young (21-30 years) and female, mirroring the department’s workforce profile.
Respondents reported strong proficiency in Maltese and English but limited competence in other
languages.
Results
The most salient barrier was time pressure during patient encounters (mean = 3.96), indicating that
workflow constraints frequently curtail thorough explanations. Systemic shortcomings followed:
under-utilization of multilingual staff (mean = 3.11) and limited availability of professional interpreter
services (mean = 3.00). Participants indicated that language barriers markedly reduced patient
comprehension (mean = 4.57) and the ability to address patient concerns (mean = 4.39).
Open-ended comments revealed reliance on ad-hoc interpreters, family members or bilingual
colleagues, raising concerns about confidentiality, accuracy, and increased repeat imaging.
Younger radiographers perceived time constraints more acutely; gender differences were modest
and not statistically significant. These findings align with broader European literature that attributes
communication breakdowns primarily to organizational, rather than individual, language deficits.
Conclusions
Language barriers in Maltese radiography are fundamentally systemic. Heavy workloads,
insufficient interpreter infrastructure, and the lack of formal mechanisms to mobilize existing
multilingual staff erode effective radiographer-patient dialogue, compromising safety, increasing
repeat examinations, and elevating radiation exposure.
Implications for Practice
1. Centralized interpreter service: Implement an on-demand, professional medical interpreter
platform integrated into radiology workflows.
2. Curricular and CPD integration: Embed mandatory cross-cultural communication and
interpreter-use training in undergraduate radiography programs and continuing professional
development.
3. Scheduling redesign: Adjust appointment-booking protocols to allocate additional time for
patients requiring interpretation, ensuring comprehensive explanations without sacrificing
departmental efficiency.
Description: B.Sc. (Hons)(Melit.)2025-01-01T00:00:00Z