Why professionalism in radiology department is mandate

This paper is aimed at critically evaluating the research article titled ‘Profession and professionalization in medical radiation science as an emergent profession’ by Sim and Alex. This article was published in the Radiography Journal. This research article assumes that Medical Radiation Science practitioners suffer from low self esteem because of the fact that Medical Radiation Science is not recognized to be as much a profession as medicine and law are. According to the article, Medical Radiation Science is an emerging profession that has yet to be recognised. The article goes on to define the meaning of the words profession and professionalization. A profession is considered to meet five criteria which include: “a possession of specialised knowledge which can be acquired only thorough higher education, representation via a professional organisation, a distinctive code of professional conduct, autonomy, and altruism”1. According to the article, since Medical Radiation Science meets three requirements that exclude autonomy and altruism, by definition, Medical Radiation Science should be considered a profession. The attitudes of Medical Radiation Science practitioners have been discussed in the article, along with the effect that workplace culture has on the Medical Radiation Science practitioners. This paper critiques the research that was conducted by Sim and Alex in the aim of proving that research is a professional mandate.

Critique

The title of the article, ‘Profession and professionalization in medical radiation science as an emergent profession,’ has failed to clearly define what the article is about. The title includes the study population and what major outcome is being measured. It is clear from the title that the study population is Medical Radiation Science practitioners. The major outcome being measured is the emergent profession and professionalization of Medical Radiation Science. It is, however, unclear what methodology will be used to measure observations made from the study.

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The aim of the article is to examine challenges that Medical Radiation Science practitioners face as they struggle to be recognized as professionals. In more detail, the purpose of the article is to look at factors that Medical Radiation Science faces in Australia, among which include: reducing operation costs, increasing consumer expectations, increasing competition within Medical Radiation Science, finding new ways to organise the Medical Radiation Science profession workforce and deregulation. The aim of this article is new, interesting, feasible and relevant. For a health care delivery system to be effective, high degrees of skill in professionalism are required2. A successful radiology department requires its practitioners to practice this skill well. Measuring performance and setting expectations with Medical Radiation Science practitioners were not issues that were held with emphasis until very lately3. There was lack of effort in raising issues and setting standards that the Medical Radiation Science practitioners needed to meet4. It is therefore crucial that researchers describe components that they can use to promote the Medical Radiation Science practitioners profession and professionalization.

The recent focus that has been seen in the media and among the medical community on professionalism among health workers is a key player on determining the involvement of the Medical Radiation Science practitioners5. According to Luke and Jude, there have been widespread deficiencies when it comes to giving safe care of high quality in the Australian hospitals6. As a result, initiatives have begun in multiple hospitals. Six overreaching goals need to be set up to ensure optimal health care. These goals are that health care should be equitably given, safe, efficient, timely, patient centred and effective7. For these goals to be achieved, the Medical Radiation Science practitioners should improve their professionalism to improve patient care8.

The research activity carried out by the subject article has been summarised in a well written abstract which quickly provides the reader with a quick glance into the article. The abstract in the article has been divided into three parts that include the purpose of the study, findings and conclusion. The findings in this article are ambiguous because no clear research methodology was followed. One of the findings includes low professional self-esteem and apathy among Medical Radiation Science practitioners that causes them to lack self-esteem that is required for them to be willing and able to learn more and take on increasing responsibilities at work. No prove of research on this issue has been shown in the article as to how the authors came up with that finding. An abstract may be all that an expert or busy reviewer with little time on their hands needs to look at to decide whether or not a research article is acceptable9.

The diagram below outlines a standard radiology department and the basic functions that are carried out, with an emphasis on clinical care delivery10. Professionalism is essential at all parts of the department.

The diagram shows that there are interactions between individuals and system interfaces in a radiology department. There is always the risk that during the interaction, miscommunication of information is always possible11. Most problems that occur in a radiology department are not caused by a deficiency in technical skill, but are rather caused by poor communication12. This bad communication is unprofessional, and it occurs between the referring physicians and the Medical Radiation Science practitioners, between the families and the Medical Radiation Science practitioners or between the Medical Radiation Science practitioners themselves13. As much as the Medical Radiation Science practitioners may be clinically competent or may have proper motivation, unprofessionalism could still occur14.

After the abstract, the article covers an introduction. The reason why an introduction is important is that it defines a question that is to be answered as the reader progresses through the article15. The introduction also gives a reason as to why an answer to this question needs to be found. The introduction is divided into parts that consist of a background on the topic in question, the rationale used, the framework used in developing the concept and so on16. In this particular paper, the authors have done a good job witting the introduction. A background check on Medical Radiation Science practitioners and the problems they face have been mentioned in passing. These problems include a low professional status, low self-esteem, lack of recognition and low public profile. The question raised is clearly stated as being whether or not the Medical Radiation Science practitioners are in a recognized profession. The introduction describes that the meanings of the words ‘profession’ and ‘professionalization’ will be analysed and answers to reduce low self-esteem and apathy among practitioners will be sought.

The next segment that follows after an introduction is the literature review. In this section, all relevant information regarding the research topic is written down as a summary. This literature review will give justification why is it important for the research to be conducted17. The authors of this article have done a good job in doing a literature review. As the introduction begged the questions: ‘What is a profession?’, the literature review of the article looks at answers given by an author called Millerson who has identified ways that can be used to recognise whether an occupation is a profession or not. This is the basis used by the authors of the article in answering their research question on what is a profession. Authors called Vollmer and Mills have also been mentioned in brief as contributors to the definition of professionalization. According to the bibliography, the authors of the article have done extensive research from 67 other authors of books, articles and websites.

The section that comes next after literature review is methodology. Methodology explains the methods used in collecting data, the participants, the settings and the manner in which the collected data was analysed18. The reasons as to why a study design is used are also given. Much of the work done in the remaining part of the article is definition of what a profession is. No research was carried out, and if it was, no documentation was made. While reading the article one cannot help asking if the information presented is an assumption of facts or the authors’ own feelings about the issue of Medical Radiation Science practitioners’ profession. A national study has been mentioned briefly as a source of information concerning Medical Radiation Science practitioners and their ability to continue learning. No methods were used in collecting data, no participants were involved to so much as give an interview and the settings and the manner in which the collected data was analysed is unclear. The reasons as to why the authors of the article briefly mentioned the national study in their article have not been clearly stated. Anyone reading this article would wonder whether the conclusions made are appropriate. Ideally, the methodology section should describe, in chronological order, the design used, the conduct and data analysis that will enable answers to the specific objectives of the research to be provided19. Headings and subheading are important so that readers can review the methodology with ease. Also included in the methodology should be the study’s design, population, setting, plan used for data analysis and manoeuvres. No headings or subheadings have been used in the subject article because no data was collected. Basically, the article did not have a research methodology section allocated to it.

Since no data was collected, no results would be generated. A results section accounts for the subjects used in the research from the time they were screened, enrolled in the study and finally included in the final analysis. A report on the whole final study population characteristics as well as results from comparative groups are made. The results are given in text format, in tables or graphs. Graphs are recommended because they are the most appropriate. The lack of tables or graphs in the subject article is a direct result of not having a methodology section in the article, all of which contribute to bad research practice.

Evaluating the general performance of individual Medical Radiation Science practitioners can be extremely difficult20. The subjective nature of topics related to the profession can make it difficult to identify the performance components related to professionalism. It is difficult to measure the many different factors that contribute to an excellent Medical Radiation Science practitioner. A complex set of behaviours that have multiple characteristics form the basis of successful Medical Radiation Science practitioner behaviour21. To be perceived as a Medical Radiation Science professional by the general public, patients or referring physicians, a health care provider must demonstrate three general attributes. These are: clinical competence, effective communication and prioritising a patient’s best interests so as to make an ethical decision22. To be perceived as a Medical Radiation Science professional, a health care provider must exhibit all three of these attributes. Demonstrating two of these three attributes caused a health care provider to be perceived as suboptimal. Professionalism is directly related to customer service and satisfaction.

After the results section, the next segment in an article should be the discussion where interpretation on the results in the light of the study is done. The results are accessed based on the general schema of current practice trends or information. The strengths and limitations of the study are analysed in this section. The authors should have compared their findings with the information from other authors or surveys and any differences noted should have been highlighted. Here we see that the subject article is lacking some more as no comparing has been made.

The conclusion is the next section after the discussion. Ideally, the conclusion sometimes covers the summary and recommendations and should be the last section in a research article. The authors have written a conclusion that summarises that Medical Radiation Science practitioners have characteristics that justify their occupation as being a profession. The conclusion also states that professionalization of Medical Radiation Science has proven problematic. A recommendation has been made that states that reflective practitioners should assist Medical Radiation Science practitioners to achieve a true professional status, address the challenges that the Medical Radiation Science profession is confronted with and to finally help Medical Radiation Science practitioners in advancing their clinical practice. The subject article has a well written conclusion.

Conclusion and recommendations

The research on ‘Profession and professionalization in medical radiation science as an emergent profession’ has its ups and downs. The authors or the research article should have provided a scholarly discussion that showed two very important things every research article needs: discussion of activity done in research and results analysis that proves that the authors have mastered the topic in discussion. The lack of research methodology, results from research and discussion of the results leaves much to be desired from the article. The topic was well written, and the introduction was exhaustive. The literature review shows many sources of information were used, but the research data from these sources should have been included in the subject article. The conclusion was well written. All in all, the subject research article was not badly written, but it could benefit if the authors made some improvements.

Professionalism is a key player in ensuring effective health care delivery. A successful radiology department, and indeed a successful Medical Radiation Science practitioner, need to possess professional skills. There was lack of identifying the importance of professionalism until very recently, when studies showed that lack of incentives was caused by failure to set expectations and measure performance of health care providers23. The radiology departments and the Medical Radiation Science practitioners that embrace programs that will enhance professionalism will demonstrate excellence in delivery of research, clinical care and education. On the other hand, those radiology departments and Medical Radiation Science practitioners who view such programs as new regulatory obstacles will fail. Despite the fact that measuring the subjective attributes defining an excellent and outstanding Medical Radiation Science professional is difficult, it is important to note that a successful radiology department is one that continually develops programs that stress the importance of professionalism among its Medical Radiation Science practitioners24.

Notes

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Clark Violato, Jen Lockyer and Hilary Fidler. “The assessment of pediatricians by a regulatory authority.” Pediatrics 117 (2006): 776-802.

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Ross Lipner, Lillian Blank, Floyd Leas and Silvia Fortna. “The value of patient and peer ratings in recertification.” Acad Med 77 (2002): 34-66.

Jane Wood, Bundy Collins and Susan Burnsidel. “Patient, faculty, and self-assessment of radiology resident performance: A 360-degree method of measuring professionalism and interpersonal/communication skills.” Acad Radiol 11 (2004): 931-939.

Clark Violato and Jen Lockyer. “Self and peer assessment of pediatricians, psychiatrists and medicine specialists: Implications for self-directed learning.” Adv Health Sci Educ Theory Pract 11 (2006): 235-244.

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Robert Gunderman. “Role models in the education of radiologists.” AJR 179 (2002): 307 -329.

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Cass Argyris. “Teaching smart people how to learn.” Harv Bus Rev 75 (1991): 99-109.

Joseph Lockyer, Clay Violato and Hilary Fidler. “The assessment of emergency physicians by a regulatory authority.” Acad Emerg Med 13 (2006): 1286-1303.

Michael Halsted. “Radiology peer review as an opportunity to reduce errors and improve patient care.” J Am Coll Radiol 12 (2004): 984-987.