European radiographers’ challenges from mammography education and clinical practice – an integrative review

Abstract

ObjectivesThis study aims to identify European radiographers’ challenges in clinical performance in mammography and the main areas of mammography that require more and better training.MethodsAn extensive search was performed to identify relevant studies focused on clinical practice, education and training in mammography published between January 2010 and December 2015 in the English language. The data were analysed by using deductive thematic analysis.ResultsA total of 27 full text articles were read, evaluating their quality. Sixteen articles out of 27 were finally selected for this integrative review. The main challenges of radiographers’ mammography education/training can be divided into three groups: training needs, challenges related to radiographers, and challenges related to the organization of education. The most common challenges of clinical performance in mammography among European radiographers involved technical performance, the quality of practices, and patient-centeredness.ConclusionsThe introduction of harmonized mammography guidelines across Europe may serve as an evidence-based tool to be implemented in practice and education. However, the variability in human and material resources as well as the different cultural contexts should be considered during this process.Teaching Points • Radiographers’ awareness of their professional identity and enhancing multiprofessional cooperation in mammography. • Radiographers’ responsibilities regarding image quality (IQ) and optimal breast imaging performance. • Patient-centred mammography services focusing on the psychosocial needs of the patient. • Challenges: positioning, QC-testing, IQ-assessment, optimization of breast compression, communication, teamwork, and patient-centred care. • Introduction of evidence-based guidelines in Europe to harmonize mammography practice and education.

Evaluation of Radiographers’ Experience in Mammography: An Explanatory Study

“…Although today, digital technologies can automatically handle the majority of software and hardware factors, positioning is still highly dependent on the radiographer's experience (5). Consistent with previous reports (5,10,11), the present results indicated that, irrespective to the radio- grapher's nationality, positioning was the main cause of repeat mammography in daily practice (Table 4).…”

“…Although today, digital technologies can automatically handle the majority of software and hardware factors, positioning is still highly dependent on the radiographer's experience (5). Consistent with previous reports (5,10,11), the present results indicated that, irrespective to the radio- grapher's nationality, positioning was the main cause of repeat mammography in daily practice (Table 4). The second leading cause of repeat mammography was image artifact, which can be explained by the fact that only 15% of the participants had always used motion artifact to evaluate a mammogram based on the ACR image quality standards (Figure 1).…”

“…To meet the study objectives, a 15-item questionnaire was developed based on previously published studies (5)(6)(7)(8)(9). The survey was divided into four main sections.…”

“…Therefore, the clinical efficacy of mammography is largely dependent on the images acquired by radiographers. In clinical practice, radiographers encounter different challenges and difficulties due to technological advances, patient interactions, individual needs, and requirements for continuous professional development (5). A recent integrative review reported that the challenges of European radiographers were related to patient positioning, breast compression, contrast, noise, sharpness, and labeling; such difficulties have been also identified in previous studies outside Europe (5).…”

A review of mammographic positioning image quality criteria for the craniocaudal projection

“…The call for a uniform and validated system prevails, 10,11,13,57 as this would support those in the education and practice of mammography. 42,79 Regardless of any such future considerations, the impetus for this review has been to determine optimum positioning for the CC projection with renewed attention required to establish which of the three identified criteria might have merit to successfully confirm inclusion of posterior breast tissue. It would be expected that knowledge arising from such research will inform which of the CC image quality criteria or any others revealed has validity to provide a platform for change of mammographic practice during image quality criteria assessment and subsequent clinical decision making for repeat imaging when the pectoral muscle is not demonstrated.…”