Hesta Friedrich-Nel - Academia.edu (original) (raw)

Papers by Hesta Friedrich-Nel

Depending on their condition, most neonates in a neonatal intensive care unit require multiple di... more Depending on their condition, most neonates in a neonatal intensive care unit require multiple diagnostic imaging examinations. Therefore, radiographers who perform these diagnostic imaging examinations should use optimal imaging techniques, to limit radiation dose and to ensure optimal image quality. The study wished to determine if radiographers were producing consistent optimal chest images and limiting radiation doses for neonates in a neonatal intensive care unit. A descriptive quantitative study was done by utilising a checklist compiled from literature to evaluate 450 neonatal chest images. Evaluation of the images indicates that radiographers seem unable to adhere to radiation control regulations. The authors propose including the checklist as part of a radiation safety improvement process, as it proved to be an assessment tool for identifying areas in image quality that require improvement.

Gaining a better understanding through inquiry of the complex ways in which students learn, or th... more Gaining a better understanding through inquiry of the complex ways in which students learn, or the impact of teaching on students\u27 learning, will ultimately result in improved quality in teaching and the engagement in the SoTL. T he aim of this session is to look into academic instruction practices by means of reflective teaching to confirm negative or positive actions that advance or obstruct the quality of student learning. Outcomes of the session are to share: 1) results of an action inquiry into reflective teaching to improve quality in teaching and learning, and 2) the reflective teaching framework that was developed as a formative tool in identifying areas where teaching can be improved and as a summative tool in judging the quality of teaching. Attendees will learn about appropriate reflective practices to engage in the Scholarship of Teaching and Learning

The South African Radiographer, 2017

The continuing professional development (CPD) guidelines of the Health Professions Council of Sou... more The continuing professional development (CPD) guidelines of the Health Professions Council of South Africa (HPCSA) include ethics, human rights and medical law. Practitioners must obtain a specified number of ethics continuing education units (CEUs). Over the decades the Society of Radiographers of South Africa (SORSA) has offered on-going CPD activities for radiographers to obtain their mandatory ethics CEUs which include human rights and medical law. To date no studies have been undertaken in South Africa to determine whether the content of CPD activities meets the HPCSA ethics guidelines in terms of whether radiographers do apply knowledge gained in their interactions with patients and other practitioners. In view of this gap in the literature this study had two broad aims. The first was to determine whether South African radiographers are of the opinion that the content of ethics CPD activities over the past 10 years enabled them to apply the information to benefit patients. The...

This study attempted to determine radiation dose levels around the operating theatre table, on ei... more This study attempted to determine radiation dose levels around the operating theatre table, on either side of the C-Arm, in order to establish if the radiation dose received by staff during back pain procedures fell within the limits set by the International Commission of Radiological Protection (ICRP). The question that arose from this goal was whether the stance of staff, in relation to the x-ray tube side of the C-Arm, influenced radiation dose levels. In order to apply the 'As-Low-As-Reasonably-Achievable' (ALARA) principle, the possibility of lowering the radiation dose in the neurological operating theatre was explored. The methodology of the study was twofold : measurements were executed by means of thermoluminescent detectors (TLD) as well as with an ionisation chamber. The measurement values resulted in a proposed protocol in terms of positioning of staff and orientation of the C-Arm in order to apply the ALARA principle during back pain procedures. Constant revisio...

The South African Radiographer, 2017

Rationale: To explore and describe renewal possibilities of the Society of Radiographers of South... more Rationale: To explore and describe renewal possibilities of the Society of Radiographers of South Africa (SORSA), in order to provide recommendations to meet the needs of the members in a cost-effective manner in relation to continuing professional development (CPD) and directed reading programmes (DRPs) provision, as well as journal distribution and management of SORSA. Objectives: Nine broad objectives underpinned the overarching purpose and aims of the survey. Methodology: A questionnaire was used to conduct a quantitative, descriptive, and exploratory survey. Invitations to participate in the online survey were placed on various SORSA regional branches’ Facebook pages, and the SORSA website. Members also received an automated text message (sms) to their cellphone (mobile) numbers on the current database. There were 374 respondents. The questions related to biographical information; DRPs, the South African Radiographer (SAR) , CPD, and the management of SORSA. Results: Respondent...

The South African Radiographer, 2010

This study attempted to determine radiation dose levels around the operating theatre table, on ei... more This study attempted to determine radiation dose levels around the operating theatre table, on either side of the C-Arm, in order to establish if the radiation dose received by staff during back pain procedures fell within the limits set by the International Commission of Radiological Protection (ICRP). The question that arose from this goal was whether the stance of staff, in relation to the x-ray tube side of the C-Arm, influenced radiation dose levels. In order to apply the ‘As-Low-As-Reasonably-Achievable’ (ALARA) principle, the possibility of lowering the radiation dose in the neurological operating theatre was explored. The methodology of the study was twofold: measurements were executed by means of thermoluminescent detectors (TLD) as well as with an ionisation chamber. The measurement values resulted in a proposed protocol in terms of positioning of staff and orientation of the C-Arm in order to apply the ALARA principle during back pain procedures. Constant revision of prot...

The South African Radiographer, 2019

The Health Professions Council of South Africa (HPCSA) introduced the continuing professional dev... more The Health Professions Council of South Africa (HPCSA) introduced the continuing professional development (CPD) system for all practitioners in 2007. The HPCSA did however identify shortcomings to the current CPD system and has proposed a maintenance of licensure (MOL) model. This article unpacks what the MOL entails in terms of clinical competence, reflection, reflective practice, and self-assessment. The MOL proposal intends to verify that each HPCSA registered practitioner maintains and improves professional knowledge, skills and performance for improved patient outcomes and health systems. Evaluation of competencies and performance through self-assessment would be required. A reflective practitioner is actively involved in their own personal development, and uses ongoing reflection-in-action and identifies development needs through self-assessment. Reference is made to other studies to analyse the implementation of reflective practice, reflection and self-assessment linked to CP...

Journal for new generation sciences, 2015

The most important projection of a patient with suspected cervical spine trauma is the lateral pr... more The most important projection of a patient with suspected cervical spine trauma is the lateral projection demonstrating C7 as well as T1. It frequently happens that the first and sometimes the second set of images do not demonstrate the cervicothoracic junction C7- T1. Literature underlines this statement through reports by Daffner (Daffner, 2000: Online) where the swimmer's projection needed to be repeated in 41% of their sample. In addition, 34% of the patients required a third radiograph. In this investigation, the swimmer's projection C7- T1 was compared to an alternative method to demonstrate C7-T1 as described in literature. The objectives were to ascertain which technique would yield the better identification of pathology, better image quality and less repeat films. A sample of 45 patients was examined at a tertiary level hospital. Two exposures were done on each member of the sample : the first was the swimmer's projection and the second with the patient reversin...

Journal for new generation sciences, 2005

Innovation in teaching and learning compel facilitators to explore creative possibilities in teac... more Innovation in teaching and learning compel facilitators to explore creative possibilities in teaching and learning. Consequently innovative assessment has replaced traditional assessment methods in the Radiographic Pathology II module. The use of an appropriate variety of assessment methods or approaches is crucial to enhance and support learning and measure performance. Thus assessment has to change from knowledge acquisition and factual recall to assess more embracing and critical learning outcomes such as problem-solving, communication, attitudes, critical thinking, professionalism and ethics. Moreover, assessment has to impact positively on learning, promote deep learning and correspond with the learning outcomes of the module. Addressing these demands in assessment, this paper presents practical examples of assessment innovation during 2004 in the Radiographic Pathology II module.

Critical Studies in Teaching and Learning, 2021

This article derives from a collaborative higher education project, conceptualised, and implement... more This article derives from a collaborative higher education project, conceptualised, and implemented by academics from seven South African universities. These academics are members of the South African Teaching Advancement at University (TAU) Fellowship. The project has its roots in the Department of Higher Education’s National Framework for Enhancing Academics as University Teachers, which identifies six leverage points or ‘imperatives for action’, one of which is the imperative to develop expectations (attributes) of academics in their role as university teachers. TAU Fellows engaged in the collaborative enquiry over a period of three years, appropriating a conceptual framework posited by Henry Giroux, of teachers as transformative intellectuals. In this article, each author reflects on his/her own scholarship of teaching and learning (SoTL) endeavours, which provided the conceptual tools to illuminate what for them and the group, are valuable professional attributes. The metaphor ...

Health SA Gesondheid, 2021

Dose optimisation is one of the radiation protection guidelines recommended by the International ... more Dose optimisation is one of the radiation protection guidelines recommended by the International Commission on Radiological Protection (ICRP) and ensures adherence to the 'as low as reasonably achievable' (ALARA) principle. Furthermore, the ICRP recommends the practice of DRLs to optimise and monitor radiation dose. Determining DRLs and comparing these values with Background: Dose optimisation is a radiation protection guideline recommended by the International Commission on Radiological Protection (ICRP) for adherence to the 'as low as reasonably achievable' (ALARA) principle. Diagnostic reference levels (DRLs) are used to optimise patients' radiation protection for diagnostic and interventional procedures and are particularly useful for frequently performed examinations such as chest X-rays. Aim: To establish the local diagnostic reference levels (LDRLs) for routine chest X-rays. Setting: Public sector hospital, Northern Cape province, South Africa. Methods: Sixty patients referred for chest X-rays fulfilling the inclusion criteria participated in this study. Patients were ≥ 18 years of age and weighed between 60 kg and 80 kg. Consent for participation was obtained. The entrance skin air kerma (ESAK) was measured by using the indirect method recommended by the International Atomic Energy Agency (IAEA). Statistical software (SAS version 9.2) was used to determine the LDRLs for chest X-rays in three different rooms. In two rooms, computed radiography (CR) was used and the other one was a digital radiography (DR) unit. The LDRL values at the research site were compared with various published international values. Results: LDRLs for chest X-rays were established. The CR LDRL value for the posteroanterior (PA) chest projection was higher than the DR (flat panel detector [FPD]) LDRL value. The LDRLs of the PA chest projections were 0.3 mGy for CR and 0.2 mGy for DR. The lateral (LAT) chest projection LDRL value was 0.8 mGy for both CR and DR (FPD) projections. The resultant LDRL between rooms at the research site was 0.3 mGy for PA 0.3 mGy and 0.8 mGy for LAT chest projections. Conclusion: The LDRLs for chest X-rays established at this research site were lower than internationally reported DRLs. We recommend that LDRLs for routine chest X-rays should be repeated every 3 years, according to the ICRP. Contribution: Currently, no established or published DRL values prescribed by the Directorate of Radiation Control (DRC) are available in South Africa. The LDRLs established for routine chest X-ray examinations at this research site can serve as a guideline for the establishment of DRL values for other anatomical regions at the research site and other radiology departments in the country.

Journal of Medical Imaging and Radiation Sciences, 2020

The purpose of the study was to evaluate student exchange experiences to gain insight into what s... more The purpose of the study was to evaluate student exchange experiences to gain insight into what students perceived as benefits, challenges, and overall areas for improvement that might inform and enhance future exchange projects. Methods: A general program evaluation survey, adapted to address the project objectives, was conducted. Eight students from Norway, Canada, and South Africa participating in an international exchange project completed an online survey. The responses were coded and organized in themes such as pre-exchange preparation, home/host country support, challenges, and new learning. Results & Conclusions: Despite the challenges the students experienced, students indicated advantages such as new learning, personal development, and expanded professional knowledge. Students gained an international perspective and deeper understanding of their profession and insight into the similarities and differences in clinical practice emphasizing the importance of creating global citizens through internationalization in radiography education. These student experiences confirmed their agency in disposition, motivation, self-efficacy, and position. R ESUM E But : Evaluer les exp eriences d' echanges d' etudiants afin de comprendre ce qui, aux yeux des etudiants, constitue des avantages, des d efis et des domaines g en eraux d'am elioration susceptibles d' eclairer les projets d' echanges d' etudiants futurs. M ethodologie : Un sondage d' evaluation g en erale du programme, adapt e en fonction des objectifs du projet, a et e r ealis e. Huit etudiants de la Norv ege, du Canada et de l'Afrique du Sud ayant particip e a un projet international d' echange d' etudiants ont r epondu a un sondage en ligne. Les r eponses ont et e cod ees et regroup ees par th emes comme la pr eparation avant l' echange, le soutien du pays d'origine/d'accueil, les d efis et les nouveaux apprentissages. R esultats et conclusions : Malgr e les d efis auxquels ils ont fait face, les etudiants ont mentionn e des avantages comme de nouveaux apprentissages, le d eveloppement personnel et un elargissement des connaissances professionnelles. Les etudiants ont acquis une perspective internationale de leur profession et une meilleure compr ehension de celle-ci, tout en d ecouvrant les similitudes et les diff erences dans la pratique clinique, mettant ainsi l'accent sur l'importance de cr eer des citoyens du monde par l'internationalisation de la formation en radiographie. L'exp erience de ces etudiants a confirm e leur capacit e d'agir en mati ere de disposition, de motivation, de sentiment d'efficacit e personnelle et de position.

Health SA Gesondheid, 2018

Background: Diagnostic radiographers working in the neonatal intensive care unit primarily aim to... more Background: Diagnostic radiographers working in the neonatal intensive care unit primarily aim to produce an image of optimal quality using optimal exposure techniques without repeating exposures, to keep neonatal radiation dose to a minimum. Objectives: The aim of the study was to determine whether radiographers were producing optimal quality chest images and, if not, whether additional training could contribute to reaching this goal in the Free State Province of South Africa. Methods: Neonatal chest image quality was determined in the Neonatal Intensive Care Unit by using a checklist based on and compiled from published guidelines to evaluate the quality of 450 randomly-selected images. Thereafter, a training programme was designed, based on the evaluation criteria of the checklist and image quality areas identified. The training also referred to positioning techniques that should be applied to ensure optimal image quality. After presentation of the training, 450 newly-produced ne...

South African Journal of Higher Education, 2016

The extended curriculum programme (ECP) in the faculty of Health Sciences at the Central Universi... more The extended curriculum programme (ECP) in the faculty of Health Sciences at the Central University of Technology (CUT), Bloemfontein, consists of six (6) different instructional programmes. These programmes have been developed for Biomedical Technology, Clinical Technology, Emergency Medical Care, Environmental Health, Radiography and Somatology. This article provides an overview of the progress and development of the ECP in the Health Sciences at CUT as a proposed road map to academic success for a specific group of students. To obtain an objective picture of students’ success in the ECP in the Health Sciences, the assessment results of all the students registered between 2007 and 2012 were retrieved and analysed retrospectively. An increase in articulation was noted from 2010 to 2012 (i.e., from 70% to 84.4%) and an average articulation percentage of 80% was achieved from 2007 to 2012. These figures indicate a successful transition from ECP to the mainstream programmes. Moreover, 58% of ECP students who registered in 2007 successfully completed their national diplomas in the extended timeframe. This group also delivered three B-Tech candidates and one student registered for a Master’s Degree. The emotional growth and personal development of students were also prominent, as observed by mainstream lecturers. The support offered to students in the current ECP model includes a mentorship programme with a qualified psychologist, supplemental instruction (SI) and the sponsorship of all textbooks and registration fees for the Health Professions Council of South Africa (HPCSA) and first aid training

Postgraduate Supervision - Future foci for the knowledge society, 2016

Creating a cadre of scholars for a knowledge society in South Africa is critical for the developm... more Creating a cadre of scholars for a knowledge society in South Africa is critical for the development of the country. One way in which this need can be addressed is to produce doctoral students capable of contributing to knowledge production. An integral element in doctoral education is the formation of a successful supervisory relationship between the doctoral supervisor and the doctoral student. In a positive and successful relationship, the expectations of the student and the supervisor are in alignment. However, it is common to see some disparities in the expectations. Although the disparity in expectations cannot be linked to a specific research supervision model, the assumption is that there may be an association when one or two supervisors and one student work together in what is referred to as the 'traditional apprenticeship model of supervision'. Strategies such as the use of open and continuous communication, the provision of timely and constructive feedback and the creation of a trusting environment are useful in addressing the disparities in the expectations of both supervisor and student. The literature on doctoral education and postgraduate supervision refers to the supervisory relationship in a number of ways. For example, Bartlett and Mercer (2000:196) call the relationship "complex" because the process may appear to participants to be inflexible and individualistic. These authors also mention the possibility of a power relationship created by the "knowing" supervisor engaging with the "unknowing student" (Bartlett & Mercer 2000:196). Other descriptions such as "unfinished business" (Green 2005:151) or "an uncertain practice" (Grant 2005:337) are also used to emphasise the possible challenges of this supervisory relationship. Adkins (2009) adds a perspective to the relationship by referring to

African Journal of Health Professions Education, Mar 11, 2014

Currently, radiography students are faced with the challenge of having to learn factual informati... more Currently, radiography students are faced with the challenge of having to learn factual information, while being taught how to interpret the information available to them to problem solve and reflect on their judgement within a given clinical context. [1,2] Problem solving is a vital competency for healthcare professionals in an era of rapidly advancing technology. [3,4] It requires critical thinking, and improves the quality of a clinical service offered and the efficiency of delivering such a service. [5] Therefore, enabling students to problem solve will in turn improve clinical competence. [4] To improve problem-solving skills of radiographers, problem-based learning (PBL) has been incorporated in the radiography curriculum in certain institutions in Africa, one of which is the Makerere University in Uganda. PBL was first introduced into medical education in the 1960s in Ontario, Canada for physicians. [2] It is a popular teaching method, utilising problem-solving skills, and has been used successfully for some radiography, nursing and paramedic curricula. [6,7] However, a gap still exists in the literature on the assessment of problem-solving abilities in radiography. The skill can be defined as the student's ability to use objectives and operations to reach a specific goal within certain constraints. [8] It requires inference, involving the identification of factors to come to reasonable conclusions. [3,9] A student who demonstrates good problem-solving skills considers relevant information to deduce judgements, inferences, statements, beliefs and opinions. This competency encompasses the ability to query evidence, present alternatives and draw conclusions. [9] Freeman and Lewis [8] highlight four components of problem solving, i.e. goal (the solution), objects (what can be used to reach the goal), operations (permitted actions in reaching the goal) and constraints (limitations). In addition, they identify the concept of well-defined problems (all necessary information is given) and ill-defined problems (little or no information is given). In the health sciences, most problems fall into the latter category. [8] The competency requires critical thinking, which causes individuals to constantly improve their skills for personal and professional growth, thus enabling healthcare workers to make more informed decisions in the clinical environment. [4,10] Therefore, teaching students to problem solve allows the practitioner to integrate theory and practice, improves clinical reasoning and addresses the needs of the patient owing to clinical efficiency and better patient care. [4,5,10] The South African Qualifications Authority (SAQA) added a new dimension to teaching, learning and assessment with the publication of the critical cross-field outcomes that students need to attain in addition to the programme outcomes. Critical thinking and problem solving are listed among the 12 outcomes. Although the publication dates back to 1995, it is valid to question the ability of third-year radiography students to attain these specific outcomes, as information in this field in a radiography context is lacking. [11] In the South African context, problem-solving skills among radiography students have not been assessed. The ability of the students to demonstrate problemsolving skills needed to be explored so that the Department of Radiography could develop a more explicit curriculum to facilitate these competencies. The aim of this study was to evaluate the problem-solving skills of thirdyear radiography students at a comprehensive South African university. Methods A descriptive exploratory research design was used to collect both quantitative and qualitative data. The study design was selected to explore, Background. Developing the problem-solving skills of student radiographers is imperative for encouraging critical thinking and allowing them to work efficiently in an era of rapidly advancing technology. Students' ability to demonstrate these skills was studied so that the Department of Radiography, at a comprehensive university in South Africa, could develop a more explicit curriculum to facilitate these competencies. Objective. To assess problem-solving skills of third-year radiography students at a comprehensive South African university. Methods. The study employed a descriptive exploratory design. The participants' responses to vignettes (in the form of clinical scenarios) were analysed using a Likert scale and action verbs developed for evaluating evidence of problem-solving skills and providing quantitative data. Field notes were made while analysing responses to each question, providing qualitative data. Results. The findings indicate that the majority of participants demonstrated a minimal ability to problem solve in a vignette. This implies that to improve problem-solving skills of student radiographers, there is a need for curriculum adjustment to nurture and encourage this competency. Conclusion. Facilitators need to be taught methods to integrate problem solving into the curriculum, and learning material must be adjusted to accommodate problem solving for this skill to become part of the programme outcomes.

Role extension has been debated amongst South African radiographers for a number of years. Howeve... more Role extension has been debated amongst South African radiographers for a number of years. However, the administration of contrast media still remains outside their scope of practice. The Society of Radiographers of South Africa (SORSA) has received anecdotal reports that radiographers are administering contrast media. This practice is a direct infringement of the rights of patients who are required to be treated and examined by health professionals who practice within their legal scope. The aim of this survey was to investigate the views and opinions of South African radiographers regarding the injecting of contrast media and the type of training needed if it were included in the scope of practice of South African radiographers. A questionnaire was sent to 845 radiographers using an online survey programme (SurveyMonkey). The questions related to biographical information, work experience, training and the medico-legal aspects of intravenous contrast media injection by radiographers. The response rate was 21% (n=177). Eighty-one percent (81%) were diagnostic radiographers. Seventy-three percent (73%) practice radiography in a major city. There was an equal representation of the public and private sector, namely 43% for both. Of those from the public sector 47% were from a tertiary healthcare facility. More than seventy-eight percent (>78%) practice radiography in a health facility that provides radiology services. Seventy-three percent (73%) were aware of mild to moderate adverse reactions to contrast media; 45% were aware of severe adverse reactions to contrast media in their workplace. Eightyfive percent (85%) thought that accredited training should include the administration of contrast media as well as resuscitation of a patient. Sixty-two percent (62%) thought the accredited training should include pharmacology and advanced resuscitation. Ninety-three percent (93%) thought the main advantage would be an increase in service delivery to patients; 85% thought the main disadvantage would be potential risk of criminal or civil litigation. Ninety-seven percent (97%) were of the opinion that radiographers who introduce contrast media to patients must have current malpractice insurance. The results of this survey provide new information on the current status of contrast media administration to the patient whose safety and rights remain at the centre of our focus. It is recommended that the statutory body, namely the professional board for radiography and clinical technology (RCT) of the Health Professions Council of South Africa (HPCSA) takes cognizance of the outcome of this study and embarks on a more extensive survey to include a larger sample which would be more representative of the South African radiography population.

The South African Radiographer, Aug 12, 2009

Role extension [1] and / or advanced practice [1] are concepts that have almost become mantras in... more Role extension [1] and / or advanced practice [1] are concepts that have almost become mantras in the radiography profession. The international movement was brought to South Africa (SA) in 2007 and 2008 respectively. During two international conferences hosted in SA, respectively in Cape Town and Durban, South African radiographers were introduced to some of the perspectives of role extension and / or advanced practice, specifically from the United States of America (USA) and United Kingdom (UK). In addition a peer reviewed article on this topic was recently published in SA [2].

Depending on their condition, most neonates in a neonatal intensive care unit require multiple di... more Depending on their condition, most neonates in a neonatal intensive care unit require multiple diagnostic imaging examinations. Therefore, radiographers who perform these diagnostic imaging examinations should use optimal imaging techniques, to limit radiation dose and to ensure optimal image quality. The study wished to determine if radiographers were producing consistent optimal chest images and limiting radiation doses for neonates in a neonatal intensive care unit. A descriptive quantitative study was done by utilising a checklist compiled from literature to evaluate 450 neonatal chest images. Evaluation of the images indicates that radiographers seem unable to adhere to radiation control regulations. The authors propose including the checklist as part of a radiation safety improvement process, as it proved to be an assessment tool for identifying areas in image quality that require improvement.

Gaining a better understanding through inquiry of the complex ways in which students learn, or th... more Gaining a better understanding through inquiry of the complex ways in which students learn, or the impact of teaching on students\u27 learning, will ultimately result in improved quality in teaching and the engagement in the SoTL. T he aim of this session is to look into academic instruction practices by means of reflective teaching to confirm negative or positive actions that advance or obstruct the quality of student learning. Outcomes of the session are to share: 1) results of an action inquiry into reflective teaching to improve quality in teaching and learning, and 2) the reflective teaching framework that was developed as a formative tool in identifying areas where teaching can be improved and as a summative tool in judging the quality of teaching. Attendees will learn about appropriate reflective practices to engage in the Scholarship of Teaching and Learning

The South African Radiographer, 2017

The continuing professional development (CPD) guidelines of the Health Professions Council of Sou... more The continuing professional development (CPD) guidelines of the Health Professions Council of South Africa (HPCSA) include ethics, human rights and medical law. Practitioners must obtain a specified number of ethics continuing education units (CEUs). Over the decades the Society of Radiographers of South Africa (SORSA) has offered on-going CPD activities for radiographers to obtain their mandatory ethics CEUs which include human rights and medical law. To date no studies have been undertaken in South Africa to determine whether the content of CPD activities meets the HPCSA ethics guidelines in terms of whether radiographers do apply knowledge gained in their interactions with patients and other practitioners. In view of this gap in the literature this study had two broad aims. The first was to determine whether South African radiographers are of the opinion that the content of ethics CPD activities over the past 10 years enabled them to apply the information to benefit patients. The...

This study attempted to determine radiation dose levels around the operating theatre table, on ei... more This study attempted to determine radiation dose levels around the operating theatre table, on either side of the C-Arm, in order to establish if the radiation dose received by staff during back pain procedures fell within the limits set by the International Commission of Radiological Protection (ICRP). The question that arose from this goal was whether the stance of staff, in relation to the x-ray tube side of the C-Arm, influenced radiation dose levels. In order to apply the 'As-Low-As-Reasonably-Achievable' (ALARA) principle, the possibility of lowering the radiation dose in the neurological operating theatre was explored. The methodology of the study was twofold : measurements were executed by means of thermoluminescent detectors (TLD) as well as with an ionisation chamber. The measurement values resulted in a proposed protocol in terms of positioning of staff and orientation of the C-Arm in order to apply the ALARA principle during back pain procedures. Constant revisio...

The South African Radiographer, 2017

Rationale: To explore and describe renewal possibilities of the Society of Radiographers of South... more Rationale: To explore and describe renewal possibilities of the Society of Radiographers of South Africa (SORSA), in order to provide recommendations to meet the needs of the members in a cost-effective manner in relation to continuing professional development (CPD) and directed reading programmes (DRPs) provision, as well as journal distribution and management of SORSA. Objectives: Nine broad objectives underpinned the overarching purpose and aims of the survey. Methodology: A questionnaire was used to conduct a quantitative, descriptive, and exploratory survey. Invitations to participate in the online survey were placed on various SORSA regional branches’ Facebook pages, and the SORSA website. Members also received an automated text message (sms) to their cellphone (mobile) numbers on the current database. There were 374 respondents. The questions related to biographical information; DRPs, the South African Radiographer (SAR) , CPD, and the management of SORSA. Results: Respondent...

The South African Radiographer, 2010

This study attempted to determine radiation dose levels around the operating theatre table, on ei... more This study attempted to determine radiation dose levels around the operating theatre table, on either side of the C-Arm, in order to establish if the radiation dose received by staff during back pain procedures fell within the limits set by the International Commission of Radiological Protection (ICRP). The question that arose from this goal was whether the stance of staff, in relation to the x-ray tube side of the C-Arm, influenced radiation dose levels. In order to apply the ‘As-Low-As-Reasonably-Achievable’ (ALARA) principle, the possibility of lowering the radiation dose in the neurological operating theatre was explored. The methodology of the study was twofold: measurements were executed by means of thermoluminescent detectors (TLD) as well as with an ionisation chamber. The measurement values resulted in a proposed protocol in terms of positioning of staff and orientation of the C-Arm in order to apply the ALARA principle during back pain procedures. Constant revision of prot...

The South African Radiographer, 2019

The Health Professions Council of South Africa (HPCSA) introduced the continuing professional dev... more The Health Professions Council of South Africa (HPCSA) introduced the continuing professional development (CPD) system for all practitioners in 2007. The HPCSA did however identify shortcomings to the current CPD system and has proposed a maintenance of licensure (MOL) model. This article unpacks what the MOL entails in terms of clinical competence, reflection, reflective practice, and self-assessment. The MOL proposal intends to verify that each HPCSA registered practitioner maintains and improves professional knowledge, skills and performance for improved patient outcomes and health systems. Evaluation of competencies and performance through self-assessment would be required. A reflective practitioner is actively involved in their own personal development, and uses ongoing reflection-in-action and identifies development needs through self-assessment. Reference is made to other studies to analyse the implementation of reflective practice, reflection and self-assessment linked to CP...

Journal for new generation sciences, 2015

The most important projection of a patient with suspected cervical spine trauma is the lateral pr... more The most important projection of a patient with suspected cervical spine trauma is the lateral projection demonstrating C7 as well as T1. It frequently happens that the first and sometimes the second set of images do not demonstrate the cervicothoracic junction C7- T1. Literature underlines this statement through reports by Daffner (Daffner, 2000: Online) where the swimmer's projection needed to be repeated in 41% of their sample. In addition, 34% of the patients required a third radiograph. In this investigation, the swimmer's projection C7- T1 was compared to an alternative method to demonstrate C7-T1 as described in literature. The objectives were to ascertain which technique would yield the better identification of pathology, better image quality and less repeat films. A sample of 45 patients was examined at a tertiary level hospital. Two exposures were done on each member of the sample : the first was the swimmer's projection and the second with the patient reversin...

Journal for new generation sciences, 2005

Innovation in teaching and learning compel facilitators to explore creative possibilities in teac... more Innovation in teaching and learning compel facilitators to explore creative possibilities in teaching and learning. Consequently innovative assessment has replaced traditional assessment methods in the Radiographic Pathology II module. The use of an appropriate variety of assessment methods or approaches is crucial to enhance and support learning and measure performance. Thus assessment has to change from knowledge acquisition and factual recall to assess more embracing and critical learning outcomes such as problem-solving, communication, attitudes, critical thinking, professionalism and ethics. Moreover, assessment has to impact positively on learning, promote deep learning and correspond with the learning outcomes of the module. Addressing these demands in assessment, this paper presents practical examples of assessment innovation during 2004 in the Radiographic Pathology II module.

Critical Studies in Teaching and Learning, 2021

This article derives from a collaborative higher education project, conceptualised, and implement... more This article derives from a collaborative higher education project, conceptualised, and implemented by academics from seven South African universities. These academics are members of the South African Teaching Advancement at University (TAU) Fellowship. The project has its roots in the Department of Higher Education’s National Framework for Enhancing Academics as University Teachers, which identifies six leverage points or ‘imperatives for action’, one of which is the imperative to develop expectations (attributes) of academics in their role as university teachers. TAU Fellows engaged in the collaborative enquiry over a period of three years, appropriating a conceptual framework posited by Henry Giroux, of teachers as transformative intellectuals. In this article, each author reflects on his/her own scholarship of teaching and learning (SoTL) endeavours, which provided the conceptual tools to illuminate what for them and the group, are valuable professional attributes. The metaphor ...

Health SA Gesondheid, 2021

Dose optimisation is one of the radiation protection guidelines recommended by the International ... more Dose optimisation is one of the radiation protection guidelines recommended by the International Commission on Radiological Protection (ICRP) and ensures adherence to the 'as low as reasonably achievable' (ALARA) principle. Furthermore, the ICRP recommends the practice of DRLs to optimise and monitor radiation dose. Determining DRLs and comparing these values with Background: Dose optimisation is a radiation protection guideline recommended by the International Commission on Radiological Protection (ICRP) for adherence to the 'as low as reasonably achievable' (ALARA) principle. Diagnostic reference levels (DRLs) are used to optimise patients' radiation protection for diagnostic and interventional procedures and are particularly useful for frequently performed examinations such as chest X-rays. Aim: To establish the local diagnostic reference levels (LDRLs) for routine chest X-rays. Setting: Public sector hospital, Northern Cape province, South Africa. Methods: Sixty patients referred for chest X-rays fulfilling the inclusion criteria participated in this study. Patients were ≥ 18 years of age and weighed between 60 kg and 80 kg. Consent for participation was obtained. The entrance skin air kerma (ESAK) was measured by using the indirect method recommended by the International Atomic Energy Agency (IAEA). Statistical software (SAS version 9.2) was used to determine the LDRLs for chest X-rays in three different rooms. In two rooms, computed radiography (CR) was used and the other one was a digital radiography (DR) unit. The LDRL values at the research site were compared with various published international values. Results: LDRLs for chest X-rays were established. The CR LDRL value for the posteroanterior (PA) chest projection was higher than the DR (flat panel detector [FPD]) LDRL value. The LDRLs of the PA chest projections were 0.3 mGy for CR and 0.2 mGy for DR. The lateral (LAT) chest projection LDRL value was 0.8 mGy for both CR and DR (FPD) projections. The resultant LDRL between rooms at the research site was 0.3 mGy for PA 0.3 mGy and 0.8 mGy for LAT chest projections. Conclusion: The LDRLs for chest X-rays established at this research site were lower than internationally reported DRLs. We recommend that LDRLs for routine chest X-rays should be repeated every 3 years, according to the ICRP. Contribution: Currently, no established or published DRL values prescribed by the Directorate of Radiation Control (DRC) are available in South Africa. The LDRLs established for routine chest X-ray examinations at this research site can serve as a guideline for the establishment of DRL values for other anatomical regions at the research site and other radiology departments in the country.

Journal of Medical Imaging and Radiation Sciences, 2020

The purpose of the study was to evaluate student exchange experiences to gain insight into what s... more The purpose of the study was to evaluate student exchange experiences to gain insight into what students perceived as benefits, challenges, and overall areas for improvement that might inform and enhance future exchange projects. Methods: A general program evaluation survey, adapted to address the project objectives, was conducted. Eight students from Norway, Canada, and South Africa participating in an international exchange project completed an online survey. The responses were coded and organized in themes such as pre-exchange preparation, home/host country support, challenges, and new learning. Results & Conclusions: Despite the challenges the students experienced, students indicated advantages such as new learning, personal development, and expanded professional knowledge. Students gained an international perspective and deeper understanding of their profession and insight into the similarities and differences in clinical practice emphasizing the importance of creating global citizens through internationalization in radiography education. These student experiences confirmed their agency in disposition, motivation, self-efficacy, and position. R ESUM E But : Evaluer les exp eriences d' echanges d' etudiants afin de comprendre ce qui, aux yeux des etudiants, constitue des avantages, des d efis et des domaines g en eraux d'am elioration susceptibles d' eclairer les projets d' echanges d' etudiants futurs. M ethodologie : Un sondage d' evaluation g en erale du programme, adapt e en fonction des objectifs du projet, a et e r ealis e. Huit etudiants de la Norv ege, du Canada et de l'Afrique du Sud ayant particip e a un projet international d' echange d' etudiants ont r epondu a un sondage en ligne. Les r eponses ont et e cod ees et regroup ees par th emes comme la pr eparation avant l' echange, le soutien du pays d'origine/d'accueil, les d efis et les nouveaux apprentissages. R esultats et conclusions : Malgr e les d efis auxquels ils ont fait face, les etudiants ont mentionn e des avantages comme de nouveaux apprentissages, le d eveloppement personnel et un elargissement des connaissances professionnelles. Les etudiants ont acquis une perspective internationale de leur profession et une meilleure compr ehension de celle-ci, tout en d ecouvrant les similitudes et les diff erences dans la pratique clinique, mettant ainsi l'accent sur l'importance de cr eer des citoyens du monde par l'internationalisation de la formation en radiographie. L'exp erience de ces etudiants a confirm e leur capacit e d'agir en mati ere de disposition, de motivation, de sentiment d'efficacit e personnelle et de position.

Health SA Gesondheid, 2018

Background: Diagnostic radiographers working in the neonatal intensive care unit primarily aim to... more Background: Diagnostic radiographers working in the neonatal intensive care unit primarily aim to produce an image of optimal quality using optimal exposure techniques without repeating exposures, to keep neonatal radiation dose to a minimum. Objectives: The aim of the study was to determine whether radiographers were producing optimal quality chest images and, if not, whether additional training could contribute to reaching this goal in the Free State Province of South Africa. Methods: Neonatal chest image quality was determined in the Neonatal Intensive Care Unit by using a checklist based on and compiled from published guidelines to evaluate the quality of 450 randomly-selected images. Thereafter, a training programme was designed, based on the evaluation criteria of the checklist and image quality areas identified. The training also referred to positioning techniques that should be applied to ensure optimal image quality. After presentation of the training, 450 newly-produced ne...

South African Journal of Higher Education, 2016

The extended curriculum programme (ECP) in the faculty of Health Sciences at the Central Universi... more The extended curriculum programme (ECP) in the faculty of Health Sciences at the Central University of Technology (CUT), Bloemfontein, consists of six (6) different instructional programmes. These programmes have been developed for Biomedical Technology, Clinical Technology, Emergency Medical Care, Environmental Health, Radiography and Somatology. This article provides an overview of the progress and development of the ECP in the Health Sciences at CUT as a proposed road map to academic success for a specific group of students. To obtain an objective picture of students’ success in the ECP in the Health Sciences, the assessment results of all the students registered between 2007 and 2012 were retrieved and analysed retrospectively. An increase in articulation was noted from 2010 to 2012 (i.e., from 70% to 84.4%) and an average articulation percentage of 80% was achieved from 2007 to 2012. These figures indicate a successful transition from ECP to the mainstream programmes. Moreover, 58% of ECP students who registered in 2007 successfully completed their national diplomas in the extended timeframe. This group also delivered three B-Tech candidates and one student registered for a Master’s Degree. The emotional growth and personal development of students were also prominent, as observed by mainstream lecturers. The support offered to students in the current ECP model includes a mentorship programme with a qualified psychologist, supplemental instruction (SI) and the sponsorship of all textbooks and registration fees for the Health Professions Council of South Africa (HPCSA) and first aid training

Postgraduate Supervision - Future foci for the knowledge society, 2016

Creating a cadre of scholars for a knowledge society in South Africa is critical for the developm... more Creating a cadre of scholars for a knowledge society in South Africa is critical for the development of the country. One way in which this need can be addressed is to produce doctoral students capable of contributing to knowledge production. An integral element in doctoral education is the formation of a successful supervisory relationship between the doctoral supervisor and the doctoral student. In a positive and successful relationship, the expectations of the student and the supervisor are in alignment. However, it is common to see some disparities in the expectations. Although the disparity in expectations cannot be linked to a specific research supervision model, the assumption is that there may be an association when one or two supervisors and one student work together in what is referred to as the 'traditional apprenticeship model of supervision'. Strategies such as the use of open and continuous communication, the provision of timely and constructive feedback and the creation of a trusting environment are useful in addressing the disparities in the expectations of both supervisor and student. The literature on doctoral education and postgraduate supervision refers to the supervisory relationship in a number of ways. For example, Bartlett and Mercer (2000:196) call the relationship "complex" because the process may appear to participants to be inflexible and individualistic. These authors also mention the possibility of a power relationship created by the "knowing" supervisor engaging with the "unknowing student" (Bartlett & Mercer 2000:196). Other descriptions such as "unfinished business" (Green 2005:151) or "an uncertain practice" (Grant 2005:337) are also used to emphasise the possible challenges of this supervisory relationship. Adkins (2009) adds a perspective to the relationship by referring to

African Journal of Health Professions Education, Mar 11, 2014

Currently, radiography students are faced with the challenge of having to learn factual informati... more Currently, radiography students are faced with the challenge of having to learn factual information, while being taught how to interpret the information available to them to problem solve and reflect on their judgement within a given clinical context. [1,2] Problem solving is a vital competency for healthcare professionals in an era of rapidly advancing technology. [3,4] It requires critical thinking, and improves the quality of a clinical service offered and the efficiency of delivering such a service. [5] Therefore, enabling students to problem solve will in turn improve clinical competence. [4] To improve problem-solving skills of radiographers, problem-based learning (PBL) has been incorporated in the radiography curriculum in certain institutions in Africa, one of which is the Makerere University in Uganda. PBL was first introduced into medical education in the 1960s in Ontario, Canada for physicians. [2] It is a popular teaching method, utilising problem-solving skills, and has been used successfully for some radiography, nursing and paramedic curricula. [6,7] However, a gap still exists in the literature on the assessment of problem-solving abilities in radiography. The skill can be defined as the student's ability to use objectives and operations to reach a specific goal within certain constraints. [8] It requires inference, involving the identification of factors to come to reasonable conclusions. [3,9] A student who demonstrates good problem-solving skills considers relevant information to deduce judgements, inferences, statements, beliefs and opinions. This competency encompasses the ability to query evidence, present alternatives and draw conclusions. [9] Freeman and Lewis [8] highlight four components of problem solving, i.e. goal (the solution), objects (what can be used to reach the goal), operations (permitted actions in reaching the goal) and constraints (limitations). In addition, they identify the concept of well-defined problems (all necessary information is given) and ill-defined problems (little or no information is given). In the health sciences, most problems fall into the latter category. [8] The competency requires critical thinking, which causes individuals to constantly improve their skills for personal and professional growth, thus enabling healthcare workers to make more informed decisions in the clinical environment. [4,10] Therefore, teaching students to problem solve allows the practitioner to integrate theory and practice, improves clinical reasoning and addresses the needs of the patient owing to clinical efficiency and better patient care. [4,5,10] The South African Qualifications Authority (SAQA) added a new dimension to teaching, learning and assessment with the publication of the critical cross-field outcomes that students need to attain in addition to the programme outcomes. Critical thinking and problem solving are listed among the 12 outcomes. Although the publication dates back to 1995, it is valid to question the ability of third-year radiography students to attain these specific outcomes, as information in this field in a radiography context is lacking. [11] In the South African context, problem-solving skills among radiography students have not been assessed. The ability of the students to demonstrate problemsolving skills needed to be explored so that the Department of Radiography could develop a more explicit curriculum to facilitate these competencies. The aim of this study was to evaluate the problem-solving skills of thirdyear radiography students at a comprehensive South African university. Methods A descriptive exploratory research design was used to collect both quantitative and qualitative data. The study design was selected to explore, Background. Developing the problem-solving skills of student radiographers is imperative for encouraging critical thinking and allowing them to work efficiently in an era of rapidly advancing technology. Students' ability to demonstrate these skills was studied so that the Department of Radiography, at a comprehensive university in South Africa, could develop a more explicit curriculum to facilitate these competencies. Objective. To assess problem-solving skills of third-year radiography students at a comprehensive South African university. Methods. The study employed a descriptive exploratory design. The participants' responses to vignettes (in the form of clinical scenarios) were analysed using a Likert scale and action verbs developed for evaluating evidence of problem-solving skills and providing quantitative data. Field notes were made while analysing responses to each question, providing qualitative data. Results. The findings indicate that the majority of participants demonstrated a minimal ability to problem solve in a vignette. This implies that to improve problem-solving skills of student radiographers, there is a need for curriculum adjustment to nurture and encourage this competency. Conclusion. Facilitators need to be taught methods to integrate problem solving into the curriculum, and learning material must be adjusted to accommodate problem solving for this skill to become part of the programme outcomes.

Role extension has been debated amongst South African radiographers for a number of years. Howeve... more Role extension has been debated amongst South African radiographers for a number of years. However, the administration of contrast media still remains outside their scope of practice. The Society of Radiographers of South Africa (SORSA) has received anecdotal reports that radiographers are administering contrast media. This practice is a direct infringement of the rights of patients who are required to be treated and examined by health professionals who practice within their legal scope. The aim of this survey was to investigate the views and opinions of South African radiographers regarding the injecting of contrast media and the type of training needed if it were included in the scope of practice of South African radiographers. A questionnaire was sent to 845 radiographers using an online survey programme (SurveyMonkey). The questions related to biographical information, work experience, training and the medico-legal aspects of intravenous contrast media injection by radiographers. The response rate was 21% (n=177). Eighty-one percent (81%) were diagnostic radiographers. Seventy-three percent (73%) practice radiography in a major city. There was an equal representation of the public and private sector, namely 43% for both. Of those from the public sector 47% were from a tertiary healthcare facility. More than seventy-eight percent (>78%) practice radiography in a health facility that provides radiology services. Seventy-three percent (73%) were aware of mild to moderate adverse reactions to contrast media; 45% were aware of severe adverse reactions to contrast media in their workplace. Eightyfive percent (85%) thought that accredited training should include the administration of contrast media as well as resuscitation of a patient. Sixty-two percent (62%) thought the accredited training should include pharmacology and advanced resuscitation. Ninety-three percent (93%) thought the main advantage would be an increase in service delivery to patients; 85% thought the main disadvantage would be potential risk of criminal or civil litigation. Ninety-seven percent (97%) were of the opinion that radiographers who introduce contrast media to patients must have current malpractice insurance. The results of this survey provide new information on the current status of contrast media administration to the patient whose safety and rights remain at the centre of our focus. It is recommended that the statutory body, namely the professional board for radiography and clinical technology (RCT) of the Health Professions Council of South Africa (HPCSA) takes cognizance of the outcome of this study and embarks on a more extensive survey to include a larger sample which would be more representative of the South African radiography population.

The South African Radiographer, Aug 12, 2009

Role extension [1] and / or advanced practice [1] are concepts that have almost become mantras in... more Role extension [1] and / or advanced practice [1] are concepts that have almost become mantras in the radiography profession. The international movement was brought to South Africa (SA) in 2007 and 2008 respectively. During two international conferences hosted in SA, respectively in Cape Town and Durban, South African radiographers were introduced to some of the perspectives of role extension and / or advanced practice, specifically from the United States of America (USA) and United Kingdom (UK). In addition a peer reviewed article on this topic was recently published in SA [2].