research: a commentary
Sibusiso Mdletshe, DTech (Rad); MTech (Rad); NHDip (Rad-RT), Dip (HRM), NDip (Rad-D)
Department of Anatomy and Medical Imaging, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
Correspondence
Sibusiso Mdletshe, Department of Anatomy and Medical Imaging, Faculty of Medical and Health Sciences, University of Auckland, M&HS building 505, Office 505-B38C, 85 park rd, grafton, Auckland 1023, New Zealand Tel:+64 9923 2669;
Fax:+27 860 570 8702; E-mail:
Received: 18 October 2022; Accepted: 17 March 2023
J Med Radiat Sci0(2023) 1–7 doi: 10.1002/jmrs.678
Abstract
Research remains one of the essential elements that drive the growth of a profession since it contributes to the development of knowledge. Research also creates value for public service and leads to better health outcomes. Research output from the Medical Imaging and Radiation Sciences (MIRS) profession is currently lacking in New Zealand while the output from Australia can also be improved. For research to be improved, there needs to be intentionality. This commentary presents proposed considerations that could contribute toward increasing research impact and research output in the MIRS profession in Australia and New Zealand.
Background
There are many benefits of research and the chief among these is that research acts as a tool for building knowledge and facilitating learning, and it is a means to understand issues and increase public awareness.1 Research allows the gathering of evidence for theories while contributing to the development of knowledge in a specific field of study. Research in healthcare remains one of the key drivers for the delivery of patient-centred care that is beneficial to healthcare professionals, patients, and communities, and creates public value for services.2,3 Since patient-centred care is respectful of and responsive to individual patient preferences, needs, and values, research allows patients to participate in quality improvement programmes that inform patient-centred care.3 Further, it has been shown that full partnership with patients is key to research success and patient and/or patient leaders must be supported and empowered to engage with research.4
The medical imaging and radiation sciences (MIRS) profession, like other healthcare professions, requires continuous research participation and output to remain relevant and effective while enhancing patient-centred
care. To achieve this, it is essential to have professionals who have the skill and confidence to undertake and lead research for the MIRS profession to retain its professional status while continuing to grow.5 The New Zealand Institute of Medical Radiation Technology (NZIMRT)6 highlights that the future of medical radiation technology in New Zealand is dependent on a progressive approach.
In the Australian context, in the legislated Professional Capabilities for Medical Radiation Practitioners, Domain 4 (Evidence-informed practitioner) has research evidence as a key component required for critical thinking and reflective practice.7 A similar requirement is found in Domain 3 (Evidence-Based Practice and Professional Learning) of the legislated Competency Standards in New Zealand.8 However, evidence suggests that the level of research participation and output remains at the level that requires significant interventions to realise the key aspirations of these domains.9,10 In Australia, research participation has been reported to have increased over the last few years, this increase has been higher among radiation therapists.11
According to The Journal of Medical and Radiation Sciences (JMRS) metrics, New Zealand contributes fewer publications to this journal which is the official
ª2023 The Author.Journal of Medical Radiation Sciencespublished by John Wiley & Sons Australia, Ltd on behalf of 1
professional journal of the Australian Society of Medical Imaging and Radiation Therapy (ASMIRT) and the NZIMRT.9 The expectation is that the journal should enjoy significant contributions from both countries as the owners of this journal. Even though research participation and output appear to be higher in Australia when compared to New Zealand within the MIRS profession (Fig. 1), there is a need to continue with efforts to drive research in both countries to improve the status quo. However, Australia has a higher number of medical radiation practitioners (18,772)11 compared to New Zealand (3533),12this contributes to research output and participation being higher in Australia. The number of doctoral qualifications in New Zealand was reported to be low (five) compared to Australia (32).13 These numbers have increased recently since both countries have experienced growth in postgraduate students.11 Further, ASMIRT established a research committee in 2019 which, among other roles, supports the development of research skills and increases the research capacity of the profession in Australia.11 In the New Zealand context, such a committee currently does not exist under the
NZIMRT ambit. This commentary is therefore aimed at presenting some considerations that could assist to increase MIRS profession research participation and output in Australia and New Zealand.
Professional context
The MIRS profession is a modern and enterprising profession that is synergistic with technological advancements, patient safety, and patient care.15 The profession has therefore seen many changes in the last few years due to the reasons outlined below:
• A shift in practice because of technology—technological advancements, including those that are aligned to artificial intelligence, are changing many practice aspects of the profession, for example, workflow management, image acquisition; reconstruction and processing, treatment planning, and quality control.15 Thorogood16 highlights that one of the key impacts of the introduction of digital technology in medical imaging is a shift in practice which has led to reduced autonomy, de- professionalisation, ease of repeats, less cognitive effort (due to reliance on images for feedback) and operation of equipment with a decreased level of knowledge and precision. The latter is a consequence of the advances in equipment that requires less effort from the operator.
This is also affirmed by several studies that are coming from various countries on the impact of artificial intelligence (AI) which demonstrate that MIRS professionals in most countries are wary of the future impact of AI in their practice.17,18Simultaneously, there are more resources that are being made to change the workflow design in medical imaging.19
• Skills mix and role changes—because of the role of technology in the MIRS profession’s practice, the role of the professionals is changing and requires the professionals to be adaptable while welcoming new knowledge, skills and practice.15The skills mix and role changes tend to be pragmatic, opportunistic and driven by local champions.20In Wales, a skills mix project was established because the radiography workforce was identified as critical given several factors which include shortage (of radiologists, oncologists and radiographers), drive for continuous improvement, ageing practising population, high staff turnover, need for career development pathways, the requirements to meet public expectations and government targets.21
• Changing service needs and demands – this is due to various reasons which include the following:
• Changing demographics with the shift towards the rapid growth of the older population and expanding life expectancy globally.22
0 5 10 15 20 25 30 35 40 45 50 55 60 65 70 75 80 85 2021
2020 2019 2018
Submissions 2018-2021
Singapore Ghana United States United Kingdom New Zealand Australia
0 5 10 15 20 25 30 35 40 45 50 55 60 2021
2020 2019 2018
Accepted 2018-2021
Singapore Ghana United States United Kingdom New Zealand Australia
Figure 1. Submission and acceptance by country in the JMRS for 2018–202114(NB: The above data only includes countries that had more than three publications for the period 2018–2021).
• The rise in chronic conditions is linked to the ageing population.22,23
• Need for early diagnosis.23
• Need to reduce carbon emissions from diagnostic imaging.24
Considerations to enhance research
If research in MIRS is to realise a significant increase in New Zealand and Australia, there needs to be intentionality to achieve this, and a few considerations are suggested below and are summarised in Figure2.
Universities must drive research
Universities that offer MIRS programmes must prioritise research through research done by staff for their own portfolios/growth, supervision of students, and collaboration with clinical departments. Universities are the drivers of research and innovation and through their research, they produce new knowledge, publications, research collaborations, public lectures and consulting services.25,26Harris5corroborates with this and points out that research in MIRS results in evidence-based change since it allows the professionals to (1) critique research, that is, question their own practice, (2) add to the body of knowledge through presenting and publishing and (3) create a culture of research as a legitimate professional activity.
One of the approaches to increase research participation is to increase the number of postgraduate students while ensuring that research conducted at the honours level is meaningful and has the potential to be publishable.
Further, universities need to prioritise attracting research funding for postgraduate qualifications.
Formation of medical imaging research strategy
Strategic planning is one of the fundamental and significant steps in achieving desirable results. The benefits of strategic planning include: (1) creation of one, forward- focused vision; (2) drawing attention to biases and flaws in reasoning; (3) tracking progress based on strategic goals.27 SAF International28 alludes to these benefits and lists them as financial benefits, forces an objective assessment, provides a framework for decision-making, enables measurement of progress and provides an organisational perspective. The establishment of a clear strategy for the Australia and New Zealand MIRS profession research is therefore crucial in the drive to enhance the research impact and output in this region.
The establishment of the research committee by ASMIRT in 2019 was a step in the right direction as this committee contributes significantly to the research strategy in Australia.11 The NZIMRT is currently considering this, and if implemented, it will be a significant contribution to enhancing the research strategy in New Zealand. In the United Kingdom, the Society of Radiographers (SoR) established a 2016–2021 research strategy with three main aims.5,29In 2021, this strategy was revised to a 2021–2026 strategy with the aim to (1) embed research at all levels of radiography practice and education, (2) raise the impact and profile of radiography through high-quality research focused on improving patient care and service delivery, and (3) expand UK radiography research capacity through
Enhancing Research Impact &
Output
Universies Must Drive Research
Formaon of Medical Imaging
Research Structures /
Strategy
Targeted Grants/Funding -
Align To Specific Themes, Available
To All Levels
Having Research Mentors
Establish a Research Culture
Idenfy Research Priories
Figure 2. Summary of the proposed considerations to enhance research impact and output.
the development of skilled and motivated research-active professionals.30,31 These strategies foster measurable deliverables that enable the measurement of progress made within a defined period.
Targeted grants/funding
Funding is crucial for research and most countries allocate a significant portion of their budget toward research. Research funding/grants are a great enabler for research growth and impact.32 Grants should be aligned to specific themes and made available to all levels.5,33 In addition to research and development grants from public funds, there are multiple sources of funds that can be accessed nationally and internationally. In Australia, the National Health and Medical Research Council (NHMRC) is the leading investor in health and medical research.34 In New Zealand, the Health Research Council New Zealand (HRCNZ) is the government’s principal funder of health research.35 Further, professional bodies offer opportunities for funding to cover expenses like conference attendance, study grants, continuing education development, research grants and scholarships.36,37 In addition, researchers in New Zealand and Australia can publish research open access at no charge in the JMRS.
The strategy for research output increase must include targeted grants that reach out to all levels of practitioners and students.
Establish a research culture
Research culture is about having a system that values research in a particular society or group of professionals that have a set of shared goals, values, attitudes, and practices. Hanover Research38 highlights that a research culture creates an environment where research is supported, expected, discussed, produced, and valued.
Creating a culture of research requires clearly communicated research goals, resources that contribute to training and support, open and collaborative relationships, individual motivation, continuous review and improvement and student involvement.38In the context of the MIRS profession, it is essential that strong collaborations are formed between universities, clinical practitioners and students while ensuring that those who have the necessary research skills take the lead and are guided by the research strategy.
Bolejko, et al.39highlight that when establishing a MIRS professional research culture, the barriers and facilitators for participation in research need to be considered. They identified assigned time, and support from colleagues and other professionals as facilitators of participation in research while lack of knowledge and skills, lack of
awareness of projects to participate in and lack of research culture at the workplace were identified as barriers to participation in research.39 Further, Chau, et al.11 assert that lack of time, lack of interest, cost and workplace support are among the contributing factors for non- participation in postgraduate research in the Australian MIRS context. Neep32 highlights that protected time is one of the key ingredients in improving a research culture and capability. A proposed approach to establish a MIRS profession research culture is shown in Figure3.39
Identify research priorities
Coupled with the strategy, funding, and research culture is the need to identify contextual research priorities. For example, studies by T€ornroos, et al.40 and The College of Radiographers41 identified several research priorities for Radiography within the European and UK contexts.
These were classified into the following broad categories:
radiographers’ profession, clinical practice in radiography, safe and high-quality use of radiation, technology in radiography, discipline of radiography science and leadership and management.40 In the UK context, similar priorities were identified and classified into the public and patient experience, accuracy and safety, education and training, service and workforce transformation and technical innovations.41 The success of research output and impact strengthening in Australia and New Zealand will therefore benefit in a scientific identification of research priorities for the region. These priorities could be aligned with the regional funders’ priorities which seek to address the health needs of the communities (including dealing with health inequities), create vibrant research environment, promote innovation, inform policy and practice through research, strengthen resilience in the health sector, prevent and manage chronic conditions, identify emerging technologies in health and medical research.35,42
Having research mentors
Finally, to succeed in enhancing MIRS research, it is critical to have research mentors. Neep32 asserts that having approachable and accessible research mentors is one of the most valuable resources in enhancing research participation and output. Hanover Research38 highlights that those with research experience and skills are needed to support those who are developing their research competence. The interaction of mentors and mentees also fosters the research culture, builds departmental research culture and provides recognition of those with excellent research skills.38 Ward, et al.43 assert that mentoring is a critical component to enhancing research participation
and output in a clinical environment and highlight examples of successful mentor-mentee relationships.
Conclusion
If we are to strengthen MIRS research impact and output in Australia and New Zealand, it is essential that a strategy is developed to achieve this. The above considerations could inform the development of such a strategy. A collaboration of the professional bodies, patients and/or patient leaders, universities and clinical departments would be effective in establishing a MIRS profession research strategy for the region. It is also acknowledged that there are several initiatives that have
been implemented in Australia and New Zealand to increase MIRS research culture and were not alluded to in this commentary.
Conflict of Interest
The author declares that he has no financial or personal relationship(s) that may have inappropriately influenced him in writing this article.
Data availability statement
No new data were collected for this commentary, all data used is available in the article and the referenced sources.
Figure 3. Establishing a Medical Imaging and Radiation Sciences (MIRS) research culture.39 Reproduced from Bolejko et al. under Creative Commons licence CC-BY 4.0. DOI: 10.1016/j.radi.2021.08.007
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