City Research Online

Abstract

Background:
Changes in therapeutic radiography have promoted the development of a consultant practitioner role in clinical practice. Clinical duties that were once performed by the clinical oncologist are now being shared in some trusts by Consultant Therapeutic Radiographer (CTRs) who are experts in their scope of practice. The first CTR was appointed in 2003, yet an evaluation of the role has remained limited.

Aims:
The thesis examines the CTR role, through the perspectives of medical, nursing, therapeutic staff and key stakeholders by means of a qualitative inquiry, with the intention to explore professional and organisational impact.

Methods:
A collective case study approach was adopted to facilitate the examination of the CTR role, using the Dimensions of Impact Framework (Gerrish et al., 2011). A three-phased research design was employed. Phase one of the study utilised a focus group with CTRs (n=4) as a scoping exercise to understand the current state of the CTR role in clinical practice. Phase two consisted of six case studies and utilised individual semi-structured interviews with CTRs (n=6) and interviews with medical, nursing and therapeutic staff (n=18) to gain a thorough view of the CTR role from their perspectives. Document analysis was also conducted using the CTR job descriptions to discern similarities or differences and examine whether the job descriptions provided the opportunity to demonstrate professional and organisational impact. In the analysis of the Phase two, data were mapped against the Dimensions of Framework to identify the perceived professional and organisational impact of the CTR role. Finally, Phase three utilised semi-structured interviews with key stakeholders (Society and College of Radiographers, NHS England and Health Education England) (n=6), to explore their views on the CTR role and on the themes derived from the six case studies

Results:
The themes identified under perceived professional impact were: professional outcomes, working relationships and identity. The themes identified under perceived organisational impact were: service targets, perceived patient experience and power.
In addition, two further themes were identified: challenges of the role and future prospects of the role were also indicated. The main challenges noted were: lack of medical knowledge; lack of time for research; increased workload; meeting the expectations of the role; medico-legal implications and financial implications. The future prospects for the role were: more engagement with the consultant practice domains (such as the research domain); increase the CTR numbers and specialities; and develop CTR’s medical knowledge; further promote the CTR role, and have a responsibility for prescribing the radiotherapy treatment.

Conclusions and recommendations
This original piece of research has provided a detailed examination of the perceived organisational and professional impact of the CTR role. It has also identified a number of challenges and considerations for the future. Recommendations for clinical practice and policy include: conduct a national evaluation to capture the impact of the CTR role, further promote the role, develop a detailed job plan, undertake a review of educational and training of the CTR; and ensure adequate clinical support and mentoring. The addition of the concepts of power of and identity to the Gerrish et al., (2011) Dimensions of Impact Framework within this research needs testing in different professional and organisational contexts.

Overall the knowledge generated from the participants’ perceptions of the CTR role presented in this thesis contributes to the literature on capturing perceived impact and provides new perspective on, and representations of, power and identity.

Publication Type:	Thesis (Doctoral)
Subjects:	R Medicine > R Medicine (General)
Departments:	Doctoral Theses School of Health & Psychological Sciences > School of Health & Psychological Sciences Doctoral Theses School of Health & Psychological Sciences > Midwifery & Radiography

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