Implementation of a radiographic simulation solution to undergraduate training


When did you first introduce the innovation?

Less than 12 months ago

Please describe the innovation you have developed

To enable students to safely practice radiographic positioning and exposure manipulation skills the department at UWE has introduced a virtual radiographic simulation, Shaderware™, which allows students to position, manipulate and radiographically examine a range of virtual patients. This simulation removes any ionising radiation risk and also the physical and manual handling risks associated with use of the ‘live’ x-ray room facility.

The software is utilised in class lectures and demonstrations of techniques by lecturing staff and is then fully available for students to use at their own convenience to further develop their understanding.

This simulation time is also supported through online workbooks which students are encouraged to complete and submit via the Virtual Learning Environment, and all submitted workbooks are marked and appropriate feedback is returned to the student to allow them to further reflect on their learning.

The virtual system gives the students a good approximation of the actual radiograph they would have achieved, along with accurate physics data on exposures and radiation doses used. These can be freely manipulated to allow students to fully understand the changes they can make on real systems in clinical practice and align this to best clinical and academic practice.

What prompted you to develop this innovation?

Feedback from previous cohorts of students has repeatedly indicated a desire for more opportunities to get practice in techniques prior to their clinical placements.

External drivers form reports post Francis report and the Mid-Staffs review indicate that more is required to ensure competence is acquired and assessed prior to students commencing their clinical placements.

Whilst wishing to respond to the obvious needs of our students and the drivers from best evidence, we were hampered by only having one x-ray room and a lack of tutor/student time to facilitate further practice for students learning. It was also evident that in our changing mix of students, in terms of demographics and location, that learning just 9-5 was no longer a fully acceptable option and that some learning at the convenience of students was to be investigated.

Therefore a widely available virtual option was deemed the best solution and that this also needed to be fully integrated into the curriculum and teaching pedagogy of the program to ensure students perceived it as a full component of their education and learning facilities.

In your view, what is it about this innovation that makes it different/important?

The two main advantages to this simulation strategy are those of:

  1. Allowing students to access the system at their convenience, so giving the freedom to learn at their own pace and as repetitively as required.
  2. Allowing students the ‘freedom to fail’ which engages them in experimenting to fully understand the implications of their choices and knowledge. That this can occur safely before any real patient interaction is seen as a major bonus.

To what extent does your innovation make use of existing approaches, resources or technologies?

We have used existing pedagogy of keynote lecture, technique practical and image interpretation format that was time tested and fit for purpose and then added a further opportunity to expand and repeat the learning experience.

Existing workbooks and teaching strategies required only very minimal changes to integrate the new facility into use.

To what degree has this innovation led to changes in education or clinical practice?

The primary change is that the time and space of learning is now much more student-centred than academic staff availability centric.

Some further issues can now be integrated into the ‘hands-on’ training, such as communication and patient interaction. This has finally resulted in the addition of service users to early stages training so students get the full ‘clinical’ experience, safely in advance of live practice.

What evidence do you have of the impact of the innovation?

Evidence from students has been sought through comments on their workbooks and on online questionnaire which is in the early stages of completion by our students who are currently completing their first clinical placement. This will be added to after placement by a focus group of students who will give their evaluation of the simulation in the light of recent clinical practice and learning.

At a recent Practice Educators review day the clinical staff gave some feedback on their evaluations to date of the present cohort. Their anecdotal review was that many students appear more critically focused on their techniques and accuracy over previous cohorts at this stage. A questionnaire has been distributed to formalise and quantify this evidence.

To what degree has the innovation been disseminated in your organisation or elsewhere?

The innovation has been presented at an internal Learning and Teaching Excellence conference earlier in the year and has just been presented (to good review) at the United Kingdom Radiological Conference in Liverpool on the 30 June 2015.

The LTE organisers have offered the opportunity and support to further develop the findings into a publishable format and the presentation has been made available online.

Please provide details of any plans you have to disseminate the innovation in the future.

With the final results to quantify after the focus group and review of the year to date, it is considered that this may be forwarded to appropriate profession specific journals for publication possibilities.