Digital imaging use : influence of digitalization on radiographers' work practice and knowledge demands

The aim: The purpose of this ethnographic study was to show how the radiographer s work practice and knowledge demands change in the transformation from analogue to distributed work.

Method: The study adopts a qualitative ethnographic approach, using participant observation of and semi-structured interviews with radiographers at five Swedish hospitals. In total, 22 radiographers were interviewed and 15 of them were observed. The study classified the radiographers work as follows: 1) Planning phase 2) Performing phase 3) Evaluating phase. To identify properties of knowledge, Blackler s theory of knowledge components was applied.

Results: The study illustrated that the introduction of PACS did not simply entail the transfer of data and information from the analogue world to the digital world, but it also entails new activities, new ways of communicating, new responsibilities and new knowledge demands for the radiographers´. The study also illustrated that the role of the radiographer has changed in three principal areas: 1) Communication in work, 2) Image processing and 3) Image quality assurance, including sending patients home. This led to changes in work practice and the radiographers were called upon to work increasingly independently, and individual practitioners require higher levels of professional expertise. The study also illustrated that radiographers applied different knowledge components in different situations in their image production work. They used embrained knowledge when planning X-ray examinations and when viewing and analyzing images. Encoded knowledge was required for the use of various kinds of documentation, such as manuals and protocols. Embodied knowledge was called for when action was needed or as problem-solving involving gut feelings . The amount of embrained knowledge increased in the transformation from analogue to distributed work. Some radiographers applied the knowledge components more reflective and some more static.

Overall, radiographers need to have critical and reflective mind in practice it is not enough to work in an uncritical way. Because work is full of problem-solving action it is not enough to perform it in an automatic action. The radiographers use the knowledge as routine actors or reflective actors.

Conclusion: The study demonstrated both that the radiographers´ work practice has become more demanding and highly scientific . Radiographers need more reflective actors in the image production process when working with PACS. Reflective actors are more flexible in their work; there is in the distributed environment little room for static work. In work they needed to analyse images, it was not enough to check them off ; they cannot just read documents, they needed to interpret them to optimize work performance. In summary, radiographers needed to have a critical and reflective attitude in practice, because work was full of problem-solving action repetitive automatic action was not enough.

List of scientific papers

I. Larsson W, Aspelin P, Bergquist M, Hillergård K, Jacobsson B, Lindsköld L, Wallbeg J, Lundberg N (2007). "The effects of PACS on radiographers work practice". Radiography 13: 235-240.
https://doi.org/10.1016/j.radi.2006.02.005

II. Larsson W, Lundberg N, Hillergård K (2008). "Use your good judgement - Radiographers knowledge in image production work" Radiography. [Accepted]
https://doi.org/10.1016/j.radi.2008.09.003