Undergraduate learning in therapeutic radiography : a curriculum model for clinical education
Competence to practise and the acquisition of key clinical skills in therapeutic
radiography is an important issue in the NHS (Department of Health, 2000c) and the
undergraduates of today are expected to be fit for purpose as therapeutic
radiographers of tomorrow. New ways of working will require a greater
understanding of how competence in clinical practice can be achieved and developed
across all staff groups in the NHS. Patients' place a great trust in NHS professionals
and this trust should act as a motivator for all professionals to develop the highest
standards in practice. The issue for educators of these professionals, centres on how to
develop training programmes, which reflect the current needs of the service for the
benefit of the patients. There is no evidence-base generated through research, which
looks at the achievement of clinical competence in therapeutic radiography, nor has
there been a curriculum review which, attempts to match learning in clinical practice
to achievement of competence.
Therapeutic radiography undergraduate programmes have traditionally followed
curriculum models based on content or learning outcome derived systems which do
not necessarily encourage a more proactive approach to skill acquisition and learning.
The enquiry employs action research as one of the key methods in order to identify
the skills associated with competence to practise. A focus group interview with one
cohort of final year therapeutic radiography undergraduates identifies aspects of
learning which students consider necessary in order to achieve clinical competence.
The interview is followed up using two of the original cohort (post qualification) to
verify further, skill acquisition for competence.
A national competence survey, for one cohort of newly qualified therapeutic
radiographers, suggests that the level of competence achieved by this cohort is at a
level considered acceptable for clinical practice. Some of the more able staff is able to
demonstrate higher level skills, which are considered necessary for higher level
practice. There were only a small number of newly qualified therapeutic
radiographers in the survey who had not yet achieved a satisfactory level ofThis enquiry identifies the skills and learner characteristics associated with
achievement of competence such as reflection, adaptability, the need to see learning
wholes rather than individual parts and the importance of self- confidence.
Models of learning and issues surrounding competence to practise were reviewed and
considered in the light of the findings from the action research. It is suggested that
undergraduate learners achieve competence through progressive achievement of
higher level skills indicative of what might be termed, a `competence continuum
model' of learning.
There is evidence to suggest that in current undergraduate education for therapeutic
radiographers, more consideration should be given to the process of learning as part of
curriculum design based on a competence continuum model.
In terms of current levels of competence in newly qualified therapeutic radiographers,
the findings of this research suggest that extant undergraduate programmes in
therapeutic radiography are meeting the needs of the service in the modem NHS.
There are opportunities, however, to develop the curriculum for clinical education,
which focuses more directly on process. For example the task-based learning
approach for the continuing development of clinical competence is shown to be a
suitable model for curriculum design for undergraduate learners in therapeutic
radiography. Examples of how task-based learning can enhance the current
programme are provided in the final chapter of this thesis