Abstract

Radiography is undergoing significant changes and challenges, including rapidly advancing technology, ongoing role development, and increasingly quality-conscious service users that require efficient, high-quality imaging services. In response to these evolvements, radiographers are increasingly expected to engage in Evidence-based Practice (EBP) and Continuing Professional Development (CPD) to effectively navigate these emerging demands.

The aim of the research was two-fold: i) to explore and critically analyse the theory of Communities of Practice (CoPs) in radiography; and ii) to develop strategies for cultivating CoPs in radiography as an alternative approach to facilitating EBP, CPD and knowledge dissemination and sharing within the profession. The study was conducted within an independent imaging organisation. Observations were carried out across seven sites varying in setting (e.g., mobile units, static departments, integrated diagnostic centres) and imaging modalities (e.g., PET-CT, MRI). Additionally, 30 semi structured interviews were undertaken with diagnostic radiographers, technologists, assistant practitioners, and clinical assistants. Data analysis was performed using the grounded theory approach of Strauss and Corbin, following the stages of open, axial and selective coding to support the systematic development of conceptual categories.

The findings were organised around three main themes, reflecting the core categories developed during the analysis: i) EBP and CPD in radiography; ii) future of radiography and iii) CoPs in radiography. Although participants generally expressed awareness of EBP, most were unable to articulate its meaning, andoverall engagement with both EBP and CPD was limited due to barriers including insufficient motivation, inadequate support, lack of time and resources, and modality- or site-specific constraints. Notably, higher levels of engagement were observed among individuals in senior positions, those with advanced qualifications, or those particularly invested in improving radiography services. Strong leadership and the cultivation of a workplace culture that values EBP and CPD were considered essential for enhancing engagement in clinical practice. Participants emphasised the growing influence of artificial intelligence and emerging technologies, noting their potential to alter core professional responsibilities, and the possibility to reshape role dynamics within radiology departments. Neither, observations nor data from the semi structured interviews revealed engagement in learning communities, or any active or established CoPs in radiography. Once the concept was described, most participants had a positive attitude towards fostering CoPs, recognising the potential benefits of sharing knowledge, ideas, and EBPs with peers or other (healthcare) professionals either virtually or in-person.

Grounded in a set of assumptions regarding the nature of learning and knowledge in a healthcare context, this thesis culminates in the development of an alternative learning framework that is responsive to the profession’s current evolvements, challenges and constraints in engaging with EBP and CPD. Building on the theory of CoPs, Situated Professional Learning Communities (SPLCs) is introduced as a practical, context-specific approach to bridging the theory-practice gap, aligning (collective) knowledge with individual competence and practice. Supported by organisational endorsement, leadership and active involvement of key stakeholders, SPLCs may serve as a strategy to enhancing EBP, supporting CPD, and promoting knowledge dissemination across radiography workforce.