The extended and advanced clinical practices of radiographers worldwide: A scoping review

This scoping review aimed to (1) map the global evidence on extended and advanced clinical practices (ACP) performed by radiographers, and (2) provide an overview of the pillars (clinical practice, leadership and management, education, and research) they relate to, as well as the radiology areas and the geographical location where they were developed.

Articles were searched in MEDLINE, CINAHL and Embase, and grey literature in ProQuest Dissertation and Theses. Studies concerning radiographers or healthcare professionals with an equivalent title (e.g., radiation technologist) performing extended role or an ACP, regardless of their medical imaging setting or country were included. The review was undertaken following JBI methodological guidance for scoping reviews. The titles and abstracts of the retrieved studies, and then the full texts of the selected papers were assessed by two independent reviewers.

A total of 2617 records were identified, of which 174 articles were included. Most of them reported practices performed in the UK (63%), and less in Canada (19%) and Australia (6%). Advanced or extended practices were linked to all four pillars, but most concerned the clinical practice pillar. The main activities for this pillar were radiograph reporting (22%), patient assessment and management (consultation) in radiotherapy (RT; 21%), RT treatment planning (14%) and ultrasound practice (13%). Studies have also shown radiographers performing breast biopsies, medication prescription, and ultrasound and CT scan reports. The main fields of radiology concerned by the changing roles were radiotherapy (42%) and conventional radiography (36%).  CONCLUSION: Extended or advanced practices are achieved through a wide variety of activities around the world. This scoping review constitutes a knowledge base on the evolution of the practices of radiographers and should contribute to their recognition and development.