The College of Radiographers’ Education and Career Framework (fourth edition): Exploring the guideline implementation gap across England using Normalisation Process Theory

Abstract

Introduction

In 2022, the College of Radiographers (CoR) published the fourth edition of their Education and Career Framework (ECF). This essential document provides a professional blueprint for the radiography career trajectory with the overarching aim of improving patient outcomes. However, publication does not guarantee adoption. To access the full benefits of the ECF, its implementation requires a strategic approach.

Methods

To advance our understanding of the translational gap between policy and practice, this observational mixed-methods study employed Normalisation Process Theory (NPT) as a theoretical frame. Focusing on the diagnostic radiography profession in England, a national consultation survey was deployed, together with four consultation workshops. The quantitative survey data was analysed using descriptive and inferential statistics. Meanwhile, the framework approach was adapted for the qualitative analysis.

Results

The data collection took place between April–June 2023. In total, 142 survey responses were returned. Each workshop was comprised of 7–11 participants. The findings were deductively interpreted through the lens of NPT, from which five core themes emerged: making sense of complexity (coherence); bringing people together (cognitive participation); being strategic (collective action); evaluating complexity (reflexive monitoring); implementation in the ‘real world’ (barriers and enablers).

Conclusion

By furthering our understanding of how the workforce has received and utilised the ECF, the gaps in its implementation were identified. This led to the development of recommendations to address the implementation gaps and enhance the ECF's adoption. The recommendations were study-derived, linked to responsible stakeholders, and grouped into four strategic priorities, aligned with the NPT domains.

Implications for practice

By enacting these evidence-based recommendations, we can enhance the ECF's translation from printed page to real-world outcomes, for the benefit of the profession, service delivery, and service users.