UNIVERSITY OF HEALTH AND ALLIED HEALTH SCIENCES

SCHOOL OF ALLIED HEALTH SCIENCES

DEPARTMENT OF MEDICAL IMAGING

PROFESSIONALISM AMONG FINAL YEAR

MEDICAL IMAGING STUDENTS IN GHANA: A MULTI-INSTITUTIONAL STUDY.

A RESEARCH PROJECT THESIS

BY:

DOMAH SUNG-BAWIERA INNOCENTIA

(ID NO. UHAS201910167)

SUPERVISOR: MR. OFORI-MANTEAW BRIGHT BISMARK

DECEMBER, 2023
 UNIVERSITY OF HEALTH AND ALLIED SCIENCES

SCHOOL OF ALLIED HEALTH SCIENCES

DEPARTMENT OF MEDICAL IMAGING

PROFESSIONALISM AMONG FINAL YEAR MEDICAL IMAGING STUDENTS IN

GHANA: A MULTI-INSTITUTIONAL STUDY.

A RESEARCH PROJECT THESIS

BY:

DOMAH SUNG-BAWIERA INNOCENTIA

UHAS201910167

A PROJECT THESIS SUBMITTED TO THE DEPARTMENT OF MEDICAL IMAGING,

SCHOOL OF ALLIED HEALTH SCIENCES, UNIVERSITY OF HEALTH AND ALLIED
SCIENCES, HO, IN PARTIAL FULFILLMENT OF THE REQUIREMENT FOR THE
AWARD OF BACHELOR OF DIAGNOSTIC IMAGING DEGREE

DECEMBER, 2023
 DECLARATION
I, DOMAH SUNG-BAWIERA INNOCENTIA, do hereby declare that this dissertation is

submitted in partial fulfilment of the requirements for the degree of BSc. Diagnostic Imaging is

the result of my independent research project or investigation and, except where otherwise, other

sources are acknowledged with explicit references and are included in the reference list. This

work has not been previously accepted in substance for any degree, and neither is it being

concurrently submitted to the candidate of any degree. I hereby permit the Department of

Medical Imaging to seek dissemination and/or publication of this dissertation in any appropriate

format, and that authorship in such circumstances shall be jointly held between any project

supervisors as first author and myself as second /or subsequent author.

NAME: DOMAH SUNG-BAWIERA INNOCENTIA

INDEX NUMBER: UHAS201910167

SIGNATURE:

DATE: 21ST DECEMBER, 2023

NAME: MR. OFORI-MANTEAW BRIGHT BISMARK

(PROJECT SUPERVISOR)

SIGNATURE:
I
DATE: 21ST DECEMBER, 2023

NAME: DR. SETH KWADJO ANGMORTERH

(HEAD OF DEPARTMENT)

SIGNATURE:

DATE: 21ST DECEMBER, 2023

II
 DEDICATION
This research is first dedicated to the Almighty God whose grace has brought me this far.

Secondly, I dedicate this to my family for their ever-available encouragement, love, and

unflinching support throughout. I would also like to dedicate this research work to my friends

and colleagues, you have always inspired me to pursue my dreams and strive for greater heights.

Without your love and encouragement, this project would not have been made possible. This

work is also dedicated to my lecturers and supervisors for their unflinching efforts in helping me

attain the required knowledge in this noble profession.

III
 ACKNOWLEDGEMENT
First and foremost, I humbly thank the Almighty God for granting me the courage, strength, and

knowledge to embark on this scholarly voyage. It is through divine guidance that I have found the

determination to surmount the challenges and uncertainties that come with rigorous academic

research. I owe a debt of gratitude to my esteemed supervisor, Mr. Ofori-Manteaw Bright

Bismark. His mentorship has been invaluable on this intellectual expedition. His unwavering

guidance, constant encouragement, unending patience, and insightful suggestions have been the

compass guiding me through this research. Without his support, this journey would have been far

more arduous, and the destination less certain. To my family, whose unwavering belief in my

abilities has been a constant source of motivation, I am eternally thankful. Your love,

understanding, and sacrifices have sustained me during the long hours of research and writing. I

must also extend my heartfelt appreciation to my classmates and friends who have been my pillars

of strength and support throughout this arduous process. Your encouragement and willingness to

share in my joys and challenges have lightened the burdens of this academic endeavor.

Furthermore, I wish to acknowledge and express my gratitude to the authors of all the resources

that have enriched this study. Their pioneering work and dedication to the pursuit of knowledge

have provided the foundation upon which my thesis is built. I recognize their contributions with

deep respect and gratitude. Lastly, to all those whose names I may not have mentioned but have

played a part, big or small, in this journey, I extend my sincere appreciation. Your contributions,

whether through insightful conversations, constructive critiques, or moral support, have all played

a significant role in the successful completion of this thesis.

IV
 Table of Contents
DECLARATION...........................................................................................................................I

DEDICATION............................................................................................................................III

ACKNOWLEDGEMENT.........................................................................................................IV

Table of Contents.........................................................................................................................V

List of Figures.............................................................................................................................IX

List of Tables................................................................................................................................X

List of Acronyms and Abbreviations........................................................................................XI

ABSTRACT...............................................................................................................................XII

CHAPTER 1: INTRODUCTION................................................................................................1

1.1 Background of the Study.......................................................................................................1

1.2 Problem Statement.................................................................................................................3

1.3 Justification/Relevance..........................................................................................................4

1.4. Aim(s)...................................................................................................................................5

1.4.1 Specific Objectives.............................................................................................................5

CHAPTER 2: LITERATURE REVIEW...................................................................................6

2.1 Definition of professionalism................................................................................................6

2.2 Professionalism in an educational setting..............................................................................7

2.2.1 Department dedication....................................................................................................7

2.2.2 Experiential learning.......................................................................................................8

V
 2.2.3 Role modelling................................................................................................................8

2.2.4 Faculty development.......................................................................................................9

2.2.5 Evaluation.....................................................................................................................10

2.3 Professionalism in a healthcare setting................................................................................10

2.3.1 Barriers in healthcare....................................................................................................11

2.3.2 Barriers in medical imaging..........................................................................................11

2.4 Strategies for developing professionalism...........................................................................12

2.4.1 Formal education and training......................................................................................12

2.4.2 Clinical supervision and mentorship............................................................................12

2.4.3 Professional development seminars for students..........................................................13

2.4.4 Promoting evidence-based practice..............................................................................13

CHAPTER 3: METHODOLOGY............................................................................................15

3.1 Introduction..........................................................................................................................15

3.2 Study Design........................................................................................................................15

3.3 Study Population..................................................................................................................16

3.4 Inclusion Criteria.................................................................................................................17

3.5 Exclusion Criteria................................................................................................................17

3.6 Sampling Technique............................................................................................................17

3.7 Sample size..........................................................................................................................17

3.8 Data collection method and instrument...............................................................................18

VI
 3.8 Pilot study............................................................................................................................18

3.9 Data analysis........................................................................................................................18

3.9.1 Summation of responses...............................................................................................19

3.7 Data storage.........................................................................................................................20

3.8 Ethical consideration...........................................................................................................20

CHAPTER 4: RESULTS...........................................................................................................21

4.1 Introduction..........................................................................................................................21

4.2 Demographics.................................................................................................................22

4.3 Core Values of Professionalism...........................................................................................26

4.4 Barriers in Achieving Professionalism and How to Maintain Professionalism..................35

4.5 Maintaining professionalism...............................................................................................36

CHAPTER 5: DISCUSSION.....................................................................................................37

5.1 Introduction..........................................................................................................................37

5.2 Demographics......................................................................................................................38

5.3 Core values of professionalism............................................................................................39

5.3.1 Accountability...............................................................................................................39

5.3.2 Altruism........................................................................................................................40

5.3.3 Compassion...................................................................................................................41

5.3.4 Excellence.....................................................................................................................42

5.3.5 Integrity.........................................................................................................................43

VII
 5.3.6 Professional duty..........................................................................................................44

5.4 Barriers to achieving professionalism.................................................................................45

5.4.1 Burnout.........................................................................................................................45

5.4.2 Lack of standardization.................................................................................................46

5.4.3 Limited access and training in medical imaging equipment........................................47

5.4.4 Economic pressures......................................................................................................47

5.5 Maintaining professionalism...............................................................................................48

5.5.1 Formal education..........................................................................................................48

5.5.2 Clinical supervision and mentorship............................................................................49

5.5.3 Maintaining professionalism through encouraging a culture of professionalism,

evidence-based practice and organizing seminars.................................................................50

CHAPTER 6: LIMITATIONS, CONCLUSION & RECOMMENDATIONS.....................52

6.1 Limitations...........................................................................................................................52

6.2 Conclusion...........................................................................................................................52

6.3 Recommendations................................................................................................................53

REFERENCES...........................................................................................................................55

APPENDICES.............................................................................................................................64

7.1 QUESTIONNAIRE.............................................................................................................64

7.2 Ethical Clearance.................................................................................................................68

VIII
 List of Figures
Figure 1: A pie chart demonstrating the distribution of males to females in the study.................22

Figure 2: Age distribution of respondents.....................................................................................23

Figure 3: University of Study........................................................................................................24

Figure 4: A bar chart representing the various programmes of study of the participants.............25

Figure 5: A bar chart demonstrating the factors that affect the level of professionalism..............35

Figure 6: A bar chart showing the participants’ responses on how professionalism can be

maintained......................................................................................................................................36

List of Tables
IX
Table 1: Population of students from the four selected universities..............................................16

Table 2: Summation of results.......................................................................................................19

Table 3: Accountability................................................................................................................26

Table 4: Altruism...........................................................................................................................27

Table 5: Compassion.....................................................................................................................28

Table 6: Excellence........................................................................................................................29

Table 7: Integrity...........................................................................................................................30

Table 8: Professional duty.............................................................................................................31

Table 9: Level of professionalism categorized according to each core value...............................32

Table 10: Total percentage score of the population on each core value........................................33

Table 12: Pearson Chi-square test for association.........................................................................34

X
 List of Acronyms and Abbreviations

ACGME- The Accreditation Council for Graduate Medical Education

APTS – American Physical Therapy Association

CPD- Continues Professional Development

NHS- National Health Scheme

REC- Research Ethics Committee

SPSS - Statistical Package for Social Sciences

STEM – Science Technology Engineering and Mathematics

UHAS - University of Health and Allied Sciences

XI
 ABSTRACT
Background: Medical imaging as a profession is bounded by codes and conducts, making every

person practicing as a professional obliged to act per the codes and conducts of the profession.

Professionalism is seen as an integral concept that is concerned with the attitudes and behaviours

as an indicator of the level of competence in medical imaging, it is seen by both educators and

students as a holistic concept that is linked to good clinical practice and a set of specific

behaviour.

Aim: The study aimed to evaluate the level of professionalism among final year medical imaging

students, exploring influencing factors, identifying barriers, and determining effective strategies

to uphold and enhance professionalism within this cohort.

Methodology: A quantitative cross-sectional online survey was used in gathering the data from

final year Medical Imaging students from four universities (N=228). Students were required to

complete a questionnaire which was adapted from the American Physical Therapy Association

(APTS). Descriptive and inferential analysis were carried out using Statistical Package for Social

Sciences version 23.0.

Result: A total of 191 questionnaires were returned indicating a response rate of 83%.

Participants from the study scored an overall score of 80.79% in professionalism with varied

levels across all six core values. The participants exhibited good scores in accountability

(83.86%), compassion (82.51%), integrity (83.99%), and professional duty (82.98%) with average

scores in altruism (72.51%) and excellence (78.75%). The gender of participants and the level of

professionalism was seen not to have any significant association, however, the university and

programme of study both had a significant association with students’ level of professionalism.

Burnout was considered the major barrier in achieving professionalism. Formal education as well
XII
as clinical training and mentorship were effective measures to maintaining high levels of

professionalism among students.

Conclusion: Radiography practice requires high levels of professionalism and so students must

be trained to possess up to standard qualities which are in line with the field of medical imaging.

The study revealed good levels of professionalism among Ghanaian clinical radiography students

which needs to be maintained.

Keywords: medical imaging students, ethics, professionalism, standard practice, core

values

XIII
 CHAPTER 1: INTRODUCTION

1.1 Background of the Study

An estimated number of 2000 patients died as a result of poor care between January 2005 and

March 2009 at a district hospital in Staffordshire, England due to professional negligence

(Francis, 2013). From 2011 to 2016, medical malpractice cases against reputable hospitals in

South Africa grew by 25% annually (Mosime, 2016). The story is no different in Ghana with an

exploration into medical malpractices revealing high rates of patient abuse, wilful neglect of

patient wishes, refusal to attend to the sick, baby-selling among others (Zutah et al., 2021). Now,

the Ghanaian patient is better informed, more discerning and increasingly aware of his/her

healthcare rights and options (Zutah et al., 2021) due to societal change and technological

advancement (Lewis, 2018). This change has made professionalism a big issue today because

these advancements have increased the public's knowledge and expectations of health

professionals making them more active participants in the healthcare delivery process than in

previous times (Lewis, 2018). Professional and occupational roles have also changed along with

the shape and size of the healthcare workforce, with conventional professional and organisational

boundaries increasingly blurred or erased (NHS Scotland, 2012). There is scrutiny of

performance and results because of the systems transparency and accountability at all levels

(NHS Scotland, 2012).

Patients and service users place a high value on professionalism because of the the culture of

trust it upholds, the degree of accountability it bestows, the function it serves as a catalyst for

quality, and the standard for the attitudes, behaviors, and activities expected of evey professional.

Despite the changing and complex nature within which the healthcare system operates (NHS

Scotland, 2012). Although professionalism has varied meanings, it has three main pillars which

1
are primary of patient welfare, respect for patient autonomy, and promotion of social justice in

healthcare (Hryhorczuk et al., 2015) The first tenet of the Physician Charter, "primacy of patient

welfare," is consistent with the ethical principle, beneficence, a fundamental ethical ideal that has

governed the doctor-patient relationship for a millennia. The second and third tenets, respect for

autonomy and the advancement of social justice in healthcare, respectively, address

contemporary notions that place a strong emphasis on patients as autonomous agents for whom

doctors serve as knowledgeable advisors, as well as ongoing debates regarding the equitable

allocation of healthcare resources (Sivaranjani & Mallikarjuna, 2016). To patients,

professionalism encompasses a range of skills and characteristics, including technical

proficiency, outward appearance, public perception, level of confidence, empathy, compassion,

understanding, patience, manners, verbal and nonverbal communication, and an anti-

discriminatory and non-judgmental attitude (NHS Scotland, 2012). However, Stern's medical

professional principle, which is characterized by altruism, accountability, responsibility,

excellence, obligation, honesty, integrity, and respect for others serve as a foundation for a more

pragmatic approach to professionalism and enable a more thorough analysis for advancement in

practical training (Sivaranjani & Mallikarjuna, 2016).

Professionalism is a crucial aspect of any profession, including medical imaging. As a medical

imaging professional, adhering to a set of codes and conducts is necessary to ensure that the

highest standards of patient care and safety is maintained. In recent years, the importance of

professionalism in medical imaging has been recognized, leading to its integration into the

radiography curriculum of many countries (Kelly & Mullan, 2018). This shift in focus towards

professionalism in medical imaging education calls for the development of a curriculum that not

only teaches technical skills but also foster problem-solving, critical thinking, creativity,

2
innovation, and soft skills (Bruce & Yearley, 2006). By emphasizing on these qualities, medical

imaging students can become well-rounded professionals who can effectively contribute to the

healthcare industry and provide patients with the care they deserve.

1.2 Problem Statement

As the healthcare industry evolves with technological advancements and changing societal

expectations, medical imaging professionals face the challenge of not only mastering technical

skills but also developing their professional competencies (Tashiya et al., 2021). Therefore, it is

imperative that final year medical imaging students, being novice in the field, become critical

thinkers, problem solvers, and innovators to keep up with current trends. However, there is a

growing concern regarding declining levels of professionalism among medical imaging students,

with a recent study revealing that medical imaging students have an inherent understanding of

professionalism but lacked cognitive awareness and were unaware of the consequences of their

mistakes (Cannavale et al., 2013). It is crucial for medical imaging students to understand the

moral, ethical, and legal implications of their actions (NHS Scotland, 2012) to maintain the

highest standards of patient care and safety. It is therefore not enough to teach professionalism

explicitly through lectures alone, as nuances and subtleties may be missed (Bruce & Yearley,

2006). Additionally, there can be discrepancies between the academic teaching of

professionalism and the attitudes and behaviours of students in the clinical field. As such, it is

crucial to teach professionalism both explicitly and implicitly, so that students can observe any

differences and understand how to apply theoretical knowledge correctly in practical settings.

Therefore, the problem of this study was to inquire if medical imaging students had up to

standard professional skills to meet the expectations of the healthcare industry. To address this

issue, there was a need to evaluate students' level of professionalism.

3
1.3 Justification/Relevance
The evaluation of the level of professionalism among medical imaging students in Ghana holds

significant importance. The findings from this study would serve as a motivating factor for the

development of highly skilled and dedicated medical imaging professionals who can effectively

manage the complexities of healthcare system and adhere to multifaceted professional ideals for

the benefit of the Ghanaian people. The study also provided valuable insights for educators on

the potential pitfalls and barriers of teaching and practising professionalism among students.

Additionally, the study's findings highlighted the importance of preceptorship in supporting the

development of medical imaging students, as clinical supervision is a crucial aspect of clinical

governance in the face of increasing patient care standards.

The results of the individual medical misconduct incidents covered in this study served as a stark

reminder of the significance of assessing the level of professionalism of radiography students.

The necessity for students to be taught about the potential consequences of their behaviour was

highlighted by incidents like the Staffordshire district hospital, where staff members were

penalised for disobeying health and safety regulations. Medical imaging personnel may be

subjected to legal action, incarceration, suspension, dismissal, or revocation of their licenses in

some extreme cases if they fail to follow rules and endanger the lives of their patients in the

process.

4
1.4. Aim(s)
The study aimed to evaluate the level of professionalism among final year medical imaging

students, exploring influencing factors, identifying barriers, and determining effective strategies

to uphold and enhance professionalism within this cohort

1.4.1 Specific Objectives

 To investigate the level of professionalism among final year medical imaging students,

based on six (6) core values: accountability, altruism, compassion, integrity, excellence

and professional duty.

 To investigate the factors that influence the level of professionalism among medical

imaging students.

 To investigate barriers that influences the level of professionalism among medical

imaging students.

 To identify effective strategies for maintaining a high level of professionalism among

medical imaging students.

5
 CHAPTER 2: LITERATURE REVIEW

2.1 Definition of professionalism

In radiography literature, the topic of professionalism is rarely discussed as evident by

disagreements among other healthcare fields. Professionalism is primarily considered as a set of

ideas, beliefs, attitudes, and behaviours that are applied through practice. The subjectivity

associated with professionalism led to an analytical analysis of medical "authoritative voices"

coming to the following conclusion: professionalism has no core definition (Sivaranjani &

Mallikarjuna, 2016). This fact is supported by S. R. Cruess et al. (2010),who states that

professionalism governs the codes and conducts of professionals who profess commitment to

competence, integrity, morality, altruism and promotion of good to the public within their scope

of practice. Epstein and Hundert (2015), define professionalism as “the habitual and prudent

application of communication, knowledge, technical skills, clinical reasoning, emotions, values,

and reflection in everyday practice for the benefit of the individual and community being served.

This concept was based on a list of values that were classified into areas such as cognitive,

technical, integrative, context, affective/moral, and mental habits. Literature further states that ,

"Professional competence is context-specific, ephemeral, and evolving (S. Huber, 2002). It is

believed that the Hippocratic Oath, which characterizes professionalism as a moral undertaking

that must be carried out in accordance with a set of norms, is what first popularized the idea of

professionalism in the healthcare sector (Ho et al., 2011). This is especially true when it comes to

what healthcare professionals should do when they interact with patients. Since the oath was

created, this definition has slightly evolved over time because of the continues evolution of the

health sector (Nortjé & Hoffmann, 2017). For Swick (2000), professionalism is centred on the

following values: altruism, high ethical and moral standards, response to societal needs and

accountability, S. R. Cruess et al. (2010) however states that a combination of these attributes
6
and the definition of professionalism from the dictionary can be used for teaching purposes.

Professionalism therefore has no clear-cut definition.

2.2 Professionalism in an educational setting

In an educational context, professionalism pertains to the conduct, mindset, and qualities that

educators, administrators, and staff members are anticipated to exhibit in order to establish a

favourable and efficient learning atmosphere (Turner et al., 2015). It encompasses a dedication to

upholding elevated benchmarks of behaviour, ethical principles, and proficiency, all while

nurturing an environment characterized by respect, cooperation, and unwavering dedication to

the educational purpose. It encompasses the knowledge, skills, and ethics that are necessary for

providing quality education (Haque et al., 2016). Teaching professionalism involves

transforming an individual into a professional who understands the attributes of professionalism

and incorporates it in his or her daily practice (R. L. Cruess, 2006). It is common to believe that

learning naturally leads to practice, however, the ability to convert learning depends on a variety

of intrinsic and extrinsic elements (Bwanga, 2019). Changing the way students think and behave

is a complex process and so if an attempt to transition a lay student into a professional is

unsuccessful, lowered professional standards may occur (Bwanga, 2019). The following are

therefore required to transform a lay student into a professional with high professional standards:

2.2.1 Department dedication

The Dean of the school, alongside the head of department and fellow faculty members, must

collectively endorse and actively participate in the development and execution of a

comprehensive curriculum aimed at educating students (Hickson et al., 2007). This entails the

establishment of a formal professionalism curriculum, which teaches acceptable and

unacceptable behaviours within the academic environment (Kretz et al., 2021). This curriculum

7
should encompass guidelines for ethical conduct, interpersonal relations, and the cultivation of a

conducive learning atmosphere to ensure a well-rounded educational experience for the students

(Kelly & Mullan, 2018).

2.2.2 Experiential learning

Professional education should encompass more than just theoretical knowledge; it should also

involve practical, hands-on experiences that students can continually draw upon. Therefore,

students require practical training opportunities to acquire firsthand experiences, which are

essential for nurturing their professional identity (Bwanga, 2019). Over the course of education

and training, there must be structured opportunities for students to speak openly about work-

related concerns in relation to professionalism, personalize them, and ideally absorb them

(Bwanga, 2019). This new understanding joins a broader body of information known as tacit

knowledge, which one knows but cannot reveal. According to literature, this type of knowledge

can be learnt but not taught and it is best learnt through practice (Bwanga, 2019; Carlson, 2013;

R. L. Cruess, 2006; Mennin, 2010).

2.2.3 Role modelling

The most successful method for conveying the elusive aspects of the medical field remains

through the influence of role models (Hilli et al., 2014). Role models play a pivotal role in

professional development, particularly in fields like the medical field, where not all aspects can

be easily quantified or taught through traditional didactic methods (Bruce & Yearley, 2006).

These role models, often experienced practitioners or mentors, serve as living examples of the

nuances of medical practice, including the ethical, interpersonal, and practical aspects that are

challenging to capture in textbooks or lectures (Carlson, 2013). Students and aspiring

professionals can learn from their experiences, judgment, and the way they navigate complex
8
situations. Professions employ collegiality as a means to define shared goals and encourage their

observance. Collegiality refers to the sense of community and cooperation within a profession, is

a valuable tool to establish common objectives and maintain professional standards (Lewis,

2018). When professionals work together harmoniously and share a commitment to ethical and

quality standards, it strengthens the overall integrity of the field and fosters trust among

colleagues and the public. Conversely, it is crucial to acknowledge that having role models who

do not meet acceptable professional standards can be equally detrimental (Bwanga, 2019).

2.2.4 Faculty development

Faculty development is pivotal in improving education (Kretz et al., 2021). Faculty development

is the process of providing professional development training and coaching to faculty members

to help them improve their work performance (Froyd et al., 2014). Faculty development is

crucial for nurturing professionalism in educational settings. It ensures that faculty members

serve as exemplary role models for students by consistently embodying professionalism in their

behaviours and interactions (Epstein & Hundert, 2015). Faculty development fosters positive

faculty-student interactions by enhancing educators' abilities to provide constructive feedback,

address concerns, and promote respectful communication (S. R. Cruess et al., 2010). This

contributes to a conducive learning environment where professionalism is upheld. Moreover,

faculty development ensures that educators adhere to institutional codes of conduct and values,

reinforcing the institution's commitment to professionalism (Tashiya et al., 2021). It also

prepares faculty members to handle challenging situations related to professionalism, such as

ethical dilemmas or student misconduct, with integrity and confidence (Lewis, 2018). Lastly,

faculty development enhances an institution's reputation by demonstrating its dedication to

professionalism, ultimately benefiting the employability and success of its graduates in the

9
professional world (Haque et al., 2016). In summary, faculty development plays a multifaceted

role in instilling and promoting professionalism within educational institutions, benefiting both

faculty and students.

2.2.5 Evaluation

Regularly conducted formative evaluations with feedback are effective and crucial tools that help

students achieve their objectives as they go through training (Huber, 2011). What was taught and

learnt must be evaluated to see if it meets the standards of lectures and the society (Wenntan et

al., 2021). Literature states that, evaluation has been proven to motivate learning, and students

being aware of the fact that they will be tested at the end of their training will be driven to learn

(Bwanga, 2019). Also, evaluation helps determine whether students are competent and reveals

their deficiency in areas for them to be addressed. Formal assessment provides a structured and

broad foundation of knowledge and skills, and certification which proves that an individual has

acquired the needed educational training (Abidin, 2013).

2.3 Professionalism in a healthcare setting

Professionalism in healthcare has been the subject of much research and discussion in recent

years. According to a study by Morrow et al. (2011), the term "professionalism" can have

different meanings for different people, depending on factors such as patient service encounter,

organizational support, work experience, and client expectations. However, in general,

professionalism in healthcare is understood to encompass a set of values, attitudes, behaviours,

and competencies that are considered essential for providing high-quality patient-centred care.

Professionalism in healthcare is a multifaceted commitment embodying clinical competence,

ethical conduct, and patient-centred care (Harris, 2013). Healthcare professionals must possess

clinical expertise while adhering to ethical principles such as respecting patient autonomy and

10
maintaining confidentiality (Rubio-Navarro et al., 2019). Prioritizing patients' well-being,

maintaining professional boundaries, and fostering teamwork are essential. Continuous learning,

accountability, adherence to standards, and a commitment to improvement constitute integral

aspects of professionalism (Uarije et al., 2017). Ultimately, professionalism in healthcare

involves delivering quality care while upholding ethical values and striving for excellence in

service delivery.

2.3.1 Barriers in healthcare

The concept of medical professionalism is surrounded by uncertainties due to the absence of a

universally accepted definition and a shared understanding among healthcare professionals (NHS

Scotland, 2012). This lack of clarity creates ambiguity regarding the ethical responsibilities and

boundaries within the healthcare sector. Moreover, economic pressures exert a significant

influence, as the escalating costs of healthcare services often push institutions to prioritize

financial objectives over patient-centred care (Hryhorczuk et al., 2015). Consequently, the

emphasis on economic targets may overshadow the ethical considerations necessary for

providing comprehensive care. Additionally, the relentless demands and stress inherent in

healthcare provision lead to burnout among healthcare practitioners, potentially compromising

the quality of care delivered (Tashiya et al., 2021). This trifecta of challenges poses significant

hurdles in fostering a robust culture of professionalism within the healthcare system.

2.3.2 Barriers in medical imaging

The field of medical imaging faces challenges stemming from several key areas. First, the

absence of standardization in imaging techniques, protocols, and reporting practices contributes

to inconsistencies in the quality and precision of imaging studies (Gadeka & Esena, 2020) .

Moreover, limited access to imaging equipment in certain regions impedes the prompt and
11
accurate diagnosis of patients, potentially delaying necessary medical intervention (Tashiya et

al., 2021). Additionally, the heavy reliance of medical imaging on technological tools makes the

field susceptible to errors, as insufficient training or technical malfunctions can compromise the

accuracy of imaging studies and subsequent diagnoses (Uarije et al., 2017). These obstacles

collectively hinder the effectiveness and reliability of medical imaging practices, highlighting the

need for standardized protocols, improved accessibility to equipment, and comprehensive

training programs to address these challenges.

2.4 Strategies for developing professionalism.

Developing professionalism in healthcare and medical imaging requires a multi-faceted approach

that includes a combination of education, training, and organizational support. Here are some

strategies that can be used to develop professionalism:

2.4.1 Formal education and training

Medical imaging specialists should receive formal education and training in medical ethics,

patient-centred care, and the principles of medical professionalism (Kretz et al., 2021). Formal

education programmes provide students with a comprehensive understanding of medical imaging

principles, techniques, and technologies (Froyd et al., 2014). This knowledge equips them with

the necessary skills to perform imaging procedures accurately and safely. By ensuring a strong

foundation of knowledge, formal education helps students training to be professionals maintain

high standards of competence and expertise (Nortjé & Hoffmann, 2017).

2.4.2 Clinical supervision and mentorship

Medical imaging specialists should receive clinical supervision and mentorship from experienced

practitioners. This can provide them with guidance and support as they develop their professional

skills and learn to navigate ethical and clinical challenges (Bwanga, 2019). Clinical supervision

12
and mentorship provide a structured framework for ongoing support, guidance, and professional

development for students. Positioning learners in a workplace environment begins a process of

socialization that aims to progressively develop practical skills, attitudes, and behaviour

(Whiting, 2009). Supervision helps ensure that imaging practices adhere to established standards

and guidelines because supervisors can review and assess the quality of imaging procedures,

provide feedback on image acquisition and interpretation techniques, and address any deviations

from best practices (Bwanga, 2019).

2.4.3 Professional development seminars for students

Organizations should develop and implement professional development programs to support the

ongoing growth and development of healthcare professionals and medical imaging specialists

(Froyd et al., 2014). These programs should focus on improving communication skills,

teamwork, and other essential competencies (Hickson et al., 2007). Organizing seminars or

workshops focused on professional practice can provide students with valuable insights into the

ethical, legal, and social aspects of medical imaging. As suggested by a study, these sessions can

address various subjects, including patient confidentiality, informed consent, communication

skills, and inter-professional collaboration. By doing so, they not only highlight the significance

of these aspects but also present practical challenges encountered in the field. (Kretz et al.,

2021).

2.4.4 Promoting evidence-based practice

Medical imaging specialists should be encouraged to stay up-to-date with the latest medical

research and use evidence-based practices in their care delivery (Bwanga, 2019). Emphasizing

evidence-based practice can be achieved by its incorporation into medical imaging education

which helps students understand the importance of using the best available evidence to guide
13
their clinical decisions (Haque et al., 2016). Teaching students how to critically appraise

research, stay updated with advancements in imaging technology, and apply evidence-based

guidelines can enhance their professionalism and ensure they provide the highest quality care to

patients.

14
 CHAPTER 3: METHODOLOGY

3.1 Introduction
This chapter contains the methodological approach that was employed in this study. It contains

the specific procedures or techniques used to identify, select, process, and analyse information

about the research topic. This section of the research paper allowed the reader to critically

evaluate the study's overall validity and reliability

3.2 Study Design

A quantitative cross-sectional web-based survey was used to evaluate the level of

professionalism among final year medical imaging students across four universities in Ghana. A

quantitative study is concerned with the objective measurement of the phenomenon under

investigation. It draws conclusions and establishes causes from the numerical data and

relationships that exist between them (Bryman et al., 2008). This approach was proven to be

useful in assessing the level of understanding of the concept under study because it provided an

objective approach which reduces subjective biases and provided a consistent evaluation across

different individuals and institutions because individuals were evaluated on the same parameters.

It also provided a standard criteria for evaluation (Brink et al., 2012). Its use within this study

gave an overall impression and synopsis of the concept under investigation and sanctions the

influence from independent variables and provided concrete values which helped in the

comparison of the level of professionalism among students and across universities and was

useful in identifying area for improvement (Bryman et al., 2008). Quantitative evaluation

provided concrete feedback that stakeholders and heads of department of the various medical

imaging departments can use to understand and identify the strength, weaknesses, trends and

patterns to spot areas of concern of their students in order to implement targeted improvement to

15
enhance professionalism. This method of evaluation proved to be efficient because a large group

of students was used for the study and so it allowed the use automated tools for data collection

and analysis which saved time and resources. A cross-sectional study collects data or information

from a sample drawn from a population at a point in time (Brink et al., 2012). In this study, this

method provided the insights of students’ level professionalism upon which future studies can be

conducted.

3.3 Study Population

The study population involved all final year medical imaging students from the University of

Health and Allied Sciences (UHAS), University of Ghana (UG), University of Cape coast (UCC)

and Kwame Nkrumah University of Science and Technology (KNUST). The study concentrated

on final year students because they are at the cusp of transitioning into the profession of medical

imaging and so such students were able to provide insights on how well their education have

prepared them for the real world. The overall goal of this study was to gather a diverse group of

students thus students offering radiography, sonography and radiotherapy who can provide

valuable insights and perspectives on the topic of professionalism specifically within the context

of medical imaging education and training. The population of students the study was conducted

on comprised of 35 students from UHAS, 51 students from UG, 40 students from KNUST and

102 students from UCC.

Table 1: Population of students from the four selected universities

SCHOOL RADIOGRAPHY SONOGRAPHY RADIOTHERAPY TOTAL

UHAS 35 NIL NIL 35

UG 45 NIL 6 51

KNUST 25 15 NIL 40

UCC 51 51 NIL 102

16
TOTAL 228

3.4 Inclusion Criteria

All final year medical imaging students from UHAS, UG, UCC and KNUST.

3.5 Exclusion Criteria

The study excluded final year students who were absent or not willing to participate in the study.

3.6 Sampling Technique

A non-probability convenience sampling technique was used because data from only those who

visited the web page through the link provided was used. Therefore, it was implied that they

were available at the time and hence, the sampling method is convenient.

3.7 Sample size

The sample was drawn from a population of 228 final year medical imaging students which was

the total student population of final year students from UG, UCC, UHAS and KNUST. The

estimated sample size required for the study was calculated using the Yamane’s formula:

N
n=
(1+ Ne 2)

Where N is the total number of final year students from the four selected universities (UG,

UHAS, UCC and KNUST), n is the sample size calculated at a confidence interval of 95% with

margin of error (e) of 5%.

228
n=
(1+228( 0.05)2)

n= 145.22

n=145

17
the sample size needed for this study was 145 final year medical imaging students but since the

questionnaire was an online survey, the number of participants that responded could not be

controlled and so the study was opened to all final year medical imaging students.

3.8 Data collection method and instrument

An online questionnaire adapted from the American Physical Therapy Association was used as

the data collection instrument. The questionnaire consisted of four sections

Section A: final year medical imaging students’ demographics (age, sex and level of education)

Section B: six core values that make up the foundation of professionalism (accountability,

altruism, compassion, integrity, excellence and professional duty) were adapted from the

American Physical Therapy Association self-assessment sheet (American Physical Therapy

Society, 2019). These core values had sample indications of professionalism in a medical

imaging students’ daily practice based on which students were required to evaluate their level of

professionalism. To measure each professional value, a three-point Likert scale was used against

every sample indicator under each professional value:1-never, 2-occassionally and 3-always.

Section C: Barriers in achieving professionalism.

Section D: Factors that maintain professionalism.

3.8 Pilot study

A prior study was conducted with ten (N=10) medical imaging students from the four (4)

universities used in this study. The research aimed to assess the reliability and validity of the data

collection tool. No alterations were made to the questionnaire after the initial phase, as it showed

no flows or ambiguity. The results obtained during the pilot study were not incorporated into the

final data analysis.

18
3.9 Data analysis
The data was analysed using the Statistical Package of Social Sciences (SPSS) version 23 and

presented in graphs and charts using Microsoft Excel 2013. The data on participants’

demographics was analysed and represented in pie charts and bar graphs. The level of

professionalism for each core value was summed by first representing each response by a score:

never-1, occasionally-2 and always-3. The total result for a core value for each participant could

then be calculated by adding the scores for the four sample indicators under each core value. The

coded data was copied to Excel for summation and percentage score for each core value was

assigned. The percentage scores were then grouped into poor, average and good.

3.9.1 Summation of responses.

The level of professionalism for each core value is summed by first representing each response

by a number: never-1, occasionally-2 and always-3. The total response for a core value for each

participant can then be calculated by adding the values (response) for the four sample indicators

under each core value. The coded data was copied to Excel for summation and percentage score

for each core value.

Example:

Core value: Accountability

Table 2: Summation of results

ITEM Never (1) Occasionally (2) Always (3)
As a medical imaging student, I:
assume responsibility and change 3
acknowledge and accept the 3
consequences of my actions
seek continuous improvement of the 3
quality of care delivered to my
patients

19
respond to goals and needs 3
Total score 12
Percentage score 100%

The table above illustrates how the total score for a participant can be calculated for a core value

and its equivalent percentage score. The percentage score for each participant is used to

categorise participants’ performance in in the six core values into poor, average, and good.

Categorization into poor, average and good.

The percentage of each core value is grouped into poor, average and good

Poor – 0%-59.99%

Average -60%-79.99%

Good – 80%-100%

3.7 Data storage

The data was stored on a laptop with an encrypted password for protection. This guaranteed the

security of the information.

3.8 Ethical consideration

Ethical approval was sought from the Ethics and Research committee (UHAS-REC A.8[118] 22-

23) of the University of Health and Allied Sciences, Ho. The questionnaire did not require

students to reveal their identity to ensure anonymity. Written consent of participants was sought

and participation was voluntary.

20
 CHAPTER 4: RESULTS
4.1 Introduction
This chapter contains a comprehensive analysis of the data collected from respondents of the

study. A presentation of these results provided an understanding of the concept understudy by

pointing out observations that were made, statistically analysing the data, and identifying trends.

The data collection instrument was an online questionnaire. The data was analysed using the

Statistical Package of Social Sciences (SPSS) version 23 and presented in graphs and charts

using Microsoft Excel 2013. The questionnaire was opened to a student population of 228 out of

which 191 responses were received indicating a response rate of 83.8%.

21
4.2 Demographics

Gender of participants

fe-
male
38%

male
62%

Figure 1: A pie chart demonstrating the distribution of males to females in the study

There were more male participants (N=118, 62%) than females (N=73, 38%) in the study as

shown in Figure 1 above.

22
 AGE OF PARTICIPANTS
70

60
Number of participants (N=191)

50

40
68

30

42
20
32
27

10
8
5 4 3
2
0
20 21 22 23 24 25 26 27 29

Age of participants (years)

Figure 2: Age distribution of respondents

The ages of respondents ranged from 20 to 29 and a modal age of 22 years (N=68, 35.6%). The

mean age was 22.7 years (SD=1.534)

*SD: Standard deviation

23
 UNIVERSITY OF STUDY

90 UCC, 82

80

70

60
Number of participants

50 UG, 45

40 UHAS, 32
KNUST, 32

30

20

10

0
UG UCC KNUST UHAS

University of study

Figure 3: University of Study

From Figure 3, the majority of the respondents were from the University of Cape Coast (N= 82,

42.4%), followed by the University of Ghana (N= 45, 23.6%).

24
 PROGRAMME OF STUDY
134
140

120

100
Number of participants

80

52
60

40

20
5

0
Diagnostic radiograpy Sonography Radiotherapy

Programme of study

Figure 4: A bar chart representing the various programmes of study of the participants

Based on Figure 4, most of the participants are pursuing diagnostic radiography (N=134,70.2%)

whereas therapy radiography was the programme least pursued by the respondents (N= 5,2.6%)

25
4.3 Core Values of Professionalism
Table 3: Accountability
ITEM Never Occasionally Always
As a medical imaging student, I: N N N
assume responsibility and change 9 (4.7%) 91 (47.6%) 91 (47.6%)
acknowledge and accept the consequences 9 (4.7%) 66 (34.6%) 116 (60%)
of my actions
seek continuous improvement of the 15 (7.9%) 65 (34%) 111 (58%)
quality of care delivered to my patients
respond to goals and needs 9 (4.7%) 64 (33.5%) 118 (61.8%)

Concerning professionalism and the importance of being accountable, a significant portion of the

students (47.6%) consistently assume responsibility and adapt to changes. Additionally, a

majority of the students (60%) recognize and accept the consequences of their actions, and a

large majority (58%) expressed their interest in delivering high-quality diagnostic and

therapeutic services. Furthermore, 61.8% of students indicated that they were responsive to goals

and the needs of their patients.

26
Table 4: Altruism
ITEM Never N Occasionally Always
As a medical imaging student, I: N N
Place patients’ needs above my own 26 (13.6%) 83 (43.5%) 82 (42.9%)
during diagnostic and therapeutic
procedures
Provide diagnostic and therapeutic 32 (16.8%) 116 (43.5%) 43 (22.5%)
services to patients even after working
hours
Provide patient services that go beyond 25 (13.1%) 119 (43.5%) 47 (24.6%)
the standard of care
Provide diagnostic and therapeutic 23 (12.0%) 100 (52.4%) 68 (35.6%)
services to an underserved and
underrepresented population

A significant percentage (86.4%) of participants indicated that they prioritize patients' needs over

their own during diagnostic and therapeutic procedures. Furthermore, a considerable number of

students (43.5%) occasionally extend their working hours to ensure patients receive the

necessary care. Additionally, a majority of students (43.5%) express their willingness to go

above and beyond the standard requirements to provide additional services to patients. Table 3

also reveals that a large majority (88%) of students either occasionally or consistently offer

diagnostic and therapeutic services to underserved and underrepresented populations.

27
Table 5: Compassion
ITEM Never Occasionally Always
As a medical imaging student, I; N N N
Try to look at things from the patient’s 10 (5.2%) 84 (44.0%) 97 (50.8%)
perspective
I am an advocate for patients’ and clients’ 18 (5.2%) 66 (34.6%) 107 (56.0%)
needs
Understand the sociocultural and 13 (6.8%) 82 (42.9%) 96 (50.3%)
psychological influences on the
individual’s life
Demonstrate respect for others and 10 (5.2%) 64 (33.5%) 117 (61.3%)
considers them as unique and of value

The information presented in Table 4 indicates that a significant percentage of students (50.8%)

consistently make an effort to view situations from the patient's perspective. Furthermore, a

majority of them (56.0%) consistently advocate for the needs of patients and clients. A higher

percentage (50.3%) consistently understand that an individual's environment plays a role in

shaping their life. When it comes to respecting and recognizing the uniqueness and value of

individuals, a majority of students (61.3%) demonstrate an understanding of this concept.

Table 6: Excellence
ITEM Never Occasionally Always
28
 N (%)
As a medical imaging student, I; N (%) N (%)
demonstrate investment in the profession of 28 (14.7%) 79 (41.4%) 84 (44.0%)
medical imaging
participate in integrative and collaborative 8 (4.2%) 77 (40.3%) 106 (55.5%)
practice to promote high-quality healthcare
and educational outcomes
use evidence constantly to support 16 (8.4%) 92 (48.2%) 83 (43.5%)
professional decisions
pursue new evidence to expand my 25 (13.1%) 85 (44.5%) 81 (42.4%)
knowledge

From Table 6 above, the participants showcased a strong commitment to achieving excellence on

the clinical field, with the majority (44.0%) expressing unwavering willingness to consistently

invest in the profession of medical imaging. Additionally, a majority (55.5%) of the students

consistently engage in integrative and collaborative practices, aiming to enhance healthcare

quality and educational outcomes.

Table 7: Integrity
ITEM Never Occasionally Always
As a medical imaging student, I; N (%) N (%) N (%)
abide by rules, regulations, and laws 13 (6.8%) 60 (31.4%) 118 (61.8%)
29
applicable to the field of medical imaging
resolve dilemmas with respect to a 9 (4.7%) 78 (40.8%) 104 (54.5%)
consistent set of core values
am trustworthy 6 (3.1%) 43 (22.5%) 142 (74.3%)
act on the bases of professional values 23 (12%) 84 (44.0%) 84 (44.0%)
even when the results put me at risk

The participants exhibited a good level of integrity as shown in Table 6 above. The majority of

the respondents always adhere to the regulations and laws (61.8%) and set of core values when

solving problems (54.5%). A large majority of students exhibit trustworthiness (74.3%) and

always act based on professional values (44%)

Table 8: Professional duty

ITEM Never Occasionally Always
As a medical imaging student, I; N (%) N (%) N (%)
demonstrate beneficence by providing 9 (4.7%) 62 (32.5%) 120 (62.8%)
optimal care

30
promote the profession of medical 8 (4.2%) 63 (33.0%) 120 (62.8%)
imaging
take pride in my profession 10 (5.2%) 68 (35.6%) 113 (59.2%)
involve in professional activities beyond 22 (11.5%) 99 (51.8%) 70 (36.6%)
the practice setting

From Table 8 it is evident that students exhibit professional duty. The majority consistently

demonstrate beneficence (62.8%), promote their choice of profession (62.8%) and take pride in

their profession (59.2%).

Table 9: Level of professionalism categorized according to each core value

Core value Level of professionalism

Poor Average Good

Accountability 18 (9.4%) 48 (25.1%) 125 (65.4%)

31
 Altruism (selflessness) 21 (11.0%) 54 (28.3%) 116 (60.7%)

Compassion 41 (21.5%) 94 (49.3%) 56 (29.3%)

Excellence 30 (15.7%) 61 (31.9%) 100 (52.4%)

Integrity 15 (7.9%) 47 (24.6%) 129 (67.5%)

Professional duty 10 (5.2%) 55 (28.8%) 126 (66.0%)

Based on the information provided in the table, it can be seen that a majority of the respondents

are accountable (65.4%), altruistic (60.7%), fairly compassionate (49.3%), excellent in their

work (52.4%), show a good level of integrity (67.5%), and are of a good professional standing

(66.0%).

Table 10: Total percentage score of the population on each core value
Core value Population percentage score

Accountability 83.86% (good)

Altruism (selflessness) 72.51% (average)

32
Compassion 82.64%(good)

Excellence 78.75% (average)

Integrity 83.99%(good)

Professional duty 82.98%(good)

The population demonstrated a good performance in accountability (83.86%), compassion

(82.64%), integrity (83.99%), and professional duty (82.98%). They also showed average levels

of altruism (72.51%) and excellence (78.75%). Cumulatively, final year medical imaging

students had a good score (80.56%) in professionalism.

The overall score for the entire group was computed by summing up the individual scores for

each participant regarding a core value and converting it into a percentage. For a single

participant, the maximum achievable score is 12, equating to 100%. Considering the whole

population of 191 participants, the maximum cumulative score reaches 2292 (12 multiplied by

191). To determine the total percentage score for a core value across the entire population, the

sum of all responses is divided by 2292 and then multiplied by 100.

Table 11: Pearson Chi-square test for association

Variable

Level of Professionalism

Gender 0.236

33
 University of 0.001
study

Programme of 0.005
study

From Table 12 above, there were significant associations between the level of professionalism

and the participants’ programme of study (p= 0.005) and educational institution (p= 0.001). there

was however no association between gender and level of professionalism (p= 0.236).

34
4.4 Barriers in Achieving Professionalism and How to Maintain Professionalism

FACTORS AFFECTING LEVEL OF PROFESSION-

ALISM

200
160
120 189
80 72 97 96
40
Number of participants

0
t s n t
ou u re tio en
rn ss za p m
Bu re rd
i ui
ic
p da eq
om ts ar in
g
on of ag
Ec m
ck li
La ica
ed
m
in
g
in
in
rt a
d
an
ss
cce
a
d
ite
im
L
Factors affecting professionalism

Figure 5: A bar chart demonstrating the factors that affect the level of professionalism

Burnout (N=189, 98.95%) was identified as the primary factor influencing the level of

professionalism in the clinical field whereas economic pressures were reported to have the least

impact (N=72, 37.69%) as shown in figure 5 above.

35
4.5 Maintaining professionalism

MAINTAINING PROFESSIONALISM
166
160 145

120 97
80 73 72

40
Number of participants

0
n p e ts
tio hi lis
m tic en
ca rs na ac d
u to o pr
stu
ed en si ed r
al m es as fo
m an
d of b e
r pr ce
-
cti
c
Fo on of en ra
v isi re id lp
er u ltu ev na
p g is o
l su ec ot
in es
th of
ica in
g om pr
lin Pr
C r ag on
u s
co ar
En in
s em
ng
nisi
a
rg
O

Ways of maintaining professionalism

Figure 6: A bar chart showing the participants’ responses on how professionalism can be

maintained.

The majority of participants (N=166, 86.91%) emphasized the importance of formal education in

upholding professionalism among medical imaging students. On the other hand, organizing

seminars on professional practice for students was the least factor identified in maintaining

professionalism (N=72, 37.69%).

36
 CHAPTER 5: DISCUSSION
5.1 Introduction
Professionalism is a fundamental aspect of the healthcare industry, and it plays a crucial role in

ensuring quality patient care and maintaining trust between healthcare professionals and their

patients (NHS Scotland, 2012). In the field of medical imaging, professionalism is of utmost

importance as it directly impacts the accuracy of diagnoses, treatment planning, and overall

patient outcomes (Spandorfer & Halpern, 2014). Evaluating the level of professionalism,

investigating the factors that influence the level of professionalism and professional barriers, and

how to maintain a high standard of professionalism are essential for fostering a culture of

excellence and continuous improvement. By addressing these objectives, this thesis seeks to shed

light on the importance of professionalism in medical imaging, assess the current state of

professionalism among final year students in Ghana, identify influencing factors and barriers,

and provide actionable insights for maintaining professionalism. Ultimately, the findings of this

study can contribute to the advancement of the medical imaging profession and the delivery of

high-quality patient care.

37
5.2 Demographics
The questionnaire was opened to a student population of 228 out of which 191 responses were

received indicating a response rate of 83.8%. The ages of respondents ranged from 20 to 29 with

a modal age of 22 years (N=68, 35.6%). The mean age was 22.7 years (SD=1.534) . The younger

generation are more are more adaptable to new technology which is a good thing in the field of

medical because more and more medical imaging equipment are advancing in terms of

technology and so a younger generation will more likely master new imaging protocols,

equipment and software (Lewis, 2018). Furthermore, young professionals bring new ideas to the

field which can lead to the discovery of new and better ways of patient-care which in the long

run can influence teaching methods and teaching curriculum and increase diversity in terms of

experiences and perspectives. A younger generation also means a longer and more impactful

career which can contribute positively to the profession of medical imaging on a local and

broader scale (Maiers, 2017). The majority of the participants were males, which could be

because of a low female response rate or underrepresentation of females in STEM-related

programmes in the country. This underrepresentation may be influenced by societal perceptions

that associate women with domestic roles that require less education (Amponsah & Mohammed,

2019). Additionally, the potential biological effects of ionizing radiation in the field of

radiography may contribute to the higher ratio of males to females in this profession (Anim-

Sampong et al., 2018). However, a study conducted in Namibia recorded a higher response rate

from females compared to males, which contrasts with the current study findings (Tashiya et al.,

2021). 5.2.1 Factors influencing professionalism

The results from the study showed no significant association between the gender of the

participants and the level of professionalism exhibited (p=0.236). However, comparing the mean

scores between males and females, females recorded a higher mean (58.945 ± 7.0669) than
38
males (57.686 ± 8.0327), indicating that females have a higher level of professionalism as

compared to males in the study as seen in an earlier study conducted among medical students

(Razak & Sharip, 2020). The possible explanation for this is that female professionals are driven

by intrinsic factors which make them caring and empathetic as compared to their male

counterparts who derive their motivation from extrinsic factors such as economic security (Tong

et al., 2023). The university of study and programme of study both had significant associations

with the level of professionalism of participants (university, p=0.001; programme, p=0.005).

This could be due to the various curriculums and approaches to teaching which vary from school

to school and also the environment in which a student is trained, as previous studies show that a

person is influenced by their environment (Bwanga, 2019). The ideals and culture of a school has

a big impact on how professional students are as the environment of the school will be made to

prioritize respect, teamwork and dedication to excellence. This can be stressed by hiring

qualified lectures who are likely to maintain a professional teaching environment. The

development of students into professionals require a setting that encourages efficient teaching

and learning with resources like technology, educational resources and infrastructure which

teaches students to flourish in their roles (Hilli et al., 2014). Therefore, gender, the university of

study and the programme of study could influence a student’s level of professionalism.

5.3 Core values of professionalism

5.3.1 Accountability

This study revealed that students showed a good level of professionalism in terms of

accountability, this finding was similar to findings from a research carried out among medical

students from UiTM Puncak Alam (Razak & Sharip, 2020). This professional value was shown

through participants’ willingness to assume responsibility and accept the consequences for their

actions and responding to goals and needs by seeking a continuous improvement in the quality of
39
care they provide to their patients (table 3). For a medical imaging professional to be

accountable, he or she must be clinically competent; this requires active efforts to attain and

maintain the necessary skills for the provision of exceptional patient care (Tashiya et al., 2021).

Students may not be completely accountable for medical imaging procedures since a majority of

procedures done by students are supervised. For a person to be accountable according to the

Society of Radiographers (UK), that individual must have the ability to perform a task, accept

responsibility for the task, and must be allowed by law to perform such a task (Johnson, 2012).

In the context of medicine, accountability can be defined as the sense of responsibility healthcare

professionals have towards patients (Mueller, 2009). This core value makes the health worker

liable to be called upon to give an account of a patient’s treatment process, therefore making it an

important element of professionalism as its absence may put patients’ lives at risk (Tashiya et al.,

2021). Accountability in Radiography enhances radiographer-patient relationships, fosters trust,

improves the quality of care, and enables efficient use of resources whilst reducing medical

mistakes and errors (Alhothaly & Alhanawi, 2021). In nursing, accountability is seen as a

concept that influences quality care, decision-making, safety standard and staff values and

understanding of accountability can influence the quality of care given to patients while

improving working conditions (Rubio-Navarro et al., 2019).

5.3.2 Altruism

Altruism is a cherished value in the healthcare sector because the practice of healthcare requires

that professionals place the interest of their patients above theirs at all times (Harris, 2013).

Altruism is defined as the devotion to the interest of others and not oneself (Merriam-Webster,

2023a). This core value can be practiced by placing patients’ needs above one’s own during

diagnostic and therapeutic procedures, providing diagnostic and therapeutic services to patients

40
even after working hours, providing patient services that go beyond the standard of care, and

providing diagnostic and therapeutic services to underserved and underrepresented population

(American Physical Therapy Society, 2019). Students in this study obtained a total average score

of 72.51% (table 2 and 9) which is consistent with a similar study conducted in Namibia

(Tashiya et al., 2021). This result though average is considered good because it is important that

healthcare workers maintain a healthy balance between work and life outside the working

environment for altruism to be effective and sustainable. This requires workplace altruistic

cultures to be promoted through organized team work rather than individual efforts (Sajjad et al.,

2021). Excessive display of altruistic value may be harmful to health workers and has been found

to be one of the leading causes of burnout and depression (Zwack & Schweitzer, 2013).

Disregarding one’s self and poor self-care, which is common among health workers have been

reported to cause the departure of individuals from the health profession, as well as inducing

mental health challenges with increased suicidal attempts (Tashiya et al., 2021).

5.3.3 Compassion

The radiology department predominantly sees patients who are afflicted by one or multiple

medical conditions which cause varying degrees of pain and discomfort to the patient. Naturally,

medical imaging professionals are mandated to deliver their services with compassion as stated

in the code of conduct for radiographers (Harris, 2013). Compassion is the deep awareness of the

suffering of another and the wish to relieve it (Merriam-Webster, 2023b). This fundamental

principle can be practiced by making an effort to view situations from the patient's standpoint,

advocating for patient needs, understanding and showing respect towards others, and recognizing

and appreciating patient and other health professionals as unique and people of worth, this in turn

fosters trust and restore patients’ dignity (Willis, 2015). Compassion can be characterised in

41
diverse way, it can be seen as an inherent feeling and an innate aspect of a person's character

from birth or experiences from previous life which play a role in shaping an individual's capacity

for compassion (Malenfant et al., 2022). For instance, nurses pointed out that their own

psychological empowerment played a role in enhancing their ability to offer compassion,

influenced by the duration of their tenure in the healthcare sector (Malenfant et al., 2022). The

students participating in this research exhibited a high level of compassion (82.64%) towards

their patients. In contrast, a separate study carried out among physical therapists in India

uncovered a lower degree of compassion among practitioners. (Kumar, 2013). The

characteristics of medical imaging processes necessitate that students are attentive to the

requirements of the patients and handle them appropriately. This entails that students must build

a shared comprehension founded on trust between themselves and their patients, particularly

when dealing with therapeutic procedures, given the prolonged and continuous interaction with

the patient.

5.3.4 Excellence

Participants had an average score of 78.75% which was conflicting with a similar study

conducted in a medical and dental college in Lahore that revealed that students had a low score

in excellence as a professional value (Rasul et al., 2021). Excellence is the quality of possessing

good qualities to a higher degree. Clinical excellence is an attribute of professionalism that is

based on the maintenance of clinical expertise, efficiency, and evidence-based practice (Davis,

2014). The implicit anticipation is that healthcare professionals across all fields are required to

fulfil three distinct responsibilities. The initial one involves executing their designated clinical

tasks, regardless of the specific nature of those tasks. The second responsibility entails not only

preserving and augmenting patient safety within their individual work but also intervening in the

42
organizational structures they are a part of, whenever necessary. The third obligation is to

actively identify opportunities for enhancing quality and ensuring the implementation of positive

changes (Smith & Plunkett, 2019). In this study, clinical excellence was shown through

participants’ zeal to participate in integrative and collaborative practice to promote high-quality

healthcare and educational outcomes, use evidence constantly to support professional decisions,

and pursuing new evidence to expand their knowledge (table 4). These are essential

characteristics because of the constant changes in the field of medical imaging that come with

technological advancement (Lewis, 2018).

5.3.5 Integrity

Integrity is the foundation of ethical healthcare practices. It ensures that healthcare providers

prioritize the well-being of patients, uphold the trust of the community, and contribute to a

system that is reliable, transparent, and compassionate. Patients and service users value

professionalism because it stimulates quality and serves as a standard for acceptable behaviours,

attitudes, and activities (NHS Scotland, 2012). Maintaining integrity in healthcare involves

educating professionals about ethical standards, fostering open communication, and establishing

clear policies (Haque et al., 2016). It requires patient-centred care, involving patients in

decisions, and creating ethics committees for guidance (Malenfant et al., 2022). Leadership

example, peer support, and whistleblower protection are essential, along with transparent

research practices. Regular policy reviews, audits, and collaboration with regulatory bodies

ensure ongoing commitment to ethical conduct. Therefore to maintain public trust in the health

system and the services it provides, medical imaging professionals must abide by rules,

regulations, and laws applicable to the field of medical imaging, resolve dilemmas based on a

consistent set of core values, are trustworthy and act on the bases of professional values at all

43
times to safeguard the profession (Harris, 2013). The total score of participants on integrity was

found to be good (83.99%). These results were however contradictory to the results from a study

conducted among physiotherapists in India which found the score of the level of excellence

among final year students to be moderate (33.87%) (Kumar, 2013) but consistent with the

findings from a paper published in Namibia on a similar topic where students portrayed a good

(80.0%) level of integrity (Tashiya et al., 2021).

5.3.6 Professional duty

In terms of professional duty, students proved that they had a good standing in professional duty

as a professional value by obtaining an overall score of 82.98%. The majority of the students

demonstrated their professional duty by demonstrating beneficence through the provision of

optimal care, promoting the profession of medical imaging, and taking pride in their profession,

with some students occasionally involving themselves in professional activities beyond the

practice setting (table 8).

Professional duty is the state of having a moral and legal responsibility towards a patient, this

responsibility includes the type of services being provided to the patients and how it is being

delivered and extends from the patients to patient relatives and all personnel on the patient’s

medical team (Tashiya et al., 2021). This core value requires medical imaging professionals to

fully inform patients and patient relatives about the available diagnostic options, the cost

involved, and their respective duration before the patient consents to undergo an examination

(Harris, 2013). By doing so, medical imaging professionals are respecting the patient’s autonomy

and their right to make their own health-related decisions (Haque et al., 2016). This also further

proves that professionals are acting in the best interest of the patient and not exploiting them

(Taylor, 2013).

44
5.4 Barriers to achieving professionalism
Medical professionalism is the foundation of ethical and effective health delivery. The

importance of professionalism has led to its inclusion in the curricula of several health

programmes, medical imaging inclusive. With its numerous importance in the practice of

medical imaging profession, burnout, lack of standardization, economic pressures and limited

access and training medical imaging equipment were barriers identified to hinder professional

practices.

5.4.1 Burnout

Burnout was the most common barrier to achieving professionalism in this study (N=189). A

prior research study affirmed this observation, demonstrating that healthcare professionals are

particularly susceptible to both physical and psychological stress (Herraiz-Recuenco et al.,

2022). According to literature, burnout among medical imaging students is caused by a

combination of academic, personal and institutional issues. The tough coursework, strict

academic requirements and the pressure to maintain good grades contribute to academic stress.

Students get overwhelmed when they have to balance theoretical and practical learning which

lead to a heavy workload, leaving less or no time for students to take a break or relax. Also, long

hours on clinical fields during clinical rotations and dealing with seriously ill patients and

difficult medical cases contribute to burnout among students (Zwack & Schweitzer, 2013).

Additionally, students may feel isolated and unsupported due to inadequate and restricted access

to faculty members which can worsen stress and burnout. Furthermore, financial concerns such

as tuition fees and the cost of living serve as an additional cause of stress to students. This can

negatively affect the level of care provided to patients due to a deterioration in energy levels and

the difficulty to meet deadlines and the production of low-quality work and medical errors which

compromise the safety of the patient. Burnout can also lead to poor interaction with colleagues,
45
supervisors and patients due to low levels of enthusiasm and motivation to work. Emotional

detachment is another effect of burnout, this causes students to be less compassionate and

empathetic to their patients making them impatient and frustrated with patients and colleagues.

As the pressure and tension increase, students find it difficult to manage and as a result, they

experience a breakdown. This leads to them being absent from their responsibilities and arriving

late to facilities.

5.4.2 Lack of standardization

Standardization plays a crucial role in ensuring quality and safety in medical imaging. It helps

establish uniform guidelines for image acquisition, interpretation, and reporting, which are

essential for accurate diagnoses and effective treatment planning. indicated that they are unaware

of the availability of standard procedure protocols (Gadeka & Esena, 2020). Without clear and

consistent standards, there may be variations in practices, protocols, and interpretations of

imaging studies. This can lead to inconsistencies in patient care and outcomes, as well as hinder

effective communication and collaboration among healthcare professionals (Gadeka & Esena,

2020), there is also the risk of errors, misinterpretations, and unnecessary repeat imaging, which

can impact patient care and increase healthcare costs (Gadeka & Esena, 2020), it becomes

challenging to establish consistent training programs, certifications, and continuing education

requirements when there are no widely accepted standards to guide these processes (Morrow et

al., 2011). The lack of standardization in the field of medical imaging was the second major

challenge in achieving professionalism in this study and was also a finding from an earlier study

which revealed that, half of the population had no knowledge of standard examination protocols

which were used across all medical imaging departments (Gadeka & Esena, 2020) as protocols

are specific to departments and so vary from department to department (Gransjøen et al., 2018).

46
5.4.3 Limited access and training in medical imaging equipment

Timely and accurate diagnoses are crucial for effective treatment planning. Without access to

imaging equipment, healthcare professionals may face difficulties in obtaining necessary images,

resulting in delayed diagnoses and potentially compromising patient outcomes (Gadeka & Esena,

2020). Secondly, limited access to imaging equipment can hinder the ability to provide

comprehensive and high-quality care. Imaging plays a vital role in diagnosing and monitoring

various medical conditions. Without access to the necessary equipment, healthcare professionals

may be limited in their ability to accurately assess and monitor patients' conditions, leading to

suboptimal care. Furthermore, limited access to imaging equipment can impact professional

development and education. Hands-on experience with imaging equipment is essential for

healthcare professionals to develop and maintain their skills. Without access to equipment,

opportunities for training, skill enhancement, and staying updated with technological

advancements may be limited, hindering professional growth (McCaffrey et al., 2016). Limited

access to training and medical imaging equipment was one of the barriers identified in this study

that hinders professionalism, this finding was similar to an earlier study among student

radiographers in Ghana where students revealed that, radiography departments were under

resourced and students were not allowed to use certain modalities (Kyei et al., 2015). This

situation hinders students from developing fresh skills and restricts their familiarity with specific

procedures and apparatus, leaving them ill-equipped for real-world scenarios due to their

insufficient grasp of workflow, suboptimal technique, and inadequate safety protocols.

5.4.4 Economic pressures

In the context of medical imaging, economic pressures can impact several aspects that contribute

to professionalism. Firstly, financial constraints can limit the availability of resources and

47
technology necessary for delivering high-quality care (Gadeka & Esena, 2020). This can include

outdated or inadequate imaging equipment and limited access to advanced imaging modalities

(Gadeka & Esena, 2020). These limitations can hinder healthcare professionals' ability to provide

optimal patient care and may compromise the accuracy and reliability of imaging studies.

Healthcare professionals, including those in medical imaging, may face pressure to see a high

volume of patients within limited time frames. A similar finding from a previous study revealed

that this situation can lead to hurried examinations, decreased time for comprehensive image

analysis, and limited chances for professional growth or collaboration with peers (Gransjøen et

al., 2018). These factors can negatively impact the quality of care and hinder the ability to

maintain high professional standards. Additionally, economic pressures can impact

reimbursement models and financial incentives, potentially favouring quantity over quality, as

observed in a study conducted in Nigeria (Promise et al., 2021). In such cases, healthcare

professionals may feel compelled to prioritize financial considerations over patient-centred care

or evidence-based practices. This can undermine professionalism by compromising ethical

decision-making and the overall well-being of patients (Hryhorczuk et al., 2015).

5.5 Maintaining professionalism

5.5.1 Formal education

Formal education was identified by participants to be the most effective way of maintain

professionalism (Figure 6). Formal education programmes provide students with a

comprehensive understanding of medical imaging principles, techniques, and technologies

(Nortjé & Hoffmann, 2017). This knowledge equips them with the necessary skills to perform

imaging procedures accurately and safely. By ensuring a strong foundation of knowledge, formal

education helps students training to be professionals maintain high standards of competence and

expertise (Nortjé & Hoffmann, 2017). This knowledge equips them with the necessary skills to
48
perform imaging procedures accurately and safely. By ensuring a strong foundation of

knowledge, formal education helps students training to be professionals maintain high standards

of competence and expertise (Nortjé & Hoffmann, 2017).. By instilling these values, formal

education helps students uphold ethical standards and deliver compassionate care (Harris, 2013).

Formal education fosters critical thinking skills, this equips students with a well-rounded

approach to challenges in a systematic manner (Lewis, 2018). This finding was supported by an

earlier study where a percentage of the students expressed that professionalism be taught and

assessed formally because it provides a structured and broad foundation of knowledge and skills,

and certification which proves that an individual has acquired the needed educational training

(Abidin, 2013).

5.5.2 Clinical supervision and mentorship

The significance of clinical supervision in upholding professionalism in medical imaging was

demonstrated by the substantial number of responses received from participants in this study,

underscoring its crucial role (Figure 6). Clinical supervision and mentorship provide a structured

framework for ongoing support, guidance, and professional development for students.

Positioning learners in a workplace environment begins a process of socialization that aims to

progressively develop practical skills, attitudes, and behaviour (Carlson, 2013). Supervision

helps ensure that imaging practices adhere to established standards and guidelines because

supervisors can review and assess the quality of imaging procedures, provide feedback on image

acquisition and interpretation techniques, and address any deviations from best practices

(Bwanga, 2019). This helps maintain high standards of patient care and accuracy in diagnoses

and students learn better. Practice learning or “learning by doing” develops knowledge faster and

better, aforementioned by previous study (McCaffrey et al., 2016). A study conducted among

49
nurses also acknowledged that clinical supervision provides a platform to discuss and navigate

ethical dilemmas that may arise providing students with the best way to approach and address

these situations in a manner that upholds professional standards (Carlson, 2013). This helps

foster a culture of ethical practice and patient-centred care. Clinical supervision encourages

lifelong learning by identifying areas for improvement, setting goals, and facilitating access to

relevant educational resources (Uarije et al., 2017).

5.5.3 Maintaining professionalism through encouraging a culture of professionalism,

evidence-based practice and organizing seminars.

Fostering a culture of professionalism within the realm of medical imaging has the potential to

cultivate a robust sense of ethical conduct, responsibility, and regard for both patients and

colleagues. This establishes a setting where students grasp the importance of upholding ethical

principles and practice standards, leading to enhanced proficiency in communication.

Consequently, these students are more adept at relaying information to patients and peers in a

manner that is not only more competent but also encourages collaboration. Instilling

professionalism can be achieved through methods such as mentorship, setting examples, and

establishing an environment conducive to learning, all of which aid students in comprehending

the gravity of their roles and obligation (Bwanga, 2019). Coupling a culture of professionalism

with evidence-based practices heightens the skill sets of students, fostering their self-assuredness

when confronted with difficult cases. Over time, students foster a strong professional identity

and are more inclined to take pride in their positions as medical imaging professionals, thereby

making affirmative contributions to the profession's standing.

Evidence-based practice involves utilizing the most current and reliable evidence in conjunction

with clinical expertise and patient preferences to inform decisions in healthcare. It prompts

50
students to meticulously assess information before arriving at well-informed choices. This

approach results in the delivery of exceptional healthcare services and the accurate rendering of

diagnoses, both of which contribute to enhanced patient outcomes. Integrating the emphasis on

evidence-based practice within medical imaging education helps students recognize the

significance of basing their clinical decisions on the most dependable available evidence (Haque

et al., 2016). Teaching students the skills to critically evaluate research, stay abreast of

advancements in imaging technology, and implement evidence-based guidelines not only boosts

their professionalism but also guarantees the provision of the utmost quality care to patients

(Malenfant et al., 2022).

Arranging seminars or workshops centred around professional practice offers students valuable

insights into the ethical, legal, and societal dimensions of medical imaging. As indicated by

research, these sessions can cover a range of topics, encompassing patient privacy, informed

consent, effective communication, and collaboration among professionals. In doing so, they not

only underscore the importance of these facets but also present real-world challenges prevalent

in the field (Kretz et al., 2021). Additionally, these seminars expose students to the latest

discoveries in the realm of medical imaging, ensuring that they remain updated on evolving

methodologies and emerging modalities, all while fostering a culture of continuous learning.

Through active participation in discussions and case-based learning, students can cultivate a

deeper comprehension of their professional obligations and the ethical predicaments they may

encounter throughout their prospective careers.

51
 CHAPTER 6: LIMITATIONS, CONCLUSION & RECOMMENDATIONS
6.1 Limitations
The sample size does not represent the entire medical imaging student population in Ghana.

Hence care must be taken when generalizing the findings from this study. Data collection for this

study involved the use of a questionnaire, which is susceptible to self-reporting bias.

Nevertheless, the researcher stressed the importance of participants being honest in their

responses. Considering the nature of the phenomenon being investigated, a mixed-method

approach would have been more suitable to evaluate the level of professionalism among the

participants, complemented by a subsequent observational study to assess their professionalism

in real-life scenarios.

6.2 Conclusion
The professionalism level of Ghanaian final medical imaging students was deemed satisfactory,

with an average score of 80.56% across the six core values. A majority of the students (N=104,

54.0%) achieved an overall good score. Among the core values, accountability and integrity

received the highest overall scores compared to the other values. While there was no significant

association between participants' gender and their professionalism level, the university and

programme of study both showed a significant association with the level of professionalism

exhibited by a participant.

The main obstacles reported by participants in achieving professionalism were burnout and the

lack of standardization in the medical imaging field. On the other hand, economic pressure was

considered to have the least impact on professionalism. In addition to identifying these obstacles,

participants also identified potential solutions to cultivate and sustain a high level of

professionalism. According to their perspectives, formal education was regarded as a

52
foundational element in establishing and nurturing professionalism. This goes beyond degree

programmes alone but also encompassing the establishment of a culture that encourages

continuous professional development (CPD) among students. Furthermore, the significance of

clinical supervision and mentorship was highlighted by students, recognizing its crucial role in

facilitating their growth from students to proficient medical imaging professionals.

6.3 Recommendations
The research aimed to assess the degree of professionalism among graduating students enrolled

in three distinct medical imaging programs: Diagnostic imaging, Sonography, and Therapy

Radiography. Future investigations could expand the scope to encompass diploma and certificate

students in medical imaging, as well as include participants from all educational levels to enable

a broader applicability of the study's findings. In addition, this research examined the level of

professionalism among students without exploring their individual understanding and

interpretation of the term "professionalism." Therefore, future studies should adopt a mixed-

method approach, incorporating qualitative methods to comprehend students' perceptions of

professionalism and quantitative methods to quantitatively measure this phenomenon.

The study's findings affirmed that burnout and the absence of standardization were the primary

factors influencing professionalism. To address these issues, healthcare organizations and

stakeholders should implement strategies for workload management, which aim to effectively

handle the workload and prevent overwhelming stress among medical imaging students by

providing mental health resources, stress management programmes, and fostering a positive

work environment that acknowledges and rewards their contributions. Moreover, stakeholders

should develop and implement standardized educational curricula for medical imaging students,

as well as clinical protocols and guidelines for medical imaging procedures. By doing so,

53
consistency can be achieved, reducing variations in image acquisition and interpretation, and

ultimately enhancing accuracy and efficiency.

54
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 APPENDICES
7.1 QUESTIONNAIRE
EVALUATING THE LEVEL OF PROFESSIONALISM AMONG FINAL YEAR
MEDICAL IMAGING STUDENTS IN GHANA.

Thank you for your participation in this research that is aimed at evaluating the level of level of
professionalism among final year Medical Imaging students in Ghana. At the end, the
information given will be used assess the level of professionalism among final year Medical
Imaging students in Ghana which will help in developing strategies that will help maintain a high
level of professionalism among students as they transition into professionals. The information
provided will be completely confidential so do not write your name or student identification
number anywhere on this questionnaire. Please read every question carefully and answer
honestly based on what you do on the clinical field. There are no right or wrong answers.
SECTION A: SOCIO-DEMOGRAPHICS

1. Sex
Male ☐
Female ☐
2. Age……………
3. Programme of study
Diagnostic radiography ☐
Sonography ☐

Radiation therapy ☐

4. Which university are you offering your undergraduate programme of study?

University of Ghana (UG) ☐
University of Cape Coast (UCC) ☐
Kwame Nkrumah University of Science and Technology (KNUST) ☐
University of Health and Allied Sciences (UHAS) ☐

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SECTION B: ASSESSING LEVEL OF PROFESSIONALISM
Students are expected to evaluate their level of professionalism based on the numbers assigned to
each of the stated core values. Kindly check/tick the item/box that most accurately describes how
frequently you exhibit each sample indicator, where 1 indicates never, 2 indicates occasionally
and 3 indicates always.

Core values

As a student radiographer, I: never (1) occasionally (2) always (3)

Accountability

1. Assume responsibility for learning and change ☐

☐
2. Acknowledge and accept the consequences for ☐ ☐
☐
my actions
3. Seek a continuous improvement of quality of care ☐ ☐
☐
delivered to my patients
4. Respond to goals and needs ☐ ☐
☐
Altruism (selflessness)

1. Place patients’ needs above my own during ☐ ☐

☐
radiographic procedures
2. Provide diagnostic and therapeutic services to patients even ☐ ☐
☐
after working hours

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 3. Provide patient services that go beyond the ☐ ☐
☐
standard of care
4. Provide diagnostic and therapeutic services to underserved ☐ ☐
☐
and underrepresented population

Compassion

1. Try to look at things from the patients’ perspectives ☐ ☐

☐
2. Am an advocate for patient and clients’ needs ☐ ☐
☐
3. Understand the socio-cultural, economic, and psychological ☐ ☐
☐
influences on the individual’s life in their environment
4. Demonstrate respect for others and ☐ ☐
☐
considers others as unique and of value

Excellence

1. Demonstrate investment in the profession of Medical Imaging ☐ ☐

☐
2. Participate in integrative and collaborative ☐ ☐
☐
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practice to promote high quality health and educational outcomes
3. Use evidence consistently to support professional decisions ☐ ☐
☐
4. Pursue new evidence to expand my knowledge ☐ ☐
☐

Integrity

1. Abide by rules, regulations and laws applicable ☐ ☐

☐
to the radiography profession
2. Resolve dilemmas with respect to a consistent set of core values ☐ ☐
☐
3. Am trustworthy ☐ ☐ ☐
4. Act on the bases of professional values even when ☐ ☐
☐
the results of the behaviour may place me at risk

Professional duty

1. Demonstrate beneficence by providing “optimal care” ☐ ☐

☐
2. Promote the profession of Medical Imaging ☐ ☐
☐
(Radiography, Sonography, Radiotherapy)
3. Take pride in my profession ☐ ☐
☐

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 4. Involve in professional activities beyond the practice setting ☐ ☐
☐

SECTION C: FACTORS THAT AFFECT STUDENTS’ THE LEVEL OF

PROFESSIONALISM

☐Economic pressures

☐Burnout

☐Limited access and training to medical imaging equipment

☐Lack of standardization in medical imaging procedures

SECTION 4: MAINTAINING THE LEVEL OF PROFESSIONALISM AMONG STUDENTS

☐Formal education and training

☐Clinical supervision and mentorship

☐Encouraging a culture of professionalism

☐Promoting evidence-based practice

☐Organising professional development programmes

7.2 Ethical Clearance

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69