An evaluation of the multiple and interrelated factors shaping evidence-based practice implementation in forensic radiographic practice

Abstract

Background: Forensic radiography is an indispensable but less well-known element of forensic science. This has the primary role of assisting the criminal justice system using medico-legal radiographic imaging. It must be underpinned by evidence-based best practices through the full implementation and application of guidelines and protocols. Essential to this process is the support of the organisations delivering forensic imaging services. Aim: To identify and explore the multiple and interrelated factors impacting guideline and best practice implementation in forensic radiography in international and United Kingdom contexts, from the perspectives of diagnostic radiographers. Methods: A multi methods study design comprising three phases was conducted. The data collected was analysed through inductive content analysis, inductive narrative and thematic approaches respectively. Results: Findings demonstrated a complex picture of current working practices with variation in levels of guideline implementation. Organisational, community and personal barriers underpinned implementation. Three synthesised themes comprising organisational awareness and support, radiographic community practice and perceptions, and research and best practice dissemination were developed from the data. These culminated in a conceptual model of the acceptance of adversity premised on the concepts of intractable organisational factors and the normalising of negative conformity. Discussion: Issues such as staffing and resource shortages lie outside the direct control of organisations, but this was not the case for all issues identified. Others may potentially be addressed through a change in organisational practice behaviours, personal mindsets, and the enhanced recognition of the diagnostic radiography profession and its forensic role. These can only be achieved through a fundamental shift in healthcare organisations and their leadership approaches to the role of evidence-based practices.