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

Spencer, H.L.; Williamson, K.E.; Robertson, A.; Anudjo, M.N.K.; Burton, C.R.

Abstract

In 2022, the College of Radiographers (CoR) published the fourth edition of their Education and Career Framework (ECF). This essential document provides a professional blueprint for the radiography career trajectory with the overarching aim of improving patient outcomes. However, publication does not guarantee adoption. To access the full benefits of the ECF, its implementation requires a strategic approach. To advance our understanding of the translational gap between policy and practice, this observational mixed-methods study employed Normalisation Process Theory (NPT) as a theoretical frame. Focusing on the diagnostic radiography profession in England, a national consultation survey was deployed, together with four consultation workshops. The quantitative survey data was analysed using descriptive and inferential statistics. Meanwhile, the framework approach was adapted for the qualitative analysis. The data collection took place between April-June 2023. In total, 142 survey responses were returned. Each workshop was comprised of 7-11 participants. The findings were deductively interpreted through the lens of NPT, from which five core themes emerged: making sense of complexity (coherence); bringing people together (cognitive participation); being strategic (collective action); evaluating complexity (reflexive monitoring); implementation in the 'real world' (barriers and enablers). By furthering our understanding of how the workforce has received and utilised the ECF, the gaps in its implementation were identified. This led to the development of recommendations to address the implementation gaps and enhance the ECF's adoption. The recommendations were study-derived, linked to responsible stakeholders, and grouped into four strategic priorities, aligned with the NPT domains. By enacting these evidence-based recommendations, we can enhance the ECF's translation from printed page to real-world outcomes, for the benefit of the profession, service delivery, and service users. [Abstract copyright: Copyright © 2025 The Authors. Published by Elsevier Ltd.. All rights reserved.]

Citation

Spencer, H., Williamson, K., Robertson, A., Anudjo, M., & Burton, C. (2025). The College of Radiographers' Education and Career Framework (fourth edition): Exploring the guideline implementation gap across England using Normalisation Process Theory. Radiography, 31(3), Article 102931. https://doi.org/10.1016/j.radi.2025.102931

• Journal Article Type: Article
• Acceptance Date: Mar 15, 2025
• Online Publication Date: Apr 16, 2025
• Publication Date: Apr 16, 2025
• Deposit Date: Apr 22, 2025
• Journal: Radiography
• Print ISSN: 1078-8174
• Publisher: Elsevier
• Peer Reviewed: Peer Reviewed
• Volume: 31
• Issue: 3
• Article Number: 102931
• DOI: https://doi.org/10.1016/j.radi.2025.102931
• Keywords: Recommendations, Implementation, Translational gap, Normalisation Process Theory, Diagnostic radiography, Education and Career Framework
• Public URL: https://keele-repository.worktribe.com/output/1197451
• Publisher URL: https://www.sciencedirect.com/science/article/pii/S1078817425000720?via%3Dihub
• Additional Information: This article is maintained by: Elsevier; Article Title: The College of Radiographers’ Education and Career Framework (fourth edition): Exploring the guideline implementation gap across England using Normalisation Process Theory; Journal Title: Radiography; CrossRef DOI link to publisher maintained version: https://doi.org/10.1016/j.radi.2025.102931; Content Type: article; Copyright: © 2025 The Authors. Published by Elsevier Ltd on behalf of The College of Radiographers.