Regulation of diagnostic radiography education and clinical practice: A comparative document analysis of Sub-Saharan Africa and international guidelines.

Abstract

Objectives: This integrative document analysis examines statutory and regulatory scopes of practice and educational requirements that inform diagnostic radiographer registration in Sub-Saharan Africa, concisely comparing global standards. A methodical literature synthesis employed a modified Donabedian model and identified key themes concerning regulatory structures and processes influencing radiography education and practice. Key findings: Seventy-six documents from Africa (n = 51, 67.1 %), Australia (n = 9, 11.8 %), North America (n = 8, 10.5 %) and Europe (n = 8, 10.5 %) were examined. Considerable global regulatory variability exists in the scope of practice regarding autonomy levels and practice areas for diagnostic radiographers. The depth and complexity of local training influence these variations. Some regulatory bodies (Namibia, South Africa, the UK and Canada) require pre-registration diagnostic radiographers to be proficient in projection radiography, CT and MRI, with stricter ultrasound and nuclear medicine restrictions. In contrast, other frameworks (Zambia, Zimbabwe, Kenya, Nigeria, Ethiopia, Rwanda, and Australia) allow a broader scope of practice. In the USA, regulations require single-modality training with additional educational requirements for multi-modality registration. The study further identified emerging attributes related to entry-level diagnostic radiographer competency profiles in regulatory documents. Conclusion: The identified variabilities highlight the need for reformation and standardisation in the international scope of practice policies. This reform should integrate emerging and threshold skills in competency profiles. These changes are crucial for adapting radiography education and practice to meet evolving healthcare demands. Additionally, this will enhance workforce mobility and improve the quality of patient care. Implications for practice: Regulatory bodies should champion current scope of practice reforms with key stakeholders to enhance global radiography workforce mobility and explore new regulatory models supporting graduates' transition into the workplace.