Student radiographers’ role ideals and role realities: Exploring the technical-interpersonal imbalance across two cohorts

INTRODUCTION: Student radiographers are routinely asked to balance technical imaging competencies with psychosocial patient care, yet evidence suggests technical priorities continue to dominate practice. This study explores whether this imbalance persists at foundational educational levels and examines how students justify their role reality. METHODS: Qualitative study using reflexive thematic analysis. Two cohorts of diagnostic radiography students from a single UK HEI participated in semi-structured focus groups. Data collection phases were 12 years apart, enabling comparison before and after the Francis inquiry. Analysis examined role ideals, role reality, and influences shaping practice patterns. RESULTS: The two cohorts demonstrated near-identical professional socialisation patterns despite a 12-year interval. Participants described balanced role ideals, but their role realities increasingly prioritised technical outputs as they accumulated placement experience. Contributing factors are separated into extrinsic themes (workplace culture, throughput pressures, visibility of technical work) and intrinsic themes (practitioner confidence, personality attributions, patient characteristics). Interpersonal skills ultimately became vehicles for achieving technical objectives, rather than valued skills in themselves. CONCLUSIONS: Embedded professional socialisation patterns overrode curriculum reforms emphasising compassionate care. Workplace cultures rewarded technical metrics while relegating patient care to subsidiary labour. This produced an identity paradox where students (particularly in Cohort 2) expertly articulated patient-centred ideals whilst adopting technically-focused practice; in short, the Francis inquiry influenced professional vocabularies but failed to restructure organisational reward systems. IMPLICATIONS FOR PRACTICE: Sustainable practice change requires alignment between educational values and workplace cultures. Organisational restructuring of competence assessment/reward is essential if curriculum changes are to have impact.