Journal of medical imaging and radiation sciences · 2026
Role expansion of radiological technologists in intraoperative fluoroscopy in Japan: A simulation-based social network analysis of interprofessional collaborative structure.
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Katagiri Kunihiko
Аннотация
INTRODUCTION: Following the 2021 revision of the Medical Radiological Technologists Act in Japan, radiological technologists (RTs) have assumed expanded responsibilities in intraoperative fluoroscopy, including greater participation in imaging support and procedural workflows. Although role expansion has been widely implemented, quantitative evidence regarding its impact on interprofessional collaborative structure within the operating theatre remains limited. This study aimed to evaluate how expanded RT involvement influences team integration and network structure.
METHODS: A simulation-based comparative social network analysis was conducted to examine structural changes rather than causal clinical effects. The analysis included 59 anonymized surgical cases from a tertiary acute-care hospital in Japan. Pre- and post-expansion networks were constructed as weighted, undirected graphs, with healthcare professional groups represented as nodes and shared working time (minutes) represented as weighted edges. Degree, closeness, and betweenness centrality measures, together with network density, were calculated. The post-expansion model incorporated an additional 30 min of intraoperative RT involvement per procedure, based on observations of institutional workflow.
RESULTS: RT degree centrality increased markedly from 2.6 to 37.0, indicating substantially greater direct connectivity with other healthcare professionals. Closeness centrality increased slightly from 0.481 to 0.486, suggesting improved network accessibility. Betweenness centrality remained relatively stable (1139 to 1146), indicating preservation of existing coordination pathways despite increased RT involvement. Network density increased from 0.21 to 0.34, reflecting enhanced overall interprofessional integration.
CONCLUSION: Expansion of RT responsibilities in intraoperative fluoroscopy was associated with improved structural integration within the interprofessional network while maintaining established coordination mechanisms. These findings suggest that RTs can become more centrally embedded within intraoperative teams without disrupting existing collaborative structures. As this study was based on structural modelling, the findings should be interpreted as evidence of potential network reconfiguration rather than direct causal effects on clinical performance or patient outcomes.
PLAIN LANGUAGE SUMMARY: Radiological technologists are increasingly taking on more responsibility during surgery to support imaging and teamwork. This study used a simulated model of surgical teams to compare how team connections changed before and after technologists took on expanded roles. This study found that technologists became more connected and involved within the team, improving overall collaboration without disrupting existing working relationships. This matters because better teamwork in the operating room can support smoother procedures and safer patient care.
METHODS: A simulation-based comparative social network analysis was conducted to examine structural changes rather than causal clinical effects. The analysis included 59 anonymized surgical cases from a tertiary acute-care hospital in Japan. Pre- and post-expansion networks were constructed as weighted, undirected graphs, with healthcare professional groups represented as nodes and shared working time (minutes) represented as weighted edges. Degree, closeness, and betweenness centrality measures, together with network density, were calculated. The post-expansion model incorporated an additional 30 min of intraoperative RT involvement per procedure, based on observations of institutional workflow.
RESULTS: RT degree centrality increased markedly from 2.6 to 37.0, indicating substantially greater direct connectivity with other healthcare professionals. Closeness centrality increased slightly from 0.481 to 0.486, suggesting improved network accessibility. Betweenness centrality remained relatively stable (1139 to 1146), indicating preservation of existing coordination pathways despite increased RT involvement. Network density increased from 0.21 to 0.34, reflecting enhanced overall interprofessional integration.
CONCLUSION: Expansion of RT responsibilities in intraoperative fluoroscopy was associated with improved structural integration within the interprofessional network while maintaining established coordination mechanisms. These findings suggest that RTs can become more centrally embedded within intraoperative teams without disrupting existing collaborative structures. As this study was based on structural modelling, the findings should be interpreted as evidence of potential network reconfiguration rather than direct causal effects on clinical performance or patient outcomes.
PLAIN LANGUAGE SUMMARY: Radiological technologists are increasingly taking on more responsibility during surgery to support imaging and teamwork. This study used a simulated model of surgical teams to compare how team connections changed before and after technologists took on expanded roles. This study found that technologists became more connected and involved within the team, improving overall collaboration without disrupting existing working relationships. This matters because better teamwork in the operating room can support smoother procedures and safer patient care.