Assessment and correlation between job satisfaction and burnout among radiographers

IntroductionPrevious research on job satisfaction (JS) and burnout has focused on physicians and nurses. However, limited work has evaluated radiographers’ JS and burnout, factors affecting them and the correlation between them. The aim of this study is to assess the level and specific factors affecting burnout and JS among radiographers and to examine the correlation between them.MethodsA questionnaire consisting of socio-demographic information and two validated instruments (Maslach Burnout Inventory-Human Services Survey for Medical Personnel (MBI-HSS (MP)) and JS Survey (JSS)) was distributed to radiographers. The MBI included 22 questions and JSS consisted of 36 questions. Mean scores were used to compare responses between participants according to demographic characteristics. Correlation between JS and burnout was examined using Pearson correlation test, with P < 0.05 determining statistical significance.Results308 radiographers returned a completed questionnaire, 48.4% of participants were male, 48.7% had 1–6 years of experience and 61.4% examined >25 patients per day. Total emotional exhaustion, depersonalization and personal accomplishment scores were 28.7, 11.3 and 35.8 respectively. Most participants felt dissatisfied with pay (n = 221, 71.8%), opportunities for promotion (n = 202, 65.6%), fringe benefits (n = 239, 77.6%), contingent rewards (n = 231, 75.0%), operating procedures (n = 190, 61.7%) and communication (n = 162, 52.6%). Burnout was associated with work experience and caseload and JS was associated with section of work. Most of the JS domains were significantly inversely related to emotional exhaustion and depersonalisation domains. Emotional exhaustion and depersonalization drew a significant positive correlation. Emotional exhaustion and depersonalization drew a significant positive correlation.ConclusionParticipating radiographers are mostly dissatisfied about their jobs and they suffer a high level of emotional exhaustion.Implications for practiceTo avoid the consequences of burnout and decreased JS on individuals and organizations, efforts should be done in alleviating the main factors affecting them.     

Burnout among Interventional Radiologists

PurposeTo characterize burnout, as defined by high emotional exhaustion (EE) or depersonalization (DP), among interventional radiologists using a validated assessment tool.Materials and MethodsAn anonymous 34-question survey was distributed to interventional radiologists. The survey consisted of demographic and practice environment questions and the 22-item Maslach Burnout Inventory–Human Services Survey (MBI). Interventional radiologists with high scores on EE (≥ 27) or DP (≥ 10) MBI subscales were considered to have a manifestation of career burnout.ResultsBeginning on January 7, 2019, 339 surveys were completed over 31 days. Of respondents, 263 (77.6%) identified as male, 75 (22.1%) identified as female, and 1 (0.3%) identified as trans-male. The respondents were interventional radiology attending physicians (298; 87.9%), fellows (20; 5.9%), and residents (21; 6.2%) practicing at academic (136; 40.1%), private (145; 42.8%), and hybrid (58; 17.1%) centers. Respondents worked < 40 hours (15; 4.4%), 40–60 hours (225; 66.4%), 60–80 hours (81; 23.9%), and > 80 hours (18; 5.3%) per week. Mean MBI scores for EE, DP, and personal achievement were 30.0 ± 13.0, 10.6 ± 6.9, and 39.6 ± 6.6. Burnout was present in 244 (71.9%) participants. Identifying as female (odds ratio 2.4; P = .009) and working > 80 hours per week (odds ratio 7.0; P = .030) were significantly associated with burnout.ConclusionsBurnout is prevalent among interventional radiologists. Identifying as female and working > 80 hours per week were strongly associated with burnout.     

To repeat or not to repeat: Radiologists demonstrated more decisiveness than their fellow radiographers in reducing the repeat rate during mobile chest radiography

IntroductionRadiologists and radiographers play a complementary role in providing an optimal image quality with decrease radiation dose and proper diagnosis during chest radiographs. We aim Investigate years of experience among radiologists and radiographers on perception of image quality and its impact on repeat rate when evaluating portable pediatric chest radiographs.MethodsIRB approved retrospective study consisted of randomly selected images (n = 131) of pediatric portable chest radiographs. Images were blindly assessed by four radiologists and four radiographers. Readers were asked to assess qualitative and quantitative image quality by rating: image quality, decision to repeat and image technique. All data was compared employing Pearson's Correlation, Visual grading characteristic (VGC) and Cohens' kappa analyses.ResultsImage quality: Radiologists (88.4%) rated images as excellent significantly more than radiographers (11.6%), and radiographers (90.1%) as poor significantly more than radiologists (9.9%) (p < 0.05). Repeat: Radiologists (57%) decided not to repeat images significantly more than radiographers (43%) (p < 0.05). Image technique: Radiologists rated images as acceptable (65%) and excellent (97.7%) significantly more than radiographers (35% and 2.3% respectively) (p < 0.05), whereas radiographers (84%) assessed image technique as poor significantly more than radiologists (16%) (p < 0.05). VGC: radiographers had slightly better qualitative evaluation of image quality than radiologists. An association between image quality (p < 0.002) and repeat decision (p < 0.044) with years of experience was established when comparing years of experience with image assessment rubric, while no association was noted with image technique (p < 0.9).ConclusionRadiologists demonstrated more decisiveness than their fellow radiographers in reducing the repeat rate of portable pediatric chest radiographs. Interestingly, years of experience only seem to affect image technique and image quality assessment among radiologists.Implications for practiceContinuous education of radiographers and close collaboration with radiologists is crucial to achieve optimal image quality and low radiation doses.     

Assessment of diagnostic radiographers’ knowledge of work-related health problems and associated effects: A multicentre study in Ghana

IntroductionWork-related health problems (WRHPs) are health conditions peculiar to a group of people or occupations including radiography in a specific work setting. These WRHPs occur as a result of prevailing work conditions which predispose workers to risks of physical or psychological distress.AimThis study assessed the knowledge of WRHPs among practicing radiographers in Ghana and evaluated the sources, causes, effects and preventive measures of WRHPs.MethodsA prospective cross-sectional design incorporating a quantitative data collection approach was used. A questionnaire was used to assess the knowledge and evaluate the effects of WRHPs among two cohorts of 31 practicing radiographers at a regional hospital (RH) and a teaching hospital (TH).ResultsAn average score of 4.2 (SD = 0.4) out of 5 (84.8%) obtained on the knowledge scale indicated very good knowledge of WRHPs among the radiographers. Physical work demands, ergonomic issues, increased workload and stress levels on on-duty radiographers due to sick absence by colleagues, large numbers of daily cases, and extra work without incentives were reported as WRHPs effects mostly experienced by the radiographers. The study also showed no significant difference between gender groups (p = 0.313), years of professional practice experience level (p = 0.319), and academic qualifications (p = 0.287) on knowledge of WRHPs.ConclusionRadiographers working in some referral and teaching hospitals in Ghana demonstrated very good knowledge of WRHPs and identified several effects of WRHPs on professional practice.Implication for practiceThe study concludes that WRHPs predispose radiographers to adverse health conditions, and administrative protocols are required to prevent or mitigate the burden.     

To keep or reject,that is the question - A survey on radiologists and radiographers’ assessments of plain radiography images

IntroductionThis study aimed to survey radiographers and radiologists' assessment of plain radiographs to identify the imaging clinicians’ differences in acceptance of image quality.MethodAn online, questionnaire was distributed among radiographers (n = 116) and radiologists (n = 76) in a hospital trust in Norway, including 30 clinical cases (one image and a short referral text) that were divided into 3 categories; keep, could keep and reject, based on European guidelines. When rejecting, the respondents identified the main reason by ticking a list (positioning, collimation, centering, artifact or exposure error). Group differences were explored using 2-tailed chi-squared test. Inter-subjectivity was measured using Cohen's kappa for multi-rater sample.ResultsIn total, 36% of the radiographers (n = 42) and 14% of the radiologists (n = 14) responded to the survey. Total response rate was 30% (56/192). Analysis showed significant difference between radiographers and radiologists in the categories of Reject (χ² = 6.3, df = 1, p = 0.01), and Could keep (χ² = 6.3, df = 1, p = 0.01), identifying radiologists as keeping more images compared to radiographers. Agreement among radiographers (Cohen's κ: 0,39; 95% CI: 0.30–0.48; p < 0.001) and radiologists (Cohen's κ: 0,23; 95% CI: 0.09–0.37; p < 0.001) respectively, is fair. The most common reason for rejecting an image is suboptimal positioning. Suboptimal collimation constituted 15% of the rejected images among radiographers, compared to 5% among radiologists. Centering, artifacts and exposure error showed quite similar rates as reasons for rejection.ConclusionRadiographers and radiologists seem to agree on the assessment of good quality images, however, radiographers seem more reluctant to accept images of lower quality than radiologists.Implications for practiceFurther research on reasons for differences in image quality assessment between radiographers and radiologists is needed. This could enable reduction in reject rates and increase image quality in conventional X-ray examinations.     

Collaboration between radiological technologists (radiographers) and junior doctors during image interpretation improves the accuracy of diagnostic decisions

Rationale and ObjectivesIn Emergency Departments (ED) junior doctors regularly make diagnostic decisions based on radiographic images. This study investigates whether collaboration between junior doctors and radiographers impacts on diagnostic accuracy.Materials and MethodsResearch was carried out in the ED of a university teaching hospital and included 10 pairs of participants. Radiographers and junior doctors were shown 42 wrist radiographs and 40 CT Brains and were asked for their level of confidence of the presence or absence of distal radius fractures or fresh intracranial bleeds respectively using ViewDEX software, first working alone and then in pairs. Receiver Operating Characteristic was used to analyze performance. Results were compared using one-way analysis of variance.ResultsThe results showed statistically significant improvements in the Area Under the Curve (AUC) of the junior doctors when working with the radiographers for both sets of images (wrist and CT) treated as random readers and cases (p ≤ 0.008 and p ≤ 0.0026 respectively). While the radiographers’ results saw no significant changes, their mean Az values did show an increasing trend when working in collaboration.ConclusionImprovement in performance of junior doctors following collaboration strongly suggests changes in the potential to improve accuracy of patient diagnosis and therefore patient care. Further training for junior doctors in the interpretation of diagnostic images should also be considered. Decision making of junior doctors was positively impacted on after introducing the opinion of a radiographer. Collaboration exceeds the sum of the parts; the two professions are better together.     

Accuracy of appendicular radiographic image interpretation by radiographers and junior doctors in Ghana: Can this be improved by training?

IntroductionAccess to image interpretation in Ghana remains a challenge with the limited number of radiologists. Radiographers with the right skills and knowledge in image interpretation could help address this challenge. The aims of the study were to determine and compare the ability (accuracy, sensitivity and specificity) of radiographers and junior doctors in interpreting appendicular trauma radiographs both before and after training.MethodsAn action research study involving a pre and post training test was carried out to determine the level of accuracy, sensitivity and specificity in abnormality detection by radiographers after undergoing training when compared to junior doctors. Eight radiographers and twelve junior doctors were invited to interpret an image bank of 30 skeletal radiographs, both before and upon completion of an educational program. The participants’ tests were scored against a reference standard provided by an experienced radiologist. Pre and post-test analysis were carried out for comparison.ResultsPost training mean accuracy (radiographers 83.3% vs 68.8%, p = 0.017; doctors 81.9% vs 71.6%, p = 0.003), sensitivity (radiographers 83.3% vs 69.2%, p = 0.042; doctors 77.2% vs 67.8% p = 0.025) and specificity (radiographers 83.3% vs 68.3%, p = 0.011; doctors 86.7% vs 75.6% p = 0.005) of both groups significantly improved. No significant differences were recorded between the radiographers and doctors after the training event.ConclusionThe study revealed that, with a well-structured training program, radiographers and junior doctors could improve on their accuracies in radiographic abnormality detection and commenting on trauma radiographs.     

A pilot image interpretation teaching intervention to improve competence and confidence of radiographers to detect left ventricular thrombus in routine cardiac MRI scans

IntroductionPrompt diagnosis of left ventricular (LV) thrombus is clinically important, as it may require immediate anti-coagulation treatment. The aim of this study was to determine if a teaching intervention delivered by cardiovascular magnetic resonance (CMR) physicians would increase the CMR radiographers’ ability to detect LV thrombus on a routine CMR scan.MethodsA cohort of 25 patients (14 with and 11 without LV thrombus) were identified. A multi-parametric CMR protocol had been performed in all patients. Ten radiographers reviewed the 25 randomised anonymised studies on a workstation, documenting the presence/absence of LV thrombus and their confidence level on a 7-point Likert scale. Two senior CMR fellows then delivered a focused teaching programme to the radiographers and all 25 randomised scans were reassessed 1 month after the teaching intervention.ResultsFollowing dedicated training, there was a significant improvement in correct thrombus identification per radiographer (pre-training: 75 ± 6% vs post-training: 85 ± 6%, p = 0.009). The size of the thrombus was not associated with the likelihood of incorrectly identifying LV thrombus size prior to the training session (p = 0.2), but a trend was observed between smaller thrombus size and incorrect identifications post-training (p = 0.06). The radiographers’ overall confidence in assessing the cases prior to the teaching session was high (5.6 ± 0.8 out of 7). Following the teaching session, self-reported confidence did not vary significantly (5.9 ± 0.7 out of 7, p = 0.42).When evaluating the teaching session, radiographers provided very positive feedback, rating the usefulness of the teaching intervention as highly educative (8.8 ± 0.4 out of 10).ConclusionsThis is the first study that has explored the ability and confidence of CMR radiographers in detecting LV thrombus on routine CMR scans as a result of the teaching intervention delivered by CMR physicians.Implications for practiceA teaching intervention can improve CMR radiographers’ diagnostic skills and diagnostic confidence.     

Occupational burnout among radiation therapists in Australia: Findings from a mixed methods study

IntroductionEvidence demonstrates that health care professionals in the palliative care context are more burned out than other health professionals. The aims of this study were to examine: (1) occupational burnout levels among radiation therapists in Australia, (2) association between demographic factors on burnout and (3) radiation therapists' perceptions of burnout.MethodsA cross-sectional online survey including the Maslach Burnout Inventory was administered to Radiation Therapists in Australia. Data were analysed using SPSS Ver 20 and open ended comments were analysed thematically using Nvivo 10.ResultsA total of 200 radiation therapists participated in the survey. RTs had a high mean (±SD) burnout score for emotional exhaustion (38.5 ± 8.2), depersonalisation (17.5 ± 4.7) and personal achievement (30.5.3 ± 4.3) compared to RTs and health workers in other studies. High levels of emotional exhaustion, depersonalisation and low levels of personal achievement were present in 93% (186/200), 87% (174/200) and 61% (122/200) of participants respectively. RTs identified high workload and staff shortages, interpersonal conflict and technology as key sources of stress in the RT work environment.ConclusionAustralian RTs' level of burnout on all three stages of burnout exceed previously reported burnout levels for similar cohorts both locally and internationally. It is important that future interventions aimed at minimising or preventing stressors are identified and implemented in the radiation therapy work environment.     

An evaluation of techniques used in superficial radiotherapy for non-melanoma skin cancer to replicate the planned treatment area: A prospective study

IntroductionAccuracy of superficial radiotherapy for non-melanoma skin cancer is dependent on replicating the original clinical mark-up. Responses from 18 UK Radiotherapy centres identified the four most common replication techniques; the accuracy and time-efficiency of each was evaluated, as well as participant preference and confidence.MethodsA 2.0  cm × 2.5  cm ellipse field was drawn around the nasal ala of a surrogate patient. Templates for each replication method (1–4) were created, and skin marks removed. Twenty-five therapeutic radiographers used each method to replicate the mark-up. Measurements were recorded for lateral and longitudinal displacement, ellipse diameter and time taken. A post-study questionnaire recorded participant preference and perceived confidence.ResultsComparison of the mean ellipse areas for methods 1–4 identified no statistically significant differences (ANOVA test; p = 0.579 to p = 0.999). Lateral and longitudinal displacements for method 1–4 showed a statistically significant difference between method 3 and each of methods 1, 2, 4 for lateral and longitudinal respectively (ANOVA; lateral: p = 0.008, p = 0.002, p = 0.05; longitudinal: p = 0.036, p = 0.000, and p = 0.000). Mean time taken was longest for method 3, and was compared using a Friedman test (p = 0.000) identifying a statistically significant difference. Twenty-two participants completed the questionnaire. 48% favoured method 2, 41% method 4. Method 3 was least favourite. A Likert scale (1–10) measured confidence. Participants had most confidence in methods 2 and 4.ConclusionIn this study, method 3 was least accurate, most time consuming, and was least favoured by users. The clinical significance of these results will depend on the margins used in local practise.     

Radiographers’ knowledge and attitudes toward dementia

IntroductionDementia is a syndrome associated with a decline in brain function, impacting how we speak, think, feel, and behave. Misunderstanding of dementia and how it affects patients and their carers is common. There is limited research on how radiographers provide adequate care to those with dementia. Radiographers with knowledge and positive attitudes can reduce stigma and fear, improving the quality of care. This study aimed to assess radiographers’ knowledge and attitudes towards dementia.MethodsA cohort of registered radiographers in Ireland participated in an online survey. Two pre-existing validated questionnaires: The Alzheimer's Disease Knowledge Scale (ADKS) and the Dementia Attitudes Scale (DAS), assessed radiographers' knowledge and attitudes towards dementia and people with dementia. Scores were compared across variables such as gender, age, grade, qualification, work setting, and the number of years qualified.ResultsA total of 123 radiographers responded. Knowledge scores did not significantly differ across demographic groups (p > 0.05). Total knowledge scores ranged from 60% to 100%. Total attitude scores ranged from 50% to 100%. Participants with a BSc, MSc, and other post-graduate degrees scored higher on the attitude scale than those with a diploma qualification (p = 0.027). Those with less than 20 years’ experience scored higher than those with more. Knowledge had little correlation with attitude (r = 0.0522; p = 0.5667).ConclusionFindings indicate variations in attitudes linked to age and experience, and some misconceptions can be observed across varying groups. Interventions to improve attitudes and raise awareness are needed.Implications for practiceThere is a need for further research and education on dementia care in the imaging department. We have identified areas requiring further education.     

Clinical audit and research in radiography practice: An exploration of the English landscape

BackgroundResearch and clinical audit are central to the quality improvement (QI) process in healthcare; whereas research produces new knowledge, clinical audit establishes if practice is meeting set standards. Thus, radiographers have responsibility to engaging in these QI activities. This study aimed to explore radiographers’ understanding, attitudes and level of involvement in clinical research and audit across England.MethodsA cross-sectional survey using an online questionnaire for data collection over a 6-week period was employed. The questionnaire consisted of open and closed ended questions. Participants were recruited through social media. The quantitative data obtained was analysed using Statistical Package for Social Sciences (SPSS) Version 26 (IBM Inc, Armonk, NY) whilst content analysis was used to analyse the free-response data.ResultsA total of 100 valid responses were obtained after exclusion of 45 partial and/or incomplete responses. Radiographers showed a positive attitude towards involvement in research and audit with overall mean score of 3.85 (SD 0.80) and 4.01 (SD 0.80), respectively. Of the respondents, 35.7% (n = 35/98) were currently involved in clinical audit projects whilst 78.6% (n = 77/98) have previously been involved. Radiographers with postgraduate degrees were significantly more likely to have initiated research, 61.5% (n = 16/26) (p = 0.01) and to have previously been involved with research, 80.8% (n = 21/26) (p = 0.02). A significant association between radiographers' role and implementation of changes, following an audit (p = 0.03) was noted. Similarly, a significant association was noted between radiographers’ role and initiation of research (p = 0.05).ConclusionClinical radiographers in England showed a positive attitude towards research and audit. However, this did not translate into actual participation in research and audit activities.Implications for practiceThe need to stimulate clinical radiographers’ interest in clinical audit and research is highlighted. Additionally, the findings support the rationale for managers to give more support including protected time to radiographers to engage in QI activities.     

The impact of focused training on abnormality detection and provision of accurate preliminary clinical evaluation in newly qualified radiographers

IntroductionPreliminary clinical evaluation (PCE) can be a useful initial assessment of traumatic abnormalities by frontline radiographers; new graduates are expected to have the skills and knowledge required to provide this initial interpretation. This study evaluates the abnormality detection performance and accuracy of PCE commenting in newly qualified radiographers.MethodFour newly qualified radiographers completed a fracture/dislocation detection task consisting of 58 cases, including providing a PCE for each suspicious area. Following this, an 8-week training program was completed to improve competence in recognizing abnormalities and providing an accurate PCE. Equally weighted jackknife alternative free-response receiver operating characteristic (wJAFROC) analysis was performed; a difference between pre- and post-training would be considered significant at a test alpha of less than 0.05.ResultsFracture/dislocation detection was significantly better in the post-training evaluation for fixed observers and random cases (F (1,57) = 4.48, p = 0.0387). The reader averaged wJAFROC FOM and 95% CIs for pre- and post-training were 0.619 (0.516, 0.737) and 0.703 (0.622, 0.852). A paired t-test demonstrated a significant difference in PCE scores in favour of the post-training evaluation p = 0.0006. This small cohort demonstrated difficulty in recognising undisplaced fractures and buckle fractures.ConclusionAn 8-week training program had a positive impact on participants' ability to localise and accurately describe fractures. Implementation of abnormality detection training should be considered during preceptorship periods. Due to the small sample size, it is inappropriate to suggest these findings are representative of all graduate radiographers.     

Design and evaluation of learning strategies for a group of radiographers in radiostereometric analysis (RSA)

IntroductionThe purpose of this study was to design and evaluate a radiostereometric analysis (RSA) program aimed at radiographers in order to increase their cognitive and practical skills, thereby increasing image quality and minimizing exposure repetition.Methods and materialsTwenty radiographers were randomized into two identically sized study groups. Training consisted of a theoretical and practical workshop using a phantom. Tests were performed to compare the effect of training to nontraining, and the effect of time duration on the maintenance of RSA skills. The effect of training was measured by a written test and three defined parameters influencing image quality.ResultsGroup A reduced significantly (p < 0.001) by 31.3 mm (21–31%) the distance between the centrum of the prosthesis (CP) and the centrum of the calibration field (CCF) and increased the number of beads (NB) visible by 3.6 (out of 18). A further significant reduction of 5.1 mm (p = 0.023), 1.0 bead more (p < 0.001) and a 2.1 (p = 0.022) point better rotation of the prosthesis (RP) was registered two months later. Group B was tested twice without training and no significant improvement was registered. One month after training group B had experienced overall significant improvement on a par with group A.ConclusionIt is realistic to implement an RSA X-ray training program where radiographers significantly improve their theoretical and practical skills in centering the CP closer to the CCF, NB and RP. A duration of up to two months after training does not influence the quality of participants' performance.     

Agreement between expert thoracic radiologists and the chest radiograph reports provided by consultant radiologists and reporting radiographers in clinical practice: Review of a single clinical site

IntroductionTo compare the clinical chest radiograph (CXR) reports provided by consultant radiologists and reporting radiographers with expert thoracic radiologists.MethodsAdult CXRs (n = 193) from a single site were included; 83% randomly selected from CXRs performed over one year, and 17% selected from the discrepancy meeting. Chest radiographs were independently interpreted by two expert thoracic radiologists (CTR1/2).Clinical history, previous and follow-up imaging was available, but not the original clinical report. Two arbiters compared expert and clinical reports independently. Kappa (Ƙ), Chi Square (χ²) and McNemar tests were performed to determine inter-observer agreement.ResultsCTR1 interpreted 187 (97%) and CTR2 186 (96%) CXRs, with 180 CXRs interpreted by both experts. Radiologists and radiographers provided 93 and 87 of the original clinical reports respectively. Consensus between both expert thoracic radiologists and the radiographer clinical report was 70 (CTR1; Ƙ = 0.59) and 70 (CTR2; Ƙ = 0.62), and comparable to agreement between expert thoracic radiologists and the radiologist clinical report (CTR1 = 76, Ƙ = 0.60; CTR2 = 75, Ƙ = 0.62). Expert thoracic radiologists agreed in 131 cases (Ƙ = 0.48). There was no difference in agreement between either expert thoracic radiologist, when the clinical report was provided by radiographers or radiologists (CTR1 χ = 0.056, p = 0.813; CTR2 χ = 0.014, p = 0.906), or when stratified by inter-expert agreement; radiographer McNemar p = 0.629 and radiologist p = 0.701.ConclusionEven when weighted with chest radiographs reviewed at discrepancy meetings, content of CXR reports from trained radiographers were indistinguishable from content of reports issued by radiologists and expert thoracic radiologists.     

Establishment of image quality for MRI of the knee joint using a list of anatomical criteria

IntroductionThe Commission of the European Communities published image quality criteria for imaging modalities. However, none were established for magnetic resonance imaging (MRI). Such criteria are warranted due to the complexity and health and safety risks associated with MRI. The purpose of this study was to establish image quality criteria for MRI examinations of the knee, providing harmonisation of image quality, improving practice and reducing risks.MethodsImage quality criteria were established following a literature review and validation by experts. The evaluation of the quality of randomly selected MR images (n = 10) with normal findings was performed by Maltese radiographers working at a local MRI institution. The visualisation of the developed anatomical criteria was performed by rating the visibility of each criterion using visual grading analysis.ResultsResults of the Friedman and Binomial tests on image quality rating scores, highlighted those anatomical criteria for each scan plane which scored significantly lower (p ≤ 0.05) than the threshold score of 3. This score was identified as the score below which anatomical structures would not be sufficiently visualised to enable adequate diagnosis.ConclusionA set of image quality anatomical criteria have been successfully developed to provide image quality standards enabling the visualisation of the complex anatomical structures of the knee joint. This concept can be applied to other MRI examinations.     

Concordance between a neuroradiologist,a consultant radiologist and trained reporting radiographers interpreting MRI head examinations: An empirical study

IntroductionThis study assessed agreement between MRI reporting radiographers and a consultant radiologist compared with an index neuroradiologist when reporting MRI head (brain/internal auditory meati [IAMs]) examinations. The effect on patient management of any discordant reports was also examined.MethodsTwo trained MRI reporting radiographers (RRs), a consultant radiologist (CR) and an index neuroradiologist (INR) reported on a random sample of 210 MRI examinations. The radiographers reported during clinical practice and the radiologists in clinical practice conditions. Two independent consultant physicians (neuro-rehabilitation and neuropsychiatry) compared these reports with the index neuroradiologist report for agreement and the clinical importance of discrepant reports.ResultsOverall observer agreement between the RRs and CR was comparable in relation to agreement with the INR: RR; 93/210 (44.3%); and the CR; 83/210 (39.4%) for all head MRI examinations (p = 0.32). For brain examinations the difference was similar: RR; 64/180 (35.6%); and CR; 54/190 (30.0%), p = 0.26. Agreement rates for the IAMs examinations were identical, 29/30 (97.7%).For all head MRI examinations (n = 210) there was a very small observed difference of <0.5% in mean agreement between the reporting radiographers and the consultant radiologist (p = 0.92) for examinations where a major disagreement would have been likely to have led to a change in patient management.ConclusionMRI reporting radiographers reported during clinical practice on MRI head examinations to a level of agreement comparable with a consultant radiologist.Implications for practiceThis is an area in which radiographers could provide additional reporting roles to the reporting service to increase capacity. Wider potential benefits include cost-effectiveness and role development/retention of radiographers.     

Evidence-based radiography: A new methodology or the systematisation of an old practice?

IntroductionEvidence based radiography (EBR) is the logical development of evidence based practice applied to radiography. The aim of this study was to investigate the opinion of a cohort of Portuguese radiographers in Southern Portugal working in public hospitals regarding evidence based practice (EBP), namely about the levels of knowledge about EBR, how they access information and how they use it within daily practice.MethodsA self-administered questionnaire was applied to a sample of 40 radiographers in the Portuguese region of Algarve. This questionnaire was validated for Portuguese speakers using the translation-retranslation method.ResultsThe final response rate was 69% (40/58). Results suggest that most radiographers trained EBR during their undergraduate training. Although, no statistically significant correlations were found in the practice of EBR against participant gender, age, training, career level, reading papers and workplace. The most frequent reason to read papers is the “interest” to do so, and national professional journals are read more often. It was found that radiographers that read scientific papers more frequently know more about research (p = 0.005), understand the importance of research for the professional activity (p = 0.023), and know more on how to conduct research papers (p = 0.034).ConclusionEBR within radiography is not yet well established, and radiographers' have varying viewpoints. Radiographers that read scientific papers more frequently understand better the philosophy behind this concept but it is very important to deepen the knowledge on this area.Implications for practiceWhen practicing radiography based on the best available scientific knowledge, professionals are ensuring the best for patients and for profession. To achieve this, and before taking any action, it is important to evaluate the current situation, and this research presents a way to do so.