Abstract
Introduction Chest X-rays are the most frequently requested X-ray imaging in English hospitals. This study aimed to assess final year UK radiography student’s confidence and ability in image interpretation of chest X-rays.
 Methods Thirty-three diagnostic radiography students were invited to assess their confidence and ability in interpreting chest x-rays from a bank of n=10 cases using multiple choice answers. Data analysis included 2x2 contingency tables, Kappa for inter-rater reliability, a Likert scale of confidence for each case, and questions to assess individual interpretation skills and ways to increase the learning of the subject.
 Results Twenty-three students participated in the study. The pooled accuracy achieved was 61% (95% CI 38.4-77.7; k=0.22). The degree of confidence and ability varied depending upon the student and the conditions observed. High confidence was noted with COVID-19 (n=12/23; 52%), lung metastasis (n=14/23; 61%), and pneumothorax (n=13/23; 57%). Low confidence was noted with conditions of consolidation (n=8/23; 35%), haemothorax (n=8/23; 35%), and surgical emphysema (n=8/23; 35%). From the sample n=11 (48%), participants stated they felt they had the knowledge to interpret chest X-rays required for a newly qualified radiographer.
 Conclusion The results demonstrated final year radiography student’s confidence and ability in image interpretation of chest X-rays. Student feedback indicated a preference for learning support through university lectures, online study resources, and time spent with reporting radiographers on clinical practice to improve ability and confidence in interpreting chest X-rays.
Highlights
Chest X-rays are the most frequently requested X-ray imaging in English hospitals
The participants' answers for the ten chest X-ray cases were assessed against true positives (TP), true negatives (TN), false positives (FP), FP categories of each of the four multiple choices and provided a breakdown of participants' judgments for each case
The responses for the n=23 participants calculated a pooled accuracy of 61.3% with a 95% confidence interval (95%CI) of 38.4 - 77.7 to observe the range of data, of which a wide variance can be observed from the participants in table 3
Summary
Chest X-rays are the most frequently requested X-ray imaging in English hospitals. This study aimed to assess final year UK radiography student’s confidence and ability in image interpretation of chest X-rays. The chest X-ray is the most frequently requested examination in X-ray imaging within England [1], with 192,000 patients being referred from general practitioners alone [2]. The interpretation of chest X-rays is deemed the most challenging as practitioners must understand the techniques used to obtain the X-ray, assess the image quality, and interpret the basic anatomy within the thoracic cavity [4]. The United Kingdom (UK) Society of Radiographers [5] advise that all UK qualified diagnostic radiographers must have the skills to perform an initial interpretation of their images under the preliminary clinical evaluation (PCE) policy to assist identification of patients with acute abnormalities [6]. The UK Health and Care Professions Council [8] recommends that all pre-registration students complete sufficient training in image interpretation to be able to practice adequately
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