Radiographers Research Articles

Pilot Study on Using Large Language Models for Educational Resource Development in Japanese Radiological Technologist Exams

Pilot Study on Using Large Language Models for Educational Resource Development in Japanese Radiological Technologist Exams

Influence of obtaining medical records and laboratory data on the sensitivity of diagnostic imaging assessment by radiological technologists.

The purpose of this study is to clarify the influence of acquiring medical record information and laboratory data on the sensitivity of detecting imaging findings among Japanese radiological technologists (RTs). RTs were presented with patient'sinformation in three distinct sequences for detecting imaging findings. True positives (TP) were identified and categorized into three groups: Group 1 (image + chief complaint), Group 2 (image + chief complaint + medical record), and Group 3 (image + chief complaint + medical record + laboratory data). Compared with Group 1, Groups 2 and 3 exhibited up to 8.3% and 16.7% higher sensitivity, respectively. Notably, Group 3 demonstrated up to 13.3% higher sensitivity than that of Group 2. Obtaining medical record information and laboratory data improved the sensitivity of imaging findings detected by RTs. This study provides valuable insights for optimizing diagnostic protocols and improving patient outcomes by leveraging supplementary clinical data to augment diagnostic accuracy.

Development of an image quality evaluation system for bedside chest X-ray images using scatter correction processing.

In plain radiography, scattered X-ray correction processing (Virtual Grid: VG) is used to estimate and correct scattered rays in images. We developed an objective evaluation system for bedside chest X-ray images using VG and investigated its usefulness. First, we trained the blind/referenceless image spatial quality evaluator (BRISQUE) on 200 images obtained by portable chest radiography. We then evaluated optimal chest phantom VG images as well as those that deviated from the VG setting conditions using BRISQUE. Furthermore, we conducted a subjective evaluation using the mean opinion score (MOS) and established an objective evaluation system for VG images. Finally, the degree of agreement between the MOS subjectively evaluated by 14 radiological technologists and that determined by the objective evaluation system for 100 clinical images obtained by portable chest radiography was calculated using Cohen's kappa coefficient. The correlation coefficient between the BRISQUE score and MOS for chest phantom images was - 0.96 (p < 0.05). The two scores showed a very high linear correlation, indicating the potential of the BRISQUE score as an alternative to MOS. The Cohen's kappa coefficient for the objective evaluation system using the optimal conversion table was 0.42. Conversely, there was a very high detection rate of 82.86% for poor-quality images. An objective evaluation system for bedside chest X-ray images using VG that uses no-reference image quality evaluation helps provide proper image quality. Furthermore, such a system can be constructed with a small amount of training data, which increases the possibility of introducing it to a variety of facilities.

Radiology Technologists certified as Radioprotection Supervisors in Nuclear Medicine: current scenario

The presence of a radiological protection supervisor is mandatory in the staff of a nuclear medicine service according to the CNEN-NN-3.05 standard. To obtain the certification of qualification as a radiological protection supervisor, it is necessary, in addition to taking the general and specific tests, to graduate from a higher education course recognized by the Ministry of Education in the areas specified by legislation. This study analyzed the number of professionals trained in radiology technology certified as supervisors of radiological protection in nuclear medicine in Brazil. For this analysis, only the list available on the regulatory agency's website up to the date of preparation of this study was considered. Of the 326 professionals found, only 2.76% have academic training in radiology technology, while physicists and physicians together represent more than half of the radiological protection supervisors (65.65%). These results show that, although the field of radiological sciences and the Radiology Technology course, specifically the one offered by the Federal University of Minas Gerais, allow students to complete their undergraduate studies able to enter this job market and act as radiological protection supervisors, there is a lower number of these professionals' certificates in this field. The study provided a parameter on the state of the art of higher education in Radiologic Technology and the insertion and interest of these professionals in certification when compared to other fields of study.

Prevalence and factors associated with workplace violence against diagnostic radiographers in Ghana: A nationwide cross-sectional study.

Workplace violence is associated with anxiety, depression, job dissatisfaction, burnout, absenteeism, staff replacement costs and productivity loss. However, no study has investigated the issue of workplace violence against diagnostic radiographers in Ghana. The aim of this study was to determine the prevalence and factors associated with workplace violence against diagnostic radiographers in Ghana. An anonymous, online, nationwide cross-sectional study was conducted from 31st January to 22nd July 2024. The survey contained questions on socio-demographic characteristics, physical violence, verbal abuse, bullying/mobbing, sexual harassment and cultural/ethnic harassment. Binomial and multivariate logistic regression analysis was performed to predict the factors associated with workplace violence. A p-value of less than 0.05 was considered statistically significant. A total of 209 diagnostic radiographers responded to the online survey. In total, 26.3% (n=55/209) of the respondents were within the age group 25-29 years, and 53.6% (n=112/209) were males. The 12-month prevalence of workplace violence among the respondents was 93.8% ([95% CI: 89.6-96.6]; p<0.001). The most prevalent forms of workplace violence were verbal abuse (n=175/209, 83.7%), physical violence (n=110/209, 52.6%) and cultural/ethnic threat (n=93/209, 44.5 %). Factors significantly linked to experiencing any form of workplace violence in both unadjusted and adjusted models were level of education and being worried about violence. Workplace violence is common among diagnostic radiographers in Ghana and victims hardly report the incident to the relevant authorities. It is recommended that future research use a qualitative approach to gain a comprehensive understanding of the factors that facilitate or hinder the reporting of workplace violence among diagnostic radiographers. Investigating workplace violence could help design and implement multifaceted interventions to ensure safe and healthy working environments for healthcare professionals, including diagnostic and therapeutic radiographers in Ghana.

The scope of practice for diagnostic radiographers in Singapore: A preliminary survey

IntroductionThere has been an increased demand for medical imaging procedures through the years. This demand requires the diagnostic radiographers in the workforce to be equipped with adequate training and understanding of their roles. The aims of this research are to distill and further describe the current scope of practice as established by the Allied Health Professional Council and map the diffusion of tasks, roles and responsibilities within Singapore’s radiography imaging modalities. MethodsA structured questionnaire was distributed to all diagnostic radiographers in Singapore through emails sent out by the Singapore Society of Radiographers. Information collected included respondents' duties in their respective imaging modalities, the professional tracks they specialised in, and their demographical information. Quantitative data analysis was conducted using SPSS and Fisher’s Exact test of independence was used to determine correlations between variables. ResultsA total of 120 questionnaire responses were obtained and after exclusion, 99 responses were analysed. It was observed that there was a significant positive correlation in radiography experience and performing specialised Computed Tomography examinations (p = 0.005). Additionally, higher radiographer designation was shown to be correlated with the ability to perform more specialised Ultrasound examinations (p < 0.001). The study demonstrated a diverse range of tasks by radiographers which was determined by education, disparity in experience, institutional practice and training provided. ConclusionThis preliminary study on Singapore diagnostic radiographers provided valuable insight and mapping of their activities in several imaging modalities, allowing for future development of a scope of practice document for Singapore. Implication for practiceThe tasks undertaken by the diagnostic radiographers were integral to imaging service delivery and play a significant role in the advancement of radiography to further enhance the quality of patient care.

Accuracy of interpretation of nasogastric tube position on chest radiographs by diagnostic radiographers: A multi-case, multi-reader study

IntroductionFeeding via a misplaced nasogastric tube (NGT) is a common but preventable cause of patient harm. The aim of this study was to determine the accuracy of diagnostic radiographers’ assessment of NGT position on chest radiographs (CXRs) and safe-to-feed decisions. MethodsA multi-case, multi-reader study was conducted using an online image interpretation platform. A test bank consisting of 15 CXRs with an NGT in-situ was created. Diagnostic radiographers without formal qualifications in CXR interpretation were recruited via two international conferences. Participants placed an electronic marker on each CXR to identify the location of the tip of the NGT and indicated whether or not they believed that the tube was safely positioned. Results68 participants were recruited. Each participant reviewed 15 CXRs, providing 1020 unique image assessments. 76 % (n = 778/1020) image assessments were completely correct (both the position of the tip of the NGT was accurately located and an appropriate safe-to-use decision made). In 5 % (n = 56/1020) of cases the NGT was safely positioned and the location of the tip was correctly identified by the participant but the tube was erroneously determined to be unsafe for feeding. In a further 6 % (n = 59/1020) of cases the participant correctly located the tip of an NGT in an unsafe position but indicated that the tube was safe to use. Participants failed to correctly identify the tip of the NGT in the remaining 12 % (n = 127/1020) of cases. ConclusionConsistent with previous studies involving other staff groups, diagnostic radiographers without formal qualification in CXR interpretation can assess NGT positioning on radiographs with moderate accuracy but require further training, including strategies for the identification of poorly-visualised tube tips, to achieve the 100 % accuracy necessary for this safety-critical task. Implications for practiceA bespoke training programme which includes teaching on image quality, tube tip identification and assessment of tube positioning using the National Patient Safety Agency (NPSA) four criteria, should be delivered prior to implementation of a radiographer-led NGT CXR evaluation service.

Anatomy of a Radiologic Technologist Workforce Crisis.

Anatomy of a Radiologic Technologist Workforce Crisis.

Exploring diagnostic radiography students’ experiences of transitioning from online to face-to-face teaching and learning, Johannesburg, South Africa

BackgroundThe COVID-19 pandemic necessitated educational institutions adopting online learning as a measure to limit the spread of the virus. When restrictions were eased, teaching and learning at higher education institutions returned to face-to-face teaching and learning. Although there have been studies on the experiences of diagnostic radiography students with online teaching and learning, there is a lack of research on students' experiences when transitioning back to face-to-face teaching and learning. Therefore, this study explored diagnostic radiography students' experiences in transitioning from online to face-to-face teaching and learning. MethodsA qualitative explorative and descriptive research design was conducted in two phases. Phase one used an open-ended online questionnaire with a single central question. In phase two, the responses from phase one were explored through in-depth interviews with diagnostic radiography students at a higher education institution. The results from phases one and two were analysed to generate themes. ResultsTwo themes were generated: 1. varying experiences and 2. online and face-to-face teaching and learning engagement. Change and preferences were categorised under theme one, the flexibility of online learning, face-to-face learning interaction, and active and responsible learning development under theme two. ConclusionDiagnostic radiography students experienced the change to face-to-face learning from online learning as challenging but were able to adapt. They preferred the flexibility of online teaching and learning and the enhanced engagement of face-to-face teaching and learning. Therefore, blended learning should be considered for radiography education in the future. They appreciated the skills they developed during online learning and incorporated these skills into their face-to-face learning.

High workload and under-appreciation lead to burnout and low job satisfaction among radiographers

IntroductionBurnout and low job satisfaction in healthcare can impact patient safety and staff retention. This study aims to gain information on the factors influencing burnout and job satisfaction among radiographers in the UK, Ireland and internationally. This can inform strategies for improving the workforce supply and demand imbalance. MethodsAn online questionnaire was developed, which included demographic questions and two validated instruments, the Maslach Burnout Inventory (MBI) and the Job Satisfaction Survey (JSS). The questionnaire was distributed to diagnostic radiographers through the EFRS Research Hub at the European Congress of Radiology, Vienna, in early March 2023. It was disseminated online through Twitter, Facebook, and email over six weeks. Results245 radiographers completed the questionnaire, with the majority (n = 207, 84.5 %) female. Not all respondents responded to all questions. The numbers of respondents for each section were: Pay n = 205, Promotion = 206, supervision = 212, fringe benefits = 211, CR = 212, OC = 214, Co-workers = 213, NoW = 211, Communication = 213 and overall JS = 205. The questionnaire had participants from twenty-one countries, with 66.5 % from Ireland. The mean values for emotional exhaustion (EE), depersonalisation (DP) and personal accomplishment (PA) indicate moderate levels of burnout among responding radiographers. 44.2 % of radiographers were dissatisfied, 43.7 % were ambivalent, and 12.1 % were satisfied overall. Workload, under-appreciated work, and time pressures were ranked as the top three factors contributing to burnout. Staff numbers, workload and poor management were the top three factors reducing job satisfaction. ConclusionBurnout levels were moderate, and overall job satisfaction was very low among radiographers. Workload and under-appreciation were key factors impacting low job satisfaction and high burnout. Implications for practiceHealthcare policies that address radiographer burnout through wage structure adjustments, targeted human capital investment, and management practices aligned with staff needs are needed. Implementing these strategies is essential for improving healthcare efficiency, staff wellbeing, and patient care outcomes.

Paediatric Central Nervous System Tumours: Symptomatology and Total Diagnostic Interval in a New Zealand Cohort

ABSTRACTBackgroundCentral nervous system (CNS) tumours are the leading cause of paediatric oncologic death and survivors face high rates of persistent disability. Timeframe from initial symptom to diagnostic radiography [total diagnostic interval (TDI)] is associated with increased morbidity and mortality. Interventions such as HeadSmart and Brain Pathways Guidelines UK have reduced TDI in the United Kingdom through public and professional education campaigns.AimsThe overarching aim of this project is to reduce TDI for brain tumours across New Zealand. As there are no local data for TDI in paediatric CNS tumours, we sought baseline data prior to local interventions, which would then inform interventions in the next project phase.MethodsRetrospective analysis of patients ≤ 18 years with a CNS tumour in the ZZ catchment between 2015 and 2020. Demographics, tumour type, presenting symptoms/signs, referral pathways and TDI were recorded.ResultsOf 72 cases, median TDI was 9 weeks (0–156 weeks). This was lower in patients aged &lt; 4 years compared with &gt; 4 years (4 weeks vs. 13 weeks), in high grade tumours compared to low grade (4 weeks vs. 13 weeks), and in other ethnicities compared with Māori/Pasifika (6 weeks vs. 16.5 weeks) (p &lt; 0.05 for all comparisons). Symptomatology was similar to Brain Pathways, however, some signs including head circumference were poorly recorded and identify areas for improvement.ConclusionsMedian TDI is higher than recommended targets, and there is ethnic disparity. This gives impetus for local intervention, using strategies comparable to Brain Pathways.

Comprehensive Analysis of Radiological Innovations, Safety Protocols, and Clinical Applications in Diagnostic Imaging and Collaboration Between X-Ray Technicians, Nurses, and Clinicians

Advancements in radiology have enhanced the method of diagnosis by ensuring highly accurate imaging results fruitful for patients. Huge developments like digital radiography, CT, MRI, and AI have improved the quality and speed of imaging services. However, remaining safety measures and effective collaboration between X-ray technicians, nurses, and clinicians to get better outcomes for a patient and reduce risks of potential radiation exposure are still important. This paper aims to present a synthesis of literary findings on recent advances in radiological examination techniques, their uses, measures to be taken to prevent harm to patients and/or staff involved in the examinations by radiation, and the required teamwork and collaboration for effective healthcare services to be rendered to patients. The study suggests that the progressive development of technology could only be met with sound safety features and improved collaboration of interdisciplinary team members to attain ideal clinical utilization.

Magnetic Resonance Imaging Liver Segmentation Protocol Enables More Consistent and Robust Annotations, Paving the Way for Advanced Computer-Assisted Analysis

Background/Objectives: Recent advancements in artificial intelligence (AI) have spurred interest in developing computer-assisted analysis for imaging examinations. However, the lack of high-quality datasets remains a significant bottleneck. Labeling instructions are critical for improving dataset quality but are often lacking. This study aimed to establish a liver MRI segmentation protocol and assess its impact on annotation quality and inter-reader agreement. Methods: This retrospective study included 20 patients with chronic liver disease. Manual liver segmentations were performed by a radiologist in training and a radiology technician on T2-weighted imaging (wi) and T1wi at the portal venous phase. Based on the inter-reader discrepancies identified after the first segmentation round, a segmentation protocol was established, guiding the second round of segmentation, resulting in a total of 160 segmentations. The Dice Similarity Coefficient (DSC) assessed inter-reader agreement pre- and post-protocol, with a Wilcoxon signed-rank test for per-volume analysis and an Aligned-Rank Transform (ART) for repeated measures analyses of variance (ANOVA) for per-slice analysis. Slice selection at extreme cranial or caudal liver positions was evaluated using the McNemar test. Results: The per-volume DSC significantly increased after protocol implementation for both T2wi (p &lt; 0.001) and T1wi (p = 0.03). Per-slice DSC also improved significantly for both T2wi and T1wi (p &lt; 0.001). The protocol reduced the number of liver segmentations with a non-annotated slice on T1wi (p = 0.04), but the change was not significant on T2wi (p = 0.16). Conclusions: Establishing a liver MRI segmentation protocol improves annotation robustness and reproducibility, paving the way for advanced computer-assisted analysis. Moreover, segmentation protocols could be extended to other organs and lesions and incorporated into guidelines, thereby expanding the potential applications of AI in daily clinical practice.

Investigation of Road Traffic Accident Trauma Cases: Occurrence and Diagnosis in Jeddah, Saudi Arabia

Objectives: Road traffic accidents (RTAs) are a leading cause of emergency department admissions, and Jeddah City is no exception. In this study, we conducted a comparative analysis of male and female patients who sustained injuries in RTAs, considering factors such as age, site of injury, and the optimal diagnostic modality, computed tomography (CT) or X-ray radiography (XR), depending on the nature of the injury. Methods: Data was collected retrospectively from the Picture Archiving and Communication System (PACS) at the Radiology Department of King Fahad General Hospital (KFGH). Collected data included patient demographics, injury locations, the initial diagnostic modality employed and its findings, and any subsequent diagnostic modality used, if necessary. We investigated the appropriateness of the initial diagnostic modality for each type of injury by comparing the diagnoses obtained from the first modality with those of the second modality. Results: Data from 200 patients (83.5% males; 16.5% females) was collected. Patients were categorized into four age groups: 16–23, 24–30, 31–60, and &gt; 60 year old groups, accounting for 28.5%, 32%, 36%, and 3.5% of patients, respectively. The most common site of injury was polytrauma with 101 cases (50.5%), followed by head and spine injuries in 64 (32%) and 17 cases (8.5%), respectively. Notably, CT was the most commonly used first diagnostic modality, employed in 88.5% of cases, all cases of polytrauma injuries, and the majority of head (93.8%), spinal (56.3%), and facial (71.4%) injuries. Whereas radiography was primarily used for chest, lower, and upper limb injuries. Conclusions: Based on our findings, we recommend CT as the initial diagnostic modality for patients with polytrauma, spinal injuries, and head injuries resulting from RTAs. However, radiography remains a valuable diagnostic tool when transporting patients to a radiology department or for follow-up purposes.

The Disadvantages of Lead Aprons and the Need for Innovative Protective Clothing: A Survey Study on Healthcare Workers' Opinions and Experiences

The use of state-of-the-art technical textiles instead of lead aprons is of great importance due to their lightweight, flexible, non-toxic and comfortable composition. In this study, we aimed to determine the disadvantages experienced by healthcare workers due to lead aprons and their opinions about innovative protective clothing. The survey, comprising seventeen questions, aimed to gather demographic information, design and physical properties of respondents' lead aprons, functionality, comfort, and performance of current protective clothing, and determine future design requirements. Within the scope of the research, a survey was administered to 52 radiation workers, and the results were analyzed statistically. Radiology technicians comprised nearly half of the respondents (34%), followed by physicians (25.5%) and nurses (19.1%). The most important problems encountered by the respondents during the use of lead aprons were defined as being heavy, restricting movement, and not fitting the body properly. Among the comfort descriptors, inability to move comfortably, weight and air permeability were considered "completely important" by the respondents, respectively. The study showed that 26.92% of the participants experienced complications with their lumbar spine, while 23.08% reported concerns with their cervical spine. Survey participants noted low air permeability and thermal comfort in lead aprons, making them unsuitable for various anatomical structures. To overcome these issues, technical textiles with easier shapeability and improved performance, such as mechanical properties and insulation, could be used instead.In order to overcome these disadvantages, producing and using technical textiles instead of lead aprons will provide a significant advantage.

Evaluation of Environmental Radiation Exposure and Algorithms for Determining the Occupational Effective Dose During 99mTc-MDP Bone Scintigraphy: A Comprehensive Analysis

This study evaluated the occupational exposure of radiopharmacists, nurses, radiological technologists, and radiological technologist assistants involved in 99mTc-MDP bone scintigraphy procedures. Actual occupational effective doses for individual staff needed ascertaining. An environmental radiation exposure audit revealed all nuclear medicine areas were compliant with ICRP and IAEA guidelines. To ascertain individual doses, they were recorded by OSL badges. The highest exposure was to the radiopharmacists, Hp(0.07) 2.19 µSv during radiolabeling. The nurse administering 99mTc-MDP recorded a dose of 0.27 µSv at Hp(0.07), 26.01% of the total occupational effective dose. The radiological technologist and assistant receive 73.05% of the total effective dose. However, the highest effective dose was received by the technologist assistant positioning patients for SPECT/CT scans, with an effective dose of 32.03 µSv. Single and double dosimetry effective dose estimate algorithms were evaluated, resulting in the double dosimetry being more accurate. The Padovani et al. algorithm was found to most closely align with 99mTc-MDP actual effective dose values (p &gt; 0.05), thereby validating the measurement methods used in this study. The research offers benchmark environmental exposure and effective doses applicable in audits and the continuous effort to enhance radiation safety for personnel during 99mTc-MDP bone scintigraphy.

The American Society of Radiologic Technologists (ASRT) AI educator survey: A cross-sectional study to explore knowledge, experience, and use of AI within education

IntroductionArtificial Intelligence (AI) is revolutionizing medical imaging and radiation therapy. AI-powered applications are being deployed to aid Medical Radiation Technologists (MRTs) in clinical workflows, decision-making, dose optimisation, and a wide range of other tasks. Exploring the levels of AI education provided across the United States is crucial to prepare future graduates to deliver the digital future. This study aims to assess educators’ levels of AI knowledge, the current state of AI educational provisions, the perceived challenges around AI education, and important factors for future advancements. MethodsAn online survey was electronically administered to all radiologic technologists in the American Society of Radiologic Technologists (ASRT) database who indicated that they had an educator role in the United States. This was distributed through the membership of the ASRT, from February to April 2023. All quantitative data was analysed using frequency and descriptive statistics. The survey's open-ended questions were analysed using a conceptual content analysis approach. ResultsOut of 5,066 educators in the ASRT database, 373 valid responses were received, resulting in a response rate of 7.4%. Despite 84.5% of educators expressing the importance of teaching AI, 23.7% currently included AI in academic curricula. Of the 76.3% that did not include AI in their curricula, lack of AI knowledge among educators was the top reason for not integrating AI in education (59.1%). Similarly, AI-enabled tools were utilised by only 11.1% of the programs to assist teaching. The levels of trust in AI varied among educators. ConclusionThe study found that although US educators of MRTs have a good baseline knowledge of general concepts regarding AI, they could improve on the teaching and use of AI in their curricula. AI training and guidance, adequate time to develop educational resources, and funding and support from higher education institutions were key priorities as highlighted by educators.

The Impact on Patient Prognosis of Changes to the Method of Notifying Staff About Accepting Patients With Out-of-Hospital Cardiac Arrest.

Our hospital is a designated emergency hospital and accepts many patients with out-of-hospital cardiac arrest (OHCA). Previously, after receiving a direct call from emergency services to request acceptance of an OHCA patient, the emergency room (ER) chief nurse notified medical staff. However, this method delayed ER preparations, so a Code Blue system (CB) was introduced in which the pending arrival of an OHCA patient was broadcast throughout the hospital. In this study, we retrospectively analyzed the impact of introducing CB at our hospital on OHCA patient prognosis to examine whether the introduction of CB is clinically meaningful. We compared consecutive cases treated before introduction of the CB (March 3, 2022, to March 22, 2023) with those treated afterwards (March 23, 2023, to July 23, 2024). A total of 30 cases per group were included. The mean number of medical staff present at admissions increased significantly from 5.4 ± 0.6 to 15.0 ± 3.0 (P < 0.001). Although not statistically significant, the introduction of the CB increased the return of spontaneous circulation (ROSC) rate from 20% to 30%, survival to discharge rate from 3% to 10%, and social reintegration rate from 0% to 3%. ROSC occurred in 15 patients. Among OHCA patients with cardiac disease, the ROSC rate tended to increase from 0% to 43% (P = 0.055). In addition, in OHCA patients with cardiac disease whose electrocardiogram initially showed ventricular fibrillation or pulseless electrical activity, the ROSC rate increased from 0% to 100%. ROSC tended to be influenced by the total number of staff and physicians present and the number of staff such as medical clerks, clinical engineers, and radiology technicians (P = 0.095, 0.076, 0.088, respectively). Introduction of a CB may increase the ROSC rate and the number of patients surviving to discharge. It also appears to improve the quality of medical care by quickly gathering all necessary medical staff so that they can perform their predefined roles.

Student radiographers’ confidence of adapting practice for autistic patients: A qualitative survey on the role of placement experiences

IntroductionHealthcare services can be inaccessible to autistic people without adaptions to clinical practice and the care provided. Therefore, understanding how radiographer education develops students' confidence in adapting care for autistic patients is crucial. This study aimed to explore how placement experience impacts student radiographer confidence in adapting care for autistic patients. MethodsUK final-year student diagnostic and therapeutic radiographers were invited to complete a qualitative online survey. The survey asked for a description of placement experiences; of observing and/or performing the care of autistic patients and how this impacted confidence in caring for autistic patients. The data was thematically analysed. Results43 responses (of 44 received) were included, from which 5 themes emerged. Those who felt placement experiences developed confidence described opportunities to apply theory learnt at university (theme 1) or drew attention to the benefit of prior (external) experience with autistic people (theme 3). However, the balance of power with the supervising radiographer (theme 2), witnessing autistic patients in distress (theme 4), and the heterogeneous nature of autism (theme 5) disrupted students’ development of confidence. ConclusionSeveral participants in this study found clinical placement developed confidence with autistic patients through applying knowledge and providing an opportunity for reflexive learning. However, various obstacles hindered this development, such as witnessing distressed patients, limited experiences with autistic patients and difficulty navigating relationships with radiographers. Implications for practiceTo improve student radiographers’ confidence of providing care for autistic patients, educators should consider methods, e.g., co-produced simulation, to fill potential gaps in their experience. There is also a pressing need for all radiographers to understand their responsibility in educating students and their impact on student wellbeing.

Minimizing Radiation Exposure in Neonatal Intensive Care Unit: A Quality Improvement Approach on X-Ray Practices

Purpose: Radiographic examinations are frequently performed for diagnostic and therapeutic purposes in neonatal intensive care units (NICUs). However, concerns are emerging regarding the safety of radiation exposure, especially in vulnerable preterm infants in periods of rapid cellular division. This quality improvement (QI) project aimed to reduce radiation hazards in level-IV NICU.Methods: We established an "X-ray prescription protocol" and educated the physicians to ensure that only essential radiographs were obtained. Additionally, we discouraged full-body infantograms and emphasized the prescription of targeted radiographs, such as chest or abdominal radiographs. Furthermore, to reduce the dose-area product (DAP, Gy·cm2) values, which act as a surrogate for radiation exposure, we provided training to radiologic technologists on meticulous collimation for each radiography session. We aimed to achieve a 30% reduction in the average monthly cumulative DAP per patient, which was calculated by dividing the total monthly DAP from radiographs in the NICU by the monthly average of patient admissions. Retrospective baseline data were collected 8 months pre-intervention and prospectively for 4 months post-interventions.Results: The average monthly X-ray count per patient was 28.3 in the pre-intervention period (October 2022 to May 2023), which decreased to 25.4 in the post-intervention period (June 2023 to September 2023), reflecting a 10.2% reduction (p=0.109). The average monthly infantogram count per patient showed an 18.0% reduction (25.9% to 21.2%, p=0.016), and the proportion of infantograms in the total X-ray counts decreased from 91.5% to 83.3% (p=0.017). The DAP value per X-ray decreased by 42.6%, from an average of 0.25 to 0.14 (p=0.011). The primary outcome, the average monthly cumulative DAP value per patient, showed a substantial reduction of 48.6%, dropping from 7.00 to 3.60 (p=0.004). The baseline characteristics and short-term morbidities of the patients did not differ significantly between the pre- and post-intervention period.Conclusion: Our QI approach, which included discouraging excessive prescriptions of infantograms and promoting optimal collimation, significantly reduced the average monthly radiation exposure in the NICU, benefiting both patients and healthcare workers.