Knowledge, skills and perceptions of diagnostic radiographers on image interpretation of chest diseases in eThekwini public hospitals

ABSTRACT Escalating current healthcare needs coupled with the dire shortage of radiologists created a climate in countries abroad to extend the role of the radiographer (Williams 2006). The South African radiography profession demonstrates similar if not worse challenges within the radiology services (Gqweta 2012). The human resource needs in the healthcare sector creates a gap in the provision of radiology services (Brandt et al 2007). Often under these circumstances radiographers are asked by emergency department's personnel to comment on radiographic appearances (Hardy and Snaith 2007). Radiographers do provide opinions in order to facilitate patient management (Gqweta 2012). Since the chest x-ray is the most commonly performed x-ray examination in x-ray departments (Manning, Leach and Bunting, 2000), it is assumed that most requests for an opinion may be directed for the clarification of this x-ray examination. Therefore radiographers need to have an in-depth understanding of the knowledge and skills related to the identification of patterns on chest images. The aim of the study was to establish and describe the current chest image interpretation skills, knowledge and perceptions of diagnostic radiographers in eThekwini Health District of KwaZulu-Natal (KZN) with regard to image interpretation. METHOD: A quantitative study using a descriptive design with a qualitative aspect using an interpretive design was employed. A simple random sample of hospitals within the eThekwini health district that have x-ray departments was drawn. All diagnostic radiographers that met the inclusion criteria from within these hospitals were invited to partake in the study and all were registered with the Health Profession Council of South Africa (HPCSA). A questionnaire was utilised to collect data on the perceptions and knowledge of diagnostic radiographers on radiographic appearances. A reporting template was provided for the respondents to report on ten (10) chest images and to standardise responses . Accuracy , specificity and sensitivity measurements were utilised to determine the image interpretation knowledge and skills of radiographers without formal training on image interpretation. The SPSS (Statistical Package for the Social Sciences) version 21 was utilised for the raw data capture and analysis. RESULTS Forty two (42) radiographers participated in the study. Almost half (46%) of the respondents were chief radiographers and twenty four point four percent (24.4%) of the respondents were senior radiographers . X-ray department managers and community service radiographers each had twelve (12%) percent representation. The majority of the respondents frequently performed chest x-rays. Furthermore they regularly observe Pulmonary Tuberculosis (PTB) abnormal patterns more than those of pneumonia and lung cancer on chest radiographs. The respondents indicated that there is a need for them to extend their roles to include image interpretation. This will ensure that radiographers are responsive to current health care needs perpetuated by the absence of radiologists and the ever rapidly increasing population. The majority of the respondents were able to identify abnormal appearances on the radiographs (high sensitivity). However there was a proportional decrease on the identification and recognition of the normal appearances (specificity). There was no respondent that obtained a mark of eighty (80%) on the image interpretation knowledge assessment section. CONCLUSION Radiographers are able to identify abnormal patterns on chest images. However they are unable to adequately exclude an abnormality (low specificity). Furthermore they lack the ability to adequately describe abnormal radiographic/radio logical appearances. The image interpretation knowledge base of radiographers is limited and specific. Therefore there is a need for an intensive education and training for prospective reporting radiographers.