The impact of intensive training in preliminary image evaluation (PIE) for radiographers in the emergency department of a regional hospital in New Zealand - A pilot study.

INTRODUCTION: New Zealand has seen an increase in the X-ray examinations in the emergency departments (ED), and the radiology report is generally unavailable immediately. This requires practitioners managing the patient to take the responsibility of detecting any abnormalities in the images and using such information for the management of the patient. There is, therefore, a need for consideration of the contribution that radiographers could make in the accurate management of the patients in ED in New Zealand. The aim of this study was to assess if an intensive preliminary image evaluation (PIE) training course improved radiographer accuracy, sensitivity, and specificity on extremity X-ray examinations in a regional ED in New Zealand. METHOD: A pre-post-intervention design was employed for this study. Seven radiographers working at a regional base hospital in New Zealand undertook image evaluation tests to evaluate their ability to detect and describe abnormalities prior to and following a 2-day intensive PIE training course. The training concentrated on acute extremity abnormalities. Tests were then scored to determine sensitivity, specificity, and accuracy. RESULTS: Following an intensive PIE training course, the post-intervention test mean demonstrated an improved sensitivity by an average of 3.99% (89.01-93.0), specificity improved by an average of 6.13% (79.77-85.90%), and accuracy improved by an average of 3.33% (77.55-80.87%). CONCLUSION: This study demonstrated that an intensive training course in PIE improved the participants' sensitivity, specificity, and accuracy when evaluating acute extremity X-ray examinations in ED at the study site, however further research is required to see if these results also represent clinical ability. IMPLICATION FOR PRACTICE: The NZ healthcare system could benefit by the introduction of a radiographers' PIE system. It is therefore recommended that when introducing PIE into an ED in New Zealand, radiographers should undertake additional training to improve image evaluation sensitivity, specificity, and accuracy prior to participation.

Evaluating the use of exposure indicators in digital x-ray imaging system: Gauteng South Africa.

INTRODUCTION: Exposure indicators (EIs) are the only indicator of correct exposure technique in digital x-ray imaging systems but the use of such indicators remains largely unexplored in a South African setting. With exposure creep in the digital radiography age being a worldwide phenomenon, the study investigated radiographers' familiarity and use of EIs, providing insight into current exposure technique practices in this setting. METHODS: An explorative and descriptive quantitative study was conducted at 10 randomly selected radiography clinical training facilities in Gauteng, South Africa. The study used a questionnaire consisting of 26 questions based on familiarity with and use of EIs and radiographers' attitude to ionising radiation. RESULTS: A response of rate of 49.3% was achieved. Results show a low number of respondents (54.3%) had a perfectly correct understanding of the exposure indicator (EI) and only 55.7% of respondents made correct use of the EI. CONCLUSION: Observable lack of familiarity and use of the EI suggests that improvements could be made to the training radiographers receive on digital imaging systems. Moreover radiographers need to be vigilant against making decisions in digital radiography using knowledge that may relate exclusively to analogue radiography.