Knowledge, clinical competencies and medico legal responsibilities required by diagnostic radiographers for the interpretation of radiographs

Abstract

In SA, image interpretation and reporting by diagnostic radiographers have yet to be validated. Currently, the only training exposure and formalized education that diagnostic radiography students get in the four-year undergraduate degree relates to pattern recognition and pathological conditions However, a review of the regulations on the scope of practice of radiographers is currently being undertaken by the Health Professions Council of South Africa (HPCSA) to include formal reporting in South Africa. Aim The aim of the study was to explore the knowledge, clinical competencies and medico-legal responsibilities required by diagnostic radiographers for the interpretation of radiographs and ultimately, to recommend training guidelines for radiographers in the interpretation of radiographic images. Methodology A qualitative descriptive study employing criterion sampling of qualified radiologists practicing within the eThekwini district of KZN province was conducted. Ethics approval to perform this study was obtained from the Durban University of Technology’s (DUT’s) Institutional Research Ethics Committee (IREC). All the participants were contacted in their personal capacity. The research tool used for this study was face-to-face, one-on-one, semi-structured and in-depth interviews, which included various questions related to radiographic image interpretation. The data from the interviews were analysed by the researcher using Tesch’s eight steps for analysing qualitative data. Moreover, all the data obtained from this research study was kept confidential and under password protection by the researcher. Findings Findings reveal that Radiologists support the interpretation of radiographic images by radiographers in rural settings, and for the radiographer’s scope of practice to be restructured to include the chest and the musculoskeletal system. Extension in the scope of practice would result in increased job satisfaction, as the overall costs, rates and turnaround time will be affected if radiographers interpret images. Moreover, image interpretation training should begin 3-5 years post degree. An in-depth knowledge of anatomy, radiological anatomy and pathophysiology is required to understand pattern recognition during image interpretation. The training would be between 6 months and 5 years. Findings also indicated that there should be continuous monitoring and accreditation for image interpretation courses, with accreditation being in the form of a diploma for each system, a degree or a certificate of competence. Assessments for image interpretation should be carried out by radiologists. The participants of this study found that clinical competency for radiographers who are performing image interpretation has to do with the assessment of the patient, with assessment determining the history, the background, the past medical history of relevance and the current presenting symptoms. The study also suggested that apart from having stringent criteria for radiographers entering the image interpretation course, radiographers must be able to triage patients and all assessments should be done by a radiologist. The findings also indicated that no harm is to be done to the patient; patient information must not be disclosed to others; radiographers should be covered in the event of adverse outcomes when interpreting images; there should be decision-making regarding the radiologic/radiographic report; and the rights of a healthcare provider are to be protected.