Beskrivende radiografer i konventionelle røntgenoptagelser af det ...

Rapport Juni 2009
Abstract
Purpose and Scope
The overall purpose of this project was twofold:
Firstly, to improve the quality of radiographic performance through an analytical and
diagnosis-related approach to radiographic examinations of patients referred from the
casualty department.
Secondly, to investigate the feasibility of introducing radiographer reporting of skeletal
examinations of patients referred the casualty department.
Patients under 18 years of age were not included in the study.
This study was limited to the description of fracture/subluxation pathology of the
extremities and a target of 95% sensitivity and specificity was set. Other pathology was
named but not described
Aims
To assess radiographers´ competence to evaluate and report emergency
radiological examinations of the appendicular skeleton of adults, before and after an
educational intervention.
To assess overall improvements in radiological image quality in the department.
To collect data to evaluate the pedagogical methods employed and to assess
radiographers´ responses to these.
Method
14 radiographers from 2 hospitals applied to join the study and all applicants, who had
completed their departmental introduction programme, were included. The process of
inclusion was, therefore, self-selection. Two participants later withdrew from the study.
A baseline study of the participants initial competence to describe radiological
examinations (100 selected examinations) was followed by a period of self-study in which
each participant was expected to report and document 400 examinations and to compare
these to a gold standard (final radiological report). This learning intervention was
supplemented by workshops, where participants could discuss their findings with
orthopaedic consultant radiologists. An e-learning platform was made available along with
radiology literature.
Finally, a second assessment of reporting competence was carried out using a further 100
selected anonymous examinations.
To assess pedagogical methods participants were asked to complete questionnaires and
observational studies were also carried out.
Results
The baseline study provided an overall average accuracy of 89.7% (range 77.6 – 96 %).
Fracture radiograph sensitivity was 94.1% (range 89.6 – 97.9 %) and specificity 85.6 %
(range 66 – 96 %).
The final study gave the following results: average accuracy 91.9 % (range 85.9 – 96.0 %).
Fracture radiograph sensitivity was 91.8% (range 88 – 96.0 %) and specificity 92.0 %
(range 75.5 – 100 %).
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