Introduction Gender-sensitive practice is a component of equitable, patient-centred care, requiring healthcare providers to recognise how gender identity and sociocultural norms shape clinical experiences and outcomes. In diagnostic radiography, examinations frequently involve close physical contact, disrobing, and exposure of private body areas, heightening patient vulnerability. However, empirical evidence on diagnostic radiographers' gender-sensitive practice remains limited, particularly within South Africa's pluralistic and historically unequal healthcare context. Therefore, this study aimed to understand diagnostic radiographers' perspectives on gender-sensitive practices. Methods A qualitative research approach with an exploratory and descriptive research design was used. Data were collected through individual semi-structured online interviews with 24 diagnostic radiographers recruited via social media across seven of the nine South African provinces and underwent descriptive analysis. Results Two themes, each with associated subthemes, were developed. The first theme, conceptualising gender sensitivity within binary structures, encompassed an understanding of gender sensitivity, sociocultural gender and sexuality binaries, and heteronormative design. The second theme, gender diversity in clinical encounters, captured the gender-related complexities in clinical encounters and participants' recommendations for inclusive and affirming practice. Conclusions South African diagnostic radiographers practise within structurally binary environments that contribute to the misgendering of patients. Clinical uncertainty regarding address and pregnancy screening reflects the absence of guidance. Findings emphasise the need for inclusive and affirming administration and standardised guidance tailored to South Africa to support gender-sensitive practice in medical imaging. Implications for practice Medical imaging departments should review their administrative procedures to ensure they reflect inclusive and affirming practice and provide required training for radiographers.
INTRODUCTION:Percutaneous coronary intervention (PCI) is widely used for coronary revascularization, with invasive coronary angiography (ICA) remaining the conventional method for guiding stent implantation. However, ICA provides only a two-dimensional luminal assessment and may underestimate vessel size, lesion morphology, stent under expansion, malapposition, and edge complications. Intravascular ultrasound (IVUS) and optical coherence tomography (OCT) provide detailed intravascular assessment and may improve PCI optimization. METHODS:This systematic review and network meta-analysis of randomized controlled trials compared ICA-guided, IVUS-guided, and OCT-guided PCI. PubMed, Embase, and Cochrane Library were searched, with an updated search to April 10, 2026. Binary outcomes were analyzed using random-effects frequentist and Bayesian network meta-analysis. ICA-guided PCI was the reference treatment. Treatment ranking was assessed using SUCRA, and inconsistency was evaluated using node-splitting. RESULTS:Thirty-three randomized trials including 25,315 participants were included. Compared with ICA-guided PCI, IVUS-guided PCI reduced target lesion revascularization, target vessel revascularization, major adverse cardiovascular events, and stent thrombosis. OCT-guided PCI reduced target lesion revascularization, all-cause death, cardiac death, target vessel myocardial infarction, and stent thrombosis compared with ICA. Myocardial infarction was directionally lower with both IVUS and OCT, although estimates were not statistically definitive. No clear difference was observed between IVUS and OCT for major clinical outcomes. Node-splitting analyses showed no significant inconsistency across treatment comparisons. CONCLUSION:Intravascular imaging-guided PCI was associated with improved outcomes compared with ICA-guided PCI. IVUS showed the most consistent benefit for repeat revascularization and major adverse cardiovascular events, whereas OCT ranked favorably for several safety outcomes. Current randomized evidence does not establish superiority of OCT over IVUS. IMPLICATIONS FOR PRACTICE:Intravascular imaging should be considered to optimize PCI, particularly in anatomically complex or high-risk coronary interventions.
INTRODUCTION:Simulation-based education is widely used in radiography and sonography training. Qualitative research offers important insights into student experiences, but methodological reporting remains a concern. This scoping review maps the reporting characteristics of qualitative radiology simulation-based education studies and examines how methodological decisions and features associated with qualitative rigour are reported. METHODS:A scoping review was conducted following Arksey and O'Malley's framework. Multiple databases were searched for peer-reviewed qualitative studies exploring diagnostic imaging students' experiences of simulation-based education. Data extraction was guided by the Standards for Reporting Qualitative Research. A thematic analysis, following Braun and Clarke, was undertaken to examine patterns in methodological reporting. RESULTS:Eleven studies met the inclusion criteria. Studies consistently reported core elements, including title/abstract, aims, problem formulation, participant group, simulation context, data collection method, limitations and ethics. Reporting was variable for research paradigms, sampling rationale, trustworthiness, reflexivity, and analytic procedures. Three themes were generated: (1) Residual Positivism - reflects the influence of positivist assumptions in qualitative inquiry; (2) The Missing Researcher - illustrates limited reflexivity; and (3) Stuck in Description - describes thematic analyses that remain close to topic summaries or descriptive accounts. CONCLUSION:The reviewed studies provide valuable insights into simulation-based education for diagnostic imaging students; however, methodological reporting was variable. The findings suggest limited engagement with qualitative paradigms, reflexive reporting and analytic decision-making, contributing to patterns of residual positivism and analyses that often remained close to topic summaries or description. IMPLICATIONS FOR PRACTICE:Qualitative radiology simulation-based education research should prioritise transparent methodological reporting, explicit engagement with research paradigms, and reflexivity to support methodological coherence and deeper analysis. Engagement with non-positivist qualitative paradigms and reflexivity may support richer interpretations of students' experiences of simulation-based education.
INTRODUCTION:Mammography education faces challenges in translating theory into practice, developing technical and professional competencies, and limited clinical training opportunities. Virtual reality (VR) emerged as a potential adjunct tool to address these challenges. The study aimed to evaluate the educational impact of a VR-based mammography training program on learning outcomes, simulation design, educational practices, and student satisfaction and self-confidence. METHODS:A cross-sectional study conducted among 62 students who completed the training. Learning outcomes were assessed using a 50-item Mammography Assessment Test (MAT) administered pre- and post-training. Student perceptions were evaluated using the Educational Practices Questionnaire (EPQ; range 16-80), Simulation Design Scale (SDS; range 20-100), and Student Satisfaction and Self-Confidence in Learning Scale (SCLS; range 13-65). RESULTS:Post-training MAT scores (75.73 ± 8.60) were significantly higher than pre-training scores (17.64 ± 5.89; p = 0.001), with female students achieving significantly higher post-test scores than males (77.80 ± 7.58 vs. 68.66 ± 8.37; p = 0.011). SDS (85.00 ± 7.51) and SCLS (51.50 ± 4.56) scores were high, reflecting strong perceptions of simulation design and learner confidence. EPQ scores (72.29 ± 8.30) were comparatively lower relative to the scale maximum, suggesting variability in perceived educational practices. A significant positive correlation was observed between SDS and SCLS scores, while no correlation was found between EPQ and other scales. Although most students preferred face-to-face learning, they reported benefits of VR in reducing anxiety and supporting skill development. CONCLUSION:VR-based mammography training was associated with improved learning outcomes and high level of student satisfaction and self-confidence. IMPLICATIONS FOR PRACTICE:VR-based mammography training is an adjunct educational tool in radiography education. However, optimal educational impact depends not only on simulation design but also on effective educational practices.
INTRODUCTION:Cholangiocarcinoma (CCA) is a heterogeneous biliary malignancy with a poor prognosis, and no standard radiotherapy regimen has been established. We evaluated long-term survival, toxicity, and prognostic factors in patients with CCA treated with helical tomotherapy (HT) at a single centre over 10 years. METHODS:Sixty-seven patients with CCA who received HT were retrospectively analysed. Disease was staged using the AJCC 8th edition. Overall survival (OS) was estimated by Kaplan-Meier analysis and compared using the log-rank test; Cox proportional hazards models identified prognostic factors. Toxicity was graded by CTCAE v5.0. RESULTS:Patients (58.2% male; mean age 61.4 ± 11.9 years) had iCCA (40.3%), hCCA (32.8%), or eCCA (26.9%); 61.2% had stage IV disease. Median follow-up was 13.0 months. Median OS was 14.0 months, with 1-, 2-, 3-, and 5-year OS rates of 55.0%, 30.5%, 19.8%, and 14.4%. Poor differentiation independently predicted worse OS (HR = 5.49; 95% CI, 1.48-20.41; p = 0.011). No grade ≥3 gastrointestinal toxicity occurred; one patient (1.5%) had grade 3 haematologic toxicity. CONCLUSION:In this heterogeneous cohort treated with HT, median OS was 14.0 months with no severe gastrointestinal toxicity. Poor histological differentiation was associated with worse OS. Given heterogeneity in treatment intent, stage, and systemic therapy, findings should be interpreted cautiously. IMPLICATIONS FOR PRACTICE:In this retrospective cohort, HT was well tolerated in the acute setting, with no severe gastrointestinal toxicity recorded, supporting its feasibility in this anatomically challenging disease. Histological differentiation may inform prognostic counselling and patient selection but requires prospective validation. Prospective studies of dose-escalated HT are needed to define its role in multimodal management.
Introduction Patient-centred communication is fundamental to radiographic practice, particularly when patients experience anxiety or uncertainty during imaging or treatment. However, it remains unclear whether broad communication expectations in radiography education and professional standards are translated into explicit, observable behaviours and integrated into education and assessment. This comparative document analysis examined the representation of patient-centred communication in selected national-level documents from five countries, using listening-related behaviours as an illustrative example. Methods Selected national-level curriculum, accreditation, registration, capability, and competency documents from the United States, the United Kingdom, Australia, Canada, and Japan were analysed deductively using a predefined extraction framework. The framework assessed communication competence, listening-related behaviours, patient-centred care, patient/family relationships, interprofessional collaboration, education, and assessment. Results Communication was addressed in all five selected national-level document sets, although institutional framing differed. It was framed as a professional competency or capability in the United Kingdom and Australia, a role-based competency framework in Canada, clinical competency and accreditation requirements in the United States, and primarily as curriculum content in Japan. Explicit observable behavioural expectations, such as listening-related behaviours, were uncommon. Listening was explicitly defined only in the Australian capability standards; elsewhere, it was represented indirectly through broader concepts, such as patient interaction, information gathering, and interpersonal communication. Conclusion The selected documents differed in the explicitness, structure, and educational integration of communication-related standards, without implying differences in education quality or clinical outcomes. Defining patient-centred communication through observable behaviours may strengthen alignment among professional expectations, learning outcomes, feedback, and assessment. Implications for practice Operationalising patient-centred communication as observable behaviours may enhance curriculum mapping, feedback, and assessment in radiographer education.
OBJECTIVE:Positron emission tomography (PET) has transformed diagnostic imaging and therapeutic monitoring by enabling quantitative assessment of molecular processes in vivo. However, reliable use of standardized uptake values (SUVs) and other PET-derived biomarkers requires strict quality assurance (QA), harmonization, and continuous performance monitoring. This review summarizes recent advances in PET harmonization strategies, international quality control (QC) guidelines, and performance evaluation of next-generation digital PET/CT systems, with special focus on the uMI 550 and uMI 780 platforms. KEY FINDINGS:SUV variability remains a major challenge in PET quantification, affecting the consistency and reliability of results across different scans and systems. One promising innovation to address quality control issues is sourceless QC using intrinsic 176Lu activity, which offers a more convenient and potentially robust alternative to traditional methods. Additionally, harmonization strategies play a crucial role in improving reproducibility, helping to standardize measurements and reduce variability across different imaging centers and protocols. CONCLUSION:This review highlights technological innovations such as silicon photomultiplier (SiPM) detectors, non-radioactive QC methods, and phantom-based harmonization tools, emphasizing their clinical relevance for multicenter studies, precision oncology, and routine practice. IMPLICATION FOR PRACTICE:Adoption of advanced systems enables dose reduction, shorter scan times, and improved image quality, benefiting both patients and workflow. Implementing intrinsic detector-based QC methods can reduce staff workload, radiation exposure, and reliance on external calibration sources.
INTRODUCTION:This study aimed to examine the perceptions of Greek radiographers and radiologists on integrating artificial intelligence (AI) in medical imaging (MI). METHODS:A convenience sampling approach was used. The questionnaire was distributed across fifteen public hospitals and two private healthcare groups. A total of 167 valid responses were collected. The data were analysed, conducting both descriptive and inferential statistics. RESULTS:A positive attitude towards the application of AI in MI was identified. Males expressed greater agreement with its positive impact compared to females (p = 0.033), while females reported greater concerns about personal data protection (p = 0.028). Increased age was associated with greater acceptance of AI for diagnostic decision-making (p = 0.014), whereas higher education was associated with lower agreement to statements on the negative impact of AI (p = 0.043). As acceptance of shared responsibility between humans and AI algorithms increased, the agreement with AI's contribution to education decreased (p = 0.006). The acceptance of autonomous AI diagnostic decision-making reinforced the recognition of its impact on the professional role of radiographers and radiologists (p = 0.040). Respondents who were more aware of potential AI-related errors were more likely to believe that diagnosis must remain a human task (p < 0.001). Respondents who recognised the possibility of AI errors were less likely to support autonomous AI decision-making (p = 0.042). The main barriers to implementing AI on MI were a lack of knowledge (64.1%), implementation costs (40.7%), and cybersecurity threats (46.1%). CONCLUSION:Respondents demonstrated an overall positive attitude towards AI integration, recognising its potential. Compared to previous studies, reservations about fully autonomous diagnostic decision-making and implementation barriers were identified. IMPLICATION FOR PRACTICE:Despite the willingness of respondents to adopt AI, the findings suggest that the successful integration of AI into radiological clinical practice in Greece will depend on addressing knowledge gaps through structured education and training, which emerged as the most significant barrier to implementation.
INTRODUCTION:Commercial polymethyl methacrylate (PMMA) computed tomography dose index (CTDI) phantoms are widely used for CT dose assessment, but their cost and limited availability may restrict routine quality assurance, especially in resource-limited settings. This study evaluated the feasibility of a low-cost 3D-printed polylactic acid (PLA) head CTDI phantom as a complementary to commercial PMMA phantoms for CT dosimetry. METHODS:A 160-mm-diameter PLA head CTDI phantom with five dosimetry holes was fabricated using fused deposition modeling. Its elemental composition, density, effective atomic number, electron density, Hounsfield units (HU), and CT dosimetry parameters were characterized. Measurements were performed on 128-slice Ingenuity Philips and GE Discovery scanners, at 80, 120, and 140 kV. CTDI was measured at two different times and then compared with PMMA. RESULTS:PLA showed properties close to PMMA, with differences of 5.08% in density, -0.015% in effective atomic number, and -4.46% in electron density. PLA HU values were lower than PMMA, ranging from 22.5 to 45.3 HU on Philips and 25.1-49.1 HU on GE. CTDIvol deviations between PLA and PMMA ranged from -9.00% to -2.82% in November 2025 and from -5.78% to -3.83% in June 2026. These deviations remained within <10%, which was generally considered acceptable for comparative phantom-based CT dosimetry. CONCLUSION:The PLA CTDI phantom showed good effective atomic number, electron density, and dosimetric agreement with the standard PMMA phantom across two CT systems and two measurement time points. IMPLICATIONS FOR PRACTICE:3D-printed PLA CTDI phantom could offer a practical, low-cost complementary tool for comparative CTDI measurement, education, protocol optimization, and quality assurance.
INTRODUCTION:Average glandular dose (Dg) is the primary metric for assessing radiation risk in screening mammography. Although Dg analysis is commonly interpreted according to compressed breast thickness (CBT), breast density (BD) may significantly influence Dg. This study evaluated the influence of BD on Dg variability using the TG282-based dosimetry model and a machine learning approach. METHODS:The cross-sectional study included 1233 full-field digital mammography images from three mammography units. Dg was estimated using a TG282-based model. Images were stratified by CBT, view (CC and MLO), and BD (ACR BI-RADS). Non-parametric tests and Spearman's correlation assessed group differences and associations. A Random Forest (RF) regression model was implemented to explore non-linear relationships between Dg and age, CBT, compression force, and BD. Model performance was assessed using R², MAE, and MAPE. Feature importance analysis identified the contribution of each predictor. Dg,75 benchmarks were defined as the 75th percentile of Dg distributions stratified by BD and CBT. RESULTS:Dg distributions were non-normal, and Dg was higher in MLO than CC views (p < 0.05). Significant differences were observed across CBT and BD categories. Dg correlated positively with mAs and exposure time, while BD and compression force showed moderate associations. Within the four-predictor RF model (R² = 0.56, MAPE = 14.38 %), compression force (45.72 %) and BD (23.93 %) had the highest relative feature importance. Dg,75benchmarks increased with BD within CBT groups. CONCLUSION:Incorporating BD improves the characterisation of Dg variability in mammography. The RF model characterised multivariable relationships between BD and compression-related factors, supporting more anatomically informed dose optimisation strategies. IMPLICATIONS FOR PRACTICE:BD-stratified Dg,75benchmarks may improve identification of atypical dose values and support targeted dose monitoring in mammography.
INTRODUCTION:Stereotactic Radiosurgery (SRS) is the treatment of choice for patients with brain metastasis subject to NHS commissioning criteria. Upon diagnosis patients are required to inform the DVLA and to cease from driving. During the SRS consultation at least 25% of patients are unaware of this and will often say that having to give up driving is worse than a diagnosis of brain metastasis due to the perceived impact on mobility and independence. In the absence of QoL driving cessation (DC) data within radiotherapy the aim of this study was to investigate the impact of DC on patients who have been treated with Stereotactic Radiosurgery (SRS). METHODS:All patients who had SRS between August 2017-December 2021 with a Karnofsky Performance Status of 60 or above received an anonymised questionnaire, analysis of closed question quantitative data was performed using Statistical Package for the Social Science (SPSS) and descriptive statistics. Content analysis was performed with the qualitative information provided via open, free text questions. RESULTS:132 patients were included with a response of 36%. All QoL themes focusing on mobility, independence, social interactions, mood change and overall quality of life demonstrated a negative impact on QoL, and that written information would be useful. CONCLUSION:Results indicated that there is a link between DC and reduction in QoL. Wider investigation of this is recommended to gain a deeper understanding of the impact. Research indicated that some of the negative impact could be mitigated with a supportive intervention, considered an important step in enhancing patient experience and care. IMPLICATIONS FOR PRACTICE:This study will help highlight and provoke discussion as to how patients can be supported as a result of DC.
Objectives Diagnostic radiography requires sustained visual attention, rapid technical execution, and continuous evaluative judgement under conditions of high cognitive load. In practice, radiographers must integrate patient presentation, positioning, radiation safety, workflow demands, and image quality assessment in real time. Many radiographers also report that insights about positioning adequacy, subtle abnormalities, or possible oversight arise only after the clinical shift has ended. Although this experience is widely described informally, it has not been formally examined within the diagnostic radiography literature. This narrative review explored whether post-shift diagnostic insight can be understood through evidence on clinical reasoning, perceptual expertise, incubation, and post-task associative processing. Key Findings The reviewed literature suggests that diagnostic expertise depends on rapid pattern recognition supported by executive control, but that complex or ambiguous cases may remain only partially resolved during high-pressure clinical work. Research on incubation, mind-wandering, and perceptual learning indicates that periods of reduced cognitive demand may enable continued reorganisation of previously encoded information, allowing overlooked details, alternative interpretations, or unresolved concerns to become more salient. This process provides a plausible account of how insight may emerge after focused clinical engagement has ceased. Conclusion Post-shift diagnostic insight can be conceptualised as a continuation of diagnostic reasoning rather than delayed reflection alone. Recognising this temporal extension of clinical reasoning has implications for practice, education, and workforce design. Implications for practice Structured opportunities for case revisitation, psychologically safe discussion of delayed recognition, and educational approaches that acknowledge cognitive recovery, may support adaptive expertise, strengthen error recognition, and contribute to more sustainable radiography practice.
Introduction “Scanxiety” refers to the anxiety and/or distress that an individual experiences before, during, or after a medical scan (e.g., MRI, ultrasound, CT, etc). Symptoms characterising scanxiety remain poorly defined and are inconsistently measured. This systematic review aimed to synthesise symptoms reported in relation to scanxiety among adult populations, and to evaluate patient reported outcome measures commonly used to measure scanxiety focusing on how well these measures capture its symptoms. Methods A best fit framework synthesis approach was applied to explore scanxiety symptoms using the five areas model (emotional, cognitive, behavioural, physiological and environmental domains). Symptoms identified were then mapped against nine measures commonly used to assess scanxiety. The quality of studies included was appraised using the Mixed Methods Appraisal Tool. Results Across 23 studies, 159 symptoms were identified in studies exploring experiences of scanxiety. Symptoms were synthesised into 18 conceptual clusters spanning all domains of the five areas model. Existing measures predominantly assessed emotional and physical symptoms, while behavioural and cognitive symptoms were inconsistently represented. Environmental symptoms were not captured by any measure reviewed. Conclusion Scanxiety is a multi-dimensional and contextually influenced experience, the symptoms of which are not adequately captured by the assessment tools included in this review. The findings have implications for clinicians working with this group, particularly how best to assess symptoms and identify scanxiety in advance to inform appropriate intervention. Implications for practice Assessment of scan-related distress extends beyond emotional and physical symptoms to include behavioural and environmental factors. Developing scanxiety-specific tools grounded in lived experience may improve identification and support across a wider range of imaging contexts.
Introduction Occupational stress harms the mental and physical health of healthcare workers, affecting their quality of life and work. Although occupational stress has been widely studied among radiological professionals, research focused specifically on nuclear medicine radiographers, particularly in South Africa, remains limited. This study aimed to identify and describe perceived occupational stressors among nuclear medicine radiographers in South Africa. Methods A cross-sectional quantitative descriptive research design was used. An online-adapted Nuclear Medicine Occupational Stress Questionnaire, using a five-point Likert scale, was distributed via WhatsApp, Facebook, and the South African Society of Nuclear Medicine social platform to nuclear medicine radiographers employed in private and government sectors in South Africa. Participants were selected using purposive sampling supplemented by snowball sampling. Data were analyzed using descriptive and inferential statistics. Results Sixty-three responses were received, yielding a response rate of 23.8%; most participants were employed in the private sector (68.3%). The most frequently reported perceived occupational stressors rated as at least moderately stressful were equipment malfunction (96.8%), non-cooperative patients during examinations (95.2%), lack of managerial support (93.7%), infrequently performed examinations (92.1%), and high daily workload (90.5%). Most demographic characteristics were not significantly associated with the highest-ranked stressors. A weak but significant association was observed between duration of employment at the current employer and perceived stress related to lack of managerial support (Spearman's ρ = 0.288, p = 0.02). Conclusion The findings suggest that perceived occupational stressors among participating nuclear medicine radiographers were mainly related to organizational, operational, and service-delivery factors rather than specific demographic variables. Implications for practice Workplace strategies that strengthen managerial support, staffing, equipment maintenance, resource management, and operational processes may help alleviate stress associated with occupational stressors in nuclear medicine practice.
Introduction To assess how the use of a silver beam filtration with deep learning reconstruction (DLR) impacts the unenhanced abdominopelvic CT in terms of soft tissues density, image quality and radiation dose. Methods This study evaluated two unenhanced abdominopelvic CT acquisitions of 110 patients performed with a conventional filtration (group A) and a silver filtration (group B). The HU values of several soft tissues and extra corporeal air were recorded for each acquisition using an identical circular ROI.Interobserver agreement and subjective qualitative analysis of image were assessed. The student's paired t-test was used to evaluate differences between the two examinations in terms of HU values, SNR, CNR, DLP and CTDIvol. Statistical difference was considered as significant at p ≤ 0.05. Results The subjective image quality and interobserver agreement were judged excellent without significant difference between both acquisitions.We found lower HU values for the silver filter than for the conventional filter with a percentage decrease between 0.03 and 0.09% except for urine which was found at 38%. However, there was no statistically significant difference except for the subcutaneous fatty tissue and urine.The radiation dose was found to be significantly lower by 36% in the examinations done with silver filter when compared to the conventional filter. Conclusion Implementing the silver filtration with DLR on non-contrast abdominopelvic CT acquisition achieves a significant dose reduction while preserving image quality, albeit a reduction of the HU value of soft tissues, more intense for positive low-density structure (urine/water). Implications for practice This fact must be taken into account in clinical routine especially in the context of indeterminate cyst or adrenal mass on non enhanced acquisition.
INTRODUCTION:High-quality mammography depends on radiological technologists' technique. However, key procedural know-how is often tacit and difficult to articulate, making it challenging for novices to reproduce expert performance. This pilot study quantified timing differences between novice and expert operators during mediolateral oblique (MLO) mammography positioning. METHODS:Left MLO positioning was performed on a mammography unit by three expert technologists and two novice students. Five volunteers without mammography experience acted as simulated patients. The procedure was recorded using three cameras. Two raters identified phase boundaries and extracted time from breast lifting and pulling to completion of compression. The procedure was divided into four phases: (1) breast lifting and pulling, (2) breast holding, (3) breast flattening, and (4) breast compression. Results are presented as individual values and medians (range). Effect sizes were expressed as median differences and ratios with 95% bootstrap intervals. RESULTS:Total positioning time was shorter for novices than experts (median 5.8 s vs 15.6 s), with a median difference of 9.8 s (95% bootstrap interval 2.3-11.7) and a median ratio of 2.7 (1.3-4.0). Phase-wise analysis showed no consistent difference in phase (1) (median difference -0.5 s; -1.6 to 2.1). Experts spent longer in phases (2)-(4): breast holding, 1.8 s (0.8-2.2); flattening, 3.6 s (2.5-3.9); and compression, 2.8 s (0.6-5.7). CONCLUSION:Experts spent longer than novices during MLO positioning, particularly during breast holding, breast flattening, and breast compression. Timing analysis may support training and clarify how novices develop proficiency. IMPLICATIONS FOR PRACTICE:Shorter procedural time may reflect reduced checking behavior or immature attentional allocation rather than easier performance. Instruction should target these phases and make goals, checking behaviors, and movement strategies explicit.
INTRODUCTION:People in prison experience significant health disparities and rely on acute hospitals for secondary care, including diagnostic imaging. Despite this, little is known about how diagnostic radiographers experience imaging people from prison in acute hospital settings. This study aimed to examine these experiences in the UK. METHODS:This paper reports the Phase One survey dataset from the EXPOSE study, a wider doctoral programme. A cross-sectional survey was conducted as Phase One of a sequential explanatory mixed-methods study. Registered diagnostic radiographers in the UK with experience in imaging people from prison were recruited using convenience and snowball sampling. Data were collected via an online survey and analysed using descriptive statistics to identify patterns and variation in reported experiences. Phase Two qualitative findings will be reported separately. RESULTS:Fifty-five diagnostic radiographers participated. Most reported high confidence and perceived ability to deliver comparable care. However, 40% indicated that knowledge of offence history influenced their professional approach to some extent. Physical restraints were commonly encountered, with inconsistent documentation of clinical risk. Workflow, radiation protection, MRI safety, and patient positioning were frequently affected. Communication practices were altered for many participants. Despite minimal reported impact on image quality, variability in practice was evident. Most participants reported no formal training and limited awareness of the equivalence of care principle, relying primarily on informal coping strategies. CONCLUSION:Diagnostic radiographers reported sustaining imaging delivery despite security-related, operational and ethical challenges. The variability in restraint-related processes, information-sharing and local protocols identifies conditions that may threaten consistent, person-centred care. IMPLICATIONS FOR PRACTICE:Imaging departments should develop local pathways covering clinical-prison role boundaries, physical restraint decisions, proportionate information-sharing, modality-specific guidance, escalation and access to organisational support.
