Ghanaian radiographers' perspectives on participating in preliminary image evaluation: A qualitative study

Radiographers in low-resource settings like Ghana often operate in environments with limited access to radiologists, resulting in informal involvement in image interpretation tasks despite a lack of formal recognition or training. Preliminary Image Evaluation (PIE), where radiographers provide initial comments on X-ray images have been successfully implemented in other countries. This study explored the perspectives of Ghanaian radiographers on PIE involvement.

A qualitative descriptive design was adopted. Semi-structured interviews were conducted with twelve purposively selected diagnostic radiographers working across various healthcare facilities in Ghana. Data were thematically analysed using Braun and Clarke's reflexive thematic analysis approach supported by NVivo™ 14 software for data organisation.

Six key themes emerged from the analysis: interest in PIE, opportunities and enablers, benefits of PIE, barriers to participation, educational preferences, and advocacy for institutional/regulatory reforms. Sixteen subthemes emerged including motivation for professional growth, improvements in patient outcomes, enhanced professional identity and support from clinical staff. Lack of educational opportunities, increase workload, legal issues, and perceived resistance from other professionals were reported as key barriers. Participants emphasized the need for structured training and clear policy guidelines to support effective radiographer PIE participation.

Radiographers in Ghana demonstrate readiness and motivation for expanded roles in PIE. The study highlights key enablers, barriers, and educational preferences influencing radiographer involvement in PIE, especially in contexts of radiologist scarcity.

System-level changes, especially in education, regulation, and interprofessional collaboration are essential to support the safe and sustainable implementation of radiographer-PIE participation, particularly in resource-limited health systems.