Assessing Ghanaian radiographers' competency in preliminary image evaluation: A pre- and post-test study

Delays in radiological reporting and its negative impact on patient outcomes have increased the interest of radiographers in Preliminary Image Evaluation (PIE). However, competency in PIE is essential to improve patient management. This study assessed the image interpretation competencies of Ghanaian radiographers following a structured educational intervention programme.

A three stage quasi-experimental, single-group pre-test and post-test design was employed. An image interpretation test tool, comprising 60 radiographic images per phase, was developed and validated. Thirty-six (36) radiographers completed both pre-test and post-test following a two-day training session on abnormality detection and interpretation. Test responses were scored against a gold standard. Diagnostic metrics including accuracy, sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and area under the curve (AUC) were calculated. Pre- and post-test results were compared using Wilcoxon signed-rank and paired samples t-tests.

Participants' mean accuracy (71.7 % v 79.5 %, p = 0.002), sensitivity (84.1 % v 90.4 %, p = 0.012), PPV (76.4 % v 89.6 %, p < 0.001) and AUC scores (0.821 v 0.878, p = 0.002) significantly improved after training. However, mean specificity (80.0 % v 85 %, p = 0.176) and NPV (87.7 % v 88 %, p = 0.087) did not significantly change post-training. Participants demonstrated improved ability in localizing (59.2 % v 68.4 %, p = 0.003), describing (55.3 % v 77.1 %, p < 0.001), and formulating diagnoses (43.1 % v 49.3 %, p = 0.022) of abnormalities.

Ghanaian radiographers demonstrated moderate baseline competencies in PIE, which significantly improved following training. These findings support the inclusion of structured image interpretation training in radiography education and continuing professional development programmes.

Radiographers can contribute to diagnostic services through PIE, particularly in resource-constrained settings. Formal integration of PIE responsibilities, supported by training, may help enhance patient care.