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Competency in chest X-ray interpretation: Variations across medical experiences and training levels
A J Koa1, W L Cheah2, T T Yew3
1Department of Radiology, Faculty of Medicine and Health Sciences, Universiti Malaysia Sarawak (UNIMAS), 94300 Kota Samarahan, Sarawak, Malaysia. fathmawati@poltekkes-pontianak.ac.id; fathmawati.ema@gmail.com.
The Medical Journal of Malaysia
|January 30, 2026
Summary
Accurate chest X-ray (CXR) interpretation improved significantly with clinical history. Doctor seniority did not impact CXR reading accuracy, highlighting the need for structured training and practice.
Area of Science:
- Medical Imaging
- Radiology
- Diagnostic Accuracy
Background:
- Chest X-ray (CXR) is a fundamental diagnostic imaging tool.
- Interpretation accuracy varies among medical professionals.
- Assessing CXR interpretation competency across career stages is crucial.
Purpose of the Study:
- To evaluate the competency of doctors in interpreting chest X-rays (CXRs).
- To assess how medical career stage influences CXR interpretation skills.
Main Methods:
- Cross-sectional study involving 305 participants (house officers, medical officers, registrars).
- Digital CXRs were interpreted using a multiple-choice format.
- Data analyzed using IBM SPSS Statistics software, version 25.
Main Results:
- Clinical history dramatically increased accurate CXR interpretation from 21% to 63.6%.
- Field of interest and confidence were linked to accuracy without history; only confidence mattered with history.
- No significant difference in interpretation ability was found across doctor seniority levels.
Conclusions:
- Structured teaching, practice, feedback, and clinical integration enhance CXR interpretation competency.
- Future multicenter studies are recommended for broader generalizability.
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