The impact of a pilot education programme on Queensland radiographer abnormality description of adult appendicular musculo-skeletal trauma

Introduction: Interpretation of trauma images by radiographers is a task substitution that has been debated for many years in Australia and enacted in various forms internationally since the 1980s. This paper describes the standardised test portion of a pilot project (which also had a clinical component) that investigated the potential for radiographers to describe abnormalities as a change to models of healthcare delivery being adopted in Queensland. Method: Randomly selected appendicular musculo-skeletal trauma images were reported by four radiologists to confirm image content. 102 images, matched for population injury incidence and body area proportionality served as a standardised image test. Ten radiographers described images before, immediately after and 8e10 weeks following an education programme. Receiver operator characteristic curves and kappa statistics were calculated to evaluate radiographer descriptive performance relative to the radiologist reports. Results: Using the Friedman and Wilcoxon signed ranks tests there was statistically significant improvement of sensitivity and accuracy of radiographer performance by the third standardised test with values: sensitivity (p ? 0.023/0.012), accuracy (p ? 0.012/0.021) specificity demonstrated no or very close statistically significant change (0.118/0.058). Kappa values (Cohen p ? 0.019/0.011, Gwet 0.025/ 0.007 and Byrt et al. 0.021/0.047) demonstrated statistically significant change across the test sequence. Positive and negative predictive values with positive likelihood ratios were also calculated. Discussion: Most (9/10) radiographers demonstrated a high level of agreement of description accuracy with the radiologists used to create the standardised test. Conclusion: With appropriate education radiographers can match radiologist descriptions of appendicular musculo-skeletal trauma.