The impact of focused training on abnormality detection and provision of accurate preliminary clinical evaluation in newly qualified radiographers

Introduction: Preliminary clinical evaluation (PCE) can be a useful initial assessment of traumatic abnormalities by frontline radiographers; new graduates are expected to have the skills and knowledge required to provide this initial interpretation. This study evaluates the abnormality detection performance and accuracy of PCE commenting in newly qualified radiographers. Method: Four newly qualified radiographers completed a fracture/dislocation detection task consisting of 58 cases, including providing a PCE for each suspicious area. Following this, an 8-week training program was completed to improve competence in recognizing abnormalities and providing an accurate PCE. Equally weighted jackknife alternative free-response receiver operating characteristic (wJAFROC) analysis was performed; a difference between pre- and post-training would be considered significant at a test alpha of less than 0.05. Results: Fracture/dislocation detection was significantly better in the post-training evaluation for fixed observers and random cases (F (1,57) = 4.48, p = 0.0387). The reader averaged wJAFROC FOM and 95% CIs for pre- and post-training were 0.619 (0.516, 0.737) and 0.703 (0.622, 0.852). A paired t-test demonstrated a significant difference in PCE scores in favour of the post-training evaluation p = 0.0006. This small cohort demonstrated difficulty in recognising undisplaced fractures and buckle fractures. Conclusion: An 8-week training program had a positive impact on participants’ ability to localise and accurately describe fractures. Implementation of abnormality detection training should be considered during preceptorship periods. Due to the small sample size, it is inappropriate to suggest these findings are representative of all graduate radiographers