Radiographers’ opinion and practice in relation to the justification of radiological medical exposures in Malta

Abstract

Purpose: To investigate local radiographers’ opinion and practice relating to any role they have in the justification of radiological procedures within the public health service in Malta. Methodology: A prospective, cross-sectional quantitative research design was adopted. A previously published questionnaire was adapted with permission to the local scenario and was distributed amongst a sample of radiographers working at a general hospital and healthcare centres in Malta. Results: Out of 117 distributed questionnaires, fifty-seven were completed, resulting in a response rate of 48.7%. Radiographers identified five main principles of justification: ensuring benefits outweigh risks, verifying adequate clinical information, assessing the impact on patient management and care, considering alternative modalities, and properly timing examinations to avoid unnecessary or duplicate scans. A significant majority (91.22%) felt they played an important role in the justification process, integrating it into their daily workflow. However, only 61.4% reported using referral criteria or guidelines. Key challenges included insufficient clinical information and the influence of traditional medical dominance. Although 88% had received prior training in justification, most expressed a desire for further education through CPD courses or lectures to improve their skills. Conclusions: Justification is key in radiation protection, with local radiographers generally recognizing their crucial role. Given the challenges faced, most participants desired additional training to enhance confidence and their autonomy to better fulfil this role. Implications for practice: While most radiographers were aware of their important role in justification, there seems to be a lack of consensus about the shared roles and responsibilities of the referrer and practitioner, as well as the use of referral guidelines. Respective stakeholders should therefore aim to provide continuing professional development courses and/or training to further enhance practices and procedures relating to the justification of radiological procedures so as to enhance efficacy of services, patient safety and outcomes.