Radiographers’ role and practice in suspected cases of child physical abuse in Malta

Abstract

Purpose: To investigate the role and practice of radiographers in the detection and management of Suspected Child Physical Abuse (SCPA) in Malta. Methodology: A non-experimental, cross-sectional and prospective research design employing a quantitative approach was adopted. Data was collected through a self designed online questionnaire, which was distributed to radiographers working within the Accident and Emergency (A&E) Department of the public general hospital, as well as Primary Health Care (PHC) Centres across Malta. Results: A total of 36 radiographers from a target population of 44 completed the questionnaire, yielding a response rate of 81.8%. Radiographers demonstrated an understanding of the concept of determining SCPA, with 61.1% acknowledging the detection and reporting of such cases as an important aspect of their role. However, 83.4% had limited familiarity with the radiological signs of SCPA. While 77.8% indicated they would report suspected cases, only 41.7% were aware of a legal obligation to report. Furthermore, 63.9% were unaware of established departmental protocols/guidelines for managing such cases. While 77.8% expressed confidence in producing high-quality images for legal purposes, many felt that they were only moderately competent (55.6%) in providing court tesmony. Half of the participants had not received any training, and 66.7% were unaware of available training opportunities. Despite this, 83.3% expressed the importance of specialised training in SCPA, with 94.4% supporting the idea that mandatory periodic training programmes for radiographers should be implemented. Conclusions: Effective management of SCPA relies on the radiographers’ ability to accurately detect and report such cases. This study reveals variability in skills and awareness, which may hinder timely and effective intervention, emphasising the need for ongoing training and clear procedural guidance to support radiographers in fulfilling their safeguarding responsibilities. Implications for Practice: Although most radiographers acknowledged their role in SCPA, this study revealed gaps in knowledge, awareness and adherence to protocols, as well as inconsistent abilities in detecting radiographic signs of SCPA. Furthermore, a lack of awareness regarding their legal obligations to report such cases was also evident. Therefore, relevant stakeholders should prioritise the development and periodic delivery of structured training. Once established, this training can be integrated into mandatory CPD courses to strengthen radiographers’ competence in the detection, management, and reporting of SCPA, ultimately enhancing child protection outcomes.