Novel training approach to improve a cohort of radiographers' image interpretation skills of trauma chest radiographs

Zambia is experiencing a critical shortage of radiologists responsible for interpreting X-ray images. Nine radiologists serve the entire population of over 18 million people. Consequently, referring physicians can receive reports late and often receive X-ray images without radiological reports attached, which may lead to delayed diagnoses and treatment of critically injured patients. This challenge could be alleviated if radiographers could assist with interpreting X-ray images. This study was undertaken to subject a cohort of Zambian radiographers to a training intervention, however, the COVID-19 pandemic necessitated using a novel approach to the intervention by delivering the training mainly through social media but also through face-to-face lectures. A cohort of 27 radiographers employed at eight public hospitals in the Copperbelt Province of Zambia undertook a training intervention using face-to-face training and image discussions on the social media WhatsApp® platform. The participants underwent a pre-and post-test in which they were asked to interpret 20 adult trauma CXR images. For the training intervention, the radiographers attended a face-to-face image interpretation lecture, after which they received training images with a radiologist report weekly for eight weeks via the WhatsApp® platform. Participants were encouraged to discuss and pose questions via the platform. The cohort of radiographers (n = 27) showed an improvement in their interpretation skills for trauma CXR images. The interpretation median scores ranged from approximately 82% to 93% in the pre-test and 85% to 97% in the post-test. The Wilcoxon signed-rank tests revealed significant differences in the interpretation ability skills for 12 of the 20 CXR images after the 8-week training, demonstrating the successful implementation of the program. When comparing three categories of radiographers' years of experience (1–5; >5–10; and >10 years), the Kruskal Wallis test could not identify significant differences in the CXR image interpretation skills among the different categories of experience (P = 0.1616). When comparing the interpretation skills of radiographers working at the three different hospital levels (Level 3 with a full-time radiologist and more than ten radiographers; Level 1 and 2 without a full-time radiologist; Level 2 with six to ten radiographers; and Level 1 with five or less radiographers), the Kruskal Wallis test revealed that the level of the hospital where the radi