背景:一个多世纪以来,放射成像在诊断医学中发挥了重要作用,尽管已知它有助于皮肤病,白内障,和癌症。相关的伤害风险导致世界各地引入了保护性法规。当前,NHS临床医生越来越多地要求和依赖诊断成像。关于普通放射学调查的辐射剂量和相关风险的知识势在必行,在全球范围内被发现是不够的。因此,有必要将教学正式纳入培训计划。
目的:这项前瞻性审核旨在建立位于苏格兰北部的四个NHS健康委员会中的医学生和推荐人的辐射剂量和常见放射学调查风险的知识。它还寻求建立先前的教学和对进一步教育干预的偏好。
■推荐人应充分了解辐射剂量和与普通放射学检查相关的风险。
■标准应达到90%的推荐人。
方法:设计了一个19个问题的在线调查,包括关于电离辐射意识的主观和客观问题,教育偏好,和受访者的人口统计,基于RCR(皇家放射科医师学院)审核标准和先前的研究。在22/02/23至22/03/2023之间进行数据收集,并将问卷分发给NHSGrampian中不同年级的高级医学生和放射科推荐人,NHS高地,NHS设得兰群岛,和NHS奥克尼。使用MicrosoftExcelVersion16.71对数据进行描述性分析。
结果:完成了二百八份问卷。22.11%(n=46)的样本人群没有接受过有关电离辐射主题的先前教学。超过一半的受访者(51.92%,n=108)将辐射风险的重要性评为重要或极其重要,69.71%(n=145)的参与者将他们的感知知识评为有限或平均。最正确地识别出CT扫描(n=203),PET-CT扫描(n=199)和胸部X射线(n=196)使患者暴露于电离辐射。一小部分参与者错误地认为MRI扫描(n=21)和超声扫描(n=2)涉及电离辐射。获得的结果未能达到RCR审核目标,其中指出,90%的医生应该知道常见的放射剂量。据观察,只有17.79%(n=37)的调查受访者在知识评估中得分超过50%,整个队列的中位知识得分为9分中的2.5分(27.78%)。先前曾就该主题进行过教学的受访者表现更好,平均得分为3.19分(35.44%)和2.04分(22.67%)。与初级临床医生和医学生相比,高级临床医生的表现更好。
■此审核发现,在选定的样本人群中,苏格兰北部地区的辐射风险知识在临床团队的各个级别中都不足。Further,围绕主题和未来审计机会的持续教育可能有助于优化知识和培训。
BACKGROUND: Radiological imaging has played an important role in diagnostic medicine for over a century, though it is known to contribute to dermatological conditions, cataracts, and cancer. The associated risk of harm has led to the introduction of protective regulations around the world. Present-day NHS clinicians are increasingly requesting and relying on diagnostic imaging. Knowledge surrounding the radiation doses of common radiological investigations and the associated risks is imperative, and on a global level has been found to be inadequate. Consequently, there is a need for the formal inclusion of teaching within training programmes.
OBJECTIVE: This prospective audit aims to establish the knowledge of radiation doses and risks of common radiological investigations of both medical students and referrers within four NHS Health Boards based in the North of Scotland. It also seeks to establish prior teaching and the preference for further educational interventions.
UNASSIGNED: Referrers should have adequate knowledge of radiation doses and the risks associated with common radiological investigations.
UNASSIGNED: The standard should be achieved by 90% of referrers.
METHODS: A 19-question online survey was devised to include subjective and objective questions on ionising radiation awareness, education preference, and respondent demographics, based on RCR (Royal College of Radiologists) audit criteria and previous studies. Data collection was conducted between the 22/02/23 to the 22/03/2023 and the questionnaire was distributed to senior medical students and radiological referrers of different grades within NHS Grampian, NHS Highland, NHS Shetland, and NHS Orkney. A descriptive analysis of the data was undertaken using Microsoft Excel Version 16.71.
RESULTS: Two hundred eight questionnaires were completed. 22.11% (n = 46) of the sample population had received no prior teaching on the topic of ionising radiation. Over half of the respondents (51.92%, n = 108) rated the importance of radiation risks as either important or extremely important, with 69.71% (n = 145) of participants rating their perceived knowledge as limited or average. Most correctly identified that a CT scan (n = 203), PET-CT scan (n = 199) and a chest x-ray (n = 196) exposed patients to ionising radiation. A small proportion of the participants incorrectly thought that an MRI scan (n = 21) and an ultrasound scan (n = 2) involved ionising radiation. The results obtained failed to meet the RCR audit target, which states that 90% of doctors should be aware of common radiological doses. It was observed that only 17.79% (n = 37) of survey respondents scored over 50% in the knowledge assessment, with the median knowledge score of the whole cohort being 2.5 out of 9 (27.78%). Respondents who had prior teaching on the topic performed better those who had no prior teaching, with average scores of 3.19 (35.44%) and 2.04 (22.67%) respectively. Senior clinicians performed better when compared to junior clinicians and medical students.
UNASSIGNED: This audit found that the knowledge of radiation risks within the North of Scotland in the selected sample population was insufficient across all levels of the clinical team. Further, continuous education around the topic and future audit opportunities may help to optimise knowledge and training.