No / Despite the United Kingdom College of Radiographers aspiration that first line reporting or commenting by radiographers be normal practice, radiographers have not as yet embraced these opportunities in clinical practice and the number of radiographer commenting (initial reporting) schemes in operation is currently limited. This study explores radiographer opinion with regard to commenting with the aim of establishing the perceived opportunities and barriers to operating a commenting scheme with respect to trauma radiography. Method A survey of 79 radiographers working within a single multi-centre Trust in the north of England was undertaken using a questionnaire. Attitudinal statements were used to elicit information on perceived opportunities and barriers to the implementation of radiographer commenting. Results Fifty three questionnaires were returned within the specified time frame (n-53/79; 67.1%). A number of barriers to implementing a commenting scheme were identified including time, technology, anatomical confidence and training. Opportunities included improving professional profile and increased professional contribution to decision making within the patient pathway. No correlation was demonstrated between respondent demographic and responses suggesting that opinions expressed were not influenced by hospital site, radiographer grade or years experience. Conclusion Radiographers generally had a positive attitude towards the implementation of radiographer commenting and felt that their operation was both beneficial to patient care and the professional profile of radiographers. However, a number of barriers were identified and while concerns regarding training may be increasingly addressed by the Department of Health’s e-learning image interpretation package, the impact of changes in technology and subsequent service operation have not yet been fully evaluated.

No / The College of Radiographers has called for ‘Red Dot’ schemes to evolve and has recommended the development of radiographer commenting. The implementation of a radiographer comment scheme assumes that radiographers previously participating in ‘red dot’ schemes have been accurately recognising radiographic abnormalities and are, therefore, able to comment upon, and describe, such radiographic appearances. Research evidence to support such an assumption is sparse. This study compares the ability of radiographers attending a short course on musculoskeletal trauma to ‘red dot’ and comment on A&E radiographic appearances. Methods: This study adopted a pre-test, post-test approach. One hundred and twenty one radiographers attending a short course on musculoskeletal trauma (Bradford Red Dot Course) were invited to undertake an assessment of their ability to recognise (‘red dot’) and describe (comment upon) radiographic abnormalities at the start and end of the short course. Results: One hundred and fifteen radiographers (n = 115/121; 95.0%) completed both the pre- and post-training assessments. Post-training mean scores per case improved on average by 9.8% [p = 0.012; 95% CI: 2.4, 17.1] for ‘red dots’ and 12.7% [p = 0.007; 95% CI: 3.8, 21.5] for commenting. However, the difference between mean ‘red dot’ and commenting scores remained similar with mean radiographer comment scores being 13.7% less than mean ‘red dot’ scores pre-training and 10.8% less post-training. Conclusions: The results of this study indicate that the accuracy of radiographer comments was significantly reduced when compared to the accuracy of ‘red dots’ for the same radiographic images. The clinical significance of these findings for departments wanting to move from a ‘red dot’ system to a radiographer commenting scheme is that without appropriate training and audit, the quality of service and assistance to the A&E department could be significantly reduced.

No / Radiographer abnormality detection schemes (RADS) were first introduced in the United Kingdom (UK) in the mid 1980s with the development of the ‘red dot scheme’. This article establishes the current position of UK RADS practice and provides insight into specific areas for development. Method: A postal questionnaire was distributed to 456 sites, including 270 emergency departments and 186 minor injuries units (MIU). Information was sought relating to: the type of emergency department and radiography service provided; details of RADS operated including any education and audit to support radiographer participation; and the mandatory/voluntary nature of the system adopted. Results: A total of 306 (n = 306/456; 74%) responses were received. The large majority of respondents (n = 284/306; 92.8%) indicated that a RADS was in operation. Of these, 221 sites operated a red dot scheme, 7 sites operated a radiographer comment system, and a further 54 sites operated both a red dot and comment scheme. Two sites indicated that a RADS other than red dot or radiographer commenting was operated. Twenty-one different methods of highlighting abnormal images were identified and eight different commenting methods. The RADS was considered mandatory at 25% of sites. Conclusion: This study confirms the continued widespread contribution of radiographers to the trauma diagnostic process through the use of RADS. The informal nature of the systems, inconsistent approaches to audit and education, and variations in the methods employed are issues which require national guidance.