Medical doctors’ awareness of radiation exposure in diagnostic radiology investigations in a South African academic institution

Abstract

BackgroundDiagnostic investigations using radiation have become a critical feature of medical practice in recent times. However, the possibility of doctors’ underestimation of risks of over-exposure of patients to diagnostic radiation still warrants further evaluation.ObjectivesTo investigate doctors’ awareness of diagnostic radiation exposure at Dr George Mukhari Academic Hospital, South Africa.MethodsThis was a cross-sectional, analytical investigation of the awareness of doctors about radiation exposure in diagnostic radiology investigations. A cluster sampling technique was employed to recruit 217 participants. Consent and approval of the participants were sought and obtained before questionnaire administration during departmental meetings between October 2017 and March 2018.ResultsOf the participants, 80% had no formal training on radiation exposure and 33.8% of them correctly estimated natural background radiation. Correct estimates of the effective dose from a single-view abdominal X-ray (AXR) were expressed by 7.5%, quantity of radiation of a single-phase computed tomography (CT) abdomen by 30.3% and dosage from a two-view unilateral mammogram by 29.1% of the participants. More than 75% of participants agreed that children are more sensitive to radiation, but only 10.5% suggested medical termination of pregnancy for a woman who had CT abdomen and pelvis with contrast. Dosage and risk of inducing fatal cancer from common but more complex imaging procedures were poorly understood. Only the doctors of the radiology department showed a statistically significant (p < 0.0001) association with regards to their radiation awareness.ConclusionBecause of the high rate of poor awareness of radiation risks observed in this study, it is important to initiate, early in the medical curriculum for medical students, the need for a rotation in the Department of Radiology, similar to such rotations in other medical specialties.

The need for nationally accepted guidelines for undergraduate nuclear medicine teaching in MBChB programmes in South Africa

“…They also commented on the need to improve undergraduate NM training in South Africa. 46 Similarly, in a study done to investigate doctors’ awareness of diagnostic radiation exposure at Dr George Mukhari Academic Hospital Ga-Rankuwa, Pretoria, Dauda et al 8 reported that 80% of the 217 participants had no formal training on radiation exposure. Dauda and colleagues also advocated for improved teaching on radiation medicine at undergraduate level.…”

“…Dauda and colleagues also advocated for improved teaching on radiation medicine at undergraduate level. 8 …”

“…Dauda and colleagues also advocated for improved teaching on radiation medicine at undergraduate level. 8 At present, there is only one unpublished study on the development of a guideline for teaching and learning nuclear medicine in undergraduate medical education in South Africa that could be useful in curriculum development. 10 However, the guidelines proposed by the author of this study have never been implemented.…”

“…Numerous studies have reported on the high level of imaging illiteracy amongst practising physicians and graduating medical students. 6 , 7 , 8 This has been associated with lack of patient referral, 9 poor quality and inadequate referral, 10 poor knowledge of radiation doses for routine imaging procedures, 7 and poor awareness of radiation risks. 8 …”

“…4,5 Numerous studies have reported on the high level of imaging illiteracy amongst practising physicians and graduating medical students. 6,7,8 This has been associated with lack of patient referral, 9 poor quality and inadequate referral, 10 poor knowledge of radiation doses for routine imaging procedures, 7 and poor awareness of radiation risks. 8 Here, we highlight the challenges of undergraduate nuclear medicine teaching, particularly in South Africa, and emphasise the need for the implementation of guidelines for undergraduate nuclear medicine education in MBChB programmes in South Africa.…”