RESUMEN
INTRODUCTION: Diagnostic reference level (DRL) values for computed tomography (CT) based on clinical indication are warranted since imaging protocols are indication-dependent. This study proposes clinical DRL values using the CT dose metrics and five patient size-related parameters while considering image quality. METHODS: The volumetric CT dose index (CTDIvol), dose-length product (DLP) and five size-related parameters of size-specific dose estimates (SSDE), namely the anterior-posterior (AP) dimension, lateral (LAT) dimension, sum dimension, effective diameter, and the body mass index (BMI), were used to calculate DRL values for CT chest-abdomen-pelvis (CAP) and abdomen-pelvis (AbP) protocols. DRL values of the clinical indications for cancer, urinary system stones and other pathologies were assessed based on the BMI classifications using the median and 75th percentile. An image subtraction algorithm was used to assess the image quality metrics (IQM) of the CT images. RESULTS: The 75th percentile for SSDEAP dimension for CAP cancer was 19.7, 14.9 and 12.7 mGy at Hospitals A, C and E, respectively. The median DLP for other AbP pathologies was 556.3, 1452.0 and 1960.7 mGy.cm for normal weight, overweight and obese patients, respectively, at Hospital A. The image quality varied among BMI classifications for different clinically indicated examinations. Although the dose increased with BMI, the image quality index was consistent because automatic tube current modulation (ATCM) was used. CONCLUSION: DRL values are influenced by patient size-related parameters and the clinical indication protocols, while the image quality index is independent of the BMI. IMPLICATIONS FOR PRACTICE: Size-related clinical DRL values and image quality index can be used to monitor and optimise dose and image quality. Acquisition parameters and image quality indexes should be investigated and adjusted when unusually high DRL values are noted.
Asunto(s)
Neoplasias , Tomografía Computarizada por Rayos X , Humanos , Dosis de Radiación , Tomografía Computarizada por Rayos X/métodos , Abdomen/diagnóstico por imagen , TóraxRESUMEN
INTRODUCTION: Interprofessional education (IPE) takes place when representatives of at least two professions work and learn together, about and from each other to provide optimal healthcare. For the successful implementation of an IPE programme, conceptualisation, planning, and operationalisation and coordination among the various professions is crucial, to assist students to obtain the desired competencies of such a programme. The purpose is to investigate if a structured IPE programme assisted radiography students to achieve competencies. METHODS: An online questionnaire was compiled from literature and completed by radiography students who participated in a structured, three-week-long IPE programme. The questionnaire was mainly quantitative (using a Likert scale), though it also consisted of qualitative elements (open-ended questions). A Fischer's Exact test was used to compare the responses of three different year groups. RESULTS: Feedback from the radiography students (n=63) indicated that they achieved this IPE programme's specific competencies: role clarification, interprofessional communication, teamwork, person-centered care and values and ethics. There was good correlation between the feedback from all three year groups. The feedback on the open-ended questions correlated with the quantitative feedback, though some students felt excluded, as there was little reference to their particular profession in the simulation session of the IPE programme. CONCLUSION: The results of the study indicate that radiography students achieved the prescribed competencies of a structured IPE programme. The results provide insight into ways to improve the IPE programme. A recommendation emanating from the results of this study is that, to improve the experience of all healthcare professions students, structured IPE programmes have to promote inclusive teaching and learning. IMPLICATIONS FOR PRACTICE: Radiography students that participate in a structured IPE programme develop competencies necessary for effective collaborative clinical practice.