Experiences of radiographers working alone in remote locations: A Far North Queensland non-participant observational study

What medical specialists want to stay in remote areas of Indonesia: Discrete choice experiments

INTRODUCTION

The equitable distribution of medical specialists in Indonesia's remote areas remains a challenge. This study investigated the preferences of medical specialists regarding retention programs aimed at addressing this issue.

METHODS

A Discrete Choice Experiment (DCE) was utilized to collect stated preferences from 341 medical specialist working in district general hospitals across 10 Indonesian provinces. The DCE retention questionnaire focused on eight key characteristics: location, medical facilities, net income, continuing professional development program, security, length of commitment, source of incentives, and caseload.

RESULTS

The study found that the most influential factors for retention in remote areas were security guarantees from the local government (OR = 6.11), fully funded continuing professional development programs (OR = 2.84), and access to advanced medical facilities (OR = 2.35).

CONCLUSION

The findings indicate that a comprehensive intervention package, with a particular emphasis on security provisions, is necessary to retain medical specialists in remote areas. Financial incentives are also recommended to improve retention. However, it is crucial to acknowledge that no single intervention will suffice, as the factors influencing specialist retention in remote areas of Indonesia are complex and multifaceted.

Medical imaging consultation practices and challenges at public hospitals in the Amhara regional state, Northwest Ethiopia: a descriptive phenomenological study

BACKGROUND

Medical imaging plays a vital role in the accurate diagnosis, treatment and outcome prediction of many diseases and injuries. However, in many African countries, deserving populations do not have access to the proper medical imaging specialists' services. As a result, clinicians continue to struggle to provide medical imaging via consultation. However, little is known about conventional referral consultation practices and their challenges. This study, therefore, aimed to explore the practice and challenges of medical imaging service consultation among health professionals and patients in the context of the Ethiopian public healthcare delivery system.

METHODS

Descriptive phenomenological study was employed to explore the practice of medical imaging service consultation among health professionals and patients in public hospitals of Amhara region from October 12, 2021 to December 29, 2021. Semi-structured interview guides were prepared separately for key-informant and in-depth interviews. A total of 21 participants (6 hospital managers, 4 medical directors, 4 department heads, 3 medical imaging coordinators and 4 patients) were selected using the maximum variation sampling technique. All interviews were audio-recorded, transcribed verbatim and subjected to inductive thematic analysis using Open Code 4.02 software.

RESULTS

Six major themes emerged following the thematic analysis: (1) medical image service delivery practices; (2) medical imaging consultation modalities; (3) benefits and drawbacks of the consultation modalities; (4) challenges; (5) challenge mitigation strategies; and (6) future recommendations. Image films, compact disks, and telegram apps were the consultation modalities used by the referring clinicians to send the medical images to radiologists. Frequent failure of imaging machines, delayed equipment maintenance, inadequate infrastructure, shortage of budget, lack of radiologists, and low-quality of printed image films were among the challenges influencing the medical imaging consultation service.

CONCLUSIONS

This research explored onsite and referral imaging consultation practices. However, there are many challenges encountered by the referring clinicians and the radiologists during the consultation process. These challenges could potentially affect clinicians' ability to provide timely diagnosis and treatment services which would ultimately affects patient health status and service delivery. Virtual consultation via teleradiology and enhancing clinicians' competence through long-term and short-term trainings are recommended to improve the referral consultation practice.

Comparison between radiographers with sonography education working in remote Australia and radiologists' interpretation of ultrasound examinations

INTRODUCTION

Radiographers working in remote Far North Queensland (FNQ), Australia, need to possess unique skills sets in order to provide culturally safe practice to predominantly Indigenous communities. Due to the lack of onsite radiologists in FNQ, radiographers need to provide preliminary findings to referring practitioners including sonographic findings. The accuracy of such findings has not been evaluated to date. The objective of this study was to compare the level of agreement and recommendations for further investigations of FNQ radiographers to teleradiologists' reports. As radiographic findings are not recorded or stored as part of routine practice, only sonographic findings were included in the study.

METHODS

Consecutive de-identified ultrasound cases were extracted between January and March 2019 inclusively by an independent investigator. The researcher scored the ultrasound cases between 1 and 4 according to levels of agreement between sonographic findings and teleradiologists' reports, and recommendations between radiographers and teleradiologists were also compared using frequency analysis.

RESULTS

Five-hundred and thirty-two ultrasound cases were included for this study. Of those, 517 (97.2%) were in complete agreement and 15 (2.8%) reported minor discrepancies. There were no moderate or major discrepancies suggesting an overall accuracy rate of 100% as the radiographer/sonographer findings were in close agreement with the teleradiologists' reports. There was complete agreement regarding further clinical recommendations in 453 (85%) cases. The discrepancy in the remaining 15% of cases did not lead to any adverse or changed patient management.

CONCLUSIONS

This study supports existing evidence about the accuracy and timely communication of sonographic findings to radiologists and other health care professionals, in keeping with the Medical Radiation Practice Board of Australia expectations. It is likely that radiographer comments on plain radiographic images are equally as reliable, but this remains to be explored.