Diagnostic Competency in Standard Chest Radiography: A Multi-Domain Assessment of Technical, Cognitive, and Professional Skills Among Radiography Undergraduates

Abstract

Background: Standard chest posteroanterior (PA) radiography is one of the most frequently performed diagnostic imaging examinations, requiring adequate technical knowledge, image-quality awareness, and professional competency to ensure accurate diagnosis and patient safety. This study evaluated the knowledge, awareness, and professional competency of radiography students regarding standard chest PA radiography.
Methods: A descriptive cross-sectional survey was conducted among 301 undergraduate, internship, and postgraduate radiography students using a validated, structured questionnaire. The instrument assessed demographic characteristics, technical knowledge, awareness of radiographic errors and image-quality criteria, and professional competency. Data were analyzed using IBM SPSS Statistics version 25. Descriptive statistics, independent samples t-test, one-way ANOVA, and Tukey post-hoc analysis were performed, with statistical significance set at p < 0.05.
Results: Overall, participants demonstrated satisfactory knowledge and awareness of standard chest PA radiography with consistently high professional competency. Significant improvements in technical knowledge were observed with increasing academic level, particularly for patient positioning (p = 0.018), central ray centering (p = 0.004), and recommended kVp selection (p = 0.025). Awareness of radiographic error recognition and image-quality assessment also improved significantly among interns and postgraduate students (p < 0.05). Professional competency related to patient care, radiation protection (ALARA), communication, ethics, and lifelong learning remained uniformly high across gender and academic levels without significant differences (p > 0.05).
Conclusion: Radiography students possess adequate foundational knowledge and strong professional attitudes toward chest PA radiography. Clinical exposure and academic progression significantly enhance technical competence and image-quality awareness, whereas professional values remain consistently positive throughout training. Strengthening competency-based clinical education and structured mentorship may further improve diagnostic accuracy, reduce repeat examinations, and promote patient safety in routine chest radiography.