Radiation dose knowledge and imaging referral practices among emergency department clinicians: implications for justification and radiation safety.

INTRODUCTION

Emergency department clinicians often request imaging under time pressure, making radiation dose knowledge important for appropriate imaging referral and justification. This study evaluated radiation dose knowledge, self-perceived knowledge, educational background, and radiation protection-related imaging referral practices among emergency clinicians.

METHODS

In this cross-sectional study, medical interns, residents, general practitioners, and specialist physicians completed a structured questionnaire assessing radiation-related education, self-perceived knowledge, objective knowledge of radiation dose and related health risks, and radiation protection-related imaging referral practices. Data were analyzed using nonparametric tests and Spearman's rank correlation in SPSS version 25. Bonferroni-adjusted significance thresholds were applied to subgroup comparisons and correlations.

RESULTS

Among 90 participants, 27.8% had received formal radiation-related education. Mean scores were 3.29 ± 1.27 for self-perceived knowledge (range, 2-10), 5.70 ± 2.05 for objective knowledge (range, 0-11), and 8.59 ± 2.24 for referral practice (range, 3-15). Objective knowledge was not significantly correlated with referral practice (ρ = -0.095, p = 0.375), and self-perceived knowledge was not significantly correlated with referral practice (ρ = 0.126, p = 0.238) or objective knowledge (ρ = 0.025, p = 0.812). Objective knowledge differed across employment-status categories (p != 0.007) and remained significant after adjustment for multiple comparisons.

CONCLUSION

Emergency department clinicians showed room for improvement in radiation-related knowledge and reported imaging referral practices. No significant associations among objective knowledge, self-perceived knowledge, and referral-practice scores were demonstrated in this sample. Clinically integrated, longitudinal radiation safety education may support imaging justification, referral decision-making, risk communication, and patient safety.