Preliminary clinical evaluation in cross-sectional imaging: A qualitative exploration of current international radiography practice.

Abstract

Introduction: Implementation and practice compliance of preliminary clinical evaluation (PCE) vary across national and international settings. The reason for these variations remains unclear, especially in relation to cross-sectional imaging. This study therefore explored PCE education and practice experiences of a multinational cohort of cross-sectional imaging radiographers with the aim of identifying effective training and implementation strategies, challenges, and opportunities for improvement. Methods: A phenomenological qualitative design was used, with purposive sampling to recruit a multinational cohort of cross-sectional imaging radiographers enrolled in a UK-based postgraduate medical imaging programme. Semi-structured, in-depth interviews were conducted via Microsoft Teams between December 2024 and February 2025. Data were analysed using Braun and Clarkes’ reflexive thematic analysis approach, facilitated by NVivo™ (v.20.0). Results: Twelve radiographers from seven different countries participated in the study. The clinical experience of participants ranged (2–8 years), with most working in public or both public and private hospitals (8/12, 67 %) and (5/12, 42 %) had multinational clinical experience. All participants had PCE as a core component of their undergraduate training, but post-qualification practice expectations vary. Four overarching themes were developed: (1) education and skill refinement, (2) drivers for practice, (3) barriers to practice, and (4) opportunities for practice. Conclusion: The findings reveal inconsistencies in PCE education, including variable module content and teaching depth, which affect clinical preparedness and confidence. Additionally, systemic barriers and communication lapses hinder PCE integration, while engagement is driven by its perceived value for others, support for clinical decision-making and presence of PCE-specific practice frameworks. Implications for practice: Standardisation of PCE education and training, establishment of clear practice frameworks and addressing communication gaps can enhance the integration of PCE into routine clinical workflows.