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Development of a checklist to enhance communication and reduce omission errors in interpretation of chest radiographs in resource-constrained settings
Thesis (PhD (Radiography))--University of Pretoria, 2025.
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University of Pretoria
2025
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| _version_ | 1867613673429663744 |
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| access_status_str | Open Access |
| author2 | Mshunqane, Nombeko |
| author_browse | Mshunqane, Nombeko |
| author_facet | Mshunqane, Nombeko |
| collection | Thesis |
| dc_rights_str_mv | © 2023 University of Pretoria. All rights reserved. The copyright in this work vests in the University of Pretoria. No part of this work may be reproduced or transmitted in any form or by any means, without the prior written permission of the University of Pretoria. |
| description | Thesis (PhD (Radiography))--University of Pretoria, 2025. |
| format | Thesis |
| id | oai:repository.up.ac.za:2263/100780 |
| institution | University of Pretoria (South Africa) |
| language | English |
| last_indexed | 2026-06-10T12:39:53.208Z |
| license_str | Other — see source repository |
| provenance_str_mv | Harvested via OAI-PMH from UPSpace — University of Pretoria Institutional Repository |
| publishDate | 2025 |
| publishDateRange | 2025 |
| publishDateSort | 2025 |
| publisher | University of Pretoria |
| publisherStr | University of Pretoria |
| record_format | dspace |
| source_str | UPSpace — University of Pretoria Institutional Repository |
| spelling | oai:repository.up.ac.za:2263/100780 Development of a checklist to enhance communication and reduce omission errors in interpretation of chest radiographs in resource-constrained settings Mshunqane, Nombeko u04352718@tuks.co.za Kekana, R.M. (Mable) Sethole, Khethiwe Margaret UCTD Sustainable Development Goals (SDGs) Checklist General practitioner Omission error Image interpretation Resource constrained hospitals Radiographers and radiologists Thesis (PhD (Radiography))--University of Pretoria, 2025. Background: Currently, there is a universal shortage of radiologists, chest radiographs are extensively used by medical doctors to diagnose and monitor treatment and predict outcomes for many diseases and abnormalities. Chest radiographs are routinely used to manage complications associated with different types of chest diseases. Chest radiographs are challenging to interpret owing to overlapping clinical features and atypical presentations. There are many hospitals in South Africa where X-rays are performed; however, there is no structured method for interpretation. Aim: This study aimed to develop a checklist to enhance communication and reduce omission errors in the interpretation of chest radiographs in resource-constrained settings. Methodology: The researchers used a three-phased exploratory sequential mixed methodology to develop a quantitative checklist. In phase one, the results from the literature review were jointly displayed with recommendations from another qualitative study to form meta-inferences. The domains were operationalised and jointly displayed to build items for a preliminary qualitative checklist for chest interpretation. The researcher developed a draft survey tool. Phase two comprised a review of the preliminary checklist and survey tool. The checklist was further developed and validated by a panel of nine experts using the Delphi technique. In phase three, the developed quantitative standardisation, communication, image evaluation, and pattern recognition (SCIEPR) checklist, was sent for field testing. The survey tool was also validated by a biostatistician before use. 103 participants (40 radiographers and 63 medical doctors) in district hospitals were recruited to use the SCIEPR checklist in clinical settings. A cross-sectional study design was applied. Purposive sampling was used, and interested participants signed consent. Participants were given four weeks per hospital to use the checklist at least three times before taking part in the three-phase Likert scale survey. The survey validated the checklist's relevance, clarity, and duration to complete. The data from open and closed questions were analysed. Quantitative data were grouped and are presented as percentages in bar graphs. Qualitative data were analysed using content analysis. Codes were grouped into categories, and themes were identified to support the quantitative results. Results: Five themes emerged from Phase 1, namely, training, standardisation, communication, image evaluation, and pattern recognition, which were used to generate items for the development of the checklist. Phase 2 produced a 35-item checklist and a data collection survey tool. Phase 3 results included responses from 41 participants showing mostly positive responses. The SCIEPR checklist was deemed relevant, well-formatted, and clear. The constructs that scored highly scored were training (41), image evaluation (41), pattern recognition (39), standardisation (38), and communication (35). However, a few participants found the SCIEPR checklist to be time-consuming and did not recommend it for busy departments; however, such responses were from those who had used the checklist only once. According to the qualitative results, the checklist improved communication, patient diagnosis, image quality, evaluation of chest radiographs, and reduced patient waiting times. The checklist may improve hospital service. Conclusion: This study focused on the development and initial validation of the SCIEPR checklist. The SCIEPR checklist was validated for evidence of concept, face, and content validity. The findings of this thesis have significant implications for policy makers involved in improving service delivery in resource-constrained hospitals as well as curriculum developers involved in training medical practitioners and radiographers. The findings demonstrated that the SCIEPR checklist has significant potential for training medical practitioners, standardising chest image interpretation, and improving interprofessional collaboration and communication to reduce omission errors related to radiographs. Future research should implement the SCIEPR checklist in a larger field with a larger number of participants to provide additional evidence of construct and psychometric validity. UCDP: CC Number: A1E904 Radiography PhD (Radiography) Unrestricted Faculty of Health Sciences SDG-03: Good health and well-being SDG-04: Quality education 2025-02-12T11:33:15Z 2025-02-12T11:33:15Z 2025-04 2025-01 Thesis * A2025 http://hdl.handle.net/2263/100780 https://doi.org/10.25403/UPresearchdata.28399178 en © 2023 University of Pretoria. All rights reserved. The copyright in this work vests in the University of Pretoria. No part of this work may be reproduced or transmitted in any form or by any means, without the prior written permission of the University of Pretoria. application/pdf University of Pretoria |
| spellingShingle | UCTD Sustainable Development Goals (SDGs) Checklist General practitioner Omission error Image interpretation Resource constrained hospitals Radiographers and radiologists Development of a checklist to enhance communication and reduce omission errors in interpretation of chest radiographs in resource-constrained settings |
| title | Development of a checklist to enhance communication and reduce omission errors in interpretation of chest radiographs in resource-constrained settings |
| title_full | Development of a checklist to enhance communication and reduce omission errors in interpretation of chest radiographs in resource-constrained settings |
| title_fullStr | Development of a checklist to enhance communication and reduce omission errors in interpretation of chest radiographs in resource-constrained settings |
| title_full_unstemmed | Development of a checklist to enhance communication and reduce omission errors in interpretation of chest radiographs in resource-constrained settings |
| title_short | Development of a checklist to enhance communication and reduce omission errors in interpretation of chest radiographs in resource-constrained settings |
| title_sort | development of a checklist to enhance communication and reduce omission errors in interpretation of chest radiographs in resource constrained settings |
| topic | UCTD Sustainable Development Goals (SDGs) Checklist General practitioner Omission error Image interpretation Resource constrained hospitals Radiographers and radiologists |
| url | http://hdl.handle.net/2263/100780 https://doi.org/10.25403/UPresearchdata.28399178 |