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Evaluation of the impact of a brief educational message on clinicians’ awareness of risks of ionising-radiation exposure in imaging investigations: a pilot pre-post intervention study

Young, Ben; Cranwell, Jo; Fogarty, Andrew W.; Skelly, Rob; Sturrock, Nigel; Norwood, Mark; Shaw, Dominick; Lewis, Sarah; Langley, Tessa; Thurley, Peter


Ben Young

Jo Cranwell

Clinical Associate Professor & Reader in Clinical Epidemiology

Rob Skelly

Nigel Sturrock

Mark Norwood

Peter Thurley


In the context of increasing availability of computed tomography (CT) scans, judicious use of ionising radiation is a priority to minimise the risk of future health problems. Hence, education of clinicians on the risks and benefits of CT scans in the management of patients is important.

An educational message about the associated lifetime cancer risk of a CT scan was added to all CT scan reports at a busy acute teaching hospital in the UK. An online multiple choice survey was completed by doctors before and after the intervention, assessing education and knowledge of the risks involved with exposure to ionising radiation.

Of 546 doctors contacted at baseline, 170 (31%) responded. Over a third (35%) of respondents had received no formal education on the risks of exposure to ionising radiation. Over a quarter (27%) underestimated (selected 1 in 30 000 or negligible lifetime cancer risk) the risk associated with a chest, abdomen and pelvis CT scan for a 20 year old female. Following exposure to the intervention for one year there was a statistically significant improvement in plausible
estimates of risk from 68.3% to 82.2% of respondents (p < 0.001). There was no change in the proportion of doctors correctly identifying imaging modalities that do or do not involve ionising radiation.

Training on the longterm risks associated with diagnostic radiation exposure is inadequate among hospital doctors.
Exposure to a simple non-directional educational message for one year improved doctors’ awareness of risks associated with CT scans. This demonstrates the potential of the approach to improve knowledge that could improve clinical practice. This approach is easily deliverable and may have applications in other areas of clinical medicine. The wider and longer term impact on radiation awareness is unknown, however, and there may be a need for regular mandatory training in the risks of radiation exposure.


Young, B., Cranwell, J., Fogarty, A. W., Skelly, R., Sturrock, N., Norwood, M., …Thurley, P. (2019). Evaluation of the impact of a brief educational message on clinicians’ awareness of risks of ionising-radiation exposure in imaging investigations: a pilot pre-post intervention study. BMC Health Services Research, 19,

Journal Article Type Article
Acceptance Date Nov 5, 2019
Online Publication Date Nov 14, 2019
Publication Date 2019-12
Deposit Date Nov 21, 2019
Publicly Available Date Nov 21, 2019
Journal BMC Health Services Research
Electronic ISSN 1472-6963
Publisher Springer Verlag
Peer Reviewed Peer Reviewed
Volume 19
Article Number 841
Keywords Computed tomography, Radiation risks, Radiation protection, Clinician knowledge, Clinician education
Public URL
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Additional Information Received: 13 June 2019; Accepted: 5 November 2019; First Online: 14 November 2019; : Ethics approval and consent to participate were not deemed necessary as the study was an evaluation of service delivery. The waiving of the need for ethical approval in this context complies with national guidelines described in Governance Arrangements for Research Ethics Committees [CitationRef removed].; : Not applicable.; : The authors BY, JC, AWF, RS, NS, MN, DS, SL, TL and PT declare they have no competing interests.


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