Competency in chest X-ray interpretation: Variations across medical experiences and training levels
ABSTRACT Introduction: Chest X-ray (CXR) remains one of the most commonly used diagnostic imaging tools in clinical practice. However, the accuracy and competency in reading and interpreting CXRs can vary significantly across different levels of medical practitioners, ranging from house officer...
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| Main Authors: | , , , |
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| Format: | Article |
| Language: | en |
| Published: |
Malaysian Medical Association
2026
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| Subjects: | |
| Online Access: | http://ir.unimas.my/id/eprint/51547/1/chest-X-ray.pdf http://ir.unimas.my/id/eprint/51547/ https://www.e-mjm.org/2026/v81n1/chest-X-ray.pdf |
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| Summary: | ABSTRACT
Introduction: Chest X-ray (CXR) remains one of the most
commonly used diagnostic imaging tools in clinical practice.
However, the accuracy and competency in reading and
interpreting CXRs can vary significantly across different
levels of medical practitioners, ranging from house officers
to senior specialists. The purpose of this study was to
assess competency in CXR interpretation among doctors at
different stages of their medical careers.
Material and Methods: This is a cross-sectional study
conducted using CXRs, which were displayed digitally. A
total of 305 participants were recruited, including house
officers, medical officers, and registrars in specialty
training. A standard set of ten radiographs was chosen, and
the participants were required to interpret the CXR in
multiple-choice format. Data analysis was performed via IBM
SPSS Statistics software, version 25.
Results: Clinical history improved the ability to accurately
interpret CXR, with the percentage of participants who
accurately interpreted CXRs increasing from 21% of
participants who achieved high scores without clinical
history to 63.6% of participants who achieved high scores
with clinical history. The participants' field of interest and
confidence level when reporting a CXR without history were
associated with higher accuracy (p<0.05) when interpreting
a CXR. However, when the clinical history was given to the
participant, only the confidence level of the participant
affected the final score of the CXR. There is no significant
difference in the ability of doctors to interpret CXR despite
the difference in seniority in practice; moreover,
undergraduate exposure does not play a significant role.
Conclusion: Structured teaching, continuous practice,
feedback and integration into clinical decision-making are
the keys that translate to greater competency in CXR
interpretation. Future researches should emphasize on
multicenter approach as it enhances the generalizability of
findings to a broader national context. |
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