title: [X-rays taken by radiologists! Influence on a continuous quality improvement process?].
abstract: OBJECTIVE
  To evaluate how the training of radiology residents in taking radiographs influences the work of radiographers and the established quality standards.
  
  
  METHODS
  A first year radiology resident was trained for 4 weeks in focusing and exposure techniques by radiographers. In a second period the resident took 582 radiograms, which were compared with those taken by technicians for error estimation on a daily basis. During a third period the radiographs were produced in a contest between the resident and a skilled radiographer. Errors were analyzed by two independent experts according to established guidelines of the German Medical Association.
  
  
  RESULTS
  At the beginning of the second period the average error rate of the resident was 11.9% as compared to 8.9% in the technicians team, in the following month 9.2% versus 15.9%. In the third period no relevant difference in errors could be observed. Finally, unexpected quality improvements were implemented like an improved standardization of focusing and exposure techniques as well as dose reduction.
  
  
  CONCLUSIONS
  Radiology residents easily learn focusing and exposure techniques and achieve comparable results as radiographers within a short period of time. The additionally achieved knowledge improves the technical process of taking radiographs. We recommend to include a two plane radiography training period in the curriculum of radiology residents. It reinforces the radiologist's role in continuous quality improvements of the diagnostic process.
authors.affiliation: Medizinisches Zentrum für Radiologie, Abteilung Strahlendiagnostik, Klinikum der Philipps-Universität Marburg. kurtz@mrs1.ukl.uni-freiburg.de
authors.forename: C
authors.initials: C
authors.lastname: Kurtz
authors.forename: W
authors.initials: W
authors.lastname: Czapp
authors.forename: I
authors.initials: I
authors.lastname: Trampe
authors.forename: R
authors.initials: R
authors.lastname: Leppek
authors.forename: K J
authors.initials: KJ
authors.lastname: Klose
mesh_terms: D003479:Curriculum; D007396:Internship and Residency; D011787:Quality of Health Care; D011829:Radiation Dosage; D011859:Radiography / Q000592:standards*; D011871:Radiology / Q000193:education*; D017749:Total Quality Management