title: Mammographic positioning quality of newly trained versus experienced radiographers in the Dutch breast cancer screening programme.
abstract: OBJECTIVE
  Our purpose was to compare mammographic positioning quality of new (NR) versus experienced screening radiographers (ER) in the Netherlands.
  
  
  METHODS
  Before starting to work in breast screening, NR must complete an education programme including a theoretical course (four days), practical training (six weeks), and a portfolio-review of 50 mammographic screening examinations performed by the radiographer. Furthermore, Dutch screening has an extensive system of quality assurance, including an audit-review of positioning quality of mammograms by ER. We analysed 13,520 portfolio views (NR) and 14,896 audit views (ER) based on pre-specified criteria, e.g., depiction of inframammary angle.
  
  
  RESULTS
  Overall positioning was more adequate for NR than ER (CC views: 97% versus 86%, p = 0.00; MLO views: 92% versus 84%, p = 0.00). NR scored better for most of the CC-criteria and showed, for instance, less folds (inadequate: 10% versus 16%, p = 0.00). In contrast, NR encountered more difficulties for MLO views in, for example, depiction of infra-mammary angle (inadequate: 38% versus 34%, p = 0.00). Overall, mammograms from NR were more often considered adequate, because of less severe errors.
  
  
  CONCLUSIONS
  NR perform better than ER in overall positioning technique. These results stress the need for continuous monitoring and training in breast screening programmes to keep positioning skills up to date.
  
  
  CONCLUSIONS
  • We evaluated positioning quality of new and experienced Dutch screening radiographers. • New radiographers outperform their experienced colleagues in mammographic positioning quality. • New radiographers make less severe errors compared to experienced colleagues. • There is a need for a continuous individual monitoring and feedback system.
authors.affiliation: Dutch Reference Centre for Screening, PO Box 6873, 6503 GJ, Nijmegen, The Netherlands. c.vanlandsveld-verhoeven@lrcb.nl.
authors.forename: Cary
authors.initials: C
authors.lastname: van Landsveld-Verhoeven
authors.affiliation: Dutch Reference Centre for Screening, PO Box 6873, 6503 GJ, Nijmegen, The Netherlands.|Department of Radiology, Academic Medical Centre, Amsterdam, The Netherlands.
authors.forename: Gerard J
authors.initials: GJ
authors.lastname: den Heeten
authors.affiliation: Dutch Reference Centre for Screening, PO Box 6873, 6503 GJ, Nijmegen, The Netherlands.
authors.forename: Janine
authors.initials: J
authors.lastname: Timmers
authors.affiliation: Dutch Reference Centre for Screening, PO Box 6873, 6503 GJ, Nijmegen, The Netherlands.|Department for Health Evidence, Radboud University Medical Center, Nijmegen, The Netherlands.
authors.forename: Mireille J M
authors.initials: MJ
authors.lastname: Broeders
mesh_terms: D001943:Breast Neoplasms / Q000000981:diagnostic imaging; D002983:Clinical Competence / Q000592:standards*; D003430:Cross-Sectional Studies; D055088:Early Detection of Cancer / Q000592:standards; D005260:Female; D006801:Humans; D008327:Mammography / Q000379:methods / Q000592:standards*; D008403:Mass Screening / Q000592:standards; D008875:Middle Aged; D009426:Netherlands; D056888:Patient Positioning / Q000592:standards*; D011871:Radiology / Q000592:standards*
keywords: Breast; Education; Mammography; Mass screening; Positioning quality; Radiographers