Critique of cervical spine radiographs among diagnostic radiography students through the lens of semantics, a dimension of the Legitimation Code Theory

Abstract

Introduction: Radiographic image critique and the implementation of remedial measures in response to technique and technical errors are essential professional responsibilities of diagnostic radiographers. Research shows that diagnostic radiography students grapple to master radiographic image critique, a critical clinical competency. This study explored cervical spine radiographic image critique among final-year diagnostic radiography students through the lens of Semantics, a dimension of the Legitimation Code Theory. Methods: An exploratory, descriptive case study design was employed. Fourteen final year students voluntarily participated in individual oral radiographic image critique in a non-examination setting. Audio-recordings were transcribed verbatim. Content analysis of data was conducted with the aid of a translation device focusing on semantic density (SD) and semantic gravity (SG). Results: Most participants demonstrated weaker SD and stronger SG when describing radiographic structures of the cervical spine. Participants showed a limited ability to describe radiographic anatomy and abnormal patterns, primarily using vague and non-technical terminology instead of technically rich and discipline-specific descriptions. Conclusion: This study highlights challenges in students’ ability to critique cervical spine radiographs with the expected skill and knowledge depth. Despite stronger image-based reasoning (stronger SG), the poor radiographic descriptions (weaker SD) and the limited use of discipline-specific terminology point to a need for improved instructional strategies to better support context-rich, conceptually grounded radiographic image critique. Implications for practice: The difficulty students face in articulating radiographic concepts with depth and context underscores the need for educational innovation. Educational strategies should be designed to develop students’ radiographic image critique skills by deliberately building SD and SG, enabling the formation of “semantic waves” in which students shift purposefully between abstract theoretical principles and concrete, image-based observations to construct and communicate meaning.