Remote X-ray operators in Australia: A scoping review of self-perceived radiographic competence and educational needs.

Introduction: Remote X-ray Operators (RXOs) are non-radiographer healthcare workers who perform basic radiographic examinations in rural and remote areas due to workforce shortages. RXOs frequently report low confidence in their radiographic skills and limited access to continuing professional education (CPE). This scoping review maps the available evidence on RXOs' self-perceived competence and educational needs.

Methods: A scoping review was conducted following PRISMA-ScR guidelines. Medline, CINAHL, and Embase were searched for studies published between January 2004 and August 2024. Eligible studies focused on RXO training, competence, or educational needs. Data were extracted on study aims, methods, and reported outcomes. A descriptive synthesis was used to identify key themes across the included literature.

Results: Nine studies were included. Recurring themes included RXOs' limited confidence in key radiographic tasks, reliance on radiographers for supervision and training, and significant barriers to accessing CPE due to geographic isolation. Training models varied considerably across jurisdictions, with inconsistent supervision and credentialing. Studies reported improved outcomes when RXOs had access to structured, practical training and radiographer-led support.

Conclusion: RXOs consistently identify gaps in their radiographic knowledge and express strong interest in further education. Flexible and standardised CPE models, delivered through remote supervision, digital tools, and targeted mentorship, may help address variability in training and support across regions.

Implications for practice: Expanding access to remote learning platforms and radiographer mentorship could strengthen RXO preparedness and service delivery. Nationally consistent licensing and training requirements may improve care quality and patient safety in underserved settings.