Measuring and evaluating safety competence in MRI environments among healthcare professionals: A systematic review

Introduction This systematic review synthesised evidence on MRI safety competence among healthcare professionals working in or entering MRI environments and examined its measurement approaches. Methods The review followed Joanna Briggs Institute methodology and PRISMA reporting guidance, and the protocol was registered in PROSPERO. Eligibility was defined using the Population–Exposure–Outcome framework: healthcare professionals working in or entering MRI environments; exposure to MRI safety, safety practices, or MRI-related risks; and outcomes reflecting MRI safety competence. CINAHL, PubMed, Scopus, and Web of Science were searched in May 2025. Eligible studies were independently screened, critically appraised using the JBI checklist for analytical cross-sectional studies, and narratively synthesised. Results Nine studies published between 2016 and 2025 were included. MRI professionals generally demonstrated greater safety knowledge than non-imaging healthcare professionals, although important knowledge gaps remained. MRI-specific education and experience were associated with knowledge; organisational policies were associated with reported practices. Measurement approaches are reported for all nine studies and were predominantly study-specific questionnaires. An established relational coordination instrument assessed team processes rather than individual competence. Measures varied in content, scoring and psychometric evaluation. Incident awareness, reporting and team coordination were interpreted as contextual indicators, rather than direct measures of competence. Conclusion Evidence indicates uneven MRI safety knowledge and associations with MRI-specific education, experience and organisational support. Heterogeneous measures do not establish comprehensive individual competence. Implications for practice Healthcare organisations should provide role-specific MRI safety education and assess competence using validated knowledge and performance measures, alongside appropriate supervision.