Perceived acceptability and usability of the RAD-CHECK flowchart for supporting consent and capacity assessment in medical imaging: An exploratory e-survey of diagnostic radiographers

INTRODUCTION: Assessing capacity to consent and making best-interest decisions are recognised challenges in radiography, particularly when caring for patients with cognitive impairment, communication difficulties, or fluctuating capacity. Despite legal and professional guidance, radiographers report uncertainty in applying these processes in practice. RAD-CHECK, developed with the Society and College of Radiographers, is a profession-specific decision-support tool for medical imaging. This study explored diagnostic radiographers' perceptions of its clarity, acceptability, feasibility, and anticipated usefulness of RAD-CHECK. METHODS: An online survey comprising closed and free-text questions was distributed nationally using a volunteer non-probability sampling approach. Eligible participants were HCPC-registered UK diagnostic radiographers who had used or reviewed RAD-CHECK. Quantitative data were analysed descriptively, and qualitative free-text responses underwent directed content analysis. RESULTS: Seventy-five responses were included. Most respondents (56/75, 74.7%) reported challenges when obtaining consent or assessing capacity in clinical practice. Among radiographers who had used RAD-CHECK in practice (32/75), 30/32 (94.0%) rated the tool as helpful or very helpful. Respondents reported high levels of agreement regarding the perceived content adequacy, clarity, usability and acceptability of the flowchart. Qualitative findings suggested that RAD-CHECK was perceived as a useful educational and decision-support resource, while highlighting the need for clearer guidance on best-interest decision-making. CONCLUSION: This exploratory evaluation found favourable perceptions of the clarity, acceptability, feasibility and anticipated usefulness of RAD-CHECK. The evaluation informed refinements to improve the clarity and usability of the flowchart; however, the effectiveness of RAD-CHECK in improving clinical decision-making remains untested. IMPLICATIONS FOR PRACTICE: Diagnostic radiographers perceived RAD-CHECK as a clear, acceptable, and potentially useful resource. Further research is needed to determine whether it improves decision-making, confidence, consistency, legal compliance, and patient-centred outcomes.