Long Article

Reduced Workplace Stress Improves Imaging Accuracy

Controlled use of ionizing radiation – radiologic x-ray technology – has revolutionized the diagnosis and treatment of disease. So much so that a physician’s treatment plan and a patient’s prognosis rely heavily on accurate results. Advances in imaging equipment make that possible. Yet, at the end of the day, the usefulness of this tool lies in the hands of a living, breathing human being.

Due in part to high demand for the service, greater emphasis has been placed on multitasking for the technologist. Resulting tension and burnout increase the potential for medical errors by CT scan technologists. Fortunately, small adjustments to the user interface (UI) can go a long way toward reducing stress levels in radiology departments.

Importance of the user interface

The UI is the point where man and machine come together. It is the merging of hardware and software that exchange information between the operator and device, so specific tasks may be performed. Informatics, an applied form of information engineering, is part of the UI involving user inputs. This communication of the technologist’s needs may occur via a computer mouse, voice recognition, keyboard, or some combination of those elements. Outputs, such as display screens and sounds translating the computer’s calculation results to the user, complete the UI.1

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A meaningful user experience, the result of optimal UI, is evaluated by both ergonomics and psychology. International Organization for Standardization (ISO) 9241 regulatory standard defines ergonomic requirements intended to ensure comfort, and thus productivity, of the user. Their regulations aid in reducing stress and avoiding accidents.1

Optimizing efficacy, efficiency, and satisfaction

There are five simple ways to improve instrument usability by lowering stress levels for technologists:

  • Simplify the toolbar – Workflow modifications such as streamlining the UI ease cognitive overload in busy radiology departments.2 Research indicates a positive impact from automating extraction of historical imaging and report data and simplifying the toolbar.2
  • Manage large datasets effectively – In a Journal of Digital Imaging study3, researchers determined that radiology departments may benefit from using alternative user interface devices (UIDs). Specifically, the study suggested considering the type of interface common to video games and video editing – industries that already understand the importance of ergonomics in picture archiving and communication system work.

    This research concluded that alternative UIDs allow for more efficient navigation of the large datasets used in medical imaging. The study did not determine whether one interface was superior to the others. This appears to be a matter of personal preference. The important takeaway is the benefit of considering devices other than the standard mouse.3
  • Set screen displays for best possible viewing – Human visual capability1 is a limiting factor in the medical imaging interface. The eye can discriminate at a maximum power of 0.21 mm, and the eye’s physiological focal point is about 60 cm from the viewer. These two factors create technical standards for radiology.1

    For optimal viewing, the diagonal dimension of the display should be located at 80 percent of the distance to the eye, corresponding to a screen size of approximately 50 cm1 (about 20 inches). The right size screen at a proper display distance can dramatically curtail eyestrain and fatigue.

  • Reduce repetitive stress – According to an American College of Radiology study4, 70 percent of radiologic technologists who worked in a fully digital radiology department suffered repetitive stress symptoms. Additionally, 68 percent reported spending two hours per day in an awkward posture while sitting in front of a picture archiving and communication system display.

    Most of the individuals surveyed attributed symptoms to imaging equipment4, second only to patient-related stress. The study concluded that repetitive stress symptoms were high among radiology technologists. Research further indicated that improved ergonomics of patient transfer, and of imaging equipment, could reduce stress symptoms.4

  • Limit re-scans – A device consisting of a color video and depth camera, as well as proprietary software and user interface, reduces radiation exposure for patients. This set-up also requires fewer re-scans, according to a report in Pediatric Radiology – a factor which adds tension to a technologist’s workday.5

    This device includes a monitor in the x-ray control room. It displays the position of the patient, in real time, in relation to automatic exposure control chambers and the image receptor area. According to the report, automatic measurements of patient thickness help the technologist set the x-ray technique and assist in detecting errors in positioning and motion before the patient is exposed.5

Nearly everyone reading this article owes an accurate medical diagnosis to radiologic technology or has a friend or loved one in their life because of it. Ergonomic and workflow improvements that help technologists do their jobs better are beneficial to everyone.


  1. A review of existing and potential computer user interfaces for modern radiology. Imaging Insights. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6108970/ Last accessed May 7, 2019.
  2. Innovation Strategies for Combating Occupational Stress and Fatigue in Medical Imaging. Journal of Digital Imaging. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3389096/ Last accessed May 8, 2019.
  3. Alternative user interface devices for improved navigation of CT datasets. Journal of Digital Imaging. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3046793/ Last accessed May 8, 2019.
  4. Repetitive stress symptoms among radiology technologists: prevalence and major causative factors. American College of Radiology. https://www.jacr.org/article/S1546-1440(10)00283-8/pdf Last accessed on May 8, 2019.
  5. Development of a tool to aid the radiologic technologist using augmented reality and computer vision. Pediatric Radiology. https://link.springer.com/article/10.1007%2Fs00247-017-3968-9 Last accessed May 8, 2019.