Public versus private clinical radiography training in Lagos State, Nigeria: a comparative cross-sectional survey of associations with graduate self-perceived competence and practice readiness.

Abstract

To compare clinical radiography training experiences (structure, resources, participation, feedback) and self-perceived competence/practice readiness between public and private radiography centres in Lagos State, Nigeria. Comparative cross-sectional survey design from August to October 2025 using a validated self-administered questionnaire distributed in person during departmental seminars and clinical debriefings at University of Lagos-affiliated centres. Centre-based settings at public and private radiodiagnostic centres. A total of 260 final-year students and recent graduates, 130 each from public and private radiodiagnostic centres. Inclusion criteria included: age ≥18 years, with ≥6 months clinical exposure, from centres affiliated to the University of Lagos. All participants completed the self-administered questionnaire. There were no interventions. The primary outcome was the self-perceived competence/practice readiness, and the secondary was participation, extent and feedback mechanisms, measured as planned without protocol deviations. All variables were measured using validated items in the questionnaire. Private centres significantly outperformed public centres in hands-on practice and feedback, with higher self-perceived competence (mean 35.6±5.7 vs 32.8±6.4; p=0.001). There were no significant differences in training structure (p=0.78). Public centres reported higher patient loads (86.2% vs 68.5%; p=0.001) but lower equipment availability (47.7% vs 72.3%; p<0.001); while private centres reported higher participation (80.0% vs 74.6%; p=0.03), hands-on practice (76.2% vs 68.5%; p=0.009) and feedback (70.0% vs 60.0%; p=0.002). Centre type was independently associated with self-perceived competence (β=2.45, 95% CI 1.12 to 3.78). Challenges included public overcrowding (70.8% vs 40.8%; p<0.001) and private equipment downtime (51.5% vs 34.6%; p=0.009). Private centres were associated with higher self-perceived competence and readiness, better resources and feedback, while public centres offered greater patient volumes. Hybrid placements and targeted infrastructure investment are recommended to help address disparities in perceived readiness.