Abstract
OBJECTIVES: 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. DESIGN: 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. SETTING: Centre-based settings at public and private radiodiagnostic centres. PARTICIPANTS: 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. PRIMARY AND SECONDARY OUTCOME MEASURES: 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. RESULTS: 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). CONCLUSIONS: 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.