Obesity is a global health issue with obese patients requiring specialised diagnosis, treatment and care through the health service. The practical and social difficulties associated with medical imaging of obese patients are an increasingly common problem and it is currently unknown how student and qualified radiographers perceive and respond to these challenges. By better understanding challenges presented in providing quality imaging and care of imaging obese patients, education for both qualified and student radiographers can be enhanced. Radiographers are heavily reliant on visual and tactile senses to locate the position of anatomical structures for diagnostic imaging and determine radiation exposure through a delicate consideration of dose, image quality and anatomical attenuation. However, obese patients require modifications to routine radiographic practice in terms of movement/assisted positioning, equipment capabilities to take increased weight or coverage. These patients may also be subject to compromised radiological diagnosis through poor visualisation of structures. In this paper, the professional and educational literature was narratively reviewed to assess gaps in the evidence base related to the skill and care knowledge for obese patients. Literature was sourced relating to discrete radiographic considerations such as the technical factors of imaging obese patients, exposure and the impact of obesity on imaging departments’ service provisions. The recent literature (post-2000 to coincide with the sharp increase in global obesity) on the perceptions of health professionals and student health practitioners has also been explored because there are no specific radiographer studies to report. By understanding the research in similar fields, we may identify what common attitudes qualified and student radiographer's hold and what challenges, technical and care related, can be prepared for.

Introduction: As the prevalence of obesity rises, radiographers must be capable of producing high-quality radiographs despite difficulties presented such as inadequate radiation penetration, increased scatter/poor image quality, and compromised surface anatomy palpation. Greater awareness and development of strategies are required because current scientific literature and learning resources addressing radiographic imaging of obese patients may be inadequate for student radiographers. This study investigates the confidence, perceived competence, and learning experiences of student radiographers imaging obese patients. Methods: After ethics approval, a qualitative study in a grounded theory tradition was conducted through focus groups with secondand third-year diagnostic radiography students (31 participants over six focus groups). Results: Key concepts of experiential learning during placement, radiographic technique, and student confidence were identified as influential at the student-supervisor level. Key concepts of negativity toward obese patients by supervising radiographers and communication operated at the patient-student-radiographer level. Students stated difficulty applying theoretical teachings in a practical sense because of their limited experience in accounting for anatomic variations and increased adipose tissue, and their difficulty was linked to specific anatomic regions. Conclusion: Students were challenged by knowledge of exposure factors and limited practical-simulated learning when imaging obese patients. Additionally, participants rated current learning resources as inadequate and preferred to be paired with a qualified radiographer for confidence and manual handling issues. Students reported negative weight bias toward obese patients by qualified/senior radiographers, and this may influence the empathy and attitudes of student radiographers.