Gap between knowledge and practice: A cross-sectional study on radiation protection among operating room staff in Zanjan Province, Iran

To evaluate the knowledge, attitude, and practice (KAP) of operating room staff regarding radiation protection in hospitals affiliated with Zanjan University of Medical Sciences, Iran, and to identify demographic factors influencing their KAP scores. This cross-sectional descriptive-analytic study was conducted from May 2022 to April 2023. It included 172 non-radiology-designated operating room personnel (including nurses, surgeons, anesthesiologists, anesthesia technicians, and operating room technicians) from six hospitals, achieving a response rate of 75%. Data were collected using a validated 32-item KAP questionnaire, comprising 10 items on knowledge, 7 on attitude, and 15 on practice. All items were rated on a 5-point Likert scale, and total scores were categorized as good, moderate, or poor. While 40.1% of participants demonstrated good knowledge and 87.2% exhibited a positive attitude, only 32.6 ​% reported good practices. Male staff had significantly higher knowledge scores than females ( P ​< ​0.05), but no gender differences were observed in attitude/practice. Age and education level showed positive correlations with KAP scores ( P ​< ​0.05), whereas work experience was not significantly associated with knowledge or practice. Despite adequate awareness and positive attitude, practical adherence to radiation safety protocols among operating room staff remains insufficient. Targeted training programs and systematic monitoring are urgently needed to bridge this gap and enhance occupational safety in operating room settings.