Cardiothoracic Ratio CTR Radiography Education Radiography Students Final Year Students Knowledge Assessment Clinical Competency Practical Application Diagnostic Radiography Chest Radiography Clinical Exposure

This cross-sectional study assessed the Cardiothoracic Ratio (CTR) knowledge and application competency among 110 final-year radiography students at the University of Benin. While a significant majority (65.5%) achieved the required theoretical knowledge threshold, leading to the rejection of the Null Hypothesis (p=0.0006) , this success masked critical deficits in practical application and precision. Key weaknesses were identified in recognizing digital measurement tools (only 54.5% correct) and essential anatomical landmarks like the Aortic arch/knob (60.0% correct). Students identified the primary barriers to competence as systemic: 81.8% reported a lack of supervised clinical exposure, and 81.8% judged existing learning resources as inadequate. The study concludes that urgent curriculum reform, focusing on mandatory simulation and hands-on clinical demonstrations, is necessary to bridge the critical gap between theoretical knowledge and practical professional competency