There is a shortage of fully trained and qualified sonographers. It seems that the traditional training route of an undergraduate degree in radiography or midwifery followed by work experience and then entry to a postgraduate course in sonography is not able to produce enough new sonographers to keep pace with increasing demand and the loss of experienced staff due to retirement. In addition, the pressure on ultrasound departments leads to restriction in the number of clinical placements that can be provided. Clinical placements are an essential part of the training process, where trainees acquire hands-on scanning skills, while supervised by experienced staff. There is clearly a need for alternative pathways to broaden the intake of new students and produce more fully trained and competent sonographers.
Some higher educational institutes have been exploring ways of bypassing the period of work experience in radiography or midwifery with various forms of direct entry courses. These include undergraduate courses in sonography or medical imaging, followed immediately by a traditional postgraduate course, or direct entry to a traditional postgraduate course from any undergraduate degree. In addition to many other concerns, such routes provide no opportunity to attain statutory registration in radiography or midwifery, and registration as a sonographer is not available, as sonography has not been given the recognition that it deserves in the form of a protected title.
In this issue of Ultrasound, Pam Parker and Gill Harrison report on the results of a survey of British Medical Ultrasound Society (BMUS) members’ views on direct entry sonography courses. Many respondents agreed that such courses would increase the number of qualified sonographers and reduce the impact on other professions such as radiography. However, there were many concerns relating to the lack of healthcare experience of such students, particularly undergraduate students, and the continuing problem of the shortage of clinical placements. In response to these concerns, BMUS has issued a statement on undergraduate education for sonography, which is contained in a letter from the BMUS Professional Development Officer, Pam Parker, published at the end of this issue. If you have any opinions on direct entry education that you would like to share in a letter to the journal, the editor would be very pleased to hear from you.
One potential way to reduce the burden of clinical placements is to use an ultrasound scanning simulator to help students to acquire practical scanning skills. In this issue, Vivien Gibbs reports on an investigation into the experiences of sonography students in using such equipment. It seems that a simulator can allow students to gain basic psychomotor skills in an unpressurised environment, while reducing the impact on patient throughput which results from traditional clinical training methods. Clearly, however, it is not possible to simulate the experience of interacting and communicating with a real patient and competence in this area must still be developed in the scanning clinic. As students develop their skills, their progress should be assessed regularly and feedback given. Gill Harrison reports on a survey of who, where and when clinical progress should be monitored. Most respondents preferred monitoring to be carried out by the clinical department mentor, who should be an experienced sonographer. There was strong support also for a three- or six-month period of preceptorship following completion of training to support the learner.
Work-related musculo-skeletal disorders are a common cause of pain and sickness absence for ultrasound practitioners and can lead to career ending injury if not resolved. Gill Harrison and Allison Harris review the factors which may lead to such injuries and recommend strategies and techniques for reducing their impact. The causes are not restricted to ergonomics, and sonographers should take some responsibility for their own safe practice, while managers should provide a supportive working environment.
Other articles in this issue include a study of the potential role of sonoelastography in obtaining successful percutaneous biopsies of soft tissue tumours, and a case report on the prenatal diagnosis of ductus arteriosus aneurysm.
I hope you enjoy this November issue of Ultrasound. I also hope to see many readers at the forthcoming BMUS Annual Scientific Meeting in Cardiff. If you are presenting a paper or poster in Cardiff, please do consider writing up your work as one of our articles so that all BMUS members can learn from your efforts.