Gill Harrison

Introduction: The sonographer workforce shortage is worldwide, with limited access to clinical training positions a major contributing factor to qualified sonographers entering the workforce. Our aim is to examine sonographer training models in English‐speaking countries where sonographers are the primary providers of diagnostic ultrasound services and clinical training (work integrated learning/WIL) is embedded within accredited course curricula to troubleshoot the sonographer workforce shortage. Methodology: An extensive search of Australian and international sonography course providers was performed. Accredited courses where WIL is a curriculum component and is assessable were included. Courses from Australia were compared to international courses and course elements that differed from the accredited Australian model were analyzed. Where possible, collaboration was sought from providers and/or the international accrediting bodies. Results: Australian sonography courses were compared to elements from New Zealand, Canada, the United Kingdom and South Africa. Strategies to increase qualified sonographers could be achieved by (1) Competency‐based time variable (CBTV) assessment of clinical skills, (2) collaboration between WIL and university course providers and increasing the number of course providers, (3) financial government support for students and training positions, (4) incorporation of simulation‐based learning (SBL) into approved WIL hours. Conclusion: The worldwide shortage of sonographers limits health service capacity with insufficient sonographers available to meet demand. Multiple innovative elements for increasing the number of entry‐level to practice sonographers have been identified. Any significant changes will need cooperation from WIL and education providers, accreditors, and government. Research on integration of these strategies into sonographer training is needed.

Introduction: Sonographers are required to deliver unexpected news to expectant parents in real time during obstetric ultrasound scans. The complexity of these interactions requires sonographers to conduct the clinical task while communicating their findings and managing the expectant parent’s response within the designated appointment time. Communication coaching for sonographers (CCS) is a tailored intervention that has previously been associated with improvements in confidence and news delivery practice. The current study explored the views and experiences of sonographers who completed CCS to evaluate and inform future delivery of this intervention. Methods: Nine sonographers participated in semi-structured qualitative interviews after completing CCS. We analysed data using a Reflexive Thematic Analysis (RTA) approach. Results: Participants reported CCS to be valuable and informative. The key themes identified included (1) innovating the path: tailored and novel training for sonographers, (2) humanising care: honouring the self, service-users and relevant others in the delivery of compassion-focused care and (3) making space: considerations for successfully delivering coaching. Participants said the coaching provided practical suggestions and was experienced as a ‘safe space’ for reflective practice that helped to enhance their capacity to identify and respond to emotion in others. There were practical challenges to taking part in CCS and organisational factors could act as a barrier; managerial championing of the intervention was crucial to uptake and completion. Conclusions: Participants viewed CCS positively. To implement CCS, there needs to be organisational coordination. Further controlled studies will be needed to establish the effectiveness of CCS.

Background: Prenatal bonding describes the emotional connection expectant parents form to their unborn child. Research acknowledges the association between antenatal imaging and enhanced bonding, but the influencing factors are not well understood, particularly for fathers or when using advanced techniques like fetal magnetic resonance imaging (MRI). This study aimed to identify variables which may predict increased bonding after imaging. Methods: First-time expectant parents (mothers = 58, fathers = 18) completed a two-part questionnaire (QualtricsXM™) about their expectations and experiences of ultrasound (n = 64) or fetal MRI (n = 12) scans in uncomplicated pregnancies. A modified version of the Prenatal Attachment Inventory (PAI) was used to measure bonding. Qualitative data were collected through open-ended questions. Multivariate linear regression models were used to identify significant parent and imaging predictors for bonding. Qualitative content analysis of free-text responses was conducted to further understand the predictors’ influences. Results: Bonding scores were significantly increased after imaging for mothers and fathers (p < 0.05). MRI-parents reported significantly higher bonding than ultrasound-parents (p = 0.02). In the first regression model of parent factors (adjusted R² = 0.17, F = 2.88, p < 0.01), employment status (β = -0.38, p < 0.05) was a significant predictor for bonding post-imaging. The second model of imaging factors (adjusted R² = 0.19, F = 3.85, p < 0.01) showed imaging modality (β = -0.53), imaging experience (β = 0.42) and parental excitement after the scan (β = 0.29) were significantly (p < 0.05) associated with increased bonding. Seventeen coded themes were generated from the qualitative content analysis, describing how scans offered reassurance about fetal wellbeing and the opportunity to connect with the baby through quality interactions with imaging professionals. A positive scan experience helped parents to feel excited about parenthood. Fetal MRI was considered a superior modality to ultrasound. Conclusions: Antenatal imaging provides reassurance of fetal development which affirms parents’ emotional investment in the pregnancy and supports the growing connection. Imaging professionals are uniquely positioned to provide parent-centred experiences which may enhance parental excitement and facilitate bonding.

Introduction: Despite widespread recognition that communicating unexpected news during obstetric ultrasound examinations is challenging, there is a dearth of research investigating how to teach evidence-based communication to sonographers. Communication Coaching is a supportive, positive method that has previously been associated with improvements in communication, patient satisfaction, and reduced burnout in clinicians. However, to date, no study has coached sonographers. This study explored stakeholders’ views on a proposed Communication Coaching intervention and used these data to adapt the intervention for use with qualified obstetric sonographers. Methods: Semi-structured interviews were conducted with people who have a vested interest in unexpected news delivery and thematic analysis was conducted on the data. Eight sonographers, six people with lived experience of receiving unexpected news and six representatives from third-sector organisations who support expectant parents were recruited (18 women; 2 men, aged between 21 and 75 years). Results: Participants viewed the planned Communication Coaching intervention favourably and suggested adaptations. The two main themes were (1) the practicalities of coaching, and (2) content. The first theme had four subthemes: (a) brief and flexible structure, (b) online modality, (c) sensitive and positive coach and (d) organisational awareness. The second theme had three subthemes: (a) specific language and behaviour recommendations, (b) adaptable to different service-users and situations and (c) confer relevant emotional skills and techniques. Conclusions: Communication Coaching could be a feasible and acceptable intervention for qualified sonographers if specific, limited adaptations are made as recommended by the stakeholders. Further evaluation of the intervention in practice is necessary.