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Introduction: Sonographers are expected to perform an increasingly broad range of imaging studies; however, how sonographers learn these new skills is not well documented. The learning landscape in which teaching occurs impacts on the way a skill may be acquired and the future attitude towards performance of the study. This study explored how the skill of arteriovenous fistula (AVF) scanning was acquired and the environment in which this learning occurred in Australian practices. The role of feedback and its reception was also explored, as feedback influences self‐reflection and the development of critical thinking skills. Methods: Semi structured interviews were conducted to explore the learning environments of qualified sonographers, with varying skill levels, who performed or who were learning to undertake AVF ultrasound examinations and had expressed an interest in participating (n = 16). After transcription, thematic analysis was employed and themes generated. Results: Three themes arose: (1) how sonographers learnt to perform AVF studies, (2) their attitudes to feedback, and (3) competency and confidence. Conclusions: In acquiring AVF scanning skills, the landscape in which sonographers learn helps shape their future attitudes to performing the ultrasound, as well as their response to seeking and receiving feedback. Feedback can contribute to future development of competence through prompting self‐reflection and critical thinking which ultimately helps limit overconfidence. Therefore, supervising sonographers are encouraged to consider the emotional state in which learning occurs, as it may impact the overall acquisition of, and practice of skills, resulting in improved professional outcomes. [ABSTRACT FROM AUTHOR]

Intra‐operative duplex ultrasound in renal transplantation was first described in 1998 and whilst reported in problematic cases, there are few reports of its routine use and no current published protocols. Since 2013, we have used intra‐operative ultrasound in all renal transplants. The formal protocol used since August 2020 is presented as a reference document for other transplant centres. A Canon Aplio 800 ultrasound system with an i22LH8 hockey‐stick transducer is used to image the renal cortex and major vessels, and an i8CX1 matrix transducer to image the graft during and after fascial closure. These transducers are fully sterilised with Sterrad and no sheathing of transducers is required. The transplant surgeon scans within the sterile field with the sonographer guiding imaging and adjusting machine settings. Ultrasound findings are discussed between team members including any requirement for interventions. Ultrasound is performed at three stages of the operation: Stage 1: after clamp release identifying issues of graft vascularity including otherwise unrecognised major vessel and anastomotic abnormalities. Stage 2: following ureteric implantation identifying compromised perfusion due to graft rotation or vessel kinking. Stage 3: after fascial closure identifying compromised perfusion due to external compression. Post‐operative scanning, including assessment of the collecting system and bladder, is performed routinely on days 1, 3, 7 and 30. The intervention is effective with no early graft losses or peri‐operative vascular thromboses. The requirements for service provision are significant including the availability of additional transducers, and sonographers with expertise in intra‐operative scanning able to attend after‐hours for extended periods. [ABSTRACT FROM AUTHOR]

Portfolios are embraced extensively in higher professional education as effective tools for students to represent their learning and help prepare them for future practice. They are very diverse, used for both formative and summative purposes; however, concerns are raised that the current emphasis on academic standards and/or the focus on employability may lead to the perception of portfolios simply as means to portray achievements. This paper argues that contemporary portfolios in digital environments can readily facilitate both purposes. It conceptualises a whole-of-programme approach to the use of portfolios in which consideration is given to the need to bring curation skills and feedback processes to the forefront of portfolio practices. For teachers considering these issues, a planning framework for the design of programme-wide portfolios is proposed.

Background: Traditionally, general practitioners (GPs) have initiated the need for, and ordered, radiological tests. With the emergence of consumer-centred care, patients have started to request scans from doctors on their own initiative. Consumeristic health care has shifted the patient–doctor dyadic relationship, with GPs trending towards accommodating patients' requests. Methods: A mixed method analysis was conducted using a survey instrument with open ended questions and concurrent interviews to explore participants' responses from their requests for radiological studies from GPs. Themes emerging from both qualitative and quantitative methodologies were mapped onto the Andersen Newman Model (ANM). Results: Data were analysed for 'predisposing,' 'need' and 'enabling' elements of the ANM model and were correspondingly mapped to patient's requests for radiological referrals according to the elements of the ANM. Participants expressed anxiety about their health, were confident in the types of radiological scans they desired and typically indicated the need for evidence of good health. Their desire for such requested scans was often enabled through prior exposure to health information and the experience of specific symptoms. Requests came with the expectation of validation, and if these requests were denied, participants indicated that they would seek another doctor who would oblige. Conclusions: In our modest study of Australian patients, participants were well informed about their health. Exposure to information seems to create a sense of anxiousness prior to visiting the doctor. Individuals sought visual proof of wellness through imaging, and doctors in return often accommodated patient requests for radiological studies to appease patients' needs and to maintain workflow. With increased availability of online health information, individuals are more educated about managing their health care. Our study investigates patients requesting their own radiological scans rather than relying on their doctors' expertise. We explore participant responses to clinical encounters where they have initiated a radiological study from their general practitioner, and their self-reported responses and outcomes from such requests. [ABSTRACT FROM AUTHOR]

Objective: Chronic venous disease is a common vascular condition, affecting up to 60% of the population worldwide. In Australia and New Zealand, chronic venous insufficiency ultrasound examinations are primarily performed by sonographers. This research aimed to explore how ultrasound examinations are being performed, providing insights into current practices and recommendations for quality improvement. Method: A questionnaire was distributed to capture demographics, practices of ultrasound, examination techniques, the use of nomenclature and experience of the respondents. Results: The analysis of 97 responses showed a heterogeneity in the clinical application of ultrasound. Most sonographers performed less than two scans per day within 30–45 minutes. Deep venous incompetence was routinely excluded by all respondents. The majority used standing, sitting and reverse Trendelenburg position except for a few using supine position. Manual augmentation was the preferred provocation manoeuvre. Anatomical variations at the junctional level were not adequately evaluated. Although Giacomini's vein was assessed by 80%, 57% of those did not evaluate paradoxical reflux. Seventy-five per cent routinely assessed non-saphenous reflux; however, over 50% were unfamiliar with lymph node venous networks. A significant number of out-dated venous terms were still being used. A low participation rate in continuing professional development was identified, which might be attributable to limited education and training programs. Conclusion: The study is a multi-faceted exploration that identified a need for standardized diagnostic and reporting guidelines. Our results could explain discrepancies in diagnostic findings and inconsistencies in the use of medical terminology, with implications for clinical decision making and assessment of surgical outcome. [ABSTRACT FROM AUTHOR]

Davies, TB, Halaki, M, Orr, R, Mitchell, L, Helms, ER, Clarke, J, and Hackett, DA. Effect of set structure on upper-body muscular hypertrophy and performance in recreationally trained men and women. J Strength Cond Res 36(8): 2176–2185, 2022—This study explored the effect of volume-equated traditional-set and cluster-set structures on muscular hypertrophy and performance after high-load resistance training manipulating the bench press exercise. Twenty-one recreationally trained subjects (12 men and 9 women) performed a 3-week familiarization phase and were then randomized into one of two 8-week upper-body and lower-body split programs occurring over 3 and then progressing to 4 sessions per week. Subjects performed 4 sets of 5 repetitions at 85% one repetition maximum (1RM) using a traditional-set structure (TRAD, n = 10), which involved 5 minutes of interset rest only, or a cluster-set structure, which included 30-second inter-repetition rest and 3 minutes of interset rest (CLUS, n = 11). A 1RM bench press, repetitions to failure at 70% 1RM, regional muscle thickness, and dual-energy x-ray absorptiometry were used to estimate changes in muscular strength, local muscular endurance, regional muscular hypertrophy, and body composition, respectively. Velocity loss was assessed using a linear position transducer at the intervention midpoint. TRAD demonstrated a significantly greater velocity loss magnitude (g = 1.50) and muscle thickness of the proximal pectoralis major (g = −0.34) compared with CLUS. There were no significant differences between groups for the remaining outcomes, although a small effect size favoring TRAD was observed for the middle region of the pectoralis major (g = −0.25). It seems that the greater velocity losses during sets observed in traditional-set compared with cluster-set structures may promote superior muscular hypertrophy within specific regions of the pectoralis major in recreationally trained subjects. [ABSTRACT FROM AUTHOR]

Introduction: Sonographers in the Western New South Wales Local Health District (WNSWLHD) reported a musculoskeletal pain prevalence rate of 95%. Participatory ergonomics, where workers are consulted about improving work conditions, was utilised to identify work-related musculoskeletal disorder (WMSD) risks and potential solutions. The aim of this study was to compare the prevalence of WMSD in a cohort of sonographers before and after implementation of ergonomic changes that were driven by recommendations from a participatory ergonomics approach. Methods: This observational mixed methods study analysed the impact of participatory ergonomic-driven interventions on changes on musculoskeletal pain in a cohort of sonographers employed within the WNSWLHD. A retrospective analysis of 10 sonographer WMSD pain surveys over five sites was completed, along with semi-structured interviews regarding which interventions were perceived as useful, which interventions were not implemented and any barriers to implementation. Results: Installation of patient monitors, use of ergonomic scanning techniques and job rotation were perceived as responsible for decreased musculoskeletal pain. Taking lunch breaks and microbreaks, use of antifatigue mats and having two sonographers perform mobile exams were not fully implemented. No interventions were perceived as responsible for increased pain. Conclusion: This small study provides preliminary evidence that a participatory ergonomics approach facilitated identification of occupation and site-specific risks for WMSD in the WNSWLHD, allowing implementation of ergonomic changes to be tailored to the workplace, resulting in a safer work environment for sonographers. [ABSTRACT FROM AUTHOR]

Introduction: Due to the increasing prevalence of kidney failure in Australia, more sonographers are being expected to perform ultrasound examinations of arteriovenous fistulae (AVF), even when they may receive little support to do so. Methods: We surveyed respondents through the Australasian Sonographers Association (ASA), regarding their demographics, workplace, and experience in relation to AVF ultrasound examinations. Results: Fifty sonographers participated from metropolitan and regional areas. Sonographers in metropolitan areas had approximately three times more access to support compared to those in rural/remote areas, in performing AVF ultrasound examinations. Self‐reported competency levels of AVF ultrasound examinations were novice/advanced beginner 28.6%, competent 30%, proficient/expert 40%. Less than a fifth of sonographers always performed a physical assessment, while almost half never physically assessed an AVF. Conclusion: Rural and remote sonographers have the least access to ongoing resources and support. The knowledge of the supporting role that non‐ultrasound methods of AVF surveillance can play in improving the quality of ultrasound assessments, varied mainly by perception of competency. Sonographer competency, education, and support in AVF assessment is vital to avoid clinical uncertainty. Australian sonographers would benefit from further education and support to improve competency, confidence and patient outcomes. [ABSTRACT FROM AUTHOR]