Occupational burnout among radiographers, sonographers and radiologists in Australia and New Zealand: Findings from a national survey

Self-compassion and psychological well-being of radiographers at work

OBJECTIVES

The aim of this study was to assess how self-compassion affects the psychological well-being of radiographers at work.

METHODS

An online survey was sent to radiology and radiotherapy departments in Rhône-Alpes, a region of France (from October 2021 to February 2022). The study is mixed: quantitative data, with closed questions and two validated scales, and qualitative data, with open questions aimed at assessing perceptions among radiologists as regards self-compassion.

RESULTS

A total of 253 radiographers (mean age 32.9 years), took part in this survey. Radiographers reported a poor level of well-being and a moderate level of self-compassion. We found a link between well-being at work and self-compassion. Gender, age, number of years of experience and the desire to receive training on well-being appear to have an impact on the level of self-compassion. The perception of self-compassion by radiologists is essentially positive.

CONCLUSION

Particular attention should be paid to radiologists who are female, young, and with only a few years of experience. Self-compassion is a protective factor for radiologists and may help them take care of themselves to continue caring for others. Training related to self-compassion should be promoted in medical imaging departments.

Radiographers' workload and burnout on performance: an empirical study

Study purpose

To assess the prevalence of burnout among radiographers, and whether demographic variables and work-related factors had any influence on burnout and perceived stress among them.

Methods

A cross-sectional quantitative survey design is adopted in this study. The participants included radiographers from Saudi Arabia. Both Maslach Burnout Inventory (MBI) and Perceived Stress Scale (PSS) were used for data collection. Participation was voluntary, and the survey was conducted online, resulting in 322 final responses considered for the data analysis.

Results

The mean emotional exhaustion (EE) score achieved was 26.01, representing medium burnout risk. However, the mean depersonalization (DP: μ = 25.25) and personal accomplishment (PA: μ = 23.65) represented high burnout risk among radiographers. Statistically significant differences (p < 0.05) were observed among the participants grouped by genders, age groups, nature of work type, and work experience. The mean perceived stress score for radiographers was identified to be 27.8, indicating high.

Conclusion

The findings underscore the critical need for targeted interventions and support mechanisms within the radiology profession, particularly focusing on younger radiographers and those with extensive work experience.

Best Practices: Burnout Is More Than Binary

Burnout among radiologists is increasingly prevalent, with potential for substantial negative impact on physician well-being, care delivery, and health outcomes. To evaluate this phenomenon using reliable and accurate means, validated quantitative instruments are essential. Variation in measurement can contribute to wide-ranging findings. This article evaluates radiologist burnout rates globally and dimensions of burnout as reported using different validated instruments and provide guidance on best practices to characterize burnout. Fifty-seven studies between 1990 and 2023 were included in a systematic review, and 43 studies were included in a meta-analysis of burnout prevalence using random effects models. Reported burnout ranged from 5% to 85%. With the Maslach Burnout Inventory (MBI), burnout prevalence varied significantly depending on instrument version. Among MBI subcategories, the prevalence of emotional exhaustion was 54% (95% CI, 45-63%), depersonalization was 52% (95% CI, 41-63%), and low personal accomplishment was 36% (95% CI, 27-47%). Other validated burnout instruments showed less heterogeneous results; studies using the Stanford Professional Fulfillment Index yielded burnout prevalence of 39% (95% CI, 34-45%), whereas the Validated Single-Item instrument yielded 34% (95% CI, 29-39%). Standardized instruments for prevalence alongside multidimensional profiles capturing experiences may better characterize radiologist burnout, including change over time.

Workplace factors impacting the wellbeing of diagnostic radiographers in clinical practice: A literature review

INTRODUCTION

The Coronavirus (COVID-19) pandemic resulted in an emphasis on external factors affecting the wellbeing of staff within the National Health Service. There is a national shortage of diagnostic radiographers in the United Kingdom, so maintaining the health and satisfaction of the current radiographic workforce is important. The aim of this literature review is to determine workplace-related factors affecting the wellbeing of diagnostic radiographers in their clinical practice.

METHODS

An interpretive phenomenological approach was selected to gain an insight of wellbeing from the perspective of radiographers and radiology managers. A systematic literature search was conducted, resulting in 10 core articles which were then thematically analysed.

RESULTS

Five themes were identified: Initial waves of COVID-19, Workload and Working Patterns, Mental Health, Sources of Support, and Recognition and Development.

DISCUSSION

COVID-19 has had a short and long-term impact on the working practices of radiographers, leading to a risk of burnout. Radiographers appreciated different forms of recognition from managers and support within their team but felt a lack of professional recognition outside the radiology department. Radiographers displayed resilience during the pandemic, using various strategies to cope with emotional challenges. A variety of external support was available to radiographers, but this was often self-directed, with in-person support difficult to access due to working patterns.

CONCLUSION

This review highlights the lack of tailored support addressing radiographers' unique experiences. As imaging modalities have different workloads and varying emotional involvement with patients, further research to provide evidence-based interventions to improve radiographers' mental health is advised.

Sound the Alarm: The Sonographer Shortage Is Echoing Across Healthcare

OBJECTIVES

The growth in ultrasound usage necessitates concurrent growth in the number of sonographers. Despite the increasing importance of ultrasound, there is a shortage of sonographers in the United States that has never been specifically quantified. This study examines recent trends in the number of ultrasound exams, sonography graduates, open sonographer positions, and wages.

METHODS

This retrospective study uses public databases and surveys including the Medical Expenditure Panel Survey (MEPS), Bureau of Labor Statistics (BLS), Integrated Postsecondary Education Data System (IPEDS), and Zippia, a human resources platform to determine metrics. These metrics include the number of ultrasound exams conducted in the United States (excluding inpatient setting), number of sonographers and sonographer wages, sonography graduates, and open sonographer positions.

RESULTS

Ultrasound exams in the United States from 2011 to 2021 increased from 38.6 million to 59.8 million (+55.1%,) while the number of sonographers (2011-2021) increased from 54,760 to 78,640 (+43.6%). There was a significant difference between supply and demand of sonographers with the number of sonography graduates (2011-2021) increasing from 4,386 to 5,393 (+23.0%) while the number of open sonographer positions (2012-2021) increased from 18,462 to 25,162 (+36.3%).

CONCLUSIONS

From 2011 to 2021, the increase in the number of ultrasound exams has significantly outpaced the increase in the number of sonographers. Furthermore, the increase in demand for sonographers has grown significantly faster than the supply, leading to a shortage and consequent strain on the healthcare system. To address the shortage, the number of sonography school openings should be increased, and the attendant challenges addressed.

Mixed shift rotations, sleep, burnout and well-being in professions similar to radiographers: A systematic review

INTRODUCTION

Delivering 24 h healthcare requires rotational shift work from doctors and the medical imaging team, while contributing to safe and timely care of patients. Additional service pressure and staff shortfall leads to workload pressures, adjusted shift patterns and risk of burnout. Evidence should be sought to the effects of this work on staff.

METHODS

This systematic review followed PRISMA reporting guidelines, using a convergent mixed methods approach according to Guidance from Joanna Briggs International. Quantitative trends and results were qualified in order to thematically analyse in conjunction with qualitative data and discussed together in context. Following initial searching, returned articles were screened by title and abstract. A team of 3 reviewers undertook blinded critical appraisal of those suitable, with quality assurance from a 4th team member. Papers passing a threshold of 75% on JBI appraisal tools were accepted for synthesis. Data extraction of appropriate articles retrieved was undertaken in parallel.

RESULTS

Following screening and critical appraisal, 13 studies were returned focusing exclusively on Non Consultant Doctors. No studies investigated diagnostic radiographers. 85% (n = 11) reported negative association between shift work and the three themes of sleep/fatigue, burnout and wellbeing: including after the introduction of shift pattern control or adjusted shift patterns. The remainder showed no change, or any improvement nullified by countermeasures to maintain service delivery.

CONCLUSION

Current working practices and shift plans in the target population showed detrimental effects on the participants - this can be suggested that Diagnostic Radiographers may suffer fatigue, burnout and poor mental health from stretched shift working patterns.

IMPLICATIONS FOR PRACTICE

Further study into the effects of shift work on Diagnostic Radiographers and other allied health professionals is indicated - relating to the above themes in the context of errors and patient safety. Additional research into Non Consultant Doctors, shift work effects and the context of wider service delivery required; with suitable interventions and education to maximise understanding of legal working practices, monitoring and self-management of symptoms.

Automation and artificial intelligence in radiation therapy treatment planning

Automation and artificial intelligence (AI) is already possible for many radiation therapy planning and treatment processes with the aim of improving workflows and increasing efficiency in radiation oncology departments. Currently, AI technology is advancing at an exponential rate, as are its applications in radiation oncology. This commentary highlights the way AI has begun to impact radiation therapy treatment planning and looks ahead to potential future developments in this space. Historically, radiation therapist's (RT's) role has evolved alongside the adoption of new technology. In Australia, RTs have key clinical roles in both planning and treatment delivery and have been integral in the implementation of automated solutions for both areas. They will need to continue to be informed, to adapt and to transform with AI technologies implemented into clinical practice in radiation oncology departments. RTs will play an important role in how AI-based automation is implemented into practice in Australia, ensuring its application can truly enable personalised and higher-quality treatment for patients. To inform and optimise utilisation of AI, research should not only focus on clinical outcomes but also AI's impact on professional roles, responsibilities and service delivery. Increased efficiencies in the radiation therapy workflow and workforce need to maintain safe improvements in practice and should not come at the cost of creativity, innovation, oversight and safety.

Graduate competencies, employability and the transnational Radiography workforce shortage: A systematic literature review of current pre-registration Radiography education and training models

INTRODUCTION

Transnational mobility of the Radiography workforce is challenged due to issues with standardisation of current education and training models which has added to the workforce shortage. To address the growing volume, scope and complexity of clinical Radiography service delivery, educational models need to be given a critical look for transnational relevance in modern times. This study aims to synthesise the characteristics of current pre-registration radiography educational programmes linked with effective knowledge, skill acquisition, and graduate employability to address the current workforce challenges through the development of newer training models.

METHODS

Using a mixed methods systematic review approach, secondary data was obtained from an EBSCOhost search involving key databases including MEDLINE, CINAHL, Academic Search Ultimate, ScienceDirect, and SCOPUS. Themes were developed following a result-based convergent data synthesis.

RESULTS

Forty articles met the predefined inclusion criteria following the study identification and screening phases. The included studies were conducted from across diverse settings including both low- and middle-income countries (LMIC) and high-income countries (HIC). Two broad themes were developed from the findings including: 1. Factors influencing graduate employability and 2) Radiography education and training programme characteristics.

CONCLUSION

The findings highlight and advocate for an innovative model for Radiography education and underscores the significance of graduates possessing multi-modality skills, varied competencies, and effective accreditation processes for training. Prioritising alignment with industry needs and holistic skill development is vital to closing the employability gap, ultimately improving graduate skills and competencies to address workforce shortage while improving patient care outcomes.

IMPLICATIONS FOR PRACTICE

Radiography training institutions should explore the development of new innovative models for multi-modality pre-registration education. This should offer adaptable routes that align seamlessly with the evolving regulatory, technological, and clinical trends.

A Meta-analysis of Burnout in Radiology Trainees and Radiologists: Insights From the Maslach Burnout Inventory

RATIONALE AND OBJECTIVES

Burnout, stemming from chronic work stress, is a significant issue in the medical field, especially among radiologists. It leads to compromised patient care and reduced job satisfaction. Addressing burnout in radiology is essential for the well-being of radiologists and, in turn, for improving patient care. This study aimed to assess the prevalence and dimensions of burnout among radiology trainees (RTs) and practicing radiologists (PRs).

MATERIALS AND METHODS

A systematic review and meta-analysis were conducted in accordance with established guidelines. The search encompassed PubMed, Scopus, Web of Science, and Embase databases up to June 20, 2023. Eligible studies that assessed the rate of burnout syndrome and/or its subscales, including depersonalization (DP), emotional exhaustion (EE), and personal accomplishment (PA), among RTs and/or PRs using the Maslach Burnout Inventory (MBI), were included. Relevant data were extracted and analyzed using R and STATA.

RESULTS

Among the 22 included studies, the pooled rates of positive MBI subscales for RTs and PRs were as follows: 54.7% (95% confidence interval [CI]: 43.8%-65.1%, I2 = 95.2%) for DP, 57.2% (95% CI: 48.7%-65.4%, I2 = 92.9%) for EE, and 38.6% (95% CI: 27%-51.7%, I2 = 95.5%) for low PA. The pooled rate indicating the presence of at least one positive MBI subscale was 82.9% (95% CI: 79.2%-86.1%, I2 = 57.4%). For two or more positive MBI subscales, the pooled rate was 55.5% (95% CI: 49.7%-61.3%, I2 = 60.2%), and for three positive MBI subscales, it was 16.7% (95% CI: 11.7%-23.3%, I2 = 82.7%).

CONCLUSION

This study emphasizes a notable prevalence of burnout in the radiology specialty, with 8 of 10 individuals exhibiting positive results in at least one MBI subscale. This highlights the urgent need for interventions and support systems to protect the well-being of both trainees and practitioners and uphold the quality of patient care.

Infection prevention and control in CT Part 2: Radiographers' and radiology nurses' perceptions of high-risk scenarios contributing to non-adherence to IPC protocols

INTRODUCTION

Adherence to standard and transmission-based precautions in the computed tomography (CT) setting is central to effective infection prevention and control (IPC), yet there is limited evidence about medical imaging (MI) professionals' self-reported predictors of IPC breaches. This is the second of a two-part series on IPC in the CT setting. Part 1 reported on Australian baseline data relating to intravenous contrast media administration and power injectors. Part 2 presents Australian radiographers' and radiology nurses' perceptions of clinical situations that reduce adherence to standard and transmission-based precautions in CT.

METHODS

A self-administered survey was distributed to Australian radiographers and radiology nurses working in CT. Responses to an open-ended question "If I was to not adhere to the standard and transmission-based precautions in the CT department, it is most likely when …" was analysed using inductive coding for themes, followed by deductive analysis mapped to the Systems Engineering Initiative for Patient Safety (SEIPS) model.

RESULTS

Study participants (n = 136) were radiographers (n = 119; 87.5%) and nurses (n = 17; 12.5%). 'Four themes were derived from the inductive analysis: (1) high-risk working conditions, (2) compliance with good practice, (3) attitudes and practice, and (4) quality of communication. Deductive analysis, using the SEIPS domains revealed that predominant issues related to 'Tasks' (43.7%) and 'Organisation' (30.6%) followed by issues related to 'Person' (16.9%), 'Tools and technology' (6.9%) and 'Environment' (1.9%).

CONCLUSION

Multi-faceted pressures on radiology staff may compromise adherence to standard and transmission-based precautions in CT. Task difficulty, time pressures whilst undertaking tasks, and reduced staffing could lead to lower adherence to standard and transmission-based precautions.

IMPLICATIONS FOR PRACTICE

Future studies that focus on evaluation of 'Tasks' and 'Organisation' domains of the SEIPS model may provide further insights to non-adherence behaviours in MI.

Exploring UK sonographers' views on the use of professional supervision in clinical practice - Stage one findings of a mixed method study

INTRODUCTION

Professional Supervision has been described across multiple professional groups, however to date, minimal research has been conducted exploring the use of professional supervision within the United Kingdom (UK) sonographer workforce.

METHODS

An online self-administered survey was conducted to explore UK sonographers views on the use of professional supervision in practice. The survey was open to sonographers, consultant or clinical specialist sonographers, ultrasound managers and professional body officers. Multiple choice questions were utilised to obtain quantitative data on the provision of support mechanisms, with free text questions allowing qualitative data to be elicited further to explore thoughts of participants.

RESULTS

A total of 112 participants completed the survey in full and response rates varied across the subgroups. Varying support mechanisms were in place for sonographers. However only 55.4 % of sonographers felt supported in the clinical workplace. Thematic analysis of qualitative data highlighted that workload pressures, staffing and retention of sonographers, were key concerns that professional supervision could improve. It was highlighted that time to undertake professional supervision could be challenging, however if training for professional supervision was in place then this could provide improved quality of care and staff support.

CONCLUSION

Participants highlighted the challenges faced by UK sonographers and the positive impact that professional supervision could have on retention and staff support. There are limited support mechanisms in place for UK sonographers and this is impacting on how participants felt they were being supported in the workplace. Stage 2 of this research project will explore sonographers' views in more detail.

IMPLICATIONS FOR PRACTICE

The approach to support mechanisms for sonographers should be considered to support improvement of professional wellbeing and retention of the sonographic workforce.

Incidence and factors associated with burnout in radiologists: A systematic review

Rationale and objectives

Burnout among physicians has a prevalence rate exceeding 50%. The radiology department is not immune to the burnout epidemic. Understanding and addressing burnout among radiologists has been a subject of recent interest. Thus, our study aims to systematically review studies reporting the prevalence of burnout in physicians in the radiology department while providing an overview of the factors associated with burnout among radiologists.

Materials and methods

The search was conducted from inception until November 13th, 2022, in PubMed, Embase, Education Resources Information Center, PsycINFO, and psycArticles. Studies reporting the prevalence of burnout or any subdimensions among radiology physicians, including residents, fellows, consultants, and attendings, were included. Data on study characteristics and estimates of burnout syndrome or any of its subdimensions were collected and summarized.

Results

After screening 6379 studies, 23 studies from seven countries were eligible. The number of participants ranged from 26 to 460 (median, 162; interquartile range, 91-264). In all, 18 studies (78.3%) employed a form of the Maslach Burnout Inventory. In comparison, four studies (17.4%) used the Stanford Professional Fulfillment Index, and one study (4.3%) used a single-item measure derived from the Zero Burnout Program survey. Overall burnout prevalence estimates were reported by 14 studies (60.9%) and varied from 33% to 88%. High burnout prevalence estimates were reported by only five studies (21.7%) and ranged from 5% to 62%. Emotional exhaustion and depersonalization prevalence estimates were reported by 16 studies (69.6%) and ranged from 11%-100% and 4%-97%, respectively. Furthermore, 15 studies (65.2%) reported low personal accomplishment prevalence, ranging from 14.7% to 84%. There were at least seven definitions for overall burnout and high burnout among the included studies, and there was high heterogeneity among the cutoff scores used for the burnout subdimensions.

Conclusion

Burnout in radiology is increasing globally, with prevalence estimates reaching 88% and 62% for overall and high burnout, respectively. A myriad of factors has been identified as contributing to the increased prevalence. Our data demonstrated significant variability in burnout prevalence estimates among radiologists and major disparities in burnout criteria, instrument tools, and study quality.

But what does it mean to us? Radiographic patients and carer perceptions of compassion

INTRODUCTION

An increased focus on compassion was one of the recommendations in the Francis Report following an inquiry into failures of care at the Mid Staffordshire NHS Trust in 2010. Responses to the Francis report did not take up the question of what compassion meant and how its recommendations might be meaningfully implemented in radiography practice. As part of two wider doctoral research studies, the findings presented in this paper reveal patients and carers perspectives of how compassionate care is experienced, based on an exploration of their experiences, views and attitudes in order to better understand its meaning and application in radiographic practice.

METHODS

A constructivist approach was taken with appropriate ethical approval. Using a combination of interviews, focus groups, co-production workshops and online discussion forums the authors explored the experiences and opinions of patients and carers about compassion in radiotherapy and diagnostic imaging. Data were transcribed and analysed thematically.

RESULTS

The thematically mapped findings are presented under four sub-themes: The values of caring vs the 'business' values of the NHS, Person-centred care, Characteristics of the radiographer and Compassion in the radiographer-patient interaction.

CONCLUSION

Looking at compassion through a patient's lens has highlighted how person-centred care consists of components not attributable to radiographers alone. The personal values of a radiographer must not only align with those of the profession they seek to join, but the value placed on compassion must also be reflected in the environment in which they practice. Alignment signifies patients are part of a compassionate culture.

IMPLICATIONS FOR PRACTICE

Equal emphasis should be placed on both technical and caring practices in order to stop the profession being perceived as target-driven, rather than one which ensures patients are at the heart of practice.

UK obstetric sonographers' experiences of the COVID-19 pandemic: Burnout, role satisfaction and impact on clinical practice

Introduction

The COVID-19 pandemic placed additional demands and stressors on UK obstetric sonographers, who were required to balance parent safety and service quality, alongside staff safety. Increased pressure can negatively impact a healthcare worker's well-being and the provision of person-centred care. The aim of this study was to explore obstetric sonographers' experiences of performing pregnancy ultrasound scans during the pandemic and to assess the impact on burnout, role satisfaction and clinical practice.

Methods

An online, anonymous cross-sectional survey was created to capture sonographers' experience alongside using the Oldenburg Burnout Inventory to evaluate burnout and Clinical Outcomes in Routine Evaluation 10 (CORE-10) to measure psychological distress.

Results

Responses were received from 138 sonographers. Of those completing the Oldenburg Burnout Inventory (n = 89), 92.1% and 91.0% met the burnout thresholds for exhaustion and disengagement, respectively. Sonographers with a higher burnout score also perceived that COVID-19 had a greater, negative impact on their practice (p < 0.05). The mean CORE-10 score of 14.39 (standard deviation = 7.99) suggests mild psychological distress among respondents. A significant decrease in role satisfaction was reported from before to during the pandemic (p < 0.001), which was associated with higher scores for burnout and psychological distress (p < 0.001). Change in role satisfaction was correlated with sonographers' perception of safety while scanning during the pandemic (R 2 = 0.148, p < 0.001). Sixty-five sonographers (73.9%) reported they were considering leaving the profession, changing their area of practice or working hours within the next 5 years.

Conclusion

Job and context-specific interventions are required to mitigate burnout and its consequences on the workforce and service provision beyond the pandemic.

Clinical workflow of sonographers performing fetal anomaly ultrasound scans: deep-learning-based analysis

OBJECTIVE

Despite decades of obstetric scanning, the field of sonographer workflow remains largely unexplored. In the second trimester, sonographers use scan guidelines to guide their acquisition of standard planes and structures; however, the scan-acquisition order is not prescribed. Using deep-learning-based video analysis, the aim of this study was to develop a deeper understanding of the clinical workflow undertaken by sonographers during second-trimester anomaly scans.

METHODS

We collected prospectively full-length video recordings of routine second-trimester anomaly scans. Important scan events in the videos were identified by detecting automatically image freeze and image/clip save. The video immediately preceding and following the important event was extracted and labeled as one of 11 commonly acquired anatomical structures. We developed and used a purposely trained and tested deep-learning annotation model to label automatically the large number of scan events. Thus, anomaly scans were partitioned as a sequence of anatomical planes or fetal structures obtained over time.

RESULTS

A total of 496 anomaly scans performed by 14 sonographers were available for analysis. UK guidelines specify that an image or videoclip of five different anatomical regions must be stored and these were detected in the majority of scans: head/brain was detected in 97.2% of scans, coronal face view (nose/lips) in 86.1%, abdomen in 93.1%, spine in 95.0% and femur in 92.3%. Analyzing the clinical workflow, we observed that sonographers were most likely to begin their scan by capturing the head/brain (in 24.4% of scans), spine (in 23.2%) or thorax/heart (in 22.8%). The most commonly identified two-structure transitions were: placenta/amniotic fluid to maternal anatomy, occurring in 44.5% of scans; head/brain to coronal face (nose/lips) in 42.7%; abdomen to thorax/heart in 26.1%; and three-dimensional/four-dimensional face to sagittal face (profile) in 23.7%. Transitions between three or more consecutive structures in sequence were uncommon (up to 13% of scans). None of the captured anomaly scans shared an entirely identical sequence.

CONCLUSIONS

We present a novel evaluation of the anomaly scan acquisition process using a deep-learning-based analysis of ultrasound video. We note wide variation in the number and sequence of structures obtained during routine second-trimester anomaly scans. Overall, each anomaly scan was found to be unique in its scanning sequence, suggesting that sonographers take advantage of the fetal position and acquire the standard planes according to their visibility rather than following a strict acquisition order. © 2022 The Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.

Professional Quality of Life Among Medical Imaging Technologists and Radiologists During COVID-19 Pandemic in India

Background

Professional quality of life is one of the growing concerns among healthcare workers especially during COVID-19 pandemic. Presence and work of radiologist and medical imaging technologist for prolonged hours with patients could be stressful and painful.

Objectives

This study aimed to assess the professional quality of life among the radiologist and medical imaging technologist by analyzing professional satisfaction, compassion, and burnout during the COVID-19 pandemic.

Methods

An online, cross-sectional, self-reported, and internet-based survey was carried out among 153 radiologists and medical imaging technologists. Descriptive statistics were used to summarize the sociodemographic variables and domains of professional quality of life scale. Cronbach's alpha was used to check internal consistency. Independent sample t-test (two-tailed) was used to compare the demographic variables and compassion satisfaction, burnout, and secondary traumatic stress.

Results

Most participants reported moderate and higher level of compassion satisfaction, whereas moderate burnout and secondary traumatic stress was reported by most participants during COVID-19 pandemic. There was negative correlation between compassion satisfaction and burnout and secondary traumatic stress.

Conclusion

The findings of this study are vital to understand the work-related quality of life among healthcare professionals not only during COVID-19 pandemic but also after the pandemic situation. There is a need to conduct qualitative evaluation to ascertain the risk factors associated with professional quality of life. The study also reflects the need to focus more on the mental health of healthcare professionals not only during and after pandemic situation.

Assessment of job satisfaction, lifestyle behaviors, and occupational burnout symptoms during the COVID-19 pandemic among radiologic technologists in Saudi Arabia

INTRODUCTION

Radiologic technologists (RTs) are among the healthcare staff negatively impacted by job dissatisfaction, occupational stress, and unhealthy lifestyle behaviors, especially during the COVID-19 pandemic. The aim of this study was to assess job satisfaction, lifestyle behaviors, occupational burnout symptoms, and associated factors among RTs in Saudi Arabia.

METHODS

A survey study was conducted from January 2021 to February 2022 using a self-administered questionnaire. The questionnaire gathered socio-demographic information, answers to the Minnesota Satisfaction Questionnaire, lifestyle behaviors, and frequency of occupational burnout symptoms. Data were analyzed to obtain descriptive and inferential statistics.

RESULTS

A total of 261 RTs completed the survey. Participants were predominantly male and most were working in public hospitals. The overall mean score for job satisfaction was 3.77 (of 5), indicating moderate job satisfaction, with two items showing low satisfaction- compensation (3.33) and advancement (3.28). The overall mean score for lifestyle behaviors was 2.00 (of 3), indicating moderate lifestyle behaviors, with the lowest scores reported in sleep quality (1.92), healthy diet (1.85), and relaxing and unwinding (1.86). For burnout symptoms, the overall mean score was 2.30, indicating moderate burnout level, with the highest score reported in experiencing physical symptoms (2.72). There were significant relationships between job satisfaction, lifestyle behaviors and burnout symptoms. A positive and moderate relationship, r = 0.53 (p < 0.05), was found between job satisfaction and healthy lifestyle behaviors. The burnout relationships with job satisfaction, r = -0.615 (p < 0.05), and healthy lifestyle behaviors, r = -0.524 (p < 0.05), were negative and moderate relationships CONCLUSION: The interrelationships between job satisfaction, lifestyle behaviors, and occupational burnout symptoms suggest that improving lifestyle behaviors and managing burnout symptoms could contribute to higher job satisfaction.

IMPLICATIONS FOR PRACTICE

Policymakers should focus their efforts in the workplace health promotion programs to play essential roles in promoting healthy lifestyle behaviors and occupational stress management, as well as, improvements of RTs career advancement and compensation.

Is there a role for professional supervision in supporting the professional and personal wellbeing of the sonographic workforce? A literature review

OBJECTIVES

The sonographer workforce in the UK is under pressure due to chronic staff shortages and increased service demands. The Health and Care Professions Council and the Society of Radiographers both advocate for the use of professional supervision to support wellbeing and development, however the use of professional supervision is not widespread within the sonographer workforce. The aim of this literature review was to explore the evidence around the use of professional supervision and how this could support sonographer wellbeing.

KEY FINDINGS

Professional supervision was found to be of importance for providing emotional support which can lead to increased job satisfaction, lower levels of burnout and subsequently impact on retention of the workforce. Professional supervision supported personal development and therefore increased quality of patient care, allowing professionals to discuss evidence-based care, policies and practice development through reflection. Whilst important for emotional and professional support, this review found that there are conflicting pressures which can impact the effectiveness of supervision including the supervisory relationship itself and time and organisational pressures. Demands on the workforce made a significant impact on the availability of quality clinical supervision.

CONCLUSION

Professional supervision has an important role in supporting the sonography workforce and enable increased wellbeing and emotional support. There are clear benefits to undertaking professional supervision to support the workforce however there are competing demands which may affect the effectiveness of professional supervision.

IMPLICATIONS FOR PRACTICE

There is limited international research on the use of professional supervision in the radiographer and sonographer workforce. There are clear benefits for supporting professional wellbeing and development under a structured professional supervision framework however within the United Kingdom there is a significant gap in the literature where further research is required.

Assessment and correlation between job satisfaction and burnout among radiographers

INTRODUCTION

Previous research on job satisfaction (JS) and burnout has focused on physicians and nurses. However, limited work has evaluated radiographers' JS and burnout, factors affecting them and the correlation between them. The aim of this study is to assess the level and specific factors affecting burnout and JS among radiographers and to examine the correlation between them.

METHODS

A questionnaire consisting of socio-demographic information and two validated instruments (Maslach Burnout Inventory-Human Services Survey for Medical Personnel (MBI-HSS (MP)) and JS Survey (JSS)) was distributed to radiographers. The MBI included 22 questions and JSS consisted of 36 questions. Mean scores were used to compare responses between participants according to demographic characteristics. Correlation between JS and burnout was examined using Pearson correlation test, with P < 0.05 determining statistical significance.

RESULTS

308 radiographers returned a completed questionnaire, 48.4% of participants were male, 48.7% had 1-6 years of experience and 61.4% examined >25 patients per day. Total emotional exhaustion, depersonalization and personal accomplishment scores were 28.7, 11.3 and 35.8 respectively. Most participants felt dissatisfied with pay (n = 221, 71.8%), opportunities for promotion (n = 202, 65.6%), fringe benefits (n = 239, 77.6%), contingent rewards (n = 231, 75.0%), operating procedures (n = 190, 61.7%) and communication (n = 162, 52.6%). Burnout was associated with work experience and caseload and JS was associated with section of work. Most of the JS domains were significantly inversely related to emotional exhaustion and depersonalisation domains. Emotional exhaustion and depersonalization drew a significant positive correlation. Emotional exhaustion and depersonalization drew a significant positive correlation.

CONCLUSION

Participating radiographers are mostly dissatisfied about their jobs and they suffer a high level of emotional exhaustion.

IMPLICATIONS FOR PRACTICE

To avoid the consequences of burnout and decreased JS on individuals and organizations, efforts should be done in alleviating the main factors affecting them.

Determining diagnostic radiographer staffing requirements: A workload-based approach

INTRODUCTION

The topic of healthcare human resource planning for diagnostic radiographers has received limited research attention to date. This research is concerned with developing a framework that can be used to determine diagnostic radiographer staffing requirements at a unit- or department level (i.e. at the micro-level).

METHODS

An inductive approach is applied to formulate requirement specifications that inform the development of the framework. A number of verification and validation activities are performed, including theoretical verification and a case study application.

RESULTS

The diagnostic radiographer staffing framework consists of seven steps that comprise a workload-based approach to determining the number of full time equivalent diagnostic radiographers that are required for each modality, or group of modalities. Both clinical and non-clinical activities are considered, and guidance is provided on calculating staffing requirements to cover leave allowances. A number of potential approaches to determining activity times are also discussed.

CONCLUSION

The framework represents a holistic approach to determining the required number of diagnostic radiographers at a practice-level, that is designed to remain relevant as technological advances are made in the field of diagnostic radiography.

IMPLICATIONS FOR PRACTICE

By providing a practical guideline, with accompanying examples, the framework is expected to hold value for individuals involved in the management of diagnostic radiography practices. The framework proposes an approach to a topic that affects every radiography practice in operation yet has received limited attention in literature to date.

Stress, a reflective self and an internal locus of control: On the everyday clinical placement experiences of older undergraduate radiographers in the UK

INTRODUCTION

Extant evidence indicates that the stresses experienced by younger undergraduate radiographers and their older counterparts vary considerably. Much of this difference has, however, emerged from analyses of the academic component of a radiography degree whereas little work has focused to date upon the specific business of clinical placement. Given this, the research herein reports findings from a qualitative study of how older undergraduate radiography students in the UK assemble their stress and stressors around clinical placement.

METHODS

An Interpretative Phenomenological Analysis was employed. N = 6 older undergraduate students undergoing their final year placement were purposively recruited from a variety of hospitals. With full institutional ethical approval, a semi-structured interview was conducted with each participant.

RESULTS

Four superordinate themes emerged. These were: (1) Self-identity and perceived competence; (2) Understaffing, instability and affect; (3) Episodic experience and feeling 'thrown-in'; (4) Unpreparedness for the challenging patient. Critically, each theme describes an interaction between stressor, experience of stress and self.

CONCLUSION

While familiar stressors were apparent, the older participating students actively made sense of them in terms of their manageability. This provides a strong contrast with existing literature, which tends to imply a more externalised locus of control among (largely younger) students.

IMPLICATIONS FOR PRACTICE

Stress in the NHS is a continuing issue and there is a clear rationale for further investigation to ascertain the level of clinical support available and to determine whether further improvements could assist students on clinical placement. Collaboration between academic institutions and clinical sites would allow open discussion around clinical stress experienced by radiography students, with locus of control a potential point of focus, fostering a proactive partnership approach to stress-management and identification of difficulties before they exacerbate.

Unprofessional practice and student professionalism dilemmas: What can radiography learn from the other health professions?

OBJECTIVE

Professionalism in radiography is a complex, multidimensional concept seldom investigated. During clinical placements, students may observe or be involved in unprofessional practice/professionalism lapses which result in professionalism dilemmas. Establishing what constitutes a professionalism dilemma and what action to take may be challenging for students and also practitioners. This is due to unclear reporting pathways and fear of retribution, both deterrents to raising concerns. The aim of this integrative literature review was to investigate how and why professionalism dilemmas occur. In addition, to explore the types of dilemma students experience during clinical placement and to contextualise and reflect on these findings within radiography. Ovid MEDLINE, PubMed, Google Scholar and the grey literature were reviewed, analysed and themed.

KEY FINDINGS

Twenty-eight papers (published between 2004 and 2020) were analysed and summarised. Four themes emerged, and were discussed within the radiography context; the nature of professionalism lapses (mistreatment, verbal abuse, exclusion and intimidation), reasons for professionalism lapses (burnout and poor role modelling), student response at the time of the professionalism dilemma (accept, resist or report) and long-term impacts on students (moral/emotional distress, professional development and choice of career).

CONCLUSION

Professionalism dilemmas are not reported in the radiography literature but are cited in radiology and other health professions studies. Student experiences of such dilemmas can be profound and long lasting. Thus, research is required to investigate specifically the professional dilemmas experienced by radiography students in the unique environment in which they develop their clinical skills.

IMPLICATIONS FOR PRACTICE

The literature review findings can be used to support the development of strategies to enhance future teaching and modelling of professionalism and develop related research in radiography.

Substitution, delegation or addition? Implications of workforce skill mix on efficiency and interruptions in computed tomography

Objectives This study evaluated multiple computed tomography (CT) workforce models to identify any implications on efficiency (length of stay, scan frequency and workforce cost) and scanning radiographer interruptions through substituting or supplementing with a trained CT assistant. Methods The study was conducted in a CT unit of a tertiary Queensland hospital and prospectively compared four workforce models, including usual practice: Model 1 used an administrative assistant (AA) and one radiographer; Model 2 substituted a medical imaging assistant (MIA) for the AA; Model 3 was usual practice, consisting of two radiographers; and Model 4 included two radiographers, with a supplemented MIA. Observational data were collected over 7 days per model and were cross-checked against electronic records. Data for interruption type and frequency, as well as scan type and duration, were collected. Annual workforce costs were calculated as measures of efficiency. Results Similar scan frequency and parameters (complexity) occurred across all models, averaging 164 scans (interquartile range 160-172 scans) each. The median times from patient arrival to examination completion in Models 1-4 were 47, 35, 46 and 33min respectively. There were between 34 and 104 interruptions per day across all models, with the 'assistant role' fielding the largest proportion. Model 4 demonstrated the highest workforce cost, and Model 2 the lowest. Conclusion This study demonstrated that assistant models offer similar patient throughput to usual practice at a reduced cost. Model 2 was the most efficient of all two-staff models (Models 1-3), offering the cheapest workforce, slightly higher throughput and faster examination times. Not surprisingly, the additional staff model (Model 4) offered greater overall examination times and throughput, with fewer interruptions, although workforce cost and possible role ambiguity were both limitations of this model. These findings may assist decision makers in selecting the optimal workforce design for their own individual contexts. What is known about the topic? Innovative solutions are required to address ongoing health workforce sustainability concerns. Workforce substitution models using trained assistants have demonstrated numerous benefits internationally, with translation to the Australian allied health setting showing promise. What does this paper add? Building on existing research, this study provides clinical workforce alternatives that maintain patient throughput while offering cost efficiencies. This study also quantified the many daily interruptions that occur within the CT setting, highlighting a potential clinical risk. To the best of our knowledge, this study is the first to empirically test the use of allied health assistants within CT. What are the implications for practitioners? Role substitution in CT may offer solutions to skills shortages, increasing expenditure and service demand. Incorporating appropriate assistant workforce models can maintain throughput while demonstrating implications for efficiency and interruptions, potentially affecting staff stress and burnout. In addition, the assistant's scope and accepted level of interruptions should be considerations when choosing the most appropriate model.

Australian radiographers' and radiation therapists' experiences during the COVID-19 pandemic

INTRODUCTION

Radiographers and radiation therapists are key patient-facing health practitioners supporting the delivery of optimal patient care during the COVID-19 pandemic. The aim of this research was to investigate the impact of COVID-19 on clinical service delivery and well-being of these healthcare professionals in Australia.

METHODS

A cross-sectional online survey of Australian radiographers and radiation therapists was conducted in June-July 2020. The survey collected data on demographic characteristics, and the impact of COVID-19 on professional practice, infection control and workplace-related stress.

RESULTS

A total of 218 responses were received. Changes in work hours (P < 0.001) and workload (P = 0.022) were experienced due to COVID-19. Diagnostic radiographers reported increased procedural pressure on mobile radiography, computed tomography and general radiography. For radiation therapists, most pressure included areas of simulation and linear accelerator. PPE was in short supply at the start of the pandemic, and at the time of the study, shortages were identified for all PPE items. There was no difference in PPE supply reported by diagnostic radiographers and radiation therapists except for hand sanitiser (P = 0.003). Respondents experienced increased personal stress (61.4%) and anxiety (58.2%) at work due to COVID-19. In addition, their work caused increased stress to their family, partners or friends (57.4%).

CONCLUSIONS

COVID-19 has resulted in changes to clinical working patterns and service delivery. PPE shortages, as well as increased workplace-related stress, were identified. Workplaces should seek to mitigate the pandemic impact through the provision of adequate PPE for safe practice as well as implement strategies to support and enhance staff well-being.

Burnout in the disciplines of medical radiation science: A systematic review

OBJECTIVE

Burnout is seen as an occupational phenomenon related to workplace stress. Professional groups within medical imaging and radiation science have been reported to suffer from burnout in the past, however research into the profession has been limited. This systematic review aims to evaluate literature measuring levels and prevalence of burnout in the professional groups within medical imaging and radiation science (MIRS). These being radiographers (radiological technologists), sonographers, radiation therapists (therapeutic radiographers) and nuclear medicine technologists.

METHODS

Electronic databases including Medline, Embase, Psycinfo and CINAHL were searched to locate studies published in English from 2000 that used a questionnaire/survey to measure burnout in the MIRS population. Also included were studies that measured burnout in a larger healthcare group that included MIRS professionals, as long as the MIRS professionals were reported as a separate group.

RESULTS

Sixteen articles met the inclusion criteria; two of these articles reported the same data and therefore were combined to leave 15 studies to review. Of the radiation therapy group, seven of the nine studies reported low or moderate burnout amongst their participants. One study reported high levels of burnout in the emotional exhaustion and depersonalisation domains, and another reported high emotional exhaustion levels. Within the other MIRS professions, five of the six studies reported moderate burnout. One group of sonographers had high levels of burnout in the emotional exhaustion domain.

CONCLUSION

For the past 20 years, levels of burnout in MIRS professionals has remained relatively steady, with the majority of studies reporting moderate levels of burnout. However, more research is needed in radiographers, sonographers and nuclear medicine technologists.

IMPLICATIONS FOR PRACTICE

Even though the review indicates moderate level of burnout, this needs addressing on an organisational and individual level to ensure stress in the workplace is managed before burnout becomes a significant issue.

Retention of radiographers: A qualitative exploration of factors influencing decisions to leave or remain within the NHS

INTRODUCTION

In many countries a widening imbalance exists between radiographer workforce supply and demand. Improving retention is a rapid method of workforce expansion which is gaining importance with policy makers and providers. To better understand the current leaver profile, this study aimed to identify why radiographers leave the NHS early, and what incentives are important in their decision to stay.

METHODS

A qualitative framework methodology used semi-structured telephone interviews to explore the perspectives of radiography managers, radiographers who have left the NHS, and those considering leaving. Purposive sampling ensured representation across radiography professional groups, geographical and organisational diversity, and stages of career.

RESULTS

Three over-arching themes were identified across all radiographer professional groups (n = 44): 1) Challenging working patterns and the impact on employee health and wellbeing; 2) Lack of flexibility in working terms and conditions; 3) Lack of timely career progression and access to CPD, and the need to feel valued. Radiographers were keen to express how they 'loved being a radiographer'; small concessions and changes to workplace culture might be the incentive to remain in radiography that some were clearly searching for. Manager participants recognised the need to offer greater flexibility in working patterns but this was challenging within financial and service delivery constraints.

CONCLUSIONS

While some influencing factors varied between radiographer professional groups, the three themes were consistent across participants. Failure to address these concerns will exacerbate the loss of experienced and highly trained staff from the NHS at a time when demand for services continues to rise.

IMPACT ON PRACTICE

Recommendations are presented related to three primary themes which will be a catalyst for sharing of best practice between radiology and radiotherapy centres.

Improving Cognitive Workload in Radiation Therapists: A Pilot EEG Neurofeedback Study

Radiation therapy therapists (RTTs) face challenging daily tasks that leave them prone to high attrition and burnout and subsequent deficits in performance. Here, we employed an accelerated alpha-theta neurofeedback (NF) protocol that is implementable in a busy medical workplace to test if 12 RTTs could learn the protocol and exhibit behavior and brain performance-related benefits. Following the 3-week protocol, participants showed a decrease in subjective cognitive workload and a decrease in response time during a performance task, as well as a decrease in desynchrony of the alpha electroencephalogram (EEG) band. Additionally, novel microstate analysis for neurofeedback showed a significant decrease in global field power (GFP) following neurofeedback. These results suggest that the RTTs successfully learned the protocol and improved in perceived cognitive workload following 3 weeks of neurofeedback. In sum, this study presents promising behavioral improvements as well as brain performance-related evidence of neurophysiological changes following neurofeedback, supporting the feasibility of implementing neurofeedback in a busy workplace and encouraging the further study of neurofeedback as a tool to mitigate burnout.

Workload for radiologists during on-call hours: dramatic increase in the past 15 years

Background

The objective of this study is to investigate the workload for radiologists during on-call hours and to quantify the 15-year trend in a large general hospital in Western Europe.

Methods

Data regarding the number of X-ray, ultrasound and computed tomography (CT) studies during on-call hours (weekdays between 6.00 p.m. and 7.00 a.m., weekends, and national holidays) between 2006 and 2020 were extracted from the picture archiving and communication system. All studies were converted into relative value units (RVUs) to estimate the on-call workload. The Mann–Kendall test was performed to assess the temporal trend.

Results

The total RVUs during on-call hours showed a significant increase between 2006 and 2020 (Kendall's tau-b = 0.657, p = 0.001). The overall workload in terms of RVUs during on-call hours has quadrupled. The number of X-ray studies significantly decreased (Kendall's tau-b = − 0.433, p = 0.026), whereas the number of CT studies significantly increased (Kendall's tau-b = 0.875, p < 0.001) between 2006 and 2020. CT studies which increased by more than 500% between 2006 and 2020 are CT for head trauma, brain CTA, brain CTV, chest CT (for suspected pulmonary embolism), spinal CT, neck CT, pelvic CT, and CT for suspected aortic dissection. The number of ultrasound studies did not change significantly (Kendall's tau-b = 0.202, p = 0.298).

Conclusions

The workload for radiologists during on-call hours increased dramatically in the past 15 years. The growing amount of CT studies is responsible for this increase. Radiologist and technician workforce should be matched to this ongoing increasing trend to avoid potential burn-out and to maintain quality and safety of radiological care.

Pilot Study: Outcomes of the Full Abdominopelvic Ultrasound Protocol for Diagnosis of Acute Appendicitis in Children: A Retrospective Chart Review

Objective:

Sonographic evaluation for acute appendicitis in children often involves an exhaustive protocol, for which the therapeutic yield has not been formally evaluated. The purpose of the study was to pilot a retrospective chart review of children receiving an abdominopelvic sonogram upon presenting with suspected acute appendicitis.

Methods:

An annual retrospective chart review was designed to review abdominopelvic sonograms to rule out appendicitis and specifically performed at a Canadian children’s teaching hospital. Studies were excluded if the requisition stated multiple clinical concerns or if the patient was >18 years at the time of the sonogram.

Results:

Based on 230 patient cases reviewed, alternative diagnostic sonographic findings were found in 141 (61%) charts. Only 18 patient cases (8%) demonstrated both alternative sonographic findings as well as a change in management by the emergency room physician.

Conclusion:

Alternative diagnostic findings, based on a complete abdominopelvic sonogram, were common (61%) in this chart review but rarely changed patient management.

Managing the unmanageable: A qualitative study exploring sonographer experiences of and training in unexpected and difficult news delivery

INTRODUCTION

Ultrasound is used to diagnose pregnancy complications such as miscarriage and fetal health conditions. Within the UK, findings identified during ultrasound examination are delivered by sonographers as standard. However, little is known about the experiences of sonographers when delivering unexpected news (DUN), the impact this has on them, or their preferences for training on news delivery.

METHODS

Qualitative interviews were completed with fourteen sonographers and were analysed using an inductive thematic approach. Key themes were identified.

RESULTS

Participants said that obstetric ultrasound often involves 'managing' the patient encounter, including: navigating (unrealistic) patient expectations; handling their own responses to unexpected findings; and managing interaction by moderating emotional expression and communication practices to deliver patient-centred and empathic care. Persistent uncertainty of outcomes, prognosis and patient reactions, alongside high workloads, and frequent siloed working, makes DUN challenging for sonographers. DUN was experienced as emotionally burdensome, and sonographers employed personal coping strategies to reduce stress/burnout. However, the greatest mitigation for stress/burnout was support from peers, though accessing this was challenging. Peers were also described as key sources of learning, especially through observation.

CONCLUSION

Challenges associated with DUN are an enduring experience for sonographers. Facilitating regular ongoing support and training would enable sonographers to cope with negative aspect of the role, including the emotional burden of DUN.

IMPLICATIONS FOR PRACTICE

Long patient lists are prioritised to deal with high demand for services. However, sonographer wellbeing needs to be a key priority to avoid stress and burnout. This means facilitating protected time to access support from colleagues, multidisciplinary working where possible, and regular access to training to support DUN. Training focusing on communication practices, alongside dealing with emotional burdens of the role would be beneficial.

UK consensus guidelines for the delivery of unexpected news in obstetric ultrasound: The ASCKS framework

Background

Studies indicate there is a need to improve the delivery of unexpected news via obstetric ultrasound, but there have been few advances in this area. One factor preventing improvement has been a lack of consensus regarding the appropriate phrases and behaviours which sonographers and ultrasound practitioners should use in these situations.

Aims

To develop consensus guidelines for unexpected news delivery in Early Pregnancy Unit and Fetal Anomaly Screening Programme NHS settings.

Methods

A workshop was conducted to identify priorities and reach consensus on areas of contention. Contributors included interdisciplinary healthcare professionals, policy experts, representatives from third-sector organisations, lay experts and academic researchers ( n = 28). Written and verbal feedback was used to draft initial guidance which was then circulated amongst the wider writing group ( n = 39). Revisions were undertaken until consensus was reached.

Results

Consensus guidelines were developed outlining the behaviours and phrases which should be used during scans where unexpected findings are identified. Specific recommendations included that: honest and clear communication should be prioritised, even with uncertain findings; technical terms should be used, but these should be written down together with their lay interpretations; unless expectant parents use other terminology (e.g. ‘foetus’), the term ‘baby’ should be used as a default, even in early pregnancy; at the initial news disclosure, communication should focus on information provision. Expectant parents should not be asked to make decisions during the scan.

Conclusions

These recommendations can be used to develop and improve news delivery interventions in obstetric ultrasound settings. The full guidelines can be accessed online as supplemental material and at https://doi.org/10.5518/100/24 .

Sonographers' level of autonomy in communication in Australian obstetric settings: Does it affect their professional identity?

INTRODUCTION

Unlike the United Kingdom, policies in Australia prevent sonographers from exercising autonomy in their level of communication with pregnant patients in the event of adverse findings. The organisational structure makes the sonographer dependent on the sonologist because sonographers do not have the authority to provide the official report. The emotional labour on sonographers is increased as they struggle to provide patient-centred care, given the limits put on their communication during the ultrasound examination. The aim of this study was to explore Australian sonographers' views on communicating adverse findings, including their level of autonomy in communicating with patients and how this influences their sense of professional identity.

METHODS

Following a national survey, seven purposively selected participants, who were qualified to perform obstetric ultrasound examinations, completed follow-up interviews. The interviews were thematically analysed with iterative comparison to the survey results. Three case studies show sonographers differed in their 'communicator type' due to geographical location and workplace setting.

RESULTS

The case studies illustrate a sonographer's communication role, and level of autonomy is negotiated/renegotiated depending on the needs and expectations of each workplace. Their communication practices varied due to the sonologist (radiologist/obstetrician) policy on sonographer/patient communication, presence and support in the clinical setting. A strong professional identity and level of autonomy came from the construction of attributes that were built over time based on multiple factors, including previous experience, geographical location, critical incidents, training and supportive work environments.

CONCLUSION

The sonography profession demands autonomy and a strong professional identity free of hierarchical barriers within a collaborative model of care.

Sonographers' communication in obstetrics: Challenges to their professional role and practice in Australia

INTRODUCTION/PURPOSE

Despite the clinical importance of patient-centred care in the sonographer/patient interaction in obstetric ultrasound, there has been very little current research in Australia on sonographer and sonologist communication practices in the event of an adverse finding. This study sought the views, experiences and practices of Australian sonographers, particularly in relation to adverse findings, with consideration of the implications for their professional role and practice.

METHODS

Qualified and trainee sonographers who perform obstetric ultrasound were invited to complete a survey through the Australasian Sonographers Association. Using qualitative methodology, the authors developed themes on a range of issues related to sonographer and sonologist communication practices and roles from responses to three open-ended questions within the survey.

RESULT

Analysis of 249 responses revealed three distinct 'Communicator types'. 'Open Communicators' confidently practice open and direct communication; 'Limited Communicators' perceived barriers preventing them from openly communicating; 'Variable Communicators' indicated various challenging 'grey areas' which created inconsistent communication practices. Variables, such as the complexity of an adverse finding and a reporting sonologist's role, attitude and level of control they exercised over sonographer communication, all influenced respondents' communication practices. Respondents believed professional bodies should agree on a standardised policy regarding sonographers' roles.

DISCUSSION

This paper highlights the complexity of the sonographer/patient interaction and outlines the difficulty in providing true patient-centred care in obstetric ultrasound.

CONCLUSION

The need for a collaborative, patient-focussed policy, which defines and recognises the role of the sonographer in the event of obstetric adverse findings, will improve the current model of care.

'Walk in my shoes': intradepartmental role shadowing to increase workplace collegiality and wellness in a large pediatric radiology department

BACKGROUND

Our nearly 500-member department implemented the shadowing program "Walk in My Shoes" to improve intradepartmental relationships and build a stronger sense of community. The program provides both clinical and non-clinical employees an opportunity to shadow colleagues in their various roles and learn more about one another's contribution to the overarching mission of caring for children and their families. The goal of this study was to understand the impact of the shadowing program on employee perceptions of various roles.

OBJECTIVE

To bridge the gap of understanding among colleagues in order to strengthen workplace interrelatedness, increase understanding of various roles, and decrease preconceived notions about roles, through shadowing.

MATERIALS AND METHODS

A preliminary survey distributed to our department in August 2018 assessed the level of interest in new wellness initiatives, including the shadowing program. The survey gauged which roles participants were interested in shadowing. The survey results revealed that 67 employees were interested in the shadowing program. We selected 39 participants and matched them to a coworker in their area of interest. The roles for shadowing included administrator, Child Life specialist, information technologist, medical assistant, nurse, radiologist, researcher and technologist. Participants were required to complete pre- and post-shadowing surveys to assess their experience. Individuals who hosted the shadow experience also completed a survey.

RESULTS

A total of 39 clinical and non-clinical staff members participated in the program. We summarized the pre- and post-survey data using median and interquartile range (IQR) and compared the results using the Wilcoxon signed-rank test. The distribution of preconceived notions about each role was not significantly different between the pre- and post-surveys (P=0.094). However, participants' value, understanding of the role they shadowed, and understanding of how the roles relate to each other were significantly greater (P<0.001). In addition, participants showed great interest in shadowing the specific role again (82%) and shadowing another role (92%). Furthermore, almost all hosts would repeat the experience (96%).

CONCLUSION

Our study showed that intradepartmental shadowing can improve clinical and non-clinical staff employees' perceptions and understanding of each other's roles in overall patient care, which in turn contributes to the broader initiative of workplace wellness. The enthusiasm and willingness of the hosts were essential for sustainability of the program and demonstrated that this type of program is feasible in a large, busy department.

Breaking bad and difficult news in obstetric ultrasound and sonographer burnout: Is training helpful?

Background

Sonographers report high levels of burnout. For those working in obstetric ultrasound, one frequently cited stressor is the delivery of bad or difficult news. Training in news delivery may reduce sonographer stress levels, but no studies have investigated sonographer experiences of this training.

Aims

To investigate sonographer experiences of difficult news delivery training and preferences for training techniques, and to assess whether news delivery training is associated with lower burnout and higher wellbeing.

Methods

A cross-sectional survey measured occupational characteristics, news delivery training experiences and preferences, burnout (on two dimensions of exhaustion and disengagement), and general mental wellbeing.

Results

Ninety sonographers (85 female; mean age = 47) responded. The majority of participants thought training in difficult news delivery had improved their practice. Preferred training techniques were observation of clinical practice and receiving service-user input. Eighty per cent of participants were experiencing exhaustion, 43.3% were experiencing disengagement and 88.9% could be classed as having a minor psychiatric disorder. Having received difficult news delivery training was associated with lower levels of disengagement, even when other variables were controlled for.

Discussion

News delivery training is perceived to be effective by sonographers and may help to reduce sonographer burnout levels.

Prevalence of Burnout among Canadian Radiologists and Radiology Trainees

Purpose

Physician burnout is on the rise compared to the average population, and radiology burnout rates are ranked high compared to other specialties. We aim to assess radiologist and radiology trainee burnout in Canada.

Methods

A survey using the abbreviated 7-item Maslach Burnout Inventory that characterizes burnout symptoms into personal accomplishment, emotional exhaustion, and depersonalization was sent to all eligible members of the Canadian Association of Radiologists in January 2018. The anonymous survey was hosted on SurveyMonkey for 1 month. A reminder e-mail was sent halfway through the survey period.

Results

Overall, 262 of 1401 invited radiology trainees and radiologists completed the survey (response rate 18.7%). With regards to personal accomplishment, we observed that (1) burnout in this domain improved with increased years worked and (2) milder symptoms were observed in community radiologists compared with their academic counterparts. In comparison with other studies of radiologist burnout, we found mild burnout symptoms in personal accomplishment, but severe symptoms in the burnout domains of both emotional exhaustion and depersonalization.

Conclusions

Canadian radiologists and radiology trainees reported above average burnout symptoms with regard to both emotional exhaustion and depersonalization. Future research directions include exploring etiologies of burnout and implementation of treatment strategies based on these identified problem areas.