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

Johnson, Judith; Arezina, Jane; McGuinness, Alison; Culpan, Anne-Marie; Hall, Louise

doi:10.1177/1742271x18816535

Cited by 38 publications

(99 citation statements)

References 31 publications

(44 reference statements)

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“…To address the second aim of the study and investigate factors associated with engagement, a hierarchical regression analysis was conducted using the variables which correlated with engagement in the correlation analyses. We entered 'wellbeing' into the model first as previous research has suggested it has a strong and consistent association with engagement [26][27][28] and it sits within the 'educational interface' of Kahu and Nelson's framework [16]. The 'immediate outcomes' variables (career satisfaction, satisfaction with performance and performance concerns) were entered next as they are thought to operate in a feedback loop with engagement, and as such could be expected to have a close association.…”

Section: Discussionmentioning

confidence: 99%

The early experiences of Physician Associate students in the UK: A regional cross-sectional study investigating factors associated with engagement

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Background The number of physician associates (PAs) training and working in the UK has increased over the last few years following the proliferation of postgraduate courses. Understanding early experiences and what impacts on engagement is important if we are to appropriately support this relatively new professional group. Methods This paper reports on a cross-sectional analysis of the first year of data from a prospective 10-year longitudinal cohort study. First year PA students (n = 89) were enrolled from five universities in one UK region where the training programmes were less than 2 years old. Data collected were: demographic information, wellbeing, burnout and engagement, expectations, placement experience, performance and caring responsibilities. Pearson's correlations were used to examine relationships between variables and to select variables for a hierarchical regression analysis to understand which factors were associated with engagement. Descriptive statistics were calculated for questions relating to experience. Results The experiences of PA students during their first 3-6 months were mixed. For example, 78.7% of students felt that there were staff on placement they could go to for support, however, 44.8% reported that staff did not know about the role and 61.3% reported that staff did not know what clinical work they should undertake. Regression analysis found that their level of engagement was associated with their perceived career satisfaction, overall wellbeing, and caring responsibilities.

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Section: Discussionmentioning

confidence: 99%

The early experiences of Physician Associate students in the UK: A regional cross-sectional study investigating factors associated with engagement

et al. 2020

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“…In the absence of clearly defined roles and departmental policies, sonographers find themselves in a difficult position because they are often forced into making a judgement on the level of communication they engage in with pregnant patients. This can cause sonographer stress and may expose them to psychological and occupational burnout …”

Section: Discussionmentioning

confidence: 99%

“…As the frontline practitioner, sonographers acknowledge the strong physical and psychological attachment that mothers have with their unborn child and understand the emotional nature of the ultrasound . They have a trusted position with a pregnant patient due to the closeness of the interaction and aim to develop a strong rapport to reduce possible anxiety around concerns about the health of the baby .…”

Section: Introductionmentioning

confidence: 99%

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

Thomas

O’Loughlin

Clark

2019

Australas J Ultrason Med

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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.

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“…1 Post-qualifying, a majority of sonographers seek continued professional development training in this area. 17 However, one unresolved challenge for sonographers and ultrasound practitioners relates to the specific words, phrases and behaviours that they should use in unexpected news delivery situations. 1 Whilst principles such as compassion and sensitivity may be widely recognised, 13,18 it is not possible to communicate in principles and parents who receive unexpected news often recall the exact words their ultrasound practitioner used.…”

Section: Introductionmentioning

confidence: 99%

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

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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 .

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

Abstract: This is a repository copy of Breaking bad and difficult news in obstetric ultrasound and sonographer burnout: Is training helpful?.

Cited by 38 publications

References 31 publications

The early experiences of Physician Associate students in the UK: A regional cross-sectional study investigating factors associated with engagement

The early experiences of Physician Associate students in the UK: A regional cross-sectional study investigating factors associated with engagement

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

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

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