Understanding the processes that contribute to a sonographer's professional identity and role in communication in obstetric ultrasound

Abstract

Introduction/Aim Sonography as a profession has developed through the evolution of ultrasound technological advancements over 50 years 1. The traditional role of a sonographer was technical with image taking, similar to radiography, followed later by a sonologist diagnosis and report. However, with the advent of real time scanning a sonographer must now identify, image and diagnose adverse findings whilst performing the scan. A sonographer's professional identity develops over time 2. Many factors are critical in shaping this identity and it is an ongoing process as a result of multiple discourses with patients, sonologists, sonographers, the social environment, education and other professional interactions 3. Sonographers’ concept of their professional role has changed over time with many believing they are more autonomous and active in patient communication. However, a sonographer's role within the Australian obstetric model of communication with pregnant patients is ambiguous 4,5. Our aim for the study was to: • Explore the role of sonographers in communicating findings directly with pregnant patients • Understand sonographers’ perception of their own professional identity • Investigate the processes that shape a sonographer's sense of self Method An online survey of Australasian Sonographer's Association members (n=249) with experience in obstetric ultrasound and follow up interviews with six sonographers. Results Sonographers believe they have an important role in maintaining a pregnant patient's trust. Open communication about the results at the time of the scan was preferred by most sonographers, however, there were some sonographers who did not want to take on the responsibility of communication and believed it was the sonologist's role. The professional culture of medical authority affects a sonographer's sense of self and professional identity. Most sonographers want empowerment and autonomy in the team. Variations in professional identity varied due to a number of factors which include the sonographer and sonologist relationship, training in how to communicate findings, lack of national policies and guidelines. and critical incidents. Sonographers found communication stressful without support from sonologists and professional bodies. Conclusion There is confusion within the profession of what a sonographer's role entails and the sense of their true professional identity. A collaborative approach by professional bodies to break down the barriers of interprofessional tensions will improve acceptance of a sonographer's important but complex role in obstetric communication.