The 21st century sonographer: Role ambiguity in communicating an adverse outcome in obstetric ultrasound

Figures & data

Table 1. Participant demographic

Participant	Gender	Age	Days	Practice setting	Policy /Protocol*	Years Scanning	Formal Training**
1	male	40–50	5	private radiology	No	20	No
2	female	60–70	3	private radiology	No	25	No
3	female	30–40	5	public hospital radiology and obstetric	Yes informal	6	No
4	male	40–50	5	private radiology	No	15	No. But informal training within an obstetrics practice previously worked in
5	female	40–50	2	private radiology	No	17	No
6	female	40–50	4	private radiology	No	23	No
7	female	50–60	5	both private radiology and obstetrician run	Not in radiologyYes private obstetric	30	Within obstetrics practice currently works in part time
8	male	40–50	5	private radiology	No	20	No
9	female	40–50	5	private obstetrician run	Yes	25	Yes
10	female	30–40	3	public tertiary	No	17	Yes at another tertiary public hospital.

* Formal Training is any formalised training in breaking bad news.

** Policy/Protocol—refers to the existence of a formal written protocol or policy in the department.

Table 2. Participants’ comments

Section A Ambiguity around the sonographer’s role

“When I started training we were not allowed to tell the patient anything, many years ago.” (Female general radiology)

“Radiologists have to be involved, and they need to be willing to step it up and be willing to come in the room and they need to give the news...” (Male general radiology)

“...this is a role of the sonographer, so it needs to be recognised not just by our own professional bodies but by the bodies that govern the industry” (male general radiology)

“I think it’s a sonographer’s call these days. I think we should use our experience and own judgment.” (Female, general radiology)

“Our bosses (obstetricians) prefer us to actually communicate with the patient if we have an adverse finding then and there.” (Female, private obstetric)

“…so we know what the expectations are. And it’s not dependent on who’s on, on the day. This is the rule; this is what you do…I think it’s the best thing for the patient.” (Male, general radiology)

“…Technically it’s outside the scope of a sonographer’s role…. sonographers aren’t technically supposed to give out information about scan results.” (Male, general radiology)

“…I think it’s part of the role…recognition of that role, recognition is important.” (Male, private radiology)

Section B Quotes for ambiguity in policy and protocol

“...there’s nothing that I know of that is set in stone about how to handle it. It varies from doctor to doctor.” (Male, general radiology)

“We don’t have a written protocol it is very much dependent on the sonographer’s style” (female, private obstetric)

“We have the ability to say nothing if we don’t want to say anything. We also have the ability to disclose everything if we feel comfortable” (female general radiology)

“I’ve never actually seen the protocol. I think it’s a bit of an unwritten one...” (Female, private radiology)

“The only training we had was when we were a student, a few workshops we may have done about breaking bad news but sort of informal really, pretty much on the job or shadowing a sonographer.” (Male, general radiology)

Section C Quotes for sonographer stress

“...your heart rate does go up as you are plucking up the courage to say...” (Male, general radiology)

“I think it’s quite stressful…….I used to feel very guilty.” (Female, obstetric public)

“It is uncomfortable and probably sadness. Cause again we are Mothers, and we feel that pain...” (Female, general radiology)

“...you try not to get emotional, but you do...” (Female, public obstetric)

“Quite often you get a tear in the eye” (Female, general radiology)

“...some sonographers I think do struggle afterwards. We’ve had plenty of female sonographers come out and get teary and have to compose themselves to return back to the room.” (Male, general radiology)

“...it would affect me emotionally, I use to get anxious for them, and I’d worry that I’d miss stuff.” (Female, public obstetric)

“Now…… I know that I have all the skills to support that patient in any way that they need.” (Female, public obstetric)

“...sometimes I’m under a bit of pressure where I work because the doctors know I’ve had more experience than they have.”(Male, general radiology)

“[Patients are] looking at the internet. Everybody’s well informed and educated...” (Female, general radiology)

“...to say ‘I am sorry’ and ‘I am so sorry for your loss’ to actually not be afraid to touch, put your hand on the patient and look them in the eye. It’s difficult.” (Female, public obstetric)

“I think for patients’ I think they need to know that someone’s still going to help them...” (Female, public obstetric)