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

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

REVIEWED BY Michele Dowling, AFASA | ASA SIG: Health and Wellbeing

REFERENCE | Authors: Johnson J, Arezina J, McGuinness A, Culpan A, & Hall L

WHY THE STUDY WAS PERFORMED

Healthcare professionals are at greater risk of experiencing occupational stress and burnout than workers in other sectors, and rates of low wellbeing and burnout in healthcare staff are rising. These increases are thought to be due to a range of factors, including increasing workloads, rising patient expectations and a greater degree of administrative duties.

Sonographers report high levels of burnout, which manifests as work-based exhaustion and disengagement from patients. Exhaustion is a state where participants feel they have been overstretched by their work, whereas disengagement is characterised by a feeling of detachment from patients or work.

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

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

HOW THE STUDY WAS PERFORMED

A cross-sectional survey hosted online was designed to measure occupational characteristics, news delivery training experiences and preferences, burnout (on two dimensions of exhaustion and disengagement), and general mental wellbeing. The study recruited qualified UK sonographers via email through the British Medical Ultrasound Society (BMUS) membership, an advert on the BMUS website, an advert at the BMUS conference, and on Twitter. Ninety sonographers (85 female; mean age = 47) responded.

Demographics (age, gender), occupational characteristics and training experiences and preferences were collected along with measures of burnout and wellbeing.

Participants provided information regarding their disciplinary background before training in sonography (e.g. midwifery; radiography), the number of hours worked in total per week and the number of hours worked in obstetric scanning.

Participants reported on any training or experience they had received in breaking bad news since qualifying, and whether this had improved their skills.

Information on wellbeing and burnout was gathered and analysed. The burnout data was broken down into subscales of exhaustion and disengagement.

WHAT THE STUDY FOUND

Many of the respondents had received news delivery training since they had qualified and felt this improved their practice. The most common training techniques were lectures and group discussions, but the most preferred learning tools were observation of clinical practice and receiving service-user input.

Burnout rates in the group were high, with most participants reporting mild to severe exhaustion or disengagement. 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.

Being recipients of training in difficult news delivery was not associated with higher wellbeing, but there was mixed evidence for an association with lower burnout. Receiving some training (compared with no training) was associated with lower disengagement, even when the impact of related variables such as age was accounted for.

Sonographers working in obstetric ultrasound report high levels of burnout which manifests as workbased exhaustion and disengagement from patients. One frequently cited stressor is the delivery of bad or difficult news.

RELEVANCE TO CLINICAL PRACTICE

This study sought to investigate experiences and preferences for difficult news delivery training in sonographers. Results suggested that most sonographers thought training was effective in improving their skills in delivering difficult news. The most frequently used training techniques were lectures and group discussions, but the sonographers’ most preferred training techniques were observation of clinical practice and receiving service-user input. Sonographers who had received training reported lower levels of disengagement. These findings suggest that training in the delivery of difficult news is valued by sonographers and may help to reduce sonographer stress levels and potential burnout.