Soundeffects news | Dr Merri Bremer (USA)

Dr Merri Bremer (USA)

Mayo Clinic, Minnesota CARDIAC & PROFESSIONAL TOPICS

As the Echocardiography Lab Education and Quality Coordinator and ACS Program Director at the Mayo Clinic, Minnesota, Dr Merri Bremer brings over 30 years of echocardiography expertise to the ASA2024 Sydney Conference. A board-certified RN with a Doctorate in Educational Leadership, she’s also an assistant professor of medicine at Mayo Clinic College of Medicine.

Dr Bremer is an active member of ASE and SDMS and is a leader in maintaining industry standards through ultrasound program accreditation (JRC-DMS) and the CCI ACS Credentialing Exam Committee. With numerous national lectures and co-authored publications, Dr Bremer is dedicated to advancing knowledge in echocardiography, education, and quality improvement. We ask Dr Bremer to delve into her remarkable journey in cardiovascular sonography and answer our questions on AI and what she is most looking forward to when she visits for our conference in May.

Looking ahead, what emerging trends or developments in AI do you anticipate will have the most profound impact on the future of education and clinical echocardiography, and how can sonographers best prepare for these changes?

Looking ahead, several emerging trends and developments in AI are likely to have a profound impact on education and clinical echocardiography:

• AI-powered diagnostic and scanning assistance: AI algorithms are increasingly capable of analysing echocardiographic images to assist clinicians in diagnosis. These algorithms can help detect abnormalities, quantify parameters, and provide decision support, ultimately improving diagnostic accuracy and efficiency. In addition, AI algorithms can provide direction and immediate feedback to novice scanners to obtain required images and improve image quality. The use of these technologies in resource-limited environments may be critical for prioritising and guiding patient care.

• Personalised learning platforms: AI-driven personalised learning platforms can adapt educational content and strategies to individual student needs, learning styles, and progress. In the field of echocardiography education, such platforms could offer tailored curricula, interactive simulations, and adaptive assessments to optimise learning outcomes.

• Virtual and augmented reality (VR/AR) simulation: VR and AR technologies are revolutionising medical education by

To prepare for these changes, sonographers can take the following steps:

• Stay informed and up to date: Keep abreast of the latest developments in AI, medical imaging, and echocardiography through conferences, workshops, journals, and online resources. Stay informed about emerging technologies and their potential applications in education and clinical practice.

• Acquire AI literacy and skills: Develop a basic understanding of AI concepts, algorithms and applications relevant to echocardiography.

• Collaborate across disciplines: Collaborate with colleagues, educators, researchers, and AI experts to explore innovative approaches to education and clinical practice. Engage in interdisciplinary projects and initiatives that leverage AI, technology and data science to improve patient care and educational outcomes.

Are there any emerging technologies or innovations in ergonomic design or workplace interventions that you believe hold promise for further reducing the incidence of WRMSDs in ultrasound?

Yes, some helpful technologies are currently being incorporated into clinical practice. Manufacturers continue to improve machine and transducer design to aid proper ergonomics. For example, transducer and cable weight continue to decrease, which reduces musculoskeletal strain. In addition, portable and handheld devices and wireless transducers may reduce awkward postures and the risk of injury. At Mayo Clinic, we piloted the use of an exoskeleton that provided arm support and improved posture. Most importantly, more and more facilities are recognising the critical need for robust ergonomic programs that teach and reinforce appropriate techniques for reducing the risk of WRMSD.

How do you balance the need for structured learning experiences with opportunities for independent exploration and problem-solving among learners in clinical settings?

Very carefully. My most important priorities:

Clear learning objectives – These provide the framework. Learners must know expectations and the desired goals.

Practice – It is important to provide guided practice opportunities, as learners typically cannot learn well in the absence of feedback. I think back to the first time I visited Australia. My husband and I went snorkelling, which I had never done before. Without the safety briefing and ongoing feedback from the crew, it would have taken much longer for me to become comfortable.

Active learning experiences – Particularly for sonographers, hands-on learning is critical. I encourage robust interaction between learners and preceptors, which may take the form of questions, observations, and case or problem-based learning. Promotion of critical thinking is key. I also encourage learners to explore different methods for achievement of the learning objectives if the provided methods don’t meet their needs.

Self-directed learning – For my ACS program courses, I provide the basic structure and resources, but my students are encouraged to explore beyond what is provided. Those who utilise this opportunity are generally the strongest students, and they are well prepared for lifelong continuous learning after graduation.

Self-reflection – Many learners have been taught to ‘memorise, regurgitate, repeat’. Periodically, I require students to pause and review what they have learned, what that means to them, and how they will change their practice going forward. This approach definitely helps with their self-awareness.

Autonomy – As learners become more skilled, there is a natural desire to operate more independently. The key is to guide an appropriate scope of independent practice while still providing supervision and support. This can be a tricky balance and is likely to be different for different learning environments. A well-defined milestone-oriented approach may be helpful – when certain milestones are achieved, learners can move to the next defined step of independence. For example, our senior entry level echo students can move to 2:1 status (two students assigned with one clinical instructor) after having completed all their senior competencies.

Why do you think it’s important for sonographers and other health professionals to gather at conferences like ASA2024 Sydney?

This is an easy question. For any sonographer, this is an important professional development and career opportunity. Conference attendees have the opportunity to learn new technologies and concepts, network and share experiences with like-minded professionals, and of course, obtain that all-important CME credit. Some of my best friends are sonographers and physicians I see once a year at the ASE meeting in the United States (although we certainly keep in touch in between). In addition, many professional or volunteer opportunities have arisen for me because of attending or participating in conferences like ASA2024. Most importantly, I am re-energised by conference attendance. I gain valuable perspectives, make new friends, develop new personal and professional goals (despite getting closer to retirement) and am inspired by the people I meet. I can’t wait!