Interview with Afrooz Najafzadeh, ASA Research Special Interest Group Chair

Research

Afrooz Najafzadeh

Research Special Interest Group Chair

In the first of many interviews with some of our members in sonography research, we started with the Chair of our Research Special Interest Group, Afrooz Najafzadeh. We asked Afrooz why research is so important to the sonography profession, how sonographers at any level can get involved in research, and what are some of the areas of interest in research right now for sonography.

Why is research important in ultrasound?

The Australian healthcare system prides itself on basing all their decision-making and policies on evidence-based best practice. The evidence is based on the findings and recommendations of credible resources such as peer reviewed research output in Australia and overseas. The AIUM, ASUM, BMUS and ASA guidelines and mission statements would not have been credible and reliable if they weren’t based on critical evaluation of the available research literature.

Research brings about new discoveries and opens the world to new possibilities. Research is now an integral part of Australian education and is now taught as early as primary school. Research is encouraged from the early years of education and is embedded in the Australian secondary and tertiary teaching curricula. Conducting higher degree research is strongly encouraged by all Australian universities and other tertiary education providers. There are financial incentives for both students and education providers in Australia to engage in higher degree research and increase the Australian universities’ research output.

Why would a sonographer choose to take on a research project?

As well as all the above reasons, the ‘Professional Competency Framework for Sonographers’ document , which was published in October 2021, has specifically stated research as an essential part of sonography education in Australia. A key component of competency frameworks is the idea of observable behaviours. These describe behaviours that evidence the ability to effectively perform the tasks which are underpinned by knowledge, skills and attitudes. The document states ‘Lifelong learner’ as a desired attribute for sonographers.

Sonographers are encouraged to actively pursue new knowledge and continue their professional development throughout their career. The competency framework expects sonographers to know the correct steps in the research pathway, which include and are not limited to:

- best available research evidence: information from valid and clinically relevant research conducted using sound quantitative or qualitative methodology,

- critical appraisal: the assessment of information for its adequacy to address requirements

- critical thinking: questioning, analysing, synthesising, interpreting

- cognitive reasoning and critical appraisal of literature and evidence

- reflective thinking: self-reflection during and after a clinical challenge or experience

- structured and informal reflection to review and integrate knowledge and findings into practice and identify any limitations or risks to practices.’

What would you say when people think research is too much to undertake?

Taking the first step is always the hardest. Conducting research should not be limited to a select few senior sonographers or be exclusively for those working in teaching hospitals with good resources and infrastructure for research. Sonographers at any level of experience have the potential to conduct research if they wish to. This does not have to be a huge undertaking such as enrolling in a higher degree course at a university or coordinating a large project.

Sonographers can take small steps towards a research activity by – for example, conducting an audit of one aspect of their practice or simply following up on an interesting clinical case. Holding in-house discussion of interesting clinical cases with colleagues is counted as a research activity. Reading up about any interesting findings and writing a paragraph or two about the case can be the first step towards writing a clinical case study. The topic of research need not be on a technical aspect of sonography. Writing can be a reflection on the day’s events, on an idea brought on after a conversation with a patient or expressing your feelings after a challenging communication or a thought-provoking discussion with a colleague.

Why do a PhD or Master by research?

- To add an academic qualification to one’s research activity

- To enable better collaboration, supervision and mentorship

- To improve on research resources

- To help work towards a goal

- To be guided by experts

- To share the research findings and have credible research output

- To benefit the wider community

- To increase sonographer-led research output

- To enable future employment as an academic.

How can we, as a profession, encourage more research undertakings?

- Continue the ASA Research Grant for funding sonographer-led research

- Facilitate research and writing workshops at national and international conferences

- Encourage sonographers to connect with the ASA Education Advisory Committee (EAC) and the ASA Special Interest Groups (SIGs) via the new ‘ask the expert’ platform to seek guidance with their research ideas

- Encourage employers to provide support for their employees seeking further education and research

- Facilitate various platforms (online and face to face), such as seminars, webinars, study days, workshops, etc., to enable sonographers to share research ideas and activities and communicate any preliminary research findings

- Support sonographers to disseminate their research activities via the ASA or the ASAR online platforms by allowing them to reach the wider membership (post their surveys to membership, promote and advertise their research, contact potential volunteers for study, invite collaboration, etc.).

What are the current challenges in the research field?

Sonographers are highly skilled and hard-working allied health professionals who often work under challenging conditions imposed by chronic workforce shortages. This, as well as a lack of funding and absence of direction and research leadership at the workplace, have discouraged many capable sonographers from taking on further education and research. Inflexible working conditions, increased workload, and the recent challenges brought by a worldwide pandemic have worsened sonographers working conditions and further impeded sonographers seeking further studies and conducting research.

What are some of the interesting areas of ultrasound research right now?

This depends on the researcher’s interests and their area of expertise. Any area that they feel there’s a gap in knowledge or that requires improvement can be used to develop a research question. All subspecialties of medical ultrasound, being MSK or paediatric sonography, can benefit from further research. The professional aspect of sonography, such as sonography regulation in Australia, sonographers’ autonomy or their working conditions can make good topics for research. Machine learning and artificial intelligence (AI) are rapidly finding their place in various modalities of medical imaging, including ultrasound. I believe AI can vastly improve sonographers’ future work practices and will no doubt aid in the diagnosis of disease. This is still in its infancy and has great potential for being a subject for ongoing research.

If there is a sonographer out there now who has an interest in research, what steps should they take to start on their journey?

They must ensure that they’re adequately supported both at home and work before they embark on their research journey. Having the right work and homelife balance is essential before sonographers can take on any extra education or conduct any research.

Research is not possible without collaboration. Sonographers must talk to as many people as possible about their research ideas or enquire about the research ideas of others. This conversation can start from home and continue into the workplace. Sonographers must find out if there is any support available from their employers or if there is an existing research team that they can collaborate with. Conducting research does not have to start at a university. There are many research projects currently underway with various radiology service providers (public and private). Interested sonographers should actively seek out these opportunities and start the conversation. This will help them to develop their research ideas and formulate their research question(s).

Interested sonographers are advised to seek guidance from the EAC or SIGs by using the new ‘Ask the Expert’ platform on the ASA website.