Clinical supervision
THE SONOGRAPHY
discussions
Clinical supervision As a profession, we recognise that clinical supervising is a demanding and often difficult pathway, requiring expertise, leadership skills, and a commitment to the professional growth of sonographers. Supervisors play a crucial role in shaping the next generation of sonographers, providing guidance, mentorship, and practical training in real-world clinical settings. Chris Gilmore FASA, Ultrasound Team Leader, and Louise Worley FASA, Tutor Sonographer, share their experience of clinical supervision and training, address the unique needs and concerns of clinical supervisors, and discuss strategies, best practices, and innovative approaches to supervision.
Chris Gilmore FASA
Ultrasound Team Leader | The Prince Charles Hospital, Brisbane
Chris is a general sonographer who works in Brisbane at the teaching facility at The Prince Charles Hospital (TPCH). In addition to servicing a busy metropolitan emergency and critical care service, TPCH provides a quaternary referral service for cardiothoracic medicine, including heart/lung transplantation, with the facility also providing many other specialist medical services such as gastroenterology, vascular, orthopaedic, geriatric, mental health, endocrine and palliative care. Chris has a broad interest in general ultrasound, including its use in assisting procedures. Chris has been credentialed in PICC insertion procedures and holds a general approval licence to administer local anaesthetics issued by the Queensland Medicine Regulation Unit.
In your experience, do clinical supervisors receive appropriate training? I would say in general that at the clinical coal-face, a sonographer (clinical supervisor) knows the clinical scan and referrer expectations quite well. In the work-integrated environment, they (clinical supervisors) will be able to impart how they perform the scan to the student. This, however, can be different to how a university teaches the scan. Image series can certainly be different – this creates dissonance. Interestingly, different universities assess competency in different ways – so it is not unusual for clinical supervisors to perform exams with variance. Additionally, only some clinical supervisors have done further training – I think a minority of sonographers have undertaken additional training to be a clinical supervisor. We need to increase this.
Should there be stricter criteria to become a clinical supervisor? Yes, there should be stricter criteria to become a clinical
supervisor – but there are different facets of where it should be stricter. Supervision, in my view, is best undertaken by a sonographer (AMS) or a sonologist. An obstetrician who performs a significant number of diagnostic OBGYN ultrasounds can be considered a sonologist, as can a vascular surgeon who performs a considerable number of diagnostic ultrasounds, etc. The key here is ‘considerable number and diagnostic level’. Sonographers should also attain a minimum standard to be a clinical supervisor – but equally, a student under clinical supervision should only be at a location (site) that can provide a minimum standard of clinical supervision. Ultrasound sits heavily in the clinical examination field, thus a site providing clinical supervision must allow timely intervention by an AMS (working in their field of expertise), such that the AMS can influence the clinical imaging examination – i.e. supervision is onsite and directly accessible to be able to scan the patient in a timely manner. I question remote supervision as not being viable supervision nor best practice. Onsite, both direct and indirect supervision are appropriate to guide a trainee through developing and advanced progress to becoming competent.
How can we better support our trainees in rural and remote settings who have limited access to clinical supervision? I think the ASA is making progress here – but more is needed. I think the repository of all recorded presentations and webinars should be kept available, on call, to the membership. Beyond this, clinical supervisors need ongoing access to the material their students are using from education providers – so education providers have a role here of necessity. Ultimately, training costs $$$, so we need more investment from all imaging providers (government and private) for training. Let’s not forget that our ‘ologist’ compatriots, through various medical registrar programs, are all paid to get their specialty.
What advice would you give to those looking to step into a clinical supervisor role? Be involved with both your student and the education provider your student uses i.e. get involved with the education provider feedback loop in as many ways as you can – committees and meetings. This will help you be informed and provide ways for you to influence training. Look to improve yourself in the way you teach and give feedback – enquire into any learning courses that your student’s education provider has, or ASA. Be a member of the ASA. Be frank with your student in discussions – acknowledge success and use constructive criticism. I have always found that treating students the same as an employee with respect to feedback loops works well – and it will certainly be the best advertisement and exemplar of expectation setting for prospective employees. 11
