THE SONOGRAPHY
discussions
What does sonography look like in the future?
What does sonography look like in the future? What will sonography look like in the future? – a question on everyone’s mind as we look ahead to the evolving landscape of sonography. Caterina Watson AFASA is a sessional academic at Edith Cowan University, and she shares her insights on point of care ultrasound (POCUS) and the opportunities and challenges it brings. She also discusses how the changes in technology affect sonography in both rural and metropolitan settings and how AI is impacting the sonography profession. Dr Mark Stieler, Director in Charge of Ultrasound at Exact Radiology Clinics, Queensland, discusses the sonographer’s full scope of practice, the role of general sonographers versus specialised sonographers, and the potential involvement of other allied health professionals in sonographic examinations.
Caterina Watson AFASA Sessional Academic | Edith Cowan University
Caterina Watson is an obstetric and gynaecologic sonographer practising in Western Australia. She completed her Master of Medical Ultrasound, with distinction, at the University of Herefordshire in England. Caterina is the current chair of the ASA’s Emerging Technologies Special Interest Group committee and enjoys outreach teaching in the South Pacific nations. Caterina is employed as a sessional academic with Edith Cowan University where she is also enrolled as a PhD candidate. The project combines her special interests in fetal neurosonography and artificial intelligence.
As a sonographer working in POCUS, what opportunities does it bring? The main opportunity is sharing knowledge and skills with allied health professionals. POCUS is performed by doctors in the ER and midwives in birthing suites. Teaching POCUS in outreach projects has enriched my clinical experience in terms of wider cultural etiquette and alternative medical practices. One of the Brisbane ASA Conference talks this year was: CQU students in VIETNAM ‘it’s not wrong, it’s different’. Exactly. Learning is a two-way process in POCUS work.
What are some of the challenges, if any? I think the main challenges in outreach POCUS are equipment based. Machines are usually reconditioned and donated for outreach projects. This is a generous act but it is common to see rooms designated for the ultrasound graveyard. Here, well14
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intentioned equipment has been donated but has failed to keep operational after a short time. The support is not long term and programs for maintenance and infrastructure should be considered when donating ultrasound equipment. Another equipment challenge would be infection control, particularly with transvaginal probes. In rural & remote locations there is a shortage of probe covers, sterilisation methods, and gloves. In terms of staff challenges, the end user of POCUS equipment should be correctly tutored in POCUS ultrasound, just as a sonographer is comprehensively trained in ultrasound. This includes the basics of ultrasound physics, instrumentation, and image interpretation. AI should not fill in all the gaps – there is a human in the loop and responsible for diagnostic output. Locally, I would like to see all Australasian POCUS staff regulated under ASAR, just as sonographers are. They should be certified by a recognised institution and required to demonstrate an appropriate CPD portfolio each triennium. This is difficult to implement on a global scale but can be benchmark practice in Australia and New Zealand.
How does POCUS affect how sonographers work in both metropolitan and rural/remote locations? The target audience for teaching POCUS will change between metropolitan vs remote locations. Metropolitan POCUS training would provide role extension skills to ER clinicians and midwives/nurses. My experience of POCUS for rural/remote locations has been to provide education and training for 4th-year medical students and local sonographers. Local sonographers will have been working for significant periods of time without certified training. Many of them are keen to see how their skills align with Australian practices and they are interested in adopting Australian approaches for ultrasound assessment.
With greater demands on sonographer knowledge, increasing protocols, and decreasing scan time, do you see a benefit to sonographer specialisation, or will the general sonographer still be the mainstay of most departments? It is in the interest of the patient to keep the general sonographer as the department mainstay. However, both are equally important to serve the healthcare model. Advances in AI will enable the general sonographer to perform more focused scanning techniques and perhaps be directed to achieve more accurate diagnostic images. This, in turn, will reduce scanning errors and improve the quality of patient care. For the future, I see little change in the ratio of general vs specialised sonographers. They are different players on the same football team.
