The pedagogical approaches used by Australian sonographers to teach psychomotor scanning skills

Author: Delwyn Nicholls

Nicholls, Delwyn, 2020 The pedagogical approaches used by Australian sonographers to teach psychomotor scanning skills, Flinders University, College of Nursing and Health Sciences

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Medical ultrasound examinations have been performed in Australia for more than five decades, but with little theory or practice evidence for the pedagogical approaches used to teach the psychomotor scanning skills. Performing a medical ultrasound examination requires an operator to use differing upper limb motor movements (at the same or disparate times), and manipulate the ultrasound equipment while they view and interpret the outcome of these actions on a two-dimensional monitor. These skills are referred to as psychomotor scanning skills. The lack of research about how this skill set is taught has restricted the analysis and review of the profession’s current teaching practices. Therefore, the goal of this study was to determine what pedagogical approaches were being used by Australian sonographers to teach psychomotor scanning skills.

To achieve the research goal, a 25-question survey instrument, labelled SonoSTePs, was purposefully designed and partially validated. A national cross-sectional cohort survey was then conducted to measure the skill teaching practices of Australian sonographers, using SonoSTePs. A census approach was used to invite 3151 qualified sonographers across Australia who were registered with the Australian Sonographer Accreditation Registry to participate in the research. Quantitative data were analysed using SPSS descriptive and comparative statistics. The open text responses were analysed using content analysis.

A total of 592 sonographers completed the survey, giving a response rate of 19%. The majority of respondents used a two-step skill teaching approach to teach scanning skills, which involved providing a skill demonstration and a narration of the skill steps (86%, n= 450/520), followed by supervised skill practice. Although the majority of respondents (64%) supervised a learner’s skill acquisition using numerous short practice sessions of less than 60 minutes, 42% of respondents reported that they used long practice sessions of over 60 minutes and the most common reason for this practice was to compensate the learner for lost skill practice opportunities. Most respondents provided guidance and coaching (92%, n=478/519), immediate error correction (79%), and physical guidance (65%) when they taught scanning skills. A large majority of respondents (83%, n=403/484) reported that they provided end-task feedback to the learner. However, the feedback was mostly one way from the educator to the learner.

These study findings suggest that Australian sonographers use a two-step model to teach psychomotor scanning skills as well as guidance and coaching, physical guidance, immediate error correction, and the provision of end-task feedback. This thesis is the first to report on the pedagogical approaches used by Australian sonographers to teach psychomotor scanning skills and to provide a synopsis of the suggested pedagogical approaches for teaching complex psychomotor skills. Further research is now needed to explore: (1) whether the two-step instructional model is the optimal approach to maximise a learner’s skill acquisition and long-term retention when acquiring, performing, and learning psychomotor scanning skills, and (2) why specific pedagogical approaches were and were not used by the respondents to support the teaching and learning of scanning skills.

Keywords: Ultrasound, cognitive overload, skill teaching, Psychomotor skill, procedural task, teaching model, integrated task practice, sonographer, feedback, physical guidance, communication, simulation

Subject: Health Sciences thesis

Thesis type: Doctor of Philosophy
Completed: 2020
School: College of Nursing and Health Sciences
Supervisor: Professor Linda Sweet