Delwyn Nicholls

Psychomotor Skills in Medical Ultrasound Imaging An Analysis of the Core Skill Set

Sonographers use psychomotor skills to perform medical ultrasound examinations. Psychomotor skills describe voluntary movements of the limb, joints, and muscles in response to sensory stimuli and are regulated by the motor neural cortex in the brain. We define a psychomotor skill in relation to medical ultrasound imaging as “the unique mental and motor activities required to execute a manual task safely and efficiently for each clinical situation.” Skills in clinical ultrasound practice may be open or closed; most skills used in medical ultrasound imaging are open. Open skills are both complex and multidimensional. Visuomotor and visuospatial psychomotor skills are central components of medical ultrasound imaging. Both types of skills rely on learners having a visual exemplar or standard of performance with which to reference their skill performance and evaluate anatomic structures. These are imperative instructional design principles when teaching psychomotor skills.

Teaching psychomotor skills in the twenty-first century: Revisiting and reviewing instructional approaches through the lens of contemporary literature

Abstract A diverse range of health professionals use psychomotor skills as part of their professional practice roles. Most health disciplines use large or complex psychomotor skills. These skills are first taught by the educator then acquired, performed, and lastly learned. Psychomotor skills may be taught using a variety of widely-accepted and published teaching models. The number of teaching steps used in these models varies from two to seven. However, the utility of these models to teach skill acquisition and skill retention are disputable when teaching complex skills, in contrast to simple skills. Contemporary motor learning and cognition literature frames instructional practices which may assist the teaching and learning of complex task-based skills. This paper reports 11 steps to be considered when teaching psychomotor skills.

A model to teach concomitant patient communication during psychomotor skill development

Many health professionals use psychomotor or task-based skills in clinical practice that require concomitant communication with a conscious patient. Verbally engaging with the patient requires highly developed verbal communication skills, enabling the delivery of patient-centred care. Historically, priority has been given to learning the psychomotor skills essential to clinical practice. However, there has been a shift towards also ensuring competent communication with the patient during skill performance. While there is literature outlining the steps to teach and learn verbal communication skills, little is known about the most appropriate instructional approach to teach how to verbally engage with the patient when also learning to perform a task. A literature review was performed and it identified that there was no model or proven approach which could be used to integrate the learning of both psychomotor and communication skills. This paper reviews the steps to teach a communication skill and provides a suggested model to guide the acquisition and development of the concomitant -communication skills required with a patient at the time a psychomotor skill is performed.

Sonographer Skill Teaching Practices Survey: Development and initial validation of a survey instrument

To report on the initial content development of the sonographer skill teaching practices survey (SonoSTePs) tool to measure skill teaching perceptions.

Continuing Development and Initial Validation of a Questionnaire to Measure Sonographer Skill-Teaching Perceptions in Clinical Practice

Objective Medical ultrasound examinations are performed by diverse professional cohorts sonographers are one group. Little evidence exists regarding the teaching practices used in medical ultrasonography and their effectiveness. We report the continued development and validation of an instrument to measure sonographer skill-teaching practice perceptions (SonoSTePs). Methods An online survey was administered to a convenience sample of sonographers who were employed in Queensland, Australia. This paper reports on the continued psychometric testing of the measurement tool. Findings The 25-item scale demonstrated good internal reliability. Exploratory factor analysis generated four factors with acceptable internal reliability: Factor 1 (Skill execution feedback, Cronbach’s α = 0.89), Factor 2 (Cognitive overload, Cronbach’s α = 0.68), Factor 3 (Teach new skill, Cronbach’s α = 0.70), and Factor 4 (Assist learners scanning, Cronbach’s α = 0.67). The combined instrument value was 0.83. The weighted kappa of the test–retest items identified that the majority of items achieved an interrater level of agreement of ≥0.5. Conclusion Results indicate that the SonoSTePs instrument items and factors are underpinned by theories and principles related to teaching a complex psychomotor skill. The initial data suggest that the tool is both reliable and valid.

The key to using a learning or skill acquisition plan

A learning plan is a tool to guide the development of knowledge, skills and professional attitudes required for practice. A learning plan is an ideal tool for both supervisors and mentors to guide the process of teaching and learning a medical ultrasound examination. A good learning plan will state the learning goal, identify the learning activities and resources needed to achieve this goal, and highlight the outcome measures, which when achieved indicate the goal has been accomplished. A skill acquisition plan provides a framework for task acquisition and skill stratification; and is an extension of the application of the student learning plan. One unique feature of a skill acquisition plan is it requires the tutor to first undertake a task analysis. The task steps are progressively learnt in sequence, termed scaffolding. The skills to develop and use a learning or skill acquisition plan are also learnt, but are an integral component to the ultrasound tutors skill set. This paper will provide an outline of how to use and apply a learning and skill acquisition plan. We will review how these tools can be personalised to each student and skill teaching environment.

Destiny lies in a brown paper bag.

Your birthplace fate or fortune What a privilege it is to have been born in Australia. My parents are third generation farmers and they and their ancestors lived in a small rural and farming community, Kyogle, on the Queensland and New South Wales border. The town has a fluctuating population. According to the census data from 2006, Kyogle’s population is approximately 4110.1 Kyogle Memorial Hospital, see image 1, was my birthplace in the mid-sixties. Despite the era, the hospital was well equipped with staff, equipment and a maternity ward. The maternity ward and operating suite provided skilled GPs with the resources to deliver babies at the hospital. The western world has much to be proud about. Australia, when compared to other developed countries is a leader in health care. When we compare Australia’s investment into health care per capita of population and as a proportion of gross domestic product (GDP) (Table 1),2 our nation is the second highest investor in healthcare in the world. Although these data refer to 2003, they are the most current comparative data available and are profound statistics.