School of Graduate Research, Central Queensland University, Cairns, Australia.
Department of Agriculture and Fisheries, Queensland Government, Rockhampton, Australia.
Radiography (Lond). 2022 Nov;28(4):889-896. doi: 10.1016/j.radi.2022.06.010. Epub 2022 Jul 1.
In Australia, sonographer's professional identity is traditionally 'caught' from clinical role models. A four-year undergraduate-postgraduate course introduced professional identity education, with simulated practice, to prepare novice sonographer students prior to clinical practice. Preclinical students learnt sonographer professional behaviour, and humanistic attributes, during simulation designed with volunteer peers as standardised patients, educator role-models, immediate feedback, self-reflection, and longitudinal multi-observer assessment. This paper reports on the transfer of learnt professional behaviour and humanistic attributes to clinical practice.
Professional behaviour evaluations completed by 94 clinical assessors described 174 students' professional behaviour and attributes one month into their initial clinical practice (2015-6). Student performance of each behaviour, and behavioural category, was quantitatively analysed by modelling binomial proportions with logistic regression.
Students demonstrated substantial learning transfer to clinical practice, achieving an overall mean score of 'consistent' sonographer professional behaviour and humanistic attributes (mean score of equal to or >3/4), one month into clinical practice. Professional behaviours varied in transferability, with 'response to patient's questions' showing least efficacy (P < 0.05). Increased deliberate practice with educator role-models improved transfer efficacy significantly (P < 0.001).
Preclinical application of theory to simulated practice, using standardised patients, educator role-models, immediate feedback, and multi-observer assessment, facilitated substantial transfer of sonographer professional behaviour and attributes to clinical practice. The efficacy of transfer varied but improved with increased deliberate practice and feedback.
The incorporation of preclinical professional behaviour education with simulated practice into the core curriculum of sonographer courses is recommended for the formation of sonographer professional identity, improved clinical outcomes and increased patient safety during the early stages of ultrasound education.
在澳大利亚，超声医师的职业身份传统上是从临床角色模型中“习得”的。四年制本科-研究生课程引入了专业身份教育，并进行模拟实践，以便在临床实践之前为新手超声医师学生做好准备。在临床实践之前，学生通过模拟学习超声医师的专业行为和人文属性，模拟设计采用志愿者作为标准化患者、教育者角色模型、即时反馈、自我反思和纵向多观察者评估。本文报告了所学专业行为和人文属性向临床实践的转移。
94 名临床评估员完成的专业行为评估描述了 174 名学生在初始临床实践一个月（2015-6 年）时的专业行为和属性。学生的每项行为及其行为类别，通过使用逻辑回归对二项式比例建模进行了定量分析。
学生在临床实践中表现出了大量的学习转移，在进入临床实践一个月后，他们的整体平均得分达到了“一致”的超声医师专业行为和人文属性（平均得分等于或大于 3/4）。专业行为的可转移性存在差异，“对患者问题的回应”表现出最低的效果（P < 0.05）。与教育者角色模型进行更多的刻意练习显著提高了转移效果（P < 0.001）。
在模拟实践中应用理论，使用标准化患者、教育者角色模型、即时反馈和多观察者评估，在超声医师课程的核心课程中预先进行临床前的专业行为教育，有助于将超声医师的专业行为和属性大量转移到临床实践中。转移的效果各不相同，但通过增加刻意练习和反馈可以提高。
建议将临床前专业行为教育与模拟实践纳入超声医师课程的核心课程中，以形成超声医师的职业身份，提高临床结果，并在超声教育的早期阶段提高患者安全性。
