Sonographer

A sonographer, or ultrasonographer, is a healthcare professional, frequently a radiographer but may be any healthcare professional with the appropriate training, who specialise in the use of ultrasonic imaging devices to produce diagnostic images, scans, videos, or 3D volumes of anatomy and diagnostic data. The requirements for clinical practice vary greatly by country. Sonography requires specialized education and skills to view, analyze and modify the scan to optimize the information in the image. Because of the high levels of decisional latitude and diagnostic input, sonographers have a high degree of responsibility in the diagnostic process. Many countries require that medical sonographers have professional certification. Sonographers must understand ultrasound physics, cross sectional anatomy, physiology and pathology.

Terminology

Sonographer is the preferred term for the specialised healthcare worker who performs diagnostic medical sonography, or diagnostic ultrasound. The alternative term ultrasonographer is in much less common use.^[1][2] The terms ultrasound technologist and ultrasound technician are deprecated.

Training and licensing

Australia

The Australasian Sonographers Association (ASA) formed in 1992 in response to the desire of sonographers across Australia for an organisation that represents and considers issues important to sonographers in the Australian healthcare environment. The ASA now has more than 4000 ^[3] individual member sonographers, and about 40 corporate members. The ASA has pledged to pursue high standards within the practice of Medical Sonography. The ASA has a structure of a board of directors and multiple representative branches in all Australian states.

Australian sonographers must be accredited by the Australasian Sonographers Accreditation Registry (ASAR). ASAR’s brief is to accredit and re-accredit on a regular basis, post-graduate ultrasound programs offered by Australian Universities (and the DMU), and to establish the criteria against which those programs and any other future Australian and New Zealand programs are to be judged. In addition a register of accredited (AMS) and student (ASS) sonographers is maintained and their continuing professional development (CPD) activities monitored and recorded.

The Health Insurance Commissison in association with the Australasian Sonographers Accreditation Registry (ASAR) introduced in 2002 a program of accreditation and continuing professional education for sonographers. The ASAR recognises registration with the Australian Orthoptic Board as appropriate accreditation for orthoptists to undertake sonography in relation to ocular structures.

Canada

The vast majority of Canadian sonographers are educated at one of ten CMA accredited training programs across the country. The Canadian Association of Registered Diagnostic Ultrasound Professionals (CARDUP) registers sonographers in three credentials: Generalist, Cardiac, and Vascular. To become registered, eligible sonographers must successfully meet CARDUP's clinical and academic requirements. CARDUP registered sonographers must also document their continuing education by maintaining a minimum 30 continuing medical education credits every three years.

The Nova Scotia Society of Diagnostic Medical Sonographers (NSSDMS) is currently working with the Nova Scotia Association of Medical Radiation Technologists (NSAMRT) to add diagnostic ultrasound as a new discipline in the proposed college. This means that diagnostic sonography would become a self-regulated profession in Nova Scotia, along with radiography, nuclear medicine, magnetic resonance imaging and radiation therapy. The Department of Health is now considering their application; the appropriate act and associated regulations have been drafted, and the associations are aiming for approval at the spring 2012 session of the legislature.^[4][5]

United Kingdom

In the UK sonographers are also responsible for the interpretation of the images and issue diagnostic reports. Sonographers in the UK are educated to a high level, training itself is delivered as a MSc/PGDip/PGCert by the universities and overseen by the Consortium for Accreditation of Sonographic Education (CASE), as training is delivered at post graduate level all sonographers must have a bachelor's degree or equivalent prior to undertaking this specialism, this means training can take a minimum of 4 years. There is currently no requirement for a sonographer to be state registered in the UK, although the majority are registered with the Health and Care Professions Council (HCPC) as a radiographer. State registration of sonographers in their own right is being eagerly sought by the profession. However the HCPC has previously sought to require statutory registration of sonographers, a motion supported by a number of professional bodies and the HCPC was rejected by the Department of Health.^[6] The rationale for this rejection remains controversial however a voluntary register is currently maintained by the College of Radiographers.^[7]

Within the United Kingdom, sonographers are employed by hospitals within the National Health Service and by private companies offering healthcare services.

United States

In the United States the most widely accepted sonographic education is provided by CAAHEP/JRC-DMS accredited programs. The profession is sub-divided in specialties such as cardiac, obstetrical, vascular, and general sonographers. General sonographers are registered in abdominal and/or obstetric and gynecologic sonography.^[8] There are two credentialing bodies in the United States for sonographers, the Cardiovascular Credentialing International (CCI) Established in 1968 and the American Registry for Diagnostic Medical Sonography (ARDMS) Established in 1975. Both CCI and ARDMS have earned the prestigious ANSI-ISO 17024 accreditation for certifying bodies from the International Organization for Standardization (ISO). Accreditation is granted through the American National Standards Institute (ANSI). Recognition of ARDMS programs in providing credentials has also earned the ARDMS accreditation with the National Commission for Certifying Agencies (NCCA). The NCCA is the accrediting arm of the National Organization for Competency Assurance (NOCA). Established in 1977 as a nonprofit organization, NOCA is a leader in setting quality standards for certifying organizations.

In 2009, New Mexico and Oregon became the first two states to require licensure of sonographers.^[9]

Work-related injury

During their careers, 84% of sonographers report experiencing some form of work-related musculoskeletal pain due to scanning in compromised positions, incorrect gripping of the transducer, spending too much time to manipulate the transducer on technically difficult exams such as obese or large pregnant patients and a lack of upper body fitness.^{[10][11][12][13][14]}

See also

• Medical imaging
• Radiologist

References

1. Advance for Imaging and Radiation Professionals
2. Sonography, What is it?
3. http://www.a-s-a.com.au/News/
4. Nova Scotia Society of Diagnostic Medical Sonographers (NSSDMS)
5. Nova Scotia Association of Medical Radiation Technologists (NSAMRT)
6. "HCPC - New Profession Process". Health and Care Professions Council. Retrieved December 25, 2015.
7. "Register of Sonographers". College of Radiographers. Retrieved December 25, 2015.
8. Occupational Outlook Handbook, 2010-11 Edition, USA Dept. of Labor, Bureau of Labor Statistics
9. American Registry for Diagnostic Medical Sonography (ARDMS)
10. David S., BSRT,"Importance of Sonographers Reporting Work-Related Musculoskeletal Injury, A Qualitative View" University of Oklahoma Health Sciences Center, Oklahoma City, OK, Journal of Diagnostic Medical SonographyMay 2005 vol. 21 no. 3 234-237
11. Joan P. Baker "The History of Sonographers" JUM January 2005 24:1-14