Professional development of advanced sonography skills in the performance of arterio-venous fistula studies: The role of the learning landscape, feedback and emotion

Introduction: Sonographers are expected to perform an increasingly broad range of imaging studies; however, how sonographers learn these new skills is not well documented. The learning landscape in which teaching occurs impacts on the way a skill may be acquired and the future attitude towards performance of the study. This study explored how the skill of arteriovenous fistula (AVF) scanning was acquired and the environment in which this learning occurred in Australian practices. The role of feedback and its reception was also explored, as feedback influences self-reflection and the development of critical thinking skills. Methods: Semi structured interviews were conducted to explore the learning environments of qualified sonographers, with varying skill levels, who performed or who were learning to undertake AVF ultrasound examinations and had expressed an interest in participating (n = 16). After transcription, thematic analysis was employed and themes generated. Results: Three themes arose: (1) how sonographers learnt to perform AVF studies, (2) their attitudes to feedback, and (3) competency and confidence. Conclusions: In acquiring AVF scanning skills, the landscape in which sonographers learn helps shape their future attitudes to performing the ultrasound, as well as their response to seeking and receiving feedback. Feedback can contribute to future development of competence through prompting self-reflection and critical thinking which ultimately helps limit overconfidence. Therefore, supervising sonographers are encouraged to consider the emotional state in which learning occurs, as it may impact the overall acquisition of, and practice of skills, resulting in improved professional outcomes.