Sonography Student Essentials

Going Back to School

• Life-altering experience with a blended group of classmates.
• Compassion is important; offer support to struggling classmates.
• Ability to work well with others is critical in healthcare.
• Classmates may become future coworkers or supervisors.

Stress: Inevitable but Manageable

• Stress is a normal reaction to challenging situations.
• Stressors: Events challenging time, energy, or resources.
• Stressors cause anxiety (worry or fear).
• Fight-or-flight response: Hormones increase heart rate, breathing, and energy.
• Stress can be immediate or build over time.
• Anxiety has cognitive, physical, and behavioral components.
• Recognize stress causes to practice self-care.
• Destructive behaviors: Avoiding situations, excessive alcohol use, procrastination, over preparing ultimately causing poor scores.
• Constructive behaviors: Recognizing stress, identifying stressors, analyzing reasons, interceding with stress-reducing activities.
• Table 1-1: Dealing with stress and anxiety
  • Anticipate stress by being financially prepared, having a support system, maintaining a healthy lifestyle, and managing time.
  • Recognize symptoms like feeling overwhelmed, physical symptoms (sweaty palms, racing heart, shortness of breath).
  • Use positive language (e.g., "I can do this").
  • Practice stress-reducing activities: walking, breathing exercises, hobbies.
• Stress can be a motivator; studying harder compensates for anxiety.
• Focus on positive thoughts and success to ease mental weariness.

Financial Preparedness

• Annual salaries vary per specialty.
• In 2018, the median base hourly wage for a sonographer was 35.16 (SDMS).
• Career is in demand.
• Financial preparation for education is crucial.
• Develop a budget.
• Consider campus employment.
• Avoid overextension; physical exhaustion hinders focus.
• Seek financial assistance: employer support, state/federal programs (low-interest loans, grants, scholarships).
• Program shares scholarship opportunities.
• Consult a tax advisor about student incentives.
• Federal student aid applications: www.fafsa.ed.gov
• Tax credits may be available for tuition and fees.
• Seek help when needed: student support services, academic advisors, counseling.
• Student Affairs offers financial wellness webinars.
• Table 1-3: Money-saving tips
  • Buy used or e-books (e-books cheaper).
  • Carpool to save money and benefit the environment.
  • Bring lunch to save weekly spending.
  • Take online courses to save on travel.
  • Seek employer reimbursement; some employers offer financial assistance and positions.

Emotional Stability and Support

• Mentally healthy individuals maintain emotional balance.
• Stress can disrupt balance, but mentally healthy people adjust and recover.
• Inform loved ones about time demands.
• Engage with friends and family during stress.
• Involve family/friends in studies: assignments, test preparation, practicing patient positioning.
• Engage with other students, sonographers, and faculty.
• Programs may offer student mentoring.

Physical Well-Being

• Physical exams often required before sonography programs:
  • Immunization
  • Laboratory tests
  • Drug screening (positive results can lead to dismissal).
• Maintain physical well-being:
  • Regular exercise
  • Well-balanced diet
  • Adequate sleep
  • Breaks for physical activity

Time Management

• Time management is crucial; balancing life is challenging; develop time management skills.
• Three fundamental steps in time management

Establishing Personal Goals

• Personal goals: Subjectively meaningful aspirations.
• Goals: Short-term, medium-term, or long-term.
• Short-term: Urgent
• Medium-term: Reachable in 1-5 years
• Long-term: Achievable in >5 years
• Hierarchical organization: urgent goals first, long-term goals last.

Establishing Educational Goals

• Educational goal: pass a test or obtain a degree.
• Educational and personal goals often overlap.
• Long-term goal: Become a certified sonographer or multi-credentialed sonographer.
• Short-term/medium-term goals combined to achieve long-term goals.
• Classroom goal: Preparing/doing well on tests (short-term) to achieve an excellent grade (long-term).
• Table 1-5: Five basic steps of goal setting
  • List priorities and rank them (academics should be high).
  • Set measurable, realistic long-term goals (GPA).
  • Set short-term goals for classroom and clinical (lab assignments, attendance).
  • Make social and personal goals (family, fitness, financial, spiritual).
  • Strive to meet goals (write them down, mark them off).

Classroom Survival Skills

• Successful students share skills:
  • Sitting near the front.
  • Healthy snacks before lectures.
  • Good notes.
  • Asking questions.
  • Efficient test preparation.
• Easy to become overwhelmed; develop skills in:
  • Pertinent coursework
  • Preparing for tests
  • Maintaining motivation
• Learning styles: Approaches individuals use for learning.
  • Understanding preferred style helps prepare for sonography school.
  • Learners: Tactile (kinesthetic), auditory, or visual.
    • Tactile learners: Prefer learning by touching or doing.
    • Auditory learners: Prefer listening or hearing.
    • Visual learners: Prefer reading or seeing pictures
• Identify preferred learning style to improve study skills and information retention: http:// www.educationplanner.org/students/self- assessments/learning-styles-styles. shtml.

Pertinent Coursework

• Relevant courses: Anatomy and physiology, public speaking, writing, basic physics.
• Medical terminology.
• Spanish medical communication.
• Program requirements vary.
• CNA certification can provide valuable knowledge/experience.
• Programs may include online coursework.
• Seek introductory computer courses if needed.
• Consider purchasing a personal computer (discounts for college students).

Preparing for Tests

• Read textbooks for comprehension.
• Take quality lecture notes.
• Create study cards and mnemonics.
• Form a study group or find a study partner.
• Develop a study schedule and take breaks.
• Find personal preparation style.
• Aim to learn, not just memorize.
• Understanding concepts impacts clinical practice and patient care.
• Seeking support for test anxiety can increase scores.
• Brain dumping should be a last resort (prohibited on national exams).
• Goal: Retain and comprehend content.
• Continually review information throughout program.

Test-Taking Tips

• Examine test length.
• Estimate time for different parts.
• Answer one item at a time.
• Look for keywords.
• Eliminate wrong answers.
• Return to harder questions.
• Hesitate before changing answers.
• Outline thoughts before answering essay questions.

Learning-Testing Cycle

• Subconscious method used in educational programs.
• Includes:
  • Preparation phase: Studying.
  • Performance phase: Testing attempt.
  • Reflection phase: Assessment (numeric grade and strategic performance).

Maintaining Motivation in the Classroom

• Easy to become overloaded.
• Approach one exam at a time.
• Looking too far ahead causes anxiety.
• Put effort into focused study time.
• Reward efforts after doing well.
• Avoid feeling depressed over scores.
• Strive to do better next time.
• Note struggles.
• Ask instructors for guidance.
• Use breaks to relax.

Clinical Survival Skills

• Success depends on:
  • Role of the sonographer.
  • Utilizing the scan lab.
  • Maintaining professionalism.
  • Maintaining work ethic.
• Observe sonographer interactions with patients, physicians, and healthcare team.

The Sonographer: A Brief Overview

• Sonographer: Skilled professional using ultrasound to create diagnostic images.
• Physician interprets images.
• Pulse-echo technique:
  • Transmitted pulse encounters tissue interfaces and reflects back.
  • Depth determined by round-trip time of flight for pulse and echo.
  • Echo shown as a dot on the monitor
• Before examination: Obtain clinical history.
• After examination: Prepare a sonographer report which gives, basic descriptive information of the study and manifestation of any sonographically identifiable abnormalities.
• Sonographers should not be diagnosticians; may be legally liable if they provide diagnoses.

Utilizing the Scan Lab

• Practice is key to gain confidence and skills.
• Programs have clinical competencies where students perform exams unassisted.
• Some programs provide sonography phantoms for practice.
• Students who practice after sonographers find organs and acoustic windows more easily.

Professionalism in the Clinical Setting

• Clinical performance is as important as classroom performance.
• Defined by clinical competence and skillful patient care.
• Medical ethics and professionalism are linked (Hippocratic Oath).
• HIPAA (1996): Safeguarding patient information = strict confidentiality.
• Do not share diagnostic information with unauthorized people.
• Never discuss patient information where overheard.
• Maintain patient privacy; keep patients covered.

Work Ethic in the Clinical Setting

• Maintain professional conduct.
• Every clinical rotation is a job interview.
• Assist sonographers with daily tasks.
• Be reliable.
• Be accountable: Uphold obligations, admit mistakes.
• Mistakes must be fixed quickly.
• Honesty is always best.
• Patient service guides actions.
• Maintain a positive attitude.
• Work Ethic: professional attitude, punctuality, empathy, cooperativeness, honesty, reliability, accountability, conscientiousness, courtesy and respectfulness
• Attitude and enthusiasm are constantly examined.
• Negative attitude may prompt a review of career choice.
• Avoid cell phone/smartwatch use in patient care settings.

Clinical Orientation and Information Gathering

• Required to visit multiple healthcare facilities.
• Learn policies and procedures of each institution.
• Tasks:
  • Obtain a department map.
  • Locate emergency crash carts.
  • Make copies of sonographic protocols.
  • Familiarize yourself with ultrasound machines.
  • Locate supplies.
  • Locate material safety data sheets and manuals.
  • Obtain a list of emergency codes

Understanding Workflow and the Imaging Department

• Learn where you fit in by viewing the entire process of how a patient moves through the organization.
• Physicians order sonographic exams.
• Departments vary but center on the interpreting physician.

Radiography (X-Ray)

• Oldest diagnostic modality.
• Radiographers: Trained professionals using x-ray to obtain images.
• May assist during fluoroscopy, pyelography, and orthography.
• Most departments use digital radiography for storage and viewing.

Computed Tomography (CT or CAT scan)

• Uses x-ray to obtain images.
• Provides high-resolution sectional viewing in multiple planes.
• Used in trauma, invasive procedures, and routine outpatient procedures.
• Understanding CT is helpful as procedures may be correlated.

Mammography

• Mammographers use x-rays to image the breast.
• Annual screening mammograms are recommended for women 40+.
• Familiarize yourself with mammographic views to understand breast pathology.

Nuclear Medicine Technology

• Uses radioactive material to diagnose/treat diseases or differentiate normal/abnormal structures.
• Radiopharmaceutical is inhaled, ingested, or injected.
• These concentrate on specific organs/systems.
• Nuclear medicine technologists operate a gamma camera to detect emitted radiation.

Magnetic Resonance Imaging

• Uses a magnetic field, radio waves, and a computer to create sectional images.
• Provides excellent resolution of internal structures and evaluates disease all over the body.
• Patients may be injected with a contrast agent

Cardiovascular Interventional Technology

• Heart catheterization performed with assistance.
• X-ray dye is used to image heart vessels for occlusion.
• Vascular interventional radiographers assist with stent placement for organs (liver, kidneys).
• Interventional Radiologists perform biopsies, drainages, paracentesis, and thoracentesis with assistance.

Appreciating Critical Thinking

• Critical thinking skills involve resourceful actions, judgments, and decisions based on knowledge, experience, integrity, and ethics.
• Use best thinking in any circumstance.
• In sonography: Apply code of ethics to decision-making.
• Correlate clinical history with sonographic findings.
• Reliable information is critical for decision-making.
• Be aware of the difference between inferences and assumptions.
• Stages of Critical Thinking Development
  • Unreflective Thinker
  • Challenged Thinker
  • Beginning Thinker
  • Practicing Thinker
  • Advanced Thinker
  • Accomplished Thinker
• Qualities of Well-Cultivated Critical Thinkers
  • Asks questions and recognizes problems.
  • Gathers and assesses information.
  • Comes to well-reasoned conclusions and solutions.
  • Tests conclusions against criteria.
  • Thinks with an open mind.
  • Communicates effectively.
• Critical thinkers ask discriminating questions to find better ideas and solutions.
• Sonographers delve deeper into patient history to establish inferences based on facts.

Student Application of Critical Thinking

• Positive correlation between clinical experience and diagnostic accuracy.
• More experience = higher probability of correct interpretations.
• Educational experience helps gain critical thinking skills.
• Observe experienced sonographers on how they interact with patients, other healthcare workers, and interpreting physicians.
• Keep a clinical journal for notes and professional reflection.
• Keeping a journal can also be therapeutic.

Summary

• Going back to school can be complicated, especially when it’s sonography school. Stress is inevitable.
• Sonographers are created in clinical! Clinical is where you apply your gained classroom and laboratory knowledge.
• Sonography school is demanding but rewarding. It is stressful but manageable.
• Make the decision now to develop classroom and clinical skills that are geared toward providing all patients with adequate care.