Abstract
Welcome to the August 2014 issue of Ultrasound. This August issue includes a typical but interesting mix of research, review and educational articles, but before I tell you about it, I would like to highlight our plans for a new Special Issue on Education and Training. The aim is to dedicate the February 2015 issue of Ultrasound to this subject. We hope this will include articles on many topical issues such as education and training for sonographers, Modernising Scientific Careers, registration and accreditation, education and training for medical specialties and overseas ultrasound training schemes. Further details are available via the BMUS Ultrapost newsletter (http://bmusultrapost.com/).. If you are involved in ultrasound education and training and have a study to publish or some views on the subject that you would like to air, the Editorial Team would be very pleased to hear from you. But please don’t delay, as the deadline for submissions is 1 October 2014.
Returning to this August issue of Ultrasound, we begin with a reminder of the risks of cross infection posed by ultrasound imaging equipment. The article by Shukla et al. describes a survey of current cleaning practices in the UK, analysis of ultrasound equipment contamination in their own hospital and assessment of the effectiveness of alternative cleaning regimens. It seems that while most UK hospital departments clean the transducer with a disinfectant wipe, some still stick to soap and water only. In the authors’ own hospital, swabs taken from ‘clean and ready for use’ ultrasound systems showed that while users were usually diligent in cleaning the transducer face, they were less so in cleaning the probe handle and monitor, as these were often contaminated with bacteria. Further laboratory studies showed that wipes containing Chlorhexidine 2%/Alcohol 70% were effective in decontaminating probes and gave lasting protection against recontamination, in contrast to soap and water. I would recommend this article to all ultrasound users.
This is followed by two articles on gynaecological applications of ultrasound. Kerr et al. report on a comparison of 2D and 3D TV ultrasound in visualising IUDs. In their study, 2D ultrasound was more effective at visualising the various parts of the T-shaped IUD. However, 3D reconstructed coronal images appeared to show perforation of the T-arm ends into the myometrium in a number of cases where this was not apparent on 2D images. They recommend the use of 3D ultrasound in addition to 2D where an IUD is being evaluated. A systematic review by Katherine Dartmouth on the common sonographic characteristic of adenomyosis concludes that there is no clear consensus in the literature as to which image characteristics are unequivocally diagnostic. Although the study results were too heterogeneous to allow statistical pooling of data, the author does include a summary of the most useful signs described in the studies, such as the presence of myometrial cysts, heterogeneous myometrium and poor delineation of the endomyometrial junction. However, recognition and rating of such features may be quite subjective and operator dependent.
Ultrasound is widely used in obstetric screening, but it is recognised that to be effective, it is necessary to follow standard protocols. Lodge et al. describe the introduction of a rolling programme of audit in Bradford, a city with one of the highest rates of birth defects, due largely to its multi-ethnic population. The audits of dating, anomaly and growth scans identified a number of areas of poor practice. Retraining and re-audit of the sonography team showed how effective such a programme can be in achieving a reliable screening service.
The last two main articles in this issue return to education and training. Farahmand et al. from the University of Medical Sciences in Tehran describe a study of the efficacy of a short workshop in improving the ability of emergency medicine residents to detect foreign bodies using ultrasound. The study was carried out on various foreign materials implanted into lamb leg and showed substantial improvements in foreign body detection after training. The authors suggest that such a short training course could enable emergency physicians to detect foreign bodies with ultrasound, relieving pressure on radiologists who are needed for more complex investigations.
The use of simulators in healthcare education has increased over the last decade but it seems that there is limited evidence as yet of their benefits. Vivien Gibbs describes a study of sonography student experiences of the use of simulators as part of their education. In this study, simulation was positively evaluated by the students in interviews and showed a number of benefits, including more interactive learning, increased confidence and reduced stress for students when starting to scan patients. It seems inevitable that sonography education will follow in the footsteps of other skill-based disciplines such as aviation, in incorporating simulators into training, but the most effective approach is yet to be established.
A final word to any educationists out there who may be reading this – summer is a great time to get some serious writing done. We look forward to seeing your submissions for the special issue before 1 October!