Abstract
The field of sonography has made remarkable progress in the application of clinical medicine over the past four decades. Sonography-based medical advances have without doubt improved patient care by providing primary and supplemental diagnoses in an increasing variety of clinical settings. However, it is important to realize that the success of sonography is directly linked to two strong yet interconnected dependencies: the skill of the operator and technological advances.
Sonography remains one of the most, if not the most, operator-dependent medical imaging modalities. Sonographic care of the patient is maximized when healthcare providers meld applied acoustic physical principles with in-depth anatomic and pathologic knowledge of the human body. This combination of knowledge and abilities provides a unique and inspiring skill for those who practice this medical art and science.
Historically, the art and science of sophisticated sonography skill sets have sat with the sonographer as well as the physician with meaningful training and experience, the sonologist. Through the years, teams of sonographers and sonologists have pushed ultrasound technology from its early relevance to where it stands today, an essential clinical asset across almost all medical specialties. Indeed, the sophistication of sonography and its related education, training, and applied clinical skills has matured in parallel with technological progression, both hardware and software. Advancements in image quality, Doppler, color Doppler, multidimensional imaging, and elastography are all examples of technological milestones that have dramatically enhanced sonography’s impact on clinical care. Yet, a long-standing unanswered argument remains: whether the demands of clinical personnel drive technology development, or whether technology development drives clinical advances. That debate is beyond the scope of this editorial.
What is clearly not up for debate is the continuous need for standards that offer patients consistency in the delivery of sonographic care while being assured that the equipment being used is safe and performs as advertised. Governmental regulatory agencies, such as the US Food and Drug Administration, provide equipment safety and technology standards on the medical devices that use ultrasound. 1 Independent organizations, such as the American Registry for Diagnostic Medical Sonography (www.ardms.org), the American Registry of Radiologic Technologists, or Cardiovascular Credentialing International, test an individual’s specific use of sonography and award credentials that document established knowledge, skills, and abilities in the practice of sonography. 2 When established healthcare certification bodies provide individuals with verified credentials, patients, employers, and other healthcare providers are assured that those credentials represent a set of standards that demonstrate individual performance expectations for associated clinical responsibilities and practices.
Enhanced levels of quality patient care occur when sonography practice laboratory accreditation is applied. Organizations such as the American College of Radiology, the American Institute of Ultrasound in Medicine, 3 and the Intersocietal Accreditation Commission (www.intersocietal.org) establish laboratory-specific standards via a process that includes an evaluation of image quality, diagnostic accuracy, and reporting. In my opinion, the highest levels of sonography practice quality are those who have earned laboratory accreditation and who also mandate that all sonographers within the practice hold credentials and, if available, certifications for non-sonographers within the practice, from an accredited certification organization.
As sonography practice continues to evolve, certification organizations must adapt to assure the public that credentials awarded to individuals represent current practice standards. This is why certification organizations continually perform clinical practice analyses to determine individual tasks so that fair, valid, and reliable assessments can be generated; these practice analyses are the benchmarks that link actual individual practices to the credentialing examination. 4 The individual’s credentials then represent the standards that the public expects and trusts.
Sonographers need to continue to hold trust with the medical community and the public, by constantly linking sonographic performance to their publicly recognized stamp of approval, the credential. Meaningful and respected credentials will get you a job or acceptance within new groups, but dedicated lifelong learning and applying new knowledge, skills, and abilities are paramount to a rewarding career and providing the best care to the patient.
