Psychomotor Skills in Medical Ultrasound Imaging

Sonographers use psychomotor skills to perform medical ultrasound examinations. Psychomotor skills describe voluntary movements of the limb, joints, and muscles in response to sensory stimuli and are regulated by the motor neural cortex in the brain. We define a psychomotor skill in relation to medical ultrasound imaging as “the unique mental and motor activities required to execute a manual task safely and efficiently for each clinical situation.” Skills in clinical ultrasound practice may be open or closed; most skills used in medical ultrasound imaging are open. Open skills are both complex and multidimensional. Visuomotor and visuospatial psychomotor skills are central components of medical ultrasound imaging. Both types of skills rely on learners having a visual exemplar or standard of performance with which to reference their skill performance and evaluate anatomic structures. These are imperative instructional design principles when teaching psychomotor skills.     

Compliance in peritoneal dialysis: A qualitative study of renal nurses

End-stage renal failure is a life-threatening condition, often treated with home-based peritoneal dialysis (PD). PD is a demanding regimen, and the patients who practise it must make numerous lifestyle changes and learn complicated biomedical techniques. In our experience, the renal nurses who provide most PD education frequently express concerns that patient compliance with their teaching is poor. These concerns are mirrored in the renal literature. It has been argued that the perceived failure of health professionals to improve compliance rates with PD regimens is because 'compliance' itself has never been adequately conceptualized or defined; thus, it is difficult to operationalize and quantify. This paper examines how a group of Australian renal nurses construct patient compliance with PD therapy. These empirical data illuminate how PD compliance operates in one practice setting; how it is characterized by multiple and often competing energies; and how ultimately it might be pointless to try to tame 'compliance' through rigid definitions and measurement, or to rigidly enforce it in PD patients. The energies involved are too fractious and might be better spent, as many of the more experienced nurses in this study argue, in augmenting the energies that do work well together to improve patient outcomes.