Exploring patient experiences of surveillance for pancreatic cystic neoplasms: a qualitative study.

BACKGROUND: Pancreatic cystic neoplasms (PCN) are considered premalignant conditions to pancreatic adenocarcinoma with varying degrees of cancerous potential. Management for individuals who do not require surgical treatment involves surveillance to assess for cancerous progression. Little is known about patients' experience and the impact of living with surveillance for these lesions. AIMS: To explore the experiences of patients living with surveillance for PCNs. METHODS: Semi-structured qualitative interviews were conducted with patients under surveillance for pancreatic cystic neoplasms in the UK. Age, gender, time from surveillance and surveillance method were used to purposively sample the patient group. Data were analysed using reflexive thematic analysis. RESULTS: A PCN diagnosis is incidental and unexpected and for some, the beginning of a disruptive experience. How patients make sense of their PCN diagnosis is influenced by their existing understanding of pancreatic cancer, explanations from clinicians and the presence of coexisting health concerns. A lack of understanding of the diagnosis and its meaning for their future led to an overarching theme of uncertainty for the PCN population. Surveillance for PCN could be seen as a reminder of fears of PCN and cancer, or as an opportunity for reassurance. CONCLUSIONS: Currently, individuals living with surveillance for PCNs experience uncertainty with a lack of support in making sense of a prognostically uncertain diagnosis with no immediate treatment. More research is needed to identify the needs of this population to make improvements to patient care and reduce negative experiences.

Role extension in advanced ultrasound practice: A framework approach and case study.

Introduction: Role extension into novel areas of ultrasound practice can be challenging for health care professionals. Expansion into existing areas of advanced practice typically occurs using established processes and accredited training; however, in areas where there is no formal training, there can be a lack of support for how to develop new and progressive clinical roles. Topic Description: This article presents how the use of a framework approach for establishing areas of advanced practice can support individuals and departments with safely and successfully developing new roles in ultrasound. The authors illustrate this via the example of a gastrointestinal ultrasound role, developed in an NHS department. Discussion: The framework approach comprises three elements, each interdependent upon and inform each other: (A) Scope of practice, (B) Education and competency and (C) Governance. (A) Defines (and communicates) the role extension and area(s) of subsequent ultrasound imaging, interpretation and reporting. By identifying the why, how and what is required this informs (B) the education and assessment of competency for those taking on new roles or areas of expertise. (C) Is informed by (A) and is an ongoing process of quality assurance to safeguard high standards in clinical care. In supporting role extension, this approach can facilitate new workforce configurations, skill expansion and enable increasing service demands to be met. Summary: By defining and aligning the components of scope of practice, education/competency and governance, role development in ultrasound can be initiated and sustained. Role extension utilising this approach brings benefits for patients, clinicians and departments.

BMUS journal club on Twitter: An analysis of the first #BMUS_JC discussions.

INTRODUCTION: Journal clubs have evolved over recent years within healthcare to encourage continuing professional development. More recently, there has been a move from face-to-face group meetings to virtual groups utilising social media platforms. This article aims to explore the discussions and narrative following the inaugural BMUS journal club, highlighting the key discussions and themes from the participants and to provide a narrative for the future of ultrasound continuing professional development. METHODS: The August 2020 journal club chat was focussed on the article featured in Ultrasound: "Sonographers' level of autonomy in communication in Australian obstetric settings: Does it affect their professional identity?" by Thomas et al. Data consisting of Twitter correspondence were extracted and analysed from the advanced search function on Twitter using #BMUS_JC thread. An initial review ensured related content was included. A second review and semantic thematic analysis was then conducted on the 123 tweets. RESULTS: In total, seven overall themes were identified between the three sub-threads within the journal club discussions. Those participating in the Twitter discussion recognised the limitations and barriers for communicating results to patients, acknowledging that training, support and regulatory involvement is required for sonographers to change practice locally and internationally. CONCLUSION: The group discussions on Twitter highlight the ongoing issues for sonographers' professional identity worldwide. Furthermore, our analysis echo other contemporary studies which indicate that Twitter journal clubs act as a fruitful and dynamic source of continuing professional development, particularly in an era where social distancing is encouraged. The outcomes of the first BMUS journal club support the wider evidence that online journal clubs can provide a successful platform for professional discussion and debate.