Regarding barriers or inhibitors to CPD

10.5 Regarding barriers or inhibitors to CPD

Whilst most of the interviewees stated that they had no major problems with the access and accumulation of CPD points, there were several recurrent themes regarding what could be seen as ‘Barriers to Participation’. Just prior to the survey and interviews, the rules for accumulation of points changed so that some activities such as internet quizzes, journal article reading and in- house meetings had a limit applied as to the number of points that could be accumulated from each. The reasoning behind this was understood and generally agreed with by the interviewees, but it was suggested that this change could affect those who lived in rural areas and those with children.

Capping of points for certain activities will disadvantage those in country areas – especially if the staff of a department are making a good effort to do a variety of talks, case studies 6 etc. (Celia)

Rural areas were highlighted as a disadvantaged area. There is not much done in rural areas. The travelling workshops 7 are good, but there is a

limit on numbers and it can be very frustrating if there are not enough places for all, especially locals. Also cost is an issue in country areas. Even though my employer helps out quite a bit there are still considerable out of pocket expenses. (Celia)

6 A popular way of dissemination of knowledge is to present an interesting sonographic case, complete with history, pathophysiology, images and outcomes to colleagues. It was argued by the accreditation registry that the quality of

these presentations was often lacking and therefore not worthy of much consideration for CPD. 7 Both the ASA and ASUM fund lecturers and workshop presenters to travel to different centres around the county

several times a year, but, of course, the number of places that can be visited is limited.

Another of the interviewees did not live in a rural area but still felt disadvantaged: Living in the outer suburbs it is difficult to go to a workshop in the evenings as it takes time to

get into and out of the city and then there’s child minding fees. Weekends are also bad

because that is the time for the kids. (Ellen)

Whilst this next interviewee did not have any difficulty gaining CPD points, she did comment: Time is a huge factor especially for family life, even if you have no children. It does affect

home life. (Gloria)

Although family commitments and personal time were also considered a barrier by the following, Helen acknowledged the role of a supportive partner in her CPD. This highlighted the difficulties that the sole parents who commented on the survey may have had.

There are barriers to obtaining CPD, especially in rural communities. Family commitments are also important and it really depends so much on the support of a partner (if there is one). It can also be difficult in cities as it takes a long time to get across town, especially in Sydney. I have been lucky to have a good partner to help out while I am away. (Helen)

Apart from personal time, increasing workloads, staff shortages and tiredness were all seen as significant barriers. The following typifies the feeling amongst the interviewees:

The problem is that the workloads are increasing dramatically all the time and the expectations are extremely high, so there is little time at work for meetings and a big problem is that after a full day’s work, you go home exhausted and too tired to even think about CPD. (Jan)

She also commented as an aside that this level of work could lead to workplace injuries and went

on to say: … and other important things such as exercise and yoga which are necessary for my well-

being may clash with evening meetings, and health comes first. (Jan)

One of the interviewees, who was not much in favour of CPD for more experienced sonographers, found there were other deterrents for her:

After 20 years you’ve had enough... Let’s improve the quality and let’s get some more honesty in it.

(Ellen)

In summary, the main points which were brought out as barriers and inhibitors to CPD for this group of sonographers were, lack of flexibility due to capping of points in certain categories, distance, time, cost and tiredness due to excessive workloads. These themes echoed those presented in the comments to the survey, flexibility to a lesser extent. It has been acknowledged even by those living in the city that rural sonographers are more disadvantaged due to distance, cost and time. Capping of points in some categories has limited those in rural areas to a certain extent by preventing them from fully utilising activities which are readily and easily available. Whilst some of the interviewees felt that perhaps some in-house CPD activities did lack rigour, as Celia commented, many departments like hers had put time and effort into the activities to make them worthwhile. In Celia’s opinion, better guidelines could be issued for different activities so that a good standard can be attained. However, she also queried whether the regulators could possibly have visited every worksite in-house education (and indeed probably visited none but their own) and due to this could not have had a good understanding of what the standard was.

Workplace concerns again came into the conversations, tiredness due to overload being the main barrier to participation in CPD. Almost as an aside the added risk of workplace injury was mentioned. Sonographer workplace injuries are thought to be very prevalent due to the nature of the job (The National Institute for Occupational Safety and Health (NIOSH) 2006; The Society of Diagnostic Medical Sonographers (SDMS) 2009). Sonographers are encouraged to keep fit and healthy to counteract the body stresses caused by scanning all day, which Jan preferred to do even if it meant missing a CPD activity.