Sonography culture: Power and protectionism

Introduction: The project aimed to explore the culture of sonography through the interpretation of the attitudes and opinions of a sample of practicing sonographers concerning the possible introduction of the graduate sonographer role. The participants' insights to their working world provided a new understanding of the professional culture of sonography and its impact on collective behaviour. Methods: A qualitative study was undertaken using a constructivist methodology within a critical theory framework. A sample population was selected using theoretical purposive sampling. The interview transcripts were thematically analysed. Results: Analysis identified main themes: protectionism, power, working world and career frameworks; these were interlinked with cross-cutting sub-themes of value, status and professional identity. The shortage of sonographers and increasing demand for ultrasound services created an imbalance that had put sonographers in a very powerful position; able to influence sonographer working practice, education and remuneration. The interpretations suggested that the initial power base of sonographers was achieved through a culture of occupational imperialism (delegation down). However, as the occupational group became established and a workforce crisis deepened, a culture of usurpation and protectionism had evolved within sonography. Conclusions: The culture of sonography had a longstanding relationship with tradition and value that provided an emotional and political platform. An increasing self-awareness of power and status, due to the workforce shortage, had fostered a usurpatory and protectionist culture encouraging resistance to any workforce transformation. (C) 2019 The College of Radiographers. Published by Elsevier Ltd. All rights reserved.