ORCID Profile
0000-0003-0069-1932
Current Organisation
University of South Australia
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Publisher: Wiley
Date: 19-11-2022
DOI: 10.1111/AJR.12811
Publisher: Springer Science and Business Media LLC
Date: 27-07-2022
DOI: 10.1186/S13089-022-00279-1
Abstract: The purpose of this study is to provide expert consensus recommendations to establish a global ultrasound curriculum for undergraduate medical students. 64 multi-disciplinary ultrasound experts from 16 countries, 50 multi-disciplinary ultrasound consultants, and 21 medical students and residents contributed to these recommendations. A modified Delphi consensus method was used that included a systematic literature search, evaluation of the quality of literature by the GRADE system, and the RAND appropriateness method for panel judgment and consensus decisions. The process included four in-person international discussion sessions and two rounds of online voting. A total of 332 consensus conference statements in four curricular domains were considered: (1) curricular scope (4 statements), (2) curricular rationale (10 statements), (3) curricular characteristics (14 statements), and (4) curricular content (304 statements). Of these 332 statements, 145 were recommended, 126 were strongly recommended, and 61 were not recommended. Important aspects of an undergraduate ultrasound curriculum identified include curricular integration across the basic and clinical sciences and a competency and entrustable professional activity-based model. The curriculum should form the foundation of a life-long continuum of ultrasound education that prepares students for advanced training and patient care. In addition, the curriculum should complement and support the medical school curriculum as a whole with enhanced understanding of anatomy, physiology, pathophysiological processes and clinical practice without displacing other important undergraduate learning. The content of the curriculum should be appropriate for the medical student level of training, evidence and expert opinion based, and include ongoing collaborative research and development to ensure optimum educational value and patient care. The international consensus conference has provided the first comprehensive document of recommendations for a basic ultrasound curriculum. The document reflects the opinion of a erse and representative group of international expert ultrasound practitioners, educators, and learners. These recommendations can standardize undergraduate medical student ultrasound education while serving as a basis for additional research in medical education and the application of ultrasound in clinical practice.
Publisher: Australasian Society for Computers in Learning in Tertiary Education
Date: 04-11-2022
DOI: 10.14742/AJET.7878
Abstract: The gradual shift to online modes of learning in higher education institutions over the past 2 decades accelerated drastically on a global scale between 2020 and 2022. Students and educators, who have initially grappled with the shift, have now become accustomed to online teaching however, there are concerns about the quality of learning that has resulted. To enable a sustainable and effective online pedagogy, educators may need to learn about fostering higher-order thinking skills, which can be challenging even for experienced educators. To conceptualise effective online pedagogy, the community of inquiry (CoI) framework emphasises cognitive presence (CP), which focuses on the higher-order thinking process. The CoI is the most widely researched framework in online pedagogy, yet contemporary CoI literature lacks collective evidence of factors that influence CP. This scoping review of the CoI literature explores the factors that influence the higher-order thinking that is indicative of CP. Inclusion criteria included evidence of CP in online learning contexts and published between January 2000 and March 2022, providing a total of 121 studies. Results suggest that teaching presence, structure of learning activities and student characteristics all influence CP. Implications for practice or policy: Higher education students enrolled in online courses should be taught how to learn effectively in an online mode. Online course educators must embed learning tasks that foster self-regulation and higher-order skills in students. Online course design should include authentic tasks for students to apply new knowledge to real-life scenarios. Educators must be offered le professional development activities to build their skills in online pedagogy. Institutions should encourage translation of online educational research to practice.
Publisher: Wiley
Date: 10-11-2016
DOI: 10.1002/SONO.12083
Publisher: Elsevier BV
Date: 08-2017
DOI: 10.1016/J.ACRA.2017.02.015
Abstract: The literature surrounding interprofessional education claims that students who learn with, from, and about one another in well-designed interprofessional programs will practice together collaboratively upon graduation, given the skills to do so. The objective of this study was to examine attitudes to interprofessional practice before and after an interprofessional learning (IPL) activity. A total of 35 postgraduate medical imaging students attended a week-long mammography workshop. The sessions provided a range of didactic sessions related to diagnosis and management of breast cancer. An IPL session was incorporated on completion of the workshop to consolidate learning. Props and authentic resources were used to increase the fidelity of the simulation. Participants completed pre- and post-workshop questionnaires comprising an interprofessional education and collaboration scale and a quiz to gauge knowledge of specific content related to professional roles. Responses to each statement in the scale and quiz score, pre or post workshop, were compared, whereas responses to open-ended questions in post-workshop survey were thematically analyzed. Seventeen paired surveys were received. There was a significant total improvement of 10.66% (P = .036). After simulation, there was a statistically significant improvement in participants' understanding (P < .05) that IPL offers holistic care to the patient and that teamwork is useful for reducing errors in patient care. Simulation helped participants develop more awareness of their role within the profession, improve their understanding of other professionals, and gain more realistic expectations of team members. This pilot study confirmed learning within an IPL simulation improved attitudes toward shared learning, teamwork, and communication. Simulation provides opportunities for learning in a safe environment, and technology can be used in erse ways to provide authentic learning.
Publisher: Wiley
Date: 18-01-2023
DOI: 10.1002/AJUM.12331
Abstract: Many guidelines have been utilised to diagnose polycystic ovarian syndrome (PCOS). The most recent are the International Evidence Based Guideline for the Assessment and Management of Polycystic Ovary Syndrome 2018 (2018 IEBG). This study aimed to assess the awareness, knowledge, and attitudes of Australasian sonographers' regarding these guidelines. An online cross‐sectional survey was disseminated to sonographers. Qualitative and quantitative questions were asked around awareness, knowledge, and attitudes towards the 2018 IEBG. Statistical and thematic analyses of the results were performed. Ninety responses were included in the final analysis. Fifty‐two percent (52.2%) of participants were aware of the 2018 IEBG but only 31.1% used it in their workplaces. Fifty‐eight percent (57.9%) of participants correctly identified the sonographic features that suggest PCOS, and 3.5% correctly identified all minimum recommended inclusions for reporting a gynaecological ultrasound for PCOS. Prior to being supplied the 2018 IEBG, 15.8% of participants correctly answered clinical scenario‐based knowledge questions, which increased to 29.4% correctly after being supplied the guideline however, this difference was not statistically significant. There were no statistically significant associations between demographics and knowledge of the 2018 IEBG. Several areas of confusion surrounding wording and interpretation of the 2018 IEBG were highlighted. Consideration should be given to barriers of implementation and strategies to overcome these. More education surrounding the sonographic diagnosis of PCOS and the 2018 IEBG is needed. Scanning protocols used amongst sonographers varied, suggesting that inconsistency in sonographic diagnosis may exist. Future reviews of the 2018 IEBG should focus on reducing ambiguity in wording, which may be responsible for some of the varied interpretation of these guidelines.
Publisher: Wiley
Date: 27-11-2015
DOI: 10.1002/SONO.12043
Publisher: Wiley
Date: 12-03-2019
DOI: 10.1002/AJUM.12138
Publisher: Wiley
Date: 08-2008
DOI: 10.1002/UOG.5526
Publisher: Wiley
Date: 27-09-2016
DOI: 10.1002/AJUM.12020
Publisher: Future Medicine Ltd
Date: 2012
DOI: 10.2217/EBO.11.61
Publisher: MDPI AG
Date: 15-08-2022
Abstract: Paediatric cancer patients have a risk of late side effects after curative treatment. Proton radiation therapy (PRT) has the potential to reduce the incidence and severity of toxicities produced by conventional photon radiation therapy (XRT), which may improve the health-related quality of life (HRQoL) in children. This systematic review aimed to identify the evidence of HRQoL outcomes in childhood cancer survivors following XRT and PRT. Medline, Embase, and Scopus were systematically searched. Thirty studies were analysed, which described outcomes of 1986 childhood cancer survivors. Most studies (n = 24) described outcomes for children with a central nervous system (CNS) tumour, four studies reported outcomes for children with a non-CNS tumour, and two studies combined CNS and non-CNS diagnoses within a single cohort. No studies analysed routine HRQoL collection during paediatric radiation oncology clinical practice. There is insufficient quality evidence to compare HRQoL outcomes between XRT and PRT. Therefore, the current state of the literature does not conclude that PRT produces superior HRQoL outcomes for childhood cancer survivors. Standardised clinical implementation of HRQoL assessment using patient-reported outcomes is recommended to contribute to improvements in clinical care whilst assisting the progression of knowledge comparing XRT and PRT.
Publisher: Wiley
Date: 21-02-2020
DOI: 10.1002/JUM.15246
Publisher: Hindawi Limited
Date: 26-08-2022
DOI: 10.1111/HSC.13978
Publisher: Elsevier BV
Date: 12-2006
Publisher: Informa UK Limited
Date: 05-2020
DOI: 10.2147/RMHP.S247774
Publisher: Wiley
Date: 05-12-2022
DOI: 10.1002/AJUM.12288
Abstract: This study aimed to determine the additional time needed to perform an endometriosis transvaginal ultrasound (eTVUS) compared to routine transvaginal ultrasound (rTVUS). A retrospective case–control study was performed. The study group included 199 eTVUS performed between September 2019 and September 2020. The control group comprised 105 consecutive rTVUS studies performed in the same time period. The time st s on the ultrasound images of all cases in both groups were reviewed to determine the time taken to perform each study. Mean, median, minimum and maximum scan times for both groups were calculated as was percentage difference between scan times. A two‐tailed, unpaired t‐test of the normalised data and a Mann–Whitney U test assessing time difference of scans between two groups were performed with P value .05 considered statistically significant. Performing eTVUS took significantly longer than rTVUS with increases in the mean (8.4 vs 13.8 min, 64%), median (7 vs 12 min, 71%), minimum (4 vs 7 min, 75%) and maximum (19 vs 42 min, 121%) scan times. The Mann–Whitney U test indicated a statistically significant difference in the median scan times (5.0, CI 4.0–6.0), P 0.001. An independent t‐test of the normalised data revealed a significantly larger mean scan time for eTVUS than rTVUS, Mean = 9.05 95%CI [13.17–4.94], t(302) = 4.327, P 0.001. R 2 = 0.583. Endometriosis transvaginal ultrasound added an average 5.4 min to rTVUS, which is statistically significant. For ultrasound departments wanting to offer this technique, doubling the scan time allocated to perform a transvaginal ultrasound (TVUS) is suggested.
Publisher: Wiley
Date: 07-02-2017
DOI: 10.1002/SONO.12096
Publisher: Elsevier BV
Date: 12-2006
Publisher: Wiley
Date: 31-08-2006
DOI: 10.1002/UOG.3188
Publisher: Wiley
Date: 31-08-2006
DOI: 10.1002/UOG.3142
Publisher: Wiley
Date: 21-11-2023
DOI: 10.1002/JUM.16129
Abstract: Endometriosis is a common and painful gynaecological condition that takes an average of 6.4years to diagnose. While laparoscopic surgery is the recommend gold standard in diagnosis of endometriosis, transvaginal ultrasound (TVS) is able to assist surgeons in the planning and management of patients, especially when there is limited visualisation in the posterior compartment. Uterosacral ligaments (USL) are located in the posterior compartment and are one of the first and most common places that endometriosis deposits, The International Deep Endometriosis Analysis (IDEA) group consensus, which are the current guidelines for DE imaging, recommends a thorough ultrasound assessment to identify endometriotic disease. This includes an assessment of anatomic structures in the posterior compartment including the USLs. However, IDEA does not explicitly articulate specifics of USL imaging and measurements on ultrasound. The primary aim of this review is to determine is to identify ultrasound techniques and characteristics of USLs in the diagnosis of deep infiltrative endometriosis (DE). The secondary aim is to describe and summarise these findings into normal and pathological findings. A systematic review was performed according to Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) guidelines. A population, interventions, comparator, and outcome framework was used to define a search strategy. Articles were screened using Covidence review management system, and data was extracted by two authors using a standardised and piolet‐tested form. Quality assessment was conducted using the Critical Appraisal Skills Programme (CASP). Medline, Embase and Scopus and Google Scholar were searched yielding 250 articles, with 22 being included in the review. Analysis of the data demonstrated inconsistent reporting of ultrasound techniques and characteristics of USLs. Most (20/22) papers described abnormal criteria of USLs, only 5/22 papers determined what the normal USL appearance is or what techniques (11/22) were applied. Even though reporting was heterogeneous, there was a high level of tertiary centre participation with gynaecological experienced operators, therefore was a high level of agreement. Through review of the current literature, this study has investigated ultrasound techniques and characteristics of USLs for the diagnosis of DE. All papers included in this review reported presence of pathological sonographic findings of the USLs when DE was presented therefore it is recommended that USL examination become a part of TVS exams when DE is clinically suspected. This study also demonstrated that there was lack of data and no agreement when it comes to measuring USLs with DE. Even so, the current evidence demonstrates that scanning the USLs, and locating, identifying, and describing USL thickening and endometriotic nodules in the various locations using the described techniques and characteristics in this review has clinical value in early diagnosis.
Publisher: Elsevier BV
Date: 03-2020
DOI: 10.1016/J.JMIR.2019.11.003
Abstract: This pilot study aimed to evaluate the knowledge and practices of South Australian radiographers regarding lateral elbow repositioning and to determine whether an educational poster could improve repositioning knowledge. The study was undertaken in four stages. Stage one involved the development of a survey to explore radiographer knowledge and practices surrounding lateral elbow repositioning. Stage two involved the development of an educational poster. Stage three was a pilot validity study. Three participants (n = 3) were involved in testing the validity and test-retest reliability of the survey and the poster. Stage four was the interventional study which involved the distribution of surveys to two radiography departments in South Australia on two occasions, before and after the distribution of the poster. Six complete data sets were analysed. The pilot validity study ensured the test-retest reliability of the survey was strong (P = .629). It was determined that an educational poster made no significant difference to the knowledge of lateral elbow radiograph repositioning among radiographers (P = .253). It was indicated that this result was not due to familiarity with the presurvey questions (P = .171). Thematic analysis of the open discussion questions found that most participants found the poster helpful but did not consider repositioning to be difficult. The introduction of the poster did not increase image repeat rate and the poster was used moderately over the study length. As this study was unable to determine whether a poster could improve the knowledge and practices of lateral elbow repositioning among radiographers, further research is needed.
Publisher: Informa UK Limited
Date: 05-04-2022
DOI: 10.1080/10872981.2022.2041366
Abstract: There is limited access to life-saving antenatal ultrasound in rural and low-resource settings largely due to shortages in skilled staff. Studies have shown healthcare practitioners can be upskilled in PoCUS through focused training, offering a viable solution to this deficit. However, standards for training and competency assessment are unclear and regulation surrounding practice is lacking. We aimed to review published literature examining antenatal PoCUS training programs, comparing teaching approaches and study methodologies. A search of electronic databases EMBASE, MEDLINE and Google Scholar was conducted. Original research articles evaluating antenatal PoCUS training of healthcare professionals worldwide were identified for analysis. Articles with limited detail on the PoCUS training intervention and those describing comprehensive diagnostic training programs were excluded. Evaluations were compared against the Kirkpatrick Evaluation Framework (KEF). Twenty-seven studies were included from an initial search result of 484 articles. There was considerable heterogeneity between the PoCUS training programs described. Course duration ranged from 3 hours to 2 years, with 11 of the 27 studies delivering obstetric-exclusive content. 44% trained multidisciplinary groups of health professionals. Long-term follow-up training and skills assessments were lacking in over half of the reviewed studies. Study quality and reporting detail varied, but overall beneficial outcomes were reported with 3/4s of the studies reaching upper KEF levels 3 and 4. PoCUS performed by upskilled healthcare professionals offers an attractive solution to the problem of inequitable access to antenatal ultrasound. A review of available literature highlighted a paucity of comparable high-quality studies needed to establish a stronger evidence base for antenatal PoCUS, and a need to standardise training and competency assessment. This review may inform educators, researchers and policy-makers on existing training formats and methodologies to assist in establishing best practice antenatal PoCUS training methods for safe service delivery by remote healthcare professionals.
Publisher: Wiley
Date: 08-2015
Publisher: Wiley
Date: 28-03-2022
DOI: 10.1002/SONO.12306
Abstract: Increases in demand for therapeutic ultrasound‐guided musculoskeletal injections have led to longer waiting times for appointments. With the right training, sonographers are well placed to perform these low‐risk procedures. This study evaluated the effect of musculoskeletal injections administered by trained sonographers with respect to patient safety and satisfaction. Patients were recruited from three radiology clinics staffed with appropriately trained sonographers. Patients who agreed to have their injection completed by a sonographer completed satisfaction surveys immediately after their appointment, with adverse reactions also recorded. Longer‐term outcomes were recorded 7–10 days later. 97% of 804 participating patients were completely satisfied with the service they received. Reported adverse events were low, with % and 8% immediately and at follow up respectively. There was demonstrated patient satisfaction with staff and the service, and support for the importance of this service in reducing the extensive waiting times experienced. This study indicates that appropriately trained sonographers can provide ultrasound‐guided musculoskeletal injections at a level of safety which is comparable to similar injection procedures explored in the literature. The high level of satisfaction of the patients suggest that this service should be extended and expanded to address patient concerns regarding long waiting times.
Publisher: Springer Singapore
Date: 15-09-2016
Publisher: Elsevier BV
Date: 2019
Publisher: Springer Science and Business Media LLC
Date: 30-12-2022
DOI: 10.1186/S12909-022-03888-5
Abstract: There is limited access to life-saving antenatal ultrasound in low-resource rural and remote settings worldwide, including Australia, mainly due to shortages in skilled staff. Point-of-care ultrasound (PoCUS) offers a viable solution to this service deficit, however, rural clinicians face many barriers accessing training and professional development critical to advancing their clinical practice. Standards for PoCUS training and competency assessment are unclear. Regulation is lacking globally, allowing untrained and inexperienced clinicians to practice PoCUS clinically. This prospective single cohort study aimed to evaluate antenatal PoCUS training workshops for General Practitioners (GPs) and Midwives/Nurses (M/Ns) from rural/remote Australia, assessing the impact of the training on trainees’ knowledge, confidence and translation of PoCUS into clinical practice. Two-day antenatal ultrasound workshops were delivered at the University of South Australia (UniSA) in 2018 and 2019 to 41 rural/remote clinicians . The training was designed and evaluated using the New world Kirkpatrick Evaluation Framework. Sixteen GPs and 25 M/Ns with mixed prior ultrasound experience were funded to attend. The course consisted of lectures interspaced with hands-on training sessions using high-fidelity simulators and live pregnant models. Pre- and post-knowledge assessments were performed. Post-workshop evaluation and follow-up surveys (3- and 6-month post-training) assessed the workshops and changes to trainees’ clinical practice. A 2-day follow-up training session was conducted 12 months after the workshops for 9 trainees. Pre ost knowledge testing demonstrated a 22% mean score improvement (95% CI 17.1 to 27.8, P 0.0001). At 6 months, 62% of trainees were performing PoCUS that had assisted in patient management and clinical diagnosis, and 46% reported earlier diagnosis and changes to patient management. 74% of trainees had increased scanning frequency and 93% reported improved scanning confidence. This study demonstrated intensive 2-day workshops can equip clinicians with valuable antenatal PoCUS skills, offering a viable solution to assist in the assessment and management of pregnant women in the rural/resource-poor setting where access to ultrasound services is limited or non-existent. Geographical isolation and lack of onsite specialist supervision poses an ongoing challenge to the continuing professional development of remote trainees and the implementation of PoCUS.
Publisher: Springer Science and Business Media LLC
Date: 14-03-2022
DOI: 10.1007/S00247-022-05290-1
Abstract: Diagnostic reference levels (DRLs) identify unusually high patient radiation exposures and are required for dose optimisation. DRLs for pediatric fluoroscopic examinations are not widely determined in Australia. Our objectives were to establish DRLs for pediatric fluoroscopic examinations in a South Australian tertiary hospital and compare these to previously published data and to explore relationships between patient dose area product (DAP), age and fluoroscopy times. Dose data from 365 pediatric patients undergoing 5 fluoroscopic examinations were retrospectively collected for a 3-year period commencing January 2018 to develop local DRLs. Relationships between DAP, age and fluoroscopy time were explored using scatterplots, Spearman's correlation, and regression analyses. Local DRLs were significantly lower than data published previously, possibly reflecting technological and procedural advancements. Each 1-year increase in patient age was associated with a 0.77 μGy·m This study provides updated Australian pediatric fluoroscopic DRLs, with the intention of promoting a national database for benchmarking pediatric doses. The local DRLs can be used for dose comparisons and optimisation between facilities.
Publisher: Wiley
Date: 27-07-2023
Abstract: This study aimed to assess the accuracy of transvaginal ultrasound (TVUS) for the mapping of endometriosis before surgery when performed by sonographers in an outpatient women's imaging centre. A prospective longitudinal cohort study was performed. The study group comprised of 201 women who underwent a comprehensive TVUS assessment, performed by a sonographer. Laparoscopy was performed as the reference standard. Complete TVUS and surgical data were available for 53 women who were included in the final analysis. Endometriosis was confirmed at a surgery in 50/53 (94.3%) participants, with 25/53 (47.2%) having deep endometriosis (DE) nodules and/or endometriomas present. TVUS for mapping of DE had an overall sensitivity of 84.0%, specificity of 89.3%, PPV of 87.5%, NPV of 86.2%, LR+ of 7.85, LR− of 0.18, and accuracy of 86.8% ( P 0.001). Ovarian immobility had poor sensitivity for detecting localised superficial endometriosis, DE, adhesions, and/or endometriomas (Left = 61.9% and right = 13.3%) but high specificities (left = 87.5% and right = 94.7%). Site‐specific tenderness had low sensitivities and moderate specificities for the same. All soft markers of endometriosis failed to reach statistical significance except for left ovarian immobility ( P = .001). Sonographers well experienced in obstetric and gynaecological imaging, working in an outpatient women's imaging setting can accurately map DE however, the performance of soft markers for detection of SE was poor.
No related grants have been discovered for Nayana Parange.