Navigating sonographer work-integrated learning: A thematic analysis of workforce pressures, training barriers and student wellbeing

Abstract

INTRODUCTION: Sonography Work-Integrated Learning (WIL) is increasingly challenged by workforce shortages, high service demands, and limited supervisory capacity. Despite WIL's critical role in sonographer education pathways, there is limited empirical understanding of how these pressures are experienced by trainees and clinical supervisors, whose insights are vital for shaping meaningful and practical reforms. This study addresses that gap. METHODS: Between July and November 2024, an online Qualtrics survey gathered insights from trainee sonographers and clinical supervisors across Australia who had participated in WIL within the past 12 months. Participants were recruited through professional contacts, sector networks and online platforms. Open-ended questions explored barriers, training challenges, support needs, and wellbeing. Responses were analyzed using reflexive thematic analysis to identify key themes. RESULTS: A total of 431 participants completed the survey: 266 clinical supervisors (62 %) and 165 trainee sonographers (38 %). Findings revealed that the clinical training environment is shaped by a complex interplay of structural, systemic, and institutional challenges, resulting in a network of interconnected pressures. These pressures place a substantial, and often underestimated, emotional and cognitive burden on sonography trainees. Respondents called for enhanced support systems, formal recognition and targeted training of clinical supervisors, and prioritization of educational outcomes and trainee wellbeing during WIL. The study underscores the need for sector-wide collaboration and sustained investment to address these challenges. CONCLUSION: WIL must be reimagined to foster supportive, effective learning environments that reflect the clinical environmental realities. IMPLICATIONS FOR PRACTICE: Without urgent reforms, trainee sonographer wellbeing and workforce sustainability are at risk.