Determinants of ultrasonography training outcomes among radiography diploma students in selected Kenya Medical Training Colleges, in Kenya public hospitals

Abstract

Background: Ultrasound technology has become an effective clinical diagnostic tool in low and middle income countries (LMICs) to meet the objectives of improved primary health care (PHC). However, availability of ultrasound machines and skill training needed continue to limit expanded use of ultrasound in LMICs. In Kenya, concerns have been raised over the quality of work output of sonographers and clinicians practicing ultrasound (Kagima et al., 2021). All these increase the risks of poor diagnosis and patient management and could result in increased morbidity and preventable deaths. This can be attributed to the quality of training and student related factors. Objectives: To determine how students ‘perception of curriculum space limitations affect ultrasonography training outcomes, to analyze how availability of ultrasound machines for training affects ultrasonography training outcomes and to examine how students attitudes on training moderates the relationship between institutional factors and ultrasonography training outcomes.

Methods: Study was carried out using a mixed research approach employing both qualitative and quantitative methods. It targeted five Kenya Medical Training College (KMTC) campuses offering the radiography course that are based in four county (Level 6) and one level 5 teaching hospitals in the country, that is, Nakuru, Uasin Gishu, Nairobi Kisumu and Kericho respectively. The target population were final year KMTC students undertaking their radiography and imaging course, the faculty members and the hospital-based instructors. Systematic random sampling was used to select 98 students, of who 45 are females and 53 males, while the census method was used to select 26 faculty members and 10 hospital-based instructors. Questionnaires for students, interview schedules for lecturers, hospital-based instructors and Focus Group discussions for students were used for data collection. Quantitative data from the questionnaire were analyzed using both descriptive and inferential data analysis.

Results: Students’ perception of curriculum space limitations did not significantly affect ultrasonography training outcomes. Availability of ultrasound machines for training significantly affects ultrasonography training outcomes and Students attitudes had a significant moderating effect on the relationship between institutional factors and ultrasonography training outcomes among diploma Radiography students. Conclusions: Students’ perception of curriculum space limitations did not have a statistically significant effect on ultrasonography training outcomes. Availability of ultrasound machines for training had a statistically significant effect on ultrasonography training outcomes. Recommendations: College management should establish clear guidelines and prerequisites for ultrasound training, ensuring that only students from relevant medical imaging or ultrasonography programs are prioritized. To address students’ lack of confidence in using the simulators for training, a blended training approach is recommended, where simulators are used to build foundational skills before transitioning to human models. Further, greater emphasis should be placed on mentorship, career guidance, and the long-term relevance of radiography and sonography careers to boost student motivation.