When the penny drops - threshold concepts in postgraduate sonographer training and development

Heather Venables, Diagnostic Imaging, University of Derby

Background and purpose

Meyer and Land (2003) present the idea that in most disciplines ... “there are ‘conceptual gateways’ or ‘portals’ that lead to a previously inaccessible, and initially perhaps ‘troublesome’, way of thinking about something”. These are the ‘penny drop’ moments that lead to transformative and irreversible learning, the dawning realisation of the interconnection of theories and practice experiences that enable students to make sense of profession-specific expectations. Threshold concepts can transform the way students think and challenge their self-identity. Both are key as they move towards autonomy as advanced practitioners. However, these insights may lead to challenge and re-evaluation of their emerging professional role. 


An informal workshop was used to explore the idea of threshold concepts and skills with ultrasound mentors and consider the key ‘penny drop’ moments in sonographer training. We consider the threshold concepts that underpin key skills (such as scan orientation and effective communication) and the stages of learning when we would expect these to be grasped. We explore the challenges in identifying students who are in a ‘stuck place’ and innovative interventions that can help students progress.


We found:

•      Mentors focused overwhelmingly on threshold skills rather than underlying concepts

•      Limited consensus on the expected timing of when key concepts should normally be grasped by students

•      More guidance is needed from the University on creative learning opportunities


Further work is required to identify threshold concepts that are implicit (but not clearly articulated) within the curriculum and discussion of ‘troublesome’ concepts needs to be encouraged. We consider novel ways of enabling students to explore threshold concepts within their own practice. Mentor training needs to include guidance to help them identify students who are in a ‘stuck place’.

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