Evaluation of the British Medical Ultrasound Society (BMUS) Preceptorship and Capability Development Framework for Sonographers: A realist approach

AbstractIntroduction In 2022, the British Medical Ultrasound Society (BMUS) launched their Preceptorship and Capability Development Framework, the first document of its kind for sonographers and an important professional milestone. Since the framework's publication, its functionality in practice has not been evaluated. To address this gap, a preliminary realist evaluation was conducted. Its aim was to advance our understanding of why the framework ‘works' (or not), how, for whom, in what context, and to what extent. Methods As a preliminary realist enquiry, the central objective was to elicit initial programme theories (IPTs) about how the framework effects change (intended or otherwise) in different contexts. The IPTs were generated ‘retroductively'. First, the incarnate theories embedded within the framework were inductively surfaced. Then, these were deductively tested in two semi-structured focus groups, comprising eight participants. Themes were surfaced using thematic analysis, from which IPTs emerged as ‘context-mechanism-outcome' configurations (CMOCs). Results The analysis surfaced three core themes: structured, systems thinking approach; human factors; and boundary-spanning benefits. From these, thirty-five IPTs emerged in the form of CMOCs, capturing the causal pathways between contexts, mechanisms, and outcomes. Conclusion Preceptorship should be a priority for the ultrasound workforce: it helps to future-proof the profession, solidify sonographer identity, elevate the professional profile, and demonstrate self-regulation. This study advances the preceptorship agenda by evaluating the framework and offering valuable insights into its ‘real world' functionality. Implications for practice The surfacing of IPTs as functional units (CMOCs) narrows the knowledge-to-practice gap; because stakeholders can discern which outcomes are triggered in which circumstances, they can target their efforts accordingly. As such, the study has important implications for practice, as its design and outputs facilitate the development of holistic implementation strategies.