Consent and Chaperone Practices in Transvaginal Ultrasound: Exploring Sonographer Knowledge, Gender, and Ethical Challenges

Abstract

Aims
To examine consent and chaperone practices in transvaginal ultrasound (TVUS) within the Irish healthcare setting, and to identify knowledge gaps, training needs, and policy challenges influencing clinical practice.

Methods
This study synthesised findings from four undergraduate radiography research projects. Three cross-sectional surveys were distributed concurrently via purposive sampling to practising sonographers (n = 24), ultrasound departmental managers (n = 14), and male sonographers (n = 13) working across Irish ultrasound services. Survey data were analysed descriptively, with free-text responses analysed thematically. A scoping review of literature was undertaken to inform contextual interpretation it is not presented as a formal component of the results.

Results
A total of 51 respondents participated. Verbal consent was the predominant method for TVUS (35/51; 69%), with written consent used less frequently. Support for written consent was expressed by 17 of 24 practising sonographers (71%) and 12 of 13 male sonographers (92%). Knowledge gaps were identified, with 10 of 24 respondents (42%) incorrectly identifying the legal age of consent and 19 of 24 (79%) unfamiliar with substituted consent frameworks. In two cohorts (practising and male sonographers), the majority reported spending less than two minutes obtaining consent (27/37; 72%). Chaperone practices varied: all male sonographers required a chaperone, while 6 of 14 departments (43%) did not routinely offer one. Patient refusal to allow male sonographers to perform TVUS was reported by 12 of 13 respondents (92%).

Conclusion
Consent and chaperone practices for TVUS in Ireland are inconsistent, with identifiable knowledge gaps and gender-specific challenges. The findings support the need for clearer TVUS-specific guidance, alongside targeted education and standardised consent and chaperone practices to support safe and equitable care.