The Accidental Pioneer: Sonography students benefit from Patty Braga’s experience, passion

From Contact magazine, Winter 2015-16

It was a crisp autumn day in 1969 and 17-year-old Patty Braga was driving the family Mustang on River Road in Passaic, N.J. With a girlfriend in tow, they were on their way to Willowbrook Mall for a day of shopping. Unfortunately, a tree at the end of a miscalculated curve got in the way. Both fully recovered from the accident, though it took Braga longer. She dislocated her hip and was in traction for three weeks at St. Joseph’s Hospital.

Professor Patty Braga, Sonography
Professor Patty Braga, department chair of PBSC’s Sonography programs

Braga needed x-rays every other day, but as she was unable to move, the machine was brought to her. A high school senior, she was a candy striper at the same hospital and had been thinking about a career in health care.

“I started talking to the x-ray technologists, and they kept saying ‘you should do this, you’ll love it,’” says Braga. “And that’s what I did. I owe my career to the car accident.”

Radiography had been in use for decades, but sonography or medical ultrasound was still in its infancy. Braga, now associate professor and chair of Palm Beach State College’s Sonography department, recalls the day when she volunteered to learn this new type of medical imaging, which uses high frequency sound waves to see inside the human body.

“I was working in the x-ray department at St. Joseph’s when the hospital’s first ultrasound machine arrived. A radiologist asked who ‘wants to learn this?’ and I said ‘I’ll do it.’ Honestly, that’s how I started. It was on-the-job training because there was no such thing as an ultrasound school in 1976.”

At St. Joseph’s, Braga teamed up with other early adopters to get the rest of the physicians on board with sonography. “That’s where my first teaching experience came from because I actually had to teach the doctors and OB-GYN residents how to use the ultrasound equipment.”

While sonography still provides those thrilling first images of babies in utero, it is now widely used in most medical specialties. Because no radiation is involved, it’s considered “gentle imaging” and is often the first choice in determining a diagnosis.

Patty Braga in 1978
Patty Braga scans a patient in 1978, early in her career as a certified diagnostic medical sonographer. James M. Monaghan, M.D. views the monitor with her.

When ultrasound schools began cropping up, Braga earned a certificate to expand her knowledge. As a diagnostic medical sonographer, she did “a little bit of everything,” becoming certified in OB-GYN, abdomen, cardiac and vascular sonography. Soon schools hired her as an instructor, and ultrasound equipment companies employed her to teach clients how to operate their new machines. “I always liked the teaching aspect,” notes Braga, who went on to get a bachelor’s and master’s degree. “It was always in the back of my head that I wanted to go in a different direction.”

The new direction took her south. Her husband had been saying for years that he wanted to move to Florida, but between working and raising two sons, the timing was never right. Finally, in 2002, they packed up. Braga saw the move as a chance to find a new challenge, and she did — in a help wanted ad for the director of Palm Beach State’s new Sonography department.

Braga has been at the helm for 12 years and teaches most of the classes. Dr. Vicki Shaver, PBSC professor and Medical Imaging chairperson, headed up Braga’s hiring committee. “It was easy to make that selection because she had experience in all aspects of radiology,” says Shaver. “She brings a wealth of knowledge to her students and really cares about their success and job placement. She’s the full package.”

Braga began at PBSC with a clean slate, designing programs to meet a demand that hasn’t abated. Job growth for sonographers is projected to increase by 39 percent through 2022, according to the U.S. Department of Labor, and the median annual pay is more than $60,000. Braga, however, discourages anyone motivated by salary alone. “You have to want to do this because you care about patients.”

Sonography Lab
Professor Braga guides student Kristina Cobia as she performs an ultrasound scan of classmate Jessica Beacham’s abdomen in PBSC’s Sonography lab on the Palm Beach Gardens campus.

The Sonography programs — an Associate in Science degree and a College Credit Certificate — focus on developing medical knowledge as well as technical precision in operating the equipment. Intensive hands-on training starts in the College’s well-equipped lab and extends to clinical rotations at local hospitals and physician practices.

Medical ultrasound relies heavily on the skill of the sonographer. As Braga teaches, a sonographer’s job is to ask “why” and investigate the possibilities when they see something abnormal. A good sonographer goes the extra mile to give the physician, typically a radiologist, as much information as possible.

“Dilated bile ducts may be seen in imaging the liver,” Braga gives as an example, “but are they dilated because there’s a stone stuck or because there’s a mass at the head of the pancreas? You’re thinking critically all the time about what that image means and where you go next.”

In the lab, students learn how to operate ultrasound equipment, with classmates and staff acting as patients. Students also perform scans using a life-size female mannequin and simulation technology, which lets them discover abnormalities and compare the 2-D ultrasound images against 3-D anatomical images on a split screen. This helps students think critically about anatomy, physiology and disease processes and hones their ability to look at 2-D images, yet think 3-D — a crucial skill in capturing the correct images.

“This is a tough field,” says Braga, who believes everybody’s capable of learning. “When students have issues, I try to counsel them and give them the confidence that they’ll be able to do this work.”

“Professor Braga calmed all of our fears and anxieties,” says student Marji Engle, a former dental hygienist who was last in college 25 years ago. “We’re in our final semester now and without her, I don’t believe we’d all be here.”

Braga herself stays sharp by working in local hospitals a few days a month. “When I first started teaching at the College, that’s all I did. Teaching is my first love, but I missed scanning patients.”

Students notice and benefit. “She comes to class in her uniform because she’s going to work right after this,” says Laura Fazaa. “I can’t imagine having a better teacher for this program.” Shaver notes that few full-time professors can juggle both, which makes Braga unique. “I really admire her ability to do it all.”

Apparently it pays off. Graduates fill the ranks of local hospitals, including most of the sonography positions at St. Mary’s Medical Center. Private practices also benefit. Mandi Sangiuolo, who graduated in 2005, is now director of imaging for Pre-Birth Centers of America. The high-risk pregnancy practice, headed by Dr. Ruel T. Stoessel, is a clinical training site for PBSC Sonography students, and Sangiuolo, who supervises 10 sonographers at three locations, has hired many of them. “The program gave me all of the knowledge that I needed to be a successful,” says Sangiuolo. “Patty brings so much to the table. Her students are ready to go.”

Braga supports the profession, too. Early on she became active in the Society of Diagnostic Medical Sonography, now in its 45th year. A former SDMS state representative and at-large director, she now serves as secretary of the executive board and since 2013, as chairperson of the SDMS Education Committee, which sets national curriculum standards for sonography programs.

Braga also serves on the Joint Review Committee on Education in Diagnostic Medical Sonography and performs site visits for schools seeking accreditation through the Commission on Accreditation of Allied Health Education Programs. Palm Beach State’s Sonography programs are CAAHEP-accredited, which enables graduates to take the profession’s national exams and earn credentials recognized worldwide.

“Being involved in SDMS and accreditation is a way to show the younger generation how much ultrasound can do for them,” says Braga. “I take my students to conferences so they can see people like me, who get up and talk with enthusiasm about the interesting studies they’ve done. It’s great for students to see that.”

Robert Van Der Velde, J.D., associate dean of academic affairs for the Palm Beach Gardens campus, visits Braga’s classes and has been scanned by the students. “I see that she has a caring touch with her students, which helps them develop the same caring touch with patients. She’s definitely one of our stars.”

For Braga, it’s simply a matter of giving back. “This profession has been really good to me. I truly love ultrasound.”

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Photos by Al Evans

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