By the completion of this unit, you will be performing full echocardiographic examinations, including Doppler and measurements to ASAR competency of Beginner Level. 

The student is aiming to achieve a level of Beginner. Beginner level competency - Level 2 - at this level the student completes the patient scan satisfactorily whilst requiring direction most (or 60%) of the time.

Practical Assessment - Echocardiography Levels of Proficiency and Scoring Criterion

• Competent: Level 4 - Student completes the scan satisfactorily and seldom requires direction (20% or less) of the time
• Advanced Beginner: Level 3 - Student completes the scan satisfactorily and requires direction some (40% or less) of the time
• Beginner: Level 2 - Student completes the scan satisfactorily and requires direction most (60% or less) of the time
• Novice: Level 1 - Student completes the scan satisfactorily and requires direction and prompts all of the time. 

The Assessment Criteria will address the following areas of your performance:

• Pre-Examination Tasks
• Instrumentation
• Scanning Technique
• Measurement Technique
• Documentation
• Post-Examination Tasks
• Additional Tasks

In order to achieve an overall grade of 'Pass' in this assessment task, you must:

• undergo the assessment task by the dates listed,
• meet the minimum required scores,
• ensure the documentation is complete, and
• upload each completed assessment for into the unit Moodle site by the due date.

Clinical placement occurs in the professional workplace. As a clinical student you are provided access to that workplace on the condition that you demonstrate behaviours and attributes of a healthcare professional and present a positive image to the clinical facility's staff and clients. As a student in the medical sonographer profession in Australia, you are also required to be working toward consistent compliance with the Code of Conduct for Medical Sonographers. Clinical sites mention professional behaviour, particularly team work and empathy, as paramount in their decision to employ a sonographer. This assessment considers your ability to communicate professionally with a diverse cultural audience of patients, staff and the general public, demonstrate professional respect for all, and function as a reliable, well organised member of the health team.

Your clinical supervisor, or delegate, will be working in the sonography area with you, directly observing your day-to-day performance. These observations and collected feedback relate to your demonstrated knowledge, skills and behaviours over a span of time, not limited to a particular scan type or patient case. The observations and feedback are then used to complete the Global Assessment of Professional Attributes (GAPA) form provided (see below).

There are three main sections to the GAPA form:

• Section 1: initiative and communication

• Section 2: responsibility and demeanour

• Section 3: overall technical knowledge and skill

The first occurs at the mid-placement point, at the end of Week 8. Please submit to online via unit Moodle. For most students this will be Monday September 3rd, 2018 @ 4pm AEST. The mid-point GAPA assessment is formative, meaning its function is to provide you and your unit coordinator with formal documented feedback on your performance, and there are no minimum required scores related to your final grade. You are expected to use that feedback to reflect on your performance, develop an action plan to address any areas of performance that are not yet at the target level for this placement, and use the remaining weeks to achieve those targets. For any behaviour that you score well on at the mid-placement assessment, it is expected that you will continue to meet that level of performance or surpass it for the rest of the placement. I recommend that you print a few copies of the GAPA for your supervisor at the start of your placement.

The second and final GAPA assessment occurs toward the end of Week 16, the final week of the placement. Please upload and submit online via the unit Moodle by the first Monday following the completion of your clinical Placement. For most students this is Monday October 29th, 2018 @ 4pm AEST. The final GAPA assessment is summative, in that it's primary use is to evaluate and document your performance relative to the stated performance targets. Your final overall grade in this assessment depends on where you stand relative to those performance targets.

If minimum scores in the mid-placement GAPA are not met, you will be regarded as a 'Student at Risk'. The unit coordinator will contact you to advise you of the risk of failing ECHO13007 and provide formative feedback. You must respond to this email to show you understand the implications of this information and give details of your plans for immediate improvement. A phone call or clinical visit will follow. Review of your progress will be completed a short time after the mid placement GAPA, at a time requested by your supervisor or unit coordinator. Unsatisfactory scores at this second GAPA will result in a fail grade for ECHO13007. You will meet with the Head of Course to discuss the instigation of an individual learning contract for you with a view to remedying your scanning skills, technical issues and/or behavioural issues. It will provide you with details of individual learning goals which must be achieved within a given time-frame. The learning contract will detail learning objectives, available learning resources, strategies and methods which will be used to assess your progress. This will likely involve scanning skills labs for tuition and assessment on a regular basis. Each learning contract is individualised to the student and situation at hand.

Occasionally student behaviour is beyond acceptable risk to clinical sites. Clinical supervisors contact CQUniversity academics immediately when this occurs. A GAPA assessment is requested at this time (which could be at any time during your placement). If the outcome of this GAPA is unsatisfactory, and/or the site feedback indicates that they can no longer host you due to the risk incurred, then this one GAPA alone, or site refusal to host, will constitute a FAIL. Where such risk exists, your placement will terminate immediately. It is difficult to place such students in the clinical environment again and hence your continued progress within the echocardiography course may be at risk.

The criteria for assessment are detailed on the GAPA form in the form of required behaviours and attributes. Behaviour attributes assessed include: initiative and communication, responsibility and demeanor and overall technical knowledge and skill.

The assessor will use the stated 0-2 scale to indicate the frequency and extent to which you demonstrate each of those.

Score Descriptor of performance

• 0: Student does not demonstrate attribute, or demonstrates in an unacceptable manner
• 1: Student demonstrates attribute, but requires improvement
• 2: Student consistently (>60% of the time) demonstrates attribute to a high level

In order to achieve an overall grade of 'Pass' in this assessment task, you must:

• undergo both the mid-placement and end-of placement assessments by the dates listed,
• on the end-of-placement assessment, meet the minimum required scores
• ensure the documentation of each assessment is complete, and
• upload each completed assessment for into the unit Moodle site by the due date.

Clinical Attendance:

It is expected that you attend 100% of the time during your 16 week clinical placement to achieve the minimum 640 hours (16 X 40 hours) of direct echocardiography observance/ participation or related activities approved by your ASAR registered clinical supervisor or appropriately qualified medical practitioner. All hours worked must be entered into the clinical attendance form. This form must be signed by your clinical supervisor, or a sonographer delegated this task by your clinical supervisor. The clinical attendance form is available in the assessment block in the unit Moodle site. A copy has been emailed to your clinical site. Please print this form and read it carefully so you understand the criteria against which your clinical attendance will be evaluated.

Public holidays are included as hours worked. You can log 8 hours worked for each public holiday. These do not need to be 'made up'. Any time you are away from your clinical institution, you MUST supply a verifiable supporting document indicating why you have not attended. Both your clinical supervisor and the unit coordinator MUST be informed of any absences from your clinical placement. Any absence for part, or all of, a working day must be made up after, or during (e.g Saturday /evenings if available), the clinical placement.

You can submit 'outside clinical placement' hours completed between the end of your year 2 placement and the commencement of the year 3 placement if appropriate. The outside clinical placement attendance form is available on the unit Moodle site. Please note: the hours must be verified (signed) by an ASAR accredited sonographer or appropriately qualified medical practitioner. Details of either your insurance, or employment, must be entered onto the outside clinical placement attendance form. Outside clinical hours can not total more than half the required hours for this unit (320 hours or less).

Clinical Logbook:

You can submit 'outside clinical placement' log books dated between the end of year 2 placement and the commencement of year 3 placement. The outside clinical placement attendance form is available on the unit Moodle site. Please note: the logbook must be verified (signed) by an ASAR accredited sonographer or appropriately qualified medical practitioner. Details of either your insurance, or employment, must be entered onto the outside clinical logbook form.

Clinical Attendance:

To pass this assessment you must achieve a minimum of 640 hours (16 X 40 hours) of clinical attendance. Any days away from your clinical site must be documented.

At the end of the scheduled 16 weeks of placement, if you have not met the 100% attendance requirement AND you have documented justifiable grounds for your absenteeism, you will be provided additional scheduled time to make up the time you have missed. (This scheduled make-up time may not immediately follow the scheduled 16 week placement, and / or may not be at the same placement site, depending on clinical availability). At the end of the scheduled 16 weeks of placement, if you have not met the 100% attendance requirement AND you do not have documented justifiable grounds for the absence, you will score a 'Fail' for this assessment item.

Clinical Logbook:

You are required to keep a tally of the number of studies. Each case will be categorised into one of the following areas: Adult, Stress/ Dobutamine, Congenital, TOE, and Paediatric.

There is no minimum number of examinations required, however please track your numbers as to ensure some experience is happening under the different categories.

In order to achieve an overall grade of 'Pass' in this assessment task, you must:

• meet the minimum number of hours required on the attendance form,
• accurately record your studies in the clinical case log,
• ensure the documentation of each assessment is complete, and
• upload each completed assessment for into the unit Moodle site by the due date.

Qualified sonographers use experience and knowledge-based clinical intuition to assist in making clinical decisions. This helps them decide things such as - what questions to ask during history taking, where to focus their scan, how to extend the scan, what images to record and what to highlight in their report. This assessment aims at developing your clinical decision making capacity.

Kerry Thoirs and Jenny Sims, two well-respected educators in imaging, have adapted a clinical decision-making framework to support student sonographers to develop clinical decision making skills and structure clinical learning.
This assessment requires you to complete a clinical case report on an ultrasound examination that you have either performed, or taken part in, while undertaking this clinical unit. You are going to produce a clinical case report in the style described by Thoirs and Sim in their published article ‘Using a clinical decision-making framework to foster sonographer student learning in the clinical setting’. Using this framework, you will appraise your professional performance including sonographic knowledge, technical skill, professionalism, teamwork, communication skills and safe clinical practice to identify goals for continuing professional development.

Using the template provided, enter the details of a Case Study. It will be structured to include five components:

• Information gathering around the patient presentation;

• Hypothesis generation – the making of a tentative diagnosis based on the information gained in the previous component;

• Sonographic assessment to gather further information;

• The combination and cognitive synthesis of previous components to make a sonographic diagnosis; and

• Reflection and consolidation of learning from the case.

The Case Study will be assessed on the following components: pre-encounter and encounter components, hypothesis generation, hypothesis driven assessment, hypothesis evaluation, reflection, referencing, terminology, word count and grammar.

They will be graded as Excellent/Good, Average, or Poor/Fail. The Case Study is out of 100 marks. A grade of 50% is required to pass. Please see the marking sheet under the assessment block of the unit Moodle site. Case reports must be submitted with all identifying factors removed. Identifying factors include such things as patient name, date of birth and clinical site name for example. 

In the event that the first submission does not meet the minimum requirements as per the marking rubric, you will be provided with feedback and guidance by the unit coordinator. You will then have an opportunity to revise and resubmit the case study within one week of receiving feedback. 

You must ask yourself the following:

• Does your encounter data include cultural considerations, protocols around patient and sonographer safety, the consent process, pre-test history and an established purpose of the examination?

• When generating a hypothesis, does it include possible pathophysiology relevant to the sonographic examination, possible associated conditions, complications or mimics of the suspected condition? What is the most likely condition suggested by the pre-encounter data? What are the associated conditions? Which structures are most likely involved?

• Did the sonographic assessment include protocol, image optimisation techniques, possible modifications required due to patient presentation or sonographic findings? Did it include the additional data obtained?

• Did the sonographic diagnosis include normal and abnormal appearances, applicable reference measurements, and future pathways for the patient with this diagnosed condition? Have you described normal and abnormal findings and correlation with other information to provide us with the most likely diagnosis and alternatives?

• Did the reflection on the clinical decision making process include how you thought critically and a reflective analysis? What was done well, what could have been done better, was the examination complete, is there a gap in skills or knowledge? Is there an appropriate action plan?