For this clinical placement you must complete a practical assessment measuring your overall aptitude and competence in completing an Echocardiogram.

You must achieve a level of Advanced Beginner' competence (Level 3) - Student completes the scan satisfactorily and requires direction some (40% or less) of the time, as detailed in the assessment criteria.

This task will be assessed by your clinical supervisor, or a delegate sonographer using the Practical Assessment Marking sheet provided on your Moodle site. Please provide a printed copy to your clinical supervisor at the commencement of your placement.

Please print this form and read it carefully so you understand the criteria against which your sonographic skill, and relevant theoretical knowledge, will be evaluated.

Discuss the best time to complete this assessment with your clinical supervisor. After the assessment ask for feedback so you can focus your efforts at improvement in the areas mentioned by your supervisor. If you do not meet the required standard on your first attempt, you must seek detailed feedback from your assessor so you can develop a strategy to improve your performance. You should share your plan for improvement with your assessor. You may then repeat this assessment and must achieve the required level. Your clinical supervisor must complete and sign the assessment form before you submit it through the assessment block in the unit Moodle site. The assessment must be attempted prior to completion of the clinical placement block.

You are permitted two attempts to complete this assessment task.

For attached competency level marking sheet please click here

This practical assessment is used to evaluate the development of the student’s ultrasound scanning abilities when undertaking a normal echocardiographic ultrasound examination.

During this clinical placement the student will be scanning real-life patients and will be assessed to an ‘Advanced Beginner’ level – requiring direction most (40% or less) of the time.

This assessment must be conducted before the end of the students’ clinical placement. As the student is permitted two attempts to complete this assessment, it is recommended that the first attempt takes place in the 14th week of the 16-week placement.

Please grade your student on each criterion according to how independent he or she is upon your direction and support. A score of 1 indicates that the student needs constant direction and advice, whilst a score of 4 indicates largely independent practice requiring direction or prompting only on complex or unusual cases.

Tick the grade best describing your student’s average performance in each area, and please describe a specific example of good performance or areas for improvement in the comments box on page 6. The student is aiming to achieve a level of ‘Advanced Beginner”. To achieve this level, the student must attain a minimum of thirty-four (36) scores of 3 (or higher) from the marking sheet.

Your clinical supervisor, or delegate, will be working in the echocardiography lab 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.

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

In each section there are multiple observable behaviours that you are required to demonstrate throughout your placement. Your assessor will score your performance based on how frequently and to what extent you demonstrate each of the listed behaviours. Your assessor is also encouraged to provide comments to expand on the scoring feedback. This assessment is performed TWICE during the placement – at the midpoint (week 8) and at the

completion (week 16). You are expected to use feedback given to you after the first GAPA 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 GAPA forms click here

Students are given a score for each for each of these behavioural attributes: Initiative and Communication, Responsibility and Demeanour, Overall Technicall Knowledge and Skill graded from 0-2. At the midpoint GAPA, the student should be given sufficient formative feedback to improve their behavioural performance if required. Any significant issues should be brought to the attention of the unit coordinator following the midpoint GAPA (or earlier if required). 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 ECHO20004 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 any time as requested by your supervisor or unit coordinator.

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 timeframe. 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.

The end-of-placement GAPA assessment is summative, in that its primary use is to evaluate and document your performance relative to the stated performance targets. The minimum required scores are listed in the Assessment Criteria section for the Global Assessment of Professional Atributes (GAPA) on your Moodle site.

The final GAPA at the completion of this placement, is a PASS/FAIL assessment item. To

PASS, the student must receive an overall score of 32 marks or more, from a potential of 44

marks, and additionally is not permitted any scores of 0. Unsatisfactory scores at this second GAPA will result in a fail grade for ECHO20004.

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.

Over the course of your 16 week clinical placement 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. Please print this form and read it carefully so you understand the criteria against which your clinical attendance will be evaluated. If you are away from your clinical institution during placement work hours, 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 supplement any defecit in log book hours with hours accrued from 'outside clinical placement'. You can submit the 'outside clinical placement' attendance form dated between the end of year 3 placement and the start of year 4 (first) placement.
Details of this are in the  'Outside Placement Hours' information tab 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 in the Outside Clinical Placement Attendance form on your moodle site.

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.

The clinical logbook serves as a record of the depth and breadth of experience you attained during the placement. It demonstrates the degree of progression of your skill development within and across examination type. You should analyse this record at regular intervals to assist in the formulation of learning goals that will support your achievement of the unit outcomes.
You are required to keep a tally of the number of studies observed, and either partially or fully completed. In the clinical log book, each case will be categorised into one of the following areas: Adult, Stress/ Dobutamine, Congenital, TOE, and Paediatric. In addition to clinical log book, students are required to complete an 'echo findings form'. This form documents referral indications and findings observed for all scans either fully or partially completed whist on placement. Complete the table and submit to your unit Moodle site with your Attendance Record.

For Clinical Logbook click here    For Echo Findings form click here

Should opportunities present, students are encouraged to take part in a broad range of cardiac focused clinical activities during their dedicated echocardiography placements. The focus of these clinical activities must support the development of echocardiography and cardiac physiology knowledge and skills. The student's ASAR registered supervisor must agree that exposure is relevant, and be happy to sign off on all hours of attendance. Any shortfall in hours of attendance, will otherwise have to be made up by the student. Students must prioritise echocardiography based practical skill sets, and accept responsibility for attaining competency levels appropriate to the end of each placement.

Please note: Each week of the logbook must be signed by your clinical site supervisor, cardiologist/radiologist, or an echocardiographer delegated by the clinical supervisor.

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

You will choose a clinical study which you have taken part in during this clinical placement and complete a clinical case study on it. The case study should be written 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’.The described published article and template are available on the unit Moodle site. Use the template provided on the Moodle site which is structured to include five components:

1. Pre-encounter and encounter components- information gathering around the patient presentation;

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

3. Hypothesis driven assessment- sonographic assessment to gather further information;

4. Hypothesis evaluation- the combination and cognitive synthesis of previous components to make a sonographic diagnosis; and

5. Reflection and consolidation of learning from the case. For guidance on these components click here

For clincal case study guidelines click here

Maintenance of patient confidentiality must be adhered throughout. The clinical information must be DE-IDENTIFIED for each case to protect patient privacy and confidentiality. Identifying factors include, but are not limited to, the clinical site name, patient name, identification number and date of birth, reporting cardiologist, clinical staff and referring doctor.

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.

The general format of a case report is as follows:

1. Pre-encounter and encounter components: These two components focus on information gathering, which involves sourcing information about the patient from patient records and from the patient directly. Students will also consider clinical, cultural, ethical and patient mobility information. Clinical supervisors assist the students in understanding the clinical context of the examination and factors that may impact on the technical appoach, safety of the patient and echocardiographer and the communication approach.

2. Hypothesis generation - In this component, the supervisor helps the student formulate the focus of the examination based on the previous information gathering components. This includes assisting with identifying possible conditions that might exist in the patient and prioritising those conditions based on discriminating clincal features.

3. Hypothesis driven assessment - This component refers to the echocardiogram examiniation and how it is conducted. It is formed by previous information gathering and hypothesis generating components and the knowledge of protocols and equipment that is used to undertake the scan. During the examination, additional information may be collected, which requires the examination technique to be modified. This may occur because of the physical and/or echocardiographic presentation of the patient. For example, echocardiographic appearances may be unfamiliar or confusing to the student or the image may be degraded because of body habitus, both of which will require a modified approach.

4. Hypothesis evaluation -In this section, the information that has been gathered in all of the sections above are integrated to form the echocardiographers report.

5. Reflection - This section of the framework is included for all students to self assess their performance and knowledge, including ethical, cultural or communication issues. With guidance from your supervisor, you can be encouraged to identify any unresolved issues by looping back to earlier parts of the framework to identify any gaps in the examination or your knowledge and to devise an action plan to adress those gaps.

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.

Evaluate the following:

• Does your encounter data include cultural considerations, protocols around patient and echocardiographer 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 echocardiogram 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 echocardiographic assessment include protocol, image optimisation techniques, possible modifications required due to patient presentation or echocardiogram findings? Did it include the additional data obtained?

• Did the echocardiographic 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?

Assessment criteria also includes using between 10 – 15 references, most from peer reviewed journal publications which lend weight to the academic discussion and conclusion. Aim for articles published in the past 5 years with no references greater than 10 years old.

• Referenced using Vancouver referencing style. Support materials for the Vancouver Referencing System are available in the course Moodle site.

• Number the pages, use headings and subheadings, use 1.5 or double spacing and a legible font.

• Within word count of 1500-2000 words. This does not include in-text citations, reference lists, appendices (if included), labels and titles for images, diagrams, tables & graphs. Word count – Words in excess of the 2000 word count will not be read / marked as part of the assessment.

• Submit the Clinical Case Study as a word document (doc., docx., not write protected) through the unit Moodle site so it is processed by Turnitin.

• You must pass this assessment to pass the course. The pass mark for this assessment is 50%.For marking RUBRIC click here

Undertaking a clinical audit, as part of a quality management process, occurs in all imaging practices on a cyclical basis. In this assessment, you will complete a small part of a clinical audit. Successful completion of this assessment is a course requirement of the Australian Sonographers Accreditation Registry (ASAR).

You will prepare a 2000 word (+/- 10%) report about quality management in a cardiac imaging workplace. This will include identifying adverse events, identifying contributing factors, near misses or potential adverse events and suggesting recommendations for quality improvement.

You will complete a report on actual or possible adverse events, near-misses, quality management factors, risk assessment and patient safety in a Cardiac Imaging Department. Your responses can include your own, or a colleague's experiences or observations in any clinical echocardiography environment.

This assessment task involves completing a series of tasks.

Many of these require understanding of quality management terminology and concepts to explain your experiences and recommendations. Explanations of terminology and the relevance of various findings are in your prescribed text. This text includes worked examples of many of your tasks. Other exemplars and resources are on the unit Moodle site. For exemplar click here