Practical Ultrasound Ultrasound

It is suggested you attempt this task by the end of week 4 of your clinical placement in case you need to repeat the assessment. You will need to plan this with your clinical supervisor. 

You are required to complete ONE (1) of the following four scanning skill exams during your clinical placement to achieve a 'beginner' level of competence:

·         Abdominal examination

·         Renal

·         Female Pelvic examination (TA OR TV)

·         Thyroid

Detailed assessment requirements will be provided to students, and a copy of the assessment form will be sent to the clinical site supervisor.

 This assessment task measures your overall aptitude and competence in completing ONE of EITHER an upper abdomen, trans-abdominal or transvaginal female pelvis, thyroid or renal ultrasound to 'beginner' competence level.

This task will be assessed by the clinical supervisor, or a sonographer / radiologist delegated this task by your clinical supervisor. Assessment will take place at your clinical site using the practical assessment form provided. A copy of the form has been emailed to your clinical site but it is advisable to 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 course Moodle site.
In this assessment you will demonstrate your ability to carry out all tasks of the ultrasound examination with intervention, guidance or correction by the assessor most of the time. The assessment must be attempted prior to completion of the clinical placement block

The Assessment Criteria will address the following areas your performance:

• Patient care and communication
• Pre-scan, scan and post-scan preparation and tasks
• Knowledge of instrumentation including optimisation of survey and images through appropriate selection of parameters and technique
• Interrogation of anatomy and acquisition of relevant images to demonstrate diagnostic sufficiency and completeness of information obtained
• Recognition and understanding of the relevant anatomy and pathology demonstrated
• Ability to recognise the need to and extend the clinical examination where appropriate
• Accurate documentation and communication of findings
• Occupational health and safety including ergonomics

For this clinical placement you are required to record all examinations. This includes scans you have performed part /or the whole of the examinations and not simply have observed them. The completed clinical logbook must be uploaded to your Moodle site assessment block by 4pm AEST Friday 9^th February 2018.The clinical logbook serves as a record of your depth and breadth of experience 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 course outcomes.

Each case will be categorised into one of the following areas: Abdomen (including renal), Superficial Structures (thyroid, testes, lumps / bumps, etc), Breast, Obstetrics (first, second or third trimester) & Gynaecology, Vascular (carotid, DVT or other) and Musculoskeletal. Each week of the logbook must be signed by your clinical site supervisor, radiologist, or a sonographer delegated by the clinical supervisor.  Copies have been emailed to your clinical site. Please print these forms/information sheets and read them carefully so you understand the criteria against which your logbook will be evaluated. The word version of your logbook is attached here.

You will pass this assessment if you logged a minimum of 5 scans (in any one of the above log book categories), of your clinical case log by the conclusion of this clinical placement:

During your placement, a total of 200 hours of attendance at clinical placement is required. Your clinical attendance form is a tally of the hours that you attend clinical placement, and must be verified (signed) by your clinical supervisor. This is your record of hours of clinical practice undertaken as part of this program.

It is expected that you attend 100% of the time during your 5 week clinical placement to achieve the minimum 200 hours (5 X 40 hours) of clinical attendance. 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.  A copy of the form 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 course 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.

Clinical Preparation Session- You were required to attend a half-day activity which prepares you for your term 3 clinical placement. This activity took place in term 2. This clinical preparation will outline expectations of your clinical supervisors and patients during your clinical placement. You will consider effective communication strategies with a range of patients and tasks associated with identifying pathology, sourcing information, extending the scan and oral reporting of findings. You must attend this session. A register of attendees will be taken. Attendees must also complete a reflection and feedback sheet.  When complete upload this to the unit Moodle site.

The pre-clinical session is a manditory component to the unit MEDS12007. If you are unable to attend, please submit a medical certificate for the date of the pre-clinical session and/ or contact the Unit co-ordinator Michael Borg.

To pass this assessment you must achieve a minimum of 200 hours (5 X 40 hours) of clinical attendance. Any days away from your clinical site must be documented. 
You must attend the clinical preparation session and complete a reflection and feedback sheet or provide a medical certificate for that specified 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 required to be in 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, and/or obtaining feedback from supervising sonographers who are doing so. 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.

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 occurs twice during the placement. The first occurs at the mid-placement point, at the end of Week 2. The mid-placement GAPA assessment is formative, meaning its function is to provide you and your unit coordinator with formal documented feedback on your performance, but 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.

The second GAPA assessment occurs toward the end of Week 5, the last week of the placement. 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 below. Your final overall grade in this assessment depends on where you stand relative to those performance targets.

The GAPA form and marking criteria is available in the assessment block in the unit Moodle site. A copy has been emailed to your clinical site but it is advisable to 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 professional behaviour will be evaluated. Your clinical supervisor (or designated assessor) will meet with you after completing each assessment to discuss it with you. This is your opportunity to get clarification on any score or comment on the assessment. Once you have had that discussion, you both need to sign and date the assessment. You should complete a brief summary of the discussion. You need to ensure that each completed assessment form has all required documentation, including the name, dated signature and registration number of your assessor as well as your dated signature. Your supervisor will provide you with a copy of the completed assessment form. You will then scan it and upload the file into the unit Moodle site using the link provided.

It is your responsibility to ensure that you remind your clinical supervisor at least a week prior to the assessment that it needs to be done, and book a meeting with him/her toward the end of the week that the assessment is due.This gives your supervisor the opportunity to collect feedback and to designate an alternate assessor if he/she will not be available.

If there are extenuating circumstances at the clinical facility that prevent you from being assessed during the required weeks, you must contact the unit coordinator in a timely manner. This will require obtaining approval for an assessment extension. It is also your responsibility to ensure regular access to the technology needed to upload your assessment by the submission due dates. In the absence of an approved assessment extension, if you have not met all of the requirements listed in the Assessment Criteria section by the stated due dates, you will fail this assessment, and because this is a pass/fail course that means you will receive a Fail grade for the unit.

On occasion, clinical sites inform us of student behaviours which either: Compromise the reputation of the clinical site and/or the University, Compromise patient / staff safety and/or well-being. In these instances students are notified that they must cease attendance at the clinical site and discuss their position with the unit coordinator and discipline lead. This may result in student behavioural misconduct procedures in line with the CQUniversity Student Behavioural Misconduct Procedure.

The criteria for assessment are detailed on the GAPA form in the form of required behaviours and attributes. The assessor will use the stated 1 - 6 scale to indicate the frequency and extent to which you demonstrate each of those.The required behaviours and attributes are grouped into 3 sections, each with its own minimum required scores.

For Section 1: Initiative and Communication, which has nine required behaviours, the minimum required set of scores are:

• no more than 1 score of 'No or insufficient opportunity to assess' (NA),
• no scores of 1 or 2,
• no more than 1 score of 3, and
• the remainder of behaviours scored at 4 or higher.

For Section 2: Responsibility and Demeanour, which has ten required behaviours, the minimum required scores are:

• no more than 1 score of NA,
• no scores of 1, 2 or 3,
• no more than 4 scores of 4, and
• the remainder of behaviours scored at 5 or higher.

For Section 3: Overall Technical Knowledge and Skill, which has three required behaviours, the minimum required scores are:

• no scores of NA and
• all behaviours scored at 4 or higher

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 due dates listed,
• on the end-of-placement assessment, meet the minimum required scores in all three sections,
• ensure the documentation of each assessment is complete, and
• upload each completed assessment form into the unit Moodle site by the due date.

If minimum required scores in the mid-placement GAPA are not met, you will be regarded as a "Student At Risk". The unit co-ordinator will contact you to advise you of the risk of failing MEDS 12007 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 visit will follow.

Review of your progress will be completed a short time after the mid placement one, at any time as requested by your supervisor or unit coordinator. Unsatisfactory scores at this second GAPA will result in a fail grade for MEDS12007.

Occasionally student behaviour is beyond acceptable risk to clinical sites. Clinical supervisors contact CQUniversity academics immediately when that 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 of MEDS12007. Where such risk exists your placement will terminate immediately. It is difficult to place such students in the clinical environment again. Your continued progress within the sonography course may be at risk.

Reflection and Goal-Setting

Students are required to complete a written reflection on their scanning skills, problem solving and communication of findings related to a clinical case. They identify personal goals for improvement and reflect on their progress during the clinical placement. Your ability to recognise pathology, record findings, extend the scan appropriately and arrive at a differential diagnosis which you communicate to others is key to your success as a sonography professional. This task will also assess your goal-setting for your own development. In order to complete this task you must keep a note of your progress using:

1. the pathology knowledge or identification / performance (problem solving abilities / scanning skill) reflective flow-chart,
2. the communication of findings / interaction reflective flow chart.

Task
Reflect upon your level of pathological knowledge, clinical problem solving, scanning skill and communication during the first three weeks of this placement based upon discussions with your supervisor concerning the four reflective flow-charts.

• Detail your strengths and areas in need of improvement.
• Based on this reflection, create a development plan for your next 2 weeks of clinical placement.
• Set “SMART” goals – that is the goals are Specific, Measurable, Achievable, Relevant and Time-specific.

Ensure that any goals set here may be completed within the next two weeks of this clinical placement.
Complete three SMART goals using the template provided.  
Two goals should be pertinent to the pathology knowledge / Performance (problem solving abilities / scanning skill) reflective flow-chart. 
One goal must relate to the communication of findings / interaction reflective flowchart.
At the end of your clinical course:

• Reflect on each SMART goal and describe if you reached your goal, what you did to achieve this, or if you did not reach your goal, why you did not and what you could have done to ensure success.
• Describe how these goals have assisted in your continuing development as a sonography professional.

The reflection on the success of each goal must be written at the end of the relevant goal sheet.
Aim for 500 words as a limit +/- 10% for each of the three goal descriptors of your achievement and what you did.
As a reflective report, it is acceptable to use the first person for this piece, but all external sources must be correctly referenced. You can include drawn reflective flow charts appropriate to your reflections in an appendix. Both the reference list and appendix do not form part of the word count limit.
Below is an example of this assessment completed to a requirements met (pass) standard with the corresponding completed marking rubric.

This assessment is assessed upon:

• Discussion regarding your perceived gaps in pathology knowledge, scan performance or communication.
• Development of three relevant SMART goals based upon your reflection and feedback
• Discussion on what you did to achieve these goals.
• Reflection upon how the goals have affected your development and your own learning journey
• Referencing

 You are required to achieve a 'requirements met' score in all areas of the marking rubric. In the event that the first submission does not meet minimum requirements as per the rubric, you will be provided with feedback and guidance by the course coordinator. You will then have an opportunity to revise and resubmit the report within one week of receiving feedback.