As you progress in your competence as a sonographer there are various 'stepping stones' by which you can measure your progress. This task is one such 'stepping stone'. You will demonstrate advanced beginner level competence in one of the required domains of practice, of which there are currently six (6).

In the previous clinical unit you demonstrated beginner competence in one domain of practice. In this unit you must complete the specified level of competence in a different domain of practice from the following:

• vascular (DVT or carotid Doppler)
• superficial structure (thyroid or testes)
• breast (female)
• musculoskeletal (shoulder)
• abdomen
• pelvic (TA and TV) in combination with / or an obstetric study from any trimester.

This assessment task measures your overall aptitude and competence in completing an ultrasound examination in one of these six domains of practice. This must be from a different domain of practice than you completed in MEDS12007. An pelvic assessment would be preferable but not mandatory.  You must achieve a level of 'advanced beginner' competence in performance of the chosen study type, as detailed in the assessment criteria. In this assessment you will demonstrate your ability to carry out all tasks of the ultrasound examination with some (40%) intervention, guidance or correction by the assessor.
This task will be assessed by your clinical supervisor, or a delegate sonographer using the proficiency scoring sheet provided. This form will be 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 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. You are only required to submit your successful attempt.

The assessment criteria will address the following areas of 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.
• Recognition and understanding of the relevant anatomy and pathology demonstrated.
• Ability to recognise the need to extend the clinical examination where appropriate.
• Accurate documentation and communication of findings.
• Occupational health and safety including ergonomics.

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.

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. 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. It is recommended that you print a few copies of the GAPA for your supervisor at the start of your placement.

The second GAPA assessment occurs toward the end of the final 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. As this placement is the second of four in the course, you should use this end-of-placement assessment as formative as well, to inform your plans for improvement in your third placement.

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 MEDS13006 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. Unsatisfactory scores at this second GAPA will result in a fail grade for MEDS13006.

If your second GAPA has resulted in a fail grade, 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.

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 of MEDS13006. 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.

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 attributes.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.

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.
Each case will be categorised into one of the following areas: Abdomen (including renal), Superficial Parts (thyroid, testes), 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.
The clinical case logbook and further information on how to complete the logbook and the minimum examination numbers required are available in the assessment block in the unit Moodle site.
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.
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 logbook form is available in the assessment block in the unit Moodle site.
Please note: The logbook must be verified (signed) by an ASAR accredited sonographer, radiologist or sonologist with industry recognised qualifications.
Details of either your insurance, or employment, must be entered in the outside clinical placement logbook.

Examinations: Minimum number

• The students are required to record a minimum of ten studies in any three of the six domains of practice (abdomen, superficial, breast, gynaecology / obstetrics, vascular and musculoskeletal).

  Please note these are the minimum numbers only, and ALL examinations that you participate in or perform are to be recorded.

You will pass this assessment if you achieve the following minimum numbers in your clinical case log by the conclusion of this clinical placement:

• You are required to record a minimum of ten studies in any three of the six domains of practice (abdomen, superficial, breast, gynaecology / obstetrics, vascular and shoulder).

PART A

You are about to enter the clinical environment for your second clinical placement to continue your preparation for your future as a sonographer. Qualified sonographers use experiential 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. You are going to begin the process of developing this clinical decision making capacity in this assessment. Kerry Thoirs and Jenny Sims,¹ 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 Sim¹ in their published article ‘Using a clinical decision-making framework to foster sonographer student learning in the clinical setting’. Using this framework will give you a chance to appraise your professional performance including sonographic knowledge, technical skill, professionalism, teamwork, communication skills and safe clinical practice to identify goals for continuing professional development.

The following section will detail the template outline for the clinical case report.

Task

Using the headings below fill out details of a scan. 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 full article is included on the unit Moodle site for you to read and refer to. The unit Moodle site contains a video explaining each component in detail and what is expected from this task.

PART B

As an accredited sonography student working in a health care facility you must possess the qualifications and experience to fulfill the requirements of your position.

Part B of your assessment task requires that you describe your current credentials in the form of a detailed curriculum vitae (CV). By completing this assessment task you will gain the ability to write CV applications for employment which will be useful to you throughout your professional career. It will also give you a chance to reflect on your achievements so far. This can be done by including any qualifications (including range and number of scans undertaken, practical assessments completed and clinical hours), work experience, voluntary activities or hobbies relevant to the role of a dedicated, caring health professional. After completion of your CV you will be able to appraise your professional performance including sonographic knowledge, technical skill, professionalism, teamwork, communication skills and safe clinical practice to identify goals for continuing professional development.

CV's which are too long rarely rate as highly as those that match length expectations. Your application will comprise your CV to a maximum of three pages.

Please note the following details:

Save/upload your file in Word format (.doc or .docx). Exceeding the length guide by 0.5 page / application component is acceptable in this component.

Further details will be available on the unit Moodle site.

Reference:

1. Thoirs K, Sim, J. Using a clinical decision-making framework to foster sonographer student learning in the clinical setting. Sonography. 2016;3;146-153. DOI: 10.1002/sono.12074

PART A

You must ask yourself the following:

• Does the information gathering include cultural considerations, protocols around patient and sonographer safety, consent process, information from reading the request, establishing the purpose of the examination?
• In the hypothesis generation does it include what condition can be identified from the examination requested, pathophysiology relevant to the sonographic examination, are there any associated conditions, complications or mimics of the suspected condition? Does it include conditions suggested by the pre-encounter data? What is the most likely condition? What are the associated conditions? Which structures are most likely involved?
• Does the sonographic assessment include protocol, image optimisation techniques, modifications required due to patient presentation or sonographic findings? Does it include sonographic and other patient data obtained during the examination?
• Does the sonographic diagnosis include normal and abnormal appearances, applicable reference measurements and, and future pathways for the patient with this condition? Have you described normal and abnormal findings and correlated with other information to provide us with the most likely diagnosis and alternatives?
• Does the reflection on the clinical decision making process include how you thought critically and a reflective analysis? What was done well, what could I have done better, was the examination complete, is there a gap in my skills or knowledge? An action plan?

Case reports must be submitted with all identifying factors removed. Identifying factors include such things as patient name, date of birth, medical record number and clinical site name for example.

PART B

• Does the CV include personal details, qualifications, clinical placements, other employment, extracurricular activities and referees?
• Does the CV include honesty in detailing skills and accomplishments.
• Explicit organisation in a logical way, so most recent, strongest or relevant are first
• Relevancy and prioritisation of content
• Correct use of grammar, spelling and punctuation?
• Adherence to the page limit?
• Correct use of terminology?
• Legible font (size 12).

A marking rubric [or listing of minimum requirements] will be posted on the unit Moodle site. 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 detailed feedback and guidance by the unit coordinator. You will then have an opportunity to revise and resubmit the report within two weeks of receiving feedback.

As a health care professional your attendance is relied upon for the provision of quality patient care. Your absence impacts service delivery and safe patient care. It is expected that you attend 100% of the time during your 10 week clinical placement to achieve the minimum 400 hours (10 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.
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. You must be either employed by the clinical site or engaged in a learning capacity which means you are supernumerary to the workplace requirements. The outside clinical placement attendance form is available in the assessment block in the unit Moodle site. Please note: The hours must be verified (signed) by an ASAR accredited sonographer, radiologist or sonologist with appropriate ultrasound qualifications.
Details of either your insurance, or employment, must be entered onto the outside clinical placement attendance form. Outside clinical hours cannot total more than half the required hours for this unit (200 hours or less).

To pass this assessment you must achieve a minimum of 400 hours (10 X 40 hours) of clinical attendance. Any days away from your clinical site must be documented.

At the end of the scheduled 10 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 10 week placement, and / or may not be at the same placement site, depending on clinical availability). At the end of the scheduled 10 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 'Fail' for this assessment item.