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. A 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 teamwork 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)
• Musculoskeletal

The daily form for the logbook must be verified and signed daily by your clinical site supervisor, radiologist, or a sonographer delegated by the clinical supervisor. The information of clinical cases needs to be entered in provided logbook spreadsheet daily.

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' logbooks dated between the end of year 2 placement and the commencement of year 3 placement. The outside clinical placement daily form and logbook spreadsheet are available in the assessment block in the unit Moodle site.

Please note: The daily form for the logbook must be verified and signed daily 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. The information of clinical cases also needs to be entered in provided logbook spreadsheet daily.

Minimum number

Students are required to record a minimum of fifty complete studies in any three of the six domains of practice (abdomen, superficial, breast, gynaecology/ obstetrics, vascular and shoulder) in entire 10-week placement, which is 150 cases in total. Each incomplete study is counted as 0.5 complete study. Please note these are the minimum numbers only, and ALL examinations that you participate in or perform are to be recorded.

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 be more than 200 hours in total, which is half of the required hours for this unit (400 hours).

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.

There are two tasks of this assessment. Task A is PowerPoint slides presentation in Zoom sessions. Task B is case report.

Task A

The Australian Sonographers Association (ASA) holds scientific conferences annually. Sonographers are invited to present their cases in ePoster format. The ePosters are displayed on large monitors within conference areas that offer maximum exposure to delegates. An ePoster can be used to provide an eye-catching visual display of a new technique, clinical insight, a case review/series or the results of original audit/research.

You will produce and present an ePoster in a style able to be present in the ASA conference. You will also mark for some ePosters presented by other students.

ePoster design

• Submitted only as a Microsoft PowerPoint presentation
• Must include title, content and reference slides. Content can be 3 to 5 slides. (5~7 slides in total).
• All slides to be in a ‘landscape’ format
• Font style and size (e.g. 16–24 points: should be large and clear enough to be easily read from a distance)
• Minimum resolution for graphics and images (72 dpi)
• Remember to consider that your colour scheme selection should be easy to read from a distance (contrast of text content with background colour)

ePoster content

The presented case must be from your own scanning case.

The topic can be (but not limited to) as below

1. Report of an interesting case (the same case can be used in task B case report assessment)
2. Summary of how to optimise the image setting with the physics explained, such as grayscale or doppler image (except total gain, TGC, depth and focus location), and demonstrate the difference in the images before and after.
3. Explain a scanning method(s) applied to overcome the obstacle encountered. (e.g. transducer manipulation, patient position, etc), and demonstrate the difference in the images before and after.
4. Discover or apply a technique for differential diagnosis (e.g. to find the origin of the lesion, nature of the lesion, etc), and explain the scientific reason(s) (e.g. anatomy, embryology, physics) .

ePoster presentation and marking

• You will need to present your own case in the allocated zoom session.
• You will also mark other students’ presentation based on the following simplified rubric.

• After each presentation, there will be a poll question in the MCQ format. You need to select the total mark you want to give to that presentation (except you own one).
• The detailed marking rubric for each presentation you marked need to be submitted in a spreadsheet format after the presentation session finishes.
• You need to nominate your presentation session and marking sessions before 18:00 (AEST) on the Monday of week 2 in your block. Otherwise the unit coordinator will allocate them for you.

Task B

The Australian Sonographers Association (ASA) publishes a scientific journal ‘Sonography’ as a commitment to ensure research is undertaken to provide an evidence base that supports the development of the profession.

A clinical case report is a written account of the diagnosis, treatment and follow up of an individual patient. It is a means of communicating something new that has been learnt in the clinical setting.

You will produce a clinical case report in a style able to be published in ‘Sonography’. The reported case must be from your own scanning case. Your article can relate to all aspects of the sonography profession. These may include, but are not limited to:

• Clinical scanning specialties e.g. abdomen and chest, breast, cardiac, musculoskeletal, obstetric, gynaecological, paediatric, small parts and vascular sonography.
• Non-clinical elements and workforce issues such as sonographer education and training, sonographer health and wellbeing.

The case report should be structured into headed sections as follows:

• Introduction
• Case Description
• Discussion
• Conclusion
  

This is a pass/fail assessment item. You must pass BOTH tasks of this assessment to pass this unit.

Task A

To pass this assessment, you must participate all the following components

1. Submit the PowerPoint slides before your allocated presentation time.
2. Present your own PowerPoint slides in the allocated session.
3. Attend at least 50% of the presentation sessions in the entire block.
4. Submit the total mark for each peer student you marked in the zoom poll during the zoom session.
5. Submit the detailed marking rubrics for each presentation with the spreadsheet file provided after each session ends.

Task B

The report requires five elements: a statement of why the case is worth reading about, an account of the case, with all relevant data, discussion of evidence that the case is unique or unexpected, possible alternative explanations for case features, conclusions with implications. The report should be 1000-1500 words and include 5 figures and at least 10 references in total.

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.

A marking rubric is available on the Moodle site.