Ultrasound

Recognition of Prior Learning

It is recognised that registrars working at, or seconding to Campbelltown ED, may already be competent in performing core emergency procedures.

Registrars who have achieved competency in other departments are required to submit documentation of accreditation, e.g. certificate or letter signed by previous term supervisor or director of training, to their term supervisors prior to commencement of term.

If documentation of RPL cannot be provided, registrars must provide a logbook of previous directly supervised and independent practice, and demonstrate competence in performing the procedure in a simulated environment, under direct supervision of their term supervisor.

If registrars cannot provide evidence of accreditation, or cannot perform the procedure in a simulated environment at the safe standard required, then they must embark on the Campbelltown ED Procedure Credentialing Pathway.

Step 1 - Course attendance

Trainee attends a certified ACEM and ASUM accredited focused ultrasound course prior to pathway commencement e.g. SonoTown. This should be done as early on in their training to allow for a longer experiential phase in order to achieve mastery of this procedure.

Trainees who have completed an accredited course more than 2-years ago are required to complete the online learning modules and case based quizzes. It is strongly recommended that all trainees complete the UTEC modules and ACEM quizzes at some point in their training, preferably as an advanced trainee.

Trainee uploads course completion certificate to shared folder for US clinical lead / faculty review, see instructions below.

Step 2 - focus Policies and guidelines

Trainee familiarises themselves with the following ACEM Standards of Focused US (FOCUS) in ED:

Trainee completes machine maintenance, image storage / transfer and disinfection quiz.

Step 3 - Direct Supervision & E-Logbook
Pathways for Accreditation: ACEM or ASUM

Trainee progresses through the ACEM Accreditation Pathway. The ACEM Credentialing Policy and information related to the ACEM US Special Skills Term can be found in the ACEM Accreditation Information link below.

Should the trainee wish to apply for ASUM Accreditation i.e. CCPU, DDU, then they will need to ensure all scans are clinically indicated and all scans are compared to a gold standard as illustrated below. More information can be found here.

Direct Supervision and E-Logbook

Trainee performs directly supervised FOCUS scans and enters these in their E-logbook.

The E-logbook stipulates the number of supervised scans required, minimum imaging sets, and the proportion of which need to be positive, clinically indicated and compared to a gold standard.

Trainee obtains the minimum imaging set required for each scan, and then labels and saves them.

Supervision of unaccredited scans

Unaccredited scans performed by trainees must be supervised either prospectively i.e. direct supervision while performing scan, or retrospectively i.e. trainee performs scan and images reviewed by supervisor. Supervisor will provide feedback during direct supervision.

Trainees cannot make clinical decisions based on unaccredited and unsupervised scans.

Clinical Governance

All images must be labelled (Surname, MRN, DOB, Indication, User initials) and stored for review.

Trainees should export their images to a USB on exam completion. The US Special Skills Term Advanced Trainee will transfer all stored images from the US machine to HDD storage device at the end of each month to ensure images are securely stored should the US machine malfunction. Stored images will assist with education, research, quality assurance and improvement initiatives.

Each scan MUST BE recorded in the patients case notes using the FOCUS scan templates below.

Step 4 - assessments

Trainee completes two (2) formative assessments (assessment for learning i.e. identify gaps in preparation for summative assessment):

  • Trainee performs scan under direct supervision.
  • Supervisor may assist and provide feedback during scan.
  • Supervisor provides feedback on scan completion.
  • Supervisor submits formative assessment form.

On completion of the E-Logbook and formative assessments, trainees will complete a summative assessment (assessment of learning):

  • Trainee performs scan under direct supervision.
  • Supervisor does not provide assistance or feedback during scan.
  • Supervisor provides feedback on scan completion.
  • Supervisor deems trainee competent or not competent to proceed with independent scanning.
  • Supervisor submits summative assessment form.
Step 5 - Pathway completion for scan type

On successful completion of the summative assessment, trainees will receive a soft copy and certificate certifying their competency in performing credentialed scan.

The completed E-Logbook and certificate will be added to the ACEM trainees CV, which has been developed by the DEMTs as part of their ITA process. The E-logbook and certificate of completion can be used to obtain accreditation in other departments.

Procedural Skill Maintenance

Trainees are required to complete 10 accredited scans every 12-months to maintain procedural competency.

Trainees are required to record independent scans in their E-logbook for review by term supervisor during ITA / End of term review process.

Pathway Summary