Practicum (or Field Experience) - Diagnostic Medical Sonography/Sonographer and Ultrasound Technician

Class

Practical, general workplace training supported by an individualized learning plan developed by the employer, college, and student.

Course Learning Objectives

As outlined in the learning plan, apply the theory, concepts, and skills involving specialized materials, tools, equipment, procedures, regulations, laws, and interactions within and among political, economic, environmental, social, and legal systems associated with the occupation and the business/industry and will demonstrate legal and ethical behavior, safety practices, interpersonal and teamwork skills, and appropriate written and verbal communication skills using the terminology of the occupation and the business/industry.

Prerequisites: DMSO 1110; DMSO 1266; DMSO 1302; DMSO 1441

Co-requisites: DMSO 2243; DMSO 2253; DMSO 2305

Required Textbooks

Practicum II Clinical Packet

Course Progression

1. 1. Demonstrate and describe the operation of the ultrasound machine (F1, 2, 3, 4, 5, 7, 8, 9, 10, 11, 12, 14, 16, C3, 5, 11, 12, 13, 14, 15, 16, 18, 19, 20)
    1. Demonstrate how to power machine on and off properly
    2. Demonstrate how to safely insert and remove the transducer from the port
    3. Select transducer
    4. Discuss proper technique for applying sterile probe covers
    5. Input patient data and identify data on the hard drive
    6. Select each application-Abd, OB, Gyn- and demonstrate presets and calculations for each application
    7. Select option for multiple gestations
    8. Annotate on screen, erase word, and erase line
    9. Select dual/simultaneous and demonstrate clinical use
    10. Identify and adjust frequency, depth, gain and identify data on monitor
    11. Select Auto Optimize and describe its function
    12. Select proper TGC curve for abdominal application
    13. Select focal zone number and position
    14. Select zoom and demonstrate clinical use
    15. Perform two caliper measurements and delete the last measurement only
    16. Demonstrate caliper measurements for circumference measurements
    17. Edit measurements
    18. Identify and select button that returns exam to basic scan mode and identify and demonstrate update function
    19. Save image to storage device, to hard drive, to external as JPEG and delete an image from an exam
    20. Select and describe functions of the print button
    21. Select and vary the dynamic range, edge enhancement, post processing maps, and identify data on monitor
    22. Select and vary harmonics and identify data on monitor
    23. Choose M-mode and demonstrate a heart rate measurement
    24. Select pulsed wave Doppler and vary gain, baseline, scale (PRF), sample size, angle correct, invert, perform a velocity measurement, and identify values and date on monitor for all
    25. Demonstrate how to end an exam and recall images for post processing
    26. Demonstrate how to properly clean and disinfect transducers.

1. 1. Prepare patient for the sonography examination and analyze the information obtained for all sonographic exams performed (F1, 2, 3, 4, 5, 7, 8, 9, 10, 11, 12, 14, 16, C3, 5, 10, 11, 12, 13, 14, 15, 16, 18, 19, 20)
    1. Verify doctor orders and evaluates requisition
    2. Collect an evaluate all pertinent patient history and prior relevant examination and lab information
    3. Identify correct patient procedure and introduce self to patient
    4. Obtain a thorough and adequate history from the patient regarding their current and past relevant medical history, to include surgeries, lab tests, diagnostic tests, etc.
    5. Demonstrate critical thinking skills by integrating the information of the exam ordered, the relevant medical history and file, and the patient’s medical history in order to relate this information to the radiologist and ensure that the proper, thorough diagnostic sonography procedure is performed according to protocol
    6. Communicate with patient appropriately before, during, and after procedure
    7. Obtain relevant patient history; including signs, symptoms, risk factors, diagnostic tests, and lab results
    8. Correctly input patient identification information into ultrasound machine
    9. Select appropriate exam preset and transducer for the examination
    10. Select all controls to obtain diagnostic images
    11. Utilize additional patient positions and transducers as necessary to obtain appropriate diagnostic images
    12. Incorporate department scanning protocols and obtain appropriate images, documenting required anatomy and using standard views in the appropriate scan planes
    13. Label every image identifying appropriate scan plane and anatomy as required
    14. Perform required measurements using calipers appropriately
    15. Demonstrate proper and appropriate use of Doppler
    16. Survey the area(s) of interest and surrounding structures thoroughly
    17. Describe tissue characteristics using acoustic terminology
    18. Recognize, correct, and/or compensate for artifacts without impairing sonographic images
    19. Identify anatomy in visualized in all images when asked by radiologist or instructors
    20. Apply knowledge of anatomy and pathology in correlation with clinical sonographic findings to form a differential diagnosis
    21. Maintain proper ergonomics when scanning.
  2. Evaluate the liver and relational anatomy (F1, 2, 3, 4, 5, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, C1, 3, 5, 7, 10, 11, 12, 13, 14, 15)Evaluate the liver in multiple scan planes
    1. Evaluate the hepatic vessels in multiple planes
    2. Evaluate the vessels with color
    3. Evaluate the ligaments and fissures
    4. Evaluate the relational anatomy
    5. Measure structures as indicated using appropriate caliper placement
    6. Demonstrate good judgment in obtaining diagnostic images, including nonstandard views
    7. Evaluate abnormal sonographic findings and document appropriately
  3. Evaluate the gallbladder, biliary system and relational anatomy (F1, 2, 3, 4, 5, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, C1, 3, 5, 7, 10, 11, 12, 13, 14, 15)
    1. Evaluate the gallbladder in multiple scan planes and patient positions
    2. Evaluate the biliary ducts in multiple planes
    3. Evaluate the relational anatomy
    4. Measure structures as indicated using appropriate caliper placement
    5. Demonstrate good judgment in obtaining diagnostic images, including nonstandard views
    6. Evaluate abnormal sonographic findings and document appropriately
  4. Evaluate the spleen and relational anatomy (F1, 2, 3, 4, 5, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, C1, 3, 5, 7, 10, 11, 12, 13, 14, 15)
    1. Evaluate the spleen in multiple scan planes
    2. Evaluate the relational anatomy
    3. Measure structures as indicated using appropriate caliper placement
    4. Demonstrate good judgment in obtaining diagnostic images, including nonstandard views
    5. Evaluate abnormal sonographic findings and document appropriately
  5. Evaluate the pancreas and relational anatomy (F1, 2, 3, 4, 5, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, C1, 3, 5, 7, 10, 11, 12, 13, 14, 15)
    1. Evaluate the pancreas in multiple scan planes
    2. Evaluate the landmarks of the pancreas
    3. Evaluate the relational anatomy
    4. Measure structures as indicated using appropriate caliper placement
    5. Demonstrate good judgment in obtaining diagnostic images, including nonstandard views
    6. Evaluate abnormal sonographic findings and document appropriately
  6. Evaluate the urinary tract and relational anatomy (F1, 2, 3, 4, 5, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, C1, 3, 5, 7, 10, 11, 12, 13, 14, 15)
    1. Evaluate the kidneys in multiple scan planes
    2. Evaluate the bladder in multiple scan planes
    3. Evaluate the relational anatomy
    4. Evaluate the vascular anatomy, flow pattern, directions, and velocities of the aorta, renal arteries, renal veins, renal hilar flow, and renal parenchymal flow
    5. Measure structures as indicated using appropriate caliper placement
    6. Demonstrate good judgment in obtaining diagnostic images, including nonstandard views
    7. Evaluate abnormal sonographic findings and document appropriately
  7. Evaluate the aorta and relational anatomy (F1, 2, 3, 4, 5, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, C1, 3, 5, 7, 10, 11, 12, 13, 14, 15)
    1. Evaluate the aorta in multiple scan planes
    2. Evaluate the relational anatomy
    3. Measure structures as indicated using appropriate caliper placement
    4. Demonstrate good judgment in obtaining diagnostic images, including nonstandard views
    5. Evaluate abnormal sonographic findings and document appropriately
  8. Evaluate the abdomen complete and relational anatomy (F1, 2, 3, 4, 5, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, C1, 3, 5, 7, 10, 11, 12, 13, 14, 15)
    1. Evaluate the liver in multiple scan planes
    2. Evaluate the gallbladder in multiple scan planes
    3. Evaluate the aorta in multiple scan planes
    4. Evaluate the pancreas in multiple scan planes
    5. Evaluate the kidneys in multiple scan planes
    6. Evaluate the spleen in multiple scan planes
    7. Evaluate the relational anatomy
    8. Measure structures as indicated using appropriate caliper placement
    9. Demonstrate good judgment in obtaining diagnostic images, including nonstandard views
    10. Evaluate abnormal sonographic findings and document appropriately
  9. Evaluate an advanced competency and relational anatomy (F1, 2, 3, 4, 5, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, C1, 3, 5, 7, 10, 11, 12, 13, 14, 15)
    1. Choose two advanced competencies from the following list: thyroid, scrotum, guidance procedure, breast, breast pathology, or gastrointestinal and relational anatomy
    2. Evaluate the appropriate anatomy in multiple scan planes
    3. Evaluate the relational anatomy
    4. Measure structures as indicated using appropriate caliper placement
    5. Demonstrate good judgment in obtaining diagnostic images, including nonstandard views
    6. Evaluate abnormal sonographic findings and document appropriately

Absences

1. Clinical Requirements (Objectives I-X) 15%

You have been assigned a Master Competency Schedule. A master copy will be updated and maintained in your student file. You will have a copy and are also responsible for tracking your progress throughout the program. Some competencies are required within a semester and some competencies are required prior to graduation. Completion of SIX competencies are required to pass this course.

Students must document 4 breast ultrasounds (over the course of the program and) prior to graduation.

You must obtain a grade of 85% or higher to pass the competencies. You must complete all required competencies by the end of the scheduled rotation to receive a grade for the course. A competency attempt may be denied for any of the following reasons:

1. Failure to perform complete survey of areas of interest
2. Transducer plane backwards in any image
3. Overall poor quality of exam
4. Incomplete protocol (required anatomy not documented in images)
5. Items marked with an asterisk (*) on front page of competency paper work
6. Failing to have competency graded by a sonographer who holds credentials for the exam type being comped. (For example, a sonographer who is ARDMS credentialed in OB/GYN cannot grade an abdominal or vascular competency.)

I understand competencies must be performed with an appropriately credentialed sonographer.

Any of the following credentials from ARDMS, ARRT, and CCI are accepted for clinical instructors in the following areas:

1. 1. Abdomen: RDMS (AB), RT(S)
  2. OB/GYN: RDMS (OB), RT(S)
  3. Breast: RDMS (AB), RDMS (BR), RT(S)
  4. Vascular: RVT, RVS

You are only allowed 3 total attempts to pass a competency. If you fail 2 competencies, you will be required to undergo remediation in the lab. After the instructor feels you are ready, you may reattempt the competency. If you fail one additional time, you will fail the course.

If you are having difficulty completing competencies due to clinical volumes, you must communicate this with the Weatherford College Sonography faculty as soon as possible so accommodations can be made. You must communicate your concerns prior to having 75% of their clinical rotation complete. No accommodations can be made after this. Completion of competencies is your responsibility. Failure to progress will result in termination from the program.

2.Clinical Affective Evaluations (Objectives I-X) 40%

The clinical instructors at the clinical site will complete two Clinical Affective Evaluations on each student; at mid-rotation and at the end of the rotation. At least one evaluation should be completed from each site of rotation.

3.Portfolio Assignment (Objectives I-X) 25%

Each student will construct an abdomen portfolio. The portfolio should follow the Portfolio Assignment Guidelines located in your clinical packet and in the DMSO 1366 Canvas course.

4. Final Examination (Objectives I-X) 20%

Thyroid scan assessment exam.

5. Required Paperwork

Intro and Exit Letters to each clinical site (submit in Canvas)
Machine Optimization Checklist (Trajecsys) *completed at each site
Assess Clinical Service Area (Trajecsys) *completed at each site
Student Evaluation of Clinical Site(s) (Trajecsys) *completed for each site
5 radiologist contacts (Trajecsys)
Clinical Education Hours Completed (Trajecsys)
Daily Clinical Logs (Trajecsys)

Grading Standards:

A: 92-100%
B: 85-91%
C: 78-84%
F: <78%

Attendance:

Attendance is a significant predictor of success. Your attendance and behavior at the clinical site is the best way to promote yourself for future employment upon graduation. Attendance of every clinical day is expected. There are TWO days permitted for absence before the student’s grade will be reduced. Every absence over the two days will decrease the final grade for clinical by 10% per occurrence. Any missed time must be made up. Failure to make up clinical absences may result in failure of the course. You must clock in through Trajecsys on a computer at your clinical site or with your cell phone. If you clock in with your cell phone, the GPS must be activated so your location at clock in can be determined through the Trajecsys website.

You are expected to be at your clinical site, in the department, 5- 10 minutes early. You will be considered tardy if up to 5 (five) minutes of the scheduled rotation is lost at any time (i.e. arriving late or leaving early). Three tardies will comprise one absence. If you miss more than 15 minutes of the scheduled rotation, this will comprise an absence.

Disabilities

ADA Statement:

Any student with a documented disability (e.g. learning, psychiatric, vision, hearing, etc.) may contact the Office on the Weatherford College Weatherford Campus to request reasonable accommodations. Phone: 817-598-6350 Office Location: Office Number 118 in the Student Services Building, upper floor. Physical Address: Weatherford College 225 College Park Drive Weatherford, TX.

Academic Integrity

Academic Integrity is fundamental to the educational mission of Weatherford College, and the College expects its students to maintain high standards of personal and scholarly conduct. Academic dishonesty of any kind will not be tolerated. Academic dishonesty includes, but is not limited to, cheating on an examination or other academic work, plagiarism, collusion, and the abuse of resource materials including unauthorized use of Generative AI. Departments may adopt discipline specific guidelines on Generative AI usage approved by the instructional dean. Any student who is demonstrated to have engaged in any of these activities will be subject to immediate disciplinary action in accordance with institutional procedures.

Hope Statement

Any student who faces challenges securing basic resources such as food, clothing, or housing and believes this may affect their performance in their course of study is urged to contact the Director of Student Resources, Dr. Deborah Cregger, for support at (817) 598-6444. Her office is on the first floor of Student Services. If the student prefers, they may contact their instructor, who can reach out on their behalf. Weatherford College also provides the Coyote Pantry. The Pantry maintains boxed and canned foods for students in need. The location of the Coyote Pantry is two blocks west of the Weatherford campus at the Baptist Student Ministry (118 E. Park Ave., Weatherford). Pantry hours are Mon-Thurs. 8:30 am-4:30 pm and Fri. 8.30 am-12:00 pm (817-599-6586).

SCANS

The Secretary’s Commission on Achieving Necessary Skills (SCANS) identified Competencies in the area of Resources, Interpersonal, Information, Systems, and Technology; and foundation skills in the areas of Basic Skills, Thinking Skills, and Personal Qualities. This course is part of a program in which each of these Competencies and skills are integrated. The specific SCANS Competencies that are recognized throughout this course are noted at the end of the appropriate Competencies or task listed.