Curriculum Library

Work-based learning outcomes

Perform transthoracic echocardiographic examination to assess the size and function of the left ventricle.
Perform transthoracic echocardiographic examinations on patients with suspected mitral valve disease.
Perform transthoracic echocardiographic examinations on patients with suspected aortic valve disease.
Perform transthoracic echocardiographic examination to assess the size and function of the right ventricle.
Perform transthoracic echocardiographic examinations on patients with suspected infective endocarditis, pericardial effusion and cardiac masses.
Perform transthoracic echocardiographic examinations on adult patients with congenital heart disease.
Perform an appropriate transthoracic echocardiographic study in a critically unwell patient and identify any significant clinical findings.
Make appropriate measurements and interpret the ultrasound data, and produce high-quality reports.
Critically appraise current literature/research studies for general cardiac ultrasound and related topics, incorporating evidence-based practice.

Work-based competencies

Work-based assessments

You must complete
4 Case-based discussion(s)
4 of the following DOPS / OCEs

Assessment Title	Type
Quantify the degree of left ventricular dysfunction in a patient with regional wall motion abnormalities	DOPS
Measure valve area using the continuity equation.	DOPS
Quantify the degree of mitral regurgitation using a range of echo derived data	DOPS
Assess severity of an intracardiac shunt using echo derived date	DOPS
Produce a clear written report of an echo procedure.	DOPS
Generate high quality ultrasound images and take accurate measurements to assess cardiac function in a patient with regional wall motion abnormalities	OCE
Generate high quality ultrasound images and take accurate measurements to assess disease severity in a patient with aortic stenosis	OCE
Generate high quality ultrasound images and take accurate measurements to assess disease severity in a patient with mitral regurgitation	OCE
Generate high quality ultrasound images and take accurate measurements to assess adult patients with a secundum atrial septal defect	OCE
Demonstrate use of a stand alone CW probe pencil probe to measure aortic valve flow from the right sternal edge and suprasternal notch	OCE

Academic Content (MSc in Clincal Science)

Important information

The academic parts of this module will be detailed and communicated to you by your university. Please contact them if you have questions regarding this module and its assessments. The module titles in your MSc may not be exactly identical to the work-based modules shown in the e-portfolio. Your modules will be aligned, however, to ensure that your academic and work-based learning are complimentary.

Learning Outcomes

Describe the coronary anatomy and its correlation with 2D views of the left ventricle.
Describe and evaluate methods used to measure and evaluate left ventricular function and recognise normal and abnormal ventricular function.
Describe normal Doppler mitral valve filling patterns and normal ranges.
Recognise the appearance of complications after myocardial infarction.
Discuss the echocardiographic features and assessment methods associated with cardiomyopathies, valvular disease and ventricular dysfunction and the relationship to surgical treatments.
Discuss the pathology, causes and echocardiographic features associated with right ventricular dysfunction and pulmonary hypertension; endocarditis and the Duke criteria for diagnosing endocarditis; pericardial disease, cardiac masses, suspected acute pulmonary embolus and blunt/penetrating cardiac trauma.
Discuss the types of valve replacement, criteria of normality and signs of failure.
Describe the echocardiographic findings typically occurring in association with a hypotensive/shocked patient and post cardiac arrest.
Explain the use of echocardiography in the ventilated patient and post-surgery patient.
Evaluate and justify the criteria for the use of transoesophaegeal echocardiography.

Indicative Content

Anatomy and physiology of the cardiovascular system with particular reference to coronary anatomy
Measurement and evaluation of left ventricular function using echocardiography
Normal Doppler mitral valve filling patterns

Pathophysiology

Review of cardiovascular anatomy and physiology
Aetiology and echocardiographic features of cardiovascular pathophysiological conditions
Recognition and evaluation of cardiovascular disorders using cardiac ultrasound and Doppler imaging

Conditions

Emergency and ICU echocardiography

Environmental issues
Clinical findings
Constraints

Role of exercise echocardiography in assessing patients for surgery/balloon valvoplasty

Role of transesophageal echocardiography (TOE )in assessing valvular pathology to determine type of intervention

Role of echocardiography in the evaluation of effective function and dysfunction of prosthetic heart valves

Useful information

Clinical experiential learning - Module guidance

Number	Work-based learning outcome	Title	Knowledge
1	1,2,3,4,5,6,7	Control infection risks in accordance with departmental protocols.	View Ultrasound Imaging in Cardiac Disease - Competency 1 Control infection risks in accordance with departmental protocols. Knowledge and skills you might demonstrate Protocols and requirements for hygiene and infection control related to the relevant range of procedures, including preparation, conduct and completion of procedure. Protocol for hand washing and how effective hand washing contributes to control of infection.
2	1,2,3,4,5,6,7	Minimise risks and hazards in compliance with health and safety policies.	View Ultrasound Imaging in Cardiac Disease - Competency 2 Minimise risks and hazards in compliance with health and safety policies. Knowledge and skills you might demonstrate The relevant health and safety regulations specific to the cardiac procedure. The potential hazards and risks and the actions to be taken to minimise these. Relevant guidelines.
3	1,2,3,4,5,6,7,8	Treat patients in a way that respects their dignity, rights, privacy and confidentiality at all times.	View Ultrasound Imaging in Cardiac Disease - Competency 3 Treat patients in a way that respects their dignity, rights, privacy and confidentiality at all times. Knowledge and skills you might demonstrate The rights of the patient with regard to privacy and dignity, confidentiality of consultation and medical records. Requirements of patients with disabilities and special needs. Key factors influencing dignity, rights, privacy and confidentiality, including age, gender, culture and beliefs.
4	1,2,3,4,5,6,7,8	Review a suitably completed request form. Greet the patient, check patient identity and ensure that the patient’s identity is confirmed as correct and fully identified on each type of recording system for each procedure.	View Ultrasound Imaging in Cardiac Disease - Competency 4 Review a suitably completed request form. Greet the patient, check patient identity and ensure that the patient’s identity is confirmed as correct and fully identified on each type of recording system for each procedure. Knowledge and skills you might demonstrate The requirements for correct completion of request forms and how to validate the request. The importance of checking and confirming the patient identity and the implications of not doing so. Confirm compliance with pre-test instructions, if appropriate.
5	1,2,3,4,5,6,7	Select suitable technology for the procedure, choosing and adapting the appropriate diagnostic technique, patient position, machine settings and transducer for each patient.	View Ultrasound Imaging in Cardiac Disease - Competency 5 Select suitable technology for the procedure, choosing and adapting the appropriate diagnostic technique, patient position, machine settings and transducer for each patient. Knowledge and skills you might demonstrate Factors influencing the choice of technology for cardiac ultrasound imaging. Clinical indications for and contraindications to cardiac ultrasound imaging for patients with cardiac disease.
6	1,2,3,4,5,6,7	Set up appropriate equipment in preparation for each type of procedure, including resuscitation equipment where appropriate. Calibrate where necessary.	View Ultrasound Imaging in Cardiac Disease - Competency 6 Set up appropriate equipment in preparation for each type of procedure, including resuscitation equipment where appropriate. Calibrate where necessary. Knowledge and skills you might demonstrate Range of equipment used, relative merits and principles of measurement, including: recognition of the errors or potential risks of using defective equipment in clinical practice and the implications of use the application of relevant troubleshooting skills identification of common faults and remedial action current safety standards, including safety testing and routine maintenance requirements for set-up and calibration specific to that procedure. preparation of life support equipment, where appropriate.
7	1,2,3,4,5,6,7	Explain the full procedure to the patient and address any questions they may have relating to the procedure.	View Ultrasound Imaging in Cardiac Disease - Competency 7 Explain the full procedure to the patient and address any questions they may have relating to the procedure. Knowledge and skills you might demonstrate The pathophysiology of the heart and the appropriate choice of procedure, considering the findings from the history and clinical examination. Common questions and concerns of patients about procedures. Requirements for patient compliance with procedures, including pre- test instructions. Risks and benefits of undertaking the procedure. The information needs of patients pre, during and post procedure. The authority level for provision of information to patients.
8	1,2,3,4,5,6,7	Gain informed consent.	View Ultrasound Imaging in Cardiac Disease - Competency 8 Gain informed consent. Knowledge and skills you might demonstrate The importance of explaining the procedure to the patient and gaining informed consent. The relevant procedures and requirements for patient conformance. Clinical indications for and contraindications to cardiac ultrasound imaging. Principles, guidance and law with respect to informed consent.
9	1,2,3,4,5,6,7	Obtain a clinical history as appropriate for each procedure.	View Ultrasound Imaging in Cardiac Disease - Competency 9 Obtain a clinical history as appropriate for each procedure. Knowledge and skills you might demonstrate Framework for clinical history taking. Normal and abnormal pathology of the heart and associated structures. Pharmacological and non-pharmacological treatment of cardiac disease. Possible sources of clinical history information.
10	1,2,3,4,5,6,7	Take appropriate action to respond to the specific needs of the patient, as defined by department protocol.	View Ultrasound Imaging in Cardiac Disease - Competency 10 Take appropriate action to respond to the specific needs of the patient, as defined by department protocol. Knowledge and skills you might demonstrate Recognition of the contraindications to testing prior to the test, as defined by department protocol. Appropriate action to be taken in the event of adverse or unexpected events/responses. The range of needs of people with disabilities within a typical care pathway for a patient with cardiac disease.
11	1,8	Generate high-quality ultrasound images and take accurate measurements to assess cardiac function.	View Ultrasound Imaging in Cardiac Disease - Competency 11 Generate high-quality ultrasound images and take accurate measurements to assess cardiac function. Knowledge and skills you might demonstrate Basic measures of systolic function velocity time integral (VTI), fractional shortening (FS), left ventricular ejection fraction (LVEF); differentiation of diastolic filling patterns; complications after myocardial infarction; causes of a hypokinetic left ventricle. Features associated with cardiac conditions: hypertrophic cardiomyopathy hypertensive heart disease replacement heart values, including paraprosthetic regurgitation and prosthetic regurgitation.
12	2,8	Generate high-quality ultrasound images and take accurate measurements to assess the mitral valve using 2D planimetry, pressure half-time, gradient, severity of regurgitation, chamber size and signal density, proximal flow acceleration and vena contracta.	View Ultrasound Imaging in Cardiac Disease - Competency 12 Generate high-quality ultrasound images and take accurate measurements to assess the mitral valve using 2D planimetry, pressure half-time, gradient, severity of regurgitation, chamber size and signal density, proximal flow acceleration and vena contracta. Knowledge and skills you might demonstrate Echocardiographic features associated with mitral valve disease, including: rheumatic disease on the mitral valve mitral valve prolapse functional mitral regurgitation. Echocardiographic assessment of severity of regurgitation. Types of replacement heart valves and the advantages and disadvantages of each type.
13	3,8	Generate high-quality ultrasound images and take accurate measurements to assess the aortic valve, and recognise a significantly stenotic aortic valve deriving peak and mean gradients using continuous wave Doppler and measuring valve area using the continuity equation.	View Ultrasound Imaging in Cardiac Disease - Competency 13 Generate high-quality ultrasound images and take accurate measurements to assess the aortic valve, and recognise a significantly stenotic aortic valve deriving peak and mean gradients using continuous wave Doppler and measuring valve area using the continuity equation. Knowledge and skills you might demonstrate Echocardiographic features associated with aortic valve disease, including: bicuspid, rheumatic and degenerative disease dilation of the ascending aorta aortic dissection replacement heart values, including paraprosthetic and prosthetic regurgitation. Echocardiographic assessment of severity of regurgitation.
14	4,8	Generate high-quality ultrasound images and take accurate measurements to assess the right ventricle, recognising right ventricular dilatation, and estimate pulmonary artery systolic pressure and right atrial pressure from the appearance of the inferior vena cava.	View Ultrasound Imaging in Cardiac Disease - Competency 14 Generate high-quality ultrasound images and take accurate measurements to assess the right ventricle, recognising right ventricular dilatation, and estimate pulmonary artery systolic pressure and right atrial pressure from the appearance of the inferior vena cava. Knowledge and skills you might demonstrate Echocardiographic features associated with abnormalities of the right ventricle, including: pulmonary stenosis tricuspid stenosis heart failure.
15	5,8	Generate high-quality ultrasound images and take accurate measurements to assess patients with suspected infective endocarditis, a cardiac mass and pericardial disease, judging the route for pericardiocentesis.	View Ultrasound Imaging in Cardiac Disease - Competency 15 Generate high-quality ultrasound images and take accurate measurements to assess patients with suspected infective endocarditis, a cardiac mass and pericardial disease, judging the route for pericardiocentesis. Knowledge and skills you might demonstrate Echocardiographic features of: typical vegetations an abscess valve complications, e.g. perforation left atrial myxoma left ventricular thrombus and trabeculation pleural and pericardial effusion tamponade and restrictive physiology. Differentiation between pericardial constriction and restrictive myopathy. Route and procedure for pericardiocentesis.
16	6,8	Generate high-quality ultrasound images and take accurate measurements to assess adult patients with a secundum atrial septal defect and calculate a shunt.	View Ultrasound Imaging in Cardiac Disease - Competency 16 Generate high-quality ultrasound images and take accurate measurements to assess adult patients with a secundum atrial septal defect and calculate a shunt. Knowledge and skills you might demonstrate Echocardiographic features of secundum atrial septal defects. Cardiac embryology. Catheter/surgical treatment of atrial septal defects. Calculation of shunts.
17	7	Generate ultrasound images and recognise clinically relevant abnormality in critically unwell patients.	View Ultrasound Imaging in Cardiac Disease - Competency 17 Generate ultrasound images and recognise clinically relevant abnormality in critically unwell patients. Knowledge and skills you might demonstrate Echocardiographic findings in pulmonary embolus, trauma, underfilling, sepsis and mechanical ventilation.
18	1,2,3,4,5,6,7,8	Review the results from each test, taking into account artefacts, necessary adjustments of values and planned/unplanned events occurring during the test.	View Ultrasound Imaging in Cardiac Disease - Competency 18 Review the results from each test, taking into account artefacts, necessary adjustments of values and planned/unplanned events occurring during the test. Knowledge and skills you might demonstrate Identification of common artefacts. The effect and implications of artefacts on the procedure results and the actions needed to be taken to rectify them.
19	1,2,3,4,5,6,7,8	Compare the values/traces obtained with the normal range/values related to the procedure.	View Ultrasound Imaging in Cardiac Disease - Competency 19 Compare the values/traces obtained with the normal range/values related to the procedure. Knowledge and skills you might demonstrate Normal/abnormal left ventricular systolic function, including wall motion abnormalities and myocardial segments.
20	1,2,3,4,5,6,7,8	Produce a clear written report of the procedure.	View Ultrasound Imaging in Cardiac Disease - Competency 20 Produce a clear written report of the procedure. Knowledge and skills you might demonstrate Requirements for content and format of reports for cardiac ultrasound procedures.
21	1,2,3,4,5,6,7,8	Actively seek accurate and validated information related to evidence-based best practice with respect to cardiac ultrasound imaging.	View Ultrasound Imaging in Cardiac Disease - Competency 21 Actively seek accurate and validated information related to evidence-based best practice with respect to cardiac ultrasound imaging. Knowledge and skills you might demonstrate Sources of relevant information and methods of access.
22	9	Present the findings of a critical review of current published research literature for general cardiac ultrasound and related topics, incorporating evidence-based practice at your local departmental meeting.	View Ultrasound Imaging in Cardiac Disease - Competency 22 Present the findings of a critical review of current published research literature for general cardiac ultrasound and related topics, incorporating evidence-based practice at your local departmental meeting. Knowledge and skills you might demonstrate Critical analysis and literature review. Evidence-based practice. Presentation skills.

Ultrasound Imaging in Cardiac Disease (SPS121) Copy