Module - Ultrasound Science, Haemodynamics and Instrumentation (SPS128)
STP
Clinical experiential learning is the range of activities trainees may undertake in order to gain the experience and evidence to demonstrate their achievement of module competencies and assessments. The list is not definitive or mandatory, but training officers should ensure, as best training practice, that trainees gain as many of these clinical experiences as possible. They should be included in training plans, and once undertaken they should support the completion of module assessments and competencies within the e-portfolio.
Clinical experiential learning
- Prepare a portfolio of images from a series of patients that demonstrate the normal and diseased features of arteries and veins on B Mode, colour Doppler and the Doppler spectra (learning outcomes 1, 2 and 3).
- Critically appraise the effect of probe manipulation, pressure (compression) and technique on the quality of the images and spectra and reflect on how this may affect the diagnosis. A portfolio of evidence should include images obtained from a variety of anatomical locations (e.g. neck, abdomen, leg) and clearly demonstrate the effects of probe manipulation, pressure and technique on the longitudinal and transverse images (i.e. one optimised image may be accompanied by many suboptimal images).
- Critically appraise the effect of machine controls and processing options on the images and spectra and reflect on how this may affect the diagnosis. A portfolio of evidence should include images obtained with a variety of probes (e.g. curvilinear, linear, phased array) from a variety of anatomical locations (e.g. neck, abdomen, leg) and clearly demonstrate the effects of machine controls (e.g. frequency selection, depth, gain, focus, dynamic range, PRF, angle correction, frame averaging, sample volume size) and processing options (e.g. harmonics, compound imaging, speckle reduction) on the longitudinal and transverse images (i.e. one optimised image may be accompanied by many suboptimal images).
- Critically appraise the characteristic appearance of arteries and veins and reflect on how these images are altered in the presence of a variety of diseases. A portfolio of evidence should include images obtained from a variety of vessels (e.g. carotid artery, aorta, iliac artery, popliteal artery, femoral vein, long saphenous vein) and clearly demonstrate a range of pathology (e.g. mild atheroma, severe atheroma, calcification, aneurysm and thrombus) and the effects on the B Mode image, the colour image and the Doppler spectrum.
- Prepare a portfolio of images from a series of volunteers, patients or phantoms that demonstrate the artefacts present on B Mode, colour Doppler and the Doppler spectra (learning outcome 4).
- Critically appraise the impact artefacts have on accurately representing anatomy/physiology and reflect on the hindrance or usefulness of artefacts in a diagnosis. A portfolio of evidence should include images that demonstrate a range of artefacts, including reverberation, mirror image, beam width/slice thickness artefacts, shadowing, enhancement, spectral broadening, aliasing.
- Prepare a portfolio of images from a series of volunteers, patients or phantoms that demonstrate correctly labelled quantitative measurements on B mode images and Doppler spectra (learning outcome 5).
- Critically appraise the precision and accuracy of quantitative measurements and reflect how errors may affect the diagnosis. A portfolio of evidence should include images obtained with a variety of probes (e.g. curvilinear, linear, phased array) from a variety of vessels (arteries and veins), and clearly demonstrate the effect of machine controls (e.g. zoom, gain, angle correction) on measurements of distance, area and velocity.
- Critically appraise the relevance of labelling and recording images and reflect on how this affects the diagnosis. A portfolio of evidence should include images obtained from a variety of vessels (e.g. right and left carotid artery) with appropriate labelling.
- Prepare a portfolio of images (with transducer in air) to demonstrate the effect of the instrumentation controls and user input on the safety indices displayed (learning outcome 6).
- Critically evaluate the effect of manipulating various controls (e.g. power, depth, focus, Doppler) on the value of the safety indices and reflect how you may cause harm to a patient. A portfolio of evidence should include values obtained with a variety of probes (e.g. curvilinear, linear, phased array) for a variety of control settings, demonstrating the variation in safety indices values and where these exceed safety recommendations.
- Participate in routine QA measurements on a range of probes on an ultrasound imaging machine, including visual inspection, crystal drop-out, image uniformity, sensitivity, noise, calliper accuracy, dead zone, resolution (axial, lateral, slice thickness) and cystic target detection (learning outcome 7).
- Critically evaluate the QA results between different probes and reflect on how this may affect image quality and diagnostics accuracy. A portfolio of evidence should include your QA report and images demonstrating all the measurements on the different probes.
- Critically appraise the relevance of a QA programme for a vascular department and discuss with your trainer.