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Page 1 of 26 12/17
Australasian Society for Ultrasound in Medicine
P (61 2) 9438 2078 F (61 2) 9438 3686 E asum@asum.com.au W www.asum.com.au
ACN 001 679 161 ABN 64 001 679 161
Australasian Society for Ultrasound in Medicine (ASUM)
Certificate in Point of Care Ultrasound (Rheumatology)
(ACPoCUS)
CURRICULUM
Page 2 of 26
Australasian Society for Ultrasound in Medicine
P (61 2) 9438 2078 F (61 2) 9438 3686 E asum@asum.com.au W www.asum.com.au
ACN 001 679 161 ABN 64 001 679 161
Table of Contents
Introduction: Who is the Australasian Society for Ultrasound in Medicine Certificate in Point of Care Ultrasound (Rheumatology) for?......………………………………………………….......
3
Capability Statements (CS)………………………………………………………………………….. 4 Overview of ACPoCUS (Rheumatology) Curriculum………………………………………….. 5
Core Units………………………………………................................................................ 5 Expected experiences and learning opportunities..………………………………………. 7
Clinical Supervisor requirements………………………………………………………………… 8 Assessments in simulation environments……………………………………………………… 9 CORE UNITS ACPoCUS (Rheumatology)……………………………………………………….. 10 Unit 1: Fundamentals of Ultrasound Practice………………………………………………….. 10
Aim……………………………………………………………………………………………… 10 Learning objectives…………………………………………………………………………... 10 Assessments………………………………………………………………………………….. 12 Resources/suggested learning activities…………………………………………………... 13
Unit 2: Needle Guidance Techniques…………………………………………………………….. 13 Aim……………………………………………………………………………………………… 14 Learning Objectives…………………………………………………………………………... 14 Core knowledge and skills to be achieved…………………………………………………. 14 Assessments………………………………………………………………………………….. 15 Resources/suggested learning activities…………………………………………………... 15
CORE CLINICAL UNITS……………………………………………………………………………... 15 Unit 3: Assessment of Upper Limb……………………………………………………………….. 15
Aim……………………………………………………………………………………………… 15 Learning Objectives………………………………………………………………………….. 16 Assessments………………………………………………………………………………….. 18 Resources/suggested learning activities…………………………………………………… 19
Unit 4: Unit 4: Assessment of Lower Limb……………………………………………………… 19 Aim……………………………………………………………………………………………… 19 Learning Objectives………………………………………………………………………….. 19 Assessments………………………………………………………………………………….. 22 Resources/suggested learning activities…………………………………………………… 23
Unit 5: Portfolio of Clinical Competence in PoCUS (Rheumatology)………………………. 23 Aim……………………………………………………………………………………………… 23 Requirements…………………………………………………………………………………. 23 Assessments………………………………………………………………………………….. 24 Final holistic clinical assessments………………………………………………………….. 24 Submission of completed Portfolio of Clinical Competence to ASUM for consideration of award of ACPoCUS………………………………………………………………………..
24
References…………………………………………………………………………………….. 25 APPENDIX 1…………………………………………………………………………………………… 26 Optional/additional clinical units……………………………………………………………………… 26 Additional Unit for ACPoCUS (Rheumatology)………………………………………………… 26
Page 3 of 26
Australasian Society for Ultrasound in Medicine
P (61 2) 9438 2078 F (61 2) 9438 3686 E asum@asum.com.au W www.asum.com.au
ACN 001 679 161 ABN 64 001 679 161
Introduction: Who is the Australasian Society for Ultrasound in Medicine Certificate in Point
of Care Ultrasound (Rheumatology) for?
The Australasian Society for Ultrasound in Medicine (ASUM) is the peak body for setting and
maintaining standards for ultrasound practice in Australia and New Zealand. ASUM provides
credentials that certify practitioners as meeting the required standards based on the following
principles:
Maintenance of the highest standards of patient safety and confidence in the ultrasound
profession.
Only those practitioners who are suitably trained and qualified to practise in a competent
and ethical manner are credentialed to do so.
Risk to patient safety is minimised through robust, transparent, flexible and adaptable
processes of credentialing.
An ASUM Certificate in Point of Care Ultrasound (ACPoCUS) (Rheumatology) certified practitioner
utilises ultrasound for specifically focussed, diagnostic and/or procedural guidance purposes across
a range of core clinical applications as defined by the 2017 European League Against Rheumatism
(EULAR) standardised procedures for ultrasound imaging in rheumatology1.
The training, credentialing and scope of practice for ACPoCUS practitioners is of a separate and
different nature to the processes used to credential practitioners who perform what are often termed
“comprehensive” ultrasound examinations.
In recognition of the rapidly evolving and broadening use of ultrasound in point of care, focussed
clinical applications, ASUM credentialing provides:
processes that are, wherever possible, evidence-based and in accord with standards of
similar professional bodies and regulators;
a potential pathway for further development of knowledge, skills and research for
practitioners, along with advanced recognition of such further development;
a potential pathway for advocacy for Government recognition of the credentials obtained.
The ACPoCUS is designed for those practitioners who wish to demonstrate, through the certification
process, that they possess knowledge, skills and competence in the clinical application of focussed
ultrasound examinations, suitable to their clinical scope of practice. Practitioners would also be
expected to further develop and enhance their skills and knowledge, as applicable to their scope of
practice, and continue this development with further certification of additional and/or enhanced
skills.
Candidates for the ACPoCUS (Rheumatology) would usually be rheumatology specialists or other
specialists with a particular interest in, and area of practice of, treatment of disease and
inflammatory conditions of the muscles, joints, tendons, ligaments, soft tissues and bones of the
body and extremities.
Given the potentially wide range of possible clinical indications a practitioner may encounter, a
candidate is required to have access to a clinical supervisor/s who can advise and monitor the
candidate’s clinical knowledge and skill development, and ensure the practitioner only undertakes
Page 4 of 26
Australasian Society for Ultrasound in Medicine
P (61 2) 9438 2078 F (61 2) 9438 3686 E asum@asum.com.au W www.asum.com.au
ACN 001 679 161 ABN 64 001 679 161
unsupervised ultrasound examinations once they have demonstrated advanced beginner level
competence2 for the specific application.
Candidates are expected to develop and demonstrate knowledge, skills and competence in the:
underpinning fundamental principles of ultrasound practice
sonographic/psychomotor skills required to produce a relevant and diagnostic examination (image acquisition)
ability to interpret (image interpretation) the ultrasound findings in the clinical context and
ability to communicate the clinical and ultrasound findings in a way that supports accurate, timely clinical management of the patient’s condition (clinical integration).
Capability Statements (CS)
The broad level knowledge, skill and abilities required of a practitioner awarded the ACPoCUS
includes, but is not limited to:
1. Use and care of ultrasound equipment including: underpinning theoretical knowledge of relevant physics and instrumentation; ultrasound bioeffects and safety issues.
2. Understanding and demonstration of psychomotor and other skills involved in producing and recognising an accurate and valid ultrasound examination and resultant data (the “sonographic process”).
3. Detailed anatomy, physiology and pathology as related to the ultrasound examinations relevant to the practitioner’s area of practice.
4. Accurate recognition and evaluation of sonographic appearances and information relevant to the practitioner’s specific area of practice including: normal anatomy; normal variants; artifacts; abnormalities.
5. Accurate critical analysis of information and ability to determine appropriate provisional diagnosis/diagnoses as a result of the ultrasound examination and in conjunction with other available clinical information as relevant.
6. Recognition of any limitations of the ultrasound examination and the effect of this on patient clinical management.
7. Ability to critically analyse findings and determine the need for further information such as: referral for more detailed ultrasound examination and diagnosis; other diagnostic tests; further clinical information; follow-up examinations.
8. Understanding of, and the ability to apply, any professional, ethical and legal issues that may be particularly relevant/unique to the ultrasound processes.
9. Understanding of, and commitment to, requirements for continuing professional development, especially as related to the use of ultrasound in their clinical practice.
10. Ability to communicate with patients/clients and colleagues in a manner that is timely, relevant and appropriate to the circumstances.
11. Ability to record ultrasound findings in the clinical record in a timely and accurate manner to facilitate appropriate continuity of patient care.
Page 5 of 26
Australasian Society for Ultrasound in Medicine
P (61 2) 9438 2078 F (61 2) 9438 3686 E asum@asum.com.au W www.asum.com.au
ACN 001 679 161 ABN 64 001 679 161
Overview of ACPoCUS (Rheumatology) Curriculum
The ACPoCUS (Rheumatology) curriculum is focussed on assessment of clinical competence in the
core areas of the scope of practice. Much of the underpinning knowledge of anatomy, pathology
and clinical medicine relevant to the area of practice is assumed knowledge and this theoretical
knowledge base is not the focus of the assessments.
Candidates are expected to familiarise themselves with the requirements of the certification process
and the professional responsibilities of themselves and their supervisor/s prior to enrolment as a
candidate. To facilitate this Candidates are expected to read this curriculum document in
conjunction with the ACPoCUS Candidate’s Education and Clinical Experience Handbook and the
ACPoCUS Clinical Supervisor Handbook.
Core units
The ACPoCUS (Rheumatology) core units are:
Unit 1: Fundamentals of Ultrasound Practice
Unit 2: Needle Guidance Techniques
Unit 3: Assessment of Upper Limb
Unit 4: Assessment of Lower Limb
Unit 5: Portfolio of Clinical Competence in PoCUS (Rheumatology)
The EULAR standardised procedures1 advise the above areas as being core areas of clinical
ultrasound competence required by specialists using focussed ultrasound in clinical rheumatology
settings. Other areas may also be assessed, dependent on the practitioner’s scope of practice
including, but not limited to: peripheral nerves, salivary glands and vascular assessment.
Candidates are encouraged to undertake optional additional clinical units as applicable to their
scope of practice. Refer to Appendix 1 for information regarding additional/advanced units
available.
To be awarded an ASUM ACPoCUS (Rheumatology) a candidate must fulfil the following
requirements:
Step 1:
Enrol in ACPoCUS with ASUM
Nominate clinical supervisor/s for ASUM approval (refer to the Candidate’s Education and Clinical Experience Handbook and the Clinical Supervisor’s Handbook for details)
Commence ACPoCUS portfolio (refer to refer to the Candidate’s Education and Clinical Experience Handbook for details).
Page 6 of 26
Australasian Society for Ultrasound in Medicine
P (61 2) 9438 2078 F (61 2) 9438 3686 E asum@asum.com.au W www.asum.com.au
ACN 001 679 161 ABN 64 001 679 161
Step 2:
Candidate identifies own learning needs and suitable educational opportunities, preferably in consultation with supervisor and/or other suitable advisor
Commence education and training in PoCUS
Commence recording examinations performed in simulation/training sessions on “model” patients in clinical record log (logbook) as part of the portfolio.
Step 3:
Have basic US skills, in relevant core clinical unit/s assessed as being at level of novice practitioner3 in simulation setting (Formative Assessment 1)
Achieve satisfactory result on Fundamentals of US Practice Quiz 1 (see separate definitions of quizzes in Unit 1: Fundamentals of Ultrasound Practice)
Commence clinical US examinations in clinical setting under supervision
Commence recording actual clinical examinations in clinical record log (logbook).
Step 4:
As skills and knowledge increase, undertake further education and training for increasing development and application of skills – learning needs identified by candidate in consultation with supervisor and/or other suitable advisor
Satisfactorily complete Fundamentals of US Practice Quizzes 2 and 3
Undertake education and training in the application of US techniques to needle/procedural guidance techniques.
Satisfactorily complete the following assessments in Unit 2: Needle Guidance Techniques: o Formative assessment of clinical skills (may be in simulated environment) o Summative assessment of clinical skills (may be in workplace or in a simulation
setting).
Step 5:
For each core clinical unit (Assessment of Upper limb, Assessment of Lower Limb) satisfactory completion of the following assessments is required:
o Formative assessment of clinical skills x 2 (see specific unit for requirements) o Summative assessment of clinical skills x 2 (see specific unit for requirements) o On-line interpretive, case-based scenario analysis quiz o Experience of specified type/number of cases as verified in clinical record log in the
portfolio.
Satisfactorily complete the final holistic on-line interpretive, case-based scenario analysis quiz to cover all core clinical areas of the ACPoCUS (that is: Assessment of Upper limb, Assessment of Lower Limb). The quiz is to assess that a candidate can satisfactorily demonstrate competence level skills in:
o image interpretation and o clinical integration of the ultrasound data.
Satisfactorily complete the final holistic summative clinical competence assessment (based on “global rating scale”3,4) of holistic clinical focussed/point of care ultrasound competence to include:
Page 7 of 26
Australasian Society for Ultrasound in Medicine
P (61 2) 9438 2078 F (61 2) 9438 3686 E asum@asum.com.au W www.asum.com.au
ACN 001 679 161 ABN 64 001 679 161
o overall psychomotor and sonographic skill, including satisfactory use of equipment; o interpretation of ultrasound findings; o due regard for patient comfort and care at all times; o integration of ultrasound examination into patient clinical management; o demonstrated understanding of role and limitations of PoCUS; and o safe and appropriate clinical practice across the core clinical applications
(Assessment of Upper limb, Assessment of Lower Limb).
Step 6:
Submit Portfolio of Clinical Competence to ASUM for consideration of award of ACPoCUS
Portfolio to consist of:
o Evidence of attendance at relevant formal teaching and learning experiences o Clinical record log verifying required scan numbers/type for all core clinical units as
defined in the curriculum o Completed formative and summative assessments for Unit 2: Needle Guidance
Techniques, with the final summative assessment being at the Advanced Beginner2 level
o Completed formative and summative clinical assessments for each specified core clinical unit with final summative assessment for each core unit at “competent” level2
o Completed final holistic summative clinical competence assessment (global
rating scale3,4) by supervisor or other approved person at “competent” level2 o Evidence of satisfactory level of achievement of the following:
Fundamentals of US Practice quizzes x 3 Case-based scenario analysis quiz x 1 for each core clinical unit Final holistic on-line interpretive, case-based scenario analysis quiz.
Step 7 (Optional):
Candidates may choose to undertake optional additional clinical units suitable to their scope of practice needs.
These may be undertaken in conjunction with the core ACPoCUS units or at a later time.
All assessment requirements, as defined in the relevant description of the unit, must be met for optional additional clinical units.
Optional additional clinical units assessed as satisfactorily completed can be notated on the ASUM issued Certificate of Point of Care Ultrasound (Rheumatology).
Expected experiences and learning opportunities
ASUM recognises that practitioners will have widely varied clinical environments and scope of
practice needs, access to educational opportunities and preferred methods of learning. The
International Federation for Emergency Medicine3 defines the essential steps in PoCUS training as
1) initial introduction 2) gaining experience 3) achieving competence3. ASUM considers this model
appropriate for all areas of practice where PoCUS is used to contribute to patient management,
including rheumatology.
See Candidate’s Education and Clinical Experience Handbook for descriptions of “relevant” teaching and learning experiences See Candidate’s Education and Clinical Experience Handbook and the Clinical Supervisor Handbook for definition of “approved”
person
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Australasian Society for Ultrasound in Medicine
P (61 2) 9438 2078 F (61 2) 9438 3686 E asum@asum.com.au W www.asum.com.au
ACN 001 679 161 ABN 64 001 679 161
Candidates are strongly encouraged to identify and undertake suitable formal education
opportunities prior to undertaking any ultrasound procedures in the clinical setting.
Candidates are strongly encouraged to undertake education and learning relating to the
Fundamentals of Ultrasound Practice, particularly the areas covered in section 1 of the content prior
to undertaking any ultrasound procedures in a clinical setting. Clinical record log (logbook)
entries for actual patients in clinical settings will not be accepted from any date recorded
prior to the satisfactory completion of the Fundamentals of Ultrasound Practice Quiz 1.
Candidates may wish to undertake courses provided by education providers who have been
endorsed by ASUM and listed on the ASUM website, or choose another educational opportunity
suitable to their needs, or arrange a structured education and training program to be conducted in
the workplace. For information on requirements of ASUM Endorsed Education Providers and
features to consider when choosing an education/training program refer to the Candidate’s
Education and Clinical Experience Handbook.
Candidates are strongly encouraged to identify on-going learning opportunities to undertake as their
skills and knowledge increase and they gain further experience.
Candidates should not view their introductory education/training sessions as providing them with
comprehensive skills and abilities. It is unlikely a candidate would be assessed as competent for
safe, unsupervised practice without the benefit of re-enforcement of the learning, and further skills
development, which come with on-going experiential learning and reflection.
Clinical supervision requirements
All ACPoCUS (Rheumatology) candidates must have access to clinical supervision during their
education and training. Candidates must nominate a suitable “Primary Clinical Supervisor” or a
combination of suitable persons to act jointly as “Primary Clinical Supervisory team” for the duration
of their candidature. The Primary Clinical Supervisor/s must be a currently practising practitioner
holding one of the following:
I. Fellowship of the Royal Australian and New Zealand College of Radiology (RANZCR) II. Diploma in Diagnostic Ultrasound (DDU) from ASUM
III. Certificate in Clinician Performed Ultrasound (CCPU) as issued by the ASUM in the relevant clinical area/s (ie rheumatology). The relevant CCPUs must have been obtained at least 2 years prior to undertaking the supervisor role and the supervisor must provide a statement regarding their on-going clinical experience in PoCUS since obtaining the CCPU
IV. An Accredited Medical Sonographer (AMS) with demonstrated experience in clinical teaching of sonographic skills, particularly for musculo-skeletal (MSK) applications and an in-depth knowledge and understanding of the underpinning principles of PoCUS applications. An AMS must be a part of a supervisory team with either one of the persons listed in points I, II and III or point V
V. An experienced specialist rheumatologist. If the rheumatologist does not hold a qualification as detailed in points I, II and III, they must be part of a supervisory team with a person with any of the qualifications listed in points I – IV above.
Further information regarding clinical supervisor requirements can be found in the Clinical
Supervisor Handbook.
Page 9 of 26
Australasian Society for Ultrasound in Medicine
P (61 2) 9438 2078 F (61 2) 9438 3686 E asum@asum.com.au W www.asum.com.au
ACN 001 679 161 ABN 64 001 679 161
Note: In exceptional (only) circumstances where a suitable Primary Clinical Supervisor or Primary
Supervisory team with the above listed qualifications cannot be found or is otherwise not
appropriate, the ACPoCUS Certification Board may, at its discretion, accept another person as
clinical supervisor or a combination of supervisors with the appropriate expertise to provide
supervision.
Candidates, in consultation with their Primary Clinical Supervisor/s, may engage other experienced
and suitably credentialed practitioners (such as an Accredited Medical Sonographer - AMS) as a
member of the Primary Supervisory team to assist in appropriate teaching and competence
assessment within their scope of practice (for example scanning competence). All practitioners
involved in clinical supervision of a candidate who will be responsible for any assessment or
verification of practice must be approved by the ACPoCUS Certification Board prior to the
commencement of the clinical supervision.
Candidates should ensure that all nominated Clinical Supervisors have been provided with a copy
of this entire ACPoCUS (Rheumatology) curriculum document and the Clinical Supervisor
Handbook.
The Primary Clinical Supervisor/s must be in a position to be able to comment authoritatively and
objectively on the candidate's clinical practice and competence. The Primary Clinical Supervisor/s is
expected to be working predominantly within the candidate's usual workplace and be available for
direct access/advice when required.
All nominated supervisors must complete a Clinical Supervisor Form verifying that they agree to
undertake the supervision and have read and agreed to fulfil the Supervisor Responsibilities
(Clinical Supervisor Handbook).
It is the candidate’s responsibility to ensure the Clinical Supervisor Form/s is/are submitted to
ASUM at the beginning of their candidature. The ACPoCUS Certification Board will confirm with
the candidate and nominated supervisor/s if the nomination/s is/are acceptable to the ACPoCUS
Certification Board.
Any proposed changes to the arrangements for clinical supervision must be notified to the
ACPoCUS Certification Board for approval as soon as possible.
Assessments in simulation environments
Candidates may choose to have their formative and/or summative assessments undertaken in a
simulation environment (if within the specific requirements of the core unit). The simulation may be
in the workplace on “model” patients or may be in a purposeful education facility. Persons who
undertake the role of assessor only, and are not involved in an on-going clinical supervisor role, do
not need to be approved by the ACPoCUS Certification Board. Such assessors do need to meet
the professional background requirements, for supervisors, as detailed previously in this document.
Page 10 of 26
Australasian Society for Ultrasound in Medicine
P (61 2) 9438 2078 F (61 2) 9438 3686 E asum@asum.com.au W www.asum.com.au
ACN 001 679 161 ABN 64 001 679 161
CORE UNITS ACPoCUS (Rheumatology)
Unit 1: Fundamentals of Ultrasound Practice
Rationale
The acquisition and interpretation of ultrasound images requires a sound understanding of the underlying physical principles of ultrasound, the interaction of ultrasound with tissue and related limitations. It is equally important to know how misleading information (artifacts) can result from the scanning process, how artifacts are minimised and the typical appearances of commonly encountered artifacts.
It is also important to understand the technical features of the equipment, how appropriate
equipment is selected for a given examination, how the settings are optimised to ensure useful
information is acquired and the terminology used to describe the findings.
All practitioners using ultrasound techniques are responsible for ensuring they have adequate and
up-to-date knowledge of the image acquisition and interpretation process and associated legal and
ethical requirements, including recognition of the philosophy of focussed (point of care) ultrasound
applications, its integration into clinical management and its limitations.
Aim
The candidate demonstrates knowledge and competent application of the physical principles and
instrumentation of ultrasound, and the broad professional, ethical and legal principles relevant to
focussed (point of care) ultrasound practice. The candidate can relate the fundamental principles to
the validity and clinical utility of the information obtained.
Candidates please note: ASUM provides an on-line tutorial which has been specifically designed
to assist candidates in their learning and preparation for the Unit 1: Fundamentals of Ultrasound
Practice quizzes. All candidates are strongly encouraged to undertake the on-line tutorial prior to
attempting the quizzes.
Learning objectives
Section 1 (relates to Quiz 1)
Physical principles of ultrasound
The candidate can describe:
the wave nature of ultrasound and its propagation through tissue
the reflection and scattering of ultrasound and how these relate to acoustic impedance
the concept of attenuation, its mechanisms and factors affecting it
refraction of ultrasound
the concept of pulsed ultrasound.
Page 11 of 26
Australasian Society for Ultrasound in Medicine
P (61 2) 9438 2078 F (61 2) 9438 3686 E asum@asum.com.au W www.asum.com.au
ACN 001 679 161 ABN 64 001 679 161
Imaging Principles and Technology
The candidate can describe the:
pulse-echo principle and how it is used in B-mode and M-mode ultrasound imaging
purpose and function of a transducer, including methods and importance of focussing
concept of an ultrasound beam and the importance of controlling beam width
major types of transducer and the factors affecting the choice of transducer for a specific application
concept of slice thickness
major aspects of image quality
principal image artifacts and their impact on image quality and clinical utility.
Image/Data Collection and Optimisation
The candidate can:
describe a range of techniques to ensure the best quality examination is obtained including: patient positioning and breathing; systematic scanning techniques.
describe and apply a range of probe manipulation techniques to produce an accurate, valid and efficient examination.
recognise standard scan planes, image orientation and associated terminology used in relevant ultrasound applications and be aware of common variations used in particular fields (for example, intracavity scanning and cardiac ultrasound).
apply equipment controls to optimise the quality of the images/data produced including: power; time gain compensation (TGC); gain; focus; depth and zoom; accurate measurements.
describe the underpinning philosophy and limitations of focussed (point of care) ultrasound examinations in the clinical setting.
Section 2 (relates to Quiz 2)
Doppler Principles and Instrumentation
The candidate can describe the:
basic principles of the Doppler effect and describe how it is used in ultrasound diagnosis
basics principles of operation of continuous wave and pulsed Doppler instrumentation
major elements of the Doppler spectral display
basic principles of colour Doppler, including power (amplitude) mode
the principal Doppler artifacts and how they can be identified and/or eliminated.
Good ultrasound practice
The candidate can:
Page 12 of 26
Australasian Society for Ultrasound in Medicine
P (61 2) 9438 2078 F (61 2) 9438 3686 E asum@asum.com.au W www.asum.com.au
ACN 001 679 161 ABN 64 001 679 161
describe the principles of adequate documentation of ultrasound images and data
accurately apply standard terminology used to describe ultrasound appearances
describe general principles of care and maintenance of equipment
describe and apply principles of infection control in the use of ultrasound and its associated equipment
explain and apply informed consent processes, particularly for invasive examinations
demonstrate due regard for patient comfort and care at all times
demonstrate satisfactory communication skills with patients and other practitioners regarding the ultrasound examination and its role in patient management, including limitations of the examination/procedure.
Section 3 (relates to Quiz 3)
The candidate can:
demonstrate an understanding of the potential impact of bioeffects and biohazards in ultrasound scanning
define the parameters used to describe patient exposure to ultrasound
explain practical approaches to reducing risk as published in relevant professional body policies.
New and Evolving Techniques
The candidate will understand the basic principles of a range of new technologies including:
contrast agents
tissue and contrast harmonic imaging
spatial compound scanning
three-dimensional (3D) scanning.
Assessments
Three quizzes directly related to Sections 1, 2 and 3 as detailed above must be satisfactorily
completed. The “satisfactory” level for each quiz is 80% or greater.
Quiz 1: Twenty multiple choice questions (MCQ) related to Section 1
Quiz 2: Twenty MCQ related to Section 2
Quiz 3: Ten MCQ related to Section 3.
Quizzes will be available on-line and “at-call” and will be time-limited. Candidates may undertake
the quizzes when they believe they are ready and have received a “log-in” code from ASUM for the
purpose.
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Australasian Society for Ultrasound in Medicine
P (61 2) 9438 2078 F (61 2) 9438 3686 E asum@asum.com.au W www.asum.com.au
ACN 001 679 161 ABN 64 001 679 161
Quiz 1 must be satisfactorily completed prior to undertaking clinical ultrasound examinations on
actual patients in a clinical setting and recording these in the clinical record log. Any clinical
examinations on actual patients in a clinical setting which pre-date successful completion of Quiz 1
will not be accepted as meeting the clinical record log requirements.
Scans performed in a simulation setting, or on “model” patients for training purposes, may be
recorded in the clinical record log prior to the satisfactory completion of Quiz 1.
Quizzes 2 and 3 should be completed at an appropriate time, in line with on-going development of
skills and clinical experience, as determined by the candidate and preferably in consultation with
their supervisor/s. All quizzes must be satisfactorily completed to be eligible for the award of the
ACPoCUS.
Access to each quiz will be time-limited. If any quiz is not satisfactorily completed the quiz must be
attempted again. Candidates must note that questions will be randomly assigned from a database
of questions. Re-attempting the quiz may result in a different set and/or order of questions
presented.
Following two unsuccessful attempts at any given quiz the candidate may be required to
demonstrate attendance at, or completion of, an ASUM endorsed formal education and learning
experience/program before being able to attempt the relevant quiz again.
If a candidate remains unsuccessful after two further attempts at a given quiz, ASUM reserves the
right to require evidence of additional remedial learning prior to further attempts, or to cancel the
candidate’s enrolment.
Resources/suggested learning activities (to be fleshed out)
Gill, Robert (2012) The Physics and Technology of Diagnostic Ultrasound: A Practitioner’s Guide.
High Frequency Publishing. ISBN 9780987292100.
ASUM on-line module (name to be included when revised edition available)
Available via the author’s website https://ultrasoundbook.net
ASUM Endorsed Education Providers’ training courses
ASUM’s annual “DDU Physics Seminar” (see ASUM website for details).
Unit 2: Needle Guidance Techniques
Rationale
The role of ultrasound scanning in focussed (point of care) clinical settings includes both diagnostic
aims and procedural guidance purposes1. Procedural guidance using ultrasound scanning can
improve patient safety and procedural efficiency1 if performed by appropriately trained and
competent practitioners.
ASUM believes all practitioners performing focussed (point of care) ultrasound examinations should
have a foundational level of knowledge and skill in the use of ultrasound guidance, and knowledge
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Australasian Society for Ultrasound in Medicine
P (61 2) 9438 2078 F (61 2) 9438 3686 E asum@asum.com.au W www.asum.com.au
ACN 001 679 161 ABN 64 001 679 161
of how ultrasound guidance can be used to improve the efficiency and effectiveness of
interventional procedures.
Equally important is for practitioners to be aware of the limitations of the techniques and their own
ability to perform ultrasound guided interventional procedures safely and efficiently. Practitioners
must only undertake ultrasound guided clinical interventions IF it is within their scope of practice
and competence level. Practitioners have an obligation not to undertake procedures in which they
are not competent.
ASUM recognises that not all practitioners will use ultrasound guidance of interventional procedures
in their practice. However, ASUM believes it is important that the foundational concepts, principles
and basic skills required are demonstrated by all candidates prior to the award of an ACPoCUS.
Aim
The candidate demonstrates foundational knowledge, and advanced beginner2 level application, of
the principles of ultrasound guidance of interventional procedures in focussed (point of care)
ultrasound practice.
Learning Objectives
The candidate can:
describe the general principles of the common methods used for ultrasound guidance for interventional procedures
demonstrate fundamental psychomotor and technical skills in using ultrasound to satisfactorily guide simple interventional procedures
describe and apply principles of infection control, according to the ASUM/ACIPC 2017 Guidelines for Reprocessing Ultrasound Transducers (ASUM website), in the use of ultrasound and its associated equipment for guidance of interventional procedures.
Core knowledge and skills to be achieved
Ultrasound guidance methods and principles:
o free-hand techniques following needle path determination with ultrasound imaging o ultrasound real-time guided techniques o technique guided by purpose designed guidance devices
Infection control:
o infection control related to ultrasound equipment
Skills:
o coordination of psychomotor skills to perform imaging and needle/device insertion simultaneously
o apply sonographic principles to optimise ultrasound imaging to enhance accuracy and clarity of image guidance
o use ultrasound guidance techniques to insert needle/device accurately and efficiently to area of interest
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Australasian Society for Ultrasound in Medicine
P (61 2) 9438 2078 F (61 2) 9438 3686 E asum@asum.com.au W www.asum.com.au
ACN 001 679 161 ABN 64 001 679 161
o apply correct and safe infection control processes to ensure risk of procedure related infection/contamination is as low as reasonably achievable (ALARA)
Assessments
Formative competence assessment (may be in a simulation or clinical setting).
Summative competence assessment (may be in simulation or clinical setting).
For the summative assessment to be deemed satisfactory, the candidate must be assessed as
meeting the level of Advanced Beginner2.
Resources/suggested learning activities
ASUM Endorsed Education Providers’ training courses
Clinical training
CORE CLINICAL UNITS
Rationale
The main purpose of focussed (point of care) ultrasound examinations in the rheumatology clinical
setting is to provide easily obtained, valid information of the patient’s current clinical problem to
inform and allow timely clinical management decisions. Ultrasound guided procedures for the
purpose of biopsy, therapeutic or diagnostic fluid aspiration and/or injections can lead to enhanced
patient safety and therapeutic and diagnostic outcomes.
The role of focussed ultrasound examinations is to answer a specific, clinical question to assist the
clinician in deciding on appropriate further clinical management, or to guide diagnostic or
therapeutic invasive procedures. The ultrasound information/data should be used to “rule in” or “rule
out” the possible diagnosis and, if the findings are equivocal, the clinician will have to consider the
need for other diagnostic and/or management strategies.
Unit 3: Assessment of Upper Limb
Aim
The candidate demonstrates skill in obtaining valid and efficient ultrasound data in the assessment
of the joints, bones and soft tissues of the upper limb to answer the specific clinical question and/or
guide the invasive procedure. The candidate can recognise when the findings are positive, negative
or equivocal and use this assessment to enhance the clinical management of the patient.
Page 16 of 26
Australasian Society for Ultrasound in Medicine
P (61 2) 9438 2078 F (61 2) 9438 3686 E asum@asum.com.au W www.asum.com.au
ACN 001 679 161 ABN 64 001 679 161
Learning objectives
The candidate can:
describe the clinical questions, related to the upper limb which may typically be addressed using focussed point of care ultrasound scanning, as described in relevant and contemporary peer-reviewed literature or relevant published protocols or standards of practice
demonstrate the technical (sonographic) ability to acquire a satisfactory ultrasound examination which is suitable to answer the clinical question, including any dynamic assessments of movement and/or applicable measurements
describe the diagnostic criteria, as described in relevant and contemporary peer-reviewed literature or relevant published protocols or standards of practice, for ultrasound findings which would support a positive, negative or equivocal diagnosis
describe the limitations of ultrasound in assessing the upper limb in a PoCUS context
demonstrate the ability to interpret the ultrasound data to determine if the findings support a positive, negative or equivocal answer to the specific clinical question
demonstrate the ability to determine the appropriate on-going patient management as a result of the ultrasound findings in conjunction with other clinical information
demonstrate the knowledge and psychomotor skills to effectively and efficiently use ultrasound to guide invasive procedures to enhance patient safety and outcomes
demonstrate the ability to describe and adequately document the ultrasound findings in the patient’s clinical record in such a way as to facilitate satisfactory continuity of care of the patient.
Expected standards of practice (Upper limb)
Key clinical questions addressed in PoCUS contexts:
o Which are the relevant joints, bones or soft tissue structures affected? o Is there evidence of abnormal fluid collection/s? o Is there evidence of abnormal bone surfaces/structure? o Is there evidence of inflammation, disruption or rupture of tendons and/or ligaments? o Is there evidence of thickening, inflammation or other abnormality of the synovium? o Is there any evidence of calcification, soft tissue masses or other abnormal space occupying
lesions in the area of interest? o Is there evidence of abnormal movement of structures on dynamic imaging? o What are the measurements of the relevant findings? o What is the clinical relevance of the findings and/or measurement/s? o Are there any other findings which may support another differential diagnosis which may
explain the patient presentation?
Minimum expected ultrasound data acquisition/protocols:
Preparation
o Prepare clinical environment o Prepare patient, including informed consent o Select and prepare ultrasound and ancillary equipment o Enter patient data into ultrasound equipment
Page 17 of 26
Australasian Society for Ultrasound in Medicine
P (61 2) 9438 2078 F (61 2) 9438 3686 E asum@asum.com.au W www.asum.com.au
ACN 001 679 161 ABN 64 001 679 161
Image acquisition
o Acquire and optimise ultrasound images/data, including correct probe choice and use of “stand-off” material if required
o Identify relevant anatomical features and landmarks following determination of clinical area of interest
o Continuous real-time imaging of the area/s of interest to include related bones, joints, tendons, ligaments, muscles, synovium and other soft tissues as relevant
o Real-time imaging of dynamic movements of anatomical features if necessary o Measurement of any areas of interest, such as tendon thickness, or if abnormality found,
area/structure measured in 2 orthogonal planes o Apply Doppler techniques as required to demonstrate areas of inflammatory change or to
distinguish vascular structures o Identify and respond to ultrasound artifacts, if required, to improve diagnostic quality of
images/data o If performing a guided invasive procedure follow all protocols as described in Core Unit 2
Needle Guidance Techniques
Minimal recorded images/ultrasound data
The following are the required minimal images to be recorded, unless the patient’s clinical situation
(for example an unstable trauma patient) renders this impracticable and/or unsafe. In this situation,
the practitioner should record whatever images are obtainable, in the time available, to answer the
clinical question without allowing the ultrasound examination to interfere with ongoing medical
treatment.
If local protocols recommend more recorded images/data for a particular examination then these
should be adhered to.
o Representative images of relevant anatomical landmarks and areas of clinical significance in at least two orthogonal planes, preferably with major landmarks annotated
o Measurements of any abnormal findings in two orthogonal planes if possible o If available short video or cine-loop of relevant dynamic movement o If performing a guided invasive procedure, record at least two images in orthogonal planes
to demonstrate needle position. During the procedure and post-procedure images may be required, depending on the procedure, to verify the outcome.
Sonographic appearances of expected positive, negative and equivocal findings
o Describe ultrasound appearances, of the relevant anatomy/area of interest, using correct sonographic terminology, including the appearances consistent with:
o Synovial thickening o Synovial fluid/effusion o Bone erosion o Tenosynovitis o Tendinopathy o Tendon rupture o Ligament tear o Masses: ganglion, tendon nodule, calcification o Bursitis o Impingement features on dynamic assessment
o Identify and describe conclusive findings, positive or negative
Page 18 of 26
Australasian Society for Ultrasound in Medicine
P (61 2) 9438 2078 F (61 2) 9438 3686 E asum@asum.com.au W www.asum.com.au
ACN 001 679 161 ABN 64 001 679 161
o Identify limitations of examination or relevance of equivocal findings
Integration of ultrasound findings with clinical information
o Describe relevance of ultrasound findings correlated to clinical presentation and other data o Evaluate findings for monitoring purposes: disease activity/progression/regression
o Integrate information with ongoing clinical management of patient
Post examination
o Ensure examination and findings adequately recorded in patient clinical record o Clean ultrasound equipment safely and correctly o Store ultrasound equipment safely and correctly o If guided invasive procedure performed, adhere to applicable infection control guidelines.
Assessments
Assessments for clinical units are focussed on the candidate demonstrating the knowledge, skill and
ability to perform an accurate, valid, efficient, and clinically relevant ultrasound examination which
has the potential to have a positive impact on patient clinical management.
Candidates are expected to develop a solid foundation of key ultrasound knowledge and skills and
apply these to clinical practice in a guided, supervised, incremental fashion. As their experience
builds, candidates may wish to undertake further formal training and education to further develop
and enhance their skills.
To be awarded an ACPoCUS (Rheumatology) a candidate must, amongst other items as described
in this curriculum, successfully meet the specific requirements of Unit 3: Assessment of Upper Limb.
The successful completion and documentation of the following assessments in Assessment of
Upper Limb is required:
o Two (2) formative assessments of clinical skills, specifically related to the assessment of the upper limb (may be in simulated environments). The two assessments are to be of joints in different parts of the upper limb ie NOT two joints in the hand.
o Two (2) summative assessments of clinical skills, specifically related to the assessment of the upper limb (must be in workplace or on models with pathology if in a simulation setting). The two assessments are to be of joints in different parts of the upper limb ie NOT two joints in the hand.
o One (1) ASUM on-line interpretive, case-based scenario analysis quiz, specifically related to the assessment of the upper limb.
Notes:
o The formative and summative assessments are not to be of the same two joint areas. There must be at least one formative or summative assessment of each of the hand (metacarpals/phalanges), wrist, elbow and shoulder.
o The summative assessments must be undertaken after no less than 50% and then 90% of the clinical record log requirements for upper limb cases have been met.
Page 19 of 26
Australasian Society for Ultrasound in Medicine
P (61 2) 9438 2078 F (61 2) 9438 3686 E asum@asum.com.au W www.asum.com.au
ACN 001 679 161 ABN 64 001 679 161
Experience of specified type/number of cases as verified in clinical record log (logbook).
For Assessment of Upper Limb, candidates must demonstrate, in their verified clinical record log,
that they have personally performed:
a minimum of 40 ultrasound scans of each of the: (This gives a total of 120 for upper limb – current CCPU is 50 shoulder, 30 hand/wrist and 20 elbow – total 100 plus 25 guided injections across all limb numbers)
o shoulder o elbow o hand/wrist
of the 40 scans for each area, at least 50% (20 scans) must have been performed in an actual clinical setting and
at least 10 cases must have involved an ultrasound guided procedure at least 25% (10 scans) must have had verified positive findings.
For full details and other clinical record log requirements refer the Candidate’s Education and
Clinical Experience Handbook.
Resources/suggested learning activities (to be fleshed out)
ASUM Endorsed Education Providers’ training courses
Clinical training
ASUM Standards of practice documents
? key references to be provided by Certification Board specialists
Unit 4: Assessment of Lower Limb
Aim
The candidate demonstrates skill in obtaining valid and efficient ultrasound data in the assessment
of the joints, bones and soft tissues of the lower limb to answer the specific clinical question and/or
guide the invasive procedure. The candidate can recognise when the findings are positive, negative
or equivocal and use this assessment to enhance the clinical management of the patient.
Learning objectives
The candidate can:
describe the clinical questions, related to the lower limb which may typically be addressed using focussed point of care ultrasound scanning, as described in relevant and contemporary peer-reviewed literature or relevant published protocols or standards of practice
Page 20 of 26
Australasian Society for Ultrasound in Medicine
P (61 2) 9438 2078 F (61 2) 9438 3686 E asum@asum.com.au W www.asum.com.au
ACN 001 679 161 ABN 64 001 679 161
demonstrate the technical (sonographic) ability to acquire a satisfactory ultrasound examination which is suitable to answer the clinical question, including any dynamic assessments of movement and/or applicable measurements
describe the diagnostic criteria, as described in relevant and contemporary peer-reviewed literature or relevant published protocols or standards of practice, for ultrasound findings which would support a positive, negative or equivocal diagnosis
describe the limitations of ultrasound in assessing the lower limb in a PoCUS context
demonstrate the ability to interpret the ultrasound data to determine if the findings support a positive, negative or equivocal answer to the specific clinical question
demonstrate the ability to determine the appropriate on-going patient management as a result of the ultrasound findings in conjunction with other clinical information
demonstrate the knowledge and psychomotor skills to effectively and efficiently use ultrasound to guide invasive procedures to enhance patient safety and outcomes
demonstrate the ability to describe and adequately document the ultrasound findings in the patient’s clinical record in such a way as to facilitate satisfactory continuity of care of the patient.
Expected standards of practice (Lower limb)
Key clinical questions addressed in PoCUS contexts:
o Which are the relevant joints, bones or soft tissue structures affected? o Is there evidence of abnormal fluid collection/s? o Is there evidence of abnormal bone surfaces/structure? o Is there evidence of inflammation, disruption or rupture of tendons and/or ligaments? o Is there evidence of thickening, inflammation or other abnormality of the synovium? o Is there any evidence of calcification, soft tissue masses or other abnormal space occupying
lesions in the area of interest? o Is there evidence of abnormal movement of structures on dynamic imaging? o What are the measurements of the relevant findings? o What is the clinical relevance of the findings and/or measurement/s? o Are there any other findings which may support another differential diagnosis which may
explain the patient presentation?
Minimum expected ultrasound data acquisition/protocols:
Preparation
o Prepare clinical environment o Prepare patient, including informed consent o Select and prepare ultrasound and ancillary equipment o Enter patient data into ultrasound equipment
Image acquisition
o Acquire and optimise ultrasound images/data, including correct probe choice and use of “stand-off” material if required
o Identify relevant anatomical features and landmarks following determination of clinical area of interest
o Continuous real-time imaging of the area/s of interest to include related bones, joints, tendons, ligaments, muscles, synovium and other soft tissues as relevant
Page 21 of 26
Australasian Society for Ultrasound in Medicine
P (61 2) 9438 2078 F (61 2) 9438 3686 E asum@asum.com.au W www.asum.com.au
ACN 001 679 161 ABN 64 001 679 161
o Real-time imaging of dynamic movements of anatomical features if necessary o Measurement of any areas of interest, such as tendon thickness, or if abnormality found,
area/structure measured in 2 orthogonal planes o Apply Doppler techniques as required to demonstrate areas of inflammatory change or to
distinguish vascular structures o Identify and respond to ultrasound artifacts, if required, to improve diagnostic quality of
images/data o If performing a guided invasive procedure follow all protocols as described in Core Unit 2
Needle Guidance Techniques
Minimal recorded images/ultrasound data
The following are the required minimal images to be recorded, unless the patient’s clinical situation
(for example an unstable trauma patient) renders this impracticable and/or unsafe. In this situation,
the practitioner should record whatever images are obtainable, in the time available, to answer the
clinical question without allowing the ultrasound examination to interfere with ongoing medical
treatment.
If local protocols recommend more recorded images/data for a particular examination then these
should be adhered to.
o Representative images of relevant anatomical landmarks and areas of clinical significance in at least two orthogonal planes, preferably with major landmarks annotated
o Measurements of any abnormal findings in two orthogonal planes if possible o If available short video or cine-loop of relevant dynamic movement o If performing a guided invasive procedure, record at least two images in orthogonal planes
to demonstrate needle position. During the procedure and post-procedure images may be required, depending on the procedure, to verify the outcome.
Sonographic appearances of expected positive, negative and equivocal findings
o Describe ultrasound appearances, of the relevant anatomy/area of interest, using correct sonographic terminology, including the appearances consistent with:
o Synovial thickening o Synovial fluid/effusion o Bone erosion o Tenosynovitis o Tendinopathy o Tendon rupture o Ligament tear o Masses: ganglion, tendon nodule, calcification o Bursitis o Impingement features on dynamic assessment
o Identify and describe conclusive findings, positive or negative o Identify limitations of examination or relevance of equivocal findings
Integration of ultrasound findings with clinical information
o Describe relevance of ultrasound findings correlated to clinical presentation and other data
Page 22 of 26
Australasian Society for Ultrasound in Medicine
P (61 2) 9438 2078 F (61 2) 9438 3686 E asum@asum.com.au W www.asum.com.au
ACN 001 679 161 ABN 64 001 679 161
o Evaluate findings for monitoring purposes: disease activity/progression/regression o Integrate information with ongoing clinical management of patient
Post examination
o Ensure examination and findings adequately recorded in patient clinical record o Clean ultrasound equipment safely and correctly o Store ultrasound equipment safely and correctly o If guided invasive procedure performed, adhere to applicable infection control guidelines.
Assessments
Assessments for clinical units are focussed on the candidate demonstrating the knowledge, skill and
ability to perform an accurate, valid, efficient, and clinically relevant ultrasound examination which
has the potential to have a positive impact on patient clinical management.
Candidates are expected to develop a solid foundation of key ultrasound knowledge and skills and
apply these to clinical practice in a guided, supervised, incremental fashion. As their experience
builds, candidates may wish to undertake further formal training and education to further develop
and enhance their skills.
To be awarded an ACPoCUS (Rheumatology) a candidate must, amongst other items as described
in this curriculum, successfully meet the specific requirements of Unit 4: Assessment of Lower Limb.
The successful completion and documentation of the following assessments in Assessment of
Lower Limb is required:
o Two (2) formative assessments of clinical skills, specifically related to the assessment of the lower limb (may be in simulated environments). The two assessments are to be of joints in different parts of the lower limb ie NOT two joints in the foot
o Two (2) summative assessments of clinical skills, specifically related to the assessment of the lower limb (must be in workplace or on models with pathology if in a simulation setting). The two assessments are to be of joints in different parts of the lower limb ie NOT two joints in the foot
o One (1) ASUM on-line interpretive, case-based scenario analysis quiz, specifically related to the assessment of the lower limb
Note:
o The formative and summative assessments are not to be of the same two joint areas. There must be at least one formative or summative assessment of each of the foot, ankle, knee and hip.
o The summative assessments must be undertaken after no less than 50% and then 90% of the clinical record log requirements for lower limb cases have been met.
Experience of specified type/number of cases as verified in clinical record log.
For Assessment of Lower Limb, candidates must demonstrate, in their verified clinical record log,
that they have personally performed:
Page 23 of 26
Australasian Society for Ultrasound in Medicine
P (61 2) 9438 2078 F (61 2) 9438 3686 E asum@asum.com.au W www.asum.com.au
ACN 001 679 161 ABN 64 001 679 161
a minimum of 40 ultrasound scans of each of the: (This gives a total of 120 for lower limb – current CCPU is 20 hips, 20 knees and 60 foot/ankle – total 100 plus 25 guided injections across all limb numbers)
o hip o knee o foot/ankle
of the 40 scans for each area, at least 50% (20 scans) must have been performed in an actual clinical setting and
at least 10 cases must have involved an ultrasound guided procedure at least 25% (10 scans) must have had verified positive findings.
For full details and other clinical record log (logbook) requirements refer to the ACPoCUS
Candidate’s Education and Clinical Experience Handbook.
Resources/suggested learning activities
ASUM Endorsed Education Providers’ training courses
Clinical training
ASUM Standards of practice documents
? key references to be provided by Certification Board specialists
Unit 5: Portfolio of Clinical Competence in PoCUS (Rheumatology)
Rationale
The award of an ACPoCUS (Rheumatology) is based on a candidate demonstrating a level of
competence2 in the core clinical applications1 of ultrasound appropriate to the clinical scope of
practice.
Overall competence as a practitioner of PoCUS in rheumatology is determined, by ASUM, by
assessment of multiple items of evidence related to the core knowledge, skills and abilities required
to use ultrasound safely, efficiently and in a way that enhances patient clinical management.
Aim
The aim of the Portfolio of Clinical Competence unit is for the candidate to be eligible for certification
as a PoCUS (Rheumatology) practitioner through submission of a portfolio of evidence verifying
that they meet the Capability Statements for ACPoCUS (Rheumatology).
Requirements
The candidate develops and maintains a portfolio of evidence throughout their education and
training in PoCUS.
On completion of all the required assessments, including those previously detailed in this curriculum
document and the final holistic clinical assessments detailed below, the candidate submits the
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P (61 2) 9438 2078 F (61 2) 9438 3686 E asum@asum.com.au W www.asum.com.au
ACN 001 679 161 ABN 64 001 679 161
portfolio of evidence and seeks the award of the Certificate in Point of Care Ultrasound
(Rheumatology) (ACPoCUS).
Final holistic clinical assessments:
Final holistic on-line interpretive, case-based scenario analysis quiz to cover all core clinical areas of the ACPoCUS Rheumatology (that is: Assessment of Upper Limb, Assessment of Lower Limb). The quiz is to assess that a candidate can satisfactorily demonstrate competent level skills in:
o image interpretation and o clinical integration of the ultrasound data.
Final holistic summative clinical competence assessment (based on “global rating scale”3,4) of clinical focussed/point of care ultrasound at the level of competence2 to include:
o overall psychomotor and sonographic skill, including satisfactory use of equipment; o due regard for patient comfort and care at all times; o interpretation of ultrasound findings; o integration of ultrasound examination into patient clinical management; o demonstrated understanding of role and limitations of PoCUS; and o safe and appropriate clinical practice across the core clinical applications
(Assessment of Upper Limb, Assessment of Lower Limb).
Submission of completed Portfolio of Clinical Competence to ASUM for consideration of award of ACPoCUS. Portfolio to consist of
o Evidence of attendance at relevant formal teaching and learning experiences o Clinical record log verifying required scan numbers/type for all core clinical units as
defined in the curriculum o Completed formative and summative assessments for Unit 2: Needle Guidance
Techniques, with the final summative assessment being at the Advanced Beginner2 level
o Completed formative and summative clinical assessments for each specified core clinical unit with final summative assessment for each core clinical unit at “competent” level2
o Completed final holistic summative clinical competence assessment (global
rating scale3,4) by supervisor or other approved person at “competent” level2 o Evidence of satisfactory level of achievement of the following:
Fundamentals of US Practice quizzes x 3 Case-based scenario analysis quiz x 1 for each core clinical unit Final holistic on-line interpretive, case-based scenario analysis quiz
See Candidate’s Education and Clinical Experience Handbook for descriptions of “relevant” teaching and learning experiences See Candidate’s Education and Clinical Experience Handbook and the Clinical Supervisor Handbook for definition of “approved” person
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P (61 2) 9438 2078 F (61 2) 9438 3686 E asum@asum.com.au W www.asum.com.au
ACN 001 679 161 ABN 64 001 679 161
Following the submission of the Portfolio of Clinical Competence, the ASUM Certification Board will
review the submission and determine if the candidate has fulfilled the requirements for the award of
ASUM Certificate in Point of Care Ultrasound (Rheumatology).
Where there are significant discrepancies in the level of achievement/competence in any area of
assessment, ASUM reserves the right to require the candidate to undergo additional assessment
prior to determining the final outcome. Additional assessments may be further competence
assessment/s undertaken by independent, ASUM appointed assessors and/or the candidate may
be asked to present for a case-based oral assessment.
Further, where there are significant discrepancies in the level of achievement/competence in any
area of assessment, and the candidate is unable to demonstrate recent (previous 2-3 years)
attendance at relevant ASUM endorsed formal teaching and learning programs, ASUM reserves the
right to require the candidate to undergo additional education at a relevant ASUM endorsed (or
specified) formal teaching and learning program prior to submitting further assessments for
consideration.
References:
1. Möller I, Janta I, Backhaus M, Ohrndorf S, Bong DA, Martinoli C, et al. The 2017 EULAR standardised procedures for ultrasound imaging in rheumatology. Ann Rheum Dis 2017, Aug 16
2. Khan K, Ramachandran S. Conceptual framework for performance assessment: Competency, competence and performance in the context of assessments in healthcare--deciphering the terminology. Med Teach 2012;34(11):920-8
3. Atkinson P, Bowra J, Lambert M, Lamprecht H, Noble V, Jarman B. International federation for emergency medicine point of care ultrasound curriculum. CJEM 2015, Mar;17(2):161-70
4. Ilgen JS, Ma IW, Hatala R, Cook DA. A systematic review of validity evidence for checklists versus global rating scales in simulation-based assessment. Med Educ 2015, Feb;49(2):161-73
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P (61 2) 9438 2078 F (61 2) 9438 3686 E asum@asum.com.au W www.asum.com.au
ACN 001 679 161 ABN 64 001 679 161
APPENDIX 1
OPTIONAL/ADDITIONAL CLINICAL UNITS
ASUM offers a range of optional, additional clinical units that candidates may wish to receive
certification for, along with the ACPoCUS core units. As the available units may be subject to
change from time to time, the current list (available on the ASUM website) should be reviewed by
candidates to determine their needs.
Key points regarding additional/optional units are:
Candidates may choose to undertake additional clinical units suitable to their scope of practice needs.
These may be undertaken in conjunction with the core ACPoCUS units or at a later time.
All assessment requirements, as for core clinical units, must be met for additional clinical units.
Additional clinical units assessed as satisfactorily completed can be notated on the ASUM issued
Certificate of Point of Care Ultrasound (Rheumatology). If undertaken in conjunction with the core
ACPoCUS units the additional units will be added to the ASUM issued Certificate. If additional units
are completed at a later time the candidate can apply to ASUM to have their Certificate re-issued
with the updated information notated on the ASUM issued Certificate.
Additional units for ACPoCUS (Rheumatology) as at January 2018
?? are these appropriate
? others
1. Lung assessment 2. Soft tissue assessment 3. Nerve blocks (peripheral) 4. Nerve blocks (central)
Recommended