Australasian Society for Ultrasound in Medicine (ASUM ... · The Australasian Society for Ultrasound in Medicine (ASUM) is the peak body for setting and maintaining standards for

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Australasian Society for Ultrasound in Medicine

P (61 2) 9438 2078 F (61 2) 9438 3686 E [email protected] 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 (Gynaecology)

(ACPoCUS)

CURRICULUM

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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 (Gynaecology) for?…………………………………………………………......

3

Capability Statements (CS)………………………………………………………………………….. 4 Overview of ACPoCUS (Gynaecology) Curriculum…………………………………………… 4

Core Units………………………………………................................................................ 5 Expected experiences and learning opportunities….…………………………………….. 7

Clinical Supervisor requirements…………………………………………………………………. 8 Assessments in simulation environments……………………………………………………… 9 CORE UNITS ACPoCUS (Gynaecology)…………………………………………………………. 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: Gynaecology and Early Pregnancy Assessment (Trans-abdominal only) ………. 15

Aim……………………………………………………………………………………………… 15 Learning Objectives…………………………………………………………………………... 15 Assessments………………………………………………………………………………….. 18 Resources/suggested learning activities…………………………………………………… 19

Unit 4: Gynaecology and Early Pregnancy Assessment (Trans-abdominal (TA) and trans-vaginal (TV))………………………………………………………………………………….

19

Aim……………………………………………………………………………………………… 19 Learning Objectives………………………………………………………………………….. 19 Assessments………………………………………………………………………………….. 22 Resources/suggested learning activities…………………………………………………… 23

Unit 5: Ultrasound Assessment of Free-Fluid (Abdomino-pelvic)………………………….. 23 Aim……………………………………………………………………………………………… 23 Learning Objectives………………………………………………………………………….. 23 Assessments………………………………………………………………………………….. 25 Resources/suggested learning activities…………………………………………………… 26

Unit 6: Portfolio of Clinical Competence in PoCUS (Gynaecology)………………………… 26 Aim……………………………………………………………………………………………… 26 Requirements…………………………………………………………………………………. 27 Final holistic clinical assessment…………………………………………………………… 27 Submission of completed Portfolio of Clinical Competence to ASUM for consideration of award of ACPoCUS……………………………………………………………………….. 27 References…………………………………………………………………………………….. 28

APPENDIX 1…………………………………………………………………………………………… 29 Optional/additional clinical units……………………………………………………………………… 29 Additional units for ACPoCUS (Gynaecology) as at January 2018…………………………. 29

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ACN 001 679 161 ABN 64 001 679 161

Introduction: Who is the ACPoCUS 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) (Gynaecology) certified practitioner

utilises ultrasound for specifically focussed, diagnostic and/or procedural guidance purposes across

a range of core clinical applications as described by the International Federation for Emergency

Medicine1 and the World Federation for Ultrasound in Medicine and Biology2.

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 (Gynaecology) would usually be medical practitioners or other

suitably registered health practitioners working in clinical settings where women with

acute/emergency gynaecological and/or possible early pregnancy presentations may be attended.

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

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unsupervised ultrasound examinations once they have demonstrated advanced beginner level

competence3 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.

Overview of ACPoCUS (Gynaecology) Curriculum

The ACPoCUS (Gynaecology) 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.

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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 (Gynaecology) core units are:

Unit 1: Fundamentals of Ultrasound Practice

Unit 2: Needle Guidance Techniques

Unit 3: Basic Gynaecology and Early Pregnancy Assessment (Trans-abdominal (TA) only)

Unit 4: Gynaecology and Early Pregnancy Assessment (Trans-abdominal and trans-vaginal (TA and

TV))

Unit 5: Ultrasound Assessment of Free-Fluid (Abdomino-pelvic)

Unit 6: Portfolio of Clinical Competence in PoCUS (Gynaecology)

The International Federation for Emergency Medicine1, the World Federation for Ultrasound in

Medicine and Biology2 and Noble and Nelson4, indicate these topic areas as important areas of

competence required by practitioners using focussed ultrasound in acute/emergency gynaecological

and possible early pregnancy clinical settings.

Candidates are also encouraged to undertake optional additional clinical units as applicable to their

scope of practice. Refer to Appendix 1 for information regarding optional/additional units available.

To be awarded an ASUM ACPoCUS (Gynaecology) 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 Handbook for details)

Commence ACPoCUS portfolio (refer to the Candidate’s Education and Clinical Experience Handbook for details).

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.

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Step 3:

Have basic US skills, in relevant core clinical unit/s assessed as being at level of novice practitioner4 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 (Basic Gynaecology and Early Pregnancy Assessment (TA),

Gynaecology and Early Pregnancy Assessment (TA and TV), and Ultrasound Assessment

of Free-Fluid (Abdomino-pelvic)) satisfactory completion of the following assessments is

required:

o Formative assessments of clinical skills x 2 (may be in simulated environments) o Summative assessments of clinical skills x 2 (must be in workplace or on models with

pathology if in a simulation setting) o On-line interpretive, case-based scenario analysis quiz x 1 o Experience of specified type/number of cases as verified in clinical record log

(logbook) 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: Basic Gynaecology and Early Pregnancy Assessment (TA), Gynaecology and Early Pregnancy Assessment (TA and TV), and Ultrasound Assessment of Free-Fluid (Abdomino-pelvic)). 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”1,5) of clinical focussed/point of care ultrasound competence to include:

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

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o safe and appropriate clinical practice across the core clinical applications (Basic Gynaecology and Early Pregnancy Assessment (TA), Gynaecology and Early Pregnancy Assessment (TA and TV), and Ultrasound Assessment of Free-Fluid (Abdomino-pelvic)).

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 Beginner3 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” level3

o Completed final holistic summative clinical competence assessment (global

rating scale1,5) by supervisor or other approved person at “competent” level3 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 (Gynaecology).

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 Medicine1 defines the essential steps in PoCUS training as

1) initial introduction 2) gaining experience 3) achieving competency1. ASUM considers this model

appropriate for all areas of practice where PoCUS is used to contribute to patient management.

Candidates are strongly encouraged to identify and undertake suitable formal education

opportunities prior to undertaking any ultrasound procedures in the clinical setting.

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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Candidates are strongly encouraged to undertake education and learning relating to Unit 1:

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 (Gynaecology) 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 or Certification in Obstetrical and

Gynaecological Ultrasound (COGU) from the Royal Australian and New Zealand College of Obstetrics and Gynaecology (RANZCOG)

III. Certificate in Clinician Performed Ultrasound (CCPU) as issued by the ASUM in the relevant clinical areas (ie gynaecology, early pregnancy). 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 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. A medical practitioner with extensive experience in clinical management of acute/emergency gynaecological presentations. If the medical practitioner 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.

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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 or 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 (Gynaecology) 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, or are verifying Logbook entries performed in simulation only, and

are not involved in an on-going clinical supervisor role, do not need to be individually approved by

the ACPoCUS Certification Board. Such assessors do need to meet the professional background

requirements, for supervisors, as detailed previously in this document.

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CORE UNITS ACPoCUS (Gynaecology)

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.

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

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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.


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:

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

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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.


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.

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.

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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 will 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

Gill, Robert (2012) The Physics and Technology of Diagnostic Ultrasound: A Practitioner’s Guide.

High Frequency Publishing. ISBN 9780987292100.

Available via the author’s website https://ultrasoundbook.net

ASUM on-line module (name to be included when revised edition available)

ASUM Endorsed Education Providers’ training courses

ASUM’s annual “Technical 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

of how ultrasound guidance can be used to improve the efficiency and effectiveness of

interventional procedures.

https://ultrasoundbook.net/

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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 beginner3 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

o apply correct and safe infection control processes to ensure risk of procedure related infection/contamination is as low as reasonably achievable (ALARA)

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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 Beginner3.



Clinical training

CORE CLINICAL UNITS

Rationale

The main purpose of focussed (point of care) ultrasound examinations in the gynaecology and/or

early pregnancy clinical setting is to provide rapid, easily obtained, valid information to influence

time-critical clinical management decisions.

The role of focussed ultrasound examinations is to answer a specific, clinical question to assist the

clinician in deciding on appropriate further clinical management. 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: Basic Gynaecology and Early Pregnancy Assessment (Trans-abdominal only)

Aim

The candidate demonstrates skill in obtaining valid and efficient trans-abdominal ultrasound data in

the assessment of the female pelvis to answer the specific clinical question. 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 female pelvis which may typically be addressed using focussed point of care trans-abdominal 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 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

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describe the limitations of trans-abdominal ultrasound in assessing the female pelvis in a PoCUS context, including the circumstances where a trans-vaginal scan or further urgent medical consultation is required

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 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 (Basic Gynaecology and Early Pregnancy Assessment

(Trans-abdominal only))

Key clinical questions addressed in PoCUS contexts:

o Is there evidence of intra or extra uterine masses? If so where? o Can the ovaries be identified? o Is there evidence of ovarian mass/es? o Does the endometrium appear consistent with the stage of the life/reproductive cycle? o Is there evidence of free fluid in the pelvis? If so where and how much? o Is there evidence of an intra-uterine pregnancy? If so, is there a visible yolk sac, fetal pole

and/or fetal heart beat? o Is there evidence of an intra-uterine contraceptive device? If so, where is it? 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 assessing if bladder filled with urine plus informed consent if

possible o Select and prepare ultrasound and ancillary equipment o Enter patient data into ultrasound equipment

Image acquisition

o Acquire and optimise trans-abdominal ultrasound images/data o Identify relevant anatomical features and landmarks including but not limited to:

o urine filled bladder o uterus and cervix o endometrium o ovaries, if possible

o Continuous real-time imaging of the pelvic organs (uterus and ovaries if possible) in their entirety in both transverse and longitudinal planes

o Measurement of the uterus and ovaries in two orthogonal planes, if identified o Assessment of the endometrial thickness in the context of the stage of the reported

life/reproductive cycle o Measurement of any abnormal masses in at least two orthogonal planes

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o If a possible gestational sac is identified in the uterus, assess using a zoomed or reduced depth image to determine if a yolk sac, fetal pole and/or fetal heart rate (FHR) is visible

o Identify and respond to ultrasound artifacts, if required, to improve diagnostic quality of images/data.

Minimal recorded images/ultrasound data

The following are the required minimal images to be recorded, unless the patient’s clinical situation

(for example a clinically unstable emergency 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 Longitudinal and transverse images of uterus, including measurements o Images, preferably, in two orthogonal planes of each ovary, including measurements o If free fluid present document location and extent o Any abnormal masses/features document with measurements in two orthogonal planes o If a possible gestational sac is identified in the uterus, document zoomed or reduced depth

images to document if a yolk sac, fetal pole and/or fetal heart rate (FHR) is visible (ideally an M-mode trace should be included of FHR)

Sonographic appearances of expected positive, negative and equivocal findings

o Describe ultrasound appearances using correct sonographic terminology 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 o Identify and respond to any limitations of the trans-abdominal ultrasound, including the

circumstances where a trans-vaginal scan or further urgent medical consultation is required, including but not limited to; equivocal findings, a patient undergoing IVF, a haemodynamically unstable patient, severe pain and/or substantial free fluid in the context of negative or equivocal ultrasound findings

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.

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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 (Gynaecology) a candidate must, amongst other items as described

in this curriculum, successfully meet the specific requirements of Unit 3: Basic Gynaecology and

Early Pregnancy Assessment (Trans-abdominal only).

The successful completion and documentation of the following assessments in Basic Gynaecology

and Early Pregnancy Assessment (Trans-abdominal only) is required:

o Two (2) formative assessments of clinical skills, specifically related to the trans-abdominal assessment of the female pelvis (may be in simulated environments)

o Two (2) summative assessments of clinical skills, specifically related to the trans-abdominal assessment of the female pelvis (must be in workplace or on models with pathology if in a simulation setting).

o One (1) ASUM on-line interpretive, case-based scenario analysis quiz, specifically related to the trans-abdominal assessment of the female pelvis and possible early pregnancy.

Note:

o At least one summative assessment must demonstrate pathology o The summative assessments must be undertaken after no less than 50% and then

90% of the clinical record log requirements for trans-abdominal gynaecological and/or early pregnancy cases have been met.

Experience of specified type/number of cases as verified in clinical record log (logbook).

For Basic Gynaecology and Early Pregnancy Assessment (Trans-abdominal only), candidates must

demonstrate, in their verified clinical record log (logbook), that they have personally performed:

a minimum of 40 trans-abdominal ultrasound scans of the female pelvis of which at least 5 scans must have a verified positive finding

o of these, at least 50% (20 scans) must have been performed in an actual clinical setting

case review of a further minimum of 10 scans with verified positive findings. This may be in clinical case review in the workplace, or review of a case library in a purposeful education facility, or by review of the ASUM case library.

Note: The trans-abdominal component of a scan which also progresses to a trans-vaginal scan

and/or a specific scan that meets the requirements for Unit 5: Ultrasound Assessment of Free Fluid

(Abdomino-pelvic) may also be recorded for the purposes of the clinical record log (logbook) for

those units. Please note this will only apply if all requirements as detailed in the core unit description

for the trans-abdominal scan are met.

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For full details and other clinical record log (logbook) requirements refer to the ACPoCUS

Candidate’s Education and Clinical Experience Handbook.



Clinical training

ASUM Standards of practice documents

? key references to be provided by Certification Board specialists

Unit 4: Gynaecology and Early Pregnancy Assessment (TA and TV)

Aim

The candidate demonstrates skill in obtaining valid and efficient trans-abdominal (TA) and trans-

vaginal (TV) ultrasound data in the assessment of the female pelvis in acute/emergency

presentations and/or early pregnancy to answer the specific clinical question. The candidate can

recognise when the findings are positive, negative or equivocal and use this assessment to


Learning objectives

The candidate can:

describe the clinical questions, related to the assessment of the female pelvis, including patients in early pregnancy, 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 (trans-abdominal and/or trans-vaginal techniques as relevant) which is suitable to answer the clinical question, including any applicable measurements



describe the limitations of ultrasound in assessing the female pelvis in acute/emergency presentations and/or early pregnancy in a PoCUS context including the circumstances where a formal referral for comprehensive ultrasound or other imaging, or further medical consultation, is required



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Expected standards of practice (Gynaecology and Early Pregnancy Assessment TA and TV)


o Is there evidence of an intra-uterine pregnancy? o Is there any evidence of a yolk sac and/or fetal pole and/or fetal heart beat? o If a fetal heart beat is present what is the fetal heart rate (FHR) as measured on M-mode? o If a fetal pole is present what is the crown-rump length (CRL) and estimated gestational

age? o Is there evidence of any intra or extra uterine masses? If so, where? o Is there evidence of ovarian masses? o Does the endometrium appear consistent with the stage of the life/reproductive cycle? o Is there evidence of an intra-uterine contraceptive device? If so, where is it? o Is there free fluid in the pelvis? If so, where and how much? o Are there any other findings which may support another differential diagnosis which may

explain the patient presentation?


Preparation

o Prepare clinical environment o Prepare patient, including assessing if bladder is filled with urine and informed consent if

possible o Select and prepare ultrasound and ancillary equipment o If performing trans-vaginal examination, ensure consent obtained and that equipment has

been adequately disinfected in accord with the published ASUM Guidelines6 o Enter patient data into ultrasound equipment

Image acquisition

o Acquire and optimise trans-abdominal ultrasound images/data o If required, acquire and optimise trans-vaginal ultrasound images/data o Identify relevant anatomical features and landmarks, including but not limited to:

o urine filled bladder (trans-abdominal only) o uterus and cervix o endometrium o ovaries, if possible

o Continuous real-time imaging of the pelvic organs (cervix, uterus and ovaries) in their entirety in both transverse and longitudinal planes

o Measurement of the uterus and ovaries in two orthogonal planes, if identified o Assessment of the endometrial thickness, in the context of the stage of the reported

life/reproductive cycle, or gestational sac in two orthogonal planes if present o Interrogation of gestational sac, if identified, using zoomed or reduced depth imaging for

presence or absence of yolk sac, fetal pole and/or fetal heart rate (FHR) o M-mode measurement of FHR if present o Measurement of CRL if fetal pole visible (ensuring fetal pole, not yolk sac, included in

measurement) o Measurement of any abnormal masses in at least two orthogonal planes o Identify and respond to ultrasound artifacts, if required, to improve diagnostic quality of

images/data. o Identify if any free fluid present in pelvis.

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ACN 001 679 161 ABN 64 001 679 161



(for example a clinically unstable 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.



o Longitudinal and transverse/coronal images of uterus, including measurements o If a possible gestational sac is identified, document zoomed or reduced depth images to

demonstrate location of gestational sac and contents if visible (yolk sac and/or fetal pole and/or fetal heart beat (M-mode))

o Documented measurements of FHR (M-mode) and CRL if possible o Images in two orthogonal planes of each ovary, if identified o If free fluid present document location and extent o Any abnormal masses/features with measurements in two orthogonal planes.


o Describe ultrasound appearances using correct sonographic terminology o Identify conclusive findings, positive or negative o Identify limitations of examination or relevance of equivocal findings


o Describe relevance of ultrasound findings correlated to clinical presentation and other data o Identify and respond to any limitations of the ultrasound examination, including the

circumstances where a referral for a formal comprehensive trans-vaginal scan or further urgent medical consultation is required, including but not limited to; equivocal findings, a patient undergoing IVF, a haemodynamically unstable patient, severe pain and/or substantial free fluid in the context of negative or equivocal ultrasound findings

o If measurements of FHR and/or gestational sac size and/or CRL performed, correlate results with standard biometric charts to establish approximate gestational age

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 Ensure trans-vaginal probe and other relevant equipment is disinfected following the ASUM

Guidelines for Reprocessing Ultrasound Transducers6 o Store ultrasound equipment safely and correctly.

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Assessments









in this curriculum, successfully meet the specific requirements of Unit 4: Gynaecology and Early

Pregnancy Assessment (TA and TV).

The successful completion and documentation of the following assessments in Gynaecology and

Early Pregnancy Assessment (TA and TV) is required:

o Two (2) formative assessments of clinical skills, specifically related to assessment of the female pelvis, including in possible early pregnancy (may be in simulated environments)

o Two (2) summative assessments of clinical skills, specifically related to assessment of the female pelvis in early pregnancy (must be in workplace or on models with an early pregnancy if in a simulation setting)

o One (1) ASUM on-line interpretive, case-based scenario analysis quiz, specifically related to the assessment of the female pelvis in acute presentations, including those in early pregnancy

Note:

o At least one formative and both summative assessments must be a trans-vaginal scan

o The summative assessments must only be undertaken after no less than 50% and then 90% of the clinical record log requirements for Gynaecology and Early Pregnancy Assessment (TA and TV) have been met.

Experience of specified type/number of cases as verified in clinical record log.

For Gynaecology and Early Pregnancy Assessment (TA and TV), candidates must demonstrate, in

their verified clinical record log, that they have personally performed:

a minimum of 40 ultrasound scans of the female pelvis in acute/emergency presentations and/or with clinically suspected or known early pregnancy.

o of these at least 75% (30 scans) must have included a trans-vaginal scan and o at least 50% (20 scans) must have been performed in an actual clinical setting

and o at least 20 scans must have a verified positive ultrasound finding of pregnancy

(intra-uterine or ectopic) o at least 25% (10 scans) must demonstrate adnexal anatomy/pathology

(examples include but is not limited to; ovarian follicles/cysts, corpus luteal cyst, haemorrhagic cyst, tubal pathology)

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ACN 001 679 161 ABN 64 001 679 161

case review of a further minimum of 10 scans with verified positive abnormal acute gynaecological findings or abnormal/ectopic early pregnancy findings. This may be in clinical case review in the workplace, or review of a case library in a purposeful education facility, or by review of the ASUM case library. The cases reviewed must include at least 5 positive cases of verified ectopic pregnancy.

For full details and other clinical record log requirements refer to the Candidate’s Education and

Clinical Experience Handbook.

Resources/suggested learning activities (to be fleshed out)


Clinical training



Unit 5: Ultrasound Assessment of Free-Fluid (Abdomino-pelvic)

Aim

The candidate demonstrates skill in obtaining valid and efficient ultrasound data in the assessment

of the abdomino-pelvic (peritoneal) spaces to answer the specific clinical question. The candidate

can recognise when the findings are positive, negative or equivocal and use this assessment to


Learning objectives

The candidate can:

describe the clinical questions, related to the Ultrasound Assessment of Free-Fluid (Abdomino-pelvic) in the context of the point-of-care ultrasound assessment of gynaecological and early pregnancy acute/emergency presentations, 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 applicable measurements



describe the limitations of ultrasound in assessing the abdomino-pelvic (peritoneal) spaces in a PoCUS context


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ACN 001 679 161 ABN 64 001 679 161


Expected standards of practice (Ultrasound Assessment of Free-Fluid (Abdomino-pelvic))


o Is there free fluid in the abdomino-pelvic peritoneal space? o If so, where is it and how extensive is it?


Preparation

o Prepare clinical environment o Prepare patient, including informed consent if possible o Select and prepare ultrasound and ancillary equipment o Enter patient data into ultrasound equipment

Image acquisition

o Acquire and optimise ultrasound images/data o Identify relevant anatomical features and landmarks, including identifying potential spaces

where free fluid may be imaged (abdominal and pelvic peritoneal spaces) o Image potential fluid spaces from multiple sonographic windows as required (for example

intercostal, subcostal, abdominal and pelvic) o Provide qualitative estimates of amount of any free fluid found o Identify and respond to ultrasound artifacts if required to improve diagnostic quality of

images/data.



(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.



o Still or cine-loop saved images of the right upper quadrant (RUQ) of the abdomen (including Morrison’s Pouch or posterior right subhepatic space and tip of the liver)

o Still or cine-loop saved images of the left upper quadrant (LUQ) of the abdomen (including the lienorenal space and tip of the spleen)

o Transverse and longitudinal pelvis

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o Describe ultrasound appearances using correct sonographic terminology o Identify conclusive findings, positive or negative o Identify limitations of examination or relevance of equivocal findings


o Describe relevance of ultrasound findings correlated to clinical presentation and other data 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.

Assessments









in this curriculum, successfully meet the specific requirements of Unit 5: Ultrasound Assessment of

Free-Fluid (Abdomino-pelvic).

The successful completion and documentation of the following assessments in Unit 5: Ultrasound

Assessment of Free-Fluid (Abdomino-pelvic) is required:

o Two (2) formative assessments of clinical skills, specifically related to the ultrasound assessment of free-fluid (abdomino-pelvic) (may be in simulated environments)

o Two (2) summative assessments of clinical skills, specifically related to the ultrasound assessment of free-fluid (abdomino-pelvic) (must be in workplace or on models with pathology if in a simulation setting)

o One (1) ASUM on-line interpretive, case-based scenario analysis quiz, specifically related to the ultrasound assessment of free-fluid (abdomino-pelvic)

Note:

o The summative assessments must only be undertaken after no less than 50% and then 90% of the clinical record log requirements for ultrasound assessment of free-fluid (abdomino-pelvic) have been met.

Experience of specified type/number of cases as verified in clinical record log.

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For Unit 5: Ultrasound Assessment of Free-Fluid (Abdomino-pelvic), candidates must demonstrate,

in their verified clinical record log, that they have personally performed:

a minimum of 40 ultrasound scans related to the assessment of free-fluid (abdomino-pelvic), in the context of acute/emergency gynaecological and/or early pregnancy presentations:

o of these, at least 5 scans must have a verified positive finding of substantial free fluid and

o 50% (20 scans) must have been performed in an actual clinical setting and must include cases of suspected, at least, acute gynaecological conditions or ectopic pregnancy

Note: If the assessment of free fluid (abdomino-pelvic) has been performed in conjunction with a

trans-abdominal and/or trans-vaginal scan, the assessment of free fluid (abdomino-pelvic)

component of those examinations may also be recorded as part of the Unit 5 requirements, for the

purposes of the clinical record log (logbook). Please note this will only apply if all requirements are

met, as detailed in the core unit description for the ultrasound assessment of free fluid (abdomino-

pelvic).

For full details and other clinical record log requirements refer to the Candidate’s Education and

Clinical Experience Handbook.

Resources/suggested learning activities (to be fleshed out)


Clinical training



Unit 6: Portfolio of Clinical Competence in PoCUS (Gynaecology)

Rationale

The award of an ACPoCUS (Gynaecology) is based on a candidate demonstrating a level of

competence3 in the core clinical applications1,2,4 of ultrasound appropriate to the clinical scope of

practice.

Overall competence as a practitioner of PoCUS in Gynaecology 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 (Gynaecology) practitioner through submission of a portfolio of evidence verifying

that they meet the Capability Statements for ACPoCUS (Gynaecology).

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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

portfolio of evidence and seeks the award of the ASUM Certificate in Point of Care Ultrasound

(Gynaecology) (ACPoCUS).

Final holistic clinical assessments:

Final holistic on-line interpretive, case-based scenario analysis quiz to cover all core clinical areas of the ACPoCUS Gynaecology (that is: Basic Gynaecology and Early Pregnancy Assessment (TA), Gynaecology and Early Pregnancy Assessment (TA and TV), and Ultrasound Assessment of Free-Fluid (Abdomino-pelvic)). 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”1,5) of clinical focussed/point of care ultrasound at the level of competence3 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 (Basic

Gynaecology and Early Pregnancy Assessment (TA), Gynaecology and Early Pregnancy Assessment (TA and TV), and Ultrasound Assessment of Free-Fluid (Abdomino-pelvic)).

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 Beginner3 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” level3

o Completed final holistic summative clinical competence assessment (global

rating scale1,5) by supervisor or other approved person at “competent” level3

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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ACN 001 679 161 ABN 64 001 679 161

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

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 (Gynaecology).

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. Atkinson P, Bowra J, Lambert M, Lamprecht H, Noble V, Jarman B. International federation for

Gynaecology point of care ultrasound curriculum. CJEM 2015, Mar;17(2):161-70

2. Dietrich CF, Goudie A, Chiorean L, Cui XW, Gilja OH, Dong Y, et al. Point of care ultrasound: A

WFUMB position paper. Ultrasound Med Biol 2017, Jan;43(1):49-58

3. 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

4. Noble VE, Nelson B. Manual of emergency and critical care ultrasound, Second Edition.

Cambridge, UK; New York: Cambridge University Press; 2011

5. 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

6. Basseal JM, Westerway SC, Juraja M, F van de Mortel T, McAuley TE, Rippey J, et

al. Guidelines for Reprocessing Ultrasound Transducers. Australasian Journal of Ultrasound in

Medicine 2017; 20: 30–40.

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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 (Gynaecology). 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 (Gynaecology) as at January 2018

???? some ideas below but are these too advanced for this level – should this be

DDU/COGU level

Level 3 Gyn (advanced gyn)

Are there any intra or extra uterine masses? If so what are their features, including blood

flow/Doppler?

Are there any structural abnormalities of the uterus (bicornuate etc)?

Are there any abnormalities of the endometrium?

US in female fertility management

Are there any structural abnormalities of the uterus (bicornuate etc)?

Are there any abnormalities of the endometrium?

? others here

Documents

Australasian Society for Ultrasound in Medicine (ASUM ... · The Australasian Society for Ultrasound in Medicine (ASUM) is the peak body for setting and maintaining standards for