CSN032 Cardiac Ultrasound Clinical Practice 2

Unit Outline: Semester 1 2025, Online

Overview

This unit is the second clinical unit of this course and aims to develop the necessary clinical and professional skills necessary as part of clinical practice. Your specialist skills will be further refined and expanded, and advanced echocardiographic skills will be developed through employment and training in a QUT approved clinical department. This unit builds on your skills, knowledge and abilities gained in the unit CSN031 Cardiac Ultrasound Clinical Practice 1. 

This is a designated unit which is essential to your course progression. Designated units include professional experience units, units requiring the development of particular skills, and units requiring demonstration of certain personal qualities. If you fail to achieve a satisfactory level of performance in a designated unit, you may be excluded from enrolment or will be put on academic probation. If you fail a designated unit twice within your course, you may be excluded. Supplementary assessment is not available on designated units.

Learning Outcomes

On successful completion of this unit you will be able to:

1. Perform a range of comprehensive adult echocardiographic examinations, advanced measurements and calculations at the standard expected by the American Society of Echocardiography (ASE).
2. Evaluate the normal and abnormal echocardiographic features and anatomy identified in a diverse range of patients during echocardiographic examinations.
3. Critically examine and interpret the clinical ultrasound request to ensure high levels of diagnostic accuracy.
4. Produce high quality digital imaging by applying the physical principles of ultrasound and adapting ultrasound instrumentation settings as appropriate.
5. Communicate evidence-based clinical practice, findings and research effectively using a range of digital, oral and written formats.

Content

Learning Approaches

This unit combines supervised clinical experience in a nominated QUT approved clinical department with a range of formative and summative assessment items undertaken by the student during the period of clinical practice.

Practical: Supervised Clinical Experience. The range and volume of your clinical experience, under the supervision of QUT approved Accredited Cardiac Sonographers or Echocardiologists, should reflect key competency areas of cardiac sonographers when examining a range of cardiac pathologies. It is your responsibility to negotiate the breadth and depth of your clinical experience with your supervisor. Your progress will be monitored and evaluated by your clinical supervisors, in consultation with QUT academic staff. Your workplace experience, as part of a multi-disciplinary team in the clinical setting, is an important part of your learning journey. You will normally undertake supervised ultrasound training no less than 3 days per week (0.6FTE) whilst enrolled. Throughout the course, you are required to record evidence of your clinical experience and competency. Mandatory completion and submission of your Clinical Portfolio is required for satisfactory completion of the program.

You are required to create and record a multi-modal case presentation of an interesting/unusual case that you have scanned, similar to what would be presented in an interesting case session of a conference. You are to follow a specific format, with PowerPoint resources available to assist you in completing this task.

Academic Consultation and Peer Collaboration: QUT academic staff are available to discuss issues relating to the clinical practice requirements on an individual basis, as necessary. You will also engage with the teaching team and your student peers via the unit's online discussion forum.

The online measurements tutorial website is available for you to practice your measurement techniques on real-life images in a simulated environment and receive instant feedback by viewing the expert-level measurement for that image. This practical support should complement the practical support that you receive from your clinical supervisor in the workplace. 

This unit is supported by an intensive block during O Week (approximately 2 days) which combines tutorials, demonstrations and interactive scanning sessions delivered at Gardens Point campus. A physiotherapist will present on the prevalence of work-related musculoskeletal (MSK) disorders within the cardiac sonography profession and will provide you with preventative strategies. You will receive direct feedback on scan and machine optimisation to reduce individual risk at various touchpoints. In addition, a guest lecturer will discuss their experiences providing cultural safe care to diverse patients, including Aboriginal and Torres Strait Islander peoples. You will have the opportunity to reflect on your own cultural backgrounds and begin to explore your own subconscious bias (QUT’s Introduction to Cultural Safety Module) These learning activities aim to ensure your longevity and sustainability providing optimal patient-centred care within the profession. 

Feedback on Learning and Assessment

During the on-campus imaging workshops, you will participate in live-scanning sessions on volunteer patients. During these sessions, you will have the opportunity to receive feedback on your imaging and measurement technique from both peers and expert sonographers. 

Individual formative feedback relating to the Clinical Portfolio submission will be provided via the Canvas site for this unit. Feedback for the case studies is provided as video screencasts from experienced senior staff which allows you to see how measurements would be performed correctly, how the image control settings are manipulated and also hear the commentary from the assessors. This reflects real-world practice where a student would review a case with clinical sonographers in the workplace. Individual, written feedback will be provided for the case presentation submission.

Results for all assessments will be displayed on the Canvas site for this unit.

Assessment

Overview

In this unit, you will undertake both written and clinical assessments related to the learning outcomes of this unit. You will perform echocardiographic imaging in the clinical setting and submit two case studies with specific valvular pathology requirements. You will also research a cardiac condition that you have imaged and prepare multi-modal PowerPoint (PPT) presentation on this topic, providing an opportunity to present your submission in the workplace or at an educational event or conference.

You must receive a satisfactory result in each assessment item in order to be awarded a grade of satisfactory in this unit. Individual assessment items are graded as Satisfactory / Unsatisfactory.

In this unit, for you to be eligible to receive a passing grade, threshold assessment conditions apply to assessment items 1 and 2.  If you do not achieve a satisfactory grade for an assessment item, you are able to make one resubmission of this work. You are advised to seek feedback on your submission from the unit coordinator prior to resubmission.  

A marking criterion is used for the allocation of grades for each assessment item.  A moderation process including cross-marking of submissions ensures individual markers apply standards consistently and fairly.

Unit Grading Scheme

S (Satisfactory) / U (Unsatisfactory)

Assessment Tasks

Assessment: Case Study Portfolio

You will be required to submit two case studies demonstrating the performance of comprehensive adult echocardiographic examinations.  This includes 2D, spectral Doppler and colour Doppler components of the examination, and all appropriate measurements and calculations required to answer the clinical question.

Case study 1 - 

1. This case study must be performed on a patient with either aortic valve stenosis (any severity) and/or a prosthetic aortic valve replacement (surgical or transcatheter – normal or abnormal).
2. This case study MUST include the use of the non-imaging continuous-wave Doppler probe - Showing the transaortic signal achieved from the apical, SSN, RSCL and RSE windows (all attempts are to be shown even if the signal quality is suboptimal), and all signals must be labelled with respect to the signal and window used, e.g., apical, RSE
3. If the image quality is optimal, this study MUST also include an attempted Simpson’s biplane Ejection Fraction

Case study 2 -

1. This case study must be performed on a patient with aortic or mitral regurgitation of at least moderate severity.
2. This case study MUST include the use of the non-imaging continuous-wave Doppler probe - Showing at least the regurgitant signal, and all signals must be labelled with respect to the signal and window used (e.g., apical, RSE).
3. If the image quality is optimal, this study MUST also include an attempted Simpson’s biplane Ejection Fraction
4. If there is both AR and MR, choose one lesion only for critical analysis of the adequacy and completeness of the study section. 
5. Note that quantification of the regurgitant lesion is NOT required but may be included for feedback purposes.

Submissions are graded as satisfactory / unsatisfactory.  A detailed marking criteria is used for the allocation of grades.  A moderation process including cross-marking of submissions ensures individual markers apply standards consistently and fairly.

This assignment is eligible for the 48-hour late submission period and assignment extensions.

Threshold Assessment:

Threshold conditions apply. If you do not achieve a satisfactory grade for this assessment task you are able to make one resubmission of this work. You are advised to seek feedback on your submission from the unit coordinator prior to resubmission.

Assessment: Interesting case presentation

You will be required to research a pathology observed in an echocardiographic examination you have performed in the clinical workplace. You will acquire the digital skills necessary to produce a PowerPoint presentation including a review of current literature relevant to the pathology and a demonstration of your imaging. You will have the opportunity to submit your work for inclusion in an online webinar series for Australian and New Zealand ultrasound students, organised by a sonography industry partner, or alternatively, to present your study at a workplace educational event. 

Submissions are graded as satisfactory / unsatisfactory.  A detailed marking criteria is used for the allocation of grades.  A moderation process including cross-marking of submissions ensures individual markers apply standards consistently and fairly.

This assignment is eligible for the 48-hour late submission period and assignment extensions.

Threshold Assessment:

Threshold conditions apply. If you do not achieve a satisfactory grade for this assessment task you are able to make one resubmission of this work. You are advised to seek feedback on your submission from the unit coordinator prior to resubmission.

Academic Integrity

Academic integrity is a commitment to undertaking academic work and assessment in a manner that is ethical, fair, honest, respectful and accountable.

The Academic Integrity Policy sets out the range of conduct that can be a failure to maintain the standards of academic integrity. This includes, cheating in exams, plagiarism, self-plagiarism, collusion and contract cheating. It also includes providing fraudulent or altered documentation in support of an academic concession application, for example an assignment extension or a deferred exam.

You are encouraged to make use of QUT’s learning support services, resources and tools to assure the academic integrity of your assessment. This includes the use of text matching software that may be available to assist with self-assessing your academic integrity as part of the assessment submission process.

Breaching QUT’s Academic Integrity Policy or engaging in conduct that may defeat or compromise the purpose of assessment can lead to a finding of student misconduct (Code of Conduct – Student) and result in the imposition of penalties under the Management of Student Misconduct Policy, ranging from a grade reduction to exclusion from QUT.

Requirements to Study

Costs

It is a Medicare requirement that all sonographer providers of ultrasound services are included in the Australian Sonographer Accreditation Registry (ASAR): Student accreditation $110.00

Travel costs associated with the on-campus, intensive block.

Resources

Resource Materials

Recommended text(s)

Anderson, B. (2017). Echocardiography: The Normal Examination and Echocardiographic Measurements (3rd ed.). Brisbane: MGA Graphics. (This text is strongly recommended for all students)

Anderson, B (2014). A Sonographer's Guide to the Assessment of Heart Disease. MGA Graphics (This text is strongly recommended for all students)

Reference book(s)

Otto, C.M. (2023). Textbook of Clinical Echocardiography (7th ed.). Philadelphia: Elsevier.

Other

American Society of Echocardiography Guideline and Recommendations: www.asecho.org 

Risk Assessment Statement

There are no out of the ordinary risks associated with this unit.

Course Learning Outcomes

CS61 Graduate Diploma in Cardiac Ultrasound

1. Critically analyse clinical information to accurately differentiate normal cardiac anatomy and complex cardiac pathologies.
   Relates to: Interesting case presentation
2. Perform independent, culturally safe and patient-centred cardiac ultrasound examinations to a high level of technical proficiency and diagnostic accuracy.
   Relates to: Case Study Portfolio
3. Communicate effectively with peers and multidisciplinary health professionals to explore the diagnostic value and limitations of cardiac ultrasound imaging.
   Relates to: Case Study Portfolio, Interesting case presentation
4. Practice as a reflective, ethical and collaborative professional committed to the sustainability of quality assured cardiac sonography practice.
   Relates to: Interesting case presentation