RCOG US module Fetal Anatomy 1

Ultrasound in Early Pregnancy Complications

Logbook for Ultrasound module 5

Contents1. DECLARTION------------------------------------------------------------------------------------------------------3

2. GUIDANCE FOR TRAINEES-------------------------------------------------------------------------------------4

3. GUIDANCE FOR TRAINERS / PRECEPTORS----------------------------------------------------------------5

4. ACQUISITION OF PRACTICAL SKILLS AT THE CLINICAL PLACEMENTS------------------------------5

5. EXAMPLE OF IMAGE ANONYMITY--------------------------------------------------------------------------6

6. RECORD OF ATTENDANCE-------------------------------------------------------------------------------------7

7. LOGBOOK----------------------------------------------------------------------------------------------------------8

8. RECORD OF SUPERVISOR’S FORMAL MEETING-----------------------------------------------------------

First meeting-----------------------------------------------------------------------------------------------------42Second meeting-------------------------------------------------------------------------------------------------43Third meeting---------------------------------------------------------------------------------------------------44Fourth and Final meeting------------------------------------------------------------------------------------45

9. TRAINEE’S ASSESSMENT OF INTERMEDIATE ULTRASOUND MODULE IN NORMAL FETAL ANATOMY--------------------------------------------------------------------------------------------------------46

Declaration

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This statement must be completed and signed after completion of the log book

I confirm that the images contained in my ultrasound log book are images which inclusively were: made only by myself (exceptionally, images of rare and unique cases obtained from sessions

with trainer may be included and the reason for doing so MUST be clearly stated) either directly or indirectly supervised made during the period of my ultrasound training for the intermediate scan module specifically for the purposes of the module for which this log book is submitted, and discussed with my ultrasound trainer/ supervisor before or after inclusion

I confirm that I have complied with the GMC standards for honesty and integrity (Domain 4) about my work experience in completing the log book. Good Medical Practice (2013).

Name: ………………………………….

Signed: ………………………………

Date: …………………………………....

GMC number: ………………………….

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Guidance for trainees

Welcome to the Intermediate Ultrasound of early pregnancy complications. The logbook is an important part of your practical training.

You should go through it very carefully, read the background information, learning outcomes and skills that you must attain. You should also sit with your trainer at the beginning of the your intermediate ultrasound training and regularly thereafter in order to set learning objectives and targets for skills acquisition for the forthcoming few months as well as review progress of the previous period. Your trainer should be able to discuss with you practical issues and scanning tips. It is anticipated that in the initial phase, you will be doing most of the scans under direct supervision and when you have acquired sufficient skills, you will be able to undertake them with your trainer in a neighboring office or within the clinic.

The logbook should be completed with attention to detail and inclusion of a variety of cases and images of good standard covering a number of early pregnancy complications as outlined in the respective sections of the curriculum. If any issues arise during training please speak to your supervisor or Local Ultrasound Educational Supervisor (LUES). If you have issues that cannot be resolved locally then you should contact your Deanery Ultrasound Coordinator. Beyond that you can contact your Head of School and finally the Ultrasound Officer at the RCOG.

During completion of the logbook you should adopt a “problem-based approach”, integrating theoretical knowledge with ultrasound appearance and where appropriate be able to advise patients on findings. As trainees you should develop a consistent and systematic approach towards a full gynaecological assessment. It is important to note that the logbook is intended to be a record of your competence rather than experience. The levels of competence are:

Level 1 The trainee demonstrates detailed knowledge & understanding and is aware of common complications/ issues relating to the competence/ clinical skill/ situation.

Level 2 The trainee is capable of performing the task or managing the clinical problem but with senior support.

Level 3 The trainee can manage the majority of cases with no direct supervision or assistance while having the insight to recognise that senior support will be needed in certain complex cases/ complications.

The ultrasound images included in the logbook should be accompanied by critical evaluation of the image quality and where it could have been improved, a brief summary of clinical details and management. The images should demonstrate aspects of the ultrasound scan which are pertinent to the clinical case. You should review suitable images with your trainer prior to attaching them to the logbook. This provides an opportunity for you to discuss the management options and the appropriateness of the selected option in the case. In one section we ask you to attach “Near-perfect” images of a particular feature. This section should be completed near the end of ultrasound module as it will demonstrate your skills immediately before the assessment. Images should be acquired by yourself except rarely where you have witnessed a very unusual case during scanning with your trainer.

Your trainer has a responsibility to ensure that the logbook is completed to an acceptable standard, that all sections are signed and that it demonstrates that you have experienced a varied case-mix during your practical training and are competent to be entered in the end-of-year practical assessments.

All patient related information i.e. name and hospital number must be concealed or removed from the images used by you while completing the logbook. The hospital name and date of the

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assessment however should be retained to ensure that the images are valid. The image shown on page 6 of the logbook is an example of what form a correct image should take.

The logbook will be reviewed by your Local Ultrasound Educational Supervisor (LUES). Once your LUES is satisfied then the logbook should be submitted to the Deanery Ultrasound Coordinator (DUC). If you have satisfactorily logged competence progression and completed all associated assessments in your ePortfolio in addition to the logbook your DUC will sign off the intermediate ultrasound module completion form. Please note that competence progression and all associated assessments have to be completed through the ePortfolio.

Ultrasound is a practical skill which takes time to develop and finesse to a high standard. It is expected that to achieve a high level of competency in this module you will need to scan 1-2 sessions per week for about a year.

This module is recommended if you want to undertake the ATSM in acute gynaecology and early pregnancy. You can complete the ultrasound module either before or parallel to ATSM training, depending on your individual needs.

You can complete this ultrasound module either before or parallel to subspecialty training, depending on your individual needs. If you wish to complete the training in parallel, you will need to discuss this and gain approval in advance from your Subspecialty Training Programme Supervisor and Deanery Ultrasound Coordinator.

Guidance for trainers/preceptors (Job description for Local ultrasound educational supervisor) Thank you for agreeing to be a trainer for the Intermediate Ultrasound of early pregnancy complications. A trainee is scheduled to attend your ultrasound scan sessions to acquire essential skills in early pregnancy complication ultrasound. The trainee will need to sit with you at the earliest opportunity to go through the learning outcomes outlined in the logbook and the skills which the trainee must acquire. These skills are varied and encompass machine-related skills, image acquisition and demonstration of appropriate patient-related skills. You should also sit with your trainee at the beginning of the module and regularly thereafter in order to set learning objectives and targets for skills acquisition for the forthcoming few months as well as review progress of the previous period.

Acquisition of practical skills at the clinical placement

Supervised practical training with the trainer aims to achieve the skills specified in the logbook.

The following factors need to be taken into consideration

1. Pre-existing experience in gynaecological ultrasound.

2. Availability of training opportunities for both trainers and trainees.

Practical training would include at least 60 directly supervised scans.

It is likely that many of the available training sessions would fall within special interest sessions of a consultant gynaecologist or the early pregnancy assessment unit. A variety of early pregnancy complications may be encountered and the number of women seen may not be consistent as with a stand-alone ultrasound list. In other cases it may be possible for the trainee to be supervised by a radiologist or a sonographer. In such circumstances, it is the trainer’s duty to ensure that the relevant professional is suited for the task and is familiar with the training programme requirements. For this reason it is suggested that a set number of sessions, or cases per session, may not be appropriate and that the trainee should log the sessions and number of cases encountered to demonstrate the case-mix and that the minimum number of supervised scans should be achieved to demonstrate acquisition of the skills.

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Example of image anonymity

Patient’s name & number concealed Hospital and Date of Scan retained

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Record of attendanceDate Number of scans

Directly Supervised Indirect supervision

Use additional sheet(s) if necessary

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Logbook

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Record of Supervisor’s Formal Meeting with Trainee

First meetingComments

Initial learning targets at start of training and till the next meeting

Learning targets achieved over previous period (Outline strengths and achievements and areas of concern from previous study phase)

Log book progress and review N/A for first meeting

Targets for next period

Student’s signature and date

Trainer’s signature and date

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Record of Supervisor’s Formal Meeting with Trainee

Second meeting 4 months

Comments

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Learning targets achieved over previous period

Log book progress and review

Targets for next period

Student’s signature and date

Trainer’s signature and date

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Record of Supervisor’s Formal Meeting with Trainee

Third meeting 8 monthsComments

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Log book progress and review

Targets for next period

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Record of Supervisor’s Formal Meeting with Trainee

Fourth and final meeting 12 monthsComments

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Trainee’s assessment of intermediate ultrasound module in Early Pregnancy complicationsTo be completed by the trainee and returned to the Deanery Ultrasound Coordinator

1. Has this training programme given you adequate skills to fulfil the learning outcome outlined in your scheme of study?

YES NO

Feedback on your LUES /Training Centre:

2. How confident are you at identifying early pregnancy complications?

Confident Fairly confident Not confident

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3. How confident are you at correlating ultrasound findings with the clinical presentation?

Confident Fairly confident Not confident

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4. How confident are you at establishing a diagnosis and formulating a plan of action?

Confident Fairly confident Not confident

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5. How confident are you at communicating your findings to the patient and colleagues?

Confident Fairly confident Not confident

Comments:

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