DMS 3514

Clinical Practicum I

Copyright 2006


University of Arkansas for Medical Sciences

College of Health Related Professions

Department of Imaging and Radiation Sciences

Diagnostic Medical Sonography Program


5 Semester Credits

352 Clinical Hours


Terry J. DuBose, M.S., RDMS

Assistant Professor & DMS Program Director

UAMS Education South, Room 204




Anthony L. Baker, M.Ed., RDMS, RVT, CNMT

DMS Program Clinical Coordinator & Faculty

UAMS Education South, Room 216





"The materials used in this course may include copyright protected materials provided for the personal educational use of the enrolled students and may not be further redistributed."




DMS 3514: Clinical Practicum I(5 Credit Hours)




1.1 Catalog Description


A practical application of course work presented in the classroom.Students are assigned educational experiences in clinical sonographic imaging at various clinical sites.


1.2 Course Rationale


A sonographer must develop psychomotor and affective learning skills in practical sonographic scanning in a clinical setting in order to demonstrate competency in this diagnostic imaging modality.Clinical assignments are structured to give the student a broad variety of sonographic observations and scanning experiences under the supervision of practicing sonographers and physicians.The student will be expected to participate in all aspects of the sonographic examinations as delineated by the clinical siteís protocol.The sonographer must be able to prepare the patient for the examination, obtain the medical history, select the appropriate equipment, follow the established examination protocols, record diagnostic images, discuss the case with the supervising physician, and understand the medical record filing system of the clinic.


1.3 General Course Objectives


Upon completion of this course the student will be able to:


A.Demonstrate knowledge and understanding of related imaging, laboratory, and testing procedures as they contribute to the clinical evaluation of anatomy and pathology to include: patient medical history and physical examination, differential diagnosis, diagnostic protocols, basic principles and procedures of pertinent protocols, and the role of sonography in patient management.


B.Demonstrate effective oral and written communications skills by using appropriate medical terminology.


C. Demonstrate an understanding of acoustic physics and its role in the analysis of sonographic image artifacts as they relate to sonographic equipment, patient care, and pathology.


D.Demonstrate knowledge of ultrasound instrumentation, instrument options, operator controls, principles of instrument control, and modes of operation.

E.Demonstrate an understanding of patient transportation, standards of patient care, personal health, patient psychological support, patient rights, and patient comfort.


F.Demonstrate an acceptable level of professional judgment, discretion, professional interaction skills, and ethical performance of duties.


G.Exhibit an understanding of medicolegal principles associated with patient care.


H.Be able to sonographically locate and obtain images of the longitudinal and transverse sections of the following organs: liver, gallbladder, left & right kidneys, pancreas, spleen, abdominal aorta, and inferior vena cava.




2.1 General Techniques


The following general teaching techniques will be used during this course:


A.demonstration and observation



D.assigned readings from professional journals and textbooks


2.2 Resource-Based Techniques


Active participation, observation, and scanning using standard sonographic equipment in the assigned clinic.Film portfolios will be developed by the student to document their progress and to provide images for self-study.




3.1 References -- Print Materials


The following print materials relate to this course.Note that the item marked by an asterisk (*) is required for use during this course.


A.     *DIAGNOSTIC MEDICAL SONOGRAPHY:Obstetrics and Gynecology,†† Berman MC & Cohen HL; 2nd Edition; Lippincott, 1997; ISBN: 0-397-55261-0.


B.     * DIAGNOSTIC MEDICAL SONOGRAPHY:Abdomen and Superficial Structures, Kawamura DM; 2nd Edition; Lippincott, 1997;††ISBN: 0-397-55263-7.


C.    * Ultrasonography: An Introduction to Normal Structural and Functional Anatomy. (2nd ED). (2004). Curry, RA and Tempkin, BB.W. B. Saunders: Philadelphia; ISBN: 0-7216-9780-1.


D.    *ESSENTIALS OF ULTRASOUND PHYSICS: Zagzebski JA; Mosby, 1996;ISBN: 0-8151-9852-3.


E.FETAL SONOGRAPHY:DuBose T. J., W. B. Saunders, 1996;
ISBN: 0-7216-5432-0 (Available at the UAMS Library & Department ofRadiologic Technology Library)




4.1†††††† Student Evaluation Procedures


A.Students will be evaluated at the end of each clinical rotation by a Clinical Instructor at the clinic to which the student is assigned.All clinical evaluations will be averaged for the Clinical Evaluation grade at the end of each semester.


B.Student image portfolios will include the student-generated images described in detail on page number nine.These images must demonstrate appropriate planes of view, content, labels, and quality in order to receive proper credit.Additional images, as recommended by the Clinical Instructor(s), should also be included.The portfolio will be turned in for evaluation at the end of each semester and will be counted as part of the clinical grade.


C.A written clinical final examination covering daily sonographic laboratory start-up, operation, and shutdown, patient care, and laboratory examination protocols will be administered at the end of each semester.


D.Film critique will be part of the clinical final examination. This will evaluate the studentís ability to recognize normal sonographic anatomy and related pathology.


E.A record of each case observed or participated in will be maintained by the student.The student is expected to participate in a minimum of 250 cases during the Fall 2004 semester.Grades will be assigned based on the following scale:


††††††††††† < 175 cases†††††††††††††† =††††††††† 0points

††††††††††† 175 - 224 cases††††††† =††††††††† 30 points

††††††††††† 225 - 249 cases††††††† = †††††††† 65 points

††††††††††† 250 - 275 cases††††††† = †††††††† 75 points

††††††††††† 276 - 300 cases††††††† =††††††††† 84 points

††††††††††† 301-325 cases††††††††† =††††††††† 93 points

††††††††††† > 325 cases†††††††††††††† =††††††††† 100 points


F.The letter grade for this course will be calculated as follows:


††††††††††† Clinical Grade of Record†††††††††††† 30%

††††††††††† Case participation (number)†††††† 30%

††††††††††† Final Exam/Film Critique†††††††††††† 35%

††††††††††† Image Portfolio††††††††††††††††††††††††††††††† 5%

†††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††† 100%††††††††


G.     The grading scale for determining letter grades in this course is as

††††††††††††††††† ††††follows:


††††††††††††††††††††††† A†††††††† 100 - 93†††††††††

††††††††††††††††††††††† B†††††††† 92 - 84†††††††††††††††††††††††

††††††††††††††††††††††† C†††††††† 83 - 75†††††††††††††††††††††††

††††††††††††††††††††††† D†††††††† 74 - 66†††††††††††††††††††††††

††††††††††††††††††††††† F††††††††† 65 - 0


H.†† Students will demonstrate their clinical competency by completing 13 clinical competency evaluations during the first three semesters of the program.These evaluations are mandatory for graduation from the DMS program and must be completed at the end of the Summer 2006 semester.Only a properly certified sonographer registered with the American Registry of Diagnostic Medical Sonographers (ARDMS) will sign the STUDENT COMPETENCY EVALUATION form.†††


4.2†††††† Clinical Evaluation Procedures


††††††††††† Students will evaluate the Clinics using the STUDENT'S EVALUATION OF THE CLINICAL ROTATION form.


4.3†††††† Performance:Lab, Clinic, and Project Evaluation


A.The student's performance will be evaluated at the end of each clinical rotation by the Clinical Instructor of Record using a CLINICAL INSTRUCTORíS EVALUATION OF THE STUDENT form.These evaluations will cover the objectives of this course, including: equipment start-up and shut-down, transducer selection, routine cleaning and care of equipment, patient care, taking the medical history, medical records, sonographic examination protocols, and student interactions with the patients and clinical staff.Each clinic will have varying equipment, exam protocols, medical record procedures, and other unique conventions which the student will be expected to master during a given rotation.Only the Clinical Instructor of Record will complete and sign this student evaluation form.

B.In the first semester (Fall 2005), the student will be expected to know each assigned clinicís protocol for the following examinations:


††††††††††† 1.††††† Gallbladder†††††††††††††††††††††††††††††† 5.††††† Aorta

††††††††††† 2.††††† Liver†††††††††††††††††††††††††††††††††††††††††† 6.††††† Spleen

††††††††††† 3.††††† Renal†††††††††††††††††††††††††††††††††††††††† 7.††††† Pelvic (Transabdominal &††††††

††††††††††† 4.††††† Pancreas††††††††††††††††††††††††††††††††† ††††††† Transvaginal)


4.4†††††† Make up of Clinical Hours


A.†† The student may request to arrange a make up of clinical hours after the studentís return to the department.


††††††††††† B.††††††† Outline of steps to be taken regarding the make up of clinical hours:


I.††††††††† notify the Clinical Instructor and the Program Director that you will be unable to be in clinic on the scheduled day


††††††††††††††††††††††† II.††††††††† contact the Clinical Instructor to schedule the make up hours


††††††††††††††††††††††† III.†††††††† agree on a time for the make up clinical hours


IV.               attend the make-up clinic as agreed


V.††††††† failure to attend a scheduled make-up day will result in an additional clinical absence that will also have to be made up




††††††††††† A.†† Students are expected to participate in the clinic under the supervision of the Clinical Instructor(s).


B.†† The student may request a student/instructor conference concerning any clinical rotation, etc. by contacting the Diagnostic Medical Sonography †† Program Director and requesting an appointment.These conferences should be scheduled for your benefit since the Clinical Instructors are here to help.


C.†† Any contested clinical evaluation must be resolved within two weeks after the return of the graded item to the student.After this time, all grades are final.




6.1†††††† General Remarks


††††††††††† Students should attend every clinical session.Students who miss more than 16 clinical hours (2 days) per semester will make up the missed time at the end of the semester.If unable to attend a clinical session, common courtesy dictates that the Clinical Instructor and Diagnostic Medical Sonography Program Director receive prior notification of the impending absence.If a student is not present in clinic at the appropriate times, and does not notify both the Clinical Instructor of Record and the DMS Program office PRIOR TO the program facultyís discovery of the absence, an automatic five (5) points will be deducted from the Clinical Practicum grade for each occurrence.Refer to the DMS Policy Handbook for specifics concerning clinical attendance and clinical make-up time.


6.2†††††† Clinical Absences and Tardiness Grading Effects


††††††††††† Dependability and promptness are essential to effective clinical work; therefore tardiness and absences will affect your clinical evaluations and final clinical grade.†† In addition, excessive clinical absences will lower the number of clinical cases the student must document, thereby lowering the clinical grade.The student should also remain cognizant that Clinical Affiliates are also potential employers of graduates.Work habits will be closely observed in the clinical settings.


6.3†††††† Conduct/Dress


††††††††††† Student conduct and dress should reflect an awareness of the studentís role as an aspiring health care professional and as a representative of the Diagnostic Medical Sonography Program of the Department of Imaging and Radiation Sciences.Please refer to the DMS Policy Handbook for specifics concerning dress and conduct.




††††††††††† All clinical paperwork, competency evaluations, and image portfolios will be due the last day of that clinical rotation.


††††††††††† The clinical Final Examination will be administered during Finals Week:19 Ė 21 December, 2005.




8.1†††††† General Remarks


††††††††††† Clinical session schedules will be distributed by the DMS Program Director and Clinical Coordinator.




Clinical Image Portfolios 

I.            Students will assemble a portfolio, consisting of 94 pictures, of their ultrasound images taken during the first three Clinical Practicums of the DMS program.The portfolios are required for graduation from the College of Health Related Professions and will make up part of each studentís clinical grade for that semester.Portfolios for Clinical Practicums I, II, & III must be completed by the end of the Summer 2006 semester.


II.                   Each portfolio will consist of longitudinal and transverse images of the following anatomy:


1.      Abdomen:

A.     Liver (Right & Left Lobes)†††††††††††† E.Pancreas

B.     Gallbladder††††††††††††††††††††††††††††††††††††† F.Spleen

C.    Common Bile Duct                         G.Aorta

D.    Right & Left Kidneys                       H.Inferior Vena Cava


2.      Gynecology (Transabdominal & Transvaginal):

A.     Non-gravid Uterus†††††††††††††††††††††††††††† D.Right & Left Ovaries

B.     Cervix

C.    Endometrium


3.      Obstetrics

A.     First Trimester Pregnancy

1.      Gravid Uterus††††††††††††††††††††††††††††† †††††††† 5.Yolk Sac

2.†† Cervix†††††††††††††††††††††††††††††††††††††††††† †††††††† 6.†† Crown-Rump Length

3.      Right & Left Ovaries †††††††††††††††† †††††††††7.†† Gestational Sac Diameter

4.†† Gestational Sac††††††††††††††††††††††††† †††††††† 8.†† Embryonic Heart Rate


B.Second and Third Trimester Pregnancy

1.      Uterine Fundus††††††††††††††††††††††††††† †††††††† 11.Cerebellum

2.      Cervix†††††††††††††††††††††††††††††††††††††††††† †††††††† 12.†† Cisterna Magnum

3.      Placenta†††††††††††††††††††††††††††††††††††††† †††††††† 13.†† Right & Left Kidneys

4.      Four-Quadrant Amniotic Fluid†† †††††††† 14.†† Complete Spine

5.      Biparietal Diameter††† ††† ††††††††††††††††††††15.†† Umbilical Cord Insertion

6.      Transverse Head Circumference††††† 16.†† Face & Lips

7.      Coronal Head Circumference†† †††††††† 17.†† Coronal Trunk(Heart,

8.      Abdominal Circumference†††††††††††††††††† †††††††(Stomach, Bladder)

9.      Femur Length††††††††††††††††††††††††††††† †††††††† 18.†† Hands & Feet

10. †††HumerusLength††††††††††††††††††††† †††††††† 19.†† Size/Age Report Sheet


4.Small Parts

A.     Thyroid (Right & Left Lobes, Isthmus)

B.     Scrotum (Right & Left Testicles, Right & Left Epididymides)

C.    Breast (Right & Left)


III.                  Images to be used for the portfolio must be of actual patients scanned in the clinics.The images will be clearly labeled and stored in a film jacket that has the studentís name printed on the outside and a numbered list of images the student wants to submit for grading.In order to keep the clinical siteís film costs at a reasonable level, please put as many images as possible on one sheet of film.


IV.               At the end of the Fall 2005 semester students will have a minimum of 30% of the portfolio completed.These images may be of the abdomen, pelvis, OB, superficial parts, etc.By the end of the Spring 2006 semester 60% of the portfolio will be completed.The portfolio will be finished at the end of the Summer 2006 Semester.


V.††††††† Students will be scheduled to attend a variety of clinical sites during their time in the DMS program.This will ensure everyone gets exposure to the various ultrasound protocols needed to build their image portfolios.



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