DMS 3824

Clinical Practicum II

 Copyright 2006


University of Arkansas for Medical Sciences

College of Health Related Professions

Department of Radiologic Technology

Diagnostic Medical Sonography


8 Semester Credits

500 Clinical Hours

 Spring DMS Junior Year


Terry J. DuBose, M.S., RDMS,

ED South Room-204



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

ED 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 3824: Clinical Practicum II (8 Credit Hours)




1.1       Catalog Description


Continuation of clinical course work at the skilled level. Prerequisite: DMS3541.


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


1.2       Course Rationale


A sonographer must develop psychomotor and affective learning experiences in practical sonographic scanning in a clinical setting in order to develop competency in this diagnostic 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 site’s protocol.  The sonographer must be able to prepare the patient for the examination, obtain the patient’s 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. During this course the student is expected to perform complete, basic examinations; including the biliary system, hepatic, renal, aorta & IVC, splenic, pancreatic, pelvic, and obstetric examinations.


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.  Apply effective oral and written communications skills using appropriate medical terminology.


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


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


E.  Understand and apply appropriate procedures in patient transportation, standards of care, personal health, psychological support, patient rights, and patient comfort.


F.  Display 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.  Perform complete sonographic examinations of the following organs: liver, gallbladder, biliary system, left & right kidneys, pelvis (non-gravid), pancreas, spleen, abdominal aorta, inferior vena cava, ovaries, placenta, amniotic fluid, umbilical cord, and fetal anatomy (fetal head, spine, abdomen, heart, femur & humerus; with measurements).


I.  Be capable of sonographically locating and measuring the fetal parameters required to date a pregnancy and to calculate the estimated fetal age and weight.




2.1       General Techniques


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


A.  Demonstration and observation


B.  Discussion


C.  Practice


D. Assigned readings from professional journals and textbooks may be       



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: A Guide to Clinical Practice; Volume 1: Obstetrics and Gynecology.  Berman, MC;  J. B. Lippincott Company, Philadelphia, 1997; ISBN: 0-397-55261-0.


B.        *DIAGNOSTIC MEDICAL SONOGRAPHY: A Guide to Clinical Practice; Volume 2: Abdomen & Superficial Structures.  Kawamura, DM;  J. B. Lippincott Company, Philadelphia, 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.               *FETAL SONOGRAPHY. DuBose, TJ.  W. B. Saunders, Philadelphia, 1996; ISBN: 0-7216-5432-0.  Available at the UAMS Library & Department of  Radiologic Technology Library.


E.                *ULTRASOUND EXAMINATION GUIDELINES.  Society of Diagnostic Medical Sonographers.  Dallas, 2000-2001.  Item # 3301.  Available through the SDMS.


F.        INTRODUCTION to ULTRASONOGRAPHY and PATIENT CARE: Craig, M.  W. B. Saunders, 1993;  ISBN: 0-7216-4229-2.  Available at the Department of  Radiologic Technology Library.




4.1       Student Evaluation Procedures


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


B.  Student image portfolios will include student-generated images described on pages 9 and 10.  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.

C.  A written final examination covering the Society of Diagnostic Medical Sonographers (SDMS) Ultrasound Examination Guidelines for the performance of abdominal, gynecological, and obstetrical examinations, daily sonographic laboratory start-up, operation, and shutdown, as well as patient care will be administered at the end of the last clinical rotation.


D.  Film critique will be part of the final examination. This will evaluate the student’s ability to recognize sonographic abdominal, gynecological, and obstetrical anatomy and pathology.


E.  A record of each case observed or participated in will be maintained by the student.  Students are expected to participate in a minimum of 250 cases during the Spring 2005 semester.  The Case Number grades will be based on the following scale:



            < 175 cases               =          0  points

            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 Evaluation                     25%

            Case Numbers                            30%

            Final Exam/Film Critique           35%

            Image Portfolio                          10%




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



A         100 – 93 %   

                        B         92 – 84 %                 

                        C         83 – 75 %                 

                        D         74 – 66 %                 

                        F          65 – 0 %                    



4.2      Clinical Evaluation Procedures


            Students will evaluate the Clinics using the Clinical Rotation Evaluation form.


4.3       Performance:  Lab, Clinic, and Portfolio Evaluation


The student's performance will be evaluated at the end of each clinical rotation by the Clinical Instructor(s) using the CLINICAL INSTRUCTOR’S EVALUATION OF THE STUDENT form.  These evaluations will cover the objectives for this course, including: equipment start-up and shut-down, transducer selection, routine cleaning and care of equipment, patient care, 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.

During the Spring semester the student will be expected to competently perform the following examinations according to the Society of Diagnostic Medical Sonographers (SDMS) Ultrasound Examination Guidelines.  Independent performance will be verified by the respective clinical instructors and documented on the Student Competency Evaluation forms.


            A.     Hepatic                                    

            B.     Biliary System

            C.     Pancreas                                 

            D.     Kidneys

            E.     Spleen                                     

            F.      Aorta & Inferior Vena Cava

            G.     Pelvis (non-pregnant) Transabdominal & Transvaginal

            H.     Obstetrical                               


4.4      Make up of Clinical Hours


A.        The student may request to arrange a make up of clinical hours after the student’s 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.        Students who schedule a make up day and then     miss that day will have to make up two days.




            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 will be required to make up the missed hours.  Failure to make up the missed clinical time will result in a grade of Incomplete (I) for the semester.  Be aware that a grade of Incomplete can have negative effects on your financial aid!   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 Site and the DMS Program office PRIOR TO the program faculty’s discovery of the absence, an automatic five (5) points will be deducted from the final Clinical Practicum grade for each occurrence. Please refer to the Student Handbook for specifics concerning student absences.


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 your grade.  Excessive clinical absences will also lower the number of cases a student observes.  The student should be aware 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 student’s role as an aspiring health care professional and as a representative of the Diagnostic Medical Sonography Program of the Department of Radiologic Technology.  Please refer to the Student Handbook for specifics concerning dress and conduct.




            All clinical paperwork will be due the week following completion of that clinical rotation. Portfolios will be due to the Diagnostic Medical Sonography Program Director the next class day after the end of a Clinical Practicum.


            The clinical Final Examination will be administered during Finals Week:  TBA




8.1       General Remarks


            Clinical session schedules will be distributed by the DMS Program faculty, also see: DMS Clinical Records Web Pages



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 student’s clinical grade for that semester.  Portfolios for Clinical Practicums I, II, & III must be completed by the end of the Junior year Summer 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.    Humerus  Length                                   19.   Size/Age Report Sheet


4.  Superficial 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 student’s name printed on the outside and a numbered list of images the student wants to submit for grading.  In order to keep the clinical site’s 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 2004 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 2005 semester 60% of the portfolio will be completed.  The portfolio will be finished at the end of the Summer 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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