University of Arkansas for Medical Sciences
Diagnostic Medical Sonography Program 
Copyright 2006

DMS 4843: Sonographic Clinical Practicum IV 
8 Semester Credits
470 Clinical Hours

Terry J. DuBose, M.S., RDMS
Tony Baker, B.S., RDMS, RVT, CNMT

Fall(4) Seniors 


1.1 Catalog Description

Continuation of clinical course work at the skilled level. Prerequisite: DMS 3631.

1.2 Course Rationale

A sonographer must develop psychomotor and affective learning experiences in practical sonographic scanning in a clinical setting in order to demonstrate  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 protocol. The sonographer must be able to prepare the patient for the examination, obtain the medical history, select appropriate equipment, follow established examination protocols, revise established protocols to fit unique patient needs, 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 examinations in the following areas: gall bladder, liver, kidneys, aorta & inferior vena cava, pancreas, spleen, pelvis (transabdominal & transvaginal), obstetrics, and superficial structures (thyroid, breast, scrotum). 

1.3 General Course Objectives

Upon completion of this course, the student will:

A. Demonstrate knowledge and an 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 procedures, and the role of sonography in patient management.

B. Employ effective oral and written communications skills utilizing appropriate medical terminology.

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

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

E. Employ patient-centered techniques in patient transportation, standards of care, personal health, psychological support, and patient rights and comfort.

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

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

H. Be able to perform complete sonographic examinations of the following organs: liver, gallbladder, left & right kidneys, non-gravid uterus, 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 able to sonographically locate and measure the fetal parameters required to date a pregnancy and to use these parameters to accurately 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 required

E.  internet-based instruction utilizing WebCT, CD ROM, and compressed video

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.

A. DIAGNOSTIC MEDICAL SONOGRAPHY: A Guide to Clinical Practice; Volume 1: Obstetrics and Gynecology (1997) M. C. Berman, Editor; J. B. Lippincott Company, Philadelphia; ISBN: 0-397-55261-0.

B. DIAGNOSTIC MEDICAL SONOGRAPHY: A Guide to Clinical Practice; Volume 2: Abdomen & Superficial Structures (1997) D. M. Kawamura, Editor; J. B. Lippincott Company, Philadelphia; ISBN: 0-397-55263-7.

C. ULTRASONOGRAPHY: AN INTRODUCTION to NORMAL STRUCTURE and FUNCTIONAL ANATOMY. (1995). Curry, RA and Tempkin, BB. W. B. Saunders: Philadelphia; ISBN: 0-7216-4585-2

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

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


4.1 Student Evaluation Procedures

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

B. Student image portfolio will include the student-generated images listed below. These images must demonstrate appropriate planes of view, content, and quality as described in the Society of Diagnostic Medical Sonographers (SDMS) Ultrasound Examination Guidelines in order to receive points. 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 the semester.

Portfolio Images including transverse, longitudinal and coronal as appropriate: Uterus & ovaries, 1st trimester pregnancy (gestational sac, yolk sac, crown-rump length, embryonic heart rate, cervix, myometrium & and adnexa), 2nd & 3rd trimester (cervix, fundus, placenta, AFI, fetal head {BPD, transverse & coronal head circumference, cerebellum & cisterna magnum, face or lips}, complete spine, abdominal circumference, umbilical cord insertion, kidneys, coronal trunk including heart, stomach & urinary bladder, femur and humerus length measurements, one hand and foot, and a fetal size/age evaluation sheet.)

C. A written final examination covering SDMS Guidelines for the performance of abdominal, obstetrical, gynecological, and superficial sonography, and sonographic laboratory daily start-up, operation, and shutdown, patient care, and laboratory examination protocols will be administered at the end of the semester.

D. A record of each case participated in will be maintained by the student. The student is expected to participate in a minimum of 250 cases during the Fall 2001 semester. Grades will be assigned by the number of cases as a percentage of the minimum requirements:

< 175 = 0 points
175 - 224 cases = 35 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

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

Clinical Grade of Record 30.%
Case participation (number) 30.%
Portfolio 15.%
Final Exam 25.%

F. 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 %

4.2 Instructor Evaluation Procedures

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

4.3 Performance: Lab, Clinic, and Project Evaluation

Student performance will be evaluated at the end of each 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 may have varying equipment, exam protocols, medical record procedures, and other unique conventions which the student will be expected to master during a given rotation.

In the Fall(4) semester Senior DMS students will be expected to competently perform the following examinations according to the Society of Diagnostic Medical Sonographers Ultrasound Examination Guidelines. Independent performance will be verified by the respective clinical instructors.

1. Hepatic 8. Obstetrical - With Fetal Assessment
2. Gallbladder 9. Scrotal
3. Pancreatic 10. Thyroid
4. Renal 11. Breast
5. Spleen 12. Endovaginal - Uterus & Ovaries
6. Aorta & Inferior Vena Cava  
7. Pelvic (non-pregnant)  

4.4 Make up of Clinical Hours

A. The student may request to arrange make up clinical hours after the student’s return to the department.

B. Outline of Steps to be Taken Regarding the Make up Clinical hours

I. notify the Clinical Instructor 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 a clinical absence for that day 


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 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 expected to make up missed work. If unable to attend a clinical session, common courtesy and the course grading structure dictates that the Clinical Instructor and Diagnostic Medical Sonography Program Secretary receive prior notification of the anticipated absence. If a student is not present in clinic at the appropriate times, and does not notify both the Clinic and the DMS Program office prior to the Program faculty's discovery of the absence, an automatic 5 points will be deducted from the final Clinical grade for each occurrence.

6.2 Clinical Absences and Tardiness Grading Effects

Dependability and promptness are essential to effective clinical work; therefore tardiness and absences can effect your clinical evaluations and grade. The student should also remain cognizant that clinical affiliates are also potential employers of graduates. Work habits will be observed in the clinical sittings.

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.


Clinical evaluations will be due the week following the completion of the rotation. Portfolios will be due to the Diagnostic Medical Sonography Program Director the next class day after the end of a clinical rotation. All Competency Evaluations, Clinical Records and Portfolio, and assigned work must be turned in before the Final Examinations are taken.


8.1 General Remarks

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