DMS 4854

Clinical Practicum V

Copyright 2006


University of Arkansas for Medical Sciences

College of Health Related Professions

Department of Radiologic Technology

Diagnostic Medical Sonography


Spring, Senior Year

8 Semester Credits

500 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 4854: Clinical Practicum V (8 Credit Hours)




1.1 Catalog Description


Continuation of clinical course work at skilled level.  Prerequesite: DMS4843 

Advanced practice supervised clinical experience emphasizing vascular and echocardiographic sonographic examination procedures.


1.2 Course Rationale


A sonographer must develop finely tuned psychomotor and affective learning skills in practical cardiac and vascular scanning in a clinical setting in order to develop competency in this dynamic imaging modality.  Clinical assignments are structured to give the student a broad variety of cardiac and vascular observations and scanning experiences under the supervision of practicing sonographers and physicians.  The student is expected to participate in all aspects of the cardiac and vascular 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, modify the established examination protocols to fit the patient’s unique requirements, record diagnostic images, record spectral Doppler waveforms, perform measurements and calculations, discuss the case with the supervising physician, and understand the medical records filing system of the clinic. During this course the student is expected to perform complete examinations in either the vascular or echocardiographic track.


1.3 General Course Objectives


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


A.     Perform all of the objectives listed in Clinical Practicum IV.


Vascular Students


B.  Interpret sonographic images of normal anatomy, normal anatomical variants, common pathological variants, and diseases as they relate to the vascular system.


C.  Apply the properties of acoustic physics and hemodynamics in the interpretation of the diagnostic images and in the control of the sonographic equipment during vascular examinations.

D.  Demonstrate the use of plethysmography, sonography, and segmental pressure measurements in the diagnosis of vascular disease.

E.  Analyze sonographic & color flow images, spectral Doppler wave forms, segmental pressures, and plethysmographic information in order to aid the interpreting physician in forming an accurate diagnosis.

F.  Show clinical competency by successfully completing the seven vascular sonography competency evaluations.


Echocardiography Students


B.  Interpret sonographic images of normal anatomy, normal anatomical variants, common pathological variants, and diseases as they relate to the cardiac system.

C.  Demonstrate the use of the various imaging windows and imaging planes in the evaluation of normal and abnormal cardiac anatomy and physiology.

             D.    Perform standard m-mode and 2D measurements.


E.  Acquire appropriate information utilizing Pulsed Wave (PW), Continuous Wave (CW) and Two-Dimensional (2D) modalities, such as valve area, pressure gradients, volumes, diastolic dysfunction, etc.

             F.  Acquire blood pressure readings during resting, exercise, and recovery stages. 

G.  Understand the operation of an EKG machine and interpret the basic results of an ECG tracing. 

H.  Show clinical competency by successfully completing the echocardiography competency evaluation.





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 observation, participation, and scanning using standard sonographic equipment in the assigned clinic. 





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.


Vascular Sonography Textbook:


A.  * Introduction to Vascular Sonography.  (5th ED) (2005).  Zwiebel,  WJ.  W.B. Saunders Company:  Philadelphia; ISBN: 0-7216-0631-8.


Cardiac Sonography Textbooks


A.  *Harry, M; Essentials of Echocardiography & Cardiac Hemodynamics; Harry, 2003


B.     *Harry, M; Cardiac Doppler Interactive Tutorial CD, Harry


C.     *Reynolds, T;  Cardiovascular Principles, Arizona Heart Institute, 1997


D.      Reynolds, T;  The Echocardiographer’s Pocket Reference, Arizona Heart Institute, 2000


E.     Kaddoura S;  Echo Made Easy, Churchill Livingston, 2002.





4.1       Student Evaluation Procedures


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


B.  A written final examination covering the Society of Diagnostic Medical Sonographers (SDMS) Ultrasound Examination Guidelines for the performance of vascular or cardiac examinations, daily sonographic laboratory start-up, operation, and shutdown, and patient care will be administered at the end of the last clinical rotation.  There will be a specific test for the vascular track as well as for the cardiac track.


C.  Film critique will be part of the final examination. This evaluates the student’s ability to recognize normal cardiac and vascular anatomy and pathology.


D.  Students will maintain accurate records of each case that they observe or participate in.  The student is expected to participate in a minimum of 250 cases during the Spring 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


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


            Clinical Evaluation                     30%

            Case Numbers                            30%

            Final Exam/Film Critique           40%




            F.  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 Clinical sites by using the Clinical Rotation Evaluation form.


4.3       Performance:  Lab and Clinic


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, to include: equipment start-up and shut-down, transducer selection, routine cleaning and care of equipment, patient care, medical history, medical records, cardiac and vascular examination protocols, and student interactions with the patients and clinical staff.  Each clinic will have varying equipment, examination protocols, medical records procedures, and other unique conventions which the student will be expected to master during a given rotation.

During the Spring 2005 semester the student will be expected to 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.     Vascular Track

1.      Lower extremity venous Doppler

2.      Lower extremity arterial Doppler

3.      Upper extremity venous Doppler

4.      Upper extremity arterial Doppler

5.      Carotid Doppler

6.      Segmental Pressures with ABI calculation

7.      Plethysmographic procedures (PPG, VPG, SPG)


B.     Cardiac Track

         1.   Parasternal Long Axis View

                                 2.   Parasternal Short Axis View

3.       Apical View

4.       Subcostal View

5.       Suprasternal View


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. If unable to attend a clinical session, common courtesy dictates that the Clinical Site 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 education; therefore excess tardiness and absences will affect your clinical evaluations and your clinical 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 while students are in the clinical environment.


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 UAMS and CHRP.  Please refer to the Student Handbook for specifics concerning dress and conduct.




            All clinical paperwork will be due the last day of the clinical rotation.  There will be two (2) clinical rotations for the Senior Spring semester.


Clinical Final Examinations Week:  TBA




8.1       General Remarks: Clinical session schedules will be distributed by the DMS Program faculty prior to the start of the clinical rotations.

Also see: DMS Clinical Records Web Pages