Course Number and Title: / CVS 201 Clinical Internship I
Prerequisite(s): / BIO 130, ECH 112, VAS 112
Course Credits and Hours: / 3 credits
0 lecture hours/week
15 lab hours/week
Course Description: / In this internship, students apply previously learned technical skills and theory in the clinical setting. The course includes demonstrations in the use and care of ultrasound equipment and initiates participation, under direct supervision, in actual sonographic procedures.
Required Text(s): / Obtain current information at https://www.dtcc.edu/student-resources/bookstores, or visit the bookstore. (Check your course schedule for the course number and section.)
Additional Materials: / Diagnostic Medical Sonography Program Student Manual
CVS Clinical Competency Requirements
CCHS Non-Employee Orientation Manual
Allied Health/Science Department Program Student Policy Manual
Method of Instruction: / Classroom
Disclaimer:
Core Course Performance Objectives (CCPOs):
1. Apply learned didactic and lab principles in the clinical setting. (CCC 1, 2, 3, 4, 5, 6; PGC 1, 2, 3, 4, 5)
2. Comply with college and clinical affiliate department policies and procedures. (CCC 1, 2, 3, 4; PGC 3, 4, 5)
3. Demonstrate professional behaviors in all matters relating to patient, family, and other healthcare members. (CCC 3, 4; PGC 4)
4. Competently operate ultrasound instrumentation and other equipment necessary for sonographic procedures. (CCC 1, 2, 5, 6; PGC 1, 2, 3, 5)
5. Explain proper pre-examination, preparation, and acquisition of pertinent patient medical information. (CCC 1, 2, 5, 6; PGC 1, 2, 3, 5)
6. Perform diagnostic medical sonographic procedures within the plan of care and the scope of responsibility. (CCC 1, 2, 3, 4, 5, 6; PGC 1, 2, 3, 4, 5)
7. Perform with competency the basic 2D echocardiogram with M-mode using real-time ultrasound equipment. (CCC 1, 2, 3, 4, 5, 6; PGC 1, 2, 3, 4, 5)
8. Perform with competency the extremity arterial and venous exams and the carotid exam using physiological testing and real-time ultrasound equipment. (CCC 1, 2, 3, 4, 5, 6; PGC 1, 2, 3, 4, 5)
See Core Curriculum Competencies and Program Graduate Competencies at the end of the syllabus. CCPOs are linked to every competency they develop.
Measurable Performance Objectives (MPOs):
Upon completion of this course, the student will:
1. Apply learned didactic and lab principles in the clinical setting.
1.1 Demonstrate the skills needed to perform basic 2D sonography and physiological tests in the clinical setting.
2. Comply with college and clinical affiliate department policies and procedures.
2.1 Comply with college policies, including the allied health department policies and the diagnostic medical sonography program policies.
2.2 Comply with clinical affiliate department policies and procedures.
2.3 Prepare and maintain a student attendance record and clinical log record.
2.4 Produce written documentation of clinical activities in a timely manner.
3. Demonstrate professional behaviors in all matters relating to patient, family, and other healthcare members.
3.1 Demonstrate appropriate interaction skills with physicians, staff, patient, family, and other healthcare members in the clinical setting.
3.2 Demonstrate professional behavior, including appropriate attire.
3.3 Practice confidentiality in verbal and written communication.
4. Competently operate ultrasound instrumentation and other equipment necessary for sonographic procedures.
4.1 Identify and explain the function of the basic, generic instrumentation controls on a duplex ultrasound system and other equipment necessary for sonographic procedures.
4.2 Select the appropriate transducer based on the procedure requested and patient body habitus.
4.3 Demonstrate the correct usage of the controls for optimal study results and image quality.
4.4 Use the system components to document the ultrasound study.
4.5 Select correct plethysmography when available and practice proper procedures based on operational knowledge as applicable.
5. Explain proper pre-examination preparation and acquisition of pertinent patient medical information.
5.1 Explain and perform pre-examination preparation by:
a. Selecting correct instrumentation.
b. Selecting or adjusting the optimum machine setting.
c. Preparing patient history and identifying clinical signs and symptoms.
d. Using proper patient positioning, safely assist the patient for the procedure.
5.2 Properly prepare and maintain the patient area within the clinical site.
6. Perform diagnostic medical sonographic procedures within the plan of care and the scope of responsibility.
6.1 Select pertinent information from the medical chart and the patient report for documentation.
6.2 Recognize and document significant clinical information and historical facts from the patient and the medical records that may impact the diagnostic information.
6.3 Apply exam protocols and criteria necessary to interpret the sonographic study.
6.4 Identify any problem encountered during examination and implement a known solution.
7. Perform with competency the basic 2D echocardiogram with M-mode using real-time ultrasound equipment.
7.1 Select the transducer and instrument settings that are appropriate for the requested part and body habitus.
7.2 Using the appropriate records, patient information, and clinical skills, perform the required competencies that include basic 2D echocardiogram and M-mode measurements.
7.3 Apply basic 2D protocol to evaluate parasternal long axis, parasternal short axis, apical chamber views (4 chamber, 5 chamber, 2 chamber, and 3 chamber where applicable), subcostal long and short axis views, and M-mode measurements.
7.4 Prepare annotated diagnostic images of the pertinent normal and abnormal anatomy in all the appropriate scan planes of the heart.
7.5 Prepare to observe and/or participate in, a transesophageal echocardiogram (TEE) and stress test echocardiogram if applicable.
8. Perform with competency the extremity arterial and venous exams, and the carotid exam using physiological testing and real-time ultrasound equipment.
8.1 Select the transducer and instrument settings appropriate to the requested part and body habitus.
8.2 Using the appropriate records, patient information, and clinical skills, perform the required competencies that include extremity arterial vascular procedures of pulse volume recording/segmental limb pressure (PVR/SLP), venous duplex, and carotid Doppler exam.
8.3 Apply the PVR/SLP protocol for lower arterial extremity examination and perform the procedures that include:
a. Identifying normal waveform and waveform morphology.
b. Producing bilateral PVR waveforms.
c. Measuring multilevel segmental pressures bilaterally and calculating ankle-brachial indices (ABI).
d. Explaining segmental pressure and determining need for exercise testing or perform thoracic outlet maneuvers, if applicable.
e. Discussing the need to perform duplex imaging where appropriate.
f. Recognizing levels suggesting stenosis and degree of flow reduction.
8.4 Apply the lower extremity venous duplex exam protocol and perform the procedures that include:
a. Imaging and identifying the deep and superficial venous system with and without compression where appropriate.
b. Listing and identifying differential diagnosis.
c. Demonstrating each vessel with spectral Doppler and documenting phasicity and augmentation where appropriate.
d. Using color and Doppler to differentiate occlusive versus partial.
8.5 Apply protocol and practice performance of the carotid and vertebral arteries procedures that include:
a. Imaging and identifying the carotid artery and its divisions (common carotid artery [CCA], bulb, internal carotid artery [ICA], and the external carotid artery [ECA]) in transverse and longitudinal views.
b. Imaging and identifying the vertebral artery in longitudinal view.
c. Demonstrating spectral waveform, and measuring peak systolic velocity (PSV) and end-diastolic velocity (EDV) in each vessel in the longitudinal view.
d. Calculating ICA/CCA ratio using existing data.
e. Demonstrating appropriate color and Doppler techniques.
f. Identifying and describing differential diagnosis that include ulceration, characterization of plaque, dissection, carotid body tumors, aneurysm, and surgical intervention.
g. Discussing flow states of CCA, ICA, ECA and vertebral artery, including stenosis, post-stenotic turbulence, occlusion, and subclavian steal syndrome.
8.6 Prepare written documentation of the observation of or participation in the following vascular ultrasound exams, if applicable, including upper extremity PVR/SLP, arterial duplex evaluation of bypass graft/hemodialysis graft, upper extremity venous duplex, vein mapping, venous insufficiency/valvular incompetency test, transcranial Doppler, and blood flow in the penis.
Evaluation Criteria/Policies:
Students must demonstrate proficiency on all CCPOs at a minimal 75 percent level to successfully complete the course. The grade will be determined using the DTCC grading system:
92 / – / 100 / = / A83 / – / 91 / = / B
75 / – / 82 / = / C
0 / – / 74 / = / F
Students should refer to the Student Handbook (https://www.dtcc.edu/academics/student-handbook) for information on the Academic Standing Policy, the Academic Integrity Policy, Student Rights and Responsibilities, and other policies relevant to their academic progress.
Core Curriculum Competencies (CCCs are the competencies every graduate will develop):
- Apply clear and effective communication skills.
- Use critical thinking to solve problems.
- Collaborate to achieve a common goal.
- Demonstrate professional and ethical conduct.
- Use information literacy for effective vocational and/or academic research.
- Apply quantitative reasoning and/or scientific inquiry to solve practical problems.
Program Graduate Competencies (PGCs are the competencies every graduate will develop specific to his or her major):
1. Perform competently a full range of echocardiography procedures.
2. Perform competently a full range of vascular sonographic procedures.
3. Use professional verbal, nonverbal, and written communication skills in patient care, procedure intervention, and professional relationships.
4. Act in a professional and ethical manner and comply with professional scope of practice.
5. Integrate critical thinking and problem solving skills as expected of a healthcare professional.
Disabilities Support Statement
The College is committed to providing reasonable accommodations for students with disabilities. You are encouraged to schedule an appointment with your campus Disabilities Support Counselor if you feel that you may need an accommodation based on the impact of a disability. A listing of campus Disabilities Support Counselors and contact information can be found at go.dtcc.edu/DisabilityServices or visit the campus Advising Center.