CQUniversity Unit Profile.

The ability to correctly analyse, interpret and understand a 12-lead electrocardiogram (ECG) and background theory is crucial in a professional cardiac diagnostic role. Comprehensive ECG analysis and interpretation can provide vital information about the location and nature of heart disease.

Students will be required to recall relevant theoretical concepts as well as perform accurate ECG interpretation following a methodological approach as outlined in lectures.  The Online Quiz will assess all ECG content in weeks 1-6 inclusive.

Students will have 100 minutes to complete the quiz once it is started.

• This assessment is open book. You may benefit from having normal Electrocardiographic reference ranges and a calculator available when attempting the quiz.
• This assessment is to be undertaken as an individual. As with all other university assessments, colluding with other students on non-group work tasks is considered academic misconduct, and may lead to action being taken by the Deputy Dean of Learning and Teaching HMAS.

It is important that you commence the Online Quiz before 6:20 pm (AEST) on Friday the 19th of April 2024. If you have not completed the test by this time, your test may be submitted incomplete or with no answers. Please note:

• Once started, the quiz cannot be paused or restarted
• Only one attempt is permitted
• The Online Quiz with automatically close at 8:00 pm (AEST) on Friday the 19th of April 2024.

In the absence of an approved extension, the ECG Online Quiz cannot be completed at a later time.

Students are reminded that IT support from the university Information and Technology Division (TASAC) is only available during AEST business hours.

• If attempt issues occur outside of business hours, students should immediately email the Unit Coordinator documenting difficulties.
•  Advice should include the date and time of the incident and a screenshot from the PC display if an error is evident.
•  Incidents will be considered on a case-by-case basis. There is no guarantee extra quiz attempts will be offered.

Students are advised to refer to the 'Assessment Policy and Procedure (Higher Education Coursework)' document for additional university guidelines regarding assessments.

Students will be assessed on their ability to recall theory and accurately interpret a 12-lead ECG using the methodological approach available on Moodle. Marks will be awarded based on the student's ability to:

• Recall 12-lead ECG theory
• Analyse calibration settings;
• Analyse cardiac rhythm, rate, and axis;
• Identify common arrhythmias; and
• Utilise correct terminology in interpreting ECG waveforms, segments, intervals, and associated anomalies.

The Online Quiz will be accessible through the assessment tab on Moodle.

This written assessment task requires you to explore a range of common cardiovascular pathologies. You will be required to analyse provided case-based clinical information, including the outcomes of a variety of cardiac diagnostic testing procedures.   Conclusions will be used to confirm patient diagnosis and strategise plausible management strategies.

Case Study:

The patient is an unwell 86-year-old male with a BSA of 1.7m2.  The patient has presented with severe hypertension and a loud systolic murmur.  In addition to other tests, the general practitioner (GP) has ordered both a cardiac ultrasound and a 12-lead electrocardiogram (ECG) to evaluate the murmur, and to exclude secondary left ventricular hypertrophy (LVH).

The GP is concerned.  The patient may be suffering from a cardiac condition such as hypertrophic cardiomyopathy with outflow tract obstruction (HOCM) or aortic stenosis (AS).  Both these conditions can cause hypertension and a systolic murmur.  These differential diagnoses must be excluded.

Selected diagnostic imaging and testing outcomes can be viewed on the unit Moodle site under the Assessment tile.

Considering the 2D echocardiographic findings presented: 

1. Which cardiac condition (HOCM or AS) does the patient have? Justify your answer.
2. Propose two (2) possible disease aetiologies.
3. Describe the symptomatic presentation commonly associated with this cardiac condition.
4. Discuss the pathophysiology of this cardiac condition, explaining why left ventricular hypertrophy (LVH) develops in response to this anomaly.  
5. Describe the 12 lead ECG findings associated with LVH. Explain why these findings are present in LVH.  
6. Quantify the LVH severity present and in doing so, identify any erroneous echocardiographic measurement data presented.  Include rationale for your conclusions.  

If not treated the mortality rates are high as this cardiac disease progresses. In this clinical setting, a cardiac catheterisation may also be done to evaluate and possibly repair the underlying cardiac condition.

1. Identify and describe a percutaneous cardiac catheterisation procedure, that might offer an alternative to surgical intervention in this patient. Include in your response, the several risks and benefits associated with this procedure.
2. After the patient undergoes treatment (surgical or transcatheter) for this cardiac condition, is left ventricular hypertrophy likely to increase or decrease over time? Justify your answer.

The written assessment must be presented in a scholarly manner.  Accurate spelling and grammar, use of discipline-specific language, paraphrasing and referencing including intext citation must be demonstrated.

Research for this assessment task is to be limited to:

• The literature sources provided on the unit Moodle eReading list (including prescribed textbooks)  
• No more than 3 additional independently sourced journal articles.

Gen AI must not be used to generate your assessment task response.

Word Count 1400 (+/- 10%)

The reference list is not included in the word count. Content beyond the word limit will not be marked.

A detailed marking rubric is published on the ECHO12006 Moodle site, with grading based on the student's ability to:

• Analyse and discuss cardiovascular findings;
• Research and evaluate topics;
• Apply academic referencing protocols;
• Apply scholarly presentation standards; and
• Apply critical reflection to practice.

The Echocardiographic Skills Assessment is comprised of two parts— Part A 'Practical' and Part B 'Measurement Performance'. Part A involves the completion of a complete M-mode and two-dimensional echocardiographic protocol. Part B involves M-mode and two-dimensional measurement performance.

Students will be assessed according to the Assessment of Readiness for Clinical (ARC) tools, which are available on the unit Moodle site. These documents detail performance criteria the student must demonstrate competence in to pass the assessment. Student competence is assessed in relation to the expectations specific to this unit of study. Students enrolled in ECHO12006 are working towards the attainment of a Novice level of competency, as detailed in the ARC tools.

PART A - Practical

Part A of the Echocardiography Skills Assessment incorporates both a Professional and Technical component and requires students to perform a  complete M-mode and two-dimensional echocardiographic examination using ultrasound equipment. Students have 70 minutes in total to complete both the Professional and Technical components.

Professional Component

The professional component of the assessment evaluates performance aspects of the sonographic exam such as communication (verbal, non-verbal, and written), professional behaviour, ergonomics, and patient care skills. This encompasses an assessment of pre-scan, scanning, and post-scan skills.

Technical Component

The technical component of the assessment evaluates the student's scanning technique, image optimisation, and ability to complete a M-mode and two-dimensioanl echocardiogram within a reasonable set time to a 'Novice' level of competency.

• The ARC tool details the required imaging sequence and performance criteria cues.
• Except for panning or sector sweeps, which are critiqued live or via video recording moderation, the collection of images stored by the student represent the echocardiographic examination performed.
• At the end of the examination the supervising tutor will acquire a variety of representative images. These images will be used during marking and moderation to ascertain achievable image quality.

Note: Part A (Practical) of the Echocardiography Skills Assessment will be video recorded for moderation purposes. The videos will not be released to students for review.

All students are required to make themselves available to act as a patient model for peer assessments. Students must additionally make themselves available for re-sit assessments if requested by the unit coordinator.

PART B - Measurement Performance

Part B of the Echocardiography Skills Assessment requires students to apply best practice guidelines when undertaking routine M-mode and two-dimensional measurement on echocardiographic images using Q-Station discipline-specific software. Students are required to accurately perform and record a series of echocardiographic measurements offline using discipline-specific analysis software. Students are required to save measurement images to a desktop folder and transcribe these measurement values onto a provided worksheet replicating clinical documentation. 

• The ARC tool details the required measurement sequence and performance criteria cues.
• Students must transcribe these measurements onto a provided worksheet replicating clinical documentation.
• The collection of images stored by the student represent the measurement examination performed.
   

Students have 35 minutes to complete this assessment.
 

Students are advised to refer to the 'Assessment Policy and Procedure (Higher Education Coursework)' document for additional university guidelines regarding assessments.

• In the absence of an approved extension, this assessment cannot be completed at a later time.
• Students will receive a FAIL for this assessment if it is not completed by the scheduled date and time and there is no approved extension.
• Should a student fail this assessment, there will be only ONE opportunity to re-sit the failed component of the assessment item.

Students will be assessed using the below documents. Students are advised to carefully review these documents which are available on the unit Moodle site.

• Part A Practical Assessment of Readiness for Clinical (ARC) Tool
• Part B Interpretation and Measurement Performance ARC Tool

PART A - Practical

To pass Part A of this assessment, a student must be deemed competent in both the Professional and Technical components. To pass these components, ALL criteria must be demonstrated to the appropriate level of competence as detailed in the ARC tools.

The professional and technical components are graded separately so that if one is passed and the other is not, only the failed component must be repeated to pass.

There is only ONE opportunity to re-sit either component of this assessment item.

PART B - Measurement Performance and Interpretation

To pass Part B of this assessment, ALL criteria must be demonstrated to the appropriate level of competence as detailed on the ARC tools. If multiple images of a single measurement are saved, only the image corresponding to the measurement transcribed on the worksheet will be assessed.

There is only ONE opportunity to re-sit this assessment item.

Mock Examination

Students will be provided with a single opportunity to attempt the Echocardiography Skills Assessment under mock examination conditions. Individual feedback will be provided to students after completing the mock assessments. Students will receive a completed MOCK Part A (Practical) ARC tool and MOCK Part B (Measurement Performance) ARC tool following moderation. Scanning feedback will be provided verbally by the tutor supervising each individual student mock practical scanning assessment.

The mock assessment will be delivered as part of the routine laboratory sessions. Note, there is no opportunity for rescheduling of missed laboratory sessions.

The purpose of this assessment is to ensure that students from the echocardiography course are well-equipped to embody the high standards of professionalism that are expected from CQUniversity students while on their follow-on clinical placement blocks. Professional behaviour is a critical part of any medical imaging profession and encompasses the manner in which we treat our colleagues, patients and the professional settings and equipment we interact with. Exemplary professional behaviour is highly valued by clinical supervisors and this information may be used to endorse students for placements if requested by clinical sites.

This assessment requires students to treat each of the lab sessions as a scheduled "work shift" and to exhibit high-quality professional attributes. This assessment is based on a continuous and ongoing evaluation of student application and attendance during labs, and behaviour exhibited during the time spent studying this unit up until the completion of all formal assessments. Aspects of professionalism will be assessed across multiple levels including, but not limited to: maintenance of laboratory documentation, Moodle forums, online tutorials, lab sessions (both manned and unmanned), interactions with peers and staff, social media, phone calls and all official correspondence with university staff, peers and the community.

Instances of substandard professional behaviour will result in a Lapse in Professionalism (LiP) point being awarded to the offending student. Should a student acquire more than three (3) LiPs, this assessment will automatically be graded a FAIL.

LiPs may be issued in three different categories:

1. Professional behaviour towards colleagues and staff
2. Professional behaviour towards patients
3. Professional behaviour towards professional settings and equipment

Further information is detailed in the Expected Professional Behaviour and LiP Allocation document, which is available on the Moodle site. Students are encouraged to review this document to be sure of behavioural expectations. Students should also be familiar with the CQUniversity Student Charter as well as the Australasian Sonographers Association (ASA) Code of Conduct (available online).

If an unprofessional attitude or behaviour is reported by fellow classmates and not witnessed by a staff member, a written warning detailing the allegations will be issued to the student and the student's response will be documented. If further evidence of ongoing unprofessional behaviour arises then a LiP may be awarded. If any exhibited attitude or behaviour is deemed as unsafe or inappropriate, this assessment will be graded as a FAIL at the discretion of the unit coordinator.

Absenteeism

Skills labs for this unit are mandatory. Students must advise the unit coordinator before the start of compulsory labs if unable to attend. Failure to notify staff (via email or phone) before the start of a missed lab will result in a LiP (Lapse in Professionalism) except in extraordinary circumstances. Lateness to labs may result in a LiP, whether notice is given or not. Labs missed for a valid reason (eg. illness or injury) require supporting documentation. Medical or health-related certificates must be in the approved formats articulated in the CQUniversity Assessment Policy and Procedure (HE Coursework), section 5.

Any missed labs must be clearly marked on the Lab Attendance Page and Reflective Feedback Form. A tutor's signature is not required in this case. There is no opportunity to 'make up' missed lab sessions.

Peer-Assisted Practice Sessions

Students are offered regular peer-assisted practice sessions, which are scheduled through Google Doc links on the Moodle site. Penalties will be applied if instructions and rules disclosed on these documents are not adhered to. Failure to abide by these regulations may result in a LiP and removal of attendance privileges.

This assessment incorporates maintenance of pertinent lab documentation including lab attendance and any Lapse in Professionalism (LiP) points accrued throughout unit delivery. To pass this unit students need to consistently display a high standard of professional behaviour including, but not limited to, punctual lab attendance. All interactions with staff and peers pertaining to this unit will be treated as a replica of the clinical work environment, and students are expected to demonstrate the professional behaviour expected in a formal work environment. No more than three (3) Lapses in Professionalism are permitted to pass the unit.

Students are required to complete the following documentation and submit to Moodle in PDF format. All documents are available on the unit Moodle page.

1. A signed Lab Agreement Form (To be completed in the first laboratory session in week 1)
2. A signed Consent Form - Sonographic Examination for Teaching Purposes (To be completed in the first laboratory session in week 1)
3. A completed and signed Lab Attendance and Professional Behaviour Assessment form (signed and uploaded to Moodle by Thursday week 12)

The "Laboratory Agreement Form" and "Consent Form", as well as the Mandatory Laboratory Induction, must be completed in the first laboratory session in week 1. Students cannot participate in laboratory activities until these documents are completed.

The "Laboratory Attendance and Professional Behaviour Rubric Form" must be uploaded to the Assessment 4b tab by Week 12 Thursday 30th May 8:00 pm (AEST) on the ECHO12006 Moodle site. Students can access these tasks on the ECHO12006 Moodle site and must complete and upload all documents to achieve a pass.

To PASS this assessment, all documentation must be completed appropriately and submitted by the due date and time. All documents must be legible, labelled appropriately and uploaded in PDF format.

The ability to set goals, self-reflect, and take advantage of feedback, are important to aid the progress of knowledge and skill development. These abilities also address industry requirements, whereby professionals must perform continuing professional development (CPD) activities.

Students are to develop goal-setting, reflection, and feedback skills through weekly activities:

1. Formative Feedback Forms (one for each laboratory session; a total of six forms). Each form must include goal setting and self-reflection, tutor feedback, and tutor signature. The feedback form must be completed before leaving the associated laboratory session.
2. Mock Assessment Reflection. This form must include a reflection on areas of strength and areas for improvement in preparation for the Skills Assessment.

The "Formative Feedback and Self-Reflection Forms" are available on the ECHO12006 Moodle site.

The Formative Feedback and Self-Reflection document is available on the Moodle site and must be presented to the supervising tutor at each of the tutorial lab sessions.

To PASS this assessment, all documentation must be completed appropriately and submitted by the due date and time. All documents must be legible, labelled appropriately and uploaded in PDF format.