The purpose of this practical assessment is to evaluate student performance when completing an echocardiographic ultrasound examination within the clinical environment, and to evaluate the student’s professionalism and attitudes to their echocardiographic practice.

The practical assessment requires students to perform all tasks associated with a standard echocardiographic ultrasound examination and to demonstrate the use of the non-imaging Doppler probe (PEDOF) application. The echocardiogram must take place within the clinical placement environment and under supervision of the clinical supervisor or delegate sonographer, unless otherwise arranged in consultation with the clinical supervisor, unit coordinator and Head of Course. The assessor may pose questions to the student prior to, during or after the echocardiographic examination, to clarify understanding of any of the assessment criteria (Practical Assessment Marking Tool available on Moodle).

The Practical Assessment Marking Tool consists of 3 sections:

• Section A is completed by the clinical supervisor.
• Section B is completed by the student.
• Section C is completed by the unit coordinator or nominated academic staff member.

The Practical Assessment Marking Tool details criterion that students must demonstrate to pass this assessment task:

• Pre-examination tasks (including professional behaviour and instrumentation).
• Examination tasks (including scanning technique and protocol, two-dimensional/colour/spectral Doppler optimisation, and measurement technique).
• Post examination tasks (including documentation, interpretation, communication, professional behaviour and additional tasks).

The practical assessment must be performed on a patient (not a peer) and must be video recorded. Patients must provide written consent by completing a consent form (available on Moodle) prior to proceeding. Video recordings should focus on visualisation of the student's dynamic image optimisation attempts and aspects of knobology, and must not show the patient's identity in any form. Please refer to the Practical Assessment Video Recording Guidelines available on the Moodle page. The student must contact the unit coordinator if these requirements cannot be fulfilled for any reason.

Submission must consist of:

• Completed Practical Assessment Marking Tool (uploaded to Moodle).
• Preliminary/final echo report (uploaded to Moodle).
• Signed patient consent form – Video recording and echocardiogram image sharing for education purposes (uploaded to Moodle).
• Video recording (uploaded to Moodle via Echo360).
• DICOM images from the echocardiographic exam used for the practical assessment (uploaded to Google drive, share link through Moodle submission).

This assessment task must take place on or before the 12th week of placement, thus allowing sufficient time for improvement before a second attempt (if required) prior to completion of the clinical placement block. If the first attempt at this assessment task is deemed unsatisfactory by the unit coordinator, only one re-attempt will be permitted. Students that fail the first attempt at this assessment should discuss their strategy for performance improvement with both their assessor and unit coordinator. The re-attempt practical assessment must be scheduled prior to the completion of the clinical placement block and may require supervision from the unit coordinator or nominated representative, in conjunction with the clinical supervisor. In some instances, students may be required to attend their local campus to complete the re-attempt. In the absence of an approved extension, students cannot complete this assessment at a later time, and will receive a fail grade for the assessment.

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

Level of GenAI use allowed:

Level 1: You must not use Al at any point during the assessment. You must demonstrate your core skills and knowledge.

The 72-hour grace period does not apply to this assessment.

Clinical Supervisors are required to grade the student using criterion provided. Criterion should be considered in the context of the required competency level that students must demonstrate by the end of the clinical practicum block. For ECHO20004, this is 'Advanced Beginner' level.

Criteria can be grouped into several main categories. These include:

• Pre-examination tasks and instrumentation (including patient identification checks, consent and appropriate professional communication).
• Scanning technique (including two-dimensional, colour and spectral Doppler optimisation, non-imaging probe use from all views and appropriate exam extension or modification).
• Measurement technique. Documentation (digital image storage and labelling). Post-examination tasks (including worksheet completion and interpretation).
• Additional tasks (incorporating ergonomics, manual handling techniques, infection control, ethical and legal requirements).

The Clinical Supervisor is required to evaluate the student's performance against multiple criteria on the Practical Assessment Marking Tool. The Clinical Supervisor will grade each criterion with a score out of 3:

• A score of 0 indicates the criterion is not demonstrated.
• A score of 1 indicates a 'Novice' level of competency, with the student requiring frequent direction and advice.
• A score of 2 indicates an 'Advanced Beginner' level of competency, with the student requiring some direction and advice.
• A score of 3 indicates a 'Competent' level, with the student practising independently requiring direction or prompting only on complex or unusual cases.

Any criterion that the assessor believes is not applicable to the clinical scenario at the time of the assessment should be identified as N/A. The assessor must provide a justification on the marking tool to explain the N/A allocation.

To pass this assessment, students must achieve a practical competency level of ‘Advanced Beginner' and attain a score of 2 or higher against ALL listed criteria.

The first attempt must be completed in the 12th week of the 16 week placement, and the re-attempt (if required) must be conducted before the end of the 16 week clinical placement. The final PASS/FAIL grade for this assessment will be at the discretion of the Unit Coordinator.

Clinical sites mention professional behaviour, particularly team work and empathy, as paramount in their decision to employ a sonographer. This assessment considers the ability of the student to communicate professionally with a diverse cultural audience of patients, staff and the general public, demonstrate professional respect for all, and function as a reliable, well organised member of the health team.

The Clinical Supervisor, or delegate, will be working in the echocardiography lab with the student, directly observing day-to-day performance. These observations and collective feedback will relate to the student's demonstration of knowledge, skills and behaviours over a span of time, not limited to a particular scan type or patient case. The observations and feedback are then used to complete the Global Assessment of Professional Attributes (GAPA) form.

There are three main sections to the GAPA form:

• Section 1: Applied Knowledge.
• Section 2: Psychomotor skills and Standard of Work.
• Section 3: Professionalism.

In each section there are multiple observable behaviours that the student is required to demonstrate throughout the placement. The assessor will score the performance of the student based on how frequently, and to what extent, each of the listed behaviours are demonstrated. The assessor is also encouraged to provide comments to expand on the scoring feedback.

This assessment is performed TWICE during the placement – at the midpoint (week 8) and at the completion of placement (week 16).

The mid placement GAPA is formative. At the mid placement GAPA, the student should be given sufficient feedback to improve their behavioural performance as required. Any significant issues should be brought to the attention of the Unit Coordinator following the mid placement GAPA (or earlier if required).

The end-of-placement GAPA assessment is summative. For any behaviour that the student scores well on at the mid-placement assessment, it is expected they will continue to meet that level of performance or surpass it for the rest of the placement.

Clinical supervisors are urged to contact the Unit Coordinator immediately for guidance if:

• Student behaviour is identified as ‘inappropriate and beyond acceptable risk’ to clinical site staff, patients and/or reputation.
• Student skill progression is deemed insufficient despite documented constructive feedback, support, and intervention.

The Unit Coordinator may request performance of a GAPA assessment at any time during a student placement. If the outcome of this GAPA is unsatisfactory, and/or the site feedback indicates that they can no longer host the student due to the risk incurred, lack of skill progression or unprofessional behaviour, this singular GAPA result may result in a FAIL grade and clinical placement termination immediately (prior to student completion of the allocated practicum block).

Level of GenAI use allowed:

Level 1: You must not use Al at any point during the assessment. You must demonstrate your core skills and knowledge.

The 72-hour grace period does not apply to this assessment.

To pass this assessment, ECHO20004 students must achieve a minimum score of 2 (‘Advanced Beginner’) against ALL listed criteria.

The assessor is also encouraged to provide comments to expand on the scoring feedback.

If minimum scores in the mid-placement GAPA are not met, a student will be regarded as a 'Student at Risk' of failing the clinical unit overall.

• The Unit Coordinator will contact the student to advise of the risk of failing the unit and provide formative feedback via email.
• The student is required to respond to this email to show they understand the implications of this information.
• The student must reflect on their performance and the feedback provided, and develop an action plan to address any areas of performance that are not yet at the target level for this placement, and use the remaining weeks to achieve those targets.
• Review of the student’s progress will be completed a short time after the mid placement GAPA, at any time as requested by the Clinical Supervisor or Unit Coordinator.

If behavioural attributes within any section of the GAPA are deemed a 'patient safety risk', student placement may be cancelled immediately, prior to completion of the allocated clinical placement block.

Unsatisfactory scores obtained at the second GAPA attempt, will result in a FAIL grade for the unit overall.

Failure of this clinical unit will require the student to meet with the Head of Course to discuss the instigation of an individual learning contract with a view to remedy scanning skills, technical issues and/or behavioural issues. The learning contract will detail learning objectives, available learning resources, strategies and methods which will be used to assess the student's progress. This will likely involve attendance at on campus scanning skills labs for tuition and assessment.

It is expected that students attend 100% of the time during clinical placement to achieve the minimum required hours of direct echocardiography observance/participation or related activities. All hours of attendance must be approved by an ASAR registered Clinical Supervisor or appropriately qualified medical practitioner.

All hours worked must be entered into the Clinical Attendance Forms. These forms must be signed by the Clinical Supervisor, or a sonographer delegated this task by the Clinical Supervisor, and submitted monthly. The Clinical Attendance Forms will be available as a cloud-based file (Google Sheets). Once each form is completed, please print or export for your supervisor to sign (digitally or on paper).

Please review the information below carefully to understand the criteria against which clinical attendance will be evaluated.

• You are required to work full-time for 16 weeks (or equivalent) to achieve a minimum of 640 hours (16 X 40 hours) of clinical experience (unless otherwise approved by work integrated learning, Head of Course, Unit Coordinator and Clinical Supervisor).
• Clinical experience required in this unit for accreditation purposes is echocardiographic only.
• You must notify both the clinical supervisor and unit coordinator of any absence and provide supporting documentation as appropriate.
• You must make up any hours absent in consultation with your clinical supervisor and unit coordinator.

Students must not organise holidays, recreational leave or personal appointments during clinical placement periods, in the absence of prior written approval.

Students must notify the clinical placement site PRIOR to their scheduled start time if they will be late arriving to the clinical placement site for any individual day throughout the clinical placement. For all absences due to illness, students must provide the Clinical Supervisor and Unit Coordinator with a medical certificate or statutory declaration.

Any injury that occurs while on placement must be reported immediately to the Clinical Supervisor and Unit Coordinator. Medical clearance may be required before returning to placement. For more information, please refer to the Clinical Placement Attendance Guidelines available through SONIA or the unit Moodle site.

Students who are absent from clinical placement due to illness or injury must phone their Clinical Supervisor and email their Unit Coordinator PRIOR to the scheduled start time for that day. Any clinical placement hours missed due to illness or injury must be made up.

Public holidays recognised by CQUniversity are outlined on the academic calendar. If a Public Holiday occurs during a period that you were scheduled to attend placement, you may log 8 hours of attendance and these hours do not need to be made up. If a designated University student vacation period coincides with the clinical placement period, students are expected to attend during this time. Students must be aware that the attendance of clinical placement takes precedence over any personal or work commitments.

Outside Clinical Placement Hours:

Outside of hours placement may only be used in the event of illness or injury and may not be utilised for personal leave requests.

In the event of illness and injury, students are permitted to supplement up to 25% of required unit hours from outside of clinical placement. These hours must be documented within three (3) months prior to unit enrolment for approval by the Unit Coordinator.

Supplementary hours outside of clinical placement must be verified (signed) by an ASAR accredited sonographer or appropriately qualified medical practitioner. Details of either the student’s insurance, or employment, must be entered onto the outside clinical placement attendance form.

Level of GenAI use allowed: 
Level 1: You must not use Al at any point during the assessment. You must demonstrate your core skills and knowledge. 

The 72-hour grace period does not apply to this assessment.

In order to achieve an overall grade of 'PASS' in this assessment task, a student must:

• Meet the minimum number of hours required on the attendance forms.
• Ensure the documentation is complete, true and accurate.
• Upload each completed assessment form into the unit Moodle site by the due date.
   

At the end of the scheduled placement block, if a student has not met the 100% attendance requirement AND has experienced extenuating circumstances beyond their control with supporting documentation, the student will be provided additional scheduled time to make up the time missed. This scheduled make-up time may not immediately follow the scheduled placement block, and/or may not be at the same placement site, depending on clinical availability. In absence of extenuating circumstances/sufficient supporting documentation, the student may score a 'FAIL' for this assessment item if attendance requirement is not satisfied.

The Clinical Case Logbook is a document designed to track clinical experience. This logbook records all observed, partially or fully completed echocardiography cases that a student is exposed to during clinical placement. The Clinical Case Log will be available as a cloud-based file (Google Sheets). Once each log is completed, the Clinical Supervisor must review, approve and sign the relevant section on the attendance form. The clinical case logs must be exported from the cloud-based system and uploaded to Moodle by the due date.

The Clinical Case Logbook records the following data: 

• The date of each examination.
• A unique identifier for each patient to ensure anonymity.
• Referral indications.
• Type of echocardiogram performed (Adult, Paediatric, Stress Echo, Dobutamine, TOE).
• Student level of scan participation (Observed, partially, or fully completed examination).
• Case findings.
• Case category (Ventricular, Valvular, Congenital, Other).
• Type of valvular pathology.
• PEDOF probe usage.
• Statistics on scan completion, PEDOF use and valvular pathology encounters.
   

Students should be engaging in learning opportunities and gaining exposure to a variety of pathologies and scan types during their clinical placement block. To ensure key areas of knowledge and clinical experience are reflected on, students are required to organise caseloads according to echocardiographic outcomes. Note that ‘ventricular function’ may include diastolic dysfunction as well as systolic; ‘valvular’ should include significant valvular pathology, where quantitative investigation has been performed; ‘congenital’ may include any previously repaired congenital anomalies; ‘other’ pathologies include masses, effusions, aortopathies etc.; and ‘Pedof’ imaging should include investigation from multiple acoustic windows and identification of multiple waveforms (not simply AS). Competencies and exposure will vary with clinical unit progression. Accurate logs of caseload exposure can help track progression of experience. Should students have any queries or concerns about caseloads, they should contact their unit coordinator immediately.

Maintenance of a Clinical Case Logbook helps to ensure that: 

• An acceptable volume of clinical work is achieved.
• Exposure to a reasonable case variety is achieved.
• Key practical skills are developing. 

Level of GenAI use allowed: 
Level 1: You must not use Al at any point during the assessment. You must demonstrate your core skills and knowledge. 

The 72-hour grace period does not apply to this assessment.

The Clinical Case Logbook serves as a record of the depth and breadth of experience a student has attained during placement. It demonstrates the degree of progression of skill development within and across examination types. Students should analyse this record at regular intervals to assist in the formulation of learning goals that will support achievement of the unit outcomes.

• The Clinical Case Logbook must be reviewed by Clinical Supervisor or echocardiographer delegated by the Clinical Supervisor for each submission.
• The Clinical Supervisor or delegate must sign the relevant section on the attendance form to confirm their review and approval of the clinical case log.
   

In order to achieve an overall grade of PASS in this assessment task, students must: 

• Accurately record all studies in the Clinical Case Logbook.
• Ensure documentation is complete, true and accurate.
• Submit the requested documentation via Moodle by the published due dates.
   

Student competency and proficiency, and corresponding case load and variety, should scaffold and increase over the placement experience. Students must consult the 'ECHO20004 Student Scope of Practice' document (available on the unit Moodle site) to understand caseload expectations. It is anticipated that students will complete no less than 4 scans per day (except in exceptional circumstances) to enable upskill in a timely manner. If a student is unable to achieve this minimum case exposure, the student must contact the Unit Coordinator.

It is expected that by the end of this clinical placement block students will be completing daily case loads between 6-8 scans per day (however, case loads may depend upon departmental expectations, clinical pathologies encountered, and individual student autonomy, proficiency and competency). 

CQUniversity Assessment Policy and Procedure guidelines apply to assessments for work integrated learning units. Students are responsible for meeting published or advised submission dates. Any delays in assessment submissions during term, in the absence of an approved extension or extenuating circumstances, will be brought to the attention of the Deputy Dean of Learning and Teaching.

Students must submit two pre-recorded case study presentations during this clinical placement, covering the pathologies described below.

• Case study - Valvular stenosis (comprehensive quantitative and/or qualitative evaluation of at least mild severity).
• Case study - Valvular regurgitation (comprehensive quantitative and/or qualitative evaluation of at least moderate severity).
• Both valvular case studies must demonstrate comprehensive valvular assessment and must include use of the non-imaging probe (Pedof) from all available views.
• Students will submit both case study presentations as a pre-recorded video file via Echo360. The presentation will be based on a clinical study which they have performed during clinical placement.
• Presentation recordings must include an audio and video feed of the student through use of a microphone and camera.
• Students will be assessed on basic presentation skills, further information will be available on Moodle.
• The majority of case study images must be completed by the student (students must have acquired at least 80% of the images), any images obtained by the Clinical Supervisor must be clearly identified.
• Students are required to participate in a case study discussion meeting (via Zoom) with the Unit Coordinator 2 weeks prior to the due date, for each submission.
• Students must obtain a signed consent form from the patient to use the study for their assessment, or successfully de-identify all patient information (from reports, DICOM files and any other location where patient info is present). A case study consent form is available on the Moodle site.
• Students may be required to participate in a follow-up question and answer session after they have submitted their presentation, if the Unit Coordinator requires further information to ascertain competency. 

The case study discussion meetings are mandatory and must be completed 2 weeks prior to each submission via Zoom. Please contact the unit Coordinator to schedule a suitable time. The purpose of the case study discussion is to track student skill development, provide timely feedback to enable any refinements to be made, and to ensure DICOM images are accessible and appropriate.

Students need to read the article ‘Using a clinical decision-making framework to foster sonographer student learning in the clinical setting’ by Thoirs and Sim prior to completing the case study presentation.  According to Thoirs and Sim (2016), clinical reasoning or clinical decision making, occurs during clinical placement when students use critical thinking based on prior theoretical knowledge relative to a specific situation or patient. A clinical decision-making framework may help students to apply theoretical knowledge in the clinical setting. This framework helps students to identify and prioritise learning, promote self-reflection and future decision making and facilitate diagnostic thought processes.

Students must use the clinical decision-making framework to evaluate the following:

• Encounter: Did the encounter data include cultural considerations, protocols around patient and echocardiographer safety, the consent process and pre-test history? Was there an established purpose of the examination?
• Hypothesis generation: When generating a hypothesis, were possible pathophysiology relevant to the echocardiogram examination, possible associated conditions, complications or mimics of the suspected condition included? What was the most likely condition suggested by the pre-encounter data? What are the associated conditions? Which structures are most likely involved?
• Assessment: Did the echocardiographic assessment include a contextual analysis of echocardiographic information obtained? What protocol, image optimisation techniques, possible modifications were required due to patient presentation or echocardiogram findings? Did it include the additional data?
• Evaluation: Did the echocardiographic examination answer the clinical question? What is the most likely diagnosis? Is a differential diagnosis possible? Did the diagnosis include normal and abnormal appearances, applicable reference measurements, and future pathways for the patient with this diagnosed condition?
• Reflection: Did reflection of the clinical decision-making process include a critical and reflective analysis of approach? What was done well or lacking during the exam? If gaps in knowledge were identified, what is the appropriate action plan in the future?
   

Each submission must include:

• In the absence of de-identified files, a signed patient consent form (uploaded to Moodle).
• PDF of presentation slides (uploaded to Moodle).
• Final report, anonymised in the absent of a consent form (upload to Moodle).
• Presentation recording (uploaded to Moodle via Echo360).
• DICOM files (uploaded to Google drive, share link through Moodle submission).

Presentation length: Maximum 30 minutes.

Referencing: Vancouver. Minimum 5 peer reviewed journal articles or relevant text books must be cited. Literature titles must be current (<5 years of age), except seminal works.

Level of GenAI use allowed: 
Level 3: You may use Al to assist with specific tasks such as drafting text, refining and evaluating your work. You must critically evaluate and modify any Al-generated content you use.

The 72-hour grace period does not apply to this assessment.

To pass this assessment, students must successfully demonstrate ALL criteria descriptors as specified on the marking rubric.

Each case study submission has two components, the presentation and the echocardiographic component. Both components must be passed to pass the case study overall.

Students are developing aptitude and overall practical competencies consistent with that of an 'Advanced Beginner' in ECHO20004. A detailed marking rubric is available on the unit Moodle site.

Case studies that do not achieve a pass grade will be returned to the student with appropriate feedback. Students are permitted one re-submission opportunity only (imaging component and/or presentation component as required). Any re-submission attempt is required within two (2) weeks of receiving feedback.

CQUniversity Assessment Policy and Procedure guidelines apply to assessments for work integrated learning units. Students are responsible for meeting published or advised submission dates. Any delays in assessment submissions during term, in the absence of an approved extension or extenuating circumstances, may result in a fail grade and will be brought to the attention of the Deputy Dean of Learning and Teaching.

This assessment task will require students to complete two (2) separate online quizzes. The quizzes will assess understanding and application of quality assurance and occupational safety and health content.

Quiz 1:

• Identifying workplace hazards
• Sonographer safety and injury prevention
• Infection control
• Communication in health care
• Fitness to practice
• Patient identification, interaction and information management
• Equipment maintenance
• Safety legislation
   

Quiz 2:

• Diagnostic imaging accreditation
• Clinical governance
• Quality improvement
• Risk management
• Safety culture

Questions may be drawn from lectures or additional resources provided in the eReading list.

The quizzes can be accessed through the assessment tab on Moodle at the assigned time.

• Each quiz will be marked out of 30 marks.
• Students have 40 minutes to complete each quiz.
• Once started, the quizzes cannot be paused or restarted.
   

The duration of each quiz is tailored to promote recall of fact, rather than research of answers unknown. It is recommended that students have a calculator available when sitting the online quizzes.

Please note:

It is the student's individual responsibility to commence each online quiz allowing adequate time for completion.

The quizzes will automatically close and submit completed student answers once the allocated time has elapsed.

Questions will be drawn from a resource bank, to allow tests to be different for each student.

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

This assessment is to be undertaken as an individual. Colluding with other students on non-group work tasks is considered academic misconduct, and may lead to action being taken the Deputy Dean of Learning and Teaching HMAS.

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

Level of GenAI use allowed: 
Level 1: You must not use Al at any point during the assessment. You must demonstrate your core skills and knowledge. 

The 72-hour grace period does not apply to this assessment.

Students will be required to answer a variety of online questions.

Question responses will be assessed according to the:

• Capability to demonstrate understanding of occupational safety and health content.
• Use of appropriate quality assurance terminology and concepts.
• Student’s ability to interpret clinical scenarios and appropriately apply quality assurance knowledge.
• Student's ability to succinctly respond with accurate and clinically relevant answers.
   

The number of marks allocated for each question will be indicated within the quiz. Question marks are allocated based on the accuracy, depth and breath of required responses.

Where a passing grade is not achieved, only one re-attempt at either quiz will be provided. Students must have attempted each quiz to be eligible for a re-attempt. The mark achieved for the re-attempted assessment task will be recorded as the final mark.

Students will be advised if they qualify for a re-attempt (including the corresponding due date) following the release of final quiz outcomes.

Please note that the quizzes must be completed before the due dates listed. The specific dates that the quizzes open and close are outlined in the due description. In the absence of an approved extension, there will be no opportunity to complete the task after this date.