A proposed new clinical assessment framework for diagnostic medical ultrasound students

Abstract

Current financial pressures within higher education institutions (HEIs) are driving new ways of delivering education and assessment. New technological developments are facilitating opportunities to rethink traditional educational methods and explore more innovative, effective approaches. Set against a background of increasing pressures to integrate technology to enhance learning, both in higher education and the NHS, education is moving towards greater integration of technology. Ultrasound education is an area which is currently being reviewed in many HEIs, as these programmes are expensive to administer for the relatively low numbers of students involved. Within ultrasound education, rigorous assessment of clinical competence is an area which is particularly expensive to undertake, and methods used in many training programmes are potentially unsustainable for HEIs in the current economic climate. In addition, clinical assessment methods used are often criticised for the difficulties encountered in trying to exclude subjectivity from the process, and ensure equity across all assessments. A new framework is therefore proposed, which has recently been accredited within a HEI ultrasound training programme by the Consortium for the Accreditation of Sonographic Education (CASE), and has been piloted during 2013. One of the components of this approach is the incorporation of an ultrasound simulator, which will help to standardise assessments and ensure students are assessed over a range of pathologies, rather than only those randomly presenting on the day of assessment. This paper discusses details of the newly accredited assessment process.

Summative clinical competency assessment: A survey of ultrasound practitioners’ views

“…The issue of simulator use as part of the assessment process has already been introduced, 7 although there are potential issues relating to this as a method of assessment. There will need to be a substantial number of different cases available, to prevent the sharing of information between trainees, but also of a similar standard of difficulty to ensure consistency in experience.…”

“…1 A CASE newsletter in 2012 6 suggested that courses were developing novel methods of assessing ultrasound competency, although no further explanation of these 'novel approaches' was provided. Haptic simulation is increasingly being used in both the teaching and assessment of ultrasound skills, 7,8 although there are very few published studies relating to validity of these new simulators. Norcini and McKinley 9 review a range of assessment methods for medical education, including the use of observation, simulation using devices and simulation using standardised patients, although it has to be questioned whether using a range of methods, without direct observation of practice could lead to task-based learning.…”

“…12 This, in addition to changes within National Health Service education funding, 13 could impact on the funding available for post-graduate ultrasound programmes. 7 Higher education institutions are reviewing the way programmes are delivered to ensure they remain cost effective. 14 Fairhead also commented in the review from the CASE annual programme monitoring report: 'A general point to emerge from this year's monitoring was the constant pressure for the programmes to become more efficient'.…”

The ScanTrainer obstetrics and gynaecology ultrasound virtual reality training simulator: A cost model to determine the cost viability of replacing clinical training with simulation training

“…Real-time expert guidance and feedback and curriculum-based interactive learning and assessment are incorporated into the system. A recent study 1 showed the ScanTrainer can be used to assess gynaecological ultrasound competence in a valid and reliable way. A new clinical assessment framework was recently proposed for diagnostic medical ultrasound students 1 including a simulator for teaching and formatively assessing obstetrics, gynaecology and general medical ultrasound students.…”

“…1 In the field of obstetrics and gynaecology ultrasound, the Medaphor ScanTrainer (MedaPhor Ltd., Cardiff Medicentre) combines 'real-feel' virtual reality simulation with recordings of real patient scans. Real-time expert guidance and feedback and curriculum-based interactive learning and assessment are incorporated into the system.…”