Training Module In Pelvic Ultrasound
Training Module in Pelvic UltrasoundPublished for the British Fertility Society British Fertility Society 2016
IntroductionCourse Aims, Learning Outcomes and CompetenciesThe trainee should acquire clinical competence in undertaking independently all aspects oftransvaginal ultrasound examinations.ReferencesReferences which detail the evidence-base to support the content of the course; pertinent furtherreading:Practical Gynaecological Ultrasound. Second Edition. Edited by Jane Bates, Cambridge UniversityPress. ISBN-13: 978-0521674508Application for TrainingPotential trainees should register with the BFS before starting the training. Application formsare available within this handbook.Application for training centre recognitionGuide to Application for Training Centre RecognitionTo be eligible as a training centre in providing pelvic ultrasound examinations for reproductivemedicine the following criteria must be met: The centre should provide access to a daily diagnostic pelvic ultrasound service. The centre should have an adequate clinical workload to ensure the trainee can undertake at leastfive scans per week. The centre should be able to have both transvaginal and transabdominal options for scanningavailable.All application forms and completion documentation must be submitted to the BFS Office.Trainee applicationsCandidates seeking to register for training in Pelvic Ultrasound must: Be a member of the British Fertility Society. Undertake training over an agreed period of time (minimum of 6 months – max of 12 months) in aUnit recognised as a "Training Centre" by the Society, under the guidance of a designated"Trainer" (also a member of the British Fertility Society). Should the trainee require more than 12months they should write to the chairman of the BFS Training Subcommittee explaining thereason for extending the training period and to agree a suitable time frame for completion. Provide payment of 150 upon application payable to the British Fertility Society Have a basic medical qualification e.g. MB ChB or be a fertility nurse.British Fertility SocietyTraining Module in Pelvic Ultrasound
Keep a log-book detailing experience in Pelvic Ultrasound scanning. Attend the BFS Pelvic Ultrasound Study Day during the time of training and when the log-book isbeing completed. Complete the Guide to Learning Maintain a record of monthly appraisals with trainer. At the end of training submit your logbook, appraisal record, guide to learning, certificate ofattendance from the study day noted above, notification of completion form and trainee feedbackform to the BFS Office for review by the BFS Training Subcommittee.Documents required for certification at the end of training Certificate of attendance from the study dayLogbook and Appraisal Record.Guide to LearningNotification of Completion form.Trainee Feedback formAppraisal, Assessment and Certification1. Log BookThe trainee must not start undertaking ultrasound examinations until the supervisor is confident thatthe trainee fully understands all the safety issues. It is recommended that the trainee should initiallyobserve at least 10 TV ultrasound examinations. All examinations must be supervised until thelogbook is completed and approved. It is expected that 50 examinations should be recorded in thelogbook before submission.2. Appraisals should be carried out at regular intervals (every month).The trainee must meet with the trainer to discuss progress of their training relevant to acquisition ofthe necessary elements of knowledge, experience and clinical competence as laid out in the syllabus.If there are problems in relation to targets for completion of training then remedial action should beinstituted. The trainer should review the logbook. Appropriate records should be kept of thesemeetings, which both trainer and trainee should sign.Monthly Meetings with TrainerDiscussion at monthly meetings with Trainer should incorporate assessment of the Trainee’sknowledge of: anatomy being examined including the major blood vessels and relationship to other pelvicorgans pelvic pathologies – accurate descriptions of common variations in morphology of the uterusand common abnormalities e.g. fibroids, endometriosis superovulation effects on ovaries early pregnancy – normal first trimester, multiple, abnormal or ectopic physical principles and selection of appropriate imaging techniques preparation of patient for ultrasound examinationBritish Fertility SocietyTraining Module in Pelvic Ultrasound
record keeping issues3. Guide to Learning should be signed off by the trainee and trainer throughout the course.AssessmentThe trainee provides the logbook and study day certificate of attendance, as well as the records ofappraisal. If the assessors determine that training has been completed satisfactorily and this isapproved by the BFS Training Committee, then the trainee will be awarded Certification.EvaluationAn evaluation process and evidence of how this will be used to improve the course in future will beutilised by the BFS Training Committee.At the end of each study day there will be evaluation forms within the information packs for eachdelegate to complete. These will be collected by the organising committee and entered into acomputer software datasheet. The results will be disseminated to speakers and organising committeein order for any adjustments to be made.After completion of the course all participants will be asked to feedback on the structure, content,assessment procedure and ease of accessing resources necessary for undertaking the course.British Fertility SocietyTraining Module in Pelvic Ultrasound
SyllabusAims of TrainingThe trainee should acquire an understanding of:iiiiiiivvviviiviiiixThe physical principals of the use of ultrasound examinationThe use and limitations of ultrasound examinationMaintenance of ultrasound equipmentThe safety issues related to the use of ultrasound for clinical diagnosisThe anatomy of the pelvic organsThe physiological changes of the pelvic organs during the ovarian cyclePathologies of the uterus and ovaries which can be detected by ultrasoundUltrasound appearance of a normal first trimester pregnancyDiagnosis of ectopic pregnancyThe trainee should develop the capacity to:iiiiiiivvRecognise that appropriate use of ultrasound examinationMaintain ultrasound equipmentIdentify the normal pelvic organs on transvaginal ultrasound examinationIdentify abnormalities in the pelvic organs on transvaginal ultrasound examinationIdentify normal and abnormal first trimester pregnancies on transvaginal ultrasoundexaminationThe trainee should acquire clinical competence in:iUndertaking independently all aspects of transvaginal ultrasound examination as describedaboveComposition of Syllabus (Theoretical and Practical Elements)Theoretical knowledge should be acquired during the course of training through:iiiiiiPersonal study appropriate to the "guide for learning"Attendance at a Pelvic Ultrasound study day.Tuition from the approved "Trainer"Practical skills will be obtained during the course of clinical training. Such experience will compriseboth supervised and unsupervised care of women undergoing pelvic ultrasound and will be recordedin the approved logbook. The tuition will be recorded in the approved Appraisal Record at monthlyintervals.British Fertility SocietyTraining Module in Pelvic Ultrasound
Guide to LearningTrainer should sign and date when trainee has acquired knowledge (clear boxes) and independentclinical skills competence (shaded boxed) targets. When each module completed thick box should besigned.1. Physics of Ultrasound ExaminationThe trainee should understand and be able to:Discuss the physical principals underlying ultrasound in relationto resolution, penetration, transducer optionsDate:Discuss image optimisation options – TA, TV, DopplerDate:Discuss the limitations of imaging techniquesDate:Discuss the maintenance of ultrasound equipmentDiscuss the evidence relating to the safety of ultrasoundDiscuss the system in place ensuring imaging quality controlwithin the departmentSection CompletedDate:Date:Date:Date:2. Pelvic AnatomyThe trainee should understand and using images they have taken be able to:Describe the ultrasound appearance of the uterus throughouta simulated and natural cycleDate:Describe the fallopian tubes, peritoneum and ligaments andmajor pelvic blood vesselsDate:Describe the other pelvic viscera e.g. bowel and bladderDate:Describe the ultrasound appearance of the ovary throughouta simulated and natural cycleBritish Fertility SocietyTraining Module in Pelvic UltrasoundDate:
Discuss the ultrasound appearance of polycystic ovaries andits relationship with polycystic ovary syndromeDate:Describe the macroscopic appearance of the endometrium atdifferent stages of the ovarian cycleDate:Section CompletedDate:3. Pelvic PathologyThe trainee should understand using images (if possible they have taken) be able to:Recognise the common variations in morphology of the uteruse.g. bicornuate uterusDate:Recognise common abnormalities e.g. fibroids, endometriosisDate:Discuss the role of ultrasound in diagnostic investigationse.g. HyCoSyDate:Recognise the features associated with hyperstimulationDate:Section CompletedDate:4. Early PregnancyThe trainee should understand and demonstrate using images they have taken (where possible):Accuracy in measuring gestation sac volume, crown rump lengthRecognise a multiple pregnancy, including chorionicityRecognise the abnormal intrauterine first trimester pregnancyRecognise ultrasound appearances consistent with anectopic pregnancyBritish Fertility SocietyTraining Module in Pelvic UltrasoundDate:Date:Date:Date:Date:
Section Completed5. Psychological Factors Related to Pelvic UltrasoundThe trainee should understand and be able to:Discuss the most appropriate environment for ultrasoundexamination to take placeDiscuss the preparation of the patient and accompanying personfor ultrasound examinationDate:Date:Discuss the issues relating to ‘giving bad news’Date:Discuss the role of ultrasound examination in conjunction withother investigations which may be undertaken as a result offindingsDate:Section CompletedDate:6. Record Keeping and AuditThe trainee should understand and be able to:Demonstrate accurate and concise writing of reportsUse terms to describe the ultrasonic appearance and texturese.g anechoic, homogenous, shadowing, enhancementDiscuss the recording of the ultrasound observation and themedico-legal implicationsDate:Date:Date:Discuss the role of the British Medical Ultrasound SocietyDate:Demonstrate ongoing assessment of practiceDate:Section CompletedDate:British Fertility SocietyTraining Module in Pelvic Ultrasound
Pelvic Ultrasound Study DayDetails of the study days are available on our website at http://www.fertility.org.uk/meetings/index.aspx. It is intended that the meetings be held annually, depending on demand. An outline of the content ofthe lectures is given below.Objectives of Lectures Provide evidence based informationProvide references/further readingProvide Lecture review for study book1.Principles, Safety and Practical aspects of Ultrasound2.Ultrasound Assessment of Ovarian and Endometrial Cycle3.Ultrasound features of PCO and PCOS4.Benign and Malignant changes in the Ovary5.Ultrasound Diagnosis of Benign Uterine abnormalities6.Ultrasound Evaluation of the Fallopian Tubes7.Scanning for Infertility Investigation and Assisted Conception Cycles8.What is the Role of Colour Doppler in Infertility Management9.Ultrasound Diagnosis of Early Pregnancy ComplicationsBritish Fertility SocietyTraining Module in Pelvic Ultrasound
Please complete and return the form preferably by email to:bfs@profileproductions.co.ukOr post to: BFS Secretatriat C/o Profile Productions LtdBoston House, 67-75 Boston Manor Road, Brentford, TW89JJt: 44 (0)20 3725 5849 f: 44 (0) 844 507 0578Notification of Completion of Training Module(To be completed by trainer)I certify that has completed the training module in Pelvic Ultrasound to my satisfaction.I confirm that I have had regular assessment sessions with the traineeand each of the required skills in the logbook has been attained.Date of commencement of practical training: / /Date satisfactorily completed theoretical course: / /Trainee name: .Trainee signature: Date: Trainer(s) in charge of training:Trainer name: Date: .Trainer signature: .Department address: . British Fertility SocietyTraining Module in Pelvic Ultrasound
RECORD OF APPRAISALDateLearning Targets AchievedLog Book ProgressTargets for Next ple10 scans completed but more that 50%inaccurate findings. Good relationship withpatients. Still rather nervous but gettingbetter.Read about physics of ultrasound, itsuse in clinical practice and themanual of the ultrasound equipment.J SmithR BlackSafety issues understood.Does not yet understand the physics ofultrasound and therefore does notunderstand how to set the equipmentappropriately.British Fertility SocietyTraining Module in Pelvic Ultrasound
DateLearning Targets AchievedBritish Fertility SocietyTraining Module in Pelvic UltrasoundLog Book ProgressTargets for Next MonthTraineeSignatureTrainersSignature
LOG BOOKThe supervising trainer must complete the following table for each case. It will be marked as follows: 0Correct findings recordedIncorrect findings recordedFeature not seen by trainee but seen by supervisorThe ideal record should show all ‘ ’ markings. A record showing mainly ‘-‘ marks indicates a potentially dangerous operator whereas a majority of ‘0’ marks indicates that moreexperience is needed.Trainee Name:Example 12British Fertility SocietyTraining Module in Pelvic Ultrasound 00-PeritonealCavityOtherIndications FindingsSignedDateFolliclesCystsTumoursLeft OvarySizeFolliclesCystsTumoursSizeRight OvaryFetal HeartFetal PoleYoke sacSizeEndometrialthicknessGestation SacCavityMyometriumPositionUterus- Probable haematomarecognised in cavitySuspected ectopic - IUpregnancy too early forviability confirmationJ Smith01/03/ 2001
Trainee Name:345678910British Fertility SocietyTraining Module in Pelvic UltrasoundFolliclesCystsTumoursLeft OvarySizeFolliclesCystsTumoursSizeRight OvaryFetal HeartFetal PoleYoke sacSizeEndometrialthicknessGestation therIndications FindingsSignedDate
Trainee Name:1112131415161718British Fertility SocietyTraining Module in Pelvic UltrasoundFolliclesCystsTumoursLeft OvarySizeFolliclesCystsTumoursSizeRight OvaryFetal HeartFetal PoleYoke sacSizeEndometrialthicknessGestation therIndications FindingsSignedDate
Trainee Name:1920212223242526British Fertility SocietyTraining Module in Pelvic UltrasoundFolliclesCystsTumoursLeft OvarySizeFolliclesCystsTumoursSizeRight OvaryFetal HeartFetal PoleYoke sacSizeEndometrialthicknessGestation therIndications FindingsSignedDate
Trainee Name:2728293031323334British Fertility SocietyTraining Module in Pelvic UltrasoundFolliclesCystsTumoursLeft OvarySizeFolliclesCystsTumoursSizeRight OvaryFetal HeartFetal PoleYoke sacSizeEndometrialthicknessGestation therIndications FindingsSignedDate
Trainee Name:3536373839404142British Fertility SocietyTraining Module in Pelvic UltrasoundFolliclesCystsTumoursLeft OvarySizeFolliclesCystsTumoursSizeRight OvaryFetal HeartFetal PoleYoke sacSizeEndometrialthicknessGestation therIndications FindingsSignedDate
Trainee Name:4344454647484950British Fertility SocietyTraining Module in Pelvic UltrasoundFolliclesCystsTumoursLeft OvarySizeFolliclesCystsTumoursSizeRight OvaryFetal HeartFetal PoleYoke sacSizeEndometrialthicknessGestation therIndications FindingsSignedDate
Please complete and return the form preferably by email to:bfs@profileproductions.co.ukOr post to: BFS Secretatriat C/o Profile Productions LtdBoston House, 67-75 Boston Manor Road, Brentford, TW89JJt: 44 (0)20 3725 5849 f: 44 (0) 844 507 0578Notification of Completion of Training Module(To be completed by trainer)I certify that has completed the training module in Pelvic Ultrasound to my satisfaction.I confirm that I have had regular assessment sessions with the traineeand each of the required skills in the logbook has been attained.Date of commencement of practical training: / /Date satisfactorily completed theoretical course: / /Trainee name: .Trainee signature: Date: Trainer(s) in charge of training:Trainer name: Date: .Trainer signature: .Department address: . British Fertility SocietyTraining Module in Pelvic Ultrasound
CHECKLIST FOR SUBMISSION OF BFS PELVIC ULTRASOUND DOCUMENTSThe following materials are required to be submitted to the Training Subcommittee for theirconsideration:Certificate of attendance from the most recent BFS PelvicUltrasound Study DayCompleted Guide to LearningCompleted Logbook (50 scans)Completed Appraisal RecordSigned Notification of Completion formCompleted Trainee Feedback formPlease do not submit your documentation until you have all elements listed above.If you have completed the module without prior approval of the BFS Training Subcommittee pleasecontacttheBFSOfficeforfurtheradvice.British Fertility SocietyTraining Module in Pelvic Ultrasound
Please complete and return the form preferably by email to:bfs@profileproductions.co.ukOr post to: BFS Secretatriat C/o Profile Productions LtdBoston House, 67-75 Boston Manor Road, Brentford, TW89JJt: 44 (0)20 3725 5849 f: 44 (0) 844 507 0578Trainee Feedback FormTrainee name: . BFS Member No: .Module Completed: .Training Centre: .Trainer Name: reestronglyagreeI was able to complete the modulein the agreed time period (6-12months)I received help and support fromthe BFS Office as necessaryMy trainer set me realistic targets atour appraisal meetingsI have been given appropriatefeedback from my trainer on myperformanceThis course has met my needsregarding my professionaldevelopmentI would recommend this certificationmodule to my colleagues/peersI would recommend this trainingcentre to my colleagues/peersTrainer ReviewPlease rate the performance of your main BFS trainer.very poorApproachabilitySupportiveTeachingRegular and Constructive ntIf applicable please rate the performance of any additional trainers.Trainer Name:.very poorpoorApproachabilitySupportiveTeachingRegular and Constructive AppraisalsWhat is the next training course that you are considering enrolling on?British Fertility SocietyTraining Module in Pelvic Ultrasoundsatisfactory
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1. Log Book The trainee must not start undertaking ultrasound examinations until the supervisor is confident that the trainee fully understands all the safety issues. It is recommended that the trainee should initially observe at least 10 TV ultrasound examinations. All examinations must be supervised until the logbook is completed and approved .
Three-dimensional ultrasound, may be acquired and displayed over time. This is variously known as 4D ultrasound, real-time 3D ultrasound, and live 3D ultrasound. When used in conjunction with 2D ultrasound, 3D ultrasound has added diagnostic and clinical value for select indications and circumstances in obstetric and gynecologic ultrasound.
Australasian Society for Ultrasound in Medicine Arterial spectral Doppler waveforms Tumour angiogenesis New technologies in ultrasound Fetal ultrasound video compression algorithm Quality of compressed ultrasound video ISSN 1441-6891 ULTRASOUND BULLETIN ASUM Multidisciplinary Ultrasound Workshop 2006 Gold Coast 24-25 March 2006
Teacher’s Book B LEVEL - English in school 6 Contents Prologue 8 Test paper answers 10 Practice Test 1 11 Module 1 11 Module 2 12 Module 3 15 Practice Test 2 16 Module 1 16 Module 2 17 Module 3 20 Practice Test 3 21 Module 1 21 Module 2 22 Module 3 25 Practice Test 4 26 Module 1 26 Module 2 27 Module 3 30 Practice Test 5 31 Module 1 31 Module .
THE ROLE OF OBSTETRIC ULTRASOUND IN PRIMARY HEALTH CARE AT A SECONDARY HOSPITAL IN SOUTH AFRICA. . Antenatal Ultrasound. 9 3. Routine Ultrasound. 9 Section II. _High Risk Pregnancies , 12 . Clinical Indications for Ultrasound Scans .49 Chart 9: Centres From Where the Patients came to Ultrasound 50 .
dysfunction. Strain on the pelvic connective tissues can lead to a myriad of pelvic floor disorders [9,10]. PFPT aims to restore normal pelvic muscle strength, endurance, power, resting tone or a combination of these to reverse damage to the muscles and connec-tive tissue [11]. aDivision o
: Stress distribution in the pelvic bone and the location of gages. (a) Medial view of the stress in pelvic bone; (b) lateral view of the stress in pelvic bone. modulus weakened to / of the normal bone means the fracture line was weakened to MPa [ , ]. e fragments were unable to keep the original position
If unable to determine pelvic fracture stabilization, stabilize with sheet or binder. Taping knees and ankles together can minimize additional rotational movement. Pelvic binders (all varieties) are correctly placed by centering over the greater trochanter of the femur. Treatment. 8. Pelvic fracture from blunt mechanism stabilized with sheet.
one fifth of all polytrauma cases [2]. Unstable pelvic fractures occur in up to 20 % of pelvic fractures and mortality can exceed 20 % in complex pelvic injury [3]. A study by Evans et al. showed that 23 % of deaths due to hemorrhage following trauma were due to bleeding from pelvic fractures [4]. Since bleeding often occurs
