Module information
Module details
- Title
- Introduction to Clinical Echocardiography
- Module code
- A-CS-S1
- Credits
- 30
- Phase
- Requirement
- Compulsory
Aim of this module
This module provides Echocardiography trainees with the knowledge and skills to perform and report high-quality transthoracic echocardiography.
Work-based content
Training activities
| # | Learning outcome | Training activity | Type | Action |
|---|---|---|---|---|
| # 1 | Learning outcome 1, 2, 3, 4, 6 |
Competency
Discuss the values and principles as laid out in the NHS Constitution, describe how will you demonstrate these in your daily practice |
Type | Action View |
| # 2 | Learning outcome 2, 4, 6 |
Competency
Control risks in accordance with departmental protocols for echocardiography procedures |
Type | Action View |
| # 3 | Learning outcome 2, 4, 6 |
Competency
Demonstrate competency in appropriate level of resuscitation as per local policy |
Type | Action View |
| # 4 | Learning outcome 3, 4, 5, 6, 7 |
Competency
Review the literature and evidence base for best practice regarding assessment of a pathology; compare best practice to local practice and make recommendations for service improvement |
Type | Action View |
| # 5 | Learning outcome 4, 5 |
Competency
Identify common indications for transthoracic (Level 1 and 2) bubble contrast, LV opacification, stress and transoesophageal echocardiography |
Type | Action View |
| # 6 | Learning outcome 5, 6, 7 |
Competency
Discuss a case where complementary technologies may be useful to further assess cardiovascular disease where echocardiography cannot differentiate fully between pathologies and/or artefact |
Type | Action View |
| # 7 | Learning outcome 6 |
Competency
Explain an echocardiography procedure to another healthcare professional, address any questions they may have related to the procedure |
Type | Action View |
| # 8 | Learning outcome 2, 4, 6 |
Competency
Gain informed consent for an echocardiography procedure, under direct supervision |
Type | Action View |
| # 9 | Learning outcome 2, 3, 4, 5, 6 |
Competency
Present a clinical history together with the images obtained for a procedure to another healthcare professional; discuss progression of disease/symptoms and agree outcomes and next steps |
Type | Action View |
| # 10 | Learning outcome 2, 3, 4, 6 |
Competency
Take appropriate action to respond to the specific needs of the patient to ensure equitable access to echocardiography procedures |
Type | Action View |
| # 11 | Learning outcome 3, 4, 6 |
Competency
Explain the procedure for obtaining results to the patient, alleviating any concerns the patient may have |
Type | Action View |
| # 12 | Learning outcome 1, 4 |
Competency
Produce high-quality cardiac ultrasound images, demonstrating use of a full range of machine controls and ultrasound probes including standalone probe |
Type | Action View |
| # 13 | Learning outcome 2, 4 |
Competency
Set up appropriate equipment in preparation for an advanced echocardiography procedure, including resuscitation equipment where appropriate, and ensure daily checks have been carried out |
Type | Action View |
| # 14 | Learning outcome 1, 3, 4, 6 |
Competency
Identify correct anatomical structures demonstrated on 2D image planes including cardiac and extracardiac anatomy |
Type | Action View |
| # 15 | Learning outcome 1, 4 |
Competency
Acquire standard views in accordance with local and national protocol for Level 2 transthoracic Echocardiogram |
Type | Action View |
| # 16 | Learning outcome 1, 4 |
Competency
Obtain standard measurements using 2D or M-mode in accordance with the local and national protocol |
Type | Action View |
| # 17 | Learning outcome 1, 4 |
Competency
Recognise imaging artefact and normal variants, including Eustachian valve, Chiari network, LV tendon |
Type | Action View |
| # 18 | Learning outcome 1, 4 |
Competency
Utilise colour flow mapping in at least two planes for all valves, optimising gain and box size |
Type | Action View |
| # 19 | Learning outcome 1, 4 |
Competency
Acquire & optimise pulsed and continuous wave Doppler traces and make measurements in accordance with the local and national protocol including use of a standalone CW probe |
Type | Action View |
| # 20 | Learning outcome 1, 4, 6 |
Competency
Produce a clear and accurate written report of a transthoracic echocardiography procedure in accordance with local and national protocols |
Type | Action View |
| # 21 | Learning outcome 6, 7 |
Competency
Critically assess a new technology being introduced into practice; consider benefits and barriers to introduction |
Type | Action View |
| # 22 | Learning outcome 1, 4, 6 |
Competency
Interpret results for a myocardial deformation/speckle tracking analysis study in line with local and national protocols |
Type | Action View |
Assessments
You must complete:
- 4 Case-Based Discussions (CBDs)
- 4 of the following Direct Observation of Practical Skills (DOPS) and/or Observed Clinical Event (OCE)
| Type | Title |
| DOPS | Carry out a procedure for an infectious patient |
| DOPS | Demonstrate appropriate care of the equipment pre, during and post procedure |
| DOPS | Identify cardiac structures in all image planes |
| DOPS | Generate high quality ultrasound images of all standard image planes |
| DOPS | Perform standard 2D/M mode measurements of the left ventricle |
| DOPS | Acquire and optimise colour Doppler of the mitral, aortic, pulmonary and tricuspid valves |
| DOPS | Acquire, optimise and perform standard measurements of pulsed and continuous wave Doppler of the left ventricular outflow tract, aortic valve and mitral valve |
| DOPS | Review the indication for the test and any appropriate records prior to a procedure |
| OCE | Introduce yourself to a patient, confirm patient identity and explain the procedure |
| OCE | Present finding of critical appraisal of ultrasound related topic at departmental meeting |
| OCE | Obtain informed consent prior to a procedure |
| OCE | Obtain a suitable clinical history during an appointment |
| OCE | Explain and discuss the procedure for obtaining results with a patient |
| OCE | Demonstrate to another healthcare professional how to manage infection risks for an echocardiography procedure including managing operator and equipment risks |
Learning outcomes
| # | Learning outcome |
|---|---|
| 1 | Perform and report high quality transthoracic echocardiography. |
| 2 | Employ strategies to manage risk in the practice of echocardiography. |
| 3 | Apply the principles of patient-centred care to provide a high-quality echocardiography service. |
| 4 | Practice echocardiography in accordance with local and national guidelines. |
| 5 | Appraise the role of echocardiography and complementary technologies in the patient pathway. |
| 6 | Demonstrate effective communication in the practice of echocardiography. |
| 7 | Identify and appraise new developments in echocardiography practice. |
Clinical experiences
Clinical experiences help you to develop insight into your practice and a greater understanding of your specialty's impact on patient care. Clinical experiences should be included in your training plan and you may be asked to help organise your experiences. Reflections and observations from your experiences may help you to advance your practice and can be used to develop evidence to demonstrate your awareness and appreciation of your specialty.
Activities
To develop a broader understanding of their specialty practice and support the completion of assessments and competencies, it is recommended a trainee should:
- Observe the use of stress echocardiography in the diagnosis & assessment of coronary artery disease.
- Observe the use of stress echocardiography in the assessment of structural heart disease.
- Observe the use of trans-oesophageal echocardiography in the diagnosis & assessment of structural heart disease to appreciate what additional information may be acquired when compared to TTE.
- Observe the use of transoesophageal echocardiography for the investigation of Infective Endocarditis to appreciate its role in the diagnostic process including advantages compared to transthoracic echo.
- Observe the use of transoesophageal echocardiography in cardiac interventional procedures such as PFO/ASD/VSD closures, LAAO, TAVI, MV clip, MV balloon valvotomy and paravalvular leak closures.
- Observe left ventricular opacification studies to appreciate the application of pharmacological contrast agents in echocardiography and compare with bubble studies.
- Observe the use of 3D echocardiography and reflect on its applications, advantages and disadvantages in the assessment of common pathologies for both transthoracic and trans- oesophageal echocardiography.
- Observe complimentary cardiac imaging such as CMR, cardiac CT, angiography and MPI.
Academic content (MSc in Clinical Science)
Important information
The academic parts of this module will be detailed and communicated to you by your university. Please contact them if you have questions regarding this module and its assessments. The module titles in your MSc may not be exactly identical to the work-based modules shown in the e-portfolio. Your modules will be aligned, however, to ensure that your academic and work-based learning are complimentary.
Learning outcomes
On successful completion of this module the trainee will be able to:
- Evaluate and critique the role of echocardiography with respect to clinical presentation, diagnosis and management.
- Explain and apply the fundamental physical imaging principles relating to clinical echocardiography.
- Explain and apply anatomical and physiological correlates to the traditional imaging planes used in transthoracic echocardiography.
- Plan, execute and evaluate detailed echocardiographic data within the context of normal findings using nationally recognised clinical guidelines and reporting techniques.
Indicative content
- Indications for and effectiveness of echocardiography with respect to patient presentation, diagnostic and treatment pathways.
- Ultrasound physics and equipment function / manipulation.
- Normal cardiovascular anatomy and physiology.
- Echocardiographic imaging planes with respect to cross sectional anatomy.
- Normal parameters and advantages versus disadvantages relating to the measurement of normal parameters.
- Introduction to the current national standards for performing and analysing data obtained during transthoracic echocardiography.
- Alternative clinical imaging techniques used in cardiology practice.