Training activity information
Details
Perform, analyse and report routine quality assurance for B-mode on a range of clinical ultrasound scanners:
- General abdominal
- Echocardiography
- Obstetrics and Gynaecology
- Vascular
Type
Entrustable training activity (ETA)
Evidence requirements
Evidence the activity has been undertaken by the trainee repeatedly, consistently, and effectively over time, in a range of situations. This may include occasions where the trainee has not successfully achieved the outcome of the activity themselves. For example, because it was not appropriate to undertake the task in the circumstances or the trainees recognised their own limitations and sought help or advice to ensure the activity reached an appropriate conclusion.
Reflection at multiple timepoints on the trainee learning journey for this activity.
Considerations
- System operation
- Scanner hardware, areas of potential failure and on image quality
- Local SOPs
- B-mode: drop-out, uniformity, sensitivity, noise, low contrast penetration, caliper accuracy of calipers/measurement tools and functional checks, spatial resolution
- M-mode for testing of phased array
- Probes: linear array, curvilinear and phased array
- Primary monitor quality assurance
- Local, national and international quality standards and recommendations
- Manufacturer proprietary testing methods
- Choice of test objects and imaging parameters
- Analysis options and commercial packages
Reflective practice guidance
The guidance below is provided to support reflection at different time points, providing you with questions to aid you to reflect for this training activity. They are provided for guidance and should not be considered as a mandatory checklist. Trainees should not be expected to provide answers to each of the guidance questions listed.
Before action
- Identify what is expected of you when performing, analysing, and reporting routine B-mode quality assurance tests for ultrasound scanners across the specified clinical applications (General abdominal, Echocardiography, Obstetrics and Gynaecology, Vascular, Breast).
- What are the expected standards for each type of scanner and clinical setting
- Consider how you will know if the B-mode QA tests were performed accurately, the analysis of performance was correct, and the report is thorough and comprehensive for each type of ultrasound scanner and application.
- Discuss with your Training Officer to gain clarity on their expectations for a successful outcome for routine B-mode QA across these varied clinical applications.
- Think about what you already know about performing, analysing, or reporting routine B-mode quality assurance for ultrasound scanners, particularly with regard to the specified clinical areas. Have you observed or participated in similar ultrasound QA tasks before?
- Consider possible challenges you might face during the B-mode QA process. These could include variations between different scanner models, accurately interpreting images from tissue-mimicking phantoms, identifying subtle performance issues specific to different clinical applications, or reporting findings clearly for diverse settings. How might you prepare to handle these challenges?
- Recognise the scope of your own practice for B-mode ultrasound QA. When will you need to seek advice or help, and from whom, especially when dealing with different clinical applications?
- Acknowledge how you feel about embarking on this training activity, considering the range of different ultrasound scanners and clinical applications involved.
- Consider the specific skills you want to develop by performing, analysing, and reporting routine B-mode quality assurance across a range of clinical ultrasound scanners. This might include proficiency in operating different ultrasound systems, accurately interpreting B-mode QA results, adapting QA protocols to specific scanner types, and generating detailed reports for various clinical contexts.
- Identify the specific insights you hope to gain regarding B-mode ultrasound performance, common artefacts in different applications, and the nuances of quality assurance in varied clinical settings.
- Consult actions identified following previous experience with ultrasound QA or similar activities. Are there any past observations or feedback that you can incorporate into your approach for this activity?
- Identify important information you need to consider before embarking on the activity. This might include specific departmental protocols for each type of ultrasound QA, the availability and suitability of different phantoms for each clinical application, and any general safety considerations when working with ultrasound equipment.
In action
- Make a note of anything that feels surprising or different from what you anticipate while performing, analysing, or reporting routine B-mode quality assurance for the diverse range of clinical ultrasound scanners.
- Does a phantom respond differently across different probes?
- Does an artefact appear that you haven’t expected in a specific clinical application?
- Does the analysis of a particular B-mode parameter yield unusual results for one of the ultrasound types?
- Consider how this experience compares with previous experiences of similar activities, especially concerning the nuances of QA across different ultrasound applications. Are the probes behaving as expected for its application
- Identify how this impacts upon your actions. For example, do you respond to the situation appropriately by cross-referencing scanner protocols for a specific application, re-evaluating the phantom setup for an echocardiography unit, or immediately seeking advice on interpreting a peculiar B-mode reading from an OB/GYN scanner?
- Do you adapt or change your approach to the B-mode QA process across the different clinical settings? Perhaps you adjust your testing sequence based on the scanner’s model, modify your data interpretation for a specific clinical application, or reformulate your report for a particular audience.
- Does it affect your ability to undertake the activity independently? Do you find yourself needing to seek immediate advice or support from a senior colleague or your Training Officer during the activity itself, especially when transitioning between different ultrasound applications?
- Do you feel confident in your ability to adjust to the unexpected behaviour or unique aspects of different ultrasound systems? Or does it affect your confidence in performing B-mode QA across such a varied range of clinical applications? Do you feel positive that you can still reach a successful conclusion?
- Identify how you work within your scope of practice when an unexpected issue arises during the B-mode ultrasound QA, particularly given the broad range of clinical applications. Do you correctly identify when an issue specific to a particular application (e.g., cardiac vs. vascular) is beyond your immediate capability and requires escalation or further consultation in real-time?
- Identify what you learn as a result of the unexpected development regarding B-mode ultrasound performance, analysis, or fault identification across the different clinical scanners.
On action
- Summarise the key points of your experience performing, analysing, and reporting routine B-mode quality assurance for the diverse range of clinical ultrasound scanners (General abdominal, Echocardiography, Obstetrics and Gynaecology, Vascular, Breast).
- Consider specific events, actions, or interactions which felt important during the activity, including your own feelings at those moments. For example, were there unique challenges or insights related to a particular ultrasound application e.g., cardiac vs. vascular QA?
- Refer to your notes from the ‘reflect-in-action’ phase for this activity to recall any unexpected occurrences e.g., unusual phantom responses across different scanner models and the range of probes or unexpected artefacts, how you reacted, and the immediate conclusion or outcome.
- Identify what learning you can take from this experience regarding B-mode ultrasound performance assessment across various clinical applications.
- What strengths did you demonstrate in performing, analysing, or reporting the QA for different scanner types and probes?
- What skills and/or knowledge gaps were evident, particularly concerning the nuances of QA for General abdominal, Echocardiography, Obstetrics and Gynaecology, Vascular, or Breast ultrasound?
- Were any previously identified actions for development regarding B-mode ultrasound QA achieved? Has your practice in this diverse area improved?
- Identify any challenges you experienced during the B-mode ultrasound QA across the different clinical settings, and how you reacted to these. Did this affect your ability to deal with the situation, and were you able to overcome the challenges? For instance, if you struggled with specific B-mode parameters or artefact identification relevant to a particular clinical application.
- Did you need to seek advice or clarification from a senior colleague or your Training Officer during or immediately after the activity, especially when transitioning between different ultrasound applications? Or did you need to escalate an issue to ensure that you were working within your scope of practice when dealing with a specific B-mode fault in a particular clinical context?
- Do you feel more confident or less confident in your ability to perform B-mode QA across such a varied range of clinical applications?
- Identify the actions / ‘next steps’ you will now take to support the assimilation of what you have learnt.
- What will you do differently next time you perform, analyse, and report routine B-mode quality assurance for a range of clinical ultrasound scanners?
- Has anything changed in terms of what you would do if you were faced with a similar situation again, particularly concerning the specific challenges of different ultrasound applications?
- Do you need to practise any specific aspect of B-mode ultrasound QA further, such as fine-tuning your analysis for specific clinical settings or demonstrating artefact mitigation techniques for different B-mode artefacts?
Beyond action
- Have you reviewed your actions from your previous reflections for this activity?
- What specific actions did you identify you would need to take to improve your practice in performing, analysing, and reporting B-mode QA across the diverse range of clinical ultrasound scanners (General abdominal, Echocardiography, Obstetrics and Gynaecology, Vascular, Breast)?
- Have you completed these identified actions? For instance, did you specifically focus on improving your understanding of B-mode QA parameters unique to echocardiography, or on artefact identification and mitigation strategies relevant to vascular ultrasound?
- How would your approach to B-mode QA for a specific clinical application be different now, incorporating these new insights or skills?
- Did discussing artefact identification with others, for example, change your view of a particular artefact or provide new strategies for mitigation? How did the mutual exchange of experiences contribute to your understanding of B-mode QA across diverse clinical settings?
- Consider how the learning from consistently performing and reflecting on B-mode ultrasound QA across various applications has supported you in preparing for the observed ‘in-person’ assessments for the module.
- Consider how your practice in B-mode ultrasound performance assessment has developed and evolved over time across the range of clinical applications.
- Reflect on your journey from your earliest experiences with this task to your current level of proficiency in distinguishing image quality issues and identifying specific artefacts within different clinical contexts.
- Recognise when something is beyond your scope of practice in B-mode ultrasound QA.
- Are you now better at identifying when a quality issue or artefact requires escalation to a more senior colleague or an ultrasound specialist, ensuring you are working within your professional boundaries?
Relevant learning outcomes
| # | Outcome |
|---|---|
| # 3 |
Outcome
Perform and report on the basic performance of MRI and ultrasound scanners. |
| # 5 |
Outcome
Identify ultrasound and MRI artefacts and advise on parameters to mitigate the impact on clinical images. |