Acute Medicine Programme

Aim: 

To deliver theoretical knowledge of ultrasound including the physics of ultrasound, instrumentation, scanning techniques, image acquisition, administration, safety and governance.

Elements: 

1. Pre-Course learning material for FAMUS ( Handbooks, Curriculum &  Videos): to equip you with introductory material that will be covered in the accredited course, for you to read through before course attendance.
2. Course Attendance:  Book a course to take you through the basic knowledge needed for accreditation and start the journey of hands-on scanning though lectures, cases, simulation training and scanning modules. 

To Complete Stage 1

1. Review learning materials & attend a FAMUS Course (please keep your certificate of attendance)
2. Complete the  FAMUS E-Learning Assessment

AIM

To deliver practical knowledge and basic scanning techniques in a controlled simulation environment before patient contact. 

Elements: 

1. Probe Manipulation: To equip you with introductory skills of how to scan using the Scan Trainer Simulator, which will take you through increasingly challenging task to build your probe manipulation and spatial awareness skills. These basic principles will stand you in good stead when progressing to the supervised scanning stage of training. 

 2. Process of Scanning:To equip you with the format of scanning using the Eve Simulator. This session takes you through scanning the Bodyworks Eve simulator in a structured way in line with the module, so a structured approach to reporting can be achieved.

Below are the contents covered during the session.

Using Intelligent Ultrasound ‘EVE’

1. Lung Ultrasound
2. Normal/ Dry Lung Pathologies (A-line Profile; Pneumothorax; Consolidation)
3. Wet Lung Pathologies (B-line Profile; Pneumonitis; COVID-19; Effusion (simple & complex) 
4. Abdominal & Renal
5. Normal/ Degrees and Complexities of free fluid
6. Degrees of hydronephrosis/ bladder assessment 

Using Abdominal Phantoms

1. Abdominal & Renal
2. Normal/ Degrees and complexities of free fluid/ bladder assessment

To Book: 

1. Simply make contact using the email imaging.academy@wales.nhs.uk
2. However, should you wish to have individual unsupervised simulation practice, please  book using this process 

To Complete Stage 2

1. Attend and engage with session (including probe manipulation modules + Eve scanning)
2. Complete the feedback  BEFORE &  AFTER the session

AIM

To complete the mandatory number of modular scans with a mentor/supervisor, thereby gaining supervised scanning experience on real patients, accompanied by supervised reporting.

Elements: 

1. Indicative number of supervised scans and pathologies needed
2. Thoracic Ultrasound – 10 scans (20 lungs)
3. includes rule out pneumothorax, increased lug water, consolidation and effusion
4. Abdominal / Renal Ultrasound – 10 scans
5. includes abdominal free fluid, bladder distention and hydronephrosis
6. DVT Ultrasound – 5 scans
7. includes a positive DVT
8. Supervised Scanning  sessions are created for trainees across Wales to attend scanning sessions to acquire the required supervised scan numbers. The creation of these sessions has been through collaboration with multiple faculty members and Intensive Care Units across Wales to take advantage of the All-Wales Juniors Contract enabling juniors for any trust to visit another trust for training. Professionals not on training contracts can still access session, although the pathway is slightly different.

Please see below for advice on your approptiate path towards training. 

Faculty within these units are supervisors/mentors who have graciously created time slots for professionals to be welcome in their unit, to train specifically at the beside with them supervising the training scan process.

Important points to remember

1.  Booking is on a first come basis

2. If after booking, you are unable to make the session, please cancel (stating why) in good time, to enable others to have access to the training slot.

3. Use approved reporting forms. (FAMUS Reporting Sheets –  Thoracic;  Abdominal/Renal;   DVT)

4. Update log book(s) as you progress. (Log books –  Thoracic;  Abdominal/Renal;  DVT)

5. Please conduct yourself professionally and within the governance structure of the unit that you are supervised in. 

Choose your Training Pathway

OPTION 1 – AIM & ICM Trainees with ALL WALES CONTRACT (Given Priority Booking)

• Access STAGE 3 on EOLAS
• Click to book a Supervised Drop-in session
• Scroll to appropriate Hospital and select Faculty providing relevant module training
• Click to be redirected to Calendly faculty availability to book a session with the chosen faculty

OPTION 2 – Other Trainees with ALL WALES CONTRACT (Non-priority Booking)

• Access STAGE 3 on EOLAS
• Click to book a Supervised Drop-in session
• Scroll to appropriate Hospital and select Faculty providing relevant module training
• Click to be redirected to Calendly faculty availability to book a session with the chosen faculty

OPTION 3 – Professionals  WITHIN Supervisors Health Board (Non-priority Booking)

• Access STAGE 3 on EOLAS
• Click to book a Supervised Drop-in session
• Scroll to appropriate Hospital and select Faculty providing relevant module training
• Click to be redirected to Calendly faculty availability to book a session with the chosen faculty

OPTION 4 – Professionals  OUTSIDE OF Supervisors Health Board (Without Honorary Contract)

• STAGE 2 completion will provide 2 simulated scan numbers for your logbook.
• Progress by Clicking to register interest in attending a Supervised scanning Day @NIAW
• Supervised Scanning Day will aim to provide 5 model scans for your logbook.
• Supervised patient scanning (department/ ?NIAW) of 5 patient scans should complete Stage 3 requirements

 

A note on Reporting…It is important to use the standardized process for reporting while scanning.

This process highlights and re-enforces the questions targeted by the scanning process and can be performed in 3 ways, as below. 

• Electronically by using the Eolas Medical or Butterfly App’s digitized form which has been created specifically for the process of electronic reporting and remote supervision. 

OR

• Using  Paper forms which can be printed out and completed after each scan by yourself and the supervisor.

OR

• Using local reporting systems or process at your training site guided by your supervisor. 

To Complete Stage 3

1. Complete the required supervised scanning modular numbers
2. Update your Logbook with all numbers

AIM

Once deemed ready to perform independent training scans, this stage aims to complete the mandatory number of modular scans by the trainee with remote supervision by a mentor/supervisor to ensure the right number of scans and pathology has been undertaken for progression to the final assessment.

DEVICE LOAN – To facilitte this stage, you can loan a handheld device from NIAW for a few months at a time, upon approval!  Click Here to Apply!!

Elements:

1. Indicative number of supervised scans and pathologies needed
2. Thoracic Ultrasound – 30 scans (60 lungs)
3. include rule out pneumothorax, increased lug water, consolidation and effusion
4. Abdominal / Renal Ultrasound – 30 scans
5. include abdominal free fluid, bladder distention and hydronephrosis
6. DVT Ultrasound – 5 scans
7. includes a positive DVT

2. Mentored ‘Independent’ Scanning:

This stage is primarily trainee led.

The expectation is that trainees, mainly in their normal working environments, will continue performing structured and reported training scans (that do not influence clinical decision making, as these are training scans). These scans should be saved and reported as per the local governance structures (see options below) and shared with the relevant mentor/supervisor for that module. 

The sharing of these scans and reports can be done periodically. We recommend a 2 monthly period of contact at the very least. 

This however depends on the location of the trainee and mentor/supervisor as highlighted below.

OPTION 1 – Trainees in the SAME site / working environment as their mentor/supervisor:This creates the opportunity for the trainee to scan using the local governance process for storing your images.

• Report the training scan using the local reporting process at your site prefrentially, but with consideration of the FAMUS/FUSIC reporting questions / sheet.
• If this is not possible, available or feasible, then the default is using the FAMUS/FUSIC standardized reporting sheet by reporting 
• Electronically on Eolas (‘add new event’, under the events & feedback section) OR  NIAW Butterfly Cloud Network (if using a  butterfly device)
• On paper ( see documents section)
• PLEASE REMEMBER: No Patient identifies on the form, No Patient identifies on the video clip uploaded AND Label images!
• Share the report with your mentor/supervisor afterwards for comment, is using EOLAS or NIAW Butterfly Cloud Network (if reporting on paper, keep hold of reports to discuss with your supervisor periodically or in an agreeable manner)
• Continue to keep a logbook of all scanning ( see documents section)
• Review cases with mentor/supervisor regularly (2 monthly as a minimum) to ensure progression at an adequate rate.
• Share your Final logbook upon attainment of the right number of scans and pathology (if indicated), with your supervisor. 

OPTION 2 – Trainees performing scans in a DIFFERENT working environment with their mentor/supervisor (e.g trainee attending departmental sonography led sessions) This creates the opportunity for the trainee to scan using the local governance process for storing your images (e.g PACS within radiology departments)

• Report the training scan using the local reporting process at your site prefrentially, but with consideration of the FAMUS/FUSIC reporting questions / sheet.
• If this is not possible, available or feasible, then the default is using the FAMUS/FUSIC standardized reporting sheet by reporting 
• Electronically on Eolas (‘add new event’, under the events & feedback section) OR  NIAW Butterfly Cloud Network (if using a  butterfly device)
• On paper ( see documents section)
• PLEASE REMEMBER: No Patient identifies on the form, No Patient identifies on the video clip uploaded AND Label images!
• Share the report with your mentor/supervisor afterwards for comment, is using EOLAS or NIAW Butterfly Cloud Network (if reporting on paper, keep hold of reports to discuss with your supervisor periodically or in an agreeable manner)
• Continue to keep a logbook of all scanning ( see documents section)
• Review cases with mentor/supervisor regularly (2 monthly as a minimum) to ensure progression at an adequate rate.
• In ultrasound/Echo departmemtal lists, this will be more or less immediate, as you will be performing mentored scan numbers in a ‘supervised’ session. (Note – your mentor can be different (local) to your supervisor, who perfoms the final assessment and sign off.
• Share your Final logbook upon attainment of the right number of scans and pathology (if indicated), with your supervisor. 

OPTION 3 – Trainees performing scans in their normal environment that is REMOTE to the mentor/supervisor, therefore necessitating remote mentoring/supervision.This creates the opportunity for the trainee to scan using the local governance process for storing your images (e.g PACS within radiology departments)

• Report the training scan using the FAMUS/FUSIC standardized reporting sheet by reporting 
• Electronically on Eolas (‘add new event’, under the events & feedback section) OR  NIAW Butterfly Cloud Network (if using a  butterfly device)
• On paper ( see documents section)
• PLEASE REMEMBER: No Patient identifies on the form, No Patient identifies on the video clip uploaded AND Label images!
• Share the report with your mentor/supervisor afterwards for comment, is using EOLAS or NIAW Butterfly Cloud Network (if reporting on paper, keep hold of reports to discuss with your supervisor periodically or in an agreeable manner)
• Continue to keep a logbook of all scanning ( see documents section)
• Review cases with mentor/supervisor regularly (2 monthly as a minimum) to ensure progression at an adequate rate.
• In ultrasound/Echo departmemtal lists, this will be more or less immediate, as you will be performing mentored scan numbers in a ‘supervised’ session. (Note – your mentor can be different (local) to your supervisor, who perfoms the final assessment and sign off.
• Share your Final logbook upon attainment of the right number of scans and pathology (if indicated), with your supervisor. 

A note on Reporting…

It is important to use the standardized process for reporting while scanning.

This process highlights and re-enforces the questions targeted by the scanning process and can be performed in 3 ways, as below. 

• Electronically by using the Eolas Medical or Butterfly App’s digitized form which has been created specifically for the process of electronic reporting and remote supervision. 

OR

• Using  Paper forms which can be printed out and completed after each scan by yourself and the supervisor.

OR

• Using local reporting systems or process at your training site guided by your supervisor. 

A note on Trainees with limited access to ultrasound machines…

Please make contact with your supervisor to explore local options AND / OR mandated trainees can contact the  National Imaging Academy’s (NIAW) Loaning devices process to loan a device for a period to enable continued progression towards accreditation.

A note on Logbook…

Regardless of the process used above, please continue to keep a  logbook record of your scanning.

To Complete Stage 4

1. Modular log book completed with reports signed off
2. Required pathologies achieved 
3. Log book updated

AIM

To objectively review all training achievements and preform a final supervisor assessment before documents sent off to the appropriate accreditation body.

Elements: 

1. Stage 1 (Knowledge Acquisition) + Stage 2 (Simulated Scanning) Checks
2. e-LFH Certificate
3. Course Attendance Certificate
4. Attendance at simulation scanning session
5.  Stage 3 (Supervised Scanning) + Stage 4 (Mentored Scanning) Checks
6. Final Logbook 
7. Course Participation (Optional but strongly encouraged) Faculty at a recent Course? 
8. Triggered Assessment (Please arrange this session with your supervisor)
9. FAMUS/ FUSIC

Summary of Training Record

Please send Summary of Training Record Form to

1. Society for Acute Medicine (SAM) for Certification (email: famus@acutemedicine.org.uk )!!

Stage 5 Completed!

1. Triggered Supervisor Assessment
2. Review of course attendance, e-learning certificate, full logbook 
3. Final forms signed and emailed to accreditation body!!!

Da iawn!!