August
2013
Module
1:
Basic:
Early
pregnancy
(8-12
weeks)
ultrasound
All
trainees
entering
at
ST1
level
will
be
required
to
complete
both
basic
modules
by
the
end
of
ST3.
The
aims
of
this
module
are:
1.
For
trainees
to
become
familiar
with
ideal
machine
set
up
and
use
of
the
transabdominal
probe
(including
probe
orientation)
2.
To
gain
competence
in
undertaking
a
basic
dating
scan
using
transabdominal
scanning
between
8-12
weeks
gestation
3.
To
encourage
an
acute
awareness
of
what
can
and
cannot
be
seen
using
the
transabdominal
route
in
early
pregnancy.
In
many
cases,
transvaginal
(TV)
ultrasound
skills
are
required
in
early
pregnancy
to
confirm
or
refute
pregnancy
site
and
viability/non-viability
(examples
include
earlier
gestation
<8
weeks,
maternal
obesity,
empty
bladder,
retroverted
uterus
etc).
Trainees
are
required
to
gain
the
TAS
competences
outlined
in
this
module
but
should
avail
themselves
of
opportunities
to
gain
exposure
to,
and
experience
in,
use
of
the
TV
probe.
This
is
not
mandatory
within
the
module
and
will
depend
on
the
availability
of
resources
within
units.
A
specific
module
will
be
developed
to
facilitate
confirmation
of
competence
in
the
use
of
TV
scanning
in
the
foreseeable
future.
Completing
the
two
basic
ultrasound
modules
is
a
very
important
achievement
and
can
act
as
a
stepping
stone
for
further
supervised
training
and
acquisition
of
more
advanced
ultrasound
competences.
Completion
of
the
two
basic
modules
does
not
imply
that
a
trainee
is
automatically
ready
for
independent
practice
in
diagnostic
ultrasound
(particularly
in
out
of
hours
unsupervised
assessment
in
early
pregnancy).
Please
note
that
assessment
before
8
weeks
gestation
and
use
of
transvaginal
ultrasound
are
not
covered
within
the
present
basic
modules.
Care
should
be
taken
in
delegating
decisions
about
clinical
management
of
patients
to
trainees
who
have
completed
only
the
basic
modules
(particularly
where
management
relies
on
the
ultrasound
findings).
The
expected
utilization
of
ultrasound
skills,
both
within
and
out
of
hours
and
whether
supervised
or
not,
should
be
determined
and
agreed
by
the
local
ultrasound
supervisor
in
the
context
of
local
protocols
for
ultrasound
scanning
(i.e.
completion
of
the
basic
modules
is
not
in
itself
an
automatic
qualification
for
all
elements
of
independent,
unsupervised
ultrasound
practice).
We
encourage
all
trainees
to
maintain
a
formal
log
of
ongoing
ultrasound
experience
once
basic
competence
has
been
confirmed.
Learning
outcomes
To
be
able
to
carry
out
appropriate:
ultrasound
identification
of
an
intrauterine
pregnancy
August
2013
ultrasound
identification
of
cardiac
activity
basic
first
trimester
biometry
referral
as
required
Trainees
should
maintain
an
awareness
of
the
limits
of
their
own
competencies
OSATS
Trans-abdominal
ultrasound
examination
of
early
(8-12
week)
pregnancy
August
2013
Knowledge
criteria
Clinical
competency
Principles
of
ultrasound
examination
Physics
Safety
Machine
set-up
and
operation
Patient
care
Principles
of
report
writing
Consent
Cultural
Diversity
Documentation
of
scan
Understand
need
for
accurate
documentation
of
scan
findings
Record
and
label
images
Principles
of
reporting
Understand
the
principles
of
conducting
a
safe
and
appropriate
ultrasound
examination
Use
an
ultrasound
machine
competently
and
independently
Record
scan
findings
clearly
and
accurately
and
keep
appropriate
hard
copy
or
video
records
of
anomalies.
Know
limits
of
own
ability
and
when
to
refer
for
further
opinion
Professional
skills
and
attitudes
Safe
use
of
the
ultrasound
machine
Appropriate
care
of
the
patient
during
examination
Training
support
Communicate
scan
findings
to
other
health
professionals
Supervised
clinical
learning
sessions
Course
including
both:
Theory
Practical
demonstration
of
machine
use
and
reporting
Evidence/
Assessment
Certificate
of
attendance
at
course
Case
based
discussion
August
2013
Knowledge
criteria
Clinical
competency
Normal
ultrasound
findings
1. Understand
morphological
features
of
normal
early
pregnancy
8-12
weeks.
2. Understand
physiology
of
cardiac
activity
in
first
trimester.
3. Understand
principles
of
gestational
sac
diameter
and
crown-rump
length
measurements
4. Understand
the
principles
of
differences
between
normal
intrauterine
gestation
sac
and
a
pseudosac
5. Understand
diagnostic
problems
which
may
occur
e.g.
empty
bladder,
obese
women
and
those
with
large
uterine
fibroids
6. Know
when
to
refer
for
a
TV
scan
Ability
to
identify
the
features
of
a
normal
gestational
sac
and
confirm
its
intrauterine
location.
Ability
to
measure
gestational
sac
size
and
crown-rump
length.
Ability
to
identify
early
cardiac
activity
using
B-mode.
Identify
fetal
number
Recognise
limits
of
competency
Know
limits
of
own
ability
and
when
to
refer
for
further
opinion
Professional
skills
and
attitudes
Conduct
scan
to
appropriate
standard
Training
support
Evidence/
Assessment
Mandatory
education
and
OSATS:
training
sessions
Trans-abdominal
ultrasound
examination
Theoretical
course
(local
or
of
early
(8-12
week)
RCOG)
pregnancy
The
majority
of
learning
opportunities
will
encompass
Log
of
experience
supervised
clinical
learning
sessions,
often
within
the
Case
based
discussion
standard
clinic
or
ward
setting
(e.g.
dating
scans
in
antenatal
clinic)
Certificate
of
course
attendance
Attendance
at
first
trimester
scans
and
the
Early
Pregnancy
Assessment
Unit
(EPAU)
Personal
study
Textbooks
of
obstetric
ultrasound
Relevant
green
top
guidelines
Guidance
on
Ultrasound
Procedures
in
Early
Pregnancy
(published
jointly
with
the
Royal
College
of
Radiologists)
August
2013
Module
1:
Basic
early
pregnancy
(8-12
weeks)
ultrasound
logbook
Competence
level
Skill
Level
1
Date
Level
2
Signature
Date
Level
3
Signature
Date
Signature
Safe
use
of
US
machine
and
correct
settings
Probe
orientation,
probe
care
and
infection
control
(transabdominal)
Confirmation
of
intrauterine
location
of
pregnancy
Detection
of
fetal
cardiac
activity
Measurement
of
gestational
sac
diameter
and
crown
rump
length.
Accurate
documentation
of
measurements
Producing
written
summary
and
interpretation
of
results
Communicating
normal
results
to
parents
Communicating
abnormal
results
to
parents
Arranging
appropriate
referral,
follow
up
or
intervention
Working
in
a
multi-disciplinary
team
August
2013
Each
OSATS
should
be
successfully
completed
for
Independent
Practice
on
3
occasions
before
the
module
can
be
signed
off
OSATS
Transabdominal
ultrasound
examination
of
early
(8-12
week)
pregnancy
Date
Signature
Date
Date
Signature
Signature
Training
courses
or
sessions
Title
Signature
of
subspecialty
training
programme
supervisor
Date
Authorisation
of
signatures
(to
be
completed
by
the
clinical
trainers)
Name
of
clinical
trainer
(please
print)
Signature
of
clinical
trainer
August
2013
COMPLETION
OF
MODULE
I
confirm
that
all
components
of
the
module
have
been
successfully
completed:
Date
Name
of
educational
supervisor
Signature
of
educational
supervisor