Introduction
The delivery of ultrasound training will be coordinated at Deanery level by the STC or School, who should appoint a ‘Deanery Ultrasound Coordinator’. Within Trusts, training will be provided by a nominated ‘Local Ultrasound Educational Supervisor’ in discussion with the College Tutor. The Educational Supervisor will approve a number of unit-based ‘Ultrasound Trainers’. There will be no central registration required at the RCOG and there will be no additional costs to the trainee. It is expected that the trainee should have access to good, quality ultrasound equipment and machines.
The role of the Deanery Ultrasound Coordinator in obstetrics and gynaecology ultrasound training
The Deanery Ultrasound Coordinator has formal responsibility for coordinating the intermediate ultrasound modules and will ensure that the quality of training and assessment in ultrasound within their Deanery is to a high standard. The appointment is made by the Deanery and in the larger Deaneries, more than one Deanery Ultrasound Coordinator may be appointed.
The Deanery Ultrasound Coordinator(s) must hold either FRCR or MRCOG/FRCOG and actively participate in obstetric and/or gynaecology ultrasound on a regular basis
The Deanery Ultrasound Coordinator is expected to become a member of (or be seconded on to) the Deanery Specialist Training Committee and will be expected to attend training assessment meetings.
Their role will be to:
- Provide guidance to local ultrasound educational supervisors and other trainers (who may include consultants, midwifes, nurses, sonographers and advanced practitioner sonographers)
- Ensure that the local ultrasound educational supervisors/trainers actively participate in obstetrics/gynaecology ultrasound (where appropriate) on a regular basis.
- Be involved in the selection process of trainees applying for the intermediate ultrasound modules
- Authorise completion of intermediate ultrasound training
- Hold an updated record of training centres, local ultrasound educational supervisors and trainers within the Deanery
- Keep an updated record of trainees’ placements and duration of training
- Work in collaboration with the Training Programme Director to highlight training opportunities and allocate trainees to available training slots. To report on progress to the Deanery Specialist Training Committee/School
- Ensure that trainees have access to the appropriate theoretical courses
General requirements for Local Ultrasound Educational Supervisors and Trainers for both intermediate and basic obstetrics and gynaecology ultrasound training
The Local Ultrasound Educational Supervisors have formal responsibility for coordinating the delivery of basic ultrasound modules. They will also be responsible for direct supervision of intermediate ultrasound modules and allocation of additional trainer(s) as appropriate.
Supervision, Delivery and Assessment
Basic Modules
Supervision -The Local Ultrasound Educational Supervisor will coordinate the appropriate in house training programme for the two basic modules and will confirm satisfactory completion of the basic ultrasound module.
Delivery of modules - Progress through the ultrasound modules is competency-based and must be assessed using the appropriate tools (OSATS, CbD etc). The generic skills assessment form should be completed with each OSATS. The modules are designed to allow a pragmatic and opportunistic approach for the majority of the ultrasound training.
Examples include teaching dating assessment within standard antenatal clinics, and assessment of presentation, liquor volume, placental site etc on delivery suite or in the day unit. Certain aspects will require more formal sessional commitment. The training for these modules is continuous – i.e. it can cross specialty years and can be continued from unit to unit as trainees rotate.
On completion of Module 1, trainees with have developed the basic skills required to confirm viability and assess gestation in early pregnancy using transabdominal ultrasound. They will be aware of when formal confirmatory ultrasound assessment is required. The module is not designed to confer the skills required to run an early pregnancy unit independently.
Competency in Module 2 will enable the trainee to assess presentation, placental site, liquor volume, basic growth parameters etc in ‘out of hours’ situations or when immediate sonographer support is not available.
Trainers must ensure that trainees remain vigilant and aware of the limits of their own competence.
Assessment - Undertaking assessment of trainees’ ultrasound competence independently should involve at least two assessors, one of whom should be the local ultrasound educational supervisor and the other ideally an independent assessor who has not been directly involved in the individual’s training. In the event of dual supervision, BOTH local ultrasound educational supervisors can be responsible for confirming competency. The ‘satisfactory completion of module’ page must be completed and signed up appropriately.
Intermediate modules
Supervision - Training must be undertaken under the supervision of an identified local ultrasound educational supervisor, with prior approval from the Deanery Ultrasound Coordinator. The local ultrasound educational supervisor should undertake at least one dedicated imaging session per week and directly supervise the trainee for the majority of the intermediate module(s). Units may need to appoint one Local Education Supervisor for obstetrics and another for gynaecology (dependent on the skills of the individual trainers). Trainees may undertake sessions under the supervision of professionals other than the local ultrasound educational supervisor (i.e. other trainers). It is the duty of the local ultrasound educational supervisor to ensure that the professional to whom the duty of training is delegated is sufficiently competent, willing and able to teach the trainee. More than one local training provider per trainee is acceptable and encouraged. In these circumstances, at least one of the providers should hold MRCOG/FRCOG or FRCR.
Delivery of modules - Progress through the intermediate ultrasound modules is competency-based and must be assessed using the appropriate tools (OSATS, CbD etc). The generic skills assessment form should be completed with each OSATS. Intermediate modules will require a combination of formal ultrasound sessions as well as utilising opportunistic training opportunities (eg supervised scanning in outpatient and antenatal clinic situations).
Assessment - Undertaking assessment of trainees’ competence should involve at least two assessors, one of whom should be the local ultrasound educational supervisor and the other, ideally an independent assessor who has not been directly involved in the individual’s training. In the event of dual supervision, BOTH ultrasound educational supervisors can be responsible for this. The Deanery Ultrasound Coordinator must also authorise completion of intermediate ultrasound training for each trainee.