Advanced Sonography

This is a two (2) year program delivered through Hybrid Learning.

  • Year One consists of online-didactic evidence-based learning.

  • Year Two consists of Preceptorship.

Total Program Tuition: $24,000.00

 

Ultrasound (US) is particularly subject to errors, more than any other diagnostic imaging technique. This includes errors in ordering examinations, performing studies, interpretation of images and data and clinical capabilities. Ultrasonography is highly operator dependent, making it essential that the Sonographer is properly trained in order to be able to implement the full diagnostic capabilities of the technique. The skill of the operator is based on the ability to maximize the diagnostic information available and to properly interpret the images.

 

Unfortunately, while it is common to utilize standardize testing to assess the Sonographer, there are a majority of errors that significantly impact the patient in both the ordering of the examination and final interpretation of the study. Ultrasonography is a very unripe field of medicine. It is sparsely regulated and has not provided an opportunity for professional development. While the demand for Sonographers has increased, there have been very few steps taken to allow professionals the opportunity for maturation. Ultrasounds are routinely performed by both registered Sonographers and medical providers, including physicians, nurse practitioners, physicians assistants, midwives, etc. The quality of the ultrasound study regularly and profoundly varies depending upon the ultrasound training, experience, expertise and qualifications of the individual performing it.

 

Although Sonographers are well trained and highly skilled, the responsibility for the interpretation and reporting of the results of ultrasound examinations, as well as the legal responsibility for all aspects of patient care, rests with the physician. The role of the Ultrasound Practitioner will not only ensure the individual performing the examination has a substantiate academic foundation, it also ensures the interpretation is more accurate and concise.

You can complete the program ANYWHERE. You do NOT have to live in Florida to complete this program. Suncoast College participates in NC-SARA. NC-SARA is an agreement among member states, districts and territories that establishes comparable national standards for interstate offerings of postsecondary distance education courses and programs. 

Admissions Requirements for Advanced Sonography Program

-Government Issued Photo Identification

-High School Diploma/GED

-Prior College Transcripts AND Ultrasound School Transcripts

-Active Ultrasound Credential(s)

-Proof of five (5) years experience (i.e. tax filings)

-Three (3) Letters of Recommendation

GRIPES OF THE FIELD

Be the Change you want to see in the World!

By introducing Advanced Practice Sonography as a Master's Program, and the need for the Ultrasound Practitioner, we can hope to eliminate the challenges faced by everyday expert Sonographers. Our goal is to improve medical outcomes and decrease the strain that taxes our medical system, drives up costs and drives down patient care. 

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CURRICULUM BREAKDOWN

UPS 510 History & Physical and SOAP Notes

This course focuses on comprehensive physical assessment which includes interpreting and applying information regarding in-depth health history, physical and psychological signs and symptoms, developmental stages, pathophysiologic changes, and psychosocial and cultural characteristics of the individual, family, and community. Enhancement of communication and observational skills are emphasized along with the development of sensitive and refined interviewing techniques.

 

UPS 520 Lab Values and Clinical Correlations

This course provides a masters level study of theory, practical application, technical performance, and evaluation of clinical chemistry laboratory procedures. Correlation of clinical laboratory data with the diagnosis and treatment, interpretation, problem solving, and correlation of laboratory findings with disease states to support diagnosis, differential diagnosis, indication or contraindication for exam and exam order error.

 

UPS 525 Interpreting Other Imaging Modalities

This course provides a masters level study of principles and interpretation of medical imaging modalities. Emphasis is on the physics of the imaging technique, viewing and interpreting films, radiographic anatomy, and clinical correlation with patient cases pertaining to magnetic resonance imaging, computed tomography, prior diagnostic and rehabilitative ultrasound imaging, and nuclear medicine.

 

UPS 610 Abdominal Sonography for the Ultrasound Practitioner

This course provides a masters level study of abdominal anatomy; physiology; patient care; and imaging/interventional techniques. Emphasis will be placed on normal and abnormal vascular, hepatic, biliary, and splenic systems. Emphasis will be placed on normal and abnormal structures and associated sonographic patterns, knowledge of advanced pathology/performance and interpretation of color flow/duplex imaging, assimilation of clinical information and radiologic imaging studies to manage and consult effectively and ultrasound guided procedures.

 

UPS 611 Kidney, Ureters, Bladder, and Prostate Sonography for the Ultrasound Practitioner

This course provides a masters level study of the urinary tract and prostate to include interventional procedures, organ transplant, musculoskeletal, clinical history, physical assessment, and appropriate exam protocol. Emphasis will be placed on normal and abnormal structures and associated sonographic patterns, knowledge of advanced pathology/performance and interpretation of color flow/duplex imaging, assimilation of clinical information and radiologic imaging studies to manage and consult effectively and ultrasound guided procedures.

 

UPS 612 Gynecology Sonography for the Ultrasound Practitioner

This course provides a masters level study of gynecological sonography to include pathologic, congenital, and structural complications, clinical history, physical assessment, and the appropriate exam protocol. Emphasis will be placed on knowledge of advanced pathology/performance and interpretation of color flow/duplex imaging, assimilation of clinical information and radiologic imaging studies to manage and consult effectively and ultrasound guided procedures.

 

UPS 613 Obstetrical Sonography for the Ultrasound Practitioner

This course provides a masters level study of obstetric sonography to include pathologic, embryologic, and structural complications, clinical history, physical assessment, and the appropriate exam protocol. Emphasis will be placed on knowledge of advanced pathology/performance and interpretation of color flow/duplex imaging, assimilation of clinical information and radiologic imaging studies to manage and consult effectively and ultrasound guided procedures.

 

UPS 614 Thyroid and Neck Sonography for the Ultrasound Practitioner

This course provides a masters level study of the thyroid and neck. Emphasis is placed on recognizing focal disease, diffuse disease, and multinodular gland, normal variants (pyramidal lobe, hypoplasia of lobe), and lymph nodes. Focus will be placed on the location of abnormal lymph nodes should be described according to the clinical nodal classification system developed by the American Joint Committee on Cancer and the American Academy of Otolaryngology-Head and Neck Surgery, or in a fashion that allows the referring clinician to convert the location of abnormal nodes to that system. Emphasis will be placed on knowledge of advanced pathology/performance and interpretation of color flow/duplex imaging, assimilation of clinical information and radiologic imaging studies to manage and consult effectively and ultrasound guided procedures.

 

UPS 615 Male Reproductive Sonography for the Ultrasound Practitioner

This course provides a masters level study of the scrotum, and male pelvic anatomy, physiology, with a focus on interpretation of vascularity, wave form analysis, and identification of disease or disorder. Emphasis will be placed on knowledge of advanced pathology/performance and interpretation of color flow/duplex imaging, assimilation of clinical information and radiologic imaging studies to manage and consult effectively and ultrasound guided procedures.

 

UPS 617 Vascular Sonography for the Ultrasound Practitioner

This course provides a masters level study of vascular anatomy, physiology, hemodynamics, wave form analysis, and treatment of vascular disease. Emphasis will be placed on renal, intracranial, vein mapping, hemodialysis graft, plethysmography, and venous insufficiency duplex/color flow testing, including clinical history, physical assessment, and appropriate exam protocol.

 

UPS 618 Pediatric Sonography for the Ultrasound Practitioner

This course provides a masters level study of neonatal and pediatric head, spine, hip, abdomen, and urinary systems anatomy, physiology, and pathophysiology. Topics will include patient care, integration of data, and imaging protocols.

 

UPS 699 Radiological Reporting for the Ultrasound Practitioner

This course focuses on the report that communicates information to referring physicians, records information for future use, and serves as the legal record that documents the imaging study. The ultrasound report should be consistent, comprehensive, easily managed, and "readable" to humans and technology alike. The Advanced Sonographer must make it possible to integrate evidence collected during the imaging procedure, including clinical data, coded terminology, technical parameters, measurements, annotations and key images.

 

UPS 700 Ultrasound Practitioner Preceptorship

This course focuses on the Advanced Sonographer Preceptorship double reading from both the Physician and Advanced Sonographer interpreting the same study, as follows:

  • A preceptor-review process that allows for the random selection of studies to be reviewed on a regularly scheduled basis.

  • Examinations and procedures representative of the work of the Ultrasound Practitioner’s and Physician’s specialty.

  • Reviewer assessment of the agreement of the original report with subsequent review (or with pathologic findings).

  • A classification of preceptor-review findings with regard to level of quality concerns (Table 1, 4-point scoring scale).

  • Policies and procedures for action to be taken on significantly discrepant preceptor-review findings for the purpose of achieving quality outcomes improvement.

  • As applicable, a classification of preceptor-review findings with regard to the level discrepancy (Table 2, 3-point scoring scale).

  • Summary statistics and comparisons generated for both the Advanced Sonographer and Physician.

  • Summary data for each facility.

PRECEPTORSHIP

The purpose of this preceptorship is to ensure there is a consistent, equitable, timely preceptor review system that monitors, tracks and trends clinical outcomes, and provides relevant information for determining the competence of the Advanced Sonographers. The preceptorship review process is designed to be fair for Advanced Sonographers, ensure patient safety, promote performance improvement, and be defensible, balanced, useful and ongoing.

 

Members of the clinical preceptorship facility’s medical staff will be actively involved in activities to measure, assess and improve performance on an organization-wide basis. The medical staff will adhere to a timely, balanced, useful and ongoing objective preceptor review process as described in this policy and procedure. The preceptor review process assesses and evaluates the quality of patient care and services based on established standards of care. The monitoring of the quality and appropriateness of patient care and safety is an ongoing, continuous process during the establishment and implementation of the Advanced Sonographer into the healthcare field.

 

Preceptor review is required to assess and determine the abilities of the Advanced Sonographer who wishes to practice independently, and to ensure qualifications from established and recognized standards of care, including, but not limited to, such variations based on:

  • Establishment of the job role

  • Occurrence reporting that describes an unusual circumstance needing intensive review

  • Sentinel events

  • Complaints from patients, colleagues or staff regarding quality of care or services

  • Requests from outside agencies, i.e., contracted hospitals or mobile diagnostic units

  • Performance outcomes

The preceptor will perform routine preceptor reviews of all studies read by the Ultrasound Practitioner. Faculty will intermittently review the studies read by both the preceptor and student to compare and assess quality. Exam review will occur for all ultrasound activity at the facility. The studies will be reviewed and assessed using the QA Form – Table 1. After review, if the findings are upheld, no additional assessment will be needed. If there is a discrepancy, the error will be assessed using QA Form – Table 2. The faculty will receive all discrepancy reports.

WHY DID WE DEVELOP THIS PROGRAM?

With the increased development and utilization of ultrasound capabilities and its already known benefits of being cost effective, portable, instant and able to evaluate the pathophysiological changes live, the need for a midlevel practitioner role is vital. In contrast, there has been an increase in radiology patient care error which have increased the costs associated with diagnostic and therapeutic exams and more importantly, jeopardized the treatment and management of patients.

 

The current environment presents to be the ideal opportunity to introduce and implement this role. It's establishment can continue to develop the positive transitions of ultrasound whilst combating the error and fiduciary waste that is endangering modern medicine.

FIELD GROWTH

An academic foundation that would recognize and differentiate a "novice" from an "advanced practice" sonography would allow the continued growth of the ultrasound field through the further expansions of ones expertise, leading to accurate results, better medical accessibility, and the continued development of the field without the perpetuating glass ceiling.

Roles can include (as allowable by state and facility): Ultrasound Practitioner, Technical Director, Department Chair, Medical Research, Trial Research, Educator, etc.

A recent study showed that two (2) sonographers were trained to help manage an abrupt, permanent increase in the number of ultrasound examinations in our department. Called "ultrasound practitioners," they functioned as physician assistants and triaged 20 to 30 cases per day, allowing the cases to be batch read at a formal reading at day's end. Practitioner 1 monitored the examinations of 2858 patients. The graded report results were as follows: A, 96.2%; B, 3.5%; C, 0.3%; and D, 0.00%. Practitioner 2 monitored the examinations of 2825 patients. The graded report results were as follows: A, 96.1%; B, 3.6%; C, 0.2%; and D, 0.00%. There were no category D reports.

HUMANITY

With the increased development and utilization of ultrasound capabilities and its already known benefits of being cost effective, portable, instant and able to evaluate the pathophysiological changes live, the need for a midlevel practitioner role is vital. In contrast, there has been a increase in radiology patient care error which have increased the costs associated with diagnostic and therapeutic exams and more importantly, jeopardized the treatment and management of patients.

NOVICE vs. EXPERT

In medicine, misdiagnosis-related errors are much more common than medication errors and can lead to poor patient outcomes. These types of errors can be minimized, however, by understanding the relationship between operator experience and a test's performance characteristics, he said.  With that in mind, the Mount Sinai team sought to evaluate the effect of operator experience on the sensitivity and specificity of point-of-care ultrasound in a prospective study of 150 children.
 

Sonographers had significantly higher sensitivity for diagnosing appendicitis with point-of-care ultrasound than Sonographers with less experience, in a study from Mount Sinai School of Medicine.  Either way, though, it's important not to rely only on point-of-care ultrasound to rule out the condition. In the prospective study of 150 patients, experienced Sonographers' sensitivity was nearly 30% higher than that of their less experienced colleagues. 

"QUALIFICATIONS"

While there is legally no mandate for formal ultrasound education in nearly all US states, there are other influential bodies which have begun the movement of proper education and credentials. There are currently four (4) independently owned and operated credentialing agencies for Ultrasonography. Each agency has a different method of assessing applicants.

  • Most credentialing agencies require a formal education from an accredited institution (there are some additional prerequisite options for those without).

  • Most insurance companies will not reimburse for vascular ultrasound examinations if the individual performing them not is properly registered.

  • Some lab accreditors (ICAVL) will only accredit facilities if the staffed Sonographers are properly registered.

  • Employers prefer registered technologists, however are ignorant to the types of registries.