ALVIN COMMUNITY COLLEGE DIAGNOSTIC CARDIOVASCULAR SONOGRAPHY PROGRAM COURSE SYLLABUS Vascular Technology Peripheral Vascular Evaluation (Vascular II) DSVT 2418 Fall, 2015 INSTRUCTORS: Deb Kleinhans, AAS, RVT Dee Dee Metzcher-Carr, BA, JD, RVT Pag e 1 | 19 Peripheral Vascular Evaluation DSVT 2418 INSTRUCTOR: Deb Kleinhans EMAIL: [email protected] Dee Dee Metzcher-Carr [email protected] OFFICE: S148 PHONE: 281-756-5663 OFFICE HOURS: Tuesday 12 – 1 pm DATES: August 24 – December 8, 2015 (To be announced in class) COURSE: DSVT 2418 Sections 01 and 60 LECTURE AND LAB: Lecture is held on Tuesday from 1:00 – 2:50 pm Morning lab is from 8:00 am – 12:00 pm Afternoon lab is from 3:00 –m – 7:00 pm OUTSIDE SCANNING 16 hours is required. Document this on the Outside scanning form COURSE DESCRIPTION: This course will begin to integrate basic concepts and apply prior knowledge and skills to understanding and evaluating for peripheral vascular diseases utilizing non-invasive vascular techniques. Emphasis will be placed on evaluation of venous and arterial diseases of the upper and lower extremities. COURSE GOALS AND OBJECTIVES: By the end of this course the student will be able to: 1. Define the etiology, signs, symptoms, and treatment for venous and arterial peripheral vascular disease. 2. Implement methods of recognition, evaluation, and quantification of those diseases utilizing technical skills including venous duplex, arterial duplex, and arterial segmental non-imaging studies. 3. Understand the pathophysiology and hemodynamic consequences of each disease. 4. Recognize and differentiate various venous and arterial interventions and treatment methods. PREREQUISITES COURSE: DSVT 1300, DSVT 2430 TEXTBOOK INFORMATION: None required. Pag e 2 | 19 COMMUNICATING WITH YOUR INSTRUCTOR: The preferred method of communicating with your instructor is through the ACC email. I will normally respond within 24 hours Monday – Thursday and by the next business day of Friday – Sunday. Please do not call cell phone unless it is an emergency. CLASS ATTENDANCY POLICY: Each student is expected to attend class regularly. It is the student’s responsibility to make up any assignments that are missed. Please call the instructor if you are absent to make arrangement for missed assignments, handouts, and/or tests. IF A STUDENT MISSES MORE THAN FOUR (4) CLASSES YOU MAY BE REMOVED FROM THE PROGRAM! STUDENTS MUST ATTEND CLASS AND LAB REGULARLY TO BE AWARDED COURSE CREDIT! PARTICIPATION IN LAB ACTIVITIES IS ALSO REQURED. STUDENTS WHO COME LATE, LEAVE EARLY, OR WHO DO NOT STAY FOR LAB WILL BE COUNTED ABSENT FOR THAT CLASS. TARDIES GREATER THAN 20 MINUTES LATE OR LEAVING EARLY WILL BE CONSIDERED AS AN ABSENCE. NOTICE: If a student leaves class or lab early, they must submit a note with their name, date, time and reason for leaving early to the instructor prior to leaving. DISCLAIMER: The instructor reserves the right to modify this syllabus as needed and will notify the students of any changes using the ACC e-mail or MyBlackboard e-mail or announcements. CODE OF ACADEMIC INTEGRITY AND HONESTY: Alvin Community College students are members of an institution dedicated to the pursuit of knowledge through a formalized program of instruction and learning. At the heart of this endeavor, lie the core values of academic integrity which include honesty, truth, and freedom from lies and fraud. Because personal integrity is important in all aspects of life, students at Alvin Community College are expected to conduct themselves with honesty and integrity both in and out of the classroom. Incidents of academic dishonesty will not be tolerated and students guilty of such conduct are subject to severe disciplinary measures. CLASSROOM PROTOCOL: It is the right of each student to participate in his or her learning, and it is the responsibility of each student to not interfere with the learning of other students. It is the expectation of the college that each student assumes the responsibility to follow college policies and procedures governing campus and classroom conduct. This information is published in the ACC Student Handbook (http://www.alvincollege.edu/resources/pdfs/student_handbook.pdf) Pag e 3 | 19 COURSE OUTLINE: Unit 1 – Evaluation of Extremity Arterial Pathology By the end of this unit the student will be able to: 1. Review of the upper and lower extremity arterial anatomy and arterial diagnostic modalities, including duplex ultrasound. 2. Define the role of non-invasive procedures in the management of extremity arterial disease. 3. List the methods for indirect arterial testing and their physiologic basis (including: Doppler, plethysomgraphy, segmental pressure). 4. Understand the etiology and pathophysiology of arterial extremity disease. 5. List signs and symptoms of arterial extremity disease. 6. Understand hemodynamic concepts and perform calculations or measurements used to evaluate for arterial pathology. 7. Correlate non-invasive findings with arteriography. Unit 2 – Evaluation of Extremity Venous Pathology By the end of this unit the student will be able to: 1. Review of upper and lower extremity venous anatomy and venous diagnostic modalities. 2. Define the role of non-invasive procedures in the management of extremity venous disease. 3. List the methods for indirect venous testing and their physiologic basis. 4. Understand the etiology and pathophysiology of venous extremity disease. 5. List signs and symptoms of venous extremity disease. 6. Perform imaging and non-imaging examination of the venous extremities. 7. State and perform the venous extremity examination protocols used to evaluate for venous pathology. 8. Understand hemodynamic concepts and perform calculations or measurements used to evaluate for venous pathology. 9. Interpret findings of abnormal venous non-invasive, imaging, and non-imaging venous diagnostic studies. 10. List and define the additional non-imaging venous exams still covered on the registry exam; venous refill time, venous capacitance, venous emptying, phleboreography. 11. Correlate non-invasive findings with venography. LATE WORK POLICY Assigned work is expected to be turned in on time. Ample time is allotted for completion of assignments. It is the student’s responsibility to make up any assignments that are missed prior to the next class period. You may email the assignment to the instructor. An assignment not turned in prior to the next class period will receive a 5 (five) point deduction. After that it will be a zero. Please call, email, or text the instructor if you are going to be absent to make arrangements for missed assignments, handouts, and/or tests. If you are going to miss a lab, please notify the instructor via a communication method listed. Late lab assignments will have 15 points deducted up to 1 week. After that it will be a zero. EXAM POLICY An exam will be given at the end of each unit. You will have 120 minutes for each exam. The exams will be averaged with the assignments to calculate the final grade. Any missed exams will be made up on the next class day or sooner by appointment in the afternoon with Susan. THERE WILL BE NO EXCEPTIONS! Pag e 4 | 19 The comprehensive final exam is required to complete the course; however, the grade will be used to replace the lowest test. Score. It will not be used against you if the grade is lower than previous test scores. Students may miss one exam and be allowed to make it up. If a second exam is missed, the final will be used to replace that grade. Any missed tests after that will be a zero. Example: first missed exam – make up, 2nd missed exam – take the final to replace, 3rd missed exam – zero, and so forth. GRADING SUMMARY Your grade is based on the AVERAGE of all the major grades you received on all course assignments and activities. Always notify your instructor if you are concerned with your grades or your status in the class. The final grade will be calculated as follows: each of the major grades will be averaged together: Unit 1, 2, 3, 4 unit exams, lab/homework/quiz average, major projects, capstone and scan eval. It is the student’s responsibility to keep up with their grades and course average. The instructor is available as needed for extra help or to discuss grades. Don’t wait until the end of the semester to address any problems. Keep track of your grades. Do not throw away any of your assignments until the semester is over. If you notice a problem, contact your instructor. Do not let your grades get out of hand. Only one semester left after this one till graduation. POINTS Unit 1 exam Unit 2 exam Unit 3 exam Unit 4 exam Final exam ( + / - ) Lab / homework average Scan eval average Capstone TOTAL  / 7 GRADING SCALE A = 91 – 100 B = 82 – 90 C = 77 – 81 F = Below 77 Students must make a grade of 77 or better to be awarded course credit. 77 is the minimal acceptable level for all courses in the DCVS program. Pag e 5 | 19 I….Incomplete. No Incompletes or “I” grades will be given except for extreme circumstances. If an “I” grade is assigned and the course work is not completed by the pre-arranged time limit, this grade will convert to an “F”. W….Withdrawal. It is recommended that the student talk to the instructor before withdrawing. Current course withdrawal information can be found in the printed version of the ACC schedule for this semester or online at ACC Course Withdrawal Instructions. Students who file withdrawal requests by the published deadline and have not exceeded the withdrawal maximum will receive a grade of W. ACC ACADEMIC SUCCESS AND SUPPORT SERVICES American with Disabilities Act ACC complies with ADA and 504 Federal guidelines by affording equal access to individuals who are seeking an education. Students who have a disability and would like classroom accommodations must register first with the Office of Disability Services, A136 (281-756-3533. Instructors are not able to provide accommodations until the proper process has been followed. BEHAVIORAL INTERVENTION TEAM (BIT) – LETTING SOMEONE KNOW The Behavioral Intervention Team (BIT) at Alvin Community College is committed to improving community safety. College faculty, staff, students and community members may communicate safety concerns to the BIT team by email, [email protected] or through an electronic reporting option located on the BIT page of the college website. ACC LEARNING LAB Located upstairs in building A, the learning lab provides students with a variety of services including tutoring (math, writing, and other disciplines); computers and printers; a testing facility; and tables/carrels for studying. Testing hours are M-TH 10:00am – 7:30pm (Tests must be completed by 8:30pm. Call 281- 756-3566 for more information. The ACC Learning Lab and Writing Center, A-235, is for help with writing assignments, tutoring, exams, and additional computer access: http://www.alvincollege.edu/resources/learning_lab.htm ACC LIBRARY WEBSITE The ACC Library is an excellent source for research and writing help. Quiet rooms are available for studying and doing class work. For more information, visit the ACC Library Website or call 281-756-3559. MYBLACKBOARD Support for MYBlackboard can be obtained by completing the Online Support Form. WEBACCESS, PASSWORDS OR ACC COMPUTER LAB INFORMATION For help with WEBACCESS, Passwords or to get information on the ACC Computer Labs visit the -ACC Help Desk Website or contact the IT Dept. Help Desk at 281-756-3544. Pag e 6 | 19 ADDITIONAL MATERIALS USB/Jump Drive or CD R/W ACC DCVS polo or T-shirt to wear to lab Stretchy shorts for scanning each other Khaki slacks, dark pants or nice jeans. No SHORTS when scanning volunteers. ACC DCVS name tag to wear to lab Ream of printer paper, ink cartridges for lab printer Ultralinq Access Renewal from the bookstore Pegasus Lectures specialty Exit Exam disk EXPECTATIONS: 1. Students are expected to complete all BlackBoard and lab assignments on time. 2. Students are expected to allocate a minimum of 10 hours per week on textbook readings, interacting with course materials, participating in class discussions , and completing assignments, quizzes and exams. 3. Students are expected to use the ACC campus computers or have a workable computer that can access the course website. Any technical problems on the student’s side WILL NOT be an acceptable excuse for late work. Scan EVALS A complete arterial and venous bilateral protocol will be performed and clipped then sent to Ultralinq for review. The protocol must be complete and thorough according to the latest ACC protocol. If there is pathology it should be appropriately interrogated. You should time yourself and complete it within 60 minutes. Print the start and end time and scan that into Ultralinq as an attachment so your time can be verified if you are using the Biosound. Be sure to clip the first image when you start and the last image when you finish even if it is after additional measurements are completed. 0.5 points at mid term and 1 point at final will be deducted for each minute over 60. Start/End time includes measurements. Both Scan EVALs will be averaged together to count as a major grade. The weeks you have a scan EVAL due it will count as your full scan, i.t., Scan EVAL, lab assignment will be due those weeks but not an additional full scan. Make sure you label these assignments as Scan EVAL #1 and Scan EVAL #2. Instructions for ALL lab assignments, including Scan EVALS, lab work, full scans and Capstones: Have your lab instructor sign the permission consent form BEFORE you begin and log it in with the proper abbreviation. Obtain patient history in compliance with HIPAA before you begin your study. The lab instructor is to back scan every volunteer; it is your responsibility to be sure this is completed before the volunteer leaves. Ask your volunteer to fill out the student evaluation form, this is to provide you feedback on what you may need to improve on. Fill out the ACC student worksheet and scan it into Ultralinq with assessment, BP, H&P, and COMPLETE interpretation. You may choose to do the Ultralinq interp filling in all blanks. Be sure to clip the info page and all report pages each time. Students will assign their scans to be read by a student peer and a faculty member according to the schedule provided. See attached. You have 24 hours to complete the peer review of your classmate. Any comments brought to attention by a peer that are valid and constructive and not overly critical will NOT be deducted from the scan grade if the faculty member agrees with the peer comment. So do Pag e 7 | 19 a good job on your peer reviews so your classmates will earn better grades and so you get better at picking out mistakes in scanning and you can then be more critical of your own scans and you will improve faster in the long run. GRADING RUBRIC It is one (1) point off for each optimization mistake. One (1) point off for each measurement mistake made. Missing view is 5 points off. Missing measurement is one (1) point off. Anything left blank on a worksheet is 3 points off (the only exception to this is for TDS patients). Have the instructor back scan and label the images so we know they were unable to be obtained. This way, we will not penalize you for missing measurements. No interpretation is 10 points off. Incomplete interpretation is 5 points off. Study labeled incorrectly is ZERO. We are not going to waste time looking for your scans. When they are no properly labeled we can’t find them. It is too difficult for faculty to try and match up studies that are not labeled properly, therefore, it will remain a zero until it is corrected and reassigned to the instructor (this must be completed within a week). Bonus points: One (1) point per minute you are under time will be added to the final grade as long as the overall quality of the scan is good. Don’t forget H&P, Assessment, and BP for all scans - MINUS 5 points if missing. Minus 25 points – no back scan completed Minus 15 points – late Notice: Lab assignments are due, submitted to Ultralinq with worksheet complete, interpretation and attachments, and assigned to the reading instructor by midnight on the day of lab. If they are turned in on time, students will receive a max grade of 100 (minus points for any problems). If it is late the grade will start with an 85 then the next week will be a ZERO. Lab assignments can be done early, during the break before that semester and during outside scan time. There will be NO REDO’s allowed on ANY assignments this fall. This includes labs, scan EVALS and full scans. Assignments can only be done up to two weeks in advance. FILE NAMING Make sure you label properly: ex.: FS# 1 or Lab #1, or 2DDrill #1 or ScanEVAL #1, or Capstone #1. Use the proper file naming protocol for Ultralinq. If scanning a volunteer use their name as the LAST Name and student initials and assignment as FIRST NAME. Make sure you label properly: Example: FS# 1 or Lab #1, or 2DDrill #1 or Scan Eval #1, or Capstone #1 Use the proper file naming protocol for Ultralinq. First Name: Your first and last name EX: Jessica Murphy Last Name: The name of your assignment EX: L1 (lab one), H3 (homework 3) PT ID #: Your three digit Ultralinq code, date, patient initials with no spaces EX: JM4081912JAD Add another number when you have two scans due from the same date/patient such as A , B, or 1, 2. Pag e 8 | 19 Sonographer ID#: Your three digit Ultralinq code BE SURE you put in your Ultralinq code under the sonographer or you will not have access to fill out the worksheet and assign it to the instructor which could cause your study to be late. Assignments that are not identified properly and assigned to their lab instructor will not be graded until they are properly labeled, late charges apply. You will have the following due weekly: Full Scan with interp Lab assignment with interp – see calendar for reading schedules and due dates. If your volunteer will need a copy of their study you should use their name as the last name and student initials and assignment as the first name. This helps us find the study if a volunteer calls with questions. PT ID #: Your three digit Ultralinq code, date, patient initials with no spaces EX: JM4081912JAD, add another number or letter for any scans that are performed on the same day. Sonographer ID#: Your three digit Ultralinq code You will have the following due weekly: (see calendar for reading schedules and due dates)  Full scan with interp  Lab assignment with interp Meetings/Inservices/Vascular Interps ATTENDANCE at medical director or guest lectures and interp classes is vitally important. If a student has to miss a scheduled special lecture they will turn in 10 powerpoint slides on each of the topics that were discussed at the meeting that was missed. These slides must be turned in on a stick or emailed to the instructor by the next class meeting. All students will attend any lectures which are pertinent given by the medical director this semester. Dates are TBA. Students may leave up to one hour early from their clinical site to attend these lectures if they fall on a clinical day and depending on where you are for clinical that day. INTERPRETATION CLASSES: Vascular interpretation classes will be held outside of scheduled class time at an off campus location. Location, times and dates will be announced in class. You are required to attend these interpretation classes and attendance will be taken. MODELS The Diagnostic Cardiovascular Sonography Program is in need of models/volunteers each night of class for the hands-on practice. If you, a family member, or friend would like to model, please have them call Susan at 281-756-5625 to schedule an appointment so a volunteer schedule can be made in advance whenever possible, and to ensure an adequate number of models for each lab. BONUS POINTS – Maximum of Two (2) added to final average. Attend professional society meetings (in addition to your required meeting) Computer CME activities-MUST BE ULTRASOUND RELATED!!!!!!! Students can arrange for other bonus points – upon approval of Instructor. Other bonus point activities may be announced by the program director/instructor. Pag e 9 | 19 Homework pass – One (1) may be used per semester. For written lecture assignment only. Check with instructor first. OUTSIDE SCAN TIME - Students are required to log in sixteen (16) hours of actual hands-on-probe-time by the end of the semester. This additional scanning practice is outside of class and lab. It can be completed here on campus during supervised scanning labs. A schedule will be posted. The scan time must be verified and documented. **See attached documentation form for details. A total of the hours are required at the bottom of the form. ACC LAB USE - ACC has MyLab 30 Gold, GE Vivid 3, Logiq 7, IE33, Sequioa C512 and Phillips ultrasound machines, available to use after hours. The vascular lab also has available at Parks Flow and Hokanson non-imaging machines available for physiological studies. You must first sign a lab use permission slip, make an appointment to avoid over-crowding, and sign in and out with campus police. **See attached lab use permission form for more details. You are required to reserve the machine that you want to use through g-mail. Your user name is: [email protected] with the password rileycat. How to sign up for a machine will be demonstrated on the first day of class. If you are not able to keep your reserved time you must email everyone to let them know that the machine is available. NO FOOD OR DRINKS IN THE SCANNING AREA OF THE LAB!! No children allowed unless attached to the machine as a model. The only people allowed in the lab are the student and the model. THAT’S IT!! Please clean up when you are finished. Leave the lab nice and tidy. CAPSTONE SCANNING At the end of the fall semester, each student will be required to pass a Capstone scanning experience in order to be awarded course credit. The fall semester capstones consist of a bilateral venous study and a bilateral arterial study. The student will be asked to scan a volunteer according to ACC protocol including proper optimization, routine measurements calculations and are bilateral. The instructor will critique the scan. Students will have 60 minutes each to complete a normal routine scan-THIS INCLUDES ALL MEASUREMENTS. The student may be asked to perform additional calculations or measurements. If pathology is present on the randomly selected volunteer you will be required to perform all additional necessary measurements. If the student is requested to perform additional advanced calculations, 15 minutes will be added to the scan time limit. This does NOT include routine pathology. Students are NOT allowed a copy of their protocol or any notes while they are scanning. Students will be graded on timeliness of image acquisition, image optimization, correct measurements, completion of study in required time, and a correct/complete tech worksheet including interpretation. Please clip all the report pages to include in the exam. ** See section under lab assignments regarding additional grading policies. You must earn an eighty (85) to pass this Capstone. Capstones, Check Offs and Competency Assessments are considered exams and fall under the jurisdiction of our academic integrity policy. Students are NOT allowed to use ANYTHING to assist them while performing skills or scan tests of any kind. Students may not have anything with them while they are testing and this includes but is not limited to the following: No phones, No backpacks, No purses, No books, No notes, No cards, No lists, No protocols, no nothing will be allowed while you are testing. The program expects students to know the procedure, protocol, formulas and any and all pertinent information in order to get the job done. If you need a pad to write information and values on while performing the procedure, the pad must be BLANK. No writing on the pad of any kind before you start. The only thing we will allow in the room with the student while performing a skill or scan test is the supplies needed, the patient’s chart, patient consent form, a blank pad or paper and the student report or hospital worksheet. This includes lab and clinical assessments. Pag e 10 | 19