1	Diagnostic Medical Sonography at Tidewater Community College
2	Choosing a program Look for programmatic accreditation Assures you can take professional certification examinations when you graduate The DMS program at TCC is accredited by the The commission on accreditation of allied health education programs (CAAHEP) via The joint review committee on education in diagnostic medical sonography (JRC-DMS). www.caahep.org
3	Ultrasound in the Medical Community
4	Ultrasound Uses sound waves to generate images in our bodies
5	Ultrasound Is not ionizing energy Requires a path to travel through Does not travel well through bones or air
6	Ultrasound Can be used to image: Abdomens Female pelvis Pregnancy Blood vessels The heart
7	Ultrasound Images Send sound into the body The sound is reflected back to the machine from the structures inside our body An image is generated and displayed
8	Tissue Types Different tissue types and sizes reflect sound Create the image we view
9	Scan Dimensions Sound sent into the body has three dimensions that affect image quality Axial Along beam path (x axis) Lateral Perpendicular to beam path (y axis) Slice thickness The z axis
10	Patient Interactions Sonography requires direct interactions with patients Cultural considerations must be considered Patient privacy is mandatory Universal precautions are always used
11	Transducers Have different frequencies to create specific images from different parts of the body.
12	Images from the Abdomen Use shades of gray to show different types of anatomy Pathology has unique apppearances
13	Small Parts Ultrasound Sonography of superficial structures: Thyroid gland Scrotum Breast
14	Images from Pregnancy Can see the normal and abnormal fetus Can determine gestational age Ultrasound should only be used when medically indicated.
15	The Fetal Heart
16	Images from the Pelvis We can see the uterus and ovaries
17	Doppler and 3D Imaging Can document blood flow and surface variations
18	3 D Technology Multiple 2D images are gathered very quickly The machine processes the images and generates the 3D image 4D is 3D seen in motion
19	Ultrasound of the Heart Can assess the chambers and valves in the heart.
20	Vascular Ultrasound Can assess blood vessels throughout the body
21	High Definition Imaging
22	The Future of Ultrasound The Department of Labor predicts Sonography to grow “faster than average” until at least 2012. Jobs are available in hospitals, doctor’s offices and imaging centers, education, mobile services and industry.
23	Digital Imaging The analog signal that comes from the transducer is digitized immediately once the signal is returned to the Ultrasound imager.
24	What are the salaries for sonographers? Salaries vary depending on years of experience, number of specialties practiced, as well geographic location. There are opportunities for full-time and part-time employment.
25	What are the salaries for sonographers? In addition to excellent career opportunities, salaries for sonographers are competitive with or higher than other professionals with similar levels of education. According to the SDMS Salary and Benefits Survey report (released March, 2005), the median salary for sonographers is $61,984. This income includes: 1) hourly salary, 2) overtime and, 3) on-call pay. The typical hourly pay rate is $29, and the number of overtime hours worked per week by sonographers is 3. The typical on-call pay rate is $3.00 per hour, and the call-in rate of pay is $42 per hour. Note: The SDMS Salary and Benefits Survey report is available for free to all SDMS members.
26	Ultrasound Salaries Vary greatly from region to region In Hampton Roads most sonographers start in the low $20’s per hour There is often “call” involved in sonography jobs Call back to the department for emergency cases
27	DMS Career Path In our continuing effort to assist prospective students with information about careers in sonography, the SDMS has released a document entitled, ARDMS Registered Sonographer Career Path. The document shows one potential career path including life-long learning and active membership in the SDMS. It also provides links to online resources that may be useful as they plan their career
28
29	DMS Specifics JOB TITLE Diagnostic Medical Sonographer JOB DESCRIPTION A Diagnostic Medical Sonographer is a Diagnostic Ultrasound Professional that is qualified by professional credentialing and academic and clinical experience to provide diagnostic patient care services using ultrasound and related diagnostic procedures. The scope of practice of the Diagnostic Medical Sonographer includes those procedures, acts and processes permitted by law, for which the individual has received education and clinical experience, has demonstrated competency, and has completed the appropriate ARDMS certification(s) which is the standard of practice in ultrasound.
30	DMS Specifics ORGANIZATIONAL REPORTING RELATIONSHIP Administrative Supervisor: Chief Sonographer * Medical Supervisor: Attending or Supervising Physician * * As defined by institution. JOB SUMMARY The Diagnostic Medical Sonographer is responsible for the independent operation of sonographic equipment, and for performing and communicating results of diagnostic examinations using sonography. The Diagnostic Medical Sonographer is responsible for daily operations of the sonographic laboratory, patient schedule, equipment maintenance, the report of equipment failures, and quality assessment (QA). The sonographer maintains a high standard of medical ethics at all times and is self-motivated to increase level of understanding and knowledge of the field, disease, and new procedures as they evolve.
31	DMS ESSENTIAL FUNCTIONS Performs clinical assessment and diagnostic sonography examinations. Uses cognitive sonographic skills to identify, record, and adapt procedures as appropriate to anatomical, pathological, diagnostic information and images. Uses independent judgment during the sonographic exam to accurately differentiate between normal and pathologic findings. Analyses sonograms, synthesizes sonographic information and medical history, and communicates findings to the appropriate physician. Coordinates work schedule with Departmental Director and/or scheduling desk to assure workload coverage.
32	DMS ESSENTIAL FUNCTIONS Assumes responsibility for the safety, mental and physical comfort of patients while they are in the sonographer's care. Assists with the daily operations of the sonographic laboratory. Maintains a daily log of patients seen / completes exam billing forms. Maintains ultrasound equipment and work area, and maintains adequate supplies. Participates in the maintenance of laboratory accreditation. Establishes and maintains ethical working relationships and good rapport with all interrelating hospitals, referral or commercial agencies. Performs other work-related duties as assigned.
33	EXAMPLES OF DUTIES & RESPONSIBILITIES Performs all requested sonographic examinations as ordered by the attending physician. Prepares preliminary reports and contacts referring physicians when required, according to established procedures. Coordinates with other staff to assure appropriate patient care is provided. Addresses problems of patient care as they arise and makes decisions to appropriately resolve the problems.
34	EXAMPLES OF DUTIES & RESPONSIBILITIES Organizes daily work schedule and performs related clerical duties as required. Assumes responsibility for the safety and well-being of all patients in the sonographic area/department. Reports equipment failures to the appropriate supervisor or staff member. Provides in-service education team on requirements of sonographic procedures as requested by other members of the health care team. Performs other related duties as assigned
35	The DMS Program The greatest percentage of clinical time and experience is in “general” or abdominal sonography Approximately 60% 20% is in small parts 20% is in OB/GYN
36	The Professional Responsibilities include, but are not limited, to: obtaining and recording an accurate patient history performing diagnostic procedures and obtaining diagnostic images analyzing technical information using independent judgement in recognizing the need to extend the scope of the procedure according to the diagnostic findings
37	The Professional Responsibilities providing an oral or written summary of the technical findings to the physician for medical diagnosis providing quality patient care collaborating with physicians and other members of the health care team. Sonographers must also be knowledgeable about and limit the risk from possible exposure to blood and body fluids. Many sonographers also assist in electronic and clerical scheduling, record keeping, and computerized image archiving. Sonographers may also have managerial or supervisory responsibilities.
38	What are some of the technical standards? Sonographers and Vascular Technologists must be able to: Lift more than 50 pounds routinely Push and pull routinely Bend and stoop routinely Have full use of both hands, wrists and shoulders Distinguish audible sounds
39	What are some of the technical standards? Adequately view sonograms, including color distinctions Work standing on their feet 80% of the time Interact compassionately and effectively with the sick or injured Assist patients on and off examining tables Communicate effectively with patients and other health care professionals Organize and accurately perform the individual steps in a sonographic procedure in the proper sequence
40	Skills Required Observation: Sonographers must be able to observe demonstrations and experiences in the basic principles of sonogaphy , including but not limited to, patient interactions, film reviews, physiologic and tissues in normal and pathologic states. All students will be responsible for observing sonogaphic films and making judgment based decisions based upon those observations. An applicant must be able to observe a patient accurately at a distance and close at hand.
41	Skills Required, cont. Communication: The applicant should be able to speak, to hear, and to observe patients in order to elicit information and perceive nonverbal communications which will help aid in the diagnostic process. Applicants must be able to communicate effectively and sensitively with patients, classmates, clinical sonographers and physicians.
42	Communication Students must be able to communicate with sonogaphers and physicians in order to present sonographic findings effectively. Communication includes not only speech but reading and writing. The candidate must be able to communicate effectively and efficiently in oral and written form with all members of the health care team.
43	Skills Required, cont. Motor: All applicants should have sufficient motor function to move patients as required. Students will be required to use both hands at once in order to obtain an adequate sonographic image.
44	Motor Skills Applicants should be able to execute motor movements reasonably required to provide general care and emergency treatment to patients. Examples of emergency treatment reasonably required of sonogaphers include cardiopulmonary resuscitation. The above mentioned actions require coordination of both gross and fine muscular movements, equilibrium, and functional use of the senses of touch and vision.
45	Skills Required, cont. Intellectual, Conceptual, Integrative, and Quantitative Abilities: The abilities include measurement, calculation, reasoning, analysis, and synthesis. Problem solving, which is used in the determination of a differential diagnosis, requires all of these intellectual abilities.
46	Spatial Reasoning In addition, the applicant should be able to comprehend three-dimensional relationships and to understand the spatial relationships of structures.
47	Skills Required, cont. Behavioral and Social Attributes: An applicant must possess the emotional health required for full utilization of his intellectual abilities, the exercise of good judgment, the prompt completion of all responsibilities attendant to the diagnosis and care of patients and the appropriate use of sonographic equipment.
48	Working Under Stress Sonographers often carry heavy workloads and are required to function effectively under stress. They must be able to adapt to changing environments, to display flexibility and to learn to make decisions based upon the findings presented in each new case or patient.
49	Skills Required, cont. Compassion, integrity, concern for others, interpersonal skill, interest, and motivation are all personal qualities that should be assessed during the admissions and education process.
50	DMS at TCC ASSOCIATE OF APPLIED SCIENCE DIAGNOSTIC MEDICAL SONOGRAPHY FIRST YEAR Fall Semester BIO 141 Human Anatomy and Physiology I (4) HLT 105 Cardiopulmonary Resuscitation (1) HLT 143 Medical Terminology I (3) MTH 126 Mathematics for Allied Health (3) PHY 100 Elements of Physics (4) STD 101 Orientation to Health Care (1) 16
51	ASSOCIATE OF APPLIED SCIENCE DIAGNOSTIC MEDICAL SONOGRAPHY Spring Semester DMS 206 Introduction to Sonography (2) DMS 207 Sectional Anatomy (2) DMS 208 Ultrasound Physics Instrumentation I (3) DMS 211 Ultrasound Imaging I (4) DMS 231 Clinical Education I (2) ENG 111 College Composition I (3) 16
52	DMS at TCC SECOND YEAR Summer Semester DMS 209 Ultrasound Physics Instrumentation II (3) DMS 221 Ultrasound Seminar I (3) DMS 232 Clinical Education II (4) 10
53	ASSOCIATE OF APPLIED SCIENCE DIAGNOSTIC MEDICAL SONOGRAPHY Fall Semester DMS 212 Ultrasound Imaging II (4) DMS 223 Introduction to Vascular Ultrasound (3) DMS 233 Clinical Education III (5) Humanities Elective (3) (PHI 226 Social Ethics is recommended) 15
54	ASSOCIATE OF APPLIED SCIENCE DIAGNOSTIC MEDICAL SONOGRAPHY Spring Semester DMS 222 Ultrasound Seminar II (3) DMS 234 Clinical Education IV (6) Social Science Elective (3) Social Science Elective (3) 15 Minimum Credits Required 72
55	How do I get into the DMS program?
56	How do I get into the DMS program? Apply by the deadline Follow the application instructions Take as many non-sonography classes as possible by the application deadline Get some medical background experience
57	DMS at TCC Application deadline is May 15 (effective 2006) every year 15 students will be accepted into the program Classes start in August General education classes in Fall semester Sonography classes start in Spring semester Didactic and clinical education components are intertwined Clinical education sites are assigned by faculty
58	DMS Application Information No students will be offered interviews unless developmental work has been completed and students are able to take MTH 126 and ENG 111 during the Fall semester.
59	DMS Application Information Applicants who are accepted will be required to submit evidence of a complete physical examination and a criminal background/sex offenders check by the Virginia State Police before the beginning of the Fall semester.
60	Criminal Background Checks Students with a positive criminal background may not be accepted for an interview. Students with a positive criminal background will be required to undergo screening for eligibility to sit for the national credentialing examinations prior to the start of the program.
61	DMS Application Information Submit an unofficial transcript along with the health professions application. Transcripts often delay the evaluation of applications and this will help ensure you receive “points” for all classes completed by the application deadline.
62	DMS Application Information Students will admitted to the program on a “point” system. The following courses may be completed prior to the start of the program and will earn applicants’ points during the application process:
63	DMS Application Points College Human Anatomy & Physiology I BIO 141 A = 30 pts.; B = 15 pts.; C = 5 pts. College Math MTH 126 or higher A = 25 pts.; B = 15 pts.; C = 5 pts.
64	Application Points College physics PHY 100 or higher This requirements will be waived for students who have taken radiographic physics A = 25 pts.; B = 15 pts.; C = 5 pts. Medical Terminology HLT 143 A = 10 pts.; B = 5 pts.; C = 1 pts.
65	DMS Application Points All remaining courses earn A = 5 pts.; B = 3 pts.; C = 1 pt. English 111 Two Social Science electives
66	Application Points A Humanities elective PHI 226 Social Ethics is recommended (See http://www.tcc.edu/academics/programs/elective.htm for a complete listing of acceptable electives) Introduction to microcomputers or documentation of computer competence No points are earned for challenge of skills Orientation to Healthcare (A = 3; B = 1)
67	DMS Application Points Students will earn points for medical background. Formal education will earn the following points: Radiography senior students or registered radiographers = 30 pts. Other two-year health programs or health related baccalaureate program = 25 pts.
68	DMS Application Points One year health programs or completion of the state licensure examination for nurse aid = 15 pts. CNA programs = 10 pts. Applicants with no medical background should consider taking a nurse aid (CNA) course in order to earn some points in this category. This is also a very good way to obtain patient care skills and be sure that a hands-on health care field is really what you want from a career choice. Work only for hands on patient care = 3 Pts.
69	DMS Clinical Education This is a full-time day program with all didactic course work located on the Virginia Beach campus of TCC. Students are responsible for their own transportation to clinical sites Excessive tardiness will result in dismissal from the program Clinical sites may be ANY hospital or other designated setting located in South Hampton Roads and the Peninsula. Program officials will assign clinical rotations to students
70	Program Absence Policy All students will adhere to a strict attendance policy 6 personal days are allowed for clinical One first Spring and Summer semesters Two Fall and second Spring semesters above that all absences may affect clinical grades and must be made up All students are allowed two personal days per semester (One in Summer semester) for didactic classes Above that all absences may affect didactic grades
71	DMS Dress Code There is a very strict dress code for clinical No acrylic nails are allowed No dark nail color is allowed Hair must be back or up and out of face All white tennis shoes are required – no color allowed on them White uniforms unless otherwise stated Some sites may allowed certain color scrubs to be worn If worn, scrubs must match and be solid colors
72	Professionalism All students may be removed from the program at program official discretion based on professionalism or other non didactic related issues All students must maintain a C in all classes or they will be removed from the program
73	Patient Privacy Students will be held to strict guidelines regarding patient privacy Any violation of patient privacy standards may result in dismissal from the program
74	Clinical Exposure and Safety Some lifting and exposure to body fluids is likely. OSHA guidelines regarding safety will be strictly enforced
75	DMS Coursework All students will be assigned significant amounts of reading and homework Not completing these assignments will impact both didactic grades and course performance Some project work will be assigned to students This may involve powerpoint or other computer based media assignments
76	Web Access All DMS students must have email access and will be required to access the web for course documents Web access can be maintained through the campus LRC
77	Professional Membership All students will be required to join a professional society while in the DMS program Approximate cost is $50.00
78	The Society of Diagnostic Medical Sonography www.sdms.org
79	The American Institute of Ultrasound in Medicine www.aium.org
80	Professional Education All students will be required to attend a continuing education seminar or meeting worth at least 5 CME credits This may require overnight travel Approximate cost of travel and lodging varies based on location of meeting Meeting cost will be approximately $200.00 per student
81	DMS Registry Examinations The DMS program provides education in general sonography Upon graduation students are eligible to sit for the ARDMS national sonography registry Cost of this examination is approximately $600.00 Students are eligible to sit for registry examinations in: Physics Abdomen OB/GYN Breast
82	Information For general TCC information or packets contact the information center at 822-1122 For other questions contact the program director at 822-7271 or ftoreno@tcc.edu Felicia M. Toreno, MSEd, RDMS, RVT Director, DMS
83	DMS Application Checklist Apply to TCC Take Math and English placement tests Apply to the DMS program Earn points by taking and completing as many non-DMS courses as possible prior to application deadline Submit unofficial transcripts and application by May 15 deadline