ACEM has selected eFAST, AAA, Needle Guidance (IV access), Focused Echo in Life Support (FELS) and Lung ultrasound as their core modules. Prior to commencing training in ultrasound, we suggest that you complete a physics and knobology module such as the UTEC module.

ACEM has an Emergency Department Ultrasound Webpage. Specific documents that should be reviewed include:

• P733 - Credentialing for emergency medicine ultrasonography

• COR742 - Guideline for the Provision of Emergency Department Focused Ultrasound Training and Governance

• G25 - Guideline for ultrasound education programs

The credentialing process requires candidates to:

• Complete an appropriate instructional educational program that addresses the criteria described in G25 Guidelines for Ultrasound Education Programs or is ASUM accredited.

• Perform and record a requisite number of accurate proctored emergency department ultrasounds and formative assessments; and

• pass a summative assessment.

Once credentialed, emergency department sonologists must meet ongoing maintenance requirements.

This should be determined at your local health service level. However, ACEM states that an emergency medicine sonologist or qualified sonographer can observe the candidate performing the ultrasound examination. This may be undertaken simultaneously as a Direct Observations of Procedural Skill (DOPS) assessment by FACEM Trainees.
 

A sonologist is a practitioner who has successfully completed this credentialing process or has successfully completed the Certificate in Clinician Performed Ultrasound (CCPU), or who possesses DDU (Diploma of Diagnostic Ultrasound), FRANZCR (Fellow of the Royal Australian and New Zealand College of Radiology) or equivalent, or qualifications such as the Postgraduate Certificate in Clinician Performed Ultrasound.

The POCUS Passport logbook is a google sheets document that you can save a copy of to your own google drive or locally on your own device. After performing a scan you will be able to enter the date, patient details and presenting complaint and particulars about the scan including if clinically indicated, your interpretation and if available a comparison to the gold standard.

The logbook is available here for download or for copying to your google drive (if logged in via your google account). 

 

You should also backup your images for review either locally on a PACS server or another mutually agreed upon way by your supervisor. We highly recommend sonoclipshare.com as a way of sharing de-identified images with your supervisor and it also makes the review process quite efficient. 

Your supervisor should then review your images along with your logbook (that can easily be shared as an editable google doc) and should be qualitatively assessed using a simple traffic light system assessing technical adequacy and diagnostic accuracy of examination, with reference to correlative imaging, surgical or clinical findings where available. The scan audit criteria are outlined in the individual modules along with the required number of scans.

The 2 formative and final summative scans should be completed by your supervisors as you progress through your required number of scans and after the completion of your logbook respectively. Criteria and assessment sheets can be found in each of the individual modules and in the logbook which you can utilise if you wish so that everything is contained in one place. 

Download formative and summative assessments.
 

We have decided to utilise the Ultrasound Competency Assessment Tool (UCAT) for supervisors to complete formative and summative assessments. For each formative and summative assessment the candidate will be assessed on the following domains:

• Preparation

• Image Acquisition

• Image Optimisation

• Clinical Integration

On completion of the UCAT the supervisor should then complete the entrustment score. The concept of entrustable professional activities (EPAs) has emerged as an approach to the assessment of workplace performance. Assessment through EPAs is centred on entrustment decisions by clinical supervisors that link trainees’ execution of POCUS with the level of supervision in their progress towards independent practice.

For the satisfactory completion of the summative assessment the candidate should perform at a competent level with minimal prompting in the majority of all the domains. The candidate should also be rated as independent (I did not need to be there) in the entrustment score.

After completing the required education program, appropriate number of proctored scans and logbook and summative assessment you have completed the requirements as outlined in the ACEM Policy 733 - Credentialing for Emergency Medicine Ultrasonography. You should also discuss if this meets your local hospital scope of practice credentialing requirement with your supervisor. 

Your supervisor can then complete the POCUS Passport certificate that outlines your completion of this module. This along with your logbook can be shown to other employers should you start at a new health service. Be mindful that there are ongoing currency requirements for each module and these requirements are outlined in each module. 

Downloadable PDF here.

McKaigney, C., Bell, C., & Hall, A. (2019). LO85: Development of a competency based assessment tool for emergency department point of care ultrasound. CJEM, 21(S1), S38-S39. doi:10.1017/cem.2019.127
 

Bell C, Hall AK, Wagner N, Rang L, Newbigging J, McKaigney C. The Ultrasound Competency Assessment Tool (UCAT): Development and Evaluation of a Novel Competency-based Assessment Tool for Point-of-care Ultrasound. AEM Educ Train. 2020 Oct 3;5(3):e10520. doi: 10.1002/aet2.10520. PMID: 34041429; PMCID: PMC8138101.
 

Bell, C., Wagner, N., Hall, A. et al. The ultrasound competency assessment tool for four-view cardiac POCUS. Ultrasound J 13, 42 (2021). https://doi.org/10.1186/s13089-021-00237-3
 

Holzhausen, Y., Maaz, A., März, M. et al. Exploring the introduction of entrustment rating scales in an existing objective structured clinical examination. BMC Med Educ19, 319 (2019). https://doi.org/10.1186/s12909-019-1736-2