Diagnostic Medical Sonography Advisory Meeting Minutes

March 15, 2023, 11:30 a.m.-1 p.m.

Meeting place

LLCC, Logan Hall, Room 1119

Purpose

Spring progress report and lab tour

Materials

Attachments sent via email

Chair

Leigh Giles-Brown, LLCC DMS Program Director

Attendees

Members in attendance

Ronald Hidalgo, Medical Director, Springfield Clinic; Sarah Minott, DMH; Branden Richardson, HSHS St. John’s/St. Francis; Tracey Roegge, HSHS St. John’s; Marjorie King, SMH; Tracey Benn Cockayne, SMH; Halle Volpe, LLCC student representative; Jason Dockter, LLCC; Leigh Giles-Brown, LLCC; Fabiola Gonzalez, LLCC; Cynthia Maskey, LLCC; Ann Neilson, LLCC; Jenni Gardner, public member

Agenda

1. Welcome and introductions

  1. Roll call and new members

2. Spring program updates

  1. Students
  2. Faculty
  3. Curriculum
  4. Clinical
  5. Registry exams
  6. Equipment

3. Old business

  1. CAAHEP Self-study
  2. Cohort 2022 graduate outcomes
  3. 2022 program resource survey results

4. New business

  1. Outreach activities
  2. Grant funding and new equipment update
  3. Lab A/V upgrade
  4. Cardiovascular sonography planning committee
  5. Student recruitment for vascular certificate

5. Program needs

  1. Clinical placements for program expansion
  2. Echocardiography equipment
  3. Guest lectures

6. Open forum

  1. Insights, trends, stakeholder needs
  2. Concerns and recommendations

Minutes

1. Welcome and introductions

  1. All attendees introduced themselves.

2. Spring program updates

Leigh Giles-Brown presented updates for students, faculty, curriculum, and equipment. Ann Neilson presented updates for clinical and registry exams. 

1. Students

There is one student remaining in the senior cohort which is the second and last cohort of the original Certificate of Achievement program. The first two DMS cohorts suffered from low enrollment of 3 students in each class year. For the 2023 class, two students were lost to personal and health issues. There are 5 students in the junior cohort which is the first for the Associate of Applied Science degree program. Nine students were accepted and 4 withdrew. One withdrew in the first week of the program due to a lack of interest. One withdrew due to health concerns. One left for personal/family reasons and the fourth student left due to academic failure. 

2. Faculty

There is one program director (Leigh Giles-Brown) and one full-time clinical coordinator (Ann Neilson) for the DMS program. There is one adjunct lab instructor (Raven Horsthemke) and one fellow (Tracey Benn-Cockayne) paid at the adjunct rate for her contribution to the proposed Cardiovascular Sonography degree program. The fellowship is offered out of an Innovation in Diversity and Inclusion grant sponsored by LLCC. 

3. Curriculum

Attendees reviewed the curriculum for both the DMS AAS degree program and the Vascular Sonography Certificate of Completion program. No questions or comments were offered. 

4. Clinical

The DMS program has 14 clinical sites that can support 17 students. The incoming 2023 cohort will have 17 students, so the number of clinical sites barely covers program needs. Some sites have already agreed to hosting more than one student per rotation and we are hoping for more sites to be able to do this as the program expands. More obstetric sites will be needed, and students may be rotated to the existing OB sites more frequently to ensure all students get what they need. If any sites can support additional students, please let Ann Neilson or Leigh Giles-Brown know. 

Updates were made to the first clinical competency expectations based on feedback from site instructors who were not comfortable verifying students are competent based on first clinical semester scanning. A practice competency list will be expected for students in their first semester with goals focusing on abdominal and small parts anatomy they have already spent two semesters working on in their lab courses prior to clinical placement. In addition, a complete obstetric anatomy competency has been added as an option for students and an obstetric growth competency has been added as a required competency for the 2nd or 3rd clinical semesters. 

5. Registry exams

Two of the three 2022 graduates are fully certified RDMS sonographers in the OB/Gyn specialty. Both graduates plan to sit for the ARDMS Abdomen board exam. One graduate decided to pursue further education in echocardiography through the Mayo Clinic DMS program. She will be able to use her successful SPI exam results to count toward her eventual echocardiography certification once she completes that program. Our sole graduating senior has already successfully completed the ARDMS SPI exam and will be eligible to sit for both the Abdominal and OB/Gyn specialty board exams after she graduates in May. DMS faculty are encouraging her to take the specialty boards as soon as possible after graduating as students tend to have greater success if they take the boards within 6 months of graduation. The junior cohort will take the ARDMS SPI exam before July.  

6. Equipment

The DMS program offers 4 full-scale ultrasound machines from a variety of manufacturers (Philips, Samsung, and GE). Students benefit from scanning each other and training phantoms for a variety of exams including transvaginal obstetric and gynecologic studies, scrotal, guided procedures (thoracentesis, paracentesis, renal biopsy, superficial masses), infant hips, neonatal heads, and obstetric biometry and anatomy. In addition, the DMS program has a CAE Vimedix Women’s Health simulator with programmable pathologies for gynecology and obstetric transabdominal and transvaginal applications. Ann Neilson added that students have access to 6 Butterfly transducers with iPads for scanning at home as well as SonoSim software which is a useful tool to assist student scanning skills and pathology recognition.  

3. Old business

1. CAAHEP Self-study

The DMS program submitted a Self-Study to the JRC-DMS and received acknowledgement of the submission. We are awaiting notification to schedule the site visit portion of the CAAHEP program accreditation process. The site visit will entail meetings with clinical site personnel, administrators, and DMS students. The DMS Program Director will update the DMS PAC on the accreditation process as it moves forward.

2. Cohort 2022 graduate outcomes

Leigh Giles-Brown previously emailed the results of the 2022 Graduate Outcomes and Program Resource Survey results. These are annual requirements and are reported to the JRC-DMS.  The results were reviewed with meeting attendees. In general, survey participants agreed that the program resources were sufficient and supportive of student engagement and success. Likewise, the employers surveyed were satisfied with how well the graduates were prepared for the workforce. The graduate survey indicated general satisfaction with the DMS program, but a desire for more lab instruction. This was due to the first cohort missing out on scanning time when the lab was closed for in-person scanning due to Covid restrictions. The 2nd and 3rd DMS cohorts have received significantly more scanning time in the DMS lab because those restrictions were lifted. 

3. 2022 program resource survey results

Comments and discussion regarding the outcomes and survey results were offered, and no questions or recommendations were presented.  

4. New business

1. Outreach activities

The DMS Program Director has been conducting outreach to local middle and high schools regularly and has hosted tour groups at LLCC to provide information about the DMS program. 

2. Grant funding and new equipment update

The program has received a lot of support from grants offered by the LLCC Foundation and other sources. The LLCC grant writer is a tremendous resource and provides timely notification of funding opportunities to the Health Professions Department. The DMS Program Director responds in a timely manner and has secured funding for a variety of teaching tools such as training phantoms and ultrasound equipment. 

3. Lab A/V upgrade

The DMS program has submitted a request for an audio/visual upgrade to the DMS lab. This would add display monitors to each of the four main scan bays that will project the ultrasound image. This will allow for students who are scan models to remain engaged and learning when they are being scanned. In addition, a second large display monitor with a quad split view will allow images from all four ultrasound machines to be displayed outside of the scan bays so the instructor can better monitor student scanning. Finally, the upgrade will add six instructional computers that students will use for processing saved ultrasound images, simulated exam worksheets, and skills assessments. Cynthia Maskey and Leigh Giles-Brown met with LLCC project and IT personnel to define the needs and scope of the project. Approval of this funding is pending for the next fiscal year budget.

4. Cardiovascular sonography planning committee

Tracey Benn-Cockayne provided a report on the Cardiovascular Sonography (CVS) Planning Committee progress. 

The CVS Planning Committee was established in the Fall due to requests for an echocardiography and vascular sonography degree program. Members have been working on completing an ICCB Form 20 which is due in late May. The report includes information on feasibility/occupational demand, curriculum, and fiscal/cost analysis. Progress has been made in identifying a clear need throughout the state based on a CVS Needs Survey that was conducted in February. The survey identified shortages of cardiac and vascular ultrasound personnel in most clinical settings.     

The CVS program as planned will have unique features as it will be designed for dual certification in both vascular and adult cardiac sonography specialty areas. Also, it would be important to offer transesophageal echocardiography (TEE) training during the program as students will be better prepared for the clinical setting. Currently, most cardiac ultrasound educational programs do not offer this, and training must take place in the workforce which puts a strain on the already understaffed resources. Having a tool on campus that will help students become familiar with TEE scanning will be most helpful. The CAE Vimedix Cardiac Simulator should be considered for the program as it has programmable pathologies that may be scanned. Students will not have exposure to these critical skills for documenting cardiac pathologies otherwise and students will end up being more employable if the training takes place during the program. Likewise, equipment to support the vascular specialty instruction will be required such as a vascular testing machine. 

5. Student recruitment for vascular certificate

Leigh Giles-Brown mentioned there have been no enrollees for the Vascular Sonography Certificate of Completion program. This program is designed for working registered sonographers who wish to expand their certification to include RVT designation. The program requires an employer participation letter that will guarantee students the chance to experience 10 hours of vascular sonography per week on the job. Lectures will be held online, and labs will run after work hours or on weekends. Please help spread the word about this program to current ultrasound staff. The lack of interest probably stems from combination staffing shortages and the low number of DMS program graduates in the first cohort. We hope more of our upcoming graduates from our larger cohorts will consider this stackable credential opportunity. 

5. Program needs

1. Clinical placements for program expansion

Clinical placements are needed for general, especially for obstetric ultrasound. Also, we will need placements for vascular and echocardiography clinical experiences if the CVS program gets approved. All current DMS affiliation agreements will be assessed for the possibility of addenda or new contracts to add echo and vascular sites. 

2. Echocardiography equipment

The CVS program will need specialty equipment.

Two of the four current ultrasound machines have adult cardiac capabilities. The CVS program will need 2 additional full-scale ultrasound machines to support a cohort of 16 students. If any of our clinical partners have any echocardiography equipment they can donate, please let Leigh Giles-Brown know. All donations will be recognized through the LLCC Foundation. Donated equipment frees up budgeted funds for other needed educational tools and is greatly appreciated! 

Also, the CAE Vimedix cardiac simulator will be an important tool for the program and two may be needed to support 16 students learning to scan pathologies. It will be useful for abdominal pathology as well since that is included in the mannikin. The estimated cost for the simulators is $90,000-$100,000 each. The CVS Planning Committee is working on additional cost estimates for general supplies. Current DMS lab space, ergonomic chairs, gel warmers, exam beds, and other furnishings will be sufficient for the addition of a CVS program. 

3. Guest lectures

Guest lectures are always welcome! Let us know if you are willing to share!  

6. Open forum

1. Insights, trends, stakeholder needs
  • Marjorie King mentioned that there is still a strong need for DMS students. She encouraged the DMS program to continue doing good work. 
  • Sarah Minnott is encouraged by the DMS program students and wants them to know that if they show enthusiasm and a desire to learn when they are in their clinical rotations, they will be considered as possible job candidates after graduation. Opportunities are available to students with positive attitudes and a willingness to scan. These students will develop their skills sooner and be more ready for the workforce.  
  • Ann Neilson mentioned that she wants to ensure students are performing to standard in the clinical settings and encouraged all site instructors to keep her informed early if there are any concerns with students.
  • Ron Hidalgo asked if site protocols are provided to the students in advance. Ann Neilson showed attendees a notebook with all site protocols that are provided to students as they are assigned to their clinical sites. Ron Hidalgo mentioned that all of the Memorial Health System and Springfield Clinic protocols will be changing by June. Ann Neilson will work with MHS and SC to obtain the new set of protocols so our students will be better prepared for clinical placements at these sites. 
  • Sarah Minnott mentioned that the DMS program gives great exposure to multiple ultrasound machines. Leigh Giles-Brown explained that there is a benefit to the students learning on machines they might encounter at our clinical partners so they will be more prepared to jump in sooner to scanning in the clinical settings. 
  • Marjorie King stressed the importance of developing students’ social and communication skills. Halle Volpe agreed that having outside volunteer scan models come into the lab has been useful to her for practicing her professional communication skills since the familiarity of working with her student peers is not present when working on outside scan models. Leigh Giles-Brown offered everyone a flyer for scan models and there is a particular need for students to practice on obstetric models. 
2. Concerns and recommendations
  • Next Meeting: Leigh Giles-Brown will send out a Doodle poll to determine the next meeting date in the Fall. She will send any important updates via email before the Fall meeting.