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Family Medicine and Primary Care


Introduction

Wits University underscores the principle of intellectual excellence and is committed to the provision of high-quality internationally competitive education, local relevance and high academic standards. The growing demand for ongoing professional development, furthermore, requires that the University offer short courses that are relevant and complement its teaching activities. This short course will fill a gap in the ongoing professional development of healthcare practitioners in line with latest international trends.


The Department of Family Medicine and Primary Care and the Department of Radiology, in partnership with Sonography Training Solutions (sTs), have collaborated on the formulation and provision of this course. The proposed curriculum was subsequently reviewed by the Chief sonographer who will also serve as the moderator.


The University of Witwatersrand short course rules will apply to this course.


Ultrasound has become integrated into the practice of many specialities, with point of care ultrasound for healthcare practitioners (POCUS) being perceived as the single most important development in family medicine since the invention of the stethoscope. This is made possible by new technological developments that permit more affordable and portable ultrasound units to be used by the bedside.


In recent years POCUS has become entrenched in family practice and allows clinicians to perform a limited, focused ultrasound examination to address relevant clinical questions, narrow down differential diagnoses, start treatment as soon as possible and minimise referrals for imaging procedures which require exposure to ionising radiation. Ultrasound is a cost effective means of screening for a wide range of disorders, thus, improving patient management, especially at a primary care level. However, ultrasound is also highly operator dependent and requires the development of high order skills in order produce and interpret the image.


There is currently a lack of clinicians with the necessary skills to provide a safe and meaningful ultrasound service in family practice and often clinicians are required to operate ultrasound equipment without formal training. Moreover, currently in South Africa no formal POCUS training, specific to family practice, is offered by any of the higher education institutions, making this short course a long overdue and highly desirable initiative.

Admission Criteria

The entry criteria for this course is a person holding an MBChB or equivalent qualifications (e.g. clinical associates, nurse practitioners, advanced midwives, qualified radiographers). More specifically, this course is targeted to primary care practitioners. This course does not carry credits towards any other qualification.


Aim

The aim of this short course is to provide knowledge and skills to healthcare practitioners that will allow them to competently perform a targeted point of care ultrasound scan and provide a limited interpretation of the image. This will assist in answering specific clinical questions and facilitate meaningful referrals to specialists. The course will be delivered in modules, each with a competency component attached to it.


Outcomes

At the end of this course, participants should be able to:

Apply knowledge of anatomy, physiology, physics and limited pathology when performing and interpreting POCUS procedures;

Perform the POCUS scanning protocols for various anatomical regions competently and in a logical sequence;

Assess the images for technical and diagnostic quality and take measures to maintain image quality throughout the scan;

Interpret the focused scan with respect to normal and abnormal ultrasound appearances and demonstrate judgement to refer appropriately when necessary;

Describe normal and abnormal appearances using correct medical terminology;

Perform patient care in a manner that ensures the welfare of the patient and demonstrates knowledge of ultrasound bio-effects and their potential for harm.

Lecturers who present the course are from academia and clinical practice. This ensures that a sound foundation of theory and practical application is applied in the teaching model of the course. The lecturers are honorary lecturers in the Department of Family Medicine.


Module lecturers:

Sue Olsson has 28 years experience as a lecturer in South Africa and more than 30 years experience as a clinical trainer globally. She holds the following qualifications from the College of Radiographers (UK): DCR(D), DCR (MU), HDCR(D).

Barbara van Dyk has 18 years’ experience as a lecturer and clinical trainer. She holds the following qualifications:  N Dip Rad (D), N Dip Rad (T), B Tech Rad (US), M Tech Rad.

Additional suitably qualified clinical tutors will be co-opted to assist with the hands-on component of the training as needs and candidate numbers require.


Moderation:

Zaiboon Holland is the Chief Sonographer at the Charlotte M Johannesburg Academic Hospital. She holds the following qualifications: National Diploma Radiography; B A - UNISA;  B Tech ultrasound-  Peninsula Technikon, 1995;   Msc MED-  Wits  2005.


Administrator:

Dr BH Modi

Department of Family Medicine

Sonar.FamMed@wits.ac.za,

Tel: 011 717 2065

Program

The course consists of two modules. The modules are optional and consist of the Obstetrics and Abdomen with Pelvis modules. These two modules run over a three-month period each.


Each module consist of the following structure:

  • One 3-day weekend of theory and hands-on training
  • Completion of a logbook over three months
  • Assessment (after successful completion of the logbook)
    • Theory (OSCE and written paper) over 2 hours
    • Clinical assessment (30 minutes) with a live patient / model

Modules

Learning material will be made available to registered candidates in electronic format.


Module 1: Obstetrics

The module aims to:

Provide a scientific basis, grounded in physical principles, for the development of ultrasound scanning skills in the clinical modules.


Provide knowledge and skills to healthcare practitioners which will allow them to competently perform a targeted POCUS obstetric scan and provide a limited interpretation of the image. This will assist in answering specific clinical questions and facilitate meaningful referrals to specialist fetal medicine departments.

Module outcomes:

At the end of this module, candidates should be able to:

  • Apply knowledge of ultrasound physics, safety principles, anatomical planes, scanning planes, transducer movements, ultrasound terminology and machine controls when performing and interpreting POCUS procedures;
  • Assess the images for technical quality and take measures to improve image quality as necessary;
  • Apply knowledge of anatomy, physiology, physics and limited pathology when performing and interpreting POCUS procedures on a pregnant patient;
  • Perform the POCUS scanning protocols for basic obstetrics competently and in a logical sequence;
  • Assess the images for technical and diagnostic quality and take measures to improve image quality as necessary;
  • Interpret the focused scan with regards to normal and abnormal ultrasound appearances and demonstrate judgement to refer appropriately and when necessary;
  • Describe normal and abnormal appearances using correct medical terminology;
  • Perform patient care in a manner which ensures the welfare of the patient and demonstrates knowledge of ultrasound bio-effects and their potential for harm.

Module 2: Abdomen and Pelvis

The module aims to:

Provide a scientific basis, grounded in physical principles, for the development of ultrasound scanning skills in the clinical modules.


Provide knowledge and skills to healthcare practitioners which will allow them to competently perform a targeted POCUS scan of the abdomen and pelvis (male and female) and provide a limited interpretation of the image. This will assist in answering specific clinical questions and facilitate meaningful referrals to specialist departments.

Module outcomes:

At the end of this module, candidates should be able to:

  • Apply knowledge of ultrasound physics, safety principles, anatomical planes, scanning planes, transducer movements, ultrasound terminology and machine controls when performing and interpreting POCUS procedures;
  • Perform the POCUS scanning protocols for basic obstetrics competently and in a logical sequence;
  • Assess the images for technical quality and take measures to improve image quality as necessary;
  • Apply knowledge of anatomy, physiology, physics and limited pathology when performing and interpreting POCUS procedures of the abdomen and pelvis;
  • Perform the POCUS scanning protocols of the abdomen and pelvis competently and in a logical sequence;
  • Assess the images for technical and diagnostic quality and take measures to improve image quality as necessary;
  • Interpret the focused scan with regards to normal and abnormal ultrasound appearances and demonstrate judgement to refer appropriately and when necessary;
  • Describe normal and abnormal appearances using correct medical terminology;
  • Perform patient care in a manner which ensures the welfare of the patient and demonstrates knowledge of ultrasound bio-effects and their potential for harm.

Venue

The training on this course is provided off-campus at Blandford Manor, Northriding, Johannesburg. This venue provides a tranquil setting with all the resources needed to offer high quality teaching and skills development. Moreover, this venue is in an accessible location for doctors who come from outside of Johannesburg and is close to the training partners Impilo Medical Systems, who will provide the ultrasound equipment and coordinate live models for the training.


Credits

The SAQA approved notional hours of this course per each module is 110 hours, including assessments and 60 logbook hours.

The SAQA credits are 11 per module.


This course will provide the following Continuous Education Units (CEU), as per the HPCSA guidelines:

  • Module 1 = 30
  • Module 2 = 30

Requirements for successful completion of this course:

Candidates must attend 100% of the contact sessions and attain a minimum overall pass mark of 60% in the Theory and Clinical components respectively. The candidate has a minimum of three and a maximum of six months to complete this course.


Methods of assessment

Formative assessment will be conducted through a logbook that will provide a means to monitor progress of scanning skills and provide corrective feedback when necessary.

The logbook consists of images that will be submitted electronically by the candidate. Feedback will be provided to the candidate in the same manner after review of, and feedback on images has been prepared. The logbook is an essential requirement for the documentation of clinical experience and details the number of required images in each of the clinical modules.


Successful completion of the logbook is a prerequisite for participation in the summative assessments.


Summative assessments will comprise of:

  • Theory (50%)
    • Written exam – 2 hours from 08h30 to 10h30

  • Clinical (50%)
    • Logbook (25%)
    • Practical exam (25%)
      • 30 minutes per student
      • The sessions start at 11h00

Re-assessment

  • Unsuccessful candidates may repeat an exam at an additional cost of 30%
  • Reassessments will be scheduled during next module assessment
  • After that the course will have to be repeated

The Department of Radiology, University of Witwatersrand, will perform the moderation of this course. In addition, there will be evaluation of this course via a questionnaire.

The fees for this course will be:

Module 1 – Obstetrics = R9 000

Module 2 – Abdomen and Pelvis = R8 500


The bank account details are:

  • Name of Account – Wits Health Consortium (PTY) LTD - Family Medicine
  • Bank – FNB
  • Branch & number – Parktown, 250455
  • Account number – 62790720398

A course registration may be cancelled more than four (4) weeks before the commencement of the course and will incur a 10% penalty. If a registration is cancelled within four (4) weeks of the start of the course, the participant will be entitled to a 50% refund of the tuition fee. Cancellations within ten (10) working days of the start of the course will not be entitled to a refund and will not be granted automatic attendance at the next round of the course.

The University of Witwatersrand student code of conduct will apply. This code can be viewed at www.wits.ac.za/students.

No

All Modules

No of Days

Course Dates

Assessment Dates

2

Obstetrics

3

17, 18 and 19 May

01-Sep

3

Abdomen & Pelvis

3

19, 20 and 21 July

20-Oct

4

Obstetrics

3

23, 24 and 25 August

24-Nov

5

Abdomen & Pelvis

3

11, 12 and 13 October

12-Jan 2020


No

Module Name

No of Days

Course Dates

Assessment Dates

2

Obstetrics

3

17, 18 and 19 May

01-Sep

4

Obstetrics

3

23, 24 and 25 August

24-Nov


No

Module Name

No of Days

Course Dates

Assessment Dates

3

Abdomen & Pelvis

3

19, 20 and 21 July

20-Oct

5

Abdomen & Pelvis

3

11, 12 and 13 October

12-Jan 2020