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Achieving RCEM POCUS Competency!
During core training the Emergency Medicine trainee will focus on learning the theory of ultrasound and gaining experience of the procedural modalities.
The diagnostic modalities are introduced in intermediate training and developed further during higher training.
Knowledge phase
Getting started...
After logging into your RCEM Learning account, complete all Ultrasound eLearning modules under the curriculum tab. These are
- U1 Ultrasound Physics
- U2 Sectional and Ultrasonic Anatomy
- U3 Pathology in relation to ultrasound
- U4 Administration and governance
- U5 FAST
- U6 AAA
- U7 Vascular access
- U8 Echo in Life support (ELS)
Also completed online learning on (added in 2021 Curriculum)
- Fascia Iliaca Block
- Ultrasound in shock
Essential reading
This is a great book from RCEM website on all of the Level ONE scans.
It has details of the POCUS Curriculum,
OSCE sheets used for triggered assessments of the 4 required scans and the Final Sign off sheet.
FRCEM Final SAQ exam will have about 3 questions on POCUS
(about 10 marks of the 180). Use this book to read up.
Attend an Ultrasound course
These courses usually run over 1-2 days.
There are lectures on basics of ultrasound, knobology, various scan modalities & governance followed by hands on training with tutors.
You will be given a certificate of attendance at the end of the course which could be used as evidence of learning.
It is not mandatory to attend a course.
You can demonstrate learning with certificates from online learning modules, reading books/blogs, attending webinars and lectures or attendance at POCUS regional training days.
Learn the new 2021 curriculum scans!
Fascia Iliaca Block
Added in RCEM 2021 curriculum
POCUS in Shock
Added in 2021 curriculum
Sonography in Hypotension and
Cardiac Arrest (SHoC) Protocol
Consensus Statement
How to write a reflective entry for your log book!
Total 30 reflective entries required!
5 for each modality.
You could just use the Kaizen E-portfolio!
OR
If you prefer writing on paper/word document please use the following checklist.
- Case reflection Title
- Your name:
- GMC number:
- Date of case:
- Location:
- Patient's gender:
- Patient's age:
- Equipment used:
- Ultrasound application used (FAST/AAA/echo/Vascular access)
- Describe the clinical scenario:
- How was ultrasound used in this case?
- Were you able to obtain usable images?
- Were you able to interpret the images?
- Did Ultrasound change management of the patient?
- What did you learn from this case?
- Images if available (anonymous)
Who can sign your log book or a ticket for you?
We have many consultants & registrars who would be happy to do this for you! Please ask the consultant or registrar on shift with you to supervise your scan, so they can offer advice, correct your technique, provide tips/tricks to improve your scanning!
Would you like some supervised scanning practice?
50% of your log-book can be practice scans! So come along to one of our monthly HOT-POCUS sessions at the John Radcliffe Emergency Department. We can do just the scans you need! You will be given feedback on each scan you perform - correcting your technique, tips to acquire and optimize your scans. All scans performed can be logged and signed off on the day.
Sign off CHECKLIST!
Are you ready with the following?
- Demonstrate learning - Certificate of attendance at a POCUS course OR certificates of completion for RCEM Ultrasound learning modules OR certificates of attendance at local modular training.
- Demonstrate experience - Log book of scans (25 each for AAA, eFAST and Shock assessment, 10 each for Fascia Iliaca Block and echo in life support and 5 Vascular Access)
- Reflective entries - 5 for each scan modality (total 30)
- Image/video gallery of scans
Additional (optional) evidence of webinars, podcasts, videos, blogs, research, attendance at conferences lectures or workshops may be submitted.
Indicative minimum number of scans for Logbook!
RCEM document says...
The goal of training is to achieve competency rather than rigid adherence to a fixed number of training scans however an indicative minimum number of scans is provided as guidance to both trainees and trainers about the number of scans that would reasonably be expected of a trainee. If the indicative number of scans is not met by the end of the training programme then the supervisor should record on e-portfolio that they are aware of this but this should not impede progress if the appropriate entrustment level for the stage of training has been obtained.
Competency phase
Suggested milestones during training!
It should be the exception that sign off for all modalities is not achieved by the end of ST5.
In ST6, trainees are expected to undertake enhanced training, consolidate log book by performing 1 scan per week and consider teaching colleagues and improve governance.
Getting the sign off for each scan!
The goal of training is to achieve competency rather than rigid adherence to a fixed number of scans.
In keeping with the other clinical SLO’s the entrustment scale is used to describe the observed and predicted capability of obtaining an adequate clinical image.
The sign off for the scan is undertaken locally.
Doctors in training - please discuss with your Educational Supervisor.
For those doctors not in a training programme/CESR aspirants, please speak with departmental POCUS lead!
Once you are ready with the checklist (see above) ask your ES/POCUS lead to watch you perform this scan (on a patient or simulated) and then give you an entrustment level on a DOPS ticket.
During Core training (by the end of CT3)
- Complete basic learning of Ultrasound Physics and knobology.
- Start scanning and create your log book.
- Learn and practice procedures with ultrasound.
- Log a minimum of
- 5 vascular access scans and
- 10 Fascia Iliaca Block scans.
- Write 10 reflective entries (5 for Vascular Access + 5 for FIB)
- Get signed off for these 2 scans by your Educational supervisor or POCUS lead before appraisal.
- Level of entrustment required = 3
During intermediate training (by the end of CT5)
- Complete learning of Ultrasound AAA, eFAST, echo in life support and Shock assessment.
- Continue scanning under supervision and maintain your log book.
- Learn and practice diagnostics with ultrasound.
- Log a minimum of
- 25 scans for AAA,
- 25 scans for eFAST,
- 25 scans for Shock assessment and
- 10 for echo in life support.
- Write 20 reflective entries (5 each)
- Get signed off for these 4 scans by your Educational supervisor or POCUS lead before appraisal.
- Ideally, complete AAA, eFAST and ELS by end of ST4 and complete Shock assessment by end of ST5.
- Level of entrustment required = 4