Standards for Undergraduate Educational Programs in Vascular Technology

I. PURPOSE

The Society for Vascular Ultrasound (SVU) "Standards For Undergraduate Educational Programs in Vascular Technology" provides guidance in curriculum planning.

II. GOALS

The goal of undergraduate educational programs in vascular technology should be to: offer the requisite knowledge, skill, and experience in vascular technology to prepare students to (1) perform patient assessments, (2) acquire and analyze data obtained using ultrasound and related diagnostic technologies, (3) provide a summary of findings to aid in patient diagnosis and management, and (4) use independent judgment and systematic problem solving methods to produce high quality diagnostic information and optimize patient information.1 Additionally, undergraduate educational programs should teach students how to communicate with patients and instill in them the respect for the dignity of patients.

III. ASSESSMENT

Student

Assessment of the student's competence must be accomplished with appropriate evaluation of knowledge and skills; both written exams and practicums may be used, and reports from externship advisors are essential. The program should aim to provide knowledge sufficient that students are able to pass credential exams such as the Registered Vascular Technology (RVT) exams administered by the American Registry of Diagnostic Medical Sonography (ARDMS). The outline of the registry exams should be used as the basis for some of the program's curriculum to ensure that students have been provided with all the necessary components of a complete education in vascular technology.

Program

Each program should have the means of evaluating its success. SVU recommends that each program establish a minimum rate of its students passing the RVT exam as one of the self-evaluation criteria. Evaluations from employers and externship advisors would be another excellent assessment tool. Graduates should be surveyed to assess how well the program prepared them for their jobs. Each program should have means of evaluating the continuing relevancy of its curriculum. Each program must have mechanisms to adapt its curriculum based on these assessments

IV. Accreditation

SVU recommends that all undergraduate educational programs in vascular technology be accredited through the Commission on Accreditation of Allied Health Education Programs (CAAHEP).2

V. Setting

Class Room Instruction

SVU believes that a high quality undergraduate educational program in vascular technology can be based in any of the following settings:

1. Community, technical, junior/senior colleges, or universities
2. Hospital, clinic
3. Post-high school secondary vocational/technical schools or institutions
4. Proprietary School

Programs can be affiliated one or more allied health profession educational program (eg, nursing, medical sonography, cardiovascular technology) or within a medical school.

Clinical Training

Each undergraduate educational program in vascular technology must provide for 12 months training and practical experience at a clinical site (externship).

VI. Admission Policies

Undergraduate educational programs should require a high school diploma as a minimum pre-requisite for admission. SVU advises that an equivalency to a high school degree can be substituted if the applicant also has two years allied health experience. SVU recommends that admission procedures also include the submission of standardized test scores that show proficiency in English, writing, and mathematics; and at least one letter of recommendation from either a high school guidance counselor or teacher. Further, SVU advises that admission policies require a passing grade in high school physics, or its equivalent, as a pre-requisite to any undergraduate educational program in vascular technology. Preferably, the programs will be able to select students with the highest scores on the standardized tests and the highest grades, both overall and in physics.

VII. Administrative Policies

Student Guidance & Employment Counseling

Undergraduate educational programs should provide counseling services for students. These counseling programs must be able to address both mental health issues and employment matters. Ideally, each program will oversee an active recruitment program, including visits and interviews by potential employers.

Student Records

Undergraduate educational programs should maintain records of each student's educational program, including grades and teacher comments. These records should extend to a report of the student's clinical training and include assessments and recommendations made by the student's employers and externship advisors.

VIII. Personnel

SVU recommends that Undergraduate educational programs in vascular technology include the following staff who meets the recommended minimum qualifications:

Administrative Program Director

The program director must

1. have an earned undergraduate degree,
2. be credentialed in vascular technology,
3. have a minimum of three years clinical experience in vascular technology, and
4. have experience in program development and teaching

Medical Director

The medical director must be a licensed physician with at least three years experience in vascular technology interpretation, lab directorship and/or formal training as stated in the ICAVL Medical Director Requirements3. Preferably the medical director will be credentialed in vascular technology.

Faculty

All didactic instructors should have the appropriate credentials for the subject being taught based on institutional requirements. Clinical instructors, those individuals overseeing the student's clinical rotation, must be credentialed in vascular technology and have a minimum of three years clinical experience in vascular technology. There must be a clinical coordinator who oversees all the student's clinical sites. The clinical coordinator must be credentialed in vascular technology, have a minimum of three years clinical experience in vascular technology, and three years teaching or preceptor experience.

Clerical

Undergraduate educational programs in vascular technology must have the necessary clerical and other support staff to meet the assessment and record-keeping requirements.

IX. Physical Resources

Facilities

All undergraduate educational programs in vascular technology must have

1. the necessary classrooms for didactic education,
2. laboratory(i.e.) for clinical practice, and
3. administration and clerical office(s)

Equipment

The laboratory should be equipped with all vascular testing instrumentation commonly used in practice. The students must be familiar with this equipment before they begin their clinical externship.

Learning Resources

All undergraduate educational programs in vascular technology must include a library or media center with resources sufficient to assist the students in the educational program. Standards references, texts, and journals, as well as computers with modems and Internet access are required.

X. Course Plan

Noninvasive vascular testing requires knowledge, communication skills, and problem-solving capabilities. Therefore, it is vital for an undergraduate educational program in vascular technology to include instruction in each of these areas to produce a competent professional. The course plan should include 12 months didactic and 12 months clinical education with a minimum of 1,680 clinical contact hours. The course can be designed, administered, and taught in such a manner that at the completion of the course of study in vascular technology, the student can:

1. Explain basic physical principles of ultrasound,
2. Demonstrate knowledge of basic hemodynamics,
3. Demonstrate knowledge of vascular anatomy and pathophysiology,
4. Elicit patient history and recognize signs and symptoms of vascular disease,
5. Perform a basic physical exam and identify the presence of vascular disease and signs and symptoms of vascular disease,
6. Describe the pathological mechanism and risk factors of vascular diseases,
7. Transport patients safely from wheelchair or cart to exam table,
8. Offer basic (medical) care to patients (e.g., dressing changes, regarding intravenous lines, changing oxygen sources, bedpans, emesis basins, ulceration's, open wounds, etc.),
9. Provide comfort and compassionate care to patients,
10. Demonstrate appropriate use of noninvasive vascular equipment controls (e.g., scale, gain, size, filter, angle correction, electronic steering, invert, sample volume size, power output, color amplitude, b-flow, flow measurement, etc.) in instruments and techniques including, but not limited to:
    1. Continuous wave (CW) Doppler and zero-crossing detector
    2. Arterial plethysmography
    3. Duplex ultrasound
       1. B-mode imaging
       2. Pulsed wave (PW) Doppler
       3. Color flow imaging
11. Understand the appropriate uses of noninvasive vascular testing (indications),
12. perform arterial exams of the lower and upper extremities including:
    1. Continuous wave (CW) Doppler waveforms
    2. Segmental pressures
    3. Segmental plethysmography
    4. Digital pressures using a photoplethysmograph (PPG)
    5. Exercise testing
    6. Duplex scanning of native arteries of the upper and lower extremities
    7. Duplex scanning of bypass grafts
    8. Thoracic outlet testing
    9. Palmer arch testing
    10. Pseudoaneurysm identification and compression
    11. Arteriovenous fistula identification
13. Perform venous exams of the lower and upper extremities using duplex ultrasound by:
    1. Image/vein compression
    2. CW Doppler
    3. Duplex imaging, b-mode, spectral PW Doppler, color Doppler
    4. Vein mapping
    5. PPG venous reflex exam
14. Perform extracranial carotid and vertebral artery exams using:
    1. Duplex imaging
    2. Duplex PW Doppler
    3. Duplex color Doppler
    4. Measurements (diameter, area, velocity)
    5. Transcranial Doppler and/or imaging
15. Perform penile artery testing
    1. Duplex imaging
    2. Duplex PW Doppler
    3. Duplex color Doppler
    4. CW Doppler
16. Perform abdominal and visceral duplex exams
    1. Renal
    2. Mesenteric
    3. Aorta-iliac (including aneurysm)
    4. IVC/iliac veins
    5. Hepato-portal
17. Analyze data collected from vascular exams and create a preliminary interpretation/summary of findings.
18. Identify the capabilities, accuracy and limitations of noninvasive vascular exams
19. Collect pertinent data and calculate basic test validation statistics
20. Describe other diagnostic tests used to assess vascular diseases (arteriography, venography, MRA, etc.)
21. Describe treatment options for patients with various levels of vascular disease
    1. Conservative
    2. Medical/pharmacology
    3. Endovascular
    4. Surgical
22. List professional sources of information and journals, including associations, credentialing and accreditation organizations, other continuing educational sources, and Internet resources.

Each course should have a written description of its

• Content,
• Learning objectives, both of knowledge and skills to be attained,
• Learning activities (reading, lecture, discussion, equipment controls, video, etc.),
• Laboratory activities (subjects to try techniques, equipment controls, interpretation, etc.)
• Clinical experience (observation and performance of all minimum noninvasive vascular techniques on normal and diseased patients of various severity),
• Preliminary interpretation experience/summary of findings,
• Student evaluation and assessment mechanisms (papers, tests, clinical tests, etc.), and
• Skill check off list (see example)

XI. Clinical Site Standards

The 12 months of clinical education must include instruction and opportunity to gain practical experience in all types of vascular studies:

• Arterial
• Venous
• Cerebrovascular (extra-cranial/intra-cranial)
• Abdominal/visceral
• Other

Clinical experiences must follow a planned curriculum in order to assure experience in all skills and techniques required.

Personnel

Externship advisers must be credentialed in vascular technology and have a minimum of three years clinical experience in vascular technology. One-on-one clinical instruction is recommended, with the maximum allowable student/teacher ratio being 2:1. Clinical instructors must be available to assist students at all times during the 12-month clinical externship.

Facilities

All laboratories or other clinical sites must be accredited. SVU advises that it is permissible for students to serve clinical externship in more than one facility to ensure that training is provided on all types of vascular studies.

Students must not be responsible for the daily operation of the laboratory at any time during their clinical externship.

XII. Additional Coursework

In order to offer a well-balanced education to students, undergraduate educational programs in vascular technology are encouraged to include instruction in the following:

1. Communications
   1. Written (i.e., report writing)
   2. Oral (i.e., personal interaction, speech)
   3. Listening
2. Computer skills
   1. Word-processing
   2. Data base management
3. Math
   1. Algebra
   2. Statistics
4. Science
   1. General physics
   2. Human anatomy and physiology
   3. General biology
   4. Chemistry
   5. Methods of research
5. Sociology/psychology
   1. Human diversity
   2. Aging
   3. Death and dying
6. Philosophy
   1. Ethical/legal issues
7. Management
   1. Reimbursement
   2. Teamwork
   3. Leadership
   4. Budget
   5. Time management
   6. Personal change
   7. Stress management

These guidelines shall remain in effect for three years unless extended, revised or rescinded by the SVU Board of Directors prior to that time.

15 December 2000

References
1. Diamond, Robert M. Task Survey Designing and Assessing Courses and Curricula: A Practical Guide (Jossey-Bass Publishers, San Francisco: 1998)
2. Blanchard, P. Nick and Thacker, James W. Effective Training-Systems, Strategies, and Practices (Prentice Hall, Upper Saddle River, New Jersey

Background to Standard