TRAINEE DETAILS Trainee Name: ……………………………………………………………………….. Hospital: Date of Examination: …………………………………………………….. Introduces self to patient and obtains relevant clinical details 1 No introduction or history 2 3 Minimal introduction and incomplete history 4 5 Complete introduction and history Explain examination 1 Incomplete or misinformation 2 3 Explanation complete but 4 5 Full, succinct explanation with indication and limitations Consent for aneuploidy screening and pre and post-test counselling 1 Incomplete or misinformation 2 3 Explanation complete but brief 4 5 Full, succinct explanation including limitations Selection of probe and examination presets 1 Inappropriate probe or inability to select settings 2 3 Correct but some hesitancy in use of equipment 4 5 Correct and confident use of equipment Demonstration of applied physics 1 Inability to demonstrate application of physics to setting 2 3 Some understanding of use of frame rate and persistence to optimise image 4 5 Detailed understanding of use of frame rate and persistence Applied understanding of ALARA 1 power / Doppler on inappropriately, little or no demonstration of ALARA 2 3 Understands principles of ALARA but not always demonstrated 4 5 Always demonstrates ALARA principles, full understanding Use of depth, focus and zoom functions 1 Suboptimal image quality 2 3 Optimises image but uncertainty in use of machine functions 4 5 Optimises image appropriately with familiarity Assess cervix and uterine contents including fetal number and amniotic fluid volume 1 Incomplete demonstration 2 3 Structures demonstrated by unsystematic approach 4 5 Systematic approach in both transverse and longitudinal planes Assess placenta: Location Anatomy Appearance 1 Incorrect demonstration 2 3 Structures demonstrated but unsystematic approach 4 5 Systematic approach in both transverse and longitudinal planes
Recognise chorionicity and amnionicity in case of multiple pregnancy 1 Incorrect assessment 2 3 Some certainty 4 5 Confident and correct assessment Measure CRL 1 Incorrect plane and measurement 2 3 Hesitancy in image acquisition and calliper placement 4 5 Systematic image acquisition and measurement Measure BPD 1 Incorrect and measurement 2 3 Hesitancy in image acquisition and calliper placement 4 5 Systematic image acquisition and measurement Measure FL 1 Incorrect plane and measurement 2 3 Hesitancy in image acquisition and calliper placement 4 5 Hesitancy in image acquisition and calliper placement Measure nasal bone 1 Incorrect and measurement 2 3 Some uncertainty in assessment 4 5 Confident assessment and demonstration Measure NT 1 Incorrect plane and measurement 2 3 Hesitancy in image acquisition and calliper placement 4 5 Systematic image acquisition and measurement Measure DV 1 Incorrect technique and measurement 2 3 Hesitancy in image acquisition and calliper placement 4 5 Systematic image acquisition and measurement Measure tricuspid regurgitation 1 Incorrect technique and measurement 2 3 Hesitancy in image acquisition and calliper placement 4 5 Systematic image acquisition and measurement Review anatomy 1 Incomplete demonstration 2 3 Structured demonstrated but unsystematic approach 4 5 Systematic approach in both transverse and longitudinal planes Assess fetal face 1 Incomplete demonstration 2 3 Structures demonstrated but unsystematic approach 4 5 Systematic approach in both transverse and longitudinal planes Review fetal heart and chest 1 Incomplete demonstration 2 3 Structures demonstrated but unsystematic approach 4 5 Systematic approach in both transverse and longitudinal planes Review fetal abdomen 1 Incomplete demonstration 2 3 Structures demonstrated but unsystematic approach 4 5 Systematic approach in both transverse and longitudinal planes Review fetal spine 1 Incomplete demonstration 2 3 Structures demonstrated but unsystematic approach 4 5 Systematic approach in both transverse and longitudinal planes Review fetal skeletal system 1 Incomplete demonstration 2 3 4 5