Certificate in Advanced Veterinary Practice C-VDI.5 Large Animal Diagnostic Imaging B. Module Outline

Transcription

1 Certificate in Advanced Veterinary Practice C-VDI.5 Large Animal Diagnostic Imaging B Module Outline Module Leader: Stephen May MA VetMB PhD DVR DEO FRCVS DipECVS Vice Principal for Teaching and Professor of Equine Medicine and Surgery CPD Unit Royal Veterinary College Hawkshead Lane North Mymms Hertfordshire AL9 7TA Tel: +44 (0) Fax: +44 (0) certavp@rvc.ac.uk

2 LEARNING OUTCOMES The aim of the module is to enable the candidate to extend and consolidate clinical knowledge and skills gained at undergraduate level, and to develop an in-depth understanding of the application of that knowledge in a practice environment in relation to Veterinary Diagnostic Imaging. Specifically, this module relates to diagnostic images obtainable with higher power mobile and fixed X-ray units the thorax and abdomen (particularly in foals), the neck, back and pelvis, and the upper limb above the carpus and tarsus and ultrasonography of the same regions. Candidates should also be aware of the indications for scintigraphy, MRI and CT in the horse, and be able to recognise how these can confirm or rule out ambiguous findings on radiographs. CONTENT At the end of the module, candidates should be able to: Recognise and describe normal radiographic anatomy candidates should possess a detailed knowledge of the normal radiographic anatomy of the horse and its variation with breed and age Make appropriate use of contrast media understand the nature of the more frequently used media and indications for their use; the procedures for performing basic contrast techniques Apply the principles of radiological interpretation the recognition of tissue types; formation of shadowgraphs; effects of superimposition and multiple shadows. Changes in opacity, size, shape, position and function of organs. The use of simple positional and contrast aids to elucidate radiographic problems. The applications of these basic principles to the evaluation of radiological signs in relation to clinical problems Understand the principles and apply diagnostic ultrasonography in veterinary practice physical principles of ultrasound, image production, display modes, artefacts, normal ultrasound appearance of the major organs (heart, lung, liver, kidney, spleen, intestine, bladder), recognition of major alterations to the normal architecture of these organs and the possible diagnostic significance of these changes Understand the principles of and the indications for scintigraphy, MRI and CT in the horse, including basic image interpretation.

3 COMMENTARY ON THE CONTENT Interpretation applies to the diagnostic radiological features of the more commonly encountered clinical conditions seen in veterinary practice. Digestive System Common radiographic and ultrasonographic abnormalities of the oesophagus and gastrointestinal tract Obstructive lesions and functional disturbances The significance of gas shadows The use of contrast media Abdomen (in particular in the foal) Recognition of changes in outline, position and opacity of organs Abdominal masses and displacements caused by them The presence of free gas or fluid Urogenital System Common abnormalities affecting the bladder, including retrograde cystography Cardiovascular System Common abnormalities affecting the heart and blood vessels and evidence of cardiovascular disease which may be recognised on plain films The principles of cardiac catheterisation and angiocardiography Respiratory System Common abnormalities affecting the trachea, thoracic wall, pleural cavity, mediastinum, diaphragm and lungs Pulmonary patterns

4 Musculoskeletal System Common abnormalities affecting bones and joints of the upper limb Fractures, dislocations, inflammatory and degenerative conditions Congenital and developmental abnormalities, metabolic disorders Trauma Axial Skeleton Common abnormalities affecting the skeleton Fractures, dislocations, congenital and developmental abnormalities Degenerative conditions Inflammatory and neoplastic changes The principles and problems associated with the use of contrast media to demonstrate lesions of the spinal cord Soft Tissue Trauma Foreign bodies Sinuses Calcification The use of contrast media Special techniques Candidates should be familiar with the general principles of contrast examinations and the performance and interpretation of the more commonly used techniques. They should understand the principles of fluoroscopy with image intensification, and Doppler ultrasonography, including colour flow, and the types of conditions in which these techniques may be usefully employed. They should also understand the nature of the images generated by scintigraphy, MRI and CT, but do not require a comprehensive knowledge of the interpretation of such images. Note on Choice of Cases: The scope of the examination is related to those conditions likely to be encountered in general veterinary practice.

5 ASSESSMENT A case report of up to 2,500 words in length. This case should be selected by the candidate to demonstrate their ability to use the competences that have been acquired to cope with a challenging situation, rather than necessarily using classic textbook cases of particular conditions. It should be presented editor-ready in a format appropriate to one of the main veterinary journals. Illustrations should be in a digital format and demonstrate the important features of the case. (See section on Instructions for Submitting Case Reports.) Examination Two sections consisting of Multiple Choice Questions (MCQs) and Extended Matching Questions (EMQs) - Section A (30 minutes) - Radiation physics and principles of diagnostic imaging (can be sat as part of C.VDI.4) - Section B (30 minutes) - Radiography, ultrasonography, CT, MRI and scintigraphy Examination Practical diagnostic imaging reading - Eight stations consisting of six sets of unseen diagnostic imaging cases, blinded to history and other case details and two sets of films marked up to test radiographic anatomy and/or film faults. Films will be read under examination conditions and twelve minutes will be made available for each film reading station.

6 ANNUAL ASSESSMENT TIMETABLE 31 st March If you are submitting work for assessment and plan to sit the exam on the following date, please inform CertAVP Admin Manager by 31 st March 30 th June Case report due in by 30 th June. Work submitted after the deadline or without prior notice as above will not be marked until the following year. Early July Examination early July date to be confirmed

7 LEARNING SUPPORT ACTIVITIES Candidates are strongly advised to have a supervisor with whom they can discuss cases. Ideal supervisors would have post-graduate qualifications in your area of interest. The module leader will not be discussing case management with any candidate. If you pay for learning support you have access to a number of features that will make it easier, and more enjoyable to study for your surgery modules: Image posted once a month by Module Leader for comment by candidates. Access to a discussion forum that is used only by candidates studying for the DI modules. The forums can be used to discuss any topic relevant to the CertAVP DI C modules or simply to find out who else is out there! Access to the RVC online library which is invaluable when researching literature for writing up case reports. This means that (with rare exception) all journal articles that you want to view can be downloaded to your PC with a few mouse clicks. This includes research articles as well as reviews and case reports. IT and Library support is available for this facility Links to useful websites and relevant journal articles Learning support is provided to aid self-directed learning and to provide easy access to published articles.

8 INSTRUCTIONS FOR SUBMITTING CASE REPORTS Please ensure that the beginning of your report includes: your name module name title word count (excluding the above, tables, photo titles and references) Case reports should use a standard structure such as: Introduction, History, Clinical Examination, Diagnostic Imaging Methods, Description and Analysis, Diagnosis, Discussion, or an alternative systematic structure that makes sense in the context of the particular cases being considered. Case reports should be referenced and references cited in a standard format. Use The Veterinary Record or The Journal of Small Animal Practice as guidance to both citation of references within the text and format of references in the reference list. The Harvard Guide to Referencing is also available to candidates enrolled for learning support or online (various web sites allow the guide to be downloaded). Candidates are reminded that case reports should be written at Master s degree level, and attention is drawn to the document Standard of CertAVP work available on the RVC CertAVP website. Previous submissions have occasionally failed because of failure to demonstrate the desired level of knowledge and understanding of the learning objectives. Although diploma-level detail is not expected, it is anticipated that to reach the required level to pass, candidates will have needed to attend some advanced level diagnostic imaging CPD, spent some time with a diplomate in diagnostic imaging, or spent the suggested learning hours reading relevant textbooks and scientific literature at an advanced level. Please submit your report as a MS Word document ( format or later)* attached to an and send it to: certavp@rvc.ac.uk

9 Please ensure digital images are submitted in a compressed format so that they can be easily transferred via . *Please note that as case reports in alternative formats have been unreadable in MS Office any other format will be sent back to the candidate

10 SUGGESTED READING Equine: Butler JA, Colles CM, Dyson SJ, Kold SE & Poulos PW. Clinical Radiology of the Horse, 3 rd edition; Blackwell Scientific Publications, Oxford, Dik, K J and Gunsser, I (2003) Atlas of Diagnostic Radiology of the Horse: Diseases of the Front and Hind Limbs. 2 nd edition. Schlutersche. Dyson, S J (Ed.) (2003) Equine Scintigraphy. Equine Veterinary Journal. Farrow, C S. (2005) Veterinary Diagnostic Imaging - The Horse. Mosby, St Louis. Murray, R C (2010) Equine MRI. Wiley-Blackwell. Reef, V B (1998) Equine Diagnostic Ultrasound. W B Saunders Co. Radiography and Physics: Kealey, J K, McAllister, H and Graham, J P (2010) Diagnostic Radiology and Ultrasonography of the Dog and Cat, 5 th edition, Chapter 1. W B Saunders. Thrall (2009) Textbook of Veterinary Diagnostic Radiology 5 th edition, Chapters 1-5. W B Saunders. Weaver, M and Barakzai, S (2009) Handbook of Equine Radiography. W B Saunders. Journals: Relevant imaging articles and case reports in the previous 5 years of: Equine Veterinary Journal In Practice Veterinary Radiology and Ultrasound * * Veterinary Radiology and Ultrasound provides a comprehensive range of imaging articles much of which is beyond the scope of the modular assessment. However, candidates should be familiar with those articles relevant to the learning objectives set out in each module.

11 Marking Regulations Version 3 25/01/ Course: RCVS Certificate of Advanced Veterinary Practice 2. Section: C Module C-VDI.5 Large Animal Diagnostic Imaging B 3. Applicable to Academic Year: 2009/10 onwards 4. Aspects of course covered by Examination CertAVP C-VDI.5 Large Animal Diagnostic Imaging B learning outcomes and topics 5. Requirement to be completed to permit entry to the examination: 1. Appropriate enrolment to the C module 2. Candidates are advised that they preferably achieve a pass grade in the relevant practice B module. 6. Form of Examination Part 1 Case report 2500 words Part 2 Examination 2 sections consisting of MCQs and EMQs. i) Section A (30 mins) - Radiation physics and principles of diagnostic imaging (can be sat as part of C.VDI.4) ii) Section B (30 mins) Diagnostic ultrasonography, CT, MRI and scintigraphy Part 3 Practical DI reading exam 7. Marking Criteria 1. Case reports grading on the RVC (17 point) marking scheme 2. DI reading exam graded following the RVC (17 point) marking scheme 8. Allocation of Marks and any additional requirements First Submission Mark aggregated and scaled to a percentage. Re-submission Only those parts of the module identified as failing in the initial submission will be remarked

12 Version 3 25/01/ Requirements to Pass Overall Work must be submitted and assessed within the 10 year registration period, or if enrolled after 1 st July 2010, within the 2 year registration period. First Submission 50% or greater in the grading of the case report mark 50% or greater in the grading of the DI reading exam Re-submission Sections graded below 50% in the first submission are re-graded on resubmission and the following criteria must be reached taking that new grading into account: 50% or greater in the grading of the case report mark 50% or greater in the grading of the DI reading exam 10. Consequences of Failure 1. A candidate who fails at their first submission will be required to re-submit the sections that have been graded below 50% in the next or a future assessment cycle, or withdraw from the Certificate. 2. A candidate who does not meet the requirements to pass overall after taking all the allowed opportunities to resubmit their work will normally be required to relinquish the course of study but s/he will have the right of appeal as described in the College Regulations. 3. Should a candidate successfully appeal to be re-admitted to the Certificate they would normally have to repeat the entire module with new case material and would incur a further assessment fee. 11. Classification The examination is only classified as a Pass or a Fail. Candidates that pass the examination will be allocated 10 credits in the CertAVP structure and the RCVS will be appropriately informed. 12. Disclosure of Marks Candidates will be advised of their marks by and they can request a letter confirmation. 13. Late submission of work Work that is submitted after the annual deadline cannot be accepted for grading in that year. Work may stay on file for grading at the next submission date or the candidate may re-submit before that date.