Job Task Analysis for ARDMS Abdomen Data Collected: June 30, 2011 Reported: Analysis Summary for: Abdomen Examination Survey Dates 06/13/2011-06/26/2011 Invited Respondents 6,000 Surveys with Demographics Completed Surveys 1,839 (completed at least one question) 1,644 (completed all questions) Response Rate, Completed Surveys 27% Page 1 of 20
Demographics Education Level Sonography Education Level N Percent On-the-job training 276 18% Certificate program 627 40% Associate's degree 411 26% Bachelor's degree 188 12% Master's degree 13 1% MD 37 2% PhD 2 0% Total 1,554 100% Table 1. Sonography Education Level Graphically, the sonography education level of respondents is represented below. Figure 1. Sonography Education Level Page 2 of 20
Highest level of education overall is displayed in the table and figure below. Highest Education Level N Percent High school diploma 48 3% Certificate program 273 18% Associate's degree 615 40% Bachelor's degree 470 30% Master's degree 65 4% MD 75 5% PhD 8 1% Total 1,554 100% Table 2. Highest Education Level Figure 2. Highest Education Level Page 3 of 20
The survey respondents were asked if they are a sonography educator. Table 3 and Figure 3 demonstrate the results. Sonography Educator N Percent Yes 400 26% No 1,154 74% Total 1,554 100% Table 3. Sonography Educator Figure 3. Sonography Educator. Number of Sonographers in Lab The task analysis included a question that asked respondents how many sonographers practice in their lab, including themselves. Table 4 shows the results. Page 4 of 20
Number of Sonographers in Lab N Percent 0-5 776 51% 6-10 432 28% 11-15 189 12% 16-20 64 4% 21+ 60 4% Total 1,521 100% Table 4. Number of Sonographers in Lab Below are Table 4 results shown graphically. Figure 4. Number of Sonographers in Lab Exams Performed by Respondents Table 5 and Figure 5 show the number of exams that respondents stated they typically conduct per month in their own practice. Page 5 of 20
Number of Exams Respondents Perform per Month # of Exams N Percent 0-50 217 14% 51-100 300 20% 101-150 360 24% 151-200 376 25% 201+ 268 18% Total 1,521 100% Table 5. Number of Exams Respondents Perform per Month Figure 5. Number of Exams Respondents Perform per Month Exams Performed by Respondent s Lab Table 6 shows the number of exams conducted in the respondent s laboratory in a typical month. Page 6 of 20
Exams Performed per Month by Respondent s Lab # of Exams N Percent 0-200 236 15% 201-500 365 23% 501-1000 436 28% 1001+ 452 29% N/A 65 4% Total 1,554 100% Table 6. Exams Performed per Month by Respondent s Lab The results from Table 6 are presented graphically in Figure 6. Figure 6. Exams Performed per Month by Respondent s Lab Page 7 of 20
Experience in the Sonography Profession Respondents were asked the number of years they have served in the sonography profession. Table 7 tabulates the results, and Figure 7 shows these results graphically. Years in Sonography # of Years N Percent 0-5 302 19% 6-10 281 18% 11-15 272 18% 16-20 224 14% 20+ 475 31% Total 1,554 100% Table 7. Years in Sonography Figure 7. Years in Sonography The survey respondents were asked in which environment they perform most of their sonographic examinations. Results are displayed in Table 8. Page 8 of 20
Work Environment N Percent Hospital: non-university 750 48% Hospital: university 171 11% Medical office 147 9% Mobile unit 25 2% Outpatient facility 197 13% Athletic facility 2 0% Imaging center 195 13% Educational facility 38 2% Other 29 2% Total 1,554 100% Table 8. Work Environment Figure 8 portrays the results graphically. Figure 8. Work Environment Page 9 of 20
Other Examinations The survey asked respondents if they perform diagnostic ultrasound exams of the breast. Table 9 and Figure 9 portray the results. Perform Breast Ultrasound Exams N Percent Yes 979 63% No 575 37% Total 1,554 100% Table 9. Perform Breast Ultrasound Exams Figure 9. Perform Breast Ultrasound Exams Page 10 of 20
The 979 survey respondents who answered Yes, that they do perform diagnostic breast ultrasounds, were then asked, If you work in a general ultrasound department, does your lab provide breast ultrasound imaging services? Table 10 and Figure 10 show the results. Breast Ultrasound Imaging Services N Percent Yes 896 92% No 83 8% Total 979 100% Table 10. Breast Ultrasound Imaging Services Figure 10. Breast Ultrasound Imaging Services Respondents were asked if their place of employment provides a dedicated breast imaging department. Results are shown in Table 11 and presented graphically in Figure 11. Page 11 of 20
Dedicated Breast Imaging Department N Percent Yes 766 49% No 785 51% Total 1,551 100% Table 11. Dedicated Breast Imaging Department Figure 11. Dedicated Breast Imaging Department Respondents were asked if their lab provides neonatal spine ultrasound imaging. Results are presented in Table 12 and Figure 12. Page 12 of 20
Neonatal Spine Ultrasound Imaging N Percent Yes 694 45% No 853 55% Total 1,547 100% Table 12. Neonatal Spine Ultrasound Imaging Figure 12. Neonatal Spine Ultrasound Imaging The following question was added late in the survey: Does a radiologist or sonographer perform prostate ultrasound imaging in your lab? Because there were 500 respondents who Page 13 of 20
had already completed the survey before this question was added, the results show a lower number of total respondents. See Table 13 and Figure 13. Who Performs Prostate Ultrasound? N Percent Sonographer 464 56% Radiologist 371 44% Total 835 100% Table 13. Who Performs Prostate Ultrasound? Figure 13. Who Performs Prostate Ultrasound? Finally, respondents were asked if their employer provides a means for continuing their medical education. Table 14 and Figure 14 demonstrate the results. Page 14 of 20
Employer Provides Means for Continuing Medical Education N Percent Yes 951 61% No 600 39% Total 1,551 100% Table 14. Employer Provides Means for Continuing Medical Education Figure 14. Employer Provides Means for Continuing Medical Education Page 15 of 20
Survey Topics Listings Below are the complete topic listings as they appeared in the survey. ID AB Survey Tasks 1. Anatomy and physiology 1.1. Evaluate anatomic structures of the liver 1.2. Evaluate anatomic structures of the biliary system 1.3. Evaluate anatomic structures of the pancreas 1.4. Evaluate anatomic structures of the spleen 1.5. Evaluate anatomic structures of the urinary system (i.e., kidneys, ureters, bladder) 1.6. Evaluate anatomic structures of the adrenal glands 1.7. Evaluate anatomic structures of the peritoneal cavity 1.8. Evaluate anatomic structures of the retroperitoneum (e.g., great vessels and branches) 1.9. Evaluate anatomic structures of the gastrointestinal system 1.10. Evaluate anatomic structures of the scrotum and contents (e.g., testes, epididymides) 1.11. Evaluate anatomic structures of the penis 1.12. Evaluate anatomic structures of the prostate 1.13. Evaluate anatomic structures of the breast 1.14. Evaluate anatomic structures of the glands of the neck (i.e., thyroid, parathyroid, salivary) 1.15. Evaluate anatomic structures of the other superficial structures (e.g., subcutaneous) 1.16. Evaluate anatomic structures of the non-cardiac chest 1.17. Evaluate anatomic structures of the infant hip 1.18. Evaluate anatomic structures of the joints (e.g., tendon, muscle, bursa) 1.19. Recognize the presence of anatomic variants/congenital anomalies of the liver 1.20. Recognize the presence of anatomic variants/congenital anomalies of the biliary system 1.21. Recognize the presence of anatomic variants/congenital anomalies of the pancreas 1.22. Recognize the presence of anatomic variants/congenital anomalies of the spleen Recognize the presence of anatomic variants/congenital anomalies of the urinary system 1.23. (i.e., kidneys, ureters, bladder) 1.24. Recognize the presence of anatomic variants/congenital anomalies of the adrenal glands Recognize the presence of anatomic variants/congenital anomalies of the retroperitoneum 1.25. (e.g., great vessels and branches) Recognize the presence of anatomic variants/congenital anomalies of the gastrointestinal 1.26. system Recognize the presence of anatomic variants/congenital anomalies of the scrotum and 1.27. contents (e.g., testes, epididymides) 1.28. Recognize the presence of anatomic variants/congenital anomalies of the penis 1.29. Recognize the presence of anatomic variants/congenital anomalies of the breast 1.30. Recognize the presence of anatomic variants/congenital anomalies of the glands of the Page 16 of 20
neck (i.e., thyroid, parathyroid, salivary) Recognize the presence of anatomic variants/congenital anomalies of the other superficial 1.31. structures (e.g., subcutaneous) 1.32. Recognize the presence of anatomic variants/congenital anomalies of the infant hip Recognize the presence of anatomic variants/congenital anomalies of the joints (e.g., 1.33. tendon, muscle, bursa) 1.34. Evaluate liver for function and/or perfusion 1.35. Evaluate biliary system for function and/or perfusion 1.36. Evaluate pancreas for function and/or perfusion 1.37. Evaluate spleen for function and/or perfusion 1.38. Evaluate urinary system (i.e., kidneys, ureters, bladder) for function and/or perfusion 1.39. Evaluate adrenal glands for function and/or perfusion 1.40. Evaluate retroperitoneum (e.g., great vessels and branches) for function and/or perfusion 1.41. Evaluate gastrointestinal system for function and/or perfusion 1.42. Evaluate scrotum and contents (i.e., testes, epididymides) for function and/or perfusion 1.43. Evaluate penis for function and/or perfusion 1.44. Evaluate prostate for function and/or perfusion 1.45. Evaluate breast for function and/or perfusion Evaluate glands of the neck for function and/or perfusion (i.e., thyroid, parathyroid, 1.46. salivary) 1.47. Evaluate other superficial structures (e.g., subcutaneous) for function and/or perfusion 1.48. Evaluate non-cardiac chest for function and/or perfusion 1.49. Evaluate infant hip for function and/or perfusion 1.50. Evaluate joints for function and/or perfusion (e.g., tendon, muscle, bursa) 2. Pathology Evaluate urinary system (i.e., kidneys, ureters, bladder) for vascular abnormalities (e.g., 2.1. renal artery stenosis) Evaluate liver for vascular abnormalities (e.g., Budd-Chiari, arteriovenous fistula, portal 2.2. vein thrombosis) Evaluate the scrotum and contents (e.g., testes, epididymides) for vascular abnormalities 2.3. (e.g., torsion) 2.4. Evaluate penis for vascular abnormalities (e.g., impotence, priapism) 2.5. Evaluate spleen for vascular abnormalities (e.g., infarction) Evaluate the retroperitoneum (e.g., great vessels and branches) for abnormalities (e.g., 2.6. aneurysm, dissection, thrombus) 2.7. Evaluate the liver for transjugular intrahepatic portosystemic shunt (TIPS) 2.8. Evaluate the vascularity of the neck structures for abnormalities 2.9. Evaluate adrenal glands for masses 2.10. Evaluate chest for fluid 2.11. Evaluate chest for masses 2.12. Evaluate for biliary infection Page 17 of 20
2.13. Evaluate for biliary masses (e.g., primary tumors, metastatic disease, etc.) 2.14. Evaluate for biliary obstruction 2.15. Evaluate for diffuse hepatocellular disease (e.g., hepatitis, fatty infiltration, cirrhosis, etc.) 2.16. Evaluate for diffuse splenic disease (e.g., splenomegaly, parenchymal changes, etc.) 2.17. Evaluate for hepatic masses (e.g., neoplasm, abscess, cyst, etc.) 2.18. Evaluate for pancreatic infection 2.19. Evaluate for pancreatic masses 2.20. Evaluate for pancreatic obstruction 2.21. Evaluate for splenic masses 2.22. Evaluate infant hip for abnormalities 2.23. Evaluate joint for effusion 2.24. Evaluate urinary system (i.e., kidneys, ureters, bladder) for masses 2.25. Evaluate urinary system (i.e., kidneys, ureters, bladder) for obstruction 2.26. Evaluate urinary system (i.e., kidneys, ureters, bladder) for parenchymal disease 2.27. Evaluate peritoneal cavity for the presence of fluid 2.28. Evaluate superficial structure for foreign body 2.29. Evaluate superficial structure for infection 2.30. Evaluate superficial structure for masses 2.31. Evaluate the breast for infection 2.32. Evaluate the breast for masses 2.33. Evaluate the gastrointestinal (GI) system for herniation 2.34. Evaluate the gastrointestinal (GI) system for inflammation (e.g., appendicitis, colitis) 2.35. Evaluate the gastrointestinal (GI) system for masses Evaluate the gastrointestinal (GI) system for obstruction (e.g., pyloric stenosis, 2.36. 2.37. intussusception) Evaluate the glands of the neck for diffuse parenchymal disease (i.e., thyroid, parathyroid, salivary) 2.38. Evaluate the glands of the neck for inflammation (i.e., thyroid, parathyroid, salivary) 2.39. Evaluate the glands of the neck for masses (i.e., thyroid, parathyroid, salivary) 2.40. Evaluate the prostate for infection/inflammatory disease 2.41. Evaluate the prostate for masses 2.42. Evaluate the prostate for parenchymal disease (e.g., benign prostatic hypertrophy) 2.43. Evaluate the retroperitoneum for masses (e.g., fibrosis, lymphadenopathy) 2.44. Evaluate the scrotum and contents (e.g., testes, epididymides) for fluid 2.45. Evaluate the scrotum and contents (e.g., testes, epididymides) for herniation 2.46. Evaluate the scrotum and contents (e.g., testes, epididymides) for masses Evaluate the scrotum and contents (e.g., testes, epididymides) for infection/inflammatory 2.47. disease 2.48. Evaluate the scrotum and contents (e.g., testes, epididymides) for parenchymal disease 2.49. Evaluate penile tissue for abnormalities (e.g., calcifications, fracture) Page 18 of 20
2.50. Evaluate hepatic transplant for complications 2.51. Evaluate kidney transplant for complications 2.52. Evaluate pancreatic transplant for complications 2.53. Evaluate the post surgical neck for abnormalities (e.g., recurrent disease, lymphadenopathy) 2.54. Evaluate abdominal wall for abnormalities related to traumatic events 2.55. Identify adrenal abnormalities related to traumatic events 2.56. Identify urinary system (i.e., kidneys, ureters, bladder) abnormalities related to traumatic events 2.57. Identify liver abnormalities related to traumatic events 2.58. Identify pancreatic abnormalities related to traumatic events 2.59. Identify retroperitoneal (e.g., great vessels and branches) abnormalities related to traumatic events 2.60. Identify scrotal and content (e.g., testes, epididymides) abnormalities related to traumatic events 2.61. Identify splenic abnormalities related to traumatic events 3. Patient care 3.1. Maintain infection control 3.2. Practice universal precautions 3.3. Use sterile technique when preparing for procedure 4. Integration of data 4.1. Assess indications for examination requested 4.2. Assess relevant clinical lab values for examination being performed 4.3. Assess relevant patient signs and symptoms for examination being performed 4.4. Correlate ultrasound findings with other imaging modalities 5. Protocols 5.1. Inform patient or referring practitioner of examination preparations (e.g., fasting for biliary imaging) 5.2. Modify the examination based on sonographic findings 5.3. Use multiple patient positions and planes to evaluate anatomic structures 5.4. Obtain measurements of anatomic structures 5.5. Obtain measurements of blood flow velocities 6. Physics 6.1. Assess artifacts of gray-scale imaging 6.2. Assess artifacts of color Doppler imaging 6.3. Assess artifacts of spectral Doppler imaging 6.4. Record images on a picture archiving and communication system (PACS) 6.5. Record images on digital media (external media, etc.) 6.6. Use 2-D real-time, gray-scale imaging (B-mode) 6.7. Use color flow imaging Page 19 of 20
6.8. Use power Doppler 6.9. Use pulsed wave Doppler 6.10. Use harmonic imaging 6.11. Use curvilinear array transducer 6.12. Use linear array transducer 6.13. Use phased array transducer 6.14. Use endorectal transducer 6.15. Use 3-D transducer 6.16. Use 4-D transducer 7. Treatment 7.1. Assist in needle biopsy procedures 7.2. Obtain consent form and patient lab results prior to a procedure 7.3. Assist during and/or provide ultrasound guidance for procedures 8. Other 8.1. Recognize findings that require immediate action Page 20 of 20