Certificate in Advanced Veterinary Practice C-VDI.3 Small Animal Diagnostic Imaging (Soft Tissue) Module Outline Module Leader: Elizabeth Baines MA VetMB DVR DipECVDI MRCVS Lecturer in Veterinary Radiology CPD Unit Royal Veterinary College Hawkshead Lane North Mymms Hertfordshire AL9 7TA Tel: +44 (0)1707 666201 Fax: +44 (0)1707 666877 Email: certavp@rvc.ac.uk www.rvc.ac.uk/certavp
LEARNING OUTCOMES This module relates to soft tissue problems affecting the digestive, cardiovascular, respiratory and urogenital systems, and other organs in the thorax and abdomen. The aim of this 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. The candidate should demonstrate: a knowledge of the radiographic features relating to the more commonly encountered clinical conditions seen in veterinary practice relevant to this module a knowledge of normal radiographic anatomy of the dog and cat relevant to this module a recognition of the effects of poor radiographic procedure and poor film processing on a radiograph an understanding of the principles of radiological physics and interpretation an understanding of the principles of diagnostic ultrasonography an understanding of the general principles of contrast radiography CONTENT At the end of the module, candidates should be able to: Use an x-ray machine to produce optimal quality radiographs for the diagnosis of soft tissue conditions described in the commentary Recognise faults and deficiencies in radiographic procedure and describe corrective measures Recognise and describe normal radiographic anatomy of the organ systems described in this module. Candidates should possess a detailed knowledge of the normal radiographic anatomy of the dog and cat and of their variations with breed and age. In other species a knowledge compatible with current use would be expected. Recognise and describe the radiographic appearance of disease affecting the organ systems described in this module, and where appropriate, list the differential diagnoses that should be considered Interpret and produce written reports of imaging examinations suitable for the requirements of this module
Apply the principles of radiological interpretation 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 soft tissue problems in small animals Understand the principles of diagnostic ultrasonography in veterinary practice physical principles of ultrasound image production display modes artefacts normal ultrasound appearance of major organs (heart, liver, kidney, spleen, bladder, prostate and uterus) recognition of major alterations to the normal architecture of these organs and the possible diagnostic significance of these changes 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 and appropriate use of fluoroscopy with image intensification. They should understand the basic principles and appropriate use of diagnostic ultrasonography in veterinary practice
COMMENTARY ON THE CONTENT Interpretation applies to the diagnostic radiological features of the more commonly encountered clinical conditions seen in veterinary practice. Candidates should be able to form a differential diagnosis based on these features: Digestive system Common abnormalities affecting the teeth, pharynx, oesophagus and gastrointestinal tract Obstructive lesions and functions disturbances The significance of gas shadows The use of contrast media Abdomen 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 kidneys, ureters, bladder, urethra, male and female genital organs The use of radiology and ultrasound in pregnancy diagnosis Intravenous urography, retrograde, cystography and urethrography (positive and negative) 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 nasal cavity, sinuses, hyoid apparatus, larynx, trachea, thoracic wall, pleural cavity, mediastinum, diaphragm and lungs Pulmonary patterns
Soft Tissue Trauma Foreign bodies Sinuses Calcification The use of contrast media
ASSESSMENT A case report of up to 2,500 words in length. This case should be selected to demonstrate the candidate s ability to use the diagnostic imaging competences that have been acquired to cope with a challenging situation, rather than necessarily using classic textbook cases of particular conditions. The case should be selected from the caseload seen by the candidate while he/she is enrolled with the RVCS for this module. It should be presented editorready 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. The original radiographs (or DICOM-format images where digital radiography is used) should accompany the case report. A formal examination paper consisting of Multiple Choice Questions (MCQs) and Extended Matching Questions (EMQs). - Section A (30 minutes) - principles of radiographic, fluoroscopic and ultrasonographic physics, equipment, contrast media, principles of image formation and radiation safety (can be sat as part of C-VDI.2) - Section B (30 minutes) special techniques and diagnostic ultrasonography Eight stations consisting of a minimum of six sets of unseen diagnostic imaging cases, blinded to history and other case details, and up to 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.
ANNUAL ASSESSMENT TIMETABLE 1 st February If you are submitting work for assessment and plan to sit the exam on the following dates, please inform CertAVP Admin Manager by 1 st February. 1 st March Case report to be submitted. Work submitted after the deadline or without prior notice as above will not be marked until the following year. 1 st June Candidates will be informed of the outcome/marks of their submitted case report. July Exam date to be confirmed (early July).
LEARNING SUPPORT ACTIVITIES Candidates are strongly advised to have a supervisor with which 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 diagnostic imaging modules: A monthly case - radiographic images are presented for the candidate to practice writing reports in the style that RVC would like module examination film reports to be written. On submission, a sample answer becomes available. 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.
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/reflective essays 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). Please submit your report as a MS Word document (97-2003 format or later)* attached to an e-mail and send it to: certavp@rvc.ac.uk Please ensure original radiographs are submitted by post or digital images are submitted on a CD or DVD in DICOM format. *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
SUGGESTED READING Small Animal: Coulson A, Lewis N. An Atlas of Interpretive Radiographic Anatomy of the Dog and Cat, 2 nd edition; Blackwell Scientific Publications, Oxford. 2008. Thrall DE (Ed). Textbook of Veterinary Diagnostic Radiology, 5 th edition. WB Saunders Co, Philadelphia. 2007. Kealy K & McAllister H. Diagnostic Radiology and Ultrasonography of the Dog and Cat, 4 th edition; WB Saunders & Co. 2004. BSAVA Manual of Canine & Feline Thoracic Imaging. Cheltenham, BSAVA Publications.2008. BSAVA Manual of Canine & Feline Abdominal Imaging. Cheltenham, BSAVA Publications. 2009 Radiography and Physics: Douglas SW, Williamson HD & Herrtage M. Principles of Veterinary Radiography, 4 th edition; Bailliere Tindall, London. 1987. Ticer JW. Radiographic Technique in Veterinary Practice, 2 nd edition. WB Saunders Co, Philadelphia. 1984. Journals: Relevant imaging articles and case reports in the previous 5 years of: Journal of Small Animal Practice 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.
Marking Regulations Version 4 25/01/2011 1. Course: RCVS Certificate of Advanced Veterinary Practice 2. Section: C Module C-VDI.3 Small Animal Diagnostic Imaging (Soft tissue) 3. Applicable to Academic Year: 2009/10 onwards 4. Aspects of course covered by Examination CertAVP C-VDI.3 Small Animal Diagnostic Imaging (Soft tissue) 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 should achieve a pass grade in Module B -SAP.1. 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.2) ii) Section B (30 mins) Special techniques and diagnostic ultrasonography Part 3 Practical DI reading exam 7. Marking Criteria Part 1 Case report grading on the RVC 0-100 (17 point) marking scheme Part 2 A single mark will be allocated to each correct response Part 3 Each report from the DI exam will be graded on the RVC 0-100 (17 point) marking scheme
8. Allocation of Marks and any additional requirements Version 4 25/01/2011 First Submission Re-submission Only those parts of the assessment identified as failing in the initial submission will be re-marked 9. 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 Part 1: Case report 50% or greater in the grading of Part 2: exam Section A (this may be passed as part of C-VDI.2) 50% or greater in the grading of Part 2: exam Section B 50% or greater in the grading of Part 3: DI reading exam Re-submission Sections graded below 50% in the first submission are re-graded on re-submission and the following criteria must be reached taking that new grading into account: 50% or greater in the grading of Part 1: Case report 50% or greater in the grading of Part 2: exam Section A (this may be passed as part of C-VDI.2) 50% or greater in the grading of Part 2: exam Section B 50% or greater in the grading of Part 3: 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 email and they can request a letter confirmation. Version 4 25/01/2011 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.