Knowledge Based Exams
In 2007 CARDUP and CSDMS were actively involved in developing and conducting the National Competency Profile Revalidation Surveys for the three Canadian Sonography Disciplines, Generalist, Cardiac and Vascular. The surveys are an extremely important process conducted every five years which provide the basis for the Canadian National Competency Profiles (NCP) for Sonography. The revalidated NCPs have formed the foundation for examination blueprinting.
In February 2007, the business and development plans for knowledge based examination development were prepared.. In January 2008, the Board hired Dr. David Cane of Catalysis Inc to be the project manager for the development of the Core and Generalist written examinations and the Examination Development Steering Committee was formed. The project began on March 30, 2008 with examination blueprinting. In June 2008, Dr. Dwight Harley Director of Psychometrics, Division of Studies in Medical Education, Faculty of Medicine and Dentistry at the University of Alberta was hired to provide psychometric analysis and principles to the examination development. Item writers came together in 2009 to create the Item Bank for the Core and Generalist exams.The Core and Generalist sonography exams were hosted in the English language on May 15th, 2010.
A similar process was followed for the Cardiac sonography exams. The Cardiac exam will be launched in 2011. Future projects include a Vascular sonography exam and exams provided in French.
There are still great opportunities for sonographer participation in the project and I encourage all interested registrants to become involved by contacting head office.
The Board will continue to provide timely updates on all initiatives and projects..
The sonography profession in Canada
Diagnostic medical sonography (also known as diagnostic ultrasound technology) involves scanning the human body with high frequency sound and plays a critical role within the health care system by providing physicians with key information that enables the diagnosis and treatment of a wide variety of conditions. If performed incorrectly there is a significant risk of harm to the patient through misdiagnosis and ineffective treatment.
Sonographers are not regulated in any Canadian jurisdiction except the province of Quebec. Consequently a process of national competency certification to verify the knowledge and skills of sonographers provides a vital service to employers, the public and the profession.
In the absence of self-regulation of the profession employers are free to hire sonographers with various levels of training. On-the-job-trained sonographers still exist in some facilities. Most employers now hire “registered or credentialed” sonographers.
Further, despite the existence of nine CMA accredited Canadian training programs, there is a severe and ongoing shortage of sonographers in Canada. Given the lack of sufficient numbers of new Canadian graduates to meet hiring needs (Canadian accredited programs provide a maximum of 165 graduates per year) employers are under constant pressure to accept aaplicants with less than optimal training and education. Employers also need a way to verify the qualifications of foreign or externally trained applicants relative to Canadian standards.
In the face of this skills shortage and lack of regulation, it is important that a certification registry identify individuals who have knowledge, skills and training relevant to the Canadian workplace.
The most well established North American Registry is the American Registry of Diagnostic Medical Sonographers (ARDMS). ARDMS operates a registration process based upon 9 sonographer designations. Registration is granted upon successful completion of written examinations. No assessment of clinical skills is required other than verification declaration of clinical training. Candidates for ARDMS registration are not required to have completed an accredited sonography training program.
Some problems exist for Canadian employers using the ARDMS Registry for Canadian purposes. The ARDMS examinations are based upon US practice standards, which are not always relevant to Canadian needs. For example, the diversity of the profession in the US justifies maintaining 9 sonographer designations. In Canada, only 3 designations are required – and none of these is equivalent to any one of the US designations. Accredited Canadian educational programs train to the National Competency Profiles endorsed by the professional in Canada, the CSDMS. Currently there is no national competency profile in the US. Finally, ARDMS examinations are not available in the French language.
Several years ago professional associations representing sonographers and specialty physicians in Canada approached ARDMS with a request that examinations for Canadians be developed, in both English and French, based upon Canadian practice standards. ARDMS was unable to accede to this request. As a result the professional associations established CARDUP, with a mandate to establish a bilingual Canadian Registry.
“The Canadian Association of Registered Diagnostic Ultrasound Professionals (CARDUP) has established a Canadian professional certification registry for diagnostic medical sonography.
There are approximately 5000 diagnostic sonographers in Canada, employed by hospitals and clinics in all provinces and territories. There are 9 accredited Canadian educational programs for medical sonography. Training programs are accredited through the Canadian Medical Association (CMA) Conjoint Accreditation process, and provide their graduates with competencies that match one or more of the National Competency Profiles (NCPs) established by CARDUP and the CSDMS and published by CARDUP.
CARDUP developed competency profiles for three sonographer designations: Generalist Sonographer, Cardiac Sonographer and Vascular Sonographer. These designations and skill sets were identified to meet the needs of Canadian health care, through both an employer needs and practitioner survey that took place in 2002 and was repeated in 2007. The practitioners, employers and educators that were surveyed provided information both about current and future skills and knowledge requirements for the profession.
Since its formation CARDUP has:
- Undertaken an employer needs survey to determine the sonography skill sets required in the Canadian workplace
- Identified three Canadian sonographer designations
- Established National Occupational Competency Profiles (NCPs) for the three sonography disciplines.
- Arranged for incorporation of the NCPs into the requirements of the Canadian Medical Association Conjoint Accreditation process from which all CMA accredited Canadian educational programs blueprint their curriculums.
- Developed and implemented a clinical skills assessment process, as an intergal component of the Canadian certification.
- Revalidated the National Competency Profiles
Still to be achieved is the development and implemantation bilingual written examinations to assess the knowledge base of registration candidates.
Third party support
CARDUP’s work to establish a Canadian Registry for sonographers has been supported by the following organizations:
- The Canadian Association of Radiologists
- The Canadian Association of Medical Radiation Technologists
- The Canadian Medical Association Conjoint Accreditation Process
- The Canadian Society of Diagnostic Medical Sonographers
- The Canadian Society of Echocardiography
- The Canadian Society for Vascular Surgery
- All Canadian sonography educational programs (9 programs in 7 provinces)