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SICP Section

Sentara School of Health Professions

Betty Ashdown, RT(R)(CT)(CV), RCIS, FAVIR, FSICP, Invasive Clinical Instructor*, School of Cardiovascular Technology, Chesapeake, Virginia
June 2004
*Betty Ashdown has since left her position at the Sentara School. Why and how did you become an educator? Ever since I can remember, I have enjoyed teaching. When I started in the field of radiologic technology, I became interested in the instruction of fellow students. I continued to take advanced level courses and ended up in the North Carolina Baptist Hospital’s program for special diagnostic radiologic procedures. After three years, I moved to Virginia. I was fortunate enough to work in angiography at Sentara Norfolk General Hospital and became an instructor in the Special Vascular Imaging program. Several years later, the Director of the Radiologic Technology Program at Tidewater Community College and I started courses in angiography, computerized tomography, and magnetic resonance imaging as continuing education courses at the community college. A couple of years later, I moved from radiology to cardiology, and after one year accepted the position of Clinical Instructor for the School of Cardiovascular Technology. How long has your program been in operation? The Sentara School of Cardiovascular Technology has been in operation for over 20 years. The first class graduated in March 1984. The program includes three different tracks: Invasive Cardiology, Echocardiography, and Peripheral Vascular Ultrasound. I became the clinical instructor for the invasive track in August 1997. Can you describe your program syllabus, both clinical and classroom? The 18-month school has an intense didactic and clinical curriculum, and is a competency-based educational program. In the first six months, the student’s attention is devoted to the basics of cardiology and patient care. By the second semester, students focus their attention on the specialty and are ready to assist in the clinical setting with diagnostic procedures. In the second and third semester, the didactic work is less and the student concentrates on developing clinical skills. The student has to complete procedural competencies in order to advance to senior level. By the time the student graduates, he/she must show competency in interventional procedures by performing the skills during actual procedures. How many students do you accept each year? We are one of the programs in the Sentara School of Health Professions, which markets all six of its programs. Last year we received 67 applications, which reflects over a 100% increase from previous years, and accepted 17 (which reflects a 75% increase over previous years). Of those accepted, 8 are dedicated to the invasive tract. Applicants must choose which modality they want prior to admission, to ensure we do not overload the clinical sites. I attribute the increase in applications to not only the increased marketing of the various programs, but also to the increased awareness of heart disease across the nation. What backgrounds do students generally have? Our students come to us with a wide range of backgrounds. Some of them have a degree in exercise science or biology, and have heard of the profession from their professor or during their clinical rotations in cardiac rehab. Others have been working for years in other careers, but have always been interested in the medical profession and decided to change careers. Some of our applicants are introduced to the field of cardiology because one of their family members has cardiovascular disease. What is your program’s annual tuition? The program is an 18-month program and the total cost of the invasive track is $8622.00 (tuition and fees). This price does not include the cost of uniforms and books. What textbooks, CDs, and websites are used in your classes? There are several books the students are required to purchase during the program. Some are: ECG Workout Exercises in Arrhythmia Interpretation, 4th ed. (Jane Huff); Pathophysiology of Heart Disease, 3rd Ed. (Leonard Lilly); The Cardiac Catheterization Handbook, 4th Ed. (Morton Kern); Invasive Cardiology: A Manual for Cath Lab Personnel (Sandy Watson); A Guide To Interpretation of Hemodynamic Data in The Coronary Care Unit (Scott Sharkey). The school has a wide variety of videos and CDs, all are available to the students in the Learning Resource Center (LRC). The 18 computers in the LRC also provide Internet access and computer applications. The LRC allows the student to use these resources at their leisure and can assist them with some of their projects. Technical support is on site and accessible. The School has recently moved into a new facility, with larger didactic classrooms as well as skills labs. The program has a skills lab that simulates a cardiac catheterization procedure room. The room consists of an old Marquette monitoring system, a table for tray set up, a Medrad injector, a HP monitor, and a mannequin on a stretcher for practicing patient prep and simulation of procedures. The invasive students also practice catheter exchange with Angiogram Sam, a model of the aortic tree and the coronary arteries around the heart. The skills lab provides the student with an opportunity to practice their skills before going into the clinical setting. What types of clinical experiences do you offer students? Currently the invasive students receive a total of 1,530 clinical hours during the 18-month program. The students are sent into the clinical arena for observation in the first semester. In the following semesters, the students may rotate through 7 different clinical sites. Their rotation includes experience at hospitals that are primarily diagnostic centers, as well as experience at the larger teaching hospital of Sentara Norfolk General Hospital, to gain experience with interventional procedures and work with patients with heart transplants. Later, they will also rotate through the EP labs and visit Children’s Hospital of The Kings Daughter for pediatric experience. Since the School is part of Sentara Healthcare, the students are fortunate to receive the majority of their clinical training at Sentara Norfolk General Hospital which was listed #21 in the Top 50 Heart Hospitals by U.S. News & World Report for 2003. How hands on does the student become and when do they start this exposure? In the first semester, I accompany each student into the cardiac catheterization lab to practice skills learned in the lab, such as sterile technique, gowning, and gloving. By the second semester, the student will be sent to outlying sites to concentrate on the scrub position of a diagnostic procedure under the guidance of experienced preceptors. While at Sentara Norfolk General Hospital, I assist the student during the procedure in the scrub position. Later they will begin to participate in the float and monitor position of the procedure and will eventually perform the role under the guidance of preceptors or myself. By the time the student graduates, the student must show competency in the various roles during an interventional cardiac catheterization Are your students cross-trained? In the first semester, all of the students are introduced to the various modalities, including echocardiology, peripheral vascular ultrasound, and invasive cardiac catheterization. The students primarily concentrate on their chosen profession by the end of the first semester. In the invasive role they will be exposed to peripheral intervention in the endovascular lab at Sentara Norfolk General Hospital. Who does your classroom and clinical teaching? Currently, the CVT program has two full-time faculty members and one part-time faculty member. The Program Coordinator is Kathy Butterbaugh. I am the invasive clinical instructor and Elizabeth Cesar is a part-time clinical instructor in echocardiography. We are currently searching for a part-time clinical instructor for the peripheral vascular track. The Program Coordinator teaches EKG I and II, Cardiovascular Pharmacology, and Cardiovascular Disease States II. Elizabeth Cesar teaches all other related subjects of echocardiography. I teach all related subjects in invasive cardiology along with Cardiovascular Disease States I, Hemodynamics I and II, and Vascular Pathology I and II. In addition, I am responsible for the clinical instruction and supervision of the invasive students. The School is also fortunate to have RN faculty from other programs to assist with the core courses of Fundamentals of Health Care, Introduction to Pharmacology, and Communications for the Health Care Provider. What is the employment outlook for your graduates? Excellent. The majority of our students are hired within the Sentara Healthcare system. Some move soon after graduation and have had no trouble acquiring jobs when they relocate. Invasive students have had a 100% employment rate since 1993. What are typical starting salaries for graduates? The starting salary, of course, varies with the various modalities. The salaries range from $15.70 to $18.00 per hour. The invasive student can also receive case rate, overtime, and call pay. A typical salary for a first-year invasive student could be in the range of $40,000 per year. What career opportunities have past graduates experienced? Several of our students have begun within the Sentara Healthcare as a Tech I and advanced to a Tech II within a couple of years. Dependent on the student’s career goals, some have advanced to the role of team leader. Some of the students have accepted management roles within the system as well. While several have gone on to pursue the role of clinical specialists or sales representative with industries, others have taken up the role of a traveling technologist. Is there currently a demand for graduates of accredited CVT programs and will there be demand in the future? Absolutely! Most of the area hospitals have recognized the strengths of our students during their rotations. Since our program’s accreditation in 1991, we have continued to reassess the strengths of the students graduating from the program and compared ourselves to others. Some of the area hospitals continue to do on-the-job training (OJT), but recognize that the person who does OJT must already have knowledge in some aspect of the medical profession to be successful. Our students are capable of taking the registry as soon as they graduate, while the OJT individual may have to wait an additional 18 to 24 months to take the registry. The cardiologist generally appreciates the knowledge of the Registered Cardiovascular Invasive Specialist (RCIS) and insists that they are part of the team. How successful have graduates been at passing the RCIS exam? The program recommends the graduate student take the RCIS exam immediately upon graduation. Since 1993, 42 invasive students have graduated. We received data on 38 of the 42, and 34 had passed the RCIS exam on the first attempt. How has the CVT program evolved over the past 5 years? Not only has the school grown in the number of students, but we have recently seen the need for more dedicated faculty to improve the outcomes of the program. 1) In 1999, all of the programs under the Sentara School of Health Professions changed their curriculums to a competency-based program. 2) Instead of relying on preceptors to evaluate the student, the student must now demonstrate competency under the direct observation of the clinical instructor. 3) The program has increase enrollment by 75% and we are looking for additional faculty as we continue to grow. What advice can you give to students considering CVT School? The cardiovascular profession is ever-changing. With the increased awareness across the nation of heart disease, and the improvements in interventional therapies, there has been more emphasis on the procedures that require an invasive cardiovascular technologist. Upon entering the CVT program, the student will be introduced to exciting developments in the treatment of cardiovascular disease. The program can be very intense at times, but the student must keep in the mind the importance of the diagnosis and treatment of the patient. The cardiovascular profession is a very rewarding occupation. The best CVT is one who is open-minded, willing to change and grow with the profession, and focus on the two main goals of quality and safety for the patient. What do you consider unique about your program? Our program is unique because it is one of the few accredited hospital-based programs in the country and it is competency-based. In addition, students receive clinical experience in one of the top cardiac centers in the country. Can you share a particularly proud teaching moment? I have had several proud moments in teaching. I have had times when I’ve seen the all-too-familiar light bulb go off after weeks of tutoring a student who is having a difficult time with a particular subject. I can also remember the feeling I had when I saw one of my graduates working on a patient in cardiogenic shock and was instrumental in saving that patient’s life. Equipment and procedures change so fast that I try to keep up to date doing lunch relief for staff in the lab and there have been times when one of my graduates have taught me a thing or two on new techniques. I am aware of the importance of continuing my education because every day it seems there is something new to learn. I teach because I like it, but when I have a student tell me I have made a difference in their life, that hits home like nothing else. A question for students. Why did you choose to become a CVT? The heart and all of its functions has always fascinated me and I always wanted to learn more information. This was a great place to start. I will be learning something new every day. My only regret is not doing it earlier in my career. Lisa Lockwood, 2nd year student Previously, I worked in the fitness and wellness business. I wanted to make the progression to work in the medical field. I had a friend that worked as a CVT and she suggested that I look into the school that SNGH (Sentara) offered. After researching the position and observing what I would be doing, I decided to apply. I was accepted and will be graduating in less than 9 weeks. Michelle Doss, 2nd year student My paramedic training gave me a great deal of respect for the heart. I knew I wanted to pursue an education that would further my understanding of the heart and allow me to make a difference in the lives of people with cardiac problems. Vanessa Ervin, 2nd year student There is a great opportunity in this field. With all of the new technology and equipment available, good things are happening. Becoming a CVT gives me the opportunity to take patient care to the next level. I can follow the patient from start to finish and know that I helped to give them a better quality of life than when they first walked through the doors. Megan Hunsinger, 1st year student After graduating from college, I felt as though my job opportunities were limited until I was introduced to cardiovascular technology. For me, it is the ideal field a fast-paced environment, with state-of-the-art technology, where patient’s lives are being improved every day. Kelly Metroka, 1st year student I chose to become a CVT for many reasons: the opportunity to work with people, good pay, and advancement potential. The field of cardiology is ever-growing and changing and I saw an opportunity to be involved in that. Stephanie Bishop, 1st year student I was a secretary for a cardiology office when I first saw an echocardiogram being performed. It amazed me that the heart we were looking at on the monitor is the primary thing keeping the patient alive. Even to this day, when I see that beating heart I am just as intrigued as I was that first day. Jennifer Boston, 1st year student Since I was a little girl, it has been my dream and desire to be a part of the medical profession. When I decided to pursue a medical career, the challenge was trying to decide which field of medicine to study. What tipped the scale toward cardiovascular technology was my fascination with the heart. My father, at the age of 51, had to have his first pacemaker inserted because of third degree heart block. He’s 77 now and had his 6th pacemaker in March of 2003. My sister Jacqueline was a cardiovascular technologist for many years and served as a supervisor in the cath lab for the U.S. Army. I was intrigued and fascinated with the techniques, disease states, and the fast-paced environment, which she talked about frequently. Yolanda Davis, 1st year student Becoming a CVT will allow me to work in a fast-paced environment that will continually challenge me to grow. More importantly, it’s my opportunity to make a difference. Kathy Dellinger, 1st year student
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