New93 role standards, now public
MedTality
Role standards

Imaging and diagnostics

Diagnostic medical sonographer

What a newly credentialed sonographer must do without supervision: confirm the patient and the question, acquire a complete and technically sound study, recognise the finding that cannot wait and get it to a physician before the patient leaves, and do all of that without ever telling anyone what the images show. Drawn from the clinical standards the sonography profession publishes for its own scope of practice.

Practice this assessmentHire for this role
Expectations
10
Safety red lines
4
Sources
3
Version
1

Built from Society of Diagnostic Medical Sonography, American Registry for Diagnostic Medical Sonography (Inteleos). Reviewed by clinicians, last on .

01What the role is measured on#

Every verdict is made of the same five dimensions. Each is scored on its own, so a candidate sees where they are strong and where to work.

  • Clinical skillsThe hands-on and judgement work of the role: recognising what matters, acting in the right order, and knowing when something cannot wait.
  • Workflow and toolsGetting the work done in a real setting: the systems, records, equipment and handoffs the role runs on, used correctly and on time.
  • Patient communicationHow the role talks with patients, families and colleagues: listening, explaining plainly, and confirming what was understood.
  • Compliance and safetyThe rules that protect people: privacy, consent, infection control, reporting duties and the safety checks the role is accountable for.
  • Role knowledgeKnowing the job itself: what the role is responsible for, where its scope ends, and who to bring in when it does.

02What a ready hire does#

What a competent diagnostic medical sonographer does on day one, dimension by dimension.

Clinical skills

  • Confirms the patient, the exam and the clinical question, then acquires every required image of a complete protocol and adapts the technique when the patient or the anatomy will not allow the standard approach.
  • Recognises normal from abnormal well enough to know what to image, what to measure and what cannot wait, without ever calling it a diagnosis.

Workflow and tools

  • Judges whether the study is diagnostic before the patient leaves the table, corrects what can be corrected, and declares what cannot.
  • Records the study and its technical observations so that the interpreting physician can rely on it, without straying into interpretation.

Patient communication

  • Stays present and honest with a patient who knows something is wrong, without confirming, denying or hinting at what the images show.
  • Conducts an intimate or uncomfortable examination so that the patient keeps control of what happens to their body.

Compliance and safety

  • Confirms the patient, the order, the side and the clinical indication before starting, and stops when any of them does not match.
  • Gets a time-critical finding to an interpreting physician while the patient is still there, and confirms it was received and owned.

Role knowledge

  • Knows that producing the study and interpreting it are different acts, and never crosses from one to the other whoever is asking.
  • Reprocesses each transducer to the level its contact requires, and treats a sheath as protection rather than as a substitute.

03Safety red lines#

Any one of these keeps a candidate from Ready Day One, whatever the rest of the score. They are published so nobody meets them for the first time in the assessment.

  • Tells a patient, a relative, a nurse or a referring clinician what the images show or what it means, or gives clinical advice on the strength of their own reading, including confirming a fetal demise or ruling out a diagnosis.

    Interpretation is the physician's act and the sonographer's impression misleads in both directions; a patient told the wrong thing by the person holding the probe cannot unhear it, and a false reassurance sends them home.

  • Lets the patient leave, or ends the shift, with a time-critical finding sitting in an unread worklist, or treats telling a receptionist or a porter as having escalated it.

    A leaking aneurysm, an ectopic pregnancy, a torsion or a proximal deep vein thrombosis kills within hours, and the delay between the image and the physician seeing it is the only part the sonographer controls.

  • Begins or completes a study without confirming the patient's identity against the order with two identifiers, or scans a different exam or side than ordered and submits it as though it were the ordered study.

    A study filed to the wrong patient produces a diagnosis for one person and a false clearance for another, and both errors travel onward in the record.

  • Completes a worksheet with duplicated, carried-forward or fabricated images or measurements, or submits a study as complete and diagnostic when required views were not obtained and the limitation is not recorded.

    The interpreting physician reports what they are shown; a fabricated or silently incomplete study produces a negative report on a region nobody actually looked at.

04Outside the role#

Knowing where the role stops is part of the standard. Going past it is not extra credit.

  • Does not interpret images or communicate findings, results or a diagnosis to patients, families or non-interpreting staff.Provides technical observations to the interpreting physician within the facility's policy, and leaves the result to the clinician responsible for it.
  • Does not perform a study without an order and a clinical indication, and does not perform non-medical keepsake fetal imaging.Confirms the order and indication, and refers a request without one back to the referring clinician.
  • Does not administer contrast agents or other medications without the required education, demonstrated competence, supervision and jurisdictional authority.Follows the facility protocol for who may administer, and escalates to the supervising physician.
  • Does not prolong exposure or raise acoustic output beyond what the diagnostic question needs, particularly in obstetric scanning.Works to as low as reasonably achievable, watching thermal and mechanical index, and ends the study when the question is answered.
  • Does not scan in a specialty area they are not credentialed and competent in.Says so plainly and arranges the study with someone who is, rather than attempting it because the patient is already there.

05How it is assessed#

  • A spoken assessment

    An examiner talks the candidate through realistic cases from this role, and follows up the way a senior colleague would.

  • Five dimensions

    Each answer is read against the expectations above and rated on the same four-level scale.

  • The 70 bar

    Every scorecard shows the score against 70, overall and for each dimension, with the reason for the verdict.

  • Safety first

    Crossing one of the safety red lines holds a pass back, however strong the rest was.

The four levels

  1. Not yet
  2. Developing
  3. Proficient
  4. Exemplary
How a verdict is made

06Sources and review#

Drawn from the certification frameworks and practice standards below, and reviewed by clinicians. Version 1, last reviewed .

Cited as sources. Not an endorsement by the organizations named.

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