Mr Paul Stoneman, Cardiology Advanced Nurse Practitioner at Beaumont Hospital, Dublin, explains why completing BSE Level 1 accreditation has had a transformative impact on his practice.
Achieving BSE Level 1 echocardiography accreditation in May 2026 has been one of the most professionally satisfying educational journeys of my career.
Although I work within acute cardiology practice and provide acute cardiovascular assessment daily, the process reinforced just how much there still is to learn when developing structured echocardiographic competence. It was both humbling and rewarding.
The BSE Level 1 accreditation process is rightly regarded as the gold standard foundation for clinicians seeking competency in focused echocardiography practice. The structure, governance, quality assurance, and standardisation embedded within the accreditation pathway ensure that candidates develop not only technical scanning ability, but also safe interpretation skills, awareness of limitations, and when to escalate. At a time where focused cardiac ultrasound is increasingly utilised across acute care settings, the value of a nationally and internationally respected accreditation framework is enormous; providing clinical credibility.
One of the most important aspects of the journey was the mentorship I received from my BSE Level 2 accredited cardiac physiologist mentor, Sinead O'Neil, who supported me throughout every stage of the process.
The value of experienced supervision, structured feedback, and protected learning cannot be overstated. The accreditation process is rigorous for good reason, and high-quality mentorship makes a substantial difference.
For anyone undertaking the pathway, one key practical lesson, that I learned the hard way, is that the logbook cases must be genuinely unique.
Individual cases cannot be reused across multiple pathology categories to demonstrate different findings. This is an important point that future candidates should understand early on in the process.
Another major advantage was completing the BSE Level 1 case library.
The 150-case library was invaluable and, in my experience, definitely provided an edge in the written examination. Repeated exposure to structured pathology recognition, standardised imaging interpretation, and normal versus abnormal variation greatly improved both confidence and pattern recognition under exam conditions.
From an Advanced Nurse Practitioner perspective, the impact of the BSE Level 1 framework on acute cardiology practice in the emergency department is profound.
Within a high-volume ED cardiology service, the ability to rapidly identify significant ventricular dysfunction, major valvular pathology, pericardial effusion, right ventricular strain patterns, or gross volume status abnormalities can meaningfully influence early decision-making, escalation, risk stratification, and patient flow. Importantly, the accreditation framework also consolidates safe governance and clinical boundaries, ensuring that focused echocardiography complements rather than replaces comprehensive echocardiographic assessment.
Overall, the experience has strengthened both my clinical practice and my appreciation for the expertise of cardiac physiologists and echocardiography services.
It has also reinforced how important robust accreditation standards are in maintaining patient safety and clinical credibility as focused echocardiography expands across acute healthcare settings.
I would strongly encourage anyone considering BSE Level 1 accreditation to commit fully to the process. It is demanding, rigorous, but unquestionably worthwhile.