DIACF-AD Diagnostic Cardiac Sonography - Echocardiography

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Overview

This program will run in its current format for the August 2020 start date. Please review the admission requirements and submit your application as soon as you can meet the requirements and related deadlines. Please note the design and delivery of this program are currently under review, and changes are expected for the August 2021 start date. Changes will be posted on this website.

  • One-year 12-month Advanced Diploma
  • August entry date 
  • Annual application deadline: January 15
  • Clinical work experience
  • Notre Dame Campus
  • Due to high demand, this funded program is open to Manitoba residents only. Applications received from Non-Manitoban residents for this program, will be cancelled and the application fee will not be refunded.
  • If you have a criminal record you may not be able to complete this program. If you are listed on a Child Abuse Registry or Adult Abuse Registry you will not be able to complete this program. See Admission Requirements for more info.
  • Learn about this program by ATTENDING AN INFORMATION SESSION. The session is approximately 60-90 minutes and will cover general program information, admission requirements, and how to apply. Sign up for a session that best fits your schedule.

Description
Diagnostic Cardiac Sonography, also known as Echocardiography, is a technology involving the application of high-frequency sound waves on patients to aid in cardiac diagnoses. As part of the patient care team, Diagnostic Cardiac Sonographers assess patients and provide information to Cardiologists for diagnoses and monitoring patients' health statuses.

The Diagnostic Cardiac Sonography program prepares students, through theoretical and clinical training, to conduct Echocardiography examinations, focusing on the heart. This content is cross-referenced to the national competency profile set up by Sonography Canada.

This is a specialized profession requiring a high degree of technical skills and hand eye coordination, and exceptional interpersonal skills.

As part of training, students will perform scans on each other therefore all students must be agreeable to participate in scanning procedures. 

Sonography Canada administers the Canadian credentials. To qualify for certification as a Cardiac Sonographer, candidates will be required to successfully complete two exams:

  1. The Core Sonographic Examination - cost $200.00
  2. The Cardiac Sonographer Examination - cost $250.00

The certification application fee is $100.00.

Admission Requirements

If your academic history includes any of the following, please visit me.rrc.mb.ca/Catalogue/Information/MyEducation for important information: post-secondary studies at an institution other than Red River College; Modified (M), English as an Additional Language (E), or GED high school courses; or home schooling.
ADMISSION REQUIREMENTS ARE DUE WITHIN 30 DAYS OF APPLYING (unless otherwise noted below).

Your application will be cancelled without a refund of the non-refundable/non-transferable application fee if you apply:

  • While still enrolled in the academic requirements listed in 1, 2, and 3 and cannot submit proof of successful completion within 30 days of applying
  • Before completing admission requirements 4, 5 and 6 and therefore cannot submit proof of completion within 30 days of applying

This is a special selection program. Offers of admittance will be made based on Multiple Mini Interviews results in descending order until all available seats are filled. Therefore, not all applicants who meet admission requirements will be offered a seat. Applicants who meet admission requirements but do not receive an offer of admittance may reapply for a future academic year by submitting a new application and application fee.

Annual application deadline: January 15

We require verification of your complete academic history including any public or private high school, college, university, or technical institutions you have attended.

Post-secondary transcripts must have been issued within 6 months prior to your application date, and submitted in a sealed envelope directly from the post-secondary institution.

If you are required to complete an English language assessment, do not submit your transcripts until requested to do so.  See Regular Admission Requirement 4 for more information.

Regular Admission Requirements

  1. Post-Secondary Education
    • Submit proof of having successfully completed 18 or more credits of degree-level (1000 level or higher) post-secondary education including:
      • 12 or more credits of Science
      • A maximum of 6 credits of Arts and Humanities may be applied towards the required 18 credits
    • A minimum grade of 65% or 'C+' is required in each course
    • Degree-level (1000 level or higher) courses approved by the degree granting institution as meeting Science or Arts and Humanities requirements will be accepted.  However, Human Anatomy and Physiology (6-credits) and Medical Terminology (3-credits) cannot be used to fulfill this requirement
      and
  2. Human Anatomy and Physiology (6-credits)
    • Submit proof of successful completion of 6-credits of Human Anatomy and Physiology
    • Courses must include a lab component
    • A minimum grade of 65% or 'C+' is required in each course
    • You must have completed the course(s) within five years of your application date. Examples:
      • January 15, 2020 application date, course completion must be on or after January 15, 2015
      • April 30, 2020 application date, course completion must be on or after April 30, 2015
        and
  3. Medical Terminology (3-credits)
    • Submit proof of successful completion of 3-credits of Medical Terminology
    • A minimum grade of 65% or 'C+' is required
    • You must have completed the course(s) within five years of your application date. Examples:
      • January 15, 2020 application date, course completion must be on or after January 15, 2015
      • April 30, 2020 application date, course completion must be on or after April 30, 2015
        and
  4. Reading Skills or English Language Assessment
    • Before applying, determine which assessment (DRP or ELA) is appropriate for your situation.
    • We strongly advise you complete the assessment before submitting your application to ensure you meet required levels.
    • Assessment results must be dated no more than two years prior to your application date.
    • Have you successfully completed the equivalent of three years of full-time secondary (high school) education in Canada, the United States, or an ELR exempt country where English was the language of instruction? To view a list of ELR exempt countries click here.
      • If yes, you appear to meet English language requirements.
        • Before applying, register for and successfully complete the Degrees of Reading Power (DRP) assessment. The minimum DRP score required for this program is 71.
        • After meeting the minimum DRP score, submit your application and transcripts for verification purposes.
          or
      • If no, you are required to meet English language requirements.
        • Before applying, successfully complete an approved English language assessment at the required levels.
        • After meeting the required levels, submit your application and assessment results. 
          or
      • If you completed all of your education in Canada, the United States, or an ELR exempt country in English but did not complete three years of high school, submit your transcripts for verification purposes and complete the Degrees of Reading Power (DRP) assessment.
        and
  5. First Aid Course
    • Submit proof of current certification in the appropriate First Aid course.  To confirm which course you need to complete for this program click here
      and
  6. Applicant Declaration for Check Documents Form
  7. Multiple Mini Interviews (MMIs)
    • Participate in MMIs
    • MMIs is an interview format that uses many short independent assessments in a timed circuit
    • Scores generated by a measuring tool help predict program success
    • This item is not due within 30 days of applying. Dates for MMIs in 2020 are March 21, 22, 28 and 29. These dates are tentative and are subject to change.
    • If you meet admission requirements 1 to 6 you will be sent an e-mail in early March confirming the dates and registration process, and inviting you to attend a voluntary MMIs preparatory workshop.

Program Progression Requirements
Program progression requirements are not due within 30 days of applying and should be submitted after you start classes.

  • Criminal Record and Adult and Child Abuse Checks
    • This program requires students to submit current original/official versions of one or more of the following checks:
      • Criminal Record Check (CRC)
      • Provincial Child Abuse Registry Check (CAR)
      • Adult Abuse Registry Check (AAR)
    • If you have a criminal record you may not be able to complete the program
    • If you are listed on an Abuse Registry you will not be able to complete the program
    • For details on this program's requirements, when to obtain and submit the documents, review the Applicant Declaration for Check Documents Form
    • These documents have expiration dates and should not be obtained prior to timeline indicated on the Applicant Declaration for Check Documents form
    • For general information on why RRC requires these checks and for links to check providers such as the Winnipeg Police, visit our Criminal Record Checks webpage
    • Submit your check documents to the RRC program contact listed on the Contact Information section of your program
      and
  • Immunizations and Testing

All Allied Health programs have Multiple Mini Interviews (MMI) as part of their admission process.

WHAT IS MULTIPLE MINI INTERVIEWS (MMI)?

In an MMI, applicants will complete a 1.5 hour circuit of approximately eight, 10-minute mini-interview stations, rotating from station to station. At each station, candidates will be presented with a ‘scenario’ or question. They will then have the opportunity to discuss with an interviewer before proceeding to the next station.

MMI utilizes multiple stations where each station is comprised of a scenario designed to evaluate a candidate’s core traits/competencies critical to success in health care professions. This includes competencies such as problem solving, critical thinking, teamwork, responsibility, ethical and moral judgement, self-awareness, conflict resolution and management skills. Applicants have essentially 7 to 8 minutes to respond. Once completed, the interviewer rates the applicant in predetermined areas using a rubric and rating scale. In the end, the scores from all stations are totaled for an overall score for each applicant. Applicants are then ranked accordingly and offered a seat in the program.

Applicants who have applied to more than one AHS program will only participate in one Multiple Mini Interview session.

WHAT MIGHT I SEE IN AN MMI SCENARIO?

As in any examination process, the actual scenarios will remain confidential. Here is one example.
Recently, the Prime Minister of Canada raised the issue of deterrent fees (a small charge, say $10, which everyone who initiates a visit to a health professional would have to pay at the first contact) as a way to control health care costs. The assumption is that this will deter people from visiting their doctor for unnecessary reasons.
Consider the broad implications of this policy for health and health care costs. For example, do you think the approach will save health care costs? At what expense?
Discuss this issue with the interviewer.

NON-COGNITIVE QUALITIES

Being a healthcare practitioner is a moral undertaking, and our admission process aims to admit students:

Who will in their behaviors reflect the following attributes

  • Responsibility
  • Empathy
  • Integrity

Who will in their professional relationships

  • Take responsibility for their actions
  • Act ethically
  • Act in a collegial and collaborative manner
  • Be reflective
  • Be reliable
  • Be trustworthy and honest
  • Demonstrate respect for others
  • Maintain confidences

We aim to admit students who will

  • Be self-directed learners
  • Be an integral part of an interprofessional healthcare team
  • Be willing to self-assess
  • Be willing to work hard
  • Communicate effectively
  • Demonstrate ability to manage time
  • Demonstrate ability to tolerate stress
  • Demonstrate good judgement
  • Recognize and respect the roles of other healthcare disciplines

On the Day of your Interview:

  • Arrive at least 30 minutes prior to your start time.
  • Bring a piece of photo identification. You do not need to bring anything else. We will have a coatroom to leave your belongings, but you are not permitted to bring anything into the MMI other than what we give you.
  • Avoid wearing perfume and scented products.

The Academic Success Centre offers optional Workshop/Information Sessions for the MMI during the month of March. Information about the workshop is emailed to applicants.

Please note:
Any applicant requiring accommodation for a documented disability for the MMI must notify the Allied Health Sciences Department in writing 5 business days prior to the first interview date at ahsadmissions@rrc.ca. Complete documentation must be provided to support the request.

English Language Assessments

English Language AssessmentMinimum Required Levels
L - Listening, S - Speaking, R - Reading, W - WritingLSRW
CAEL (Canadian Academic English Language)
70707070
CanTEST (Canadian Test of English for Scholars and Trainees)
RRC Institutional or Official CanTEST accepted EXCEPT for the Medical Laboratory Sciences (MLS) program. The MLS program requires the Official CanTEST (the RRC Institutional CanTEST will not be accepted).
4.54.54.54.5
Communication for Health Professionals (RRC Pathway)
Canadian Citizens: LINC programs are not available.
8888
Communication for Internationally Educ Health Prof (RRC Pathway)
Canadian Citizens: LINC programs are not available.
8888
IELTS - Academic (International English Language Testing System)
7.07.07.07.0
TOEFL-iBT (Test of English as a Foreign Language - internet Based Test)
24232427

Who Should Enrol?

You may be interested in a career in Diagnostic Cardiac Sonography if you:

  • Desire to work in a medical environment
  • Are compassionate and motivated to help the sick and injured
  • Have a strong academic background, especially in science
  • Have an aptitude for effective communication
  • Are able to cope with constant changes in technology and in your work environment
  • Have an eye for detail, excellent analytical and critical thinking skills, and good spatial reasoning
  • Have excellent hand eye coordination
  • Have excellent people skills
  • Understand the responsibility of your role within the diagnostic medical team
  • Have good computer skills

When working in the health care profession, there are many physical and emotional demands.  As a Diagnostic Cardiac Sonographer, you must:

  • Be in good physical and mental health, and be able to stand or walk for extended periods of time without resting
  • Have the ability to lift 50 pounds
  • Be able to push and pull, and bend and stoop routinely
  • Have full use of both hands, wrists, arms and shoulders
  • Have the ability to operate the scanner controls and the transducer simultaneously and effectively
  • Be able to distinguish audible sounds
  • Have the ability to identify colour distinctions in order to adequately view sonograms
  • Demonstrate the use of safe and effective body mechanics while working with patients
  • Be able to safely lift, transfer, and position patients, some of whom may be in a state of unconsciousness or who may be large and heavy and have limited or no weight bearing capabilities
  • Be able to interact compassionately and effectively with the sick and injured
  • Communicate effectively with patients and other health care professionals
  • Have the ability to organize and accurately perform the individual steps in a sonographic procedure in the proper sequence

Additionally, you may:

  • Experience repetitive strain injuries
  • Be exposed to extreme patient injuries
  • Be required to work extended hours
  • Be exposed to infectious diseases, blood and bodily fluids, toxic materials, noise, allergens, and physical and emotional stress
  • Encounter aggressive and agitated patients, visitors, and staff
  • Experience physical and compassion fatigue 

Locations, Dates and Fees

Next Estimated Term 1 Start Date (subject to change)

Location Start Date Apply Link
Notre Dame Campus Aug 31, 2020 Apply now

Costs (estimates only; subject to change)

Program/Student Fees
Year 1
$6,598.001
Books and Supplies
Year 1
$1,000.002
Other Fees
Year 1
$800.003
1Includes three clinical terms
2To be determined
3Sonography Canada Certification Exam Fee (approximate)

Red River College is a participating institution in the HigherEdPoints program. Through this program, students are able to convert Aeroplan® Miles and TD Points into funds to help cover their tuition. Family members and friends can also contribute to a student’s education by converting their loyalty points - anyone can donate their points to an individual student.

Visit the HigherEdPoints website for more information about the program and/or to set up an account to convert your points.

Courses and Descriptions

(Click the course name to view the description of the course)
Year 1
Term 1Credit Hours
ULTR-1001DMS Physics 1
3
Term 2Credit Hours
ULTR-2001DMS Physics 2
4
Term 3Credit Hours
Term 4Credit Hours
Term 5Credit Hours
Recognition of Prior Learning (RPL)
In addition to Transfer of Credit from a recognized post secondary institution, other RPL processes are available for RPL courses. Click here for more information. For courses with no RPL, please check www.rrc.ca/rpl for additional contact information.
MEDL-1032Interprofessional Education
More Information

A clear understanding of interprofessional relationships is necessary for effective patient care in the clinical setting. Interprofessional education will develop the learners’ understanding of their role and the role of other professions in the health care team. The course covers topics such as health sciences professions, collaboration, consultation, team-building, and developing partnerships through active presentations, discussion, and interaction between all students registered in programs of the department of Allied Health Sciences.

MEDL-1032Interprofessional Education
More Information

A clear understanding of interprofessional relationships is necessary for effective patient care in the clinical setting. Interprofessional education will develop the learners’ understanding of their role and the role of other professions in the health care team. The course covers topics such as health sciences professions, collaboration, consultation, team-building, and developing partnerships through active presentations, discussion, and interaction between all students registered in programs of the department of Allied Health Sciences.

MEDR-1022Medical Terminology
More Information

This course is a self-study course. The course focuses on study of prefixes, suffixes, combining forms from which medical terms are derived. Medical abbreviations are also included.

ULTR-1001DMS Physics 1
More Information

This course introduces the physics and instrumentation relevant to the safe and effective practice of diagnostic medical sonography.  The following topics will be covered: sonographic terminology, the physics of sound, pulsed ultrasound, sound amplitude, power and intensity, sound attenuation, the interaction of sound in tissue, diagnostic ultrasound transducers, ultrasound sound beams and focusing, spatial and temporal resolution, real-time scanning and real-time timing, and ultrasound instrumentation.

ULTR-1006Cardiac Sonography 1
More Information

This course introduces cardiac sonography and cardiac scan techniques. It is designed to enable the student to recognize and understand normal anatomy, physiology, and the sonographic appearance of the heart. Diagnostic Cardiac Sonography 1 integrates anatomy and physiology with sonographic principles in the imaging of the heart. The focus of this course is on the assessment and interpretation of patterns in the normal heart as seen with Two Dimensional, M-mode, and Doppler (color, CW, and pulsed wave) imaging. The focus of the course then shifts to the etiology, hemodynamics, signs and symptoms, and sonographic patterns as relevant to the interpretation and quantification of cardiac disease including mitral, aortic, tricuspid, pulmonary, segmental wall anatomy, coronary artery, cardiomyopathy, heart failure, hypertension (systemic and pulmonary), cardiac masses, pericardial disease, cardiac masses, prosthetic heart valves, diseases of the aorta, and Diastolic Function (provocative maneuvers). The course will integrate theory and laboratory practices.

ULTR-1007Cardiac Laboratory Techniques 1
More Information

Cardiac Laboratory Techniques 1 and Laboratory Modules introduce students to sonographic imaging of the heart. The course will teach communication, professional responsibility, patient care, PHIA, ergonomics, and workplace safety with the operation of sonographic equipment in the creation and interpretation of 2 Dimensional, M-mode and Cardiac Doppler imaging. These topics will be reinforced in Cardiac Laboratory Techniques 2, as well as the clinical practicum.

ULTR-1008Cardiac Practicum 1
More Information

The focus in Term 3 is to build on the theoretical knowledge learned in the didactic phase of the program and application in a clinical setting. This term should reinforce the practical skills introduced in DCS Laboratory Techniques 1 and 2. The main focus of Term 3 clinical will be the introduction and participation in an Echocardiography departmental setting, while under the supervision of qualified professionals; the student should demonstrate increasing independence and progress from a novice performance level to entry level of competency in the profession of Cardiac Sonography (Term 5). During Term 3 the students will be introduced to scanning of actual patients, while applying and strengthening:  theoretical knowledge, recognition of theoretical pathology, patient care skills, patient history taking, the completion of a cardiac technical impression, case presentation to a Cardiologist as required, all while participating in all aspects of an Echocardiography Department. 

Prerequisites:
ULTR-1009Human Workplace Relations 1
More Information

This course is designed to develop the student’s awareness and demonstration of safety practices when performing ultrasound exams and transporting equipment. It will identify the principles and application of Routine Practices, Medical Techniques, patient care, patient transfers, cultural awareness, and ethics and professionalism as per Sonography Canada.

ULTR-2001DMS Physics 2
More Information

This course builds upon the content in ULTR-1001 covering the physics and instrumentation relevant to the safe and effective practice of diagnostic medical sonography. Specific topics covered included Instrumentation, Doppler, Artifacts, Quality Assurance, and Bioeffects.  

Prerequisites:
ULTR-2006Cardiac Sonography 2
More Information

Diagnostic Cardiac Sonography 2 is a continuation of Diagnostic Cardiac Sonography 1. The focus of this course has shifted to the etiology, hemodynamics, signs and symptoms and sonographic patterns as relevant to the interpretation and quantification of cardiac disease processes, including, Diastolic Function, Cardiac Embryology and Fetal Circulation, and Congenital Heart Disease. Sonographic techniques and modalities such as Transesophageal Echocardiography, Stress Echocardiography, Contrast Echocardiography and Provocative Maneuvers, and 3D/RT3D (4D) Echocardiography will also be covered in this term.  Students will be challenged throughout this course to fully appreciate the many variables and factors in the accurate assessment and documentation of cardiac pathology. 

Prerequisites:
ULTR-2007Cardiac Laboratory Techniques 2
More Information

Cardiac Laboratory Techniques 2 will continue to teach communication, professional responsibility, patient care, PHIA, ergonomics, and workplace safety with the operation of sonographic equipment. Using appropriate safety techniques, students will complete final preparations for clinical practicum by transitioning to complete independent cardiac sonography examinations (routine/protocol). 

Prerequisites:
ULTR-2008Cardiac Practicum 2
More Information

While participating in Echocardiogram examinations performed in the clinical sites Echocardiography Department (under direct clinical supervision) students will build upon the theoretical knowledge gained from the didactic phase of the program. Skills learned in ULTR-1008 are expanded, and an increasing level of independence from novice to entry to practice should be demonstrated. Throughout ULTR-2008 the students will continue to scan patients (hands-on experience), while applying and strengthening: theoretical knowledge, recognition of theoretical pathology, patient care skills, patient history taking, the completion of a cardiac technical impression, case presentation to a Cardiologist as required, all while participating in all aspects of an Echocardiography Department.  

Prerequisites:
ULTR-2009Human Workplace Relations 2
More Information

This course is designed to complement the material taught in Term 1 and provide the students with tools/techniques they can utilize in their hospital training and future roles as sonographers. The content in this course will cover Department communication procedures and how to handle an emergency situation; Differing hospital codes; Aseptic techniques; Geriatrics and Pediatrics; Communication skills; Sensitive practices; Recognizing signs of sexual abuse, Ethics and Professionalism as per Sonography Canada.

ULTR-3005Cardiac Practicum 3
More Information

In Term 5 (last 8 week duration) of the DCS Program, students continue in their clinical practicum with an emphasis on successfully completing their Canadian Clinical Skills Assessment (CCSA). The focus in Term 5 is to continue to build on the theoretical knowledge learned in the didactic phase of the program and application in a clinical setting. The main focus of Term 5 clinical will be to build upon skills introduced in terms 3 and 4 while participating in all aspects of an Echocardiography departmental setting, under the supervision of qualified professionals; the student should be demonstrating increasing independence and progression from a novice performance level to now building into the entry level of competency in the profession of Cardiac Sonography (Term 5). During Term 5 the students will continue to scan patients (hands on experience), while applying and strengthening:  theoretical knowledge, recognition of theoretical pathology, patient care skills, patient history taking, the completion of a cardiac technical impression, case presentation to a Cardiologist as required, all while participating in all aspects of an Echocardiography Department. 

Prerequisites:

Recent Changes

Addition of Multiple Mini Interview (MMI)

The MMI process is designed to assess attributes essential for success in health professions. This process is being adopted by colleges and universities across Canada and globally as a fair and effective method of interviewing candidates for health care profession programs. 

The MMI utilizes multiple interview stations.  Each station is comprised of a scenario designed to evaluate core traits/competencies essential for success in health care professions. This includes competencies such as problem solving, critical thinking, teamwork, responsibility, ethical and moral judgement, self-awareness, conflict resolution, and management skills.

At each station, applicants will read a scenario and then respond. The interviewer(s) will assign ratings using a rubric, which is a guide listing specific criteria for grading or scoring, as well as a rating scale. In the end, the scores from all stations are totaled for an overall score for each applicant.

The MMI process is not meant to be perceived as a barrier.  It is a way of identifying applicants who exhibit critical competencies for success and those who may need additional supports prior to program entry.

Prior to participating in an MMI, applicants will be invited to attend an MMI workshop. 

Recognition of Prior Learning

Recognition of Prior Learning (RPL) is a process which documents and compares an individual's prior learning gained from prior education, work and life experiences and personal study to the learning outcomes in College courses/programs. For more information, please visit www.rrc.ca/rpl.

Graduate Employment Report

Red River College surveys its graduates on an annual basis to collect data related to the graduates’ employment status, salary, occupation and skill use. In addition, graduates are asked to indicate their level of satisfaction regarding the education they received at Red River College.

Visit www.rrc.ca/numbers/reports/graduate-satisfaction for graduate satisfaction and employment reports.

Employment Potential

Ultrasound is practiced in major urban and rural hospitals. In Manitoba there is also mobile ultrasound, where the sonographer travels with a portable ultrasound machine to service smaller rural communities. In other provinces there are also private clinics.

Some graduates are working in related teaching, management, and research positions. Others are employed as application specialists, technical advisors, or representatives for diagnostic imaging equipment and supply manufacturers.

In 2013, an entry level technologist in Manitoba could expect to make approximately $31.56 per hour as a starting wage.

As of June 2015, there is a shortage of these qualified professionals.

Contact Information

For general information about this program or how to apply, contact Enrolment Services at 204-632-2327.

For detailed program information, contact:

Shaun Lysak
Academic Coordinator
Room AB13B, Notre Dame Campus
204-631-3417

Admitted students may submit their criminal record and abuse registry check documents to the above individual.

How to Apply

For information on how to apply to this program, follow the link below.

www.rrc.ca/howtoapply

Student Evaluation of Program

Every year Red River College surveys students, in all full-time programs, to learn more about their college experience. The questionnaire includes questions about students’ experiences with College programs, facilities, and services offered.

Visit www.rrc.ca/numbers/reports/student-evaluation-of-program for student evaluation of program reports.

College Support Services

Red River College is committed to student success and provides valuable support services to assist in helping students make the most of their time at RRC.

Visit www.rrc.ca/supports for more information.

Page produced on 2019-12-05 08:47:06
Red River College endeavours to provide the most current version of all program and course information on this website. Please be advised that classes may be scheduled between 8:00 a.m. and 10:00 p.m. The College reserves the right to modify or cancel any course, program, process, or procedure without notice or prejudice. Fees may change without notice.