Advanced Evoked Potential Measurement Techniques

Details

Title

Advanced Evoked Potential Measurement Techniques

Type

Stage Two

Module code

HPS252

Requirement

Compulsory

Module objective

By the end of this module the Clinical Scientist in HSST, in respect to advanced electrophysiology, will be able to apply their expert knowledge, skills and experience in the clinical setting to review emerging evidence of new developments in scientific, technological and clinical practice with respect to advanced techniques to measure evoked potentials, including those undertaken during intraoperative monitoring.

They will be able to formulate an appropriate investigation/monitoring strategy for each patient, analyse, interpret and where appropriate provide comprehensive supervised clinical reports. The Clinical Scientist in HSST will be able to formulate an appropriate plan for investigation and management, in conjunction with medical colleagues, being aware of the need to expedite investigation in suspected serious disease. They will be aware of the need to refer appropriately for medical intervention or further investigation by other healthcare practitioners.

The Clinical Scientistsin HSST will also be expected to identify opportunities for innovative approaches to the development, delivery and evaluation of new clinical electrophysiology services and lead these developments.

Knowledge and understanding

By the end of this module the Clinical Scientist in HSST will be able to analyse, synthesise, evaluate and critically apply their expert knowledge, including:

• the disease pathophysiology relevant to the patient population referred for specialist evoked potential measurement, including those with movement disorders including:
  • cortical and subcortical myoclonus
  • tic disorders
  • psychogenic movement disorders
• indications and limitations;
• current guidelines;
• pharmacology and therapeutics relevant to the technique;
• how to recognise normal and abnormal evoked potential waveforms;
• how to identify the cause of abnormal evoked potentials relating to movement;
• how to formulate the differential diagnosis of the causes of abnormal evoked potentials in patients with various movement disorders.

Technical and clinical skills

By the end of this module the Clinical Scientist in HSST will have a critical understanding of current evidence and its application to the performance and mastery of a range of technical skills. They will also be expected to apply and evaluate their knowledge with respect to clinical presentation, investigation, diagnosis and management of diseases and conditions in which movement-related cortical potentials may be tested. Within a clinical setting they will:

Back averaging:

• determine the onset of movement as accurately as possible;
• record from the muscle most involved in the jerks;
• set the triggering parameters appropriately;
• record from the appropriate the cortical areas;
• set the machine parameters appropriately (filters and time base);
• acquire sufficient number of averages;
• interpret the responses in accordance with the clinical findings.

Bereitschafts potential:

• determine the onset of movement as accurately as possible;
• record from the muscle under investigation;
• record from the corresponding cortical area under investigation;
• set the machine parameters appropriately (filters and time base);
• mark and measure the obligatory responses.

By the end of this module the Clinical Scientist in HSST will be expected to critically reflect and apply in practice a range of clinical skills. They will communicate effectively with patients, relevant clinicians and other healthcare professionals and will:

• plan/select the appropriate evoked potentials using specified protocols;
• analyse all data;
• interpret evoked potentials and relate normal and abnormal results to the symptoms, signs, family history, medical history, etc.;
• interpret the evoked potentials results with relevant imaging and/or psychophysical studies;
• provide a clinical interpretation of the evoked potential data, placing the results in the context of clinical examination, and produce a clinical report;
• provide a clear, informative and accurate clinical report with recommendations for further diagnostic and/or treatment options if appropriate;
• provide advice and, where appropriate, communicate effectively the implications of the findings to patient, relevant clinicians, patients and the public, and other healthcare professionals;
• reflect on the challenges of applying research to practice in relation to the development and implementation of novel investigations better to facilitate diagnosis and management.

Professional practice:

• consistently work to high standards of clinical practice, applying knowledge and evidence, making decisions and evaluating the impact of those decisions;
• monitor, evaluate and maintain clinical practice standards;
• balance data confidentiality, security and protection, and the sharing of data with relevant stakeholders, including patients, to ensure high-quality patient- centred care;
• critically review the literature and disseminate findings and scientific data and make recommendations for future activity;
• ensure clinical and scientist colleagues are kept up to date with new and novel techniques used within the service;reflect on the challenges of applying research to practice in relation to the development and implementation of novel investigations better to facilitate diagnosis and management.
• work with patients and parents to develop and update patient information materials appropriate to service requirements;
• share data on clinical practice standards with service users and managers to encourage dialogue and debate;
• support and contribute to the development of multidisciplinary clinical team working and work with the team to determine scientific service priorities;
• be committed to and support continuous improvement of neurophysiological services, with particular reference to auditing practice, evidence-based practice, innovation, new and improved technologies;
• reflect on the challenges of applying research to practice in relation to the development and implementation of novel investigations better to facilitate diagnosis and management.