By the end of this module the Clinical Scientist in HSST will be able to critically analyse and synthesise their understanding of neurophysiological measurement applying their knowledge whilst performing a range of technical procedures and clinical skills and demonstrating the ability to evaluate their own response to both normal and complex situations using the professional attributes and insights required of a Consultant Clinical Scientist. This module will enable Clinical Scientists in HSST to develop a broader perspective on the investigation and management of patients referred to their service and practical skills to conduct neurophysiological measurements relevant to GI and urodynamic practice.
Knowledge and understanding
By the end of this module the Clinical Scientist in HSST will be able to critically analyse, synthesise and apply their knowledge with respect to a range of neurophysiological measurement investigations including:
The principles of physiological measurements in common use for neurophysiology:
- surface and needle electromyography (EMG).
- Electroencephalogram (EEG).
- stimulus and evoked potentials.
- nerve conduction studies.
- sensory awareness etc.
The clinical scientific practices associated with performance of these measurements including:
- appropriate test preparation.
- performance of test.
- accurate and succinct reporting of the data acquired.
Students’ written evaluations of their practice should demonstrate new insights into the application of current theories of the role of neurophysiological measurements in the diagnosis of diseases affecting the gastrointestinal and urological systems.
Technical and clinical skills
By the end of this module the Clinical Scientist in HSST will be able to demonstrate a critical understanding of current research and its application to the performance of the following technical skills to ensure the quality delivery of investigations appropriate to their specialist interest, including:
- sensory investigations.
- nerve conduction studies.
- somatosensory evoked potentials.
- autonomic investigations.
- sympathetic provocation tests.
- assessment of sympathetic postganglionic function; quantitative ionotropic fatigability test.
- sensory awareness.
- pudendal nerve terminal motor latency.
Reflect on the challenges of applying research to practice in relation to these procedures and suggest improvements, building on available evidence.By the end of this module the Clinical Scientist in HSST will be able to demonstrate a critical understanding of current relevant research, theory and knowledge and its application to the performance of clinical skills, applying rigorous scientific critiques to the evaluation of data related to clinical practice in the support of clinical decision making and patient management and critically reflect on their performance and be competent in:
- common neurophysiological investigations, and their indications and differentiate between neuropathic and myopathic disorders prior to surgical intervention
- visceral compliance, sensory thresholds and nerve latency with respect to the patient’s symptomatology and interpret this clinical data to produce accurate, succinct diagnostic quality clinical reports of these tests.
develop treatment plans in context with patient investigations and:
- explain the purpose, indications, contraindications and process for performing a range of common neurophysiological investigations used in urodynamic and GI practice:
- gain written informed consent from a series of patients referred to a gastrointestinal physiology or urodynamic service.
- perform neurophysiological tests under supervision.
- analyse the results and produce a written report.
- interpret clinical data and produce diagnostic quality clinical reports.
- in partnership with the clinical team identify areas of current practice that could be improved and design and evaluate a suitable intervention based on a critical review of evidence to improve practice.
Clinical Scientists in HSST will be required, in partnership with the clinical team, to identify areas of current practice that could be improved and design and evaluate a suitable intervention based on a critical review of evidence to improve practice.
Attitudes and behaviours
By the end of the module the Clinical Scientist in HSST Neurophysiological Measurement will be expected to evaluate their own response to both normal and complex situations consistently demonstrating the professional attributes and insights required of a Consultant Clinical Scientist. Within the limits of professional competence referring as appropriate to senior staff and:
- provide leadership regarding service and professional issues.
- know and maintain highest standards of professional behaviour.
- establish and influence the culture of health and safety in the workplace.
- ensure that examination, whilst clinically appropriate and within the constraints of the role of Consultant Clinical Scientist, consider social, cultural and religious boundaries; appropriately communicate findings and make alternative arrangements where necessary.