Audiovestibular Assessment & Rehabilitation —
Training activity: 12

Details

Assist in the safe performance and interpretation of the following diagnostic tests on adults and document the results:

• Videonystagmography, including: static body positional testing and headshake test
• Caloric testing
• Video head impulse test;
• Vestibular-evoked myogenic potential testing (either cervical or ocular)

Type

Developmental training activity (DTA)

Evidence requirements

Evidence the activity has been undertaken by the trainee​.

Reflection on the activity at one or more time points after the event including learning from the activity and/or areas of the trainees practice for development.

An action plan to implement learning and/or to address skills or knowledge gaps identified.

Considerations

• Patient centred care and support
• Explanation of tests and gaining consent
• Screening tests where appropriate
• Contraindications to testing
• Infection control
• Local and national recommended procedures and protocols, and international best practice
• Reference ranges
• Signs of central dysfunction

Reflective practice guidance

The guidance below is provided to support reflection at different time points, providing you with questions to aid you to reflect for this training activity. They are provided for guidance and should not be considered as a mandatory checklist. Trainees should not be expected to provide answers to each of the guidance questions listed.

Before action

• What are the principles behind each of these vestibular diagnostic tests?
• What are the contraindications and safety considerations?
• How are the tests performed and what are the key parameters to observe during interpretation?
• Have you reviewed the theory and protocols for each vestibular test?
• Have you observed experienced clinicians performing these assessments?

In action

• What is your role in assisting with each vestibular test?
• Are you ensuring the patient understands the instructions?
• How are you monitoring the patient’s comfort and safety during tests like caloric irrigation or positional changes?
• What are you observing on the VNG monitor or during vHIT and VEMP testing?
• How are you documenting the observed responses?
• Are you finding certain tests more complex to assist with than others?
• Are you beginning to recognise any patterns in the patient’s responses during the tests?
• What are you learning about the practical application and potential challenges of these vestibular assessments?
• Are there any aspects of the interpretation that are becoming clearer?

On action

• Reflect on the adult patients undergoing vestibular testing. What were their reactions to the different tests (Videonystagmography, Caloric testing, Video head impulse test, Vestibular-evoked myogenic potential testing)? Did you observe any common responses or difficulties patients experienced? How were the results documented, and what patterns did you observe in the nystagmus or other responses?
• What did you learn about the safe performance of these adult vestibular diagnostic tests, including patient preparation and monitoring for adverse reactions? What insights did you gain into the interpretation of the results and how they contribute to understanding vestibular disorders? Were there any aspects of a particular test or interpretation that were more challenging or surprising?
• What safety precautions or patient communication strategies are crucial for these vestibular assessments? What areas of vestibular diagnostics and interpretation do you need to explore further?

Beyond action

• Reflecting on your initial involvement in adult vestibular testing and comparing it with any subsequent experiences or learning or discussions with qualified clinicians, has your understanding of the purpose and interpretation of these complex tests deepened?
• How has assisting with these vestibular tests influenced your ability to recognise vestibular symptoms in patient case histories or understand onward referral pathways to specialties like Physiotherapy, Neurology, or ENT?
• As you develop, how will this early exposure to vestibular diagnostics inform your ability to contribute to the assessment and management of patients with balance disorders?

Relevant learning outcomes

#	Outcome
# 7	Outcome Practice in partnership with the multidisciplinary team to perform balance function assessments in adults, using a range of core diagnostic tests.