Training activity information
Details
Make appropriate onward referrals to one of the following related specialties:
- Physiotherapy
- Neurology
- ENT
- Psychology
- Elderly care/falls prevention service
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
- Scope of practice
- Role of the multidisciplinary team in the care of patients with vestibular dysfunction
- professional language
- Summary of reason(s) for referral
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 is your current understanding of the roles and expertise of each of the listed related specialties (Physiotherapy, Neurology, ENT, Psychology, Elderly care/falls prevention service) in the context of vestibular disorders?
- What are some common indicators or findings from vestibular assessments that might necessitate referral to each of these specialties?
- Are you aware of any local referral pathways or guidelines for patients with vestibular conditions?
- What criteria should be considered when determining the most appropriate specialty for onward referral?
- Will you be exploring the importance of timely and appropriate referrals for optimal patient care?
- Will you review information about the roles of the different specialties in managing vestibular disorders?
- Will you discuss common referral scenarios with your training officer or other qualified clinicians?
- Consider possible challenges you might face (e.g., uncertainty about the most appropriate referral). How might you prepare to address this uncertainty?
In action
- How are you approaching the task of considering which specialty might be appropriate for referral? What information are you prioritising?
- What decisions are you making as you consider different scenarios or patient presentations? Are you leaning towards a particular specialty based on certain symptoms?
- Are you clear on when to refer to ENT but less sure about when Psychology might be appropriate?
- How effective is your consideration of the patient’s needs and presenting symptoms in guiding your potential referral decisions? Are you able to link specific vestibular findings to the expertise of different specialties?
- What challenges are you facing as you think about making appropriate referrals? Are you unsure about the specific criteria for referral to each specialty?
- Are there alternative referral options you should be considering for a given scenario? Have you thought about all the potential specialties that could be involved?
- Are you focusing on the appropriateness of onward referral based on the information available to you?
- Are you being influenced by information regarding referrals given to you by senior clinicians? And have you considered this in the context of national guidelines or research?
On action
- Begin by summarising your thought process when considering referrals for different potential vestibular presentations. What key indicators or patient characteristics guided your thinking towards specific specialties? What were the different scenarios or patient types you considered (either real or hypothetical)? What were the key features of each that influenced your referral considerations? What were your initial thoughts about when to refer to each of the listed specialties?
- What specific skills or knowledge did you develop or improve regarding onward referrals? Did you gain a better understanding of the scope of practice of each specialty? Were there any unexpected challenges or successes in determining appropriate referrals? What did you learn from these? For example, did you initially overlook a particular specialty for a specific presentation? How crucial is it to understand referral pathways for effective patient management? How did your initial expectation on who you may need to refer to change during the appointment or after the review of the results?
- What areas for continued development have been identified regarding your understanding of referral pathways? Do you need to familiarise yourself with local referral guidelines? Will you be more mindful of considering onward referrals for certain patient presentations? Will you research the referral criteria for each specialty or discuss specific cases with your supervisor? What support or resources might you need to further develop your understanding of appropriate onward referrals?
Beyond action
- Have your understanding of the appropriate referral pathways evolved since this DTA?
- Compare this experience with subsequent instances where you considered or made referrals in your training. What have you learned from those real-life scenarios that might influence your perspective on the principles discussed in this DTA?
- Revisit your reflections from other DTAs, particularly those involving patient management or case discussions. Have those experiences highlighted the importance of specific referral routes?
- How has thinking about onward referrals in this DTA informed your approach to holistic patient management in other areas of your training?
- How have you applied the principles of appropriate referral in your subsequent clinical experiences? Are you more aware of the indicators for referral to different specialties?
- Identify clear actions for continued development of your knowledge of local and national referral guidelines. How will you ensure you remain up-to-date with the most appropriate referral pathways in your future role?
- When a referral would be beneficial but a local pathway may not be set up, how might you approach that (linking to service development and multidisciplinary team working)? How can you strengthen links between departments or set up new pathways to streamline patient care?
Relevant learning outcomes
| # | Outcome |
|---|---|
| # 7 |
Outcome
Practice within their own personal and professional scope, identifying where onward referral is appropriate. |