Training activity information
Details
Prepare and perform neurological monitoring including one of the following:
- Bispectral Index monitoring
- EEG
- ICP
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
- Limitations of techniques
- SOPs
- Local and national guidance
- Interpretation and validation of waveform
- Interpretation of the waveform for diagnostic value
- Patient centred care and support
- Communication with patients, relatives and the clinical team
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 specific skills or knowledge related to Bispectral Index monitoring, EEG, or ICP monitoring (depending on which you will perform) are you expected to develop through this activity?
- What is your current understanding of the principles and practicalities of the specific neurological monitoring technique(s) you will be performing (Bispectral Index, EEG, or ICP)?
- Are you familiar with the equipment involved, including its setup, calibration, and potential troubleshooting issues?
- Do you understand the relevant safety protocols and guidelines associated with neurological monitoring?
- Consider the specific insights you hope to gain from engaging with the practical aspects of preparing and performing neurological monitoring. Think about what you already know about neurological monitoring techniques.
- What specific gaps in your knowledge or skills do you hope this activity will address?
- Discuss this training activity with your training officer to gain clarity of understanding regarding the specific requirements, patient context (if applicable), and expected level of autonomy.
- Consider possible challenges you might face during the preparation and performance of neurological monitoring (e.g., technical difficulties, patient factors, interpretation of initial readings) and think about how you might handle them.
- Will you review any relevant protocols, guidelines, or manufacturer instructions beforehand?
- Do you need to observe this procedure being performed by an experienced colleague before attempting it yourself?
In action
- As you are preparing the equipment, what steps are you taking? Why are you performing the preparation in this specific order?
- While applying electrodes or setting up the transducer, what decisions are you making about placement or connection?
- Why are you making these decisions? Are there parts of the setup or performance that feel routine (intuitive), and are there others that require conscious thought or checking guidelines?
- Is the equipment setup proceeding as expected, or are there unexpected issues?
- What challenges are you encountering, such as patient movement, skin preparation issues, or equipment error messages?
- How are you attempting to resolve them in the moment? What are you learning about the practicalities of applying this specific monitoring technique to a critically ill patient as the activity unfolds?
- How is your existing knowledge of neurological monitoring principles guiding your actions during the procedure?
- If the initial attempt isn’t working (e.g., poor signal quality), are there alternative approaches or troubleshooting steps you could try now?
- Are you performing within your defined scope of practice for this activity?
- If you encounter something beyond your scope, what support or guidance (e.g., from your training officer or clinical staff) might you need immediately?
On action
- Begin by summarising the key points of the experience of preparing and performing the chosen neurological monitoring technique (Bispectral Index, EEG, or ICP).
- What were the main steps involved?
- What were the key observations or data points you encountered?
- What skills or knowledge did you develop or improve through this activity? For example, did you enhance your technical skills in setting up the equipment, your understanding of the physiological principles behind the monitoring, or your ability to interpret the initial data?
- Were there any unexpected challenges or successes during the activity? What did you learn from these? For instance, did you encounter any technical difficulties you had to troubleshoot, or did you successfully obtain a clear and interpretable signal?
- In what ways did your reflection-in-action (during the activity) influence how the activity unfolded? Did any on-the-spot adjustments or decisions you made have a noticeable impact on the outcome?
- What areas for continued development have been identified as a result of this activity? Are there specific aspects of neurological monitoring that you feel you need to explore further or practice more?
- How can you apply the learning from this activity to your routine practice? Will this experience change how you approach similar tasks in the future?
- Identify the actions / ‘next steps’ you will now take to support the assimilation of what you have learned. For example, will you review relevant literature, seek further practical experience, or discuss your learning with your training officer?
- What support or resources might you need to further develop in the areas identified through this reflection?
Beyond action
- What were your initial thoughts and reflections at the time (reflect-in-action and reflect-on-action)? What new perspectives do you have on this DTA now that some time has passed and you have gained more experience?
- What behaviours and practices have you observed in others related to neurological monitoring or the technical skills involved that you have you assimilated into your own practice since this DTA?
- What broader learning or actions have emerged from looking back at this experience and related experiences collectively in relation to neurological monitoring and patient care? What learning or actions might you now identify?
- Has your view of the situation changed as a result of analysing this experience with others?
- How has the knowledge and skill gained from preparing and performing neurological monitoring supported you in other training activities (e.g., communication skills when explaining monitoring to a simulated patient, report writing, understanding patient safety)?
- How have you applied this knowledge since the original experience? Have you had opportunities to perform or interpret neurological monitoring in other contexts or simulations? How have your skills developed since then? How has experience since influenced your wider practice in critical care?
- Identify the transferable skills you are developing through this training activity (e.g., technical proficiency, problem-solving, attention to detail, understanding of complex equipment). How might these skills be applicable in different aspects of your future role as a Healthcare Scientist? Identify clear actions for continued development of the skills introduced through this activity. What further learning or experiences will you seek out to enhance your competence in neurological monitoring and its interpretation?
Relevant learning outcomes
| # | Outcome |
|---|---|
| # 4 |
Outcome
Apply neurological monitoring techniques to monitor critically ill patients. |
| # 5 |
Outcome
Apply techniques to monitor respiratory function in critically ill patients. |
| # 8 |
Outcome
Practice safely in accordance with guidance and legislation to minimise risk in all elements of patient care. |