Imaging (Echocardiography) —
Training activity: 26

Details

Discuss results of an adapted protocol for stroke with a patient/healthcare professional

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.

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

• Before this activity, what echocardiographic findings might indicate a cardiac source of the patient’s stroke?
• How will you explain these findings to the patient and their potential implications for future stroke risk?
• What information is important to communicate to the neurology team regarding potential cardiac contributors to the stroke?
• How will you discuss the need for potential long-term anticoagulation or other preventative measures with the patient?

In action

• How are you structuring the discussion? What key echocardiographic findings potentially relevant to the patient’s stroke (e.g., presence of left atrial appendage thrombus, PFO, significant aortic atheroma) are you highlighting? How are you explaining the potential link between these findings and the stroke? Who is your audience, and how is that influencing your communication? Are you tailoring your explanation based on whether you are speaking to a patient who has just experienced a stroke or a healthcare professional involved in their care? Are you deciding how to explain complex concepts like paradoxical embolism in an understandable way? Are you comfortable discussing potentially concerning cardiac findings in the context of a recent stroke? Are you consciously using clear and sensitive language?

• Do you feel you are effectively communicating the echocardiographic findings and their potential relevance to the patient’s stroke? Are the questions being asked relevant to the information you have provided? Are you observing effective strategies for communicating findings that may have significant implications for the patient’s future management? Are you learning how to address patient anxieties and healthcare professional inquiries related to the cardiac contribution to stroke? Are you drawing upon your understanding of stroke, cardiac sources of embolism, related echocardiographic findings, and your communication skills?

• Could you use diagrams to illustrate potential embolic sources like a PFO or left atrial thrombus? Are there patient information resources about stroke and cardiac risk factors that you could provide? If questions arise about specific treatment options to prevent future strokes based on the echocardiographic findings that are beyond your current expertise, would you seek guidance from a senior colleague or the neurology team? Are the explanations and discussions you are having appropriate for your level of training, particularly regarding the complex management of patients post-stroke?

On action

• Summarise the key echocardiographic findings related to stroke risk from the adapted protocol. Describe how you communicated these results to the patient and/or healthcare professional. Note their reactions and any questions they had.
• Reflect on your ability to explain echocardiographic findings relevant to stroke risk to different audiences. Were you able to tailor your explanation appropriately? Were there any challenges in conveying the clinical significance of the findings? How does this relate to explaining imaging results?
• Identify any areas where you can improve your communication skills when discussing findings related to stroke risk. How will you ensure you provide clear and relevant information to both patients and healthcare professionals in the future?

Beyond action

• Have you discussed echo findings in stroke patients with the patients themselves and with the neurology team? How have you explained the potential link between cardiac findings and their stroke? Have you addressed any implications for secondary stroke prevention?
• How has your ability to explain the role of echocardiography in identifying potential cardiac causes of stroke to both patients and other healthcare professionals improved? Are you more confident in discussing the implications of findings such as atrial fibrillation or PFO in the context of stroke risk?
• How will your communication skills in this area support your role in the multidisciplinary care of stroke patients and in strategies for secondary prevention? What did you learn about effectively conveying the cardiac contributions to stroke risk?

Relevant learning outcomes

#	Outcome
# 2	Outcome Explain imaging results to patients and other health care professionals.
# 3	Outcome Distinguish and justify actions based on clinical and ECG findings.
# 5	Outcome Appraise new guidelines and evidence to inform practice.
# 6	Outcome Demonstrate safe practice in line with local, national and international guidelines and standards.
# 7	Outcome Assess and evaluate a patient’s clinical presentation and make recommendations for cardiac imaging.
# 8	Outcome Evaluate cardiac care pathways.
# 9	Outcome Summarise complex information into a concise and logical reports for specialist and non-specialist audiences.