Training activity information
Details
Prepare the room and equipment for anorectal physiology investigations and endoanal ultrasound scanning
Type
Entrustable training activity (ETA)
Evidence requirements
Evidence the activity has been undertaken by the trainee repeatedly, consistently, and effectively over time, in a range of situations. This may include occasions where the trainee has not successfully achieved the outcome of the activity themselves. For example, because it was not appropriate to undertake the task in the circumstances or the trainees recognised their own limitations and sought help or advice to ensure the activity reached an appropriate conclusion.
Reflection at multiple timepoints on the trainee learning journey for this activity.
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 does success look like?
- Identify what is expected of you in relation to achieving a successfully prepared room and equipment setup according to department protocol for anorectal physiology investigations and endoanal ultrasound scanning.
- Consider how the learning outcomes apply, specifically in relation to preparing and cleaning the room and equipment, and how proper preparation impacts patient comfort and experience.
- Discuss with your training officer to gain clarity of what is expected of you in relation to the specific equipment setup requirements for each investigation, such as the settings for anorectal manometry equipment or cleaning requirements for the endoanal ultrasound scanner.
- What is your prior experience of this activity?
- Think about what you already know about preparing clinical rooms or equipment for any procedures. Are you familiar with the specific equipment used for anorectal manometry or endoanal ultrasound scanning?
- Consider possible challenges you might face during the activity, such as missing equipment, malfunctioning equipment, or ensuring required infection control precautions are met during setup.
- Recognise the scope of your own practice for this activity i.e. know when you will need to seek advice or help, and from whom. You will need to seek advice from your Training Officer when required, for example if there are unresolved equipment malfunctions or if there is uncertainty about setup requirements for different types of anorectal manometry equipment (e.g., water perfused vs solid state).
- Acknowledge how you feel about undertaking the preparation of the room and equipment for the investigations and scanning as specified.
- What do you anticipate you will learn from the experience?
- Consider the specific skills you want to develop, such as executing equipment setup according to protocol, applying infection control precautions during setup, and anticipating practical requirements for performing the investigations.
- Identify the specific insights you hope to gain into specific troubleshooting steps for equipment issues or the practical requirements of preparing the room and equipment.
- What additional considerations do you need to make?
- Consult actions identified following previous experiences of preparing clinical environments or troubleshooting equipment issues.
- Identify important information you need to consider before embarking on the activity, such as reviewing department protocols for room and equipment preparation, reviewing information about different types of anorectal manometry equipment, or ensuring familiarity with the investigation room layout.
In action
- Is anything unexpected occurring?
- Are you noticing anything surprising or different from what you anticipate whilst setting up the equipment or preparing the clinical room?
- Are you encountering situations such as:
- The required equipment (e.g., endoanal ultrasound probe) is missing or malfunctioning, challenging the preparation checklist?
- A specific safety check reveals an issue with the manometry system’s calibration or cleanliness, requiring immediate action?
- You encounter an issue with room cleanliness or infection control that was not anticipated, challenging the readiness for the investigation?
- How are you reacting to the unexpected development?
- How is this impacting your actions? For example, are you responding to the situation appropriately? Are you adapting or changing your approach to the order of setup or equipment management?
- Consider the steps you are taking in the moment, such as:
- Immediately documenting the equipment malfunction and retrieving alternative equipment while ensuring compliance with safety protocols
- Halting the preparation to consult the departmental guideline or Training Officer to resolve a newly identified equipment issue or contamination concern
- How are you feeling in that moment? For instance, are you finding it difficult to troubleshoot the equipment issue effectively? Is it affecting your confidence in ensuring the room meets all safety and cleanliness standards?
- What is the conclusion or outcome?
- Identify how you are working within your scope of practice. For example, are you successfully resolving minor equipment conflicts yourself by substituting standard materials? Or are you needing support because a major technical equipment issue requires senior technical review before the room can be deemed safe for use?
- What are you learning as a result of the unexpected development? For example, are you mastering a more efficient technique for checking all required accessories? Or gaining insight into the critical nature of maintaining safety and cleanliness protocols?
On action
- What happened?
-
- Begin by summarising the key steps you took when preparing the investigation room, retrieving the specific equipment (catheter/probe, recording system), conducting infection control checks, and ensuring all necessary supplies were available.
- Consider specific events, actions, or interactions which felt important, such as how you ensured the appropriate cleaning agents were used for the transducer, or how you arranged the monitoring screen to optimise visibility during the expected procedure.
- Include any ‘reflect-in-action’ moments where you had to adapt to the situation as it unfolded, for instance, immediately addressing an unexpected technical fault with the manometry catheter before the patient arrived, requiring substitution.
- How did you feel during this experience, e.g., did you feel focused on meticulous adherence to the preparation checklist or confident in troubleshooting minor technical setup issues?
- How has this experience contributed to your developing practice?
- Identify what learning you can take from this experience regarding the critical nature of thorough equipment setup and readiness for safe and effective investigations.
- What strengths did you demonstrate, e.g., systematic checking of all required supplies?
- What skills and/or knowledge gaps were evident, e.g., unfamiliarity with the specific cleaning requirements for all components of the endoanal ultrasound scanning equipment?
- Compare this experience against previous engagement with similar activities – were any previously identified actions for development achieved?
- Has your practice improved in efficiently setting up the manometry recording system and verifying connections?
- Identify any challenges you experienced, such as needing to seek advice or clarification on scope of practice regarding ensuring the electrical safety of the monitoring equipment, and how you reacted to this.
- What will you take from the experience moving forward?
- Identify the actions or ‘next steps’ you will now take to support the assimilation of what you have learnt, including from any feedback you have received, with regards to refining your equipment and room preparation checklist.
- What will you do differently next time you approach preparing the room and equipment, for instance, by proactively consulting the department’s infection control guidance specific to high-risk accessories?
- Do you need to practise any aspect of the activity further, such as safely handling and setting up the recording transducer or key learning outcomes related to preparing the room and equipment for anorectal physiology investigations?
Beyond action
- Have you revisited the experiences?
- How have your subsequent experiences of cleaning equipment or performing the full investigation since completing this specific training activity led you to revisit your initial approach or decisions during that activity? For example, encountering significant interference during a study, forced you to re-evaluate the meticulousness of the safety and setup checks you applied to equipment prior to commencing the investigation during your first attempt at this training activity.
- Considering what you understand about equipment longevity, proper setup, and how equipment maintenance impacts data quality now, were the actions or considerations you identified after your initial reflection on this training activity sufficient?
- How have you since implemented or adapted improvements in your efficiency and accuracy in setup based on further learning and experiences? For example, how you proactively reviewed and integrated the steps for checking the water-perfused system integrity after learning that leaks can cause artefacts during investigation.
- Has discussing challenges encountered during equipment setup or the impact of poor room preparation on patient flow with colleagues, peers, or supervisors changed how you now view your initial experience in this training activity? For example, how professional storytelling with a senior colleague about a delay caused by missing accessories, refined your understanding of the critical nature of thorough resource verification during preparation.
- How have these experiences impacted upon current practice?
- How has the learning from this initial training activity, in combination with subsequent technical experiences like calibration and cleaning, contributed to your overall confidence and competence in preparation, adhering to protocol, and understanding equipment requirements, particularly in preparing for assessments like Direct Observations of Practical Skills (DOPS)? For example, how your accumulated ability in ensuring the specific equipment setup requirements are met now enables you to confidently present a prepared room and equipment for an anorectal physiology investigation during a DOPS assessment.
- How has reflecting back on this specific training activity, combined with everything you’ve learned since, shaped your current approach to procedural preparation and ensuring optimal set-up for all investigations? How does this evolved understanding help you identify when something is beyond your scope of practice or requires escalation? For example, how your evolved approach means you now routinely seek advice from the Training Officer or technical support immediately when a calibration check for the manometry system fails persistently, recognising this falls outside routine preparation scope.
- Looking holistically at your training journey, how has this initial equipment preparation experience, revisited with your current perspective, contributed to your development in meeting the learning outcomes related to preparing the room and equipment and recognising problems which may result in an inaccurate study? For example, how this foundational experience has supported your development in practicing safely by providing the necessary knowledge base for the subsequent learning outcomes focused on safely performing the investigation itself.
Relevant learning outcomes
| # | Outcome |
|---|---|
| # 1 |
Outcome
Describe the requirements of anorectal physiology investigations including indications and contraindications, and take a patient history. |
| # 2 |
Outcome
Prepare the room and equipment for anorectal physiology investigations and endoanal ultrasound scanning and clean the room and equipment following the completion of investigations. |
| # 7 |
Outcome
Apply and adapt their approach to the patient’s individual tolerance, personal experience and anxieties, demonstrating sensitivity to the emotional implications of intimate and invasive investigations on a patient’s wellbeing. |