Training activity information
Details
Prepare the equipment and environment for high-resolution oesophageal manometry, including calibration of the oesophageal manometry catheter
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 preparing the equipment and environment for high-resolution oesophageal manometry, based on the module’s aim.
- Consider how the learning outcomes apply, specifically in relation to ensuring the equipment is correctly prepared and the catheter accurately calibrated according to established procedures.
- Discuss with your training officer to gain clarity of what is expected of you in relation to equipment setup, calibration, and ensuring the setup is crucial for obtaining high-quality data and ensuring patient safety.
- What is your prior experience of this activity?
- Think about what you already know about preparing and calibrating high-resolution oesophageal manometry equipment.
- Consider possible challenges you might face during the activity, such as technical issues or specific equipment requirements.
- 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 technical issues arise or when specific equipment requirements are unclear.
- Acknowledge how you feel about preparing the equipment and environment for the manometry. How confident are you in undertaking the calibration?
- What do you anticipate you will learn from the experience?
- Consider the specific skills you want to develop, such as equipment preparation and calibration for manometry.
- Identify the specific insights you hope to gain into the importance of correct setup and calibration for the accuracy and reliability of manometry results.
- What additional considerations do you need to make?
- Consult actions identified following previous experiences of similar equipment tasks.
- Identify important information you need to consider before embarking on the activity, such as specific equipment protocols, safety checks, or required materials.
In action
- Is anything unexpected occurring?
- Are you noticing anything surprising or different from what you anticipate whilst preparing the equipment and environment or calibrating the catheter?
- Are you encountering situations such as:
- Technical issues arise with the manometry equipment (e.g., pressure sensors drift or fail calibration), challenging the standard preparation checklist?
- Logistical issues arise with moving large equipment into position that challenge the planned room layout?
- A specific safety check reveals a potential issue with the manometry system that was not anticipated in the plan?
- 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 equipment preparation or calibration technique?
- Consider the steps you are taking in the moment, such as:
- Immediately documenting the equipment malfunction and implementing alternative steps (e.g., using backup calibration materials) while ensuring compliance with safety protocols.
- Halting the setup process to consult the departmental guideline or Training Officer to resolve a newly identified equipment safety concern.
- How are you feeling in that moment? For instance, are you finding it difficult to troubleshoot the technical issue effectively? Is it affecting your confidence in ensuring the catheter is accurately calibrated?
- What is the conclusion or outcome?
- Identify how you are working within your scope of practice. For example, are you successfully resolving the minor technical issue by implementing an approved alternative calibration setup yourself? Or are you needing support because a major technical equipment issue (e.g., complete sensor failure) requires senior technical review before the room can be deemed ready?
- What are you learning as a result of the unexpected development? For example, are you mastering a more efficient technique for verifying the pressure sensor integrity? Or gaining insight into the criticality of calibration accuracy for reliable results?
On action
- What happened?
- Begin by summarising the key steps you took when preparing the equipment and environment for high-resolution oesophageal manometry, including the calibration process.
- Consider specific events, actions, or interactions which felt important, such as how you ensured compliance with safety protocols during the equipment setup, or how you verified the accuracy of the catheter calibration.
- Include any ‘reflect-in-action’ moments where you had to adapt to the situation as it unfolded, for instance, immediately consulting a technical guide when faced with an unexpected safety concern regarding the manometry equipment.
- How did you feel during this experience, e.g., did you feel stressed by the logistical challenge or confident in your knowledge of calibration protocols?
- How has this experience contributed to your developing practice?
- Identify what learning you can take from this experience regarding planning and preparation.
- What strengths did you demonstrate, e.g., meticulous adherence to the preparation checklist?
- What skills and/or knowledge gaps were evident, e.g., unfamiliarity with the correct settings required for different types of manometry catheters or transducer technology?
- Compare this experience against previous engagement with similar activities – were any previously identified actions for development achieved?
- Has your practice improved in efficiently verifying equipment readiness and mitigating technical issues?
- Identify any challenges you experienced, such as needing to seek advice or clarification on scope of practice regarding whether specific equipment preparation still met required departmental safety standards, and how you reacted to this.
- What will you take from the experience moving forward?
- Identify the actions you will now take to support the assimilation of what you have learnt, including from any feedback you have received, with regards to improving the efficiency and documentation of your room preparation process.
- What will you do differently next time you approach preparation and calibration for HR Manometry, for instance, by proactively reviewing academic content on the advantages and disadvantages of water-perfused versus solid-state techniques?
- Do you need to practise any aspect of the activity further, such as troubleshooting equipment setup issues or key learning outcomes related to performing routine maintenance and calibration procedures specific to the equipment?
Beyond action
- Have you revisited the experiences?
- How have your subsequent experiences of performing high-resolution oesophageal manometry investigations since completing this specific training activity led you to revisit your initial approach or decisions during that activity? For example, experiencing significant technical interference during a patient study forced you to re-evaluate the meticulousness of the preparation of the equipment and catheter calibration you applied during your first attempt at this training activity.
- Considering what you understand about routine maintenance, ensuring accurate data for analysis, and reporting 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 equipment setup and pre-check procedures based on further learning and experiences? For example, how you proactively reviewed and integrated specific safety check steps to ensure the electrical integrity of the manometry system, demonstrating you have adapted improvements based on further learning.
- Has discussing equipment setup challenges or the impact of poor preparation on workflow 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 data loss caused by incorrect catheter calibration refined your understanding of the critical nature of performing routine maintenance and calibration procedures.
- How have these experiences impacted upon current practice?
- How has the learning from this initial training activity, in combination with subsequent technical experiences like analysis and report drafting, contributed to your overall confidence and ability in applying knowledge of equipment requirements and maintenance, 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 met now enables you to confidently present a prepared and calibrated system for HR Manometry 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 technical verification?
- 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 calibration checks persistently fail, recognising this falls outside routine setup scope.
Relevant learning outcomes
| # | Outcome |
|---|---|
| # 2 |
Outcome
Identify the requirements for upper gastrointestinal investigations in a range of patients with different conditions, adapting the procedure to answer the specific question while taking the patients’ needs into account. |
| # 3 |
Outcome
Perform routine maintenance and calibration procedures specific to the equipment required for each investigation of the upper gastrointestinal tract. |