Training activity information
Details
Prepare the equipment and environment for ambulatory 24-hour pH/pH-impedance monitoring, including calibrating the 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 24-hour pH/pH-impedance monitoring.
- Consider how the learning outcomes apply, specifically in relation to ensuring the equipment is correctly prepared and the catheter accurately calibrated.
- Discuss with your training officer to gain clarity of what is expected of you in relation to the aspects of equipment setup and calibration that are crucial for obtaining accurate data over a 24-hour period.
- What is your prior experience of this activity?
- Think about what you already know about preparing and calibrating 24-hour pH/pH-impedance monitoring equipment.
- Consider possible challenges you might face during the activity, such as specific equipment requirements or ensuring patient diary functions correctly.
- 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 undertaking the preparation of the equipment and environment in the context of this training activity.
- 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 24-hour monitoring.
- Identify the specific insights you hope to gain into the importance of correct setup and calibration for the reliability of prolonged pH/impedance recordings.
- 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 patient instructions for the monitoring period (medications, diary events) or specific equipment settings.
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 for pH/pH-impedance monitoring?
- Are you encountering situations such as:
- The pH/impedance catheter fails to maintain stable calibration readings across multiple channels, threatening the 24-hour data quality?
- A specific safety check reveals an issue with the impedance system’s electrical integrity, challenging the readiness for the patient?
- Logistical hurdles arise regarding the correct software settings for a specific impedance catheter type?
- 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 performing a secondary calibration check using fresh buffers to eliminate reagent error before assuming equipment malfunction.
- Halting the setup process to consult the Training Officer regarding specific electrical safety protocols when managing impedance equipment.
- How are you feeling in that moment? For instance, are you finding it difficult to resolve the calibration discrepancy? Is it affecting your confidence in the long-term data integrity of the catheter?
- What is the conclusion or outcome?
- Identify how you are working within your scope of practice. For example, are you successfully troubleshooting minor connectivity issues related to the multiple impedance channels? Or are you needing support because failure to achieve successful calibration necessitates using alternative equipment or rescheduling, requiring senior intervention?
- What are you learning as a result of the unexpected development? For example, are you mastering a more efficient technique for calibrating multiple pH/impedance channels accurately? Or gaining insight into the specific technical requirements for 24-hour monitoring equipment?
On action
- What happened?
- Begin by summarising the key steps you took when preparing the equipment and environment for 24-hour pH/pH-impedance monitoring, including the calibration process.
- Consider specific events, actions, or interactions which felt important, such as how you ensured the impedance channels were functioning correctly, or how you verified the accuracy of the pH probe calibration across different buffers.
- Include any ‘reflect-in-action’ moments where you had to adapt to the situation as it unfolded, for instance, immediately attempting an alternative calibration sequence when the initial reading failed the quality check.
- How did you feel during this experience, e.g., did you feel focused on meticulous technical precision or stressed by the complexity of the multi-channel calibration?
- How has this experience contributed to your developing practice?
- Identify what learning you can take from this experience regarding equipment preparation and calibration procedures.
- What strengths did you demonstrate, e.g., systematic adherence to the calibration protocol for both pH and impedance channels?
- What skills and/or knowledge gaps were evident, e.g., unfamiliarity with the specific implications of transducer technology on the recording quality?
- Compare this experience against previous engagement with similar activities – were any previously identified actions for development achieved?
- Has your practice improved in performing routine maintenance and calibration procedure?
- Identify any challenges you experienced, such as needing to seek advice or clarification on scope of practice regarding whether equipment instability required professional technical repair rather than in-house troubleshooting, 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 refining your pH/pH-impedance calibration technique and ensuring equipment readiness.
- What will you do differently next time you approach preparing the equipment and environment for 24-hour pH/pH-impedance monitoring, for instance, by proactively reviewing academic content on transducer technology and its impact on recording fidelity?
- Do you need to practise any aspect of the activity further, such as managing the multiple impedance channel checks or key learning outcomes related to calibration procedures?
Beyond action
- Have you revisited the experiences?
- How have your subsequent experiences of analysing 24-hour pH/pH-impedance studies since completing this specific training activity led you to revisit your initial approach or decisions during that activity? For example, encountering corrupted impedance channel data during analysis forced you to re-evaluate the diligence of the preparation and calibration checks applied to the multi-channel catheter during your first attempt at this training activity.
- Considering what you understand about equipment maintenance and its relation to achieving accurate long-term data acquisition 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 calibration documentation based on further learning and experiences? For example, how you proactively reviewed and integrated the steps for verifying the electrical integrity of the impedance channels before confirming equipment readiness.
- Has discussing technical issues in 24-hour monitoring or the impact of calibration errors on data reliability 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 monitoring failure caused by a poorly calibrated pH probe refined your understanding of the critical nature of systematic technical verification.
- How have these experiences impacted upon current practice?
- How has the learning from this initial training activity, in combination with subsequent analysis experiences and procedural performance, contributed to your overall confidence and ability in performing maintenance and calibration procedures, particularly in preparing for assessments like Direct Observations of Practical Skills (DOPS)? For example, how your accumulated ability in ensuring the complex pH/impedance equipment is accurately calibrated now enables you to confidently set up and calibrate the equipment for a 24-hour ambulatory oesophageal pH/pH-impedance study 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 ensuring long-term data integrity?
- 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 manager immediately when issues arise with transducer technology that might compromise the quality of the impedance channels, recognising this falls outside routine setup and calibration 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. |