Training activity information
Details
Recognise the indications for pelvic floor neuromodulation and its uses
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
- What are the key differences in taking a gastrointestinal history from a paediatric patient compared to an adult? Consider communication styles, the role of parents/guardians, and the types of symptoms that might be more prevalent in children.
- For the two specific investigations you will be involved in (Anorectal physiology, Oesophageal manometry, Ambulatory studies, Breath testing), what specific information needs to be elicited during the history taking process to determine suitability and guide the investigation?
- What are the age-specific considerations for each of these investigations?
- What safeguarding considerations are particularly relevant when interacting with paediatric patients and their families?
- What specific skills in communicating with paediatric patients and their parents/guardians do you hope to develop?
- What challenges might you encounter in obtaining a comprehensive history from a paediatric patient (e.g., communication barriers, lack of cooperation), and how do you hope to learn to navigate these?
- What specific questions or templates are used within your department for taking paediatric gastrointestinal histories for these investigations? Will you review these beforehand?
- Will you research age-appropriate communication techniques before this activity?
- Have you considered how you will ensure you obtain the necessary information while also being sensitive to the child’s and family’s needs?
- What are your current feelings about taking a paediatric patient history, and how can you prepare yourself to approach this with confidence and sensitivity?
In action
- Pay attention to your actions as you ask questions and interact with the paediatric patient and their parent/guardian. How are you initiating conversations? What types of questions are you asking, and in what order? How are you adapting your communication style for a child?
- What decisions are you making as the history taking progresses? Are you deciding to probe further into certain symptoms? Are you adjusting your questions based on the child’s or parent’s responses? What is influencing these decisions?
- Are you finding it easy to build rapport? Are you consciously thinking about how to phrase sensitive questions?
- Are you obtaining clear and relevant details about the patient’s symptoms, medical history, and lifestyle? Are the patient and parent understanding your questions?
- What challenges are you facing during the history taking process? Is the child reluctant to talk? Is the parent providing unclear or incomplete information? Are there any language barriers? Are you finding it difficult to navigate sensitive topics?
- What immediate insights are you gaining about taking a paediatric gastrointestinal history? Are you noticing effective communication techniques? What difficulties are arising that you might need to address in future?
- Are you relating the information being provided to the potential indications and contraindications for the tests? Are you recognising patterns or red flags based on your prior learning?
- Are there alternative ways you could phrase your questions to elicit more information or to be more easily understood by the child or parent? Could visual aids or different communication techniques be helpful?
- What support or guidance might you need from your supervising clinician during this history taking session? Are you unsure about the relevance of certain information? Would you like advice on how to approach a sensitive topic?
- Are you working within the ethical guidelines and your level of experience when interacting with a paediatric patient and their family? Are you ensuring appropriate supervision and respecting patient confidentiality (where applicable)?
On action
- Begin by summarising the key aspects of the paediatric patient history you obtained. What were the main presenting symptoms?
- What relevant medical history was reported?
- What information was gathered regarding their lifestyle and diet?
- Were you able to gather all the necessary information for the two chosen investigations?
- Describe the interactions with the paediatric patient and their parent/guardian.
- What communication techniques seemed most effective?
- Were there any challenges in engaging with either the child or the adult?
- What skills or knowledge did you develop or improve through obtaining this paediatric patient history under supervision?
- Did you enhance your ability to communicate with children or their parents about sensitive topics?
- Were there any unexpected pieces of information revealed during the history taking?
- What did you learn from how these unexpected details emerged and how you responded to them? Did you adjust your approach based on the responses you received?
- How does this experience relate to the specific requirements for taking a history for anorectal physiology, oesophageal manometry, ambulatory studies, or breath testing in a paediatric population?
- What areas for continued development have been identified as a result of this activity?
- Do you need to improve your questioning techniques for certain age groups?
- Are there specific aspects of paediatric gastrointestinal history that you need to learn more about?
- How can you apply the learning from this activity to future paediatric history-taking sessions?
- Will you modify your approach based on what you learned in this session?
- Identify the actions you will now take to support the assimilation of what you have learned.
- Will you review paediatric gastrointestinal conditions, discuss the case with your supervisor, or seek further guidance on specific questioning techniques?
- What support or resources might you need to further develop your skills in this area, such as specific guidelines for paediatric history taking or examples of effective communication strategies?
Beyond action
- Compare this experience with any other history-taking experiences you have had with paediatric patients or their guardians. What behaviours and practices related to communication, engagement, and information gathering have you since incorporated into your own practice?
- Revisit your reflections from this training activity and consider any learning points or ‘next steps’ you identified.
- Have you sought further information or guidance on taking paediatric gastrointestinal histories since then?
- How has your understanding of the specific information needed for these investigations in children evolved?
- Recognise that this training activity contributes to your overall ability to interact with and gather information from paediatric patients and their families. How has this experience supported the development of your communication, active listening, and empathy skills, which are relevant to other aspects of your training?
- How have you applied the skills and knowledge gained from this training activity in subsequent interactions with paediatric patients, even if for different investigations or in different contexts?
- Have you become more confident in your ability to gather relevant information?
- Identify the transferable skills you are developing through this activity, such as communication with children and adults, building rapport, and asking targeted questions to obtain necessary information.
- Identify clear actions for continued development of your skills in obtaining paediatric gastrointestinal histories, considering how you might handle more sensitive topics or engage with children of different age groups in the future.
Relevant learning outcomes
| # | Outcome |
|---|---|
| # 7 |
Outcome
Identify indications for the use of percutaneous tibial nerve stimulation (PTNS) and sacral nerve neuromodulation (SNM). |