Training activity information
Details
Review two complex patient cases, and make recommendations for further treatment and investigation for surgically altered oesophagus
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 is your current understanding of the physiological changes that occur after different types of oesophageal surgery?
- What are the common complications and symptoms experienced by patients with surgically altered oesophagus that might require further investigation or treatment?
- Are you familiar with the different types of upper gastrointestinal physiology investigations that might be relevant in these cases (e.g., oesophageal manometry, pH-impedance, endoscopy)? What are the indications for each?
- Do you know where to access relevant patient information and guidelines for managing these complex cases?
- What specific insights do you hope to gain from reviewing these complex patient cases?
- Think about what you already know about managing patients with surgically altered oesophagus. What are the gaps in your knowledge or experience that you hope this activity will address?
- Do you anticipate learning more about specific investigation techniques or treatment pathways for this patient group?
- Consider possible challenges you might face when reviewing these complex cases, such as incomplete information or difficulty in determining the most appropriate next steps.
- How might you approach these challenges (e.g., seeking further information, discussing with colleagues)?
- Will you review any relevant literature or case studies on surgically altered oesophagus before engaging with the patient cases?
In action
- Pay attention to your actions as you review each patient case. How are you approaching the task of analysing the patient history, investigation results, and other relevant information? Why are you doing it this way?
- What decisions are you making as you progress through each case? This might include decisions about which information is most relevant, potential diagnoses, and possible next steps.
- How effective are your current approaches in understanding the complexities of each case and formulating potential recommendations?
- What challenges are you facing as you review these cases? For example, are there ambiguities in the information, conflicting data, or uncertainty about the most appropriate course of action?
- Are you identifying patterns, recognising specific post-surgical complications, or improving your ability to synthesise complex information?
- How does this activity connect with your existing knowledge and skills related to upper gastrointestinal physiology, oesophageal surgery, and diagnostic investigations?
- Are there alternative approaches you could be considering for analysing the cases or formulating your recommendations? For example, could you focus on specific symptoms first, or prioritise certain types of investigations?
On action
- Summarise the key aspects of the two complex patient cases you reviewed. This might include the presenting symptoms, relevant past medical history (especially related to the surgical alteration), previous investigations, and any initial treatment provided.
- What were the main challenges or complexities presented by each case?
- Were there ambiguities in the clinical picture, conflicting investigation results, or difficulties in understanding the impact of the surgical alteration on their physiology?
- What recommendations for further treatment and investigation did you make for each case? Note down the rationale behind these recommendations.
- What resources or guidelines did you consult (if any) during your review of these cases?
- What new knowledge or understanding did you gain about the physiology of the surgically altered oesophagus?
- Did you learn more about specific post-surgical complications or adaptations?
- What did you learn about the indications and utility of different diagnostic investigations in patients with surgically altered oesophagus?
- Did the cases highlight the value of specific techniques like Wireless pH monitoring or High-resolution impedance manometry (HRiM)?
- Were there any unexpected findings or insights from the patient cases?
- What areas for continued development have been identified as a result of this activity?
- Do you feel you need to further research specific surgical procedures, their physiological consequences, or particular diagnostic tests?
- How can you apply the learning from this activity to future case reviews or discussions involving patients with surgically altered oesophagus?
- What specific actions will you take to consolidate your learning? This could include reviewing relevant literature, discussing the cases with senior colleagues, or seeking out opportunities to observe related investigations or procedures.
Beyond action
- What were your key takeaways and recommendations at the time of the activity?
- Have you revisited your initial recommendations for treatment and investigation in light of subsequent learning or experiences?
- Would you make the same recommendations now, or has your understanding evolved?
- How has the experience of reviewing these complex cases supported you in approaching other challenging patient scenarios?
- How have you applied the knowledge gained about surgically altered oesophagus or the process of complex case review in your subsequent practice?
- Have you encountered similar cases, and if so, how did this experience inform your approach?
- Identify the transferable skills you developed through this training activity, such as the ability to analyse complex information, synthesise data from various sources, and make reasoned recommendations.
- How will these skills be valuable in your future role as a healthcare scientist?
- Identify clear actions for continued development in the area of managing patients with surgically altered oesophagus or complex upper gastrointestinal conditions.
- What further learning or experiences would you seek out to enhance your expertise in this area?
Relevant learning outcomes
| # | Outcome |
|---|---|
| # 3 |
Outcome
Analyse and interpret the data producing complete reports for both high-resolution oesophageal manometry and oesophageal pH-impedance monitoring, making recommendations for subsequent management/treatment. |
| # 5 |
Outcome
Practice professionally within the multidisciplinary team. |