Training activity information
Details
Review a referral request for two of the following and determine investigation suitability for the patient:
- Antroduodenal manometry
- Sphincter of Oddi manometry
- Barostat
- Capsule studies
- Endoflip
- Liver eleastography/fibroscan
- Other relevant specialist investigations
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 specific knowledge about the indications and contraindications for each of the listed investigations are you expected to utilise?
- What is your current understanding of the clinical indications for Antroduodenal manometry, Sphincter of Oddi manometry, Barostat, Capsule studies, Endoflip, and Liver eleastography/fibroscan?
- Are you familiar with the typical patient presentations and referral information that would suggest the need for these investigations?
- Do you know how to access relevant guidelines or protocols for determining investigation suitability?
- What specific insights do you hope to gain regarding the decision-making process for selecting appropriate specialist investigations?
- Think about what you already know about gastrointestinal disorders and their investigation. What are the gaps in your knowledge regarding the suitability of these
- Consider possible challenges you might face, such as incomplete referral information or complex patient histories. How might you approach these challenges?
- Will you review any relevant literature or guidelines on the indications and contraindications of these investigations beforehand?
In action
- How are you approaching the task of assessing the patient’s information and the requested investigations? Why are you doing it this way?
- What criteria are you using to determine the suitability of each investigation for the patient?
- What decisions are you making as you evaluate the referral, such as what information is most relevant or what questions need further clarification?
- How effective is your current approach in helping you determine the suitability of the requested investigations?
- What challenges are you facing as you review the referral? For example, is there insufficient information, are the symptoms unclear, or are there multiple potential investigations?
- What can you learn from the process of reviewing this referral as it unfolds? Are you identifying specific indications or contraindications for certain investigations?
- Are there alternative approaches you could be considering for evaluating the suitability of the investigations? For example, could you focus on the patient’s primary symptom first, or consider the least invasive options initially?
- Are you working within the guidelines and protocols for determining investigation suitability?
On action
- Summarise the key aspects of the two referral requests you reviewed.
- Include the patient’s presenting symptoms, relevant medical history, and the specific investigations being requested.
- What were the main reasons for the referrals for each patient?
- What factors did you consider when determining the suitability of the requested investigations for each patient?
- Did you identify any potential contraindications or limitations?
- What were your initial thoughts on the suitability of the requested investigations for each patient?
- Did you consult any specific guidelines or protocols during your review?
- What did you learn about the indications for the different specialist gastrointestinal physiology investigations (Antroduodenal manometry, Sphincter of Oddi manometry, Barostat, Capsule studies, Endoflip, Liver eleastography/fibroscan)?
- What factors are important in determining the suitability of these investigations for different patient presentations?
- Did the referral requests highlight any specific disorders or conditions where these investigations are particularly useful?
- How did this activity enhance your understanding of applying the requirements for performing specialist gastrointestinal physiology investigations?
- In what ways did your initial assessment of the referral requests align with your final determination of suitability?
- Were there any discrepancies, and what did you learn from them?
- What aspects of determining investigation suitability do you feel you need to develop further?
- Do you need to learn more about the nuances of specific investigations or particular patient populations?
- How will you approach reviewing referral requests for specialist gastrointestinal physiology investigations in the future?
- What resources or information will you seek out to improve your ability to determine investigation suitability?
Beyond action
- Consider evaluating and re-evaluating your initial assessments of the referral requests and your decisions regarding the suitability of the investigations. What were the key factors that influenced your decisions at the time?
- Compare this experience with other subsequent experiences where you have been involved in patient referrals or determining the appropriateness of diagnostic tests. What similarities or differences do you notice in the referral information and your approach?
- Have you revisited your understanding of the indications and contraindications for the listed specialist investigations (Antroduodenal manometry, Sphincter of Oddi manometry, Barostat, Capsule studies, Endoflip, Liver eleastography/fibroscan)? Has your knowledge evolved since this training activity?
- Recognise that this activity contributes to your ability to apply the requirements for performing specialist gastrointestinal physiology investigations in a range of patients. How has this initial experience of reviewing referrals influenced your subsequent understanding of when these investigations are appropriate?
- How has this activity informed your understanding of the range of disorders diagnosed by these advanced gastrointestinal investigations? Has it helped you to better appreciate the implications for the patient and potential treatments?
- Identify the transferable skills you developed such as critical evaluation of clinical information and decision-making regarding diagnostic pathways. How will these skills be essential in your future role?
- Identify clear actions for continued development in understanding the nuances of referral criteria for specialist gastrointestinal investigations. What further learning resources or discussions with senior colleagues could enhance your expertise in this area?
Relevant learning outcomes
| # | Outcome |
|---|---|
| # 1 |
Outcome
Apply the requirements for performing specialist gastrointestinal physiology investigations in a range of patients including paediatrics. |
| # 2 |
Outcome
Perform a range of the specialist gastrointestinal physiology investigations, including safe intubation of the upper and lower gastrointestinal tract in a variety of adult and paediatric patient conditions. |
| # 6 |
Outcome
Identify the range of disorders diagnosed by advanced gastrointestinal investigations, the implications for the patient, impact their quality of life, potential treatments and the differential diagnosis. |