Training activity information
Details
Review a patient history for patients referred for two of the following investigations and make recommendations for further investigations:
- 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 aspects of patient history will be most relevant in determining the need for further investigations?
- What key clinical information do you need to extract from a patient history to determine the appropriateness of Antroduodenal manometry, Sphincter of Oddi manometry, Barostat, Capsule studies, Endoflip, and Liver eleastography/fibroscan?
- Are you familiar with common algorithms or pathways for investigating different gastrointestinal symptoms and conditions?
- Do you understand the role of these specific investigations in the broader diagnostic workup?
- What specific skills in interpreting patient histories and linking them to potential investigations do you hope to develop?
- Think about what you already know about gastrointestinal disorders and their progression. How will this activity help you to understand the sequence of investigations that might be required?
- Do you anticipate learning more about how initial investigation results might influence the need for further, more specialised testing?
- Discuss this training activity with your training officer or supervisor to understand the types of patient histories you will be reviewing and the expected format for your recommendations.
- Consider possible challenges, such as ambiguous or incomplete patient information. How will you approach these situations?
- Will you review any case studies or examples of how patient histories guide investigation pathways for these specific tests?
In action
- How are you systematically analysing the symptoms, past medical history, and any previous investigations? Why are you doing it this way?
- What are you prioritising as you evaluate the patient’s information to identify potential further investigations?
- What decisions are you making as you consider which further investigations might be appropriate?
- How effective is your current approach in helping you identify potential further investigations based on the patient history?
- What challenges are you facing as you review the patient history? For example, is the history complex, are there inconsistencies, or is the initial referral unclear?
- What can you learn from the process of reviewing this patient history as it unfolds? Are you improving your ability to link symptoms to potential underlying conditions and relevant investigations?
- Are there alternative approaches you could be considering for reviewing the patient history to identify further investigations? For example, could you focus on ruling out certain conditions first, or consider investigations based on the most likely differential diagnoses?
- Are you considering the potential benefits and risks of further investigations for this patient?
On action
- Summarise the key aspects of the patient histories you reviewed.
- Include relevant symptoms, past medical history, and any previous investigations and their results.
- What were the reasons for the initial referrals leading to the consideration of these specialist investigations?
- What additional investigations did you recommend for each patient, and what was the rationale behind these recommendations?
- What specific aspects of the patient histories informed your recommendations?
- Did you consider any alternative investigations to those initially suggested?
- What did you learn about the clinical context and patient profiles where Antroduodenal manometry, Sphincter of Oddi manometry, Barostat, Capsule studies, Endoflip, Liver eleastography/fibroscan are considered?
- How do patient history and presenting symptoms guide the selection of appropriate further investigations in gastrointestinal physiology?
- Did you gain a better understanding of the diagnostic pathways for specific gastrointestinal disorders?
- How did this activity relate to your understanding of the range of disorders diagnosed by advanced gastrointestinal investigations?
- In what ways did the patient histories influence your recommendations for further investigations? Were there any unexpected findings in the histories that changed your thinking?
- What aspects of reviewing patient histories and formulating recommendations for further investigations do you feel you need to strengthen?
- How will you approach reviewing patient histories for specialist gastrointestinal investigations in the future?
- What specific knowledge or resources will you focus on to improve your ability to make appropriate recommendations?
Beyond action
- Consider evaluating and re-evaluating your initial review of the patient histories and the recommendations you made for further investigations. What was your reasoning behind those recommendations?
- Have you revisited your knowledge of the clinical presentations and differential diagnoses associated with conditions requiring these specialist investigations? Has your understanding deepened since this training activity?
- Recognise that this training activity contributes to your ability to identify the range of disorders diagnosed by advanced gastrointestinal investigations. How has reviewing patient histories enhanced your ability to link clinical presentations to potential diagnoses and relevant investigations?
- How has this experience influenced your approach to obtaining a thorough patient history? Are there specific aspects you now pay closer attention to when reviewing patient information?
- Identify the transferable skills you developed such as detailed analysis of clinical information, logical reasoning, and formulating diagnostic plans. How will these skills be crucial in your future practice as a Clinical Scientist?
- Identify clear actions for continued development in interpreting patient histories and making informed recommendations for further investigations in gastrointestinal physiology. What opportunities can you seek to review a wider range of complex patient cases?
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. |
| # 3 |
Outcome
Employ compassionate communication with patients to obtain informed consent ensuring patient comprehension. |
| # 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. |