Paediatric Neurophysiology —
Training activity: 1

Details

Plan and prepare to conduct an EEG for: Full term neonate (first 28 days of life) Infant (up to one year) Child under five Child over five

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 effectively planning and preparing the clinical environment for EEG recordings across these diverse paediatric age groups.
• Consider how the learning outcomes apply, specifically in relation to preparing patients and environments for testing, maintaining safety and patient dignity and ensuring your planning integrates effective and compassionate communication considerations for each developmental stage.
• Discuss with your training officer to gain clarity of what is expected of you in relation to specific procedural planning for non-standard requirements, such as necessary specialised monitoring equipment checks or strict environmental protocols for a full-term neonate.

What is your prior experience of this activity?

• Think about what you already know about technical planning, resource logistics, and environmental control requirements for neurophysiology studies.
• Consider possible challenges you might face during the activity, such as adapting the testing environment for a high-risk neonate currently housed in an incubator, or tailoring patient instructions for diverse parental comprehension levels, and think about how you might handle them.
• 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:
  • When planning a complex study for a child with known photic sensitivity where standard preparation guidelines need clinical adjustment
  • If required age-appropriate safety equipment e.g., specialised cot padding or fixation devices for infants is unavailable or compromised, affecting the ability to meet patient safety
  • When coordinating the study environment for a full-term neonate requiring complex connection management due to medical lines or equipment
• Acknowledge how you feel about planning and preparing for EEGs across this broad spectrum of paediatric ages, from fragile newborns to co-operative older children.

What do you anticipate you will learn from the experience?

• Consider the specific skills you want to develop, such as efficiently translating age-specific clinical protocols into a functional preparation checklist (e.g., ensuring appropriate sleep deprivation compliance is checked for older children).
• Identify the specific insights you hope to gain into the logistical differences required between setting up a quiet, minimal handling environment for a sleeping infant versus a stimulating environment for an uncooperative toddler.

What additional considerations do you need to make?

• Consult actions identified following previous experiences of planning or preparing for procedures where environmental factors (e.g., noise, temperature) directly impacted recording quality.

Identify important information you need to consider before embarking on the activity, such as reviewing local age-specific protocols for handling patient logistics (e.g., NICU entry requirements) and ensuring pre-test patient education materials are suitable for the parent/guardian.

In action

Is anything unexpected occurring?

• Are you noticing anything surprising or different from what you anticipate whilst planning and preparing the room for a specific paediatric age group?
• Are you encountering situations such as:
  • Conflicting information regarding patient cooperation or mobility that challenges your equipment layout plan?
  • Difficulty in verifying the availability of age-specific safety equipment e.g., cot-side padding for an infant?
  • A logistical hurdle arises, such as unexpected scheduling conflicts or immediate unavailability of a dedicated paediatric testing room?

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 scheduling or resource allocation due to unexpected logistical hurdles?
• Consider the steps you are taking in the moment, such as:
  • Immediately seeking clarification on complex patient status e.g., infection risk or mobility limitations from nursing staff to adjust the preparation protocol
  • Halting the physical preparation to ensure all required pre-test checklists for equipment functionality are completed before proceeding
• How are you feeling in that moment? For instance, are you finding it difficult to maintain focus on age-specific safety requirements while managing logistics? Is it affecting your confidence in ensuring patient dignity during the preparation phase?

What is the conclusion or outcome?

• Identify how you are working within your scope of practice. For example, are you successfully adapting the room setup for a child with complex needs within standard protocols? Or are you needing support because a major technical equipment check (e.g., amplifier self-test) fails unexpectedly and requires senior technical staff intervention?
• What are you learning as a result of the unexpected development? For example, are you gaining insight into the criticality of age-specific preparation checks for successful paediatric EEG acquisition?

On action

What happened?

• Begin by summarising the key steps you took when planning and preparing the clinical environment for the specific paediatric EEG case e.g., preparing the patient for transfer, checking safety equipment, and reviewing the age-specific protocol.
• Consider specific events, actions, or interactions which felt important, such as how you coordinated the preparation with nursing staff to ensure minimal disruption to a full-term neonate, or how you ensured all electrode supplies were correct for an infant’s smaller head size.
• Include any ‘reflect-in-action’ moments where you had to adapt to the situation as it unfolded, for instance, immediately seeking advice when discovering the designated testing room was unexpectedly too cold to maintain the dignity and comfort of a child.
• How did you feel during this experience, e.g., did you feel rushed to resolve the issue or confident in your ability to adapt the plan?

How has this experience contributed to your developing practice?

• Identify what learning you can take from this experience regarding planning and preparation. What strengths did you demonstrate, e.g., technical knowledge of required electrode supplies for the age group? What skills and/or knowledge gaps were evident, e.g., unfamiliarity with the specific checklist requirements for preparing for a child with complex needs?
• Compare this experience against previous engagement with similar activities – Has your practice improved in anticipating logistical challenges?
• Identify any challenges you experienced, such as needing to seek advice or clarification on scope of practice regarding whether certain medication checks needed to be explicitly confirmed with the Training Officer before finalising the preparation plan, and how you reacted to this.

What will you take from the experience moving forward?

• Identify the actions or ‘next steps’ you will now take to support the assimilation of what you have learnt, including from any feedback you have received, with regards to meticulous age-appropriate EEG preparation.
• What will you do differently next time you approach planning a paediatric EEG, for instance, by proactively establishing clearer communication channels with the ward staff to verify environmental readiness before attending the patient?
• Do you need to practise any aspect of the activity further, such as reviewing specific safety protocols for different paediatric monitoring equipment or key learning outcomes related to maintaining patient dignity?

Beyond action

Have you revisited the experiences?

• How have your subsequent experiences planning and preparing EEG recordings across diverse paediatric age groups since completing this specific training activity led you to revisit your initial approach or decisions during that activity? For example, how an instance where a subsequent urgent case required highly sterile conditions in a NICU environment, significantly testing the speed and meticulousness of your resource planning, forced you to re-evaluate the depth of risk assessment regarding environmental safety you applied during your first attempt at this training activity.
• Considering what you understand about age-specific safety requirements, scheduling logistics, and resource availability 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 EEG planning and preparation checklist based on further learning and experiences? For example, how you proactively reviewed and integrated the manufacturer’s specific guidelines on patient monitoring equipment compatibility for infants, demonstrating you have adapted improvements based on further learning.
• Has discussing unexpected technical failures or delays due to poor preparation or the impact of inappropriate planning on workflow 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 time when incorrect electrode supplies caused a delay for an anxious child, refined your understanding of the critical nature of pre-activity resource verification during planning.

How have these experiences impacted upon current practice?

• How has the learning from this initial training activity, in combination with subsequent EEG planning and preparation experiences, contributed to your overall confidence and competence in efficiently planning and preparing the clinical environment for children, particularly in preparing for assessments like Direct Observations of Practical Skills (DOPS) related to planning and preparing for a paediatric EEG? For example, how your accumulated ability in rapidly ensuring all required equipment and age-appropriate safety checks are complete now enables you to confidently present a prepared environment for an EEG recording 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 planning and preparing for paediatric EEGs? 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 Clinical Governance Lead immediately when a required environmental adaptation e.g., highly specialised incubator modification for a pre-term neonate falls outside routine preparation scope, recognising this requires specialist input.
• Looking holistically at your training journey, how has this initial EEG planning and preparation experience, revisited with your current perspective, contributed to your development in meeting the learning outcomes related to preparing patients and environments and demonstrating effective communication skills? For example, how this foundational experience has supported your development in practicing safely by providing the necessary knowledge base for the subsequent learning outcomes focused on performing the actual diagnostic test.

Relevant learning outcomes

#	Outcome
# 2	Outcome Prepare patients and environments for testing, maintaining safety and patient dignity.
# 3	Outcome Demonstrate effective and compassionate communication skills with all stakeholders, including patients and the multidisciplinary team.