Training activity information
Details
Review the evidence base for the use of IOM on patients and feedback to colleagues
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 IOM, its purpose, and the types of procedures where it is commonly used? What knowledge do you have of the evidence supporting its use in different clinical scenarios?
- What specific clinical applications of IOM are you interested in researching? What aspects of the evidence base (e.g., effectiveness, limitations, cost-benefit) do you want to explore? How do you anticipate IOM contributes to patient safety and outcomes? Think about what you already know about the task / activity. What is your existing knowledge of IOM techniques and the types of physiological parameters monitored? Have you encountered IOM in any previous learning or clinical experiences?
- Understand the scope of your review, the expected format for your feedback, and any specific areas of IOM they would like you to focus on. Where will you find reliable evidence on IOM? How will you critically appraise the literature you find? How will you synthesise the information into a concise and informative summary for your colleagues? Are you interested in learning more about IOM and its evidence base? Do you feel equipped to undertake this review?
In action
- How are you approaching the task of reviewing the evidence base? Are you systematically searching for relevant literature, critically evaluating the sources, and taking notes on key findings? Why are you choosing specific search terms or databases? Are you deciding which research papers or guidelines are most relevant to the scope of your review? Are you making decisions about how to summarise and synthesise the information you are finding? Does identifying different types of evidence (e.g., research articles, guidelines) feel intuitive, or do you need to consciously think about the hierarchy of evidence? Is critically appraising the methodology of research papers something you find straightforward, or does it require more focused effort?
- Are you successfully identifying evidence that supports or refutes the use of IOM in different patient populations or surgical procedures? Are you gaining a clearer understanding of the clinical applications and limitations of IOM? Are you finding it difficult to locate relevant research or to critically appraise the studies you find? Are you struggling to synthesise the information from multiple sources into a coherent overview? Are you identifying specific areas where the evidence for IOM is strong or weak? Are you learning about different methodologies used to evaluate the effectiveness of IOM? Are you able to relate the evidence you are reviewing to your understanding of neurophysiology and the principles of IOM? Does this review highlight areas where you need to deepen your knowledge of research methodology or specific IOM techniques?
- Could you refine your search terms to find more targeted information? Are there different ways you could organise your notes to better understand the evidence? Are you unsure about how to interpret the findings of a particular study? Would it be helpful to discuss the evidence base for IOM with someone who has more experience in this area? Ensure your review focuses on understanding and appraising the evidence base, and you are not attempting to provide clinical recommendations beyond your current level of training.
On action
- Begin by summarising the key points from the evidence base you reviewed regarding the use of IOM on patients. What were the main findings, recommendations, or areas of consensus/disagreement in the literature? What types of studies or evidence were most prevalent in your review (e.g., systematic reviews, randomised controlled trials, case series)? Did you notice any gaps in the evidence base for specific applications of IOM? What were the reported benefits and limitations of using IOM in different surgical procedures or patient populations? Did you notice any specific guidelines or protocols recommended for the use of IOM? What methodological approaches were used in the studies you reviewed to evaluate the effectiveness of IOM?
- What key evidence supports or refutes the use of IOM in different clinical scenarios? What specific applications of IOM have a strong evidence base, and which areas require further research? What factors influence the effectiveness and interpretation of IOM data? Did you learn about different types of electrodes, stimulation techniques, or physiological responses? Were there any unexpected findings or insights from the evidence you reviewed? Did any studies challenge your prior assumptions about IOM? In what ways did your reflection-in-action (during the review process) influence your understanding of the evidence? Did you adjust your search strategy or focus on specific aspects of the literature as you progressed? How does this experience relate to the requirements for post-programme practice? How will understanding the evidence base for IOM inform your future professional decisions and practice?
- What areas for continued development related to the evidence base for IOM have been identified? For example, do you need to further explore specific surgical applications of IOM, different types of evoked potentials used in IOM, or the interpretation of IOM findings in complex cases? How can you apply the learning from this activity to your routine practice? How will you approach future discussions or decisions related to the use of IOM? Identify the actions / ‘next steps’ you will now take to support the assimilation of what you have learned. This might include sharing your findings with colleagues, seeking opportunities to observe IOM procedures, or reviewing further literature on specific aspects of IOM. What support or resources might you need to further develop your understanding of the evidence base for IOM? This could include discussing the literature with experienced colleagues or seeking out relevant educational materials.
Beyond action
- How do your initial conclusions and the feedback you provided to colleagues compare with your current understanding of IOM, considering any further literature you may have encountered or clinical experiences you have had? What were your key takeaways from the evidence at the time? Have subsequent experiences or learning challenged or reinforced those takeaways? What new insights might you have now? Have discussions with others highlighted different interpretations of the evidence or pointed towards areas you may have overlooked?
- Recognise that this DTA contributes to your overall training experience by building your critical appraisal skills and your understanding of evidence-based practice within neurophysiology. How has this experience influenced your approach to evaluating new information or guidelines in the field? How have you applied the knowledge gained from reviewing the IOM evidence since the original activity? Have you been more informed in discussions about the use of IOM, or when considering its potential benefits and limitations in different contexts? How have your skills developed in terms of accessing, interpreting, and synthesising research evidence? Has this DTA contributed to your ability to critically evaluate scientific literature?
- Identify the transferable skills you are developing through this training activity, such as critical thinking, literature review, and the ability to form evidence-based opinions. These skills are crucial for lifelong learning and professional development. Identify clear actions for continued development related to the evidence base for IOM. Are there specific areas of IOM where you need to explore the evidence further? How will you stay updated on new research in this rapidly evolving field? How might your understanding of the evidence base for IOM influence your approach to future clinical practice or research activities? Will you be more likely to question current practices or advocate for evidence-based approaches?
Relevant learning outcomes
| # | Outcome |
|---|---|
| # 7 |
Outcome
Apply legislation and guidelines and manage risk in the performance of upper limb nerve conduction studies and a multi-modality evoked potential studies. |
| # 11 |
Outcome
Appraise intraoperative monitoring (IOM) techniques and evidence base for practice. |
| # 12 |
Outcome
Demonstrate effective and compassionate communication skills with all stakeholders, including patients and the multidisciplinary team. |