Training activity information
Details
Obtain informed consent for lower limb nerve conduction studies and inform patient of results dissemination
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 obtaining informed consent and informing patients about results dissemination for lower limb nerve conduction studies.
- Consider how the learning outcomes apply, specifically in relation to explaining procedures for consent and demonstrating effective and compassionate communication.
- Discuss with your training officer to gain clarity of what is expected of you in relation to successful informed consent and results dissemination communication.
What is your prior experience of this activity?
- Think about what you already know about obtaining informed consent and discussing results dissemination with patients.
- Consider possible challenges you might face during the activity, such as explaining complex procedures clearly, addressing patient anxieties, ensuring the patient understands the information, or managing expectations about results, 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:
- If the patient requires detailed legal/ethical clarification on results dissemination
- When a patient refuses consent for specific, potentially painful parts of the study
- If the patient has difficulty understanding due to language barriers or cognitive impairment and requires specialist communication support
- Acknowledge how you feel about obtaining informed consent for conduction studies in this context.
What do you anticipate you will learn from the experience?
- Consider the specific skills you want to develop, such as tailoring explanations to individual patients, using clear and compassionate language, checking for understanding, and adhering to consent protocols, drawing upon previous experiences.
- Identify the specific insights you hope to gain into understanding the legal and ethical requirements of consent or appreciating the impact of effective communication on patient autonomy and trust.
What additional considerations do you need to make?
- Consult actions identified following previous experiences of obtaining consent or discussing results.
- Identify important information you need to consider before embarking on the activity, such as the specific consent form requirements, the standard procedure for results dissemination, and any institutional policies on patient communication.
In action
Is anything unexpected occurring?
- Are you noticing anything surprising or different from what you anticipate whilst explaining the study procedures or the results dissemination pathway?
- Are you encountering situations such as:
- The patient expresses unexpected anxiety or refusal regarding the F-Wave stimulation, requiring immediate clarification of the procedure and communication?
- Complex questions arise about how the results dissemination impacts their employment or legal status, challenging your knowledge of institutional reporting protocols?
- The patient raises a concern about a specific potential risk that was not included in your standard explanation, requiring a tailored response?
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 explaining risks or confirming comprehension in the moment?
- Consider the steps you are taking in the moment, such as:
- Immediately slowing down the explanation and providing detailed reassurance or alternative phrasing to address the patient’s specific concern about stimulus discomfort
- Halting the consent process to seek immediate internal clarification regarding the specific legal limitations of results dissemination for that patient’s pathway
- How are you feeling in that moment? For instance, are you finding it difficult to maintain clarity and composure while navigating ethical boundaries? Is it affecting your confidence in obtaining truly informed consent?
What is the conclusion or outcome?
- Identify how you are working within your scope of practice. For example, are you successfully addressing the patient’s concerns and obtaining full consent by adapting the explanation? Or are you needing support because the patient’s confusion regarding their capacity to consent requires the involvement of a senior clinician or legal governance lead?
- What are you learning as a result of the unexpected development? For example, are you mastering a more effective technique for verifying patient comprehension of procedural risks? Or gaining insight into the criticality of clear communication regarding administrative processes like results reporting?
On action
What happened?
- Begin by summarising the key steps you took when obtaining informed consent and discussing results dissemination with the patient.
- Consider specific events, actions, or interactions which felt important, such as how you explained the electrical stimulation required for motor and F-Wave studies to alleviate anxiety, or how you clarified the timeline and pathway for results reporting.
- Include any ‘reflect-in-action’ moments where you had to adapt to the situation as it unfolded, for instance, immediately adapting your explanation to simplify complex terminology about measurement values when the patient appeared confused about the meaning of velocity and latency.
- How did you feel during this experience, e.g., were you confident in your ability to adapt your communication to ensure comprehension or stressed by the potential need to seek supervisory input on ethical guidelines?
How has this experience contributed to your developing practice?
- Identify what learning you can take from this experience regarding consent and communication. What strengths did you demonstrate, e.g., compassionate communication when discussing discomfort? What skills and/or knowledge gaps were evident, e.g., unfamiliarity with specific legal requirements for capacity to consent or explaining the results pathway?
- Compare this experience against previous engagement with similar activities – has your practice improved in explaining complex procedures clearly and verifying patient understanding?
- Identify any challenges you experienced, such as needing to seek advice or clarification on scope of practice regarding the safe termination of the study if the patient rescinded consent mid-procedure, 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 obtaining informed consent and effective results communication.
- What will you do differently next time you approach explaining the study procedure, for instance, by proactively using the ‘teach-back’ method to ensure the patient understood the timing and recipient of the factual report?
- Do you need to practise any aspect of the activity further, such as refining the explanation of specific electrical stimulation parameters or key learning outcomes related to demonstrating effective communication skills?
Beyond action
Have you revisited the experiences?
- How have your subsequent experiences obtaining consent and managing patient expectations 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 patient had significant ethical or legal queries regarding data dissemination forced you to re-evaluate the brevity of your explanation regarding post-procedure reporting you applied during your first attempt at this training activity.
- Considering what you understand about informed consent and compassionate communication 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 consent discussion and results management based on further learning and experiences? For example, how you proactively reviewed and implemented a standardised process for discussing the expected format and recipient of the factual report, demonstrating you have adapted improvements based on further learning.
- Has discussing challenging consent scenarios or the impact of unclear results communication 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 patient who was distressed due to unclear results dissemination timelines, refined your understanding of the critical nature of managing expectations during the consent phase.
How have these experiences impacted upon current practice?
- How has the learning from this initial training activity, in combination with subsequent consent and communication experiences, contributed to your overall confidence and competence in explaining procedures and obtaining informed consent, particularly in preparing for assessments like OCEs? For example, how your accumulated ability in clearly outlining procedural risks and benefits now enables you to confidently handle questions during a consent OCE assessment.
- How has reflecting back on this specific training activity, combined with everything you’ve learned since, shaped your current approach to obtaining informed consent? 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 Ethics Committee representative immediately when a patient raises concerns regarding data privacy or legal constraints that fall outside routine institutional consent forms.
- Looking holistically at your training journey, how has this initial consent and communication experience, revisited with your current perspective, contributed to your development in meeting the learning outcomes related to consent and communication? For example, how this foundational experience has supported your development in meeting subsequent learning outcomes focused on producing factual reports, ensuring the technical data is appropriately disseminated.
Relevant learning outcomes
| # | Outcome |
|---|---|
| # 4 |
Outcome
Explain procedures to patients in order to obtain informed consent for peripheral nerve conduction studies. |
| # 12 |
Outcome
Demonstrate effective and compassionate communication skills with all stakeholders, including patients and the multidisciplinary team. |