Nerve Conduction Studies & Evoked Potentials 2 —
Training activity: 5

Details

Produce factual reports for a lower limb nerve conduction study for peripheral neuropathy screen

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 producing factual reports for lower limb nerve conduction studies focused on peripheral neuropathy screening.
• Consider how the learning outcomes apply, specifically in relation to preparing reports that reflect an understanding of patient pathways and demonstrating effective communication.
• Discuss with your training officer to gain clarity of what is expected of you in relation to a successful, factual, and clinically relevant report.

What is your prior experience of this activity?

• Think about what you already know about reporting on clinical investigations, particularly nerve conduction studies.
• Consider possible challenges you might face during the activity, such as accurately summarising findings, ensuring the report is factual and objective, reflecting an understanding of patient pathways, or communicating results effectively in written form, 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 ambiguous or conflicting findings require expert pathological interpretation before a definitive conclusion is written
  • When unsure about the appropriate terminology for grading peripheral neuropathy severity
  • If the report needs to be expedited urgently due to high clinical priority
• Acknowledge how you feel about reporting in the context of this training activity.

What do you anticipate you will learn from the experience?

• Consider the specific skills you want to develop, such as selecting key findings to include, structuring a clear and concise report, using appropriate terminology, and linking findings to the context of peripheral neuropathy screening and patient pathways, drawing upon previous experiences.
• Identify the specific insights you hope to gain into understanding how reports are used by other healthcare professionals or appreciating the importance of accurate and timely reporting within patient pathways.

What additional considerations do you need to make?

• Consult actions identified following previous experiences of writing clinical reports.
• Identify important information you need to consider before embarking on the activity, such as standard report templates, required elements for this type of study and context, and how the report fits into the overall patient pathway.

In action

Is anything unexpected occurring?

• Are you noticing anything surprising or different from what you anticipate whilst drafting the factual report and summarising findings?
• Are you encountering situations such as:
  • The collected measurements (amplitude, latency, velocity, F-Wave) show complex, borderline changes that are difficult to translate into a clear, concise factual statement regarding the neuropathy screen?
  • You find difficulty integrating the clinical history and examination findings into the objective report structure, challenging the assessment of findings within the patient pathway?
  • The data suggests the severity of the peripheral neuropathy requires specific grading terminology that you are unfamiliar with

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 report structure or terminology to ensure clarity?
• Consider the steps you are taking in the moment, such as:
  • Immediately seeking clarification on the required terminology for describing complex findings related to nerve conduction in the peripheral neuropathy screen
  • Reviewing departmental templates or peer reports to ensure consistency in language used to communicate technical data effectively
• How are you feeling in that moment? For instance, are you finding it difficult to maintain objectivity while translating complex data? Is it affecting your confidence in producing a document that accurately reflects the patient pathway?

What is the conclusion or outcome?

• Identify how you are working within your scope of practice. For example, are you successfully describing complex measurements and documenting findings using standard clinical language? Or are you needing support because the interpretation or required grading of neuropathy severity requires senior pathological input before the factual report can be finalised?
• What are you learning as a result of the unexpected development? For example, are you mastering a more effective strategy for structuring reports to reflect an understanding of patient pathways? Or gaining insight into the critical importance of precise technical documentation?

On action

What happened?

• Begin by summarising the key steps you took when producing the factual report for the lower limb NCS.
• Consider specific events, actions, or interactions which felt important, such as how you organised the extensive measurement data from multiple lower limb nerves, or how you ensured the report structure reflected the patient’s place in the diagnostic pathway.
• Include any ‘reflect-in-action’ moments where you had to adapt to the situation as it unfolded, for instance, changing the terminology used to describe borderline findings to maintain factual objectivity and seeking input on grading peripheral neuropathy severity.
• How did you feel during this experience, e.g., were you confident in selecting appropriate report language or challenged by the difficulty of integrating complex data into a concise summary?

How has this experience contributed to your developing practice?

• Identify what learning you can take from this experience regarding factual reporting. What strengths did you demonstrate, e.g., accurate transcription and presentation of technical measurement values? What skills and/or knowledge gaps were evident, e.g., unfamiliarity with standard report templates or specific terminology used for grading neuropathy severity?
• Compare this experience against previous engagement with similar activities – has your practice improved in producing reports that effectively communicate findings and reflect the patient pathway?
• Identify any challenges you experienced, such as needing to seek advice or clarification on scope of practice regarding how to factually report contradictory clinical history alongside objective NCS data, 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 producing factual reports for peripheral neuropathy screens.
• What will you do differently next time you approach report production, for instance, by proactively integrating specific, agreed-upon departmental terminology for findings that suggest small fibre involvement?
• Do you need to practise any aspect of the activity further, such as reviewing different report templates or key learning outcomes related to preparing factual reports?

Beyond action

Have you revisited the experiences?

• How have your subsequent experiences producing factual reports, especially those requiring precise grading of neuropathy severity or complex narrative summarisation, 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 report required the inclusion of complex clinical correlation to justify the grading of neuropathy severity forced you to re-evaluate the objectivity and clinical relevance of the report structure you applied during your first attempt at this training activity.
• Considering what you understand about factual reporting, patient pathways, and effective 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 NCS reporting technique and terminology based on further learning and experiences? For example, how you proactively reviewed and integrated standardized report templates to ensure clear delineation between technical data and factual summary, demonstrating you have adapted improvements based on further learning.
• Has discussing reports where terminology was ambiguous or where the pathway was not clearly reflected with colleagues, peers, or supervisors changed how you now view your initial experience in this training activity? For example, how professional storytelling with a supervising physician about a report where ambiguous phrasing led to confusion regarding motor vs. sensory deficit, refined your understanding of the critical nature of concise, unambiguous language in reports.

How have these experiences impacted upon current practice?

• How has the learning from this initial training activity, in combination with subsequent report production experiences, contributed to your overall confidence and competence in preparing reports that reflect patient pathways, particularly in preparing for assessments like Case-Based Discussions (CBDs)? For example, how your accumulated ability in summarising technical findings into clear factual reports now enables you to efficiently present study outcomes during a CBD assessment.
• How has reflecting back on this specific training activity, combined with everything you’ve learned since, shaped your current approach to factual reporting? 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 immediately when a report requires language regarding legal or employment implications, recognising this falls outside factual reporting scope.
• Looking holistically at your training journey, how has this initial factual report experience, revisited with your current perspective, contributed to your development in meeting the learning outcomes related to reporting and communication? For example, how this foundational experience has supported your development in meeting subsequent learning outcomes focused on interpreting complex findings, ensuring they can be accurately communicated.

Relevant learning outcomes

#	Outcome
# 8	Outcome Prepare reports that reflect an understanding of patient pathways.
# 12	Outcome Demonstrate effective and compassionate communication skills with all stakeholders, including patients and the multidisciplinary team.