Training activity information
Details
Adapt and explain the sleep procedure to the patient/parent/carer to ensure co-operation with the diagnostic testing
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 adapting and explaining the sleep procedure (Polysomnography (PSG) or Multiple Sleep Latency Test (MSLT)) to the patient, parent, or carer, ensuring their full cooperation with the diagnostic testing.
- Consider how the learning outcomes apply, specifically in relation to preparing and planning for sleep investigations, performing PSG and MSLT with guidance, and demonstrating effective and compassionate communication skills with stakeholders.
- Discuss with your training officer what constitutes a successful explanation of sleep procedures, tailored for different patient groups (adult/paediatric) and their families, ensuring understanding and reducing anxiety.
What is your prior experience of this activity?
- Think about what you already know about explaining medical procedures. Have you explained sleep studies (PSG or MSLT) before, or adapted your explanation based on the individual’s age or understanding?
- Consider possible challenges you might face during the activity, such as explaining the numerous sensors involved (e.g., EEG, EOG, EMG, respiratory effort), managing patient/parent anxiety about sleeping/napping in the lab, ensuring compliance with the protocol (e.g., MSLT requirements), or addressing concerns about comfort and privacy.
- 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:
- Regarding complex patient histories affecting the study protocol
- If specific patient concerns about comfort or privacy cannot be resolved through routine reassurance
- If consent issues for paediatric patients arise
- Acknowledge how you feel about explaining sleep studies, which involve many sensors and specific patient behaviours, to ensure cooperation.
What do you anticipate you will learn from the experience?
- Consider the specific communication skills you want to develop, such as explaining the technical and procedural aspects of sleep studies (PSG, MSLT) clearly and effectively to different individuals (patient, parent, carer).
- Identify the specific insights you hope to gain into tailoring your language and approach to ensure understanding and maximise cooperation for these lengthy and involved tests.
What additional considerations do you need to make?
- Consult actions identified following previous experiences of explaining procedures that require significant patient involvement or behaviour modification.
- Identify important information you need to consider before explaining the procedure, such as reviewing the specific protocol for the planned study (PSG or MSLT), understanding the patient’s history and the clinical question, considering the age and likely understanding of the patient/parent/carer, and preparing any necessary patient information leaflets or visual aids.
In action
Is anything unexpected occurring?
- Are you noticing anything surprising or different from what you anticipate whilst explaining the PSG or MSLT procedure?
- Are you encountering situations such as:
- The patient expresses severe anxiety about the numerous sensors (EEG, respiratory, EMG leads) or the sleeping environment.
- The parent/carer expresses confusion about the precise timing or compliance requirements for the Multiple Sleep Latency Test (MSLT) naps?
- The patient raises concerns about comfort or privacy that are not easily addressed by routine reassurance, potentially affecting compliance?
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 sensor application or protocol requirements?
- Consider the steps you are taking in the moment, such as:
- Immediately using compassionate communication techniques to address anxiety and proactively demonstrating or showing visual aids of the sensors to demystify the setup.
- Seeking immediate guidance from a sleep physiologist or supervisor if the patient refuses a critical component of the study, to determine the necessary adaptation.
- How are you feeling in that moment? For instance, are you finding it difficult to explain the specific, complex timing requirements of the sleep protocol? Is it affecting your confidence in ensuring full patient/parent compliance?
What is the conclusion or outcome?
- Identify how you are working within your scope of practice. For example, are you successfully reassuring the patient and clarifying the study requirements to ensure cooperation? Or are you needing support because the patient’s clinical needs require a non-standard protocol requiring senior input?
- What are you learning as a result of the unexpected development? For example, are you mastering an improved strategy for setting expectations regarding the sensor application process? Or gaining insight into the critical communication steps required for complex procedures like MSLT?
On action
What happened?
- Begin by summarising the key points of the interaction where you explained the specific sleep procedure (PSG or MSLT, which follow an overnight PSG).
- Consider specific events, actions, or interactions which felt important, including your own feelings during the experience.
- How did you adapt your explanation of the sleep procedure for the specific patient/parent/carer to ensure co-operation? What communication techniques did you use?
- How did the patient and/or parent/carer respond to your explanation?
- Did anything unexpected occur during the explanation or consent process? Include any moments where you adapted your approach in the moment (reflect-in-action).
How has this experience contributed to your developing practice?
- What learning can you take from this experience regarding adapting explanations and demonstrating effective and compassionate communication skills when explaining sleep procedures? What strengths did you demonstrate? What skills and/or knowledge gaps were evident?
- Compare this experience against previous engagement with similar communication activities. Were any previous identified actions for development achieved? Has your practice improved?
- Identify any challenges you experienced in explaining the procedure or obtaining appropriate consent and how you reacted to these. Did adapting your approach impact the patient’s response or willingness to cooperate? Were you able to overcome the challenges?
- Identify anything significant about the activity. Did you need to seek advice or clarification regarding communication strategies or protocols?
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 regarding adapting explanations and demonstrating effective communication skills for sleep procedures, including from any feedback you have received.
- What will you do differently next time you explain a sleep procedure to a patient/parent/carer?
- Has anything changed in terms of what you would do if you were faced with a similar situation again?
- Do you need to practise any aspect of explaining sleep procedures or specific communication techniques further? What resources or support might you seek to further develop your communication skills?
Beyond action
Have you revisited the experiences?
- Have you reviewed your past reflections on adapting explanations for sleep procedures (like PSG or MSLT) for patients or parents/carers to ensure co-operation?
- What specific actions did you identify in previous reflections concerning your strategies for explaining complex sleep studies, addressing patient/carer concerns, or ensuring understanding to facilitate co-operation?
- Have you actively incorporated these identified improvements into your recent explanations for sleep procedures? Are you ready to demonstrate improved skill in adapting and explaining sleep procedures based on revisiting past experiences and learning?
- Has discussing challenging patient/carer interactions regarding sleep studies with peers or senior staff provided new perspectives on your past experiences?
How have these experiences impacted upon current practice?
- How does reviewing your history of adapting explanations for sleep procedures inform your preparation for Observed Communication Events (OCEs), such as obtaining a detailed patient history for a sleep study or explaining MSLT to a patient/carer and obtaining consent?
- How has your ability to adapt and explain sleep procedures, considering the need to ensure co-operation for accurate data acquisition, developed and evolved over time?
- Does revisiting past experiences help you identify situations where explaining sleep procedures might be particularly challenging, perhaps due to patient anxiety, cultural factors, or complexity of the study, and where you might need assistance or senior support?
Relevant learning outcomes
| # | Outcome |
|---|---|
| # 5 |
Outcome
Prepare, and plan for the following sleep investigations polysomnography (PSG) and multiple sleep latency tests (MSLT). |
| # 6 |
Outcome
Perform PSG and MSLT with guidance from a sleep physiologist. |
| # 9 |
Outcome
Demonstrate effective and compassionate communication skills with all stakeholder including patients and the multidisciplinary team. |