Training activity information
Details
Participate in theatre briefing/huddles, discuss, and confirm intraoperative neuromonitoring plans for spinal surgery, documenting any adaptations to the plans following discussion with surgeon and/or anaesthetist.
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?
- Have you identified the expectations for discussing and adapting intraoperative neuromonitoring (IONM) plans with the surgeon and anaesthetist?
- How do the learning outcomes apply, specifically regarding professional communication and making necessary adjustments to the pre-operative plan based on the day’s information?
- Have you discussed with your Training Officer what constitutes a ‘confirmed’ plan and how to document adaptations made during the huddle?
What is your prior experience of this activity?
- What do you already know about theatre huddle protocols, and how do you feel about communicating your monitoring strategy to the multidisciplinary team (MDT)?
- What challenges, such as conflicting information from the surgical team or sudden changes in the surgical approach, do you anticipate?
- Do you recognise when to seek advice from a senior scientist if a proposed plan adaptation falls outside your scope of practice?
What do you anticipate you will learn from the experience?
- What specific skills in professional communication and collaborative planning do you want to develop?
- What insights do you hope to gain regarding the concerns of surgeons and anaesthetists that may influence your monitoring strategy?
What additional considerations do you need to make?
- Have you consulted feedback from previous theatre briefings?
- What critical information, such as the specific levels of spinal instrumentation or the patient’s baseline neurological status, must you consider before the briefing?
In action
During the activity is anything unexpected occurring?
- Are the surgeon or anaesthetist proposing a change to the surgical approach or instrumentation levels that contradicts the pre-operative plan?
How are you reacting to the unexpected development?
- How are you adapting the monitoring plan in the moment and communicating these technical changes to the multidisciplinary theatre team?
- Do you feel positive about reaching a safe and confirmed plan?
What is the conclusion or outcome?
- Are you successfully ensuring that the necessary adjustments are documented while remaining within your prescribed scope of practice?
On action
What happened?
- How would you summarise the experience of confirming the intraoperative neuromonitoring plans during the theatre huddle?
- Which specific interactions with the surgeon or anaesthetist felt most significant to you, especially regarding adaptations made to the pre-operative plan based on information available on the day?
- How did you feel when documenting plan adaptations and ensuring all members of the multidisciplinary theatre team were aligned?
- Were there any ‘reflect-in-action’ moments where you had to quickly adjust your communication style to address concerns raised by the surgical team?
How has this experience contributed to your developing practice?
- What strengths did you demonstrate in effective and professional communication during the briefing?
- How does this experience compare to previous huddles for you—has your ability to discuss the risks and benefits of the monitoring approach improved?
- Were there any knowledge gaps regarding the planned surgical instrumentation that you identified during the discussion?
- Did you need to seek clarification from a senior scientist to ensure the adapted plan remained within your prescribed scope of practice?
What will you take from the experience moving forward?
- What ‘next steps’ will you take to improve your involvement in theatre briefings, perhaps by reviewing specific spinal cord and vertebral column surgical procedures beforehand?
- Would you approach the confirmation of the monitoring plan differently if faced with a similar sudden change in the surgical approach?
Beyond action
Have you revisited the experiences?
- Have you reviewed your previous reflections on participating in theatre huddles and confirming IONM plans?
- What specific actions did you previously identify to improve your ability to discuss the risks and benefits of the monitoring approach?
- Have you completed those actions, and how has this influenced your readiness to lead these discussions independently?
- When engaging in professional storytelling with peers, how has analysing their experiences with difficult briefing scenarios transformed your own approach to multidisciplinary communication?
How have these experiences impacted upon current practice?
- How has the accumulated learning from these briefings supported your preparation for the module in-person assessments?
- How has your ability to adapt the monitoring plan based on real-time information developed, and can you identify instances where this foundational knowledge has improved your situational awareness in theatre?
- What transferable skills in negotiation and professional conduct have you developed that will assist you in other high-pressure MDT environments?
Relevant learning outcomes
| # | Outcome |
|---|---|
| # 1 |
Outcome
Follow the pre-operative plan for intraoperative neuromonitoring for spinal surgery, making any necessary adjustments based on information available on the day of monitoring. |
| # 7 |
Outcome
Demonstrate effective and professional communication skills with the multidisciplinary theatre team. |