Training activity information
Details
Correctly position intraoperative neuromonitoring system(s) used for spinal surgeries in theatre, including correct and safe positioning of cables, amplifiers, stimulators, and other ancillary equipment.
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 the safe and correct positioning of cables, amplifiers, and stimulators within the theatre environment?
- How do the learning outcomes apply to ensuring equipment placement does not interfere with the MDT or patient safety?
- Have you discussed with your Training Officer the specific ergonomics and cabling requirements for the planned surgery?
What is your prior experience of this activity?
- What do you know about theatre layout and the importance of maintaining sterility during equipment setup?
- What challenges, such as limited space or electrical interference from other theatre equipment, do you anticipate?
What do you anticipate you will learn from the experience?
- What technical skills related to theatre ergonomics and cable management do you want to refine?
- What insights do you hope to gain regarding the prevention of IONM complications and injuries through meticulous setup?
What additional considerations do you need to make?
- Have you reviewed previous setup faults or positioning errors?
- What information regarding the specific surgical approach (e.g., prone vs. lateral) must you consider when positioning the IONM system?
In action
During the activity is anything unexpected occurring?
- Are you discovering limited space for the system or identifying potential cable interference with other theatre devices?
How are you reacting to the unexpected development?
- Are you proactively changing your approach to cable management to ensure patient safety and maintain a sterile field?
- Is the physical layout of the theatre affecting your confidence in maintaining a seamless procedural workflow?
What is the conclusion or outcome?
- Are you learning a more efficient technique for positioning the amplifiers and stimulators in a crowded theatre environment?
On action
What happened?
- How would you summarise the process of positioning the amplifiers, stimulators, and cabling for this case?
- What specific actions did you take to ensure the safe positioning of equipment and ancillary items within the theatre environment?
- How did you feel about your ability to maintain a sterile field while managing cables and connections?
How has this experience contributed to your developing practice?
- What strengths did you demonstrate in troubleshooting theatre ergonomics or electrical interference during the setup?
- Has your technical practice in minimising risks and preventing complications through equipment positioning improved since your last procedure?
- What challenges, such as limited space or cable management, did you experience, and how did you react to these?
What will you take from the experience moving forward?
- What actions will you take to ensure your technical setup is even more efficient next time, particularly regarding the specific theatre layout?
- Do you need to practice any specific aspect further, such as the systematic check of stimulator and amplifier placement?
Beyond action
Have you revisited the experiences?
- Have you revisited your reflections on the physical setup of amplifiers, stimulators, and cabling in theatre?
- What actions did you identify to improve theatre ergonomics and patient safety, and have you successfully implemented these in your current practice?
- How has discussing equipment layout ’near-misses’ with colleagues changed your perspective on maintaining a sterile field while managing technical connections?
How have these experiences impacted upon current practice?
- How will your proficiency in positioning IONM systems support you in the in-person assessments focused on setting up equipment according to specific cases?
- How has your practice in troubleshooting theatre layout challenges evolved, and can you recognise when a setup configuration is beyond your scope of practice?
- What transferable skills in technical logic and risk mitigation did you develop through this activity?
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. |
| # 4 |
Outcome
Identify and respond to factors that impact intraoperative neuromonitoring for spinal surgery including technical problems and physiological effects. |
| # 7 |
Outcome
Demonstrate effective and professional communication skills with the multidisciplinary theatre team. |