Training activity information
Details
Complete pre-monitoring checks on the intraoperative neuromonitoring system (machine) used for spinal surgery and remedy any faults found.
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 performing internal calibration and system checks? How do the learning outcomes apply, specifically in relation to identifying and remedying technical faults before the procedure begins?
- What clarity have you gained from your Training Officer regarding the troubleshooting of common hardware or software errors?
What is your prior experience of this activity?
- What do you know about the specific IONM instrumentation and system self-tests?
- What challenges, such as stimulator failures or amplifier noise, do you anticipate?
- How do you feel about the responsibility of ensuring the machine is ready for a high-stakes surgical case?
What do you anticipate you will learn from the experience?
- What systematic troubleshooting skills do you hope to develop?
- What insights into the requirements for high-quality signal recording will you gain from this technical verification?
What additional considerations do you need to make?
- Have you consulted logs of previous equipment faults?
- What critical manufacturer or departmental protocols must you review before starting the checks?
In action
During the activity is anything unexpected occurring?
- Is a hardware fault, a software error, or a failed internal calibration occurring during the system self-test?
How are you reacting to the unexpected development?
- Are you troubleshooting the recording or stimulation problem independently, or are you seeking immediate advice from a senior colleague?
- Is the technical problem affecting your confidence in the upcoming monitoring?
What is the conclusion or outcome?
- Have you successfully remedied the fault and verified that the system is safe for patient use?
On action
What happened?
- What were the key points of the pre-monitoring system checks you performed?
- How did you approach identifying and remedying any technical faults found on the machine?
- How did you feel during the troubleshooting process, especially if the procedure start time was imminent?
How has this experience contributed to your developing practice?
- What learning did you take regarding the instrumentation and software checks for this specific system?
- How has your ability to resolve recording or stimulation problems developed compared to your earlier training?
- Did you need to escalate a technical issue to ensure you were working within your scope of practice?
What will you take from the experience moving forward?
- What ‘next steps’ will you take to ensure machine readiness, perhaps by reviewing the manufacturer’s troubleshooting guide?
- What would you do differently if a similar hardware fault occurred in a high-pressure situation again?
Beyond action
Have you revisited the experiences?
- Have you reviewed your actions regarding the identification and remedying of technical faults during machine checks?
- Have you completed actions to improve your understanding of the manufacturer’s internal calibration protocols?
- How has professional storytelling about equipment malfunctions shaped your commitment to technical verification?
How have these experiences impacted upon current practice?
- How has your systematic approach to pre-monitoring checks developed your diagnostic reasoning when interpreting signal quality later in the procedure?
- Can you identify instances where your foundational knowledge of IONM instrumentation has helped you resolve a software error independently?
- What transferable skills in systematic troubleshooting did you develop that will help you evaluate new monitoring technologies in the future?
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. |