Training activity information
Details
Generate reports for intraoperative neuromonitoring for spinal surgeries and document communication with the theatre team for:
- Free-run electromyography
and/or
- Triggered electromyography
Type
Developmental training activity (DTA)
Evidence requirements
Evidence the activity has been undertaken by the trainee.
Reflection on the activity at one or more time points after the event including learning from the activity and/or areas of the trainees practice for development.
An action plan to implement learning and/or to address skills or knowledge gaps identified.
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 are the intended outcomes?
- How will you apply the requirements of the learning outcomes, such as to produce concise and accurate reports specifically for free-run or triggered EMG during spinal surgery?
- What knowledge of local and national guidelines for documenting theatre communication is required before you start drafting these reports?
What specific knowledge do you need?
- What do you need to recall regarding the effects of anaesthetic drugs and muscle relaxants on EMG signals to ensure an accurate interpretation of the data?
- What is the significance of distinguishing real neurophysiological changes from technical artefacts in your final written report?
What do you anticipate learning?
- How will this activity help you develop your skills in synthesising signal changes and applying appropriate alarm criteria compared to the patient’s baseline?
In action
What are you doing?
- How are you currently synthesising the EMG signal changes in the context of the surgical steps you observed?
- What decisions are you making about which theatre annotations and comments are most critical to include in the factual report?
- What aspects of differentiating real EMG signals from artefacts feel intuitive to you during this reporting phase?
How are you progressing?
- How effectively are you correlating the anaesthetic and systemic changes documented during the case with the final EMG waveforms?
- What challenges are you encountering in maintaining a concise and accurate narrative while documenting complex theatre communication?
How are you adapting?
- Are you considering alternative ways to present the alarm criteria if the baseline comparisons appear ambiguous?
- Are you ensuring the report correctly reflects the medicolegal implications of the findings according to national guidelines?
On action
What did you notice?
- What were the most significant neurophysiological findings you documented in these EMG reports?
- What key points did you notice about how theatre communication was captured and translated into the written report?
What did you learn from the activity?
- What did you learn about differentiating technical artefacts from real EMG signals during the reporting phase?
- How did your understanding of the effects of anaesthetic drugs or muscle relaxants influence your interpretation of the documented changes?
- In what ways did your dynamic ‘reflect-in-action’ during the surgery help you structure a more accurate and factual final report?
What will you take from the experience moving forward?
- What areas for development have you identified regarding your ability to produce concise reports that meet national and international guidelines?
- How will you modify your use of annotations and comments in future cases to ensure a more complete medicolegal record?
Beyond action
Have you revisited the experiences?
- Looking back at your early EMG reports, how has your ability to differentiate real neurophysiological changes from technical artefacts changed now that you have encountered a wider variety of iatrogenic complications in theatre?
How have these experiences impacted upon your current practice?
- How has the process of synthesising complex EMG signal changes impacted your current reporting style for other modalities, such as somatosensory or motor evoked potentials?
How might these experiences contribute towards your future practice?
- How will your refined skills in documenting theatre communication and using annotations inform your future role in providing expert evidence for medicolegal reviews?
Relevant learning outcomes
| # | Outcome |
|---|---|
| # 1 |
Outcome
Practice according to local protocols and national and international guidelines to ensure the integrity of data recorded for intraoperative neuromonitoring. |
| # 2 |
Outcome
Produce concise and accurate reports for intraoperative neuromonitoring during spinal surgery according to local, national, and international guidelines. |
| # 5 |
Outcome
Demonstrate effective and professional communication. |