Training activity information
Details
Present a case study on a patient who underwent spinal surgery where somatosensory evoked potential changes (alerts) were noted.
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 evaluating SSEP alerts help you demonstrate your ability to interpret signal changes and understand the specialty’s impact on patient care?
What specific knowledge do you need?
- What were the specific alarm criteria applied in this case, and how did the SSEP changes relate to the specific surgical steps being performed at that time?
- What is your current understanding of the medicolegal implications of these alerts as documented in the case report?
What actions will you take in preparation?
- How will you structure your presentation to facilitate a meaningful discussion with colleagues regarding the prognostic value of these specific signal changes?
In action
What are you doing?
- How are you currently explaining the relationship between the SSEP changes and the specific surgical mechanisms involved?
- What decisions are you making about which waveform comparisons best illustrate the application of alarm criteria?
How are you progressing?
- How effectively are you leading the discussion on the clinical significance of the alerts documented in the case?
- What can you learn from your colleagues’ feedback as you present the prognostic value of the noted signal changes?
How are you adapting?
- Are you identifying any alternative interpretations of the SSEP signal drop that you should be considering based on peer input?
- Are you ensuring that your evaluation of the case alerts stays within the current evidence base for spinal IONM?
On action
What did you notice?
- How would you summarise the relationship between the SSEP alerts and the specific surgical steps described in your case study?
What did you learn from the activity?
- What did you learn about applying appropriate alarm criteria when comparing IONM signals to their baselines?
- How effectively were you able to evaluate the prognostic value of the SSEP changes noted in this case?
- What insights did you gain from your colleagues’ feedback regarding the medicolegal significance of the documented alerts?
What will you take from the experience moving forward?
- How will the learning from this case study improve your ability to identify and report significant SSEP fluctuations in your routine practice?
- What specific actions will you take to further your understanding of how systemic factors like hypoxia or blood loss impact SSEP morphology?
Beyond action
Have you revisited the experiences?
- Since revisiting the SSEP alerts you presented, how has professional storytelling with your peers influenced how you now apply alarm criteria in real-time surgical settings?
How have these experiences impacted upon your current practice?
- How has this evaluation of signal morphology and surgical steps deepened your ability to discuss intraoperative changes with clinical colleagues?
How might these experiences contribute towards your future practice?
- What transferable skills in critical appraisal and evidence-based practice did you gain from this case study?
- How are these shaping your future approach to interpreting complex EP data?
Relevant learning outcomes
| # | Outcome |
|---|---|
| # 3 |
Outcome
Describe patient pathways for those undergoing intraoperative neuromonitoring during spinal surgery. |
| # 5 |
Outcome
Demonstrate effective and professional communication. |