Electrophysiology —
Training activity: 1

Details

Prepare patients and the environment for testing

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?
  • Identify what is expected of you in relation to preparing patients and the environment for testing.
  • Consider how the learning outcomes apply, such as, prepare and set up the test environment and patient and related to employing effective communication.
  • What does a prepared patient and environment look like for electrophysiology testing, considering factors like communication, comfort, safety, and equipment readiness?
  • Discuss with your training officer to gain clarity on what is expected of you in preparing patients and the environment.
• What is your prior experience of this activity?
  • Think about what you already know about preparing patients and the testing environment for electrophysiology or similar procedures.
  • Consider possible challenges you might face, such as patient anxiety, language barriers, specific needs or technical setup issues, and how you might handle them.
  • Recognise the scope of your own practice for this activity i.e. know when you will need to seek advice or help, and from whom, regarding patient preparation or environment setup.
  • Acknowledge how you feel about preparing patients and the environment for testing.
• What do you anticipate you will learn from the experience?
  • Consider the specific skills you want to develop in patient preparation and environment setup – drawing upon previous experiences.
  • Identify specific insights you hope to gain, perhaps regarding different patient groups, optimising the environment for different tests (VEP, ERG, EOG, PERG), or enhancing communication techniques.
• What additional considerations do you need to make?
  • Consult actions identified following previous experiences of preparing patients and the environment for testing.
  • Identify important information you need to consider before embarking on the activity, such as specific patient needs, required equipment, room setup, or communication strategies for different ages/backgrounds.

In action

• Is anything unexpected occurring?
  • Are you noticing anything surprising or different from what you anticipate whilst you prepare patients and the environment for testing?
  • Are you encountering situations such as:
    • A piece of equipment failing a pre-use check or not powering on as expected?
    • Room acoustic integrity or lighting that was not present before, compromising the setup required for tests like ERG?
    • Unfamiliar setup requirement necessary for a specific patient population, such as adapting the environment for a patient with mobility issues?
    • Patient’s high level of anxiety is unexpectedly complicating the necessary positioning or comfort adjustments.
• How are you reacting to the unexpected development?
  • How is this impacting your actions? For example, are you responding to the situation appropriately? Are you adapting or changing your approach to the preparation of the patient and the environment? Is it affecting your ability to undertake the activity independently?
  • In the moment, you should consider your immediate actions:
    • Are you re-checking cable connections or power sources immediately to resolve the equipment failure?
    • Are you consulting relevant Standard Operating Procedures (SOPs) for equipment calibration or room setup more thoroughly than planned?
    • If the challenge relates to the patient, are you changing your initial approach to setting up the room based on a new insight about patient comfort or specific equipment needs?
    • For highly complex issues (either technical or patient-related), are you seeking advice from a more experienced colleague or your training officer to understand the anomaly with the clinical setting?
    • Crucially, are you changing your initial approach to setting up the room based on a new insight about patient flow or specific equipment needs?
  • How are you feeling in this moment? For example, if a piece of equipment fails the pre-use check or you encounter an unexpected issue with room acoustic integrity for ERG, consider:
    • Is the equipment failure affecting your confidence in completing the pre-use checks thoroughly or safely?
    • Are you finding it difficult to adapt your established setup protocol when faced with an environmental anomaly?
    • Do you feel positive you could reach a successful conclusion by troubleshooting the environment issue without needing to escalate to senior support?
• What is the conclusion or outcome?
  • Identify how you are working within your scope of practice. For example, are you:
    • Successfully managing the situation yourself?
    • Needing support because the equipment malfunction requires specialist repair or senior input, meaning it is beyond your current scope?
  • What are you learning as a result of the unexpected development? For example, are you learning:
    • A new troubleshooting technique for optimising the stimulator connection or a more efficient method for checking room integrity?
    • A specific adaptation for preparing the setting for a particular patient type?

On action

• What happened?
  • Begin by summarising the key points of the experience of preparing patients and the environment for electrophysiological testing.
  • Consider specific events, actions, or interactions that felt important during the preparation process, such as setting up specific diagnostic devices, confirming ambient lighting conditions, or ensuring the patient was psychologically ready for the tests.
  • Include any ‘reflect-in-action’ moments where you had to adapt to the situation as it unfolded, for instance, adjusting the patient positioning or troubleshooting a minor issue with the environment. How did you feel during this experience?
• How has this experience contributed to your developing practice?
  • Identify what learning you can take from this experience regarding preparing patients and the environment.
  • What strengths did you demonstrate (e.g., efficiency in workflow, adherence to safety protocols, empathetic communication)?
  • What skills and/or knowledge gaps were evident (e.g., unfamiliarity with specific calibration requirements or optimal workflow for concurrent testing)?
  • Compare this experience against previous preparation activities. Were any previously identified actions for development achieved? Has your practice in preparing the environment improved?
  • Identify any challenges you experienced during preparation (e.g., difficulty confirming equipment calibration, patient anxiety) and how you reacted to these. Did this affect your ability to deal with the situation? Were you able to overcome the challenges?
  • Acknowledge any changes in your own feelings now that you are looking back on the experience.
• What will you take from the experience moving forward?
  • Identify the actions or ‘next steps’ you will now take to support the assimilation of what you have learned, including from any feedback received regarding your ability to prepare patients and the environment for testing.
  • What will you do differently next time you prepare patients and the environment? Has anything changed in terms of what you would do if you were faced with a similar situation again?
  • Do you need to practise any aspect of preparing patients or the environment further? E.g., Practising a pre-test communication script to reduce patient anxiety, or refining a checklist for confirming optimal environmental conditions (e.g., light levels, electrical noise).

Beyond action

• Have you revisited the experiences?
  • Have you reviewed your actions from your previous reflections for this activity?
  • What specific actions did you previously identify you would need to take to improve your practice related to efficient workflow, safety protocols, or empathetic communication during patient preparation?
  • Have you completed these previously identified actions? If so, how did completing them impact your subsequent performance of this activity?
  • Are you ready to demonstrate this new learning confidently and consistently when preparing patients and the environment?
  • Engage in professional storytelling with peers or colleagues about challenges and successes in preparing the testing environment e.g., managing ambient light/electrical noise or ensuring psychological patient readiness. Has discussing these experiences changed your perspective or approach?
• How have these experiences impacted upon current practice?
  • Consider how the accumulated learning from performing or reflecting on preparing patients and the environment will support you in preparing for observed ‘in-person’ assessments for this module, such as an Observed Communication Event (OCE) or a Direct Observation of Practical Skills (DOPS).
  • How has your practice in preparing patients and the environment developed and evolved over time, including recognising when environmental control or patient readiness is beyond your scope of practice?

Relevant learning outcomes

#	Outcome
# 2	Outcome Prepare and set up the test environment and patient for different electrophysiological tests.
# 7	Outcome Employ effective communication with a range of individuals including the patient and the multidisciplinary team.