Training activity information
Details
Perform electrophysiology recordings on patients and troubleshoot for the following artefacts:
- Alpha
- Electrode
- Muscle
- Extraneous and stimulus
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 performing electrophysiology recordings on patients and troubleshooting the identified artefacts.
- Consider how the learning outcomes apply, specifically around performing recordings and basic troubleshooting.
- What does a successful recording involve, including identifying and addressing artefacts like Alpha, Electrode, Muscle, Extraneous, and stimulus artefacts?
- Discuss with your training officer to gain clarity on what is expected of you in performing recordings and troubleshooting.
- What is your prior experience of this activity?
- Think about what you already know about operating electrophysiology equipment, recording signals, and recognising different types of artefacts.
- Consider possible challenges you might face during recording, such as persistent artefacts, equipment malfunctions, or patient non-cooperation, and think about 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 complex troubleshooting or equipment issues.
- Acknowledge how you feel about performing electrophysiology recordings on patients and being able to troubleshoot for the specified artefacts.
- What do you anticipate you will learn from the experience?
- Consider specific skills you want to develop in operating recording equipment and effectively identifying and troubleshooting various artefacts – drawing upon previous experiences.
- Identify specific insights you hope to gain regarding the source of different artefacts, techniques for noise reduction, or optimising recording parameters (e.g., filters, amplifiers, rejection ratios).
- What additional considerations do you need to make?
- Consult actions identified following previous experience of performing recordings or troubleshooting, if any.
- Identify important information you need to consider before embarking on the activity, such as equipment setup, recording protocols for specific tests, expected waveform characteristics (even if just for identifying deviations due to artefacts), and common troubleshooting steps for each artefact type.
In action
- Is anything unexpected occurring?
- Are you noticing anything surprising or different from what you anticipate whilst you perform the electrophysiology recordings and troubleshoot for the listed artefacts?
- Are you encountering situations, such as:
- a specific type of artefact (Alpha, Muscle, Extraneous) persisting despite initial troubleshooting efforts
- a troubleshooting step you are performing (e.g., re-pasting an electrode to fix an Electrode artefact) is not yielding the anticipated result or is leading to a new, unforeseen issue like a Stimulus artefact
- How are you reacting to the unexpected development?
- How is this impacting your actions? For example, are you responding to the situation appropriately?
- Consider the steps you are taking in the moment, such as are you:
- Immediately re-checking relevant calibration records or consulting equipment manuals regarding the specific artefact type?
- Consulting relevant SOPs for daily checks or troubleshooting more thoroughly than planned?
- Seeking advice from a more experienced colleague or your training officer if the artefact is complex, to understand the anomaly or confirm the next steps?
- Changing your initial approach to troubleshooting based on new insights, such as isolating a specific piece of equipment suspected of causing extraneous noise?
- Adapting your instructions to the patient to minimise movement or promote a quiet state if the artefact is patient-related (e.g. Alpha)?
- Finding it difficult to adapt your technique to resolve the issue?
- How are you feeling in this moment? For example, if faced with a persistent artefact (such as Alpha, Muscle, Extraneous) or if a troubleshooting step (e.g., re-pasting an electrode to fix an Electrode artefact) is unexpectedly leading to a Stimulus artefact, consider:
- Is the emergence of a new artefact affecting your confidence in the diagnostic sequence you are following?
- Are you finding it difficult to adapt your filtering or recording parameters to eliminate the Extraneous artefact without compromising the resultant waveform?
- Do you feel positive you could reach a successful conclusion by systematically identifying and resolving the root cause of the noise?
- What is the conclusion or outcome?
- Identify how you are working within your scope of practice. For example, are you needing support because a persistent calibration or equipment error requires manufacturer intervention?
- What are you learning as a result of the unexpected development? For example, are you learning a new diagnostic approach to identifying the root cause of specific artefacts (e.g., differentiating muscle movement from external noise), or a more robust method for performing a specific filter check?
On action
- What happened?
- Begin by summarising the key points of the experience of performing recordings and systematically troubleshooting artefacts.
- Consider specific events, actions, or interactions that felt important during the recordings and troubleshooting, such as encountering a significant Alpha rhythm artefact, diagnosing the root cause of an Electrode artefact, or applying filtering techniques to minimize extraneous noise. How did you feel during this experience?
- Include any ‘reflect-in-action’ moments where you had to adapt to the situation as it unfolded, for instance, adjusting the filter settings or re-checking the grounding connections to resolve an unexpected artefact.
- How has this experience contributed to your developing practice?
- Identify what learning you can take from this experience of performing recordings and troubleshooting.
- What strengths did you demonstrate (e.g., systematic approach to troubleshooting, effective application of basic electronics knowledge (e.g., filters, amplifiers), efficient management of muscle artefact)?
- What skills and/or knowledge gaps were evident (e.g., unfamiliarity with advanced rejection ratios or difficulty identifying the precise origin of complex extraneous artefacts)?
- Compare this experience against previous recording or troubleshooting activities. Has your practice in this area improved?
- Identify any challenges you experienced (e.g., persistent artefact despite troubleshooting, time constraints) and how you reacted to these.
- 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 you will now take to support the assimilation of what you have learned, including from any feedback you have received on your ability to undertake the recordings and troubleshoot effectively.
- What will you do differently next time you perform recordings and troubleshoot artefacts?
- Do you need to practise any aspect of performing recordings or troubleshooting further? E.g., Practising systematic root cause analysis for persistent electrode artefacts, or reviewing advanced filter settings and rejection ratios to optimise signal quality during recordings.
Beyond action
- Have you revisited the experiences?
- Have you reviewed your actions from your previous reflections for performing electrophysiology recordings and troubleshooting artefacts?
- What specific actions did you previously identify you would need to take to improve your practice related to systematic troubleshooting, effective application of filters/amplifiers, or efficient management of specific artefacts (Alpha, Muscle, etc.)?
- 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 performing recordings and troubleshooting?
- Share experiences of complex artefact resolution scenarios with peers or colleagues. Has their feedback or similar stories broadened your perspective on signal quality management?
- How have these experiences impacted upon current practice?
- Consider how the accumulated learning from performing or reflecting on recordings and troubleshooting will support you in preparing for observed ‘in-person’ assessments for this module, specifically focusing on obtaining a good recording during DOPS like ‘Set up equipment and perform a VEP test on a patient’ or ‘Set up equipment and perform an ERG test on a patient’.
- How has your practice related to performing recordings and troubleshooting artefacts developed and evolved over time, including recognising when persistent signal quality issues or complex extraneous noise environments are beyond your scope of practice?
Relevant learning outcomes
| # | Outcome |
|---|---|
| # 3 |
Outcome
Perform recordings of the electrophysiological tests and perform basic troubleshooting. |