Training activity information
Details
Perform and interpret diagnostic tests for patients with complex needs and create clinical reports
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 this specific activity. This involves successfully performing appropriate electrophysiology tests on patients with complex needs, interpreting results that may be affected by their condition, and creating relevant clinical reports.
- What constitutes a successful test session with a patient with complex needs, ensuring their safety, comfort, and obtaining the best possible data? What specific considerations are needed for interpreting results and reporting findings for this group?
- Discuss with your training officer to gain clarity of what is expected of you when working with patients with complex needs.
- What is your prior experience of this activity?
- Think about what you already know about working with patients with various complex needs (e.g., physical disabilities, cognitive impairments, behavioural issues) and performing electrophysiology tests.
- Consider possible challenges you might face, such as communication barriers, managing physical limitations or involuntary movements, adapting the environment, dealing with potential artefacts related to their condition, or interpreting results in the context of their complex medical profile. Think about how you might handle these challenges.
- 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 managing complex patient needs, interpreting unusual results influenced by their condition, or liaising with other healthcare professionals involved in their care.
- Acknowledge how you feel about performing and interpreting diagnostic testing for patients with complex needs.
- What do you anticipate you will learn from the experience?
- Consider the specific skills you want to develop in assessing the needs of patients with complex conditions, adapting test procedures and communication strategies, managing the testing environment for safety and comfort, and interpreting test findings while accounting for co-morbidities, drawing upon previous experiences.
- Identify specific insights you hope to gain, perhaps regarding the impact of specific complex conditions on electrophysiological responses, techniques for positioning and supporting these patients, or strategies for effective communication with carers or support staff.
- What additional considerations do you need to make?
- Consult actions identified following previous experience of working with patients with complex needs or performing standard electrophysiology tests, if any.
- Identify important information you need to consider before embarking on the activity, such as reviewing patient notes carefully for relevant history and needs, planning for potential difficulties, ensuring appropriate staffing levels, and understanding local protocols for testing patients with complex needs.
In action
- Is anything unexpected occurring?
- Are you noticing anything surprising or different from what you anticipate while performing, interpreting, and reporting tests for patients with complex needs?
- Are you encountering situations such as:
- Involuntary movements or tremors significantly compromising the signal and requiring immediate technical adaptation?
- The patient’s specific complex need (e.g., severe dementia, language barrier) unexpectedly hindering communication despite prior planning?
- The test results showing confounding factors that are potentially linked to their complex medical profile rather than the target visual condition?
- How is this experience comparing with previous experiences of similar activities, like performing tests on patients with complex needs or reporting on their results?
- How are you reacting to the unexpected development?
- How is this impacting your actions? Did you adapt or change your technical approach, communication, or patient handling procedure in the moment?
- Consider the steps you are taking in the moment, such as:
- Immediately adjusting filter settings or increasing averaging parameters to counteract movement artefacts?
- Are you switching communication methods (e.g., visual aids, simplifying language) to try and reconnect with a patient experiencing difficulty?
- Are you seeking immediate assistance for safe patient handling or repositioning required due to their complex needs?
- How are you feeling in that moment? For instance, are you finding it difficult to adapt your approach when testing patients with complex needs? Is it affecting your confidence in maintaining safety and data quality? Are you feeling positive you can successfully create the clinical reports?
- What is the conclusion or outcome?
- Identify how you are working within your scope of practice when performing, interpreting, and reporting for patients with complex needs (e.g., recognising when persistent non-compliance necessitates test termination and clear documentation).
- What are you learning as a result of the unexpected development? For example, are you gaining key learning about adaptive positioning and technical modifications for patients with motor impairments, or improving your ability to write reports that carefully contextualise findings within the patient’s complex history?
On action
- What happened?
- Begin by summarising the key points of the experience of performing tests, interpreting results, and creating clinical reports for a patient with complex needs.
- Consider specific events, actions, or interactions that felt important during the testing, interpretation, or reporting process, especially how the patient’s specific needs impacted the test environment or procedure. How did you feel during this experience?
- Include any ‘reflect-in-action’ moments where you adapted your approach in the moment during the activity, for instance, instantly modifying filter settings to counteract involuntary movement artefacts or rapidly switching communication strategies.
- How has this experience contributed to your developing practice?
- Identify what learning you can take from this experience with patients with complex needs.
- What strengths did you demonstrate (e.g., commitment to patient safety and comfort, technical skill in adapting protocols for physical limitations)?
- What skills and/or knowledge gaps were evident (e.g., unfamiliarity with communication aids, difficulty interpreting results potentially confounded by complex medical history)?
- Compare this experience against previous times you have worked with patients with complex needs. Were any previously identified actions for development achieved? Has your practice in managing difficult testing scenarios improved?
- Identify any challenges you experienced (e.g., communication barriers, persistent artefacts) and how you reacted to these. Did this affect your ability to deal with the situation? Were you able to overcome the challenges?
- Identify anything significant about this activity, such as needing to seek advice or clarification on interpreting complex data or needing to escalate to ensure specialised support for the patient’s needs.
- 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 received regarding your ability to undertake diagnostic tests for patients with complex needs. What feedback have you had about your clinical report writing skills?
- What will you do differently next time you test and report for patients with complex needs? 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 working with patients with complex needs further? E.g., Practising adaptive positioning techniques for patients with motor impairment, or reviewing guidance on communication strategies for non-verbal patients.
Beyond action
- Have you revisited the experiences?
- Have you reviewed your actions from your previous reflections for performing and interpreting diagnostic tests for patients with complex needs and creating clinical reports?
- What actions did you identify you would need to take to improve your practice related to adapting testing techniques for various complex needs, improving communication with patients or carers, or interpreting results where patient factors impact data quality? Have you completed these actions? Are you ready to demonstrate this new learning into practice?
- Engage in professional storytelling about performing/interpreting tests and reporting for patients with complex needs with peers, near peers, or colleagues. Consider if your view of the situation has changed because of analysing this with others.
- How have these experiences impacted upon current practice?
- Consider how the accumulated learning from performing or reflecting on performing/interpreting tests and reporting for patients with complex needs will support you in preparing for relevant observed ‘in-person’ assessments for this module, such as the Direct Observation of Practical Skills (DOPS) specifically for performing a test on a patient with complex needs or Observed Communication Events e.g., taking a history with communication barriers.
- Consider how your practice related to performing/interpreting tests and reporting for patients with complex needs has developed and evolved over time. This includes recognising when something related to this activity is beyond your scope of practice.
Relevant learning outcomes
| # | Outcome |
|---|---|
| # 1 |
Outcome
Develop test plans from information given on referrals. |
| # 2 |
Outcome
Prepare patients and the clinical environment for both standard and advanced electrophysiological techniques. |
| # 3 |
Outcome
Perform standard and advanced electrophysiological techniques using correct procedures. |
| # 4 |
Outcome
Identify, assess and remedy issues encountered while performing testing. |
| # 5 |
Outcome
Interpret and report results of electrophysiological tests. |
| # 7 |
Outcome
Employ effective communication with a range of individuals, including the patient and the multidisciplinary team. |