Training activity information
Details
Perform and interpret diagnostic tests and create clinical reports for:
- Maculopathy
- Optic neuropathy
- Retinopathy
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 relevant electrophysiology tests for patients with maculopathy, optic neuropathy, or retinopathy, accurately interpreting the results, and creating a clinical report.
- What constitutes a successful diagnostic workup and report for these conditions? What specific test findings are expected or relevant for each pathology (e.g., mfERG for maculopathy, VEP/ERG for optic neuropathy/retinopathy)?
- Discuss with your training officer to gain clarity of what is expected of you in performing, interpreting, and reporting for these specific pathologies.
- What is your prior experience of this activity?
- Think about what you already know about the electrophysiology tests relevant to these conditions (ERG, VEP, mfERG, PERG) and about these specific pathologies from academic study or clinical exposure.
- Consider possible challenges you might face, such as atypical test results, differentiating between conditions, writing a clear and concise report, or understanding the clinical context of these specific diseases. 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 complex interpretations, uncertain diagnoses, or reporting findings.
- Acknowledge how you feel about performing and interpreting the specified diagnostic tests and creating the associated clinical reports.
- What do you anticipate you will learn from the experience?
- Consider the specific skills you want to develop in selecting appropriate test batteries for these conditions, interpreting the specific waveform changes associated with each pathology, and structuring a clear and clinically useful report, drawing upon previous experiences.
- Identify specific insights you hope to gain, perhaps regarding the correlation between electrophysiological findings and imaging/clinical findings, or the variability of responses within these patient groups.
- What additional considerations do you need to make?
- Consult actions identified following previous experience of performing tests, interpreting results, or writing clinical reports, if any.
- Identify important information you need to consider before embarking on the activity, such as understanding the pathophysiology of maculopathy, optic neuropathy, and retinopathy, reviewing relevant literature on electrophysiological findings, report templates, and communication strategies for discussing findings.
In action
- Is anything unexpected occurring?
- Are you noticing anything surprising or different from what you anticipate while performing, interpreting, and reporting tests for specific pathologies?
- Are you encountering situations such as:
- Atypical or conflicting electrophysiological results where, for instance, a patient suspected of Maculopathy shows normal mfERG results but abnormal VEPs?
- Difficulty in differentiating the electrophysiological signature between two overlapping pathologies (e.g., certain Retinopathies vs. Optic Neuropathies)?
- A key piece of necessary patient information missing (e.g., concurrent imaging data) that compromises your ability to interpret and report confidently?
- How is this experience comparing with previous experiences of similar activities, like performing tests or reporting on other conditions?
- How are you reacting to the unexpected development?
- How is this impacting your actions? Did you adapt or change your test battery, interpretation process, or reporting focus in the moment?
- Consider the steps you are taking in the moment, such as:
- Immediately adding an alternative or supplementary test (e.g., adding PERG when initial VEP findings were ambiguous) to clarify the findings?
- Are you pausing the reporting process to seek immediate advice on the differential diagnosis from a senior clinician based on the conflicting waveforms?
- Are you re-checking ISCEV standards specific to the pathology (e.g., defining significant abnormality criteria for Optic Neuropathy) before concluding your interpretation?
- How are you feeling in that moment? For instance, are you finding it difficult to perform and / or interpret the tests? Is it affecting your confidence to synthesise the results for the report? Do you feel positive that you can be successful for all conditions listed?
- What is the conclusion or outcome?
- Identify how you are working within your scope of practice when performing, interpreting, and reporting for these pathologies (e.g., ensuring the report clearly identifies findings while deferring definitive diagnosis to the specialist).
- What are you learning as a result of the unexpected development? For example, are you gaining critical analytical insight into the variability of electrophysiological responses across different Maculopathies, or improving your ability to structure a report that concisely presents complex, multi-test data?
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 one of the specified conditions (Maculopathy, Optic neuropathy, or Retinopathy).
- Consider specific events, actions, or interactions that felt important during the testing, interpretation, or reporting process, such as correlating electrophysiological findings with retinal imaging or previous clinical notes. 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, immediately adding an alternative test (e.g., VEP or PERG) due to ambiguous initial findings or re-checking annotation standards mid-report creation.
- How has this experience contributed to your developing practice?
- Identify what learning you can take from this experience with these specific pathologies.
- What strengths did you demonstrate (e.g., accurate selection of test battery, analytical skill in differentiating waveform changes specific to the pathology)?
- What skills and/or knowledge gaps were evident (e.g., unfamiliarity with rare presentations of the pathology, difficulty writing a concise and clinically informative report)?
- Compare this experience against previous times you have tested or reported on similar pathologies. Were any previously identified actions for development achieved? Has your practice in diagnostic analysis and formal clinical reporting improved?
- Identify any challenges you experienced (e.g., conflicting data, complex interpretation issues) 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 the pathology or interpretation, or needing to escalate to ensure you were working within your scope of practice.
- 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 perform and interpret the diagnostic tests. What feedback have you had with regards to your clinical report writing?
- What will you do differently next time you test and report for these pathologies? 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 this activity further? E.g., Practising reviewing ISCEV standards for specific waveform characteristics associated with different retinal/optic nerve conditions, or refining the structure and narrative of the clinical report.
Beyond action
- Have you revisited the experiences?
- Have you reviewed your actions from your previous reflections for performing and interpreting diagnostic tests and creating clinical reports for Maculopathy, Optic neuropathy, and Retinopathy?
- What actions did you identify you would need to take to improve your practice related to deepening your understanding of specific pathologies, improving waveform interpretation, or enhancing your clinical report writing skills? 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 on specific pathologies 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 on specific pathologies will support you in preparing for relevant observed ‘in-person’ assessments for the S-OV-S3 module, such as Case-Based Discussions where you interpret results and discuss diagnoses) or Observed Communication Events e.g., giving a verbal report or discussing a patient result and interpretation with a supervisor.
- Consider how your practice related to performing/interpreting tests and reporting on specific pathologies 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. |