Training activity information
Details
Perform and interpret diagnostic tests for paediatric patients 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 paediatric patients, interpreting the potentially variable results, and creating clinical reports tailored for this group.
- What constitutes a successful test session with a paediatric patient, balancing data quality with cooperation and comfort? What specific considerations are needed for interpreting paediatric waveforms and reporting findings?
- Discuss with your training officer to gain clarity of what is expected of you when working with paediatric patients.
- What is your prior experience of this activity?
- Think about what you already know about working with children in a clinical setting, performing electrophysiology tests, or writing clinical reports.
- Consider possible challenges you might face, such as securing cooperation from different age groups, adapting protocols for young children or infants, dealing with movement artefacts, interpreting developing waveforms, or communicating findings effectively to parents/guardians. 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 difficult paediatric patients, interpreting ambiguous paediatric results, or reporting findings in a sensitive manner.
- Acknowledge how you feel about performing and interpreting diagnostic tests for paediatric patients
- What do you anticipate you will learn from the experience?
- Consider the specific skills you want to develop in paediatric patient management, adapting communication and techniques for different ages, interpreting age-dependent waveform changes, and writing clear reports for a paediatric context, drawing upon previous experiences.
- Identify specific insights you hope to gain, perhaps regarding the typical developmental trajectory of electrophysiological responses, strategies for making testing fun or less intimidating, or the unique challenges and rewards of working with children.
- What additional considerations do you need to make?
- Consult actions identified following previous experience of working with children or performing standard electrophysiology tests, if any.
- Identify important information you need to consider before embarking on the activity, such as age-appropriate techniques and protocols (e.g., ISCEV guidelines for paediatric ERG), strategies for building rapport with children and parents, and understanding normal paediatric ranges for test parameters.
In action
- Is anything unexpected occurring?
- Are you noticing anything surprising or different from what you anticipate while performing, interpreting, and reporting tests for paediatric patients?
- Are you encountering situations such as:
- Sudden and persistent patient cooperation failure (e.g., child crying, high movement artefact) despite using established communication techniques?
- Unanticipated parental anxiety or difficulty with communication/instructions compromising the test environment?
- The paediatric waveform obtained being significantly different from the age-matched norm in an unexpected way, complicating interpretation?
- How is this experience comparing with previous experiences of similar activities, like performing tests on children 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 communication, technical approach, or testing sequence in the moment?
- Consider the steps you are taking in the moment, such as:
- Immediately implementing a non-standard technique (e.g., a rapid light flash sequence) to secure some minimal data before cooperation is lost?
- Are you pausing the test to specifically address parental concerns or reassure the child, shifting your focus to communication management?
- Are you seeking immediate advice regarding the interpretation of a highly atypical paediatric waveform based on the child’s developmental age?
- How are you feeling in that moment? For instance, are you finding it difficult to adapt your approach for paediatric patients? Is it affecting your confidence in managing the child-facing role? Are you feeling positive you can undertake the tests successfully in order to create the clinical report?
- What is the conclusion or outcome?
- Identify how you are working within your scope of practice when performing, interpreting, and reporting for paediatric patients (e.g., successfully balancing the need for data acquisition with the child’s psychological safety).
- What are you learning as a result of the unexpected development? For example, are you gaining key learning about effective paediatric behaviour management strategies during electrophysiology, or improving your ability to document the limitations of the data obtained due to non-compliance?
On action
- What happened?
- Begin by summarising the key points of the experience of performing tests, interpreting results, and creating clinical reports for a paediatric patient.
- Consider specific events, actions, or interactions that felt important during the testing, interpretation, or reporting process, paying particular attention to interactions with the child and their parent/guardian. 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, modifying your communication style instantly based on the child’s response or rapidly switching protocols due to compliance issues.
- How has this experience contributed to your developing practice?
- Identify what learning you can take from this experience with paediatric patients.
- What strengths did you demonstrate (e.g., empathetic communication, skill in adapting test protocols for age/development)?
- What skills and/or knowledge gaps were evident (e.g., unfamiliarity with managing specific paediatric behavioural challenges, difficulty interpreting age-dependent waveforms)?
- Compare this experience against previous times you have worked with paediatric patients. Were any previously identified actions for development achieved? Has your practice in paediatric electrophysiology and communication improved?
- Identify any challenges you experienced (e.g., cooperation failure, parental anxiety) 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 adapting the approach or needing to escalate regarding the child’s comfort or safety.
- 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 diagnostic tests for paediatric patients. What feedback have you had with regards to your report writing?
- What will you do differently next time you test and report for paediatric patients? 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 paediatric patients further? E.g., Developing age-appropriate rapport-building methods, or reviewing ISCEV guidelines for specific paediatric test parameters.
Beyond action
- Have you revisited the experiences?
- Have you reviewed your actions from your previous reflections for performing and interpreting diagnostic tests for paediatric patients and creating clinical reports?
- What actions did you identify you would need to take to improve your practice related to adapting testing techniques for children, improving communication with children and their guardians, or interpreting results from paediatric tests? 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 paediatric patients 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 paediatric patients will support you in preparing for relevant observed ‘in-person’ assessments for this module, such as Direct Observations of Practical Skills e.g., 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 paediatric patients 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. |