Training activity information
Details
Review referrals and plan the appropriate ophthalmic imaging testing strategy
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, considering learning outcomes related to creating imaging plans based on referral information, combining information from electrophysiological and imaging findings to inform a diagnosis, modifying and adapting protocols dependent on patients’ needs, and selecting and operating ophthalmic imaging equipment.
- What constitutes a successful review of a referral and a well-planned imaging strategy that is appropriate for the patient’s suspected condition and needs?
- Discuss with your training officer to gain clarity on what is expected of you in this referral review and planning process.
- What is your prior experience of this activity?
- Think about what you already know about reviewing clinical referrals, understanding ophthalmic conditions, and the capabilities of different imaging modalities.
- Consider possible challenges you might face, such as ambiguous referrals, complex patient histories, choosing between multiple imaging options, or needing to adapt standard protocols, 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 difficult referrals or complex planning decisions.
- Acknowledge how you feel about the process of reviewing referrals to plan for an appropriate testing strategy.
- What do you anticipate you will learn from the experience?
- Consider the specific skills you want to develop in critically analysing referral information and formulating efficient and effective imaging plans – drawing upon previous experiences.
- Identify specific insights you hope to gain regarding the correlation between referral information and appropriate imaging techniques, how to sequence tests, or adapting strategies for different patient groups or conditions.
- What additional considerations do you need to make?
- Consult actions identified following previous experience of reviewing clinical information or planning procedures, if any.
- Identify important information you need to consider before embarking on the activity, such as patient history details, potential contraindications for certain tests, availability of specific equipment, and relevant clinical guidelines or protocols.
In action
- Is anything unexpected occurring?
- Are you noticing anything surprising or different from what you anticipate while reviewing referrals and planning the testing strategy?
- Are you encountering situations such as the referral information being ambiguous, complex medical history contradicting the test request, or an immediate need to deviate from the standard testing sequence based on a critical finding?
- How is this experience comparing with previous experiences of similar activities, like reviewing other referrals or planning other tests?
- How are you reacting to the unexpected development?
- Identify how this is impacting your actions during referral review and planning. Are you responding to the situation appropriately? Are you adapting or changing your approach? Is it affecting your ability to undertake the activity independently?
- In the moment, what steps are you taking, such as immediately pausing the planning process to consult clinical guidelines, or rapidly modifying your planned test sequence to account for unexpected clinical constraints?
- How are you feeling in this moment? Are you finding it difficult to adapt your initial planning strategy? Is the conflicting information affecting your confidence in choosing the most appropriate tests?
- What is the conclusion or outcome?
- Identify how are you working within your scope of practice when reviewing referrals and planning the testing strategy (e.g., are you successfully prioritizing clinical urgency while escalating uncertainty regarding diagnosis)?
- Identify what are you learning as a result of the unexpected development (e.g., a more effective technique for quickly cross-referencing clinical guidelines with referral symptoms)?
On action
- What happened?
- Begin by summarising the key points of the experience of reviewing the referral and formulating the testing strategy.
- Consider specific events, actions, or interactions that felt important during the planning process, such as analysing ambiguous information, justifying test choice, or incorporating patient history.
- Include any ‘reflect-in-action’ moments, where you had to adapt to the situation as it unfolded, for instance, immediately consulting clinical guidelines or changing the testing sequence based on a critical note. 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 referral review and planning.
- What strengths did you demonstrate (e.g., analytical skill in planning, adherence to protocols)?
- What skills and/or knowledge gaps were evident (e.g., unfamiliarity with planning for specific complex diagnoses or sequencing challenges)?
- Compare this experience against previous planning activities. Were any previously identified actions for development achieved? Has your practice in formulating testing strategies improved?
- Identify any challenges you experienced during the review (e.g., ambiguous referral data, conflicts in patient history) 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 the activity, such as needing to seek advice or clarification on the required tests or escalating to ensure you were working within your scope of practice.
- Acknowledge any changes in your own feelings now you are looking back on the experience.
- What will you take from the experience moving forward?
- Identify the action you will now take to support the assimilation of what you have learnt, including from any feedback you have received with regards to your ability to review referrals and plan for appropriate testing.
- What will you do differently next time you review a referral and plan testing? 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 the activity further? E.g., Practising cross-referencing referral symptoms with standard protocols.
Beyond action
- Have you revisited the experiences?
- Have you reviewed the actions identified in your previous reflections for reviewing referrals and planning the appropriate ophthalmic imaging testing strategy?
- What specific actions did you previously identify you would need to take to improve your practice, such as improving your referral review process, refining your rationale for test selection, or better considering patient factors in your planning? 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 reviewing referrals and planning strategy?
- Engage in professional storytelling about handling ambiguous or incomplete referrals, or defining the subsequent imaging testing strategy rationale for complex differential diagnoses with peers, near peers, or colleagues. 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 reviewing referrals and planning strategy will support you in preparing for relevant observed ‘in-person’ assessments for the module. This includes Observed Communication Events (OCEs) like ‘Discuss with a supervisor a testing plan based on a patient referral,’ or Case-Based Discussions. This specifically relates to demonstrating your ability to create imaging plans based on referral information.
- How has your practice related to reviewing referrals and planning strategy developed and evolved over time? This includes recognising when something related to this activity is beyond your scope of practice, such as when a referral is too complex or requires specialist input for planning.
Relevant learning outcomes
| # | Outcome |
|---|---|
| # 1 |
Outcome
Create imaging plans based on referral information. |
| # 3 |
Outcome
Combine information from electrophysiological and imaging findings to inform a diagnosis. |
| # 6 |
Outcome
Modify and adapt protocols dependent on patients’ needs. |
| # 8 |
Outcome
Select and operate ophthalmic imaging equipment. |