Clinical Exercise Testing —
Training activity: 10

Details

Undertake cardiopulmonary exercise testing, generating a report appropriate for physiological interpretation, including relevant technical comments

Type

Developmental training activity (DTA)

Evidence requirements

Evidence the activity has been undertaken by the trainee​.

Reflection on the activity at one or more time points after the event including learning from the activity and/or areas of the trainees practice for development.

An action plan to implement learning and/or to address skills or knowledge gaps identified.

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 is the standard protocol for CPET in your department? What measurements are taken, and how is the data analysed?
• What are the key components of a comprehensive CPET report, including physiological interpretation and technical comments? Who is the intended audience for this report?
• What specific skills in performing CPET, interpreting the complex physiological data, and generating a clear and informative report do you hope to develop?
• What do you already know about cardiopulmonary physiology, exercise responses in health and disease, and the principles of CPET?
• Will you observe experienced colleagues performing CPET and generating reports? What specific aspects will you focus on?
• What potential challenges might you face during the test (e.g., patient limitations, technical issues)? How will you prepare for these? How will you approach the interpretation of potentially complex data?
• How do you feel about the responsibility of undertaking a complex test like CPET and generating a report that will inform clinical decision-making?

In action

• Pay attention to the patient’s performance throughout the test, their physiological responses, and any technical issues arising with the equipment. What decisions are you making during the test (e.g., encouragement, when to stop based on criteria)? As you begin to generate the report immediately after, what key physiological parameters and technical observations are you prioritising for inclusion?
• How are you progressing with the activity? How effective are your actions in guiding the patient to a maximal or symptom-limited exercise effort? What challenges are you facing in ensuring accurate data collection or in identifying the most relevant technical comments for the report? What can you learn about conducting and reporting CPET as you complete this activity? How does this relate to your understanding of cardiorespiratory physiology and the interpretation of CPET data?
• How are you adapting to the situation? If unexpected physiological responses occur during the test, how are you adapting your approach and considering their potential significance for the report? What support or clarification might you need if you are unsure about how to interpret a particular finding or how to document a technical issue appropriately? Are you ensuring that your actions and reporting remain within your level of competence and training?

On action

• What were the key physiological responses of the patient during the CPET? Were there any technical issues encountered during the test? What were the most significant findings that will need to be included in the report? What challenges did you face in conducting the test or beginning to formulate the report?
• What did you learn about the practical aspects of conducting a CPET? Did you gain a better understanding of the integration of different physiological parameters during exercise? What did you learn about the type of technical comments that are important to include in a CPET report for physiological interpretation?
• How will you structure your CPET report to ensure it is clear, comprehensive, and relevant for physiological interpretation? What specific technical comments will you ensure are included in your report? What further learning or resources would help you to improve your skills in conducting and reporting CPETs? What actions / ‘next steps’ will you take to finalise the CPET report, including technical comments? What support or resources might you need to further develop your skills in CPET performance and reporting?

Beyond action

• Have you conducted further cardiopulmonary exercise tests and written reports? How has your approach to conducting the test and structuring the report evolved?
• Have you received feedback on your CPET reports? How has this feedback informed your subsequent practice?
• Consider if your understanding of physiological interpretation of CPET data and the importance of technical comments has deepened through further learning and experience.
• Have you had opportunities to discuss complex CPET cases with senior colleagues?
• Has your confidence in conducting CPETs and interpreting the results increased?
• Has this experience improved your ability to communicate complex physiological information in your reports?
• Do you now have a better understanding of the clinical significance of different CPET parameters?
• How will you approach future CPETs and the generation of comprehensive reports?
• What clear actions for continued development in the area of CPET performance and reporting have been identified?

Relevant learning outcomes

#	Outcome
# 1	Outcome Prepare equipment and the environment in order to undertake clinical exercise assessments.
# 2	Outcome Prepare patients to undertake field and formal clinical exercise assessments.
# 4	Outcome Undertake clinical exercise assessments.
# 5	Outcome Identify, critically analyse and report key clinical exercise assessment parameters.
# 6	Outcome Prepare reports answering clinical questions using the results of exercise tests, in conjunction with other physiological parameters and patient history.
# 7	Outcome Employ effective communication skills and compassion with a range of patients enabling patients to understand their treatment pathway.
# 8	Outcome Demonstrate a patient centered approach to practice, considering communication with patients and relatives and the patient experience.