Clinical Exercise Testing —
Training activity: 6

Details

Undertake incremental shuttle walk assessments with patients and provide a report of the findings

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 protocol for an incremental shuttle walk test? What equipment is required, and what measurements need to be taken?
• What patient groups are typically indicated for ISWT, and what factors need to be considered when preparing a patient for this test?
• What specific skills in performing ISWT, interpreting the results in relation to clinical context, and reporting the findings do you hope to gain?
• What do you already know about field exercise testing and the principles of ISWT?
• Will you review the ISWT protocol and discuss it with your training officer? Will you practice setting up the test and giving instructions?
• What potential challenges might you encounter during the assessment (e.g., patient fatigue, difficulties following instructions)? How will you prepare to address these?
• How do you feel about guiding patients through this exercise test and then reporting on their performance?

In action

• What are you doing? Pay attention to how you are instructing the patient, setting the pace, and observing their performance. What decisions are you making about encouragement and when to terminate the test if necessary based on safety criteria? How are you monitoring the patient’s physiological responses and perceived exertion?
• How are you progressing with the activity? How effective is your approach in guiding the patient through the assessment and obtaining a valid measure of their exercise capacity? What challenges are you facing in ensuring the patient understands the instructions or in accurately recording the distance and reasons for termination? What can you learn about conducting shuttle walk tests as you perform them? How does this activity link to your understanding of functional exercise capacity and its assessment?
• How are you adapting to the situation? Are there alternative ways you could be motivating the patient? What immediate actions might you need to take if the patient reports significant symptoms or demonstrates signs of distress? What support or guidance might you require if you are unsure about whether to terminate the test? Are you ensuring the assessment is conducted safely and within your competence?

On action

• How far did the patient walk, and what were the reasons for test termination? What were the patient’s physiological responses (e.g., heart rate, oxygen saturation) and perceived exertion levels during the test? Were there any difficulties in administering the test (e.g., patient understanding, maintaining pace)? What were the key findings of the assessment?
• What did you learn about the protocol for the incremental shuttle walk test? Did you gain a better understanding of how to assess a patient’s functional exercise capacity using this test? What did you learn about patient motivation and encouragement during exercise testing?
• How will you structure your report to clearly present the findings of the shuttle walk test? What strategies will you use in future assessments to ensure accurate results and patient safety? What further learning or resources would enhance your understanding of shuttle walk testing and its interpretation? What actions / ‘next steps’ will you take to ensure the report is comprehensive and relevant? What support or resources might you need to further refine your technique in administering this test?

Beyond action

• Have you conducted further incremental shuttle walk assessments? What similarities and differences did you observe compared to your initial experience?
• Have you had the chance to see how the results of your reports informed patient management or rehabilitation programmes?
• Consider if your understanding of functional exercise capacity assessment and the interpretation of shuttle walk test results has grown.
• Have you discussed the nuances of administering this test with other professionals?
• Has your ability to assess patients’ functional capacity using the incremental shuttle walk test improved?
• Has this experience influenced your communication and interaction with patients during physical assessments?
• Do you now have a greater appreciation for the factors that can affect a patient’s performance on this type of test?
• What transferable skills, such as exercise testing administration, observation of physiological responses, and report writing, did you enhance?
• How will you approach future shuttle walk assessments, taking into account your past experiences and reflections?

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.
# 3	Outcome Select the appropriate clinical exercise assessment based on referral criteria.
# 4	Outcome Undertake clinical exercise assessments.
# 6	Outcome Prepare reports answering clinical questions using the results of exercise tests, in conjunction with other physiological parameters and patient history.
# 8	Outcome Demonstrate a patient centered approach to practice, considering communication with patients and relatives and the patient experience.