Advanced Practice - Arterial —
Training activity: 8

Details

Produce descriptive clinical reports of ultrasound scan analysis

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.

Considerations

• Limitations of scan
• Local, national and international guidelines
• Communication skills
• Acting on urgent findings
• Patient pathways
• Multidisciplinary working

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 produce descriptive clinical reports of ultrasound scan analysis that are accurate, concise, and clinically relevant.
• Consider how the learning outcomes apply, specifically in relation to clearly communicating the findings and conclusions of the lower limb arterial ultrasound findings.
• Discuss with your training officer to gain clarity of what is expected of you in relation to departmental reporting templates, required components of a comprehensive report (e.g., measurements, interpretation, conclusion, recommendations), and expected terminology.

What is your prior experience of this activity?

• Think about what you already know about key elements of a good clinical report.
• Consider possible challenges you might face during the activity, such as translating complex scan findings into clear, written descriptions, ensuring consistency, or formulating appropriate conclusions and recommendations.
• 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. You will need to seek advice from your Training Officer when required, for example on reviewing a report with a senior colleague before finalisation, particularly for complex or unusual findings.
• Acknowledge how you feel about independently producing a comprehensive and accurate clinical report.

What do you anticipate you will learn from the experience?

• Consider the specific skills you want to develop, such as clarity and conciseness in medical writing, enhancing your ability to link scan findings to clinical implications, and gaining proficiency in structuring comprehensive reports.
• Identify the specific insights you hope to gain into how reports contribute to patient management decisions and communication within the healthcare team.

What additional considerations do you need to make?

• Consult actions identified following previous experiences of previously drafted reports or received feedback on written communication.
• Identify important information you need to consider before embarking on the activity, such as departmental guidelines or national recommendations for ultrasound reporting.

In action

Is anything unexpected occurring?

• Are you noticing anything surprising or different from what you anticipate whilst producing a descriptive clinical report of ultrasound scan analysis?
• Are you encountering situations such as:
  • Difficulty arises in translating complex or borderline haemodynamic findings into clear, concise, and objective clinical language for the final report conclusion?
  • A conflict exists between different data points (e.g., visual B-mode appearance vs. calculated velocity ratio), challenging the final descriptive statement regarding disease severity?

How are you reacting to the unexpected development?

• How is this impacting your actions? For example, are you responding to the situation appropriately? Are you adapting or changing your approach to clarifying the report terminology or ensuring the objective data is clearly prioritised?
• Consider the steps you are taking in the moment, such as:
  • Immediately pausing the report drafting to consult departmental reporting templates or specific grading criteria to ensure consistent terminology
  • Reviewing the raw data or measurements once more to resolve the conflict before committing the finding to the final report
• How are you feeling in that moment? For instance, are you finding it difficult to maintain objectivity when interpreting borderline results? Is it affecting your confidence in ensuring the report is unambiguous for the referring clinician?

What is the conclusion or outcome?

• Identify how you are working within your scope of practice. For example, are you successfully structuring the report to clearly present measurements and factual findings, leading to a concise summary? Or are you needing support because the required conclusion involves specific legal or administrative phrasing (e.g., prognosis, risk stratification) outside of standard technical reporting, requiring senior review?
• What are you learning as a result of the unexpected development? For example, are you mastering a more efficient strategy for proofreading and ensuring clarity in clinical report language? Or gaining insight into the critical terminology used by the multidisciplinary team for patient management?

On action

What happened?

• Begin by summarising the key steps you took when producing a descriptive clinical report of an ultrasound scan analysis.
• Consider specific events, actions, or interactions which felt important, such as how you ensured the terminology used for describing stenosis severity was consistent with departmental guidelines or how you clearly articulated the conclusion based on complex haemodynamic data.
• Include any ‘reflect-in-action’ moments where you had to adapt your reporting based on new insights or clarifications during the process, for instance, immediately re-checking raw data and adjusting the wording when faced with conflicting information regarding the severity grade.
• How did you feel during this experience, e.g., did you feel focused on maintaining the factual integrity of the data or stressed by the ambiguity in correlating findings with the diagnosis?

How has this experience contributed to your developing practice?

• Identify what learning you can take from the experience of producing a clinical report. What strengths did you demonstrate, e.g., accurate transcription and objective presentation of technical measurement values?
• What skills and/or knowledge gaps were evident, e.g., difficulty translating complex haemodynamic profiles into concise, clinically relevant descriptive terminology or unfamiliarity with the required format for recommendations?
• Compare this experience against previous engagement with similar activities – were any previously identified actions for development in clinical reporting achieved? Has your practice improved in producing descriptive clinical reports?
• Identify any challenges you experienced, such as needing to seek advice or clarification on scope of practice regarding the level of interpretive commentary appropriate for the report, and how you reacted to this.

What will you take from the experience moving forward?

• Identify the actions or ‘next steps’ you will now take to support the assimilation of what you have learnt, including from any feedback you have received, with regards to improving the clarity, conciseness, and accuracy of descriptive clinical reports.
• What will you do differently next time you approach report production, for instance, by proactively reviewing the departmental reporting template requirements before drafting the final conclusion?
• Do you need to practise any aspect of the activity further, such as refining terminology for describing disease severity or key learning outcomes related to producing an interpretive clinical report?

Beyond action

Have you revisited the experiences?

• How have your subsequent experiences of producing descriptive clinical reports of ultrasound scan analysis since completing this specific training activity led you to revisit your initial approach or decisions during that activity? For example, how an instance where a subsequent report required precise terminology to communicate complex, borderline haemodynamic findings forced you to re-evaluate the clarity and conciseness of the language you applied during your first attempt at reporting.
• Considering what you understand about standard reporting protocols, concise descriptive language, and linking findings to clinical implications now, were the actions or considerations you identified after your initial reflection on this training activity sufficient? How have you since implemented or adapted improvements in your clinical report writing based on further learning and experiences? For example, how you proactively reviewed and implemented a structured reporting checklist to ensure consistency in terminology and conclusion formulation.
• Has discussing reports where the conclusion was unclear or the impact of minor typographical errors in reported data with peers or supervisors changed how you now view your initial experience in this training activity? For example, how professional storytelling with a supervising physician about a report where ambiguous phrasing led to clinical confusion refined your understanding of the critical nature of unambiguous report content.

How have these experiences impacted upon current practice?

• How has the learning from this initial training activity, in combination with subsequent clinical report production experiences, contributed to your overall confidence and competence in producing descriptive clinical reports of ultrasound scan analysis, particularly in preparing for assessments like Case-Based Discussions (CBDs) or OCEs? For example, how your accumulated ability in structuring complex scan findings into a clear, concise narrative now enables you to confidently prepare the associated diagnostic clinical reports required for a Case-Based Discussion.
• How has reflecting back on this specific training activity, combined with everything you’ve learned since, shaped your current approach to producing descriptive clinical reports? How does this evolved understanding help you identify when something is beyond your scope of practice or requires escalation? For example, how your evolved approach means you now routinely seek advice immediately when drafting a report conclusion that requires clinical prognostication outside of factual description, recognising this requires senior input for preparing the associated diagnostic clinical reports.
• Looking holistically at your training journey, how has this initial clinical report production experience, revisited with your current perspective, contributed to your development in meeting the learning outcomes related to preparing the associated diagnostic clinical reports and communicating effectively with a range of patients and other professionals? For example, how this foundational experience has supported your development in gaining proficiency in structuring comprehensive reports.

Relevant learning outcomes

#	Outcome
# 6	Outcome Produce an interpretive clinical report of the lower limb arterial ultrasound findings.
# 9	Outcome Appraise the impact of research evidence on national guidelines.