Advanced Practice - Arterial —
Training activity: 9

Details

Communicate findings of arterial scans to:

• The multidisciplinary team
• A patient

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

• Communication of results
• Roles of various members of the wider team
• Treatment options and pathways for patients (local and national guidelines)
• Explaining results to non-scientist audience
• Adapting communication e.g. language, culture, age, mental capacity and jargon
• Equality and diversity
• Patient experience

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 identify and communicate the results of the scan to both patients and the multidisciplinary team effectively and appropriately.
• Consider how the learning outcomes apply, specifically in relation to adapting your communication style to each audience and conveying complex scientific information clearly.
• Discuss with your training officer to gain clarity of what is expected of you in relation to expectations for patient communication (e.g., managing emotional responses, discussing risk factors) and for communicating with the MDT (e.g., brevity, focus on clinical significance).

What is your prior experience of this activity?

• Think about what you already know about communication strategies found effective when communicating complex medical information.
• Consider possible challenges you might face during the activity, such as conveying sensitive or unexpected findings, managing patient anxiety, or responding to questions from the MDT.
• 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 handling a particularly challenging patient conversation or when clarifying findings with a clinician.
• Acknowledge how you feel about effectively communicating scan findings to diverse audiences.

What do you anticipate you will learn from the experience?

• Consider the specific skills you want to develop, such as active listening skills, developing strategies for explaining complex scientific information simply, and enhancing your ability to tailor your communication style.
• Identify the specific insights you hope to gain into the impact of effective communication on patient understanding and adherence, and on multidisciplinary team collaboration.

What additional considerations do you need to make?

• Consult actions identified following previous experiences of prior feedback or self-identified areas for improvement in communication skills.
• Identify important information you need to consider before embarking on the activity, such as potential patient reactions to findings and prepare key messages.

In action

Is anything unexpected occurring?

• Are you noticing anything surprising or different from what you anticipate whilst communicating findings of arterial scans to the multidisciplinary team or a patient?
• Are you encountering situations such as:
  • The patient reacts with unexpected emotional distress or denial when informed of critical findings (e.g., severe limb ischaemia), complicating the compassionate communication process?
  • A clinician from the MDT asks a highly specific, complex haemodynamic question (e.g., about collateral flow compensation) that was not explicitly covered in the scan report?

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 communication style (e.g., increasing empathy, simplifying terminology) or technical detail provided?
• Consider the steps you are taking in the moment, such as:
  • Immediately shifting to an empathetic listening posture and pausing the delivery of information to address the patient’s emotional response
  • Adapting language to simplify the complex scientific findings (e.g., velocity changes) into understandable clinical concepts for the patient or focusing the MDT conversation on clinical significance
• How are you feeling in that moment? For instance, are you finding it difficult to maintain composure and clarity while managing patient anxiety? Is it affecting your confidence in conveying the critical nature of the findings effectively?

What is the conclusion or outcome?

• Identify how you are working within your scope of practice. For example, are you successfully tailoring your explanation to ensure comprehension by the patient and MDT member while maintaining professionalism? Or are you needing support because the patient’s emotional distress is too severe to manage independently or the MDT question requires specialist consultation beyond your current expertise?
• What are you learning as a result of the unexpected development? For example, are you mastering a more effective technique for framing bad news compassionately? Or gaining insight into the key information points prioritized by the MDT when reviewing arterial scan results?

On action

What happened?

• Begin by summarising the key points of your experience communicating arterial scan findings to the multidisciplinary team and to a patient.
• Consider specific events, actions, or interactions which felt important, such as how you tailored the explanation of significant disease to alleviate patient anxiety or how you ensured the multidisciplinary team received clear, concise, and clinically actionable information.
• Include any ‘reflect-in-action’ moments where you had to adapt your communication style or content as the conversation unfolded, for instance, immediately shifting to non-verbal cues and simpler language when a patient with complex needs exhibited confusion or distress.
• How did you feel during this experience, e.g., did you feel confident in tailoring the complex explanation or challenged by the need to manage emotional responses during sensitive discussions?

How has this experience contributed to your developing practice?

• Identify what learning you can take from the experience of communicating scan findings. What strengths did you demonstrate, e.g., compassionate communication when delivering sensitive findings or clear distillation of complex technical data for the MDT?
• What skills and/or knowledge gaps were evident, e.g., unfamiliarity with the appropriate terminology or level of detail required for a specific referring clinician or difficulty anticipating patient questions about prognosis?
• Compare this experience against previous engagement with similar activities – were any previously identified actions for development in communication achieved? Has your practice improved in identifying and communicating the results of the scan to both patients and the multidisciplinary team?
• Identify any challenges you experienced, such as needing to seek advice or clarification on scope of practice regarding communicating complex prognosis or managing severe emotional distress in a patient, 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 tailored communication strategies for diverse audiences.
• What will you do differently next time you approach communication of findings, for instance, by proactively preparing simplified analogies or visual aids to explain complex haemodynamic concepts to patients?
• Do you need to practise any aspect of the activity further, such as role-playing difficult conversations with vulnerable patients or key learning outcomes related to identifying and communicating scan results to both patients and the multidisciplinary team?

Beyond action

Have you revisited the experiences?

• How have your subsequent experiences of communicating findings of arterial scans to both the MDT and patients 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 patient exhibited severe denial or anxiety when informed of critical findings forced you to re-evaluate the sensitivity and phrasing you applied during your first attempt at delivering sensitive results.
• Considering what you understand about compassionate communication, tailoring explanations for diverse audiences, and managing emotional responses 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 communication strategies based on further learning and experiences? For example, how you proactively integrated specific strategies for simplifying complex haemodynamic concepts using analogies for patient explanations.
• Has discussing challenging communication scenarios (e.g., managing patient distress, answering complex MDT questions) with peers or colleagues changed how you now view your initial experience in this training activity? For example, how professional storytelling with a senior colleague about a communication failure that led to patient non-adherence refined your understanding of the critical nature of effective patient education and rapport building.

How have these experiences impacted upon current practice?

• How has the learning from this initial training activity, in combination with subsequent communication experiences, contributed to your overall confidence and competence in communicating findings of arterial scans to the MDT and patients, particularly in preparing for assessments like DOPS or OCEs? For example, how your accumulated ability in managing sensitive conversations now enables you to confidently communicate scan results to a relevant clinician during an OCE assessment.
• How has reflecting back on this specific training activity, combined with everything you’ve learned since, shaped your current approach to communicating findings of arterial scans? 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 assistance when complex information needs to be escalated or communicated by a more senior colleague when faced with severe ethical or emotional barriers, recognising this requires senior input for identifying and communicating scan results to both patients and the multidisciplinary team.
• Looking holistically at your training journey, how has this initial communication of scan findings experience, revisited with your current perspective, contributed to your development in meeting the learning outcomes related to communicating effectively with a range of patients and other professionals and identifying and communicating scan results to both patients and the multidisciplinary team? For example, how this foundational experience has supported your development in tailoring explanations using simplified language.

Relevant learning outcomes

#	Outcome
# 7	Outcome Identify and communicate the results of the scan to both patients and the multidisciplinary team.
# 8	Outcome Summarise the treatment pathways for lower limb PAD.