Advanced Practice - Venous —
Training activity: 8

Details

Produce descriptive clinical reports for the following:

• Chronic DVT
• Acute DVT
• Deep venous insufficiency
• Superficial venous insufficiency
• Superficial vein map

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 team 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 successfully producing descriptive clinical reports for various venous conditions (DVT, insufficiency, vein map).
• Consider how the learning outcomes apply, specifically in relation to producing an interpretive clinical report of the lower limb vein ultrasound findings.
• Discuss with your training officer to gain clarity of what is expected of you in relation to expected format, required terminology, and the necessary level of detail for a clinically useful report for each specific venous condition.

What is your prior experience of this activity?

• Think about what you already know about medical writing, the structure of clinical reports, and the key elements to include for various venous conditions (e.g., acute DVT vs. deep venous insufficiency).
• Consider possible challenges you might face during the activity, such as ensuring clarity for different audiences (e.g., surgeon vs. primary care physician), synthesising complex multi-segment findings, or ensuring consistency in descriptive terminology.
• 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 for ambiguous findings, complex cases requiring nuanced phrasing, or when documenting an urgent finding that necessitates immediate action.
• Acknowledge how you feel about embarking on this clinical reporting activity.

What do you anticipate you will learn from the experience?

• Consider the specific skills you want to develop, such as concise communication, structured reporting, and translating complex findings into clinically relevant textual descriptions.
• Identify the specific insights you hope to gain into effective clinical communication and the impact of report quality on patient management decisions.

What additional considerations do you need to make?

• Consult actions identified following previous experiences of clinical documentation or reporting (e.g., improving clarity or ensuring all relevant sections are completed).
• Identify important information you need to consider before embarking on the activity, such as specific reporting guidelines for DVT and venous insufficiency, and departmental reporting templates.

In action

Is anything unexpected occurring?

• Are you noticing anything surprising or different from what you anticipate whilst producing descriptive clinical reports for various venous conditions?
• Are you encountering situations such as:
  • Difficulty selecting appropriate, standardised terminology to describe complex or borderline findings (e.g., differentiating acute vs. chronic DVT features)?
  • A need to generate a pre-operative vein map report that requires highly precise anatomical descriptions outside the standard descriptive template?

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 ensuring clarity and accuracy in reporting ambiguous findings?
• Consider the steps you are taking in the moment, such as:
  • Immediately consulting the departmental reporting template to verify standardised descriptive terminology for acute DVT features
  • Carefully reviewing the anatomical mapping diagrams against the accompanying text to ensure precision and compliance for a vein map
• How are you feeling in that moment? For instance, are you finding it difficult to translate complex physiological findings into concise, clinically relevant text? 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 drafting a clinically concise and accurate report using approved departmental terminology? Or are you needing support because an urgent finding necessitates immediate clinical escalation and verification by senior staff before the report is finalised?
• What are you learning as a result of the unexpected development? For example, are you mastering report terminology for chronic venous disease? Or gaining insight into the critical components of a clinically useful descriptive report?

On action

What happened?

• Begin by summarising the key steps you took when producing the descriptive clinical report, detailing which type of report you completed (e.g., Acute DVT report) and how you structured the findings.
• Consider specific events, actions, or interactions which felt important during the report writing process, such as ensuring clarity and conciseness, accurate terminology for pathology, or your own feelings about conveying the findings.
• Include any ‘reflect-in-action’ moments where you had to adapt to the situation as it unfolded, for instance, immediately revising terminology to maintain objectivity when faced with borderline findings or seeking clarification on reporting standards.
• How did you feel during this experience, e.g., did you feel focused on adherence to reporting standards or stressed by the potential for ambiguity in the descriptive language?

How has this experience contributed to your developing practice?

• Identify what learning you can take from producing this report. What strengths did you demonstrate, e.g., adherence to reporting standards or ability to communicate complex findings clearly?
• What skills and/or knowledge gaps were evident, e.g., unfamiliarity with the specific detail required for a superficial vein map or difficulty ensuring appropriate clinical recommendations were implied in the conclusion?
• Compare this experience against previous engagement with similar activities – were any previously identified actions for development achieved? Has your practice improved in translating complex findings into clinically relevant textual descriptions?
• 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 a descriptive report or escalating a finding to ensure its proper representation, 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 structure and terminology of descriptive clinical reports.
• What will you do differently next time you approach clinical reporting, for instance, by proactively developing a standardized descriptive language bank for common venous pathologies (e.g., acute DVT vs. chronic PTS).
• Do you need to practise any aspect of the activity further, such as refining your descriptive language 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 venous clinical reports 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, metric mapping details for a surgical vein map forced you to re-evaluate the clarity and completeness of the descriptive language you applied during your first attempt at reporting.
• Considering what you understand about reporting protocols, clinical terminology for venous pathology, and ensuring report accuracy 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 venous report writing based on further learning and experiences? For example, how you proactively reviewed and integrated specific, standardised reporting templates for DVT and venous insufficiency to ensure consistent nomenclature, demonstrating you have adapted improvements based on further learning.
• Has discussing reports where the conclusion was unclear or the impact of imprecise terminology on surgical planning with colleagues 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 regarding reflux severity 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 for venous conditions, particularly in preparing for assessments like CBDs? For example, how your accumulated ability in structuring complex venous findings into a clear, concise report now enables you to efficiently articulate the diagnostic features of a complex DVT case during a CBD assessment.
• 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 falls outside routine reporting scope.
• 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 objectives related to producing an interpretive clinical report? 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 vein ultrasound findings.