Back Module: S-NI-S5

Reporting and Reviewing Intraoperative Neuromonitoring

Module information

Module details

Title
Reporting and Reviewing Intraoperative Neuromonitoring
Type
Specialist
Module code
S-NI-S5
Credits
10
Phase
3
Requirement
Compulsory

Aim of this module

This module aims to provide trainees with experience reviewing data and reporting intraoperative neuromonitoring for spinal surgery.

Work-based content

Training activities

# Learning outcome Training activity Type Action
# 1 Learning outcome 1, 5 Training activities

Document and arrange to have faulty equipment checked and repaired. To include:

 

  • Communication with internal departments
  • Communication with external services
  • Testing and checking of equipment once repaired and returned.
 Type DTA Action View
# 2 Learning outcome 1, 2, 5 Training activities

Generate reports for intraoperative neuromonitoring for spinal surgeries and document communication with the theatre team for:

 

  • Lower limb somatosensory evoked potentials
  • Upper limb somatosensory evoked potentials
  • Lower limb motor evoked potentials
  • Upper limb motor evoked potentials
 Type ETA Action View
# 3 Learning outcome 1, 2, 5 Training activities

Generate reports for intraoperative neuromonitoring for spinal surgeries and document communication with the theatre team for:

 

  • Free-run electromyography

and/or

  • Triggered electromyography
 Type DTA Action View
# 4 Learning outcome 3 Training activities

Back up and archive data and reports from intraoperative neuromonitoring for spinal surgeries

 Type ETA Action View
# 5 Learning outcome 1, 3 Training activities

Contribute to a database of intraoperative neuromonitoring cases performed

 Type DTA Action View
# 6 Learning outcome 3, 5 Training activities

Produce a process map of the patient pathway for spinal surgeries through the service from referral to dissemination and archival of report. Present this to an appropriate non-expert group for example a patient interest group, PPI group or other healthcare professionals who do not work in IONM.

 Type DTA Action View
# 7 Learning outcome 3, 5 Training activities

Present a case study on a patient who underwent spinal surgery where somatosensory evoked potential changes (alerts) were noted.

 Type DTA Action View
# 8 Learning outcome 3, 4, 5 Training activities

Present a case study on a patient who underwent spinal surgery where motor evoked potential changes (alerts) were noted.

 Type DTA Action View
# 9 Learning outcome 1, 2, 5 Training activities

Audit an intraoperative neuromonitoring corrective spinal surgery case report against guidelines and report findings to a relevant department meeting.

 

 

 Type DTA Action View
# 10 Learning outcome 1, 4, 5 Training activities

Critically evaluate a SOP used for spinal surgery intraoperative neuromonitoring against guidelines and make recommendations for improvements.

 Type DTA Action View

Assessments

Complete 2 Case-Based Discussions

Complete 2 DOPS or OCEs

Direct Observation of Practical Skills Titles

  • Check and test intraoperative neuromonitoring equipment following repair or routine servicing.
  • Complete a final intraoperative neuromonitoring report where somatosensory evoked potentials, motor evoked potentials, free running or triggered EMG have been employed in spinal surgery.

Observed Communication Event Titles

  • Discuss the report from a case where there have been intraoperative neuromonitoring changes with a colleague.
  • Obtain a detailed follow up on a patient that has had intraoperative neuromonitoring.

Learning outcomes

# Learning outcome
1

Practice according to local protocols and national and international guidelines to ensure the integrity of data recorded for intraoperative neuromonitoring.
2

Produce concise and accurate reports for intraoperative neuromonitoring during spinal surgery according to local, national, and international guidelines.
3

Describe patient pathways for those undergoing intraoperative neuromonitoring during spinal surgery.
4

Critically evaluate the evidence base for intraoperative neuromonitoring.
5

Demonstrate effective and professional communication.

Clinical experiences

Clinical experiences help you to develop insight into your practice and a greater understanding of your specialty's impact on patient care. Clinical experiences should be included in your training plan and you may be asked to help organise your experiences. Reflections and observations from your experiences may help you to advance your practice and can be used to develop evidence to demonstrate your awareness and appreciation of your specialty.

Activities

  • Visit an IQIPs accredited department of any discipline to appreciate the potential role of IQIPs within intraoperative neuromonitoring services
  • Attend a surgical team meeting/discussion where spinal surgery cases of note are reviewed and discussed
  • Observe patient care along the patient pathway from post-op recovery to post-op clinics to appreciate the patients’ experience of their care
  • Review a report for complex intraoperative neuromonitoring/mapping to appreciate the extra modalities that may be needed and reporting requirements

Academic content (MSc in Clinical Science)

Important information

The academic parts of this module will be detailed and communicated to you by your university. Please contact them if you have questions regarding this module and its assessments. The module titles in your MSc may not be exactly identical to the work-based modules shown in the e-portfolio. Your modules will be aligned, however, to ensure that your academic and work-based learning are complimentary.

Learning outcomes

  1. Interpret and synthesise IONM signal changes in the context of spinal surgeries.
  2. Critically evaluate IONM signals considering the anaesthetic and systemic changes.
  3. Demonstrate understanding of the importance of IONM baselines.
  4. Critically apply appropriate alarm criteria to interpret IONM signals compared to their baselines.
  5. Critically evaluate IONM reports understanding their significance and medicolegal implications.

Indicative content

  • Effects of anaesthetics drugs and muscle relaxants on the different IONM modalities. Anaesthetic fade.
  • Effects of systemic factors (hypoxia, blood loss, blood pressure, temperature) on electrophysiological signals (EPs and EMG).
  • Appropriate comparison of IONM signals with their baselines.
  • Interpretation of IONM signal changes and their relevance to the surgical step.
  • Identification of artefacts, and differentiation from real IONM signals.
  • Relevant information to document during the signals acquisition: role of annotations and comments.
  • Importance of accurate and timely communication with the surgical team.
  • Generating a complete factual IONM report.
  • Importance of the accuracy of the written report, and the potential medicolegal implications.

Module assigned to

Specialties

Specialty code Specialty title Action
Specialty code SPS2-3-25 Specialty title Neurophysiology: Intraoperative Neuromonitoring [2025] Action View
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