Patient Pathway —
Training activity: 5

Details

Conduct and report clinical interviews, and take histories from complex patients, leading to clear establishment of a goal setting for either clinical assessment or intervention delivery.

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.

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?

• How have you reviewed the learning outcomes to ensure you are prepared to conduct a patient episode from referral to treatment, specifically focusing on the identification of appropriate healthcare technology?
• How do you plan to demonstrate that your history-taking techniques allow you to effectively appraise patient experiences and requirements across specialist service areas?
• What essential communication strategies have you identified as necessary to inform and educate a range of stakeholders, including the patient and their family, during the interview?

What is your prior experience of this activity?

• What is your existing knowledge regarding the clinical indicators and technical considerations for the specific complex patient group you are about to interview?
• What specific challenges do you anticipate when taking a history from a complex patient (e.g., conflicting information or communication barriers), and how have you planned to handle them?
• How do you recognise the scope of your own practice for this activity, and do you know at what point you will need to seek advice or specialist help from a senior colleague?
• How would you describe your current feelings regarding your ability to manage the professional responsibility of establishing clinical goals that directly impact patient management?

What do you anticipate you will learn from the experience?

• What specific insights do you hope to gain regarding how a patient’s personal goals and lifestyle dictate the selection and prescription of healthcare technology?
• In what ways do you anticipate this activity will improve your proficiency in translating complex technical information into a narrative that is accessible and meaningful for the patient?

What additional considerations do you need to make?

• How have you consulted the actions identified in your previous reflections to ensure you are building upon feedback regarding your patient liaison or reporting style?
• What important information (e.g., specific clinical guidelines, patient case notes, or equipment limitations) have you identified that you must consider before embarking on this interview?

In action

During the activity is anything unexpected occurring?

• How are you currently approaching the sequence of the clinical interview, and why have you chosen this particular logical flow to explore the patient’s history?
• What surprises or deviations from the anticipated clinical picture are you noticing as the patient shares their lived experience?
• How are you identifying if the provided history is sufficient to establish clear goals, or if the case requires further specialist clarification?

How are you reacting to the unexpected development?

• How are you adjusting your communication style in real-time to ensure the patient feels informed and empowered to participate in the goal-setting process?
• What logic-based decisions are you making right now regarding which technical interventions are most relevant to suggest based on the patient’s immediate feedback?
• How are you feeling in this moment? Is the complexity of the patient’s phenotypes or emotional state affecting your confidence in reaching a successful clinical conclusion?

What is the conclusion or outcome?

• How effectively are you working within your professional scope of practice, and at what point did you determine that senior or multidisciplinary input was required?
• In what ways are your real-time decisions ensuring that the final established goals are clinically robust and patient-centred?

On action

What happened?

• How would you summarise the key points of the clinical interview, specifically detailing the patient’s history and the final goals established?
• What specific clinical details or interactions—such as a particular patient concern or a complex medical indicator—felt most significant during the session?
• Which ‘reflect-in-action’ moments did you notice where you had to adapt your approach, such as pivoting the interview to address a newly identified patient goal?

How has this experience contributed to your developing practice?

• What specific skills or strengths did you demonstrate regarding the ability to synthesise a complex patient history into an actionable clinical report?
• In what ways did your real-time decisions influence the final quality and accuracy of the established clinical goals?
• How does the experience of conducting this patient episode relate to the requirements for your future post-programme practice as a Clinical Scientist?
• Have your feelings changed now that you are looking back on the experience and the responsibility of establishing these clinical goals?

What will you take from the experience moving forward?

• What specific areas for continued development in clinical interviewing or stakeholder communication have you identified as a result of this task?
• What specific ‘next steps’ will you now take, such as seeking feedback on your reporting style, to support the assimilation of what you have learned?
• What support or resources (e.g., expert mentorship or access to specialist clinical guidelines) do you need to further develop your expertise in this field?

Beyond action

Have you revisited the experiences?

• How have you reviewed your actions from previous reflections for this activity to determine if you have completed identified tasks, such as refining your history-taking technique or mastering specific clinical assessments?
• Are you now ready to demonstrate this new learning into practice when navigating increasingly complex or ambiguous patient phenotypes?
• In what ways has professional discussions with peers regarding your approach to complex histories changed your view on how to navigate cases where clinical information is incomplete?

How have these experiences impacted upon your current practice?

• How has the accumulated learning from these patient episodes supported your preparation for ‘in-person’ assessments for the module, such as Observed Communication Events (OCE) or Case-Based Discussions (CBD)?
• How has your practice in aligning technical prescriptions with patient goals developed and evolved since you first performed this activity?
• In what ways are you now more confident in recognising when something is beyond your scope of practice and knowing exactly when to escalate a complex case for senior specialist review?

Relevant learning outcomes

#	Outcome
# 2	Outcome Communicate clearly and effectively with a range of stakeholders to inform and educate.
# 3	Outcome Conduct a patient episode from referral to treatment including identification and prescription of healthcare technology.
# 5	Outcome Appraise patient experiences, requirements and goals across specialist service areas.