Clinical experiential learning is the range of activities trainees may undertake in order to gain the experience and evidence to demonstrate their achievement of module competencies and assessments. The list is not definitive or mandatory, but training officers should ensure, as best training practice, that trainees gain as many of these clinical experiences as possible. They should be included in training plans, and once undertaken they should support the completion of module assessments and competencies within the e-portfolio.
Clinical experiential learning
Electromyography and Nerve Conduction Studies and Evoked Potentials
- Identify a patient with a peripheral nerve or muscular problem requiring EMG and/or nerve conduction investigations and, with permission, follow the progress of the patient from the initial consultation, through investigations and follow-up appointment, and reflect on your learning from this process.
- Identify five patients with different peripheral nerve or muscular conditions (e.g. motor neuron disease, myasthenia gravis, etc.), write a case study on each patient and critically reflect on the role of EMG and nerve conduction studies in such conditions.
- Observe the application of evoked potentials in the surgical setting and describe, compare and contrast the different techniques used and the evidence base underpinning their use.
- Identify a patient with multiple sclerosis and, with permission, follow the progress of the patient from initial consultation, through investigations, including evoked potentials, and follow-up appointment, and reflect on your learning from this process.
- Attend a neurology, neurosurgery, neuromuscular or neurorehabilitation clinic and critically appraise the process of referral, diagnosis and treatment, including the range of healthcare professionals that contribute to the care of each patient and how the interprofessional team work together.
- Use your clinical experience to critically evaluate the use of evoked potentials and nerve conduction studies.
It is also recommended that trainees undertake the following clinical experiential learning:
- Observe the surgical treatment of patients with a peripheral nerve entrapment, such as carpal tunnel syndrome, and discuss the evidence base underpinning the surgical and non-surgical management of peripheral nerve entrapment.
- Attend an outpatient clinic and observe the work of the therapists in the treatment and management of peripheral nerve entrapment conditions.
- Observe paediatric EMG and reflect of the differences between assessing children and adults.
- Participate and contribute to multidisciplinary team meetings (MDTs) and case presentation sessions and discuss the role of MDTs in the diagnosis and management of patients.
Paediatric EEG
- Identify a paediatric patient with an epilepsy syndrome requiring EEG and, with permission, follow the progress of the patient from the initial consultation, through investigations and follow-up appointment and reflect on your learning from this process.
- Identify five patients with different epilepsies or neurological conditions (e.g. childhood absence epilepsy, West syndrome), write a case study on each patient, critically reflect on the role of EEG in paediatric conditions and evaluate the use of EEG in childhood.
- Observe the application of EEG in the non-dedicated environment and describe the different techniques used.
- Observe a paediatric epilepsy clinic and critically appraise the process of referral, diagnosis and treatment, including the range of healthcare professionals that contribute to the care of each patient and how the interprofessional team work together.
- Use your clinical experience to critically evaluate the range of montage derivations and recording parameters used in paediatric EEG.
It is also recommended that trainees undertake the following clinical experiential learning:
- Observe the surgical treatment of patients with intractable epilepsy, evaluate the evidence base underpinning the surgical and medical management of intractable epilepsy, and present your findings to colleagues.
- Observe neonatal EEG and reflect of the maturation of the EEG.
- Participate and contribute to multidisciplinary team meetings (MDTs) and case presentation sessions and discuss the role of MDTs in the diagnosis and management of patients.
EEG in the Intensive Care Setting
- Identify a patient in the intensive care setting requiring EEG and, with permission, follow the progress of the patient from the initial admission, through investigations and outcome. Reflect on your learning from this process.
- Identify three intensive care patients referred for EEG for different reasons (e.g. status epilepticus, head injury, etc.), write a case study on each patient and critically reflect on the role of EEG in such conditions.
- Observe the application of cerebral function monitoring in the intensive care setting and describe the different techniques used.
- Attend an intensive care unit ward round and critically appraise the process of admission, diagnosis and treatment, including the range of healthcare professionals that contribute to the care of each patient and how the interprofessional team work together.
It is also recommended that trainees undertake the following clinical experiential learning:
- Observe the neurosurgical treatment of intensive care patients and discuss how this experience will shape your professional practice.
- Observe neonatal intensive care cerebral function monitoring.
- Participate and contribute to multidisciplinary team meetings (MDTs) and case presentation sessions and discuss the role of MDTs in the diagnosis and management of patients.
Sleep and Long term Monitoring
- Identify a patient undergoing a sleep study and, with permission, follow the progress of the patient from the initial consultation, through investigations and follow-up appointment, and reflect on your learning from this process.
- Identify a patient undergoing long-term monitoring and, with permission, follow the progress of the patient from the initial consultation, through investigations and follow-up appointment, and reflect on your learning from this process.
- Identify a patient referred for a multiple sleep latency test or polysomnography, write a case study on the patient and critically reflect on the role of the multiple sleep latency test in the diagnosis of narcolepsy or excessive daytime somnolence.
- Identify two patients referred for long-term monitoring for different conditions (e.g. intractable epilepsy, non-epileptic attacks), write a case study on each patient and critically reflect on the evidence base underpinning the role of long-term monitoring in the management of each condition.
- Attend a sleep disorders or specialist epilepsy clinic and critically appraise the process of admission, diagnosis and treatment, the contribution of each member of the healthcare team contributing to the care pathway and the factors that promote effective interprofessional working.
- Using your clinical experience gained in this module critically evaluate, including the underpinning evidence base, the application of videotelemetry and ambulatory recording in the diagnosis of epileptic and non-epileptic attacks and adults and children.
It is also recommended that trainees undertake the following clinical experiential learning:
- Observe the neurosurgical treatment of patients with intractable epilepsy and discuss the advantages and disadvantages and evidence base for each treatment modality and present your findings at a departmental meeting.
- Observe a range of sleep studies undertaken within respiratory and sleep science and discuss the similarities and differences between the service provided by a neurophysiology and respiratory and sleep service.
- Participate and contribute to multidisciplinary team meetings (MDTs) and case presentation sessions and discuss the role of MDTs in the diagnosis and management of patients.