• Self-directed learning
• Hands-on or experiential learning
• Discussion

Description – Where were you? What was the event/experience? What happened? What did you do? Who was there? What did other people do? What were your learning goals? What did you learn?

 Recently assessed a 50 year old lady amateur athlete for popliteal entrapment, tests suggested a problem but no obvious evidence of PAES detected. Discussed with colleague and consultant, we all thought that ilac endofibrosis was more likely as PAES would have caused symptoms years ago. Did a 'google' search, iliac endofibrosis more likely in cyclists and speed skaters, less commonly reported in athletes.

Feelings – What did you think and feel before the event? What did you think and feel during the event? What do you think others thought and felt? What did you think and feel after the event? What do you think and feel now? What do others think and feel now?

 It was my own thoughts to assess for iliac endofibrosis as I have seen this before and I am a keen runner also. The patient returned and scanned before and after exercise, tests proving positive for endofibrosis of distaal external iliac artery/common femoral origin.

I felt very satisfied with my input into this case.

Evaluation – What was good and bad about the event/experience? What went well? What didn’t go so well? What did you do well? What did you and others contribute to the situation (positives and negatives)? Did the event meet your expectations? How did this benefit service users? How did this contribute to the quality of the service you deliver?

It was good that a diagnosis was reached but unfortunate for the patient that she had two hospital visits for tests elsewhere and one visit to our hospital before a 4th test revealed the problem.

I knew the lady was returning for scan and felt rather nervous, hoping our new 'diagnosis' would be correct.

As the modified exercise test and arterial ultrasound confirmed our thoughts, outcome was as expected.

We will now alter our entrapment testing on the basis of symptoms and presentation to take into account the possibility of iliac/CFA endofibrosis as a cause.

Analysis – What are the reasons this situation happened? What sense can you make out of the situation? How could this have been a more positive experience for everyone involved?

 It was a positive experience for staff as well as patient, an interesting and good result obtained.

Conclusion – What else could you have done? How could this have been a more positive experience for everyone involved? What could you have done differently? How did this improve your practice? What new skills do you need to develop? What new knowledge do you need?

 I dont think we could have done anything differently at the time of the first scan. The second scan gave us confidence, experience and knowledge to consider alternative cause thus improving our practice.

No new skills required but further reading regarding causes, symptoms and treatment of endofibrosis is required.

Action plan – What do you need to do now? What is your very next action? What do you need to learn? What CPD can you now do to meet your learning needs? What support do you need to achieve your learning goals? What will you do in the future if this happened again?

 Literature serch on endofibrosis to learn about treatment. I probably need a little protected CPD/admin time.

Relevant article - Diagnosis and management of iliac artery endo fibrosis, results of  a Delphi consensus study. European Journal of vascular and endovascular surgery, july 2016, vol 52, issue 1, pages 90 - 98.

If a similair situation/case arose again, we will have new protocols in place.

Which KSF dimensions does this CPD activity help you to meet?

How has this activity enabled you to meet the dimensions?

How has this activity helped you maintain a continuous, up-to-date and accurate record of your CPD activities?

 It has prompted further reading and a discussion on altering departmental scanning protocols.

How is this activity different to other activities you have done? How does it demonstrate that you do a mixture of learning activities? How is it relevant to your current or future practice?

 It caused discussion and further reading regarding a rare condition.

In what way has this CPD activity contributed to the quality of your practice and the service you deliver?

 It has given knowledge and understanding of an unusual condition and also altered departmental protocols for all staff.

Service users can be patients, carers, referrers, colleagues, other professionals, students and learners, service purchasers, commissioners or members of a community of practice. In what way has this CPD activity benefited service users? In what way did you intend this activity to benefit service users?

 I think it has added to our professional approach in that a firm routine/protocol has been promulgated rather than 'making it up on the spot'. This will give confidence to patients and clinicians referring to us.