Neurophysiology is a discipline within Healthcare Science where healthcare practitioners and healthcare scientists measure the function of the nervous system to help in the diagnosis and/or monitor the progress of neurological disorders.
Healthcare practitioners and healthcare scientists perform a range of different tests, in patients of all ages, all of which require a considerable amount of patient contact and also good communication skills as each involves attaching electrodes to the patient and encouraging co-operation before the recordings can be made.
Clinical Neurophysiology departments are usually based in hospitals and linked to neurological centres. Most of the investigations in neurophysiology are recorded in dedicated environments, however they are also performed at the patient’s bedside, in the intensive care and special baby care units and also in the operating theatre.
There are four types of tests which are performed in neurophysiology departments:
•Evoked Potentials (EPs)
•Nerve conduction studies (NCS)
The electroencephalogram or EEG is the recording of the function of the cerebral cortex (brain) by applying electrodes to the scalp overlying the various lobes of the brain. The EEG records, over time, the changes in the electrical potentials generated by the cerebral cortex. This investigation has several uses but it main role is in patients suffering from epilepsy.
Evoked potentials (EPs)
Evoked potentials are electrical changes within the nervous system in response to a sensory stimulus (i.e. visual). The main use of evoked potentials are to investigate neurological disorders such as optic neuritis or multiple sclerosis (MS).
Nerve conduction studies
These studies measure the function of the peripheral nerves, those responsible for movement (motor function) and sensation (sensory function). The nerves are tested by applying a small electrical current to them and recording the response. These tests are used in neurological and other conditions that affect the function of the peripheral nerves. These tests are performed by healthcare practitioners and healthcare scientists but also Clinical Neurophysiologists (doctors who specialise in clinical neurophysiology).
Electromyography is performed by doctors who specialise in Clinical Neurophysiology, however healthcare practitioners and healthcare scientists assist during these tests. Electromyography test the function of the skeletal muscle and are used in the diagnosis of neurological conditions which affect the muscles such as motor neurone disease, plexopathy or radiculopathy.
Other specialised techniques are also performed by Neurophysiology departments and these include:
•Long-term ambulatory EEG
•Monitoring during surgical procedures
•Visual Electrodiagnostic Investigations
Qualifications and Training
A new training scheme is now in place for all of Healthcare Science, which includes Clinical Neurophysiology, as a result of the Modernising Scientific Careers (MSC) programme introduced by the Department of Health.
Modernising Scientific Careers has four levels of training programmes for all of healthcare science, the entry to the different levels of training depends on qualifications and work experience.
The four levels are:
•Practitioner Training Programme (PTP)
•Scientific Training Programme (STP)
•Higher Specialist Training (HSST
The role of an assistant or associate is to undertake task based roles under supervision. The associate will undertake more advanced and complex tasks than the assistant.
Healthcare science assistants work towards a vocational qualification, whilst healthcare associates are commonly trained through a foundation degree or diploma.
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Practitioner Training Programme (PTP)
The Practitioner Training Programme will lead to an approved and accredited BSc Honours degree in Healthcare Science. Neurophysiology is partnered by Audiology and Ophthalmic and Visual Science under Neurosensory Sciences.
The degree integrates academic learning and workplace based training. The degree will include 50 weeks of workplace-based training over the three years.
Typically at least two if not three A2/A levels, which include science subjects, and a good spread of GCSE’s at A to C grades are required as entry qualifications to these healthcare science degree courses. Equivalent qualifications may be accepted by some universities and you would need to check with each university before applying.
Some Universities that offer the Practitioner Training Programme are listed below. Use their search facility to find the appropriate course.
Scientific Training Programme (STP)
The Scientific Training Programme (STP) is a post graduate training programme and leads to an accredited Master’s Degree (MSc) and certification of workplace-based training in Neurosensory sciences. Neurosensory sciences also includes audiological science and ophthalmic and vision science.
STP trainees will be employed by an NHS Trust. On successful completion of the training STP graduates will be able to apply for NHS posts as Healthcare Scientists.
The Scientific Training Programme is delivered through approved and accredited three year workplace training in a chosen specialism. The trainees will also be required to undertake a master’s degree in the specialism. Entry qualifications for the Scientific Training Programme is an upper second or better BSc Honours degree in a relevant pure or applied science. The commonly accepted degrees for Neurophysiology are:
•Pure or Applied Physics
- To apply for Scientific Training Programme posts there is an annual application cycle which opens every January. More information on this can be obtained from the following website:
For more information regarding the Scientific Training Programme
Higher Specialist Training (HSST)
NHS higher specialist scientific training (HSST) will be a training programme similar to medical consultant training, leading to medical Royal College examination where these exist or may have a doctoral award.
Information changes frequently so please use the link to visit the NHS Careers website.