Training activity information
Details
Review tests which have failed next generation sequencing (NGS) quality control metric thresholds, and identify the reason for failure and downstream consequences
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.
Considerations
- How QC metric thresholds are reviewed
- The role quality control plays in ensuring laboratory services meet national standards of quality and safety
- requirements for describing quality control in diagnostic reports
- The implications of quality on patient care
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
- Identify what is expected of you in relation to this specific activity e.g. understanding the expectations related to reviewing failed NGS QC tests, identifying reasons for failure, and determining downstream consequences. Discuss with your training officer to gain clarity on what is expected of you for this specific review task.
- Think about what you already know about reviewing failed QC tests or handling data that does not meet expected thresholds in a genomic context. Consider possible challenges you might face when reviewing the failed tests and identifying reasons/consequences, and think about how you might handle them. For example, challenges related to understanding the QC metrics, accessing necessary information, or interpreting complex data. Recognise the scope of your own practice for this activity. Know when reviewing a failed NGS QC test might require seeking advice or help, and from whom. Acknowledge how you feel about embarking on this training activity. Do you feel confident based on previous experiences, or are there aspects you are unsure about?
- Consider the specific skills you want to develop by reviewing failed NGS QC tests. Draw upon previous experiences to identify areas for growth. Perhaps you want to improve your understanding of specific QC metrics or your ability to troubleshoot reasons for failure. Identify the specific insights you hope to gain from engaging with this activity. For instance, insights into common causes of NGS QC failure or the practical impact of failures on downstream clinical processes.
- Consult actions identified following previous experiences of reviewing QC data or similar tasks. Were there any notes or action points from prior reflections that are relevant here? Identify important information you need to consider before embarking on this review. This might include accessing relevant Standard Operating Procedures (SOPs), understanding the specific NGS assay protocols, or knowing where to find data on previous failures.
In action
- As you are reviewing the failed NGS QC tests, make a note of anything that feels surprising or different from what you anticipate. For example, does a test fail for a novel reason you haven’t encountered before, do multiple metrics fail unexpectedly for a single sample, or does the identified reason for failure contradict initial assumptions? Consider how this experience compares with previous experiences of similar activities, such as reviewing other QC reports or investigating data anomalies. Does it feel more or less familiar, especially concerning the intricacies of NGS QC failures?
- Identify how any unexpected developments, such as a perplexing failure reason or an unusual combination of failed metrics, impact your immediate actions. Do you immediately consult additional documentation, cross-reference with historical data, or seek input from a laboratory colleague or bioinformatician? Do you adapt or change your approach to investigating the failure or assessing its downstream consequences? For instance, do you refine your diagnostic pathway, use a different analytical tool to examine raw data, or adjust your communication strategy for reporting the issue? Consider how you feel in that moment. Do you find it difficult to adapt your investigation when faced with an ambiguous or complex failure? Does it affect your confidence in accurately identifying the root cause or predicting the downstream impact? Do you feel positive you can reach a successful conclusion?
- Identify how you work within your scope of practice when dealing with the unexpected event. Do you recognise when you might need to seek immediate advice or help, such as when the cause of failure is beyond your technical expertise or when the downstream clinical consequences require specialist interpretation? Identify what you learn as a result of the unexpected development. For instance, do you discover a new troubleshooting technique for a specific NGS QC issue, gain a deeper understanding of the interplay between different QC metrics, or learn a more effective way to communicate complex failures and their consequences to clinical teams?
On action
- Begin by summarising the key points of the experience of reviewing the failed NGS QC tests. What were the specific tests you reviewed, and what were the QC metrics that failed? What was the initial reason for failure you identified, and what were the downstream consequences you determined? Consider any specific events, actions, or interactions which felt important during the review process. This could include initial observations, troubleshooting steps, or discussions with colleagues.
- Identify what learning you can take from this specific experience of reviewing failed NGS QC tests. What strengths did you demonstrate during this review process? For example, were you effective at identifying common failure modes, using QC tools, or determining the impact on subsequent steps? What skills and/or knowledge gaps were evident? For instance, was there a specific QC metric you found difficult to understand, was troubleshooting the reason for failure challenging, or were the downstream consequences unclear? Compare this experience against previous engagement with similar activities, such as reviewing other types of QC reports or troubleshooting data issues. Were any previously identified actions for development in appraising laboratory quality control systems achieved? Has your practice in this area improved? Identify any challenges you experienced while reviewing the failed tests and how you reacted to these. Did these challenges affect your ability to deal with the situation? Were you able to overcome them? Did you need to seek advice or clarification from your training officer or a colleague regarding the QC failure or its consequences? Did you need to escalate anything to ensure you were working within your scope of practice?
- Identify the actions / ‘next steps’ you will now take to support the assimilation of what you have learnt from this experience. This includes incorporating any feedback you may have received on your review of the failed tests. What will you do differently next time you review failed NGS QC tests? Has anything changed in terms of what you would do if you were faced with a similar situation again, perhaps with different QC metrics or failure types? Do you need to practise any aspect of the activity further to develop your ability? For instance, do you need to spend more time understanding specific QC metrics or troubleshooting common NGS failure modes?
Beyond action
- Have you reviewed the notes from your previous reflections for this training activity or for similar activities involving QC review or troubleshooting? What specific actions for improvement did you previously identify? For example, did you identify a need to better understand a specific QC metric, improve your troubleshooting skills for common NGS failure modes, or gain clarity on documenting downstream consequences? Have you completed those identified actions? If so, how have they impacted your ability to perform this training activity now? If not, what are the barriers, and what further steps do you need to take? Are you now ready to demonstrate this new learning when undertaking this training activity again? How can you tell that your understanding or skill in reviewing failed NGS QC tests has improved as a result of addressing those actions?
- Considering all your experiences with reviewing failed NGS QC tests, how has your practice developed and evolved over time? For example, are you quicker at identifying potential reasons for failure, more confident in determining downstream consequences, or better at communicating findings? Have your combined experiences helped you to recognise more clearly when a failed QC test situation is beyond your current scope of practice and when you need to seek advice or escalate? How does the learning from undertaking this training activity multiple times and reflecting on it prepare you for generating a quality control report? How has reflecting on reviewing failed QC tests informed your understanding of generating or explaining QC reports? How do these repeated experiences and your reflections demonstrate your progress towards being entrusted to undertake this training activity repeatedly, consistently, and effectively with indirect supervision? What evidence from your reflections and practice shows this development?
Relevant learning outcomes
| # | Outcome |
|---|---|
| # 5 |
Outcome
Appraise laboratory quality control systems. |