Training activity information
Details
Perform the analyses involved in the detection of major organ disease and cancers to laboratory standard operating procedures to include:
- UE
- LFT
- Bone profile
- Amylase/lipase
- Troponin/BNP
- Lipids
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
- Local and national training guidelines, including standards and pathways
- Method selection, including assay advantages and limitations, and quality parameters
- Equipment calibration and maintenance
- Quality control; EQA and IQC
- National and International guidelines
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?
- Identify what is expected of you in relation to performing the specified analyses (e.g., LFTs, troponin/BNP, lipids) according to laboratory standard operating procedures (SOPs).
- Consider how the learning outcomes apply, specifically in relation to performing biochemical assays and analysing and interpreting the resultant biochemical data.
- Discuss with your training officer to gain clarity of what is expected of you in relation to acceptable levels of accuracy, precision, and strict adherence to analytical protocols.
What is your prior experience of this activity?
- Think about what you already know about performing laboratory analyses, including specific assays like UE, LFT, bone profile, amylase/lipase, or troponin/BNP.
- Consider possible challenges you might face during the activity, such as sample handling issues (e.g., haemolysis), instrument troubleshooting, or adhering strictly to the detailed SOPs.
- Recognise the scope of your own practice for this activity i.e. know when you will need to seek advice or help, and from whom. You will need to seek advice from your Training Officer when required, for example if an instrument error cannot be resolved through routine troubleshooting or if complex sample preparation is required.
- Acknowledge how you feel about embarking on performing these core clinical analyses.
What do you anticipate you will learn from the experience?
- Consider the specific skills you want to develop, such as refining practical skills related to performing the analyses listed (e.g., lipids, bone profile) and mastering instrument operation.
- Identify the specific insights you hope to gain into the analytical methods used or how performing the assays contributes to understanding major organ disease pathophysiology.
What additional considerations do you need to make?
- Consult actions identified following previous experiences of performing similar automated or manual biochemical analyses.
- Identify important information you need to consider before embarking on the activity, such as safety procedures, specific quality control requirements, and ensuring access to the relevant Standard Operating Procedures (SOPs) for each assay.
In action
Is anything unexpected occurring?
- Are you noticing anything surprising or different from what you anticipate whilst performing analyses like LFTs, bone profile, amylase/lipase, or troponin/BNP?
- Are you encountering situations such as:
- An analyser error or instrument flag occurs that deviates from routine performance when running a major organ disease assay (e.g., UE, LFT)?
- A sample is visibly compromised (e.g., highly haemolysed or lipaemic), challenging routine sample handling or potentially compromising the result quality?
- Difficulty arises in adhering strictly to the timing requirements of a specific analytical procedure?
How are you reacting to the unexpected development?
- How is this impacting your actions? For example, are you responding to the situation appropriately? Are you adapting or changing your approach to reagent preparation or analyser operation?
- Consider the steps you are taking in the moment, such as:
- Immediately re-running quality control material or diluting a sample
- Halting the analytical process to consult the specific Standard Operating Procedure (SOP) to troubleshoot a technical issue
- How are you feeling in that moment? For instance, are you finding it difficult to resolve an unexpected instrument issue? Is it affecting your confidence in troubleshooting analyser performance?
What is the conclusion or outcome?
- Identify how you are working within your scope of practice. For example, are you successfully troubleshooting a minor equipment issue according to SOPs? Or are you needing support because a complex analyser error is unresolvable or requires specialist technical intervention?
- What are you learning as a result of the unexpected development? For example, are you mastering a more efficient technique for handling compromised samples (e.g., lipaemic lipids)? Or gaining insight into the critical nature of SOP adherence for reproducible analysis?
On action
What happened?
- Begin by summarising the key steps you took when performing the analyses involved in the detection of major organ disease and cancers, such as LFTs, bone profile, amylase/lipase, or troponin/BNP.
- Consider specific events, actions, or interactions which felt important, such as how you managed the quality control process for the assays or the precise steps you took for reagent preparation before starting the run.
- Include any ‘reflect-in-action’ moments where you had to adapt to the situation as it unfolded, for instance, immediately halting the analyser to troubleshoot an unexpected analyser error code or dealing with a visibly compromised (e.g., highly lipaemic) sample. How did you feel during this experience, e.g., did you feel confident in troubleshooting the analyser or unsure how to proceed with the unusual sample handling? Did you have an understanding of how sample quality might affect results?
How has this experience contributed to your developing practice?
- Identify what learning you can take from this experience regarding performing core clinical biochemistry analyses. What strengths did you demonstrate, e.g., meticulous adherence to the Standard Operating Procedure (SOP) for reagent preparation? What skills and/or knowledge gaps were evident, e.g., the difference between chemistry and immunoassay instruments?
- Compare this experience against previous engagement with similar activities – were any previously identified actions for development achieved? Has your practice improved in resolving common equipment issues during analytical runs?
- Identify any challenges you experienced, such as needing to seek advice or clarification on scope of practice regarding resolving a complex analyser error, and how you reacted to this.
What will you take from the experience moving forward?
- Identify the actions or ‘next steps’ you will now take to support the assimilation of what you have learnt, including from any feedback you have received, with regards to improving the efficiency and reliability of analytical performance for major organ assays.
- What will you do differently next time you approach performing routine analyses, for instance, by proactively checking instrument logs for recurring error messages before starting a batch run?
- Do you need to practise any aspect of the activity further, such as mastering the technical steps or key learning outcomes related to performing biochemical assays?
Beyond action
Have you revisited the experiences?
- How have your subsequent experiences of troubleshooting analytical issues or performing other analyses since completing this specific training activity led you to revisit your initial approach or decisions during that activity?
- Considering what you understand about analytical principles, assay precision, and the relationship between analytical quality and clinical context now, were the actions or considerations you identified after your initial reflection on this training activity sufficient? How have you since implemented or adapted improvements in your validation of quality control (QC) results and adherence to SOPs based on further learning and experiences? For example, have you changed your thought process on reagent preparation and QC checks for the assays after learning more about the downstream clinical impact of inaccurate results.
- Has discussing the practical aspects of performing these assays or the importance of analytical quality with colleagues, peers, or supervisors changed how you now view your initial experience in this training activity? For example, howdiscussion with a senior colleague about a delayed patient management decision due to a lack of confidence in the initial troponin/BNP result refined your understanding of the critical nature of quality assurance in analytical performance.
How have these experiences impacted upon current practice?
- How has the learning from this initial training activity, in combination with subsequent analytical experiences, contributed to your overall confidence and competence in efficiently performing analyses and maintaining analytical quality, particularly in preparing for assessments like Direct Observations of Practical Skills (DOPS)? For example, how your accumulated ability in adherence to SOPs and performing rigorous quality control checks now enables you to confidently execute the procedural steps for reagent preparation or sample analysis during a DOPS assessment.
- How has reflecting back on this specific training activity, combined with everything you’ve learned since, shaped your current approach to performing core laboratory assays? How does this evolved understanding help you identify when something is beyond your scope of practice or requires escalation? For example, when to escalate more significant QC failures.
- Looking holistically at your training journey, how has this initial analytical performance experience, revisited with your current perspective, contributed to your development in meeting the learning outcomes related to performing biochemical assays?
Relevant learning outcomes
| # | Outcome |
|---|---|
| # 1 |
Outcome
Perform biochemical assays involved in the assessment of major organ function and cancer diagnosis and monitoring. |
| # 2 |
Outcome
Analyse and interpret biochemical data generated in the assessment of major organ function and cancer diagnosis and monitoring. |