Major Organs and Cancer —
Training activity: 8

Details

Interpret the results of faecal analyses involved in the detection of major organ disease and cancers to laboratory standard operating procedures to include:

• Faecal elastase,
• FIT
• Faecal calprotectin

Type

Developmental training activity (DTA)

Evidence requirements

Evidence the activity has been undertaken by the trainee​.

Reflection on the activity at one or more time points after the event including learning from the activity and/or areas of the trainees practice for development.

An action plan to implement learning and/or to address skills or knowledge gaps identified.

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 are the intended outcomes of the training activity?

• Consider how the learning outcomes apply, specifically in relation to your ability to analyse and interpret biochemical data and evaluate national guidelines for diseases of the major organs and cancer?
• What fundamental knowledge do you need to secure before beginning, such as the clinical indications and purpose for each of these three faecal tests?
• Are you fully familiar with the laboratory Standard Operating Procedures (SOPs) governing the interpretation and reporting of these specific markers?

What do you anticipate you will learn from the experience?

• What specific insights do you hope to gain into how these biochemical parameters support diagnosing, assessing treatment response, and monitoring patients with gastrointestinal (GIT) diseases and cancers?
• How do you expect this activity to improve your understanding of the scientific principles behind each assay and the specific analytes being measured?
• What is your existing knowledge of the normal reference ranges for these markers, and how do you anticipate elevated or decreased levels will typically correlate with pathological states?
• How will this experience enhance your ability to formulate clinical hypotheses or identify potential abnormalities based on patterns found in faecal analyses?

What actions will you take in preparation for the experience?

• How will you engage with your training officer to clarify the expected reporting templates and the depth of clinical interpretation required in your specific department?
• Which national or international guidelines (such as those for colorectal cancer screening or IBD management) will you review to ensure your practice aligns with current best-practice standards?
• How have you prepared yourself for potential challenges, such as encountering ambiguous results, difficult sample matrices, or incomplete clinical histories on a request?
• How do you currently feel about your level of ability in interpreting these results, and do you know exactly when you will need to seek advice or escalate a complex case to a senior colleague?

In action

What are you doing?

• How are you approaching the interpretation of these faecal results, and why are you following the specific steps outlined in the laboratory Standard Operating Procedures (SOPs)?
• What decisions are you making as you systematically analyse the results for faecal elastase, FIT, or calprotectin against established reference ranges?
• As you review the data, which aspects of the interpretation—such as identifying a clearly positive FIT result—feel intuitive, and which require more conscious effort or reference to national guidelines?
• How are you deciding which clinical details from the request form are most important to highlight in your final interpretive report?

How are you progressing with the activity?

• How effective are your actions in accurately categorising results as normal, borderline, or indicative of major organ disease or cancer?
• What challenges are you facing during the interpretation—for instance, are you encountering ambiguous patterns or results that are difficult to categorise based on the provided clinical history?
• What are you learning about the practical application of national guidelines as you work through the diagnostic pathways for these specific markers?
• How does the specific case you are currently interpreting connect to your existing knowledge of gastrointestinal (GIT) diseases and tumorigenesis?

How are you adapting to the situation?

• If you encounter an unusual or unexpected result pattern, what alternative clinical hypotheses or diagnostic pathways are you considering?
• What support or guidance do you need in this moment if you are unsure about the clinical significance of a borderline result or the need for follow-up testing?
• Are you ensuring that you are working strictly within your current scope of practice and ability while formulating these interpretations?
• If you identify a significant abnormality, are you considering the appropriate escalation procedures to ensure timely patient management?

On action

What did you notice?

• How would you summarise the key points of the experience, specifically regarding the cases where you interpreted faecal elastase, FIT, or faecal calprotectin?
• What were the main findings or patterns you observed across the different results, and were there any significant abnormalities—such as a highly elevated calprotectin or a positive FIT—that stood out to you?
• What were your initial reactions and thoughts immediately after completing the interpretations and drafting the reports?
• Were you satisfied with how you applied the laboratory Standard Operating Procedures (SOPs) to reach your conclusions?

What did you learn from the activity?

• What specific skills or knowledge did you develop through analysing and interpreting this biochemical data in the context of major organ function and cancer monitoring?
• How did this activity improve your ability to evaluate and apply national guidelines for the diagnosis and management of diseases associated with the gastrointestinal system and cancer?
• Were there any unexpected challenges—such as discordant clinical history or ambiguous borderline results—and what did you learn from how you overcame them?
• In what ways did your reflection-in-action (the decisions you made in the moment) influence the final outcome of your interpretations?
• How does this experience of interpreting faecal markers relate to the requirements for your future practice as a post-programme Clinical Scientist?

What will you take from the experience moving forward?

• What areas for continued development have you identified, such as a need to further research the clinical sensitivity of these markers or the impact of specific comorbidities on their results?
• How will you apply the learning from this activity—particularly your evolved systematic approach—to your routine practice when interpreting other biochemical investigations?
• What clear actions or ‘next steps’ will you now take to support the assimilation of what you have learned, such as reviewing feedback from your training officer or studying more complex clinical cases?
• What support or resources do you need to further develop in this area, such as access to updated diagnostic algorithms or time to discuss challenging interpretations with senior colleagues?

Beyond action

Have you revisited the experiences?

• How have your subsequent experiences of interpreting gastrointestinal markers since completing this activity led you to revisit your initial approach to national guidelines for cancer screening? For example, how a subsequent case involving a borderline FIT result forced you to re-evaluate the depth of your clinical correlation during your first attempt at this training activity.
• Considering what you understand about pancreatic insufficiency and faecal elastase now, were the actions or considerations you identified after your initial reflection sufficient to ensure adherence to laboratory SOPs? How have you since implemented improvements in your systematic analysis of biochemical data based on further learning?
• Has discussing faecal calprotectin results or the impact of inflammatory bowel disease (IBD) monitoring with colleagues, peers, or supervisors changed how you view your initial interpretation in this activity? For example, how professional storytelling with a senior colleague about an unusual case of colorectal cancer vs. inflammation changed your perspective on the clinical significance of these variations?

How have these experiences impacted upon your current practice?

• How has the learning from this initial activity, in combination with subsequent experiences in major organ function assessment, contributed to your overall confidence in preparing for assessments like Case-based Discussions (CBDs) or OCEs? For example, how your accumulated ability to evaluate clinical pathways now enables you to present a complex gastrointestinal case during an OCE assessment?
• How has reflecting back on this specific training activity shaped your current approach to identifying potential abnormalities in biochemical results? How does this evolved understanding help you identify when a result is beyond your scope of practice or requires immediate clinical advice?
• Looking holistically at your training journey, how has this initial experience in faecal analysis supported your development in meeting the learning outcomes related to cancer diagnosis and monitoring? For example, how this foundational experience has improved your efficiency in interpreting screening markers like FIT?

How might these experiences contribute towards your future practice?

• What transferable skills, such as diagnostic reasoning or critical evaluation of analytical techniques, have you developed across this and other activities? How will these skills be valuable as you take on more complex tasks or supervise others in the laboratory?
• What clear actions for continued development of your interpretive skills have you identified for your future career? For instance, how will you address the need to further understand rarer gastrointestinal pathologies or to practice advising clinical colleagues on appropriate testing strategies?
• How will your understanding of the interconnectedness of major organ systems—developed through this activity—inform your role in multidisciplinary team (MDT) meetings? For example, how will your ability to illustrate the role of biochemistry in patient management support your future practice as a post-programme Clinical Scientist?

Relevant learning outcomes

#	Outcome
# 2	Outcome Analyse and interpret biochemical data generated in the assessment of major organ function and cancer diagnosis and monitoring.
# 3	Outcome Evaluate the national guidelines for diagnosis and management of diseases associated with the major organ systems and cancer.