Training activity information
Details
Receive samples and referral information for a range of solid cancers, to include:
- Colorectal
- Melanoma
- Lung
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.
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 receiving samples and referral information for colorectal, lung and melanoma samples. Review the relevant learning outcome, which is to apply the appropriate sample acceptance criteria in terms of cellularity, necrosis, and tumour burden.
- Discuss with your training officer to gain clarity of what is expected of you in relation to applying appropriate sample acceptance criteria or managing the receipt of incomplete clinical documentation.
What is your prior experience of this activity?
- Think about what you already know about receiving samples and referral information for solid cancers.
- Consider possible challenges you might face during the activity, such as incomplete referral information or issues with sample integrity e.g., low neoplastic cell content or poor fixation, and think about how you might handle them.
- 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 regarding complex sample acceptance criteria or ambiguous referral details.
- Acknowledge how you feel about receiving the samples and referrals for the solid cancers.
What do you anticipate you will learn from the experience?
- Consider the specific skills you want to develop, such as efficiently assessing samples against acceptance criteria and communicating requirements.
- Identify the specific insights you hope to gain into common issues with samples or referrals for colorectal and melanoma, or how sample handling impacts downstream molecular analysis.
What additional considerations do you need to make?
- Consult actions identified following previous experiences of receiving samples or reviewing clinical documentation.
- Identify important information you need to consider before embarking on the activity, such as the specific sample acceptance criteria for solid cancers, reviewing relevant learning outcomes, and exploring the ‘considerations’ in the curriculum.
In action
Is anything unexpected occurring?
- Are you noticing anything surprising or different from what you anticipate whilst accepting samples or reviewing documentation for colorectal, lung and melanoma referrals?
- Are you encountering situations such as:
- Sample quality concerns (e.g., low cellularity or tumour burden) unexpectedly challenging the application of sample acceptance criteria?
- Critical clinical documentation (e.g., patient history or tumour specifics) being incomplete or missing from the referral?
- Unusual transport conditions or packaging that might compromise sample integrity?
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 flagging the issue and seeking clarification from the submitting clinic? Are you adapting or changing your approach to sample receipt or documentation?
- Consider the steps you are taking in the moment, such as immediately documenting the missing clinical details or pausing the acceptance process to verify cellularity standards against the required learning outcome.
- How are you feeling in that moment? For instance, are you finding it difficult to adapt your procedural checklist? Is it affecting your confidence in ensuring the sample acceptance criteria are met?
What is the conclusion or outcome?
- Identify how you are working within your scope of practice. For example, are you successfully resolving the documentation ambiguity by liaising with the referring clinic? Or are you needing support because the sample quality requires senior sign-off before rejection?
- What are you learning as a result of the unexpected development? For example, are you gaining insight into the criticality of pre-analytical documentation checks for downstream NGS testing?
On action
What happened?
- Begin by summarising the key steps you took when receiving samples and referral information for colorectal, lung and melanoma cases.
- Consider specific events, actions, or interactions which felt important, such as how you assessed the samples against the acceptance criteria regarding cellularity, necrosis, and tumour burden, or how you managed ambiguous details in the referral documentation.
- Include any ‘reflect-in-action’ moments where you had to adapt to the situation as it unfolded, for instance, immediately addressing unexpected low neoplastic cell content by seeking confirmation from the histopathology lab.
- How did you feel during this experience, e.g., did you feel stressed by the urgency of confirming sample quality or confident in applying the acceptance criteria?
How has this experience contributed to your developing practice?
- Identify what learning you can take from this experience regarding appropriate sample acceptance criteria for solid cancers. What strengths did you demonstrate, e.g., meticulous attention to detail when cross-referencing referral information with physical sample condition?
- What skills and/or knowledge gaps were evident, e.g., unfamiliarity with the required documentation for complex metastatic melanoma samples?
- Compare this experience against previous engagement with similar activities – were any previously identified actions for development achieved? Has your practice improved in consistently applying the sample acceptance criteria?
- Identify any challenges you experienced, such as needing to seek advice or clarification on scope of practice regarding whether a sample with borderline viability could proceed to nucleic acid extraction, 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 ensuring comprehensive and accurate sample reception and initial assessment.
- What will you do differently next time you approach receiving complex colorectal samples, for instance, by immediately double-checking the pathology report for tumour content percentages before logging the sample?
- Do you need to practise any aspect of the activity further, such as reviewing detailed guidelines on sample handling protocols or key learning outcomes related to applying appropriate sample acceptance criteria?
Beyond action
Have you revisited the experiences?
- How have your subsequent experiences of receiving samples and referral information for colorectal, lung and melanoma cancers since completing this specific training activity led you to revisit your initial approach or decisions during that activity? For example, how a subsequent case involving extremely low neoplastic cell content despite the pathology report forced you to re-evaluate the stringency of your initial acceptance criteria assessment you applied during your first attempt at this training activity?
- Considering what you understand about sample acceptance criteria (cellularity, necrosis, tumour burden) 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 process for initial sample assessment and documentation based on further learning and experiences? For example, how you proactively reviewed and integrated the definitive departmental policy on handling samples with compromised integrity or ambiguous documentation based on further learning.
- Has discussing challenging sample receipts involving missing clinical documentation or the impact of poor sample quality on downstream molecular analysis with colleagues, peers, or supervisors changed how you now view your initial experience in this training activity? For example, how professional storytelling with a senior colleague about a time when critical referral details were missed in the pre-analytical phase refined your understanding of the critical nature of meticulous pre-analytical documentation checks?
How have these experiences impacted upon current practice?
- How has the learning from this initial training activity, in combination with subsequent experiences, contributed to your overall confidence and competence in receiving and assessing solid cancer samples (colorectal, lung and melanoma), particularly in preparing for assessments like Observed Communication Events (OCEs)? For example, how your accumulated ability in consistently applying appropriate sample acceptance criteria now enables you to confidently advise another healthcare professional on sample quality and acceptance criteria during an OCE assessment?
- How has reflecting back on this specific training activity, combined with everything you’ve learned since, shaped your current approach to initial sample handling? How does this evolved understanding help you identify when something is beyond your scope of practice or requires escalation? For example, how your evolved approach means you now routinely seek advice from your Training Officer immediately when faced with a highly ambiguous referral or a sample requiring non-standard handling due to infection risk?
- Looking holistically at your training journey, how has this initial experience, revisited with your current perspective, contributed to your development in meeting the learning outcomes related to applying appropriate sample acceptance criteria in the context of downstream testing?
Relevant learning outcomes
| # | Outcome |
|---|---|
| # 1 |
Outcome
Apply the appropriate sample acceptance criteria in terms of cellularity, necrosis and tumour burden in the context of downstream testing for solid cancers. |