Training activity information
Details
Prepare a range of reports relevant to paediatric referrals
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 preparing accurate, clear, and clinically relevant reports for paediatric genetic investigations.
- Consider how the learning outcomes apply, specifically those concerning the interpretation of genomic variants and interpreting / reporting results with recommendations.
- What does effective reporting look like, contributing to communicating diagnostic information and implications for family members to clinicians and other healthcare professionals?
- Discuss with your training officer to gain clarity on expectations for different types of reports.
What is your prior experience of this activity?
- Think about what you already know about writing genetic reports, particularly for paediatric patients.
- Consider possible challenges you might face during the activity, such as summarising complex findings concisely, including appropriate recommendations, or ensuring clarity for different audiences, and think about how you might plan to handle them.
- Recognise the scope of your own practice for preparing these types of reports.
- Acknowledge how you feel about preparing reports for paediatric referrals without direct supervision.
What do you anticipate you will learn from the experience?
- Consider the specific skills you want to develop related to structuring, writing, and reviewing genetic reports for paediatric patients.
- Identify specific insights you hope to gain regarding how to effectively communicate complex genomic information and its clinical implications to healthcare professionals and how to tailor reports appropriately.
What additional considerations do you need to make?
- Consult actions identified following previous experience of preparing reports for referrals.
- Identify important information you need to consider before embarking on the activity, such as the essential components typically included in a genetic report for paediatric referrals e.g., results, interpretation, recommendations, limitations.
- You should also review the required level of detail and appropriate language for different report types (e.g., urgent results) and the guidelines for nomenclature and variant classification.
In action
Is anything unexpected occurring?
- Are you noticing anything surprising or different from what you anticipate while preparing the report for this paediatric genetic referral?
- Are you encountering situations such as:
- Significant difficulty in synthesising complex findings from multiple tests (e.g., NGS and CNV assay results) into a clear, concise, and clinically actionable report?
- Struggling to clearly and sensitively communicate the clinical significance of a VUS or an incidental finding to the intended audience (clinician/family)?
- The need to formulate specific and appropriate recommendations for follow-up testing or management where the guidelines are ambiguous or case-dependent?
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 the structure or content of the report?
- Consider the steps you are taking in the moment, such as:
- Immediately structuring the report in a specific way or adding clear caveats to manage a complex case with numerous findings or uncertain clinical significance?
- Seeking immediate feedback from a senior colleague or clinical scientist on your draft report before finalisation, particularly regarding complex interpretation or recommendations?
- Are you ensuring that your report accurately outlines the methodologies used, the interpretation, and any potential limitations?
- How are you feeling in that moment? For instance, are you finding it difficult to decide how to clearly and concisely communicate the clinical significance of the findings? Is it affecting your confidence in ensuring the accuracy and completeness of the report?
What is the conclusion or outcome?
- Identify how you are working within your scope of practice. For example, are you successfully managing the reporting complexity, or needing support because the case involves novel legal, ethical, or interpretative considerations that require senior review?
- What are you learning as a result of the unexpected development? For example, are you learning a new technique for summarising complex genomic findings concisely for non-specialist clinicians, or gaining crucial insight into the specific reporting requirements for VUS in a paediatric context?
On action
What happened?
- Begin by summarising the key points of the experience of preparing a range of reports for paediatric genetic referrals.
- Consider specific events, actions, or interactions which felt important, such as structuring complex findings, formulating clear recommendations for patient management, or adapting language for different clinical audiences.
- Include any ‘reflect-in-action’ moments where you had to adapt to the situation as it unfolded, for instance, immediately restructuring a report section to manage conflicting data or seeking urgent clarification on the clinical significance of a finding mid-draft. How did you feel during this experience?
How has this experience contributed to your developing practice?
- Identify what learning you can take from this experience regarding interpreting and reporting genetic testing results relevant to paediatric conditions.
- What strengths did you demonstrate e.g., ability to synthesise complex data concisely? What skills and/or knowledge gaps were evident e.g., unfamiliarity with the required standards for a comprehensive paediatric report or difficulty phrasing the clinical significance of a VUS?
- Compare this experience against previous reporting activities – were any previous identified actions for development achieved? Has your practice in reporting improved?
- Identify any challenges you experienced e.g., integrating findings from multiple test platforms or ensuring timely delivery of urgent results and how you reacted to these. Did this affect your ability to deal with the situation? Were you able to overcome the challenges?
- Identify anything significant about the activity, such as needing to seek advice or clarification on reporting terminology or needing to escalate the case interpretation to ensure that you were working within your scope of practice.
- Acknowledge any changes in your own feelings with regards to preparing a range of reports specifically related to paediatric referrals.
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 regarding your ability to prepare a range of reports relevant to paediatric referrals.
- What will you do differently next time you prepare a paediatric report to ensure it is timely, accurate, and clinically actionable? Has anything changed in terms of what you would do if you were faced with a similar situation again?
- Do you need to practise any aspect of the activity further, such as reviewing guidelines for interpretation and reporting genetic data or seeking feedback mechanisms to further improve your reporting skills?
Beyond action
Have you revisited the experiences?
- Have you reviewed your actions from your previous reflections for this activity? What specific actions did you previously identify you would need to take to improve your practice related to interpreting and reporting genomic testing with appropriate recommendations?
- Have you completed these previously identified actions? For example, if you planned to review guidelines for nomenclature and variant classification, how did completing this action impact the accuracy and completeness of the reports you currently prepare?
- Engage in professional storytelling with peers, near peers, or colleagues about report writing. Have you received feedback on your reports or discussed report content in MDT meetings that has led to changes in your reporting style or the clarity of your recommendations for patient management?
How have these experiences impacted upon current practice?
- Consider how the accumulated learning from performing or reflecting on report preparation will support you in preparing for observed ‘in-person’ assessments for the module, such as a DOPS titled ‘Prepare a report for a paediatric genetic investigation’.
- How has your practice related to communication and reporting developed and evolved over time? For example, how have the principles of report preparation (interpreting and reporting genomic testing) been applied to reporting on other types of genetic tests or for different patient groups outside of paediatric referrals?
- What specific areas of reporting (e.g., clarity, detail, recommendations) do you need to focus on for continued development, and how will your foundational reporting skills help you communicate relevant information effectively to clinicians and families in the future?
Relevant learning outcomes
| # | Outcome |
|---|---|
| # 4 |
Outcome
Interpret genomic variants, including copy number changes, and investigate the clinical significance of variants using bioinformatic tools using best practice guidelines. |
| # 5 |
Outcome
Interpret and report genomic testing relevant to paediatric conditions, including appropriate recommendations for patient management. |