Prenatal Genomics —
Training activity: 10

Details

Participate in service delivery for prenatal services

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?

• How do you plan to apply appropriate testing strategies for patients referred due to increased screening risk, abnormal ultrasound findings, or family history?
• How have you explored the curriculum ‘considerations’ to focus your attention on the maternity clinical care pathway and the role of multidisciplinary team (MDT) meetings in aiding interpretation?
• What essential knowledge have you identified as necessary regarding the national screening programme for aneuploidy and the National Foetal Anomaly Screening Programme before you begin participating in service delivery?
• Have you considered how your role in the service will contribute to interpreting and reporting prenatal genomic findings, ensuring that management recommendations are appropriate for the patient and family?
• How will you demonstrate the use of specialist knowledge to deliver a safe and high-quality prenatal genomic service?

What do you anticipate you will learn from the experience?

• What specific insights do you hope to gain regarding the logistical challenges of delivering a timely and reliable service, particularly concerning Key Performance Indicators (KPIs) and turnaround times?
• How do you expect this activity to improve your proficiency in navigating the ethical and legal dimensions of prenatal diagnosis, including legislation associated with the unborn foetus?
• In what ways do you anticipate developing your skills in quality management, such as contributing to External Quality Assurance (EQA) schemes or internal quality control procedures?
• How will this experience enhance your ability to understand the impact of service urgency on the clinical care pathway and the prioritisation of high-risk prenatal cases?

What actions will you take in preparation for the experience?

• What will you discuss with your Training Officer specifically in order to gain clarity on your specific responsibilities within the laboratory workflow, including sample handling, testing pipelines, and reporting?
• Which specific resources have you reviewed, such as Standard Operating Procedures (SOPs) for sample reception or procedures for handling urgent results?
• How have you planned to handle potential challenges, such as encountering technical limitations like maternal cell contamination (MCC), mosaicism, or allele drop-out during routine service?
• How have you identified your feelings about embarking on this activity, considering the responsibility for routine clinical service delivery in a high-pressure prenatal environment?
• What actions have you taken to ensure your contributions to service delivery—such as managing urgent clinical requests—remain within your scope of practice?

In action

What are you doing?

• How are you currently approaching your role in the prenatal service workflow, and why are you choosing this particular sequence of tasks—such as prioritising urgent rapid aneuploidy testing for screen-positive cases over routine samples?
• What decisions are you making as the service activity progresses, particularly regarding the selection of appropriate testing strategies for patients referred following an abnormal ultrasound scan or a family history of a genomic condition?
• What aspects of your service practice feel intuitive, such as routine sample processing, and what—such as applying specialist knowledge to ensure a safe and high-quality service—requires more conscious effort and reference to Standard Operating Procedures (SOPs)?

How are you progressing with the activity?

• How effectively are you achieving the activity of service delivery, specifically in ensuring that interpretive reports for prenatal findings include appropriate and actionable management recommendations?
• What challenges are you facing during this activity, such as managing high workloads while adhering to strict Key Performance Indicators (KPIs) and turnaround time targets?
• What can you learn from the service delivery as it unfolds, particularly when encountering technical limitations such as maternal cell contamination (MCC), mosaicism, or allele drop-out that may impact the required turnaround time?
• How does this activity connect to your existing knowledge of the maternity clinical care pathway and the national screening programmes for aneuploidy and foetal anomalies?

How are you adapting to the situation?

• What alternative approaches are you considering if a bottleneck arises in the workflow or if an unexpected sample issue (e.g., poor quality or labelling error) complicates the testing pipeline?
• What support or guidance might you need in this moment from a senior colleague or training officer, especially when dealing with a complex query from a clinician regarding consent, safeguarding, or the legislation associated with the unborn foetus?
• Are you working within your scope of practice, and do you know when to escalate an urgent clinical request to ensure timely action and adherence to laboratory protocols?
• How are you adjusting your communication with other healthcare professionals (e.g., midwives or sonographers) to provide advice on sample requirements while maintaining a high-quality service?

On action

What did you notice?

• How would you summarise the key points of your participation in the prenatal service delivery, specifically regarding your involvement in sample processing, quality management procedures, or clinical MDT discussions?
• Which specific events or interactions felt most important during the service delivery, such as liaising with clinicians regarding sample requirements or addressing communication barriers regarding result delivery?
• Which ‘reflect-in-action’ moments did you notice where you had to adapt as the situation unfolded, such as rapidly prioritising an urgent rapid aneuploidy request or escalating a bottleneck in the workflow?
• What were your feelings while taking on the responsibility for routine laboratory service delivery, particularly knowing the high-stakes nature of prenatal results and the sensitivity of the clinical pathway?

What did you learn from the activity?

• What specific skills or knowledge did you develop regarding the prenatal patient pathway, from the initial referral (e.g., increased screening risk or abnormal ultrasound) to the final interpretive report?
• What did you learn from any unexpected challenges or successes, such as managing urgent clinical requests under pressure or identifying technical limitations like maternal cell contamination (MCC)?
• In what ways did your ‘reflection-in-action’ influence the outcome, such as how your decision to seek immediate advice on a complex query ensured the delivery of a safe and high-quality service?
• How does this experience relate to the requirements for post-programme practice as a Clinical Scientist, particularly in maintaining Key Performance Indicators (KPIs) and adhering to national standards like the Foetal Anomaly Screening Programme?

What will you take from the experience moving forward?

• What areas for continued development have been identified, such as a need to gain more experience with External Quality Assurance (EQA) schemes or a deeper understanding of the legal dimensions of the unborn foetus?
• How can you apply the learning from this activity to your routine practice, such as proactively reviewing SOPs for urgent sample handling or improving how you communicate testing limitations to clinical teams?
• What specific ‘next steps’ will you take to support the assimilation of what you have learned, such as contributing to continuous service improvement initiatives or reviewing procedures for consent and safeguarding?
• What support or resources have you identified as necessary for your ongoing development, such as access to expert mentorship regarding quality management or further opportunities to participate in complex prenatal MDT discussions?

Beyond action

Have you revisited the experiences?

• Have you reviewed your actions from previous reflections for this activity to determine if you have completed identified steps to improve your contribution to a high-quality service?
• How do your current observations of the prenatal service workflow—from sample processing to reporting—compare to your initial understanding of the complexities involved in meeting Key Performance Indicators (KPIs) and turnaround times?
• Have you engaged in professional storytelling with peers or colleagues regarding service delivery challenges, such as managing bottlenecks or urgent clinical requests, and how has this exchange changed your perspective?
• What observable professional practices, such as rapid communication or escalation protocols, have you assimilated into your approach by comparing this experience with service delivery in other specialties?
• How has your view of the maternity clinical care pathway evolved since your initial participation in the service, particularly regarding the role of multidisciplinary team (MDT) meetings?

How have these experiences impacted upon your current practice?

• How has your understanding of the broader operational aspects of the prenatal service pathway influenced your daily interactions with clinical, administrative, and laboratory colleagues?
• Can you identify specific instances where your specialist knowledge of service urgency supported you in prioritising testing for a screen-positive case, an abnormal scan referral, or a case with a family history of a genomic condition?
• How has the accumulated learning from participating in service delivery supported your preparation for in-person assessments, such as the Observed Communication Event (OCE) ‘Provide advice to another healthcare professional on the requirements for a sample for prenatal investigation’?
• In what ways has your current practice in interpreting and reporting genomic findings been enhanced by a holistic view of the service, ensuring your management recommendations are appropriate for the patient and family?
• How have you applied foundational knowledge regarding consent and safeguarding to ensure you are delivering a safe and high-quality prenatal genomic service in your routine work?

How might these experiences contribute towards your future practice?

• What transferable skills in teamwork, workflow management, and problem-solving have you developed that will be essential for your future role in service improvement and innovation?
• How will your understanding of logistical challenges and service delivery help you contribute to the future implementation of new genomic technologies not yet formally adopted in the UK?
• What clear actions for continued development have you identified to ensure your practice remains aligned with the evolving National Foetal Anomaly Screening Programme?
• How has this experience shaped your professional identity as a Clinical Scientist, particularly in your commitment to a patient-centred approach within a high-pressure clinical service?
• What strategies will you employ to stay proficient in quality management, such as contributing more actively to External Quality Assurance (EQA) schemes or service audits?

Relevant learning outcomes

#	Outcome
# 1	Outcome Apply appropriate testing strategies to patients referred for increased screening risk.
# 2	Outcome Apply appropriate testing strategies to patients referred following abnormal ultrasound scan findings.
# 3	Outcome Apply appropriate testing strategies to patients with a family history of a genetic disorder.
# 6	Outcome Interpret and report prenatal genomic findings, including appropriate recommendations for patient management.
# 7	Outcome Employ specialist knowledge of prenatal genomics to deliver a safe and high quality prenatal genomic service.