Adult Genomics —
Training activity: 9

Details

Participate in service delivery for adult services

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 participating in service delivery for adult services. Review the relevant learning outcomes, including the employing of specialist knowledge to deliver a safe and high-quality adult genomic service.
• Discuss with your training officer what constitutes meaningful participation, considering tasks such as sample reception, assay setup, data analysis, reporting, or communication within the lab or with clinical teams.

What is your prior experience of this activity?

• Think about what you already know about the operational aspects of a genomic service. Have you participated in service delivery in other modules or contexts?
• Consider possible challenges you might face, such as managing workflow, adhering to turnaround times, handling urgent requests, or navigating communication within the service pathway. How might you handle these?
• Recognise the scope of your own practice, knowing when you will need to seek advice or help, and from whom. Acknowledge how you feel about embarking on contributing to the routine delivery of the adult genomics service.

What do you anticipate you will learn from the experience?

• Consider the specific skills you want to develop, drawing upon previous experiences (if any). For example, you might aim to improve your understanding of laboratory workflow or enhancing your time management in a service environment.
• Identify the specific insights you hope to gain from engaging with this activity, such as a deeper appreciation for the logistical challenges of delivering a high-quality service or the importance of quality control and assurance processes.

What additional considerations do you need to make?

• Consult any actions you identified following previous experiences, perhaps from prior service delivery involvement or observations of the service.
• Identify important information you need to consider before embarking on the activity. This might include reviewing relevant Standard Operating Procedures (SOPs), understanding the typical turnaround times for different tests, or familiarising yourself with the structure of the adult genomics team.

In action

Is anything unexpected occurring?

• Are you noticing anything surprising or different from what you anticipate while participating in the service delivery?
• Are you encountering situations such as:
  • An urgent request coming in that conflicts with the scheduled workflow or staffing levels, requiring immediate reprioritisation of your current tasks?
  • A major problem or bottleneck occurring in the service delivery pathway e.g., instrument failure, unexpected sample contamination that needs immediate technical or procedural attention?
  • Communication barriers or misunderstandings arising when liaising with clinical staff or other departments regarding sample requirements or result delivery?
• How is this experience comparing with previous experiences of similar activities?

How are you reacting to the unexpected development?

• How is this impacting your actions? Did you adapt or change your approach to workflow management or communication in the moment?
• Consider the steps you are taking in the moment, such as:
  • Immediately running diagnostic checks or consulting relevant Standard Operating Procedures (SOPs) if equipment issues or process failures occur.
  • Changing your prioritisation of tasks based on the urgency of an unexpected clinical query or sample issue.
  • Seeking immediate advice or support from a senior member of staff regarding a service delivery issue that falls outside of routine procedure.
• How are you feeling in that moment? Is the unexpected urgency affecting your confidence in ensuring all actions are aligned with SOPs and quality management? Are you finding it difficult to adapt your established task list to manage competing priorities? Do you feel positive you can reach a successful conclusion?

What is the conclusion or outcome?

• Identify how you are working within your scope of practice when participating in service delivery e.g., successfully mitigating minor noise issues but escalating a major equipment fault to biomedical engineering or management.
• What are you learning as a result of the unexpected development? For example, are you gaining a crucial insight into the importance of turnaround time in the patient pathway, or mastering an effective workflow for handling and escalating urgent requests within the adult genomics service?

On action

What happened?

• Begin by summarising the key points of the experience, detailing the specific activities you participated in as part of the service delivery e.g., sample reception, test processing, report sign-out, or quality control.
• Describe how your actions or involvement contributed to the overall workflow of the adult genomics service.
• Describe the key interactions you had with other members of the team or other healthcare professionals, and whether you observed or participated in any multidisciplinary team (MDT) discussions relevant to adult genomics. What felt important about these interactions?

How has this experience contributed to your developing practice?

• Identify what learning you can take from this experience. What skills or knowledge did you develop or improve by participating in the service delivery e.g., understanding the importance of turnaround time or quality assurance?
• What did you learn about the workflow, challenges, and priorities within the adult genomics service, such as managing urgent requests?
• How does your participation in service delivery integrate with other aspects of your training (e.g., performing analysis, preparing reports)?
• Were there moments where you had to adapt your behaviour or actions based on the situation as it unfolded (reflect-in-action)?

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 learned about service delivery, including any feedback you have received on your ability to participate in service delivery for adult services.
• How will your understanding of service delivery inform your daily practice and interactions within the team? What will you do differently next time based on your participation, for instance, communicating more clearly about sample requirements?
• What areas for continued development have been identified in your ability to contribute effectively to the adult genomics service delivery?
• What aspects of the service would you like to learn more about, and how can you contribute to improving the service delivery or workflow?

Beyond action

Have you revisited the experiences?

• Revisit your participation in service delivery for adult services. Reflect on the processes you were involved in and the challenges or insights you gained (e.g., managing turnaround time).
• Compare your current understanding of the operational aspects of the adult genomics service with your initial understanding from this activity. How has your perspective evolved (e.g., better appreciation for logistical complexity)?
• Have interactions with colleagues in different parts of the service or involvement in other activities provided a broader perspective on the patient pathway and the importance of quality assurance?

How have these experiences impacted upon current practice?

• Can you identify specific instances where your involvement in service delivery has influenced how you now approach your daily tasks, manage your time, or interact with colleagues (e.g., prioritising urgent samples)?
• How has this experience contributed to your understanding of the importance of efficient, safe, and high-quality service delivery in adult genomics?
• How does the accumulated learning from this activity support your preparation for observed ‘in-person’ assessments, such as an Observed Communication Event (OCE) titled ‘Provide an urgent result to another healthcare professional’?
• As you progress in your career, how will your understanding of the broader context of service delivery, gained from this activity, help you to identify areas for service improvement and innovation in the adult genomics service?
• What actions will you take to continue developing your understanding of service management and quality assurance?

Relevant learning outcomes

#	Outcome
# 1	Outcome Apply appropriate testing strategies to patients referred for adult-onset disorders.
# 2	Outcome Perform molecular analysis for patients referred with adult-onset disorders.
# 3	Outcome Perform chromosomal analysis for patients referred for adult-onset disorders.
# 4	Outcome Interpret genomic variants, including copy number and structural changes and investigate the clinical significance of variants using bioinformatic tools using best practice guidelines.
# 5	Outcome Interpret and report genomic testing relevant to adult-onset disorders, including appropriate recommendations for patient management.
# 6	Outcome Employ specialist knowledge of adult genomics to deliver a safe and high-quality adult genomic service.