Cancer —
Training activity: 1

Details

Perform duty scientist tasks for cancer investigations to include:

• Triage of referrals
• communication with other specialties to inform genomic testing and clinical management

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 will you prepare to select laboratory testing strategies and triage referrals for sporadic cancer, germline cancer, and pharmacogenetics (e.g., DPYD)?
• How do you plan to apply integrative knowledge of various laboratory techniques (such as FISH, RT-PCR, or RNA fusion panels) when investigating these cases?
• What strategies will you use to demonstrate appropriate communication skills when presenting results or providing advice to healthcare professional colleagues?
• What do you need to know before embarking on the activity? Consider reviewing the National Genomic Test Directory, local Standard Operating Procedures (SOPs) for triage, and the specific requirements for different sample types like FFPE, bone marrow, or cell-free DNA.

What do you anticipate you will learn from the experience?

• What specific insights do you hope to gain regarding the clinical impact of your triage decisions on patient management, particularly for urgent haematological or solid tumour referrals?
• Thinking about what you already know, how will this role build upon your existing skills in variant interpretation and reporting to help you transition into a more senior, decision-making capacity?

What actions will you take in preparation for the experience?

• How will you gain clarity on the scope of the duty scientist role and the limits of your responsibility?
• What possible challenges do you anticipate—such as handling inappropriate referrals, managing urgent clinical requests, or communicating complex technical limitations to non-genomics specialists—and how have you planned to handle them?
• How do you feel about taking on this level of responsibility? How are you preparing for the professional responsibility involved in this role?

In action

What are you doing?

• How are you currently approaching the triage of referrals for sporadic cancer, germline susceptibility, and pharmacogenetics? Why have you selected these specific laboratory testing strategies?
• What real-time decisions are you making as you communicate with other specialties to ensure the genomic testing appropriately informs patient management?
• Which parts of the duty scientist role—such as basic triage—feel intuitive, and which—such as applying integrative knowledge of diverse laboratory techniques —require more conscious effort?

How are you progressing with the activity?

• How effective are your current actions in ensuring the most appropriate testing strategies are applied to the cancer investigations you are triaging?
• What challenges are you facing in the moment—such as managing high-volume urgent requests or communicating technical limitations to non-genomics colleagues—and what are you learning as the duty day unfolds?
• How does this activity connect to your existing knowledge and skills in genomic interpretation and reporting?

How are you adapting to the situation?

• What immediate support or guidance do you need from your Training Officer or a senior Clinical Scientist to resolve a complex triage or reporting query?
• As you provide advice and present results to healthcare professional colleagues, are you ensuring that you are working strictly within your professional scope of practice?

On action

What did you notice?

• Summarise the key points of your time as a duty scientist, specifically detailing the steps you took to triage referrals and the instances where you had to communicate with other specialties.
• Which specific cases (sporadic, germline, or pharmacogenetic) did you handle, and what were the essential clinical or technical details that most significantly influenced your choice of testing strategy?

What did you learn from the activity?

• What specific skills or knowledge did you improve regarding selecting laboratory testing strategies and interpreting results for sporadic cancer, germline cancer, and pharmacogenetic testing?
• How has this experience enhanced your ability to apply integrative knowledge of different laboratory techniques (such as FISH, RT-PCR, or NGS) to the investigation of cancer cases?
• In what ways did you improve your communication skills when presenting investigation results or providing advice to healthcare professional colleagues?
• Were there any unexpected challenges or successes during the duty day—such as managing an urgent clinical request or dealing with an inappropriate referral—and what did you learn from these?
• How did your reflection-in-action (the real-time decisions you made while triaging or communicating) influence how the activity unfolded and the quality of the service provided?
• How does the experience of performing ‘duty scientists’ tasks relate to the requirements for your post-programme practice as a Clinical Scientist?

What will you take from the experience moving forward?

• What specific areas for continued development in cancer triage, reporting, or professional communication have you identified as a result of this activity?
• How can you apply the learning from this experience to your routine practice to ensure cancer investigations are consistently handled to a high standard?
• Identify the specific actions you will now take—such as reviewing updated National Genomic Test Directory criteria or seeking feedback on your communication with clinicians—to support the assimilation of what you have learned?
• What support or resources (e.g., senior clinical scientist mentorship, attendance at MDT meetings, or access to specialist oncology databases) do you need to further develop in these areas?

Beyond action

Have you revisited the experiences?

• How has your perspective on triaging referrals and selecting laboratory testing strategies for sporadic, germline, and pharmacogenetic cases evolved as you have encountered a wider range of clinical scenarios since this activity?
• Comparing these experiences with your Observed Training Activities (OTAs), what specific observable behaviours—such as your proficiency in identifying appropriate testing for acquired solid tumours or haematological malignancies—have you now fully assimilated into your routine practice?
• As part of a module review, what patterns or necessary actions have you identified by revisiting reflections from multiple training activities related to duty scientist tasks and service delivery?
• Through discussions with senior colleagues, has your understanding of how to manage complex inter-specialty communications or urgent clinical requests changed as a result of that mutual exchange?

How have these experiences impacted your current practice?

• Recognising that these tasks are not isolated incidents, how has this experience supported your development in wider areas, such as writing clinical reports or providing advice to other healthcare professionals?
• How have you applied the integrative knowledge of laboratory techniques (e.g., FISH, NGS, or RNA fusion panels) gained from this activity to improve the safety and quality of the cancer genomic service you provide today?
• How is the learning from your duty scientist rotations supporting your preparation for ‘in-person’ assessments related to variant classification and reporting?

How might these experiences contribute towards your future practice?

• What transferable skills—such as the ability to synthesise complex technical data with diverse clinical information or manage time-sensitive pressures—are you continuing to develop as you move toward becoming a Clinical Scientist?
• What clear actions have you identified for the continued development of your specialist knowledge to ensure you consistently deliver a high-quality service in your future post-programme practice?

Relevant learning outcomes

#	Outcome
# 1	Outcome Select the laboratory testing strategy, analyse, interpret and report tests for patients referred with acquired cancer.
# 2	Outcome Select the laboratory testing strategy, analyse, interpret and report tests for patients referred with germline cancer.
# 3	Outcome Select the laboratory testing strategy, analyse, interpret and report pharmacogenomic testing in cancer patients.
# 4	Outcome Apply integrative knowledge of laboratory techniques applied to the investigation of cases referred for cancer.
# 5	Outcome Demonstrate appropriate communication skills to present the results of investigations into acquired and germline cancer cases clearly to healthcare professional colleagues.