Cancer —
Training activity: 2

Details

Select, analyse, interpret and report the appropriate genomic testing for acquired Chronic Myeloid Leukaemia (CML).

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?

• Do you have a clear understanding of the laboratory testing strategy required for CML (e.g., FISH, RT-PCR) and how to accurately analyse, interpret, and report these results for patients with acquired cancer?
• How will you apply your integrative knowledge of laboratory techniques (such as molecular and cytogenetic methods) to investigate these cases of cancer?
• What steps will you take to ensure you can demonstrate appropriate communication skills to present these findings and case results clearly to your healthcare professional colleagues?
• What foundational knowledge do you need to acquire before embarking on this activity to ensure you can provide a high-quality diagnostic service?

What do you anticipate you will earn from the experience?

• What specific insights do you hope to gain regarding the clinical significance of CML findings (such as the Philadelphia chromosome or BCR::ABL1 transcript levels) and how they influence patient management?
• Thinking about what you already know, which aspects of CML diagnostics or reporting do you find most challenging or interesting to learn more about?

What actions will you take in preparation for the experience?

• How will you gain clarity on the CML testing pathway and the expectations for your case presentation?
• What challenges do you anticipate (e.g., interpreting low-level transcripts or discordant results), and how have you planned to handle them?
• How do you feel about embarking on this activity, considering the direct impact that CML monitoring and diagnostic results have on a patient’s treatment journey?

In action

What are you doing?

• How are you currently approaching the selection and analysis of CML tests (e.g., FISH, RT-PCR, karyotyping), and what real-time decisions are you making to ensure the strategy matches the clinical referral?
• Which aspects of the CML testing process feel intuitive, and where are you consciously relying on specific guidelines or protocols right now?

How are you progressing with the activity?

• How effective are your strategies in identifying CML-specific findings (such as the Philadelphia chromosome or BCR::ABL1 transcripts), and what technical challenges—like low-quality metaphases or signal noise—are you encountering?
• How are you applying integrative knowledge of different laboratory techniques as the data unfolds to ensure a comprehensive investigation of the case?

How are you adapting to the situation?

• What immediate support or alternative methodologies do you need to resolve ambiguous results or technical discrepancies as they arise?
• How are you ensuring your communication of these findings to healthcare colleagues is clear, accurate, and remains within your professional scope of practice?

On action

What did you notice?

• Summarise the key points of the CML referral and the specific laboratory testing strategy (e.g., FISH, RT-PCR, or karyotyping) you selected to investigate the case.
• What were the primary genetic findings (such as the Philadelphia chromosome), and were there any clinical details that significantly influenced your final analysis?

What did you learn from the activity?

• How did you improve your ability to integrate knowledge across different techniques to provide a comprehensive interpretation for diagnosis or monitoring?
• What insights did you gain from managing technical challenges—such as low-level transcripts or signal noise—and how did your decisions during the activity influence the final report?

What will you take from the experience moving forward?

• How will you apply this learning to your routine practice to ensure CML results are communicated clearly and accurately to colleagues?
• What specific next steps or resources (e.g., updated guidelines or senior consultation) have you identified to further develop your analytical and reporting skills in this area?

Beyond action

Have you revisited the experiences?

• How has your perspective on selecting CML testing strategies (e.g., FISH vs. RT-PCR) evolved as you have gained more experience with other acquired cancers?
• Have discussions with peers changed how you view your earlier interpretations of complex or discordant CML results?
• How does this CML activity compare to other training experiences—what specific laboratory behaviours have you now assimilated into your routine practice?

How have these experiences impacted upon your current practice?

• How has the foundational knowledge of BCR::ABL1 monitoring and the Philadelphia chromosome informed your current problem-solving in other cancer cases?
• In what ways are you now applying the communication and presentation skills developed during this activity to your wider interactions with the multidisciplinary team?
• How is the learning from this case helping you prepare for upcoming Case-based Discussions or other in-person assessments?

How might these experiences contribute towards your future practice?

• What transferable skills—such as integrating multi-modal data or reporting within strict clinical pathways—will be most valuable as you progress toward becoming a Clinical Scientist?
• How will the principles learned here help you adapt to future advancements in CML monitoring technologies or changes in national testing algorithms?
• What clear actions have you identified to continue developing your expertise in the molecular diagnostics of acquired cancers?

Relevant learning outcomes

#	Outcome
# 1	Outcome Select the laboratory testing strategy, analyse, interpret and report tests for patients referred with acquired cancer.
# 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.