Cancer —
Training activity: 4

Details

Select, analyse, interpret and report the appropriate genomic testing for Non-Small Cell Lung Cancer (NSCLC).

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 NSCLC (e.g., NGS panels for EGFR/KRAS/BRAF, fusion analysis, or ctDNA liquid biopsies) and how to accurately analyse, interpret, and report these results for patients with acquired acquired cancer?
• How will you apply your integrative knowledge of various laboratory techniques (such as molecular sequencing, FISH for gene fusions) to investigate these cases?
• 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 regarding NSCLC molecular drivers and current therapeutic guidelines (e.g., eligibility for targeted TKIs) do you need to acquire before embarking on this activity?

What do you anticipate you will learn from the experience?

• What specific insights do you hope to gain regarding the clinical significance of NSCLC biomarkers (such as identifying resistance mutations like EGFR T790M) and how they directly influence patient management?
• Thinking about what you already know, which aspects of NSCLC genomic analysis—such as interpreting low-frequency variants or integrating tissue and liquid biopsy data—do you find most challenging or interesting to explore?

What actions will you take in preparation for the experience?

• How will you gain clarity on the local NSCLC testing pathway and the expectations for your clinical reports?
• What challenges do you anticipate (e.g., managing small biopsy samples with low neoplastic content or interpreting novel gene fusions), and how have you planned to handle them?
• How do you feel about embarking on this activity, considering the critical role that rapid genomic profiling plays in selecting effective targeted therapies for NSCLC patients?

In action

What are you doing?

• How are you currently approaching the selection and analysis of genomic tests for NSCLC (e.g., NGS panels for EGFR/KRAS/BRAF, fusion analysis, or ctDNA liquid biopsies), and what real-time decisions are you making to ensure the strategy matches the clinical referral?
• Which aspects of the NSCLC genomic analysis feel intuitive, and where are you consciously relying on specific guidelines or protocols (such as those for targeted TKI eligibility) right now?

How are you progressing with the activity?

• How effective are your actions in achieving the genomic profiling of the case, and what technical challenges—such as small biopsy samples with low neoplastic content or interpreting low-frequency variants—are you encountering?
• How are you applying integrative knowledge of different laboratory techniques (e.g., NGS, FISH, and IHC) as the data unfolds to ensure a comprehensive investigation of the NSCLC?

How are you adapting to the situation?

• What immediate support or alternative methodologies do you need to resolve ambiguous genomic results or discordant tissue and liquid biopsy findings 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 NSCLC referral and the specific laboratory testing strategy (e.g., NGS panels for EGFR/KRAS/BRAF, fusion analysis, or ctDNA liquid biopsies) you selected to investigate the case.
• What were the primary genomic findings (such as actionable mutations or gene fusions), and were there any clinical details or sample quality issues (e.g., low neoplastic content in small biopsies) 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 (e.g., molecular sequencing, FISH, and immunohistochemistry) to provide a comprehensive interpretation for the investigation of acquired cancer?
• What insights did you gain from managing technical challenges—such as interpreting low-frequency variants or discordant tissue/liquid biopsy results—and how did your reflection-in-action during the process influence the final report?

What will you take from the experience moving forward?

• How will you apply the learning from this activity to your routine practice to ensure NSCLC results are communicated clearly and accurately to healthcare professional colleagues?
• What specific next steps or resources (e.g., updated therapeutic guidelines or senior consultation) have you identified to further develop your skills in presenting complex genomic investigations within a multidisciplinary context?

Beyond action

Have you revisited the experiences?

• How has your perspective on selecting NSCLC testing strategies (e.g., tissue NGS vs. ctDNA liquid biopsies) evolved as you have gained more experience with other acquired cancer referrals?
• Have discussions with peers or colleagues changed how you view your earlier interpretations of complex NSCLC findings, such as low-frequency variants or discordant results?
• Compare this experience with your Observed Training Activities—what specific laboratory behaviours and analytical practices for lung cancer profiling have you now assimilated into your routine workflow?

How have these experiences impacted upon your current practice?

• How has your integrative knowledge of NSCLC biomarkers (e.g., EGFR, KRAS, and gene fusions) informed your current problem-solving when investigating other solid tumour types?
• In what ways are you now applying the communication and presentation skills developed during this activity to your wider interactions with the multidisciplinary team (MDT)?
• How is the learning from these NSCLC cases helping you prepare for upcoming Case-based Discussions (CBDs) or other in-person assessments for this module?

How might these experiences contribute towards your future practice?

• What transferable skills—such as translating multi-modal genomic data into clear clinical reports—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 NSCLC diagnostics, such as the emergence of new targeted therapies or refined resistance monitoring technologies?
• What clear actions have you identified to continue developing your expertise in precision oncology and the molecular investigation 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.