Training activity information
Details
Within genomic counselling sessions, describe in lay terms, how genomic tests contribute to current and future management of conditions
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.
Considerations
- Limits and future direction
- The use of a genomic diagnosis in establishing treatment strategies and personalised medicine, including in oncology, adult medicine, paediatrics and prenatal settings
- Emerging interventions and management
- Current and anticipated future uses of therapeutics
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?
- Consider how the learning outcomes apply, specifically in relation to successfully explaining this contribution using language that is accessible and understandable to the patient.
- Discuss with your training officer to gain clarity of what is expected of you in relation to translating complex management pathways (e.g., surveillance, pharmacogenomics) into lay terms and managing discussions about the future scope of genomic medicine.
What is your prior experience of this activity?
- Think about what you already know about explaining the link between diagnostic information (like genomic results) and clinical management or surveillance plans.
- Consider possible challenges you might face during the activity, such as helping patients understand the practical implications of genomic information for long-term healthcare, including their importance for people who are asymptomatic.
- Recognise the scope of your own practice for this activity i.e. know when you will need to seek advice or help, and from whom. You will need to seek advice from your Training Officer when required, for example if the management discussion involves deviating from standard management pathways. Acknowledge how you feel about explaining the role of genomic testing in current and future management plans to patients.
What do you anticipate you will learn from the experience?
- Consider the specific skills you want to develop, such as using specific examples or analogies to illustrate how genomic information guides management.
- Identify the specific insights you hope to gain into how patients perceive the value of genomic testing for long-term health planning, and what challenges they may face in this process.
What additional considerations do you need to make?
- Consider your previous experiences of explaining the relevance of genomic test for patient management.
- Consider the specific management guidelines or surveillance recommendations for the condition, and how to address questions about the evolving nature of genomic medicine.
- Consider any unique circumstances, such as a variant that displays reduced penetrance, or health conditions that might contraindicate standard screening.
In action
Is anything unexpected occurring?
- Are you noticing anything surprising or different from what you anticipate whilst describing the contribution of genomic tests to management in lay terms?
- Are you encountering situations such as:
- The patient’s questions about future implications, or their reaction to potential management strategies differing from what you anticipated?
- The patient’s life plans (pregnancy, travel) or anxiety create a conflict with standard management advice?
How are you reacting to the unexpected development?
- How is this impacting your actions? For example, are you addressing specific patient concerns about their care pathway and offering to find out more information if needed?
- Consider the steps you are taking in the moment, such as drawing a diagram or translating research evidence to explain the costs.
- How are you feeling in that moment? For instance, are you finding it difficult to describe the contribution clearly? Is it affecting your confidence in explaining potential future management implications?
What is the conclusion or outcome?
- Identify how you are working within your scope of practice. For example, were you able to describe the contribution of genomic tests to current and future management using lay terms? Or are you needing support because the patient’s questions about future implications require specific clarification on novel or experimental therapies outside routine clinical offering?
- What are you learning as a result of the unexpected development? For example, are you learning from handling the unexpected questions or reactions during this explanation?
On action
What happened?
- Begin by summarising the key steps you took when explaining the current and future clinical utility of the genomic test.
- Consider specific events, actions, or interactions which felt important, such as the patient’s specific questions about the risk of not proceeding with recommended screening.
- Include any ‘reflect-in-action’ moments where you had to adapt to the situation as it unfolded, for instance, moving to exploring the patient’s previous experiences of medical screening/the condition to understand the source of their anxiety.
- How did you feel during this experience, e.g., did you feel confident in describing the current care plan but challenged by managing patient expectations regarding potential future therapies?
How has this experience contributed to your developing practice?
- Identify what learning you can take from this experience regarding explaining clinical utility in lay terms. What strengths did you demonstrate, e.g., translating complex surveillance or preventative management evidence into accessible language?
- What skills and/or knowledge gaps were evident, e.g., difficulty simplifying concepts related to the research pipeline or pharmacogenomics?
- Compare this experience against previous engagement with similar activities, has your practice improved in helping patients understand and adapt to a genomics-driven care plan?
- Identify any challenges you experienced, such as needing to seek advice or clarification on non-standard management options.
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 learnt, including from any feedback you have received, with regards to improving your communication of genomic clinical utility.
- What will you do differently next time you approach explaining future management, for instance, by proactively using a timeline visual aid to distinguish between current care, clinical trials, and distant research goals?
- Do you need to practise any aspect of the activity further, such as enhancing knowledge of condition management guidelines influenced by genomics or key learning outcomes related to communicating the research pipeline?
Beyond action
Have you revisited the experiences?
- Considering what you understand about simplifying management information and linking tests to surveillance protocols now, how have you since implemented improvements in your management communication technique? For example, how you proactively developed a standard visual aid illustrating the different screening required at each life stage.
- Has discussing cases, such as the impact of unclear explanation on adherence to current management plans, with colleagues, peers, or supervisors changed how you now view your initial experience in this training activity?
How have these experiences impacted upon current practice?
- How has the learning from this initial training activity, in combination with subsequent experiences contributed to your overall confidence and ability in describing the current and future clinical utility of genomic tests for patients?
- How has reflecting back on this specific training activity, combined with everything you’ve learned since, shaped your current approach to describing the contribution of genomic tests to management?
- Looking holistically at your training journey, how has this experience, revisited with your current perspective, contributed to your development in meeting the learning outcomes related to decision-making and communication? For example, how this foundational experience has supported your development in setting appropriate patient expectations regarding the integration of genomic medicine into clinical care.
Relevant learning outcomes
| # | Outcome |
|---|---|
| # 1 |
Outcome
Apply counselling skills to lead consultations involving genomic testing in complex scenarios. |
| # 4 |
Outcome
Compare the benefits and limitations of genomic screening for risk prediction and advise on their application/use in practice. |