Training activity information
Details
Prepare representative patient samples from a range of tissue types and identify the following types of inflammatory processes:
- Acute inflammation
- Chronic inflammation
- Granulomatous inflammation
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
- Types of inflammation, including inflammatory cell types, their roles and the stages of inflammation
- Disease states associated with inflammation and risk to the patient
- Identification of inflammation
- Normal levels of inflammation
- Local SOPs
- Specimen block sampling and macroscopic description
- Quality of blocks
- RCPath tissue pathways
- Macroscopic pathological features specific to the disease entity
- Selection of adjunct histological techniques to demonstrate the different cell types and agents involved in inflammatory processes
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 preparing samples and identifying inflammatory processes.
- Consider how the learning outcomes apply, specifically in relation to using histological techniques to demonstrate the different types of inflammation.
- Discuss with your training officer to gain clarity of what is expected of you in relation to preparing the patient samples from a range of tissue types. Which of the different inflammatory processes do you feel you need more understanding of?
What is your prior experience of this activity?
- Think about what you already know about preparing patient samples or identifying inflammatory processes microscopically.
- Consider possible challenges you might face during the activity, such as distinguishing different types of inflammation or preparing specific tissue types, and think about how you might handle them.
- 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 or a Senior Pathologist when required, for example:
- If you find atypical inflammatory features or complex tissue reactions (e.g., highly cellular chronic inflammation) that complicate clear identification.
- When the required preparation technique for a specific tissue sample (e.g., lymphoid tissue) might compromise the ability to identify granulomas accurately.
- Acknowledge how you feel about preparing the patient samples consistently across the range of tissue types and having to identify the specified inflammatory process types.
What do you anticipate you will learn from the experience?
- Consider the specific skills you want to develop, such as sample preparation techniques for histological examination and identifying specific inflammatory patterns.
- Identify the specific insights you hope to gain into the microscopic features of different inflammatory processes.
What additional considerations do you need to make?
- Consult actions identified following previous experience of preparing samples or examining slides for inflammation.
- Identify important information you need to consider before embarking on the activity, such as relevant staining techniques or typical microscopic appearances for the specific inflammatory types.
In action
Is anything unexpected occurring?
- Are you noticing anything surprising or different from what you anticipate whilst preparing the sample or identifying the inflammation microscopically?
- Are you encountering situations such as:
- The inflammatory features are unclear or difficult to classify e.g., highly cellular chronic inflammation lacking typical morphology, challenging differentiation between acute and chronic processes
- An atypical pattern of inflammation is present e.g., a foreign body reaction that is initially mistaken for classic granulomatous inflammation, not aligning with immediate expectations based on training
How are you reacting to the unexpected development?
- How is this impacting your actions? For example, are you responding to the situation appropriately? Are you adapting or changing your approach to identification?
- Consider the steps you are taking in the moment, such as:
- Immediately revisiting previous experience with similar slides to influence your current identification strategy
- Attempting to handle the ambiguity by focusing on specific hallmark cells e.g., neutrophils for acute or macrophages for granulomatous to guide classification
- How are you feeling in that moment? For instance, are you finding it difficult to adapt your approach to identification? Is it affecting your confidence in reaching a definite conclusion?
What is the conclusion or outcome?
- Identify how you are working within your scope of practice. For example, are you successfully resolving the ambiguity yourself? Or are you needing support because the uncertainty requires verification from a senior colleague?
- What are you learning as a result of the unexpected development? For example, are you mastering a more effective technique for distinguishing subtle inflammatory features? Or gaining insight into how past experience influences current identification?
On action
What happened?
- Begin by summarising your process for preparing and identifying the inflammation types in this sample.
- Consider specific events, actions, or interactions which felt important, such as whether specific features of acute, chronic, or granulomatous inflammation were clear or difficult to identify.
- Include any ‘reflect-in-action’ moments where you had to adapt to the situation as it unfolded, for instance, if you encountered an unexpected difficulty distinguishing between highly cellular chronic inflammation and granulomatous inflammation. How did you feel during this experience, e.g., did you feel focused on differentiating cell populations or stressed by the ambiguity?
How has this experience contributed to your developing practice?
- Identify what learning you can take from this experience regarding inflammation identification. What strengths did you demonstrate, e.g., differential identification skills or feature recognition? What skills and/or knowledge gaps were evident, e.g., unfamiliarity with the atypical morphology of certain chronic inflammatory processes?
- Compare this experience against previous engagement with similar activities – Has your practice improved in your understanding of the morphological differences between these inflammation types?
- Identify any challenges you experienced, such as needing to seek advice to confirm the identification of atypical inflammatory features, and what you learned from that interaction regarding scope of practice.
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 following any feedback you have received with regards to your ability to prepare patient samples across different tissue types. What actions are needed to further develop your ability to identify the range of inflammatory processes identified?
- What specific features will you pay closer attention to the next time you identify inflammatory processes, for instance, focusing on the composition of the cellular infiltrate to classify chronicity?
- Do you need to practise any aspect of the activity further, such as reviewing atlases or resources on complex inflammation morphology?
Beyond action
Have you revisited the experiences?
- How have your subsequent experiences identifying inflammation in different tissue types, different cases, or in the context of different diseases since completing this specific training activity led you to revisit your initial approach or decisions during that activity?
- Considering what you understand about the microscopic appearances of different types of inflammation, their significance in disease processes, and quality management standards now, were the actions or considerations you identified after your initial reflection on this training activity sufficient? How have you since implemented or adapted improvements in your approach to preparing or identifying inflammatory processes based on further learning and experiences?
- Has discussing challenging cases involving inflammation, or the role of inflammation in patient management, 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 identifying inflammation, contributed to your overall confidence and ability in identifying different types of inflammation when performing microscopical assessment of stained slides and practicing safely, particularly in preparing for assessments like DOPS?
- How has reflecting back on this specific training activity, combined with everything you’ve learned since about pathology, shaped your current approach to identifying inflammation? How does this evolved understanding help you identify when something is beyond your scope of practice or requires escalation?
- Looking holistically at your training journey, how has this initial experience identifying inflammation, revisited with your current perspective, contributed to your development in meeting the learning outcomes related to using histological techniques to demonstrate inflammation and practicing safely?
Relevant learning outcomes
| # | Outcome |
|---|---|
| # 1 |
Outcome
Use histological techniques to demonstrate the different types of inflammation. |
| # 9 |
Outcome
Practice safely in accordance with quality management and accreditation standards. |