Training activity information
Details
Dissect a range of gynaecological specimens received for endometrial and/or ovarian cancer:
- Hysterectomy
- Total abdominal hysterectomy and bilateral salpingoophorectomy
- Oophorectomy
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.
Considerations
- Local SOPs
- Specimen preparation, orientation, inking, block sampling and macroscopic description
- Quality of blocks
- RCPath cancer datasets
- Macroscopic pathological features specific to the disease entity
- Cervical cancer screening programme
- NICE guidance
- Molecular testing strategies and national guidance
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 key anatomical features of the uterus, ovaries, and fallopian tubes that you need to identify during dissection?
- What are your objectives in terms of assessing tumour location, size, depth of invasion, and spread to adjacent structures?
- Discuss the different types of gynaecological cancers (endometrial and ovarian) and their characteristic macroscopic features with your training officer.
- Review the standard dissection protocols for hysterectomy, total abdominal hysterectomy and bilateral salpingoophorectomy, and oophorectomy specimens, including the assessment of margins and lymph nodes.
- What are the important factors to consider when orientating these specimens for dissection?
- Consider the specific insights you hope to gain regarding the macroscopic presentation of endometrial and ovarian cancers and their relationship to surrounding tissues.
- Think about your existing knowledge of gynaecological anatomy and how this will guide your dissection technique.
- What specific skills in dissecting complex gynaecological specimens, identifying relevant pathological features, and sampling key areas do you aim to develop?
- Discuss this training activity with your training officer to clarify the expected dissection approach and the rationale for block selection in different types of gynaecological cancer.
- Consider potential difficulties such as distorted anatomy due to previous treatments or the presence of adhesions, and how you might manage these.
- Reflect on your current understanding of the staging of endometrial and ovarian cancers and how macroscopic assessment contributes to this.
In action
- What is your systematic approach to examining and dissecting hysterectomies, TAHBSOs, and oophorectomies for suspected malignancy?
- Why are you prioritising certain steps (e.g., examining the endometrium, myometrium, cervix, ovaries, fallopian tubes)?
- What decisions are you making regarding the sampling of the tumour, margins, adnexa, and lymph nodes (if present)?
- What macroscopic features are influencing your block selection?
- How comfortable are you with identifying the different anatomical components of the female reproductive tract?
- What aspects of assessing tumour spread or identifying different tumour types are requiring more concentration?
- How well is your dissection demonstrating the relationship between the tumour and adjacent structures?
- Are you encountering any challenges in assessing the depth of invasion or involvement of other organs?
- What immediate insights are you gaining about the gross presentation of endometrial and ovarian cancers?
- How does this correlate with your theoretical knowledge?
- Are there alternative dissection methods that might provide a clearer assessment of key prognostic factors?
- Would a second opinion on the dissection strategy be helpful?
- Are you confident that your dissection and sampling will allow for accurate staging and grading of the gynaecological malignancy?
On action
- What were the key macroscopic features of the different gynaecological specimens you dissected (hysterectomy, total abdominal hysterectomy and bilateral salpingoophorectomy, oophorectomy)?
- How did the type and extent of endometrial and/or ovarian cancer manifest macroscopically?
- What were the key steps in dissecting these specimens to assess tumour size, depth of invasion, involvement of adjacent structures, and lymph nodes?
- How did the clinical presentation and imaging findings correlate with the macroscopic findings at dissection?
- What difficulties did you encounter while dissecting these gynaecological specimens?
- How were they resolved?
- What did you learn about the crucial elements of gynaecological cancer dissection for accurate staging and prognosis?
- How has this activity enhanced your understanding of gynaecological anatomy and pathology related to cancer?
- How will this experience influence your future approach to dissecting gynaecological malignancy specimens?
- Are there any specific gynaecological specimen dissection techniques you need to develop further?
- How will you ensure you are adequately assessing and sampling the key prognostic factors in these specimens?
- Should you seek further training or resources on dissecting complex gynaecological cancer cases?
Beyond action
- How did dissecting different types of gynaecological specimens (e.g., hysterectomy vs. oophorectomy) contribute to your understanding of the anatomy and pathology of the female reproductive system?
- Review your reflections on these gynaecological dissection activities. What key learning points have you identified regarding specimen orientation and the importance of specific features for reporting?
- How has the knowledge gained from dissecting gynaecological malignancy specimens influenced your ability to anticipate the information required by clinicians? How has this affected your subsequent preparation and dissection of other specimens?
- Consider how your understanding of gynaecological cancer dissection will support you in writing draft histological reports for these cases.
- What transferable skills, such as meticulous handling of delicate tissues, did you develop through this activity?
- What clear actions will you take to further develop your expertise in dissecting gynaecological malignancy specimens?
Relevant learning outcomes
| # | Outcome |
|---|---|
| # 2 |
Outcome
Dissect the most common malignant specimens from a range of organ systems. |
| # 3 |
Outcome
Employ the appropriate specimen preparation, orientation, inking, block sampling and dissection rationale based on the clinical history for malignant specimens. |
| # 5 |
Outcome
Practice safely in accordance with quality management and accreditation standards. |