Training activity information
Details
Perform daily quality control checks of the processes involved in the histological pathway, identify trends and make recommendations for remedial actions where required
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
- Local SOPs
- Test datasheets
- Quality control process
- Quality management system
- Implication for downstream processes
- Sampling adequacy
- Control samples
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 performing daily quality control (QC) checks.
- Review the learning outcomes related to practicing safely in accordance with quality management and evaluating equipment and methods.
- Success means diligently performing all required daily QC checks, accurately recording results, identifying deviations or trends, and suggesting appropriate remedial actions.
- Discuss with your training officer to gain clarity of what is expected, focusing on the specific QC checks required, the documentation process, and the criteria for identifying trends or needing remedial action.
What is your prior experience of this activity?
- Think about your previous exposure to QC processes in a laboratory setting. Have you performed daily QC checks before, even if for different processes?
- Consider possible challenges you might face, such as identifying subtle issues during checks, accurately interpreting QC data, or determining the root cause of a problem. Think about how you might handle these challenges.
- Recognise the scope of your own practice in performing QC and recommending actions; know when and from whom you will need to seek advice or help, especially when issues arise or complex trends are observed.
- Acknowledge how you feel about embarking on this activity, particularly if it feels routine but critical, or if you anticipate encountering problems, you might not know how to solve.
What do you anticipate you will learn from the experience?
- Consider the specific skills you want to develop, such as performing meticulous daily checks, interpreting QC data effectively, recognising trends over time, and learning to troubleshoot and recommend remedial actions.
- Identify the specific insights you hope to gain into the importance of daily QC for maintaining the quality and reliability of the entire histological pathway and ensuring patient safety.
What additional considerations do you need to make?
- Consult actions identified following previous experiences with QC or troubleshooting laboratory processes.
- Identify important information you need to consider before embarking on the activity, such as reviewing the specific QC protocols for each process e.g., embedding centre temperature, microtome function, staining reagents, understanding the expected ranges or results, and knowing the procedure for reporting issues.
In action
Is anything unexpected occurring?
- Are you noticing anything surprising or different from what you anticipate whilst performing daily QC checks?
- Are you encountering situations such as:
- A result is immediately outside the acceptable range e.g., embedding centre temperature is too high, or a control slide is unacceptable
- You are noticing subtle deviations or potential trends that cause you to pause and investigate further, even if currently within tolerance
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 investigation?
- Consider the steps you are taking in the moment, such as:
- Immediately reacting and deciding on the next step when a result is outside the acceptable range e.g., stopping the process, isolating the issue
- Making decisions in the moment about whether a result requires immediate remedial action or just monitoring for future trends
- Immediately documenting the results and any actions taken as per quality management standards
- How are you feeling in that moment? For instance, are you finding it difficult to confidently determine the root cause of a QC failure? Is it affecting your confidence in recommending remedial actions?
What is the conclusion or outcome?
- Identify how you are working within your scope of practice. For example, are you successfully identifying a QC trend and recommending appropriate monitoring? Or are you needing support because the out-of-range result requires a complex investigation into reagent efficacy or equipment function?
- Identify what you learnt as a result of the unexpected development. For example, are you mastering a more effective strategy for interpreting complex QC data? Or gaining insight into the process for identifying trends and making sound remedial action recommendations?
On action
What happened?
- Begin by summarising the daily QC checks you performed.
- Describe the results for each check, noting any deviations or potential trends observed.
- Consider specific observations or findings during the QC process that felt important.
- Include any ‘reflect-in-action’ moments where you responded immediately to out-of-range results or made initial decisions about potential causes.
How has this experience contributed to your developing practice?
- Identify what learning you can take from the experience. What did you learn about the critical control points in the histological pathway?
- How did this experience enhance your ability to interpret QC data, identify trends, and determine appropriate remedial actions?
- What strengths did you demonstrate e.g., meticulous checks or identifying issues? What skills or knowledge gaps were evident, particularly regarding troubleshooting or trend analysis?
- Identify any challenges you faced e.g., ambiguous results, difficult troubleshooting and how you reacted. Did you need to seek advice regarding findings or remedial actions? What was the outcome?
What will you take from the experience moving forward?
- Identify the actions / ‘next steps’ you will now take to support the assimilation of what you have learnt, including from any feedback you have received on your performance of quality control checks. What actions do you need to take to further develop your recommendations for remedial action?
- What specific checks will you perform with greater attention or what steps will you take differently next time when performing daily QC?
- Do you need to practise any aspect of the activity further, such as reviewing specific QC parameters, troubleshooting guides, or trend analysis methods?
Beyond action
Have you revisited the experiences?
- How have your subsequent experiences performing daily quality control (QC) checks, encountering different issues, or identifying trends across a longer period, since completing this specific training activity led you to revisit your initial approach to QC or the remedial actions you recommended?
- Considering your current understanding of quality management and accreditation standards, evaluating equipment and methods, and the principles of IQA, 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 QC process, trend analysis, or recommendations based on further learning and experiences? For example, how analysing External Quality Assurance (EQA) results for a relevant process prompted you to implement improvements in documenting minor fluctuations in reagent QC, which you had previously overlooked.
- Has discussing challenging QC findings, trends, or the effectiveness of remedial actions 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 QC and quality assurance experiences, contributed to your overall confidence and ability in practicing safely in accordance with quality management and accreditation standards and evaluating equipment and methods?
- How has reflecting back on this specific training activity, combined with everything you’ve learned since about QC and laboratory management, shaped your current approach to performing QC checks, identifying trends, and making recommendations? How does this evolved understanding help you identify when something is beyond your scope of practice or requires escalation in relation to quality control? For example, your developed ability in trend analysis contributes to your confidence in performing internal quality control for a case prior to reporting and helps you identify when something is beyond your scope of practice e.g., when complex equipment maintenance is required and escalate the issue.
- Looking holistically at your training journey, how has this initial experience, revisited with your current perspective, contributed to your development in meeting the learning outcomes related to practicing safely and evaluating methods?
Relevant learning outcomes
| # | Outcome |
|---|---|
| # 4 |
Outcome
Practice safely in accordance with quality management and accreditation standards. |
| # 5 |
Outcome
Evaluate equipment and methods to ensure the continued delivery and development of an effective histopathology service. |