Training activity information
Details
Receive a range of H&I samples and enter onto laboratory IMS
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
- The local repertoire, source of requests and turnaround times for investigations performed by the training H&I laboratory
- Sample acceptance criteria, including sample type and volume required
- Clinical indications for solid organ and haemopoietic stem cell transplantation and blood transfusion and HLA disease association and pharmacogenomic reactions
- Patient centred care and support, including clinical urgency, previous testing performed and care of samples
- Minimum data set required for identification of laboratory samples
- Factors affecting sample integrity and appropriate corrective action
- Local procedures
- Local and national legislation, protocols and guidelines for information governance
- Infection control
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 effectively receiving and logging a range of H&I samples.
- Consider how the learning outcomes apply, specifically in relation to applying acceptance criteria, practicing in accordance with quality standards, and employing safe working practices when handling and entering samples.
- Discuss with your training officer to gain clarity of what is expected of you in relation to sample verification procedures, documentation standards, and ensuring correct data fields are entered into the laboratory IMS.
What is your prior experience of this activity?
- Think about what you already know about sample handling, clinical labelling requirements, and using a laboratory IMS.
- Consider possible challenges you might face during the activity, such as receiving mislabelled or incorrectly collected samples, or unexpected technical issues with the laboratory IMS.
- 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 a sample has been received that requires rejection but this decision is complex due to clinical urgency or ambiguity in acceptance criteria.
- Acknowledge how you feel about embarking on the systematic process of sample reception and logging into the laboratory IMS.
What do you anticipate you will learn from the experience?
- Consider the specific skills you want to develop, such as rapid verification of sample integrity or efficient data entry into the laboratory IMS.
- Identify the specific insights you hope to gain into the criticality of pre-analytical phase checks on downstream test validity.
What additional considerations do you need to make?
- Consult actions identified following previous experiences of similar sample handling or data entry procedures.
- Identify important information you need to consider before embarking on the activity, such as reviewing the local sample acceptance policy, national guidance for H&I samples, and specific laboratory IMS protocols for new patient registration.
In action
Is anything unexpected occurring?
- Are you noticing anything surprising or different from what you anticipate whilst receiving and logging H&I samples?
- Are you encountering situations such as:
- The received sample is in an incorrect tube type or quantity, compromising viability or compliance with acceptance criteria?
- You encounter an unexpected severe labelling issue or quantity inadequacy, requiring immediate deviation from the standard acceptance protocol?
- The laboratory Information Management System (IMS) presents an unexpected challenge or error message during the data entry phase?
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 sample verification or IMS data entry?
- Consider the steps you are taking in the moment, such as:
- Immediately documenting the sample discrepancy and initiating the local procedure for rejection or querying the requesting clinician
- Halting the data entry process to consult technical support or the Training Officer regarding an IMS error message
- How are you feeling in that moment? For instance, are you finding it difficult to respond appropriately to the sample discrepancy? Is it affecting your confidence in continuing sample reception independently?
What is the conclusion or outcome?
- Identify how you are working within your scope of practice. For example, are you successfully resolving the IMS issue by restarting the software? Or are you needing support because the sample discrepancy requires a complex clinical decision regarding rejection that exceeds your scope of practice?
- What are you learning as a result of the unexpected development? For example, are you mastering a more efficient technique for troubleshooting IMS errors? Or gaining insight into the criticality of meticulous labelling checks during sample reception?
On action
What happened?
- Begin by summarising the key steps you took when receiving and logging the H&I samples onto the Laboratory Information Management System (IMS).
- Consider specific events, actions, or interactions which felt important, such as how you verified a time-critical sample’s integrity or managed a batch of unclear requests or difficult samples.
- Include any ‘reflect-in-action’ moments where you had to adapt to the situation as it unfolded, for instance, immediately adapting your IMS entry sequence when faced with a system error or confirming labelling integrity with a colleague.
- How did you feel during this experience, e.g., did you feel rushed by high volume or focused on accuracy when dealing with unclear requests?
How has this experience contributed to your developing practice?
- Identify what learning you can take from this experience regarding sample reception and data entry. What strengths did you demonstrate, e.g., meticulous adherence to acceptance criteria?
- What skills and/or knowledge gaps were evident, e.g., unfamiliarity with managing complex data fields in IMS or troubleshooting specific system issues?
- Compare this experience against previous engagement with similar activities – were any previously identified actions for development achieved? Has your practice improved in applying acceptance criteria or practicing in accordance with quality standards?
- Identify any challenges you experienced, such as system issues, difficult samples, or needing to seek advice or clarification on scope of practice regarding sample rejection criteria, and how you reacted to this.
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 the efficiency and accuracy of sample logging.
- What will you do differently next time you approach receiving and entering samples, for instance, by consulting the Training Officer immediately when receiving a sample with compromised integrity or proactively clarifying unclear requests via phone?
- Do you need to practise any aspect of the activity further, such as specific IMS functions or key learning outcomes related to applying acceptance criteria and safe working practices?
Beyond action
Have you revisited the experiences?
- How have your subsequent experiences of receiving H&I samples and entering data onto the IMS since completing this specific training activity led you to revisit your initial approach or decisions during that activity? For example, how a subsequent case involving urgent sample rejection due to unexpected contamination or mislabelling forced you to re-evaluate the meticulousness of your initial sample verification checks during your first attempt at this training activity.
- Considering what you understand about sample integrity, quality standards, and IMS procedures 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 sample receipt and data logging accuracy based on further learning and experiences? For example, how you proactively implemented a mandatory cross-check of patient demographics between the referral form and the IMS system based on further learning.
- Has discussing common IMS data entry errors or unexpected logistical challenges in sample receipt or the impact of inaccurate logging on downstream testing with colleagues, peers, or supervisors changed how you now view your initial experience in this training activity? For example, how professional storytelling with a senior colleague about a time when mislabelled samples caused a significant delay in urgent testing refined your understanding of the critical nature of adherence to protocols during initial sample receipt.
How have these experiences impacted upon current practice?
- How has the learning from this initial training activity, in combination with subsequent experiences of receiving H&I samples and data entry, contributed to your overall confidence and competence in handling laboratory samples efficiently and accurately, particularly in preparing for observed assessments (DOPS or OCEs) related to sample handling and data recording? For example, how your accumulated ability in meticulous record-keeping and procedural adherence now enables you to handle unexpected labelling discrepancies confidently during an assessment.
- How has reflecting back on this specific training activity, combined with everything you’ve learned since, shaped your current approach to sample verification and IMS logging? How does this evolved understanding help you identify when sample integrity issues or data discrepancies might be beyond your scope of practice and require escalation to the Training Officer? For example, how your evolved approach means you now routinely seek advice from your supervisor immediately when a critical data discrepancy is found that compromises patient identification, recognising this falls outside routine troubleshooting scope.
- Looking holistically at your training journey, how has this initial sample reception experience, revisited with your current perspective, contributed to your development in meeting the learning outcomes related to applying acceptance criteria and employing safe working practices? For example, how this foundational experience has supported your development in transferable skills such as meticulous record-keeping and understanding of quality protocols that will be valuable in future roles or responsibilities.
Relevant learning outcomes
| # | Outcome |
|---|---|
| # 1 |
Outcome
Apply acceptance criteria, preparation and storage requirements to H&I laboratory specimens. |
| # 6 |
Outcome
Practice in accordance with quality and accreditation standards. |
| # 7 |
Outcome
Employ safe working practices to maintain laboratory equipment, prepare, handle and store laboratory reagents and patient samples. |