Training activity information
Details
Prepare a crossmatch report for clinical colleagues for a standard risk solid organ transplant patient
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 procedures and national guidelines
- Clinical interpretation
- Results and patient history
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 a clear, accurate, and concise crossmatch report tailored for clinical colleagues concerning a standard risk patient.
- Consider how the learning outcomes apply, specifically in relation to interpreting test results and practicing in accordance with quality standards.
- Discuss with your training officer to gain clarity of what is expected of you in relation to including mandatory information (e.g., final result, test method, serum used), using appropriate clinical terminology, and adhering to strict reporting turnaround times.
What is your prior experience of this activity?
- Think about what you already know about writing factual clinical reports, communicating laboratory results to non-laboratory staff, and the definition of a standard risk transplant case.
- Consider possible challenges you might face during the activity, such as accurately translating complex technical findings into clinically relevant statements or ensuring the report is delivered within the urgent timescale required for transplantation.
- 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 unexpected complications arise regarding the report structure for a patient who, despite being standard risk, has complex clinical features that must be included.
- Acknowledge how you feel about preparing a report that is essential for the transplant team’s decision-making process.
What do you anticipate you will learn from the experience?
- Consider the specific skills you want to develop, such as effective written communication of critical data or adherence to formal report templates and quality checks.
- Identify the specific insights you hope to gain into how clinical colleagues use the crossmatch report to finalise the transplant decision.
What additional considerations do you need to make?
- Consult actions identified following previous experiences of preparing clinical reports or handling urgent documentation.
- Identify important information you need to consider before embarking on the activity, such as reviewing the required elements of the crossmatch report template, confirming the final assigned crossmatch result, and verifying the expected recipient of the report.
In action
Is anything unexpected occurring?
- Are you noticing anything surprising or different from what you anticipate whilst preparing the crossmatch report for clinical colleagues?
- Are you encountering situations such as:
- A seemingly ‘standard risk’ case having minor complexities (e.g., historic, low-level DSA) that require careful phrasing in the report?
- Unexpected difficulty in structuring the report or translating technical results into clear clinical language?
- Ambiguity in the required content or format of the report according to local reporting policy?
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 the report wording or formatting?
- Consider the steps you are taking in the moment, such as:
- Immediately reviewing previous report templates to ensure standardised, objective language is used for complex details
- Seeking clarification from the Training Officer on the appropriate tone or level of detail required for the clinical team
- How are you feeling in that moment? For instance, are you finding it difficult to ensure both accuracy and brevity? Is it affecting your confidence in preparing the report independently?
What is the conclusion or outcome?
- Identify how you are working within your scope of practice. For example, are you successfully producing an accurate, concise report that adheres to policy? Or are you needing support because the urgency or sensitivity of the patient status requires immediate senior review before report sign-off?
- What are you learning as a result of the unexpected development? For example, are you mastering the professional communication style for clinical reporting? Or gaining insight into which specific technical details are most critical for the transplant clinician?
On action
What happened?
- Begin by summarising the key steps you took when preparing the crossmatch report.
- Consider specific events, actions, or interactions which felt important, such as how you selected the most clinically relevant information (e.g., serum used, assay type) and ensured the conclusion was concise.
- Include any ‘reflect-in-action’ moments where you had to adapt to the situation as it unfolded, for instance, immediately revising the technical description to use clinician-friendly terminology or seeking urgent clarification on the required turnaround time for the report.
- How did you feel during this experience, e.g., did you feel efficient in communication or stressed by time constraints?
How has this experience contributed to your developing practice?
- Identify what learning you can take from this experience regarding communicating crossmatch results effectively to clinicians. What strengths did you demonstrate, e.g., accuracy and conciseness of the report?
- What skills and/or knowledge gaps were evident, e.g., familiarity with specific clinical terminology used by transplant surgeons or ensuring clinical relevance?
- Compare this experience against previous engagement with similar activities – were any previously identified actions for development achieved? Has your practice improved in preparing clinical reports?
- Identify any challenges you experienced, such as ensuring clinical relevance, time pressure, or needing advice on scope of practice regarding interpretive vs factual phrasing, 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 your report writing and communication skills for clinical colleagues.
- What will you do differently next time you approach preparing a crossmatch report, for instance, by proactively confirming the required report structure with the clinical team?
- Do you need to practise any aspect of the activity further, such as clear report structuring or key learning outcomes related to interpreting test results?
Beyond action
Have you revisited the experiences?
- How have your subsequent experiences of preparing a crossmatch report for clinical colleagues since completing this specific training activity led you to revisit your initial approach or decisions during that activity? For example, how a subsequent non-standard case required a more detailed and nuanced report forced you to re-evaluate the brevity and clarity of information provided during your first attempt at this training activity.
- Considering what you understand about clinical needs, appropriate reporting structure, and the communication of critical laboratory information 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 report structure or ensuring necessary details (e.g., serum used, method) based on further learning and experiences? For example, how you proactively reviewed and integrated feedback from the clinical team on essential information to include in the final report.
- Has discussing report requirements with clinical colleagues or seeking feedback on report clarity changed how you now view your initial experience in this training activity? For example, how professional storytelling with a senior colleague about a report where key information was missed, causing a clinical query and delay, refined your understanding of the critical nature of synthesising complex data for effective clinical decision-making.
How have these experiences impacted upon current practice?
- How has the learning from this initial training activity, in combination with subsequent experiences of report preparation, contributed to your overall confidence and competence in communicating critical laboratory information effectively, particularly in preparing for observed assessments (DOPS or OCEs) such as ‘Present laboratory results at a multidisciplinary team meeting’? For example, how your accumulated ability in scientific writing and synthesising complex data now enables you to confidently present laboratory findings during an OCE assessment.
- How has reflecting back on this specific training activity, combined with everything you’ve learned since, shaped your current approach to crossmatch reporting?
- How does this evolved understanding help you identify when a case is not ‘standard risk’ or requires a more detailed or nuanced report and when this requires expert clinical liaison? For example, how your evolved approach means you now routinely seek expert clinical liaison immediately when a result is highly time-sensitive or suggests unexpected clinical complexity, recognising this requires senior involvement.
- Looking holistically at your training journey, how has this initial reporting experience, revisited with your current perspective, contributed to your development in meeting the learning outcomes related to interpreting test results and practicing in accordance with quality standards? For example, how this foundational experience has supported your development in transferable skills such as professional communication and understanding clinical relevance that will be valuable in future roles or responsibilities.
Relevant learning outcomes
| # | Outcome |
|---|---|
| # 4 |
Outcome
Interpret test results for the range of techniques performed. |
| # 6 |
Outcome
Practice in accordance with quality and accreditation standards. |