Training activity information
Details
Assess and register patients onto the national deceased donor transplant list
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
- National requirements for transplant patient registration
- Local procedures
- Local protocols for the clinical and laboratory work up of patients awaiting deceased donor solid organ transplantation
- Additional testing requirements
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 successfully assessing a patient for suitability for registration on the national deceased donor transplant list.
- Consider how the learning outcomes apply, specifically in relation to assessing patient suitability and practicing in accordance with quality standards.
- Discuss with your training officer to gain clarity of what is expected of you in relation to what information is required, and how it is accurately entered into the national registration system according to requirements.
What is your prior experience of this activity?
- Think about what you already know about handling patient data for transplant listing or other national registries.
- Consider possible challenges you might face during the activity, such as incomplete data, urgency, or complex clinical information.
- 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 faced with complex clinical eligibility questions or incomplete mandatory data fields.
- Acknowledge how you feel about the responsibility of ensuring accurate patient registration on a national system.
What do you anticipate you will learn from the experience?
- Consider the specific skills you want to develop, such as reviewing patient clinical and laboratory data to assess transplant list suitability.
- Identify the specific insights you hope to gain into the administrative and logistical aspects of the national organ donation and transplantation system.
What additional considerations do you need to make?
- Consult actions identified following previous experiences of handling patient data or national registry submissions.
- Identify important information you need to consider before embarking on the activity, such as what checks are in place to ensure data accuracy before final registration.
In action
Is anything unexpected occurring?
- Are you noticing anything surprising or different from what you anticipate whilst assessing and registering patients onto the national deceased donor transplant list?
- Are you encountering situations such as:
- The national registration system malfunctions or shows unexpected data validation errors during urgent patient entry?
- The patient’s clinical data includes highly complex co-morbidities or non-standard documentation that does not fit routine fields, complicating accurate assessment for listing?
- A critical piece of mandatory registration data is incomplete, requiring immediate communication with the clinical team to obtain it while the registration window is closing?
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 data verification or risk management during registration?
- Consider the steps you are taking in the moment, such as:
- Immediately implementing manual verification checks on data integrity while simultaneously contacting IT/supervisor regarding system errors
- Seeking clarification from the Training Officer regarding how to accurately represent complex clinical documentation within the standardised registration fields
- How are you feeling in that moment? For instance, are you finding it difficult to manage the time pressure associated with national listing protocols? Is it affecting your confidence in ensuring 100% data accuracy?
What is the conclusion or outcome?
- Identify how you are working within your scope of practice. For example, are you successfully ensuring accurate data entry despite logistical challenges? Or are you needing support because the complexity of the risk management required for non-standard patient data necessitates senior clinical governance review?
- What are you learning as a result of the unexpected development? For example, are you gaining insight into the criticality of procedural adherence and troubleshooting specific national system protocols?
On action
What happened?
- Begin by summarising the key steps you took when assessing and registering the patient onto the national deceased donor transplant list.
- Consider specific events, actions, or interactions which felt important, such as the criteria you assessed for registration, or the process of gathering information and performing necessary checks.
- Include any ‘reflect-in-action’ moments where you had to adapt to the situation as it unfolded, for instance, dealing with incomplete information or system issues during the registration process.
- How did you feel during this experience, e.g., did you feel focused on maintaining data accuracy or stressed by the complexity of the criteria?
How has this experience contributed to your developing practice?
- Identify what learning you can take from this experience regarding patient assessment for transplantation and the national listing process. What strengths did you demonstrate, e.g., adherence to quality standards?
- What skills and/or knowledge gaps were evident, e.g., gaps in your understanding of the assessment criteria or process?
- Compare this experience against previous engagement with similar activities – were any previously identified actions for development achieved? Has your practice improved in your understanding of the assessment and registration process?
- Identify any challenges you experienced, such as interpreting complex clinical histories or navigating the registration system, and how you reacted to this. Were you able to overcome them?
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 patient assessment for transplantation.
- What will you do differently next time you approach assessing and registering a patient for the transplant list, for instance, by proactively checking specific assessment criteria or using the registration system?
- Do you need to practise any aspect of the activity further, such as applying specific assessment criteria or using the registration system or key learning outcomes related to assessing the suitability of patients?
Beyond action
Have you revisited the experiences?
- How have your subsequent experiences of assessing and registering patients onto the national deceased donor transplant list since completing this specific training activity led you to revisit your initial approach or decisions during that activity? The subsequent allocation decisions may lead you to evaluate your initial assessment and registration process.
- Considering what you understand about listing criteria or ensuring accuracy of patient data submission now, were the actions or considerations you identified after your initial reflection on this training activity sufficient? You should review any actions for improvement you identified in previous reflections for this activity.
- How have you since implemented or adapted improvements in your understanding of registration criteria or ensuring accuracy of patient data submission based on further learning and experiences? For example, improving your understanding of registration criteria or ensuring accuracy of patient data submission forced you to re-evaluate the meticulousness of data verification during your first attempt at this training activity.
- Has discussing the registration process, the importance of timely and accurate data, or common pitfalls or the impact of inaccurate registration data on successful organ allocation 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 patient registration experiences, contributed to your overall confidence and ability in understanding and applying the criteria for listing patients for solid organ transplantation, particularly in preparing for assessments like DOPS or OCEs? For example, how your accumulated ability in understanding the link between accurate registration data and successful organ allocation now enables you to support observed assessments (DOPS or OCEs) or case-based discussions related to pre-transplant workup and patient management 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 listing patients for solid organ transplantation? How does this evolved understanding help you identify when a patient’s case is complex (e.g., high PRA, previous transplant) and requires careful consideration of listing criteria or expert input from the transplant team, and when this is beyond your scope of practice?
- Looking holistically at your training journey, how has this initial patient registration experience, revisited with your current perspective, contributed to your development in meeting the learning outcomes related to meticulous data handling, application of national guidelines, understanding of clinical eligibility criteria, and working within a national framework? For example, how this foundational experience has supported your development in transferable skills such as meticulous data handling, application of national guidelines, understanding of clinical eligibility criteria, and working within a national framework.
Relevant learning outcomes
| # | Outcome |
|---|---|
| # 3 |
Outcome
Assess the suitability of patients for crossmatch and transplantation in deceased and live donor settings. |
| # 7 |
Outcome
Practice in accordance with quality management and accreditation standards. |