Training activity information
Details
HLA type a deceased potential donor according to local protocols
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
- Internal quality controls and external quality assessment measures
- Interpretation of HLA typing data
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 HLA typing a deceased potential donor accurately and within the required timeframe according to local protocols.
- Consider how the learning outcomes apply, specifically in relation to performing appropriate testing and practicing in accordance with quality standards.
- Discuss with your training officer to gain clarity of what is expected of you in relation to how you ensure quality control measures are met for urgent deceased donor samples.
What is your prior experience of this activity?
- Think about what you already know about performing DNA extraction or molecular typing techniques before.
- Consider possible challenges you might face during the activity, such as sample quality, urgency, or limited sample volume.
- 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 an unexpected system failure compromises the rapid typing assay when a deceased donor sample is mid-run.
- Acknowledge how you feel about performing critical tests under time pressure for a deceased donor offer.
What do you anticipate you will learn from the experience?
- Consider the specific skills you want to develop, such as performing rapid HLA typing assays on deceased donor samples.
- Identify the specific insights you hope to gain into the logistical and technical considerations for urgent deceased donor testing.
What additional considerations do you need to make?
- Consult actions identified following previous experiences of performing urgent laboratory assays or troubleshooting molecular typing.
- Identify important information you need to consider before embarking on the activity, such as what the specific turnaround time requirements for this activity are.
In action
Is anything unexpected occurring?
- Are you noticing anything surprising or different from what you anticipate whilst HLA typing a deceased potential donor?
- Are you encountering situations such as:
- The deceased donor sample yields unexpectedly low DNA volume or quality, compromising the reliability of the rapid molecular typing assay?
- A contamination issue is suspected or evident during the typing assay (e.g., failed controls), necessitating a halt to the procedure?
- The typing results show an ambiguity that cannot be resolved using routine primary methods and the clock is ticking for the organ offer?
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 technical troubleshooting or urgent protocol adherence?
- Consider the steps you are taking in the moment, such as:
- Immediately initiating an urgent troubleshooting protocol, possibly re-extracting DNA (if sample volume allows) or checking reagent integrity
- Escalating the unresolved ambiguity to the Training Officer for a decision on whether to attempt advanced resolution methods or report the ambiguity immediately
- How are you feeling in that moment? For instance, are you finding it difficult to maintain methodical procedure under the pressure of the urgent timeline? Is it affecting your confidence in achieving a valid and accurate result?
What is the conclusion or outcome?
- Identify how you are working within your scope of practice. For example, are you successfully troubleshooting the contamination issue and obtaining a reliable result? Or are you needing support because unresolved technical failure prevents the completion of the typing within the mandated time window, requiring senior technical intervention?
- What are you learning as a result of the unexpected development? For example, are you mastering the rapid technical execution and quality control requirements of urgent deceased donor HLA typing?
On action
What happened?
- Begin by summarising the key steps you took when performing the HLA typing for the deceased potential donor.
- Consider specific events, actions, or interactions which felt important, such as the specific sample type used and how you applied the local protocols to the typing process, or the technical steps you followed and any specific assays or equipment used.
- Include any ‘reflect-in-action’ moments where you had to adapt to the situation as it unfolded, for instance, troubleshooting an assay or modifying a step due to sample limitations.
- How did you feel during this experience, e.g., did you feel focused on performing appropriate testing or stressed if the sample quality was poor or the results were challenging?
How has this experience contributed to your developing practice?
- Identify what learning you can take from this experience regarding HLA typing deceased donors according to local protocols. What strengths did you demonstrate, e.g., technical proficiency or adherence to quality standards?
- What skills and/or knowledge gaps were evident, e.g., gaps in your technical proficiency or understanding of protocols?
- Compare this experience against previous engagement with similar activities – were any previously identified actions for development achieved? Has your practice improved in your technical skill in HLA typing?
- Identify any challenges you experienced, such as time pressure, technical issues with the assay, or ambiguous results, and how you reacted to these. 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 performance of appropriate testing.
- What will you do differently next time you approach HLA typing a deceased potential donor, for instance, by proactively practicing specific assay techniques or troubleshooting steps?
- Do you need to practise any aspect of the activity further, such as specific assay techniques or troubleshooting steps or key learning outcomes related to performing appropriate testing?
Beyond action
Have you revisited the experiences?
- How have your subsequent experiences of HLA typing deceased donors since completing this specific training activity led you to revisit your initial approach or decisions during that activity? The subsequent matching run results or the outcome of the organ offer may lead you to evaluate your initial typing process and results.
- Considering what you understand about the efficiency of urgent processing or refining your understanding of rapid typing methods 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 efficiency of urgent processing or refining your understanding of rapid typing methods based on further learning and experiences? For example, improving the efficiency of urgent processing or refining your understanding of rapid typing methods forced you to re-evaluate the speed and accuracy of urgent sample reception and processing during your first attempt at this training activity.
- Has discussing urgent deceased donor typing or the specific challenges of this activity (e.g., sample quality, time pressure) or the impact of inappropriate planning on workflow 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 deceased donor typing experiences, contributed to your overall confidence and ability in performing urgent and accurate HLA typing on deceased donors, particularly in preparing for assessments like DOPS or OCEs? For example, how your accumulated ability in understanding the critical timeline and the need for robust methods now enables you to confidently execute urgent laboratory work or HLA typing 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 HLA typing deceased donors?
- How does this evolved understanding help you identify when a deceased donor sample is problematic, typing results are ambiguous, or requires rapid expert review and troubleshooting, and when this is beyond your scope of practice?
- Looking holistically at your training journey, how has this initial deceased donor typing experience, revisited with your current perspective, contributed to your development in meeting the learning outcomes related to working accurately under pressure, rapid decision-making, technical proficiency in urgent assays, and adherence to strict protocols and timelines? For example, how this foundational experience has supported your development in transferable skills such as working accurately under pressure, rapid decision-making, technical proficiency in urgent assays, and adherence to strict protocols and timelines.
Relevant learning outcomes
| # | Outcome |
|---|---|
| # 1 |
Outcome
Perform appropriate testing for potential deceased solid organ donors. |
| # 7 |
Outcome
Practice in accordance with quality management and accreditation standards. |