Training activity information
Details
Select and interpret the appropriate techniques for the investigation of an inherited disorder of haemoglobin
Type
Developmental training activity (DTA)
Evidence requirements
Evidence the activity has been undertaken by the trainee.
Reflection on the activity at one or more time points after the event including learning from the activity and/or areas of the trainees practice for development.
An action plan to implement learning and/or to address skills or knowledge gaps identified.
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 are the intended outcomes of the training activity?
- How will you ensure you gain the detailed practical knowledge and experience required for the screening investigation and interpretation of inherited haemoglobin disorders?
- How will reviewing learning outcomes help you focus on the requirement to select and interpret rather than just perform the techniques?
- In what ways will you prepare to describe the limitations of the techniques used, such as electrophoresis or HPLC, in the context of specific clinical presentations?
- What steps will you take to ensure you can apply internal quality control (IQC) and external quality assessment (EQA) to draw valid conclusions about the performance of your assays?
- How will you demonstrate the communication skills necessary to present case results clearly to healthcare professional colleagues, including generating a differential diagnosis?
What do you anticipate you will learn from the experience?
- What specific insights do you hope to gain regarding the laboratory methods used to detect and characterise abnormal haemoglobins and thalassaemias?
- How do you anticipate this experience will improve your ability to interpret complex data, such as HPLC plots or gel electrophoresis patterns?
- What do you expect to learn about the correlation between genotype and phenotype in inherited haemoglobin disorders?
- How will this activity help you identify necessary downstream or reflex tests to aid in definitive disease classification?
- In what ways do you anticipate this activity will build upon your existing knowledge of red cell pathology to prepare you for the responsibilities of post-programme practice?
What actions will you take in preparation for the experience?
- How will you discuss the specific techniques (e.g., HPLC, electrophoresis, or molecular methods) with your training officer to ensure you understand the required protocols and standards?
- Which theoretical principles and clinical guidelines (such as BSH guidelines) for haemoglobinopathies and thalassaemias will you review beforehand to ensure analytical accuracy?
- How will you prepare for potential challenges, such as interpreting complex or overlapping electrophoretic patterns or understanding molecular reports?
- What resources, such as reference materials or case studies, will you identify to support your ability to reach a robust interpretation?
- How do you feel about embarking on this task, and what areas have you identified for focused preparation to increase your confidence in this specialised area?
In action
What are you doing?
- As you select specific techniques for the haemoglobinopathy screen (e.g., HPLC, gel electrophoresis, or DNA analysis), what is your rationale for choosing these specific methods for this patient’s clinical presentation?
- What methodological considerations are you prioritising during the setup, such as ensuring correct sample loading or buffer conditions?
- What real-time observations are you making—for example, identifying specific chromatography patterns or electrophoresis bands—and how are these influencing your immediate next steps?
- Which aspects of your practice feel intuitive due to your experience with protein or genetic assays, and which require more conscious effort, such as the precise interpretation of a complex genotype-phenotype correlation?
How are you progressing with the activity?
- How effective are your actions in achieving a clear separation or identification of abnormal haemoglobin variants?
- How are you applying the principles of internal quality control (IQC) as the run progresses to conclude that the assay performance is reliable before you proceed to interpretation?
- What limitations of the techniques are becoming apparent in the moment, such as overlapping peaks on an HPLC plot or the sensitivity of a specific electrophoresis method?
- How does this investigation connect to your existing knowledge of haemoglobin genetics, structure, and the molecular basis of thalassaemias?
How are you adapting to the situation?
- Based on your initial findings (e.g., the presence of an unknown peak or band), what downstream or reflex tests—such as molecular diagnostics or solubility tests—are you now considering to reach a definitive disease classification?
- How are you adapting your communication style to ensure you can present these emerging findings clearly to a healthcare professional colleague or specialist?
- What support or guidance might you need in this moment, such as consulting a molecular specialist or referring to established diagnostic guidelines, to resolve ambiguities in the data?
- Are you confident that your interpretations and technical decisions remain within your defined scope of practice?
On action
What did you notice?
- How would you summarise the key procedural elements you followed to select and interpret the most appropriate laboratory investigations—such as HPLC, gel electrophoresis, or molecular methods—for this specific inherited haemoglobin disorder?
- What were the significant observations or data patterns (e.g., specific chromatogram peaks or electrophoresis bands) that you focused on during the interpretation?
- How did you evaluate the internal quality control (IQC) and external quality assessment (EQA) data to draw valid conclusions about the reliability of the assay performance before finalising your results?
- What did you notice about your communication of the results and the case findings when presenting a differential diagnosis to your healthcare professional colleagues?
- Were there any unexpected technical challenges or findings, such as unusual patterns or difficulties in sample processing, and how did you manage these in the moment?
What did you learn from the activity?
- What new skills or knowledge did you develop regarding the diagnostic pathways and selection of techniques used to classify complex haemoglobinopathies or thalassaemias?
- How has this experience improved your ability to describe the practical limitations of the techniques you selected, and how did these limitations influence your final interpretation?
- In what ways did your reflection-in-action (decisions made as the investigation unfolded) influence the final outcome or the identification of necessary reflex tests?
- What insights did you gain into the correlation between genotype and phenotype, and how different laboratory results complement each other to reach a definitive diagnosis?
- How does this experience relate to the high-level interpretive and professional requirements of your future role as a Clinical Scientist in post-programme practice?
What will you take from the experience moving forward?
- What specific areas for continued development have you identified in your ability to select appropriate investigations or synthesize multidisciplinary data?
- How will you apply the learning from this activity to your routine laboratory practice, particularly when interpreting atypical results or identifying the need for downstream molecular testing?
- What specific ‘next steps’ will you now take, such as reviewing BSH guidelines or participating in multidisciplinary team (MDT) meetings, to support the assimilation of what you have learned?
- What support or resources, such as specialist mentoring or access to molecular genetics reference materials, would be beneficial for your ongoing development in this field?
Beyond action
Have you revisited the experiences?
- How has your understanding of the different types of haemoglobinopathies and thalassaemias, and the interpretation of various diagnostic tests (e.g., HPLC, electrophoresis, molecular testing), deepened as you evaluate your initial engagement with this task?
- When comparing this experience with training activities focusing on acquired anaemias or enzyme/membrane disorders, what key differences have you noted in the diagnostic approaches for inherited versus acquired conditions?
- As part of a module review, have any complexities in the interpretation of screening or diagnostic results become more apparent with further learning or exposure to different case scenarios?
- How has engaging in professional storytelling with colleagues about challenging cases of inherited haemoglobin disorders shed new light on your interpretation or diagnostic strategies?
How have these experiences impacted upon your current practice?
- How has this training activity helped you view investigations not as isolated incidents, but as a contribution to your broader expertise in diagnosing a range of haematological conditions?
- In what ways has your learning from this activity influenced your ability to interpret routine blood counts or morphology in individuals who may have an underlying, previously undetected haemoglobinopathy?
- How have you applied your knowledge of internal quality control (IQC) and external quality assessment (EQA) since the original experience to ensure your conclusions about assay performance are defensible?
- How has your proficiency in describing the limitations of techniques—such as the sensitivity of HPLC for specific variants—improved the quality of the diagnostic advice you provide to healthcare professional colleagues?
- How have these reflections supported your preparation for observed ‘in-person’ assessments, such as Case-Based Discussions (CBDs) or Direct Observations of Practical Skills (DOPS) related to haemolytic anaemias?
How might these experiences contribute towards your future practice?
- What transferable skills, such as the ability to integrate clinical history with complex laboratory findings or understanding the principles of genetic testing, will be most valuable in your future professional role?
- What clear actions for continued development have you identified, such as mastering the interpretation of complex molecular reports or understanding intricate genotype-phenotype correlations?
- How has the learning from this activity provided the necessary foundations for the high-level interpretive and analytical responsibilities required for post-programme professional practice?
Relevant learning outcomes
| # | Outcome |
|---|---|
| # 1 |
Outcome
Select techniques for the investigation of clinical presentations in haematology, haemostasis and transfusion science and medicine. |
| # 3 |
Outcome
Interpret the results of the laboratory investigations for cases including red and white cell disorders and haemostatic and platelet disorders, haematological malignancy and transfusion serology. |
| # 4 |
Outcome
Describe the limitations of techniques applied in the investigation of clinical presentations in haematology, haemostasis and transfusion science. |
| # 5 |
Outcome
Apply the principles of internal quality control and external quality assessment and draw conclusions about assay performance. |
| # 6 |
Outcome
Demonstrate appropriate communication skills to present the results of investigations and cases clearly to healthcare professional colleagues. |