Specialist Haematology Copy —
Training activity: 17

Details

Prepare and present a case study for the investigation of a of bone marrow failure syndrome

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.

Considerations

• Sample requirements
• Clinical presentation
• Testing algorithms
• Patient treatment pathway
• Local SOPs
• National and international guidelines

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 background knowledge about different bone marrow failure syndromes (e.g., aplastic anaemia, myelodysplasia), their investigation, and case study presentation is needed?
• What insights do you hope to gain regarding the diagnostic workup for these complex conditions, including the role of morphology, cytogenetics, and other relevant investigations?
• What is your current understanding of the different types of bone marrow failure and their distinguishing features?
• How will you prepare the case study (e.g., selecting a relevant case, reviewing the clinical picture and laboratory findings)?
• What potential difficulties might you face during the preparation or presentation (e.g., integrating complex data, discussing prognosis), and how will you plan to overcome them?
• How do you feel about preparing and presenting a case on bone marrow failure?

In action

• During the preparation of the case study, how are you structuring the information to clearly present the diagnostic challenges and the thought process involved?
• As you present the case, how are you adapting your explanation to ensure the audience understands the complexities of bone marrow failure syndromes?
• If questions arise regarding alternative diagnoses or further investigations, how are you responding and justifying your approach in the moment?
• Are you reflecting on the effectiveness of your communication and the clarity of the case presentation as it unfolds?

On action

• What were the key clinical features and laboratory findings (including peripheral blood counts, morphology) of the bone marrow failure syndrome case you presented?
  • What further investigations (e.g., bone marrow aspirate and trephine findings, cytogenetics, molecular tests, specialised tests like PNH clones) were relevant to the case?
  • How did you structure your case presentation to clearly outline the diagnostic process and challenges?
  • What questions or discussion points arose from your presentation?
• What are the different categories and specific examples of bone marrow failure syndromes?
  • What is the role of comprehensive laboratory investigations, including morphology and ancillary studies, in diagnosing and differentiating these syndromes?
  • What are the challenges in diagnosing bone marrow failure, given the potential for overlapping features between different conditions?
  • How important is the correlation of clinical findings with laboratory results in these cases?
• How will this experience improve your ability to prepare and present complex haematological cases, particularly those involving diagnostic challenges?
  • What key laboratory tests and their interpretation will you focus on when investigating potential bone marrow failure?
  • How will you communicate the complexities of such cases to colleagues and in multidisciplinary team meetings?

Beyond action

• Have you prepared or presented other case studies involving bone marrow failure syndromes since this training activity? How did your approach to investigation and presentation evolve?
• Have you reviewed your initial reflect-on-action notes from this presentation? What aspects of understanding and presenting the complex investigation of bone marrow failure do you now view differently?
• Can you recall discussions or situations where your understanding of the laboratory investigation of bone marrow failure syndromes (e.g., aplastic anaemia, myelodysplastic syndromes) was relevant?
• Has this training activity improved your ability to synthesise complex clinical and laboratory data in the context of bone marrow failure?
• Do you feel more confident in discussing the laboratory findings and differential diagnoses related to bone marrow failure syndromes with other healthcare professionals?
• Has preparing this case study enhanced your understanding of the multidisciplinary approach required in the investigation and management of these conditions?
• Have the skills in information gathering, critical analysis, and communication developed through this activity been transferable to other areas of your professional practice?
• How will your experience in preparing and presenting complex cases of bone marrow failure be valuable in future educational or professional settings?
• Will your understanding of the laboratory’s role in diagnosing and classifying bone marrow failure syndromes contribute to your ability to work effectively within multidisciplinary teams?
• How might this experience inform your future development in areas such as haematopoietic stem cell transplantation or supportive care for patients with bone marrow failure?

Relevant learning outcomes

#	Outcome
# 3	Outcome Perform a range of laboratory and molecular testing techniques to diagnose and monitor treatment of haematological malignancy in the correct clinical context, including the interpretation and reporting of results.
# 4	Outcome Interpret and comply with national and international guidelines on the diagnosis and management of haematological cancer.
# 7	Outcome Perform quality assurance and control tasks across the range of investigations.