Training activity information
Details
Discuss with a patient the duration of consent and storage for gametes to include:
- Legal limits of consent
- Consent for posthumous use
- Extension of consent beyond initial storage period and review
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
- Incapacity to consent
- Difficult conversations around posthumous use
- UK legal framework for consent and implications after death
- Assessment of ongoing fertility impairment
- Introductions and confirming patient identity
- Communication of complex information to non-experts
- Two-way communication to ensure patient awareness of procedures
- Expectation management
- Awareness of limitations
- Local patient support policy and counselling services
- Acknowledgment of emotional difficulties
- Shared decision making
- HFEA Code of Practice
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
- How will you define success in discussing the duration of consent and storage for gametes, encompassing legal limits, posthumous use, and extensions of consent?
- What are the specific expectations of you regarding compliance with statutory and regulatory frameworks (e.g., HFEA Code of Practice and consent forms) and clear communication to enable informed consent?
- What should you discuss with your training officer to gain clarity on the intricacies of these discussions and the specific regulations?
- What do you already know about HFEA regulations, legal limits of consent, or sensitive discussions around posthumous use of gametes?
- What possible challenges might you face (e.g., patient emotional responses to discussions about future use, complex legal terminology, cultural or religious sensitivities), and how might you prepare to handle them?
- When would you need to seek advice or help regarding legal interpretation, ethical considerations, or patient support during this discussion, and from whom?
- How do you feel about embarking on this training activity, especially given the sensitive nature of some topics?
- What specific skills do you want to develop, such as explaining complex legal information clearly, addressing sensitive topics like posthumous use, or navigating patient questions about the duration of consent and storage?
- What specific insights do you hope to gain regarding patient understanding of long-term gamete storage implications, the practical application of HFEA consent regulations, or effectively managing discussions about the future use of gametes?
- Have you reviewed any actions identified following previous similar discussions or experiences related to HFEA compliance or consent processes?
- What important information do you need to consider before this discussion, such as the latest HFEA guidelines, specific patient circumstances, or available counselling resources for implications of consent withdrawal or posthumous use?
In action
- While discussing the duration of consent, including legal limits, posthumous use, and extensions, does anything feel surprising or different from what you anticipated? For example, is the patient raising unexpected legal questions, expressing strong emotions about posthumous use, or having misconceptions about storage limits?
- How is this experience comparing with any previous experiences you’ve had explaining complex regulations or discussing sensitive future-related topics with patients?
- How are any unexpected developments impacting on your actions?
- Are you responding to the situation appropriately, or are you needing to adapt or change your approach to ensure clear communication and facilitate understanding? For instance, if the patient is struggling with a specific legal concept, how are you re-explaining it?
- How do you feel in the moment? Do you find it difficult to adapt your explanation, is it affecting your confidence in conveying the information, or do you feel positive that you are reaching a successful conclusion, ensuring the patient fully understands the implications?
- Throughout the discussion, how are you working within your scope of practice?
- Do you need to recognise any points where seeking advice or help might be necessary, perhaps regarding legal nuances or ethical dilemmas?
- What are you learning in the moment from any unexpected questions or adaptations you are making during the discussion about gamete storage duration and consent?
On action
- Begin by summarising the key points of the discussion regarding the duration of consent and storage for gametes, including legal limits, posthumous use, and extensions.
- Consider any specific events, actions, or interactions that felt important, including your own feelings during the experience. For example, did the patient raise complex legal queries, express strong emotions about posthumous use, or struggle to grasp certain concepts?
- Include any ‘reflect-in-action’ moments, where you adapted your communication style or explanations as the discussion unfolded.
- Identify what learning you can take from this experience.
- What strengths did you demonstrate in explaining complex legal information or handling sensitive topics like posthumous use?
- What skills and/or knowledge gaps were evident, perhaps concerning specific HFEA regulations or counselling aspects?
- Compare this experience against previous engagement with similar activities. Were any previously identified actions for development achieved?
- Has your practice improved in terms of clarity, accuracy of information, or managing patient expectations regarding long-term storage?
- Identify any challenges you experienced and how you reacted to these. Did this affect your ability to convey information independently, or were you able to overcome the challenges effectively?
- Identify anything significant about the activity, such as if you needed to seek advice or clarification during or after the discussion. Or did you need to escalate the situation to ensure that you were working within your scope of practice, especially concerning legal or ethical boundaries?
- Identify the actions or ‘next steps’ you will now take to support the assimilation of what you have learnt. This includes any feedback you may have received. For instance, what will you do differently next time you discuss gamete storage duration and consent, particularly regarding the most sensitive aspects?
- Has anything changed in terms of what you would do if you were faced with a similar situation again?
- Do you need to practise any aspect of the activity further, such as explaining legal terminology in simpler terms or addressing patient concerns about future use?
Beyond action
- Looking back at your various attempts to discuss gamete consent duration and complex topics like posthumous use, what specific actions did you previously identify to improve your practice?
- Have you consistently applied these improvements, demonstrating a higher level of competence and confidence in subsequent discussions?
- Has gaining different perspectives from others changed your understanding or approach to explaining legal limits, posthumous use, or consent extensions? What transformative insights have emerged from these shared reflections?
- Considering your accumulated learning from this training activity, how will this knowledge and skill development prepare you for relevant assessments, such as explaining posthumous use of gametes to a patient or examining HFEA consents for appropriateness and accuracy?
- How has your ability to explain complex regulatory information and manage sensitive discussions developed and evolved over time?
- Are you now more adept at navigating nuanced patient questions regarding consent and storage, and are you clearer on when you need to seek expert legal or ethical advice?
Relevant learning outcomes
| # | Outcome |
|---|---|
| # 2 |
Outcome
Practice safely in accordance with the statutory and regulatory framework. |
| # 3 |
Outcome
Explain procedures to patients, facilitating understanding to enable informed consent to be provided. |
| # 4 |
Outcome
Apply and adapt skills to communicate effectively with patients and the multidisciplinary team. |