Training activity information
Details
Take consent from a patient for storage of sperm for fertility preservation including a supportive conversation around options should a suitable sample not be produced
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
- 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
- Patient centred care and support
- Local patient support policy and Counselling services
- Acknowledgment of emotional difficulties
- Shared decision making
- Further options for failure to produce a sample
- Storage in paediatric patients
- Azoospermic samples
- When SSR may be appropriate
- Future potential of germ cell therapies
- Record keeping
- HFEA regulations
- BBV screening
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 when taking consent for sperm storage for fertility preservation, especially when discussing options if a suitable sample is not produced?
- What are the specific expectations of you, considering the relevant learning outcomes for this module, such as practicing safely in accordance with statutory and regulatory frameworks, and effectively explaining procedures to patients?
- What information would you need to discuss with your training officer to ensure clarity on expectations for this sensitive conversation?
- What do you already know about taking consent, communicating sensitive medical information, or discussing fertility preservation options with patients?
- What possible challenges do you anticipate might arise during this conversation (e.g., patient emotional distress, complex information, uncertainty about outcomes), and how might you prepare to handle them?
- Have you considered the scope of your own practice for this activity? When would you need to seek advice or help, and from whom (e.g., a counsellor, multidisciplinary team, your training officer)?
- What specific communication skills do you aim to develop or refine, especially regarding providing supportive conversations during potentially difficult discussions about sample production outcomes?
- What specific insights do you hope to gain about patient perspectives on fertility preservation, the consent process, or effective ways to manage expectations?
- Are there any actions identified following previous experiences with similar patient interactions or consent processes that you should consult?
- What important information do you need to consider before this activity, such as detailed HFEA regulations regarding sperm storage, the financial impacts for the patient, or the available counselling support for individuals or couples facing infertility?
In action
- As you are taking consent and discussing options for fertility preservation, what feels surprising or different from what you anticipated? For example, is the patient reacting in a way you didn’t expect to the discussion about the possibility of not producing a suitable sample?
- How does this experience compare with any previous experiences you’ve had with sensitive patient conversations or consent processes?
- Is the patient’s emotional state or questions differing from what you’ve encountered before?
- Think about any unexpected moments, how are these impacting on your actions?
- Are you responding to the situation appropriately, or are you needing to adapt or change your approach during the conversation? For instance, if the patient is becoming distressed, are you pausing or altering your communication style?
- How do you feel in the moment? Do you find it difficult to adapt, is it affecting your confidence, or do you feel positive that you can guide the conversation to a successful conclusion, enabling informed consent?
- Consider the entire interaction, how are you ensuring you work within your scope of practice, especially when you discuss sensitive topics or potential outcomes?
- Are you identifying when you might need to seek further advice?
On action
- Begin by summarising the key points of the consent conversation and the discussion around options if a suitable sample was not produced.
- Consider any specific events, actions, or interactions that felt important, including your own feelings during the experience. For example, did the patient ask unexpected questions, express strong emotions, or did you feel particularly challenged by a certain part of the conversation?
- Include any ‘reflect-in-action’ moments, where you adapted your approach or behaviour as the situation unfolded. How did these real-time adjustments impact the flow of the conversation?
- Identify what learning you can take from this experience. What strengths did you demonstrate in your communication, in explaining the procedure, or in managing the sensitive discussion? What skills and/or knowledge gaps were evident, particularly regarding HFEA regulations or patient support?
- Compare this experience against previous engagement with similar activities. Were any previously identified actions for development achieved? Has your practice improved in areas like empathy, clarity, or handling difficult news?
- Identify any challenges you experienced and how you reacted to these. Did this affect your ability to deal with the situation 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 consent process. Or did you need to escalate the situation to ensure you were working within your scope of practice?
- 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 take consent for fertility preservation, especially concerning sensitive discussions?
- 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, perhaps refining your explanation of options or your supportive communication techniques?
Beyond action
- Considering all your past experiences of taking consent for sperm storage and discussing sensitive topics, what actions did you identify for improvement in previous reflections on this training activity?
- Have you successfully implemented these actions in more recent attempts, demonstrating this new learning in your practice?
- Has your view of the situation or your approach to consent conversations changed as a result of discussing it with others?
- Reflecting on your collective experiences, how will the learning gained from repeatedly engaging with this training activity support you in preparing for assessments, particularly those related to explaining procedures or obtaining consent?
- How has your practice in taking consent and having supportive conversations developed and evolved over time?
- Can you now more confidently identify when something is beyond your current scope of practice, and when you need to seek further advice or assistance during such sensitive discussions?
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. |