Training activity information
Details
Assess and prepare semen samples for treatment, to include:
- gradient centrifugation
- swim-up technique
- surgically retrieved sperm samples e.g. PESA and microTESE
- frozen patient samples
- frozen donor samples
- retrograde samples
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
- Method selection
- Witnessing requirements
- Chain of custody
- In-house standard operating procedures
- Aseptic technique
- Infection control
- Record keeping and traceability
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 assessing and preparing the semen sample.
- Consider how the learning outcomes apply, specifically in relation to achieving the optimal sperm yield and motility for the chosen treatment.
- Discuss with your Training Officer to gain clarity of what is expected of you in relation to how you will determine if the preparation was successful based on post-preparation assessment.
What is your prior experience of this activity?
- Think about what you already know about techniques like gradient centrifugation and swim-up, and whether you have handled surgically retrieved or frozen sperm samples before.
- Consider possible challenges you might face during the activity, such as handling samples with low count or poor motility.
- 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 the post-preparation assessment indicates a sub-optimal yield.
- Acknowledge how you feel about embarking on this activity, especially with complex samples.
What do you anticipate you will learn from the experience?
- Consider the specific skills you want to develop, such as refining the execution of sperm preparation techniques.
- Identify the specific insights you hope to gain into how sample quality influences the choice and execution of preparation methods.
What additional considerations do you need to make?
- Consult actions identified following previous experiences of handling semen or surgically retrieved samples.
- Identify important information you need to consider before embarking on the activity, such as the SOPs for the specific preparation technique being used and whether the sample is fresh, frozen, or surgically retrieved.
In action
Is anything unexpected occurring?
- Are you noticing anything surprising or different from what you anticipate whilst assessing and preparing the semen sample?
- Are you encountering situations such as:
- A gradient or swim-up preparation yielding fewer motile sperm than anticipated?
- A frozen or surgically retrieved sample presenting unexpected handling difficulties?
How are you reacting to the unexpected development?
- How is this impacting your actions? For example, are you responding to the situation appropriately? Did you adapt the preparation technique or timing based on the initial assessment of the sample?
- Consider the steps you are taking in the moment, such as seeking input from a senior colleague before proceeding with an alternative method.
- How are you feeling in that moment? For instance, are you finding it difficult to work with a sample that didn’t behave as expected during processing? Is it affecting your confidence in optimising the preparation technique?
What is the conclusion or outcome?
- Identify how you are working within your scope of practice. For example, were you able to successfully prepare the sample for the intended treatment? Or are you needing support because the optimal post-preparation assessment indicates a sub-optimal yield?
- What are you learning as a result of the unexpected development? For example, are you mastering techniques for optimising preparation for different or challenging sample types in the moment?
On action
What happened?
- Begin by summarising the key steps you took when assessing and preparing the specific semen sample(s) for treatment. What preparation technique did you use (e.g., gradient, swim-up) and what was your reasoning for this choice?
- Consider specific events, actions, or interactions which felt important, such as the initial assessment of motility or the physical handling of a specific sample type, such as a surgically retrieved sample.
- Include any ‘reflect-in-action’ moments where you had to adapt to the situation as it unfolded, for instance, adjusting centrifugation speed or processing volumes based on the initial post-thaw assessment.
- How did you feel during this experience, e.g., did you feel determined to achieve an optimal yield or challenged by a low count sample?
How has this experience contributed to your developing practice?
- Identify what learning you can take from this experience regarding assessing and preparing semen samples. What strengths did you demonstrate, e.g., effective selection of the optimal preparation technique?
- What skills and/or knowledge gaps were evident, e.g., handling specific challenging samples like frozen or surgically retrieved sperm?
- Compare this experience against previous engagement with similar activities – were any previously identified actions for development related to sample preparation achieved? Has your practice improved in achieving optimal yield and motility for treatment?
- Identify any challenges you experienced, such as poor post-preparation assessment results or technical issues during density gradient centrifugation, and how you reacted to this. This might include needing to seek advice or clarification on scope of practice regarding the choice of technique for a complex sample type.
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 refining the execution of complex preparation techniques.
- What will you do differently next time you approach assessing and preparing a semen sample for treatment?
- Do you need to practise any aspect of the activity further, such as handling surgically retrieved sperm samples or key learning outcomes related to optimising sperm yield for treatment?
Beyond action
Have you revisited the experiences?
- How have your subsequent experiences of assessing and preparing semen samples for treatment since completing this specific training activity led you to revisit your initial approach or decisions during that activity? For example, how an instance where a subsequent case required preparation of a challenging sample forced you to re-evaluate the rationale behind selecting density gradient vs. swim-up techniques during your first attempt at this training activity.
- Considering what you understand about different sperm preparation methods and technique selection now, were the actions or considerations you identified after your initial reflection on this training activity sufficient?
- How have you since implemented or adapted improvements in your sample handling and processing techniques based on further learning and experiences? For example, how you proactively integrated observable behaviours and practices related to quality control and aseptic technique based on further learning or new technologies.
- Has discussing complex sample preparations or difficulties with surgically retrieved sperm with colleagues, peers, or supervisors changed how you now view your initial experience in this training activity? For example, how professional storytelling with a senior colleague about processing a low-yield sample refined your understanding of the complexities involved in sample preparation.
How have these experiences impacted upon current practice?
- How has the learning from this initial training activity, in combination with subsequent sample preparation experiences, contributed to your overall confidence and ability in sample preparation techniques, particularly in preparing for assessments like DOPS or OCEs? For example, how your accumulated practical skills developed in laboratory techniques and technique selection now enables you to confidently perform sample preparation, particularly processing surgically retrieved samples, during a Direct Observation of Practical Skills (DOPS) assessment.
- How has reflecting back on this specific training activity, combined with everything you’ve learned since, shaped your current approach to assessing and preparing semen samples? How does this evolved understanding help you identify when something is beyond your scope of practice or requires escalation? For example, how your evolved approach means you now routinely seek advice from your Training Officer immediately when the post-preparation assessment indicates a sub-optimal yield, requiring senior consultation on proceeding with the treatment or selecting an alternative method (i.e. IVF vs ICSI).
- Looking holistically at your training journey, how has this initial sample preparation experience, revisited with your current perspective, contributed to your development in meeting the learning outcomes related to achieving optimal sperm yield and motility for the chosen treatment? For example, how this foundational experience has supported your development in aseptic technique, critical assessment of sample suitability, and problem-solving, skills essential for all laboratory manipulation procedures.
Relevant learning outcomes
| # | Outcome |
|---|---|
| # 1 |
Outcome
Evaluate the suitability and prepare sperm for treatment. |
| # 2 |
Outcome
Outline the appropriate treatment pathways for patients based on the clinical parameters. |