Training activity information
Details
Discuss with patient’s, oocyte/embryo survival and next steps following thawing/warming
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
- Implications for treatment
- Number of embryos to transfer
- In-house standard operating procedures
- Confirm patient identify
- Record keeping
- Effective communication of scientific information in an understandable manner to patients
- Breaking bad news
- Patient centred care and support
- Patient pathway
- Methods of patient support
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 communicating with patients about the outcome of thawing or warming their cryopreserved oocytes or embryos and discussing the subsequent steps in their treatment pathway.
- Consider how the learning outcomes apply, specifically in relation to applying and adapting skills to communicate effectively with patients and appraising the impact of cryopreservation on viability.
- Discuss with your Training Officer to gain clarity of what is expected of you in relation to how to outline appropriate treatment pathways based on survival rates.
What is your prior experience of this activity?
- Think about what you already know about communicating sensitive or potentially difficult information to patients.
- Consider possible challenges you might face during the activity, such as discussing survival rates, especially if they are not optimal, and outlining subsequent treatment options.
- 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 may need to seek advice from your Training Officer when required, for example, if the patient has changed their mind on the number of embryos to thaw and replace. Acknowledge how you feel about undertaking this communication, which requires both clinical knowledge and strong interpersonal skills.
What do you anticipate you will learn from the experience?
- Consider the specific skills you want to develop, such as refining specific communication skills through this interaction.
- Identify the specific insights you hope to gain into tailoring communication approach to different patient needs and responses.
What additional considerations do you need to make?
- Consult actions identified following previous experiences of patient interactions or Observed Communication Events (OCEs).
- Identify important information you need to consider before embarking on the activity, such as reviewing the patient’s clinical history and specific outcomes, preparing survival statistics, or potential next steps (e.g., options for further treatment).
In action
Is anything unexpected occurring?
- Are you noticing anything surprising or different from what you anticipate whilst communicating the survival rate and next steps?
- Are you encountering situations such as:
- The patient exhibits severe, unexpected emotional distress or anger in response to the outcome
- The patient raises complex ethical or legal questions about the future use of the cells that exceed routine discussion protocols
- A communication barrier (e.g., misunderstanding due to lay language, hearing impairment) arises unexpectedly
How are you reacting to the unexpected development?
- How is this impacting your actions? For example, are you responding to the situation appropriately? Are you adapting or changing your approach to communication style or content?
- Consider the steps you are taking in the moment, such as immediately adjusting your language to simpler phrasing and using open-ended questions to check comprehension.
- How are you feeling in that moment? For instance, are you finding it difficult to maintain composure while managing patient distress? Is it affecting your confidence in explaining the subsequent treatment pathway?
What is the conclusion or outcome?
- Identify how you are working within your scope of practice. For example, are you successfully managing patient anxiety through empathetic communication and clarifying the next steps? Or are you needing support because the patient requires professional emotional support or detailed legal clarification that falls outside the scope of your communication role?
- What are you learning as a result of the unexpected development? For example, are you gaining insight into the critical role of empathetic communication in delivering sensitive clinical outcomes?
On action
What happened?
- Begin by summarising the key steps you took when discussing the survival rate and subsequent steps in their treatment plan with the patient.
- Consider specific events, actions, or interactions which felt important, such as how you structured the discussion to convey information about survival and next steps.
- Include any ‘reflect-in-action’ moments where you had to adapt to the situation as it unfolded, for instance, immediately adjusting your communication style to simplify complex outcomes when the patient expressed confusion.
- How did you feel during this experience, e.g., challenged by the need to manage patient emotion and maintain composure?
How has this experience contributed to your developing practice?
- Identify what learning you can take from this experience regarding communicating complex information sensitively. What strengths did you demonstrate, e.g., empathy and clarity when outlining subsequent treatment options?
- What skills and/or knowledge gaps were evident, e.g., difficulty addressing complex ethical questions about the future use of oocytes?
- Compare this experience against previous engagement with similar activities – were any previously identified actions for development achieved? Has your communication practice improved in applying and adapting your communication skills?
- Identify any challenges you experienced, such as patient distress or unexpected questions about legal constraints and how you reacted to this. This might include needing to seek advice or clarification on scope of practice regarding offering additional emotional support or escalating ethical queries and how you reacted to this.
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 your patient communication strategy for delivering sensitive results.
- What will you do differently next time you approach discussing cryopreservation outcomes, for instance, by proactively preparing for potential questions regarding post-thaw outcome variability and future options?
- Do you need to practise any aspect of the activity further, such as explaining survival rates or outlining treatment options or key learning outcomes related to applying and adapting communication skills with patients?
Beyond action
Have you revisited the experiences?
- How have your subsequent experiences of patient communication activities involving difficult news or complex information since completing this specific training activity led you to revisit your initial approach or decisions during that activity? For example, a subsequent interaction requiring highly empathetic communication due to emotional distress forced you to re-evaluate the clarity and structure of your initial explanation of survival rates and next steps during your first attempt at this training activity.
- Considering what you understand about sensitive communication, emotional impact of outcomes, and management of patient expectations 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 sensitive communication skills and explanations of clinical outcomes based on further learning and experiences? For example, how you proactively integrated observable behaviours and practices related to sensitive communication, managing patient expectations, or explaining clinical outcomes based on further learning.
- Has discussing patient communication challenges or the emotional impact of cryopreservation outcomes on patients 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 a difficult conversation regarding low survival rates refined your understanding of the critical nature of empathetic communication and patient support.
How have these experiences impacted upon current practice?
- How has the learning from this initial training activity, in combination with subsequent patient communication experiences, contributed to your overall confidence and ability in explaining complex concepts and managing patient expectations, particularly in preparing for assessments like DOPS or OCEs? For example, how your accumulated skills in empathetic communication, active listening, and explaining technical information clearly now enable you to confidently perform a thorough and compassionate discussion of survival rates and next steps during an Observed Communication Event (OCE) assessment.
- How has reflecting back on this specific training activity, combined with everything you’ve learned since, shaped your current approach to patient communication involving sensitive clinical information? 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 immediately when a patient raises complex ethical, legal, or severe emotional concerns, recognising that these issues require support beyond routine discussion and fall outside the scope of your communication role.
- Looking holistically at your training journey, how has this initial discussion experience, revisited with your current perspective, contributed to your development in meeting the learning outcomes related to appraising the impact of cryopreservation on viability and applying and adapting skills to communicate effectively with patients? For example, how this foundational experience has supported your development in empathetic communication, managing difficult conversations, and explaining complex concepts like survival rates or alternative treatment pathways, enhancing your awareness of the emotional impact of cryopreservation outcomes on patients.
Relevant learning outcomes
| # | Outcome |
|---|---|
| # 4 |
Outcome
Appraise the impact of cryopreservation on viability of gametes and embryos. |
| # 6 |
Outcome
Apply and adapt skills to communicate effectively with patients and the multidisciplinary team. |