Back Module: S-HT-S2

Specialist Haematology

Module information

Module details

Title
Specialist Haematology
Type
Specialist
Module code
S-HT-S2
Credits
20
Phase
3
Requirement
Optional

Aim of this module

The module will provide the trainee with experience of the clinical and laboratory investigation and management of congenital and acquired bleeding disorders and management of thrombophilia. The trainee will gain experience of the clinical and laboratory investigation and management of haematological malignancy. This module will also provide an understanding and experience of the investigation of disorders of red and white blood cells.

Work-based content

Training activities

# Learning outcome Training activity Type Action
# 1 Learning outcome 1,2,7 Training activities

Devise and perform a protocol to investigate a prolonged prothrombin time (PT) and activated partial thromboplastin time (APTT)

 Type ETA Action View
# 2 Learning outcome 1,2,7 Training activities

Select appropriate tests for monitoring all types of anticoagulation therapy to include:

  • INR
  • Anti Xa based test
 Type ETA Action View
# 3 Learning outcome 1,2,7 Training activities

Perform, compare and contrast the results for a single analyte using two of the following methods:

  • Clotting based test,
  • Chromogenic based test
  • Immunological based test
 Type DTA Action View
# 4 Learning outcome 1,7 Training activities

Perform and troubleshoot analyser calibration

 Type DTA Action View
# 5 Learning outcome 1,7 Training activities

Validate and verify a test using a new reagent

 Type DTA Action View
# 6 Learning outcome 1,2,7 Training activities

Select, perform and interpret the appropriate tests for screening for a micro angiopathic haemolytic anaemia for example DIC and TTP

 Type ETA Action View
# 7 Learning outcome 1,7 Training activities

Prepare and present a case study for the investigation of a non accidental injury

 Type DTA Action View
# 8 Learning outcome 1,2,7 Training activities

Perform an inhibitor screen and calculate the level in Bethesda units

 Type DTA Action View
# 9 Learning outcome 1,2,7 Training activities

Perform testing to investigate a potential platelet disorder or antiplatelet therapy

 Type DTA Action View
# 10 Learning outcome 1,2,7 Training activities

Select, perform and interpret the appropriate tests for easy bruising, bleeding or menorrhagia

 Type ETA Action View
# 11 Learning outcome 3,4,7 Training activities

Select, perform and interpret for the investigation of a haematological malignancy to include investigation by:

  • Morphology
  • Immunophenotyping
  • Molecular
  • Karyotyping/cytogenetics
 Type DTA Action View
# 12 Learning outcome 3,4,7 Training activities

Identify and annotate the normal morphological features of a bone marrow aspirate and a bone marrow trephine

 Type DTA Action View
# 13 Learning outcome 3,4,7 Training activities

Select, perform and interpret diagnostic techniques for the investigation of acute myeloid leukaemia (AML) and myelodysplastic syndromes (MDS)

 Type DTA Action View
# 14 Learning outcome 3,4,7 Training activities

Select, perform and interpret diagnostic techniques for the investigation of myeloproliferative neoplasms (MPN) and chronic myelogenous leukaemia (CML)

 Type DTA Action View
# 15 Learning outcome 3,4,7 Training activities

Select, perform and interpret diagnostic techniques for the investigation of acute lymphoblastic leukaemia (ALL) in paediatric and adult populations

 Type DTA Action View
# 16 Learning outcome 3,4,7 Training activities

Select, perform and interpret diagnostic techniques for the investigation of mature lymphoid neoplasms to include:

  • Chronic lymphocytic leukaemia
  • Monoclonal B lymphocytosis
  • Plasma cell myeloma
 Type DTA Action View
# 17 Learning outcome 3,4,7 Training activities

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

 Type DTA Action View
# 18 Learning outcome 5,6,7 Training activities

Select, perform and interpret diagnostic techniques for the investigation of dietary-related anaemia

 Type ETA Action View
# 19 Learning outcome 5,6,7 Training activities

Select, perform and interpret diagnostic techniques for the investigation of antenatal Haemoglobinopathy and thalassaemia testing in line with the national screening programme

 Type DTA Action View
# 20 Learning outcome 5,7 Training activities

Interpret morphological and FBC features associated with infectious aetiology and identify further investigations to confirm the underlying cause to include:

  • Malaria
  • Infectious mononucleosis
  • Bacterial infections/sepsis
 Type ETA Action View

Assessments

Complete 4 Case-Based Discussions

Complete 4 DOPS or OCEs

Direct Observation of Practical Skills Titles

  • Perform the initial morphological investigation for an acute leukaemia and determine confirmatory testing.
  • Perform the initial morphological investigation for a chronic leukaemia and determine confirmatory testing.
  • Investigate a positive haemoglobinopathy screen as per the national screening programme.
  • Investigate a patient with unexplained bleeding as per national guidelines.
  • Perform a thrombophilia screen and use national guidelines to recommend further testing.
  • Determine the cause of a prolonged APTT as per hospital SOPs.

Observed Clinical Event Titles

  • Discuss follow on testing with another healthcare professional.
  • Communicate the results of a positive antenatal test to the antenatal team.
  • Present a case to other healthcare professionals.
  • Discuss the implications of prenatal diagnosis of suspected hemoglobinopathy.
  • Discuss the implications of anticoagulation therapy including the choice of drug.
  • Communicate the risk of bleeding to a surgical team on completion of investigation of abnormal screening results.

Learning outcomes

# Learning outcome
1

Identify appropriate clinical and laboratory investigations for the investigation of haemostasis.
2

Interpret and report results of investigations of haemostasis in the correct clinical context.
3

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

Interpret and comply with national and international guidelines on the diagnosis and management of haematological cancer.
5

Perform a range of laboratory-based techniques to investigate anaemia, red cell disorders and white cell disorders.
6

Identify appropriate clinical and laboratory investigations and outline the management of acquired and hereditary red cell disorders.
7

Perform quality assurance and control tasks across the range of investigations.

Clinical experiences

Clinical experiences help you to develop insight into your practice and a greater understanding of your specialty's impact on patient care. Clinical experiences should be included in your training plan and you may be asked to help organise your experiences. Reflections and observations from your experiences may help you to advance your practice and can be used to develop evidence to demonstrate your awareness and appreciation of your specialty.

Activities

  1. Attend an obstetric/haematological antenatal clinic to appreciate the management of the pregnancy and patient experience.
  2. Attend a multidisciplinary team meeting where a haematological malignancy or haemostasis case is discussed.
  3. Attend a haematological malignancy clinic to appreciate the interaction between healthcare professionals and the patient.
  4. Attend a haemostasis clinic to appreciate the interaction between healthcare professionals and the patient.
  5. Attend and observe an anticoagulation clinic to appreciate the patient self-testing involved in managing their conditions.
  6. Attend a pre-surgical meeting/clinic appointment for a patient with a recognised bleeding disorder or thrombophilia, who requires surgery.

Academic content (MSc in Clinical Science)

Important information

The academic parts of this module will be detailed and communicated to you by your university. Please contact them if you have questions regarding this module and its assessments. The module titles in your MSc may not be exactly identical to the work-based modules shown in the e-portfolio. Your modules will be aligned, however, to ensure that your academic and work-based learning are complimentary.

Learning outcomes

On successful completion of this module the trainee will be able to:

  1. Evaluate the design, operation and performance of laboratory, molecular and point-of-care techniques used in the investigation of bleeding disorders.
  2. Appraise the diagnosis and management of bleeding disorders, evaluating the causes, risks, diagnosis and treatment options for thrombophilia.
  3. Explain the classification and aetiology of red cell disorders and haematological malignancies, evaluating the design, operation and performance of laboratory and molecular techniques used in the investigation and management of these.
  4. Apply integrative knowledge to differentiate the morphological features associated with red cell disorders, haematological malignancies and infectious aetiologies.
  5. Evaluate the principles and mechanisms of treatment for red cell disorders and haematological malignancies, including the importance and implementation of national guidance and working in partnership with other clinical specialisms.

Indicative content

  • Hereditary and acquired primary and secondary bleeding disorders, including nature and sites of bleeding and risks associated with severity.
  • Hereditary and acquired thrombotic disorders, including structure and aetiology of thrombus formation and relative risk and environmental factors.
  • The genetic basis and functional defects of hereditary bleeding and thrombotic disorders.
  • Disseminated intravascular coagulation (DIC).
  • Principles, scientific basis range and selection of analytical procedures applied in the investigation of bleeding and thrombotic disorders.
  • Presentation and laboratory investigation of bleeding and thrombotic disorders, and relevant BSH guidelines.
  • Clinical interpretation of diagnostic results, treatment strategies and management (including clotting factor replacement therapy, anticoagulant therapy, and prophylaxis).
  • Familial studies.
  • National guidelines.
  •  WHO classification.
  • Myeloid malignancies.
  • Lymphoid malignancy.
  • Overview of rare haematological malignancy, HLH, TAM, blastic dendritic cell, and systemic mastocytosis.
  • Iron metabolism, iron overload and iron deficiency. Anaemia of chronic disease and hepcidin.
  • B12/folate metabolism, pernicious anaemia, B12 and/or folate deficiency. Drug interference in folate metabolism.
  • Overview of haemolytic anaemia.
  • Malaria and inherited anaemias (haemoglobinopathy, thalassaemia, enzymopathy and membrane).
  •  Current concepts on the aetiology, pathogenesis and molecular mechanisms of:
    • AML
    • MPS
    • MPN
    • ALL
    • Mature lymphoid neoplasms
    • Bone marrow failure syndromes
    • Dietary-related anaemias
    • Hereditary anaemias
    • Haemolytic anaemias
  • Diagnosis, management and treatment and monitoring strategies for the aforementioned conditions, with a focus on current guidelines.
  • Principles of chemo- and radio-therapy and the rationale behind Medical Research Council (MRC) AML and ALL clinical trials.
  • Prognostic and survival statistics for haematological malignancies.
  • IQC and EQA
  • BSH, WHO and NICE guidelines.
  • The partnership between the haematology discipline and other clinical specialisms in the investigation of bleeding disorders, the investigation and management of haematological conditions and patient care.

Module assigned to

Specialties

Specialty code Specialty title Action
Specialty code SLS1-2-22 Specialty title Haematology & Transfusion Science [2022] Action View
Specialty code SLS1-2-23 Specialty title Haematology & Transfusion Science [2023] Action View
Specialty code SLS1-2-24 Specialty title Haematology & Transfusion Science [2024] Action View
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