Module - Immunity and the Principles and Practice of Clinical Immunology (SLS103)

STP

Aim of this module

This module will provide the trainee with an introduction to the immune system and immune responses. They will understand the organisation and delivery of a clinical immunology laboratory service. In the work-based module they will be expected to apply this knowledge as they learn to perform some common methods used in clinical immunology and gain an understanding of the interpretation of patient results in a variety of clinical settings.

Work-based learning outcomes


  1. Interpret routine requests for common clinical immunology investigations in the correct clinical context and process the specimens that accompany those requests.
  2. Use laboratory IT systems for handling, processing and storage of patient data.
  3. Perform a range of laboratory techniques used in the workplace in clinical immunology.
  4. Report the results of commonly performed clinical immunology investigations of major organ function.
  5. Apply the principles of internal quality control and external quality assessment and draw conclusions about assay performance.

 

 

Work-based Competencies


Learning outcome Title Knowledge
1 1,2

Identify the most appropriate test for at least two example clinical presentations.

  • The repertoire, specimen requirements, referral pattern and storage, ordering, reference ranges and turnaround times of the methods used in Clinical Immunology.
  • The major clinical users of the immunology service for protein tests, autoantibody tests and allergy tests.
  • The range of investigative techniques used in Clinical Immunology and their application.
2 1,2

Receive, label and store of a wide range of immunological specimens.

  • Minimum data set required for identification of samples and the importance of ensuring that this is complete and correct.
  • Factors affecting sample integrity and appropriate corrective action.
  • Procedures for handling samples which may contain category 2,3 and 4 pathogens.
  • Types and implications of hazards and risks associated with handling of specimens and relevant control measures.
  • The quality management process that ensures the correct location and storage of documentation and specimens at each stage of process.
  • Safe laboratory practices, including principles of decontamination of equipment and work areas.
  • Local and national health and safety policies and procedures and their application.
  • Relevant records, their importance and how to complete these correctly.
  • Correct use of manual and computerised systems for generating labels for the products and components.
  • Specimen preservation, distribution, separation, storage and disposal procedures.
3 3,5

Select and apply appropriate control materials.

  • Selection and use of suitable and appropriate control materials.
  • Use and application of reagents for analysis.
  • Correct conditions and locations for storage of test reagents.
4 3,5

Use automated methods, techniques and instrumentation to include at least four of the following:

  • protein analysis
  • immunoassay
  • nephelometry/turbidimetry
  • electrophoresis
  • immunofixation
  • iso-electric focusing
  • densitometry
  • immunoblotting
  • immunodiffusion
  • immunofluorescence
  • microscopy
  • agglutination assays
  • flow cytometry
  • allergy testing.
  • Capabilities and limitations of methods, techniques and equipment.
  • Use, care, monitoring, calibration and routine maintenance of clinical immunology laboratory equipment to include (relevant to automated methods available) from the following list:
    • pipettes
    • balances
    • centrifuges
    • refrigerators
    • water baths
    • incubators
    • pH meters
    • freezers
    • radioactive counters,
    • sample preparation units
    • automated analysers.
5 1,4,5

Interpret laboratory data in light of clinical details on patients with common disorders where the immune system is dysfunctional, including at least two of the following:

  • protein disorders
  • autoimmune disorders
  • immunodeficiency disorders
  • basic allergy testing.
  • Organisation and components of the immune system.
  • Immunoglobulins, complement and opsonins.
  • Inflammatory markers.
  • Ranges and values needed for interpretation of results.
  • Cellular components (lymphocytes; granulocytes; monocytes/macrophages).
  • Humoral components (autoantibodies: the range of autoantibodies and the role they play in autoimmune disease; immunoglobulins: importance of their levels and their absence; complement: importance of their levels and their absence).
  • Central molecules of the immune system (major histocompatibility molecules class I & II; CD molecules/cell surface markers; receptor molecules; recognition molecules; adhesion molecules; effector molecules). Majority are used in conjunction with flow cytometry. It will be important to have a basic knowledge of their use in a clinical immunology laboratory and in which diseases their levels and absence is crucial.
  • Antigen presentation.
  • Innate immune response (endothelial cells; neutrophils; macrophages; natural killer cells; complement). Have a basic working knowledge of which of the components of the innate immune system routine assays can be usefully examined in a clinical immunology laboratory and in which suspected key diseases such assays are performed.
  • Adaptive immune response (antigen processing; dendritic cells; T cell responses; B cell responses; primary and secondary responses; vaccination/immunisation). Have a basic working knowledge of which of the components of the adaptive immune system routine assays can be usefully examined in a clinical immunology laboratory and in which suspected key diseases such assays are performed.
  • Outcome of immune responses (immunity/immunological memory; direct and indirect functions of antibodies; incidental tissue damage; hypersensitivity and allergy).
  • Causes and physiological basis of allergy caused by IgE involvement. Have a good basic working knowledge of the major assay performed in clinical immunology laboratories that aid the diagnosis of suspected allergic reactions.
  • Hypersensitivity causes and physiological factors. Have a good basic working knowledge of the major assays performed in a clinical immunology laboratory that will aid in the diagnosis of severe hypersensitivity reactions.
6 1,2,4

Produce basic interpretative reports on immunological investigations.

  • The information to be included in an interpretative report.
  • How to construct an interpretative report and the format required for presentation.
  • Limits of responsibility in the authorisation and issue of interpretative reports.
  • Clinical conditions that may require urgent action and how to instigate such action.
  • Normal and abnormal results and their significance to the clinical question or condition.
7 1,3

Control infection risks in accordance with departmental protocols.

  • Protocols and requirements for hygiene and infection control related to the relevant range of investigations, including preparation, conduct and completion of investigation.
  • Protocol for hand washing and how effective hand washing contributes to control of infection.
8 1,3

Minimise risks and hazards in compliance with health and safety policies.

  • The relevant health and safety regulations for laboratory and clinical investigations.
  • The specific health and safety regulations for the specialism, type of specimen/sample and investigation.
  • The potential hazards and risks and the actions to be taken to minimise these.
  • Responsibilities and scope of practice of laboratory personnel involved in performing investigations and reporting those investigations to users.

Work-based assessment


Complete 1 Case-Based Discussion(s)
Complete 1 of the following DOPS and/or OCEs
Type Title
DOPS Receive label and store a selection of immunological specimens
DOPS Perform laboratory techniques used in clinical immunology
DOPS Demonstrate the ability to use laboratory IT systems for handling processing and storage of patient data
OCE SLS103