Curriculum standards

Ready to perform without supervision

Expected behaviours of a trainee who can routinely perform this activity without needing supervision

The trainee will:

• review and clearly summarise relevant investigations undertaken prior to palliative care involvement
• discuss the benefits, cost, rationale, and risks of investigation options, including the option to have no investigations
• explore and address patients’ concerns and expectations about investigation plans
• explain findings or possible outcomes of investigations to patients where appropriate

Requires some supervision

Possible behaviours of a trainee who needs some supervision to perform this activity

The trainee may:

• discuss the benefits, complications, indications, and risks of investigations with patients before ordering investigations
• explain the results of investigations to patients
• arrange investigations, providing accurate and informative referrals, and liaise with other services where appropriate

Ready to perform without supervision

Expected behaviours of a trainee who can routinely perform this activity without needing supervision

The trainee will:

• identify adverse outcomes that may result from proposed investigations

Requires some supervision

Possible behaviours of a trainee who needs some supervision to perform this activity

The trainee may:

• consider safety aspects of investigations when planning them
• seek guidance with interpretation of test results for less common tests, indications for tests, or unexpected test results

Ready to perform without supervision

Expected behaviours of a trainee who can routinely perform this activity without needing supervision

The trainee will:

• regularly self-evaluate personal clinical practice around ordering of investigations
• seek feedback from colleagues and learners on their own clinical practice
• address gaps in knowledge and skills through self-directed learning and continuing professional development
• supervise junior colleagues' decision making around ordering of investigations
• use teaching opportunities around ordering and interpreting investigations
• use appropriate guidelines, evidence sources, and decision support tools when considering investigations
• participate in clinical audits to improve test ordering strategies

Requires some supervision

Possible behaviours of a trainee who needs some supervision to perform this activity

The trainee may:

• undertake professional development to maintain currency with investigation guidelines

Ready to perform without supervision

Expected behaviours of a trainee who can routinely perform this activity without needing supervision

The trainee will:

• apply relevant research literature and evidence-based guidelines to decisions around investigations
• support clinical research to build the palliative care evidence base in the use of investigations
• provide patients with relevant information if a proposed investigation is part of a research program
• obtain written consent from patients if the investigation is part of a research program

Requires some supervision

Possible behaviours of a trainee who needs some supervision to perform this activity

The trainee may:

• refer to evidence-based clinical guidelines around investigations
• consult current research on investigations

Ready to perform without supervision

Expected behaviours of a trainee who can routinely perform this activity without needing supervision

The trainee will:

• consider patients’ cultural and religious backgrounds, attitudes, and beliefs, and their impact on the acceptability of proposed investigations

Ready to perform without supervision

Expected behaviours of a trainee who can routinely perform this activity without needing supervision

The trainee will:

• respect patients’ decisions to decline certain investigations where appropriate
• advise patients there may be additional costs, which patients may wish to clarify before proceeding
• explain the expected benefits as well as the potential burdens and risks of proposed investigations before obtaining informed consent or other valid authority
• advocate for the patient to have appropriate and timely investigations, including interventional procedures undertaken in keeping with their goals of care

Requires some supervision

Possible behaviours of a trainee who needs some supervision to perform this activity

The trainee may:

• identify appropriate proxy decision makers when required for consent for investigations
• choose not to investigate in situations where it is not appropriate for ethical reasons
• involve patients in decision making regarding investigations, obtaining the appropriate informed consent, including financial consent, if necessary

Ready to perform without supervision

Expected behaviours of a trainee who can routinely perform this activity without needing supervision

The trainee will:

• evaluate the benefits, burdens, costs, and potential risks of each investigation in varying settings and clinical situations
• justify the selection of investigations based on the patients’ goals of care, likely benefit, prognosis, and stage of disease

Requires some supervision

Possible behaviours of a trainee who needs some supervision to perform this activity

The trainee may:

• choose the most appropriate investigations for clinical scenarios in discussion with patients

Ready to perform without supervision

Expected behaviours of a trainee who can routinely perform this activity without needing supervision

The trainee will:

• ensure results are checked in a timely manner, taking responsibility for following up results
• communicate investigation results in a timely manner to other teams involved in patients’ care

Ready to perform without supervision

Expected behaviours of a trainee who can routinely perform this activity without needing supervision

The trainee will:

• ensure investigations ordered are cost effective
• advocate for equity of access to appropriate investigations of all patient groups, irrespective of age, gender, race, or socioeconomic status