Curriculum standards

Ready to perform without supervision

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

The trainee will:

• explain diagnosis, investigation, and management options for acute events to patients and their families, whānau, and/or carers, using language appropriate to the patient and family’s understanding and desire for information
• negotiate realistic treatment goals, and determine and explain expected prognoses and outcomes
• address questions, misunderstandings, and concerns about patients’ conditions and management options
• respond to verbal and nonverbal cues and emotions while discussing acute medical events with patients, their families, whānau, and/or carers
• communicate with other health professionals, and complete appropriate documentation about acute changes in patients’ conditions and adjustments to their management plans

Requires some supervision

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

The trainee may:

• demonstrate communication skills to sufficiently support multidisciplinary teams, patients, their families, whānau, and/or carers
• determine patients’ understanding of their disease and their preferred goals of care, where possible
• acknowledge and escalate questions, misunderstandings, and concerns about patients’ conditions and management options to appropriate members of the multidisciplinary team

Ready to perform without supervision

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

The trainee will:

• maintain up-to-date certification in basic life support
• evaluate and explain the benefits and risks of clinical interventions based on individual patients’ circumstances
• analyse adverse incidents and sentinel events to identify system failures and contributing factors
• identify evidence-based practice gaps using clinical indicators, and implement changes to improve patients’ outcomes

Requires some supervision

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

The trainee may:

• recognise the risks and benefits of interventions
• raise appropriate issues for review at morbidity and mortality meetings
• evaluate the quality and safety processes implemented within the workplace, and identify gaps in their structure

Ready to perform without supervision

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

The trainee will:

• regularly evaluate personal clinical practice around provision of acute care
• seek feedback on own clinical practice
• address gaps in knowledge and skills through self-directed learning and continuing professional development
• supervise junior colleagues in managing acute and emergency events in palliative care
• use teaching opportunities arising from acute and emergency events in palliative care

Requires some supervision

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

The trainee may:

• participate in inter- and intra-team education around acute events in palliative care to enhance team effectiveness
• provide constructive feedback to junior colleagues to contribute to improvements in individuals’ skills

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 clinical practice in managing acute and emergency events in palliative care
• support and participate in research to build the palliative care evidence base in acute and emergency events encountered in palliative care

Requires some supervision

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

The trainee may:

• demonstrate efficient use of literature databases to retrieve evidence
• use information from credible sources to aid in decision making
• refer to evidence-based clinical guidelines and protocols on acutely unwell patients
• demonstrate an understanding of the limitations of evidence and the challenges of applying research in daily practice

Ready to perform without supervision

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

The trainee will:

• negotiate health care decisions around acute or emergency events in culturally appropriate ways, by considering health literacy, language barriers, cultures, religion, and belief systems
• integrate culturally appropriate care of Māori and Aboriginal and Torres Strait Islander peoples into management of acute events
• consider cultural, ethical, and religious values and beliefs in leading multidisciplinary teams in acute and emergency events encountered in palliative care

Requires some supervision

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

The trainee may:

• demonstrate recognition of, respect, and sensitivity to cultural factors in the community serviced
• proactively identify barriers to access to health care

Ready to perform without supervision

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

The trainee will:

• consider the consequences of delivering treatment that is deemed medically futile, recognising that patients and their families, whānau, and/or carers may have different views
• demonstrate critical reflection on personal beliefs and attitudes, including how these may affect health care policy and patients’ care during acute events
• initiate and engage in ethical discussions around decision making to facilitate patient- and family-centred care, and minimise and address moral distress in the multidisciplinary team

Requires some supervision

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

The trainee may:

• communicate medical management plans as part of multidisciplinary plans for patients
• establish, where possible, patients’ wishes and preferences about care
• contribute to building a positive, respectful, and inclusive culture within teams

Ready to perform without supervision

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

The trainee will:

• identify the need for escalation of care, and escalate to appropriate staff or services when needed
• integrate evidence into clinical decision making around management of acute events in palliative care
• reconcile conflicting advice from other specialties, applying judgement in making clinical decisions in the presence of uncertainty
• incorporate available resources and local guidelines and contexts into decision making
• acknowledge there is invariably more than one appropriate treatment plan, and justify the treatment plan chosen

Requires some supervision

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

The trainee may:

• involve additional staff to assist in patients’ care in a timely manner when required
• recognise personal limitations and seek help in an appropriate way when required

Ready to perform without supervision

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

The trainee will:

• work respectfully and effectively with colleagues during management of acute events
• ensure appropriate multidisciplinary assessment and management of acute events
• initiate emergent escalation of care within and between teams to effectively manage acute patient events

Requires some supervision

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

The trainee may:

• collaborate with and engage other team members during management of acute events, based on their roles and skills
• encourage an environment of openness and respect

Ready to perform without supervision

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

The trainee will:

• use a considered and rational approach to the responsible use of resources, balancing costs against outcomes
• prioritise patients’ care based on need, and consider available health care resources
• collaborate with colleagues to develop policies and protocols for the investigation and management of common acute medical problems in palliative care

Requires some supervision

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

The trainee may:

• understand the systems for the escalation of care for deteriorating patients
• understand the role of clinician leadership and advocacy in appraising and redesigning systems of care that lead to better patient outcomes in acute events in palliative care