Curriculum standards
Entrustable Professional Activities
LG 9: Communication with patients
Communication with patients
Communicate with patients across different stages of life-limiting illnesses
This activity requires the ability to:
- enhance the setting for the conversation, and include other team members as needed
- adapt conversations to the audience, including adjustment for age, cognition, development, and cultural and linguistic considerations
- use language appropriate to patients’ understanding and desire for information
- assess patients’ understanding prior to giving any information
- respond to verbal and nonverbal cues and emotions
- select and use appropriate communication modalities and strategies
- plan conversations, and be ready to modify plans as needed
- develop mutually agreed management plans
- verify patients’ understanding of information shared
- develop, summarise, document, and implement plans following communication to ensure actions occur
Professional practice framework domain
Medical expertise
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
- use language appropriate to patients’ understanding and desire for information
- address questions, misunderstandings, and concerns about patients’ conditions and management options
- provide accessible information to patients to enable informed decisions about diagnostic, therapeutic, and management options
- use medical expertise and knowledge about illnesses and trajectories to guide complicated and emotional decision making in palliative care, including prognosis, advance care planning, goals of care, symptoms, and end-of-life conversations
Communication
Ready to perform without supervision
Expected behaviours of a trainee who can routinely perform this activity without needing supervision
The trainee will:
- tailor communication modalities to the circumstances, including emails, face-to-face, or phone calls
- include significant others in conversations when appropriate
- encourage and respond to questions from patients and other health professionals
- respond to verbal and nonverbal cues and emotions during consultations and conversations with patients and other health professionals
- consider patients’ capacity for decision making and consent, and involve them in their care with consideration to age, development, and personal preferences, appropriate to their family context
- include family and other carers in patients’ care and, when appropriate, bridge understanding and conversations between patients and their families, whānau, and/or carers
- document key conversations, and share details with patients and the wider care team
- use language appropriate to patients’ understanding and desire for information
- assess patients’ understanding prior to giving information
Requires some supervision
Possible behaviours of a trainee who needs some supervision to perform this activity
The trainee may:
- select appropriate modes of communication
- engage patients in discussions, avoiding the use of jargon
- check patients’ understanding of information
- adapt communication style in response to patients’ age and developmental level, and cognitive, cultural, physical, situational, and socioeconomic factors
- collaborate with patient liaison officers as required
Quality and safety
Ready to perform without supervision
Expected behaviours of a trainee who can routinely perform this activity without needing supervision
The trainee will:
- discuss potential benefits and harms of management strategies, and ensure patients and their families, whānau, and/or carers understand these conversations to ensure safe and quality care
- recognise and take precautions where patients may be vulnerable, including issues of child protection or self-harm
- participate in processes to manage patient complaints
Teaching and learning
Ready to perform without supervision
Expected behaviours of a trainee who can routinely perform this activity without needing supervision
The trainee will:
- supervise colleagues in managing communication with patients and their families, whānau, and/or carers, and with other health professionals
- maximise teaching opportunities around communication skills
Requires some supervision
Possible behaviours of a trainee who needs some supervision to perform this activity
The trainee may:
- participate in learning opportunities to enhance communication skills
- take opportunities to teach and supervise others to enhance their communication skills
Research
Ready to perform without supervision
Expected behaviours of a trainee who can routinely perform this activity without needing supervision
The trainee will:
- incorporate communication strategies from guidelines and peer-reviewed literature into clinical practice
- support and participate in research in adherence with ethics and governance requirements
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
- demonstrate an understanding of the limitations of the evidence and the challenges of applying research in daily practice
Cultural safety
Ready to perform without supervision
Expected behaviours of a trainee who can routinely perform this activity without needing supervision
The trainee will:
- demonstrate effective and culturally competent communication with people of different backgrounds and cultures, including Māori and Aboriginal and Torres Strait Islander peoples
- use qualified interpreters and members of cultural and religious communities to help meet the communication needs of patients, their families, whānau, and/or carers
- provide plain-language and culturally appropriate written materials to patients
Requires some supervision
Possible behaviours of a trainee who needs some supervision to perform this activity
The trainee may:
- identify when to use interpreters
- allow enough time for communication across linguistic and cultural barriers
Ethics and professional behaviour
Ready to perform without supervision
Expected behaviours of a trainee who can routinely perform this activity without needing supervision
The trainee will:
- demonstrate respectful professional relationships with patients and health professionals
- communicate with integrity, transparency, empathy, and respect with patients and other health professionals
- support patients’ rights to seek second opinions
Requires some supervision
Possible behaviours of a trainee who needs some supervision to perform this activity
The trainee may:
- communicate appropriately, consistent with the context, respecting patients’ needs and preferences
- demonstrate a caring attitude towards patients
- respect patients, including protecting their rights to privacy and confidentiality
- behave equitably towards all, irrespective of gender, age, culture, socioeconomic status, sexual preferences, beliefs, contribution to society, illness-related behaviours, or the illness itself
- use social media ethically and according to legal obligations to protect patients’ confidentiality and privacy
Leadership, management, and teamwork
Ready to perform without supervision
Expected behaviours of a trainee who can routinely perform this activity without needing supervision
The trainee will:
- communicate effectively with team members involved in patients’ care, and with patients and other health professionals
- collaborate with other health professionals within the palliative care team and from other care teams when formulating clinical assessments and plans
- model and facilitate an environment where all team members feel they can participate in communication, contribute to conversations, and have their opinions valued
Requires some supervision
Possible behaviours of a trainee who needs some supervision to perform this activity
The trainee may:
- summarise, clarify, and communicate responsibilities of health care team members
- participate in multidisciplinary care planning, including communication with the wider team about palliative care priorities
- maintain the focus for health care team members on patient outcomes
Health policy, systems, and advocacy
Ready to perform without supervision
Expected behaviours of a trainee who can routinely perform this activity without needing supervision
The trainee will:
- communicate and collaborate with other services (such as regional or remote paediatric teams and community palliative care services) and key stakeholders (such as government organisations) to enhance care for patients and their families, whānau, and/or carers at patient and system levels
Requires some supervision
Possible behaviours of a trainee who needs some supervision to perform this activity
The trainee may:
- communicate with and involve other health professionals as appropriate