Curriculum standards

Ready to perform without supervision

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

The trainee will:

• communicate clearly with other team members, and coordinate efforts of multidisciplinary team members
• use closed-loop and clear communication with other health care team members during resuscitation
• relay the patient presentation, care progress and management plan to colleagues factually, clearly, succinctly and with prioritised clinical information
• facilitate early communication with patients, families, and health care team members to allow shared decision making
• negotiate realistic treatment goals, and determine and explain the expected prognoses and outcomes
• employ communication strategies appropriate for younger patients or those with cognitive difficulties
• explain the situation to patients in a sensitive and supportive manner, avoiding jargon and confirming their understanding
• determine the level of health literacy of individual patients and level of understanding of agreed care decisions
• provide clear and effective discharge summaries with recommendations for ongoing care

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 the function of multidisciplinary teams
• if possible, determine patients’ understanding of their diseases and what they perceive as the most desirable goals of care

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 advanced life support
• use clinical information technology systems for conducting prospective and retrospective clinical audits
• 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
• coordinate and encourage innovation, and objectively evaluate improvement initiatives for outcomes and sustainability
• document treatment given without consent in an emergency according to local guidelines

Requires some supervision

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

The trainee may:

• evaluate the quality of processes through well-designed audits
• recognise the risks and benefits of all 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:

• demonstrate effective supervision skills and teaching methods which are adapted to the context of the training, including being informed of the RACP curriculum and assisting with assessments as required
• encourage questioning among junior colleagues and students in response to unanswered clinical questions
• seek guidance and feedback from healthcare teams to reflect on encounters and improve future patients’ care

Requires some supervision

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

The trainee may:

• mentor and train others to enhance team effectiveness
• provide constructive feedback to junior colleagues to contribute to improvements in individuals’ skills
• coordinate and supervise junior colleagues from the emergency department and wards

Ready to perform without supervision

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

The trainee will:

• select studies based on optimal trial design, freedom from bias, and precision of measurement, and apply to clinical practice as appropriate
• evaluate the value of treatments in terms of relative and absolute benefits, cost, potential patient harm, and feasibility
• evaluate the applicability of the results of clinical studies to the circumstances of individual patients, especially those with multiple comorbidities
• specify research evidence to the needs of individual patients

Requires some supervision

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

The trainee may:

• demonstrate efficient searching 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 the evidence and the challenges of applying research in daily practice
• explain that routine care will continue if the participant decides not to participate in research

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 in a culturally appropriate way by considering variation in family structures, cultures, religion, or belief systems
• integrate culturally appropriate care of Māori and Aboriginal and Torres Strait Islander peoples into patients’ management
• consider cultural, ethical, and religious values and beliefs in leading multidisciplinary teams

Requires some supervision

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

The trainee may:

• practise cultural competency appropriate for the community served
• proactively identify barriers to access to healthcare

Ready to perform without supervision

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

The trainee will:

• develop management plans that are based on medical assessments of the clinical conditions and multidisciplinary assessments of functional capacity
• advise patients of their rights to refuse medical therapy, including life-sustaining treatment
• consider the consequences of delivering treatment that is deemed futile, directing to other care as appropriate
• facilitate interactions within multidisciplinary teams respecting values, encouraging involvement, and engaging all participants in decision making
• demonstrate critical reflection on personal beliefs and attitudes, including how these may affect patient care and health care policy

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
• establish, where possible, patients' wishes and preferences about care
• contribute to building a productive 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:

• recognise the need for escalation of care, and escalate to appropriate staff or services
• integrate evidence related to questions of diagnosis, therapy, prognosis, risks, and cause into clinical decision making
• reconcile conflicting advice from other specialties, applying judgement in making clinical decisions in the presence of uncertainty
• use care pathways effectively, including identifying reasons for variations in care

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 a timely fashion 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 collaboratively with staff in the emergency department, intensive care, and other subspecialty inpatient units, and health professionals in the community with shared patients
• manage the transition of acute medical patients through their hospital journeys
• lead a team by providing engagement while maintaining a focus on outcomes
• manage and initiate open disclosure as necessary

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, based on their roles and skills
• ensure appropriate multidisciplinary assessment and management
• encourage an environment of openness and respect to lead effective teams

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 patient care based on need, and consider available resources
• collaborate with emergency medicine staff and other colleagues to develop policies and protocols for the investigation and management of common acute medical problems

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