Curriculum standards
Knowledge guides
LG21: Regional, rural and remote paediatrics
Key presentations and conditions
Advanced Trainees will have a comprehensive depth of knowledge of these presentations and conditions.
Epidemiology, pathophysiology, and clinical sciences
Advanced Trainees will have a comprehensive depth of knowledge of the principles of the foundational sciences.
Important specific issues
Advanced Trainees will identify important specialty-specific issues and the impact of these on diagnosis and management and integrate these into care.
Presentations
- Undifferentiated general paediatric presentations (LG15)
- Neonatal and perinatal medicine presentations (LG16)
- Acute care paediatric presentations (LG17)
- Developmental paediatric presentations (LG18)
- Adolescent and young adult medicine presentations (LG19)
- Child safety and maltreatment presentations (LG20)
For each presentation and condition, Advanced Trainees will know how to:
Synthesise
- recognise the clinical presentation
- identify relevant epidemiology, prevalence, pathophysiology, and clinical science
- take a comprehensive clinical history
- conduct an appropriate examination
- establish a differential diagnosis
- plan and arrange appropriate investigations
- consider the impact of illness and disease on patients and their quality of life when developing a management plan
Manage
- provide evidence-based management
- prescribe therapies tailored to patients’ needs and conditions
- recognise potential complications of disease and its management, and initiate preventative strategies
- involve multidisciplinary teams
Consider other factors
- identify individual and social factors and the impact of these on diagnosis and management
Health and wellbeing status of rural children
- Child health priorities for rural and remote populations
- Disease prevalence in rural and remote populations
- Key factors contributing to the discrepancy in health and developmental outcomes of children and young people in rural and remote areas when compared to those in metropolitan areas
- Regional measures of the health and wellbeing of children and young people, e.g., the Australian Early Development Census
- The influence of the built environment on the health of children and young people in rural and remote areas, including factors such as:
- household crowding
- water quality and sanitation
- The influence of the physical environment on the health and wellbeing of children and young people, including the role of:
- environmental exposures, such as dust / smoke and lead exposure
- environmental risks of injury / drowning
- exposure to natural environments
- regional climate and climate change
- The influence of the social environment on the health and wellbeing of children and young people in rural and remote areas, including factors such as:
- connection to family and culture
- isolation
- social expectations
Clinical practice in rural and remote regions
- Appreciate the relative costs and benefits of requiring travel for clinical investigations, interventions, and other aspects of paediatric care, noting the financial and other physical or social burdens that this travel places on families and health systems
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Appreciation for nuances of providing safe and effective paediatric care with reduced access to on-site resources, such as:
- collaboration with communtity and primary health
- flexible approaches
- independent practice
- resource utilisation
- use of technology
- Basic principles of retrieval medicine including key issues in preparing paediatric and neonatal patients for safe aeromedical transport
- Broad paediatric knowledge, including robust knowledge of management strategies for common conditions while waiting for support or referral to tertiary services (refer to other General Paediatrics knowledge guides for specific presentations and conditions)
- Importance of continuing professional development and upskilling
- Level and type of paediatric care that can be provided within the regional context with guidance by subspecialist/s (at a distance) for complex paediatric patients or those with uncommon conditions
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The uses and limitations of telehealth services for:
- developmental assessments and ongoing care
- disability services including allied health
- paediatric specialist medical care
- support for paediatric acute care and resuscitation
Rural and remote context
- Appreciation of geographical distances between rural and remote communities and nearest hospital, and nearest metropolitan centre
- Barriers to health for children living in rural and remote regions
- Disparities in health status and access to health care of children living in rural and remote areas
- Sociodemographic and cultural profile of rural and remote communities and regions within the jurisdiction of practice and more broadly
Rural and remote health services
- Availability, functions, and access to patient retrieval services
- Available resources of rural hospitals and remote clinics
- Regional health service structures and referral pathways
- Service availability in regions within jurisdiction of practice, including:
- allied health
- disability and other support services
- emergency care
- primary care
- specialist paediatric care
- Strategies and availability of resources to improve access to health care, such as funding for transport
- The role of rural generalist doctors, nurses, and allied health professionals who are not specialised in paediatrics in providing paediatric care in consultation with paediatric specialists