Curriculum standards
Entrustable Professional Activities
LG8: Communication with patients
Communication with patients
Discuss diagnoses and management plans with patients
This activity requires the ability to:
- select a suitable context to discuss diagnosis and management plans, and include patients, their families, whanau and/or carers, and other team members, as appropriate
- devise a patient-centred perspective, including adjusting for age, developmental stage, cognition, and disabilities
- select and use appropriate communication strategies and modalities
- structure conversations intentionally
- negotiate mutually agreed management plans
- verify patients’ understanding of information conveyed
- develop and implement plans for ensuring actions occur
- document conversations
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:
- inform patients of all aspects of their clinical management, including assessments and investigations
- provide information to patients to enable them to make informed decisions about diagnostic, therapeutic, and management options
- provide patients with adequate opportunity to question or refuse interventions and treatments
- seek to understand the concerns and goals of patients, and plan management in partnership with them
- anticipate and be able to correct any misunderstandings patients may have about their conditions and/or risk factors
Requires some supervision
Possible behaviours of a trainee who needs some supervision to perform this activity
The trainee may:
- apply knowledge of the scientific basis of health and disease to the management of patients
- demonstrate an understanding of clinical problems being discussed
- formulate management plans in partnership with patients
- attend family meetings
Communication
Ready to perform without supervision
Expected behaviours of a trainee who can routinely perform this activity without needing supervision
The trainee will:
- convey information considerately and sensitively to patients, seeking clarification if unsure of how best to proceed
- use appropriate communication strategies and modalities for communication, including:
- emails
- face-to-face
- telehealth
- phone calls
- convey information considerately and sensitively to patients, seeking clarification if unsure of how best to proceed
- elicit patients’ views, concerns, and preferences, promoting rapport
- provide information to patients in plain language, avoiding jargon, acronyms, and complex medical terms
- encourage questions, and answer them thoroughly
- ask patients to share their thoughts or explain their management plan in their own words, to verify understanding
- treat children, adolescents, and young people respectfully, and listen to their views
- recognise the role of family and/or carers and, when appropriate, encourage patients to involve their family and/or carers in decisions about their care
- inform patients / their families of multidisciplinary meeting and other professional meeting discussion outcomes
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, developmental level, and cognitive, physical, cultural, socioeconomic, and situational factors
- collaborate with patient liaison officers
- use interpreters
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 with patients their condition and the available management options, including potential benefits and harms
- provide information to patients in a way they can understand before asking for their consent
- consider young people’s capacity for decision making and consent
- recognise and take precautions where patients may be vulnerable, such as issues of child protection or self-harm
- participate in processes to manage patient complaints
Requires some supervision
Possible behaviours of a trainee who needs some supervision to perform this activity
The trainee may:
- inform patients of the material risks associated with proposed management plans
- treat information about patients as confidential
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:
- encourage junior colleagues to participate in difficult or important family conversations, and provide an opportunity to debrief / reflect afterwards
- discuss the aetiology of diseases and explain the purpose, nature, and extent of the assessments to be conducted
- obtain informed consent or other valid authority before involving patients in teaching
- encourage and support junior colleagues in their communication with families, providing feedback
Requires some supervision
Possible behaviours of a trainee who needs some supervision to perform this activity
The trainee may:
- respond appropriately to information sourced by patients, and to patients’ knowledge regarding their condition
Research
Ready to perform without supervision
Expected behaviours of a trainee who can routinely perform this activity without needing supervision
The trainee will:
- provide information to patients in a way they can understand before asking for their consent to participate in research
- obtain an informed consent or other valid authority before involving patients in research
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 Māori and Aboriginal and Torres Strait Islander peoples
- effectively communicate with members of other cultural groups by meeting patients’ specific language, cultural, and communication needs
- use qualified language interpreters or cultural interpreters to help meet patients’ communication needs
- 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:
- encourage and support patients to be well informed about their health, and to use this information wisely when they make decisions
- encourage and support patients and, when relevant, their families and/or carers, in caring for themselves and managing their health
- demonstrate respectful professional relationships with patients
- prioritise honesty, patients’ welfare, and community benefit above self-interest
- develop a high standard of personal conduct, consistent with professional and community expectations
- support patients’ rights to seek second opinions
- recognise own limitations and engage someone else in the team or a senior colleague for specific discussions if needed
Requires some supervision
Possible behaviours of a trainee who needs some supervision to perform this activity
The trainee may:
- respect the preferences of patients
- communicate appropriately, consistent with the context, and respect patients’ needs and preferences
- maximise patients’ autonomy, and support their decision making
- avoid sexual, intimate, and financial relationships with parents and carers
- 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
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
- discuss medical assessments, treatment plans, and investigations with patients and primary care teams, working collaboratively with all
- discuss patient care needs with team members to align them with the appropriate resources
- facilitate an environment where all team members feel they can contribute and their opinion is valued
- communicate accurately and succinctly, and motivate others on the health care team
Requires some supervision
Possible behaviours of a trainee who needs some supervision to perform this activity
The trainee may:
- answer questions from team members
- summarise, clarify, and communicate responsibilities of team members
- keep team members focused 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:
- collaborate with other services, such as community health centres and consumer organisations, to help patients navigate the healthcare system
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