Curriculum standards
Entrustable Professional Activities
LG8: Investigations and procedures in nuclear medicine
Longitudinal care
Manage and coordinate the longitudinal care of patients with chronic illness, disability, and/or long-term health issues, and patients at the end of their lives
This activity requires the ability to:
- develop management plans and goals in consultation with patients, families, and/or carers
- manage chronic and advanced conditions, complications, disabilities, and comorbidities
- collaborate with other care providers
- ensure continuity of care
- facilitate self-management and self-monitoring in patients and/or their families or carers
- engage with the broader health policy context
- recognise the dying phase
- support patients to plan for their advance care, and document their own wishes
- manage end-of-life care plans
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:
- regularly assess and review care plans for patients with chronic conditions and disabilities, based on short- and long-term clinical and quality of life goals
- provide documentation on patients’ presentation, management, and progress, including key points of diagnosis and decision making to inform coordination of care
- ensure patients contribute to their needs assessments and care planning
- monitor treatment outcomes, effectiveness, and adverse events
- assess patients’ physical and psychological symptoms
- avoid unnecessary investigations or treatments, ensuring physical and psychosocial support
- estimate prognosis and communicate this appropriately, if requested, including the uncertainties around such estimates
- develop and clearly document individualised end-of-life care plans, including patients’ preferences for treatment options, resuscitation plans, preferred place of care, and preferred place of death
- review the goals of care and treatment plans with patients, families, or carers if significant changes in patients’ conditions or circumstances occur
Requires some supervision
Possible behaviours of a trainee who needs some supervision to perform this activity
The trainee may:
- assess patients’ knowledge, beliefs, concerns, and daily behaviours related to their chronic condition and/or disability and its management
- contribute to medical record entries on histories, examinations, and management plans in a way that is accurate and sufficient as a member of multidisciplinary teams
- demonstrate an understanding of the principles of care for patients at the end of their lives
- provide timely assessment, and document patients’ care plans
- manage physical symptoms in alignment with patients’ wishes
- take steps to alleviate patients’ symptoms and distress
- correctly identify patients approaching the end of life, and provide symptomatic treatment
Communication
Ready to perform without supervision
Expected behaviours of a trainee who can routinely perform this activity without needing supervision
The trainee will:
- encourage patients’ self-management through education to take greater responsibility for their care, and support problem solving
- encourage patients’ access to self-monitoring devices and assistive technologies
- communicate with multidisciplinary team members, and involve patients in that dialogue
- establish supportive relationships with patients, families, or carers based on understanding, trust, empathy, and confidentiality
- explore patients’ concerns across physical, spiritual, cultural, and psychological domains thoughtfully
- identify opportunities to discuss end-of-life care
- communicate effectively and in a timely manner with other health professionals involved in patients’ care
- refer to national best practice standards around the management of patients with allergy
- provide standardised action plans, such as the Australasian Society of Clinical Immunology and Allergy anaphylaxis and/or allergic reactions management plan
Requires some supervision
Possible behaviours of a trainee who needs some supervision to perform this activity
The trainee may:
- provide healthy lifestyle advice and information to patients on the importance of self-management
- work in partnership with patients, and motivate them to comply with agreed care plans
- discuss with patients, family, or carers the goals of care and treatment, and document this in patients’ clinical records
- ensure consistent messages are given to patients, families, or carers about treatment options, their likelihood of success, risks, and prognosis
- provide honest and clear clinical assessment summaries of situations, using plain language and avoiding medical jargon
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:
- conduct medication chart safety audits and multidisciplinary mortality and morbidity meetings, and provide feedback to colleagues
- use innovative models of chronic disease care, using telehealth and digitally integrated support services
- review medicine use, and ensure patients understand safe medication administration to prevent errors
- support patients’ self-management by balancing between minimising risk and helping them become more independent
- participate in quality improvement processes impacting on patients’ abilities to undertake normal activities of daily living
Requires some supervision
Possible behaviours of a trainee who needs some supervision to perform this activity
The trainee may:
- participate in continuous quality improvement processes and clinical audits on chronic disease management
- identify activities that may improve patients’ quality of life
- communicate the content of discussions about prognosis and advance care planning to multidisciplinary teams
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:
- contribute to the development of clinical pathways for chronic diseases management, based on current clinical guidelines
- educate patients to recognise and monitor their symptoms, and undertake strategies to assist their recovery
- reflect on personal practice and use this process to guide continuing professional development
Requires some supervision
Possible behaviours of a trainee who needs some supervision to perform this activity
The trainee may:
- use clinical practice guidelines for chronic diseases management
- participate in upskilling in best practice end-of-life care
- encourage junior colleagues to participate in multidisciplinary case reviews, mortality and morbidity meetings, and adverse event reviews
Research
Ready to perform without supervision
Expected behaviours of a trainee who can routinely perform this activity without needing supervision
The trainee will:
- prepare reviews of literature on patients' encounters to present at journal club meetings
- search for and critically appraise evidence to resolve clinical areas of uncertainty
Requires some supervision
Possible behaviours of a trainee who needs some supervision to perform this activity
The trainee may:
- search literature using problem / intervention / comparison / outcome (PICO) format
- recognise appropriate use of review articles
- recognise that the evidence may be insufficient to resolve uncertainty and make definitive decisions
Cultural safety
Ready to perform without supervision
Expected behaviours of a trainee who can routinely perform this activity without needing supervision
The trainee will:
- encourage patients from culturally and linguistically diverse backgrounds to join local networks to receive the support needed for long-term self-management
- practise culturally responsible medicine based on understanding the personal, historical, and cultural influences on patients, families, and carers
- offer support to patients, families, and carers to include cultural or religious practices in their care
- incorporate appropriate LGBTQIA+ safe language, including gender affirming language
Requires some supervision
Possible behaviours of a trainee who needs some supervision to perform this activity
The trainee may:
- provide culturally safe chronic disease management
- recognise, respect, and respond to individual preferences and needs of patients, regardless of their culture and religious beliefs
- support patients, families, and carers with communication difficulties associated with cultural and linguistic diversity
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:
- share information about patients’ health care in a manner consistent with privacy laws and professional guidelines on confidentiality
- use consent processes for the release and exchange of health information
- assess patients’ decision-making capacity, and appropriately identify and use alternative decision makers
- recognise feelings of moral distress and burnout in themselves and colleagues
- enhance the quality of life for patients before death to minimise pain and suffering caused by ineffective treatments
- recognise the complexity of ethical issues related to human life and death, when considering the allocation of scarce resources
Requires some supervision
Possible behaviours of a trainee who needs some supervision to perform this activity
The trainee may:
- share information between relevant service providers
- acknowledge and respect the contribution of health professionals involved in patients’ care
Judgement and decision making
Ready to perform without supervision
Expected behaviours of a trainee who can routinely perform this activity without needing supervision
The trainee will:
- implement stepped care pathways in the management of chronic diseases and disabilities
- recognise patients’ needs in terms of both internal resources and external support on long-term health care journeys
- maximise patients’ autonomy and their best interests when making treatment decisions
- liaise with other relevant services, providing referrals as necessary
Requires some supervision
Possible behaviours of a trainee who needs some supervision to perform this activity
The trainee may:
- recognise personal limitations and seek help in an appropriate way when required
- define and document patients’, families’, or carers’ goals and agreed outcomes
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:
- coordinate whole-person care through involvement in all stages of patients’ care journeys
- use a multidisciplinary approach across services to manage patients with chronic diseases and disabilities
- develop collaborative relationships with patients, families, carers, and a range of health professionals
Requires some supervision
Possible behaviours of a trainee who needs some supervision to perform this activity
The trainee may:
- participate in multidisciplinary care for patients with chronic diseases and disabilities, including organisational and community care, on a continuing basis, appropriate to patients’ context
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:
- use health screening for early intervention and chronic diseases management
- assess alternative models of health care delivery for patients with chronic diseases and disabilities
- participate in government initiatives for chronic diseases management to reduce hospital admissions and improve patients’ quality of life
- help patients access initiatives and services for patients with chronic diseases and disabilities
Requires some supervision
Possible behaviours of a trainee who needs some supervision to perform this activity
The trainee may:
- demonstrate awareness of government initiatives and services available for patients with chronic diseases and disabilities, and display knowledge of how to access them