Curriculum standards
Entrustable Professional Activities
LG7: Clinical assessment and management – neonatal and perinatal medicine
Clinical assessment and management - neonatal and perinatal medicine
Clinically assess and manage neonatal and perinatal patients
This activity requires the ability to:
- assess healthy newborns
- expertly assess and manage common (key) neonatal presentations and conditions to a high standard
- recognise and plan investigations and management of less common or more complex neonatal presentations or conditions, in consultation with subspecialists
- prepare for, perform, and lead effective advanced neonatal resuscitation
- lead the inpatient team management of neonatal patients not requiring intensive care
- initiate management of critically unwell neonates
- recognise neonatal patients who require transfer, and prepare the patient for transfer
- communicate and collaborate with neonatologists, neonatal transport teams, other health professionals, and community providers, including when planning transfer of care and/or discharge
- manage patients within their family and community context, considering cultural, socioeconomic, and geographical factors
- plan appropriate care and follow-up of neonatal patients on discharge
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:
- anticipate the need for resuscitation at complex births
- recognise immediate life-threatening neonatal conditions and critically unwell neonates, and respond appropriately
- prepare for, and perform, effective advanced neonatal resuscitation
- assess healthy newborns and common neonatal presentations
- manage patients with common (key) neonatal / perinatal concerns to a high standard
- recognise and plan investigation and management of less common or more complex neonatal presentations or conditions, in consultation with subspecialists
- systematically identify causes of acute deterioration in health status
- choose evidence-based investigations or assessment tools, and frame them as an adjunct to comprehensive clinical assessments
- synthesise and interpret findings from histories, examinations, and investigations to devise the most likely provisional diagnoses via reasonable differential diagnoses
- initiate care of seriously unwell neonatal patients requiring surgery and/or transfer to intensive care unit
- manage acutely unwell neonates suitable for the inpatient ward and not requiring intensive care
- initiate ventilation and inotropic support of neonatal patients, with support from appropriate intensive care specialists or emergency staff
- assess the severity of problems, the likelihood of complications, and the nature and extent of potential clinical outcomes
- develop plans of multidisciplinary treatment, rehabilitation, and secondary prevention following acute events
Requires some supervision
Possible behaviours of a trainee who needs some supervision to perform this activity
The trainee may:
- recognise and correctly interpret abnormal findings
- synthesise pertinent information to direct clinical encounters and diagnostic categories
- apply basic neonatal life support
- initiate management of acutely unwell neonates, with support from other clinicians
Communication
Ready to perform without supervision
Expected behaviours of a trainee who can routinely perform this activity without needing supervision
The trainee will:
- communicate with patients about the benefits, risks, and potential side effects of proposed therapies
- educate patients about the intended use, expected outcomes, and potential side effects for each prescribed intervention
- facilitate and support open family discussions or meetings to deliver bad news or prognostic information
- communicate effectively with other health professionals and community providers, including on discharge and/or transfer of care
Requires some supervision
Possible behaviours of a trainee who needs some supervision to perform this activity
The trainee may:
- discuss and explain the rationale for treatment options with patients
- explain the benefits and burdens of therapies, considering patients’ individual circumstances
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:
- prescribe therapies in accordance with evidence, guidelines, and protocols
- report adverse events, and carry out appropriate open disclosure and management of complications
Requires some supervision
Possible behaviours of a trainee who needs some supervision to perform this activity
The trainee may:
- identify errors and escalate appropriately
- adhere to guidelines and protocols
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:
- effectively teach and supervise junior doctors and other health professionals in neonatal resuscitation, newborn examination, and recognition and management of common neonatal conditions
Requires some supervision
Possible behaviours of a trainee who needs some supervision to perform this activity
The trainee may:
- participate in neonatal teaching activities
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 safe communication and care for 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 where appropriate
- enquire, acknowledge, and reflect on patients’ beliefs and values, and how these might impact on health and choices
- offer support to patients, families, and carers to include cultural or religious practices in their care
Requires some supervision
Possible behaviours of a trainee who needs some supervision to perform this activity
The trainee may:
- display respect for patients’ cultures, and attentiveness to social determinants of health
- display an understanding of at least the most prevalent cultures in society, and an appreciation of their sensitivities
- access interpretive or culturally focused services when appropriate
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:
- manage and share information about patients’ health care in adherence to privacy laws, confidentiality, and professional guidelines
- recognise complexities around patient consent when there may be disputes between parents, carers and health care providers, or court orders in place
Requires some supervision
Possible behaviours of a trainee who needs some supervision to perform this activity
The trainee may:
- demonstrate professional conduct, honesty, and integrity
- identify carers’ preferences regarding management and the role of families in decision making
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:
- manage patients within their family and community context, considering cultural, socioeconomic, and geographical factors
- identify and address carers’ concerns, expectations, and goals
- develop management plans in consultation with carers
- assess if patients’ current location (such as regional unit, postnatal ward, or perinatal centre) can provide the appropriate level of care or if the patient needs to be transferred to another location
- make appropriate decisions regarding referring or transferring patients to other services for further management, including regional and remote patients
- recognise professional limitations
Requires some supervision
Possible behaviours of a trainee who needs some supervision to perform this activity
The trainee may:
- demonstrate clinical reasoning by gathering focused information relevant to patients’ care
- consider and prioritise patients’ issues using a structured approach
- recognise personal limitations, and, when required, seek help in an appropriate way
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:
- lead advanced neonatal resuscitations and inpatient care
- manage and plan follow-up, including for patients that live in regional or remote locations, in liaison with their local health services
Requires some supervision
Possible behaviours of a trainee who needs some supervision to perform this activity
The trainee may:
- share relevant information with members of the health care team
- contribute effectively to inpatient teams
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:
- support care that is closest to home for the patient and their family or carers
- demonstrate appropriate use of local, regional, and national health services and systems
Requires some supervision
Possible behaviours of a trainee who needs some supervision to perform this activity
The trainee may:
- identify and navigate components of the healthcare system relevant to patients’ care
- identify and access relevant community resources to support patients’ care
- consider transport issues and costs to patients when arranging the transfer of patients to other settings