Curriculum standards
Entrustable Professional Activities
LG8: Clinical assessment and management – adolescent and young adult medicine
Clinical assessment and management – adolescent and young adult medicine
Clinically assess and manage adolescent and young adult patients across multiple settings
This activity requires the ability to:
- holistically assess and manage adolescents and young people in inpatient and outpatient settings
- perform appropriate, comprehensive, and opportunistic psychosocial and health risk assessments of adolescents and young people
- manage patients within their personal, family, and community context, considering their development stage and cultural, socioeconomic, and geographical factors
- plan, manage, and support transition to adult care
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:
- perform comprehensive adolescent psychosocial health assessments, including risk, mental health, sexual health, and substance use
- assess and manage acute presentations in adolescents
- assess and manage common (key) adolescent presentations and conditions to a high standard
- assess and manage less common or more complex adolescent presentations and conditions, in liaison with subspecialists
- identify stage of cognitive and sociocultural development
- assess and manage the psychosocial impacts of medical conditions
- manage patients with common mental health concerns, in liaison with mental health support services
- plan appropriate monitoring and follow-up to promote wellbeing and prevent harm
- monitor treatment outcomes, effectiveness, and adverse events
- regularly review the goals of care and treatment plans with patients
- initiate opportunistic screening and management of complications and comorbid conditions
- appropriately plan and manage transition to adult services
Requires some supervision
Possible behaviours of a trainee who needs some supervision to perform this activity
The trainee may:
- develop appropriate management plans for current concerns
- develop safe management plans for general paediatric inpatients and outpatients that may not consider all holistic care needs
- select medicines for common conditions appropriately, safely, and accurately
- identify potential side effects and practical prescription points, such as medication compatibility and monitoring in response to therapies
- identify neurodevelopmental and behavioural concerns for patients
- identify mental health concerns for patients
Communication
Ready to perform without supervision
Expected behaviours of a trainee who can routinely perform this activity without needing supervision
The trainee will:
- undertake appropriate consultation with adolescents and young adults, including allowing review time independent of carers during part of the consultation
- establish and apply requirements and limits of confidentiality when interviewing adolescents and young adults by themselves
- recognise the development of health independence and requirements around consent when working with adolescent patients
- build rapport with adolescents, and support development of autonomy in the young person’s individual health care that is appropriate to their developmental stage
- provide information to patients and carers to enable them to make a fully informed decision from various diagnostic, therapeutic, and management options
- educate patients about the intended use, expected outcomes, and potential side effects for each prescribed medication
- facilitate and support open family discussions or meetings to deliver bad news or prognostic information
- educate patients to recognise and monitor symptoms, and when to seek help
- use motivational interviewing to achieve healthy behaviour change
- communicate effectively with other professionals involved in patients’ lives to promote wellbeing, such as those working in education, mental health, allied health, and statutory child protection services
- write comprehensive and accurate summaries of care, including discharge summaries, clinic letters, and transfer documentation
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:
- recognise and appropriately deal with aggressive and violent behaviours in accordance with health service policies and procedures
- obtain informed consent before undertaking any investigation or procedure
- analyse adverse incidents and sentinel events to identify system failures and contributing factors
Requires some supervision
Possible behaviours of a trainee who needs some supervision to perform this activity
The trainee may:
- take precaution against assaults from confused or agitated patients, ensuring appropriate care of patients
- identify medication errors, and institute appropriate measures
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
- incorporate appropriate LGBTQIA+ safe language
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:
- hold information about patients in confidence unless the release of information is required for safety of patients or others, or by law or public interest
- access and keep up to date with current legislation regarding mental health and mandatory reporting requirements
- respect, where appropriate, patients’ decisions to refuse investigations or treatment, even if their decisions may not be appropriate or evidence based
- demonstrate awareness of complex issues related to genetic information obtained from investigations, and subsequent disclosure of such information
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
- consider patients’ decision-making capacity
- identify patients’ preferences regarding management and the role of families in decision making
- not advance personal interest of professional agendas at the expense of patient or social welfare
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:
- apply knowledge and experience to identify patients’ problems, making logical, rational decisions, and acting to achieve positive outcomes for patients
- manage patients within their family and community context, considering cultural, socioeconomic, and geographical factors
- use care pathways effectively, including identifying reasons for variations in care
- recognise own limitations and, when required, seek help in an appropriate way
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
- inadequately consult with senior colleagues
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 holistic care for complex patients
- work effectively as a member of multidisciplinary teams to achieve the best health outcome for patients
- lead inpatient teams
- efficiently manage outpatient clinics
- engage and facilitate multidisciplinary team meetings, family meetings, and complex case conferences
- establish and follow clear transition plans for adolescent patients, using appropriate 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
- work effectively in outpatient clinics
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:
- participate in health promotion, disease prevention and control, screening, and reporting notifiable diseases
- contribute to processes for managing risks, and identify strategies for improvement in transition of care
- apply the principles of efficient and equitable allocation of resources to meet individual, community, and national health needs
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