Curriculum standards
Entrustable Professional Activities
LG10: Clinical assessment and management – developmental and behavioural paediatrics
Clinical assessment and management – developmental and behavioural paediatrics
Clinically assess and manage patients with developmental and behavioural problems
This activity requires the ability to:
- effectively manage outpatient clinics with neurodevelopmental and behavioural patients
- perform comprehensive and appropriate assessments of children’s development, behaviour, learning, and emotions within their biopsychosocial context
- holistically manage neurodevelopmental and behavioural presentations and conditions, including safe and evidence-based prescribing and monitoring of psychotropic medications
- formulate appropriate management plans and goals that are strengths-based
- collaborate with and lead multidisciplinary teams, including community providers
- practice patient- and family-centred care that considers the patients’ cultural, socioeconomic and geographical context
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:
- assess and manage patients with common (key) neurodevelopmental and behavioural presentations and conditions to a high standard
- assess and manage patients with less common or more complex neurodevelopmental and behavioural presentations and conditions, in coordination with other health professionals
- assess and manage patients with common mental health concerns, in liaison with mental health support services
- perform a comprehensive assessment of a child’s development, behaviour, learning, and emotions, taking into account biological, psychosocial, comorbidity, and social environmental factors, including family dynamics
- choose evidence-based investigations or assessment tools, and frame them as an adjunct to comprehensive clinical assessments
- minimise unnecessary, potentially harmful, and/or painful investigations where possible
- synthesise and interpret findings from histories, examinations, and investigations to devise the most likely provisional diagnoses via reasonable differential diagnoses
- assess the severity of problems, the likelihood of complications, and clinical outcomes
- use diagnostic formulations to construct individualised, multimodal management plans
- devise a strengths-based approach to the care of patients with developmental or behavioural challenges, neurodiversity, or disabilities
- identify and refer patients to appropriate early intervention and developmental services
- consider and select appropriate pharmacological and non-pharmacological therapies, considering patients’ age, comorbidities, adverse reactions, preparations, availability, and patients’ preference
- 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
Requires some supervision
Possible behaviours of a trainee who needs some supervision to perform this activity
The trainee may:
- synthesise pertinent information to direct clinical encounters and diagnostic categories
- develop appropriate management plans for current concerns
- 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
- perform basic aspects of assessing and managing common neurodevelopmental conditions, with support
- 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:
- check patients’ level of literacy and access to the internet when considering use of written or online communications
- actively and empathetically listen to, and prioritise, the needs and concerns of patients
- communicate with patients respectfully and non-judgementally
- provide information to patients in plain language, avoiding jargon, acronyms, and complex medical terms
- clearly explain diagnoses and management in ways that both patients and families and carers understand
- communicate management plans with recommendations and goals for treatment to patients effectively, including in written form
- encourage patients to ask questions, and answer them thoroughly
- clearly and concisely document assessment findings, recommendations, and management plans in patients’ medical records and written reports
- provide medical evidence, assessments, and correspondence to support patients to access disability, mental health, and other support services
- prioritise positive and strengths-based language in communication regarding patients
Requires some supervision
Possible behaviours of a trainee who needs some supervision to perform this activity
The trainee may:
- adapt communication style in response to patients’ age and developmental level, and cognitive, physical, cultural, socioeconomic, and situational factors
- discuss and explain the rationale for treatment options with patients
- prepare timely and accurate communication in the form of letters and reports to disseminate relevant medical information to patients, other health professionals, and other relevant agencies
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:
- practice patient- and family-centred care
- prescribe medications in accordance with evidence, guidelines, and protocols (including schedule 8 prescribing)
- review medicines regularly to reduce non-adherence, and monitor treatment effectiveness, possible side effects, and drug interactions, ceasing unnecessary medicines
Requires some supervision
Possible behaviours of a trainee who needs some supervision to perform this activity
The trainee may:
- identify medication errors, and institute appropriate measures
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:
- provide clear and appropriate education to patients, families, carers, and other providers regarding child health and development
Requires some supervision
Possible behaviours of a trainee who needs some supervision to perform this activity
The trainee may:
- explain the expected developmental stages of a child
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:
- demonstrate professional values, including compassion, empathy, respect for diversity, integrity, honesty, and partnership to all patients
- demonstrate an awareness of complex issues related to documentation of sensitive information gathered in clinical encounters, and subsequent sharing of such information
- demonstrate an 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:
- prioritise patient and social welfare over own personal interest and professional agenda
- demonstrate professional conduct, honesty, and integrity
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
- 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:
- seek support to manage patients in challenging contexts
- 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
- efficiently manage outpatient clinics
- engage and facilitate multidisciplinary team meetings, family meetings, and complex case conferences
Requires some supervision
Possible behaviours of a trainee who needs some supervision to perform this activity
The trainee may:
- work effectively in outpatient clinics
- refer and liaise with multidisciplinary 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:
- apply the principles of efficient and equitable allocation of resources to meet individual, community, and national health needs
- advocate for, or contribute to, systems or structures that provide equitable access to care for all paediatric patients
- advocate for child- and family-friendly clinical and support services
Requires some supervision
Possible behaviours of a trainee who needs some supervision to perform this activity
The trainee may:
- support patients to link with relevant community services
- identify systems or structures that are a barrier to equitable access to health care