Curriculum standards
Entrustable Professional Activities
LG11: Procedures
Procedures
Plan, prepare for, perform, and provide aftercare for important practical procedures
This activity requires the ability to:
- select appropriate procedures in partnership with patients, their families, or carers
- obtain informed consent
- set up the equipment, maintaining an aseptic field
- perform procedures
- manage unexpected events and complications during and after procedures
- provide aftercare for patients
- communicate aftercare protocols and instructions to patients and medical and nursing staff
- maintain logbook of procedures, and participate in continuing education
- perform open disclosure and reporting of incidents when required
- interpret the results and outcomes of procedures, including imaging and reports, and communicate these to patients and referring doctors.
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:
- select procedures by assessing patient-specific factors, risks, benefits, and alternatives
- confidently and consistently perform a range of common procedures
- ensure team members are aware of all allergies / adverse reactions identified, and take precautions to avoid allergies / adverse reactions during procedures
- ensure patients have complied with procedure preparation
- confirm the correct position / site / side / level on patients for planned procedures
- recognise and effectively manage complications arising during or after procedures
- recognise and correctly interpret normal and abnormal findings of diagnostic procedures
- demonstrate a level of procedural proficiency in flexible bronchoscopy / intercostal catheter insertion prior to focusing on more advanced procedures (e.g., radial endobronchial ultrasound, rigid bronchoscopy, cryotherapy) or pleural procedures (tunnelled pleural catheter, thoracoscopy), and understand their role in respiratory scope of practice
Requires some supervision
Possible behaviours of a trainee who needs some supervision to perform this activity
The trainee may:
- assess patients and identify indications for procedures
- check for allergies and adverse reactions
- consider risks and complications of procedures
- interpret results of common diagnostic procedures
- organise and document post-procedure review of patients
Communication
Ready to perform without supervision
Expected behaviours of a trainee who can routinely perform this activity without needing supervision
The trainee will:
- accurately document procedures in clinical notes, including informed consent, procedures requested and performed, reasons for procedures, medicines given, aseptic technique, and aftercare
- explain procedures clearly to patients, families and carers, including reasons for procedures, potential alternatives, and possible risks, to facilitate informed choices
- counsel patients sensitively and effectively, and support them to make informed choices
- address patients’, families’, or carers’ concerns relating to procedures, providing opportunities to ask questions
- tailor language according to individual patients’ age and capacity to understand
- communicate effectively with team members, patients, families, and carers prior to, during, and after procedures
- ensure team members are confident and competent in their assigned roles
Requires some supervision
Possible behaviours of a trainee who needs some supervision to perform this activity
The trainee may:
- explain the process of procedures to patients without providing a broader context
- help patients, families, and carers choose the procedure
- communicate with members of procedural teams so all team members understand who each member is
- discuss post-procedural care with patients, families, and carers
- complete relevant patients’ documentation, and conduct an appropriate clinical handover
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:
- obtain informed consent or other valid authority before undertaking any procedure
- set up all necessary equipment, and consistently use universal precautions and aseptic technique
- confirm patients’ identification, verify the procedure, and, where appropriate, the correct position / site / side / level for the procedure
- ensure that information on patients’ consent forms match procedures to be performed
- identify, document, and appropriately notify of any adverse events or equipment malfunction
- maintain procedural logbooks with incorporation of procedure details, outcomes, and adverse events
- engage in regular self-audit processes, and implement quality improvement changes when required
Requires some supervision
Possible behaviours of a trainee who needs some supervision to perform this activity
The trainee may:
- provide information in a manner so that patients, families, and carers are fully informed when consenting to any procedures
- demonstrate an inconsistent application of aseptic technique
- identify patients using approved patients’ identifiers before any treatment or intervention is initiated
- attempt to perform a procedure in an unsafe environment
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:
- refer to and/or be familiar with relevant published procedural guidelines prior to undertaking procedures
- organise or participate in in-service training on new technology
- provide specific and constructive feedback and comments to junior colleagues
- initiate and conduct skills training for junior staff and other team members
Requires some supervision
Possible behaviours of a trainee who needs some supervision to perform this activity
The trainee may:
- participate in continued professional development
- help junior colleagues develop new skills
- actively seek feedback on personal technique until competent
Cultural safety
Ready to perform without supervision
Expected behaviours of a trainee who can routinely perform this activity without needing supervision
The trainee will:
- consider individual patients’ cultural perceptions of health and illness, and adapt practice accordingly
Requires some supervision
Possible behaviours of a trainee who needs some supervision to perform this activity
The trainee may:
- respect religious, cultural, linguistic, and family values and differences
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:
- confidently perform common procedures
- identify appropriate proxy decision makers when required
- show respect for knowledge and expertise of colleagues
- maximise patient autonomy in decision making
Requires some supervision
Possible behaviours of a trainee who needs some supervision to perform this activity
The trainee may:
- perform procedures when adequately supervised
- follow procedures to ensure safe practice
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:
- identify roles and optimal timing for diagnostic procedures
- critically appraise information from assessment and evaluation of risk / benefit to prioritise patients on waiting lists
- make clinical judgements and decisions based on the available evidence
- select the most appropriate and cost-effective diagnostic procedures
- adapt procedures in response to assessments of risks to individual patients
- select appropriate investigations on the samples obtained in diagnostic procedures
Requires some supervision
Possible behaviours of a trainee who needs some supervision to perform this activity
The trainee may:
- prioritise which patients receive procedures first (if there is a waiting list)
- assess personal skill levels, and seek help with procedures when appropriate
- use tools and guidelines to support decision making
- recommend suboptimal procedures for patients
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:
- explain critical steps, anticipated events, and equipment requirements to teams on planned procedures
- provide staff with clear aftercare instructions, and explain how to recognise possible complications
- identify relevant management options with colleagues, according to their level of training and experience, to reduce error, prevent complications, and support efficient teamwork
- coordinate efforts, encourage others, and accept responsibility for work done
Requires some supervision
Possible behaviours of a trainee who needs some supervision to perform this activity
The trainee may:
- ensure all relevant team members are aware that a procedure is occurring
- discuss patients’ management plans for recovery with colleagues
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:
- discuss serious incidents at appropriate clinical review meetings
- initiate local improvement strategies in response to serious incidents
- use resources efficiently when performing procedures
Requires some supervision
Possible behaviours of a trainee who needs some supervision to perform this activity
The trainee may:
- perform procedures in accordance with organisational guidelines and policies
For each procedure/investigation, trainees should be able to perform the components of the procedure indicated below. Please select a procedure/investigation from the dropdown to see its component.
These procedures may be considered within scope of practice in Respiratory Medicine, however additional training and demonstration of competence is suggested: Mandatory, Desired, Optional (depending on exposure). Procedural competence includes procedure set up.
Select and evaluate the anticipated value of the procedure
Obtain informed consent
Procedural proficiency & competence
OptionalManage / discuss complications
Provide after-care for patients
Interpret results
Communicate with patients and other health care providers
Maintenance of procedural logbook and continuing education
Select and evaluate the anticipated value of the procedure
Obtain informed consent
Procedural proficiency & competence
MandatoryManage / discuss complications
Provide after-care for patients
Interpret results
Communicate with patients and other health care providers
Maintenance of procedural logbook and continuing education
Select and evaluate the anticipated value of the procedure
Obtain informed consent
Procedural proficiency & competence
DesiredManage / discuss complications
Provide after-care for patients
Interpret results
Communicate with patients and other health care providers
Maintenance of procedural logbook and continuing education
Select and evaluate the anticipated value of the procedure
Obtain informed consent
Procedural proficiency & competence
OptionalManage / discuss complications
Provide after-care for patients
Interpret results
Communicate with patients and other health care providers
Maintenance of procedural logbook and continuing education
Select and evaluate the anticipated value of the procedure
Obtain informed consent
Procedural proficiency & competence
MandatoryManage / discuss complications
Provide after-care for patients
Interpret results
Communicate with patients and other health care providers
Maintenance of procedural logbook and continuing education
Select and evaluate the anticipated value of the procedure
Obtain informed consent
Procedural proficiency & competence
OptionalManage / discuss complications
Provide after-care for patients
Interpret results
Communicate with patients and other health care providers
Maintenance of procedural logbook and continuing education
Select and evaluate the anticipated value of the procedure
Obtain informed consent
Procedural proficiency & competence
OptionalManage / discuss complications
Provide after-care for patients
Interpret results
Communicate with patients and other health care providers
Maintenance of procedural logbook and continuing education
Select and evaluate the anticipated value of the procedure
Obtain informed consent
Procedural proficiency & competence
OptionalManage / discuss complications
Provide after-care for patients
Interpret results
Communicate with patients and other health care providers
Maintenance of procedural logbook and continuing education
Select and evaluate the anticipated value of the procedure
Obtain informed consent
Procedural proficiency & competence
MandatoryManage / discuss complications
Provide after-care for patients
Interpret results
Communicate with patients and other health care providers
Maintenance of procedural logbook and continuing education
Select and evaluate the anticipated value of the procedure
Obtain informed consent
Procedural proficiency & competence
DesiredManage / discuss complications
Provide after-care for patients
Interpret results
Communicate with patients and other health care providers
Maintenance of procedural logbook and continuing education
Select and evaluate the anticipated value of the procedure
Obtain informed consent
Procedural proficiency & competence
OptionalManage / discuss complications
Provide after-care for patients
Interpret results
Communicate with patients and other health care providers
Maintenance of procedural logbook and continuing education
Select and evaluate the anticipated value of the procedure
Obtain informed consent
Procedural proficiency & competence
DesiredManage / discuss complications
Provide after-care for patients
Interpret results
Communicate with patients and other health care providers
Maintenance of procedural logbook and continuing education
Select and evaluate the anticipated value of the procedure
Obtain informed consent
Procedural proficiency & competence
OptionalManage / discuss complications
Provide after-care for patients
Interpret results
Communicate with patients and other health care providers
Maintenance of procedural logbook and continuing education
Select and evaluate the anticipated value of the procedure
Obtain informed consent
Procedural proficiency & competence
MandatoryManage / discuss complications
Provide after-care for patients
Interpret results
Communicate with patients and other health care providers
Maintenance of procedural logbook and continuing education
Select and evaluate the anticipated value of the procedure
Obtain informed consent
Procedural proficiency & competence
OptionalManage / discuss complications
Provide after-care for patients
Interpret results
Communicate with patients and other health care providers
Maintenance of procedural logbook and continuing education
Select and evaluate the anticipated value of the procedure
Obtain informed consent
Procedural proficiency & competence
DesiredManage / discuss complications
Provide after-care for patients
Interpret results
Communicate with patients and other health care providers
Maintenance of procedural logbook and continuing education
Select and evaluate the anticipated value of the procedure
Obtain informed consent
Procedural proficiency & competence
OptionalManage / discuss complications
Provide after-care for patients
Interpret results
Communicate with patients and other health care providers
Maintenance of procedural logbook and continuing education
Select and evaluate the anticipated value of the procedure
Obtain informed consent
Procedural proficiency & competence
MandatoryManage / discuss complications
Provide after-care for patients
Interpret results
Communicate with patients and other health care providers
Maintenance of procedural logbook and continuing education
Select and evaluate the anticipated value of the procedure
Obtain informed consent
Procedural proficiency & competence
MandatoryManage / discuss complications
Provide after-care for patients
Interpret results
Communicate with patients and other health care providers
Maintenance of procedural logbook and continuing education
Select and evaluate the anticipated value of the procedure
Obtain informed consent
Procedural proficiency & competence
DesiredManage / discuss complications
Provide after-care for patients
Interpret results
Communicate with patients and other health care providers
Maintenance of procedural logbook and continuing education
Select and evaluate the anticipated value of the procedure
Obtain informed consent
Procedural proficiency & competence
DesiredManage / discuss complications
Provide after-care for patients
Interpret results
Communicate with patients and other health care providers
Maintenance of procedural logbook and continuing education