Gastroenterology curriculum standards

Site: RACP Online Learning
Course: Advanced Training Curricula
Book: Gastroenterology curriculum standards
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Date: Friday, 4 April 2025, 4:30 AM

About this resource

The new Advanced Training in Gastroenterology curriculum consists of curriculum standards and learning, teaching, and assessment (LTA) programs.

This resource outlines the curriculum standards for Advanced Training inGastroenterology for trainees and supervisors. The curriculum standards should be used in conjunction with the Advanced Training in Gastroenterology LTA programs.

Download the curriculum standards PDF

Competencies

Competencies outline the expected professional behaviours, values and practices that trainees need to achieve by the end of training. Competencies are grouped by the 10 domains of the professional practice framework. Competencies will be common across all or most training programs.


Medical expertise

Professional standard. Physicians apply knowledge and skills informed by best available current evidence in the delivery of high quality, safe practice to facilitate agreed health outcomes for individual patients and populations.

Knowledge. Apply knowledge of the scientific basis of health and disease to the diagnosis and management of patients.

Synthesis. Gather relevant data via age- and context-appropriate means to develop reasonable differential diagnoses, recognising and considering interactions and impacts of comorbidities.

Diagnosis and management. Develop diagnostic and management plans that integrate an understanding of individual patient circumstances, including psychosocial factors and specific vulnerabilities, epidemiology, and population health factors in partnership with patients, families, or carers, and in collaboration with the health care team.

Communication

Professional standard. Physicians collate information, and share this information clearly, accurately, respectfully, responsibly, empathetically and in a manner that is understandable. Physicians share information responsibly with patients, families, carers, colleagues, community groups, the public, and other stakeholders to facilitate optimal health outcomes.

Effective communication. Uses a range of effective and appropriate verbal, nonspeaking, and written communication techniques, including active listening.

Communication with patients, families, and carers. Use collaborative, effective, and empathetic communication with patients, families, and carers.

Communication with professionals and professional bodies. Use collaborative, respectful, and empathetic clinical communication with colleagues, other health professionals, professional bodies, and agencies.

Written communication. Document and share information about patients to optimise patient care and safety.

Privacy and confidentiality. Maintain appropriate privacy and confidentiality, and share information responsibly.

Quality and safety

Professional standard. Physicians practice in a safe, high quality manner within the limits of their expertise. Physicians regularly review and evaluate their own practice alongside peers and best practice standards and conduct continuous improvement activities.

Patient safety. Demonstrate a safety focus and continuous improvement approach to own practice and health systems.

Harm prevention and management. Identify and report risks, adverse events and errors to improve healthcare systems.

Quality improvement. Participate in quality improvement activities to improve quality of care and safety of the work environment.

Patient engagement. Enable patients to contribute to the safety of their care.

Teaching and learning

Professional standard. Physicians demonstrate a lifelong commitment to excellence in practice through continuous learning and evaluating evidence. Physicians foster the learning of others in their profession through a commitment to mentoring, supervising, and teaching.1

Lifelong learning. Undertake effective self-education and continuing professional development.

Self-evaluation. Evaluate and reflect on gaps in own knowledge and skills to inform self-directed learning.

Supervision. Provide supervision for junior colleagues and/or team members.

Teaching. Apply appropriate educational techniques to facilitate the learning of colleagues and other health professionals.

Patient education. Apply appropriate educational techniques to promote understanding of health and disease amongst patients and populations.

References

1. Adapted from Richardson D, Oswald A, Chan M-K, Lang ES, Harvey BJ. Scholar. In: Frank JR, Snell L, Sherbino J, editors. The Draft CanMEDS 2015 Physician Competency Framework – Series IV. Ottawa: The Royal College of Physicians and Surgeons of Canada; 2015 March.

Research

Professional standard. Physicians support creation, dissemination and translation of knowledge and practices applicable to health. They do this by engaging with and critically appraising research and applying it in policy and practice to improve the health outcomes of patients and populations.

Evidence-based practice. Critically analyse relevant literature and refer to evidence-based clinical guidelines and apply these in daily practice.

Research. Apply research methodology to add to the body of medical knowledge and improve practice and health outcomes.

Cultural safety*

This is a placeholder for the competencies in the cultural safety domain.

These competencies will be included at a later date.

Professional standard. Physicians engage in iterative and critical self-reflection of their own cultural identity, power, biases, prejudices, and practising behaviours. Together with the requirement of understanding the cultural rights of the community they serve, this brings awareness and accountability for the impact of the physician’s own culture on decision making and health care delivery. It also allows for an adaptive practice where power is shared between patients, family, whānau and/or community and the physician, to improve health outcomes.

Physicians recognise the patient and population’s rights for culturally safe care, including being an ally for patient, family, whānau and/or community autonomy and agency over their decision making. This shift in the physician's perspective fosters collaborative and engaged therapeutic relationships, allows for strength-based (or mana-enhanced) decisions, and sharing of power with the recipient of the care, optimising health care outcomes.

Physicians critically analyse their environment to understand how colonialism, systemic racism, social determinants of health, and other sources of inequity have and continue to underpin the healthcare context. Consequently, physicians then can recognise their interfacing with, and contribution to, the environment in which they work to advocate for safe, more equitable and decolonised services and create an inclusive and safe workplace for all colleagues and team members of all cultural backgrounds.2

*The RACP has adopted the Medical Council of New Zealand’s definition of cultural safety: Cultural safety can be defined as:

  • the need for doctors to examine themselves and the potential impact of their own culture on clinical interactions and healthcare service delivery.
  • the commitment by individual doctors to acknowledge and address any of their own biases, attitudes, assumptions, stereotypes, prejudices, structures, and characteristics that may affect the quality of care provided.
  • the awareness that cultural safety encompasses a critical consciousness where health professionals and healthcare organisations engage in ongoing self-reflection and self-awareness and hold themselves accountable for providing culturally safe care, as defined by the patient and their communities.

References

2. Curtis et al. “Why cultural safety rather than cultural competency is required to achieve health equity”. International Journal for Equity in Health (2019) 18:174

Ethics and professional behaviour

Professional standard. Physicians’ practice is founded upon ethics, and physicians always treat patients and their families in a caring and respectful manner. Physicians demonstrate their commitment and accountability to the health and well-being of individual patients, communities, populations and society through ethical practice. Physicians demonstrate high standards of personal behaviour.

Beliefs and attitudes. Reflect critically on personal beliefs and attitudes, including how these may impact on patients’ care.

Honesty and openness. Act honestly, including reporting accurately and acknowledging their own errors.

Patient welfare. Prioritise patients’ welfare and community benefit above self-interest.

Accountability. Be personally and socially accountable.

Personal limits. Practise within their own limits and according to ethical and professional guidelines.

Self-care. Implement strategies to maintain personal health and wellbeing.

Respect for peers. Recognise and respect the personal and professional integrity, roles, and contribution of peers.

Interaction with professionals. Interact equitably, collaboratively, and respectfully with other health professionals.

Respect and sensitivity. Respect patients, maintain appropriate relationships, and behave equitably.

Privacy and confidentiality. Protect and uphold patients’ rights to privacy and confidentiality.

Compassion and empathy. Demonstrate a caring attitude towards patients and endeavour to understand patients’ values and beliefs.

Health needs. Understand and address patients’, families’, carers’, and colleagues’ physical and emotional health needs.

Medical and health ethics and law. Practise according to current community and professional ethical standards and legal requirements.

Judgement and decision making

Professional standard. Physicians collect and interpret information, and evaluate and synthesise evidence, to make the best possible decisions in their practice. Physicians negotiate, implement, and review their decisions and recommendations with patients, their families and carers, and other healthcare professionals.

Diagnostic reasoning. Apply sound diagnostic reasoning to clinical problems to make logical and safe clinical decisions.

Resource allocation. Apply judicious and cost-effective use of health resources to their practice.

Task delegation. Apply good judgement and decision making to the delegation of tasks.

Limits of practice. Recognise their own limitations and consult others when required.

Shared decision making. Contribute effectively to team-based decision-making processes.

Leadership, management, and teamwork

Professional standard. Physicians recognise, respect, and aim to develop the skills of others, and engage collaboratively to achieve optimal outcomes for patients and populations. Physicians contribute to and make decisions about policy, protocols, and resource allocation at personal, professional, organisational, and societal levels. Physicians work effectively in diverse multidisciplinary teams and promote a safe, productive, and respectful work environment that is free from discrimination, bullying, and harassment.

Managing others. Lead teams, including setting directions, resolving conflicts, and managing individuals.

Wellbeing. Consider and work to ensure the health and safety of colleagues and other health professionals.

Leadership. Act as a role model and leader in professional practice.

Teamwork. Negotiate responsibilities within the health care team and function as an effective team member.

Health policy, systems, and advocacy

Professional standard. Physicians apply their knowledge of the nature and attributes of local, national, and global health systems to their own practices. They identify, evaluate, and influence health determinants through local, national, and international policy. Physicians deliver and advocate for the best health outcomes for all patients and populations.

Health needs. Respond to the health needs of the local community and the broader health needs of the people of Australia and Aotearoa New Zealand.

Prevention and promotion. Incorporate disease prevention, health promotion, and health surveillance into interactions with individual patients and their social support networks.

Equity and access. Work with patients and social support networks to address determinants of health that affect them and their access to needed health services or resources.

Stakeholder engagement. Involve communities and patient groups in decisions that affect them to identify priority problems and solutions.

Advocacy. Advocate for prevention, promotion, equity, and access to support patient and population health needs within and outside the clinical environment.

Resource allocation. Understand the factors influencing resource allocation, promote efficiencies and advocate to reduce inequities.

EPA 1: Team leadership

EPA 1

Team leadership

Lead a team of health professionals

This activity requires the ability to:

  • prioritise workload
  • manage multiple concurrent tasks
  • articulate individual responsibilities, expertise, and accountability of team members
  • understand the range of team members' skills, expertise, and roles
  • acquire and apply leadership techniques in daily practice
  • collaborate with and motivate team members
  • encourage and adopt insights from team members
  • act as a role model.

Professional practice framework domain

Medical expertise

confident
Ready to perform without supervision

Expected behaviours of a trainee who can routinely perform this activity without needing supervision

The trainee will:

  • synthesise information from other disciplines to develop an optimal, goal-centred plan for the patient
  • assess and effectively manage clinical risk in various scenarios
  • demonstrate clinical competence and skills by effectively supporting team members

direction
Requires some supervision

Possible behaviours of a trainee who needs some supervision to perform this activity

The trainee may:

  • demonstrate adequate knowledge of health care issues by interpreting complex information
  • assess the spectrum of problems to be addressed
  • apply medical knowledge to assess the impact and clinical outcomes of management decisions
  • provide coordinated and quality health care for populations or patients as a member of a multidisciplinary team

Communication

confident
Ready to perform without supervision

Expected behaviours of a trainee who can routinely perform this activity without needing supervision

The trainee will:

  • provide support and motivate patients or populations and health professionals by effective communication
  • demonstrate a transparent, consultative style by engaging patients, families, carers, relevant professionals and/or the public in shared decision making
  • demonstrate rapport with people at all levels by tailoring messages to different stakeholders
  • work with patients, families, carers, and other health professionals to resolve conflict that may arise when planning and aligning goals

direction
Requires some supervision

Possible behaviours of a trainee who needs some supervision to perform this activity

The trainee may:

  • communicate adequately with colleagues
  • communicate adequately with patients and families or carers and/or the public
  • respect the roles of team members

Quality and safety

confident
Ready to perform without supervision

Expected behaviours of a trainee who can routinely perform this activity without needing supervision

The trainee will:

  • identify opportunities to improve care by participating in surveillance and monitoring of adverse events and near misses
  • identify activities within systems to reduce errors, improve patient and population safety, and implement cost effective change
  • place safety and quality of care first in all decision making

direction
Requires some supervision

Possible behaviours of a trainee who needs some supervision to perform this activity

The trainee may:

  • participate in audits and other activities that affect the quality and safety of patients’ care
  • participate in multidisciplinary collaboration to provide effective health services and operational change
  • use information resources and electronic medical record technology where available

Teaching and learning

confident
Ready to perform without supervision

Expected behaviours of a trainee who can routinely perform this activity without needing supervision

The trainee will:

  • regularly self-evaluate personal professional practice, and implement changes based on the results
  • actively seek feedback from supervisors and colleagues on their own performance
  • identify personal gaps in knowledge and skills, and engage in self-directed learning
  • maintain current knowledge of new technologies, health care priorities and changes of patients’ expectations
  • teach competently by imparting professional knowledge
  • manage and monitor learner progress providing regular assessment and feedback

direction
Requires some supervision

Possible behaviours of a trainee who needs some supervision to perform this activity

The trainee may:

  • accept feedback constructively, and change behaviour in response
  • recognise the limits of personal expertise, and involve other health professionals as needed
  • demonstrate basic skills in facilitating colleagues’ learning

Research

confident
Ready to perform without supervision

Expected behaviours of a trainee who can routinely perform this activity without needing supervision

The trainee will:

  • ensure that any protocol for human research is approved by a human research ethics committee, in accordance with the national statement on ethical conduct in human research

direction
Requires some supervision

Possible behaviours of a trainee who needs some supervision to perform this activity

The trainee may:

  • understand that patient participation in research is voluntary and based on an appropriate understanding about the purpose, methods, demands, risks, and potential benefits of the research

Cultural competence

confident
Ready to perform without supervision

Expected behaviours of a trainee who can routinely perform this activity without needing supervision

The trainee will:

  • demonstrate culturally competent relationships with professional colleagues and patients
  • demonstrate respect for diversity and difference
  • take steps to minimise unconscious bias, including the impact of gender, religion, cultural beliefs, and socioeconomic background on decision making

direction
Requires some supervision

Possible behaviours of a trainee who needs some supervision to perform this activity

The trainee may:

  • demonstrate awareness of cultural diversity and unconscious bias
  • work effectively and respectfully with people from different cultural backgrounds

Ethics and professional behaviour

confident
Ready to perform without supervision

Expected behaviours of a trainee who can routinely perform this activity without needing supervision

The trainee will:

  • promote a team culture of shared accountability for decisions and outcomes
  • encourage open discussions of ethical and clinical concerns
  • respect differences of multidisciplinary team members
  • understand the ethics of resource allocation by aligning optimal patients and organisational care
  • effectively consult with stakeholders to achieve a balance of alternative views
  • acknowledge personal conflicts of interest and unconscious bias
  • act collaboratively to resolve behavioural incidents and conflicts such as harassment and bullying

direction
Requires some supervision

Possible behaviours of a trainee who needs some supervision to perform this activity

The trainee may:

  • support ethical principles in clinical decision making
  • maintain standards of medical practice by recognising the health interests of patients or populations as primary responsibilities
  • respect the roles and expertise of other health professionals
  • work effectively as a member of a team
  • promote team values of honesty, discipline, and commitment to continuous improvement
  • demonstrate understanding of the negative impact of workplace conflict

Judgement and decision making

confident
Ready to perform without supervision

Expected behaviours of a trainee who can routinely perform this activity without needing supervision

The trainee will:

  • evaluate health services and clarify expectations to support systematic and transparent decision making
  • make decisions when faced with multiple and conflicting perspectives
  • ensure medical input to organisational decision making
  • adopt a systematic approach to analysing information from a variety of specialties to make decisions that benefit health care delivery

direction
Requires some supervision

Possible behaviours of a trainee who needs some supervision to perform this activity

The trainee may:

  • monitor services and provide appropriate advice
  • review new health care interventions and resources
  • interpret appropriate data and evidence for decision making

Leadership, management, and teamwork

confident
Ready to perform without supervision

Expected behaviours of a trainee who can routinely perform this activity without needing supervision

The trainee will:

  • combine team members’ skills and expertise in delivering patient care and/or population advice
  • develop and lead effective multidisciplinary teams by developing and implementing strategies to motivate others
  • build effective relationships with multidisciplinary team members to achieve optimal outcomes
  • ensure all members of the team are accountable for their individual practice

direction
Requires some supervision

Possible behaviours of a trainee who needs some supervision to perform this activity

The trainee may:

  • understand the range of personal and other team members’ skills, expertise, and roles
  • acknowledge and respect the contribution of all health professionals involved in patient care
  • participate effectively and appropriately in multidisciplinary teams
  • seek out and respect the perspectives of multidisciplinary team members when making decisions

Health policy, systems, and advocacy

confident
Ready to perform without supervision

Expected behaviours of a trainee who can routinely perform this activity without needing supervision

The trainee will:

  • engage in appropriate consultation with stakeholders on the delivery of health care
  • advocate for the resources and support for health care teams to achieve organisational priorities
  • influence the development of organisational policies and procedures to optimise health outcomes
  • identify the determinants of health of the population, and mitigate barriers to access to care
  • remove self-interest from solutions to health advocacy issues

direction
Requires some supervision

Possible behaviours of a trainee who needs some supervision to perform this activity

The trainee may:

  • communicate with stakeholders within the organisation about health care delivery
  • understand methods used to allocate resources to provide high quality care
  • promote the development and use of organisational policies and procedures

EPA 2: Supervision and teaching

EPA 2

Supervision and teaching

Supervise and teach professional colleagues

This activity requires the ability to:

  • provide work-based teaching in a variety of settings
  • teach professional skills
  • create a safe and supportive learning environment
  • plan, deliver, and provide work-based assessments
  • encourage learners to be self-directed and identify learning experiences
  • supervise learners in day-to-day work and provide feedback
  • support learners to prepare for assessments.

Professional practice framework domain

Medical expertise

confident
Ready to perform without supervision

Expected behaviours of a trainee who can routinely perform this activity without needing supervision

The trainee will:

  • combine high-quality care with high-quality teaching
  • explain the rationale underpinning a structured approach to decision making
  • consider the patient-centric view during consultations
  • consider the population health effect when giving advice
  • encourage learners to consider the rationale and appropriateness of investigation and management options

direction
Requires some supervision

Possible behaviours of a trainee who needs some supervision to perform this activity

The trainee may:

  • teach learners using basic knowledge and skills

Communication

confident
Ready to perform without supervision

Expected behaviours of a trainee who can routinely perform this activity without needing supervision

The trainee will:

  • listen and convey information clearly and considerately
  • establish rapport and demonstrate respect for junior colleagues, medical students, and other health professionals
  • communicate effectively when teaching, assessing, and appraising learners
  • actively encourage a collaborative and safe learning environment with learners and other health professionals
  • support learners to deliver clear, concise, and relevant information in both verbal and written communication
  • encourage learners to tailor communication as appropriate for different patients (e.g. younger or older people) and/or different populations

direction
Requires some supervision

Possible behaviours of a trainee who needs some supervision to perform this activity

The trainee may:

  • observe learners to reduce risks and improve health outcomes

Quality and safety

confident
Ready to perform without supervision

Expected behaviours of a trainee who can routinely perform this activity without needing supervision

The trainee will:

  • support learners to deliver quality care while maintaining their own wellbeing
  • apply lessons learned about patient safety by identifying and discussing risks with learners
  • assess learners’ competence, and provide timely feedback to minimise risks to care
  • maintain the safety of patients and organisations involved with education, and appropriately identify and action concerns

direction
Requires some supervision

Possible behaviours of a trainee who needs some supervision to perform this activity

The trainee may:

  • observe learners to reduce risks and improve health outcomes

Teaching and learning

confident
Ready to perform without supervision

Expected behaviours of a trainee who can routinely perform this activity without needing supervision

The trainee will:

  • demonstrate knowledge of the principles, processes, and skills of supervision
  • provide direct guidance to learners in day-to-day work
  • work with learners to identify professional development and learning opportunities based on their individual learning needs
  • offer feedback and role modelling
  • participate in teaching and supervision of professional development activities
  • encourage self-directed learning and assessment
  • develop a consistent and fair approach to assessing learners
  • tailor feedback and assessment to learners’ goals
  • seek feedback and reflect on own teaching by developing goals and strategies to improve
  • establish and maintain effective mentoring through open dialogue
  • support learners to identify and attend formal and informal learning opportunities
  • recognise the limits of personal expertise, and involve others appropriately

direction
Requires some supervision

Possible behaviours of a trainee who needs some supervision to perform this activity

The trainee may:

  • demonstrate basic skills in the supervision of learners
  • not tailor learning, assessment, and feedback to individual learners
  • not match teaching and learning objectives clearly to outcomes
  • not encourage learners to be self-directed

Research

confident
Ready to perform without supervision

Expected behaviours of a trainee who can routinely perform this activity without needing supervision

The trainee will:

  • clarify junior colleagues’ research projects’ goals and requirements, and provide feedback on the merits or challenges of proposed research
  • monitor the progress of learners’ research projects regularly, and may review research projects prior to submission
  • support learners to find forums to present research projects
  • encourage and guide learners to seek out relevant research to support practice

direction
Requires some supervision

Possible behaviours of a trainee who needs some supervision to perform this activity

The trainee may:

  • guide learners with respect to the choice of research projects
  • ensure that the research projects planned are feasible and of suitable standards

Cultural competence

confident
Ready to perform without supervision

Expected behaviours of a trainee who can routinely perform this activity without needing supervision

The trainee will:

  • consider cultural, ethical and religious values and beliefs in teaching and learning
  • role model a culturally appropriate approach to teaching
  • encourage learners to seek out opportunities to develop and improve their cultural competence
  • encourage learners to consider culturally appropriate care of Aboriginal and Torres Strait Islander and Māori peoples in patients’ management

direction
Requires some supervision

Possible behaviours of a trainee who needs some supervision to perform this activity

The trainee may:

  • function effectively and respectfully when working with and teaching with people from different cultural backgrounds

Ethics and professional behaviour

confident
Ready to perform without supervision

Expected behaviours of a trainee who can routinely perform this activity without needing supervision

The trainee will:

  • apply principles of ethical practice to teaching scenarios
  • act as a role model to promote professional responsibility and ethics among learners
  • respond appropriately to learners seeking professional guidance

direction
Requires some supervision

Possible behaviours of a trainee who needs some supervision to perform this activity

The trainee may:

  • demonstrate professional values, including commitment to high-quality clinical standards, compassion, empathy, and respect
  • provide learners with feedback to improve their experiences

Judgement and decision making

confident
Ready to perform without supervision

Expected behaviours of a trainee who can routinely perform this activity without needing supervision

The trainee will:

  • prioritise workloads and manage learners with different levels of professional knowledge or experience
  • link theory and practice when explaining professional decisions
  • promote joint problem solving
  • support a learning environment that allows for independent decision making
  • use sound and evidence-based judgement during assessments and when communicating feedback to learners
  • escalate concerns about learners appropriately

direction
Requires some supervision

Possible behaviours of a trainee who needs some supervision to perform this activity

The trainee may:

  • provide general advice and support to learners
  • use health data logically and effectively to investigate difficult diagnostic problems

Leadership, management, and teamwork

confident
Ready to perform without supervision

Expected behaviours of a trainee who can routinely perform this activity without needing supervision

The trainee will:

  • maintain personal and learners’ effective performances and continuing professional development
  • maintain professional, clinical, research and/or administrative responsibilities while teaching
  • help to shape organisational culture to prioritise quality and work safety through openness, honesty, shared learning, and continued improvement
  • create an inclusive environment in which learners feel part of the team

direction
Requires some supervision

Possible behaviours of a trainee who needs some supervision to perform this activity

The trainee may:

  • demonstrate the principles and practice of professionalism and leadership in health care
  • participate in mentor programs, career advice, and general counselling

Health policy, systems, and advocacy

confident
Ready to perform without supervision

Expected behaviours of a trainee who can routinely perform this activity without needing supervision

The trainee will:

  • advocate for suitable resources to provide quality supervision and maintain training standards
  • explain the value of health data in the care of patients or populations
  • support innovation in teaching and training

direction
Requires some supervision

Possible behaviours of a trainee who needs some supervision to perform this activity

The trainee may:

  • not integrate public health principals into teaching and practice

EPA 3: Quality improvement

EPA 3

Quality improvement

Identify and address failures in health care delivery

This activity requires the ability to:

  • identify and report actual and potential (near miss) errors
  • conduct and evaluate system improvement activities
  • adhere to best practice guidelines
  • audit clinical guidelines and outcomes
  • contribute to the development of policies and protocols designed to protect patients and enhance health care
  • monitor one’s own practice and develop individual improvement plans.

Professional practice framework domain

Medical expertise

confident
Ready to perform without supervision

Expected behaviours of a trainee who can routinely perform this activity without needing supervision

The trainee will:

  • use population health outcomes to identify opportunities for improvement in delivering appropriate care
  • evaluate environmental and lifestyle health risks, and advocate for healthy lifestyle choices
  • use standardised protocols to adhere to best practice and prevent the occurrence of wrong site/wrong patient procedures
  • regularly monitor personal professional performance

direction
Requires some supervision

Possible behaviours of a trainee who needs some supervision to perform this activity

The trainee may:

  • contribute to processes on identified opportunities for improvement
  • recognise the importance of prevention and early detection in clinical practice
  • use local guidelines to assist patient care decision making

Communication

confident
Ready to perform without supervision

Expected behaviours of a trainee who can routinely perform this activity without needing supervision

The trainee will:

  • support patients to have access to, and use, high-quality, easy-to-understand information about health care
  • support patients to share decision making about their own health care, to the extent they choose
  • assist patients’ access to their health information, as well as complaint and feedback systems
  • discuss with patients any safety and quality concerns they have relating to their care
  • implement organisation's open disclosure policy

direction
Requires some supervision

Possible behaviours of a trainee who needs some supervision to perform this activity

The trainee may:

  • demonstrate awareness of the evidence for consumer engagement and its contribution to quality improvement in health care
  • apply knowledge of how health literacy might affect the way patients or populations gain access to, understand, and use health information

Quality and safety

confident
Ready to perform without supervision

Expected behaviours of a trainee who can routinely perform this activity without needing supervision

The trainee will:

  • demonstrate safety skills including infection control, adverse event reporting, and effective clinical handover
  • participate in organisational quality and safety activities, including morbidity and mortality reviews and clinical incident reviews
  • participate in systems for surveillance and monitoring of adverse events and near misses, including reporting such events
  • ensure that identified opportunities for improvement are raised and reported appropriately
  • use clinical audits and registries of data on patients’ experiences and outcomes, and learn from incidents and complaints, to improve health care

direction
Requires some supervision

Possible behaviours of a trainee who needs some supervision to perform this activity

The trainee may:

  • demonstrate understanding of a system approach to improving the quality and safety of health care
  • demonstrate understanding of the principles of root cause analyses (RCA) and corrective action preventative action (CAPA) plans, and participate as a member of the team if possible

Teaching and learning

confident
Ready to perform without supervision

Expected behaviours of a trainee who can routinely perform this activity without needing supervision

The trainee will:

  • translate quality improvement approaches and methods into practice
  • participate in professional training in quality and safety to ensure a contemporary approach to safety system strategies
  • supervise and manage the performance of junior colleagues in the delivery of safe, high-quality care

direction
Requires some supervision

Possible behaviours of a trainee who needs some supervision to perform this activity

The trainee may:

  • work within organisational quality and safety systems for the delivery of clinical care
  • use opportunities to learn about safety and quality theory and systems

Research

confident
Ready to perform without supervision

Expected behaviours of a trainee who can routinely perform this activity without needing supervision

The trainee will:

  • ensure that any protocol for human research is approved by a human research ethics committee, in accordance with the national statement on ethical conduct in human research

direction
Requires some supervision

Possible behaviours of a trainee who needs some supervision to perform this activity

The trainee may:

  • understand that patient participation in research is voluntary and based on an appropriate understanding about the purpose, methods, demands, risks, and potential benefits of the research

Cultural competence

confident
Ready to perform without supervision

Expected behaviours of a trainee who can routinely perform this activity without needing supervision

The trainee will:

  • undertake professional development opportunities that address the impact of cultural bias on health outcomes

direction
Requires some supervision

Possible behaviours of a trainee who needs some supervision to perform this activity

The trainee may:

  • communicate effectively with patients from culturally and linguistically diverse backgrounds

Ethics and professional behaviour

confident
Ready to perform without supervision

Expected behaviours of a trainee who can routinely perform this activity without needing supervision

The trainee will:

  • align improvement goals with the priorities of the organisation
  • contribute to developing an organisational culture that enables and prioritises patients’ safety and quality of care

direction
Requires some supervision

Possible behaviours of a trainee who needs some supervision to perform this activity

The trainee may:

  • comply with professional regulatory requirements and codes of conduct

Judgement and decision making

confident
Ready to perform without supervision

Expected behaviours of a trainee who can routinely perform this activity without needing supervision

The trainee will:

  • use decision-making support tools, such as guidelines, protocols, pathways, and reminders
  • analyse and evaluate current care processes to improve health care

direction
Requires some supervision

Possible behaviours of a trainee who needs some supervision to perform this activity

The trainee may:

  • access information and advice from other health care practitioners to identify, evaluate, and improve patients’ care management

Leadership, management, and teamwork

confident
Ready to perform without supervision

Expected behaviours of a trainee who can routinely perform this activity without needing supervision

The trainee will:

  • formulate and implement quality improvement strategies as a collaborative effort, involving all key health professionals
  • support multidisciplinary team activities to lower patients' risk of harm, and promote multidisciplinary programs of education
  • actively involve clinical pharmacists in the medication use process

direction
Requires some supervision

Possible behaviours of a trainee who needs some supervision to perform this activity

The trainee may:

  • demonstrate attitudes of respect and cooperation among members of different professional teams
  • partner with clinicians and managers to ensure that patients receive appropriate care and information on their care

Health policy, systems, and advocacy

confident
Ready to perform without supervision

Expected behaviours of a trainee who can routinely perform this activity without needing supervision

The trainee will:

  • participate in all aspects of the development, implementation, evaluation, and monitoring of governance processes
  • participate regularly in multidisciplinary meetings in which quality and safety issues are standing agenda items and innovative ideas and projects for improving care are actively encouraged
  • measure, analyse, and report on a set of specialty specific process of care and outcome clinical indicators, and a set of generic safety indicators
  • take part in the design and implementation of the organisational systems for:
    • defining the scope of clinical practice
    • performance monitoring and management
    • clinical, and safety and quality, education and training

direction
Requires some supervision

Possible behaviours of a trainee who needs some supervision to perform this activity

The trainee may:

  • maintain a dialogue with service managers about issues that affect patient care
  • contribute to relevant organisational policies and procedures
  • help to shape an organisational culture that prioritises safety and quality through openness, honesty, learning, and quality improvement

EPA 4: Clinical assessment and management, including prescribing

EPA 4

Clinical assessment and management, including prescribing

Clinically assess and manage the ongoing care of patients, including prescribing

This activity requires the ability to:

  • identify and access sources of relevant information about patients
  • obtain patient histories
  • examine patients
  • synthesise findings to develop provisional and differential diagnoses
  • discuss findings with patients, families and/or carers
  • generate a management plan
  • present findings to other health professionals.

Professional practice framework domain

Medical expertise

confident
Ready to perform without supervision

Expected behaviours of a trainee who can routinely perform this activity without needing supervision

The trainee will:

  • elicit an accurate, organised, and problem-focused medical history (including collateral history) considering physical, psychosocial, and risk factors
  • perform a full physical examination to establish the nature and extent of problems
  • synthesise and interpret findings from the history and examination to devise the most likely provisional diagnoses via reasonable differential diagnoses
  • assess the severity of problems, the likelihood of complications and clinical outcomes
  • identify and evaluate information relevant to the provisional and differential diagnosis
  • develop management plans based on relevant information, and consider the balance of benefit and harm by taking patients’ personal sets of circumstances into account
  • review medicines regularly to reduce non-adherence, monitor treatment effectiveness, possible side effects, and drug interactions, and cease unnecessary medicines

direction
Requires some supervision

Possible behaviours of a trainee who needs some supervision to perform this activity

The trainee may:

  • take patient-centred histories, considering psychosocial factors
  • perform accurate physical examinations
  • recognise and correctly interpret abnormal findings
  • synthesise pertinent information to direct the clinical encounter and diagnostic categories
  • develop appropriate management plans
  • be aware of potential side effects and practical prescription points, such as medication compatibility and monitoring in response to therapies

Communication

confident
Ready to perform without supervision

Expected behaviours of a trainee who can routinely perform this activity without needing supervision

The trainee will:

  • communicate openly, listen, and take patients’, families' or carers' concerns seriously, and give them adequate opportunity to question
  • provide information to patients, family, or carers to enable them to make informed decisions from various diagnostic, therapeutic, and management options
  • communicate clearly, effectively, respectfully, and promptly with other health professionals involved in patients’ care
  • discuss and evaluate the risk and benefits of treatment options, making decisions in partnership with patients

direction
Requires some supervision

Possible behaviours of a trainee who needs some supervision to perform this activity

The trainee may:

  • anticipate, read, and respond to verbal and nonspeaking cues
  • demonstrate active listening skills
  • communicate patients’ situations to colleagues, including senior clinicians

Quality and safety

confident
Ready to perform without supervision

Expected behaviours of a trainee who can routinely perform this activity without needing supervision

The trainee will:

  • demonstrate safety skills including infection control, adverse event reporting, and effective clinical handover
  • recognise and effectively deal with aggressive and violent patient behaviours through appropriate training
  • obtain informed consent before undertaking any investigation or providing treatment, except in emergencies
  • ensure that patients are informed of the material risks associated with any part of the proposed management plans
  • assess indications, contraindications, safety profiles, and potential benefits when prescribing medications

direction
Requires some supervision

Possible behaviours of a trainee who needs some supervision to perform this activity

The trainee may:

  • perform hand hygiene and take infection control precautions at appropriate moments
  • take precaution against assaults from confused or agitated patients, and ensure appropriate care of patients
  • document history and physical examination findings, and synthesise with clarity and completeness

Teaching and learning

confident
Ready to perform without supervision

Expected behaviours of a trainee who can routinely perform this activity without needing supervision

The trainee will:

  • set defined objectives for clinical teaching encounters, and solicit feedback on mutually agreed goals
  • regularly reflect upon and self-evaluate professional development
  • obtain informed consent before involving patients in teaching activities
  • turn clinical activities into an opportunity to teach, appropriate to the setting

direction
Requires some supervision

Possible behaviours of a trainee who needs some supervision to perform this activity

The trainee may:

  • set unclear goals and objectives for self-learning
  • self-reflect infrequently
  • deliver teaching considering learners’ level of training

Research

confident
Ready to perform without supervision

Expected behaviours of a trainee who can routinely perform this activity without needing supervision

The trainee will:

  • search for, find, compile, analyse, interpret, and evaluate information relevant to the research subject

direction
Requires some supervision

Possible behaviours of a trainee who needs some supervision to perform this activity

The trainee may:

  • refer to guidelines and medical literature to assist in clinical assessments when required
  • demonstrate an understanding of the limitations of the evidence and the challenges of applying research in daily practice

Cultural competence

confident
Ready to perform without supervision

Expected behaviours of a trainee who can routinely perform this activity without needing supervision

The trainee will:

  • acknowledge patients’ beliefs and values, and how these might impact on health
  • demonstrate effective and culturally competent communication and care for Aboriginal and Torres Strait Islander and Māori peoples, and members of other cultural groups
  • use a professional interpreter, a health advocate, or a family or community member to assist in communication with patients
  • use plain language patient education materials, and be culturally and linguistically sensitive

direction
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
  • appropriately access interpretive or culturally focused services

Ethics and professional behaviour

confident
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
  • hold information about patients in confidence, unless the release of information is required by law or public interest
  • assess patients’ capacity for decision making, and involve a proxy decision maker appropriately

direction
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 or professional agendas at the expense of patient or social welfare
  • consider the efficacy of medicines in treating illnesses, including the relative merits of different pharmacological and nonpharmacological options

Judgement and decision making

confident
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
  • make logical, rational decisions, and act to achieve positive patients’ outcomes
  • use a holistic approach to health considering comorbidity, uncertainty, and risk
  • use the best available evidence for the most effective therapies and interventions to ensure quality care
  • evaluate new medicines in relation to their possible efficacy and safety profile for individual patients

direction
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
  • recognise personal limitations, and seek help in an appropriate way when required
  • consider the following factors for all medicines:
    • contraindications
    • cost to patients, families, and the community
    • funding and regulatory considerations
    • generic versus brand medicines
    • interactions
    • risk-benefit analysis

Leadership, management, and teamwork

confident
Ready to perform without supervision

Expected behaviours of a trainee who can routinely perform this activity without needing supervision

The trainee will:

  • work effectively as a member of multidisciplinary teams to achieve patients’ best health outcomes
  • demonstrate awareness of colleagues in difficulty, and work within the appropriate structural systems to support them while maintaining patient safety
  • advocate for patients when conflicts occur between the medical team

direction
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

Health policy, systems, and advocacy

confident
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
  • aim to achieve the optimal cost-effective patient care to allow maximum benefit from the available resources

direction
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 health system relevant to patients’ care
  • identify and access relevant community resources to support patient care
  • prescribe in accordance with the organisational policy

EPA 5: Acute care

EPA 5

Acute care

Manage the early care of acutely unwell patients

This activity requires the ability to:

  • assess seriously unwell or injured patients and initiate management
  • recognise clinical deterioration, and respond by following the local process for escalation of care
  • recognise and manage acutely unwell patients who require resuscitation
  • lead the resuscitation team initially, and involve other necessary services
  • liaise with transport services and medical teams, including anaesthetists, surgeons, and theatre staff
  • perform this activity primarily in inpatient settings.

Professional practice framework domain

Medical expertise

confident
Ready to perform without supervision

Expected behaviours of a trainee who can routinely perform this activity without needing supervision

The trainee will:

  • recognise immediately life-threatening conditions and deteriorating and critically unwell patients, and respond appropriately, including organisation and coordination of logistics for emergency procedures if required (e.g. emergency endoscopic procedures)
  • perform advanced life support according to resuscitation council guidelines to a high level of advanced resuscitation skills
  • demonstrate knowledge of potential risks and complications of resuscitation
  • effectively assess, diagnose, and manage acute undifferentiated clinical presentations
  • select investigations that ensure maximum patient safety through excluding or diagnosing critical patient issues
  • systematically identify causes of acute deterioration in health status and levels of physical and cognitive functioning
  • proactively, and in a timely manner, manage escalations or transitions of care
  • develop plans of multidisciplinary treatment, rehabilitation, and secondary prevention following acute events
  • provide clear and effective discharge summaries with recommendations for ongoing care

direction
Requires some supervision

Possible behaviours of a trainee who needs some supervision to perform this activity

The trainee may:

  • recognise seriously unwell patients requiring immediate care, and respond appropriately
  • apply basic life support as indicated
  • understand general medical principles of caring for patients with undifferentiated and undiagnosed conditions
  • identify potential causes of current deterioration, and comply with escalation protocols
  • facilitate initial tests to assist in diagnosis, and develop management plans for immediate treatment
  • document information to outline the rationale for clinical decisions and action plans
  • assess perioperative and periprocedural patients

Communication

confident
Ready to perform without supervision

Expected behaviours of a trainee who can routinely perform this activity without needing supervision

The trainee will:

  • communicate clearly with other team members, and coordinate efforts of multidisciplinary team members
  • use closed-loop and clear communication with other health care team members during resuscitation
  • facilitate early communication with patients, families, carers, and health care team members to allow for shared decision making
  • negotiate realistic treatment goals, and determine and explain the expected prognosis and outcomes
  • employ communication strategies appropriate for younger patients or those with cognitive difficulties
  • explain the situation to patients in a sensitive and supportive manner, avoiding jargon, and confirm their understanding
  • determine the level of health literacy and level of understanding of agreed care decisions of individual patients

direction
Requires some supervision

Possible behaviours of a trainee who needs some supervision to perform this activity

The trainee may:

  • demonstrate communication skills to sufficiently support the function of multidisciplinary teams
  • if possible, determine patients’ understanding of their diseases and what they perceive as the most desirable goals of care

Quality and safety

confident
Ready to perform without supervision

Expected behaviours of a trainee who can routinely perform this activity without needing supervision

The trainee will:

  • maintain up-to-date certification in advanced life support
  • use clinical information technology systems for conducting retrospective and prospective clinical audits
  • evaluate and explain the benefits and risks of clinical interventions based on individual patients’ circumstances
  • analyse adverse incidents and sentinel events to identify system failures and contributing factors
  • identify evidence-based practice gaps using clinical indicators, and implement changes to improve patients’ outcomes
  • coordinate and encourage innovation, and objectively evaluate improvement initiatives for outcomes and sustainability

direction
Requires some supervision

Possible behaviours of a trainee who needs some supervision to perform this activity

The trainee may:

  • evaluate the quality of processes through well-designed audits
  • recognise the risks and benefits of operative interventions
  • raise appropriate issues for review at morbidity and mortality meetings
  • evaluate quality and safety processes implemented within the workplace, and identify gaps in their structure

Teaching and learning

confident
Ready to perform without supervision

Expected behaviours of a trainee who can routinely perform this activity without needing supervision

The trainee will:

  • demonstrate effective supervision skills and teaching methods which are adapted to the context of the training
  • encourage questioning among junior colleagues and students in response to unanswered clinical questions
  • seek guidance and feedback from health care teams to reflect on encounters and improve future patients’ care

direction
Requires some supervision

Possible behaviours of a trainee who needs some supervision to perform this activity

The trainee may:

  • coordinate and supervise junior colleagues from the emergency department and the wards
  • provide constructive feedback to junior colleagues to contribute to improvements in individuals’ skills
  • mentor and train others to enhance team effectiveness

Research

confident
Ready to perform without supervision

Expected behaviours of a trainee who can routinely perform this activity without needing supervision

The trainee will:

  • select studies based on optimal trial design, freedom from bias, and precision of measurement
  • evaluate the value of treatments in terms of relative and absolute benefits, cost, potential patient harm, and feasibility
  • evaluate the applicability of results of clinical studies to the circumstances of individual patients, especially those with multiple comorbidities
  • specify research evidence to the needs of individual patients

direction
Requires some supervision

Possible behaviours of a trainee who needs some supervision to perform this activity

The trainee may:

  • specify research evidence to the needs of individual patients
  • use information from credible sources to aid in decision making
  • refer to evidence-based clinical guidelines and protocols on acutely unwell patients
  • demonstrate an understanding of the limitations of evidence and the challenges of applying research in daily practice

Cultural competence

confident
Ready to perform without supervision

Expected behaviours of a trainee who can routinely perform this activity without needing supervision

The trainee will:

  • negotiate healthcare decisions in a culturally appropriate way by considering variation in family structures, cultures, religion, or belief systems
  • integrate culturally appropriate care of Aboriginal and Torres Strait Islander and Māori peoples into patients’ management
  • consider cultural, ethical, and religious values and beliefs in leading multidisciplinary teams

direction
Requires some supervision

Possible behaviours of a trainee who needs some supervision to perform this activity

The trainee may:

  • practice cultural competency appropriate for the community serviced
  • proactively identify barriers to access to health care

Ethics and professional behaviour

confident
Ready to perform without supervision

Expected behaviours of a trainee who can routinely perform this activity without needing supervision

The trainee will:

  • develop management plans that are based on medical assessments of the clinical conditions and multidisciplinary assessments of functional capacity
  • advise patients of their rights to refuse medical therapy, including life-sustaining treatment
  • consider the consequences of delivering treatment that is deemed futile, and direct to other care as appropriate
  • facilitate interactions within multidisciplinary teams respecting values, encouraging involvement, and engaging all participants in decision making
  • demonstrate critical reflection on personal beliefs and attitudes, including how these may affect patient care and health care policy

direction
Requires some supervision

Possible behaviours of a trainee who needs some supervision to perform this activity

The trainee may:

  • communicate medical management plans as part of the multidisciplinary plans
  • establish, where possible, patients’ wishes and preferences about care
  • contribute to building a productive culture within teams

Judgement and decision making

confident
Ready to perform without supervision

Expected behaviours of a trainee who can routinely perform this activity without needing supervision

The trainee will:

  • recognise the need for escalation of care, and escalate to appropriate staff or services
  • integrate evidence related to questions of diagnosis, therapy, prognosis, risks, and cause into clinical decision making
  • reconcile conflicting advice from other specialties, and apply judgement in making clinical decisions in the presence of uncertainty
  • use care pathways effectively, including identifying reasons for variations in care

direction
Requires some supervision

Possible behaviours of a trainee who needs some supervision to perform this activity

The trainee may:

  • involve additional staff to assist in a timely fashion when required
  • recognise personal limitations, and seek help in an appropriate way when required

Leadership, management, and teamwork

confident
Ready to perform without supervision

Expected behaviours of a trainee who can routinely perform this activity without needing supervision

The trainee will:

  • work collaboratively with staff in the emergency department, intensive care, and other subspecialty inpatient units
  • manage the transition of acute medical patients through their hospital journey
  • lead a team by providing engagement while maintaining a focus on outcomes

direction
Requires some supervision

Possible behaviours of a trainee who needs some supervision to perform this activity

The trainee may:

  • collaborate with and use other team members based on their roles and skills
  • ensure appropriate multidisciplinary assessments and management
  • encourage an environment of openness and respect to lead effective teams

Health policy, systems, and advocacy

confident
Ready to perform without supervision

Expected behaviours of a trainee who can routinely perform this activity without needing supervision

The trainee will:

  • encourage an environment of openness and respect to lead effective teams
  • prioritise patient care based on needs, and consider available health care resources
  • collaborate with emergency medicine staff and other colleagues to develop policies and protocols for the investigations and management of common acute medical problems

direction
Requires some supervision

Possible behaviours of a trainee who needs some supervision to perform this activity

The trainee may:

  • understand the systems for the escalation of care for deteriorating patients
  • understand the role of clinician leadership and advocacy in appraising and redesigning systems of care that lead to better patient outcomes

EPA 6: Longitudinal care, including transitions and end-of-life

EPA 6

Management of gastroenterological conditions from birth to adolescence, including transitions and end-of-life care

Manage and coordinate the longitudinal care of patients with complex gastroenterological conditions, including transitions and end-of-life

This activity requires the ability to:

  • develop management plans and goals in consultation with patients, families and carers, including advanced care directives
  • manage complex and advanced chronic conditions, complications, disabilities, and comorbidities
  • collaborate with other health care providers, including transition of patient care
  • ensure continuity of care, including appropriate patient support for end-of-life care plans
  • facilitate patients’, families’ or carers’ self-management and self-monitoring
  • engage with the broader health policy context.

Professional practice framework domain

Medical expertise

confident
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' presentations, management and progress, including key points of diagnosis and decision making to inform coordination of care
  • ensure that patients contribute to their needs assessments and care planning
  • monitor treatment outcomes, effectiveness, and adverse events
  • facilitate an optimal transition of care for patients, including from paediatric to adult care
  • develop and clearly document individualised end-of-life care plans

direction
Requires some supervision

Possible behaviours of a trainee who needs some supervision to perform this activity

The trainee may:

  • assesses patients’ knowledge, beliefs, concerns, and daily behaviours related to their chronic condition or disability and its management
  • accurately and sufficiently contribute to medical record entries on histories, examinations, and management plans as a member of multidisciplinary teams
  • demonstrate an understanding of the principles of care for patients at the end of their lives

Communication

confident
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
  • communicate with patients, families, or carers about transition of care, and engage and support these parties in decision making
  • identify opportunities to discuss end-of-life care, aligning it with patients’ values and preferences

direction
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
  • ensure consistent messages are given to patients, families, or carers about treatment options, their likelihood of success, risks and prognosis

Quality and safety

confident
Ready to perform without supervision

Expected behaviours of a trainee who can routinely perform this activity without needing supervision

The trainee will:

  • maintain up-to-date certification
  • 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 patients to become more independent
  • participate in quality improvement processes impacting on patients’ abilities to undertake normal activities of daily living

direction
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

Teaching and learning

confident
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

direction
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

Research

confident
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

direction
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

Cultural competence

confident
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

direction
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

Ethics and professional behaviour

confident
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, consistent with privacy laws and professional guidelines about confidentiality
  • use consent processes for the release and exchange of health information
  • assess patient decision-making capacity, and appropriately identify and use alternative decision makers

direction
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

confident
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 a long-term health care journey
  • recognise appropriate stages of end-of-life and limitation of treatment

direction
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

Leadership, management, and teamwork

confident
Ready to perform without supervision

Expected behaviours of a trainee who can routinely perform this activity without needing supervision

The trainee will:

  • use a multidisciplinary approach across services to manage patients with chronic diseases and disabilities
  • develop collaborative relationships with patients, families, or carers, and a range of health professionals
  • coordinate whole-person care through involvement in all stages of the patients’ care journey
  • effectively manage challenges of dealing with death and grief

direction
Requires some supervision

Possible behaviours of a trainee who needs some supervision to perform this activity

The trainee may:

  • participate in multidisciplinary team care for patients with chronic diseases and disabilities, including organisational and community care on a continuing basis appropriate to patient context

Health policy, systems, and advocacy

confident
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 to patients with chronic diseases and disabilities
  • participate in government initiatives for chronic diseases management to reduce hospital admissions and to improve patients’ quality of life
  • help patients access initiatives and services for patients with chronic diseases and disabilities

direction
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 knowledge of how to access them

EPA 7: Communication with patients

EPA 7

Communication with patients

Discuss diagnoses and management plans with patients

This activity requires the ability to:

  • select a suitable context, and include family or carers and other team members
  • select and use appropriate modalities and communication strategies
  • adopt a patient-centred perspective, including adjusting for age, gender identity, cognition, and disability
  • structure conversations intentionally
  • verify patient, family, or carer understanding of information conveyed
  • develop and implement a plan for ensuring actions occur
  • ensure the conversation is documented.

Professional practice framework domain

Medical expertise

confident
Ready to perform without supervision

Expected behaviours of a trainee who can routinely perform this activity without needing supervision

The trainee will:

  • anticipate and be able to correct any misunderstandings patients may have about their conditions and/or risk factors
  • inform patients of all aspects of their clinical management, including assessments and investigations, and give them adequate opportunity to question or refuse interventions and treatments
  • seek to understand the concerns and goals of patients, and to plan management in partnership with them
  • provide information to patients to enable them to make an informed decision about diagnostic, therapeutic and management options

direction
Requires some supervision

Possible behaviours of a trainee who needs some supervision to perform this activity

The trainee may:

  • apply knowledge of the scientific basis of health and disease to the management of patients
  • demonstrate an understanding of the clinical problems being discussed
  • formulate management plans in partnership with patients

Communication

confident
Ready to perform without supervision

Expected behaviours of a trainee who can routinely perform this activity without needing supervision

The trainee will:

  • select appropriate strategy and modality for communication (e.g. face-to-face, email, or phone calls)
  • use chosen communication modalities in a professional and ethical manner, considering confidentiality and medicolegal implications (e.g. confidentiality and information security of electronic communication)
  • ensure appropriate documentation of all communications with and/or regarding patients with other health professionals, such as ensuring phone calls, texts, and emails are captured in medicolegal notes
  • elicit patients’ views, concerns, and preferences, promoting rapport
  • provide information to patients in plain language, avoiding jargon, acronyms, and complex medical terms
  • encourage questions, and answer them thoroughly
  • ask patients to share their thoughts or to explain the management plan in their own words, to verify understanding
  • convey information considerately and sensitively to patients, and seek clarification if unsure of how best to proceed
  • treat children and young people respectfully, and listen to their views
  • recognise the role of family or carers and, when appropriate, encourage patients to involve their family or carers in decisions about their care

direction
Requires some supervision

Possible behaviours of a trainee who needs some supervision to perform this activity

The trainee may:

  • select appropriate modes of communication
  • engage patients in discussions, avoiding the use of jargon
  • check patients’ understanding of information
  • adapt communication style in response to patients’ age, developmental level, and cognitive, physical, cultural, socioeconomic, and situational factors
  • collaborate with patient liaison officers as required

Quality and safety

confident
Ready to perform without supervision

Expected behaviours of a trainee who can routinely perform this activity without needing supervision

The trainee will:

  • discuss with patients their condition and the available management options, including their potential benefits and harms
  • provide information to patients in a way they can understand before asking for consent
  • consider young people’s capacity for decision making and consent
  • recognise and take precautions where patients may be vulnerable, such as issues of child protection, self-harm, or elder abuse
  • participate in processes to manage patients’ complaints

direction
Requires some supervision

Possible behaviours of a trainee who needs some supervision to perform this activity

The trainee may:

  • inform patients of the material risks associated with proposed management plans
  • treat information about patients as confidential

Teaching and learning

confident
Ready to perform without supervision

Expected behaviours of a trainee who can routinely perform this activity without needing supervision

The trainee will:

  • discuss the aetiology of diseases and explain the purpose, nature, and extent of assessments to be conducted
  • obtain informed consent or other valid authority before involving patients in teaching

direction
Requires some supervision

Possible behaviours of a trainee who needs some supervision to perform this activity

The trainee may:

  • respond appropriately to information sourced by patients and to patients’ knowledge regarding their condition

Research

confident
Ready to perform without supervision

Expected behaviours of a trainee who can routinely perform this activity without needing supervision

The trainee will:

  • provide information to patients that is based on guidelines issued by the National Health and Medical Research Council and/or Health Research Council of NZ
  • provide information to patients in a way they can understand before asking for their consent to participate in research
  • obtain informed consent or other valid authority before involving patients in research

direction
Requires some supervision

Possible behaviours of a trainee who needs some supervision to perform this activity

The trainee may:

  • demonstrate an understanding of the limitations of the evidence, and the challenges of applying research in daily practice
  • refer to evidence-based clinical guidelines

Cultural competence

confident
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 competent communication with Aboriginal and Torres Strait Islander and Māori peoples
  • effectively communicate with members of other cultural groups by meeting patients’ specific language, cultural, and communication needs
  • when necessary, use qualified language interpreters or cultural interpreters to help to meet patients’ communication needs
  • provide plain language and culturally appropriate written materials to patients when possible

direction
Requires some supervision

Possible behaviours of a trainee who needs some supervision to perform this activity

The trainee may:

  • identify when to use interpreters
  • allow enough time for communication across linguistic and cultural barriers

Ethics and professional behaviour

confident
Ready to perform without supervision

Expected behaviours of a trainee who can routinely perform this activity without needing supervision

The trainee will:

  • encourage and support patients to be well informed about their health, and to use this information wisely when they are making decisions
  • encourage and support patients and, when relevant, their families or carers, in caring for themselves and managing their health
  • demonstrate respectful professional relationships with patients
  • prioritise honesty, patient welfare, and community benefit above self-interest
  • develop a high standard of personal conduct, consistent with professional and community expectations
  • support patients’ rights to seek second opinions

direction
Requires some supervision

Possible behaviours of a trainee who needs some supervision to perform this activity

The trainee may:

  • respect the preferences of patients
  • communicate appropriately, consistent with the context, and respect patients’ needs and preferences
  • maximise patient autonomy and support their decision making
  • avoid sexual, intimate, and/or financial relationships with patients
  • demonstrate a caring attitude towards patients
  • respect patients, including protecting their rights to privacy and confidentiality
  • behave equitably towards all, irrespective of gender, age, culture, social and economic status, sexual preferences, beliefs, contribution to society, illness-related behaviours or the illness itself
  • use social media ethically and according to legal obligations to protect patients’ confidentiality and privacy

Leadership, management, and teamwork

confident
Ready to perform without supervision

Expected behaviours of a trainee who can routinely perform this activity without needing supervision

The trainee will:

  • communicate effectively with health care team members involved in patients’ care, and with patients, families and carers
  • discuss medical assessments, treatment plans, and investigations with patients and primary care teams, and work collaboratively with them
  • discuss patients’ care needs with health care team members to align them with the appropriate resources
  • facilitate an environment in which all team members feel they can contribute and their opinion is valued
  • communicate accurately and succinctly, and motivate others on the health care team

direction
Requires some supervision

Possible behaviours of a trainee who needs some supervision to perform this activity

The trainee may:

  • answer questions from team members
  • summarise, clarify, and communicate responsibilities of health care team members
  • keep health care team members focused on patient outcomes

Health policy, systems, and advocacy

confident
Ready to perform without supervision

Expected behaviours of a trainee who can routinely perform this activity without needing supervision

The trainee will:

  • collaborate with other services, such as community health centres and consumer organisations, to help patients navigate the healthcare system

direction
Requires some supervision

Possible behaviours of a trainee who needs some supervision to perform this activity

The trainee may:

  • communicate with and involve other health professionals as appropriate

EPA 8: Procedures

EPA 8

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, families, or carers, and other involved health professionals
  • obtain informed consent
  • set up the equipment, maintaining infection control
  • 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
  • interpret the results and outcomes of procedures, including imaging and reports
  • communicate the outcome of the procedure and associated investigations to patients
  • perform this activity across multiple relevant settings.

Professional practice framework domain

Medical expertise

confident
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 available evidence, patient-specific factors, risks, benefits, and alternatives
  • confidently and consistently perform a range of common procedures
  • ensure that 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 pre-procedure preparation
  • confirm the correct position/site/side/level on the patient for planned procedures
  • recognise and effectively manage complications arising during or after procedures
  • recognise and correctly interpret normal and abnormal findings of diagnostic procedures

direction
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 postprocedure reviews of patients

Communication

confident
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 the clinical notes, including informed consent, procedures requested and performed, reasons for procedures, medicines given, infection control 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 and carers’ concerns relating to procedures, providing opportunities to ask questions
  • tailor language according to 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

direction
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 to choose procedures
  • communicate with members of procedural teams so all team members understand who each member is
  • discuss postprocedural care with patients, families and carers
  • complete relevant patients’ documentation, and conduct an appropriate clinical handover

Quality and safety

confident
Ready to perform without supervision

Expected behaviours of a trainee who can routinely perform this activity without needing supervision

The trainee will:

  • maintain up-to-date certification for procedures, including records of completed procedures for quality assurance purposes
  • obtain informed consent or other valid authority before undertaking any procedure
  • set up all necessary equipment, and consistently use universal precautions and infection control techniques
  • confirm patients’ identification, verify the procedure, and, where appropriate, the correct site/side/level for procedures
  • ensure that information on patients’ consent forms matches procedures to be performed
  • identify, document, and appropriately notify of any adverse events or equipment malfunctions
  • assess patients in immediate postprocedural state for complications, and respond appropriately

direction
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, or carers are fully informed when consenting to procedures
  • demonstrate an inconsistent application of infection control 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

confident
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

direction
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 techniques until competent

Cultural competence

confident
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

direction
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

confident
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
  • recognise own limitations, including scope of expertise, and seek help when required

direction
Requires some supervision

Possible behaviours of a trainee who needs some supervision to perform this activity

The trainee may:

  • perform procedures when adequately supervised
  • recognise own limitations, including scope of expertise, and seek help when required
  • follow procedures to ensure safe practice

Judgement and decision making

confident
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 assessments, and evaluations of risks and benefits, 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

direction
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 level, and seek help with procedures when appropriate
  • use tools and guidelines to support decision making
  • recommend suboptimal procedures for patients

Leadership, management, and teamwork

confident
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 errors, prevent complications, and support efficient teamwork
  • coordinate efforts, encourage others, and accept responsibility for work done

direction
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

confident
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
  • advocate for adequate resources, and use resources efficiently when performing procedures

direction
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

EPA 9: Investigations

EPA 9

Investigations

Select, organise, and interpret investigations

This activity requires the ability to:

  • select, plan, and use evidence-based clinically appropriate investigations
  • prioritise patients receiving investigations, if there is a waiting list
  • evaluate the anticipated value of investigations
  • work in partnership with patients, their families, or carers to facilitate choices that are right for them
  • provide aftercare for patients if needed
  • interpret the results and outcomes of investigations
  • communicate the outcomes of the investigations to patients.

Professional practice framework domain

Medical expertise

confident
Ready to perform without supervision

Expected behaviours of a trainee who can routinely perform this activity without needing supervision

The trainee will:

  • choose evidence-based investigations and frame them as an adjunct to comprehensive clinical assessments
  • assess patients’ concerns, and determine the need for tests that are likely to result in overall benefit
  • develop plans for investigations, identifying their roles and timing
  • recognise and correctly interpret abnormal findings considering patients’ specific circumstances, and act accordingly

direction
Requires some supervision

Possible behaviours of a trainee who needs some supervision to perform this activity

The trainee may:

  • provide rationale for investigations
  • understand the significance of abnormal test results, and act on these
  • consider patient factors and comorbidities
  • consider age-specific reference ranges

Communication

confident
Ready to perform without supervision

Expected behaviours of a trainee who can routinely perform this activity without needing supervision

The trainee will:

  • explain options to patients, with the potential benefits, risks, costs, burdens, and side effects of each option, including the option to have no investigations
  • use clear and simple language, and check that patients understand the terms used, and that they agree to proceed with proposed investigations
  • identify patients’ concerns and expectations, and provide adequate explanations on the rationale for individual test ordering
  • confirm whether patients have understood the information they have been given, and the need for more information before deciding
  • use written material, visual, or other aids, that are accurate and up to date, to support discussions with patients
  • explain findings or possible outcomes of investigations to patients, families, and carers
  • give information that patients may find distressing in a considerate way

direction
Requires some supervision

Possible behaviours of a trainee who needs some supervision to perform this activity

The trainee may:

  • discuss the indications, risks, benefits, and complications of investigations with patients before ordering investigations
  • explain the results of investigations to patients
  • arrange investigations providing accurate and informative referrals, liaising with other services where appropriate

Quality and safety

confident
Ready to perform without supervision

Expected behaviours of a trainee who can routinely perform this activity without needing supervision

The trainee will:

  • identify adverse outcomes that may result from proposed investigations, focusing on patients’ individual situations
  • ensure adequate documentation and storage of results
  • promptly follow up results to ensure findings are acted on in a timely way

direction
Requires some supervision

Possible behaviours of a trainee who needs some supervision to perform this activity

The trainee may:

  • consider safety aspects of investigations when planning them
  • seek help with interpretation of test results for less common tests or indications, or unexpected results
  • attempt to perform a procedure in an unsafe environment

Teaching and learning

confident
Ready to perform without supervision

Expected behaviours of a trainee who can routinely perform this activity without needing supervision

The trainee will:

  • use appropriate guidelines, evidence sources, and decision support tools
  • participate in clinical audits to improve test ordering strategies for diagnoses and screening

direction
Requires some supervision

Possible behaviours of a trainee who needs some supervision to perform this activity

The trainee may:

  • undertake professional development to maintain currency with investigation guidelines

Research

confident
Ready to perform without supervision

Expected behaviours of a trainee who can routinely perform this activity without needing supervision

The trainee will:

  • provide patients with relevant information if a proposed investigation is part of a research program
  • obtain written consent from patients if the investigation is part of a research program

direction
Requires some supervision

Possible behaviours of a trainee who needs some supervision to perform this activity

The trainee may:

  • refer to evidence-based clinical guidelines
  • consult current research on investigations

Cultural competence

confident
Ready to perform without supervision

Expected behaviours of a trainee who can routinely perform this activity without needing supervision

The trainee will:

  • understand patients’ views and preferences about any proposed investigation and the adverse outcomes they are most concerned about

direction
Requires some supervision

Possible behaviours of a trainee who needs some supervision to perform this activity

The trainee may:

  • consider patients’ cultural and religious backgrounds, attitudes, and beliefs, and how these might influence the acceptability of proposed investigations

Ethics and professional behaviour

confident
Ready to perform without supervision

Expected behaviours of a trainee who can routinely perform this activity without needing supervision

The trainee will:

  • act in accordance with the scope of the authority (e.g. advanced care directives, power of attorney)
  • discuss with patients how decisions will be made once the investigation has started and the patient is not able to participate in decision making
  • respect patients’ decisions to refuse investigations, even if their decisions may not be appropriate or evidence based
  • advise patients there may be additional costs, which patients may wish to clarify before proceeding
  • explain the expected benefits as well as the potential burdens and risks of any proposed investigation before obtaining informed consent or other valid authority
  • demonstrate awareness of complex issues related to genetic information obtained from investigations, and subsequent disclosure of such information

direction
Requires some supervision

Possible behaviours of a trainee who needs some supervision to perform this activity

The trainee may:

  • identify appropriate proxy decision makers when required
  • choose not to investigate in situations where it is not appropriate for ethical reasons
  • practice within current ethical and professional frameworks
  • practice within own limits, and seek help when needed
  • involve patients in decision making regarding investigations, and obtain the appropriate informed consent, including financial consent if necessary

Judgement and decision making

confident
Ready to perform without supervision

Expected behaviours of a trainee who can routinely perform this activity without needing supervision

The trainee will:

  • evaluate the costs, benefits, and potential risks of each investigation in a clinical situation
  • adjust investigative paths depending on test results received
  • consider whether patients’ conditions may get worse or better if no tests are selected

direction
Requires some supervision

Possible behaviours of a trainee who needs some supervision to perform this activity

The trainee may:

  • choose the most appropriate investigations for the clinical scenario in discussion with patients
  • recognise personal limitations and seek help in an appropriate way when required

Leadership, management, and teamwork

confident
Ready to perform without supervision

Expected behaviours of a trainee who can routinely perform this activity without needing supervision

The trainee will:

  • consider the role other members of the health care team might play, and what other sources of information and support are available
  • ensure results are checked in a timely manner, and take responsibility for following up on results

direction
Requires some supervision

Possible behaviours of a trainee who needs some supervision to perform this activity

The trainee may:

  • demonstrate understanding of what parts of an investigation are provided by different doctors or health professionals

Health policy, systems, and advocacy

confident
Ready to perform without supervision

Expected behaviours of a trainee who can routinely perform this activity without needing supervision

The trainee will:

  • select and justify investigations regarding the pathological basis of disease, utility, safety, appropriateness, and cost
  • consider resource utilisation through peer review of testing behaviours

EPA 10: Clinic management

EPA 10

Clinic management

Manage an outpatients clinic

This activity requires the ability to:

  • manage medical procedures and treatments
  • manage clinic services, including triage and waitlist management
  • oversee quality improvement activities
  • communicate with patients
  • liaise with other health professionals and team members
  • demonstrate problem-solving skills
  • responsibly use public resources.

Professional practice framework domain

Medical expertise

confident
Ready to perform without supervision

Expected behaviours of a trainee who can routinely perform this activity without needing supervision

The trainee will:

  • effectively identify and address current clinical concerns as well as longer-term clinical objectives, as appropriate to patient context
  • evaluate environmental and lifestyle health risks, and advocate for healthy lifestyle choices
  • create accurate and appropriately prioritised problem lists in the clinical notes or as part of an ambulatory care review
  • update documentation in a time frame appropriate to the clinical situation of patients

direction
Requires some supervision

Possible behaviours of a trainee who needs some supervision to perform this activity

The trainee may:

  • demonstrate understanding of the importance of prevention, early detection, health maintenance, and chronic condition management

Communication

confident
Ready to perform without supervision

Expected behaviours of a trainee who can routinely perform this activity without needing supervision

The trainee will:

  • help patients navigate the healthcare system to improve access to care by collaboration with other services, such as community health centres and consumer organisations
  • link patients to specific community-based health programs and group education programs

direction
Requires some supervision

Possible behaviours of a trainee who needs some supervision to perform this activity

The trainee may:

  • wherever practical, meet patients’ specific language and communication needs
  • facilitate appropriate use of interpreter services and translated materials

Quality and safety

confident
Ready to perform without supervision

Expected behaviours of a trainee who can routinely perform this activity without needing supervision

The trainee will:

  • practice health care that maximises patient safety
  • adopt a systematic approach to the review and improvement of professional practice in the outpatients clinic setting
  • identify aspects of service provision that may be a risk to patients’ safety
  • ensure patients are informed about fees and charges

direction
Requires some supervision

Possible behaviours of a trainee who needs some supervision to perform this activity

The trainee may:

  • take reasonable steps to address issues if patient safety may be compromised
  • understand a systematic approach to improving the quality and safety of health care
  • participate in organisational quality and safety activities, including clinical incident reviews

Teaching and learning

confident
Ready to perform without supervision

Expected behaviours of a trainee who can routinely perform this activity without needing supervision

The trainee will:

  • evaluate their own professional practice
  • demonstrate learning behaviour and skills in educating junior colleagues
  • contribute to the generation of knowledge
  • maintain professional continuing education standards relevant to the profession

direction
Requires some supervision

Possible behaviours of a trainee who needs some supervision to perform this activity

The trainee may:

  • recognise the limits of personal expertise and involve other professionals as needed to contribute to patients’ care
  • use information technology appropriately as a resource for modern medical practice

Research

confident
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 involving patients in research
  • inform patients about their rights, the purpose of the research, the procedures to be undergone, and the potential risks and benefits of participation before obtaining consent

direction
Requires some supervision

Possible behaviours of a trainee who needs some supervision to perform this activity

The trainee may:

  • refer to evidence-based clinical guidelines
  • consult current research on investigations

Cultural competence

confident
Ready to perform without supervision

Expected behaviours of a trainee who can routinely perform this activity without needing supervision

The trainee will:

  • apply knowledge of the cultural needs of the community serving and how to shape service to those people
  • mitigate the influence of own culture and beliefs on interactions with patients and decision making
  • adapt practice to improve patient engagement and healthcare outcomes

direction
Requires some supervision

Possible behaviours of a trainee who needs some supervision to perform this activity

The trainee may:

  • acknowledge the social, economic, cultural, and behavioural factors influencing health, at individual and population levels

Ethics and professional behaviour

confident
Ready to perform without supervision

Expected behaviours of a trainee who can routinely perform this activity without needing supervision

The trainee will:

  • identify and respect the boundaries that define professional and therapeutic relationships
  • respect the roles and expertise of other health professionals
  • comply with the legal requirements of preparing and managing documentation
  • demonstrate awareness of financial and other conflicts of interest

direction
Requires some supervision

Possible behaviours of a trainee who needs some supervision to perform this activity

The trainee may:

  • understand the responsibility to protect and advance the health and wellbeing of individuals and communities
  • maintain the confidentiality of documentation, and store clinical notes appropriately
  • ensure that the use of social media is consistent with ethical and legal obligations

Judgement and decision making

confident
Ready to perform without supervision

Expected behaviours of a trainee who can routinely perform this activity without needing supervision

The trainee will:

  • understand the principles of assessing urgency of care, and triage appropriately
  • integrate prevention, early detection, health maintenance, and chronic condition management, where relevant, into clinical practice
  • work to achieve optimal and cost-effective patients’ care that allows maximum benefit from the available resources

direction
Requires some supervision

Possible behaviours of a trainee who needs some supervision to perform this activity

The trainee may:

  • understand the appropriate use of human resources, diagnostic interventions, therapeutic modalities, and health care facilities

Leadership, management, and teamwork

confident
Ready to perform without supervision

Expected behaviours of a trainee who can routinely perform this activity without needing supervision

The trainee will:

  • prepare for and conduct clinical encounters in a well-organised and time-efficient manner
  • support colleagues who raise concerns about patient safety
  • work effectively as a member of multidisciplinary teams or other professional groups
  • ensure all important discussions with colleagues, multidisciplinary team members, and patients are appropriately documented
  • review discharge summaries, notes, and other communications written by junior colleagues

direction
Requires some supervision

Possible behaviours of a trainee who needs some supervision to perform this activity

The trainee may:

  • attend relevant clinical meetings regularly

Health policy, systems, and advocacy

confident
Ready to perform without supervision

Expected behaviours of a trainee who can routinely perform this activity without needing supervision

The trainee will:

  • demonstrate capacity to engage in the surveillance and monitoring of the health status of populations in the outpatient setting
  • maintain good relationships with health agencies and services
  • advocate for adequate resources, and apply the principles of efficient and equitable allocation of resources to meet individual, community, and national health needs

direction
Requires some supervision

Possible behaviours of a trainee who needs some supervision to perform this activity

The trainee may:

  • understand common population health screening and prevention approaches

Knowledge guide

Knowledge guides provide detailed guidance to trainees on the important topics and concepts trainees need to understand to become experts in their chosen specialty.

Knowledge guides are specialty specific.

The knowledge guides listed below have been developed for the Advanced Training in Cardiology (Paediatrics & Child Health) program.

Knowledge guide 1: Scientific foundations of gastroenterology

Knowledge guide 2: Gastrointestinal emergencies

Knowledge guide 3: Upper gastrointestinal and small bowel luminal disease

Knowledge guide 4: Lower gastrointestinal, luminal, and anal conditions

Knowledge guide 5: Liver disease/hepatology

Knowledge guide 6: Pancreatic and biliary disease

Knowledge guide 7: Inflammatory Bowel Disease (IBD)

Knowledge guide 8: Gastrointestinal cancer

Knowledge guide 9: Function and motility

Knowledge guide 10: Nutrition