Rehabilitation medicine curriculum standards (adult)
Site: | RACP Online Learning |
Course: | Advanced Training Curricula |
Book: | Rehabilitation medicine curriculum standards (adult) |
Printed by: | Guest user |
Date: | Friday, 4 April 2025, 4:31 AM |
Table of contents
- About this resource
- Competencies
- Entrustable Professional Activities
- Knowledge guides
- Knowledge guide 1: Traumatic brain injury
- Knowledge Guide 2: Stroke management
- Knowledge guide 3: Neurological conditions
- Knowledge guide 4: Spinal cord dysfunction
- Knowledge guide 5: Amputation of limb and prosthetics
- Knowledge guide 6: Musculoskeletal conditions
- Knowledge guide 7: Cardiac and respiratory conditions
- Knowledge guide 8: Adults with disabilities arising in childhood
- Knowledge guide 9: Rehabilitation of older people
- Knowledge guide 10: Rehabilitation of other specific conditions
- Knowledge guide 11: Pain
- Knowledge guide 12: Orthotics and footwear
- Knowledge guide 13: Spasticity and its management
About this resource
The new Advanced Training in Rehabilitation Medicine (adult) curriculum consists of curriculum standards and learning, teaching, and assessment (LTA) programs.
This resource outlines the curriculum standards for Advanced Training in Rehabilitation Medicine (adult) for trainees and supervisors. The curriculum standards should be used in conjunction with the Advanced Training in Rehabilitation Medicine (adult) LTA programs.
Download the curriculum standards PDFCompetencies
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.2 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.
References
2. 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.
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.3
*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
3. 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.
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.
Entrustable Professional Activities
Entrustable Professional Activities (EPAs) outline the essential work tasks trainees need to be able to perform in the workplace without supervision by the end of training.

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
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 patients
- use evidence-based care to meet the needs of patients or populations
- assess and effectively manage clinical risk in various scenarios
- demonstrate clinical competence and skills by effectively supporting team members
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
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
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
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
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
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 selfdirected 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
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
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
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 safety
Ready to perform without supervision
Expected behaviours of a trainee who can routinely perform this activity without needing supervision
The trainee will:
- demonstrate culturally safe 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
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
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
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
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
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
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
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
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
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
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 the learner to consider the rationale and appropriateness of investigation and management options
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
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
- encourage learners to tailor communication as appropriate for different patients, such as younger or older people, and/or different populations
- support learners to deliver clear, concise, and relevant information in both verbal and written communication
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
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 learnt 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
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
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 supervise professional development activities Teaching and learning
- 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
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
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
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 safety
Ready to perform without supervision
Expected behaviours of a trainee who can routinely perform this activity without needing supervision
The trainee will:
- role model a culturally appropriate approach to teaching
- encourage learners to seek out opportunities to develop and improve their own cultural competence
- encourage learners to consider culturally appropriate care of Aboriginal and Torres Strait Islander and Māori peoples in patients’ management
- consider cultural, ethical and religious values and beliefs in teaching and learning
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
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
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
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 Judgement and decision making
- support a learning environment that allows for independent decision making
- use sound and evidence-based judgement during assessments and when communicating feedback to learners, and escalate concerns about learners appropriately
- escalate concerns about learners appropriately
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
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 Leadership, management, and teamwork
- maintain professional, clinical, research and/or administrative responsibilities while teaching
- create an inclusive environment in which learners feel part of the team
- help to shape organisational culture to prioritise quality and work safety through openness, honesty, shared learning, and continued improvement
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
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
Requires some supervision
Possible behaviours of a trainee who needs some supervision to perform this activity
The trainee may:
- 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, mitigate, and report actual and potential (near miss) errors
- conduct 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
Ready to perform without supervision
Expected behaviours of a trainee who can routinely perform this activity without needing supervision
The trainee will:
- regularly review patients or population health outcomes to identify opportunities for improvement in delivering appropriate care
- evaluate population, 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
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
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 easily understood, high-quality information about health care appropriate to their identity, including gender, culture, and religion
- 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 the organisation's open disclosure policy
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
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 quality and registries of data on patients' experiences and outcomes, learning from incidents and complaints to improve health care
Requires some supervision
Possible behaviours of a trainee who needs some supervision to perform this activity
The trainee may:
- demonstrate understanding of a systematic approach to improving the quality and safety of health care
Teaching and learning
Ready to perform without supervision
Expected behaviours of a trainee who can routinely perform this activity without needing supervision
The trainee will:
- 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 high-quality, safe care
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
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
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 safety
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
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
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
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
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 (guidelines, protocols, pathways, and reminders)
- analyse and evaluate current care processes to improve health care
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
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
- actively involve clinical pharmacists in the medication-use process
- support multidisciplinary team activities to lower patient risk of harm, and promote multidisciplinary programs of education
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
Health policy, systems, and advocacy
Ready to perform without supervision
Expected behaviours of a trainee who can routinely perform this activity without needing supervision
The trainee will:
- advocate for patients with disabilities and the provision of disability support services
- participate in all aspects of the development, implementation, evaluation, and monitoring of governance processes
- participate regularly in multidisciplinary meetings where quality and safety issues are standing agenda items, and where innovative ideas and projects for improving care are actively encouraged
- measure, analyse, and report 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
- demonstrate awareness of funding programs, outcome and benchmarking services, and state-specific rehabilitation services/guidelines
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
- demonstrate an understanding of clinical governance, healthcare standards, or current guidelines
EPA 4: Clinical assessment and management of function
EPA 4
Clinical assessment and management of function
Clinically assess and manage the ongoing care of patients
This activity requires the ability to:
- identify and access relevant information about patients, including obtaining patient collateral histories
- examine patients, including their medical, physical, functional, and psychosocial health
- evaluate psychosocial, personal, and environmental factors that influence independence
- select, plan, and use evidence-based clinically appropriate investigations
- develop and implement management plans and goals of care
- discuss findings with patients, their families and/or carers
- work in partnership with patients, their families and/or carers to facilitate choices that are right for them
- collaborate and communicate with health professionals.
Professional practice framework domain
Medical expertise
Ready to perform without supervision
Expected behaviours of a trainee who can routinely perform this activity without needing supervision
The trainee will:
- perform a full physical examination to establish the nature and extent of problems
- assess a range of factors, including:
- medical history
- patients' mental state and cognitive function
- personal and contextual factors influencing severity and nature of patients' disabilities
- psychological history
- social, environmental, and attitudinal factors that contribute to disability
- assess the contextual aspects of patients' lifestyle to maximise function
- recognise and manage issues of function, including changes to function over time, or patient goals
- outline the natural history of common diseases and conditions, and the prognosis of these conditions
- describe the relationship between disease and functioning using the International Classification of Diseases (ICD) and the International Classification of Functioning, Disability and Health (ICF)
- use objective outcome measures in patients' assessments
- choose appropriate diagnostic tools to assess function
- assess the severity of problems, preventative strategies, and the likelihood of complications and clinical outcomes
- develop management plans based on relevant guidelines, and consider the balance of benefit and harm by taking patients' personal sets of circumstances into account
- recognise different models of care
- work with the patients' limitations and participation restrictions
- identify short- and long-term consequences of disability
- identify areas where patients and families may require further support and advocacy
- choose and interpret evidence-based investigations, and frame them as an adjunct to comprehensive clinical assessments
- identify the patients' disorder requiring pharmacotherapy, therapies and/or prescriptions
- recognise the risk of opioid dependence for chronic pain management, and provide intervention for de-escalation of use
- consider age, chronic disease status, lifestyle factors, allergies, potential drug interactions, and patients' preferences prior to prescribing new medications
- plan for follow-up and monitoring
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
- not be able to articulate potential risks of day-to-day clinical decisions, such as prescription errors or falls risks
- assess patients using a biomedical approach, rather than a holistic rehabilitation approach
- 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
- be aware of potential side effects and practical prescription points, such as medication compatibility and monitoring in response to therapies
- prescribe inappropriate drugs to patients without considering patient context or demographic
Communication
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' concerns seriously, giving them adequate opportunity to question
- use sensitive language when introducing tests and/or the assessment process to patients and their families or carers
- support patients with cognitive impairment in decision making, including using an interpreter or speaking in simpler language, using pictures or photos, and putting explanations in writing
- communicate clearly, effectively, respectfully, and promptly with other health professionals involved in patients' care
- use clear and simple language, checking that patients understand the terms used and that they agree to proceed with proposed investigations
- discuss and evaluate the risks and benefits of treatment options, making decisions in partnership with patients
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
- take control of patients' decisions and tasks of daily living to save time, leading to further functional decline
- explain the results of investigations to patients
- arrange investigations, providing accurate and informative referrals, and liaising with other services where appropriate
- discuss and explain the rationale for treatment options with patients, their families or carers
- explain the benefits and burdens of therapies, considering patients' individual circumstances
Quality and safety
Ready to perform without supervision
Expected behaviours of a trainee who can routinely perform this activity without needing supervision
The trainee will:
- 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 an emergency)
- ensure patients are informed of the material risks associated with any part of proposed management plans
- identify and document risk prevention strategies
- identify high-risk patients, such as those with cognitive impairment or at risk of falls, and those with reduced insight into their conditions
- outline risk prevention strategies, including home environment and medications
- review medicines regularly to reduce non-adherence, monitoring treatment effectiveness, possible side effects, and drug interactions, and ceasing unnecessary medicines
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, ensuring appropriate care of patients
- document history and physical examination findings, and synthesise with clarity and completeness
- demonstrate uncertainty as to when a risk assessment is required
- monitor side effects of medicines prescribed
- identify medication errors and institute appropriate measures
Teaching and learning
Ready to perform without supervision
Expected behaviours of a trainee who can routinely perform this activity without needing supervision
The trainee will:
- use the ICF/ICD framework as a tool to guide teaching sessions
- set defined objectives for clinical teaching encounters, and solicit feedback on mutually agreed goals
- regularly reflect 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
- use appropriate guidelines, evidence sources, and decision support tools
- use appropriate guidelines and evidence-based medicine resources to maintain a working knowledge of current medicines and other non-pharmacological treatment options, and keep up to date on new treatments and therapies
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
- display limited engagement in teaching other team members, or fail to include functional issues in teaching sessions
- undertake professional development to maintain currency with investigation guidelines
- reflect on prescribing, and seek feedback from supervisors
Research
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
- obtain written consent from patients if the investigation is part of a research program
- use sources of independent information about medicines that provide accurate summaries of the available evidence on new medicines or therapies
- select suitable research and quality assurance projects available at the training location, such as Australasian Rehabilitation Outcomes Centre (AROC) data and Functional Independence Measure (FIM) assessments
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 evidence, and the challenges of applying research in daily practice
- consult current research on investigations, and make therapeutic decisions according to the best evidence
- insufficiently engage with available research opportunities regarding assessment of function
Cultural safety
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 professional interpreters, health advocates or family or community members to assist in communication with patients
- use plain language education materials while demonstrating cultural and linguistic sensitivity to patients
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
Ready to perform without supervision
Expected behaviours of a trainee who can routinely perform this activity without needing supervision
The trainee will:
- document patient assessments using a legal format, where required
- apply laws governing practice on consent, capacity, and elder abuse and neglect
- 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, involving a proxy decision maker appropriately
- balance the rights of patients with the wishes and expectations of families or carers
- discuss with patients how decisions will be made once the investigation has started and the patient is not able to participate in decision making
- advise patients there may be additional costs, which patients may wish to clarify before proceeding
- make prescribing decisions based on good safety data when benefits outweigh the risks involved
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
- assume there is always functional impairment in certain patient groups, such as older patients or patients with amputations
- display a lack of awareness for the management of an impairment to ensure function
- identify appropriate proxy decision makers when required
- involve patients in decision making regarding investigations and obtaining the appropriate informed consent, including financial consent if necessary
- consider the efficacy of medicines in treating illnesses, including the relative merits of different pharmacological and non-pharmacological options
- follow regulatory and legal requirements and limitations regarding prescribing
Judgement and decision making
Ready to perform without supervision
Expected behaviours of a trainee who can routinely perform this activity without needing supervision
The trainee will:
- select the most appropriate care setting for rehabilitation, such as inpatient, day hospital, outpatient, home based, or outreach
- apply knowledge and experience to identify patients' problems, making logical, rational decisions, and acting to achieve positive outcomes for patients
- 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
- identify social determinants of health that may impact on patients' care
- implement tailored approaches to promote functional independence through shared decision making using the ICF framework
- assess the urgency, complexity, and related risks of situations
- conduct a capacity assessment when an appropriate trigger is identified, such as health, financial, legal, or lifestyle
- use a systematic approach to select treatment options
- use medicines safely and effectively to get the best possible results
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, seeking help when required in an appropriate way
- lack awareness of facilities, therapies, and environmental changes that can be made to improve function in health conditions and impairments
- lack awareness of how to promote independence and quality of life
- 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
Ready to perform without supervision
Expected behaviours of a trainee who can routinely perform this activity without needing supervision
The trainee will:
- produce clear plans, including discharge plans and equipment required
- collaborate with patients' health care teams to perform comprehensive capacity assessments, as needed
- provide information to clinicians and other staff on the need for patient mobilisation and involvement in activities of daily living, including how to assess risks to patients
- provide clinicians with expertise and advice to recognise the needs of carers and mechanisms for taking action
- work effectively as a member of multidisciplinary teams to achieve the best health outcomes for patients
- demonstrate awareness of colleagues in difficulty, and work within the appropriate structural systems to support them while maintaining patients' safety
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
- show limited awareness of rehabilitation team structures and processes used to improve function and environmental access
Health policy, systems, and advocacy
Ready to perform without supervision
Expected behaviours of a trainee who can routinely perform this activity without needing supervision
The trainee will:
- work with patients and families to identify opportunities for disease prevention, health promotion, and health protection
- participate in health promotion and protection, disease prevention, control, and screening, and reporting notifiable diseases
- aim to achieve optimal cost-effective patients' care to allow maximum benefit from the available resources
- facilitate timely access to resources, including the public guardian and/or trustee, legal advice, appeal mechanisms, and family education and support
- provide information on services such as support groups, respite services, and other carer support services
Requires some supervision
Possible behaviours of a trainee who needs some supervision to perform this activity
The trainee may:
- identify and navigate components of the healthcare system relevant to patients' care
- identify and access relevant community resources to support patients' care
- show limited knowledge of local and national health policy systems and need for advocacy on function and community access
EPA 5: Handover of care
EPA 5
Handover of care
Manage the handover of patient care between health professionals, providers, and contexts
This activity requires the ability to:
- manage a transition of patient care to ensure the optimal continuation of care between providers
- identify the appropriate health care providers and other stakeholders with whom to share patient information
- exchange pertinent, contextually appropriate, and relevant patient information
- work flexibly between settings, including emergency departments, acute, subacute, outpatient, and community/home visits
- recognise clinical deterioration and respond by following the local process for escalation of care.
Professional practice framework domain
Medical expertise
Ready to perform without supervision
Expected behaviours of a trainee who can routinely perform this activity without needing supervision
The trainee will:
- use a goal-based, patient-centred approach to facilitate patients' optimal level of functioning and participation in society
- follow-up patients once discharged, where required
- facilitate optimal handovers for patients
- identify and manage key risks for patients during handovers
- anticipate possible changes in patients' conditions, and provide recommendations on how to manage them
- provide rehabilitation care during all stages of care, including ICU, acute, community, and ambulatory care
- manage overlaps in care, including paediatric transition to adult medicine
- recognise immediate life-threatening conditions, deteriorating and critically unwell patients, and respond appropriately
- conduct risk assessments at admission, determining acute complications that may arise recognise patients' instability/level of stability and manage according to resources available, seeking help where required
- conduct accurate risk assessments in a collaborative manner, and recognise the early need for transition of care to higher dependency settings
- adapt care as the complexity, uncertainty, and ambiguity of patients' clinical situations evolve
Requires some supervision
Possible behaviours of a trainee who needs some supervision to perform this activity
The trainee may:
- understand the details of patients' conditions, illness severity, and potential emerging issues, with appropriate actions
- provide accurate summaries of patients' information with accurate identification of problems or issues
Communication
Ready to perform without supervision
Expected behaviours of a trainee who can routinely perform this activity without needing supervision
The trainee will:
- write relevant and detailed medical record entries, including clinical assessments and management plans
- write comprehensive and accurate summaries of care, including discharge summaries, clinic letters, and transfer documentation
- initiate and maintain verbal communication with other health professionals when required
- communicate with patients, families or carers about transition of care, and engage and support these parties in decision making
- explain acute situations to patients in a sensitive and supportive manner, avoiding jargon and confirming their understanding
Requires some supervision
Possible behaviours of a trainee who needs some supervision to perform this activity
The trainee may:
- communicate clearly with clinicians and other caregivers
- use standardised verbal and written templates to improve the reliability of information transfer and prevent errors and omissions
- communicate accurately and in a timely manner to ensure an effective transition between settings, and continuity and quality of care
Quality and safety
Ready to perform without supervision
Expected behaviours of a trainee who can routinely perform this activity without needing supervision
The trainee will:
- identify patients at risk of a poor transition of care, and mitigate this risk
- maintain up-to-date certification in advanced life support
- use electronic tools (where available) to securely store and transfer patient information
- use consent processes, including written consent if required, for the release and exchange of information
- demonstrate an understanding of the medicolegal context of written communications
Requires some supervision
Possible behaviours of a trainee who needs some supervision to perform this activity
The trainee may:
- ensure that handovers are complete, or work to mitigate risks if a handover was incomplete
- ensure all outstanding results or procedures are followed up by receiving units and clinicians
- keep patients' information secure, and adhere to relevant legislation regarding personal information and privacy
Teaching and learning
Ready to perform without supervision
Expected behaviours of a trainee who can routinely perform this activity without needing supervision
The trainee will:
- integrate clinical education in handover sessions and other transition of care meetings
- tailor clinical education to the level of the professional parties involved
- seek guidance and feedback from health care teams to reflect on encounters and improve future patient care
Requires some supervision
Possible behaviours of a trainee who needs some supervision to perform this activity
The trainee may:
- take opportunities to teach junior colleagues during handovers as necessary
- provide constructive feedback to junior colleagues to contribute to improvements in individuals' skills
Research
Ready to perform without supervision
Expected behaviours of a trainee who can routinely perform this activity without needing supervision
The trainee will:
- evaluate the value of treatments in terms of relative and absolute benefits, cost, potential patient harm, and feasibility
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 and protocols on acutely unwell patients
- use information from credible sources to aid decision making
Cultural safety
Ready to perform without supervision
Expected behaviours of a trainee who can routinely perform this activity without needing supervision
The trainee will:
- communicate with careful consideration of health literacy, language barriers, and culture about patient preferences and whether they are realistic and possible, respecting patient choices
- recognise the timing, location, privacy, and appropriateness of information sharing with patients and their families or carers
Requires some supervision
Possible behaviours of a trainee who needs some supervision to perform this activity
The trainee may:
- include relevant information regarding patients’ cultural or ethnic background in handovers, and whether an interpreter is required
Ethics and professional behaviour
Ready to perform without supervision
Expected behaviours of a trainee who can routinely perform this activity without needing supervision
The trainee will:
- disclose and share only contextually appropriate medical and personal information
- demonstrate understanding of the clinical, ethical, and legal rationale for information disclosure
- share information about patients' health care in a manner consistent with privacy laws and professional guidelines on confidentiality
- demonstrate understanding of the additional complexity related to some types of information (e.g. genetic information or blood-borne virus status), and seek appropriate advice about disclosure of such information
- interact in a collegiate and collaborative way with professional colleagues during transitions of care
- advise colleagues of patients' wishes to refuse medical therapy, including life-sustaining treatment
- facilitate interactions within multidisciplinary teams, respecting values, encouraging involvement, and engaging all participants in decision making
Requires some supervision
Possible behaviours of a trainee who needs some supervision to perform this activity
The trainee may:
- maintain respect for patients, families, carers, and other health professionals, including respecting privacy and confidentiality
- communicate patients' wishes and preferences about care
Judgement and decision making
Ready to perform without supervision
Expected behaviours of a trainee who can routinely perform this activity without needing supervision
The trainee will:
- ensure patients' care is in the most appropriate facility, setting or provider
- recognise the need for escalation of care, escalating to appropriate staff or service
- demonstrate an understanding of the pathophysiological sequelae of the conditions of patients undergoing rehabilitationpriate facility, setting, or provider
Requires some supervision
Possible behaviours of a trainee who needs some supervision to perform this activity
The trainee may:
- use a structured approach to considering and prioritising patients' issues
- recognise personal limitations and seek help in an appropriate way when required
Leadership, management, and teamwork
Ready to perform without supervision
Expected behaviours of a trainee who can routinely perform this activity without needing supervision
The trainee will:
- demonstrate multidisciplinary teamwork, with the patient at the centre
- share the workload of transitions of care appropriately, including delegation
- demonstrate understanding of the medical governance of patient care and the differing roles of team members
- show respect for the roles and expertise of other health professionals, and work effectively as a member of professional teams
- ensure that multidisciplinary teams provide opportunities for patients' engagement and participation when appropriate
Requires some supervision
Possible behaviours of a trainee who needs some supervision to perform this activity
The trainee may:
- recognise factors that impact on the transfer of care, and help subsequent health professionals understand the issues to continue care
- work to overcome the potential barriers to continuity of care, and appreciate the role of handover in overcoming these barriers
Health policy, systems, and advocacy
Ready to perform without supervision
Expected behaviours of a trainee who can routinely perform this activity without needing supervision
The trainee will:
- contribute to processes for managing risks and identifying strategies for the improvement of transitions of care
- engage in organisational processes to improve transitions of care, such as formal surveys or follow-up phone calls after hospital dischargess
Requires some supervision
Possible behaviours of a trainee who needs some supervision to perform this activity
The trainee may:
- factor transport issues and costs to patients into arrangements for transferring patients to other settings
- advocate for escalation of care for deteriorating patients when needed
EPA 6: Longitudinal care (including end of life care)
EPA 6
Longitudinal care
Manage and coordinate the longitudinal care of patients with chronic illness, disability and/or long-term health issues
This activity requires the ability to:
- develop individualised goals and management plans in consultation with patients their families and/or carers
- manage chronic conditions, complications, disabilities, and comorbidities
- collaborate with other health care providers
- ensure continuity of care
- facilitate patients’, families’ or carers’ self-management and self-monitoring
- engage with the broader health policy context
- support patients to plan for their advance care and document their own wishes.
Professional practice framework domain
Medical expertise
Ready to perform without supervision
Expected behaviours of a trainee who can routinely perform this activity without needing supervision
The trainee will:
- evaluate medical, social, emotional, work, and recreational aspects of function
- use the International Classification of Functioning (ICF) to develop a functioning profile beyond the diagnosis of patients’ health conditions
- recognise patients’ specific needs based on their personal circumstances and level of participation
- regularly assess and review care goals and plans for patients with chronic conditions and disabilities based on short- and long-term clinical and quality-of-life goals
- assist patients to maximise functional independence
- adapt care as the complexity, uncertainty, and ambiguity of patients’ clinical situations evolve
- provide documentation on patients’ presentations, management, and progress, including key points of diagnosis and decision making to inform coordination of care
- ensure patients contribute to their needs assessment and care planning
- monitor treatment outcomes, effectiveness, and adverse events
- identify the needs of patients who require modified independence (home modification or equipment) in collaboration with medical teams/health providers
- explain the longer-term impacts of disability to patients, including the economic, environmental, and cultural barriers likely to be encountered
- outline strategies to support patients and their families or carers through different life stages and locations, including uncertainty of prognosis, alternatives, or complications in the timeline
- monitor the impact of interventions on functioning using the ICF framework
- recognise transition points, from restorative to compensatory and palliative management
- provide safe, effective, and goal-directed access to exercise, equipment, and therapy to optimise end-of-life care
Requires some supervision
Possible behaviours of a trainee who needs some supervision to perform this activity
The trainee may:
- assess patients’ knowledge, beliefs, concerns, and daily behaviours related to their chronic condition or disability and its management
- contribute to medical record entries on the history, examination, and management plan in a way that is accurate and sufficient as a member of multidisciplinary teams
- not be able to use assessment scales to quantify domains of impairment and disability (in order to establish quantifiable improvements following interventions)
Communication
Ready to perform without supervision
Expected behaviours of a trainee who can routinely perform this activity without needing supervision
The trainee will:
- encourage health promotion by providing healthy lifestyle advice and information to patients on the importance of self-management
- encourage patients’ access to self-monitoring devices and assistive technologies
- communicate with multidisciplinary team members, and involve patients in that dialogue
- discuss patients’ progress towards shared goals
- manage expectations of patients and their families or carers as patients’ conditions change
- thoughtfully explore patients’ concerns across physical, psychological, and cultural domains
- identify opportunities to discuss end-of-life care, aligning it with patients’ values and preferences
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, the likelihood of success, risks, and prognosis
- discuss with family or carers appropriate support and bereavement care
Quality and safety
Ready to perform without supervision
Expected behaviours of a trainee who can routinely perform this activity without needing supervision
The trainee will:
- maintain up-to-date certification
- use innovative models of chronic disease care, including 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
- review all deaths to determine the safety and quality of patients’ end-of-life care and how it could be improved
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
- communicate the content of discussions about advance care planning to multidisciplinary teams
- ensure that actual care is aligned with documented patient wishes
Teaching and learning
Ready to perform without supervision
Expected behaviours of a trainee who can routinely perform this activity without needing supervision
The trainee will:
- 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
- provide supervision, support, and teaching to develop the skills of junior colleagues on end-of-life care
- recognise feelings of moral distress and burnout in themselves and colleagues
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
- participate in upskilling in best practice of end-of-life care management
- encourage junior colleagues to participate in multidisciplinary case reviews, mortality and morbidity meetings, and adverse event reviews
Research
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
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 safety
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
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
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 law and professional confidentiality guidelines
- use consent processes for the release and exchange of health information
- assess patients’ decision-making capabilities, and appropriately identify and use alternative decision makers when needed
- enhance the quality of life for patients before death to minimise pain and suffering caused by ineffective treatments
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
- ensure that information on advance care plans, treatment plans, goals of care, and patients’ treatment preferences is available to all involved in patients’ care
- ensure patients’ dignity is preserved
Judgement and decision making
Ready to perform without supervision
Expected behaviours of a trainee who can routinely perform this activity without needing supervision
The trainee will:
- 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
- maximise patients’ autonomy and their best interests when making treatment decisions
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
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 patients’ care journeys
- define the roles and responsibilities of team members involved in patients’ care
- achieve agreement between multidisciplinary teams about patients’ treatment options
Requires some supervision
Possible behaviours of a trainee who needs some supervision to perform this activity
The trainee may:
- participate in multidisciplinary care for patients with chronic diseases and disabilities, including organisational and community care on a continuing basis appropriate to patient context
- document multidisciplinary care plans, including the terminal phase
Health policy, systems, and advocacy
Ready to perform without supervision
Expected behaviours of a trainee who can routinely perform this activity without needing supervision
The trainee will:
- 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 improve patients' quality of life
- help patients access initiatives and services for patients with chronic diseases and disabilities
- use available resources within the setting to manage the needs of patients and their families or carers
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 display knowledge of how to access them
- support community-based service providers to build capacity for people to be cared for in their preferred place of death
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 and/or carers and other team members
- adopt a patient-centred perspective, including adjusting for cognition and disabilities
- select and use appropriate modalities and communication strategies
- structure conversations intentionally
- negotiate a mutually agreed management plan
- verify patient, family or carer understanding of the information conveyed
- develop and implement a plan for ensuring actions occur
- ensure the conversation is documented, using communication aides as needed
Professional practice framework domain
Medical expertise
Ready to perform without supervision
Expected behaviours of a trainee who can routinely perform this activity without needing supervision
The trainee will:
- anticipate 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 and possible alternate approaches, including assessments and investigations, and give 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 informed decisions about diagnostic, therapeutic, and management options
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 clinical problems being discussed
- formulate management plans in partnership with patients
Communication
Ready to perform without supervision
Expected behaviours of a trainee who can routinely perform this activity without needing supervision
The trainee will:
- use an appropriate communication strategy and modalities for communication, such as face-to-face, digital health, email, or phone calls
- provide information to patients in plain language, avoiding jargon, acronyms, and complex medical terms
- elicit patients’ views, concerns, and preferences, promoting rapport
- encourage questions, and answer them thoroughly
- ask patients to share their thoughts or explain the management plan in their own words, to verify understanding
- convey information considerately and sensitively to patients, seeking clarification if unsure of how best to proceed
- treat young people respectfully, and listen to their views
- use active listening skills to determine the understanding of patients and their family or carers
- recognise the role of family or carers and, when appropriate, encourage patients to involve their family or carers in decisions about their care
- evaluate, adjust, and tailor the mode and content of communication to patients’ circumstances and levels of understanding
- use easy-to-read resources to support comprehension
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' understandings of information
- adapt communication styles 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
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 risk to benefit ratios
- provide information to patients in a way they can understand before asking for their consent
- consider patients' capacity for decision making and consent
- recognise and take precautions where patients may be vulnerable, such as issues of self-harm or elder abuse
- participate in processes to manage patient complaints
Requires some supervision
Possible behaviours of a trainee who needs some supervision to perform this activity
The trainee may:
- inform patients of the risks associated with the proposed management plan
- treat information about patients as confidential
Teaching and learning
Ready to perform without supervision
Expected behaviours of a trainee who can routinely perform this activity without needing supervision
The trainee will:
- 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
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
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
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 safety
Ready to perform without supervision
Expected behaviours of a trainee who can routinely perform this activity without needing supervision
The trainee will:
- demonstrate effective and culturally 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
- use qualified language interpreters or cultural interpreters to help meet patients’ communication needs when necessary
- provide plain language and culturally appropriate written materials to patients when possible
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
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
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
Ready to perform without supervision
Expected behaviours of a trainee who can routinely perform this activity without needing supervision
The trainee will:
- summarise case complexities into clear plans and goals for patients, their family or carers, and health care teams
- discuss medical assessments, treatment plans, and investigations with patients and primary care teams, working collaboratively with them
- communicate effectively with health care team members involved in patients’ care, and with patients, families or carers
- discuss patients’ care needs with health care team members to align patients with appropriate resources
- facilitate an environment in which all team members feel they can contribute and their opinions are valued
- communicate accurately and succinctly, and motivate other health care team members
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
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 by working in collaboration with other services, such as community health centres and consumer organisations
- advocate on behalf of patients for appropriate resources and equipment to achieve relevant goals and a sustainable discharge plan
- advocate for patient resources relevant to specific needs, such as facilitating resources and funding applications
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 and their families or carers
- obtain informed consent
- set up equipment, maintaining an aseptic field
- perform procedures
- manage unexpected events/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
- communicate the outcomes of procedures and associated investigations to patients
- perform this activity across multiple relevant settings.
Professional practice framework domain
Medical expertise
Ready to perform without supervision
Expected behaviours of a trainee who can routinely perform this activity without needing supervision
The trainee will:
- select procedures by assessing patient-specific factors, risks, benefits, and alternatives
- confidently and consistently perform intramuscular and intra-articular injections to improve functional outcomes
- ensure team members are aware of all allergies/adverse reactions identified, taking precautions to avoid allergies/adverse reactions during procedures
- ensure patients have complied with pre-procedure preparation
- confirm the correct position/site/side and level on patients for planned procedures
- recognise and effectively manage complications arising during or after procedures
- recognise and correctly interpret normal and abnormal findings of diagnostic procedures
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 patients’ post-procedure reviews
- perform botulinum toxin A injections
Communication
Ready to perform without supervision
Expected behaviours of a trainee who can routinely perform this activity without needing supervision
The trainee will:
- accurately document procedures in the clinical notes, including informed consent, procedures requested and performed, reasons for procedures, medicines given, aseptic technique, and aftercare
- explain procedures clearly to patients and family or carers, including reasons for procedures, potential alternatives, and possible risks, to facilitate informed choices
- counsel patients sensitively and effectively, supporting them to make informed choices
- address patients’ and family or 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, and family or carers prior to, during, and after procedures
- ensure team members are confident and competent in their assigned roles
Requires some supervision
Possible behaviours of a trainee who needs some supervision to perform this activity
The trainee may:
- explain the process of procedures to patients without providing a broader context
- help patients and family or carers to choose the procedure
- communicate with members of procedural teams so all team members understand who each member is
- discuss post-procedural care with patients, family or carers
- complete relevant patients’ documentation, and conduct an appropriate clinical handover
Quality and safety
Ready to perform without supervision
Expected behaviours of a trainee who can routinely perform this activity without needing supervision
The trainee will:
- obtain informed consent or other valid authority before undertaking any procedure
- set up all necessary equipment, and consistently use universal precautions and aseptic technique
- confirm patients’ identification, verify the procedure, and, where appropriate, the correct site/side/level for procedures
- ensure information on patients’ consent forms match procedures to be performed
- identify, document, and appropriately notify of any adverse event or equipment malfunction
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 and families or carers are fully informed when consenting to any procedure
- demonstrate an inconsistent application of aseptic technique
- identify patients using approved patient identifiers before any treatment or intervention is initiated
- attempt to perform a procedure in an unsafe environment
Teaching and learning
Ready to perform without supervision
Expected behaviours of a trainee who can routinely perform this activity without needing supervision
The trainee will:
- refer to and/or be familiar with relevant published procedural guidelines prior to undertaking procedures
- organise or participate in in-service training on new technology
- provide specific and constructive feedback and comments to junior colleagues
- initiate and conduct skills training for junior staff
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
Research
Ready to perform without supervision
Expected behaviours of a trainee who can routinely perform this activity without needing supervision
The trainee will:
- understand individual patients’ cultural perceptions of health and illness, adapting practice accordingly
Requires some supervision
Possible behaviours of a trainee who needs some supervision to perform this activity
The trainee may:
- respect religious, cultural, linguistic, and family values and differences
Cultural safety
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 patients' autonomy in decision making
Requires some supervision
Possible behaviours of a trainee who needs some supervision to perform this activity
The trainee may:
- perform procedures when adequately supervised
- follow procedures to ensure safe practice
Ethics and professional behaviour
Ready to perform without supervision
Expected behaviours of a trainee who can routinely perform this activity without needing supervision
The trainee will:
- identify roles and optimal timings for diagnostic procedures
- critically appraise information from assessment and evaluation 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
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, seeking help with procedures when appropriate
- use tools and guidelines to support decision making
- recommend suboptimal procedures for patients
- refer to external service providers for procedures or assessments that could be performed safely and competently by the rehabilitation medicine trainee
Leadership, management, and teamwork
Ready to perform without supervision
Expected behaviours of a trainee who can routinely perform this activity without needing supervision
The trainee will:
- explain critical steps, anticipated events, and equipment requirements to teams on planned procedures
- provide staff with clear aftercare instructions, and explain how to recognise possible complications
- identify relevant management options with colleagues, according to their level of training and experience, to reduce error, prevent complications, and support efficient teamwork
- coordinate efforts, encourage others, and accept responsibility for work done
Requires some supervision
Possible behaviours of a trainee who needs some supervision to perform this activity
The trainee may:
- ensure all relevant team members are aware that a procedure is occurring
- discuss patients’ management plans for recovery with colleagues
Health policy, systems, and advocacy
Ready to perform without supervision
Expected behaviours of a trainee who can routinely perform this activity without needing supervision
The trainee will:
- discuss serious incidents at appropriate clinical review meetings
- initiate local improvement strategies in response to serious incidents
- use resources efficiently when performing procedures
Requires some supervision
Possible behaviours of a trainee who needs some supervision to perform this activity
The trainee may:
- perform procedures in accordance with the organisational guidelines and policies
EPA 9: Clinic management
EPA 9
Clinic management
Manage an outpatients clinic
This activity requires the ability to:
- manage medical procedures and treatments
- manage clinic services
- 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
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 an accurate and appropriately prioritised problem list 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
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
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 collaborating with other services, such as community health centres and consumer organisations
- link patients to specific community-based health programs and group education programs
- use telehealth and digitally integrated support services to enable patients' access to care
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
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 outpatient clinic settings
- identify aspects of service provision that may be a risk to patients' safety
- ensure that patients are informed about fees and charges
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 patients' 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
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
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 to contribute to patients’ care as needed
- use information technology appropriately as a resource for modern medical practice
Research
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
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 safety
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 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 patients’ engagement and health care outcomes
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, both at individual and population levels
Ethics and professional behaviour
Ready to perform without supervision
Expected behaviours of a trainee who can routinely perform this activity without needing supervision
The trainee will:
- identify and respect 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
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 the use of social media is consistent with ethical and legal obligations
Judgement and decision making
Ready to perform without supervision
Expected behaviours of a trainee who can routinely perform this activity without needing supervision
The trainee will:
- identify local services available to support clinic patients
- integrate prevention, early detection, health maintenance, and chronic condition management into clinical practice, where relevant
- work to achieve optimal and cost-effective patient care that allows maximum benefit from available resources
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
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 efficient manner
- identify and manage patients who have special requirements, including sedation, mobility/transport, or consent from next of kin/person responsible
- 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
- support colleagues who raise concerns about patient safety
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
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
- apply the principles of efficient and equitable allocation of resources to meet individual, community, and national health needs
Requires some supervision
Possible behaviours of a trainee who needs some supervision to perform this activity
The trainee may:
- understand common population health screening and prevention approaches
Knowledge guides
Knowledge guides (KGs) 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 Rehabilitation medicine program.

Knowledge guide 1: Traumatic brain injury
Key presentations and conditions
Advanced Trainees will have a comprehensive depth of knowledge of these presentations and conditions.
Less common or more complex presentations and conditions
Advanced Trainees will understand these presentations and conditions.
Advanced Trainees will understand the resources that should be used to help manage patients with these presentations and conditions.
Epidemiology, pathophysiology, and clinical sciences
Advanced Trainees will describe the principles of the foundational sciences.
Investigations, procedures, and clinical assessment tools
Advanced Trainees will know the indications for and how to interpret the results of these investigations, procedures, and clinical assessments tools.
Advanced Trainees will know how to explain the investigation, procedure, or clinical assessment tool to patients, families, and carers.
Important specific issues
Advanced Trainees will identify important specialty-specific issues and the impact of these on diagnosis and management.
Knowledge Guide 2: Stroke management
Key presentations and conditions
Advanced Trainees will have a comprehensive depth of knowledge of these presentations and conditions.
Epidemiology, pathophysiology, and clinical sciences
Advanced Trainees will describe the principles of the foundational sciences.
Investigations, procedures, and clinical assessment tools
Advanced Trainees will know the indications for and how to interpret the results of these investigations, procedures, and clinical assessments tools.
Advanced Trainees will know how to explain the investigation, procedure, or clinical assessment tool to patients, families, and carers.
Important specific issues
Advanced Trainees will identify important specialty-specific issues and the impact of these on diagnosis and management.
*References to patients in the remainder of this document may include their families or carers.
Knowledge guide 3: Neurological conditions
Key presentations and conditions
Advanced Trainees will have a comprehensive depth of knowledge of these presentations and conditions.
Less common or more complex presentations and conditions
Advanced Trainees will understand these presentations and conditions.
Advanced Trainees will understand the resources that should be used to help manage patients with these presentations and conditions.
Epidemiology, pathophysiology, and clinical sciences
Advanced Trainees will describe the principles of the foundational sciences.
Investigations, procedures, and clinical assessment tools
Advanced Trainees will know the indications for and how to interpret the results of these investigations, procedures, and clinical assessments tools.
Advanced Trainees will know how to explain the investigation, procedure, or clinical assessment tool to patients, families, and carers.
Important specific issues
Advanced Trainees will identify important specialty-specific issues and the impact of these on diagnosis and management.
Knowledge guide 4: Spinal cord dysfunction
Key presentations and conditions
Advanced Trainees will have a comprehensive depth of knowledge of these presentations and conditions.
Less common or more complex presentations and conditions
Advanced Trainees will understand these presentations and conditions.
Advanced Trainees will understand the resources that should be used to help manage patients with these presentations and conditions.
Epidemiology, pathophysiology, and clinical sciences
Advanced Trainees will describe the principles of the foundational sciences.
Investigations, procedures, and clinical assessment tools
Advanced Trainees will know the indications for and how to interpret the results of these investigations, procedures, and clinical assessments tools.
Advanced Trainees will know how to explain the investigation, procedure, or clinical assessment tool to patients, families, and carers.
Important specific issues
Advanced Trainees will identify important specialty-specific issues and the impact of these on diagnosis and management.
Knowledge guide 5: Amputation of limb and prosthetics
Key presentations and conditions
Advanced Trainees will have a comprehensive depth of knowledge of these presentations and conditions.
Less common or more complex presentations and conditions
Advanced Trainees will understand these presentations and conditions.
Advanced Trainees will understand the resources that should be used to help manage patients with these presentations and conditions.
Epidemiology, pathophysiology, and clinical sciences
Advanced Trainees will describe the principles of the foundational sciences.
Investigations, procedures, and clinical assessment tools
Advanced Trainees will know the indications for and how to interpret the results of these investigations, procedures, and clinical assessments tools.
Advanced Trainees will know how to explain the investigation, procedure, or clinical assessment tool to patients, families, and carers.
Important specific issues
Advanced Trainees will identify important specialty-specific issues and the impact of these on diagnosis and management.
Knowledge guide 6: Musculoskeletal conditions
Key presentations and conditions
Advanced Trainees will have a comprehensive depth of knowledge of these presentations and conditions.
Less common or more complex presentations and conditions
Advanced Trainees will understand these presentations and conditions.
Advanced Trainees will understand the resources that should be used to help manage patients with these presentations and conditions.
Epidemiology, pathophysiology, and clinical sciences
Advanced Trainees will describe the principles of the foundational sciences.
Investigations, procedures, and clinical assessment tools
Advanced Trainees will know the indications for and how to interpret the results of these investigations, procedures, and clinical assessments tools.
Advanced Trainees will know how to explain the investigation, procedure, or clinical assessment tool to patients, families, and carers.
Important specific issues
Advanced Trainees will identify important specialty-specific issues and the impact of these on diagnosis and management.
Knowledge guide 7: Cardiac and respiratory conditions
Key presentations and conditions
Advanced Trainees will have a comprehensive depth of knowledge of these presentations and conditions.
Less common or more complex presentations and conditions
Advanced Trainees will understand these presentations and conditions.
Advanced Trainees will understand the resources that should be used to help manage patients with these presentations and conditions.
Epidemiology, pathophysiology, and clinical sciences
Advanced Trainees will describe the principles of the foundational sciences.
Investigations, procedures, and clinical assessment tools
Advanced Trainees will know the indications for and how to interpret the results of these investigations, procedures, and clinical assessments tools.
Advanced Trainees will know how to explain the investigation, procedure, or clinical assessment tool to patients, families, and carers.
Important specific issues
Advanced Trainees will identify important specialty-specific issues and the impact of these on diagnosis and management.
Knowledge guide 8: Adults with disabilities arising in childhood
Key presentations and conditions
Advanced Trainees will have a comprehensive depth of knowledge of these presentations and conditions.
Less common or more complex presentations and conditions
Advanced Trainees will understand these presentations and conditions.
Advanced Trainees will understand the resources that should be used to help manage patients with these presentations and conditions.
Epidemiology, pathophysiology, and clinical sciences
Advanced Trainees will describe the principles of the foundational sciences.
Investigations, procedures, and clinical assessment tools
Advanced Trainees will know the indications for and how to interpret the results of these investigations, procedures, and clinical assessments tools.
Advanced Trainees will know how to explain the investigation, procedure, or clinical assessment tool to patients, families, and carers.
Important specific issues
Advanced Trainees will identify important specialty-specific issues and the impact of these on diagnosis and management.
Knowledge guide 9: Rehabilitation of older people
Key presentations and conditions
Advanced Trainees will have a comprehensive depth of knowledge of these presentations and conditions.
Less common or more complex presentations and conditions
Advanced Trainees will understand these presentations and conditions.
Advanced Trainees will understand the resources that should be used to help manage patients with these presentations and conditions.
Epidemiology, pathophysiology, and clinical sciences
Advanced Trainees will describe the principles of the foundational sciences.
Investigations, procedures, and clinical assessment tools
Advanced Trainees will know the indications for and how to interpret the results of these investigations, procedures, and clinical assessments tools.
Advanced Trainees will know how to explain the investigation, procedure, or clinical assessment tool to patients, families, and carers.
Important specific issues
Advanced Trainees will identify important specialty-specific issues and the impact of these on diagnosis and management.
Knowledge guide 10: Rehabilitation of other specific conditions
Key presentations and conditions
Advanced Trainees will have a comprehensive depth of knowledge of these presentations and conditions.
Less common or more complex presentations and conditions
Advanced Trainees will understand these presentations and conditions.
Advanced Trainees will understand the resources that should be used to help manage patients with these presentations and conditions.
Epidemiology, pathophysiology, and clinical sciences
Advanced Trainees will describe the principles of the foundational sciences.
Investigations, procedures, and clinical assessment tools
Advanced Trainees will know the indications for and how to interpret the results of these investigations, procedures, and clinical assessments tools.
Advanced Trainees will know how to explain the investigation, procedure, or clinical assessment tool to patients, families, and carers.
Important specific issues
Advanced Trainees will identify important specialty-specific issues and the impact of these on diagnosis and management.
Knowledge guide 11: Pain
Key presentations and conditions
Advanced Trainees will have a comprehensive depth of knowledge of these presentations and conditions.
Less common or more complex presentations and conditions
Advanced Trainees will understand these presentations and conditions.
Advanced Trainees will understand the resources that should be used to help manage patients with these presentations and conditions.
Epidemiology, pathophysiology, and clinical sciences
Advanced Trainees will describe the principles of the foundational sciences.
Investigations, procedures, and clinical assessment tools
Advanced Trainees will know the indications for and how to interpret the results of these investigations, procedures, and clinical assessments tools.
Advanced Trainees will know how to explain the investigation, procedure, or clinical assessment tool to patients, families, and carers.
Important specific issues
Advanced Trainees will identify important specialty-specific issues and the impact of these on diagnosis and management.
Knowledge guide 12: Orthotics and footwear
Key presentations and conditions
Advanced Trainees will have a comprehensive depth of knowledge of these presentations and conditions.
Less common or more complex presentations and conditions
Advanced Trainees will understand these presentations and conditions.
Advanced Trainees will understand the resources that should be used to help manage patients with these presentations and conditions.
Epidemiology, pathophysiology, and clinical sciences
Advanced Trainees will describe the principles of the foundational sciences.
Investigations, procedures, and clinical assessment tools
Advanced Trainees will know the indications for and how to interpret the results of these investigations, procedures, and clinical assessments tools.
Advanced Trainees will know how to explain the investigation, procedure, or clinical assessment tool to patients, families, and carers.
Important specific issues
Advanced Trainees will identify important specialty-specific issues and the impact of these on diagnosis and management.
Knowledge guide 13: Spasticity and its management
Key presentations and conditions
Advanced Trainees will have a comprehensive depth of knowledge of these presentations and conditions.
Epidemiology, pathophysiology, and clinical sciences
Advanced Trainees will describe the principles of the foundational sciences.
Investigations, procedures, and clinical assessment tools
Advanced Trainees will know the indications for and how to interpret the results of these investigations, procedures, and clinical assessments tools.
Advanced Trainees will know how to explain the investigation, procedure, or clinical assessment tool to patients, families, and carers.
Important specific issues
Advanced Trainees will identify important specialty-specific issues and the impact of these on diagnosis and management.