Curriculum standards

Ready to perform without supervision

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

The trainee will:

• participate in surveillance and monitoring of adverse events
• identify activities within systems to reduce errors, improve patient and population safety, and implement cost-effective change
• consider safety and quality of care in all decision making
• participate in interdisciplinary collaboration to provide effective health services and operational change
• raise and escalate concerns where there is an issue with patient safety or quality of care
• demonstrate the ability to offer an apology or explanation where appropriate
• use open disclosure

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
• use information resources and electronic medical record technology where available

Ready to perform without supervision

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

The trainee will:

• reflect regularly to self-evaluate personal professional practice, skills, and knowledge, and address gaps through self-directed learning
• actively seek feedback from supervisors and colleagues on performance as a team member and leader
• supervise junior doctors and support multidisciplinary teams

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

Ready to perform without supervision

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

The trainee will:

• actively engage with patients to learn about their cultural needs
• 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

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
• apply the ethics of resource allocation by aligning optimal patient and organisational care
• acknowledge personal conflicts of interest and unconscious bias
• act collaboratively to resolve unacceptable behaviour and conflicts, such as harassment and bullying
• acknowledge burnout in self and colleagues
• work with the team to promote a healthy working environment
• be self-aware and seek help if there are concerns of stress or burnout

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
• show empathy and understanding to colleagues and patients

Ready to perform without supervision

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

The trainee will:

• make decisions when faced with multiple and conflicting perspectives from the health care team
• 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
• recognise and work within limits of own personal competence

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

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

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 patients’ care
• participate effectively and appropriately in multidisciplinary teams
• seek out and respect the perspectives of multidisciplinary team members when making decisions
• ensure that finding out patients’ priorities and goals is worked towards

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 and safeguard vulnerable groups
• identify the determinants of health of the population, and mitigate barriers to access to care

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

Ready to perform without supervision

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

The trainee will:

• communicate clearly and respectfully when supervising and teaching
• supervise other health professionals, junior colleagues, and medical students in communication tasks
• provide communication skills when teaching other health professionals, junior colleagues, and medical students
• listen and convey information clearly and considerately

Requires some supervision

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

The trainee may:

• demonstrate accessible, supportive, and compassionate behaviour

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

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

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 principles, processes, and skills of supervision while supervising learners in day-to-day work
• work with learners to identify and address individual learning needs
• have awareness of the varying knowledge and abilities, depending on level of training
• provide feedback and assessment tailored to learners’ goals and learning needs
• encourage self-directed learning and assessment
• develop a consistent and fair approach to assessing learners
• communicate openly to establish and maintain effective mentoring relationships
• recognise the limits of personal educational expertise, and involve others appropriately
• self-reflect on personal teaching practice regularly, and address gaps through self-directed learning
• seek feedback from colleagues and learners on teaching performance
• participate in teaching and supervision of professional development activities

Requires some supervision

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

The trainee may:

• demonstrate developing skills in the supervision of learners
• apply a standardised approach to teaching, assessment, and feedback, generally considering individual learners’ needs
• implement teaching and learning activities that are partially aligned to learning goals
• adoption of a teaching style that partially facilitates learner self-directedness

Ready to perform without supervision

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

The trainee will:

• provide guidance and support for junior colleagues’ research projects
• support learners to find forums to present research projects
• 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

Ready to perform without supervision

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

The trainee will:

• demonstrate a culturally appropriate approach to teaching
• encourage learners to seek out opportunities to develop and improve their own cultural safety
• encourage learners to incorporate culturally appropriate care of Māori and Aboriginal and Torres Strait Islander peoples into 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

Ready to perform without supervision

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

The trainee will:

• role model ethical and professional behaviour to learners, including respect for colleagues and patients, practising within limits of competence, acknowledging own errors, and reflecting on the impact of own beliefs on patient care
• incorporate teaching of relevant medical and health ethics and law into educational opportunities

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

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
• explain decisions to learners by linking theory and practice
• support learners to make independent decisions
• apply objective evidence and expected standards to justify feedback and assessment decisions
• 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

Ready to perform without supervision

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

The trainee will:

• support learners’ effective performance and continuing professional development, while maintaining one’s own
• maintain professional, clinical, research, and/or administrative responsibilities while teaching
• create an inclusive environment whereby learners feel part of the team

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

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:

• integrate public health principles into teaching and practice

Ready to perform without supervision

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

The trainee will:

• assist patients’ access to their health information, as well as complaint and feedback systems
• discuss with patients and health care professionals any safety and quality concerns
• 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:

• recognise contribution of consumer engagement to quality improvement in health care
• recognise how health literacy might affect the way patients or populations gain access to, understand, and use health information

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:
  • clinical incident reviews
  • corrective and preventive action plans
  • morbidity and mortality reviews
  • root cause analyses
• participate in systems for surveillance and monitoring of adverse events and near misses, including reporting such events
• ensure that identified opportunities for improvement are raised and reported appropriately
• use clinical audits and registries of data on patients’ experiences and outcomes, learnings 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 awareness of a systematic approach to improving the quality and safety of health care

Ready to perform without supervision

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

The trainee will:

• participate in professional training in quality and safety
• 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

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:

• recognise 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

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

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 and/or the community
• contribute to developing a culture that enables and prioritises patients’ safety and quality of care

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

Ready to perform without supervision

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

The trainee will:

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

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 practitioners to identify, evaluate, and improve patients’ management

Ready to perform without supervision

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

The trainee will:

• formulate and implement quality improvement strategies as a collaborative effort involving all key health professionals
• support multidisciplinary team activities to lower patients’ risk of harm, and promote multidisciplinary programs of education

Requires some supervision

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

The trainee may:

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

Ready to perform without supervision

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

The trainee will:

• participate in all aspects of the development, implementation, evaluation, and monitoring of governance processes
• participate regularly in multidisciplinary meetings where quality and safety issues are standing agenda items
• measure, analyse, and report a set of palliative care-specific process of care and outcome clinical indicators, and a set of generic safety indicators

Requires some supervision

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

The trainee may:

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

Ready to perform without supervision

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

The trainee will:

• demonstrate high-level communication skills, ensuring compassion and empathy
• respond to verbal and nonverbal cues and emotion while giving medical information and negotiating management plans
• explain diagnoses in context of serious illness communication, including significant investigation findings and further management options, using language appropriate to patients’ understanding and desire for information
• address questions, misunderstandings, and concerns about the condition and management options
• address prognoses if requested, demonstrating a sensitive approach and ensuring understanding of past discussions and history
• include significant others in conversations when appropriate
• communicate with other health professionals and members of the multidisciplinary team as needed
• write relevant and detailed medical record entries, including clinical assessments and management plans

Requires some supervision

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

The trainee may:

• recognise communication triggers by cues, and require further training in communication skills to support patient care
• require supervisor input for complex or highly emotional conversations
• recognise engagement with multidisciplinary colleagues to support management plans and elicit broad understanding of patients’ and family members’ distress

Ready to perform without supervision

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

The trainee will:

• incorporate infection control into clinical practice
• participate in effective clinical handover
• recognise and effectively deal with aggressive patient behaviours through appropriate training
• obtain informed consent before undertaking any investigations or providing treatment (except in emergencies)
• contribute to monitoring and evaluation strategies around clinical assessment and management, such as clinical audits
• evaluate and explain the benefits and risks of clinical interventions based on individual patients’ circumstances
• identify evidence-based practice gaps using clinical indicators, and implement changes to improve patients’ outcomes

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 clinical practice
• seek feedback on own clinical practice
• address gaps in knowledge and skills through self-directed learning and continuing professional development
• supervise junior colleagues in the provision of clinical care
• obtain informed consent before involving patients in teaching activities
• use teaching opportunities arising from clinical encounters
• use clinical encounters to educate patients on relevant aspects of health and disease

Requires some supervision

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

The trainee may:

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

Ready to perform without supervision

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

The trainee will:

• apply evidence-based guidelines to clinical practice
• analyse the relevant research literature in depth, and apply it to clinical practice
• support clinical research to build the palliative care evidence base

Requires some supervision

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

The trainee may:

• apply evidence-based guidelines and relevant review papers to clinical practice

Ready to perform without supervision

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

The trainee will:

• use plain-language patient education materials, and demonstrate cultural and linguistical sensitivity
• demonstrate effective and culturally safe communication and care for Māori and Aboriginal and Torres Strait Islander peoples, and members of other cultural groups
• use professional interpreters, health advocates, or community members to assist in communication with patients, and understand the potential limitations of each
• acknowledge patients’ beliefs and values, and how these might impact on health

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
• apply knowledge of the most common cultures in society to clinical practice
• appropriately access interpretive or culturally focused services

Ready to perform without supervision

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

The trainee will:

• demonstrate professional values, including compassion, empathy, respect, integrity, and honesty to all patients
• maintain patient privacy and confidentiality according to legal guidelines
• assess patients’ capacity for decision making, involving surrogate decision makers appropriately

Ready to perform without supervision

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

The trainee will:

• apply knowledge and clinical experience to diagnose and manage patients’ problems, making logical, rational decisions
• consider comorbidity, uncertainty, and risk when formulating differential diagnoses and management plans
• use the best available evidence for the most effective therapies and interventions to ensure quality care

Requires some supervision

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

The trainee may:

• demonstrate clinical reasoning by gathering focused information relevant to patients’ care
• recognise personal limitations and seek help in an appropriate way when required

Ready to perform without supervision

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

The trainee will:

• work effectively as a member of multidisciplinary teams to achieve the best health outcome for patients
• identify colleagues in difficulty, and work within the appropriate structural systems to support them while maintaining patients’ safety
• refer patients appropriately

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

Ready to perform without supervision

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

The trainee will:

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

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 patient care

Ready to perform without supervision

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

The trainee will:

• explore preferred location for care and preferred location for death
• actively involve patients in their own care, meet their information needs, and make shared decisions about care settings
• communicate with patients about options and plans for transitions in care settings, including the reasons and/or risks associated with such transitions
• communicate and consult with other health professionals and members of the multidisciplinary team regarding transitions of care
• write relevant and detailed medical record entries, including clinical assessments and management plans
• provide handovers to receiving health professionals
• accept handovers from other health professionals
• write comprehensive and accurate summaries of care and transfer documentation
• effectively use telehealth to support care

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 health professionals
• 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 effective transitions between settings, and continuity and quality of care

Ready to perform without supervision

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

The trainee will:

• use triage tools to prioritise order of transfers in or out of care settings
• identify patients at risk of adverse outcomes, including symptom crisis or death during transition of care, and mitigate this risk
• use consent processes, including written consent if required, for the release and exchange of information
• analyse adverse incidents and sentinel events during transitions of care to identify system failures and contributing factors

Requires some supervision

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

The trainee may:

• ensure that handovers are complete, or work to mitigate risks if incomplete
• ensure all outstanding results or procedures are followed up by receiving units and clinicians
• keep patients' information secure, adhering to relevant legislation regarding personal information and privacy

Ready to perform without supervision

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

The trainee will:

• supervise junior colleagues in managing transitions of care Teaching and learning
• use teaching and learning opportunities arising from transitions of care, including teaching patients and during handover sessions

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

Ready to perform without supervision

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

The trainee will:

• communicate in a culturally appropriate way by considering health literacy, language barriers, culture, religion, and belief systems when discussing transition of care with patients
• use culturally appropriate services to support patients in care transitions

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

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 during transitions of care in line with clinical, ethical, and legal requirements
• work effectively with primary / community-based care

Requires some supervision

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

The trainee may:

• maintain respect for patients and other health professionals, including respecting privacy and confidentiality

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 aligned with their own goals and is occurring in the most appropriate 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 consider and prioritise patients’ issues
• recognise personal limitations and seek help in an appropriate way when required

Ready to perform without supervision

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

The trainee will:

• delegate appropriately during transitions of care
• work effectively with the multidisciplinary team and other clinicians to ensure smooth transitions of care
• demonstrate knowledge of the medical governance of patient care, and the differing roles of team members

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 to understand the issues to continue care
• work to overcome the potential barriers to continuity of care, appreciating the role of handover in overcoming these barriers

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 identify strategies for improvement in transition of care
• engage in organisational processes to improve transitions of care, such as formal surveys or follow-up phone calls after hospital discharge

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

Ready to perform without supervision

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

The trainee will:

• communicate with other health professionals, members of the multidisciplinary team, and family regarding acute changes in patients’ conditions and management plans
• negotiate realistic treatment goals
• determine and explain expected prognoses and outcomes
• explain diagnosis, investigation, and management options for acute events to patients using language appropriate to their understanding and desire for information
• address questions, misunderstandings, and concerns about conditions and management options
• respond to verbal and nonverbal cues and emotion while discussing acute medical events with patients
• write relevant and detailed medical record entries, including clinical assessments and management plans
• actively involve patients in their own care, meet their information needs, and make shared decisions about care settings

Requires some supervision

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

The trainee may:

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

Ready to perform without supervision

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

The trainee will:

• contribute to monitoring and evaluation strategies around managing acute medical care, such as clinical audits and morbidity and mortality meetings

Requires some supervision

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

The trainee may:

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

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 clinical practice around provision of acute care
• seek feedback about acute care from colleagues and learners on their own clinical practice
• address gaps in knowledge and skills through self-directed learning and continuing professional development
• supervise junior colleagues in managing acute care situations in palliative care
• use teaching opportunities arising from acute care situations in palliative care

Requires some supervision

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

The trainee may:

• coordinate and supervise junior colleagues from the emergency department and wards

Ready to perform without supervision

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

The trainee will:

• apply relevant research literature and evidence-based guidelines to clinical practice in managing acute events in palliative care
• support clinical research to build the palliative care evidence base in acute care

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

Ready to perform without supervision

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

The trainee will:

• negotiate health care decisions around an acute event in a culturally appropriate way by considering health literacy, language barriers, cultures, religion, and belief systems
• integrate culturally appropriate care of Māori and Aboriginal and Torres Strait Islander peoples into management of acute events

Ready to perform without supervision

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

The trainee will:

• advise patients of their rights to decline certain medical therapy, including life-sustaining treatment
• consider the consequences of delivering treatment that is deemed non-beneficial, directing to other care as appropriate
• demonstrate critical reflection on personal beliefs and attitudes, including how these may affect patients’ care during acute events and affect health care policy

Ready to perform without supervision

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

The trainee will:

• identify the need for escalation of care, and involve other appropriate staff or services
• integrate evidence related to questions of diagnosis, therapy, prognosis, risks, and cause into clinical decision making around management of acute events in palliative care
• reconcile conflicting advice from other specialties, applying judgement in making clinical decisions in the presence of uncertainty
• use care pathways effectively, including identifying reasons for variations in care
• address psychological distress of events on patients
• identify patients at high risk of adverse events, and undertake appropriate future care planning

Requires some supervision

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

The trainee may:

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

Ready to perform without supervision

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

The trainee will:

• work effectively with the multidisciplinary team and other clinicians during management of acute events

Requires some supervision

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

The trainee may:

• collaborate and engage with other team members during management of acute events, based on their roles and skills
• ensure appropriate multidisciplinary assessment and management of acute events
• encourage an environment of openness and respect to lead effective teams

Ready to perform without supervision

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

The trainee will:

• use a considered and rational approach to the responsible use of resources, balancing costs against outcomes
• prioritise patients' care based on need, and consider available health care resources
• develop and review policies and protocols for the investigation and management of common acute medical problems in palliative care

Requires some supervision

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

The trainee may:

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

Ready to perform without supervision

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

The trainee will:

• use telehealth effectively
• develop rapport
• tailor communication content and style to meet patients’ needs
• include significant others in conversations, and facilitate family meetings when appropriate
• respond to verbal and nonverbal cues and emotions
• document and share information about key conversations with patients to optimise patient care and safety
• assess patients’ understanding prior to giving any information
• model shared decision making by exploring patients’ concerns, informing them, prioritising their wishes, and respecting their beliefs

Requires some supervision

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

The trainee may:

• provide information to patients in plain language, avoiding jargon, acronyms, and complex medical terms
• convey information considerately and sensitively to patients, seeking clarification if unsure of how best to proceed
• treat children and young people respectfully, and listen to their views

Ready to perform without supervision

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

The trainee will:

• discuss potential benefits and risks of management strategies
• assess patient capacity for decision making and informed consent if concerns are expressed by the patients’ family or carer
• recognise and respond appropriately where patients may be vulnerable, such as issues of elder abuse, family violence, or self-harm
• participate in processes to manage patient complaints
• ensure timely, purpose-driven, and effective communication and documentation that supports continuous, coordinated, and safe care for patients

Requires some supervision

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

The trainee may:

• treat information about patients as confidential

Ready to perform without supervision

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

The trainee will:

• address gaps in knowledge and skills through self-reflection, seeking feedback and self-directed learning and continuing professional development
• supervise junior colleagues in managing communication with patients

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 best available evidence
• obtain informed consent or other valid authority before involving patients in research
• write articles / reports and other scientific writing
• display oral communication skills, including those for both planned presentations and spontaneous speech
• communicate scientific information to others in journal clubs and conference presentations

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 Māori and Aboriginal and Torres Strait Islander peoples
• effectively communicate with members of other cultural groups by meeting patients’ specific communication, cultural, and language needs
• use qualified language interpreters or cultural interpreters effectively to help meet patients’ communication needs
• 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

Ready to perform without supervision

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

The trainee will:

• demonstrate respectful professional relationships with patients
• prioritise honesty, patients’ welfare, and community benefit above self-interest
• use appropriate consent processes for the release and sharing of patients’ information
• respect patients’ rights to privacy and confidentiality
• support patients’ decision making preferences
• support patients’ rights to seek second opinions
• avoid sexual, intimate, and financial relationships with patients
• behave equitably towards all, irrespective of gender, age, culture, socioeconomic status, sexual preferences, beliefs, contribution to society, illnessrelated behaviours, or the illness itself
• use social media ethically and according to legal obligations

Ready to perform without supervision

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

The trainee will:

• communicate effectively with team members involved in patients’ care, and with patients
• facilitate an environment where all team members feel they can contribute and their opinion is valued

Requires some supervision

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

The trainee may:

• keep health care team members focused on patient outcomes

Ready to perform without supervision

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

The trainee will:

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

Ready to perform without supervision

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

The trainee will:

• discuss the benefits, rationale, and risks of medication options
• provide written instructions and information to patients when appropriate
• communicate medication changes effectively to other health providers

Requires some supervision

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

The trainee may:

• discuss and explain the rationale for treatment options with patients
• explain the benefits and burdens of therapies, considering patients’ individual circumstances
• write clearly legible scripts or charts using generic names of required medications in full, including mg / kg / dose information and all legally required information
• seek further advice from experienced clinicians or pharmacists when appropriate

Ready to perform without supervision

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

The trainee will:

• review medicines regularly
• check that dose conversions are accurate, appropriate, and safe when rotating opioids
• institute timely follow-ups after medication changes
• contribute to monitoring and evaluation strategies around prescribing, including clinical audits
• analyse adverse incidents and sentinel events to identify system failures and contributing factors
• identify patients at increased risk from medications in the home, such as risk of misuse or diversion, and initiate risk mitigation practices

Requires some supervision

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

The trainee may:

• check doses before prescribing
• monitor side effects of prescribed medicines
• identify medication errors, and institute appropriate measures
• use electronic prescribing systems safely
• rationalise medicines to avoid polypharmacy

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 clinical practice around prescribing
• seek feedback from colleagues and learners on their own clinical practice
• address gaps in knowledge and skills through self-directed learning and continuing professional development
• supervise junior colleagues’ prescribing
• use teaching opportunities arising from prescribing
• educate patients about their medication management plans
• use appropriate guidelines and evidence-based medicine resources to maintain a working knowledge of current medicines
• train carers, where appropriate, about the indications for administration of medications and when to seek assistance

Requires some supervision

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

The trainee may:

• undertake continuing professional development to maintain currency with prescribing guidelines
• reflect on prescribing, and seek feedback from a supervisor

Ready to perform without supervision

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

The trainee will:

• apply relevant research literature and evidence-based guidelines to prescribing practice
• support clinical research to build the palliative care evidence base in prescribing

Requires some supervision

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

The trainee may:

• make therapeutic decisions according to the best evidence
• recognise where evidence is limited, compromised, or subject to bias or conflict of interest

Ready to perform without supervision

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

The trainee will:

• interpret and explain information to patients at the appropriate level of their health literacy
• use plain-language and culturally appropriate patient education materials

Requires some supervision

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

The trainee may:

• appreciate patients’ cultural and religious backgrounds, attitudes, and beliefs, and take into account how these might influence the acceptability of pharmacologic and non-pharmacological management approaches

Ready to perform without supervision

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

The trainee will:

• reflect on the ethical implications of pharmaceutical industry-funded research and marketing
• consider the financial implications of prescribing

Requires some supervision

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

The trainee may:

• follow regulatory and legal requirements and limitations regarding prescribing
• follow organisational policies regarding pharmaceutical representative visits and drug marketing

Ready to perform without supervision

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

The trainee will:

• use a systematic approach to select treatment options
• prescribe medicines appropriate to patients’ clinical needs, in doses that meet their individual requirements, for a sufficient length of time, with the lowest cost and risk of potential harm to them
• evaluate new medicines in relation to their possible efficacy and safety profile for individual patients

Requires some supervision

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

The trainee may:

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

Ready to perform without supervision

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

The trainee will:

• collaborate with multidisciplinary teams to ensure safe and effective medicine use

Requires some supervision

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

The trainee may:

• work collaboratively with pharmacists
• participate in medication safety and morbidity and mortality meetings

Ready to perform without supervision

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

The trainee will:

• choose medicines in relation to comparative efficacy, safety, and cost-effectiveness against medicines already on the market
• contribute to the development of and review of prescribing guidelines

Requires some supervision

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

The trainee may:

• prescribe in accordance with organisational policy and evidence-based practice

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
• explain procedures clearly to patients, including reasons for procedures, potential alternatives, and possible risks
• address patients’ concerns relating to procedures, and provide the opportunity to ask questions
• communicate effectively with team members and patients prior to, during, and after procedures

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 choose procedures
• communicate with members of procedural teams to ensure aligned awareness of individuals’ roles
• discuss post-procedural care with patients
• complete relevant patients’ documentation, and conduct appropriate post-procedure clinical handovers

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 procedures
• identify, document, and appropriately notify of any adverse events or equipment malfunction

Requires some supervision

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

The trainee may:

• ensure patients are fully informed when consenting to procedures
• identify patients using approved patients’ identifiers before any treatments or interventions are initiated
• attempt to perform procedures in safe environments

Ready to perform without supervision

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

The trainee will:

• use relevant published procedural guidelines when arranging or undertaking procedures
• 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 around procedures
• help junior colleagues develop new procedural skills
• actively seek feedback on personal technique until competent

Ready to perform without supervision

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

The trainee will:

• consider individual patients’ cultural perception of health and illness, and adapt practice accordingly with regards to procedures

Requires some supervision

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

The trainee may:

• respect cultural, linguistic, and religious values and differences of patients, families, whānau and/or carers when considering procedures

Ready to perform without supervision

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

The trainee will:

• identify appropriate surrogate decision makers when required
• undertake procedures within own limits of expertise

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

Ready to perform without supervision

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

The trainee will:

• identify roles and optimal timing for diagnostic and therapeutic procedures
• select the most appropriate and cost-effective diagnostic or therapeutic procedures
• adapt procedures in response to assessments of risks to individual patients

Requires some supervision

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

The trainee may:

• prioritise which patients receive procedures first, if there is a waiting list
• assess personal skill levels, and seek help with procedures when appropriate
• use tools and guidelines to support decision making regarding procedures

Ready to perform without supervision

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

The trainee will:

• provide staff with clear aftercare instructions, and explain how to recognise possible complications
• collaborate with colleagues to identify differences in training and/or experience, and work together to reduce errors, prevent complications, and increase team efficiency

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

Ready to perform without supervision

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

The trainee will:

• discuss serious incidents at appropriate clinical review meetings
• initiate local improvement strategies in response to serious incidents
• use resources efficiently when performing procedures

Requires some supervision

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

The trainee may:

• perform procedures in accordance with organisational guidelines and policies

Ready to perform without supervision

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

The trainee will:

• review and clearly summarise relevant investigations undertaken prior to palliative care involvement
• discuss the benefits, cost, rationale, and risks of investigation options, including the option to have no investigations
• explore and address patients’ concerns and expectations about investigation plans
• explain findings or possible outcomes of investigations to patients where appropriate

Requires some supervision

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

The trainee may:

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

Ready to perform without supervision

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

The trainee will:

• identify adverse outcomes that may result from proposed investigations

Requires some supervision

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

The trainee may:

• consider safety aspects of investigations when planning them
• seek guidance with interpretation of test results for less common tests, indications for tests, or unexpected test results

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 clinical practice around ordering of investigations
• seek feedback from colleagues and learners on their own clinical practice
• address gaps in knowledge and skills through self-directed learning and continuing professional development
• supervise junior colleagues' decision making around ordering of investigations
• use teaching opportunities around ordering and interpreting investigations
• use appropriate guidelines, evidence sources, and decision support tools when considering investigations
• participate in clinical audits to improve test ordering strategies

Requires some supervision

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

The trainee may:

• undertake professional development to maintain currency with investigation guidelines

Ready to perform without supervision

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

The trainee will:

• apply relevant research literature and evidence-based guidelines to decisions around investigations
• support clinical research to build the palliative care evidence base in the use of investigations
• provide patients with relevant information if a proposed investigation is part of a research program
• obtain written consent from patients if the investigation is part of a research program

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 around investigations
• consult current research on investigations

Ready to perform without supervision

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

The trainee will:

• consider patients’ cultural and religious backgrounds, attitudes, and beliefs, and their impact on the acceptability of proposed investigations

Ready to perform without supervision

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

The trainee will:

• respect patients’ decisions to decline certain investigations where appropriate
• advise patients there may be additional costs, which patients may wish to clarify before proceeding
• explain the expected benefits as well as the potential burdens and risks of proposed investigations before obtaining informed consent or other valid authority
• advocate for the patient to have appropriate and timely investigations, including interventional procedures undertaken in keeping with their goals of care

Requires some supervision

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

The trainee may:

• identify appropriate proxy decision makers when required for consent for investigations
• choose not to investigate in situations where it is not appropriate for ethical reasons
• involve patients in decision making regarding investigations, obtaining the appropriate informed consent, including financial consent, if necessary

Ready to perform without supervision

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

The trainee will:

• evaluate the benefits, burdens, costs, and potential risks of each investigation in varying settings and clinical situations
• justify the selection of investigations based on the patients’ goals of care, likely benefit, prognosis, and stage of disease

Requires some supervision

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

The trainee may:

• choose the most appropriate investigations for clinical scenarios in discussion with patients

Ready to perform without supervision

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

The trainee will:

• ensure results are checked in a timely manner, taking responsibility for following up results
• communicate investigation results in a timely manner to other teams involved in patients’ care

Ready to perform without supervision

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

The trainee will:

• ensure investigations ordered are cost effective
• advocate for equity of access to appropriate investigations of all patient groups, irrespective of age, gender, race, or socioeconomic status

Ready to perform without supervision

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

The trainee will:

• facilitate handover and continuity of care
• maintain a flexible approach to communication, depending on the setting, such as aged care facility, clinic, and home environments
• write comprehensive and accurate letters
• provide written plans to patients and support persons when appropriate
• communicate with multidisciplinary teams regarding management plans for community palliative care and outpatient clinic patients
• communicate with general practitioners, community palliative care, and any other specialists involved in patients’ care
• effectively manage patients using telehealth

Ready to perform without supervision

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

The trainee will:

• contribute to monitoring and evaluation strategies around the provision of community palliative care and outpatient care, including clinical audits
• identify aspects of service provision that may be a risk to patients’ and staff safety
• ensure that patients are informed about fees and charges

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 clinical practice around clinic and community management
• seek feedback from colleagues, learners, and patients on their own clinical practice
• address gaps in knowledge and skills through self-directed learning and continuing professional development
• supervise junior colleagues in managing palliative care patients in the outpatient clinic setting
• use teaching opportunities arising from clinic and community encounters

Ready to perform without supervision

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

The trainee will:

• apply relevant research literature and evidence-based guidelines to clinical practice in community and outpatient settings
• obtain informed consent or other valid authority before involving outpatients 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

Ready to perform without supervision

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

The trainee will:

• demonstrate effective and culturally safe communication and care for Māori and Aboriginal and Torres Strait Islander peoples, and members of other cultural groups in the outpatient clinic and community
• use professional interpreters, health advocates, family members, whānau, carers, or community members to assist in communication with patients, and understand the potential limitations of each
• consider the influence of own culture and beliefs on interactions with patients and decision making in the community and outpatient settings

Ready to perform without supervision

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

The trainee will:

• understand, recognise, and respect the roles and responsibilities of other health professionals when managing community palliative care patients and outpatients
• demonstrate awareness of financial and other conflicts of interest in community and outpatient settings

Requires some supervision

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

The trainee may:

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

Ready to perform without supervision

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

The trainee will:

• optimise patient care using available resources

Ready to perform without supervision

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

The trainee will:

• work effectively as a member of multidisciplinary teams or other professional groups during the delivery of care through outpatient clinics and community palliative care

Requires some supervision

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

The trainee may:

• attend relevant clinical meetings regularly

Ready to perform without supervision

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

The trainee will:

• maintain good relationships with health agencies and services
• apply the principles of efficient and equitable allocation of resources
• facilitate patients’ access to relevant community-based resources and organisations

Ready to perform without supervision

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

The trainee will:

• discuss end-of-life care with patients in line with their wishes for information, and document this in clinical records
• communicate with other health professionals and members of the multidisciplinary team regarding end-of-life care as needed
• discuss with family and/or carers appropriate support and bereavement care
• facilitate family meetings
• respond to verbal and nonverbal cues and emotions

Requires some supervision

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

The trainee may:

• discuss with patients the goals of care and treatment, and document this in clinical records
• provide honest and clear clinical assessment summaries of situations, using plain language and avoiding medical jargon
• identify proxy decision makers and patients’ wishes for them to be involved in discussions about their end-of-life care
• explore patients’ concerns at the end of life across cultural, physical, psychological, and spiritual domains

Ready to perform without supervision

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

The trainee will:

• contribute to monitoring and evaluation strategies around the provision of end-of-life care, including clinical audits
• analyse adverse incidents and sentinel events to identify system failures and contributing factors
• identify evidence-based practice gaps using clinical indicators, and implement changes to improve patients’ outcomes
• contribute to multidisciplinary mortality and morbidity meetings

Requires some supervision

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

The trainee may:

• collect and review data on the safety and effectiveness of end-of-life care delivery
• communicate the content of discussions about prognosis and advance care planning to multidisciplinary teams
• ensure that actual care is aligned with patients’ documented wishes

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 clinical practice around end-of-life care
• seek feedback from colleagues and learners on their own clinical practice
• address gaps in knowledge and skills through self-directed learning and continuing professional development
• supervise junior colleagues in managing end-of-life care
• use teaching opportunities arising from the provision of end-of-life care
• facilitate education on end-of-life care for non-palliative care specialists

Requires some supervision

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

The trainee may:

• encourage junior colleagues to participate in multidisciplinary case reviews, mortality and morbidity meetings, and adverse event reviews

Ready to perform without supervision

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

The trainee will:

• apply relevant research literature and evidence-based guidelines to clinical practice in end-of-life care
• support clinical research to build the end-of-life care evidence base

Requires some supervision

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

The trainee may:

• recognise that the evidence may be insufficient to resolve uncertainty and make definitive decisions

Ready to perform without supervision

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

The trainee will:

• practise culturally responsible end-of-life care
• identify culturally appropriate decision makers
• offer support to patients to include cultural or religious practices in their care

Requires some supervision

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

The trainee may:

• understand, respect, and respond to individual preferences and needs of patients, regardless of their culture and religious beliefs
• support patients with communication difficulties associated with cultural and linguistic diversity

Ready to perform without supervision

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

The trainee will:

• recognise the complexity of ethical issues related to human life and death
• identify and address moral distress and burnout

Requires some supervision

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

The trainee may:

• respond appropriately to distress or concerns of colleagues and patients

Ready to perform without supervision

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

The trainee will:

• exercise sound judgement in providing end-of-life care, making decisions that uphold the dignity, comfort, and preferences of patients and their families within the limitations of available resources

Requires some supervision

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

The trainee may:

• define and document patients’ goals and agreed outcomes

Ready to perform without supervision

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

The trainee will:

• work effectively with the multidisciplinary team and other clinicians to provide optimal end-of-life care
• provide support in patients’ preferred place of care
• coordinate end-of-life care to minimise fragmentation of care

Requires some supervision

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

The trainee may:

• document multidisciplinary care plans

Ready to perform without supervision

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

The trainee will:

• participate in developing frameworks for organisational advance care planning
• advocate for the needs of individual patients, social groups, and cultures within the community who have specific palliative care needs or inequitable access to palliative care services
• allocate health care resources effectivelys

Requires some supervision

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

The trainee may:

• support community-based service providers to build capacity for people to be cared for in their preferred place of death