Curriculum standards

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
• work with patients and other health professionals to resolve conflict that may arise when planning and aligning goals
• demonstrate rapport with people at all levels by tailoring messages to different stakeholders

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 the public
• respect the roles of team members

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 interdisciplinary collaboration to provide effective health services and operational change
• 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:

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

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:

• 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 discussion 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, achieving 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 an understanding of the negative impact of workplace conflict

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, 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

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 patients’ care
• participate effectively and appropriately in multidisciplinary teams
• seek out and respect the perspectives of multidisciplinary team members when making decisions

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 healthcare
• advocate for the resources and support of 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

Ready to perform without supervision

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

The trainee will:

• 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 different populations
• listen and convey information clearly and considerately
• 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:

• 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 their own wellbeing
• apply lessons learned about patient safety by identifying and discussing risks with learners
• assess learners’ competence, and provide timely feedback to minimise risks to care
• maintain the safety of patients and organisations involved with education, and appropriately identify and action concerns, including the involvement of senior team members if necessary

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
• identify and participate in new learning experiences which build skills

Ready to perform without supervision

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

The trainee will:

• demonstrate knowledge of the principles, processes, and skills of supervision
• provide direct guidance to learners in day-to-day work
• work with learners to identify professional development and learning opportunities, based on their individual learning needs
• offer feedback and role modelling
• participate in teaching and supervision professional development activities
• encourage self-directed learning and assessments
• develop a consistent and fair approach to assessing learners
• tailor feedback and assessments 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
• apply a standardised approach to teaching, assessment, and feedback without considering individual learner needs
• implement teaching and learning activities that are misaligned to learning goals
• adopt a teaching style that discourages learners’ self-directedness

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 project goals and requirements, and provide feedback regarding the merits or challenges of proposed research
• support learners to find forums to present research projects
• monitor the progress of learners’ research projects regularly, and may review research projects prior to submission
• 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 planned research projects 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:

• role model a culturally safe 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 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:

• 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

Ready to perform without supervision

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

The trainee will:

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

• maintain personal and learners’ effective performance and continuing professional development
• maintain professional, clinical, research, and/or administrative responsibilities while teaching
• help shape organisational culture to prioritise quality and work safety through openness, honesty, shared learning, and continued improvement
• 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:

• incompletely integrate public health principals 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:

• support patients to have access to, and use, easy-to-understand, high-quality information about health care
• support patients to share decision making about their own health care, to the extent they choose
• direct patients on processes for accessing their own health information, as well as complaint and feedback systems
• discuss with patients any safety and quality concerns they have relating to their care
• assist patients to understand about hospital open disclosure policy
• 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

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, clinical incident reviews, root cause analyses, and corrective action preventative action plans
• participate in systems for surveillance and monitoring of quality care, 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 healthcare

Requires some supervision

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

The trainee may:

• demonstrate an understanding of a systematic approach to improving the quality and safety of health care
• demonstrate understanding of the principles of organisational quality and safety activities, including root cause analyses and corrective and preventive action plans

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
• maintain continuing professional development obligations as per regulatory requirements

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:

• apply the principles which underpin ethical research
• understand the processes for obtaining research ethics approval within an organisation
• 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
• ensure research adherence to the local and national codes for the responsible conduct of research
• communicate to the patient that they will not be treated differently should they opt to not participate in research
• engage in collaborative and ethical research practice with all stakeholders, and acknowledge own and others’ contributions to research
• ensure research is conducted in accordance with Good Clinical Practice

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

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 patients from culturally and linguistically diverse backgrounds, including through effective collaboration with interpreters
• 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
• contribute to developing an organisational 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’ care 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, and promote interdisciplinary programs of education to lower patients' risk of harm
• actively involve clinical pharmacists in the medication-use process

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, 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:
• clinical, and safety and quality education and training
• defining the scope of clinical practice
• performance monitoring and management

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 shape 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:

• communicate openly, listen, and take carers and patients’ concerns seriously, giving them adequate opportunity to ask questions
• provide developmentally appropriate information to patients to enable them to make fully informed decisions from various diagnostic, therapeutic, and management options
• communicate clearly, effectively, respectfully, and promptly with other health professionals involved in patients’ care, including in written correspondence, medical records and verbal communications
• use age-appropriate communication skills with patients, considering both family and/or carers' wishes and patients’ autonomy when discussing medical information

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 nonverbal cues
• demonstrate active listening skills
• communicate patients’ situations to colleagues, including senior clinicians
• document clinical encounters to convey clinical reasoning and the rationale for decisions
• arrange investigations, providing accurate and informative referrals, and liaising 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:

• demonstrate safety skills, including infection control, adverse event reporting, and effective clinical handover
• recognise and effectively deal with aggressive and violent patient behaviors through appropriate training
• obtain informed consent before undertaking any investigation or providing treatment (except in emergencies)
• ensure patients are informed of the material risks associated with any part of proposed management plans
• outline risk mitigation strategies for patients living with chronic endocrine conditions who are at risk of acute deterioration

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 patients and/or families, while still ensuring appropriate care of patients
• document history and physical examination findings, and synthesise with clarity and completeness

Ready to perform without supervision

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

The trainee will:

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

Requires some supervision

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

The trainee may:

• need assistance to set goals and clear objectives for self-learning
• engage in self-reflection, and require encouragement to do this more frequently
• deliver teaching considering learners’ levels of training

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
• use relevant resources to assist with resolving clinical problems, including practice guidelines and current literature

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

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 a professional interpreter, health advocate, or a family or community member to assist in communication with patients, and understand the potential limitations of each
• acknowledge patients’, families’ and/or carers' 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’, families’, and/or carers’ 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

Ready to perform without supervision

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

The trainee will:

• demonstrate professional values, including compassion, empathy, respect for diversity, integrity, honesty, and partnership to all patients
• hold information about patients in confidence, unless the release of information is required by law or public interest
• assess patients’ capacity for decision making, involving family or carers appropriately
• recognise the limits of parents‘ ability to consent
• demonstrate an understanding of the ethical implications of pharmaceutical industry marketing and funded research
• not advance personal interest or professional agendas at the expense of patient or social welfare

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
• follow organisational policies on 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:

• 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

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
• demonstrate awareness of colleagues in difficulty, and work within the appropriate structural systems to support them while maintaining patient 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

Ready to perform without supervision

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

The trainee will:

• participate in health promotion, disease prevention and control, screening, and reporting notifiable diseases
• aim to achieve the optimal cost-effective patient care to allow maximum benefit from the available resources

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:

• explain the impact of an endocrine disorder on adolescents’ and young adults’ leisure and work activities
• explain confidentiality to the young person
• adopt a developmentally appropriate approach to transition, and assess patients’ understanding of their illness and health care needs, and work with them to increase their understanding
• identify the need to shift responsibility for decision making from parents or carers to patients, and work with parents or carers and patients on planning this
• ensure all members of the multidisciplinary team contribute to transition plans
• ensure communication regarding transition includes the general practitioner and all current care providers

Requires some supervision

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

The trainee may:

• perform appropriate psychosocial and mental health assessments using recognised tools
• use communication skills and strategies that help patients make informed decisions
• recognise and explore the worries and concerns of adolescent patients and their family and/or carers
• communicate sensitively with adolescents and young adults
• recognise when it is appropriate to communicate with patients individually versus when it is appropriate to communicate with patients and their family members and/or carers
• discuss with patients the differences between paediatric and adult care, such as the involvement of the parent or carer in decisions for adult patients versus paediatric patients

Ready to perform without supervision

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

The trainee will:

• ensure patients are informed of risks associated with any part of proposed management plans
• use of “Transition readiness checklist” to assess preparedness of young person for transition

Requires some supervision

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

The trainee may:

• document patients’ histories with clarity and completeness

Ready to perform without supervision

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

The trainee will:

• educate adolescents and young adults about their conditions and their impacts on their lives

Requires some supervision

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

The trainee may:

• explain how patient education can empower young adults to take responsibility for their health
• ensure the young person understands and has a sick day management plan, and knows who to contact during the transition process

Requires some supervision

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

The trainee may:

• discuss topics including sexuality and contraception sensitively, and consider the cultural and religious beliefs of patients and their families

Ready to perform without supervision

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

The trainee will:

• explain the role of GPs in patients’ care, including relevant guidelines and how they apply
• explain confidentiality and what this means for young people and their family and/or carers
• recognise legal issues around consent and assessment of capacity and competence

Ready to perform without supervision

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

The trainee will:

• identify the right time to start facilitating transition by considering the needs of individual patients, and discuss this with the patient
• select the appropriate specialist to transition the patient, taking into account the availability of youth-orientated services

Requires some supervision

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

The trainee may:

• consider whether a paediatric or adult setting may be more appropriate to conduct procedures and/or investigations
• communicate with the GP regarding transition

Ready to perform without supervision

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

The trainee will:

• ensure sufficient handover, including robust notes to convey complex history and/or rationale for past decisions
• consider the timing of transition in relation to other specialties in which the patient is receiving care

Requires some supervision

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

The trainee may:

• recognise the importance of, and integrate with, the multidisciplinary team in the management of adolescents and young adults
• recognise and work collaboratively with other health care providers, including allied health workers and psychologists

Ready to perform without supervision

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

The trainee will:

• connect patients with local or online peer support groups
• contribute to the development of a written transition policy, which is a document that sets out principles, standards, and practices of how transitions are managed at the centre
• advocate for resources to support efficient and more effective transitions

Requires some supervision

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

The trainee may:

• apply local and international guidelines around transitions

Ready to perform without supervision

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

The trainee will:

• communicate clearly with other team members, and coordinate efforts of multidisciplinary team members
• convey information to other medical professionals involved in patients’ care, including ICU, retrieval services, and other medical teams
• support health professionals in remote settings to manage acutely unwell patients
• use closed-loop and clear communication with other health care team members during resuscitation
• relay patients’ presentation, care, progress, and management plans to colleagues factually, clearly, succinctly, and with prioritised clinical information
• facilitate early communication with patients, families, and health professionals to allow shared decision making
• negotiate realistic treatment goals, and determine and explain expected prognoses and outcomes
• employ communication strategies appropriate for younger patients or those with cognitive difficulties
• explain the situation to patients in a sensitive and supportive manner, avoiding jargon and confirming their understanding
• determine the level of health literacy of individual patients and level of understanding of agreed care decisions

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

Ready to perform without supervision

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

The trainee will:

• maintain up-to-date certification in advanced life support
• use clinical information technology systems for conducting prospective and retrospective clinical audits
• evaluate and explain the benefits and risks of clinical interventions based on individual patients’ circumstances
• analyse adverse incidents and sentinel events to identify system failures and contributing factors
• identify evidence-based practice gaps using clinical indicators, and implement changes to improve patients’ outcomes
• coordinate and encourage innovation, and objectively evaluate improvement initiatives for outcomes and sustainability
• consider alternative strategies if complications arise or treatment is ineffective
• participate in organisational quality and safety activities, including morbidity and mortality reviews and clinical incident reviews
• document treatment given without consent in an emergency according to local guidelines

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 all interventions
• raise appropriate issues for review at morbidity and mortality meetings
• evaluate the quality and safety processes implemented within the workplace, 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:

• demonstrate effective supervision skills and teaching methods which are adapted to the context of the training
• encourage questioning among junior colleagues and students in response to unanswered clinical questions
• seek guidance and feedback from health care teams to reflect on encounters and improve future patients’ care
• regularly reflect and self-evaluate professional development
• obtain informed consent before turning clinical activities into teaching opportunities, ensuring patients are aware of the risks

Requires some supervision

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

The trainee may:

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

Ready to perform without supervision

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

The trainee will:

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

Requires some supervision

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

The trainee may:

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

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

Requires some supervision

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

The trainee may:

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

Ready to perform without supervision

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

The trainee will:

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

Requires some supervision

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

The trainee may:

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

Ready to perform without supervision

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

The trainee will:

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

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 collaboratively with staff in the emergency department, intensive care, and other subspecialty inpatient units
• lead a team by providing engagement while maintaining a focus on outcomes
• manage the transition of acute medical patients through their hospital journey, including appropriate handover on discharge to community health professionals
• manage and initiate open disclosure as necessary

Requires some supervision

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

The trainee may:

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

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 patient care based on need, and consider available health care resources
• collaborate with emergency medicine staff and other colleagues to develop policies and protocols for the investigation and management of common acute medical problems

Requires some supervision

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

The trainee may:

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

Ready to perform without supervision

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

The trainee will:

• encourage patients’ self-management through education to take greater responsibility for their care, and support problem solving
• work in partnership with patients, and motivate them to adhere to agreed management plans
• communicate with multidisciplinary team members, and involve patients in that dialogue
• communicate with patients about transition of care, and engage and support them in decision making

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
• encourage patients' access to self-monitoring devices and assistive technologies

Ready to perform without supervision

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

The trainee will:

• use innovative models of chronic disease care using telehealth and digitally integrated support services
• review medicine use, and ensure patients understand safe medication administration to prevent errors
• support patients’ self-management by balancing between minimising risk and helping patients to become more independent
• initiate and participate in quality improvement processes impacting on patients’ abilities to undertake normal activities of daily living

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

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

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
• educate patients to recognise and monitor their symptoms, and undertake strategies to assist their recovery
• educate patients regarding sick day management plans for common and important endocrine conditions

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
• prepare research protocols to evaluate interventions and outcomes for chronic disease

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 and limitations of review articles

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

Ready to perform without supervision

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

The trainee will:

• share information about patients’ health care, consistent with privacy laws and confidentiality and professional guidelines
• use consent processes for the release and exchange of health information
• recognise patients’ evolving decision-making capacity, and appropriately engage adolescents in decision making

Requires some supervision

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

The trainee may:

• confidentially share information between relevant service providers
• acknowledge and respect the contribution of other health professionals involved in patients’ care
• seek consent from patients to discuss their care at multidisciplinary clinical meetings

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 long-term health care journeys

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

Ready to perform without supervision

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

The trainee will:

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

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 patients’ context

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 hospital-related complications and improve patients’ quality of life
• assist patients to access initiatives and services for patients with chronic diseases and disabilities

Requires some supervision

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

The trainee may:

• demonstrate an awareness of government initiatives and services available for patients with chronic diseases and disabilities, and display knowledge of how to access them

Ready to perform without supervision

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

The trainee will:

• use an age-appropriate communication strategy and modalities for communication, such as written information, emails, face-to-face, or phone calls
• elicit patients’ views, concerns, and preferences, promoting rapport
• provide information to patients in plain language, avoiding jargon, acronyms, and complex medical terms
• encourage questions, and answer them thoroughly
• ask patients to share their thoughts or explain their management plans in their own words, to verify understanding
• 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
• communicate with adolescents in an age-appropriate manner, acknowledging their developing autonomy
• communicate with adolescents separately from family or carers as needed, ensuring confidentiality (when appropriate) and respect of their evolving capacity
• set clear professional boundaries for communication with patients
• explain diagnoses, incidental findings, management, and long-term impacts to parents and carers
• explain the implications of different diagnoses and/or treatments for patients’ current and future pregnancies
• discuss options for pregnancies with endocrine disease sensitively with pregnant adolescents and their family or carers

Requires some supervision

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

The trainee may:

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

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 potential benefits and harms
• provide information to patients in a way they can understand, before asking for their consent
• consider young people’s capacity for decision making and consent
• recognise and take precautions where patients may be vulnerable, such as issues of child protection, family violence, or self-harm
• participate in processes to manage patient complaints, and participate in open disclosure discussions with patients

Requires some supervision

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

The trainee may:

• inform patients of the material risks associated with proposed management plans
• treat information about patients as confidential, while still acknowledging the limitations of confidentiality in cases of harm to a child or adolescent

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 the assessments to be conducted
• obtain informed consent or other valid authority before involving patients in teaching
• encourage questions and observations from junior staff and students to facilitate open communication and teaching
• provide constructive feedback to junior colleagues to contribute to improvements in individuals’ skills
• engage with community organisations and public health channels to promote preventative and public health strategies in clear and relevant language
• recognise the significance of role modelling all aspects of the work of a physician in interactions with junior staff and medical students, for their learning

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

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
• provide information to patients in a way they can understand before asking for their consent to participate in research
• obtain an 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:

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

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 with Māori and Aboriginal and Torres Strait Islander peoples
• effectively communicate with members of other cultural groups by meeting patients’ specific language, cultural, and communication needs
• use qualified language interpreters or cultural interpreters to help meet patients’ communication needs
• provide plain language and culturally appropriate written materials to patients when possible
• respect patients’ cultural views, and incorporate these when developing management plans where 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:

• encourage and support patients to be well informed about their health, and to use this information wisely when they make decisions
• encourage and support patients in caring for themselves and managing their health
• demonstrate respectful professional relationships with patients
• identify when it is appropriate to communicate with the patient versus their family or carer
• prioritise honesty, patients’ 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, socioeconomic 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

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

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

Ready to perform without supervision

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

The trainee will:

• collaborate with other services, such as community health centres and consumer organisations, to help patients navigate the healthcare system
• collaborate with public health organisations to promote preventative health information
• advocate for appropriate immunisations and vaccines while maintaining respect for the views and wishes of individual patients

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

Ready to perform without supervision

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

The trainee will:

• discuss and evaluate the risks, benefits, and rationale of treatment options, making decisions in partnership with patients and their family or carers
• write clear and legible prescriptions in plain language, and include specific indications for the anticipated duration of therapy
• demonstrate dosing and include written instructions, and ask the patient, parent, or carer to demonstrate where required
• educate patients and their carers about the intended use, expected outcomes, and potential side effects for each prescribed medication, addressing the common, rare, and serious side effects at the time of prescribing, to improve patients’ adherence to pharmacotherapy
• describe how the medication should and should not be administered, including any important relationships to food, time of day, and other medicines being taken
• educate patients and their carers on correct self-administration of medications when using specialised devices
• outline strategies to assist with children taking unpalatable medicines
• ensure patients’ and carers’ understanding by repeating back pertinent information, such as when to return for monitoring and whether therapy continues after this single prescription
• identify patients’ and carers’ concerns and expectations, and explain how medicines might affect their everyday lives

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, families or carers
• explain the benefits and burdens of therapies, considering patients’ individual circumstances
• write clearly legible scripts or charts using generic names of the required medication in full, including mg / kg / dose information and all legally required information
• ensure time of medication administration is accurate for all medications, particularly for those that are time sensitive
• 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 to reduce non‑adherence, and monitor treatment effectiveness, possible side effects, and drug interactions, ceasing unnecessary medicines
• use electronic prescribing tools where available, and access electronic drug references to prevent errors caused by drug interactions and poor handwriting
• encourage the use of medication aides to facilitate adherence, where applicable
• prescribe new medicines only when they have been demonstrated to be safer or more effective at improving patient-oriented outcomes than existing medicines
• participate in clinical audits to improve prescribing behaviour
• identify medication-related adverse events, and develop protocols to minimise medication-related adverse events in hospitals
• report suspected adverse events, and record them in patients’ medical records

Requires some supervision

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

The trainee may:

• check medication doses before prescribing
• check that the administration timing for prescribed medications is accurately and clearly documented
• monitor side effects of medicines prescribed
• identify medication errors and institute appropriate measures
• use manual and/or 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:

• use continuously updated software for computers and electronic prescribing programs
• ensure patients understand management plans, including adherence issues
• use appropriate guidelines and evidence-based medicine resources to maintain a working knowledge of current medicines, keeping up to date on new medicines

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
• undertake continuing professional development to maintain up-to-date knowledge of new medications and the evidence for their use
• 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:

• critically appraise research material to ensure any new medicine improves patient-centred outcomes more than older medicines, and not just more than placebo
• participate in research of new therapeutics
• obtain informed consent from participants by informing patients about their rights, the purpose of the research, the procedures to be undergone, and the potential risks and benefits of participation
• ensure that usual care is not compromised if patients decline participation in research
• 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
• use sources of independent information about medicines that provide accurate summaries of the available evidence on new medicines

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
• allow patients to make informed and voluntary decisions to participate in research

Ready to perform without supervision

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

The trainee will:

• explore patients’ understanding of and preferences for non-pharmacological and pharmacological management
• offer patients effective choices based on their expectations of treatment, health beliefs, and cost
• interpret and explain information to patients at the appropriate level of their health literacy
• anticipate queries to help enhance the likelihood of medicines being taken as advised
• ensure appropriate information is available at all steps of the medicine management pathway
• offer approved patient information resources in languages other than English, where these are available

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 how these might influence the acceptability of pharmacological 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:

• provide information on medication to patients about:
  • how to take the medicine
  • potential side effects
  • what it does
  • what it is for
  • when it should be stopped
• make prescribing decisions based on good safety data when the benefits outweigh the risks involved
• demonstrate an understanding of the ethical implications of pharmaceutical industry-funded research and marketing
• prescribe according to best evidence-based practice and in partnership with patients, and without undue influence from pharmaceutical industry interactions

Requires some supervision

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

The trainee may:

• consider the efficacy of medicines in treating illnesses, including the relative merits of different non-pharmacological and pharmacological approaches
• 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 selecting treatment options
• use medicines safely and effectively to get the best possible results
• choose suitable medicines only if medicines are considered necessary and will benefit patients
• prescribe medicines appropriately to patients’ clinical needs, in doses that meet their individual requirements, for a sufficient length of time, with the lowest cost 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, and seek help in an appropriate way when required
• consider the following factors for all medicines:
  • cost to patients, families, and the community
  • funding and regulatory considerations
  • generic versus brand medicines
  • interactions
  • precautions and contraindications
  • 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:

• interact with medical, pharmacy, and nursing staff 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
• prescribe for individual patients, considering history, current medicines, allergies, and preferences, ensuring that health care resources are used wisely for the benefit of patients
• advocate for patients’ access to medications that would be of benefit to their condition from evidence-based clinical assessments and judgement, when necessary

Requires some supervision

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

The trainee may:

• prescribe in accordance with the organisational policy
• prescribe in accordance with the Pharmaceutical Benefit Scheme

Ready to perform without supervision

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

The trainee will:

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

Requires some supervision

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

The trainee may:

• discuss the indications, risks, benefits, and complications of investigations with patients before ordering investigations
• explain the results of investigations to patients
• arrange investigations, providing accurate and informative referrals, and liaise with other services where appropriate
• explain the process of procedures to patients without providing a broader context

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 or procedures, focusing on patients’ individual situations
• participate in clinical practice audits to ensure best available evidence-based practice is offered
• where appropriate, collaborate with colleagues and multidisciplinary teams to ensure investigations are accurate and of clinical value
• discuss clinical incidents at appropriate clinical review meetings
• initiate local improvement strategies in response to clinical incidents

Requires some supervision

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

The trainee may:

• consider safety aspects of investigations and procedures
• seek help with the interpretation of test results for less common tests or indications or unexpected results
• perform investigations and procedures in accordance with the 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:

• use appropriate guidelines, evidence sources, and decision-support tools
• participate in clinical audits to improve knowledge of test sensitivity / specificity and relevance for diagnoses and screening
• teach junior staff about evidence-based use of investigations
• organise or participate in in-service training on investigations and procedures, including the use and interpretation of new technologies
• 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:

• undertake professional development to maintain currency with investigation guidelines
• participate in continued professional development
• help junior colleagues develop new skills
• actively seek feedback on personal techniques until competent

Ready to perform without supervision

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

The trainee will:

• provide patients or carers with relevant information if a proposed investigation is part of a research program
• obtain written consent from patients or carers if the investigation is part of a research program
• 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, and that patients may withdraw consent at any time

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
• demonstrate adherence to the principles of ethical research, including consent

Ready to perform without supervision

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

The trainee will:

• understand patients’ views and preferences about any proposed investigations, including handling, storage, and disposal of test samples, and the adverse outcomes they are most concerned about

Requires some supervision

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

The trainee may:

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

Ready to perform without supervision

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

The trainee will:

• remain within the scope of the authority given by patients (except for emergencies)
• when necessary, discuss with patients how decisions will be made once an investigation has started, if the patient is not able to participate in decision making
• respect patients’ decisions to refuse investigations, even if their decisions may not be evidence-based or in their best interests medically
• advise patients and carers of the potential costs of investigations, which patients may wish to clarify before proceeding
• explain the expected benefits, as well as the potential burdens and risks, of any proposed investigation before obtaining informed consent or other valid authority
• demonstrate an awareness of complex issues related to genetic information obtained from investigations, and subsequent disclosure of such information, and obtain documented informed consent from patients prior to proceeding with such investigations
• comply with consent processes, privacy law, and professional guidelines to maintain patient confidentiality

Requires some supervision

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

The trainee may:

• identify appropriate proxy decision makers when required
• choose not to investigate in situations where it is not appropriate for ethical reasons
• practise within current ethical and professional frameworks
• practise within one’s own limits, and seek help when needed
• involve patients and carers in decision making regarding investigations, and 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 costs, benefits, and potential risks of each investigation in a clinical situation
• liaise with colleagues and other members of multidisciplinary teams, providing clinical context to investigation outcomes when necessary
• adjust the investigative path depending on test results received
• consider the clinical impact if no tests are selected
• 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:

• choose the most appropriate investigation for the clinical scenario, in discussion with patients
• recognise personal limitations, and seek help in an appropriate way when required
• assess personal skill levels, and seek help with procedures when appropriate
• use tools and guidelines to support decision making

Ready to perform without supervision

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

The trainee will:

• consider the role of other health professionals, and what other sources of information and support are available
• ensure results are checked in a timely manner, taking responsibility for following up results and progressing management as appropriate based on these results
• 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:

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

Ready to perform without supervision

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

The trainee will:

• select and justify investigations regarding the pathological basis of disease, appropriateness, utility, safety, and cost effectiveness
• consider resource use through peer review of testing behaviours
• use resources efficiently when ordering investigations or performing procedures

Ready to perform without supervision

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

The trainee will:

• help patients navigate the healthcare system to improve access to care by collaboration with other services, such as general practitioners, community health centres, and consumer organisations
• ensure patients understand the need for, and purpose of, a valid referral at each visit, and the duration of validity of the referral
• 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
• update referring doctor / team of the attendance outcome and management plan in a timely manner, appropriate to the clinical situation of the patient

Requires some supervision

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

The trainee may:

• wherever practicable, meet patients’ specific language and communication needs
• facilitate appropriate use of interpreter services and translated materials
• work in partnership with patients to develop agreed care plans and optimise motivation for adherence

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 setting
• identify aspects of service provision that may be a risk to patients’ safety, and escalate appropriately
• ensure that patients are informed about waiting times and any 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 different ways to evaluate and improve the quality and safety of outpatient health care
• participate in organisational quality and safety activities, including clinical incident reviews

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
• obtain patients' consent before involving students or other health professional observers in patient consultations
• contribute to the generation of knowledge
• provide supervision to junior colleagues to ensure the provision of quality patient care
• 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 as needed to contribute to patients’ care
• use information technology appropriately as a resource for modern medical practice

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 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
• ensure that usual care is not compromised if patients decline participation in research

Requires some supervision

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

The trainee may:

• allow patients to make informed and voluntary decisions to participate in research

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 being served, and how to shape service delivery to its people
• mitigate the influence of own culture and beliefs on interactions with patients and decision making
• adapt practices which improve patient engagement and health outcomes and are underpinned by cultural safety
• identify and refer to, or engage, culturally appropriate support services for those with chronic health conditions

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

Ready to perform without supervision

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

The trainee will:

• identify and respect the boundaries that define professional and therapeutic relationships
• respect the roles and expertise of other health professionals
• comply with the legal requirements of preparing and managing documentation
• demonstrate an 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 that the use of social media is consistent with ethical and legal obligations
• ensure appropriate consent procedures, and evaluate patients’ capacity / competence to make decisions regarding their health care
• use the legal framework for decision making and consent in paediatrics

Ready to perform without supervision

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

The trainee will:

• triage referrals according to urgency of care required
• integrate prevention, early detection, health maintenance, and chronic condition management, where relevant, into clinical practice
• work to achieve optimal and cost-effective patient care that allows maximum benefit from the available resources
• decide on the effective use of telehealth, outreach, and liaison services, when appropriate and where available

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

Ready to perform without supervision

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

The trainee will:

• prepare for and conduct clinical encounters in a well-organised and time-efficient manner
• work effectively as a member of multidisciplinary teams or other professional groups
• work effectively with patients’ primary care providers
• ensure that all important discussions with colleagues, multidisciplinary team members, and patients are appropriately documented
• review discharge summaries, notes, and other communications written by junior colleagues, and provide feedback
• support colleagues who raise concerns about patients’ safety
• consider urgency of care, and work effectively to maximise patients’ access to health services

Requires some supervision

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

The trainee may:

• attend relevant clinical meetings regularly
• identify causes of inefficiency in the clinic review process, and potential solutions
• ensure all members of the multidisciplinary team are respectful of colleagues and interact appropriately and professionally

Ready to perform without supervision

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

The trainee will:

• demonstrate the 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
• partner with organisations to address aspects of service provision that may be a risk to patients’ safety, such as overbookings, technology issues affecting efficiency, and clinic referral waitlists
• 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
• identify tools required to improve quality of service provision, and advocate for these within the health care organisation