Curriculum standards

About this resource

The new Advanced Training in Adolescent and Young Adult Medicine curriculum consists of curriculum standards and learning, teaching, and assessment (LTA) programs.

This document outlines the curriculum standards for Advanced Training in Adolescent and Young Adult Medicine for trainees and supervisors. The curriculum standards should be used in conjunction with the Advanced Training in Adolescent and Young Adult Medicine LTA program.

Download the curriculum standards PDF

LG1: Competencies

Competencies outline the expected professional behaviours, values and practices that trainees need to achieve by the end of training.

Competencies are grouped by the 10 domains of the professional practice framework.

Competencies will be common across training programs.

Medical expertise

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

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

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

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

Communication

Professional standard. Physicians collate information, and share this information clearly, accurately, respectfully, responsibly, empathetically, and in a manner that is understandable.

Physicians share information responsibly with patients, families, carers, colleagues, community groups, the public, and other stakeholders to facilitate optimal health outcomes.

Effective communication. Use a range of effective and appropriate verbal, nonverbal, written and other communication techniques, including active listening.

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

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

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

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

Quality and safety

Professional standard. Physicians practice in a safe, high quality manner within the limits of their expertise.

Physicians regularly review and evaluate their own practice alongside peers and best practice standards and conduct continuous improvement activities.

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

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

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

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

Teaching and learning

Professional standard. Physicians demonstrate a lifelong commitment to excellence in practice through continuous learning and evaluating evidence.

Physicians foster the learning of others in their profession through a commitment to mentoring, supervising, and teaching.¹

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

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

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

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

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

References

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

Research

Professional standard. Physicians support creation, dissemination and translation of knowledge and practices applicable to health.

They do this by engaging with and critically appraising research, and applying it in policy and practice to improve the health outcomes of patients and populations.

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

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

Cultural safety*

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

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

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

Critical reflection. Engage in iterative and critical self-reflection and demonstrate cultural safety in the context of their own cultural identity, power, biases, prejudices and practising behaviours.

Allyship. Recognise the patient and population’s rights to culturally safe care, including being an ally for patient, family, whānau and/or community autonomy and agency over their decision-making.

Inclusive communication. Apply culturally safe communication, acknowledging the sharing of power, and cultural and human rights to enable patients, families and whānau to engage in appropriate patient care decisions.

Culturally safe environment. Contribute to a culturally safe learning and practice environment for patients and team members. Respect patients may feel unsafe in the healthcare environment.

*The RACP has adopted the Medical Council of New Zealand’s definition of cultural safety. Cultural safety can be defined as:²

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

References

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

Ethics and professional behaviour

Professional standard. Physicians’ practice is founded upon ethics, and physicians always treat patients and their families, communities and populations in a caring and respectful manner.

Physicians demonstrate their commitment and accountability to the health and wellbeing of individual patients, communities, populations and society through ethical practice.

Physicians demonstrate high standards of personal behaviour.

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

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

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

Accountability. Be personally and socially accountable.

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

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

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

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

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

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

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

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

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

Judgement and decision making

Professional standard. Physicians collect and interpret information, and evaluate and synthesise evidence, to make the best possible decisions in their practice.

Physicians negotiate, implement, and review their decisions and recommendations with patients, their families and carers, and other healthcare professionals.

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

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

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

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

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

Leadership, management, and teamwork

Professional standard. Physicians recognise, respect, and aim to develop the skills of others, and engage collaboratively to achieve optimal outcomes for patients and populations.

Physicians contribute to and make decisions about policy, protocols, and resource allocation at personal, professional, organisational, and societal levels.

Physicians work effectively in diverse multidisciplinary teams and promote a safe, productive, and respectful work environment that is free from discrimination, bullying, and harassment.

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

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

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

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

Health policy, systems, and advocacy

Professional standard. Physicians apply their knowledge of the nature and attributes of local, national, and global health systems to their own practices. They identify, evaluate, and influence health determinants through local, national, and international policy.

Physicians deliver and advocate for the best health outcomes for all patients and populations.

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

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

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

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

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

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

Sustainability. Manage the use of healthcare resources responsibly in everyday practice.

Entrustable Professional Activities

Entrustable Professional Activities (EPAs) outline the essential work tasks trainees need to be able to perform in the workplace.

LG2: Team leadership

Learning Goal 2

Team leadership

Lead a team of health professionals

This activity requires the ability to:

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

Professional practice framework domain

Medical expertise

confident
Ready to perform without supervision

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

The trainee will:

synthesise information with other disciplines to develop optimal, goal-centred plans for patients
use evidence-based care to meet the needs of patients or populations
assess and effectively manage clinical risk in various scenarios
demonstrate clinical competence and skills by effectively supporting team members

direction
Requires some supervision

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

The trainee may:

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

Communication

confident
Ready to perform without supervision

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

The trainee will:

provide support and motivate patients or populations and health professionals by effective communication
demonstrate a transparent, consultative style by engaging patients, families, carers, relevant professionals and/or the public in shared decision making
work with patients, families, carers, 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

direction
Requires some supervision

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

The trainee may:

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

Quality and safety

confident
Ready to perform without supervision

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

The trainee will:

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

direction
Requires some supervision

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

The trainee may:

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

Teaching and learning

confident
Ready to perform without supervision

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

The trainee will:

regularly self-evaluate personal professional practice, and implement changes based on the results
actively seek feedback from supervisors and colleagues on their own performance
identify personal gaps in 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

direction
Requires some supervision

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

The trainee may:

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

Cultural safety

confident
Ready to perform without supervision

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

The trainee will:

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

direction
Requires some supervision

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

The trainee may:

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

Ethics and professional behaviour

confident
Ready to perform without supervision

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

The trainee will:

promote a team culture of shared accountability for decisions and outcomes
encourage open discussion of ethical and clinical concerns
respect differences of multidisciplinary team members
recognise 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

direction
Requires some supervision

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

The trainee may:

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

Judgement and decision making

confident
Ready to perform without supervision

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

The trainee will:

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

direction
Requires some supervision

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

The trainee may:

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

Leadership, management, and teamwork

confident
Ready to perform without supervision

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

The trainee will:

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

direction
Requires some supervision

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

The trainee may:

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

Health policy, systems, and advocacy

confident
Ready to perform without supervision

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

The trainee will:

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

direction
Requires some supervision

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

The trainee may:

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

LG3: Supervision and teaching

Learning Goal 3

Supervision and teaching

Supervise and teach professional colleagues

This activity requires the ability to:

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

Professional practice framework domain

Medical expertise

confident
Ready to perform without supervision

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

The trainee will:

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

direction
Requires some supervision

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

The trainee may:

teach learners using basic knowledge and skills

Communication

confident
Ready to perform without supervision

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

The trainee will:

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
support learners to deliver clear, concise, and relevant information in both verbal and written communication
listen and convey information clearly and considerately

direction
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

Quality and safety

confident
Ready to perform without supervision

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

The trainee will:

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

direction
Requires some supervision

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

The trainee may:

observe learners to reduce risks and improve health outcomes

Teaching and learning

confident
Ready to perform without supervision

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

The trainee will:

demonstrate knowledge of the principles, processes, and skills of supervision
provide direct guidance to learners in day-to-day work
work with learners to identify professional development and learning opportunities based on their individual learning needs
offer feedback and role modelling
participate in teaching and supervision of professional development activities
encourage self-directed learning and assessment
develop a consistent and fair approach to assessing learners
tailor feedback and 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

direction
Requires some supervision

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

The trainee may:

demonstrate basic skills in the supervision of learners
apply a standardised approach to teaching, assessment, and feedback without considering individual learners’ needs
implement teaching and learning activities that are misaligned to learning goals
adopt a teaching style that discourages learner self-directedness

Research

confident
Ready to perform without supervision

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

The trainee will:

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

direction
Requires some supervision

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

The trainee may:

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

Cultural safety

confident
Ready to perform without supervision

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

The trainee will:

role model a culturally appropriate approach to teaching
encourage learners to seek out opportunities to develop and improve their own cultural safety
encourage learners to consider culturally appropriate care of Aboriginal and Torres Strait Islander peoples and Māori into patients’ management
function effectively and respectfully when working with and teaching with individuals from the LGBTQIA+ community
consider cultural, ethical, and religious values and beliefs in teaching and learning

direction
Requires some supervision

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

The trainee may:

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

Ethics and professional behaviour

confident
Ready to perform without supervision

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

The trainee will:

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

direction
Requires some supervision

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

The trainee may:

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

Judgement and decision making

confident
Ready to perform without supervision

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

The trainee will:

prioritise workloads and manage learners with different levels of professional knowledge or experience
link theory and practice when explaining professional decisions
promote joint problem solving
support a learning environment that allows for independent decision making
use sound and evidence-based judgement during assessments and when giving feedback to learners
escalate concerns about learners appropriately
recognise own limitations and seek help, when required, in an appropriate way

direction
Requires some supervision

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

The trainee may:

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

Leadership, management, and teamwork

confident
Ready to perform without supervision

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

The trainee will:

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

direction
Requires some supervision

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

The trainee may:

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

Health policy, systems, and advocacy

confident
Ready to perform without supervision

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

The trainee will:

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

direction
Requires some supervision

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

The trainee may:

incompletely integrate public health principals into teaching and practice

LG4: Quality improvement

Learning Goal 4

Quality improvement

Identify and address failures in health care delivery

This activity requires the ability to:

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

Professional practice framework domain

Medical expertise

confident
Ready to perform without supervision

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

The trainee will:

use population health outcomes to identify opportunities for improvement in delivering appropriate care
regularly review patients’6 or population health outcomes to identify opportunities for improvement in delivering appropriate care
advocate for inclusion of evaluation of environmental and lifestyle risks
use standardised protocols to adhere to best practice and prevent the occurrence of wrong-site, wrong-patient procedures
regularly monitor personal professional performance
plan and deliver interventions to promote health and minimise harm

direction
Requires some supervision

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

The trainee may:

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

Communication

confident
Ready to perform without supervision

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

The trainee will:

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

direction
Requires some supervision

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

The trainee may:

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

Quality and safety

confident
Ready to perform without supervision

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

The trainee will:

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

direction
Requires some supervision

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

The trainee may:

demonstrate understanding of a systematic approach to improving the quality and safety of health care
work within organisational quality and safety systems for the delivery of clinical care

Teaching and learning

confident
Ready to perform without supervision

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

The trainee will:

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

direction
Requires some supervision

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

The trainee may:

use opportunities to learn about safety and quality theory and systems

Research

confident
Ready to perform without supervision

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

The trainee will:

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

direction
Requires some supervision

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

The trainee may:

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

Cultural safety

confident
Ready to perform without supervision

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

The trainee will:

undertake professional development opportunities that address the impact of cultural bias on health outcomes
recognise ethnicity and racial discrimination in health care environments
incorporate LGBTQIA+ safe language

direction
Requires some supervision

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

The trainee may:

communicate effectively with individuals with different cultural, language, or learning needs

Ethics and professional behaviour

confident
Ready to perform without supervision

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

The trainee will:

align improvement goals with the priorities of the organisation
contribute to developing an organisational culture that enables and prioritises patients’ safety and quality
recognise different legislative requirements of different organisations and disciplines

direction
Requires some supervision

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

The trainee may:

comply with professional regulatory requirements and codes of conduct

Judgement and decision making

confident
Ready to perform without supervision

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

The trainee will:

use decision-making support tools, such as guidelines, protocols, pathways, and reminders
analyse and evaluate current care processes to improve care delivery
recognise own limitations and seek help, when required, in an appropriate way

direction
Requires some supervision

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

The trainee may:

access information and advice from other health practitioners to identify, evaluate, and improve patients’ care management
inadequately consult with senior colleagues

Leadership, management, and teamwork

confident
Ready to perform without supervision

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

The trainee will:

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

direction
Requires some supervision

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

The trainee may:

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

Health policy, systems, and advocacy

confident
Ready to perform without supervision

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

The trainee will:

participate in all aspects of the development, implementation, evaluation, and monitoring of governance processes
participate regularly in multidisciplinary meetings 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 education and training
- defining the scope of clinical practice
- performance monitoring and management
- safety and quality education and training
explain the concepts behind youth participation and policy frameworks
recognise the roles and importance of quality improvement and advocacy frameworks
describe principles and techniques of advocacy
apply principles of advocacy for the needs and rights of patients
advocate for services for patients within the healthcare system and across other agencies
support political and public advocacy at local, national, and international level

direction
Requires some supervision

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

The trainee may:

maintain a dialogue with service managers about issues that affect patients’ 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

LG5: Clinical assessment and management

Learning Goal 5

Clinical assessment and management

Clinically assess and manage the ongoing care of patients

This activity requires the ability to:

identify and access sources of relevant information about patients7
obtain patient histories
assess family dynamics and involvement of the family in the care of adolescents and young adults
examine patients
synthesise findings to develop provisional and differential diagnoses
select appropriate investigations in consultation with patients, and ensure timely interpretation and follow up of results
recognise clinical deterioration and respond appropriately
discuss findings with patients
develop formulation and management plans
discuss formulation and management with other health professionals

Professional practice framework domain

Medical expertise

confident
Ready to perform without supervision

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

The trainee will:

elicit accurate, organised, and problem-focused medical histories, considering physical, psychosocial, risk factors, and protective and resilience factors
assess, diagnose, and manage acute undifferentiated clinical presentations
identify stage of cognitive and sociocultural development
perform full physical examinations to establish the nature and extent of problems
conduct mental state examinations
conduct assessments of substance use behaviours, poly-substance use, and risk
perform comprehensive adolescent health assessments
use standardised questionnaires
recognise and evaluate deviations from normal development
perform nutritional assessments
develop plans for multidisciplinary treatment and secondary prevention following acute events
assess and manage a range of complex medical conditions, including chronic conditions, disability, eating disorders, gender identity concerns, mental health problems, sexual health concerns, and substance use
assess and manage the psychosocial impacts of medical conditions
assess and manage young people with neurodevelopmental conditions, such as attention deficit hyperactivity disorder (ADHD) and autism spectrum disorder (ASD)
manage the physical and mental health comorbidities of neurodevelopmental conditions
provide acute stabilisation and management of malnourished patients

direction
Requires some supervision

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

The trainee may:

take patient-centred histories, considering psychosocial factors
perform accurate physical examinations
recognise and correctly interpret abnormal findings
synthesise pertinent information to direct the clinical encounter and diagnostic categories
develop appropriate management plans
recognise insulin resistance
recognise risk factors for eating disorders
recognise seriously unwell patients requiring immediate care
provide rationale for investigations

Communication

confident
Ready to perform without supervision

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

The trainee will:

communicate openly, listen, and take patients’ concerns seriously, giving them adequate opportunity to ask questions
provide information to patients and their family or carers to enable them to make fully informed decisions from various diagnostic, therapeutic, and management options
develop and communicate management plans
write clear and concise reports to advocate for patients
negotiate the initial plan and any changes with patients, carers, and colleagues
communicate with patients at different levels of development
maintain the confidentiality of information obtained from patients
communicate clearly, effectively, respectfully, and promptly with other health professionals involved in patients’ care
access and liaise with mental health providers, including hospital and community-based providers
provide dietary counselling
use motivational interviewing to achieve healthy behaviour change

direction
Requires some supervision

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

The trainee may:

anticipate, read, and respond to verbal and nonverbal cues
demonstrate active listening skills
communicate patients’ situations to colleagues, including senior clinicians and allied health professionals
discuss the indications, risks, benefits, and complications of investigations with patients before ordering investigations
explain the results of investigations to patients

Quality and safety

confident
Ready to perform without supervision

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

The trainee will:

demonstrate safety skills, including infection control, adverse event reporting, and effective clinical handover
recognise and effectively deal with aggressive and violent patient behaviours through appropriate training
obtain informed consent before undertaking any investigation or providing treatment (except in an emergency)
ensure patients are informed of the material risks associated with any part of proposed investigations or management plans
analyse adverse incidents and sentinel events to identify system failures and contributing factors

direction
Requires some supervision

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

The trainee may:

perform hand hygiene, and take infection control precautions at appropriate moments
take precaution against assaults from confused or agitated patients, ensuring appropriate care of patients
document history and physical examination findings, and synthesise with clarity and completeness
evaluate the quality of processes through well-designed audits
evaluate the quality and safety processes implemented within the workplace, and identify gaps in their structure

Teaching and learning

confident
Ready to perform without supervision

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

The trainee will:

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
demonstrate effective supervision skills and teaching methods that are adapted to the context of the training
use appropriate guidelines, evidence sources, and decision support tools

direction
Requires some supervision

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

The trainee may:

set unclear goals and objectives for self-learning
self-reflect infrequently
deliver teaching considering learners’ level of training
provide constructive feedback to junior colleagues to contribute to improvements in individuals’ skills

Research

confident
Ready to perform without supervision

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

The trainee will:

search for, find, compile, analyse, interpret, and evaluate information relevant to the research subject
evaluate the applicability of the results of clinical studies to the circumstances of individual patients, especially those with multiple comorbidities

direction
Requires some supervision

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

The trainee may:

refer to guidelines and medical literature to assist in clinical assessments when required
demonstrate an understanding of the limitations of evidence and the challenges of applying research in daily practice
refer to evidence-based clinical guidelines and protocols on acutely unwell patients

Cultural safety

confident
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 linguistic sensitivity
demonstrate effective and culturally safe communication and care for Aboriginal and Torres Strait Islander peoples, Māori, 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’ beliefs and values, and how these might impact on health
incorporate appropriate LGBTQIA+ safe language
demonstrate awareness of patients’ views and preferences about any proposed investigation and the adverse outcomes they are most concerned about

direction
Requires some supervision

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

The trainee may:

display respect for patients’ cultures, and attentiveness to social determinants of health
display openness and respect for patients’ different cultures and patients from the LGBTQIA+ community
appropriately access interpretive or culturally focused services

Ethics and professional behaviour

confident
Ready to perform without supervision

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

The trainee will:

demonstrate professional values, including compassion, empathy, respect for diversity, integrity, honesty, and partnership to all patients
access and keep up to date with current legislation regarding mental health and mandatory reporting requirements
hold information about patients in confidence, unless the release of information is required for the safety of patients or others, or by law or public interest
identify relevant state and federal legislation, policies, procedures, and protocols in relation to suspected sexual assaults
assess patients’ capacity for decision making, involving a proxy decision maker appropriately
respect, where appropriate, patients’ decisions to refuse investigations, even if their decisions may not be appropriate or evidence based
demonstrate awareness of complex issues related to genetic information obtained from investigations, and subsequent disclosure of such information

direction
Requires some supervision

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

The trainee may:

demonstrate professional conduct, honesty, and integrity
consider patients’ decision-making capacity
identify patients’ preferences regarding management and the role of families in decision making
not advance personal interest or professional agendas at the expense of patient or social welfare

Judgement and decision making

confident
Ready to perform without supervision

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

The trainee will:

apply knowledge and experience to identify patients’ problems, 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
recognise the need for escalation of care, and escalate to appropriate staff or services
use care pathways effectively, including identifying reasons for variations in care
recognise the limits to confidential care in the context of safety, electronic clinical records, and legislative requirements

direction
Requires some supervision

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

The trainee may:

demonstrate clinical reasoning by gathering focused information relevant to patients’ care

Leadership, management, and teamwork

confident
Ready to perform without supervision

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

The trainee will:

work effectively as a member of multidisciplinary teams to achieve the best health outcomes for patients
demonstrate awareness of colleagues in difficulty, and work within the appropriate structural systems to support them while maintaining patient safety
outline local community services and processes
recognise the contributions of different medical subspecialties and practitioners in the diagnosis, assessment, and treatment of health issues and complications
recognise the role of other agencies and professionals in the evaluation and management of adolescent and young adult health issues
work collaboratively with staff in the emergency department, intensive care, and other subspecialty inpatient and outpatient / community units

direction
Requires some supervision

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

The trainee may:

share relevant information with members of the healthcare team
liaise and collaborate with outside agencies
demonstrate understanding of what parts of an investigation are provided by different doctors or health professionals

Health policy, systems, and advocacy

confident
Ready to perform without supervision

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

The trainee will:

participate in health promotion, disease prevention and control, screening, and reporting notifiable diseases
aim to achieve optimal cost-effective patient care to allow maximum benefit from the available resources
collect and handle forensic samples, maintaining chain of evidence requirements
outline relevant national, state, and federal government decision-making processes regarding clinical and support services for patients
collaborate with colleagues to develop policies and protocols for the investigation and management of common medical problems
collaborate with emergency medicine staff and other colleagues to develop policies and protocols for the assessment and management of adolescent and young adult patients

direction
Requires some supervision

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

The trainee may:

identify and navigate components of the healthcare system relevant to patients’ care
identify and access relevant community resources to support patients’ care
understand the systems for the escalation of care for deteriorating patients

LG6: Management of transitions in care

Learning Goal 6

Management of transitions in care

Manage the transition of patient care between health professionals, providers, and contexts

This activity requires the ability to:

anticipate likely transitions of care, such as from paediatric to adult care
provide anticipatory guidance to patients8 to support their ability to transfer to different care contexts in due course
manage transition of patients’ care to ensure the optimal continuation of care between providers
identify the appropriate care providers and other stakeholders with whom to share patient information
exchange pertinent, contextually appropriate, and relevant patient information in ways that safeguard patient privacy
perform this activity in multiple settings, including inpatient, ambulatory, and critical care settings

Professional practice framework domain

Medical expertise

confident
Ready to perform without supervision

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

The trainee will:

facilitate an optimal transition of care for patients
identify and manage key risks for patients during transition periods
anticipate possible changes in patients’ conditions, and provide recommendations on how to manage them to both patients and appropriate care providers
identify appropriate local subspecialist teams and services when indicated, in addition to primary care
recognise generic versus disease-specific components of transition
outline the roles of specialist services

direction
Requires some supervision

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

The trainee may:

understand the details of patients’ conditions, illness severity, and potential emerging issues, with appropriate actions
provide accurate summaries of patients’ information with accurate identification of problems or issues

Communication

confident
Ready to perform without supervision

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

The trainee will:

write relevant and succinct medical record entries, including clinical assessments and management plans
write comprehensive and accurate summaries of care, including discharge summaries, clinic letters, and transfer documentation
initiate and maintain verbal communication with other health professionals when required
communicate with patients about transitions of care, and engage and support these parties in decision making
liaise with other agencies, including guardianship boards and schools
engage and consult with child protection services
lead the medical component of case conferences

direction
Requires some supervision

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

The trainee may:

communicate clearly with clinicians and other caregivers
use standardised verbal and written templates to improve the reliability of information transfer and prevent errors and omissions
communicate accurately and in a timely manner to ensure effective transitions between settings, and continuity and quality of care
attend and contribute to interdisciplinary case conferences

Quality and safety

confident
Ready to perform without supervision

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

The trainee will:

identify patients at risk of poor transitions of care, and mitigate risks where possible
use electronic tools (where available) to securely store and transfer patient information
use consent processes, including written consent if required, for the release and exchange of information
demonstrate understanding of the medicolegal context of written communications

direction
Requires some supervision

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

The trainee may:

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

Teaching and learning

confident
Ready to perform without supervision

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

The trainee will:

integrate respectful clinical education in handover sessions and other transition of care meetings
tailor clinical education to the level of the professional parties involved

direction
Requires some supervision

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

The trainee may:

take opportunities to teach junior colleagues during handover, as necessary

Cultural safety

confident
Ready to perform without supervision

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

The trainee will:

communicate with careful consideration to health literacy, language barriers, and culture regarding patient preferences, and whether they are realistic and possible, respecting patient choices
incorporate appropriate LGBTQIA+ safe language
consider socioeconomic factors when deciding appropriate adult services for patients

direction
Requires some supervision

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

The trainee may:

include relevant information regarding patients’ cultural or ethnic background in handovers, and whether an interpreter is required

Ethics and professional behaviour

confident
Ready to perform without supervision

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

The trainee will:

disclose and share only contextually appropriate medical and personal information
demonstrate understanding of the clinical, ethical, and legal rationale to disclose information
share information about patients’ health care in a manner consistent with privacy law and professional guidelines on confidentiality, taking patient preferences into account
demonstrate understanding of the additional complexity related to some types of information, such as genetic information, blood-borne-virus status, and LGBTQIA+ status, and seek appropriate advice about disclosure of such information
interact in a collegiate and collaborative way with professional colleagues during transitions of care
recognise the timing, location, privacy, and appropriateness of sharing information with patients

direction
Requires some supervision

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

The trainee may:

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

Judgement and decision making

confident
Ready to perform without supervision

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

The trainee will:

ensure patients’ care is in the most appropriate facility, setting, or provider
use mental health legislation appropriately if transition to involuntary care status is required

direction
Requires some supervision

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

The trainee may:

use a structured approach to consider and prioritise patients’ and parent / carer issues
recognise personal limitations and seek help in an appropriate way when required

Leadership, management, and teamwork

confident
Ready to perform without supervision

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

The trainee will:

share the workload of transitions of care appropriately, including delegation
demonstrate understanding of the medical governance of patient care, and the differing roles of team members
show respect for the roles and expertise of other health professionals, and work effectively as a member of professional teams
ensure that multidisciplinary teams provide the opportunity for patients’ and parent / carer engagement and participation when appropriate
participate in shared care with specialist services as appropriate
recognise the role of interagency collaboration, including across sectors, such as health, education, and justice
work in multidisciplinary teams and with colleagues from a wide range of professional groups

direction
Requires some supervision

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

The trainee may:

recognise factors that impact the transfer of care, and help subsequent health professionals understand any issues that may influence self-management or continuity of care
work to overcome the potential barriers to continuity of care, appreciating the role of handover in overcoming these barriers

Health policy, systems, and advocacy

confident
Ready to perform without supervision

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

The trainee will:

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

direction
Requires some supervision

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

The trainee may:

factor transport issues and costs to patients into arrangements for transferring patients to other settings

LG7: Longitudinal care

Learning Goal 7

Longitudinal care

Manage and coordinate the longitudinal care of patients with chronic conditions, disability, and/or long-term health issues, including coordinating and delivering a successful transition from paediatric to adult care

This activity requires the ability to:

assess family dynamics and involvement of the family in the care of adolescents and young adults
develop management plans and goals in consultation with patients9
manage chronic and advanced conditions, complications, disabilities, and comorbidities
collaborate with other care providers
ensure continuity of care
facilitate transitions from parent-led care to self-management, according to developing capabilities
facilitate patients’ self-management and self-monitoring
coordinate and deliver successful transitions from paediatric to adult care
engage with the broader health policy context

Professional practice framework domain

Medical expertise

confident
Ready to perform without supervision

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

The trainee will:

investigate and manage unexplained chronic physical symptoms
regularly assess and review care plans for patients with chronic conditions and disabilities based on short- and long-term clinical and quality-of-life goals
manage patients with complex and chronic conditions and disabilities within a multidisciplinary team
manage patients on a long-term basis, including patients with common mental disorders, substance use problems, eating disorders, and overweight / obese adolescents
provide documentation on patients’ presentation, management, and progress, including key points of diagnosis and decision making, to inform coordination of care
ensure patients contribute to their needs assessments and care planning
differentiate and appreciate the value of adolescents’ perspectives, as well as those of their parents / carers
monitor treatment outcomes, effectiveness, and adverse events, and adjust care plans accordingly
assess and support readiness for transfer to adult services

direction
Requires some supervision

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

The trainee may:

assess patients’ knowledge, beliefs, concerns, and daily behaviours related to their chronic condition and/or disability and its management
contribute to medical record entries on histories, examinations, and management plans in a way that is accurate and sufficient as a member of multidisciplinary teams

Communication

confident
Ready to perform without supervision

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

The trainee will:

provide developmentally appropriate anticipatory guidance to parents / carers to support adolescent patients to develop their capacity for self-care in due course
encourage patients’ self-management through education to take greater responsibility for their care, and support problem solving
discuss, motivate, and support adherence to treatment plans
apply the principles of motivational interviewing
encourage patients’ access to self-monitoring devices and assistive technologies
communicate with multidisciplinary team members, and involve patients in that dialogue
promote engagement in follow-up
liaise across paediatric and adult services, including primary care
liaise with school and community-based professionals
write comprehensive and accurate summaries of care, including discharge summaries, clinic letters, and transfer documentation

direction
Requires some supervision

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

The trainee may:

compile and summarise patient records in preparation for transition of care from paediatric to adult services
provide healthy lifestyle advice and information to patients on the importance of self-management
work in partnership with patients and parents / carers, and motivate them to comply with agreed care plans
appreciate the importance of communicating with schools and community-based professionals

Quality and safety

confident
Ready to perform without supervision

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

The trainee will:

apply 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
regularly review the latest evidence and clinical guidelines
support patients’ self-management by balancing the need to minimise risk while helping patients to become more independent
participate in quality improvement processes, such as those to improve patients’ and parents’ / carers’ quality of life

direction
Requires some supervision

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

The trainee may:

know how to review the latest evidence and clinical guidelines
participate in continuous quality improvement processes and clinical audits on chronic disease management
identify activities that may improve patients’ quality of life
use clinical practice guidelines for chronic diseases management

Teaching and learning

confident
Ready to perform without supervision

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

The trainee will:

contribute to the development of clinical pathways for chronic diseases management based on current clinical guidelines
educate patients to recognise and monitor their symptoms, and undertake strategies to assist their recovery
participate in teaching and training of junior staff
integrate clinical education in handover sessions and other relevant meetings

direction
Requires some supervision

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

The trainee may:

participate in training more junior staff

Research

confident
Ready to perform without supervision

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

The trainee will:

prepare reviews of literature on patients’ encounters to present at journal club meetings
search for and critically appraise evidence to resolve clinical areas of uncertainty
contribute to wider research efforts as appropriate

direction
Requires some supervision

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

The trainee may:

search literature using problem / intervention / comparison / outcome (PICO) format
understand the appropriate use and differences between review articles, systematic reviews, and meta-analyses

Cultural safety

confident
Ready to perform without supervision

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

The trainee will:

provide culturally safe chronic disease management that improves health and wellbeing outcomes
encourage patients from culturally and linguistically diverse backgrounds to join local networks to receive the support needed for long-term self-management
incorporate appropriate LGBTQIA+ safe language

direction
Requires some supervision

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

The trainee may:

seek out opportunities to improve cultural awareness and cultural safety

Ethics and professional behaviour

confident
Ready to perform without supervision

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

The trainee will:

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

direction
Requires some supervision

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

The trainee may:

share information between relevant service providers
acknowledge and respect the contribution of health professionals involved in patients’ care
comply with workplace guidelines around social media use with patients and families

Judgement and decision making

confident
Ready to perform without supervision

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

The trainee will:

implement stepped care pathways in the management of chronic diseases and disabilities
recognise patients’ needs in terms of both internal resources and external support on long-term health care journeys

direction
Requires some supervision

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

The trainee may:

recognise personal limitations and seek help in an appropriate way when required

Leadership, management, and teamwork

confident
Ready to perform without supervision

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

The trainee will:

coordinate whole-person care through involvement in all stages of patients’ care journeys
use a multidisciplinary approach across services and settings, such as health, education, welfare, and justice, to manage patients with chronic diseases and disabilities
develop collaborative relationships with patients and a range of health professionals
work collaboratively with medical colleagues and allied health staff
support colleagues in other disciplines
participate with colleagues in the provision of palliative care
support colleagues in paediatric and adult settings to develop transition programs in their specialties

direction
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

Health policy, systems, and advocacy

confident
Ready to perform without supervision

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

The trainee will:

use health screening for early intervention and chronic diseases management
assess alternative models of care delivery to patients with chronic conditions and disabilities
participate in government initiatives for chronic diseases management to reduce hospital admissions and improve patients’ quality of life
help patients access initiatives and services for patients with chronic conditions and disabilities, including mental health
advocate for the provision of skills and services within paediatric and adult sectors to facilitate the development of transition services

direction
Requires some supervision

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

The trainee may:

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

LG8: Communication with patients

Learning Goal 8

Communication with patients

Discuss diagnoses and management plans with patients

This activity requires the ability to:

select suitable contexts, and include family and/or carers and other team members
adopt a patient-centred perspective, including adjusting for cognition and disabilities
select and use appropriate modalities and communication strategies
structure conversations intentionally
negotiate mutually agreed management plans
verify patient, family, or carer understanding of information conveyed
develop and implement plans for ensuring actions occur
ensure conversations are documented

Professional practice framework domain

Medical expertise

confident
Ready to perform without supervision

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

The trainee will:

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

direction
Requires some supervision

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

The trainee may:

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

Communication

confident
Ready to perform without supervision

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

The trainee will:

use appropriate communication strategies and modalities for communication, such as 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 plan in their own words, to verify understanding
convey information considerately and sensitively to patients, seeking clarification if unsure of how best to proceed
communicate effectively with individuals from the LGBTQIA+ community
provide information and support regarding health promotion in adolescence with respect to personal care
inform formal carers about medical conditions and health-promoting practices
treat children and young people respectfully, and listen to their views
recognise the role of family or carers and, when appropriate, encourage patients to involve their family / carers in decisions about their care
use basic techniques of cognitive behaviour therapy (CBT), motivational interviewing, family therapy, and brief interventions

direction
Requires some supervision

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

The trainee may:

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

Quality and safety

confident
Ready to perform without supervision

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

The trainee will:

discuss with patients their condition and the available management options, including 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 and deliberate self-harm
participate in processes to manage patients’ complaints

direction
Requires some supervision

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

The trainee may:

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

Teaching and learning

confident
Ready to perform without supervision

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

The trainee will:

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

direction
Requires some supervision

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

The trainee may:

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

Research

confident
Ready to perform without supervision

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

The trainee will:

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

direction
Requires some supervision

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

The trainee may:

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

Cultural safety

confident
Ready to perform without supervision

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

The trainee will:

demonstrate effective and culturally safe communication by meeting patients’ specific language and cultural 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
incorporate appropriate LGBTQIA+ safe language, including gender affirming language

direction
Requires some supervision

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

The trainee may:

identify when to use interpreters
allow enough time for communication across linguistic and cultural barriers
display openness and respect for patients from the LGBTQIA+ community

Ethics and professional behaviour

confident
Ready to perform without supervision

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

The trainee will:

encourage and support patients to be well informed about their health, and to use this information wisely when they make decisions
encourage and support patients in caring for themselves and managing their health
demonstrate respectful professional relationships with patients
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
establish rapport and engagement, assuring confidentiality within the patient-professional relationship
negotiate limits of confidentiality and communicate exceptions effectively

direction
Requires some supervision

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

The trainee may:

respect the preferences of patients
communicate appropriately, consistent with the context, and respect patients’ needs and preferences
maximise patient autonomy, and support their decision making
avoid sexual, intimate, and/or financial relationships with patients
demonstrate a caring attitude towards patients
respect patients, including protecting their rights to privacy and confidentiality
behave equitably towards all, irrespective of gender, age, culture, 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

Leadership, management, and teamwork

confident
Ready to perform without supervision

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

The trainee will:

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

direction
Requires some supervision

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

The trainee may:

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

Health policy, systems, and advocacy

confident
Ready to perform without supervision

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

The trainee will:

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

direction
Requires some supervision

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

The trainee may:

communicate with and involve other health professionals as appropriate

LG9: Prescribing

Learning Goal 9

Prescribing

Prescribe therapies tailored to patients’ needs and conditions

This activity requires the ability to:

take and interpret medication histories
choose appropriate medicines based on an understanding of pharmacology, taking into consideration age, benefits, comorbidities, potential drug interactions, and risks
communicate with patients about the benefits and risks of proposed therapies
provide instructions on medication administration effects and side effects
monitor medicines for efficacy and safety
review medicines and interactions, and cease where appropriate
collaborate with pharmacists

Professional practice framework domain

Medical expertise

confident
Ready to perform without supervision

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

The trainee will:

identify the patients’ disorders requiring pharmacotherapy
consider non-pharmacologic therapies
consider age, allergies, chronic disease status, lifestyle factors, patient preference, and potential drug interactions prior to prescribing new medications
prescribe appropriate medication in a range of circumstances, such as contraception, pre-conception, pregnancy, malnutrition, refeeding, and mental health conditions
explain common drug adverse effects, including interactions with other substances (licit or illicit)
plan for follow-up and monitoring

direction
Requires some supervision

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

The trainee may:

be aware of potential side effects and practical prescription points, such as medication compatibility and monitoring in response to therapies
select medicines for common conditions appropriately, safely, and accurately
demonstrate understanding of the rationale, risks, benefits, side effects, contraindications, dosage, and drug interactions
identify and manage adverse events

Communication

confident
Ready to perform without supervision

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

The trainee will:

provide information to patients about:
- how to take the medicine
- potential side effects
- what the medicine does
- what the medicine is for
- when it should be stopped
manage patients’ requests for information about contraception
discuss and evaluate the risks, benefits, and rationale of treatment options, making decisions in partnership with patients
educate patients about the intended use, expected outcomes, and potential side effects for each prescribed medication, addressing the common, rare, and serious 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 or substances being taken
identify patients’ concerns and expectations, and explain when to return for monitoring

direction
Requires some supervision

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

The trainee may:

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

Quality and safety

confident
Ready to perform without supervision

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

The trainee will:

review medicines regularly to reduce non‑adherence, and monitor treatment effectiveness, possible side effects, evolving contraindications (such as pregnancy risk), 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
prescribe medications based on evidence-based indications
participate in clinical audits to improve prescribing behaviour, including an approach to polypharmacy and prescribing cascade
report suspected adverse events to the Advisory Committee on Medicines, and record it in patients’ medical records
demonstrate compliance with permits and regulations of scheduled medications

direction
Requires some supervision

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

The trainee may:

check doses before prescribing
monitor side effects of medicines prescribed
identify medication errors and institute appropriate measures
use electronic prescribing systems safely
rationalise medicines to avoid polypharmacy
follow prescribing guidelines and stewardship for medications that have higher potential for misuse, abuse, or dependence

Teaching and learning

confident
Ready to perform without supervision

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

The trainee will:

use appropriate guidelines and evidence-based medicine resources to maintain a working knowledge of current medicines, keeping up to date on new medicines

direction
Requires some supervision

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

The trainee may:

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

Research

confident
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-oriented outcomes

direction
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

Cultural safety

confident
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
seek out opportunities to improve understanding and awareness of LGBTQIA+ cultural safety
ensure appropriate information is available at all steps of the medicine management pathway

direction
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

Ethics and professional behaviour

confident
Ready to perform without supervision

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

The trainee will:

make prescribing decisions based on good safety data when the benefits outweigh the risks involved
demonstrate understanding of the ethical implications of pharmaceutical industry-funded research and marketing
prescribe within legislative frameworks, and comply with professional standards and approved guidelines
determine if patients are competent to consent to taking medications, and gain appropriate consent

direction
Requires some supervision

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

The trainee may:

consider 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

Judgement and decision making

confident
Ready to perform without supervision

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

The trainee will:

use a systematic approach to select 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

direction
Requires some supervision

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

The trainee may:

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

Leadership, management, and teamwork

confident
Ready to perform without supervision

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

The trainee will:

interact with medical, pharmacy, and nursing staff, and community care teams, to ensure safe and effective medicine use

direction
Requires some supervision

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

The trainee may:

participate in medication safety and morbidity and mortality meetings

Health policy, systems, and advocacy

confident
Ready to perform without supervision

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

The trainee will:

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 healthcare resources are used wisely for the benefit of patients

direction
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

LG10: Clinic management

Learning Goal 10

Clinic management

Manage an outpatient clinic

This activity requires the ability to:

manage medical procedures and treatments
manage clinic services
oversee quality improvement activities
communicate with patients12
liaise with other health professionals and team members
demonstrate problem-solving skills
responsibly use public resources

Professional practice framework domain

Medical expertise

confident
Ready to perform without supervision

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

The trainee will:

effectively identify and address current clinical concerns, as well as longer-term clinical objectives, as appropriate to patients’ context
evaluate environmental and lifestyle health risks, and advocate for healthy lifestyle choices
create accurate and appropriately prioritised problem lists in the clinical notes or as part of ambulatory care reviews
update documentation in a timeframe appropriate to the clinical situation of patients
recognise when a patient cannot be managed in an outpatient setting, and refer appropriately for urgent or inpatient care

direction
Requires some supervision

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

The trainee may:

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

Communication

confident
Ready to perform without supervision

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

The trainee will:

help patients navigate the healthcare system to improve access to care by collaboration with other services, such as community health centres and consumer organisations
document clinical encounters appropriately through contemporaneous, comprehensive notes and clinic letters
link patients to specific community-based health programs and group education programs
communicate with other professionals involved in patients’ care as clinically indicated, via letters, direct conversations, and case conferences

direction
Requires some supervision

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

The trainee may:

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

Quality and safety

confident
Ready to perform without supervision

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

The trainee will:

participate in the development and evaluation of clinical services
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
ensure that patients are informed about fees and charges

direction
Requires some supervision

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

The trainee may:

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

Teaching and learning

confident
Ready to perform without supervision

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

The trainee will:

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

direction
Requires some supervision

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

The trainee may:

use information technology appropriately as a resource for modern medical practice

Research

confident
Ready to perform without supervision

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

The trainee will:

engage in, foster, and encourage research
obtain informed consent or other valid authority before involving patients in research
inform patients about their rights, the purpose of the research, the procedures to be undergone, and the potential risks and benefits of participation before obtaining consent

direction
Requires some supervision

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

The trainee may:

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

Cultural safety

confident
Ready to perform without supervision

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

The trainee will:

apply knowledge of the cultural needs of the community being served, and how to shape service to those people
mitigate the influence of own culture and beliefs on interactions with patients and decision making
adapt practice to improve patient engagement and health outcomes
incorporate appropriate LGBTQIA+ safe language

direction
Requires some supervision

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

The trainee may:

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

Ethics and professional behaviour

confident
Ready to perform without supervision

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

The trainee will:

identify and respect the boundaries that define professional and therapeutic relationships
respect the roles and expertise of other health professionals
comply with the legal requirements of preparing and managing documentation
demonstrate awareness of financial and other conflicts of interest
manage situations in which confidentiality cannot be assured

direction
Requires some supervision

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

The trainee may:

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

Judgement and decision making

confident
Ready to perform without supervision

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

The trainee will:

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

direction
Requires some supervision

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

The trainee may:

understand the appropriate use of human resources, diagnostic interventions, therapeutic modalities, and health care facilities
recognise the limits of personal expertise, and involve other professionals as needed to contribute to patients’ care

Leadership, management, and teamwork

confident
Ready to perform without supervision

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

The trainee will:

prepare for, and conduct, clinical encounters in a well-organised and time-efficient manner
work effectively as a member of multidisciplinary teams or other professional groups
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
support colleagues who raise concerns about patients’ safety

direction
Requires some supervision

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

The trainee may:

attend relevant clinical meetings regularly

Health policy, systems, and advocacy

confident
Ready to perform without supervision

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

The trainee will:

demonstrate capacity to engage in the surveillance and monitoring of the health status of populations in the outpatient setting
maintain good relationships with health agencies and services
develop policies and procedures
apply the principles of efficient and equitable allocation of resources to meet individual, community, and national health needs
explain the importance of clinical governance

direction
Requires some supervision

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

The trainee may:

understand common population health screening and prevention approaches

Knowledge guides

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

Trainees are not expected to be experts in all areas or have experience related to all items in these guides.

LG11: Foundations of adolescent and young adult medicine

Epidemiology, pathophysiology, and clinical sciences

Advanced Trainees will have in-depth knowledge of the topics listed under each clinical sciences heading.

For the statistical and epidemiological concepts listed, trainees should be able to describe the underlying rationale, the indications for using one test or method over another, and the calculations required to generate descriptive statistics.

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Investigations, procedures, and clinical assessment tools

Advanced Trainees will know the scientific foundation of each investigation and procedure, including relevant anatomy and physiology. They will be able to interpret the reported results of each investigation or procedure.

Advanced Trainees will know how to explain the investigation or procedure to patients, families, and carers, and be able to explain procedural risk and obtain informed consent where applicable.

View

Important specific issues

Advanced Trainees will identify important specialty-specific issues and the impact of these on diagnosis and management and integrate these into care.

View

Brain development across adolescence
Characteristics of adolescence and young adulthood (10–24 years old) as a developmental stage, including changes across this period, and patterns of engagement with family and peers
Cognitive development and capacity to consent
Epidemiology and patterns of abuse, such as:
- emotional abuse
- exposure to domestic and/or family violence
- neglect
- physical abuse
- sexual abuse
- short- and long-term effects of abuse
Epidemiology of the common health conditions affecting adolescents, including:
- gender
- reproductive
- sexual
Injuries
Intellectual disabilities across adolescence, and how adolescent development might affect these, such as:
- Down syndrome
- fetal alcohol spectrum disorder (FAS-D)
- fragile X syndrome
Mental health
Normal and abnormal patterns of growth and pubertal development
Nutritional requirements
Physical disabilities, and how adolescent development might affect these, such as:
- cerebral palsy
- muscular dystrophy
- spina bifida
Principles of pharmacology, such as:
- chronic pain medications
- commonly used psychotropic medications
- gender-affirming hormones
- impact of growth and development on drug dosing and metabolism
- indications, contraindications, and side effects of:
  - medications for attention deficit hyperactivity disorder (ADHD)
  - medications to improve sleep
  - puberty blockers
Psychosocial screening, including rationale and different approaches
Public health significance of:
- health risk behaviours
- immunisations
- notifiable diseases
- sexually transmitted infections
Sexual and reproductive health issues, including menstruation and contraception
Substance use disorders

Common interventions

Allied health support
Cognitive behavioural therapy (CBT)
Family therapy
Family-based treatment (FBT)
Motivational interviewing
Psychopharmacology
Trauma-informed care

Common interventions

Body mass index (BMI)
Bone age tests
Bone mineral density tests
Comprehensive adolescent health assessment, including Home, Education / employment, Eating / exercise, Activities, Drugs and alcohol, Sexuality, Suicide and depression, Safety (HEEADSSS)
Genetic investigations, such as microarray and fragile X testing
Growth charts
Nutritional screening blood tests, such as ferritin, vitamin D, and other micronutrient screening
Physical examination, including Tanner staging (when appropriate and with consent)
Screening examinations and investigations, and their indications, such as:
- audiology
- blood pressure, including orthostatic measurement, heart rate (including orthostatic)
- cholesterol / lipids
- haemoglobin A1C (HbA1C) test
- hormone levels for pubertal assessment
- standardised questionnaires
- vision

Adolescent development and stages, such as:
- cognitive development
- gender identity exploration and consolidation
- physical change, including linear growth and puberty
- psychosocial
- sexual health and sexuality
Concepts of, and factors that support, resilience throughout the life course
Conceptual frameworks, such as:
- biopsychosocial model of health
- child protection frameworks and legislation
- harm reduction model
- life course perspectives, such as the triple dividend
- positive youth development
- resilience
- risk and protective factors
- social and commercial determinants of health
- transtheoretical model of change
- trauma-informed care
Confidentiality considerations, such as:
- balancing adolescent and parent perspectives
- limitations
- medicolegal frameworks
- principles of clinical ethics and autonomy
Developmental theories, and how these can be framed within contemporary knowledge of adolescent brain development, including:
- developmental tasks of adolescence
- emerging independence and cognitive, physical, and sociocultural development
- impact of trauma
- self-identity
Distinction between gender identity and sexual orientation
Education system considerations, such as:
- impact of disrupted education
- school access and educational support, especially for students with neurodiversity
- school and education processes for young people with cognitive, physical, and psychiatric / psychological disabilities
- school and post-secondary education structures
- school health, including health promotion and clinical services
Exploratory and risk-taking behaviours
Health policies, resources, and services:
- access to services in regional and remote communities
- common barriers to health care
- communication processes and relationships between acute care services, community centres, primary health, and private sector
- delivery of health services within individual communities
- disability support accessibility, policies, services, and resources
- education resources and support for young people with neurobehavioural and developmental conditions
- managing young people with cognitive disabilities, neurobehavioural conditions, and neurodiversity
- public health policy and legislation affecting the health and wellbeing of young people
- role of government and non-government agencies
- role of primary health, local, and community-based services
- role of school health services for adolescents
Impact of family life, including:
- protective factors, such as:
  - improving communication within families
  - parenting strategies for young people with cognitive disabilities
  - range of parenting styles appropriate for adolescents and young adults (AYA)
  - supporting neurodivergent youth within the family
- risk factors, such as:
  - caregiver burnout
  - family and/or domestic violence awareness and screening
  - family separation and blended families
  - impact of psychosocial issues on families and young people
Impacts of bullying, including:
- face-to-face
- in schools
- online
- the role of bystander
Interaction between health and other services, such as mental health and substance use, and other sectors, such as education, housing, legal, welfare, and youth justice
Legal environment of the care of AYA, such as:
- capacity, consent, and refusal of treatment, including assessing capacity to consent and the mature minor concept
- child maltreatment, including recognition and reporting requirements
- confidentiality, including laws, concepts, and processes for safe-guarding privacy
- gender-affirming medical care
- guardianship issues
- indications for involuntary treatment
- mandatory reporting requirements
Medical implications in adolescence and adulthood of common procedures that occurred earlier in childhood, such as caecostomies, management of spasticity, and percutaneous endoscopic gastrostomy (PEG)
Prevalence and risk factors for physical violence, including intimate partner violence, in the local community
Principles of health promotion and harm minimisation
Principles of protective behaviours
Sleep hygiene
Specific health contexts, such as:
- Aboriginal and Torres Strait Islander peoples and Māori adolescents
- adolescents in custodial contexts, including on youth justice orders
- adolescents in out-of-home care
- adolescents whose parents have an addiction, mental illness, or a disability
- LGBTQIA+ adolescents
- neurodiverse adolescents
- pregnant and parenting adolescents
- refugee and asylum seeker families
- socioeconomically disadvantaged young people
- victims of physical and/or sexual abuse
- young people who are homeless or living in precarious housing
Supporting AYA transitioning to adult care settings
Techniques for engaging and communicating with AYA

LG12: Physical conditions

Key presentations and conditions

Advanced Trainees will have a comprehensive depth of knowledge of these presentations and conditions.

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Less common or more complex presentations and conditions

Advanced Trainees will understand these presentations and conditions.

Advanced Trainees will understand the resources that should be used to help manage patients with these presentations and conditions.

View

Epidemiology, pathophysiology, and clinical sciences

Advanced Trainees will have a comprehensive depth of knowledge of the principles of the foundational sciences.

View

Investigations, procedures, and clinical assessment tools

Advanced Trainees will know the scientific foundation of each investigation and procedure, including relevant anatomy and physiology. They will be able to interpret the reported results of each investigation or procedure.

Advanced Trainees will know how to explain the investigation or procedure to patients, families, and carers, and be able to explain procedural risk and obtain informed consent where applicable.

View

Important specific issues

Advanced Trainees will identify important specialty-specific issues and the impact of these on diagnosis and management and integrate these into care.

View

Presentations

Abnormal behaviour
Abnormal eating
Abnormal sensation
Allergic symptoms:
- acute
- chronic
Amenorrhoea
Anaemia
Collapse
Constipation
Cough / Wheeze
Diarrhoea
Discharge:
- genital
Dizziness / Vertigo
Dyspnoea
Fatigue
Growth failure
Headache
Hyperglycaemia
Hypertension
Hypoglycaemia
Hypotension
Joint hypermobility and instability
Loss of consciousness / Fainting
Medically unexplained symptoms
Menstrual disorders
Nausea and vomiting
Obesity
Pain:
- abdominal
- chronic
- muscle
- pelvic
Palpitations
Postural orthostatic tachycardia syndrome (POTS)
Recurrent urinary tract infections
Respiratory difficulties
Seizures
Sexual dysfunction
Skin concerns, such as:
- acne
- pruritis
- rash
Sleep disorders
Specific nutrient deficiencies, such as:
- iron
- vitamin B12
- vitamin D
Syncope and pre-syncope
Urinary symptoms
Weakness and paralysis
Weight concerns:
- gain
- loss
- overweight
- underweight

Conditions

Allergy
Amenorrhoea
Anaemia
Asthma
Autism spectrum disorder (ASD)
Avoidant restrictive food intake disorder (ARFID)
Cerebral palsy
Chronic fatigue syndrome / Myalgic encephalomyelitis
Chronic neurological disability
Continence:
- faecal
- urinary
Delayed sleep phase
Disabilities and associated conditions
Disorders of puberty
Eating disorders
Ehlers–Danlos syndrome
Epilepsy
Fever
Fibromyalgia
Functional bowel disorders
Functional neurological disorder
Head injury
Infectious conditions
Kidney conditions
Malnutrition and micronutrient disorders
Metabolic syndrome and obesity
Migraine and other headache syndromes
Neurodevelopmental disorders:
- complex
Pain:
- back
- chest
- chronic widespread
- complex regional pain syndrome
- musculoskeletal
Refeeding syndrome
Rhinitis
Sinusitis
Skin conditions, such as:
- acne
- drug-related
- eczema
- genital dermatology
- viral
Sleep-related breathing disorders
Somatoform disorder
Urinary tract infection

For each presentation and condition, Advanced Trainees will know how to:

Synthesise

recognise the clinical presentation
identify relevant epidemiology, pathophysiology, and clinical science
take a relevant clinical history
conduct an appropriate examination
establish a differential diagnosis
plan and arrange appropriate investigation
consider the impact of illness and disease on patients and families, and their quality of life

Manage

provide evidence-based management
for less common or more complex presentations and conditions the trainee must also seek expert opinions
prescribe therapies tailored to patients’ needs and conditions
recognise potential complications of disease and its management, and initiate preventative strategies
involve multidisciplinary teams

Consider other factors

identify individual and social factors and the impact of these on diagnosis and management

Presentations

Abdominal mass / Hepatosplenomegaly
Bloody stools / Melaena
Haematuria
Oncological presentations
Proteinuria
Raised serum creatinine
Swelling:
- joint

Conditions

Bronchiectasis
Connective tissue diseases
Cystic fibrosis
Diabetes
Encephalitis
Heart disease:
- congenital
Inflammatory arthropathies
Inflammatory bowel disease
Kidney failure
Myopathy
Oncological disease
Peripheral neuropathy
Pregnancy
Rheumatological disorders
Sleep disorders, including narcolepsy
Thyroid disorders

Synthesise

recognise the clinical presentation
identify relevant epidemiology, pathophysiology, and clinical science
take a relevant clinical history
conduct an appropriate examination
establish a differential diagnosis
plan and arrange appropriate investigation
consider the impact of illness and disease on patients and families, and their quality of life

Manage

provide evidence-based management
for less common or more complex presentations and conditions the trainee must also seek expert opinions
prescribe therapies tailored to patients’ needs and conditions
recognise potential complications of disease and its management, and initiate preventative strategies
involve multidisciplinary teams

Consider other factors

identify individual and social factors and the impact of these on diagnosis and management

Aetiology and natural history for common and uncommon medical conditions of adolescents and young adults (AYA)
Best practice guidelines
Common causes of mortality and morbidity, such as:
- chronic illness
- disability
- infectious diseases
- injuries:
  - intentional
  - unintentional
- malignancy
- mental health problems
- sexual health problems
Epidemiology of chronic illness in adolescents
Pharmacology of medications prescribed for AYA
Psychosocial contribution to physical symptoms in adolescence

Investigations

Electrocardiogram (ECG)
Electroencephalogram (EEG)
Imaging, such as:
- bone age
- bone mineral density scan (DEXA)
- x-rays
Initial assessment and examination of victims of sexual assault
Overnight oximetry
‘Second line’ and evolving investigative approaches to diagnose undifferentiated diseases
Sexually transmitted infection investigations
Tests and biopsies, such as:
- blood, such as:
  - hormones
  - nutritional screen
- skin
- stool
- urine

Chronic fatigue syndrome diagnosis, investigations, and principles of multidisciplinary management, including pacing
Chronic illness considerations, such as:
- impact on cognitive, emotional, physical, sexual, and social adolescent development
- management in a multidisciplinary team
- management of comorbidities, such as alcohol and other drug use, and mental health
Chronic pain management, such as:
- appropriate medical investigations
- non-pharmacological and pharmacological management of chronic pain and comorbidities
- role of allied health and patient education
Comorbidities in overweight and underweight patients
Complexities of optimising management for patients with multiple comorbidities
Concepts of motivational interviewing
Costs and benefits of:
- diagnostic interventions
- management plans
- therapeutic interventions
Difference between curative, palliative, and rehabilitative approaches to disease management
Effective ways of working with families
Impact of family function and dysfunction
Indications for referral to specialised units and/or subspecialists
Investigating and managing atypical presentations with other subspecialists
Issues around school non-attendance
Principles of palliative care / end-of-life care
Specific considerations needed for the following groups:
- Aboriginal and Torres Strait Islander peoples and Māori adolescents
- adolescents whose parents have a mental illness or substance misuse
- adolescents with a disability
- LGBTQIA+ adolescents
- neurodiverse young people
- refugee and asylum seeker families
- socioeconomically disadvantaged young people
- unhoused young people
- victims of physical and/or sexual abuse
- young people in custody or out-of-home care
The role of the family in the assessment and management of health issues

LG13: Psychological and behavioural health

Key presentations and conditions

Advanced Trainees will have a comprehensive depth of knowledge of these presentations and conditions.

View

Less common or more complex presentations and conditions

Advanced Trainees will understand these presentations and conditions.

Advanced Trainees will understand the resources that should be used to help manage patients with these presentations and conditions.

View

Epidemiology, pathophysiology, and clinical sciences

Advanced Trainees will have a comprehensive depth of knowledge of the principles of the foundational sciences.

View

Investigations, procedures, and clinical assessment tools

Advanced Trainees will know the scientific foundation of each investigation and procedure, including relevant anatomy and physiology. They will be able to interpret the reported results of each investigation or procedure.

Advanced Trainees will know how to explain the investigation or procedure to patients, families, and carers, and be able to explain procedural risk and obtain informed consent where applicable.

View

Important specific issues

Advanced Trainees will identify important specialty-specific issues and the impact of these on diagnosis and management and integrate these into care.

View

Presentations

Abnormal illness behaviour
Academic difficulty
Aggression:
- physical
- verbal
Attention and concentration difficulties
Body image concerns
Bullying and other forms of victimisation and social exclusion
Communication and language difficulties
Deliberate self-harm
Disordered eating:
- food refusal
- picky eating
Extreme emotions
Fatigue / Tiredness
Gaming, internet, and social media use concerns
Pain:
- chronic
School refusal and excessive absenteeism
Sleep difficulties
Somatisation
Suicidal ideation
Weight concerns:
- overweight
- underweight

Conditions

Adjustment disorders
Anxiety disorders:
- selective mutism
- social
Attachment disorders
Attention deficit hyperactivity disorder (ADHD)
Autism spectrum disorder (ASD)
Behavioural addictions, such as:
- electronic device use
- pornography
- problematic gambling or gamification
- video gaming
Chronic fatigue syndrome
Complex neurodevelopmental disorders
Conduct disorder
Deliberate self-harm
Depression
Eating disorders:
- anorexia nervosa
- avoidant restrictive food intake disorder (ARFID)
- binge eating disorder
- bulimia nervosa
Functional neurological and somatoform disorders
Gender dysphoria
Obsessive compulsive disorder
Psychosis
Sleep disorders
Specific learning disorders
Suicide attempt

For each presentation and condition, Advanced Trainees will know how to:

Synthesise

recognise the clinical presentation
identify relevant epidemiology, pathophysiology, and clinical science
take a relevant clinical history
conduct an appropriate examination
establish a differential diagnosis
plan and arrange appropriate investigation
consider the impact of illness and disease on patients and families, and their quality of life

Manage

provide evidence-based management
for less common or more complex presentations and conditions the trainee must also seek expert opinions
prescribe therapies tailored to patients’ needs and conditions
recognise potential complications of disease and its management, and initiate preventative strategies
involve multidisciplinary teams

Consider other factors

identify individual and social factors and the impact of these on diagnosis and management

Presentations

Electronic device addiction
Suicide attempt

Conditions

Bipolar disorder
Factitious disorder
Personality disorders
Psychotic disorders
Trauma and stressor-related disorders

Synthesise

recognise the clinical presentation
identify relevant epidemiology, pathophysiology, and clinical science
take a relevant clinical history
conduct an appropriate examination
establish a differential diagnosis
plan and arrange appropriate investigation
consider the impact of illness and disease on patients and families, and their quality of life

Manage

provide evidence-based management
for less common or more complex presentations and conditions the trainee must also seek expert opinions
prescribe therapies tailored to patients’ needs and conditions
recognise potential complications of disease and its management, and initiate preventative strategies
involve multidisciplinary teams

Consider other factors

identify individual and social factors and the impact of these on diagnosis and management

Early developmental trauma and its impact on adolescent development, such as adverse childhood events
Epidemiology of mental health conditions
Pathophysiology of starvation and refeeding syndrome
Pharmacology of common psychotropic medications, such as:
- anti-anxiety medications
- antidepressants
- antipsychotics
- non-stimulants
- stimulants
Psychological and pathological features of eating disorders
Risk screening in patients presenting with suicidal ideation, including the importance of asking suicidal patients if they have a plan

Investigations

Anthropometric centile charts
Body mass index (BMI)
Bone mineral density imaging
Sleep study

Screening / Clinical assessment tools

ADHD assessment tools
ASD assessment tools
Child behaviour checklist (CBCL)
Cognitive and adaptive functioning assessment tools
Comprehensive psychosocial assessment (Home, Education / employment, Eating / exercise, Activities, Drugs and alcohol, Sexuality, Suicide and depression, Safety [HEEADSSS])
Fatigue assessments
Mental health questionnaires and risk assessments
Mental state examination
Speech and pragmatic language assessment tools
Strengths and difficulties questionnaire (SDQ)
Substance use screening tools

Concept of body image
Counselling and supporting distressed young people
Integrating mental health management within medical settings
Management considerations for adolescents and young adults (AYA) with ADHD:
- difference in presentation in diagnosis between early, middle, and late adolescence, and young adults
- management of sleep and other complications
- non-pharmacological and pharmacological management of ADHD and comorbidities
- regulations for prescribing stimulant medications
Management considerations for AYA with ASD:
- awareness of the principles of positive behaviour support, including environmental adaptation to meet sensory needs with neurodevelopmental disorders
- common co-occurring conditions
- management of common mental health conditions and functional disorders
- medications used to support co-occurring conditions, including atypical antidepressants and antipsychotics
- role of allied health professionals when assessing, diagnosing, and supporting neurodivergent youth
- support specific adolescent developmental tasks that may be more challenging for neurodivergent youth, such as:
  - navigating romantic or sexual relationships
  - protecting online safety
Management of risk-taking behaviours, violence, and harm minimisation
Mental health act, and laws surrounding involuntary treatment
Principles of trauma-informed care / understanding of adverse childhood events
Sleep disorders management, both pharmacological and non-pharmacological, and screening for obstructive sleep apnoea
Specific considerations needed for the following groups:
- Aboriginal and Torres Strait Islander peoples and Māori adolescents
- adolescents whose parents have a mental illness or substance misuse
- adolescents with a disability
- homeless young people
- LGBTQIA+ adolescents
- neurodiverse young people
- refugee and asylum seeker families
- socioeconomically disadvantaged young people
- victims of physical and/or sexual abuse
- young people in custody or out-of-home care

LG14: Gender, sexual, and reproductive health

Key presentations and conditions

Advanced Trainees will have a comprehensive depth of knowledge of these presentations and conditions.

View

Less common or more complex presentations and conditions

Advanced Trainees will understand these presentations and conditions.

Advanced Trainees will understand the resources that should be used to help manage patients with these presentations and conditions.

View

Epidemiology, pathophysiology, and clinical sciences

Advanced Trainees will have a comprehensive depth of knowledge of the principles of the foundational sciences.

View

Investigations, procedures, and clinical assessment tools

Advanced Trainees will know the scientific foundation of each investigation and procedure, including relevant anatomy and physiology. They will be able to interpret the reported results of each investigation or procedure.

Advanced Trainees will know how to explain the investigation or procedure to patients, families, and carers, and be able to explain procedural risk and obtain informed consent where applicable.

View

Important specific issues

Advanced Trainees will identify important specialty-specific issues and the impact of these on diagnosis and management and integrate these into care.

View

Gender health presentations

Gender identity exploration and diversity

Gender health conditions

Gender incongruence

Sexual and reproductive health presentations

Abnormal uterine bleeding:
- amenorrhoea
- irregular (anovulatory)
- menorrhagia
Genital skin lesions
Pelvic discharge
Pelvic pain:
- dysmenorrhea
- dyspareunia

Sexual and reproductive health conditions

Bacterial vaginosis
Common genital dermatological conditions
Endometriosis
Gynaecomastia
Menstrual conditions
Polycystic ovary syndrome (PCOS)
Precocious puberty
Pregnancy
Pubertal delay
Sexually transmitted infections:
- chlamydia
- gonorrhoea
- hepatitis:
  - B
  - C
- herpes simplex virus (HSV)
- human immunodeficiency virus (HIV)
- human papillomavirus (HPV)
- human T-lymphotropic virus 1 (HTLV-1)
- syphilis
- trichomonas

For each presentation and condition, Advanced Trainees will know how to:

Synthesise

recognise the clinical presentation
identify relevant epidemiology, pathophysiology, and clinical science
take a relevant clinical history
conduct an appropriate examination
establish a differential diagnosis
plan and arrange appropriate investigation
consider the impact of illness and disease on patients and families, and their quality of life

Manage

provide evidence-based management
for less common or more complex presentations and conditions the trainee must also seek expert opinions
prescribe therapies tailored to patients’ needs and conditions
recognise potential complications of disease and its management, and initiate preventative strategies
involve multidisciplinary teams

Consider other factors

identify individual and social factors and the impact of these on diagnosis and management

Presentations

Sexual:
- abuse
- assault
- dysfunction

Conditions

Ectopic pregnancy
Female genital mutilation
Ovarian cysts:
- complex
- simple
Pelvic inflammatory disease
Uterine abnormalities:
- acquired
- congenital

Synthesise

recognise the clinical presentation
identify relevant epidemiology, pathophysiology, and clinical science
take a relevant clinical history
conduct an appropriate examination
establish a differential diagnosis
plan and arrange appropriate investigation
consider the impact of illness and disease on patients and families, and their quality of life

Manage

provide evidence-based management
for less common or more complex presentations and conditions the trainee must also seek expert opinions
prescribe therapies tailored to patients’ needs and conditions
recognise potential complications of disease and its management, and initiate preventative strategies
involve multidisciplinary teams

Consider other factors

identify individual and social factors and the impact of these on diagnosis and management

Gender health

Pharmacology, mechanism of action, and side effects of:
- assessment for pubertal stage
- assessment of capacity to consent
- management of gender affirming hormones:
  - oestrogen
  - testosterone
- management of menstrual suppression
- management of pubertal suppression

Sexual and reproductive health

Adolescent reproductive health care needs
Aetiology, epidemiology, and management of sexually transmitted infections
Hormonal and physiological changes during puberty
Normal menstrual cycle, and the concept of anovulatory cycling during pubertal development
Normal physical growth and pubertal development, including expected chronology and Tanner staging
Normal physiological changes in pregnancy
Pharmacology of common contraceptive agents, such as:
- adverse effects
- common myths
- contraindications
- failure rate
- mechanism of action
- options for contraception, such as:
  - barrier methods
  - emergency
  - hormonal
  - implantable
  - injectable
  - permanent, such as hysterectomy, and oophorectomy
- other indications for use of contraceptive agents
- side effects
- suitability
- use of contraception in adolescents with chronic illness, disability, and intellectual impairment
Prevalence of health risk behaviours and mental health issues during puberty
Sexual and reproductive anatomy and physiology
Stages of normal sexual development
Role of immunisations in sexual health

Investigations

Blood investigations, such as:
- blood-borne virus serology
- menorrhagia, such as iron and coagulation studies
- reproductive bloods, such as:
  - follicle-stimulating hormone (FSH)
  - luteinising hormone (LH)
  - oestradiol
  - testosterone
Bone age
Bone mineral density scan (DEXA)
Initial assessment and examination of victims of sexual assault
Microbiology tests, such as:
- rectal
- throat swab
- vaginal
Ultrasound
Urine tests
X-ray

Procedures

Immunisations, such as:
- hepatitis:
  - B
  - C
- HPV
Long-acting reversible contraceptive insertion and removal, such as:
- Implanon
- intrauterine devices

Specific considerations for the following groups:
- Aboriginal and Torres Strait Islander peoples and Māori adolescents
- adolescents whose parents have a mental illness or substance misuse
- adolescents with a disability
- asexual individuals
- homeless young people
- LGBTQIA+ adolescents
- neurodiverse young people
- refugee and asylum seeker families
- socioeconomically disadvantaged young people
- victims of physical and/or sexual abuse
- young people in custody or out-of-home care

Gender health

Medical gender affirming care:
- pharmacological management of gender
- surgical gender affirming care
Non-medical gender affirming care:
- binding
- social transition
Principles of gender identity

Sexual and reproductive health

Considerations in adolescent and young adult pregnancy, such as:
- impact on adolescent development
- impact on chronic disease, including medication safety
- management of patients with neurodevelopmental conditions / intellectual impairment
- public health impact of unintended adolescent pregnancy, such as adoption and common issues faced by AYA as parents
- termination, including clinical issues and local laws
Considerations of the implications for the individual of the recognition of an LGBTQIA+ identity and orientation
Impact of sexual development on adolescents with chronic physical and neurodevelopmental conditions
Principles of sexuality, including consensual safe sexual practices

LG15: Alcohol and other substance use

Key presentations and conditions

Advanced Trainees will have a comprehensive depth of knowledge of these presentations and conditions.

View

Less common or more complex presentations and conditions

Advanced Trainees will understand these presentations and conditions.

Advanced Trainees will understand the resources that should be used to help manage patients with these presentations and conditions.

View

Epidemiology, pathophysiology, and clinical sciences

Advanced Trainees will have a comprehensive depth of knowledge of the principles of the foundational sciences.

View

Investigations, procedures, and clinical assessment tools

Advanced Trainees will know the scientific foundation of each investigation and procedure, including relevant anatomy and physiology. They will be able to interpret the reported results of each investigation or procedure.

Advanced Trainees will know how to explain the investigation or procedure to patients, families, and carers, and be able to explain procedural risk and obtain informed consent where applicable.

View

Important specific issues

Advanced Trainees will identify important specialty-specific issues and the impact of these on diagnosis and management and integrate these into care.

View

Presentations

Alcohol and nicotine use, including vaping
Intoxication and overdose
Misuse of prescription drugs
Polysubstance use
Problematic substance use
Withdrawal syndromes:
- acute agitation
- cravings
- insomnia
- seizures

Conditions

Nicotine use disorder

For each presentation and condition, Advanced Trainees will know how to:

Synthesise

recognise the clinical presentation
identify relevant epidemiology, prevalence, pathophysiology, and clinical science
take a developmentally comprehensive clinical history
conduct an appropriate examination
establish a differential diagnosis
plan and arrange appropriate investigations
consider the impact of illness and disease on patients and their quality of life when developing a management plan
consider the impact of illness and disease on growth and the bidirectional impact on education, peers, and family relationships

Manage

provide evidence-based management
prescribe therapies tailored to patients’ needs and conditions
recognise potential complications of disease and its management, and initiate preventative strategies
involve multidisciplinary teams

Consider other factors

identify individual and social factors and the impact of these on diagnosis and management
identify educational / vocational pathways

Conditions

Alcohol use disorder
Cannabis hyperemesis syndrome
Cannabis use disorder
Common disorders which are amplified or unmasked by substance use, such as:
- attention deficit hyperactivity disorder (ADHD)
- bipolar affective disorders
- conduct disorder
- depression and anxiety
- psychotic disorders

For each presentation and condition, Advanced Trainees will know how to:

Synthesise

recognise the clinical presentation
identify relevant epidemiology, prevalence, pathophysiology, and clinical science
take a developmentally comprehensive clinical history
conduct an appropriate examination
establish a differential diagnosis
plan and arrange appropriate investigations
consider the impact of illness and disease on patients and their quality of life when developing a management plan
consider the impact of illness and disease on growth and the bidirectional impact on education, peers, and family relationships

Manage

provide evidence-based management
prescribe therapies tailored to patients’ needs and conditions
recognise potential complications of disease and its management, and initiate preventative strategies
involve multidisciplinary teams

Consider other factors

identify individual and social factors and the impact of these on diagnosis and management
identify educational / vocational pathways

Adverse childhood events associated with adolescent substance use
Common mental illness and neurodevelopmental comorbidities associated with adolescent substance use
Higher prevalence of substance use and behavioural addictions among minority populations, and the social determinants of health that contribute to this inequity
Natural history of substance use in adolescents, and the long-term effects of this into adulthood
Neurobiology of addiction, and the key neurotransmitters and neurocircuitry pathways involved
Pharmacokinetics and pharmacodynamics of addictive substances, such as alcohol, cannabinoids, and nicotine
Physiology of tolerance and withdrawal
Primary, secondary, and tertiary prevention strategies for young people who use substances
Public health burden of substance use in young people, including emergency service utilisation, school or vocational disengagement, and crime
Spectrum of substance use, and that substance use and substance use disorders exist on a continuum of severity
Trends in substance use by young people, such as:
- alcohol
- illicit substances
- prescription drugs
- tobacco and vapes

Appropriate use and interpretation of drug testing, such as urine drug screening
Blood tests to identify complications of substance use, such as blood-borne viruses
Home, Education / employment, Eating / exercise, Activities, Drugs and alcohol, Sexuality, Suicide and depression, Safety (HEEADSSS) framework to screen for drug and alcohol use
Targeted physical exams to assess for complications arising from substance use, including:
- abdominal, such as:
  - hepatomegaly
- cardiac, such as:
  - endocarditis
  - hypertension / cardiomyopathy
- neurology, such as:
  - delirium
  - neuropathy
- respiratory, such as:
  - asthma
  - lung injury
- skin, such as:
  - infections
  - track marks
Validated alcohol and other drugs (AOD) instruments to assess for various parameters of substance use, such as:
- Alcohol, Smoking and Substance Involvement Screening Test – youth (ASSIST-Y)
- Alcohol Use Disorders Identification Test (AUDIT)
- Australian Treatment Outcomes Profile (ATOP)
- Car, Relax, Alone, Forget, Friends, Trouble (CRAFFT)

Basic principles of motivational interviewing
Brief interventions (ask, assess, advise, assist, arrange):
- behavioural
- pharmacotherapies
- psychological modalities
Comorbidity of mental illness and substance use, and the importance of addressing both as dual diagnoses
Concepts of trauma-informed care
Critical importance of early intervention, opportunistic screening, and prevention in adolescent substance use
Harm minimisation and commonly available strategies
Impact of adolescent substance use on families, and interventions to support them
Multidisciplinary approach, avoiding stigmatising language and adhering to principles of confidentiality
Referral to specialist addiction services
Risk factors for ongoing substance use problems, such as:
- blood-borne viruses
- development of substance use disorder
- mental health crisis
- overdose and death
- sexually transmitted infections
- unplanned pregnancies
Specific considerations needed for the following groups:
- Aboriginal and Torres Strait Islander peoples and Māori adolescents
- adolescents whose parents have a mental illness or substance misuse
- adolescents with a disability
- homeless young people
- LGBTQIA+ adolescents
- neurodiverse young people
- refugee and asylum seeker families
- socioeconomically disadvantaged young people
- victims of physical and/or sexual abuse
- young people in custody or out-of-home care

LG16: Nutrition and disordered eating

Key presentations and conditions

Advanced Trainees will have a comprehensive depth of knowledge of these presentations and conditions.

View

Less common or more complex presentations and conditions

Advanced Trainees will understand these presentations and conditions.

Advanced Trainees will understand the resources that should be used to help manage patients with these presentations and conditions.

View

Epidemiology, pathophysiology, and clinical sciences

Advanced Trainees will have a comprehensive depth of knowledge of the principles of the foundational sciences.

View

Investigations, procedures, and clinical assessment tools

Advanced Trainees will know the scientific foundation of each investigation and procedure, including relevant anatomy and physiology. They will be able to interpret the reported results of each investigation or procedure.

Advanced Trainees will know how to explain the investigation or procedure to patients, families, and carers, and be able to explain procedural risk and obtain informed consent where applicable.

View

Important specific issues

Advanced Trainees will identify important specialty-specific issues and the impact of these on diagnosis and management and integrate these into care.

View

Presentations

Body image concerns
Constipation
Delayed puberty
Diarrhoea
Eating issues / Disordered eating:
- food refusal
- pica
- picky eating
Fainting / Loss of consciousness / Postural dizziness
Fatigue
Growth concerns
Headache
Oligomenorrhoea / Amenorrhoea
Nausea
Pain:
- abdominal
- muscle
Vomiting
Weight concerns:
- overweight
- underweight

Conditions

Anorexia nervosa / Atypical anorexia nervosa
Avoidant restrictive food intake disorder (ARFID)
Binge-eating disorder
Bulimia nervosa
Insulin resistance
Metabolic syndrome
Protein energy malnutrition

For each presentation and condition, Advanced Trainees will know how to:

Synthesise

recognise the clinical presentation
identify relevant epidemiology, prevalence, pathophysiology, and clinical science
take a comprehensive clinical and biopsychosocial history
conduct an appropriate examination
establish a differential diagnosis
plan and arrange appropriate investigations and consultations
consider the impact of injury and disease on patients and their quality of life when developing a management plan

Manage

provide evidence-based management
prescribe therapies tailored to patients’ needs and conditions
recognise potential complications of disease and its management, and initiate preventative strategies
involve multidisciplinary teams

Consider other factors

identify individual and social factors and the impact of these on diagnosis and management

Presentations

Long-term enteral / parenteral feeding

Conditions

Female athlete triad
Functional gastroparesis
Rumination

For each presentation and condition, Advanced Trainees will know how to:

Synthesise

recognise the clinical presentation
identify relevant epidemiology, prevalence, pathophysiology, and clinical science
take a comprehensive clinical and biopsychosocial history
conduct an appropriate examination
establish a differential diagnosis
plan and arrange appropriate investigations and consultations
consider the impact of injury and disease on patients and their quality of life when developing a management plan

Manage

provide evidence-based management
prescribe therapies tailored to patients’ needs and conditions
recognise potential complications of disease and its management, and initiate preventative strategies
involve multidisciplinary teams

Consider other factors

identify individual and social factors and the impact of these on diagnosis and management

Enteral / Parenteral nutrition
Metabolic syndrome
Normal growth and development
Nutritional requirements in adolescence
Overweight and obesity in adolescence
Pathophysiology of starvation and refeeding syndrome
Protein energy malnutrition
Psychological and pathological features of eating disorders
Refeeding syndrome, including risk factors, recognition, and management

Investigations

Abdominal ultrasound
Anthropometric measurements / centile charts
Biochemical results in the presence of:
- chronic vomiting
- obesity
- refeeding
- starvation
Bone age
Bone mineral density
Electrocardiogram (ECG)
Nutritional screening blood tests, such as:
- cholesterol, triglycerides
- ferritin
- haemoglobin A1c (HbA1c)
- other micronutrient screening
- vitamin D levels
Screening tools, such as:
- Eating Disorder Examination Questionnaire (EDE-Q)
- Sick, Control, One, Fat, Food (SCOFF) questionnaire

Comorbidities in overweight and underweight patients
Consequences and management options for long-term amenorrhoea
Ethical and legal considerations around nutritional support
Indications for hospitalisation in patients with eating disorders or weight loss
Indications for referral to specialised units and/or subspecialists
Long-term health risks of underweight and overweight patients, and their correlation with a multidisciplinary approach, close follow up, and early identification
Management of chronically overweight patients, such as:
- bariatric surgery
- medication
- role of lifestyle modification
Medical complications of malnutrition
Models of care for eating disorder management, such as:
- cognitive behavioural therapy – enhanced
- family-based treatment (FBT)
- indications for restrictive intervention
- medical monitoring
- role of pharmacological management
- specialist supportive clinical management
- temperament-based therapy with supports
Role of the family in the assessment and management of health issues
Specific considerations needed for the following groups:
- Aboriginal and Torres Strait Islander peoples and Māori adolescents
- adolescents whose parents have a mental illness or substance misuse
- adolescents with a disability
- homeless young people
- LGBTQIA+ adolescents
- neurodiverse young people
- refugee and asylum seeker families
- socioeconomically disadvantaged young people
- victims of physical and/or sexual abuse
- young people in custody or out-of-home care

Site:	RACP Online Learning
Course:	Advanced Training Curricula
Book:	Curriculum standards

Printed by:	Guest user
Date:	Saturday, 29 November 2025, 12:06 AM

Description

Advanced Training in Adolescent and Young Adult Medicine

Table of contents

About this resource

LG1: Competencies

Medical expertise

Communication

Quality and safety

Teaching and learning

Research

Cultural safety*

Ethics and professional behaviour

Judgement and decision making

Leadership, management, and teamwork

Health policy, systems, and advocacy

Entrustable Professional Activities

2

3

4

5

6

7

8

9

10

LG2: Team leadership

Medical expertise

Communication

Quality and safety

Teaching and learning

Cultural safety

Ethics and professional behaviour

Judgement and decision making

Leadership, management, and teamwork

Health policy, systems, and advocacy

LG3: Supervision and teaching

Medical expertise

Communication

Quality and safety

Teaching and learning

Research

Cultural safety

Ethics and professional behaviour

Judgement and decision making

Leadership, management, and teamwork

Health policy, systems, and advocacy

LG4: Quality improvement

Medical expertise

Communication

Quality and safety

Teaching and learning

Research

Cultural safety

Ethics and professional behaviour

Judgement and decision making

Leadership, management, and teamwork

Health policy, systems, and advocacy

LG5: Clinical assessment and management

Medical expertise

Communication

Quality and safety

Teaching and learning

Research

Cultural safety

Ethics and professional behaviour

Judgement and decision making

Leadership, management, and teamwork

Health policy, systems, and advocacy

LG6: Management of transitions in care

Medical expertise

Communication

Quality and safety

Teaching and learning

Cultural safety

Ethics and professional behaviour

Judgement and decision making

Leadership, management, and teamwork

Health policy, systems, and advocacy

LG7: Longitudinal care