Curriculum standards

Ready to perform without supervision

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

The trainee will:

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

Requires some supervision

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

The trainee may:

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

Ready to perform without supervision

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

The trainee will:

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

Requires some supervision

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

The trainee may:

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

Ready to perform without supervision

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

The trainee will:

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

Requires some supervision

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

The trainee may:

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

Ready to perform without supervision

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

The trainee will:

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

Requires some supervision

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

The trainee may:

• refer to evidence-based clinical guidelines and protocols on acutely unwell patients

Ready to perform without supervision

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

The trainee will:

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

Ready to perform without supervision

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

The trainee will:

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

Ready to perform without supervision

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

The trainee will:

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

Requires some supervision

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

The trainee may:

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

Ready to perform without supervision

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

The trainee will:

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

Requires some supervision

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

The trainee may:

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

Ready to perform without supervision

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

The trainee will:

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

Requires some supervision

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

The trainee may:

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