Curriculum standards
Curriculum standards
Advanced Training in Palliative Medicine (Adult Medicine and Chapter)
Entrustable Professional Activities
LG8: Communication with patients
Communication with patients
Communicate with patients across different stages of life-limiting illnesses
This activity requires the ability to:
- plan for and deliver person-centred clinical conversations
- interpret patient and family cues in communication content and style
- recognise and respond to emotion
- collaborate in family meetings
- prepare communication strategies to adjust for age, culture, language, health literacy, cognitive impairment, and sensory impairment
- develop, document, and progress mutually agreed management plans
- self-reflect on outcomes of communication
Professional practice framework domain
Medical expertise
Ready to perform without supervision
Expected behaviours of a trainee who can routinely perform this activity without needing supervision
The trainee will:
- explore the concerns and goals of patients, and plan management in partnership with them
- explain diagnosis, investigation, and management options using language appropriate to patients’ understanding and desire for information
- address questions, misunderstandings, and concerns, and provide accessible information to patients
- discuss relevant themes, including:
- advance care planning
- anticipated disease trajectory
- end-of-life care
- goals of patient care, including treatment withdrawal or limitation
- loss of capacity
- prognosis
- requests for hastened death
- requests for treatment with negligible benefit
- requests for voluntary assisted dying
- respond to existential distress
Requires some supervision
Possible behaviours of a trainee who needs some supervision to perform this activity
The trainee may:
- address common communication issues in palliative care
Communication
Ready to perform without supervision
Expected behaviours of a trainee who can routinely perform this activity without needing supervision
The trainee will:
- use telehealth effectively
- develop rapport
- tailor communication content and style to meet patients’ needs
- include significant others in conversations, and facilitate family meetings when appropriate
- respond to verbal and nonverbal cues and emotions
- document and share information about key conversations with patients to optimise patient care and safety
- assess patients’ understanding prior to giving any information
- model shared decision making by exploring patients’ concerns, informing them, prioritising their wishes, and respecting their beliefs
Requires some supervision
Possible behaviours of a trainee who needs some supervision to perform this activity
The trainee may:
- provide information to patients in plain language, avoiding jargon, acronyms, and complex medical terms
- convey information considerately and sensitively to patients, seeking clarification if unsure of how best to proceed
- treat children and young people respectfully, and listen to their views
Quality and safety
Ready to perform without supervision
Expected behaviours of a trainee who can routinely perform this activity without needing supervision
The trainee will:
- discuss potential benefits and risks of management strategies
- assess patient capacity for decision making and informed consent if concerns are expressed by the patients’ family or carer
- recognise and respond appropriately where patients may be vulnerable, such as issues of elder abuse, family violence, or self-harm
- participate in processes to manage patient complaints
- ensure timely, purpose-driven, and effective communication and documentation that supports continuous, coordinated, and safe care for patients
Requires some supervision
Possible behaviours of a trainee who needs some supervision to perform this activity
The trainee may:
- treat information about patients as confidential
Teaching and learning
Ready to perform without supervision
Expected behaviours of a trainee who can routinely perform this activity without needing supervision
The trainee will:
- address gaps in knowledge and skills through self-reflection, seeking feedback and self-directed learning and continuing professional development
- supervise junior colleagues in managing communication with patients
Research
Ready to perform without supervision
Expected behaviours of a trainee who can routinely perform this activity without needing supervision
The trainee will:
- provide information to patients that is based on best available evidence
- obtain informed consent or other valid authority before involving patients in research
- write articles / reports and other scientific writing
- display oral communication skills, including those for both planned presentations and spontaneous speech
- communicate scientific information to others in journal clubs and conference presentations
Cultural safety
Ready to perform without supervision
Expected behaviours of a trainee who can routinely perform this activity without needing supervision
The trainee will:
- demonstrate effective and culturally competent communication with Māori and Aboriginal and Torres Strait Islander peoples
- effectively communicate with members of other cultural groups by meeting patients’ specific communication, cultural, and language needs
- use qualified language interpreters or cultural interpreters effectively to help meet patients’ communication needs
- provide plain-language and culturally appropriate written materials to patients when possible
Requires some supervision
Possible behaviours of a trainee who needs some supervision to perform this activity
The trainee may:
- identify when to use interpreters
- allow enough time for communication across linguistic and cultural barriers
Ethics and professional behaviour
Ready to perform without supervision
Expected behaviours of a trainee who can routinely perform this activity without needing supervision
The trainee will:
- demonstrate respectful professional relationships with patients
- prioritise honesty, patients’ welfare, and community benefit above self-interest
- use appropriate consent processes for the release and sharing of patients’ information
- respect patients’ rights to privacy and confidentiality
- support patients’ decision making preferences
- support patients’ rights to seek second opinions
- avoid sexual, intimate, and financial relationships with patients
- behave equitably towards all, irrespective of gender, age, culture, socioeconomic status, sexual preferences, beliefs, contribution to society, illnessrelated behaviours, or the illness itself
- use social media ethically and according to legal obligations
Leadership, management, and teamwork
Ready to perform without supervision
Expected behaviours of a trainee who can routinely perform this activity without needing supervision
The trainee will:
- communicate effectively with team members involved in patients’ care, and with patients
- facilitate an environment where all team members feel they can contribute and their opinion is valued
Requires some supervision
Possible behaviours of a trainee who needs some supervision to perform this activity
The trainee may:
- keep health care team members focused on patient outcomes
Health policy, systems, and advocacy
Ready to perform without supervision
Expected behaviours of a trainee who can routinely perform this activity without needing supervision
The trainee will:
- collaborate with other health professionals and services, such as community health centres and consumer organisations, to help patients navigate the healthcare system