Entrustable Professional Activities

LG10: Communication in child-centred care

Learning Goal 10

Communication in child-centred care

Communicate effectively and professionally with patients, carers, families, health professionals, care partners, and other community members engaging with the health service

This activity requires the ability to:

  • communicate and build rapport with children and young people
  • communicate and build working relationships with families and carers
  • practice patient and family centred care
  • communicate with team members and other health professionals across different contexts and modalities
  • communicate with care partners, such as education, NGOs, justice systems, child safety and welfare
  • synthesise clinical information into accurate and safe handovers and summaries
  • communicate respectfully and professionally
  • negotiate mutually agreed plans
  • produce comprehensive medical reports, including thorough documentation of findings and justifiable opinions for children in whom a suspicion of any form of child maltreatment has been identified
  • deliver education to patients, families, and health professionals at appropriate levels of understanding

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:

  • communicate clearly the working diagnosis, other possible diagnoses, and rationale behind management plans to patients and other health professionals
  • anticipate, and be able to correct, any misunderstandings patients may have about their conditions and 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
  • provide timely updates to patients and health professionals when there is a change in plan or new result
  • define, summarise, and clarify 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
  • use clinical encounters to provide appropriate education to patients and carers on their health needs
  • synthesise clinical information into clear, accurate, safe, and professional summaries and handovers
  • present succinct clinical cases to colleagues, providing justification for proposed plan and raise points for discussion

direction
Requires some supervision

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

The trainee may:

  • explain the scientific basis of health and disease to patients
  • demonstrate an understanding of the clinical problem being discussed
  • formulate management plans in partnership with patients
  • present a working diagnosis to colleagues

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 an appropriate communication strategy and modalities for communication, such as emails, face-to-face, phone calls, or video conferencing formats
  • actively support, and effectively use, interpreters and other communication assistance means during every clinical encounter with patients who cannot communicate confidently or verbally in English, and document this in the medical record
  • demonstrate efforts to develop rapport with, and show compassion for, patients
  • actively listen to and prioritise the needs and concerns of patients
  • communicate with patients respectfully and non-judgementally
  • provide information to patients in plain language, avoiding jargon, acronyms, and complex medical terms
  • encourage questions, and answer them thoroughly
  • ask difficult or sensitive questions and engage children in interviews in a sensitive manner
  • 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
  • treat children and young people respectfully, and listen to their views
  • demonstrate effective interview and examination skills in the conduct of forensic medical assessments
  • demonstrate ability to draw out and reconcile accounts of the situation from different individuals
  • communicate clearly, effectively, respectfully, and promptly with other health professionals and stake holders involved in patients’ care
  • recognise the role of family or carers and, when appropriate, encourage patients to involve their family or carers in decisions about their care
  • communicate respectfully and collaboratively in all discussions in the health care setting
  • use appropriate defusing and deescalation strategies for angry patients, prioritising safety of self and colleagues
  • generate professional and timely written documentation, correspondence and reports, and ensure appropriate recipients
  • communicate formally with different stakeholders
  • present written reports, visual depictions of data, and oral presentations

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

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:

  • ensure appropriate documentation of communications in the medical record or other appropriate means of record keeping
  • 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 in communication where patients may be vulnerable, such as issues of child protection
  • participate in processes to manage patient complaints
  • engage consumers in quality improvement activities

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 the proposed management plan
  • 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:

  • provide appropriate and ongoing education for patients
  • obtain informed consent, or other valid authority, before involving patients in teaching
  • demonstrate and teach effective communication strategies to junior colleagues and students
  • reflect on communication interactions that did not go as expected and demonstrate openness to feedback, continuous learning, and improvement

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 from authorities
  • 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
  • communicate any research findings to appropriate stakeholders

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

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

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
  • demonstrate strict adherence to patient confidentiality and consideration for the setting of clinical discussions with team members
  • seek consent from patients to communicate with other organisations involved in patients’ care
  • apply a broad interview framework with capacity to explore possibility of:
    • fabrication, exaggeration, or induction by the child’s carer of medical symptoms or physical illness
    • inflicted injury
    • neglect of physical, emotional, psychological, nutritional, medical care, or educational needs
    • psychological harm due to the actions of carers
    • sexual abuse

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
  • disseminate the findings and recommendations using written reports and oral presentations
  • discuss medical assessments, treatment plans, and investigations with patients, transfer hospital and/or primary care teams
  • work collaboratively with patients, transfer hospital, and primary care teams
  • discuss patient care needs with healthcare team members to align them with the appropriate resources
  • facilitate an environment where all team members feel they can contribute and their opinion is valued
  • make strategies to respectfully negotiate plans in the best interest of the patient at times when there are differences in opinions between health professionals

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

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, consumer organisations, support services, and child protection agencies to help patients navigate the healthcare system
  • effectively and safely use appropriate/approved digital technologies and systems to facilitate improved communication

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