Curriculum standards

Ready to perform without supervision

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

The trainee will:

• discuss and evaluate the risks, benefits, and rationale of treatment options, making decisions in partnership with patients
• 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
• write clear, legible, and cogent prescriptions in plain language, and include specific indications for the anticipated duration of therapy
• use and provide curated and evidence-based medication information handouts to patients
• describe how the medication should and should not be administered, such as any important relationships to food, time of day, and other medicines being taken
• provide information to patients about:
  • how to take it
  • potential side effects
  • what it does
  • what the medicine is for
  • when it should be stopped
• explain details of medication regimens, including drug dose, side effects, and schedule where appropriate
• ensure and support patient’s understanding of key information pertaining to medication administration, safety, and ongoing prescription plan
• identify and address patients’ concerns and expectations
• communicate with patients about future plans for weaning of psychotropic medication
• educate patients to recognise and monitor symptoms and when to seek help

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, including all legally required information
• seek further advice from experienced clinicians or pharmacists, when appropriate

Ready to perform without supervision

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

The trainee will:

• prescribe medications and management in accordance with evidence, guidelines, and protocols
• review medicines regularly to monitor efficacy and safety, and make necessary adjustments
• use electronic prescribing tools where available, and access electronic drug references to prevent errors caused by drug interactions and poor handwriting
• prescribe new medicines only when they have been demonstrated to be safer or more effective at improving patient-oriented outcomes than existing medicines
• participate in clinical audits to improve prescribing behaviour, including an approach to polypharmacy and prescribing cascade
• report suspected adverse events to relevant agencies, and record it in patients’ medical records

Requires some supervision

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

The trainee may:

• monitor side effects of medicines prescribed
• identify medication errors and institute appropriate measures
• use electronic prescribing systems safely
• describe issues raised by polypharmacy

Ready to perform without supervision

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

The trainee will:

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

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

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
• use sources of independent information that provide accurate summaries of the available evidence on new medicines
• research appropriate safety information and possibility of drug interactions
• develop and document procedure for psychotropic medication trial and share this with patients and general practitioner

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
• refer to guidelines and medical literature when required
• recognise where evidence is limited, compromised, or subject to bias or conflict of interest
• recognise the limitations of evidence and the challenges of applying research in daily practice

Ready to perform without supervision

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

The trainee will:

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

Requires some supervision

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

The trainee may:

• appreciate patients’ cultural and religious backgrounds, attitudes, and beliefs, and how these might influence the acceptability of pharmacological and non-pharmacological management approaches

Ready to perform without supervision

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

The trainee will:

• use a collaborative approach with families in making decisions about pharmacotherapy
• make prescribing decisions based on good safety data when the benefits outweigh the risks involved
• recognise the ethical implications of pharmaceutical industry-funded research and marketing
• follow organisational policies regarding pharmaceutical representative visits and drug marketing
• follow regulatory and legal requirements and limitations regarding prescribing
• consider and address beliefs and attitudes towards psychotropic medication usage
• consider possible indications for psychotropic medication trial, such as:
  • degree of functional impairment
  • differential diagnosis
  • target symptoms
• recognise the ethical concerns involving pharmaceutical companies presenting research favouring a medication directly to practitioners

Requires some supervision

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

The trainee may:

• consider the efficacy of medicines in treating illnesses, including the relative merits of different non-pharmacological and pharmacological approaches

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 patients
• evaluate new medicines in relation to their possible efficacy and safety profile for individual patients

Requires some supervision

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

The trainee may:

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

Ready to perform without supervision

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

The trainee will:

• interact with medical, pharmacy, and nursing staff to ensure safe and effective medicine use
• seek appropriate advice from senior colleagues if drug combinations are in use or proposed, where there are multiple behavioural target symptoms, or treatments for associated medical conditions
• seek appropriate advice from senior colleagues in complex situations relating to psychotropic medication, including:
  • lack of efficacy
  • unexpected side effects
  • multiple target symptoms
• involve general practitioner in longitudinal management of psychotropic medication, where appropriate

Requires some supervision

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

The trainee may:

• work collaboratively with pharmacists
• participate in medication safety and morbidity and mortality meetings

Ready to perform without supervision

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

The trainee will:

• choose medicines in relation to comparative efficacy, safety, and cost-effectiveness against medicines already on the market
• prescribe for individual patients, considering history, current medicines, allergies, and preferences, ensuring that healthcare resources are used wisely for the benefit of patients

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