Curriculum standards

Ready to perform without supervision

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

The trainee will:

• explain to patients and carers the options, including the potential benefits, risks, burdens, and side effects, including the option to have no investigations
• use clear and simple language, and check that patients and carers understand the terms used and agree to proceed with proposed investigations
• confirm patients and carers understand the information they have been given, and the need for more information before deciding
• identify patients’ and carers’ concerns and expectations, and provide adequate explanations on the rationale for individual test ordering
• use written material, visual aids or other aids that are accurate and up to date to support discussions with patients and carers
• explain findings or possible outcomes of investigations to patients, families, or carers
• give information that patients and carers may find distressing in a considerate and culturally safe way

Requires some supervision

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

The trainee may:

• discuss the indications, risks, benefits, and complications of investigations with patients before ordering investigations
• explain the results of investigations to patients in a timely manner
• arrange investigations providing accurate and informative referrals, liaising with other services where appropriate

Ready to perform without supervision

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

The trainee will:

• identify adverse outcomes that may result from a proposed investigation, focusing on patients’ individual situations

Requires some supervision

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

The trainee may:

• consider safety aspects of investigations when planning them
• seek help with interpretation of test results for less common tests or indications, or for unexpected results, when required

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, evidence sources, and decision-making support tools when selecting and interpreting investigations
• participate in clinical audits to improve test ordering strategies for diagnoses and screening
• provide education to peers, junior doctors, medical students, and/or other health professionals that is tailored to their level of knowledge and current learning needs

Requires some supervision

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

The trainee may:

• undertake professional development to maintain currency with investigation guidelines

Ready to perform without supervision

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

The trainee will:

• provide patients with relevant information if a proposed investigation is part of a research program
• obtain written informed consent from patients if the investigation is part of a research program

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
• consult current research on investigations

Ready to perform without supervision

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

The trainee will:

• understand and mitigate patients’ and their families’ views and preferences about any proposed investigation and the adverse outcomes they are most concerned about

Requires some supervision

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

The trainee may:

• consider patients’ cultural and religious backgrounds, attitudes, and beliefs, and how these might influence the acceptability of proposed investigations
• involve patient liaison officers where relevant

Ready to perform without supervision

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

The trainee will:

• remain within the scope of the authority given by patients and carers, except in emergencies
• advise patients and carers when there may be additional costs, which patients may wish to clarify before proceeding
• discuss with patients and carers how decisions will be made once the investigation has started and the patient is not able to participate in decision making
• respect patients’ and carers’ decisions to refuse investigations, even if their decisions may not be appropriate or evidence based
• demonstrate awareness of escalation mechanisms if decisions made by parents or carers pose the risk of harm to a minor (e.g., legal entities)
• explain expected benefits as well as potential burdens and risks of any proposed investigation before obtaining informed consent or other valid authority
• demonstrate awareness of complex issues related to genetic information obtained from investigations, and subsequent disclosure of such information

Requires some supervision

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

The trainee may:

• identify appropriate proxy decision makers when required
• choose not to investigate in situations where it is not appropriate for ethical reasons
• practice within current ethical and professional frameworks
• practice within own limits, and seek help when needed
• involve patients in decision making regarding investigations, and obtain appropriate informed consent, including financial consent if necessary
• collaborate with other subspecialties, where appropriate, to ensure informed consent is provided to patients and their carers

Ready to perform without supervision

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

The trainee will:

• evaluate the costs, benefits, and potential risks of each investigation in a clinical situation
• adjust the investigative path depending on test results received
• consider whether patients’ conditions may get worse or better if no or alternative tests are selected

Requires some supervision

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

The trainee may:

• choose the most appropriate investigations for the clinical scenario, in discussion with patients
• 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:

• consider the role other members of the health care team might play, and what other sources of information and support are available
• consistently communicate effectively, collaboratively, and respectfully with team members and other relevant health professionals involved in the investigation process
• ensure results are checked in a timely manner, and take responsibility for following up on results and communicating them to other clinicians, patients, family members, or carers

Requires some supervision

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

The trainee may:

• demonstrate an understanding of what parts of an investigation are provided by different doctors or health professionals

Ready to perform without supervision

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

The trainee will:

• select and justify investigations regarding the pathological basis of disease, utility, safety, appropriateness, and cost
• consider resource utilisation through peer review of testing behaviours