Entrustable Professional Activities

LG10: Fitness for work assessment

Learning Goal 8

Fitness for work assessment

Assess workers’/patients’ ability to return to work

This activity requires the ability to:

  • review job task analysis, job descriptions, and employer-specific policies and procedures
  • assess task demands, psychosocial hazards, and environment of employees’ work
  • define and negotiate the standards of fitness required
  • perform clinical assessments of fitness for work that include evaluations of psychosocial factors that increase the risk of poor return to work outcomes
  • elicit careful, well-targeted occupational and educational histories
  • interpret, synthesise, and critically review reports provided by other health professionals in determining fitness for work, including functional capacity evaluations and neuropsychological reports
  • describe the consequences of injury and/or illness and, in particular, its effect on workers’/patients’ ability to work
  • prepare and implement return to work or rehabilitation plans for workers/patients
  • compose detailed medical reports in response to worker, employer, insurer, and/or medicolegal requests

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:

  • demonstrate a holistic approach to hazard identification within the workplace
  • interpret job task analysis
  • interpret functional capacity assessments and neuropsychological reports appropriately
  • determine the biomechanical components of manual work, and understand the interplay of psychosocial hazards in the development and management of musculoskeletal conditions and impacts on fitness to work
  • determine the psychological and physiological components of roles and how they may impact on fitness to work
  • identify potential psychosocial factors present in workers/patients that may lead to poor return to work outcomes
  • conduct focused walkthroughs of workplaces directed at the placement of workers
  • identify the likely requirements for alertness, consistent performance, judgement, responsiveness, stamina, and strength for common occupational roles
  • discuss with workers/patients the implications for employment of medication and convalescence from procedures
  • describe the likely effect of levels of substance use on impairment
  • estimate the level of impairment, the nature of workers’/patients’ disabilities, and what roles they can perform
  • describe the consequences of therapeutic drug use on workers’/patients’ performances
  • describe the consequences of surgical procedures on workers’/patients’ performances, and the likely recovery period for procedures affecting workers’/patients’ mobility or stamina
  • evaluate the likely effect of described work conditions on health, given the individual circumstances of workers/patients

direction
Requires some supervision

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

The trainee may:

  • demonstrate understanding of occupational hazards and risks within workplaces
  • demonstrate some interpretation of job task analysis
  • understand the components and needs of specialised testing, such as functional capacity and neuropsychological assessments
  • define common terms used to describe body actions and the ways of moving articles at work

Communication

confident
Ready to perform without supervision

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

The trainee will:

  • discuss the schedule of items for the level of fitness required for the work involved
  • discuss ways to maintain employment for workers no longer able to meet the demands of their job, e.g. through non-work-related illness
  • question workers and employer representatives in ways that serve to cross-check subjective remarks
  • manage situations where workers are found not to be fit according to the examination standard, including the management of anger
  • write workers’ compensation reports that refer to fitness for work or impairment assessments
  • elicit relevant information about the requirements of jobs and their ambience from conversations with employer representatives

direction
Requires some supervision

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

The trainee may:

  • draft and complete medical certificates and reports

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:

  • identify special rules on fitness for driving (such as crane, forklift, heavy vehicle, personal, and rail), and fitness for air crew and diving

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:

  • gain understanding of workers’/patients’ daily activities based on careful and comprehensive occupational histories, and persist sufficiently in questioning to obtain this

Research

confident
Ready to perform without supervision

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

The trainee will:

  • discuss the application of the various guides to assessing impairment in Australia and Aotearoa New Zealand
  • recognise the World Health Organization’s international classification of disability, functioning, and health

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:

  • recognise equal opportunity and/or disability discrimination law
  • recognise local laws and guidelines on incapacity payments and return to work

Judgement and decision making

confident
Ready to perform without supervision

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

The trainee will:

  • assess the organisational demands on workers/patients and how they affect day-to-day work
  • discern and refuse to accept standards or schedules of fitness testing that are not congruent with work requirements
  • define appropriate restrictions for workers/patients in the workplace if needed
  • define appropriate placements for people with disabilities
  • differentiate between impairment, functional capacity, and social participation, and recognise that severe impairment is not necessarily mirrored by a major change to social participation and vice versa
  • explain and negotiate a return to work plan, where a worker has limited capacity for work

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:

  • liaise in a timely and appropriate manner with other health care professionals involved in workers’/patients’ care

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:

  • demonstrate extensive in-depth knowledge of the standards of fitness in relevant legislation or industry standards
  • demonstrate in-depth knowledge of fitness to work guidelines