Entrustable Professional Activities

LG8: Communication with patients, families, and health professionals

Learning Goal 8

Communication with patients, families, and health professionals

Communicate effectively and professionally with patients, carers, families, health professionals, 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/or carers
  • practice patient and family-centred care
  • communicate with team members and other health professionals across different contexts and modalities
  • synthesise clinical information into accurate and safe handovers and summaries
  • negotiate mutually agreed plans
  • deliver education to patients, families, carers, 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/or 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 information to patients to enable them to make informed decisions about diagnostic, therapeutic, and management options
  • provide patients with a chronic disease management plan
  • define, summarise, and clarify the concerns and goals of patients, and plan management in partnership with them
  • provide timely updates to patients and care providers when there are changes in plans or new results
  • use clinical encounters to provide appropriate education to patients, family, and/or carers on their health needs
  • synthesise clinical information into clear, accurate, comprehensive, and professional summaries and handovers for other health professionals, including discharge summaries, clinic letters, and transfer documentation
  • present succinct clinical cases to colleagues, providing justification for proposed plans, and raise points for discussion
  • provide safe and supportive expert advice for colleagues seeking professional paediatric opinion
  • consult specialists, such as child maltreatment specialist paediatricians, radiologists, neurosurgeons, and ophthalmologists, in cases of child maltreatment
  • formulate defensible evidence-based opinions in relation to likelihood of child maltreatment, in consultation with child maltreatment specialist paediatricians

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, and a rationale for management plans

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, or phone calls
  • actively support and effectively use professional interpreters and other communication assistance means during every clinical encounter with patients unable to communicate confidently or verbally in English, at a level required for health understanding, and document this in medical records
  • check patients’ level of literacy and access to the internet when considering use of written or online communications
  • actively and empathetically 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 patients to ask questions, and answer them thoroughly
  • encourage 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 patients respectfully, and listen to their views
  • undertake appropriate consultation with adolescents and young adults, including allowing review time independent of carer during part of the consultation
  • establish and apply requirements and limits of confidentiality when interviewing adolescents and young adults by themselves
  • recognise the development of health independence and requirements around consent when working with adolescent patients
  • support the role of family or carers, and, when appropriate, encourage patients to involve their family or carers in decisions about their care
  • use appropriate defusing and de-escalation strategies for angry patients, prioritising own safety and that of the team
  • demonstrate effective formal professional communication skills with different stakeholders across multiple platforms
  • establish rapport with people at all levels by tailoring messages to different stakeholders
  • ensure appropriate documentation in medical records or other appropriate means of record keeping
  • produce comprehensive medicolegal reports for the child protection and criminal justice system, that are appropriately peer reviewed

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 and developmental level, and cognitive, physical, cultural, socioeconomic, and situational factors
  • anticipate, read, and respond to verbal and nonverbal cues
  • demonstrate active listening skills to communicate patients’ situations to colleagues, including senior clinicians

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 and carers, including verbal, written, and digital information
  • reflect on communication interactions that did not go as expected, and demonstrate openness to feedback, continuous learning, and improvement
  • provide education to peers, junior doctors, medical students, and other health professionals that is tailored to their level of knowledge and current learning needs

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 research information to patients that is based on national guidelines
  • obtain informed consent or other valid authority before involving patients in research
  • provide information to patients in a way they can understand before asking for their consent to participate in research
  • communicate any research findings to appropriate stakeholders
  • understand when young people are able to consent for participation in research

direction
Requires some supervision

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

The trainee may:

  • obtain an informed consent or other valid authority before involving patients in research
  • 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
  • communicate effectively with members of other cultural groups by meeting patients’ specific language, cultural, and communication needs
  • use qualified language interpreters or cultural interpreters where appropriate
  • demonstrate consideration and accommodation for differing gender and parenting roles in communication interactions
  • provide plain language and culturally appropriate written / digital materials to patients where appropriate
  • use qualified language interpreters or cultural interpreters where 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 and, when relevant, their families or carers, in caring for themselves and managing their health
  • demonstrate respectful professional relationships with patients
  • demonstrate communicating strengths-based holistic care
  • prioritise honesty, patients’ welfare, and community benefit above self-interest
  • practice with a high standard of personal conduct, consistent with professional and community expectations
  • support patients’ rights to seek second opinions
  • manage and share information about patients’ health care in adherence to privacy laws, confidentiality, and professional guidelines
  • demonstrate strict adherence to patient confidentiality, and consideration for the setting of clinical discussions with patients and team members
  • seek consent from patients to communicate with other organisations involved in patients’ care
  • complete clinical notes and correspondence efficiently and within a reasonable time frame
  • ensure all appropriate recipients are included in patient correspondence
  • maintain professional boundaries with patients according to professional codes of conduct

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:

  • consistently communicate effectively, collaboratively, and respectfully with team members, other health professionals, and community members
  • communicate effectively with local service providers, primary care and other community organisations in planning and management of care, including referring and receiving health services
  • facilitate an environment where all team members feel they can contribute and their opinion is valued
  • formulate 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 health care 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:

  • use appropriate 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