Entrustable Professional Activities

LG10: Care for patients from rural / remote areas

Learning Goal 10

Care for patients from rural / remote areas

Provide high-level paediatric care for patients from rural and remote areas

This activity requires the ability to:

  • manage patients with consideration for their geographical context and access to health resources
  • identify and work to address barriers to health in rural and remote areas
  • adopt an independent, flexible, and resourceful approach to rural paediatrics
  • provide optimal paediatric care with effective utilisation of health care resources, within and beyond the patients’ local community
  • provide care to patients that is linked between inpatient, outpatient, and community settings liaise and coordinate with local, regional, and referral services
  • liaise and coordinate with local, regional, and referral services
  • plan and coordinate appropriate longitudinal follow-up that is closest to the patients’ home

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:

  • perform comprehensive assessments of paediatric patients with broad presentations across all organ systems
  • independently manage inpatients and outpatients in a regional setting, while recognising when to seek assistance from colleagues
  • liaise appropriately with off-site subspecialists (eg. metropolitan or tertiary centre) to instigate investigation and management where appropriate
  • undertake opportunistic health screening, considering local and environmental health priorities
  • provide opportunistic and directed health promotion education, considering local and environmental health priorities
  • demonstrate the ability to function effectively across inpatient and community contexts in parallel
  • consider local and regional burden of disease in possible differentials and antibiotic selection
  • tailor management plans to target the strengths and limitations of patients’ context
  • provide safe and effective phone advice for health professionals caring for patients in rural and remote locations

direction
Requires some supervision

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

The trainee may:

  • identify own limitations, and seek support of other health professionals
  • manage patients’ presenting complaints without consideration for their broad health needs or context
  • provide phone advice without consideration for the local context

Communication

confident
Ready to perform without supervision

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

The trainee will:

  • communicate closely with regional paediatricians, GPs, child health nurses, and other community health professionals in planning patient management and follow-up
  • communicate sensitively, respectfully, and collaboratively with local health professionals, appreciating the challenges and limitations of rural and remote services
  • communicate in a variety of means appropriate to the context, including remote, virtual, and telehealth
  • communicate and make joint decisions with retrieval services including discussion around stabilisation and mode of retrieval

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:

  • comply with local safety and quality standards
  • monitor and report adverse events
  • consider practical solutions to improving health care safety and quality in rural and remote sites

direction
Requires some supervision

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

The trainee may:

  • identify errors or limitations in care

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:

  • take action to develop knowledge and skills to improve care provided to local populations
  • provide planned and opportunistic education of local health care workers and students in paediatric medicine

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:

  • support the management of patients within cultural and family contexts, appreciating the importance of connection to Country and family roles
  • use qualified language interpreters or cultural interpreters where appropriate
  • advocate for, and practice, culturally safe care

direction
Requires some supervision

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

The trainee may:

  • demonstrate awareness of cultural considerations

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:

  • demonstrate consideration of the social, cultural, and psychological impact of referral and travel to large metropolitan hospitals on patients and families
  • appropriately use health care resources, considering cost and benefit
  • take efforts to ensure patients access available services to reduce barriers to health care, such as subsidised patient transport

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:

  • demonstrate sound initiative to problem solve independently, where appropriate
  • recognise disease burden and risk in patients’ geographical locations
  • recognise the limitations of local health services, and refer and transfer care appropriately and in a timely manner
  • use available investigations appropriately, and consider the cost, benefits, and potential impact of referral for further investigations in metropolitan centres
  • demonstrate a flexible and adaptable approach to managing patients to a high standard with limited resources
  • demonstrate consideration for medical, physical, and logistical complexities of patient retrieval

direction
Requires some supervision

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

The trainee may:

  • communicate with referral hospitals to assist with decision making

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:

  • lead and coordinate care of patients with multisystem and chronic disease, with input from metropolitan subspecialists
  • work collaboratively within teams to optimise patient-centred care in the regional setting
  • demonstrate effective teamwork skills to support other members of the health care team within regional or remote settings
  • advocate for quality, safe, and effective care in the best interest of patients
  • advocate for access to necessary resources to benefit the health and development of patients in rural and remote settings

direction
Requires some supervision

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

The trainee may:

  • liaise with metropolitan subspecialists when required

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 an awareness of population health priorities in regional areas
  • recognise and work within limitations of local health services, such as reduced access to primary care
  • communicate with local stakeholders and community members to address the health care needs of rural and remote patients
  • seek to address and/or advocate for addressing the determinants of health of the population, and mitigate barriers to access to care
  • participate in health promotion, disease prevention and control, screening, and reporting of notifiable diseases
  • contribute to, or participate in, advocacy and policy activities to improve health for rural and remote children
  • use telehealth services and other technology to facilitate access to health care remotely, where appropriate

direction
Requires some supervision

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

The trainee may:

  • understand the structure of local and regional health services