Entrustable Professional Activities

LG8: Communication with patients

Learning Goal 8

Communication with patients

Discuss diagnoses and management plans with patients

This activity requires the ability to:

  • select a suitable context to discuss diagnosis and management plans, and include patients, their families, whanau and/or carers, and other team members, as appropriate
  • devise a patient-centred perspective, including adjusting for age, developmental stage, cognition, and disabilities
  • select and use appropriate communication strategies and modalities
  • structure conversations intentionally
  • negotiate mutually agreed management plans
  • verify patients’ understanding of information conveyed
  • develop and implement plans for ensuring actions occur
  • document conversations

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:

  • inform patients of all aspects of their clinical management, including assessments and investigations
  • provide information to patients to enable them to make informed decisions about diagnostic, therapeutic, and management options
  • provide patients with adequate opportunity to question or refuse interventions and treatments
  • seek to understand the concerns and goals of patients, and plan management in partnership with them
  • anticipate and be able to correct any misunderstandings patients may have about their conditions and/or risk factors

direction
Requires some supervision

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

The trainee may:

  • apply knowledge of the scientific basis of health and disease to the management of patients
  • demonstrate an understanding of clinical problems being discussed
  • formulate management plans in partnership with patients
  • attend family meetings

Communication

confident
Ready to perform without supervision

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

The trainee will:

  • convey information considerately and sensitively to patients, seeking clarification if unsure of how best to proceed
  • use appropriate communication strategies and modalities for communication, including:
    • emails
    • face-to-face
    • telehealth
    • phone calls
  • convey information considerately and sensitively to patients, seeking clarification if unsure of how best to proceed
  • elicit patients’ views, concerns, and preferences, promoting rapport
  • provide information to patients in plain language, avoiding jargon, acronyms, and complex medical terms
  • encourage questions, and answer them thoroughly
  • ask patients to share their thoughts or explain their management plan in their own words, to verify understanding
  • treat children, adolescents, and young people respectfully, and listen to their views
  • recognise the role of family and/or carers and, when appropriate, encourage patients to involve their family and/or carers in decisions about their care
  • inform patients / their families of multidisciplinary meeting and other professional meeting discussion outcomes

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, developmental level, and cognitive, physical, cultural, socioeconomic, and situational factors
  • collaborate with patient liaison officers
  • use interpreters

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:

  • discuss with patients their condition and the available management options, including potential benefits and harms
  • provide information to patients in a way they can understand before asking for their consent
  • consider young people’s capacity for decision making and consent
  • recognise and take precautions where patients may be vulnerable, such as issues of child protection or self-harm
  • participate in processes to manage patient complaints

direction
Requires some supervision

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

The trainee may:

  • inform patients of the material risks associated with proposed management plans
  • treat information about patients as confidential

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:

  • encourage junior colleagues to participate in difficult or important family conversations, and provide an opportunity to debrief / reflect afterwards
  • discuss the aetiology of diseases and explain the purpose, nature, and extent of the assessments to be conducted
  • obtain informed consent or other valid authority before involving patients in teaching
  • encourage and support junior colleagues in their communication with families, providing feedback

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 information to patients in a way they can understand before asking for their consent to participate in research
  • obtain an informed consent or other valid authority before involving patients in research

direction
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
  • 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 competent communication with Māori and Aboriginal and Torres Strait Islander peoples
  • effectively communicate with members of other cultural groups by meeting patients’ specific language, cultural, and communication needs
  • use qualified language interpreters or cultural interpreters to help meet patients’ communication needs
  • provide plain language and culturally appropriate written materials to patients

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 to be well informed about their health, and to use this information wisely when they make decisions
  • encourage and support patients and, when relevant, their families and/or carers, in caring for themselves and managing their health
  • demonstrate respectful professional relationships with patients
  • prioritise honesty, patients’ welfare, and community benefit above self-interest
  • develop a high standard of personal conduct, consistent with professional and community expectations
  • support patients’ rights to seek second opinions
  • recognise own limitations and engage someone else in the team or a senior colleague for specific discussions if needed

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 patients’ autonomy, and support their decision making
  • avoid sexual, intimate, and financial relationships with parents and carers
  • 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

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:

  • communicate effectively with team members involved in patients’ care, and with patients
  • discuss medical assessments, treatment plans, and investigations with patients and primary care teams, working collaboratively with all
  • discuss patient care needs with team members to align them with the appropriate resources
  • facilitate an environment where all team members feel they can contribute and their opinion is valued
  • communicate accurately and succinctly, and motivate others on the health care team

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 team members
  • keep team members focused on patient outcomes

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:

  • collaborate with other services, such as community health centres and consumer organisations, to help patients navigate the healthcare system

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