Curriculum standards

Ready to perform without supervision

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

The trainee will:

• communicate clearly with other team members, and coordinate efforts of multidisciplinary team members, including working closely with other medical specialists
• use closed-loop and clear communication with other team members during resuscitation
• facilitate early communication with patients, families, carers, and team members to allow shared decision making
• negotiate and review realistic treatment goals, and determine and explain the expected prognoses and outcomes
• employ developmentally appropriate communication strategies appropriate for children, adolescents, and young adults and those with cognitive difficulties
• maintain respect for parents’ / families’ wishes in regard to communications with their child, adolescent, or young adult
• communicate with patients in a sensitive and supportive manner, avoiding jargon and confirming their understanding
• determine individual patients' level of health literacy and understanding of agreed care decisions

Requires some supervision

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

The trainee may:

• demonstrate communication skills to sufficiently support the function of multidisciplinary teams
• determine patients’ understanding of their diseases and what they perceive as the most desirable goals of care
• communicate appropriately to the age and developmental stage of patients, and to parents or carers
• recognise adolescents and young adults as a specific group with specific communication needs
• use interpreters

Ready to perform without supervision

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

The trainee will:

• maintain up-to-date certification in advanced life support
• maintain up-to-date knowledge of acute oncological and haematological conditions, including specific toxicities from new therapies, such as immune mediated toxicities
• use clinical information technology systems for conducting prospective and retrospective clinical audits
• evaluate and explain the benefits and risks of clinical interventions based on individual patients’ circumstances
• analyse adverse incidents and sentinel events to identify system failures and contributing factors
• document treatment given without consent in an emergency according to local guidelines
• identify evidence-based practice gaps using clinical indicators, and implement changes to improve patients’ outcomes
• coordinate and encourage innovation, and objectively evaluate improvement initiatives for outcomes and sustainability

Requires some supervision

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

The trainee may:

• evaluate quality of processes through well-designed audits
• recognise the risks and benefits of operative interventions
• evaluate quality and safety processes implemented within the workplace, and identify gaps in their structure
• raise appropriate issues for review at morbidity and mortality meetings

Ready to perform without supervision

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

The trainee will:

• demonstrate effective supervision skills and teaching methods adapted to the context of the training
• encourage questioning among junior colleagues and students in response to unanswered clinical questions
• seek guidance and feedback from health care teams to reflect on encounters and improve future patients’ care
• seek opportunities to debrief after serious acute events

Requires some supervision

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

The trainee may:

• mentor and train others to enhance team effectiveness
• provide constructive feedback to junior colleagues to contribute to improvements in individuals’ skills
• coordinate and supervise junior colleagues from the emergency department and wards

Ready to perform without supervision

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

The trainee will:

• select studies based on optimal trial design, freedom from bias, and precision of measurement
• evaluate the value of treatments in terms of relative and absolute benefits, cost, potential patient harm, and feasibility
• evaluate the applicability of the results of clinical studies to the circumstances of individual patients, especially those with multiple comorbidities
• specify research evidence to the needs of individual patients

Requires some supervision

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

The trainee may:

• demonstrate efficient searching of literature databases to retrieve evidence
• use information from credible sources to aid in decision making
• refer to evidence-based clinical guidelines and protocols on acutely unwell patients
• demonstrate an understanding of the limitations of the evidence and the challenges of applying research in daily practice

Ready to perform without supervision

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

The trainee will:

• negotiate health care decisions in a culturally appropriate way by considering variation in family structures, cultures, religion, gender identity, sexual orientation, and belief systems
• integrate culturally appropriate care of Māori and Aboriginal and Torres Strait Islander peoples into patients’ management
• consider cultural, ethical, and religious values and beliefs in leading multidisciplinary teams

Requires some supervision

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

The trainee may:

• practise cultural competency appropriate for the community serviced
• proactively identify barriers to access to healthcare

Ready to perform without supervision

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

The trainee will:

• develop management plans that are based on medical assessments of the clinical conditions and multidisciplinary assessments of functional capacity
• advise patients of their rights to refuse medical therapy, including life-sustaining treatment
• consider the consequences of delivering treatment that is deemed futile, directing to other care
• facilitate interactions within multidisciplinary teams, respecting values, encouraging involvement, and engaging all participants in decision making
• demonstrate critical reflection on personal beliefs and attitudes, including how these may affect patient care and health care policy

Requires some supervision

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

The trainee may:

• communicate medical management plans as part of multidisciplinary plans
• establish, where possible, patients’ wishes and preferences about care
• contribute to building a productive culture within teams

Ready to perform without supervision

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

The trainee will:

• recognise the need for escalation or de-escalation of care, and refer to appropriate staff or services
• integrate evidence related to questions of diagnosis, therapy, prognosis, risks, and cause into clinical decision making
• reconcile conflicting advice from other specialties, applying judgement in making clinical decisions in the presence of uncertainty
• use care pathways effectively, including identifying reasons for variations in care

Requires some supervision

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

The trainee may:

• involve additional staff to assist in a timely manner when required
• 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:

• work collaboratively with staff in the emergency department, intensive care, and other subspecialty inpatient units
• manage the transition of acute medical patients through their hospital journey
• lead a team by providing engagement while maintaining a focus on outcomes

Requires some supervision

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

The trainee may:

• collaborate with and engage other team members, based on their roles and skills
• ensure appropriate multidisciplinary assessment and management
• encourage an environment of openness and respect to lead effective teams

Ready to perform without supervision

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

The trainee will:

• use a considered and rational approach to the responsible use of resources, balancing costs against outcomes
• prioritise patients' care based on need, and consider available health care resources
• collaborate with emergency medicine staff and other colleagues to develop policies and protocols for the investigation and management of common acute medical problems

Requires some supervision

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

The trainee may:

• understand the role of clinician leadership and advocacy in appraising and redesigning systems of care that lead to better patient outcomes
• understand the systems for the escalation of care for deteriorating patients