Curriculum standards

Ready to perform without supervision

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

The trainee will:

• encourage patients' self-management through education to take greater responsibility for their care, and support problem solving
• build robust relationships with patients that will be sustainable for both parties throughout the cancer journey
• encourage patients' access to self-monitoring devices and assistive technologies
• communicate with multidisciplinary team members, and involve patients in that dialogue
• write relevant and detailed medical record entries, including clinical assessments and management plans
• write comprehensive and accurate summaries of care, including discharge summaries, clinic letters, and transfer documentation
• initiate and maintain verbal communication with other health professionals, when required
• communicate with patients about transition of care, and engage and support these parties in decision making
• explain the impact of oncological / haematological disease, acute or ongoing, on adolescents' and young adults' leisure and work activities

Requires some supervision

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

The trainee may:

• provide healthy lifestyle advice and information to patients on the importance of self-management
• work in partnership with patients, and motivate them to comply with agreed care plans
• communicate clearly with clinicians and other caregivers
• use standardised verbal and written templates to improve the reliability of information transfer and prevent errors and omissions
• communicate accurately and in a timely manner to ensure an effective transition between settings, and continuity and quality of care
• assess patients' understanding of their illness and health care needs, and work with them to increase their understanding
• use communication skills and strategies that help patients make informed decisions
• recognise and explore the worries and concerns of adolescent and adult patients with cancer and haematological disorders
• identify the need to shift responsibility for decision making from parents to patients, and work with patients on planning this
• communicate sensitively with adolescents and young adults
• recognise when it is appropriate to communicate with patients individually versus when it is appropriate to communicate with patients and their family members and/or carers
• discuss with patients the differences between paediatric and adult care, such as the involvement of the parent or carer in decisions for adult patients versus paediatric patients

Ready to perform without supervision

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

The trainee will:

• use innovative models of chronic care using telehealth and digitally integrated support services
• review medicine use and ensure patients understand safe medication administration to prevent errors
• support patients' self-management by balancing between minimising risk and helping patients to become more independent
• participate in quality improvement processes impacting on patients' abilities to undertake normal activities of daily living
• identify patients at risk of a poor transition of care, and mitigate this risk
• use electronic tools (where available) to securely store and transfer patient information
• use consent processes, including written consent if required, for the release and exchange of information
• demonstrate understanding of the medicolegal context of written communications
• ensure patients are informed of the risks associated with any part of proposed management plans

Requires some supervision

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

The trainee may:

• participate in continuous quality improvement processes and clinical audits on chronic disease management
• identify activities that may improve patients' quality of life
• ensure that handover is complete, or work to mitigate risks if the handover was incomplete
• ensure all outstanding results or procedures are followed up by receiving units and clinicians
• keep patients' information secure, adhering to relevant legislation regarding personal information and privacy
• document patients' histories with clarity and completeness

Ready to perform without supervision

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

The trainee will:

• educate patients to recognise and monitor their symptoms, and undertake strategies to assist their recovery
• contribute to the development of clinical pathways for cancer treatment and toxicities, and chronic diseases management based on current clinical guidelines
• integrate clinical education in handover sessions and other transition of care meetings
• tailor clinical education to the level of the professional parties involved
• educate adolescents and young adults about their conditions and their impacts on their lives (e.g. sexuality and contraception)
• provide appropriate written / online information and resources relevant to the transition stage

Requires some supervision

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

The trainee may:

• explain how patient education can empower adolescents and young adults to take responsibility for their health
• take opportunities to teach junior colleagues during handover, as necessary
• use clinical practice guidelines for chronic diseases management

Ready to perform without supervision

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

The trainee will:

• search for and critically appraise evidence to resolve clinical areas of uncertainty

Requires some supervision

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

The trainee may:

• search literature using problem / intervention / comparison / outcome (PICO)
• recognise appropriate use of review articles

Ready to perform without supervision

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

The trainee will:

• encourage patients from culturally and linguistically diverse backgrounds to join local networks to receive the support needed for long-term self-management
• communicate with careful consideration to health literacy, language barriers, and culture and religion about patient preferences, including whether they are realistic and possible, respecting patients' choices
• recognise the timing, location, privacy, and appropriateness of sharing information with patients

Requires some supervision

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

The trainee may:

• provide culturally safe chronic disease management
• include relevant information regarding patients' cultural, religious, and ethnic background in handovers, including whether an interpreter is required

Ready to perform without supervision

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

The trainee will:

• share information about patients' health care, consistent with privacy laws and confidentiality and professional guidelines
• use consent processes for the release and exchange of health information
• assess patients' decision-making capacity, and appropriately identify and use alternative decision makers
• disclose and share only contextually appropriate medical and personal information
• share information about patients' health care in a manner consistent with privacy law and professional guidelines on confidentiality
• demonstrate understanding of the clinical, ethical, and legal rationale for information disclosure
• demonstrate understanding of the additional complexity related to some types of information, such as genetic information and blood borne virus status, and seek appropriate advice about disclosure of such information
• interact in a collegiate and collaborative way with professional colleagues during transitions of care
• explain the role of GPs in patients' care, including relevant guidelines and how they apply

Requires some supervision

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

The trainee may:

• share information between relevant service providers
• acknowledge and respect the contribution of health professionals involved in patients' care
• maintain respect for patients and other health professionals, including respecting privacy and confidentiality

Ready to perform without supervision

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

The trainee will:

• implement stepped care pathways in the management of chronic diseases and disabilities
• recognise patients' needs in terms of both internal resources and external support on a long-term health care journey
• ensure patients' care is in the most appropriate facility, setting, or provider, including involving adolescent and young adult (AYA) services when necessary
• identify the right time to start facilitating transition by considering the needs of individual patients
• select appropriate specialists to transition patients to (e.g. GP, specialist in paediatric or adult sector, survivorship care, or palliative care)

Requires some supervision

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

The trainee may:

• recognise personal limitations and seek help in an appropriate way when required
• use a structured approach to consider and prioritise patients' issues

Ready to perform without supervision

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

The trainee will:

• coordinate whole-person care through involvement in all stages of patients' care journeys
• use a multidisciplinary approach across services to manage patients with serious and chronic diseases and disabilities
• develop collaborative relationships with patients and a range of health professionals
• demonstrate understanding of the medical governance of patient care, and the differing roles of team members
• show respect for the roles and expertise of other health professionals, and work effectively as a member of professional teams
• ensure that multidisciplinary teams provide the opportunity for patients' engagement and participation when appropriate
• recognise and work collaboratively with other health care providers, (e.g. allied health workers, psychologists, and AYA services)
• ensure sufficient handover, including robust notes to convey complex history and/or rationale for past decisions
• share the workload of transitions of care appropriately, including delegation

Requires some supervision

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

The trainee may:

• participate in multidisciplinary care for patients with serious and chronic diseases and disabilities, including organisational and community care on a continuing basis, appropriate to patients' context
• recognise factors that impact on the transfer of care, and help subsequent health professionals understand the issues to continue care
• work to overcome the potential barriers to continuity of care, appreciating the role of handovers in overcoming these barriers
• recognise the importance of the multidisciplinary team in the management of adolescents and young adults

Ready to perform without supervision

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

The trainee will:

• use health screening for early intervention and chronic diseases management
• assess alternative models of health care delivery to patients with chronic diseases and disabilities
• participate in hospital / government initiatives for serious and chronic diseases management to reduce hospital admissions and improve patients' quality of life, using ‘hospital in the home' programs and shared care with providers closer to home
• help patients access initiatives and services for patients with serious and chronic diseases and disabilities
• contribute to processes for managing risks, and identify strategies for improvement in transition of care
• engage in organisational processes to improve transitions of care, such as formal surveys or follow-up phone calls after hospital discharge
• connect patients with local or online peer support groups
• contribute to the development of a written transition policy, which is a document that sets out principles, standards, and practices of how transitions are managed at the centre
• advocate for resources to support efficient and more effective transitions

Requires some supervision

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

The trainee may:

• demonstrate awareness of government initiatives and volunteer / philanthropic services available for patients with serious and chronic diseases and disabilities, and display knowledge of how to access them
• factor transport issues and costs to patients into arrangements for transferring patients to other settings
• apply local and international guidelines around transitions