Entrustable Professional Activities

LG11: Procedures

Learning Goal 11

Procedures

Plan, prepare for, perform, and provide aftercare for important practical procedures

This activity requires the ability to:

  • select appropriate procedures in partnership with patients, their families, and/or carers
  • obtain informed consent
  • set up the equipment, maintaining an aseptic field
  • perform procedures
  • manage unexpected events and complications during and after procedures
  • provide aftercare for patients
  • communicate aftercare protocols and instructions to patients and medical and nursing staff
  • interpret the results and outcomes of procedures, including imaging and pathology reports
  • communicate the outcome of procedures and associated investigations to patients
  • perform this activity across multiple relevant settings
  • plan follow-up investigations

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:

  • select procedures by assessing patient-specific factors, including alternatives, benefits, and risks
  • confidently and consistently perform a range of common procedures
  • ensure team members are aware of all allergies and adverse reactions identified, and take precautions to avoid allergies and adverse reactions during procedures
  • ensure patients have complied with preprocedural preparation
  • confirm the correct position / site / side / level on patients for planned procedures
  • recognise and manage effectively complications arising during or after procedures
  • recognise and correctly interpret normal and abnormal findings of diagnostic procedures
  • interpret results in context of patients, and relay information to patients and their family
  • perform a lumbar puncture (LP)

direction
Requires some supervision

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

The trainee may:

  • assess patients and identify indications for procedures
  • check for allergies and adverse reactions
  • consider risks and complications of procedures
  • interpret results of common diagnostic procedures
  • organise and document postprocedural review of patients

Communication

confident
Ready to perform without supervision

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

The trainee will:

  • accurately document procedures in the clinical notes, including informed consent, procedures requested and performed, reasons for procedures, medicines given, aseptic technique, and aftercare
  • explain procedures clearly to patients, families, and carers, including reasons for procedures, potential alternatives, and possible risks, to facilitate informed choices
  • counsel patients sensitively and effectively, and support them to make informed choices
  • address patients’, families’, or carers’ concerns relating to procedures, providing opportunities to ask questions
  • tailor language according to individual patients’ age and capacity to understand
  • communicate effectively with team members, patients, families, and carers prior to, during, and after procedures
  • ensure team members are confident and competent in their assigned roles

direction
Requires some supervision

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

The trainee may:

  • explain the process of procedures to patients without providing a broader context
  • help patients, families, and carers choose procedures
  • communicate with members of procedural teams so all team members understand who each member is
  • discuss postprocedural care with patients, families, and carers
  • complete relevant patients’ documentation, and conduct appropriate clinical handovers

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:

  • obtain informed consent or other valid authority before undertaking any procedure
  • set up all necessary equipment, and consistently use universal precautions and aseptic technique
  • confirm patients’ identification, verify the procedure and, where appropriate, the correct position / site / side / level for the procedure
  • ensure that information on patients’ consent forms matches procedures to be performed
  • identify, document, and appropriately notify of any adverse events or equipment malfunction

direction
Requires some supervision

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

The trainee may:

  • provide information in a manner so that patients, families, and carers are fully informed when consenting to any procedures
  • demonstrate an inconsistent application of aseptic technique
  • identify patients using approved patients’ identifiers before any treatment or intervention is initiated

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:

  • refer to and/or be familiar with relevant published procedural guidelines prior to undertaking procedures
  • organise or participate in in-service training on new technology
  • provide specific and constructive feedback and comments to junior colleagues
  • initiate and conduct skills training for junior staff

direction
Requires some supervision

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

The trainee may:

  • participate in continued professional development
  • help junior colleagues develop new skills
  • actively seek feedback on personal technique until competent

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:

  • consider individual patients’ cultural perception of health and illness, and adapt practice accordingly

direction
Requires some supervision

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

The trainee may:

  • respect religious, cultural, linguistic, and family values and differences

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:

  • confidently perform common procedures
  • identify appropriate proxy decision makers when required
  • show respect for the knowledge and expertise of colleagues
  • maximise patient autonomy in decision making

direction
Requires some supervision

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

The trainee may:

  • perform procedures when adequately supervised
  • follow procedures to ensure safe practice

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:

  • identify roles and optimal timing for diagnostic procedures
  • critically appraise information from the assessment and evaluation of risks and benefits to prioritise patients on waiting lists
  • make clinical judgements and decisions based on the available evidence
  • select the most appropriate and cost-effective diagnostic procedures
  • adapt procedures in response to assessments of risks to individual patients
  • select appropriate investigations on the samples obtained in diagnostic procedures

direction
Requires some supervision

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

The trainee may:

  • prioritise which patients receive procedures first (if there is a waiting list)
  • assess personal skill levels, and seek help with procedures when appropriate
  • use tools and guidelines to support decision making
  • recommend suboptimal procedures for patients

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:

  • explain critical steps, anticipated events, and equipment requirements to teams on planned procedures
  • provide staff with clear aftercare instructions, and explain how to recognise possible complications
  • identify relevant management options with colleagues, according to their level of training and experience, to reduce errors, prevent complications, and support efficient teamwork
  • coordinate efforts, encourage others, and accept responsibility for work done

direction
Requires some supervision

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

The trainee may:

  • ensure all relevant team members are aware that a procedure is occurring
  • discuss patients’ management plans for recovery with colleagues

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:

  • discuss serious incidents at appropriate clinical review meetings
  • initiate local improvement strategies in response to serious incidents
  • use resources efficiently when performing procedures

direction
Requires some supervision

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

The trainee may:

  • perform procedures in accordance with the organisational guidelines and policies