Curriculum standards

Ready to perform without supervision

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

The trainee will:

• write accurate, clear, complete, and timely 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 transitions of care and follow-up plans, and engage and support these parties in decision making
• apply communication and networking skills within the regional perinatal service
• encourage patients’ self-management through education to take greater responsibility for their care, and support problem solving
• encourage patients’ access to self-monitoring devices and assistive technologies
• communicate with multidisciplinary team members, and involve patients in that dialogue
• communicate with health providers for continuity of ongoing care outside the neonatal and early childhood setting
• counsel patients about the impact of long-term illness on the child and family

Requires some supervision

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

The trainee may:

• 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 effective transitions between settings and continuity and quality of care
• provide healthy lifestyle advice and information to patients on the importance of self-management
• work in partnership with patients, and support them in accessing the care they need

Ready to perform without supervision

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

The trainee will:

• identify patients at risk of poor transitions of care, and implement strategies to mitigate this risk
• use standardised handover tools to ensure a systematic and complete handover of relevant patient information
• 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
• recognise the medicolegal context of written communications
• use innovative models of chronic disease 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 them become more independent
• participate in quality improvement processes impacting on patients’ abilities to undertake normal activities of daily living
• follow up patients with the multidisciplinary team
• discuss the impact of polypharmacy in chronic illnesses

Requires some supervision

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

The trainee may:

• ensure that handover is complete, or work to mitigate risks if 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
• participate in continuous quality improvement processes and clinical audits on chronic disease management
• identify activities that may improve patients’ quality of life

Ready to perform without supervision

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

The trainee will:

• integrate clinical education in handover sessions and other transition of care meetings
• tailor clinical education to the level of the professional parties involved
• contribute to the development of clinical pathways for chronic diseases management based on current clinical guidelines
• educate patients to recognise and monitor their symptoms, and undertake strategies to assist their recovery

Requires some supervision

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

The trainee may:

• 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:

• prepare reviews of literature on patients’ encounters to present at journal club meetings
• 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) format
• 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:

• communicate with careful consideration to health literacy, language barriers, and culture regarding patient preferences, and whether they are realistic and possible, respecting patient choices
• recognise the timing, location, privacy, and appropriateness of sharing information with patients
• encourage patients from culturally and linguistically diverse backgrounds to join local networks to receive the support needed for long-term self-management
• apply culturally safe practices to enhance patients’ and families’ care journeys

Requires some supervision

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

The trainee may:

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

Ready to perform without supervision

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

The trainee will:

• disclose and share only contextually appropriate medical and personal information
• comprehend the clinical, ethical, and legal rationale for information disclosure
• share information about patients’ care in a manner consistent with privacy laws and professional guidelines on confidentiality
• comprehend 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
• use consent processes for the release and exchange of health information
• assess patients’ decision-making capacity, and appropriately identify and use proxy decision makers

Requires some supervision

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

The trainee may:

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

Ready to perform without supervision

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

The trainee will:

• ensure patients’ care is in the most appropriate facility, setting, or provider
• 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 long-term health care journeys

Requires some supervision

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

The trainee may:

• use a structured approach to consider and prioritise patients’ issues
• 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:

• share the workload of transitions of care appropriately, including delegation
• recognise 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
• coordinate whole-person care through involvement in all stages of patients’ care journeys
• use a multidisciplinary approach across services to manage patients with chronic diseases and impairments
• develop collaborative relationships with patients and a range of health professionals
• collaborate with paramedical staff, multidisciplinary teams, and community services
• integrate care of sick neonates, considering multisystem interactions and long-term implications of complications of care in severely ill neonates
• demonstrate multidisciplinary support, including local medical officers and community services
• plan and appropriately manage transitions of patients and their families to ongoing care providers

Requires some supervision

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

The trainee may:

• recognise factors that impact transfers 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 handover in overcoming these barriers
• participate in multidisciplinary care for patients with chronic diseases and impairments, including organisational and community care on a continuing basis, appropriate to patients’ context

Ready to perform without supervision

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

The trainee will:

• explain the regional organisation of health services in the outpatient setting and how to access them, such as postnatal services, dietetics, or physiotherapists
• explain the organisation of hospital extension services as transitions to outpatient care, such as extended postnatal care, hospital in the home, and home enteral nutrition services for enteral tube feeding
• explain the organisation of outreach educational programs
• explain the organisation of perinatal / neonatal transport programs
• recognise the requirements for down transfers of convalescent infants
• contribute to processes for managing risks, and identify strategies for improvements in transitions of care
• engage in organisational processes to improve transitions of care, such as formal surveys or follow-up phone calls after hospital discharge
• use health screening for early intervention and chronic diseases management
• assess alternative models of health care delivery to patients with chronic diseases and impairments
• participate in government initiatives for chronic disease management to reduce hospital admissions and improve patients’ quality of life
• show patients how to access initiatives and services for patients with chronic diseases and impairments
• recognise when a child is at risk, and escalate concerns to relevant child protection services as required

Requires some supervision

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

The trainee may:

• factor transport issues and costs to patients into arrangements for transferring patients to other settings
• demonstrate awareness of government services and initiatives available for patients with chronic diseases and disabilities, and display knowledge of how to access them