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 openly, actively listen, and take patients’ concerns seriously, giving them adequate opportunity to ask questions
• incorporate appropriate LGBTQIA+ safe language, including gender affirming language
• engage patients in exploration of the biological, psychological, and social components of their illness
• provide information to patients and their family or carers to enable them to make fully informed decisions from various diagnostic, therapeutic, and management options
• assess decision-making capacity, and review patients who want to discharge against medical advice
• explain and discuss the risks, benefits, and costs (monetary and adverse effects) of diagnostic and therapeutic interventions
• discuss prognosis, and formulate realistic treatment goals
• collaborate with other specialties to balance conflicting treatment choices with patients’ overall best interests
• explain medical management plans clearly and promptly as part of a multidisciplinary team
• check quality and accuracy of reports or documentation generated by others and technologies, including artificial intelligence-informed large language models
• demonstrate effective strategies to minimise patient risk at points of clinical handover / change in patient care providers
• support patients and families in adjusting to acute and chronic illness
• provide clear and concise medicolegal and administrative reports
• provide timely updates to both patients and other healthcare providers in the event of a change in clinical condition or management
• discuss emotive issues with sensitivity, such as futility, limits of care, patient deterioration, and impending or unexpected death

Requires some supervision

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

The trainee may:

• anticipate, read, and respond to verbal and nonverbal cues
• demonstrate active listening skills
• communicate patients’ situations to colleagues, including senior clinicians

Ready to perform without supervision

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

The trainee will:

• demonstrate safety skills, including infection control, adverse event reporting, and effective clinical handover
• recognise and effectively deal with aggressive and violent patient behaviours through appropriate training
• be aware of gender stereotypes and bias, including the importance of using correct pronouns
• obtain informed consent before undertaking any investigation or providing treatment (except in an emergency)
• ensure patients are informed of the material risks associated with any part of proposed management plans
• ensure patients’ safety while avoiding inappropriate overuse of investigations
• practice open disclosure in the event of medical error
• report any perceived risk to clinical safety, such as inadequate staffing levels or access blocks
• demonstrate an awareness of evolving concepts and approaches to quality and safety improvement, and management of risks within organisations
• demonstrate an ability to weigh the risk / benefit of proposed treatments against the risk / benefit of doing nothing

Requires some supervision

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

The trainee may:

• document history and physical examination findings, and synthesise with clarity and completeness
• take precaution against assaults from confused or agitated patients, ensuring appropriate care of patients
• perform hand hygiene, and take infection control precautions at appropriate moments

Ready to perform without supervision

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

The trainee will:

• set defined objectives for clinical teaching encounters, and elicit feedback on mutually agreed goals
• self-evaluate clinical practice
• obtain informed consent before involving patients in teaching activities
• turn clinical activities into an opportunity to teach, appropriate to the setting
• engage in continual professional development activities
• consolidate dissonance between clinical heuristics and evidence-based medicine
• demonstrate methods for updating clinical beliefs and practices as new valid evidence becomes available

Requires some supervision

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

The trainee may:

• set unclear goals and objectives for self-learning
• self-reflect infrequently
• deliver teaching considering learners’ level of training

Ready to perform without supervision

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

The trainee will:

• demonstrate the ability to accurately interrogate available literature when required for clinical care
• critically appraise literature, demonstrate awareness of limitations, and apply available evidence to the diagnosis and management of patients
• formulate research questions relevant to clinical practice and health systems to address practice gaps or ongoing needs
• foster enquiry and research among colleagues in response to unanswered clinical questions
• be aware of active clinical trials being undertaken in the workplace
• explain how to report possible adverse events for patients participating in clinical trials
• characterise personal clinical reasoning style and determine its alignment with evidence-based approaches

Requires some supervision

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

The trainee may:

• refer to guidelines and medical literature to assist in clinical assessments when required
• demonstrate awareness of the limitations of 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:

• explain the need for culturally safe care
• recognise the specific challenges for patients from culturally diverse backgrounds
• explain cultural diversity and how this affects patients’ health and interactions with the healthcare system
• use culturally specific patient resources and physical spaces when available
• use professional language interpreters and translated written material when available
• engage specific support services when available, such as Aboriginal liaison services and Hāpai Kaimahi Hauora
• ask patients about their preferences, such as name, family involvement, and same-gendered staff
• be aware of gender stereotypes and bias, including the importance of using correct pronouns
• demonstrate effective and culturally safe communication and care for Aboriginal and Torres Strait Islander peoples and Māori, and members of other cultural groups
• acknowledge patients’ beliefs and values, and how these might impact on health

Requires some supervision

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

The trainee may:

• display respect for patients’ cultures, and attentiveness to social determinants of health
• be cognisant of at least the most prevalent cultures in society, and an appreciation of their sensitivities
• appropriately access interpretive or culturally focused services

Ready to perform without supervision

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

The trainee will:

• demonstrate professional values, including compassion, empathy, respect for diversity, integrity, honesty, and partnership to all patients
• hold information about patients in confidence, unless the release of information is required by law or public interest
• reflect on cases where clinical enquiry and judgements have led to incorrect clinical decisions

Requires some supervision

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

The trainee may:

• demonstrate professional conduct, honesty, and integrity
• consider patients’ decision-making capacity
• identify patients’ preferences regarding management and the role of families in decision making
• not advance personal interest or professional agendas at the expense of patient or social welfare
• identify local requirements for informed consent

Ready to perform without supervision

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

The trainee will:

• assess patients’ capacity for decision making, involving a proxy decision maker appropriately
• explain the range of certainty around diagnoses, and the benefits and risks of treatments
• apply knowledge and experience to identify patients’ problems, making logical, rational decisions, and acting to achieve positive outcomes for patients
• use a holistic approach to patient care, considering comorbidity, uncertainty risk, and patient preference
• use the best available evidence for the most effective therapies and interventions to ensure quality care
• evaluate the value of diagnostic tests in terms of sensitivity, specificity, likelihood ratios, predictive value, cost effectiveness, reproducibility, and patient convenience
• implement processes to facilitate reflection and review of clinical cases that elicited doubt or uncertainty
• appraise the accuracy, relevance, and ability to implement recommendations provided by other specialists
• reconcile conflicting advice from other specialties, and apply judgement in making clinical decisions in the presence of uncertainty
• recognise and acknowledge when the diagnosis is not clear despite appropriate investigation
• identify situations where integrated care is in the best interests of individual patients
• recognise own limitations and seek help, when required, in an appropriate way

Requires some supervision

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

The trainee may:

• demonstrate clinical reasoning by gathering focused information relevant to patients’ care
• recognise personal limitations and seek help, when required, in an appropriate way

Ready to perform without supervision

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

The trainee will:

• determine the appropriate admitting team based on the care needs for individual patients, and be able to negotiate with other admitting teams
• set clear parameters for monitoring medical illness and/or escalating medical care
• demonstrate ability to recognise a colleague in difficulty, and how to evaluate and address the potential implications on their wellbeing and risk, and on patient safety
• collaborate with specialty colleagues, and facilitate their input to provide optimal patient care
• collaborate with allied health disciplines to ensure effective multidisciplinary teamwork
• manage under-performing staff members
• deal with conflict in a constructive and respectful way
• demonstrate task delegation to maximise efficiency and the appropriate use of individual skill sets and teaching / learning without compromising patient safety
• recognise factors required to build an effective team
• demonstrate and encourage effective time management and task prioritisation while working within a team
• give both positive and negative feedback to staff members under supervision

Requires some supervision

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

The trainee may:

• share relevant information with members of the healthcare team

Ready to perform without supervision

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

The trainee will:

• participate in health promotion, disease prevention and control, screening, and reporting of notifiable diseases
• contribute to the development of guidelines and protocols
• explain the difficulties of balancing equitable resource allocation
• recognise key equity determinants as they pertain to clinical care, and devise strategies to address them
• be familiar with institutional support frameworks and options when advocating for patients or disadvantaged populations
• communicate system-level concerns through appropriate local channels
• advocate for high cost or off-label medication for individual patients when needed
• work with healthcare systems to develop innovative ways to balance quality care delivery with resource limitations and cost
• contribute to clinical redesign projects
• advocate for all disadvantaged, unsupported, and/or vulnerable patient groups to improve access and delivery of care
• consider the importance of environmental sustainability when designing health systems and policies

Requires some supervision

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

The trainee may:

• identify and navigate components of the healthcare system relevant to patients’ care
• identify and access relevant community resources to support patients’ care