Entrustable Professional Activities

LG8: Communication with patients

Learning Goal 8

Communication with patients

Discuss diagnoses and management plans with patients

This activity requires the ability to:

  • select suitable contexts, and include patients, their families, whānau, and/or carers, and other team members
  • adopt a patient-centred perspective, including adjusting for developmental stage and disabilities
  • select and use appropriate modalities and communication strategies
  • structure conversations intentionally
  • facilitate and guide discussion, encouraging participation from patients and families
  • integrate information from the multidisciplinary team to outline care considerations and identify shared goals
  • negotiate mutually agreed management plans
  • manage conflict as it arises
  • verify patients’, their families’, whānau, and/or carers’ understanding of information conveyed
  • develop and implement plans to ensure actions occur
  • document conversations

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:

  • anticipate and correct any misunderstandings patients may have about their conditions and/or risk factors
  • inform patients of all aspects of their clinical management, including assessments and investigations, giving adequate opportunity to question or refuse interventions and treatments
  • seek to understand the concerns and goals of patients, and plan management in partnership with them
  • provide information to patients to enable them to make informed decisions about diagnostic, therapeutic, and management options
  • factor in diverse views from patients, families, carers, and medical teams into goals and planning
  • explore and facilitate realistic goals, wishes, and ways of successfully managing patients’ functional activities on a day-to-day basis

direction
Requires some supervision

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

The trainee may:

  • apply knowledge of the scientific basis of health and disease to the management of patients
  • demonstrate an understanding of clinical problems being discussed
  • formulate management plans in partnership with 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:

  • use an appropriate communication strategy and modalities for communication, such face-to-face, videoconferencing, phone calls, and email
  • elicit patients’ views, concerns, and preferences, promoting rapport
  • provide information to patients in plain language, avoiding jargon, acronyms, and complex medical terms
  • encourage questions, and answer them thoroughly
  • ask patients to share their thoughts or explain their management plans in their own words, to verify understanding
  • convey information considerately and sensitively to patients, seeking clarification if unsure of how best to proceed
  • respond to patients’, families’, whānau, and/or carers’ emotions regarding discussions
  • treat children (tamariki) and young people respectfully, and listen to their views
  • use communication aids, such as interpreters, to enable patients to partake in discussions
  • communicate the outcomes of family meetings to wider team members who were absent from meetings
  • debrief after difficult and/or emotionally charged meetings

direction
Requires some supervision

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

The trainee may:

  • select appropriate modes of communication
  • engage patients in discussions, without jargon
  • check patients’ understanding of information
  • adapt communication style in response to patients’ age, developmental level, and cognitive, physical, cultural, socioeconomic, and situational factors
  • collaborate with patient liaison officers and/or advocacy team members as required

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:

  • create a safe and supportive environment to enable patients to explore and discuss plans or goals during family meetings
  • discuss with patients their condition and available management options, including potential benefits and harms
  • consider young people’s capacity for decision making and consent
  • provide patients with clear information, checking their understanding before asking for their consent
  • recognise and take precautions where patients may be vulnerable, such as issues of child protection or self-harm
  • participate in processes to manage adverse events and patient complaints

direction
Requires some supervision

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

The trainee may:

  • inform patients of the risks associated with proposed management plans
  • treat information about patients as confidential

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:

  • discuss the aetiology of diseases, and explain the purpose, nature, and extent of the assessments and management to be conducted
  • obtain informed consent or other valid authority before involving patients in teaching

direction
Requires some supervision

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

The trainee may:

  • respond appropriately to information sourced by patients, and to patients’ knowledge regarding their condition

Research

confident
Ready to perform without supervision

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

The trainee will:

  • provide information to patients that is based on evidence-based guidelines
  • provide information to patients in a way they can understand before asking for their consent to participate in research
  • obtain informed consent or other valid authority before involving patients in research

direction
Requires some supervision

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

The trainee may:

  • refer to evidence-based clinical guidelines
  • recognise the limitations of the evidence and the challenges of applying research in daily practice

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:

  • demonstrate effective and culturally safe communication with all groups, including Aboriginal and Torres Strait Islander peoples and Māori
  • effectively communicate by meeting patients’ specific language, cultural, and communication needs
  • provide plain language and culturally safe written materials to patients when possible

direction
Requires some supervision

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

The trainee may:

  • identify when to use interpreters
  • allow enough time for communication across linguistic and cultural barriers

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:

  • promote health literacy for patients and their families and carers
  • encourage and support patients, their families, whānau, and/or carers in caring for themselves and managing their health
  • demonstrate respectful professional relationships with patients
  • prioritise patients’ welfare and community benefit above self-interest
  • develop a high standard of personal conduct, consistent with professional and community expectations
  • support patients’ rights to seek second opinions
  • recognise that the values, biases, or perspectives of patients, physicians, and other health professionals may have an impact on patient care, and modify the approach to patients accordingly

direction
Requires some supervision

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

The trainee may:

  • respect the preferences of patients
  • communicate appropriately, consistent with the context, and respect patients’ needs and preferences
  • maximise patient autonomy, and support their decision making
  • demonstrate a caring attitude towards patients
  • respect patients, including protecting their rights to privacy and confidentiality
  • use social media ethically and according to legal obligations to protect patients’ confidentiality and privacy
  • behave equitably towards all, irrespective of gender, age, culture, socioeconomic status, sexual preferences, beliefs, contribution to society, illness-related behaviours, or the illness itself

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:

  • communicate effectively with team members involved in patients’ care, and with patients, families, whānau, and/or carers
  • discuss medical assessments, treatment plans, and investigations with patients and primary care teams, working collaboratively with all
  • discuss patients’ care needs with healthcare team members to align them with the appropriate resources
  • facilitate an environment in which all team members feel they can contribute, and their opinion is valued
  • lead conflict resolution within the multidisciplinary team
  • communicate accurately and succinctly, and motivate others on the healthcare team

direction
Requires some supervision

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

The trainee may:

  • address questions from team members, and participate in conflict resolution within the team
  • summarise, clarify, and communicate responsibilities of healthcare team members
  • keep healthcare team members focused on patient goals and outcomes

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:

  • collaborate with other services to help patients navigate the health, education, and disability systems

direction
Requires some supervision

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

The trainee may:

  • communicate with and involve other professionals and agencies as appropriate