Entrustable Professional Activities

LG6: Communication

Learning Goal 6

Communication with patients and health professionals

Communicate effectively and professionally with patients, carers, families, health professionals, and other community members engaging with the health service

This activity requires the ability to:

  • select suitable contexts and include family, whānau, and/or carers, and other team members
  • communicate with team members and other health professionals across different contexts and modalities
  • adopt a patient-centred perspective, including adjusting for cognition and disabilities
  • select and use appropriate modalities and communication strategies
  • synthesise clinical information into accurate and safe handovers and summaries
  • structure conversations intentionally, respectfully, and professionally
  • negotiate mutually agreed plans
  • verify patients’ understanding of information conveyed
  • develop and implement plans to ensure actions occur
  • deliver education to patients, families, and health professionals at appropriate levels of understanding
  • 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
  • clearly communicate the working diagnosis, other possible diagnoses, and rationale behind management plans to patients and other health professionals
  • inform patients of all aspects of their clinical management, including assessments and investigations
  • provide information to patients to enable them to make informed decisions about diagnostic, therapeutic, and management options
  • provide patients with adequate opportunity to question or refuse interventions and treatments
  • listen to and discuss the concerns and goals of patients, and plan management in partnership with them
  • synthesise clinical information into clear, accurate, safe, and professional summaries and handovers
  • present succinct clinical cases to colleagues, provide justification for proposed plans, and raise points for discussion

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 appropriate communication strategies and modalities for communication, such as emails, face-to-face, or phone calls
  • 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 their understanding
  • convey information considerately and sensitively to patients, seeking clarification if unsure of how best to proceed
  • communicate clearly, effectively, respectfully, and promptly with other health professionals and stakeholders involved in patients’ care
  • communicate respectfully and collaboratively in all discussions in the healthcare setting
  • treat children and young people respectfully, and listen to their views
  • recognise the role of family or carers, and, when appropriate, encourage patients to involve their family or carers in decisions about their care

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, avoiding the use of 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 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:

  • discuss with patients their condition and the available management options, including potential benefits and harms
  • provide information to patients in a way they can understand before asking for their consent
  • consider young people’s capacity for decision making and consent
  • recognise and take precautions where patients may be vulnerable, such as issues of child protection, self-harm, or elder abuse
  • participate in processes to manage patient complaints in an appropriate setting
  • store documented communication securely, with appropriate access and confidentiality

direction
Requires some supervision

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

The trainee may:

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

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 to be conducted
  • obtain informed consent or other valid authority before involving patients in teaching
  • communicate any research findings to appropriate stakeholders

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 guidelines issued by the Health Research Council of New Zealand
  • provide information to patients in a way they can understand before asking for their consent to participate in research
  • obtain an 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
  • demonstrate an understanding of 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 Māori (tangata whenua) and Pacific peoples
  • communicate safely with members of other cultural groups by respecting patients’ specific language, cultural, and communication needs
  • use qualified language interpreters or cultural interpreters to help meet patients’ communication needs
  • provide plain language and culturally safe written materials to patients when possible
  • incorporate Māori views on health, including the four cornerstones of the Māori health model known as te whare tapa whā
  • acknowledge patients’ beliefs and values, and how these might impact on health

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:

  • encourage and support patients to be well informed about their health, and to use information wisely when they make decisions
  • encourage and support patients, and, when relevant, their families or carers, in caring for themselves and managing their health
  • demonstrate respectful professional relationships with patients
  • prioritise honesty, 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

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

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, and 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 appropriate resources
  • facilitate an environment in which all team members feel they can contribute, and their opinion is valued
  • 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:

  • answer questions from team members
  • summarise, clarify, and communicate responsibilities of healthcare team members
  • keep healthcare team members focused on patient 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, such as community health centres and consumer organisations, to help patients navigate the healthcare system

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 health professionals as appropriate