Curriculum standards

Ready to perform without supervision

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

The trainee will:

• document procedures accurately 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
• check team members are confident and competent in their assigned roles
• explain to patients the potential benefits, burdens, costs, risks, and side effects of each option, including the option to have no investigations or procedures
• use clear and simple language, and check that patients understand the terms used and agree to proceed with proposed investigations
• identify patients’ concerns and expectations, providing adequate explanations on the rationale for individual test ordering
• confirm whether patients understand the information they have been given, and whether they need more information before deciding
• use written or visual material or other aids that are accurate and up to date to support discussions with patients
• explain findings or possible outcomes of investigations to patients, families, and carers
• give information that patients may find distressing in a considerate way

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
• discuss the indications, benefits, complications, and risks of investigations with patients before ordering investigations
• explain the results of investigations to patients
• arrange investigations, providing accurate and informative referrals, and liaise with other services where appropriate

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
• check that information on patients’ consent forms matches procedures to be performed
• identify, document, and appropriately notify of any adverse events or equipment malfunction
• identify adverse outcomes that may result from proposed investigations, focusing on patients’ individual situations

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 treatments or interventions are initiated
• perform a procedure in an unsafe environment
• consider safety aspects of investigations when planning them
• seek help with interpretation of test results for less common tests or indications or unexpected results

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
• use appropriate guidelines, evidence sources, and decision support tools
• participate in clinical audits to improve test ordering strategies for diagnoses and screening

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
• undertake professional development to maintain currency with investigation guidelines

Ready to perform without supervision

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

The trainee will:

• provide patients with relevant information if a proposed investigation is part of a research program
• obtain written consent from patients if the investigation is part of a research program

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
• consult current research on investigations

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

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
• consider patients’ cultural and religious backgrounds, attitudes, and beliefs, and how these might influence the acceptability of proposed investigations

Ready to perform without supervision

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

The trainee will:

• perform common procedures confidently
• identify appropriate proxy decision makers when required
• show respect for knowledge and expertise of colleagues
• maximise patient autonomy in decision making
• remain within the scope of the authority given by patients (with the exception of emergencies)
• discuss with patients how decisions will be made once the investigation has started and the patient is not able to participate in decision making
• respect patients’ decisions to refuse investigations, even if their decisions may not be appropriate or evidence based
• advise patients when there may be additional costs, which they may wish to clarify before proceeding
• explain the expected benefits as well as the potential burdens and risks of any proposed investigations before obtaining informed consent or other valid authority
• demonstrate awareness of complex issues related to genetic information obtained from investigations, and subsequent disclosure of such information
• acknowledge patients’ beliefs and values, and how these might impact on health
• incorporate Māori views on health, including the four cornerstones of the Māori health model known as te whare tapa whā

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
• identify appropriate proxy decision makers when required
• choose not to investigate in situations where it is not appropriate for ethical reasons
• practise within current ethical and professional frameworks
• practise within own limits, and seek help when needed
• involve patients in decision making regarding investigations, obtaining the appropriate informed consent, including financial consent, if necessary

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 a waiting list
• make clinical judgements and decisions based on 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
• evaluate the benefits, costs, and potential risks of each investigation in a clinical situation
• adjust the investigative path depending on test results received
• consider whether patients’ conditions may get worse or better if no tests are selected

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
• seek help for choosing the optimal procedures for patients when needed
• choose the most appropriate investigations for clinical scenarios in discussion with patients
• 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:

• explain anticipated events, critical steps, 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 error, prevent complications, and support efficient teamwork
• coordinate efforts, encourage others, and accept responsibility for work done
• assess the roles that other members of the healthcare team perform, and what other sources of information and support are available
• check results in a timely manner, taking responsibility for following up results

Requires some supervision

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

The trainee may:

• check that all relevant team members are aware that a procedure is occurring
• discuss patients’ management plans for recovery with colleagues
• demonstrate understanding of what parts of investigations are provided by different doctors or health professionals

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
• select and justify investigations regarding the pathological basis of disease, appropriateness, cost effectiveness, safety, and utility
• consider resource use through peer review of testing behaviours

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