Curriculum standards
Curriculum standards
Advanced Training in Rheumatology (Adult Medicine)
Entrustable Professional Activities
LG5: Clinical assessment and management
Clinical assessment and management
Clinically assess and manage the ongoing care of patients
This activity requires the ability to:
- identify and access sources of relevant information about patients
- obtain patient histories
- examine patients
- synthesise findings to develop provisional and differential diagnoses
- discuss findings with patients, families, and/or carers
- generate management plans
- present findings to other health professionals
Professional practice framework domain
Medical expertise
Ready to perform without supervision
Expected behaviours of a trainee who can routinely perform this activity without needing supervision
The trainee will:
- elicit accurate, organised, and problem-focused medical histories considering physical, psychosocial, and risk factors
- perform full physical examinations to establish the nature and extent of problems
- synthesise and interpret findings from histories and examinations to devise the most likely provisional diagnoses via reasonable differential diagnoses
- assess the severity of problems, the likelihood of complications, and clinical outcomes
- develop management plans based on relevant guidelines, and consider the balance of benefit and harm by taking patients’ personal sets of circumstances into account
- provide appropriate monitoring for long-term complications
- use pre-test probability of diseases and prevalence and predictive value of certain tests
- recognise and manage risks of diagnostic biases, such as eligibility for medications used in the management of certain conditions
Requires some supervision
Possible behaviours of a trainee who needs some supervision to perform this activity
The trainee may:
- take patient-centred histories, considering psychosocial factors
- perform accurate physical examinations
- recognise and correctly interpret abnormal findings
- synthesise pertinent information to direct clinical encounters and diagnostic categories
- develop appropriate management plans
Communication
Ready to perform without supervision
Expected behaviours of a trainee who can routinely perform this activity without needing supervision
The trainee will:
- communicate openly, listen, and take patients’ concerns seriously, giving them adequate opportunity to ask questions
- communicate the risks and benefits of immunosuppression
- provide information to patients and their family or carers to enable them to make fully informed decisions from various diagnostic, therapeutic, and management options
- communicate clearly, effectively, respectfully, and promptly with other health professionals involved in patients’ care
- communicate clinical uncertainties, both diagnostic and management-related, with colleagues, patients, families, and carers
- evaluate and manage risks and benefits of treatment, and communicate these to patients
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
Quality and safety
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
- use clinical information technology systems for conducting prospective and retrospective clinical audits
- evaluate and explain the benefits and risks of investigations, clinical interventions, or proposed management plans based on individual patients’ circumstances
- coordinate and encourage innovation, and objectively evaluate improvement initiatives for outcomes and sustainability
Requires some supervision
Possible behaviours of a trainee who needs some supervision to perform this activity
The trainee may:
- perform hand hygiene, and take infection control precautions at appropriate moments
- take precaution against assaults from confused or agitated patients, ensuring appropriate care of patients
- document history and physical examination findings, and synthesise with clarity and completeness
Teaching and learning
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 solicit feedback on mutually agreed goals
- reflect upon and self-evaluate professional development regularly
- obtain informed consent before involving patients in teaching activities
- turn clinical activities into an opportunity to teach, appropriate to the setting
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
Research
Ready to perform without supervision
Expected behaviours of a trainee who can routinely perform this activity without needing supervision
The trainee will:
- search for, find, compile, analyse, interpret, and evaluate information relevant to the research subject
- select studies based on optimal trial design, freedom from bias, and precision of measurement
- remain up to date with emerging treatment options
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
- recognise the limitations of evidence and the challenges of applying research in daily practice
Cultural safety
Ready to perform without supervision
Expected behaviours of a trainee who can routinely perform this activity without needing supervision
The trainee will:
- use plain-language patient education materials, and demonstrate cultural and linguistic sensitivity
- demonstrate effective and culturally safe communication and care for Aboriginal and Torres Strait Islander peoples and Māori, and members of other cultural groups
- use a professional interpreter, health advocate, or a family or community member to assist in communication with patients, and understand the potential limitations of each
- 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
- display an understanding for cultural sensitivities
- appropriately access interpretive or culturally focused services
Ethics and professional behaviour
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
- assess patients’ capacity for decision making, involving a proxy decision maker appropriately
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
Judgement and decision making
Ready to perform without supervision
Expected behaviours of a trainee who can routinely perform this activity without needing supervision
The trainee will:
- 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 health, considering comorbidity, risk, and uncertainty
- use the best available evidence for the most effective therapies and interventions to ensure quality care
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 in an appropriate way when required
Leadership, management, and teamwork
Ready to perform without supervision
Expected behaviours of a trainee who can routinely perform this activity without needing supervision
The trainee will:
- work effectively as a member of multidisciplinary teams to achieve the best health outcomes for patients
- recognise colleagues in difficulty, and work within the appropriate structural systems to support them while maintaining patient safety
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
Health policy, systems, and advocacy
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 notifiable diseases
- aim to achieve the optimal cost-effective patient care to allow maximum benefit from the available resources
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