Nephrology curriculum standards

Ready to perform without supervision

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

The trainee will:

• accurately document procedures 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/or 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’ and families’ and/or carers’ concerns relating to procedures, providing opportunities to ask questions
• tailor language according to patients’ age and capacity to understand
• communicate effectively with team members, patients, and family and/or carers prior to, during, and after procedures
• ensure team members are confident and competent in their assigned roles

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 and family and/or carers to choose the procedure
• communicate with members of procedural teams so all team members understand who each member is
• discuss post-procedural care with patients and family and/or carers
• complete relevant patients’ documentation and conduct an appropriate clinical handover

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 and verify the procedure and, where appropriate, the correct site/side/level for the procedure
• ensure that information on patients’ consent forms match procedures to be performed
• identify, document, and appropriately notify of any adverse event or equipment malfunction
• explain the risk and benefit associated with a kidney biopsy
• gain informed consent regarding kidney biopsy
• explain the risks, safety benefits, and consequences of dialysis access
• conduct a quality kidney biopsy based on current guidelines

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/or carers are fully informed when consenting to any procedure
• demonstrate an inconsistent application of aseptic technique
• identify patients using approved patients’ identifiers before any treatment or intervention is initiated
• attempt to perform a procedure in an unsafe environment

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

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 to develop new skills
• actively seek feedback on personal technique until competent

Ready to perform without supervision

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

The trainee will:

• understand individual patients’ cultural perceptions 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

Ready to perform without supervision

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

The trainee will:

• confidently perform common procedures
• identify appropriate substitute decision makers when required
• show respect for knowledge and expertise of colleagues
• maximise patient autonomy in decision making

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

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 timings for diagnostic procedures
• critically appraise information from assessments and evaluations 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

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 level, and seek help with procedures when appropriate
• use tools and guidelines to support decision making
• recommend suboptimal procedures for patients

Ready to perform without supervision

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

The trainee will:

• explain critical steps, anticipated events, 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

Requires some supervision

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

The trainee may:

• ensure all relevant team members are aware that a procedure is occurring
• discuss patients’ management plans for recovery with colleagues

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

Requires some supervision

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

The trainee may:

• perform procedures in accordance with organisational guidelines and policies