Entrustable Professional Activities

EPA 8: Procedures

EPA 8

Procedures

Plan, prepare for, perform, and provide aftercare for important practical procedures and investigations

This activity requires the ability to:

  • evaluate the anticipated value of the procedure or investigation
  • select appropriate procedures or investigations in partnership with patients and their family members or carers
  • communicate potential risks and benefits prior to obtaining informed consent
  • set up the equipment, maintaining an aseptic field
  • perform procedures and investigations where appropriate
  • manage unexpected events and complications during and after procedures and investigations
  • provide aftercare for patients
  • communicate aftercare protocols and instructions to patients and medical and nursing staff
  • interpret the results and outcomes of procedures and investigations, including imaging and reports
  • communicate the outcome of procedures and associated investigations to patients
  • perform this activity across multiple relevant settings

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:

  • select procedures and investigations by assessing patient-specific factors, risks, benefits, and alternatives
  • confidently and consistently perform a range of common procedures and investigations
  • ensure that team members are aware of all allergies/adverse reactions identified, and take precautions to avoid allergies/adverse reactions during procedures or investigations
  • ensure patients have complied with pre-procedure preparation
  • confirm the correct position/site/side/level on the patient for the planned procedure
  • recognise and manage effectively complications arising during or after procedures or investigations
  • recognise and correctly interpret normal and abnormal findings of diagnostic procedures or investigations

direction
Requires some supervision

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

The trainee may:

  • assess patients and identify indications for procedures or investigations
  • check for allergies and adverse reactions
  • consider risks and complications of procedures or investigations
  • interpret results of common diagnostic procedures or investigations
  • perform a range of common procedures and investigations
  • understand the significance of abnormal test results, and act on them
  • organise and document post-procedure or investigation reviews of 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:

  • explain procedures and investigations clearly to patients, family or carers, including reasons for procedures or investigations, possible risks, benefits, burdens, costs, side effects, and potential alternatives, including the option to have no investigations or procedures
  • counsel patients sensitively and effectively, and support them to make informed choices
  • address patients' and family or carers' concerns relating to procedures or investigations, providing opportunities to ask questions
  • tailor language according to patients' age and capacity to understand
  • communicate effectively with team members, patients, family and carers prior to, during, and after procedures or investigations
  • accurately document procedures and investigations in the clinical notes, including informed consent, procedures or investigations requested and performed, reasons for procedures or investigations, medicines given, aseptic technique, and aftercare

direction
Requires some supervision

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

The trainee may:

  • explain the process of procedures or investigations to patients without providing a broader context
  • help patients, family or carers to choose procedures or investigations
  • communicate with members of procedural teams so all team members understand who each member is
  • discuss post-procedural care with patients, family or carers
  • complete relevant patients' documentation and conduct an appropriate clinical handover

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:

  • identify adverse outcomes that may result from proposed investigations and procedures, focusing on patients' individual situations
  • obtain informed consent or other valid authority before undertaking any procedure or investigation
  • set up all necessary equipment, and consistently use universal precautions and aseptic technique
  • confirm patients' identification, verify the procedure or investigation, and, where appropriate, the correct site/side/level for the procedure or investigation
  • ensure that information on patients' consent forms matches procedures or investigations to be performed
  • identify, document, and appropriately notify of any adverse event or equipment malfunction

direction
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 patients, family or carers are fully informed when consenting to any procedure or investigation
  • 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 or investigation in an unsafe environment
  • seek help with interpretation of test results for less common tests or indications or unexpected results

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:

  • refer to and/or be familiar with relevant published guidelines prior to undertaking procedures or investigations
  • 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

direction
Requires some supervision

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

The trainee may:

  • participate in continued professional development to maintain currency with investigation guidelines
  • help junior colleagues develop new skills
  • actively seek feedback on personal technique until competent

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

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
  • consult current research on investigations and procedures

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:

  • consider individual patients’ cultural perceptions of health and illness, and adapt practice accordingly

direction
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

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:

  • confidently perform common procedures or investigations
  • identify appropriate proxy decision makers when required
  • show respect for knowledge and expertise of colleagues
  • maximise patient autonomy in decision making
  • respect patients' decisions to refuse investigations or procedures, even if their decisions may not be appropriate or evidence based
  • demonstrate awareness of complex issues related to genetic information obtained from investigations or procedures, and subsequent disclosure of such information

direction
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

Judgement and decision making

confident
Ready to perform without supervision

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

The trainee will:

  • identify role and optimal timing for diagnostic procedures and investigations
  • evaluate the costs, benefits, and potential risks of each investigation or procedure in a clinical situation
  • adapt procedures or investigations in response to assessments of risks to individual patients
  • make clinical judgements and decisions based on the available evidence

direction
Requires some supervision

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

The trainee may:

  • prioritise which patients receive procedures or investigations first (if there is a waiting list)
  • recognise personal limitations and seek help (e.g. from heart team) in an appropriate way when required
  • use tools and guidelines to support decision making
  • recommend suboptimal procedures or investigations for patients

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:

  • explain critical steps, anticipated events, and equipment requirements to teams on planned procedures or investigations
  • 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
  • ensure team members are confident and competent in their assigned roles

direction
Requires some supervision

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

The trainee may:

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

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:

  • discuss serious incidents at appropriate clinical review meetings
  • initiate local improvement strategies in response to serious incidents
  • use resources efficiently when performing procedures

direction
Requires some supervision

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

The trainee may:

  • perform procedures and investigations in accordance with the organisational guidelines and policies

For each procedure/investigation, trainees should be able to perform the components of the procedure indicated below. Please select a procedure/investigation from the dropdown to see its components.

Yes

Not applicable n/a

Evaluate the anticipated value of the procedure /investigation

Communicate potential risks and benefits prior to obtaining informed consent

Set up the equipment, maintaining an aseptic field

n/a

Perform procedures/ investigations where appropriate

n/a

Manage unexpected events and complications during and after procedures/ investigations

 

Provide aftercare for patients

Communicate after-care protocols and instructions to patients and medical and nursing staff

Interpret the results/ outcomes of procedures/ investigations, including imaging and reports

Communicate the outcome of the procedure and associated investigations to patients

Perform this activity across multiple relevant settings

n/a

Evaluate the anticipated value of the procedure /investigation

Communicate potential risks and benefits prior to obtaining informed consent

Set up the equipment, maintaining an aseptic field

n/a

Perform procedures/ investigations where appropriate

n/a

Manage unexpected events and complications during and after procedures/ investigations

 

Provide aftercare for patients

Communicate after-care protocols and instructions to patients and medical and nursing staff

Interpret the results/ outcomes of procedures/ investigations, including imaging and reports

Communicate the outcome of the procedure and associated investigations to patients

Perform this activity across multiple relevant settings

n/a

Evaluate the anticipated value of the procedure /investigation

Communicate potential risks and benefits prior to obtaining informed consent

Set up the equipment, maintaining an aseptic field

Perform procedures/ investigations where appropriate

n/a

Manage unexpected events and complications during and after procedures/ investigations

 

Provide aftercare for patients

Communicate after-care protocols and instructions to patients and medical and nursing staff

Interpret the results/ outcomes of procedures/ investigations, including imaging and reports

Communicate the outcome of the procedure and associated investigations to patients

Perform this activity across multiple relevant settings

n/a

Evaluate the anticipated value of the procedure /investigation

Communicate potential risks and benefits prior to obtaining informed consent

Set up the equipment, maintaining an aseptic field

Perform procedures/ investigations where appropriate

n/a

Manage unexpected events and complications during and after procedures/ investigations

 

Provide aftercare for patients

Communicate after-care protocols and instructions to patients and medical and nursing staff

Interpret the results/ outcomes of procedures/ investigations, including imaging and reports

Communicate the outcome of the procedure and associated investigations to patients

Perform this activity across multiple relevant settings

n/a

Evaluate the anticipated value of the procedure /investigation

Communicate potential risks and benefits prior to obtaining informed consent

Set up the equipment, maintaining an aseptic field

Perform procedures/ investigations where appropriate

Manage unexpected events and complications during and after procedures/ investigations

 

Provide aftercare for patients

Communicate after-care protocols and instructions to patients and medical and nursing staff

Interpret the results/ outcomes of procedures/ investigations, including imaging and reports

Communicate the outcome of the procedure and associated investigations to patients

Perform this activity across multiple relevant settings

n/a

Evaluate the anticipated value of the procedure /investigation

Communicate potential risks and benefits prior to obtaining informed consent

Set up the equipment, maintaining an aseptic field

Perform procedures/ investigations where appropriate

n/a

Manage unexpected events and complications during and after procedures/ investigations

 

Provide aftercare for patients

Communicate after-care protocols and instructions to patients and medical and nursing staff

Interpret the results/ outcomes of procedures/ investigations, including imaging and reports

Communicate the outcome of the procedure and associated investigations to patients

n/a

Perform this activity across multiple relevant settings

n/a

Evaluate the anticipated value of the procedure /investigation

Communicate potential risks and benefits prior to obtaining informed consent

Manage unexpected events and complications during and after procedures/ investigations

Provide aftercare for patients

Communicate after-care protocols and instructions to patients and medical and nursing staff

 

Interpret the results/ outcomes of procedures/ investigations, including imaging and reports

Communicate the outcome of the procedure and associated investigations to patients

Perform this activity across multiple relevant settings

n/a

Evaluate the anticipated value of the procedure /investigation

Communicate potential risks and benefits prior to obtaining informed consent

Manage unexpected events and complications during and after procedures/ investigations

Provide aftercare for patients

Communicate after-care protocols and instructions to patients and medical and nursing staff

 

Interpret the results/ outcomes of procedures/ investigations, including imaging and reports

Communicate the outcome of the procedure and associated investigations to patients

Perform this activity across multiple relevant settings

n/a

Evaluate the anticipated value of the procedure /investigation

Communicate potential risks and benefits prior to obtaining informed consent

n/a

Set up the equipment, maintaining an aseptic field

n/a

Perform procedures/ investigations where appropriate

Manage unexpected events and complications during and after procedures/ investigations

n/a
 

Provide aftercare for patients

Communicate after-care protocols and instructions to patients and medical and nursing staff

Interpret the results/ outcomes of procedures/ investigations, including imaging and reports

Communicate the outcome of the procedure and associated investigations to patients

Perform this activity across multiple relevant settings

n/a

Evaluate the anticipated value of the procedure /investigation

Communicate potential risks and benefits prior to obtaining informed consent

Set up the equipment, maintaining an aseptic field

Perform procedures/ investigations where appropriate

Manage unexpected events and complications during and after procedures/ investigations

 

Provide aftercare for patients

Communicate after-care protocols and instructions to patients and medical and nursing staff

Interpret the results/ outcomes of procedures/ investigations, including imaging and reports

Communicate the outcome of the procedure and associated investigations to patients

Perform this activity across multiple relevant settings

n/a

Evaluate the anticipated value of the procedure /investigation

Communicate potential risks and benefits prior to obtaining informed consent

Set up the equipment, maintaining an aseptic field

Perform procedures/ investigations where appropriate

n/a

Manage unexpected events and complications during and after procedures/ investigations

 

Provide aftercare for patients

Communicate after-care protocols and instructions to patients and medical and nursing staff

Interpret the results/ outcomes of procedures/ investigations, including imaging and reports

Communicate the outcome of the procedure and associated investigations to patients

Perform this activity across multiple relevant settings

n/a

Evaluate the anticipated value of the procedure /investigation

Communicate potential risks and benefits prior to obtaining informed consent

Set up the equipment, maintaining an aseptic field

n/a

Perform procedures/ investigations where appropriate

Manage unexpected events and complications during and after procedures/ investigations

n/a
 

Provide aftercare for patients

Communicate after-care protocols and instructions to patients and medical and nursing staff

Interpret the results/ outcomes of procedures/ investigations, including imaging and reports

Communicate the outcome of the procedure and associated investigations to patients

Perform this activity across multiple relevant settings

n/a

Evaluate the anticipated value of the procedure /investigation

Communicate potential risks and benefits prior to obtaining informed consent

n/a

Set up the equipment, maintaining an aseptic field

n/a

Perform procedures/ investigations where appropriate

Manage unexpected events and complications during and after procedures/ investigations

n/a
 

Provide aftercare for patients

Communicate after-care protocols and instructions to patients and medical and nursing staff

Interpret the results/ outcomes of procedures/ investigations, including imaging and reports

Communicate the outcome of the procedure and associated investigations to patients

Perform this activity across multiple relevant settings

n/a

Evaluate the anticipated value of the procedure /investigation

Communicate potential risks and benefits prior to obtaining informed consent

Set up the equipment, maintaining an aseptic field

Perform procedures/ investigations where appropriate

n/a

Manage unexpected events and complications during and after procedures/ investigations

 

Provide aftercare for patients

Communicate after-care protocols and instructions to patients and medical and nursing staff

Interpret the results/ outcomes of procedures/ investigations, including imaging and reports

Communicate the outcome of the procedure and associated investigations to patients

Perform this activity across multiple relevant settings

n/a

Evaluate the anticipated value of the procedure /investigation

Communicate potential risks and benefits prior to obtaining informed consent

Set up the equipment, maintaining an aseptic field

Perform procedures/ investigations where appropriate

Manage unexpected events and complications during and after procedures/ investigations

 

Provide aftercare for patients

Communicate after-care protocols and instructions to patients and medical and nursing staff

Interpret the results/ outcomes of procedures/ investigations, including imaging and reports

Communicate the outcome of the procedure and associated investigations to patients

Perform this activity across multiple relevant settings

n/a

Evaluate the anticipated value of the procedure /investigation

Communicate potential risks and benefits prior to obtaining informed consent

n/a

Set up the equipment, maintaining an aseptic field

n/a

Perform procedures/ investigations where appropriate

Manage unexpected events and complications during and after procedures/ investigations

n/a
 

Provide aftercare for patients

Communicate after-care protocols and instructions to patients and medical and nursing staff

Interpret the results/ outcomes of procedures/ investigations, including imaging and reports

Communicate the outcome of the procedure and associated investigations to patients

Perform this activity across multiple relevant settings

n/a

Evaluate the anticipated value of the procedure /investigation

Communicate potential risks and benefits prior to obtaining informed consent

Set up the equipment, maintaining an aseptic field

Perform procedures/ investigations where appropriate

Manage unexpected events and complications during and after procedures/ investigations

 

Provide aftercare for patients

Communicate after-care protocols and instructions to patients and medical and nursing staff

Interpret the results/ outcomes of procedures/ investigations, including imaging and reports

Communicate the outcome of the procedure and associated investigations to patients

Perform this activity across multiple relevant settings

n/a

Evaluate the anticipated value of the procedure /investigation

Communicate potential risks and benefits prior to obtaining informed consent

Set up the equipment, maintaining an aseptic field

n/a

Perform procedures/ investigations where appropriate

n/a

Manage unexpected events and complications during and after procedures/ investigations

 

Provide aftercare for patients

Communicate after-care protocols and instructions to patients and medical and nursing staff

Interpret the results/ outcomes of procedures/ investigations, including imaging and reports

Communicate the outcome of the procedure and associated investigations to patients

Perform this activity across multiple relevant settings

n/a

Evaluate the anticipated value of the procedure /investigation

Communicate potential risks and benefits prior to obtaining informed consent

Set up the equipment, maintaining an aseptic field

Perform procedures/ investigations where appropriate

n/a

Manage unexpected events and complications during and after procedures/ investigations

 

Provide aftercare for patients
for balloon pump/impella procedures

Communicate after-care protocols and instructions to patients and medical and nursing staff

Interpret the results/ outcomes of procedures/ investigations, including imaging and reports

Communicate the outcome of the procedure and associated investigations to patients

Perform this activity across multiple relevant settings

n/a

Evaluate the anticipated value of the procedure /investigation

Communicate potential risks and benefits prior to obtaining informed consent

Set up the equipment, maintaining an aseptic field

Perform procedures/ investigations where appropriate

Manage unexpected events and complications during and after procedures/ investigations

 

Provide aftercare for patients

Communicate after-care protocols and instructions to patients and medical and nursing staff

Interpret the results/ outcomes of procedures/ investigations, including imaging and reports

Communicate the outcome of the procedure and associated investigations to patients

Perform this activity across multiple relevant settings

n/a

Evaluate the anticipated value of the procedure /investigation

Communicate potential risks and benefits prior to obtaining informed consent

Set up the equipment, maintaining an aseptic field

Perform procedures/ investigations where appropriate

n/a

Manage unexpected events and complications during and after procedures/ investigations

 

Provide aftercare for patients

Communicate after-care protocols and instructions to patients and medical and nursing staff

Interpret the results/ outcomes of procedures/ investigations, including imaging and reports

Communicate the outcome of the procedure and associated investigations to patients

n/a

Perform this activity across multiple relevant settings

n/a

Evaluate the anticipated value of the procedure /investigation

Communicate potential risks and benefits prior to obtaining informed consent

Set up the equipment, maintaining an aseptic field

Perform procedures/ investigations where appropriate

n/a

Manage unexpected events and complications during and after procedures/ investigations

 

Provide aftercare for patients

Communicate after-care protocols and instructions to patients and medical and nursing staff

Interpret the results/ outcomes of procedures/ investigations, including imaging and reports

Communicate the outcome of the procedure and associated investigations to patients

Perform this activity across multiple relevant settings

n/a

Evaluate the anticipated value of the procedure /investigation

Communicate potential risks and benefits prior to obtaining informed consent

n/a

Set up the equipment, maintaining an aseptic field

n/a

Perform procedures/ investigations where appropriate

Manage unexpected events and complications during and after procedures/ investigations

n/a
 

Provide aftercare for patients

Communicate after-care protocols and instructions to patients and medical and nursing staff

Interpret the results/ outcomes of procedures/ investigations, including imaging and reports

Communicate the outcome of the procedure and associated investigations

n/a

Evaluate the anticipated value of the procedure /investigation

Communicate potential risks and benefits prior to obtaining informed consent

Set up the equipment, maintaining an aseptic field

Perform procedures/ investigations where appropriate

n/a

Manage unexpected events and complications during and after procedures/ investigations

 

Provide aftercare for patients

Communicate after-care protocols and instructions to patients and medical and nursing staff

Interpret the results/ outcomes of procedures/ investigations, including imaging and reports

Communicate the outcome of the procedure and associated investigations to patients

n/a

Perform this activity across multiple relevant settings

n/a