Gastroenterology curriculum standards

Ready to perform without supervision

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

The trainee will:

• explain options to patients, with the potential benefits, risks, costs, burdens, and side effects of each option, including the option to have no investigations
• use clear and simple language, and check that patients understand the terms used, and that they agree to proceed with proposed investigations
• identify patients’ concerns and expectations, and provide adequate explanations on the rationale for individual test ordering
• confirm whether patients have understood the information they have been given, and the need for more information before deciding
• use written material, visual, 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:

• discuss the indications, risks, benefits, and complications of investigations with patients before ordering investigations
• explain the results of investigations to patients
• arrange investigations providing accurate and informative referrals, liaising 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:

• identify adverse outcomes that may result from proposed investigations, focusing on patients’ individual situations
• ensure adequate documentation and storage of results
• promptly follow up results to ensure findings are acted on in a timely way

Requires some supervision

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

The trainee may:

• consider safety aspects of investigations when planning them
• seek help with interpretation of test results for less common tests or indications, or unexpected results
• 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:

• 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:

• 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:

• understand patients’ views and preferences about any proposed investigation and the adverse outcomes they are most concerned about

Requires some supervision

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

The trainee may:

• 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:

• act in accordance with the scope of the authority (e.g. advanced care directives, power of attorney)
• 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 there may be additional costs, which patients may wish to clarify before proceeding
• explain the expected benefits as well as the potential burdens and risks of any proposed investigation 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

Requires some supervision

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

The trainee may:

• identify appropriate proxy decision makers when required
• choose not to investigate in situations where it is not appropriate for ethical reasons
• practice within current ethical and professional frameworks
• practice within own limits, and seek help when needed
• involve patients in decision making regarding investigations, and obtain 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:

• evaluate the costs, benefits, and potential risks of each investigation in a clinical situation
• adjust investigative paths 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:

• choose the most appropriate investigations for the clinical scenario 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:

• consider the role other members of the health care team might play, and what other sources of information and support are available
• ensure results are checked in a timely manner, and take responsibility for following up on results

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

Ready to perform without supervision

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

The trainee will:

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