Entrustable Professional Activities

LG 5: Communication with patients

Learning Goal 5

Communication with patients

Discuss diagnoses and management plans with patients

This activity requires the ability to:

  • select a suitable setting and include family and/or carers and other team members
  • adopt a patient-centred perspective, including adjusting for educational level and cultural background, current level of intoxication or withdrawal, and patients’ cognitive capacity and disabilities
  • select and use appropriate modalities and communication strategies
  • structure conversations intentionally
  • negotiate a mutually agreed management plan
  • verify patient understanding of information conveyed
  • develop and implement a plan for ensuring actions occur
  • document the conversation and inform stakeholders, such as GPs and specialists

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:

  • use active listening skills, open ended and targeted questioning to improve rapport, gain a clear account of patients’ perspectives, and optimise assessment
  • assess patients’ capacity and decision-making skills, and communicate accordingly
  • use motivational interviewing skills
  • provide feedback sensitively to patients about their conditions and/or risk factors
  • inform patients of all their management options, and give them adequate opportunity to question or refuse interventions and treatments
  • seek to understand the concerns and goals of patients, and plan management in partnership with them

direction
Requires some supervision

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

The trainee may:

  • apply knowledge of the scientific basis of health and disease to the management of patients
  • demonstrate an understanding of clinical problems being discussed
  • formulate management plans in partnership with 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:

  • summarise treatment plans and goals for patients
  • evaluate, adjust, and tailor the mode and content of communication to patients’ circumstances and levels of understanding
  • modify communication styles and techniques to accommodate patients’ current mental state, level of intoxication or withdrawal, and capacity
  • use appropriate communication modalities such as face-to-face, phone calls, or video, reflecting the objectives of the encounter and possible risks
  • provide information to patients in plain language, avoiding jargon, acronyms, and complex medical terms
  • encourage questions, and answer them thoroughly
  • recognise the possible role of family, and engage accordingly, with the patients' agreement

direction
Requires some supervision

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

The trainee may:

  • select appropriate modes of communication
  • engage patients in discussions, avoiding the use of jargon
  • check patients' understandings of information
  • adapt communication styles in response to patients' age, developmental level, and cognitive, physical, cultural, socioeconomic, and situational factors
  • collaborate with patient liaison officers as required

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:

  • discuss with patients their condition and the available management options, including potential benefits and harms, and any legal considerations
  • provide information to patients in a way they can understand before asking for their consent
  • participate in processes to manage patient complaints
  • recognise where patients may not have capacity to make decisions about management, and communicate accordingly

direction
Requires some supervision

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

The trainee may:

  • inform patients of the material risks associated with the proposed management plan
  • treat information about patients as confidential

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:

  • obtain informed consent or other valid authority before involving patients in teaching

direction
Requires some supervision

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

The trainee may:

  • respond appropriately to information sourced by patients, and to patients' knowledge regarding their condition

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 information to patients that is based on guidelines issued by the National Health and Medical Research Council and/or Health Research Council of NZ
  • provide information to patients in a way they can understand before asking for their consent to participate in research
  • obtain informed consent or other valid authority before involving patients in research

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
  • demonstrate an understanding of the limitations of the evidence and the challenges of applying research in daily practice

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:

  • demonstrate effective and culturally competent safe communication with Māori and Aboriginal and Torres Strait Islander peoples
  • effectively communicate with members of other cultural groups by meeting patients’ specific language, cultural, and communication needs
  • use qualified language interpreters or cultural interpreters to help meet patients’ communication needs when necessary
  • provide plain language and culturally appropriate written materials to patients when possible

direction
Requires some supervision

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

The trainee may:

  • identify when to use interpreters
  • allow enough time for communication across linguistic and cultural barriers

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:

  • encourage and support patients to be well informed about their health and to use this information wisely when they make decisions
  • encourage and support patients and, when relevant, their families or carers, in caring for themselves and managing their health
  • demonstrate respectful professional relationships with patients
  • prioritise honesty, patients’ welfare, and community benefit above self-interest
  • develop a high standard of personal conduct, consistent with professional and community expectations
  • support patients’ rights to seek second opinions

direction
Requires some supervision

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

The trainee may:

  • respect the preferences of patients
  • communicate appropriately, consistent with the context, and respect patients’ needs and preferences
  • maximise patient autonomy and support their decision making
  • avoid sexual, intimate, and/or financial relationships with patients
  • demonstrate a caring attitude towards patients
  • respect patients, including protecting their rights to privacy and confidentiality
  • behave equitably towards all, irrespective of gender, age, culture, socioeconomic status, sexual preferences, beliefs, contribution to society, illness-related behaviours or the illness itself
  • use social media ethically and according to legal obligations to protect patients’ confidentiality and privacy

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:

  • communicate effectively with health care team members involved in patients' care
  • discuss medical assessments, treatment plans and investigations with patients and primary care teams, and work collaboratively with them
  • discuss patient care needs with team members to align them with the appropriate resources
  • facilitate an environment where all team members feel they can contribute and their opinion is valued
  • communicate accurately and succinctly, and motivate others in the health care team to do likewise

direction
Requires some supervision

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

The trainee may:

  • answer questions from team members
  • summarise, clarify, and communicate responsibilities of team members
  • keep team members focused on patient outcomes

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:

  • help patients navigate the healthcare system by working in collaboration with consumer groups and other services, such as non-government organisations (NGOs), peer support groups, private providers, general practices, and primary care organisations
  • advocate for patients with substance use and addictive disorders in all settings, recognising the impacts of stigma on patient health, wellbeing, and access to care

direction
Requires some supervision

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

The trainee may:

  • communicate with and involve other health professionals as appropriate