Recognise expertise and roles of other health team members and staff

Support new unit (team) members

Use appropriate techniques and support when responding to patients and families in distress, and facilitate consultant involvement early in the process; to include participation in open disclosure discussions

Can explain the common conditions of the unit effectively to patients and undertake informed consent for common elective and emergency conditions

• See College position paper for Informed Consent and the Medical Council New Zealand statement

Explain clinical reasoning to current health team using concise language and a structured approach

Keep patients and significant others informed of management plan progress

Communicate effectively within multidisciplinary teams, reflecting an understanding of, and respect for, different health professional perspectives

Identify the common health issues relating to the clinical service and associated advocacy work undertaken by the hospital/health service

Recognise vulnerable or marginalised populations who may have limited access to healthcare resources within the hospital community

Consider how culture, beliefs and health literacy can affect patient understanding of their care and expectations

Recognise own cultural values/biases that may impact on role as a doctor and in interactions with others

Adhere to the limits of patient information that can be divulged in different settings, e.g. family and carers, ward rounds, handover

Identify and justify patient management options for common problems and conditions

Review patients on a regular basis and make decisions based on their response to treatment

Retrieve and use high-quality information from electronic sources for clinical decision making. Document decisions and reasons for same

Able to succinctly present the patient scenario and discuss management plan

Contribute to multi-disciplinary team briefings about patients, e.g. ward meetings

Present common cases effectively to senior medical staff and other health professionals

Perform a comprehensive examination of all systems

Work within unit-based protocols with regard to pre-operative assessment and care, operative procedures and post-operative care:

• apply medical knowledge to clinical practice
• implement and evaluate a management plan relevant to the patient following discussion with a senior clinician
• identify when patient transfer is required, and manage risks prior to and during patient transfer
• recognise indications for, and risks of, fluid and electrolyte therapy and blood products
• provide appropriate aftercare and arrange follow up for common procedures 
• safely manage anti-coagulant therapy and manage diabetes
• recognise acute cardiac events and use relevant resuscitation/drug protocols
• initiate resuscitation of the unwell patient. Recognise indicators for sepsis and implement clinically relevant plan
• maintain a clinically relevant patient management plan of fluid, electrolyte and blood product use
• recognise and manage fluid and electrolyte imbalances in a patient
• effectively use semi-automatic and automatic defibrillators
• provide appropriate aftercare and arrange follow up for more complex procedures
• recognise when patients are ready for discharge and arrange referral to relevant members of the healthcare team to promote planning for safe discharge

Specify peri-operative management of anticoagulants and antiplatelet agents and recognise prescription and/or administration errors

Follow-up and interpret investigation results appropriately to guide patient management

Comply with legal requirements in patient care, e.g. Mental Health Act, death certification

Mindful of potential impact of resource constraint on patient care

Collaborate effectively with other specialist teams involved in the patient’s care

Effectively prioritise patients with multiple medical conditions of varying disease severity

Engage junior doctors, nursing and ancillary staff in ward rounds

Use effective strategies to deal with difficult or vulnerable patients

Set an appropriate tone for any communication with patients and their families, peers and colleagues

Communicate effectively with complex patients to take clinical history, identifying key comorbidities, e.g. use open and closed questions to elicit information

Collect and collate relevant information from other team members or specialist teams pertinent to decision making or patient management

Use graded assertiveness where appropriate

Acknowledge the potential impact of cultural differences in the acceptance of treatment for common conditions and work within those parameters

Identify any gaps between management plan and patient wishes

Work with the patient/family/carers to develop a management plan that addresses the needs and preferences of the patient

Use investigation findings to refine diagnoses for common conditions

Recognise when a management plan is failing and, where appropriate, seek senior input to devise an alternative plan

Demonstrate appropriate self-awareness and insight

Delegate appropriate tasks to junior members, ensuring supervision is maintained

Present complex cases effectively to senior medical staff and other health professionals

Evaluate outcomes of medication therapy. Monitor and review the patient’s response to treatment

• aligned to NPS MedicineWise

Provide appropriate aftercare and arrange follow-up for all procedures

Audit own and team performance in relation to patient progress and outcome

Act as a role model of professional behaviour in the workplace

Use multi-disciplinary team meetings as teaching and educational opportunities

Adapt level of supervision to learner’s competence and confidence