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

Identify key issues on which to advocate for the patient to ensure their immediate clinical care and requirements are achieved

Able to succinctly present the patient scenario and discuss management plan

Has awareness and acknowledges errors or omissions in own decision making

Document and report adverse events in accordance with local incident reporting 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

Safely prescribe use of antimicrobials and be aware of the influence of the pharmaceutical industry. Clearly understand proper surgical prophylaxis and distinguish this from therapeutic use of antibiotics for bacterial infections

Show insight on what needs to be improved

Contribute to unit morbidity/mortality meetings

Engage with Basic and Intermediate surgical constructs

• see extract from Essential Surgical Skills document (pp. 11-12)

Identify issues that impede teamwork and suggest actions; after discussion with Unit Head, assist with implementation

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

Contribute to analysis of complex cases and imperfect outcomes, and identify any changes needed to care processes or systems

Retrieve, comprehend and apply results of systematic reviews, clinical prediction rules, decision analysis and clinical practice guidelines

Participate in systemic quality process of evaluation and improvement, such as patient safety initiatives or proposed clinical service changes

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

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

Identify areas of improvement in teaching/ learning activities and work with Unit Head/ Director of Surgery to implement change

Chair/facilitate morbidity/mortality meetings, and identify desirable changes to processes and systems of care

Competent with intermediate and many of the advanced Essential Surgical Skills constructs

• refer to pages 12-14 of the Essential Surgical Skills Document