At the early registrar level it is expected that a prevocational doctor will have acquired the skills, knowledge and behaviours to competently plan an operating list.
This task describes a number of activities, as below, where proficiency should be achievable by the end of PGY3. The doctor is encouraged to download the key clinical task guidelines and seek the support of his/her supervisor for feedback on performance.
- Plan, allowing for elective and ward patients
- Note medical and strategic issues, e.g. diabetes, day case vs. inpatient
- Work out (provisional) appropriate order
- Review with consultant, e.g. discuss with operation theatre, anaesthetic team, make sure ward nurse is informed and attend to patient issues
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PGY 1
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PGY 2
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PGY 3
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Collaboration and teamwork
- Establish respectful good working relationships with team members and other healthcare professionals
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Communication
- Provide updates to the current health team, e.g. new critical issues or changes in a patient’s condition
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Health advocacy
- Demonstrate awareness of the cultural diversity and requirements of patients
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Medical expertise
- Identify and provide relevant and succinct information when ordering investigations. Ensure tests and results are documented
- Know and work within hospital, state and government policies and legislation relating to prescribing. Make use of guidelines and standard documents, e.g. National Inpatient Medication Chart
- Accurately and safely prescribe (common) medications and recognise (potential) administration errors
- Know the types, causes and risks of medication errors and adverse drug reactions
- Use standard reporting mechanisms to report medication errors and adverse drug reactions
- Understand the key features of antibiotic prophylaxis and appropriate therapeutic use, noting local protocols and the Therapeutic Guidelines (Antibiotics)
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Collaboration and teamwork
- Recognise expertise and roles of other health team members and staff
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Communication
- Communicate effectively within multidisciplinary teams, reflecting an understanding of, and respect for, different health professional perspectives
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Health advocacy
- Identify key issues on which to advocate for the patient to ensure their immediate clinical care and requirements are achieved
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Judgement and clinical decision making
- Select appropriate procedures, with involvement of senior clinicians and the patient
- Able to succinctly present the patient scenario and discuss management plan
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Leadership and management
- Able to ensure that ward patients are ready for theatre on time
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Medical expertise
- 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
- Follow-up and interpret investigation results appropriately to guide patient management
- Work within unit-based protocols with regard to pre-operative assessment and care, operative procedures and post-operative care:
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Professionalism
- Mindful of potential impact of resource constraint on patient care
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Collaboration and teamwork
- Collaborate effectively with other specialist teams involved in the patient’s care
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Communication
- Collect and collate relevant information from other team members or specialist teams pertinent to decision making or patient management
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Health advocacy
- Identify any gaps between management plan and patient wishes
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Judgement and clinical decision making
- Plan the order of an operating list and discuss with consultant
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Leadership and management
- Remain calm under pressure
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Medical expertise
- Present complex cases effectively to senior medical staff and other health professionals