Milestone

Entry

Last updated 13 September 2022
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Instructions

Expand each role using the menu on the left to reveal its capabilities. Clicking on each capability on the left will show the associated competencies on the right hand side. These can then be expanded to provide more detail on the required knowledge, skills and attributes.

Compare competencies of the roles at different milestones

13. Engage in reflective practice and ongoing learning

Know

  • Know that reflective practice is a core aspect of personal and professional development and learning, and includes developing the capacity to reflect on personal attitudes, beliefs, values, learning style and clinical skills and knowledge to engage in a process of continuous learning and improvement.
  • Ensure insight into areas of concern and areas for improvement to optimise likelihood of strategies being implemented to support sustainable practice and improved wellbeing.

Do

  • Incorporate reflective practice and intellectual humility into daily work.
  • Actively seek formal or informal feedback from patients, peers, senior GP colleagues, mentors and non-GP specialist colleagues.
  • Use reflective practice and evaluative judgement to identify:
    • if own practice is ethical and professional (capability 11)
    • if personal attitudes, values and beliefs may be impacting quality of care provided. For example, identifying if a heartsink response to patients (individuals perceived to be placing an unreasonable burden on the treating doctor) is impacting effective therapy; it can be helpful to recognise that these patients often have complex health issues and comprehensive care needs and require adequate time for consultations and/or a team-based approach to care (capability 12)
    • if clinical practice is evidence-based, and if not, determine whether it is in line with peers (capability 14)
    • whether there is justification and rationale for clinical choices (capability 14)
    • if effective communication, both verbal and non-verbal (including written), is being used with patients and within healthcare teams (capabilities 3 and 4)
    • if care provided is culturally safe (capability 1)
    • any near misses and reflect on critical incidents (capability 15).

Do

  • Reflect on gaps in clinical skills and knowledge to engage in a process of continuous learning.
  • Develop learning plans to meet these needs.
  • Consider strategies to stimulate learning and encourage reflection, such as role plays, observation of consultations, case presentations at practice meetings and critical case discussions.

Know

  • Understand limits of own skills and knowledge.

Do

  • Identify when supervisor assistance and support or referral is required and access this in a timely fashion, understanding that the safety of the patient is a paramount consideration.
  • Undertake reflective practice .
  • Consider common clinical situations that would require access to a senior colleague for an opinion or other assistance; for example:
    • prescribing of Schedule 8 or unfamiliar medications
    • undertaking unfamiliar procedures
    • assessing individuals with complex presentations; for example, multimorbidity, prescribed multiple medications, cluster B personality traits, previous trauma
    • assessing individuals who are significantly unwell or at risk of clinical deterioration (eg have red flags symptoms or signs [competency 5.1.1])
    • patients with a new serious diagnosis where the doctor needs to ‘break bad news’ (eg malignancy)
    • patients with unfamiliar symptoms (eg skin rashes)
    • challenging consultations (eg ‘heartsink’ response to patients, nursing home visits, home visits, aggressive patients, medicolegal documentation requests)
    • patients from demographic groups with which the doctor has had limited clinical experience (eg neonates and young children, pregnant women, adolescents with mental health issues, returned travellers, Aboriginal and Torres Strait Islander peoples, people of refugee background).

Know

  • Understand that feedback is an essential component of reflective practice that supports learning and professional development.

Do

  • Seek feedback from others who have observed or participated in consultations and/or observed professional practice, including peers, colleagues in healthcare teams, patients and their families and carers, and professional organisations.
  • Seek feedback on various aspects of clinical practice and professionalism, including:
    • culturally safe care (from Aboriginal and Torres Strait Islander peoples and from individuals in cross-cultural consultations)
    • communication skills
    • clinical documentation, including adequacy of referral letters
    • prescribing patterns
    • clinical problem-solving
    • compliance with investigation and disease management guidelines.
  • Obtain feedback through, for example:
    • clinical audits
    • formal feedback surveys
    • ad hoc conversations.
  • Demonstrate intellectual humility.

Be

  • Be engaged in and enthusiastic about learning.

Know

  • Know the benefits of mentoring for professional development and self care, including:
    • improved social and emotional wellbeing
    • enhanced connection and collegiality with colleagues
    • confidence in communication and leadership skills
    • increased motivation, job satisfaction and sense of self-worth
    • improved relationships with patients and colleagues
    • career progression
    • stronger clinical knowledge and skills.
  • Understand the structures required for an effective mentor–mentee relationship and what is required of a mentee, including:
    • understanding the role of mentoring
    • acknowledging boundaries and respecting mentor time constraints
    • setting short-, medium- and long-term goals
    • having a capacity for insight into own needs and for self-reflection
    • establishing trust.
  • Consider the characteristics of a mentor that would be helpful for own career development and interests.

Do

  • Identify and reflect on a range of issues that would be useful to discuss with a mentor.
Open all sections

Instructions

Expand each role using the menu on the left to reveal its capabilities. Clicking on each capability on the left will show the associated competencies on the right hand side. These can then be expanded to provide more detail on the required knowledge, skills and attributes.

Compare competencies of the roles at different milestones

14. Integrate best available scientific evidence, teaching and research into practice

Know

  • Know commonly used guidelines for assessment and management of common conditions and how to access these.
  • Know how to undertake a literature review to find answers to identified clinical problems not covered in guidelines.

Do

  • Think critically and assess the relevance and validity of a guideline or research paper to a particular individual or condition and:
    • consider the design and type of the guideline, research or analysis, and thus the level of evidence for the findings
    • consider whether the study design addressed potential sources of bias, confounding factors and/or conflicts of interest
    • consider whether the data analyses were correct
    • consider whether the data justified the conclusions drawn
    • compare the similarities and differences of the patient population studied to the individual(s) to whom the practitioner wishes to apply the findings.

Know

  • Demonstrate:
    • a willingness to consider clinical questions
    • insight into limitations of own knowledge
    • curiosity and a willingness to learn.
  • Frame clinical questions concisely and accurately.
  • Access appropriate guidelines and/or seek out assistance from senior colleagues and/or undertake literature reviews to find answers to these questions.

Know

  • Know that hypothetical deductive reasoning is an important skill to be learnt in problem-based learning. This involves the ability to explore causes of a patient’s problem and make decisions about the management of the problem, applying basic science and clinical knowledge. Multiple hypotheses are generated to explain the presentation, which are then tested using enquiry and diagnostic decisions and may be used to identify the most appropriate management plan.

Do

  • Clearly articulate clinical problems and hypotheses to explain presentations.
  • Consider strategies that could be used to identify the most likely diagnosis, including additional history-taking, consideration of risk factors, examination, investigations and/or procedures.
  • Demonstrate effective use of hypothetical deductive reasoning for a variety of common clinical presentations identified in practice.
Open all sections

Instructions

Expand each role using the menu on the left to reveal its capabilities. Clicking on each capability on the left will show the associated competencies on the right hand side. These can then be expanded to provide more detail on the required knowledge, skills and attributes.

Compare competencies of the roles at different milestones

15. Display commitment to practice quality and safety

Know

  • Understand what is meant by ‘near miss’, ‘adverse event’ and ‘critical incident’.

Do

  • Use reflective practice to identify near misses, adverse events and critical incidents, and engage in discussion with peers and senior colleagues to debrief and identify potential contributing factors and quality improvement strategies.

Be

  • Be collaborative and engaged.
  • Be willing to discuss and consider strategies with colleagues to minimise risk of future incidents.
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