Milestone

Fellowship

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.

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13. Engage in reflective practice and ongoing learning

Know

  • Understand prevalent and priority health conditions in the local community and emerging health issues.

Do

  • Consider ways to address inequity and emerging health issues in the local community.
  • Participate in ongoing professional development relevant to learning style and needs; this may include:
    • the use of small group learning and journal clubs
    • Balint groups
    • clinical audit and e-audit tools
    • participation in external data extraction/research projects
    • active learning modules
    • cultural awareness training
    • peer review of journal articles
    • graduate certificate or diploma courses, master’s degree

Do

  • Engage in reflective practice during and after consultations with Aboriginal and Torres Strait Islander peoples and in all cross-cultural consultations, with a focus on:
    • strengths and weaknesses of communication skills
    • effectiveness of cultural assessment
    • gaining feedback from individuals as to whether they perceived that their cultural beliefs and practices were heard and integrated into management plans
    • addressing barriers to follow-up or access to other health services.
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

Do

  • Undertake a structured approach when reviewing research evidence.
  • Review and apply the relevance and validity of research and/or guidelines to diagnosis and/or management of a particular individual or condition by considering:
    • the design and type of research (eg quantitative, qualitative or mixed methods) or analysis, and the levels of evidence for the findings
    • whether the study design addressed potential sources of bias, confounding factors and/or conflicts of interest
    • whether the data analyses were correct
    • whether the data justified the conclusions drawn
    • the similarities and differences of the patient population studied (eg age, ethnicity, presence of comorbidities or complications) compared to the individuals to whom the practitioner wishes to apply the findings
    • the research hierarchy, which reflects the potential of each study design to answer a particular research question, based on the probability that its design has minimised the impact of bias on the results.

Do

  • Clearly articulate clinical questions that could be addressed through primary care research.
  • Use the PICO framework to build clinical questions that are directly relevant to the problem at hand; to inform a review of guidelines and/or a broader literature review of evidence summaries, systematic reviews and meta-analyses (eg Cochrane database); and to determine if research has been done in the area.
  • Continue to engage in clinical problem-solving and identify the best available evidence to guide diagnosis and management and to understand prognosis and prevention.

Be

  • Be interested in learning.
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 common clinical indicators and the governance structures in own practice – including relevant practice policies and processes – for identifying and managing near misses and critical incidents.

Do

  • Manage consequences and reduce risk of future critical incidents by, for example:
    • identifying any near misses and critical incidents and assuming responsibility for understanding contributing factors, and driving strategies to address these
    • identifying barriers to quality improvement and addressing these
    • considering clinical indicators that could be used to track progress against quality improvement strategies, and participating in establishing these within the practice or participating in clinical audits in relevant areas.

Know

  • Ensure that practice processes are followed and are robust for:
    • handover when leave is taken
    • checking patient results and incoming correspondence and taking appropriate actions as a result
    • following up on recall communication (letters or SMS) that has not been actioned by the patient
    • checking that referrals to non-GP specialists for serious health issues have been actioned by the receiving clinic and that the patient has an appointment booked.
  • Identify any potential strategies for improvement in practice systems to reduce risks.
  • Inform patients of their responsibilities and the practice processes for being informed of their results.

Know

  • Understand the value of quality improvement initiatives in the following areas:
    • provision of culturally safe and trauma-informed care
    • infection prevention and control, including:
      • hand hygiene
      • environmental hygiene
      • body fluid spills management
      • sterilisation
      • immunisation of self and staff
      • standard and transmission-based precautions (eg outbreak control, including identifying individuals who may have communicable diseases, and implementing appropriate procedures to minimise risk of spread)
      • healthcare-associated infection surveillance, including notifiable diseases
    • providing continuity of care; for example, adequacy of referral letters and health summaries, use of recall systems to ensure follow-up, timely review of non-GP specialist letters, pathology and radiology results
    • prescribing in line with clinical guidelines
    • clinical record-keeping; for example, adequate progress notes, collection of demographic data and currency of medication and allergy records.

Do

  • Consider clinical indicators to develop quality improvement strategies. Clinical indicators may include:
    • patient experience surveys
    • proportion of clinical files with health summaries and up-to-date adverse drug reaction warnings
    • provision of care that adheres to clinical guidelines
    • use of interpreter service for patients of linguistically diverse backgrounds
    • quality of referral letters
    • currency of medication lists
    • evidence of timely review of test results
    • maintenance of infection control standards
    • proportion of files with appropriate recalls.
  • Demonstrate clinical leadership by improving clinical outcomes by suggesting quality and safety developments in healthcare provision at both micro and macro levels. Clinical leadership responsibilities include:
    • determining priorities for allocation of resources to support quality patient care
    • contributing to the development of a workplace culture of trust and honesty to encourage open discussion about adverse events without apportioning blame
    • developing systems to flag and respond to concerns about patient care
    • monitoring clinical performance indicators.

Know

  • Describe the importance of practice policies and procedures that relate to discrimination, equal opportunity, harassment and bullying.

Do

  • Manage identified hazards and health and safety risks in the practice as they affect:
    • personal safety; for example, the use of personal alarms, how to manage violence in the workplace
    • patient safety; including recall and follow-up, and management of environmental hazards, such as sharps, spills or infection risks.
  • Reflect on what support should be offered to staff in the practice; for example, vaccinations, ongoing training and development appropriate to their role and the practice population, and training in cultural awareness and Aboriginal and Torres Strait Islander health.
  • Participate in review of practice policies and procedures that relate to discrimination, equal opportunity, harassment and bullying, where possible.
  • Be involved in reviewing injuries or concerns in the practice.

Be

  • Be collaborative and involved, especially in performance and incident reviews.
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