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Clinical Competency Rubric

6. Professionalism

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Table of contents

6.1 Professional knowledge, behaviour and attitudes

This requires knowledge of ethical principles, as well as duty-of-care and maintenance of appropriate therapeutic boundaries. The ability to appropriately review potential and actual critical incidents in order to manage consequences and reduce future risk is also an important consideration in this domain. The response to scrutiny of own professional behaviour, being open to feedback and demonstrating a willingness to change is included.

6.2 Learning and professional development.

Being able to respond appropriately to feedback as an educational dialogue, demonstrating the ability to reflect on performance, and identifying personal learning needs are important components of this competency. Using critical appraisal skills, actively participating in clinical audits, and demonstrating a commitment to ongoing professional development all form part of this domain of assessment.

Required knowledge

Knowledge of own scope of safe practice
Ethical principles in medicine
Legislation relevant to general practice

Required attitudes

Empathy
Collegiality
Self-awareness
Professionalism
Commitment to learning and development
Commitment to contribute to improving the evidence base for general practice research
Respect for patient autonomy
Commitment to self/family care

Required skills

Reflective practice

Skills focus: Professional knowledge, attitudes and behaviours

6.1 Professional knowledge, behaviour and attitudes

CS4.1.1 Adherence to relevant codes and standards of ethical and professional behaviour
CS4.1.2 Duty of care is maintained
CS4.1.4 Critical incidents and potential critical incidents are identified and managed

6.2 Learning and professional development

CS4.2.1 Professional knowledge and skills are reviewed and developed
CS4.2.2 Reflection and self-appraisal are undertaken regularly

Criteria:

Encourages scrutiny of professional behaviour, is open to feedback and demonstrates a willingness to change
Exhibits high standards of moral and ethical behaviour towards patients, families and colleagues (including an awareness of appropriate doctor/patient boundaries)
Appropriately manages ethical dilemmas that arise
Identifies and manages clinical situations where there are obstacles to provision of duty of care
Implements strategies to review potential and actual critical incidents to manage consequences and reduce future risk
Personal health issues are identified and managed by accessing professional support as needed
Judges the weight of evidence, using critical appraisal skills and an understanding of basic statistical terms, to inform decision-making
Shows a commitment to professional development through reflection on performance and the identification of personal learning needs
Attends and participates in all learning and assessment activities of an educational program
Actively engages in feedback as a dialogue, discussing performance and setting own goals for professional development
Personally participates in audits and quality improvement activities and uses these to evaluate and suggest improvements in personal and practice performance

6.1 Performance lists

Criteria (competent at level of Fellowship)	Performs consistently at the standard expected
Encourages scrutiny of professional behaviour, is open to feedback and demonstrates a willingness to change	Seeks feedback and engages in dialogue about professional behaviour
Exhibits high standards of moral and ethical behaviour towards patients, families and colleagues including an awareness of appropriate doctor/patient boundaries	Respects patient-doctor boundaries Maintains confidentiality Recognises professional limitations Respects the patient’s culture and values Care of the patient is the primary concern Practicing medicine safely at all times Shows honesty at all times Takes responsibility for own actions Respects patient autonomy Recognising unethical behaviours by colleagues Managing conflicts of interest
Appropriately manages ethical dilemmas that arise	Aware of own values and belief systems and how these may have an impact on patient care Considers multiple perspectives and options available to facilitate a decision Making decisions when professional and personal values diverge Be able to justify the decision that is made and reflect on the outcome
Identify and manage clinical situations where there are obstacles to provision of duty of care	Understands issues involved in contact tracing for communicable disease where the patient wishes to remain anonymous Able to manage expectations of workplace stakeholders when dealing with workers compensation injuries Describes how the requirements of Mandatory reporting can impact on the provision of care . Reviews of fitness to drive and is aware that this could impact on patient care or the therapeutic relationship Manage emotionally labile situations (terminal illness, euthanasia, unwanted pregnancy) Manage patient-practitioner relationships that may present a conflict of interest Manage professional differences (eg criteria for referral, timeliness of intervention) Caring for patients with challenging conditions and beliefs (such as poor adherence to advice, declining life sustaining therapy because of beliefs)
Implements strategies to review potential and actual critical incidents to manage consequences and reduce future risk	Recognising what has happened Acting immediately to rectify the problem, if possible, including seeking any necessary help and advice Explaining to the patient as promptly and fully as possible what has happened and the anticipated short-term and long-term consequences Acknowledging any patient distress and providing appropriate support Complying with any relevant policies, procedures and reporting requirements, subject to advice from your medical indemnity insurer Reviewing adverse events and implementing changes to reduce the risk of recurrence Reporting adverse events to the relevant authority, as necessary
Personal health issues are identified and managed by accessing professional support as needed	Identifies physical/psychological impairment which may impact wellbeing or ability to manage responsibilities, and ensures that a robust management plan is developed

6.2 Performance lists

Criteria (competent at level of Fellowship)	Performs consistently at the standard expected
Judges the weight of evidence, using critical appraisal skills and an understanding of basic statistical terms, to inform decision-making	Uses critical appraisal skills in determining whether resources are applicable to a particular patient
Shows a commitment to professional development through reflection on performance and the identification of personal learning needs	Reflects on clinical skills and knowledge in order to engage in a process of continuous learning Reflection and self-appraisal are undertaken regularly Appraise and review response to constructive feedback Participating regularly in activities that maintain and further develop knowledge, skills and performance Regularly reviewing continuing medical education and continuing professional development activities to ensure that they are consistent with those recommended the relevant professional organisation and regulatory authorities
Attends and participates in all learning and assessment activities of an educational program	Attends learning activities as required by the program Actively participates in learning activities Actively participates in assessment activities
Actively engages in feedback as a dialogue, discussing performance and setting own goals for professional development	Actively seeks feedback Contributes to feedback by reflecting on performance Identifies areas of improvement
Personally participates in audits and quality improvement activities and uses these to evaluate and suggest improvements in personal and practice performance	Undertakes a clinical audit
Aboriginal and Torres Strait Islander health context Develop strategies to promote a culturally safe practice environment Integrate knowledge of history of government policies and consequent health impacts into delivery of care Advocate for and use policies and initiatives that promote equity in healthcare
Rural health context Effectively manage any conflicts between personal and professional roles Effectively communicate limits of role boundaries to patients, staff and community members Regularly review and implement plans to meet professional learning and support needs Support and mentor colleagues in managing professional isolation

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