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The Clinical Competencies for the CCE

Competencies

3. Diagnosis, decision-making and reasoning

Last revised: 19 Mar 2024

C2.2 General practitioners diagnose and manage the full range of health conditions in a diverse range of patients, across the lifespan through a therapeutic relationship.

This is about a conscious, structured approach to making diagnoses and decision-making. The focus is on the content and includes all the steps leading up to formulating a diagnosis or problem list. This also includes diagnostic accuracy that does not necessarily require the correct diagnosis, but that the direction of reasoning was appropriate and accurate. The trainee’s ability to think about and reflect on their reasoning is another aspect of this assessment domain. This competency is closely aligned with information gathering; however, it can also be assessed in different ways.

Criteria

  1. Integrates and synthesises knowledge to make decisions in complex clinical situations
  2. Modifies differential diagnoses based on clinical course and other data as appropriate
  3. Demonstrates diagnostic accuracy; this does not require the correct diagnosis, but that the direction of reasoning was appropriate and accurate
  4. Collects/reports clinical information in a hypothesis-driven manner
  5. Articulates an appropriate problem definition
  6. Formulates a rational list of differential diagnoses, including most likely, less likely, unlikely and cannot miss diagnoses
  7. Directs evaluation and treatment towards high-priority diagnoses
  8. Demonstrates metacognition (thinking about own thinking)

Aboriginal and Torres Strait Islander health context

  1. Demonstrates effective diagnostic and management strategies that enhance health outcomes for Aboriginal and Torres Strait Islander patients

For the trainee

The focus here is on the steps leading up to formulating a working diagnosis, relevant differential diagnoses and a problem list. Using a safe diagnostic strategy and describing how you developed a specific problem list are assessed in this area. By formulating a clinically appropriate working diagnosis, you demonstrate diagnostic accuracy. This does not require the correct diagnosis but that the direction of your reasoning was appropriate and accurate.

This event attracts CPD points and can be self recorded

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