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The RACGP Curriculum for Australian General Practice 2016

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Curriculum coverThe complete 2016 Curriculum consists of a number of units in addition to contextual units. All units will be available for download as a PDF shortly.

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Common training outcomes

Definition

The Royal Australian College of General Practitioners Curriculum for Australian General Practice defines the common training outcomes for general practice as those 'training outcomes that are relevant to consulting with all patients in unsupervised general practice'. They outline the minimum skill sets required for competent practice as a general practitioner.

This curriculum statement provides the required common training outcomes for general practice and was first developed by the RACGP for its vocational training registrars in 1999. It was subsequently updated for The Royal Australian College of General Practitioners Curriculum for General Practice (2007).

The name 'common learning objectives' has been changed to 'common training outcomes', although the actual training requirements of this section have not changed.

Rationale and general practice context

The RACGP developed the common training outcomes after taking into account:

  • what GPs need to know (the domains of general practice)
  • why most people seek the services of a GP (common patient presentations)
  • the health needs and priorities of Australia's population.

Common patient presentations

General practice primarily involves providing advice to individual patients in the diagnosis, treatment and management of medical conditions.

General practitioners manage the majority of medical presentations in the community. The Curriculum for Australian General Practice reflects the type of patient presentations that come to the attention of GPs and therefore highlight:

  • problems which significantly contribute to morbidity and mortality
  • common presentations which exemplify general practice
  • presentations requiring special skills
  • health problems which present differently in different population groups
  • presentations with a public health significance
  • health problems that have been shown to be preventable.

Key educational principles and concepts

This curriculum for Australian General Practice is based on the following key educational concepts and principles:

Needs focused training

Directed toward meeting the healthcare needs and priorities of the Australian community.

Learning as a continuum

Integrates vocational training with undergraduate, postgraduate and continuing medical education.

Lifelong learning

Encourages a commitment to continuous improvement of knowledge and skills throughout the GP's learning life.

Experiential learning

Emphasises training as a supervised 'real world' clinical experience of consulting with patients presenting with the common and significant conditions that exemplify general practice.

Purpose driven learning

Clearly states purposes and curriculum requirements to enable learners to make informed choices about learning pathways.

Integrated training

Balances and integrates experiential, information based and reflective learning.

Adult learning

Uses models of learning based on recognition of different learning styles and needs.

Self directed learning

Expects adult learners to exercise significant autonomy in making choices about their learning.

Feedback

Requires high quality and regular feedback to learners on their performance as an integral and critical part of teaching and supervision.

Assessment

Regular assessment of learner achievement of curriculum learning objectives during and at the end of training to determine satisfactory completion of training requirements.

Related curriculum areas

Refer also to the curriculum section:

The five domains of general practice

The five domains of general practice represent the critical areas of knowledge, skills and attitudes necessary for competent unsupervised general practice. They are relevant to every patient interaction. Teaching and learning is based on the acquisition of these key knowledge, skills and attitudes.

This section relates the five domains of general practice to the common training outcomes.

Domain 1. Communication skills and the patient-doctor relationship

Good communication skills enable a GP to develop a relationship with patients in order to understand both the illness and the patient's experience of that illness, and to move freely between clinical problem solving and the patient's experience of the problem.

Communication skills and the patient-doctor relationship includes the following areas:

  • communication skills
  • patient centeredness
  • communicating health promotion
  • whole person care.

Domain 2. Applied professional knowledge and skill

The application of professional knowledge and skills requires a comprehensive, patient centred approach. This applies not only to health and disease, but also to the individual's experience of illness in terms of their culture, family and community. This approach includes analysis of the appropriateness and cost effectiveness of all clinical interactions.

Applied professional knowledge and skills includes the following areas:

  • physical examination and procedural skills
  • medical conditions
  • decision making.

Domain 3. Population health and the context of general practice

Population health, in the context of general practice, is an essential component of primary healthcare. The GP has an evolving role with the potential to create change at the individual patient, practice, and community levels within the healthcare system. This requires knowledge of the socio-political, economic, geographical, cultural and family influences on the health of patient groups and their communities.

Population health and the context of general practice includes the following areas:

  • epidemiology
  • public health
  • prevention
  • family influence on health
  • resources.

Domain 4. Professional and ethical role

The GP's professional and ethical role relates to their behaviour with respect to patients, colleagues and the community. Professional ethics are based on belief systems of the profession and the community.

Professional and ethical role includes the following areas:

  • duty of care
  • standards
  • self appraisal
  • teacher role
  • research
  • self care
  • networks.

Domain 5. Organisational and legal dimensions

Organisational and legal dimensions includes the following areas:

  • information technology/e-health
  • records
  • reporting
  • confidentiality
  • practice management.

Training Outcome of the five domains of general practice

1. Communication skills and the patient-doctor relationship

CTOT1.1

General practitioners who are competent in this domain will be able to:

  • critically appreciate the nature of the relationship between patient and doctor and its therapeutic potential
  • understand of different consultation models
  • use a patient centred approach
  • have the communication skills and attitudes needed to foster effective whole person care
  • have the skills to undertake effective individualistic and opportunistic health education and promotion.
CTOT1.2

The minimum knowledge, skills and attitudes in this domain that GPs need to demonstrate are how to:

  • establish rapport and be empathic with patients
  • develop good listening and language skills appropriate to the patient
  • adopt appropriate verbal and nonverbal communication styles for different situations (eg. emotional states, state of health, disadvantage, cultural background)
  • elicit the patient's issues, problems and concerns
  • engender confidence and trust (and advocate on the patient's behalf where appropriate)
  • use body language and touch in an appropriate manner to establish trust in a therapeutic relationship
  • find common ground with patients about their problems and expectations
  • negotiate an effective management plan and agree on respective responsibilities and limits with the patient and their family
  • communicate effectively and appropriately with significant others (eg. partner and family)
  • recognise opportunities for health promotion and education and respond appropriately to increase the patient's capacity for self care
  • confirm the patient's understanding of the problem, management, advice and follow up.

2. Applied professional knowledge and skills

CTOT2.1

General practitioners who are competent in this domain will need to demonstrate:

  • a knowledge of significant medical conditions and approaches to undifferentiated problems
  • skills in information gathering, physical examination, the undertaking of procedures and clinical decision making
  • a critical appreciation of the need for continuity and integration of care, cost effective investigations, rational prescribing and the need to continually undertake critical self appraisal.
CTOT2.2

The minimum knowledge, skills and attitudes in this domain that GPs need to demonstrate are how to:

  • take a history and perform a physical examination relevant to presenting problems
  • develop a working diagnosis from their knowledge and experience and the information gathered
  • critically use investigations and interpret the results to refine the working diagnosis
  • recognise and manage the significantly ill patient
  • consider the possibility of serious illness inherent in many common presentations
  • competently manage common problems (including undifferentiated illness)
  • negotiate, prioritise and implement management plans
  • prescribe safely and cost effectively from an informed knowledge base
  • use hospital and community based expertise, resources and networks effectively
  • make valid and timely decisions about referral and follow up
  • develop and maintain essential procedural skills
  • recognise their own abilities and limitations, responding appropriately
  • accept and manage uncertainty
  • be critical and discriminating in the use of information from a range of sources
  • consistently apply universal precautions principles.

3. Population health and the context of general practice

CTOT3.1

General practitioners who are competent in this domain will need to:

  • have an understanding of demographics, epidemiology, public health problems and health needs of special groups
  • be aware of the patterns and prevalence of disease and be able to participate in population based preventive strategies
  • have a critical appreciation of the impact on the health of the patient of their socio-political, economic, work, spiritual and cultural background and needs, and their relationships with family and significant others
  • possess skills in advocacy and in using community resources
  • appreciate the importance of a public health perspective in general practice.
CTOT3.2

The minimum knowledge, skills and attitudes in this domain, which GPs need to demonstrate, are how to:

  • elicit and take into account a patient's socio-political, economic, work, spiritual, linguistic and cultural background and needs, as well as their relationships with family and significant others in relation to their health
  • understand and respond to the special needs and characteristics of their practice population including disease prevention and health promotion screening and recall systems, and access and equity issues
  • use a working knowledge of, and be involved in assisting the health of the community locally, regionally and nationally. This includes participating in community based prevention and education strategies and accessing available health services such as networking with other GPs, GP organisations and healthcare providers, involvement in the public health system and strategies (eg. notifiable diseases and environmental issues)
  • understand and utilise the Australian healthcare system (including its funding planning, services policies and community resources).

4. Professional and ethical role

CTOT4.1

General practitioners who are competent in this domain will need to demonstrate:

  • the special duty of care that arises when a patient-doctor relationship is established and the patient's needs involve the risk of injury. Doctors have a duty to exercise due care and skill to avoid any such injury and will become legally liable for the consequences of their own negligence
  • reflective skills and self appraisal
  • maintenance of professional standards, which imply that all doctors have an obligation to keep abreast of, and be informed about technical advances, new techniques and new therapies appropriate to their field of medicine (or field in which they profess to have special skills)
  • special duty of care at all times
  • professional standards of practice according to contemporary ethical principles
  • skills in reflection and professional self appraisal and being committed to lifelong learning and continuous professional improvement
  • skills that fulfil their role as teacher, leader and change agent
  • an understanding of research, evaluation and audit skills
  • use of professional networks and maintenance of their own wellbeing and that of their families.
CTOT4.2

The minimum knowledge, skills and attitudes in this domain that the general practice registrar needs to demonstrate are:

  • special duty of care:
    • responsibility for the optimal care of patients (including acting on patient cues, respecting patient-doctor boundaries and confidentiality, recognising own limitations, ensuring appropriate reporting and follow up, and undertaking advocacy as appropriate)
    • respect for a patient's culture and values, and an awareness of how these have an impact on the therapeutic relationship
    • understand the rights of patients to access competent, compassionate care, to be fully informed and their right to self determination
  • reflective skills and self appraisal:
    • the capacity for self awareness, reflection and self appraisal
    • the skills of lifelong learning
    • basic skills in clinical audit, critical appraisal and critical incident analysis, and professional development
    • networks for personal and clinical support
    • time management and coping skills sufficient to maintain care of self and family
  • maintenance of professional standards:
    • achieve and maintain professionally defined clinical practice standards
    • adhere to the professional codes of ethics
    • contribute to the development of general practice by gaining skills in areas such as teaching, research and evaluation.

5. Organisational and legal dimensions

CTOT5.1

General practitioners who are competent in this domain will need to:

  • ensure adequate arrangements are made for the availability and accessibility of care, and to ensure safety netting, screening and recall systems are in place
  • have a critical appreciation of patient and practice information technology and management requirements, medical records and legal responsibilities, and reporting, certification and confidentiality requirements
  • understand effective practice management principles and processes.
CTOT5.2

The minimum knowledge, skills and attitudes that GPs need to demonstrate are:

  • use of personal, organisational and time management skills in practice
  • accurate and legible recordings of consultations and referrals to enable continuity of care by GPs and other colleagues
  • use and evaluation of practice management skills relating to patient access guidelines, staff management, teamwork, office policies and procedures, and financial and resource management
  • manage information and data systems relating to clinical standards, guidelines and protocols; medical records; information technology; communication and transfer of patient related information; screening, recall and related systems; and access and confidentiality
  • incorporate medicolegal knowledge and responsibilities relating to certification, confidentiality, legal report writing, prescribing; informed consent, duty of care, and litigation
  • work within statutory and regulatory requirements
  • meet acceptable practice standards.

The Royal Australian College of General Practitioners (RACGP) ABN 34 000 223 807
RACGP House, 100 Wellington Parade, East Melbourne, Victoria 3002 Australia
Tel: +61 (3) 8699 0414 Fax: +61 (3) 8699 0400

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