Pediatric Emergency Medicine

Entrustment (how much supervision did this activity need?)

1. ●I had to do
2. ●I had to talk them through
3. ●I needed to prompt
4. ●I needed to be there just in case
5. ●I didn’t need to be there

Type of observation

1. ●direct
2. ●case review

Patient age

1. ●infant
2. ●child
3. ●adolescent

Medical Expert

• □ME 2.2 Elicit an accurate, relevant history
• □ME 2.2 Perform a physical examination relevant to the presentation
• □ME 2.2 Adapt the assessment to the child’s age and developmental stage
• □ME 2.2 Construct a differential diagnosis that recognizes both common and important uncommon diagnoses
• □ME 2.2 Synthesize information for succinct presentation to a supervisor
• □ME 1.4 Recognize conditions and presentations that may require urgent/emergent care

Communicator

• □COM 2.1 Conduct the interview in a patient- and family-centred manner
• □COM 2.3 Identify other sources of information (e.g., family, medical record) that may assist in the patient’s care

Professional

• □P 1.1 Work within personal limits, asking for assistance as needed

Case description

Feedback provided

Next steps

Entrustment (how much supervision did this activity need?)

1. ●I had to do
2. ●I had to talk them through
3. ●I needed to prompt
4. ●I needed to be there just in case
5. ●I didn’t need to be there

Presentation

1. ●altered neurological status
2. ●cardiac dysrhythmia
3. ●cardiorespiratory arrest
4. ●respiratory failure
5. ●shock
6. ●status epilepticus
7. ●other (please specify)

Setting

1. ●clinical
2. ●simulation

Medical Expert

• □ME 2.2 Perform a focused assessment in a time effective manner without missing key elements
• □ME 2.1 Determine the priorities for patient care
• □ME 2.4 Provide initial stabilization of ABCs
• □ME 4.1 Ask for additional assistance and/or other services when indicated
• □ME 3.4 Perform the sequence of resuscitation as per established protocols

Collaborator

• □COL 1.3 Work effectively as a member of a resuscitation team
• □COL 2.2 Communicate clearly, citing names (or other identification) and using closed loop communication

Professional

• □P 4.1 Maintain professional clinical performance in stressful situations

Case description

Feedback provided

Next steps

Entrustment (how much supervision did this activity need?)

1. ●I had to do
2. ●I had to talk them through
3. ●I needed to prompt
4. ●I needed to be there just in case
5. ●I didn’t need to be there

Presentation

1. ●head trauma
2. ●thoracic trauma
3. ●abdominal/pelvic trauma
4. ●polytrauma
5. ●other (please specify)

Setting

1. ●ED
2. ●simulation

Medical Expert

• □ME 2.2 Perform a primary and secondary survey in a timely manner
• □ME 2.2 Recognize clinically significant findings
• □ME 2.4 Propose initial steps in intervention

Collaborator

• □COL 1.2 Demonstrate knowledge of the roles of each member of the trauma team
• □COL 1.2 Work effectively with other members of the trauma team
• □COL 2.2 Communicate clearly, citing names (or other identification) and using closed loop communication

Professional

• □P 4.1 Maintain professional clinical performance in stressful situations

Case description

Feedback provided

Next steps

Entrustment (how much supervision did this activity need?)

1. ●I had to do
2. ●I had to talk them through
3. ●I needed to prompt
4. ●I needed to be there just in case
5. ●I didn’t need to be there

Age

1. ●neonate
2. ●infant
3. ●child
4. ●adolescent

Presentation type

1. ●general medical
2. ●minor injury

Medical Expert

• □ME 1.4 Perform a clinical assessment that addresses all relevant issues
• □ME 2.2 Develop a differential diagnosis relevant to the presentation
• □ME 2.2 Differentiate between a common and/or uncomplicated presentation and one that is atypical and/or related to a more complex disease process
• □ME 2.2 Select and/or interpret investigations
• □ME 2.4 Develop and implement a management plan, including follow-up and indication to return to the emergency department

Communicator

• □COM 2.1 Conduct the interview in a patient- and family-centred manner
• □COM 2.3 Seek and synthesize relevant information from other sources (e.g., family, medical record)
• □COM 5.1 Document the encounter to convey the assessment, clinical reasoning and rationale for decisions and/or recommendations

Health Advocate

• □HA 1.1 Facilitate the patient’s access to needed services and resources

Case description

Feedback provided

Next steps

Entrustment (how much supervision did this activity need?)

1. ●I had to do
2. ●I had to talk them through
3. ●I needed to prompt
4. ●I needed to be there just in case
5. ●I didn’t need to be there

Age

1. ●infant/toddler
2. ●child
3. ●adolescent

Communicator

• □COM 1.1 Establish rapport with the patient and family
• □COM 1.1 Engage the patient in the discussion as appropriate for their developmental stage
• □COM 3.1 Provide accurate information about the condition and plans for investigation and/or management
• □COM 3.1 Use plain language and avoid medical jargon
• □COM 3.1 Verify understanding of information conveyed and clarify where appropriate
• □COM 4.3 Explore expectations and answer questions from the patient and/or family
• □COM 4.3 Use communication skills and strategies that help the patient and/or family make informed decisions
• □COM 4.1 Communicate in a manner that is respectful, non-judgmental and culturally aware

Case description

Feedback provided

Next steps

Entrustment (how much supervision did this activity need?)

1. ●I had to do
2. ●I had to talk them through
3. ●I needed to prompt
4. ●I needed to be there just in case
5. ●I didn’t need to be there

Collaborator

• □COL 1.1 Establish respectful and collegial relationships with other members of the health care team
• □COL 1.2 Make effective use of the scope and expertise of other health care professionals
• □COL 1.1 Respond appropriately to input from other health care professionals
• □COL 1.3 Communicate effectively with other health care professionals

Professional

• □P 1.1 Recognize and respond to requests for assistance

Case description

Feedback provided

Next steps

Entrustment (how much supervision did this activity need?)

1. ●I had to do
2. ●I had to talk them through
3. ●I needed to prompt
4. ●I needed to be there just in case
5. ●I didn’t need to be there

Age

1. ●infant
2. ●child
3. ●adolescent/adult

Presentation

1. ●altered neurologic status
2. ●cardiac dysrhythmia
3. ●cardiorespiratory arrest
4. ●respiratory failure
5. ●severe/multisystem trauma
6. ●shock
7. ●status epilepticus

Setting

1. ●ED
2. ●other clinical unit
3. ●simulation

Medical Expert

• □ME 2.1 Recognize a patient’s unstable or critical presentation and initiate management
• □ME 1.4 Act decisively and maintain control of crisis situations
• □ME 2.4 Provide concurrent treatment and ongoing assessment of the patient’s clinical condition
• □ME 2.4 Manage hemodynamic support and monitoring
• □ME 2.4 Manage non-invasive and/or invasive ventilation
• □ME 5.2 Demonstrate situational awareness
• □ME 3.1 Integrate planned procedures or therapies into resuscitative efforts
• □ME 4.1 Ask for additional assistance and/or other services when indicated
• □ME 2.4 Reassess, re-evaluate and adjust resuscitative and diagnostic efforts as appropriate
• □ME 2.2 Recognize when ongoing resuscitation efforts are no longer effective and should be discontinued
• □ME 2.4 Coordinate care to arrange for safe and appropriate disposition

Communicator

• □COM 5.1 Document the encounter to convey the assessment, clinical reasoning and rationale for decisions and/or recommendations

Collaborator

• □COL 1.2 Delegate tasks and direct team members to aid in resuscitation
• □COL 1.3 Participate and/or lead debriefing of an event with the health care team

Leader

• □L 4.2 Establish clear leadership in resuscitative efforts

Professional

• □P 4.1 Maintain professional clinical performance in stressful situations

Case description

Feedback provided

Next steps

Entrustment (how much supervision did this activity need?)

1. ●I had to do
2. ●I had to talk them through
3. ●I needed to prompt
4. ●I needed to be there just in case
5. ●I didn’t need to be there

Injury type

1. ●CNS
2. ●dental
3. ●ENT
4. ●genitourinary
5. ●MSK
6. ●ocular
7. ●plastics
8. ●other (please specify)

Setting

1. ●ED
2. ●outpatient clinic

Medical Expert

• □ME 2.2 Gather information about the nature of the injury
• □ME 2.2 Perform a physical examination relevant to the presentation
• □ME 2.2 Select and/or interpret investigations
• □ME 2.4 Develop a plan for management
• □ME 2.4 Determine the appropriate setting for ongoing care, including admission or discharge
• □ME 4.1 Arrange disposition and follow-up care as relevant

Communicator

• □COM 3.1 Share information and explanations with the patient and/or family clearly and accurately
• □COM 5.1 Document the encounter to convey the assessment, clinical reasoning and rationale for decisions and/or recommendations

Collaborator

• □COL 3.2 Provide safe transfer of care, oral and/or written

Case description

Feedback provided

Next steps

Entrustment (how much supervision did this activity need?)

1. ●I had to do
2. ●I had to talk them through
3. ●I needed to prompt
4. ●I needed to be there just in case
5. ●I didn’t need to be there

Age

1. ●neonate
2. ●infant
3. ●child
4. ●adolescent

Medical Expert

• □ME 1.4 Perform a clinical assessment that addresses all relevant issues
• □ME 2.2 Gather clinical information to determine the patient’s clinical status and health care needs
• □ME 2.2 Develop a working diagnosis and differential diagnosis relevant to the presentation
• □ME 2.4 Develop a management plan to guide initial investigations and treatments
• □ME 2.4 Reassess and adapt the management plan to include further investigation, treatment, and/or discharge
• □ME 2.3 Integrate the patient’s and family’s perspective and context into the care plan
• □ME 4.1 Arrange follow-up and/or reassessment, as relevant

Communicator

• □COM 5.1 Document the encounter to convey the assessment, clinical reasoning and rationale for decisions and/or recommendations

Leader

• □L 2.1 Consider resource utilization when choosing care options

Scholar

• □S 3.4 Integrate best evidence and clinical expertise

Case description

Feedback provided

Next steps

Entrustment (how much supervision did this activity need?)

1. ●I had to do
2. ●I had to talk them through
3. ●I needed to prompt
4. ●I needed to be there just in case
5. ●I didn’t need to be there

Type of observation

1. ●direct
2. ●indirect

Presentation

1. ●agitation
2. ●behavioural issue(s)
3. ●depression/anxiety
4. ●eating disorder
5. ●familial/social issue(s)
6. ●gender dysphoria/incongruity
7. ●psychosis
8. ●suicidal ideation, intent, and/or attempt

Chemical or physical restraint applied

1. ●no
2. ●yes

Involuntary admission/treatment

1. ●no
2. ●yes

Setting

1. ●clinical
2. ●simulation

Medical Expert

• □ME 5.2 Apply policies, procedures, and evidence-based practices when dealing with patient, staff, and provider safety, including violent and potentially violent situations
• □ME 1.4 Perform a clinical assessment that addresses all relevant issues
• □ME 2.2 Assess risk of harm to self and others
• □ME 2.4 Develop and implement a management plan, including a risk management plan
• □ME 4.1 Determine the need, timing and priority of referral to a mental health professional

Communicator

• □COM 1.5 Apply de-escalation and conflict resolution skills, as needed
• □COM 3.1 Convey to the patient/family the rationale for a decision regarding involuntary treatment and/or hospitalization
• □COM 5.1 Document the encounter to convey the assessment, clinical reasoning and rationale for decisions and/or recommendations

Collaborator

• □COL 3.2 Communicate safety issues and risk management plans at handover to another physician or care team

Professional

• □P 3.1 Apply knowledge of relevant mental health legislation

Case description

Feedback provided

Next steps

Entrustment (how much supervision did this activity need?)

1. ●I had to do
2. ●I had to talk them through
3. ●I needed to prompt
4. ●I needed to be there just in case
5. ●I didn’t need to be there

Acuity

1. ●high
2. ●low

Medical Expert

• □ME 1.4 Perform a clinical assessment that addresses all relevant issues
• □ME 2.1 Assess the clinical urgency and potential for deterioration
• □ME 2.2 Gather information about the exposure/causal entity, including extent of exposure, timing, and any concomitant exposures or ingestions
• □ME 2.2 Select and/or interpret investigations
• □ME 2.4 Develop a plan for supportive care, decontamination, antidotal therapy and/or enhanced elimination as appropriate
• □ME 2.2 Assess the nature of the ingestion or exposure, intentional or accidental
• □ME 2.4 Develop a plan for ongoing care, including admission or consultation as required
• □ME 5.2 Ensure personal protection for the health care team and perform decontamination as relevant

Communicator

• □COM 3.1 Share information and explanations with the patient and/or family clearly and accurately

Professional

• □P 3.1 Adhere to requirements for mandatory reporting

Case description

Feedback provided

Next steps

Entrustment (how much supervision did this activity need?)

1. ●I had to do
2. ●I had to talk them through
3. ●I needed to prompt
4. ●I needed to be there just in case
5. ●I didn’t need to be there

Type of maltreatment

1. ●physical
2. ●emotional
3. ●sexual
4. ●neglect

Direct observation of disclosure of calling CPS

1. ●yes
2. ●no

Medical Expert

• □ME 2.2 Recognize and respond to factors that raise the suspicion of child maltreatment and/or neglect
• □ME 2.2 Recognize sentinel clinical findings suggesting child maltreatment and/or neglect, including injuries, behavioural and emotional changes and other clinical signs
• □ME 1.6 Work within professional boundaries, delegating forensic interviewing to other professionals as indicated
• □ME 2.2 Assess a patient for signs and symptoms of child maltreatment and/or neglect
• □ME 3.4 Collect specimens for assessment of sexually transmitted infections
• □ME 2.2 Select and/or interpret investigations
• □ME 2.4 Develop a plan for management
• □ME 4.1 Determine the need to involve specialized care professionals, child protective services, or law enforcement

Communicator

• □COM 5.1 Document evidence of child maltreatment and/or neglect, including the use of diagrams and photographs as appropriate

Professional

• □P 3.1 Apply relevant aspects of child welfare legislation

Case description

Feedback provided

Next steps

Entrustment (how much supervision did this activity need?)

1. ●I had to do
2. ●I had to talk them through
3. ●I needed to prompt
4. ●I needed to be there just in case
5. ●I didn’t need to be there

Age

1. ●toddler/child
2. ●adolescent

Medical Expert

• □ME 3.1 Determine the most appropriate plan for sedation and/or systemic analgesia
• □ME 3.2 Obtain and document informed consent, explaining the risks and rationale for the proposed procedure
• □ME 3.1 Incorporate non-pharmacologic adjuncts such as distraction, child life therapy and comfort care
• □ME 5.2 Select and apply monitoring strategies demonstrating knowledge of potential complications or adverse events
• □ME 3.4 Provide procedural sedation and/or systemic analgesia in a skilful and safe manner
• □ME 3.4 Recognize and respond to a complication or adverse event

Communicator

• □COM 5.1 Document the procedure and outcome

Collaborator

• □COL 1.2 Communicate effectively with patient, family, and/or assistant(s) during the procedure

Case description

Feedback provided

Next steps

Entrustment (how much supervision did this activity need?)

1. ●I had to do
2. ●I had to talk them through
3. ●I needed to prompt
4. ●I needed to be there just in case
5. ●I didn’t need to be there

Age

1. ●infant
2. ●child
3. ●adolescent/adult

Procedure

1. ●bag valve mask ventilation
2. ●cardioversion/defibrillation
3. ●casting without reduction lower limb
4. ●casting without reduction upper limb
5. ●chest tube placement – percutaneous
6. ●chest tube placement - traditional
7. ●endotracheal intubation
8. ●gastrostomy tube replacement/temporization
9. ●incision and drainage of an abscess
10. ●intraosseous insertion
11. ●laryngeal mask airway insertion
12. ●lumbar puncture
13. ●reduction of an extremity fracture
14. ●surgical airway
15. ●wound repair (complex)
16. ●wound repair (simple)

Setting

1. ●ED
2. ●other clinical
3. ●simulation

Medical Expert

• □ME 3.2 Obtain and document informed consent, explaining the risks and rationale for a proposed procedure
• □ME 3.4 Gather and/or manage the availability of appropriate instruments and materials
• □ME 3.4 Position the patient appropriately
• □ME 3.4 Demonstrate aseptic technique: skin preparation; draping; establishing and respecting the sterile field; hand cleanse, mask, gown and glove
• □ME 3.4 Select and provide sedation and local analgesia, as appropriate
• □ME 3.4 Perform the procedure in a technically skilful and safe manner
• □ME 3.4 Monitor patient comfort and safety, and adjust the procedure as needed
• □ME 3.4 Establish and implement a plan for post-procedure care
• □ME 3.4 Recognize and respond to a complication or adverse event

Communicator

• □COM 5.1 Document the procedure and outcome

Collaborator

• □COL 1.2 Communicate effectively with patient, family, and/or assistant(s) during the procedure

Professional

• □P 1.1 Work within personal limits, asking for assistance as needed

Case description

Feedback provided

Next steps

Entrustment (how much supervision did this activity need?)

1. ●I had to do
2. ●I had to talk them through
3. ●I needed to prompt
4. ●I needed to be there just in case
5. ●I didn’t need to be there

Type of observation

1. ●direct
2. ●review of images, documentation and case

Case mix

1. ●e-Fast
2. ●abdominal
3. ●cardiac
4. ●lung
5. ●procedural
6. ●soft tissue

Medical Expert

• □ME 3.2 Explain the POCUS procedure, including risks and rationale
• □ME 3.4 Adjust instrument settings to optimize image quality
• □ME 3.4 Acquire views and images relevant to the examination being performed
• □ME 3.4 Monitor patient comfort and safety, and adjust the procedure as needed
• □ME 2.2 Interpret the findings of the POCUS examination
• □ME 4.1 Determine the need and timing of referral for definitive imaging

Communicator

• □COM 5.1 Record high quality images of significant findings
• □COM 5.1 Document the encounter to convey the assessment, clinical reasoning and rationale for decisions and/or recommendations

Collaborator

• □COL 1.2 Communicate effectively with patient, family, and/or assistant(s) during the procedure

Case description

Feedback provided

Next steps

Entrustment (how much supervision did this activity need?)

1. ●I had to do
2. ●I had to talk them through
3. ●I needed to prompt
4. ●I needed to be there just in case
5. ●I didn’t need to be there

Medical Expert

• □ME 1.1 Demonstrate responsibility and accountability for decisions regarding patient care
• □ME 1.5 Prioritize among patients based on clinical acuity
• □ME 1.4 Perform relevant and time-effective clinical assessments
• □ME 2.4 Develop and implement plans for investigation and/or management
• □ME 2.4 Anticipate clinical response and progress to other settings of care, including home or referral for admission

Collaborator

• □COL 1.2 Work effectively with other physicians and health care professionals

Leader

• □L 4.1 Integrate supervisory and teaching responsibilities into the workload of the shift

Professional

• □P 1.1 Respond to requests from patients or other health care professionals
• □P 4.1 Manage the mental and physical challenges that impact physician wellness and/or performance

Case description

Feedback provided

Next steps

Entrustment (how much supervision did this activity need?)

1. ●I had to do
2. ●I had to talk them through
3. ●I needed to prompt
4. ●I needed to be there just in case
5. ●I didn’t need to be there

Type of observation

1. ●direct
2. ●patient/family feedback

Medical Expert

• □ME 2.1 Ascertain participants’ understanding of the situation and the reason for the encounter
• □ME 5.2 Recognize when the situation requires the intervention of security or law enforcement

Communicator

• □COM 1.1 Demonstrate empathy, respect and compassion
• □COM 1.2 Ensure the physical environment is suitable for the nature of the situation (e.g., privacy, safety)
• □COM 3.1 Share information and explanations with the patient and/or family clearly and accurately
• □COM 3.1 Verify understanding of information conveyed and clarify where appropriate
• □COM 1.4 Identify, verify and validate non-verbal cues
• □COM 2.2 Manage the flow of the encounter
• □COM 1.5 Recognize when strong emotions (such as anger, fear, anxiety, or sadness) are impacting an interaction and respond appropriately
• □COM 1.5 Apply de-escalation and conflict resolution skills, as needed
• □COM 2.2 Summarize and close the encounter effectively
• □COM 5.1 Document the encounter to convey the discussion and its outcome

Collaborator

• □COL 2.2 Listen to understand and acknowledge other perspectives

Case description

Feedback provided

Next steps

Entrustment (how much supervision did this activity need?)

1. ●I had to do
2. ●I had to talk them through
3. ●I needed to prompt
4. ●I needed to be there just in case
5. ●I didn’t need to be there

Context

1. ●transfer from pre-hospital care (high acuity)
2. ●transfer to other services

Medical Expert

• □ME 2.2 Determine the patient’s clinical status and health care needs
• □ME 2.4 Determine the setting of care appropriate for the patient’s health care needs
• □ME 2.4 Anticipate changes in health status
• □ME 4.1 Establish plans for ongoing care, including follow-up on investigations and response to treatment

Communicator

• □COM 5.1 Document the encounter to convey the assessment, clinical reasoning and rationale for decisions and/or recommendations

Collaborator

• □COL 3.2 Summarize patient issues providing rationale for recommendations
• □COL 3.2 Provide guidance for next steps in management
• □COL 1.3 Work with other health care professionals to address barriers to access to resources and to manage patient and caregiver expectations of care

Leader

• □L 2.1 Apply knowledge of the resources and/or services available in other care settings

Case description

Feedback provided

Next steps

Entrustment (how much supervision did this activity need?)

1. ●I had to do
2. ●I had to talk them through
3. ●I needed to prompt
4. ●I needed to be there just in case
5. ●I didn’t need to be there

Collaborator

• □COL 2.1 Delegate tasks and responsibilities in an appropriate and respectful manner

Scholar

• □S 2.3 Be accessible and supportive to junior learners
• □S 2.4 Identify the learning needs and desired learning outcomes of others
• □S 2.4 Provide clinical teaching and/or other informal learning activities
• □S 2.5 Provide feedback to enhance learning and performance
• □S 3.4 Integrate best evidence and clinical expertise

Case description

Feedback provided

Next steps

Entrustment (how much supervision did this activity need?)

1. ●I had to do
2. ●I had to talk them through
3. ●I needed to prompt
4. ●I needed to be there just in case
5. ●I didn’t need to be there

Teaching format

1. ●small group session
2. ●didactic lecture
3. ●rounds
4. ●journal club
5. ●other

Scholar

• □S 2.4 Identify the learning needs and desired learning outcomes of others
• □S 2.4 Develop learning objectives for a teaching activity
• □S 3.3 Critically evaluate the integrity, reliability, and applicability of health-related research and literature
• □S 3.4 Integrate best evidence and clinical expertise
• □S 2.4 Present the information in an organized manner to facilitate understanding
• □S 2.4 Use audiovisual aids effectively
• □S 2.4 Facilitate interaction, questions and discussion

Case description

Feedback provided

Next steps

Entrustment (how much supervision did this activity need?)

1. ●I had to do
2. ●I had to talk them through
3. ●I needed to prompt
4. ●I needed to be there just in case
5. ●I didn’t need to be there

Medical Expert

• □ME 1.1 Demonstrate responsibility and accountability for decisions regarding patient care, acting in the role of most responsible physician
• □ME 1.5 Carry out professional duties in the face of multiple, competing demands
• □ME 5.2 Demonstrate situational awareness regarding the acuity and activity of patient care and resource use in the department
• □ME 1.4 Manage the breadth of PEM patient presentations in a time-effective manner
• □ME 4.1 Coordinate the involvement of consulting services in patient care

Collaborator

• □COL 1.2 Work with administrative staff to address department capacity issues
• □COL 1.3 Communicate effectively with other health care professionals

Leader

• □L 4.2 Liaise with pre-hospital care/emergency medical services to manage patient flow and transfers
• □L 4.1 Integrate supervisory and teaching responsibilities into the overall management of the department

Professional

• □P 1.1 Work within personal limits, asking for assistance as needed

Case description

Feedback provided

Next steps

Entrustment (how much supervision did this activity need?)

1. ●I had to do
2. ●I had to talk them through
3. ●I needed to prompt
4. ●I needed to be there just in case
5. ●I didn’t need to be there

Medical Expert

• □ME 5.2 Demonstrate situational awareness regarding the acuity and activity of patient care and resource use in the department
• □ME 5.2 Use structured handover tools and strategies to enhance patient safety

Collaborator

• □COL 3.2 Summarize information about the status of the emergency department’s patient flow and resources as well as hospital resources (e.g., beds available, intensive care status)
• □COL 3.2 Provide guidance on the prioritization of tasks and reassessments (e.g., unstable patients, critical lab results)
• □COL 3.2 Summarize patient issues, providing rationale for key decisions
• □COL 3.2 Provide information about expected patients (via EMS dispatch, patient transfer, call back) and lab/radiology results on discharged patients that require follow up
• □COL 3.2 Communicate effectively with the receiving physician(s), clarifying issues as needed
• □COL 3.2 Exchange information needed for handover with the healthcare team members (e.g., charge nurse) as needed

Case description

Feedback provided

Next steps

Entrustment (how much supervision did this activity need?)

1. ●I had to do
2. ●I had to talk them through
3. ●I needed to prompt
4. ●I needed to be there just in case
5. ●I didn’t need to be there

Medical Expert

• □ME 2.2 Integrate information from the clinical assessment to determine the patient’s clinical status and health care needs
• □ME 2.4 Assess the need and timing of transfer to another level of care
• □ME 2.4 Provide guidance for ongoing care in the local setting, for care prior to transfer, and/or for management of changes in the patient’s clinical status during medical transport
• □ME 4.1 Determine the need for consultation with other specialists

Communicator

• □COM 2.3 Request and synthesize patient information gathered by another health professional
• □COM 5.1 Document advice provided to off-site health care professionals

Collaborator

• □COL 1.3 Communicate effectively with other health care professionals

Leader

• □L 2.1 Apply knowledge of the resources and/or services available in other care settings

Health Advocate

• □HA 1.1 Advocate for appropriate accompaniment of caregivers with patients

Case description

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Entrustment (how much supervision did this activity need?)

1. ●I had to do
2. ●I had to talk them through
3. ●I needed to prompt
4. ●I needed to be there just in case
5. ●I didn’t need to be there

Medical Expert

• □ME 2.2 Review clinical history, imaging and other relevant data as necessary
• □ME 2.2 Interpret the results of investigations in the context of the patient’s presentation
• □ME 2.4 Develop a management plan, which may include a change in management, recall to the emergency department and/or referral to another service

Communicator

• □COM 3.1 Share information and explanations with the patient and/or family clearly and accurately
• □COM 3.1 Verify understanding of information conveyed and clarify where appropriate
• □COM 4.3 Answer questions from the patient and/or family
• □COM 5.1 Document the encounter to convey the assessment, clinical reasoning and rationale for decisions and/or recommendations

Case description

Feedback provided

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