Clinical Context
EPA 4 – Team communication applies in any clinical context but the critical aspects are to:
- communicate timely, accurate and concise information to facilitate transfer of care across various health sector boundaries including:
- at referral from ambulatory and community care.
- at admission.
- between clinical services and multidisciplinary teams.
- at changes of shift.
- at discharge to ambulatory and community care.
- produce timely, accurate and concise documentation of episodes of clinical care.
Training Material
EPA 4 Task Descriptors
The EPA 4 – Team communication assessment form lists the tasks that may be observed, noting that there is no requirement to observe all components. Prevocational doctors will be asked to tick the relevant tasks, but this may be changed by the assessor.
Click to view task descriptors
- Communicate effectively to:
- facilitate high-quality care at any transition point.
- ensure continuity of care.
- share patient information with other health care providers and multidisciplinary teams in conjunction with referral or the transfer of responsibility for patient care.
- use local agreed modes of information transfer, including oral, electronic and written formats to communicate (at least):
- patient demographics.
- a concise medical history and relevant physical examination findings.
- current problems and issues.
- details of relevant and pending investigation results.
- medical and multidisciplinary care plans.
- planned outcomes and indications for follow-up.
- Document effectively to:
- enable other health professionals to understand the issues and continue care.
- produce written summaries of care, including admission and progress notes, team referrals, discharge summaries, and transfer documentation.
- produce accurate records appropriate for secondary purposes.
- complete accurate medical certificates, death certificates and cremation certificates.
- enable the appropriate use of clinical handover tools.
How to Put EPA 4 into Practice
The focus of EPA 4 – Team communication is predominantly on interprofessional communication rather than patient communication.
There are many opportunities to consider EPA 4 – Team communication with a focus on either verbal or written interactions. Frequently, the verbal interactions may be more opportunistic and involve listening to the prevocational doctor as they carry out their work. The written communication EPAs may be more formalised and planned.
Some opportunities include:
Verbal Communication:
- Listen to the prevocational doctor as they make a referral to an inpatient unit from the ward or Emergency Department.
- If you are receiving a call about one of your patients for advice, you may consider how clear the communication was.
- Listen to handover at shift change in the Emergency Department.
- Listen to the prevocational doctor presentation in a multidisciplinary or planning meeting.
Written Communication:
- Make the time to review a discharge summary or transfer of care document written by the prevocational doctor.
- Review a written referral written by the prevocational doctor.
- Review a death certificate with the prevocational doctor.
Areas to consider for feedback:
- Did I understand what was being asked (and if not, why not?)
- What there a lot more information that needed to be added (verbally – where there lots of extra questions)
- If the communication was confusing, could a structure like ISBAR have helped?
- Do I think the prevocational doctor actually understood what what happening?
- Are there some tips the assessor can provide for summarising or succinctness?