strands & components

Strands & Components of the LEAP Framework

What are the strands and domains of medical professionalism?

The following is a brief description of the 3 strands and ten domains of medical professionalism upon which the framework is based. These outline the diverse roles and the wide range of skills, knowledge, attitudes and attributes that are considered to be part of being a medical professional today.

Strand One - Clinical Expertise

Clinical expertise strand

Expertise as a medical practitioner depends on the possession of a large body of knowledge and procedural skill. Experts have the ability to access, retrieve and use the information that they possess. They are able to integrate new with existing knowledge and discern critical features and fundamental issues when presented with clinical and diagnostic problems. The use of medical informatics, “the management and use of information in health”, has an increasing role to play in the face of the rapidly expanding knowledge base of all areas of medicine and so has been included in this strand.

This strand comprises three components or domains:

• Medical expertise
• Clinical judgement
• Medical informatics

Medical expertise

The medical practitioner possesses and maintains the medical and procedural knowledge necessary to conduct the clinical aspects of their professional practice.

Clinical judgement

They are able to apply their knowledge and procedural skills to make an informed, accurate diagnosis and provide appropriate treatment from the range of options available.

Medical informatics (clinical)

They are aware of the range of technologies available to them to assist in the maintenance and extension of their medical and procedural knowledge base, as well as their diagnostic skills. They make use of these technologies as required, both as a user and as a provider of information to other professionals and stakeholders in the health care system.

Strand Two - Risk Management

Risk management strand

Risk management can be defined as “the identification, investigation, analysis and evaluation of risks and the selection of the most advantageous method of correcting, eliminating or reducing identifiable risks”.

The medical practitioner needs to be aware of those aspects of their practice that contribute to less than optimum patient outcomes. The use of medical informatics also has a role to play in the minimisation of risk in medical practice.

This strand comprises four domains:

• Communication
• Practice management
• Medical informatics (practice)
• Personal management and insight.

Communication

The medical practitioner ensures honest and open communication with patients and their families. Patients are fully advised of the range of treatments available to them, and any associated risks so that valid consent can be obtained for treatment. They are effective listeners who demonstrate empathy with their patients in order to elicit all information relevant to making an effective diagnosis. Cultural and other factors that contribute toward the individuality of specific patients are appreciated and accommodated in the communication methods employed. In the event of outcomes that are considered sub-optimal, appropriate communication is undertaken with patients.

Practice management

The medical practitioner is aware of the factors that contribute to effective practice management and strives for best practice in this area.

Medical informatics (practice)

They are aware of the range of technologies available to them to help attain best practice in their practice environment. They make use of these technologies as required, in order to optimise patient outcomes.

Personal management and insight

They constantly reflects on all facets of their professional practice in order to optimise patient outcomes. Part of this reflection involves an awareness of their own suitability for practice and a monitoring of self.

Strand Three - Professional Values and Responsibilities

Professional values and responsibilities strand

Medical practitioners need to exhibit beliefs and behaviours that reflect the expectations of those they serve (society) and those with whom they interact as part of their profession. Individual practitioners are no longer immune from the gaze or expectations of either of these groups. They need to be sensitive to cultural and linguistic diversity and responsive to the cultural needs of their patients and families.

This strand of medical professionalism in the CPD framework acknowledges this and is comprised of three domains:

• Relationships and accountability
• Advocacy and equity
• Education

Relationships and accountability

The medical practitioner is dedicated to serving the interests of the patient, respecting patient autonomy and enabling patients to make informed decisions about their treatment.

They possess a knowledge and understanding of the legal and ethical framework in which they and their profession operate. They contribute to and abide by the Code of Ethics of their appropriate professional body. They appreciate the competing interests that can arise in the modern practice setting, and that they must practise in a manner that is without compromise in pursuing the interests of their patients and society.

They work collaboratively with other health professionals to maximise patient outcomes and demonstrate appropriate personal and interpersonal behaviours in all interactions with patients and others involved with their treatment. Patient confidentiality is respected, but balanced with public interest considerations.

The medical practitioner has a responsibility for assisting in the creation and implementation of continuous improvement initiatives in the profession. Individually and collectively, they have a responsibility for ensuring the competence of practitioners in their field, and for ensuring that rigorous mechanisms are in place for dealing with colleagues who are found not to be so.

Medical practitioners evince core humanistic values such as honesty, integrity and compassion in their relationships with others at all times, ensuring that patients and others are never exploited for the personal gain of the practitioner.

Advocacy and equity

The medical practitioner works actively to promote equity and justice and the elimination of discrimination in the health care system. They are an advocate for consumers of healthcare, being particularly aware of disadvantaged groups in the community, as well as providers of healthcare. There is a dedication to continuous improvement in the health care system, with an awareness of the need for collaboration with healthcare stakeholders, such as government, insurers, private sector provider organisations, allied health professionals and consumer groups.

Education

The medical practitioner has a commitment to lifelong learning for themselves and others in the profession. To this end they are involved in the education and training of medical students, early postgraduates and new practitioners in ways that demonstrate an understanding of appropriate teaching and learning theories and practices, and act as role models for these. They actively promote and are involved in credible scientific research to validate existing and generate new knowledge, and possess a desire to share the knowledge of their profession with others, including colleagues and other health professionals, and more widely in society. They have a responsibility to ensure that new knowledge generated from the profession is appropriately used.

Further Information

Domain descriptions

The full descriptions of each of the domains of professionalism can be viewed and downloaded from the CPMC website or a hard copy can be sent to you upon request.

The information on this page can also be downloaded as a PDF for printing:

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