Documentation
Learning outcomes
| Stage 1 | Stage 2 | Stage 3 |
|---|---|---|
Demonstrates comprehensive and legible case record documentation including discharge summaries and written liaison with referrers, primary care providers and community organisations (where relevant), under supervision. | Provides timely, structured and reasoned written reports and letters in a variety of settings (e.g. medicolegal reports, coronial inquiries, academic work). | Records timely, clear and accurate documentation in patient files and maintains documentation as required by the employer (e.g. accurate prescribing, risk assessments, mental state evaluations, updated management plans with justifications of changes, discharge and transfer of care documentation, etc.). |
Resources
Below is a selection of RANZCP resources to help build knowledge and understanding in this learning area. These are provided as an entry point, and do not reflect formal learning or assessment requirements.
LearnIt modules (member login required)
- Risk assessment and management of violence in general adult psychiatry
- Aboriginal and Torres Strait Islander mental health - cultural considerations for risk assessment
- Forensic Psychiatry - approaches to violence risk assessment
- Australian Clinical Practice Skills - Module 4: Individualising case formulations and management plans
- Aboriginal and Torres Strait Islander mental health - Module 2: Developing a mental health management plan for an Aboriginal or Torres Strait Islander patient
Clinical guideline