EXSS4021

Exercise in Multimorbidity

Tutorial 1: Scope of Practice

1. Aim and Learning Outcomes

The primary aims of this tutorial are to:

 Identify key ethical considerations in case-based scenarios and apply the principles
and responsibilities that underpin the ESSA Code of Professional Conduct and Ethical
Practice
 Apply the principles of foundational, advanced and extended scope of practice to make
appropriate judgements on the responsibilities and expertise of an AEP in a client-
centred, multi-disciplinary care environment
 Synthesise information from medical history, patient interview and assessments to
formulate a written report to the client’s referrer

ESSA Standards

At the completion of this unit, students will be able to:

1.3.1 Illustrate the scope of practice of Accredited Exercise Physiologist (AEP) and the
scope of roles available for AEP practice

1.3.2 Employ core principles of case management and appropriate clinical reporting in
the delivery of clinical, health and wellness, work conditioning and rehabilitation
services within the boundaries of the ESSA AEP scope of practice and the
healthcare system framework.

1.3.3 Practise professional conduct that incorporates the principles, legislation,

regulations, rights and responsibilities that underpin: the ESSA Code of
Professional Conduct and Ethical Practice; therapeutic and collegial relationships;
and professional practice in a client centred, multi-disciplinary care environment.

3.3.7 Formulate and demonstrate measurement, evaluation and reporting of exercise

capacity including verbal and written communication with clients, referrer and
other relevant stakeholders
3.3.9 Discuss core principles of functional capacity as it relates to regulations, scientific
evidence, safe practice, client need and a multi-disciplinary care environment.

2. Case Studies
Scenario
You work in a private clinic that specialises in older adults. Your clinic has a close working
relationship with some local GPs and specialists that will often refer complex cases to you.

Please refer to the case studies in the file “EXSS4021_Tutorial Case Studies”.

These cases will be used throughout the tutorials so you can build on the work from the
previous tutorial and see the cases from beginning to end.

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 3. Ethical Considerations and Scope of Practice
For each case study, complete the information below. You may want to refer to the resources
provided on Canvas, including the ESSA Code of Professional Conduct and Ethical Practice,
ESSA Scope of Practice Policy, the Can I do this now? Decision Tree, and the Task
Delegation Framework.

Worksheet 3.1: Case Study 1

Question 1: What aspects of the patient’s care are within the foundational AEP scope of practice, and what would
require additional training/ skills (i.e. expanded scope of practice)?

Question 2: Using the table below, identify what aspects of the patient’s care require referral, the health care
practitioners you would refer to (this may include the original referrer e.g. GP &/or task delegation), justification for
the referral and priority for the patient’s care.

Health Concern Required treatments/ Health care Priority How should the
interventions practitioners health care team
involved collaborate?

Worksheet 3.2: Case Study 2

Question 1: What aspects of the patient’s care are within the foundational AEP scope of practice, and what would
require additional training/ skills (i.e. expanded scope of practice)?

Question 2: Using the table below, identify what aspects of the patient’s care require referral, the health care
practitioners you would refer to (this may include the original referrer e.g. GP &/or task delegation), justification for
the referral and priority for the patient’s care.

Health Concern Required treatments/ Health care Priority How should the
interventions practitioners health care team
involved collaborate?

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Worksheet 3.3: Case Study 3

Question 1: What aspects of the patient’s care are within the foundational AEP scope of practice, and what would
require additional training/ skills (i.e. expanded scope of practice)?

Question 2: Using the table below, identify what aspects of the patient’s care require referral, the health care
practitioners you would refer to (this may include the original referrer e.g. GP &/or task delegation), justification for
the referral and priority for the patient’s care.

Health Concern Required treatments/ Health care Priority How should the
interventions practitioners health care team
involved collaborate?

4. Clinical applications AI
The University has co-designed a new resource with students, AI in Education, to help
students upskill in their understanding and application of generative AI. The goal of this
resource is to democratise knowledge and skill around generative AI so that all students
everywhere can be equipped with the ability to use this new technology productively and
responsibly. You can access this resource here: https://bit.ly/students-ai

Clinical use of AI to support delivery of healthcare and/or automate indirect clinical tasks is an
emerging and evolving area. New systems and tools continue to be developed, however
professional guidelines regarding appropriate and ethical use are lagging. While new
technologies may be capable of reducing administrative burden by automating many tasks,
clinicians must take care to ensure they understand and address issues such as risks to
patient safety from inaccurate AI generated health advice, risks of bias and inequity, risks to
patient privacy and cyber security risks.

The Therapeutic Goods Administration (TGA) state that healthcare professionals have a
responsibility to:

 Report any potential cyber security issues with medical devices (including software)
to the TGA directly by phoning 1800 809 361

 Pass on relevant cyber security risk information associated with use of the device/
software to the patient

 Communicate benefits and risks of using the medical device/ software to the patient,
such that they are suitably informed to provide consent

 Upskill themselves on the safe and secure use of the medical device/ software,
where the device/ software is a common tool used by the professional for delivery of
healthcare

 Act on any advice from the TGA, the device/ software manufacturer or sponsor in the
event that a cyber security vulnerability or risk is disclosed

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 NSW Health has developed a living evidence resource summarising use cases, scientific
evidence and recommendations for implementation within healthcare, available here:
https://aci.health.nsw.gov.au/statewide-programs/critical-intelligence-unit/artificial. To date,
ESSA has not published recommendations for AEPs using AI tools in practice. In the
meantime, resources from other professional organisations can be used to guide you, such as
those provided on Canvas from AMA, RAGCP and AHPRA.

4.1 What tool should I use and is it safe?

Worksheet 4.1

1. Read the NSW Health guidance regarding data security and intellectual property. Make sure to read the
information in each of the tabs labelled ‘Issues’, ‘Best bets’, and ‘Real world solutions’.
2. Complete the table below to identify the capability and data security of some tools claiming to support
healthcare clinicians. You will need to search each tool’s website to find their data handling policy and
compare this to the NSW Health ‘Best bets’ guidelines.
3. Identify a tool that you feel meets your needs as a clinician to help you generate a report back to a referring
medical practitioner, while also satisfying data security guidelines. If they offer a free trial, consider signing
up to use the tool to complete activity 4.2 and/or the Case Study Report (Part A) assessment task.

AI Tool What does it do? Is it a generic Does it meet Does it offer a Would you
tool or Australian data free trial? (Y/N) use it in
healthcare security clinic? (Y/N)
specific? guidelines? (Y/N)
PatientNotes
Heidi Health
MyClerk
Clinical Notes AI
Nabla Copilot
Abridge
Dragon Medical
Australia
ConsultNote.ai
Medical AI Scribe
Lyrebird Health
Otter AI
Microsoft Copilot
ChatGPT

4.2 Generate a GP letter

Use either one of the tools identified above, or an AI model such as ChatGPT or
Microsoft Copilot, to generate a template for you to use to write a letter back to the
referring GP for one of the three case studies.
The letter should include:
 Summary of subjective & objective assessments
 Professional interpretation of the data
 Changes/ updates to the client’s clinical status
 Notable findings requiring follow-up or further referral
 Brief summary of your management plan

If using a generic AI tool such as ChatGPT or Microsoft Copilot, use the recommended
RTRI prompt structure to ask the tool to generate a template that you can then copy into
your usual word processing software.

Swap GP letters with a partner. Critically evaluate your partner’s letter, providing
feedback on appropriate use of language, effective synthesis of case information, the

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 content and presentation of their professional interpretation of the data, and how concise
the letter is.

4.3 As a class, discuss your thoughts on the process of using AI tools or AI generated
templates in this way. Consider:
 Did you find it helpful? Why/ why not?

 Did the template contain all the essential elements for an effective GP letter, or was
something missing?

 How much did the wording of the prompt affect the template that was generated?

 Can you see yourself using AI tools in this way in your practice as an AEP? Why/
why not?

 How should you acknowledge your use of the AI tool for the assessment task?

 How would you acknowledge your use of AI tools in clinical practice?

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