Professional Practice

Question 1

What are the four ethical principles?

Answer 1

1. Justice
2. Autonomy
3. Beneficence
4. Non-maleficence

Question 2

What is Justice?

Answer 2

equity, fairness of treatment or fair distribution of resources. PTs must try to maximise fairness regardless of age, race, gender or any other factor

Question 3

What is Autonomy?

Answer 3

The right of a patient to be self-governing or to function independently. Involves giving the patient enough information to make an informed decision.

Question 4

What is Beneficence?

Answer 4

The duty to do good. PT’s course of actions should always be in the best interest of the patient.

Question 5

What is non-maleficence?

Answer 5

The principle is to do no harm, prevent harm or remove harm. The course of action affecting the patient should not cause harm, whether it is by omission (what we don’t do) or commission (what we do).

Question 6

What is scope of practice?

Answer 6

It is composed of the following:
1. education and training
2. governing body
3. institution

Question 7

What are some physiotherapy interventions?

Answer 7

Consultation, education, therapeutic exercise, manual therapy and soft tissue techniques, electro-physical agents, mechanical modalities, functional activity training, cardio-respiratory techniques, and prescribing aids and devices

Question 8

What is NOT in PT scope of practice?

Answer 8

1. diagnosing medical conditions and diseases
2. presciribing or discussing the use of medication
3. other medical interventions not in PT scope of practice

Question 9

What are physiotherapy restricted activities?

Answer 9

1. Tracheal suctioning
2. Spinal manipulation
3. Acupuncture (including dry needling)
4. Treating a wound below the dermis
5. Assessment or rehabilitation of pelvic musculature
6. Administering a substance by inhalation

Question 10

What are restricted activities that cannot be delegated?

Answer 10

1. acupuncture
2. communicating a diagnosis
3. spinal manipulation
4. internal assessment or rehab of pelvic musculature

Question 11

Can tracheal suctioning and inhalation of substances (oxygen) be delegated to family members if they have been trained to do so by an authrpized individual?

Answer 11

Yes

Question 12

What are the two types of consent?

Answer 12

Expressed consent (verbal consent, physical gesture) and Implied consent (performing actions that give clinician permission to act)

Question 13

What are the four components of consent?

Answer 13

1. Capacity
2. Voluntariness
3. Disclosure
4. Understanding

Question 14

What is the definition of “Capacity” for consent?

Answer 14

The patient must have the ability to understand the interaction and appreciate the consequences of their decisions.

Question 15

What is the definition of “Voluntariness” for consent?

Answer 15

The patient must never be coerced/manipulated into making a decision.

Question 16

What is the definition of “Disclosure” for consent?

Answer 16

The physio must disclose any information a reasonable person in the same circumstance would require to make an informed decision.

Question 17

What is the definition of “Understanding” for consent?

Answer 17

It’s the responsibility of the physio to ensure that the patient understands and has not misinterpreted the information (always provide opportunities for questions)

Question 18

Is there an age determinant for capacity?

Answer 18

No.

Question 19

What is the minimum requirement of a substitute decision maker?

Answer 19

Must be above the age of 16 or the parent of the patient.

Question 20

Does consent need to be gained multiple times?

Answer 20

Consent must be gained once and must be gained again if there has been any changes in Rx or if the patient has withdrawn consent.

Question 21

Is persuasion and coercion acceptable for gaining consent?

Answer 21

Persuasion is acceptable for consent, coercion is NOT acceptable for consent. Coercion relies on threats or force, persuasion involves using reasoning and arguments.

Question 22

When must consent be gained?

Answer 22

1. Before assessing
2. Before treating
3. Before giving personal information to a third party

Question 23

What are the three general requirements for all records?`

Answer 23

1. well organized
2. understandable
3. accurate

Question 24

How must a clinician correct mistakes when record keeping?

Answer 24

Single line strike through, sign and date and the reason for the correction

Question 25

Who has rights to a patient's records?

Answer 25

1. patients or their authorized representative 2. care providers within circle of care 3. authorized assessor or investigator from a college 4. police under a missing person's act (no criminal activity is suspected, used to help locate a person, information can be presented orally if more appropriate)

Question 26

How long should patients records be kept for?

Answer 26

Minimum 10 years since discharge or 10 years after turning 18 years old?

Question 27

How must documents be destroyed or removed after 10 years?

Answer 27

Must be destroyed in an irreversible manner that maintains privacy and confidentiality

Question 28

Do patient's need to be notified when their records have been transferred to another health information custodian?

Answer 28

Yes, they must be notified

Question 29

Are physiotherapy assistants under the responsibility of the physio?

Answer 29

Yes

Question 30

Can PTA perform assessments, reassessments, changes in Rx plans, or any restricted controlled acts such as acupuncture?

Answer 30

No

Question 31

What are common types of mandatory reports?

Answer 31

1. sexual abuse 2. Incompetence 3. incapacity 4. holding out as a physiotherapist 5. child abuse or neglect 6. abuse or neglect in LTC or retirement home 7. privacy breaches 8. disclosure to prevent harm 9. termination of employment

Question 32

What must a physiotherapist do if there has been a privacy breach?

Answer 32

Must report to the Information and Privacy Commissioner and the persons whose information has been affected, and must inform them of their right to make a complaint to the Information and Privacy Commissioner

Question 33

Do physiotherapists only report child abuse or neglect from patients?

Answer 33

No, it is the responsibility of the PT to report any suspicion based on reasonable grounds that a child requires protection to the CHILDREN'S AID SOCIETY

Question 34

Who does the physiotherapist need to report to if there has been a case of incompetence, capacity, sexual abuse or holding out?

Answer 34

The appropriate college of physiotherapists must be contacted

Question 35

Do physiotherapists need to report to the Registrar of the Retirement Homes Regulatory Authority if there has been a breach in an LTC home or retirement home?

Answer 35

Yes

Question 36

Is it illegal for a non-registered member to use the title of "physiotherapist"

Answer 36

Yes

Question 37

What is the title that registered members with provisional practice (passed written exam but not clinical exam) must use instead of physiotherapist?

Answer 37

Interim physiotherapist or physiotherapy resident

Question 38

What must a physiotherapist do when making a referral to avoid a conflict of interest?

Answer 38

1. Disclose the situation to the patient prior to making the referral 2. Inform the patient of alternatives 3. Document the discussion in the patient's chart

Question 39

Should a physiotherapist discuss their personal life to build rapport with a patient?

Answer 39

No, this can create a conflict of interest

Question 40

What must a physio do if a professional boundary is breached?

Answer 40

1. Identify the breach 2. Correct the bad behaviour 3. Document actions taken to correct the bad behaviour

Question 41

What are examples of professional boundary breaches?

Answer 41

1. Personal disclosure by the physio 2. Giving or receiving gifts 3. engaging in business or leisure activities with the patient 4. doing special favours for a patient 5. comments, words or gestures which are not related to clinical care 6. entering into a personal/social relationship with a patient

Question 42

Can physiotherapists treat family members?

Answer 42

Only if there is an emergency, and they cannot charge a fee

Question 43

Can physiotherapists enter into a personal or romantic relationship with their patients?

Answer 43

Only if it has been a year since they were discharged, there is no longer a power imbalance, and the patient is no longer dependent on the physiotherapist

Question 44

What is the boundary reflective test?

Answer 44

1. The witness test - would you do or say the same thing if someone else were watching? 2. The document test - would you document what you said or did in the patient's records? 3. The explanation test - can you explain what you did and why 4. The justification test - do you know your professional obligations, and does what you did follow it?

Question 45

What are ways to avoid poor communication?

Answer 45

1. Clearly explain risks and benefits 2. Avoid using jargon 3. Show empathy

Question 46

What are the six key features of effective communication?

Answer 46

1. Courtesy (greet client, introduce self, look them in the eye) 2. Clarity (use plain language, ensure understanding, opportunities for questions) 3. Listening (ask about feelings and concerns, paraphrase what they tell you) 4. Consider culture (cultural influences can shape perspectives on health, learn about hopes and fears) 5. Get on the same page (discuss goals, ensure mutual understanding regarding next steps) 6. Body language (physio's pay attention to their own body language and the client's)

Question 47

What are some alternative methods of communication?

Answer 47

Interpreters, handwriting, visual gestures, technology, diagrams, and printed education materials

Question 48

Can a physio collaborate with another healthcare team member when they are both working on the same goal?

Answer 48

Physiotherapists can only work with other healthcare members when their services are COMPLEMENTARY to each other.

Question 49

What must physios consider when collaborating with other healthcare members?

Answer 49

That the physiotherapy must be COMPATIBLE with the other services and forms of care

Question 50

Should physios take steps to understand what other forms of care a client is receiving?

Answer 50

Yes

Question 51

Can physios contact and speak with other members of the healthcare team to understand what type of care they are receiving?

Answer 51

Yes, this should be done to avoid clinicians performing the same treatment

Question 52

Is it fine for a physiotherapist and an occupational therapist to work together with a patient?

Answer 52

Yes, physios should participate in concurrent treatment of the same condition when approaches are complementary, benefit the client, and an appropriate use of human/financial resources

Question 53

What are the main points to consider when thinking of collaborative care?

Answer 53

1. COMPLIMENTARY (services must compliment each other) 2. COMPATIBILITY (services must be compatible with each other)

Question 54

Do physios need to provide a range of alternatives when making a referral?

Answer 54

Yes, this is to avoid conflict of interest and ensure disclosure

Question 55

Is a referral for physio required for government-funded physiotherapy or in-hospital physio?

Answer 55

Yes

Question 56

Is a referral required for out-of-hospital physio or a government-funded clinic

Answer 56

No