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COKO Professional Practice sample exam Q's What sentence best describes the roles of the College and professional associations? i. The College serves the public interest and the professional associations serve the interests of the profession. ii. The College and the professional associations both serve the public interest. iii. The College and the professional associations both serve the interests of the profession. iv. The professional associations direct the operations of the College. correct answer The best answer is i. The College's mandate is to regulate the profession in order to serve and protect the public interest. Answer ii is not the best answer because professional associations are designed to serve the interests of their members. While professional associations care about the public interest and often take actions that assist the public interest, they are under no statutory duty to do so and are accountable only to their members. Answer iii is not the best answer because the College is not permitted to serve the interests of its members under its statute. While it tries to ensure that it regulates its members sensitively and fairly, and consults with its members, the College's mandate is the public interest. Answer iv is not correct. While the College consults with the professional associations and considers seriously their views and respects their expertise, the College is not under the control of any professional association. Ethics Scenario: David, a kinesiologist, is always polite to his patients/clients, in a formal way. He feels good about himself. However, he often says "God" to express surprise. The phrase means nothing to him and no one has ever expressed concerns about it. One of his patients/clients, Paul, has shared that he is very religious. Whenever David says "God" Paul flinches a bit. What should David do? correct answer David notices and asks Paul if the use of the word "God" bothers Paul. Paul says that, actually it does. David makes a point of not saying "God" anymore in front of Paul. After discussing the incident with a colleague, David decides that the ethical thing for him to do is to stop using the word "God" as an expression of surprise whenever he is with a patient/client because David cannot tell in advance who will be offended. This relates to the Code of Ethics that kins must follow. Discontinuing Professional Services Scenario correct answer Donna, a kinesiologist, wants to stop treating a patient/client because the patient/client has stopped paying. She reads an article in the College's newsletter suggesting that patients/clients should be given at least two weeks to find a new kinesiologist before one stops treating the patient/client. Donna cannot see why she needs to see a patient/client who is not paying for her services and does not follow the newsletter suggestion. The patient/client experiences pain once the treatment stops and
misses ten days of work before the patient/client can find another kinesiologist to treat him. The patient/client complains to the College. After investigating the complaint the College requires Donna to appear before it to receive a verbal caution because Donna abandoned a patient/client who was in pain without giving the patient/client adequate time to find another kinesiologist. The fact that Donna was not paid did not remove her duty to the patient/client who was in pain. David, a kinesiologist, is registered with the College. David's father is no longer registered with the College. David's father sometimes drops into David's office to treat his former long term patients/clients. The office assistant refers to David's father as "Doctor" when booking patients/clients. A patient/client complains to the College when her extended health insurance refused to pay for David's father's services because he was unregistered. Is David at risk for his father's conduct? correct answer The answer is yes. It is professional misconduct to permit a person to hold themselves out as practising the profession when they are not registered. Similarly, permitting a person to illegally use the title "Doctor" in one's practice would often be seen as professional misconduct if David knew about it. David condoned the conduct that occurred at David's office. David, by being registered, gave credibility and status to the illegal conduct of his father. David could face a discipline hearing. Donna, a kinesiologist, does not really assess her patients/clients. She just asks the patient/client what is wrong and then gives all of them exactly the same treatment. A patient/client, Paula, came in with a serious condition. Donna did not recognize it. Paula's condition worsened. Donna still did not recognize it. After three months Paula went to the emergency department of the hospital and was immediately diagnosed and treated correctly. What is this a case of? correct answer This is an Incompetence Scenario. Paula complained to the College about Donna's incompetence. The Inquiries, Complaints and Reports Committee looked at Donna's records and heard Donna's explanation for what she had done. It sent the case to discipline. The Discipline Committee agreed that Donna showed a lack of knowledge, skill and judgment. It ordered Donna to participate in specific upgrading courses aimed at assessment. David, a kinesiologist, has been drinking a lot more alcohol the last few months. He has been coming to work with a hangover. More recently he has been drinking at lunch. One day David comes back after lunch drunk. Paul, a patient/client, notices that David smells of alcohol and that David is stumbling around the office. What is this a case of? correct answer This is an Incapacity Scenario.
Obtaining a broad consent (often called a "blanket consent") in writing from the patient/client on his or her arrival at the office is probably a bad idea because: i. The patient/client does not know if they will need someone to drive them home afterwards. ii. The patient/client does not have confidence in the kinesiologist yet. iii. The patient/client does not know what they are agreeing to. iv. The patient/client does not know how long the visit will be. correct answer The best answer is iii. Informed consent requires the patient/client to understand the nature, risks and side- effects of the specific procedure proposed by the kinesiologist, as well as who will be performing the assessment or treatment. It is impossible for the patient/client to know these things upon their arrival at the office. Answer i is not the best answer because it focuses on a side-issue and does not address the main issue. Answer ii is not the best answer because having confidence in the kinesiologist is not enough for there to be informed consent. A patient/client may trust the kinesiologist and that may motivate the giving of consent, but the patient/client still needs to know what they are agreeing to. Answer iv is not the best answer because it focuses on a side-issue and does not address the main issue. Consent Scenario No. 2 David, a kinesiologist, proposes that his patient/client Paul take a vitamin and mineral supplement. David says: "Try these: they will make you think more clearly". Paul takes one immediately and buys a bottle from the receptionist. When arriving at home Paul reads about the supplement on the internet and learns that it contains megadoses of Vitamin A1 which, if taken for a long period of time, could lead to liver and other damage. Paul complains to the College. David tells the College that he was relying on Paul's implied consent by swallowing the first pill and buying a bottle from the receptionist. The Inquiries, Complaints and Reports Committee issues a decision critical of David for not obtaining informed consent because: correct answer • David did not explain the nature of the "pill" including that it had megadoses of Vitamin A;
- David did not explain how the supplement would make Paul think more clearly;
- David misrepresented the hoped for benefit of the supplement as there was little evidence to support his very strong statement that it would make Paul think more clearly;
- David did not explain the way in which the supplement was to be used (how often to take the supplement and for what period of time);
- David did not explain the alternatives to taking the supplement including not taking anything; and, perhaps more importantly,
- David did not explain the risks of taking the supplement to Paul.
Consent Scenario No. 3 correct answer Donna, a kinesiologist, proposes a procedure for her patient/client Paula. Paula does not understand the proposed procedure at all. She is clearly incapable. Donna knows that Paula appointed her friend Pat to be her power of attorney for personal care. However, Pat is travelling outside of the country and cannot be reached. Therefore Pat is not able to make the decision. Donna contacts Paula's elderly mother, but Paula's mother is frail herself and does not feel confident in making the decision. Thus Paula's mother is not willing to act as a substitute decision maker. Paula's sister is willing and able to make the decision on Paula's behalf and appears to understand the information and its consequences for Paula. Paula's sister is able to give the consent even though she is not the highest ranked substitute. Consent Scenario No. 4 David, a kinesiologist, proposes a procedure for his patient/client Paul. Paul does not understand the proposed procedure at all. He is clearly incapable. David knows that Paul appointed his friend Pat to be his power of attorney for personal care. Pat is going to inherit Paul's money when Paul dies. Paul has a lot of money. Paul is going to die within a few months. The proposed procedure is simple and painless, would make the patient/client more comfortable through a difficult illness and has little risk of harm. David is convinced that Pat is refusing to consent to the treatment in order to inherit more money (even though treatment is not very expensive). The rest of Paul's family is very upset because they want Paul to receive the treatment. What should David do? correct answer David suggests that the family contact the office of the Public Guardian and Trustee. This will help the substitute decision-makers come to a decision. Which of the following is the highest ranked substitute decision maker (assuming that everyone was willing and able to give consent): i. A power of attorney for personal care for the patient/client. ii. The patient's/client's live-in boyfriend. iii. The patient's/client's mother. iv. The patient's/client's son. correct answer The best answer is i. Only a court appointed guardian is higher ranked than a power of attorney for personal care. Answer ii is not the best answer because the patient's/client's spouse or partner is a lower ranked substitute decision maker. In addition, it is not clear that the live-in boyfriend is a spouse (under the Health Care Consent Act, they must have been living together for at least one year, have had a child together or have a written cohabitation agreement to be spouses). Answers iii and iv are not
Donna's friends who also hire Paula. Paula is extremely grateful. Later Donna recommends a change in treatment that will not be covered by Paula's insurance. Paula wonders to herself if Donna is recommending this treatment in order to get back the money for cleaning Donna's house. Paula also feels that she cannot say no or else she will lose her job cleaning the houses of Donna's friends. Did the dual relationship contribute to Paula's confusion? Personal Opinions Scenario correct answer Paul, a patient/client discussing world events, pushes for David's, his kinesiologist's, views on immigration. At first David resists, but eventually says he has some concerns about the abuses of the immigration system. David says he has heard, often directly from patients/clients, about how they have lied to the immigration authorities. Paul loudly criticizes the immigration authorities for allowing too many immigrants into the country. Paul is overheard by other patients/clients in the clinic at the time, including some who are new Canadians. The other patients/clients tell other staff at the clinic that they feel uncomfortable with either David or Paul around. Sexual Abuse Scenario No. 1 correct answer Donna, a kinesiologist, tells a colleague about her romantic weekend with her husband at Niagara-on-the-Lake for their anniversary. Donna makes a joke about how wine has the opposite effect on the libido of men and women. Paula, a patient/client, is sitting in the reception area and overhears. When being treated by Donna, Paula mentions that she overheard the remark and is curious as to what Donna meant by this, as in her experience, wine helps the libido of both partners. Has Donna engaged in sexual abuse? Donna clearly has crossed boundaries by making the comment in a place where a patient/client could overhear it. However, the initial comment was not directed towards Paula and was not meant to be heard by her. It would certainly be sexual abuse for Donna to answer Paula's question. Donna should apologize for making the comment in a place where Paula could hear it and state that Donna needs to focus on Paula's treatment. Sexual Abuse Scenario No. 2 correct answer David, a kinesiologist, is attracted to his patient/client Paul. David notices that he is looking forward to working on the days when Paul will be there. David extends the sessions a few minutes in order to chat informally with Paul. David thinks Paul might be interested as well by the way that he makes eye contact. David notices that he is touching Paul on the back and the arm more often. David decides to ask Paul to join him for a coffee after his next visit to discuss whether Paul is interested in him. If Paul is interested, David will transfer Paul's care to a colleague. If Paul is not interested then David will make the relationship purely professional. David decides to ask a colleague, Donna, for advice. Donna, correctly, tells David that he has already engaged in sexual abuse by letting the attraction develop while continuing to treat Paul. Donna also says that it is important for David
to transfer the care of Paul right away and to cease pursuing a personal/romantic relationship with him. Donna reminds David that dating a patient/client is prohibited for a period of at least one year after the patient/client leaves the kinesiolgist's care, and that dating a client within this period would be considered sexual abuse that could lead to the revocation of David's registration. Which of the following is sexual abuse: i. Taking a sexual history when it is clinically necessary to do. ii. Using glamour shots of scantily dressed Hollywood stars as your interior design theme in order to attract younger patients/clients. iii. Telling an employee a sexual joke when there are no patients/clients around. iv. Dating a former patient/client after not having had any contact with the patient/client or their health care for a period of five years. correct answer The best answer is ii. These pictures sexualize the atmosphere at the clinic which is inappropriate in a health care setting. Answer i is not the best answer because taking a sexual history is appropriate when it is needed to assess the patient/client and it is done professionally. Answer iii is not the best answer because the sexual abuse rules only apply to patients/clients. Sexual behaviour with employees may, however, constitute sexual harassment under the Human Rights Code and could otherwise be unprofessional. Answer iv is not the best answer because the person has not been a patient/client more than one year at the time of dating. However, it might still be unprofessional to date a former patient/client after they stop being a patient/client regardless of the time period, particularly if the kinesiologist had an intense or intimate role in the treatment of the patient/client. Interprofessional Collaboration Scenario correct answer Donna, a Kinesiologist, has started up her own rehabilitation clinic. Donna receives a referral from a GP for one of his more challenging patients, Paula, who was involved in a Motor Vehicle Accident three years earlier and has not responded well to the treatment she has received. Paula was seen by a physiatrist who completed a normal physical assessment and had a cervical recumbent MRI completed. The physiatrist has continually recommended cervical muscular strengthening with ROM stretching that has been carried out by a physiotherapist. Paula reports feeling much worse after rehabilitation treatments and insists that her pain and dysfunction have had little to no improvement over the years of treatment. Her physiatrist wants her to continue with the exercise regimen. Donna completes her own physical assessment and declines to complete the physiatrist's suggested exercise regimen. Donna convinces Paula's GP to obtain a set of lateral stress X-rays.
(which is a recognized exception to the prohibition) and did it under the delegation of a physician. Thus he is not at risk for illegal conduct. However, he might still face civil liability if he did so negligently (e.g., if an infection develops because of poor sterile technique and a failure to advise the wrestler to follow up with his own physician). Controlled Acts Scenario No. 2 correct answer Diana, a chiropractor, performs spinal manipulation on her patient/client Petra. Spinal manipulation is a controlled act authorized to chiropractors under the Chiropractic Act. Diana is authorized to perform that controlled act. Controlled Acts Scenario No. 3 correct answer David, a kinesiologist, has a plate of cookies in his waiting room. Paul a patient/client eats one and goes into anaphylactic shock. David is called into the room. David recalls that Paul has a peanut allergy and realizes that the cookies may have peanuts in them. David looks in Paul's briefcase and finds an EpiPen containing a measured dose of epinephrine. David injects the epinephrine into Paul's muscle and calls 911. Paul recovers. While David did perform a controlled act not authorized to him (administering a drug by injection), he did so under an emergency which is a recognized exception to the controlled acts rule. Controlled Acts Scenario No. 4 correct answer Donna, a kinesiologist, only works part time. Her other job is to perform artistic body piercings. Even though such piercings go beyond the dermis, this procedure is exempted under the Minister's regulation on controlled acts. Controlled Acts Scenario No. 5 correct answer David, a kinesiologist, works with a physician. Because of David's knowledge of anatomy, the physician trusts David to perform injections on patients/clients at precise anatomical locations. The physician delegates intra-muscular injections of local anaesthesia to patients/clients as part of their pain management treatments. David is permitted by the delegation to perform these injections. However, both David and the physician will be responsible if something goes wrong Which of the following is a controlled act: i. Removing broken glass that has been deeply embedded in a child's leg. ii. Cleaning a scrape on a child's elbow with soap and water. iii. Applying alcohol to that scrape on a child's elbow.
iv. Wrapping the child's wounds. correct answer The best answer is i. Deeply embedded glass almost certainly has gone beyond the dermis and is sitting in deeper tissue. There may be an issue as to whether this is an emergency (likely not as in most cases it would be possible to take the child to a hospital or physician's clinic for treatment), but that does not change the fact that removing the glass is a controlled act. Similarly, the household exemption does not apply to these sorts of procedures. Answer ii is not the best answer because a scrape on the skin implies that it has not gone beneath the dermis. Answer iii is not the best answer because applying a substance to the skin is not administering a substance by inhalation or injection. Answer iv is not the best answer because the procedure is above the skin and does not fall within any of the other controlled acts. Scope of Practice Scenario correct answer Donna, a kinesiologist, is seeing Paula, a patient/client diagnosed with Stage IV cancer. Paula is scheduled for surgery next week to be followed by chemotherapy. Paula's physician says that the treatment has a 50% chance of success (i.e., meaning she has a 50% chance of being alive and cancer free in five years' time). Paula's physician also said that without treatment, Paula had a less than 5% chance of surviving for five years. After a careful assessment, Donna advises the patient/client to cancel both the surgery and the chemotherapy. Donna recommends a combination of relaxation tapes and a fasting cleansing program followed by an all fruit diet instead. Laura dies within two months and the family go to the police asking that Donna be prosecuted under the risk of harm clause. In this case, Donna appears to have provided treatment that is outside of the scope of practice for kinesiologists. The treatment also appears to have no evidence to support it. There was an inherent risk of harm in advising the patient/client to reject the proposed medical treatment that had evidence of a reasonable chance of recovery for a treatment that had not been fully researched. Use of Titles Scenario correct answer David, a kinesiologist, teaches at a school that trains kinesiologists. The school has a clinic where patients/clients are seen. David supervises the students at the clinic. The students refer to him as "Doctor David" at the clinic. The Dean of the school pulls David aside and tells him to ask his students to stop calling him "Doctor" in the clinic where there are patients/clients. It is okay in the classroom, but not the clinic. David reviews the Regulated Health Professions Act and realizes that the Dean is correct. David is assisting in the treatment of patients/clients there and thus is not permitted to call himself (or allow others to call him) "Doctor" there. David also recognizes that he was being a poor model for the students.
Professional Negligence Mandatory Report Scenario correct answer David, a kinesiologist, is sued in Small Claims Court by a patient/client, Paul. Paul claims that he told David about pain in his lower abdomen but that David attributed those symptoms to stress. After two weeks of supportive treatment for the stress, despite increasing pain, Paul went to the emergency department. Paul was rushed into surgery for appendicitis and stayed in the hospital for almost a week. Paul claims David should have referred David to another health care provider to rule out appendicitis before treating the symptoms as purely stress related. The Small Claims Court judge agreed and ordered David to pay Paul $10,000 for his malpractice. David reports the finding to the College. The College places a note about the finding on the public register. Duty to Warn Mandatory Report Scenario correct answer Donna is a kinesiologist who works for a company that provides long-term disability management services for an insurance company's claimants. They have a contract to complete Functional Capacity Assessments (FCA) for one particular insurance company that pays Donna's company only after they are able to complete an FCA and report. Donna hires Paul, another kinesiologist, to assist her. Paul is trained by Donna on the FCA process they use to service their various insurance clients. Included with the process is a cardiovascular component to the FCA. Paul inquires with Donna as to what point they would discontinue cardiovascular testing for increased blood pressure rate. Donna tells Paul never. She tells Paul that it is imperative that they complete their testing so that they can conclude their written report; only then will they get paid. Donna tells Paul that it is the claimant's job to get their own physicians to sign off on their company's form stating that they can participate in Donna's FCA. Paul then asks if the FCA is completed regardless of a completed form. Donna says yes because forms are given in advance for completion. Donna also stated that she could tell if the cardiovascular testing was too strenuous just by watching the clients. If it looked like too much she could just decrease the intensity, that no one ever dies, and that they would call 911 before that. Donna also told Paul that they had a BP cuff in the cupboard but it was too much work to use and takes too much time. She reiterated that the more tests their company completes the more they can get paid. Donna also reminded Paul that she was the senior kinesiologist in charge so it was her decision, not his. Paul is required to take some action to protect the clients/patients if Donna's approach reasonably creates a significant risk of serious bodily h Is a mandatory report required where a kinesiologist overhears another kinesiologist tell two male patients/clients a sexually explicit joke that causes the patients/clients to laugh loudly? i. No. Dirty jokes are not sexual abuse.
ii. Yes. This is sexual harassment. The report should be made to the Human Rights Tribunal. iii. No. The patients/clients liked the joke and would not have been harmed by it. iv. Yes. This constitutes sexual abuse. correct answer The best answer is iv. Sexual abuse includes comments of a sexual nature to a patient/client. Reporting sexual abuse is mandatory. While it is unlikely that punitive action will be taken by the College (perhaps a sensitivity course), it is still important that kinesiologists learn that such conduct can be harmful to some patients/clients. One never knows what experiences patients/clients have had in their past that might make even a dirty joke harmful. Answer i is incorrect because dirty jokes are sexual abuse as that term is defined in the Regulated Health Professions Act. Answer ii is not the best answer because there are no mandatory reporting requirements under the Human Rights Code. Also, the Regulated Health Professions Act uses the term sexual abuse rather than sexual harassment and gives that term a unique meaning. Answer iii is not the best answer because whether the patient/client was a willing participant or not is irrelevant. The comment still should not have been made. Also, one never knows what experiences patients/clients have had in their past that might make even a dirty joke harmful. In addition, sexualizing the practice of the profession is inherently confusing to patients/clients who assume that there is not sexual aspect to their relationship with kinesiologists. Public Register Scenario correct answer Donna, a kinesiologist, has separated from her husband. Donna's husband has hit her a number of times. Since the separation, Donna's husband has been following her. The police cannot seem to stop him. Donna moves to another city. She asks the Registrar not to put her business address or telephone number on the public register so that Donna's husband cannot find her. Donna provides documents from the police and the courts about her husband's behaviour. The Registrar removes Donna's contact information from the register. Professional Corporation Scenario correct answer David, a kinesiologist, has had a business corporation for many years before the College was created. His wife and children are shareholders. It is not a professional corporation. What are his options? David has to do something. He cannot continue to operate a regular business corporation once he becomes registered because it does not follow the rules for professional corporations. David has to either change his business corporation into a professional corporation, or give up the business corporation. David's wife and children cannot be shareholders of the professional corporation unless they are also registered with the College. If David gives up the business corporation, he cannot practice the profession through it. David should speak to his accountant or lawyer to get advice as to what is best for him.
Record Keeping Scenario correct answer David, a kinesiologist, has been practising for 35 years in the same practice, and has built up a busy and successful practice. He decides he is ready for retirement but wonders what he is supposed to do with his patient/client records. Does he have to keep them himself? Ordinarily he would have to retain patient/client records for 10 years from the last interaction with the patient/client, or the patient's/client's 18th birthday, whichever is later. But, in this case David may be transferring his practice over to another kinesiologist to take over the business and patients/clients. If this is the case, he does not have to retain the records himself but needs to notify the patients/clients of the transfer of their patient/client records. This can be done through a combination of telling patients/clients on their next visit and placing a notice in the local newspaper. Which one of the following does not need to be recorded in the patient's/client's record? i. The patient's/client's birth date. ii. The person who recommended the patient/client to you. iii. The patient's/client's health concerns. iv. The treatment plan for the patient/client. correct answer The best answer is ii. Only if the patient/client was referred by another health care provider must there be a record of who recommended the patient/client. If another patient/client referred the person or the person found out about your service through advertising, that does not have to be recorded (although in some cases it would be helpful to record this information). Answer i is not the best answer because kinesiologists need to record the patient's/client's birth date. It is relevant to many treatment decisions. Answer iii is not the best answer because kinesiologists need to record the patient's/client's health concerns (sometimes called chief complaints). It is relevant to many treatment decisions. Answer iv is not the best answer because kinesiologists need to record the treatment plan for the patient/client. It is relevant to following through with the treatment on future visits and for justifying one's actions should questions be raised later. Conflict of Interest Scenario No. 1 correct answer Donna, a kinesiologist, owns a practice down the street from a gym. She has been practicing there for less than a year. She is trying to build her practice and wants people to know she is new to the neighbourhood. Donna offers to give the manager of the gym free services in return for having him and his staff refer patients/clients to Donna's practice. The manager of the gym thinks this is a great idea, and offers Donna a free membership to the gym if Donna also refers patients/clients to his gym. While this may seem like a good business decision, Donna is in a conflict of interest for two reasons. Donna cannot give free services to the manager of the fitness center in order to obtain referrals as this would
constitute a collateral benefit. Patients/clients should be referred to Donna because they need her services and not because the referring person is getting free service. Further, Donna cannot accept free membership at the gym as this would conflict with her duty to refer patients/clients to a gym only if Donna honestly believed that this would be in their best interest. In addition, unless there was something special about the local gym, Donna should recommend that the patient/client go to the gym that they are most likely to actually use. The referrals would be based on professional judgment and not on any 'kickbacks' she may receive. Conflict of Interest Scenario No. 2 correct answer David is a kinesiologist who has a busy and successful practice. Recently, he began using a new "daily back protection" video. Patients/clients have responded quite well to it. David calls the company to tell them his feedback from his patients/clients and that he likes using the product, and to order copies. The company asks him if he would like to be in a new advertising campaign they are going to put into some health and wellness magazines where he would provide statements similar to what he just gave to the company for promoting the product. They plan to put a picture of him within the advertisement and identify him by name and qualifications. They say they cannot pay him because they are still a small company, and don't have the budget for it. He thinks, why not? He likes the product, and since he is not getting paid he is not inappropriately benefiting from the relationship. Unfortunately, this would still likely be a conflict of interest and would be professional misconduct. A kinesiologist cannot use their professional status to promote a product commercially. This is so even though he has not been paid for the endorsement. It can be assumed that he will benefit from the advertisement in some indirect manner (for example, he may have increased patient/client influx from those people who see the advertisement). Also, without making any observations or assessments of an individual, a kinesiologist should not be making any sort of clinical recommendations. David can give advice on products and remedies, including in choosing what type of videos to recommend to patients/clients, provided it is within a kinesiologist-patient/client relationship, and it is based on professional judgment regarding a patient's/client's individual needs through proper assessment. Advertising Scenario correct answer Donna, a kinesiologist, has just started performing a new procedure with her patients/clients that helps improve posture and is noticing great results. She wants to let other people know she now does this procedure so that clients can choose to come to her for it, or maybe even have another health care provider refer clients to her to have her perform it. She adds her weekly advertisement in the community paper with a description of the service. She makes sure the description only describes the procedure and does not offer any guaranteed outcomes, compare it to other procedures or provide reasons why she might be a better choice because she performs this procedure. However, she wants people to know the great results she has been seeing with her patients/clients. So, with the consent of a few of her patients/clients, she takes some before and after pictures and publishes them in the local
Donna responds that the patient/client was extremely challenging and after doing all that she could for the patient/client the patient/client became verbally abusive and Donna had to terminate the professional relationship. Donna's letter is sent to the patient/client who replies that she was never verbally abusive to Donna and that Donna is making this up to defend herself. The Inquiries Reports and Complaints Committee (ICRC) obtains statements from the patient's/client's husband, Donna's receptionist and a couple of patients/clients who were around at the time. It is difficult to reconcile the stories but the picture that emerges is that there was a verbal confrontation in which both parties may have used intemperate language. The ICRC decides that this is not a case for discipline, particularly since there have been no previous complaints about Donna. However, the ICRC sends Donna a letter of caution reminding her of the need to be professional in her dealings with patients/clients even in challenging circumstances. Fitness to Practise Scenario - The Typical Case correct answer David is a kinesiologist working with John, another kinesiologist. John reports to the College that he is terminating his partnership with David because David's drinking is beginning to affect his work. John is tired of covering for David when he comes to the office two hours late after a binge. The Registrar makes some inquiries that tend to confirm John's report. David, however, denies he has any problems. The Registrar reports the matter to the ICRC. The ICRC asks David for consent to obtain a copy of his medical records, which David provides. Those records indicate that David has separated from his wife who accuses him of drinking and that David has recently been charged for impaired driving. The ICRC directs that David attend an assessment with a specialist in substance abuse disorders. The report from the specialist indicates that David clearly has a substance abuse disorder. The ICRC refers David to the Fitness to Practise Committee for a hearing and suspends David's certificate of registration until the hearing can be completed. David enters and successfully completes a 30-day in-patient treatment program for substance abuse and is an active participant in the recommended after-care program. At the Fitness to Practise hearing David's lawyer and the College's lawyer present a joint submission asking the Committee to find that David is incapacitated, as defined in the Act, and order that David's certificate of registration be restored on the condition that he continue in regular treatment, that he work with another kinesiologist who will monitor David's performance at work and that regular reports be made to the College of David's progress. The Committee accepts the joint submission. Quality Assurance Scenario No. 1 correct answer Donna, a kinesiologist, fails to complete and submit her annual self-assessment. Accordingly, Donna is selected to participate in the Peer and Practice Assessment Process.
A practice assessor is appointed. The practice assessor meets with Donna, conducts an interview, and reviews her professional development and self-assessment activities. The practice assessor prepares a report for the Committee that describes Donna's responses and the professional development activities that Donna participated in. The Committee may decide that there is no reason to take any action because Donna has learned from this experience about the importance of completing her annual self-assessment and keeping records of professional development activities. Quality Assurance Scenario No. 2 correct answer David, a kinesiologist, is randomly selected for a peer and practice assessment. A practice assessor is appointed. David cooperates with the practice assessor's review of his records and inspection of his office. The practice assessor provides a report to the Committee, who reviews the report and finds that David has not been keeping adequate clinical records. The Committee gives David an opportunity to respond in writing. After reviewing David's response, the Committee decides that David must take a record keeping course. The Committee also directs that David's practice be reassessed in one year's time to see if there has been an improvement. If a kinesiologist is selected for a peer and practice assessment, the kinesiologist should: i. Cooperate with the practice assessor's review, including permitting the assessor to inspect his or her office and upon request, provide any requested records. ii. Permit the practice assessor to inspect his or her home. iii. Give the assessor all records except those that are confidential. iv. Complete all required professional development records and fill in gaps in client records before sending them to the practice assessor. correct answer The best answer is i. Kinesiologists have a duty to cooperate with peer and practice assessments. Answer ii is the not best answer because practice assessors are not permitted to enter private homes. Answer iii is not the best answer because the practice assessor's right to access premises and records overrides patient/client confidentiality. Answer iv is not the best answer because while a practice assessment is a good opportunity to improve record keeping and other practices, a kinesiologist should always update client records immediately so that they are accurate. Kinesiologists should never wait until they are selected for an assessment to update their records. Additionally, if records are falsified, the Committee may report the kinesiologist's name and this allegation to the Inquiries, Complaints and Reports Committee. PHIPA Scenario correct answer Three kinesiologists work together in an office. They decide they will act as an organization for privacy purposes. Their organization is the Health Information
