Teaching session worksheet
>click here for printable version<How does this module work?
Step 1. The week before the teaching session the Registrar and Supervisor identify two of the Registrar’s recent patient interactions that have professional boundary implications. To identify such cases refer to the section below, “Identification of Registrar’s recent patient interactions for discussion of professional boundaries”.
Step 2. The Registrar reviews the two cases and works through the relevant questions writing down his or her thoughts for further discussion. The relevant questions are in the section “Registrar worksheet - specific questions to explore professional boundaries cases”.
Step 3. The Registrar and Supervisor meet to discuss the two cases and the Registrar’s responses to the relevant questions. These should lead to further discussion of the “key questions” [see below]
Finally, if either the Registrar or Supervisor are interested in exploring this further they can look at the associated links and resources. [see “Post teaching session worksheet”]
Key questions for teaching session (after discussion of the cases):
- What do we mean by professional boundaries?
- What are the common situations in which professional boundaries are crossed?
- What are the common excuses we use for crossing boundaries?
- When might it be appropriate to cross professional boundaries?
- Is there something about general practice that makes us more prone to crossing these boundaries than other health professionals?
- Are there any external circumstances that influence the risk for individual GPs. [eg changing workforce, shifting community expectations, cultural issues]
- What are the potential consequences of crossing professional boundaries for the doctor, the patient and the community?
- Are there any structures that could be put in place at the practice level to deal with or prevent these problems?
Identification of Registrar’s recent patient interactions for discussion of professional boundaries
[to be done by Supervisor and Registrar the week before]
The following is a set of questions to help identify doctor patient interactions where professional boundary issues may be of concern. The aim is to identify 2 patient interactions for further analysis in the next teaching session. Follow the questions in stepwise order until two interactions have been identified from different categories.
Have you recently treated any patient:
- Who is a family member or member of staff?
- Who has offered you a gift?
- With whom you have been consulting about relationship or intimate problems?
- Who has insisted that they only want to see you and you have tried to fit them in to suit?
- Who has repeatedly attended for minor ailments?
- For whom you have issued a medical certificate where you have felt uneasy?
- Who consistently makes appointments at the end of the consulting session?
- For whom you have found yourself doing “something extra” that is outside your normal practice pattern?
- Where you have used self disclosure?
Once you have identified two patient interactions the Registrar should spend some time over the next few days working through the questions on the “Registrar worksheet - specific questions to explore professional boundaries cases” for each case. The answers should be written down for further discussion with the Supervisor in the next in-practice teaching session.
Depending on the type of patient-doctor interaction, the specific questions will vary. Please use the questions that are relevant to your two particular cases.