Communication and Professionalism - Quiz 1

There are six characteristics of professional. What are they?

education, clinical practice, knowledge, unique identity, collective contexts, ethics and values

Autonomy

practice independently without supervision or societal control

How to achieve trust of society

transparency

legitimacy

effectiveness

transparency

clear and honest

how you talk to patients and document

legitimacy

evidence based

effectiveness

knowledge and skills to be effective

What is the governing body of physical therapy?

APTA

Purpose of APTA

increase member value and engagement (recruit/support members)

ensure a sustainable profession (national and state advocate/address issues)

enhance care (EBP/cont education)

increase expertise (18 sections)

provides info to consumers/clinicians

the 9 core values

What does the Tennessee Board of Physical Therapy do?

regulates PT practice

reviews qualifications of licenses

interprets issues related to practice

takes disciplinary action

Professionalism:

grounded in strong professional identity where the science and art of PT come together

What are the three aspects of professional identity?

clinical, interpersonal, ethics/values

What is the importance of professionalism?

- ensures worthiness of trust

- adv degrees + inc autonomy = higher expectations

- PTs are expected to place interests/well-being ahead of other values

- raised expectations due to rising healthcare cost

- expectation to deliver the best outcome that meets the patient’s expectations/values

What may lead to unprofessional behaviors?

-low self-esteem and burnout

-disparate workloads, fatigue, and sleep deprivation

-unsupportive work environment and leadership

-societal and personal life stressors

-inadequate supervision

-toxic and substance abuse

-derisory recognition for superior performance and model behavior

-resource constraint for streamlining process

Ethics defined

the systematic reflection on fundamental values and moral principles (right and wrong)

What are possible ethical situations in rehab in regards to patient centered care?

society and cultural influences

views of aging and the elderly

same-sex health care providers

blood transfusions

What are possible ethical situations in rehab regarding family dynamics?

parenting practices

gender roles

What are possible ethical situations in rehab regarding clinical care centered?

insurance changes

Over-capacity institutions - not enuf PTs to cover pts

resource availability

operational pressures

operational pressures

length of stay

productivity requirements

documenting through lunch

burn out

4 cornerstones of medical ethics

autonomy

nonmaleficence

beneficence

justice

Autonomy in ethics

individuals right to make informed decisions without being coerced, give consent, and not be swayed

nonmaleficence

intension to do no harm

beneficence

do good by the patient

balanced with doing good by yourself and protecting yourself from burnout

justice

fair, equitable distribution, accessibility of resources

ATPA core values

accountability

altruism

collaboration

compassion and caring

duty

excellence

inclusion

integrity

social responsibility

Accountability

active acceptance of responsibility, including self-regulation and other behaviors

alturism

primary regard for or devotion to the interest of patients and clients, thus assuming the responsibility of placing needs of ahead of self-interest

collaboration

working together with others to achieve shared goals

compassion and caring

the desire to identify with or sense something of another's experience/the concern, empathy, and consideration for the needs and values of others.

duty

commitment to meeting one's obligations to provide effective services, to serve the profession, and to positively influence the health of society

Excellence

consistent use of current knowledge and skills while understanding personal limits, integrate the patient or client perspective, embrace advancement, and challenging mediocrity

inclusion

create a welcoming and equitable environment for all

Integrity

adherence to high ethical principles or standards, being truthful, ensuring fairness, following through on commitments, and verbalizing to others the rationale for actions

Social Responsibility

the promotion of a mutual trust between the profession and the larger public

APTA Guide of Conduct

helps PTs interpret the code of ethics in 5 main roles

1. management of patients

2. consultation

3. education

4. administration

5. research

Ethics by state

not uniform across all states

Jurisprudence tests

many institutions have ethics committees

Jurisprudence Tests

exam that assesses knowledge of the state laws and regulations relevant to their profession

Negligence or malpractice

failing to exercise a standard of care that is considered normal

stark law

medical referrals and financial incentives

- makes sure that no one can bride a patient to go somewhere or refer someone

Conflict of interest

acting in a biased way, such as gift baskets etc

obtaining informed consent

written or verbal

power of attorney

usually family member and end of life needs

advanced directive

living will: medical treatments you would and would not like to keep you alive, organ donation

RIPS

Realm

Individual Process

Situation

- offers a framework for making ethical decisions in a systematic way

Realm (RIPS)

where the decision occurs and who is impacted

step 1

- individual

- organization/institution

- society

individual process

steps 2-5

2. moral sensitivity and awareness

3. moral judgement

4. moral motivation and intention

5. moral courage/character and action

moral sensitivity and awareness

recognizing and interpreting ethical situations

moral judgement

deciding between right and wrong

moral motivation and intention

desire to act ethically, the intention to do good

ethical values over personal and financial values

moral courage/character and action

Implementing action: perseverance to act, reporting duty - when no one is looking, what do we do?

Situation

step 6

actual ethical cause/concern

-distress

-temptation

-dilemma

-silence

Distress

we know the right action but encounter a barrier

Temptation

we know what we should do

Dilemma

2 or more correct options

Silence

is the issue being ignored

Ethical Breeches

improper management of a surgical patient

failure to supervise or monitor a patient

improper use of a biophysical agent

inappropriate relationships with patients

fraudulent billing

Moral Residue

the psychological aftereffects of moral distress; for example, guilt, depression, or anxiety

Moral disengagement

once a person justifies or rationalizes small ethical indiscretions, it becomes easier to justify bigger ones, leading to a pattern of unethical behaviors (starts small and continually gets bigger)

Ethical Fading

over time, individuals may become desensitized to ethical considerations, leading to a gradual erosion of their ethical standards

professional misconduct

go before the state board of PT

different from professional liability in which is a civil matter

APTA code of ethics principle #1

(respect everyone) physical therapists shall respect the inherent dignity and rights of all individuals

APTA code of ethics principle #2

(be trustworthy) Physical therapists shall be trustworthy and compassionate in addressing the rights and needs of patients/clients

APTA code of ethics principle #3

(good judgements) Physical therapists shall be accountable for making sound professional judgments.

APTA code of ethics principle #4

(act with integrity) Physical therapists shall demonstrate integrity in their relationships with patients/clients, families, colleagues, students, research participants, other health care providers, employers, payers, and the public.

APTA code of ethics principle #5

(follow the law) Physical therapists shall fulfill their legal and professional obligations

APTA code of ethics principle #6

(keep learning) Physical therapists shall enhance their expertise through the lifelong acquisition and refinement of knowledge, skills, abilities, and professional behaviors

APTA code of ethics principle #7

(promote fair practices) Physical therapists shall promote organizational behaviors and business practices that benefit patients/clients and society.

APTA code of ethics principle #8

(serve the community) Physical therapists shall participate in efforts to meet the health needs of people locally, nationally, or globally.

Andragogy

the art and science of adult learning

Knowles' 6 assumptions of Adult learners

- need to know

- self-concept

- prior experience

- readiness to learn

- orientation to learning

- motivation to learn

need to know/relevance

adults want to know why they are learning something and why it matters

Self-concept/autonomy

adults are self-directed and like to be treated as capable and self-directed learners

prior experience

adults bring unique life and professional experiences that should be tapped into

readiness to learn

learning is best when there's a need to solve real problems

clients are most open to change when they experience a functional loss or increased disability

Orientation to learning

prefer problem-centered learning over content-centered (general)

motivation to learn

- motivation is affected by personal goals and expectations

- identify and align education with personal values and motivators

- internal and external motivation

internal motivation

The personal drive to do the best work possible whether there are rewards or not.

external motivation

When personal drive comes from the desire to receive something, such as a reward or recognition for achieving results.

Barriers to leanring

- low health literacy

- cultural or language barriers

- anxiety, pain, fear

- past negative experiences

- fixed beliefs

Solutions to overcome learning barriers

simple language

visuals

repetition

trust

bite size pieces

timing of info

motivational interviewing

teach back

Transformative learning

a problem arises

engage in critical thinking and reflection

acting

challenging assumptions and principles

getting deep insights or "aha" moments

Humanistic Learning

self-directed learning

student or client-driven

PT is a facilitator, not just an instructor

individualized and collaborative in nature

Experiential (kolb) learning

-adults are shaped by past experiences

- useful for instructing movement, exercise, and physical skills

4 steps to experiential leanring

1. concrete experience

2. reflective observation

3. abstract conceptualization

4. active experimentation

profession characteristics: education

introductory doctorate; based on theory, facts, and evidence

profession characteristics: clinical practice

can evolve into speciality areas

profession characteristics: knowledge

lifelong commitment to learn

profession characteristics: unique indentity

Movement Specialists

profession characteristics: collective context

various settings and roles in patient care and wellness

profession characteristics: ethics and values

APTA core ethics/values