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Press enter to return to the slide.Slide TextSpaceSUBMIT ALLsubmit allSUBMITsubmitSubmitUnmutevolumeZoom to fit<html><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'>Welcome to the learning module on Manitoba’s </font><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'><i>Regulated Health Professions Act</i></font><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'>.</font></textformat></p></html><html><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'>Manitoba’s regulated health professionals are at the beginning of a new age in regulation. The end goal is to have all regulated health professions come under one umbrella legislation – the </font><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'><i>Regulated Health Professions Act</i></font><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'> (RHPA). The RHPA comprises broad legislation that replaces all individual acts governing each regulated health profession. </font></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'> </font></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'>Two important changes that this legislative model enacts are: (1) each college regulated under the RHPA – for example, the Colleges of Registered Nurses, Audiologists and Speech-Language Pathologists, Physicians and Surgeons, Physiotherapists, College of Paramedics of Manitoba, Psychiatric Nurses, Medical Laboratory Technologists, and Opticians – must develop and maintain a continuing competence program; and (2) all regulated health colleges must promote inter-professional collaboration with other colleges. This learning module provides you an opportunity to learn about the RHPA, how the RHPA supports collaborative practice and your professional obligations under the RHPA. </font></textformat></p></html><html><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'>After completion of this learning module, you will be able to:</font></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 18px'><textformat leading='0' tabstops='[0, 18, 48, 96, 144]'><font face='Arial' size='16.5pt' style="font-size:16.5pt;display: inline-block; text-align:left; min-width: 18px; margin-left: -18px;" color='#000000'>•</font><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'>understand professional self-regulation and the role of regulatory colleges in the province’s health care system;</font></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 18px'><textformat leading='0' tabstops='[0, 18, 48, 96, 144]'><font face='Arial' size='16.5pt' style="font-size:16.5pt;display: inline-block; text-align:left; min-width: 18px; margin-left: -18px;" color='#000000'>•</font><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'>outline the core content of the umbrella legislation (the RHPA) as it applies across Manitoba’s regulated health professions;</font></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 18px'><textformat leading='0' tabstops='[0, 18, 48, 96, 144]'><font face='Arial' size='16.5pt' style="font-size:16.5pt;display: inline-block; text-align:left; min-width: 18px; margin-left: -18px;" color='#000000'>•</font><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'>describe how the RHPA impacts regulated health professionals’ practice and interprofessional collaboration;</font></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 18px'><textformat leading='0' tabstops='[0, 18, 48, 96, 144]'><font face='Arial' size='16.5pt' style="font-size:16.5pt;display: inline-block; text-align:left; min-width: 18px; margin-left: -18px;" color='#000000'>•</font><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'>demonstrate awareness of registrants’ professional obligations and employers’ responsibilities under the RHPA;</font></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 18px'><textformat leading='0' tabstops='[0, 18, 48, 96, 144]'><font face='Arial' size='16.5pt' style="font-size:16.5pt;display: inline-block; text-align:left; min-width: 18px; margin-left: -18px;" color='#000000'>•</font><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'>demonstrate knowledge of the applicability of and accountability to the code of ethics, standards of practice, and practice directions of your college; and</font></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 18px'><textformat leading='0' tabstops='[0, 18, 48, 96, 144]'><font face='Arial' size='16.5pt' style="font-size:16.5pt;display: inline-block; text-align:left; min-width: 18px; margin-left: -18px;" color='#000000'>•</font><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'>explain the reserved acts model and describe the implications and importance of collaborative practice among health professionals.</font></textformat></p></html><html><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'>All regulated professionals must be registered with or licensed by their professional regulatory college. Some may also belong to a professional association and/or a union. How does a regulatory college differ from these other organizations? </font></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'> </textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'><i>Colleges</i></font><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'> are mandated by the provincial government to regulate health professions in the interest of public protection. Colleges are therefore regulatory bodies</font><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'><i>. </i></font><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'> In order to practise as a regulated health professional, registration in a regulatory body is mandatory. Colleges may choose to refer to registered professionals as registrants or as members of the College. In contrast, health professionals join </font><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'><i>associations</i></font><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'> and/or </font><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'><i>unions</i></font><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'> as members, and these organizations operate in the interests of their membership. </font></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'><i>Associations</i></font><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'> and other professional-interest groups often lobby the government on behalf of and create networking opportunities for their members. Their mandates might include mobilizing their members to vote in favour of their professional interests regarding specific health care and social-justice issues during elections. Membership in associations is voluntary.</font></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'> </font></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'>In contrast, </font><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'><i>unions</i></font><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'> act in the employment sphere as bargaining agents. Unions negotiate collective agreements for members, and file grievances on behalf of their members when employers do not comply with collective agreements. If you practise in a unionized environment, your membership in the union and payment of dues is mandatory.</font></textformat></p></html><html><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'><b>Now, let’s test your knowledge of the RHPA</b></font></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'>Consider your current understanding of the RHPA and the role of self-regulation. Read the statements below and mark how strongly you agree with each. </font></textformat></p></html><html><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'>The </font><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'><i>Regulated Health Professions Act (also called the RHPA)</i></font><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'> came into force on January 1, 2014, when the first two groups of health professionals, audiologists and speech-language pathologists, became governed by their College under the Act. All regulated health professionals will eventually be brought under the RHPA in phases.</font></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'> </font></textformat></p></html><html><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'>The RHPA</font><i> </i><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'>brings consistency to the many and various rules and processes that have regulated health professionals over the years via separate pieces of legislation in Manitoba. </font><i> </i><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'>The mandates, requirements, and obligations for each college, their professional registrants, and registrants’ employers are the same across all health care professions, under the RHPA. This uniformity clarifies the role of regulatory bodies for the public and shows an understanding on the government’s part of the overlapping scopes of practice among many health professions.</font></textformat></p></html><html><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'>Self-regulation refers to a governance model wherein the provincial government has delegated its responsibility for setting and enforcing rules of practice that the occupation or profession must follow. </font></textformat></p></html><html><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'>Since each profession has a specialized body of knowledge, external regulation without this knowledge would be difficult and potentially unsafe. The profession understands its registrants’ obligations and duties better than anyone else, so it makes sense to have professionals regulate themselves – as long as they do so in the public interest, and through a transparent entity (the College). A profession’s mandate to self-regulate by a college of peers is a privilege that places the public trust in the College. Therefore, under the RHPA, all regulated health professional colleges, their registrants, and registrant employers have obligations that must be met to ensure this trust is maintained. </font></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'>If a college does not meet these obligations or makes decisions that are in the interest of the profession and not the public, the government can remove the profession’s privilege to self-regulate. If this were to occur (as it has in another province and in the United Kingdom), then the government would take over the administrative roles and authorities of college staff and committees, and the profession would have limited say in the profession’s values, policies, and standards for education and practice. </font></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'>It is therefore important that all health professionals understand and meet the requirements and obligations of self-regulation, as stipulated in the RHPA. </font></textformat></p></html><html><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'>Click on the pictures to review each parties legal obligation. </font></textformat></p></html><html><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'>All colleges under the RHPA are required by law to carry out the responsibilities of self-regulation, and to share the mandate of protecting the public’s interest. Registration with your college and the registration of your colleagues at other Colleges sends the public the message that you are a well-educated, qualified and trustworthy professional, and will continue to be so throughout your professional career. Therefore, the public expects that all Colleges have programs and processes in place that support and ensure competent, safe and ethical practice. </font></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'>All colleges must establish a council and two statutory committees – Complaints Investigation and an Inquiry Committee, and the requirement of a Continuing Competency Program. </font></textformat></p></html><html><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'>The three main obligations for every college under the RHPA are to:</font></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 18px'><textformat leading='0' tabstops='[0, 18, 48, 96, 144]'><font face='Arial' size='16.5pt' style="font-size:16.5pt;display: inline-block; text-align:left; min-width: 18px; margin-left: -18px;" color='#000000'>•</font><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'>establish initial registration and ongoing renewal requirements;</font></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 18px'><textformat leading='0' tabstops='[0, 18, 48, 96, 144]'><font face='Arial' size='16.5pt' style="font-size:16.5pt;display: inline-block; text-align:left; min-width: 18px; margin-left: -18px;" color='#000000'>•</font><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'>establish the standards of practice and provides resources to help registrants meet these standards; and </font></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 18px'><textformat leading='0' tabstops='[0, 18, 48, 96, 144]'><font face='Arial' size='16.5pt' style="font-size:16.5pt;display: inline-block; text-align:left; min-width: 18px; margin-left: -18px;" color='#000000'>•</font><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'>take action when standards of practice are not met. </font></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'> </font></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'>Each of these duties has specific tasks associated with them.</font></textformat></p></html><html><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'>The College establishes requirements and administers the initial registration process to ensure applicants have obtained the required education and competence before entering practice.</font></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'>The College also sets annual renewal requirements and monitors registrants’ engagement in continuing competence requirements, to assure the public that all registrants are competent throughout their active careers. </font></textformat></p></html><html><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'>The College also establishes the standards of practice and provides resources and support services to encourage competent practice. </font></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'>The College approves and publishes documents to clearly communicate professional expectations and obligations to its registrants and to the public. Each college also develops regulations under the RHPA to delineate the scope of practice of the profession and to outline the parameters within which specific activities and procedures (known as “the reserved acts”) can be performed. </font></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'> </font></textformat></p></html><html><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'>There are three specific documents defined in the RHPA: i) a code of ethics; ii) standards of practice; and iii) practice directions. The College may provide registrants with resources and supports to encourage continuing competence based on the regulatory requirements.</font></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'>Click on the picture to read the definition of each document type. </font></textformat></p></html><html><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'>As indicated earlier, a registrant must adhere to the code of ethics, standards of practice, and practice directions. These documents outline your obligations to practice safely, ethically, and competently. </font></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'>If there is a concern that a registrant fails to meet any of these regulatory requirements, then the College follows a process to manage a complaint in order to ensure public protection and fairness to the registrant. </font></textformat></p></html><html><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'>In appropriate cases, efforts are made to resolve the complaint using educational and supportive strategies that aim to correct and improve the registrant’s knowledge, skill or judgement. </font></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'>If an inquiry hearing finds that the registrant did not practice safely or ethically, then these findings must be made available to the public to ensure transparency. </font></textformat></p></html><html><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'>Where an employer or a registrant of a regulated health profession either:</font></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 12px'><textformat leading='0' tabstops='[0, 12, 48, 96, 144]'><font face='Arial' size='16.5pt' style="font-size:16.5pt;display: inline-block; text-align:left; min-width: 12px; margin-left: -12px;" color='#000000'>•</font><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'>has concerns that a registrant might be incompetent or unfit to practise, or</font></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 12px'><textformat leading='0' tabstops='[0, 12, 48, 96, 144]'><font face='Arial' size='16.5pt' style="font-size:16.5pt;display: inline-block; text-align:left; min-width: 12px; margin-left: -12px;" color='#000000'>•</font><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'>has reason to believe that a registrant has abused a client or patient, </font></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'>that person is </font><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'><i>legally required</i></font><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'> to file such concerns or reasonable beliefs in a report to the registrar of the relevant college.</font><b> </b></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'>Employers are also legally required to report to the College any suspension or termination of the employment of a health professional when the decision is based on incompetence or fitness-to-practise issues.</font></textformat></p></html><html><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'>Click on the pictures to review each parties legal obligation. </font></textformat></p></html><html><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'>In professional self-regulation, rights are balanced with responsibilities. Each college communicates regularly with its registrants to raise awareness of their responsibilities and to support their efforts to meet the obligations of a self-regulated professional. Have you ever wondered, when you get such a message from your college, if other colleges ask the same of their registrants? Well the answer, is yes. </font></textformat></p></html><html><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'>Under the RHPA, all registrants of all regulated health professions colleges have the same professional obligations, including the duty to:</font></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 18px'><textformat leading='0' tabstops='[0, 18, 48, 96, 144]'><font face='Arial' size='16.5pt' style="font-size:16.5pt;display: inline-block; text-align:left; min-width: 18px; margin-left: -18px;" color='#000000'>•</font><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'>Ensure the College has your current contact business and personal information;</font></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 18px'><textformat leading='0' tabstops='[0, 18, 48, 96, 144]'><font face='Arial' size='16.5pt' style="font-size:16.5pt;display: inline-block; text-align:left; min-width: 18px; margin-left: -18px;" color='#000000'>•</font><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'>Report unfit, incompetent or unethical practice of peers to the College;</font></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 18px'><textformat leading='0' tabstops='[0, 18, 48, 96, 144]'><font face='Arial' size='16.5pt' style="font-size:16.5pt;display: inline-block; text-align:left; min-width: 18px; margin-left: -18px;" color='#000000'>•</font><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'>Use the legislated title of the profession appropriately;</font></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 18px'><textformat leading='0' tabstops='[0, 18, 48, 96, 144]'><font face='Arial' size='16.5pt' style="font-size:16.5pt;display: inline-block; text-align:left; min-width: 18px; margin-left: -18px;" color='#000000'>•</font><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'>Practice according to the profession’s specific, published standards of practice, practice directions and code of ethics;</font></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 18px'><textformat leading='0' tabstops='[0, 18, 48, 96, 144]'><font face='Arial' size='16.5pt' style="font-size:16.5pt;display: inline-block; text-align:left; min-width: 18px; margin-left: -18px;" color='#000000'>•</font><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'>Engage in the College’s prescribed Continuing Competency Program; and</font></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 18px'><textformat leading='0' tabstops='[0, 18, 48, 96, 144]'><font face='Arial' size='16.5pt' style="font-size:16.5pt;display: inline-block; text-align:left; min-width: 18px; margin-left: -18px;" color='#000000'>•</font><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'>Complete all registration renewal requirements, including payment of fees, on time. </font></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'> </font></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'>The details of how to meet these requirements may differ between professions, depending on college-specific regulations; nonetheless, all registrants are required by law to meet these obligations. Each of these will now be explained.</font></textformat></p></html><html><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'><i>Ensure the College has your current contact information.</i></font></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'> </font></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'>Under the RHPA you have an obligation to ensure the College has the most current information. Why? Two main reasons. </font></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'>First, because the public has the right to know where you work, if you have a current registration or licence to practise, and any restriction to practise (e.g. must work under supervision); and how to get in touch with you at your place of employment. </font></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'>Second, the College needs your current information because self-regulation is a partnership between the College and its registrants. The College will contact you, for example, about various college activities, such as your required engagement in a given college process. Some colleges may have additional requirements such as notification of a change in employment status (e.g. a leave of absence). </font></textformat></p></html><html><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'>Therefore, if you have made a change to your name, business or personal contact information, then you must let the college know within the timeframe specified by the college’s by-law. </font></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'>Some colleges may have additional requirements such as notification of a change in employment status (e.g. a leave of absence). </font></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'>Maintaining a current public register of all registrants – which the college is required to do – ensures that the public can confirm your current standing with the college and contact you at your place of employment for professional reasons (for example, to request a copy of a clinical record). Other information the college keeps in its official register is </font><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'><i>not</i></font><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'> made public.</font></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'>Some colleges may have additional requirements such as notification of a change in employment status (e.g. a leave of absence). </font></textformat></p></html><html><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'>If you reasonably believe another registrant of your college is unfit, suffers from a physical or mental disorder that may affect his or her ability to practice safely, is incompetent, or is unethical in his or her practice, you </font><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'><u>must</u></font><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'> report your concerns about the registrant to your College. If you are aware of a situation like this, contact your College to discuss your duty to report.</font></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'> </font></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'>It is important to also know your other mandatory reporting obligations as listed in other laws – for example, the duty to report the abuse of a child or vulnerable person to the appropriate authorities.</font></textformat></p></html><html><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'><i>Consider this situation: On several occasions, a registered psychiatric nurse smells alcohol on the breath of a peer. The peer also sleeps during the night shift and has made medication administration errors. </i></font></textformat></p></html><html><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'><i>The registered psychiatric nurse reports her concerns to management, and the peer is scheduled to meet with human resources and the union representative. </i></font></textformat></p></html><html><p align='left' style='text-align:left;direction: ltr; padding-left: 36px'><textformat leading='0' tabstops='[0, 36, 48, 96, 144]'><font face='Symbol' size='16.5pt' style="font-size:16.5pt;display: inline-block; text-align:left; min-width: 36px; margin-left: -36px;" color='#000000'>·</font><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'>In this situation, both the employer and the registered psychiatric nurse have an obligation to ensure a report is submitted to the College.</font></textformat></p></html><html><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'><i> </i></font><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'>The RHPA recognizes the importance to public safety of title protection, meaning that other professionals – including non-regulated professionals – cannot use the title that the government has granted to your profession. If an individual does not hold a certificate of registration and a current certificate of practice from a college, he or she cannot use the protected title for that profession. In turn, as a registrant with a college, you are responsible for ensuring that your clients and/or patients know with which college you are registered. So, you must use your professional title when communicating with the public and other professionals.</font></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'>Click on the book icon to read the list of approved titles and abbreviations for your regulatory college. </font></textformat></p></html><html><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'><i>Consider this situation:</i></font></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'><i>Mike, who was educated as a physiotherapist, is on a leave of absence from work. He has not renewed his certificate of practice, because he is not practicing and is attending school full time. Mike is considering volunteering at a kid’s overnight camp for a two-week period. The camp director knows he was practising as a physiotherapist. Can the director tell parents that Mike is a physiotherapist? </i></font></textformat></p></html><html><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'><i>No. In this situation Mike cannot use his professional title. Mike must not volunteer his services as a physiotherapist or imply that he is a physiotherapist to the camp director or to others, because he does not hold a current certificate of practice.</i></font></textformat></p></html><html><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'><i>Now consider a time when you were a client –at a dentist’s office, your physician’s office, or at the optical store. A person walks in to provide a service (take an x-ray; ask you medical-related questions, and take your weight or blood pressure; or provide advice on eyeglass selection). You do not know if this person is the dentist, dental hygienist, or dental assistant; physician, registered nurse, or licensed practical nurse; or the receptionist, store manager, optometrist, or optician – unless he or she tells you his or her professional title.</i></font></textformat></p></html><html><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'><i>You cannot assume the client or patient knows who you are and what your professional title is, just because you are performing a role or service. Depending on your professional title, the patient or client’s expectations about that service may vary. </i></font></textformat></p></html><html><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'><i>It is the responsibility of the registrant to meet the requirements of all college documents in the practice of the profession.</i></font> <font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'><i>These obligations stand, regardless of whether the registrant practises privately or for an employer; the policies of an employer do not relieve the individual registrant of the duty to meet the profession’s standards of practice.</i></font></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'>As indicated earlier, each college will have its own set of regulations, approved by the government, which stipulate </font><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'><i>how</i></font><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'> obligations must be carried out. Regulations are part of the law that governs self-regulated professions. </font></textformat></p></html><html><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'>Colleges also have the right, under the RHPA, to develop and uphold standards of practice, codes of ethics, and practice directions. Such documents are approved by the council of each college in consultation with registrants and other stakeholders. </font></textformat></p></html><html><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'><i>A family practice unit maintains client records for a period of seven years. However, both the College of Registered Nurses and the College of Physicians and Surgeons requires their registrants to maintain the client records for a period of ten years. What actions should the registered nurses and physicians take in this situation? </i></font></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'></textformat></p></html><html><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'><i>Both regulated professionals have an obligation to advocate for systems that support their ability to meet the standards of practice. Therefore, both health professionals would need to communicate the standards to their employer and advocate for change in its client record retention policy, and to document the steps they have taken to address the situation.</i></font></textformat></p></html><html><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'>Since knowledge and clinical methodologies evolve, the RHPA requires that all health professionals must remain current in their knowledge and skills in practice. </font></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'>Engagement in such a program accomplishes two things: 1) it communicates to the public that the regulated health professional is competent to practise; and 2) it separates them from unregulated health professionals, who do not have the same level of responsibility to protect the public’s interest. </font></textformat></p></html><html><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'>As previously discussed, the certificate of practice signals to the public that you are competent to practise. To ensure this is the case, the RHPA requires all colleges to develop and implement a Continuing Competency Program that their registrants must participate in, to </font><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'><i>maintain</i></font><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'> their competence and to </font><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'><i>enhance</i></font><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'> the practice of the profession. Since knowledge and clinical methodologies evolve, the RHPA requires that all health professionals must remain current in their knowledge and skills in practice. </font></textformat></p></html><html><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'>Each regulatory college defines its own continuing competence</font><i> </i><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'>requirements through regulations, and creates specific program materials and measurement tools relevant to their profession. The RHPA allows for such programs to include reviewing of registrant competence, mandatory participation by registrants in specified competence programs, and conducting practice audits. </font></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'>Continuing competence activities for a given profession might comprise of </font><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'><i>completing professional education activities, developing a learning plan, engaging in self-reflection activities, or undergoing peer or practice review.</i></font></textformat></p></html><html><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'><i>All regulated health professionals are required to renew annually, their certificate of practice with the College. </i></font></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'>The certificate of practice is a term used in the RHPA to replace a variety of phrases (such as renewed registration, licence to practise, and current membership) with a single term for all health professions. However, some colleges have chosen to continue using an older term when communicating with their registrants. </font></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'>The certificate of practice gives registrants the authority to practise and is issued by the college annually to registrants who complete the renewal process, including payment of fees, by a specified deadline. Your College may continue to use a different term for the process and the outcome (for example, a renewed licence to practise), but in the language of the RHPA, completion of the renewal process results in the issuance of a </font><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'><i>certificate of practice.</i></font></textformat></p></html><html><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'>It is important to know that even though you might hold a certificate of registration, if you have not paid your practice renewal fee on time and/or completed other obligations (such as answering questions on the renewal form or obtaining liability insurance), you will not hold a certificate of practice and you are therefore </font><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'><i>not eligible to work,</i></font><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'> to use the title of your profession, or to call yourself a regulated health professional until you complete an administrative process. </font></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'>The RHPA stipulates that this process is managed through the registrar, who issues an intent to cancel certificates for nonpayment of fees or failure to comply any of the other registration requirements. </font></textformat></p></html><html><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'><i>Karen, a trained medical laboratory technologist, has been on maternity leave for the past seven months. She originally thought that she would take a full year off work, so she did not renew her certificate of practice. However, her partner has decided to take a few months of paternity leave, so Karen decides to return to work early. Karen has informed her employer she will be returning to work in two weeks. </i></font></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'></textformat></p></html><html><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'><i>Karen cannot return to work until she has a current certificate of practice. Karen will obtain the certificate of practice when she meets all the college’s registration processes and pays her annual registration fee.</i></font></textformat></p></html><html><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'><i>Self-regulation is a privilege granted to a profession by the government that acknowledges that the profession is in the best position to regulate its registrants. To maintain this privilege, registrants need to take an active role in the College. </i></font></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'>By granting this privilege, the government communicates to the public that College-registered and -certified professionals differ from unregulated professionals, since they are held to a higher level of accountability, standard of competence, and professional conduct. </font></textformat></p></html><html><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'>You can get involved in self-regulation in a number of ways; for example, you can:</font></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 18px'><textformat leading='0' tabstops='[0, 18, 48, 96, 144]'><font face='Arial' size='16.5pt' style="font-size:16.5pt;display: inline-block; text-align:left; min-width: 18px; margin-left: -18px;" color='#000000'>•</font><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'>Run for council or participate in a college committee;</font></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 18px'><textformat leading='0' tabstops='[0, 18, 48, 96, 144]'><font face='Arial' size='16.5pt' style="font-size:16.5pt;display: inline-block; text-align:left; min-width: 18px; margin-left: -18px;" color='#000000'>•</font><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'>Keep abreast of current information and changing college processes by regularly accessing the college’s website;</font></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 18px'><textformat leading='0' tabstops='[0, 18, 48, 96, 144]'><font face='Arial' size='16.5pt' style="font-size:16.5pt;display: inline-block; text-align:left; min-width: 18px; margin-left: -18px;" color='#000000'>•</font><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'>Participate in consultation opportunities by attending college focus groups or completing feedback surveys about new college regulations, bylaws, standards of practice, practice directions, or college processes; and</font></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 18px'><textformat leading='0' tabstops='[0, 18, 48, 96, 144]'><font face='Arial' size='16.5pt' style="font-size:16.5pt;display: inline-block; text-align:left; min-width: 18px; margin-left: -18px;" color='#000000'>•</font><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'>Vote.</font></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'> </font></textformat></p></html><html><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'>Click on the pictures to review each parties legal obligation. </font></textformat></p></html><html><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'>Under the RHPA, employers of health professionals are also held accountable to the public. Their primary obligation is to hire health professionals who are registered with the appropriate college. This ensures that those in a position to observe the behaviour of health professionals in practise will communicate to the College any concerns about potential risk to public safety, so it may take appropriate action. </font></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'>As mentioned earlier, when a registrant is reasonably believed to be unfit, incapacitated, or otherwise conducting him or herself in an unprofessional manner, agencies and employers must file a written report to the respective regulated health professional college, and to give a copy of the report to the registrant. </font></textformat></p></html><html><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'><i>Jordon is moving from Ontario to Manitoba. His new Manitoba employer confirms Jordon was registered in Ontario. However, Jordon has not yet applied for registration with the regulatory college in Manitoba. </i></font></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'><i>What is the Manitoba employer’s responsibility in this situation?</i></font></textformat></p></html><html><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'><i>The employer must ensure that Jordon does not start to work as a regulated professional until he is registered in Manitoba.</i></font></textformat></p></html><html><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'>Click on the pictures to review each parties legal obligation. </font></textformat></p></html><html><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'>Under the RHPA, the duty to report a registrant of another profession arises when two or more professionals “practise in association” and one of the professionals believes that the other is suffering from a physical or mental condition or disorder of a nature or to an extent that the other registrant is unfit to continue to practice or that his or her practice should be restricted. In this situation, the registrant must inform the registrar of the other professional’s college about that belief and the reason for it. </font></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'>Click on the icon to read the full definition of “practise in association” </font></textformat></p></html><html><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'>Consider this situation.  A physiotherapist, paediatrician and speech-language pathologist provide services at a private children’s rehabilitation centre. All three professionals share the reception area and office expenses- but maintain different clientele. The physiotherapist believes that the speech-language pathologist (or SLP) is suffering from a mental health or physical health condition and is unfit to practice.</font></textformat></p></html><html><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'>If the physiotherapist reasonably believes this, the physiotherapist must report the SLP to the College of Audiologists and Speech-Language Pathologists of Manitoba.</font></textformat></p></html><html><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'>Click on the pictures to review each parties legal obligation. </font></textformat></p></html><html><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'>The “Reserved Acts” model outlines specific activities that have been deemed risky, and even dangerous, if not performed by a qualified and competent regulated health professional. These activities are “reserved” for and restricted to being performed by registrants whose profession has been named (in the regulations under the RHPA) as appropriately competent to perform the act. </font></textformat></p></html><html><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'>The RHPA uses broad language about reserved acts and does not specifically state an actual procedure. This is because no one profession “owns” any one reserved act. For the most part, several professions will share a reserved act, with differences in their level of authority deriving from the depth and breadth of knowledge required of the profession performing it. </font></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'>A profession may have access to the reserved act – working below the dermis. However, the professional may not be allowed to do all procedures classified as working below the dermis. Such as cleaning a deep wound, performing a venipuncture or even performing surgery. </font></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'>In other words, the sharing of these reserved acts means there is overlap in </font><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'><i>scope of practic</i></font><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'>e between professions. (We will look at Scope of Practice terminology and concepts next in this learning module). </font></textformat></p></html><html><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'>Each college explains further in its regulations under the RHPA and in college documents the specific rules for and limits under which the reserved act can be performed. A college might, for example, require its registrants to acquire additional education in a practice area before performing the act.</font></textformat></p></html><html><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'><i>Why do you need to know about reserved acts if your profession has not been granted authority to perform any one of them?</i></font></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 12px'><textformat leading='0' tabstops='[0, 12, 48, 96, 144]'><font face='Arial' size='16.5pt' style="font-size:16.5pt;display: inline-block; text-align:left; min-width: 12px; margin-left: -12px;" color='#000000'>•</font><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'>You should be aware of the reserved acts and associated college regulations to ensure you are not performing procedures or engaging in activities that you are </font><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'><i>not authorized</i></font><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'> to perform. </font></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 12px'><textformat leading='0' tabstops='[0, 12, 48, 96, 144]'><font face='Arial' size='16.5pt' style="font-size:16.5pt;display: inline-block; text-align:left; min-width: 12px; margin-left: -12px;" color='#000000'>•</font><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'>This knowledge also increases your understanding of the expectations that your colleagues and other professions will have of you. </font></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'>Click on the icon to read the list of reserved acts as published in the RHPA.</font></textformat></p></html><html><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'>If you are in a formal leadership role or you work with professionals from other regulatory health colleges, it is important you understand the model in which you and the team provide patient or client services. This means that you know the others’ professional scopes of practice, are able to clarify each role, and confirm what each profession is allowed to do under the RHPA (and relevant regulations). This knowledge will come into play when assigning activities, considering how client or patient care needs will be met and by whom, and when writing policies and procedures. Healthcare leaders also need to know the individual professional’s personal competence level. Assigning and organizing effective collaborative teams requires that you make the most efficient use of your team members and their authority to perform certain acts, while considering client-centred care.  </font></textformat></p></html><html><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'>A scope of practice comprises a set of activities that a qualified, competent and registered health care practitioner may practise under the law and the profession’s standards of practice. The concept of “scope of practice” is what differentiates one health profession from another, and it also identifies what activities they have in common. </font></textformat></p></html><html><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'>A profession’s scope of practice might be considered tripartite, including:</font></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'>1) a broad statement that defines the profession; </font></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'>2) the designated protected title for the profession; and </font></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'>3) the reserved act(s) that the profession is authorized, in regulation, to perform.</font></textformat></p></html><html><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'>A registrant may perform only those reserved acts that are granted to the profession by the government. To be in a profession’s scope of practice, a procedure or activity must be both:</font></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 18px'><textformat leading='0' tabstops='[0, 18, 48, 96, 144]'><font face='Arial' size='16.5pt' style="font-size:16.5pt;display: inline-block; text-align:left; min-width: 18px; margin-left: -18px;" color='#000000'>•</font><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'>accepted, practised by, and known to the profession (through entry-level curriculum and/or additional education and training); and</font></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 18px'><textformat leading='0' tabstops='[0, 18, 48, 96, 144]'><font face='Arial' size='16.5pt' style="font-size:16.5pt;display: inline-block; text-align:left; min-width: 18px; margin-left: -18px;" color='#000000'>•</font><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'>stipulated in college-specific regulations as appropriate for performance by a registrant of their class of registration.</font></textformat></p></html><html><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'>Before you perform a procedure or an activity, consider these three main questions:</font></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 24px'><textformat leading='0' tabstops='[0, 24, 48, 96, 144]'><font face='Calibri' size='16.5pt' style="font-size:16.5pt;display: inline-block; text-align:left; min-width: 24px; margin-left: -24px;" color='#000000'>1.</font><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'>Is the activity or procedure considered a reserved act?</font></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 24px'><textformat leading='0' tabstops='[0, 24, 48, 96, 144]'><font face='Calibri' size='16.5pt' style="font-size:16.5pt;display: inline-block; text-align:left; min-width: 24px; margin-left: -24px;" color='#000000'>2.</font><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'>Do I have the legal authority to perform the reserved act?</font></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 24px'><textformat leading='0' tabstops='[0, 24, 48, 96, 144]'><font face='Calibri' size='16.5pt' style="font-size:16.5pt;display: inline-block; text-align:left; min-width: 24px; margin-left: -24px;" color='#000000'>3.</font><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'>Do I have the personal competence, and any required additional education, to perform the reserved act?</font></textformat></p></html><html><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'><b>Is the activity or procedure considered a reserved act?</b></font></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'><b>There are activities or procedures that you may </b></font><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'>perform as part of your day-to-day work and are not reserved acts. For example, health care professionals taking a client/patient history, conducting a physical assessment, performing an EKG and providing advice or education. </font></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'>However, it is important to know the high risk activities or procedures that are reserved acts. For example, prescribing, dispensing or selling drugs; fitting eyeglasses, contact lenses and hearing instruments; and managing labour. </font></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'></textformat></p></html><html><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'>Therefore before you act in a situation, you are responsible to ensure you know if the activity or procedure is a reserved act, if there are exemption under the RHPA and if it is one that is authorized to your profession</font></textformat></p></html><html><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'><b>Does your profession have the legal authority to perform the act?</b></font></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'>After you confirm the procedure or activity is a reserved act, find out if you have the legal right under the RPHA and in your college’s regulations to perform the procedure. </font></textformat></p></html><html><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'><b>Do you have the personal competence, and any required additional education, to perform the reserved act?</b></font></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'>To assess your personal competence, consider these five questions: </font></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 24px'><textformat leading='0' tabstops='[0, 24, 48, 96, 144]'><font face='Calibri' size='16.5pt' style="font-size:16.5pt;display: inline-block; text-align:left; min-width: 24px; margin-left: -24px;" color='#000000'>1.</font><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'>do I have the required training or education as outlined by my College and any organizational policy</font></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 24px'><textformat leading='0' tabstops='[0, 24, 48, 96, 144]'><font face='Calibri' size='16.5pt' style="font-size:16.5pt;display: inline-block; text-align:left; min-width: 24px; margin-left: -24px;" color='#000000'>2.</font><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'>do I know how to perform the reserved act competently, to ensure client and patient safety? </font></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 24px'><textformat leading='0' tabstops='[0, 24, 48, 96, 144]'><font face='Calibri' size='16.5pt' style="font-size:16.5pt;display: inline-block; text-align:left; min-width: 24px; margin-left: -24px;" color='#000000'>3.</font><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'>have I considered all the possible unintentional outcomes associated with performing the reserved act. </font></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 24px'><textformat leading='0' tabstops='[0, 24, 48, 96, 144]'><font face='Calibri' size='16.5pt' style="font-size:16.5pt;display: inline-block; text-align:left; min-width: 24px; margin-left: -24px;" color='#000000'>4.</font><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'>how will I manage the potential negative situations that might arise? </font></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 24px'><textformat leading='0' tabstops='[0, 24, 48, 96, 144]'><font face='Calibri' size='16.5pt' style="font-size:16.5pt;display: inline-block; text-align:left; min-width: 24px; margin-left: -24px;" color='#000000'>5.</font><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'>am I the best person to perform this reserved act in order to meet the client’s or patient’s immediate needs?</font></textformat></p></html><html><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'><b>Now consider the client care needs.</b></font></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'>You should ask yourself these questions: </font></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'>1) are the client’s or patient’s care needs well determined, or can I determine them based on my education and knowledge? </font></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'>2) based on the client’s or patient’s condition, can I manage the care needs independently, or do I need to consult or refer the client or patient to another professional? </font></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'>3) is the client’s or patient’s condition within what I feel comfortable in managing? </font></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'>These questions help determine both the level of care needed and whether or not you are the right health care professional to perform the reserved act in this situation. </font></textformat></p></html><html><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'><b>Now consider the environment in which you are providing services and your workplace resources. </b></font></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'>Do you have the needed equipment and supplies to proceed? You may also want to consider if there are clinical decision support tools available to help you provide the care that is needed and to make the required decisions. Are there others who can provide advice or guidance, or can take over the care if needed? </font></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'></textformat></p></html><html><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'>Let’s take a look at practice snapshots of situations wherein health professionals must assess their personal competence to perform a reserved act. Click on your college’s logo to review a specific example. You are encouraged to review all available practice snapshots and to consider their relevance to your own context of practice</font></textformat></p></html><html><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'><b>Reserved act #3</b></font><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'>: Performing a procedure on tissue a) below the dermis</font></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'>A medical laboratory technologist (MLT) who has practised for 10 years in a Microbiology laboratory, has been transferred to a Core lab. The MLT is now expected to perform phlebotomy. The MLT has not taken blood from patients since graduation. </font></textformat></p></html><html><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'><u>Knowledge, Skill and Judgment</u></font> </textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'>The MLT has the legal authority to draw from patients, but in this situation the MLT lacks recent experience, and their skill maybe lacking given the MLT has not drawn blood for 10 years. </font></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'><u>Client Factors</u></font></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'>A patient’s condition can vary from less to more complex. Additional skills may be required to perform phlebotomy in more complex situations. </font></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'><u>Environment</u></font></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'>The MLT has access to the available equipment needed; and other more experienced professionals.</font></textformat></p></html><html><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'>Therefore, given the lack of experience and skill, and the availability of other skilled professionals its best the MLT inform the supervisor of their lack of experience and skill; and obtain the required experience by observing, refresher training of skills, and coaching from a more experience MLT before proceeding to practice independently. The MLT would need to consult with and refer more complex situations to another professional, until they gain the required experience and skill required to meet the patient care needs. Through observation and practice under supervision, the MLT will gain competence in managing future situations. </font></textformat></p></html><html><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'>An audiologist who is the sole practitioner in a private clinic receives a physician’s referral to conduct an audiologic evaluation for a client presenting with a hearing loss. As part of the test battery, the audiologist performs otoscopy (inserts the speculum of an otoscope into the ear canal to examine the tympanic membrane (eardrum) and interior of the ear canal. </font></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'>The audiologist finds the client has a build-up of cerumen (ear wax) which must be removed to continue with the evaluation. This requires that curettes, suction, and syringed water be introduced into the external ear canal to loosen and remove the ear wax. Is the audiologist competent to carry out this procedure?</font></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'></textformat></p></html><html><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'>Knowledge, Skill and Judgement</font></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'>The audiologist has the legal authority to perform the reserved acts #4 and #5 and knows that some colleagues perform cerumen management. This audiologist has studied the procedure. However, she has never performed the procedure. </font></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'>Client Factors</font></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'>The audiologist determines that this client’s condition is stable and would not be greatly impacted by the procedure if performed by a competent practitioner. However, there is a risk of damaging the ear canal, ear drum, and middle ear if the procedure is not performed properly.</font></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'>Environment</font></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'>In this situation, the audiologist does not have the equipment needed to properly and safely perform the procedure. Nor does the audiologist have immediate access to a competent and experienced practitioner in cerumen management to consult with or who could oversee, should the audiologist decide to perform the procedure himself. </font></textformat></p></html><html><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'>Given the lack of knowledge and skill, the risk to the client, and the lack of environmental supports (equipment and consultation resources), it is best that the audiologist stops the assessment and refer the client to another audiologist who performs cerumen management. </font></textformat></p></html><html><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'>While covering vacation time for a colleague, the SLP encounters a client who uses a tracheoesophageal voice prosthesis as a result of surgery for laryngeal cancer. The SLP notices that the prosthetic device requires cleaning. Removing the device for cleaning could cause pain or discomfort for the client. A topical anesthetic could be applied to minimize the pain. Is the SLP competent to apply the topical anesthetic?</font></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'></textformat></p></html><html><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'> </font></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'><u>Knowledge, Skill and Judgement</u></font></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'>The Speech-Language Pathologist has never applied a topical anesthetic for this purpose.</font></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'><u>Client Factor</u></font></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'>The client is at risk of aspirating the anesthetic if applied incorrectly or too liberally.</font></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'><u>Environment</u></font></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'>Since the Speech-Language Pathologist is covering for another member of staff, there is no professional expertise on site for consultation before and/or during the procedure. </font></textformat></p></html><html><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'>In this analysis, all three factors point to a high-risk situation. The Speech-Language Pathologist has limited knowledge and skill in managing clients with tracheoesophageal voice prosthesis; the client is at risk if the procedure is not executed correctly. Therefore, in this situation, the Speech-Language Pathologist would not perform the procedure. </font></textformat></p></html><html><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'>A family physician is planning to offer office-based cosmetic procedures to patients, including:</font></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 12px'><textformat leading='0' tabstops='[0, 12, 48, 96, 144]'><font face='Arial' size='16.5pt' style="font-size:16.5pt;display: inline-block; text-align:left; min-width: 12px; margin-left: -12px;" color='#000000'>•</font><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'> botulinum toxin (Botox therapy)</font></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 12px'><textformat leading='0' tabstops='[0, 12, 48, 96, 144]'><font face='Arial' size='16.5pt' style="font-size:16.5pt;display: inline-block; text-align:left; min-width: 12px; margin-left: -12px;" color='#000000'>•</font><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'>dermal filler injections</font></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 12px'><textformat leading='0' tabstops='[0, 12, 48, 96, 144]'><font face='Arial' size='16.5pt' style="font-size:16.5pt;display: inline-block; text-align:left; min-width: 12px; margin-left: -12px;" color='#000000'>•</font><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'>lasers for photodamaged skin (lasers and intense pulsed light for sun damage and wrinkles)</font></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 12px'><textformat leading='0' tabstops='[0, 12, 48, 96, 144]'><font face='Arial' size='16.5pt' style="font-size:16.5pt;display: inline-block; text-align:left; min-width: 12px; margin-left: -12px;" color='#000000'>•</font><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'>hair removal. </font></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'></textformat></p></html><html><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'><u>Knowledge, Skill and Judgement</u></font></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'>While the physician does have the authority to perform the reserved acts associated with these procedures, the physician has not obtained any additional education or experience that would qualify him or her to perform them. </font></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'><u>Client Factors</u></font></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'>The physician would also consider the risk of performing each of these procedures and the possible negative outcomes associated with performing them, since cosmetic treatments vary in terms of complexity and risks for each client. For example, for a patient seeking laser treatment for a chronic case of rosacea (a chronic skin disease), is this family physician the best health care professional to provide the treatment, or should the physician refer to a more experienced and competent practitioner, such as a dermatologist? </font></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'><u>Environment</u></font></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'>Besides adequate training, the physician would also need to ensure all of the equipment and space needed to safely perform the procedures is available. This would include the required emergency medical supplies to manage any possible negative outcomes associated with the procedures. </font></textformat></p></html><html><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'>It is up to the physician to check if there are restrictions on doctors performing such procedures such as the need for specific educational requirements listed either in the College’s regulation or via a practice direction. Additional education and experience, if required, must be obtained before the family physician will be deemed competent before proceeding. This may mean taking additional courses, seeking a mentor or shadowing a competent colleague, and engaging in supervised practice opportunities from another health professional.</font></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'> </font></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'>Considering this risk assessment, the family physician is not yet competent to carry out in-office cosmetic procedures.</font></textformat></p></html><html><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'>A physiotherapist is newly hired at a continuing care and rehabilitation facility, after working for the past 10 years in a private outpatient clinic. During orientation, the physiotherapist sees that many of the clients have tracheotomies and require frequent suctioning during therapy. The physiotherapist has not performed this reserved act since graduation. What should she do?</font></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'></textformat></p></html><html><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'><u>Knowledge, Skill and Judgement</u></font></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'>The physiotherapist has the authority under the RHPA and College regulation to suction a tracheotomy. However, the therapist does not have current knowledge or skill in performing the activity. </font></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'><u>Client Factors</u></font></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'>Most clients have had the tracheotomy long term, and their care needs, including their needs for suctioning during therapy, are well established. </font></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'><u>Environment</u></font></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'>Given that tracheotomy suctioning is a common practice among the physiotherapy and nursing staff at the facility, there are sufficient resources (e.g. policy, consultation opportunities, and equipment) to support the safe delivery of care by this physiotherapist. </font></textformat></p></html><html><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'>In this situation, the physiotherapist would therefore communicate to her supervisor the need to gain some updated training and supervised experience with suctioning a tracheotomy before performing the activity independently. </font></textformat></p></html><html><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'>An RN working a family practice unit is asked to suture a wound following the removal of a lesion on a healthy adult client. However, there are no policies in place to support RNs in suturing and the RNs regulatory college requires additional education that this RN has not completed. </font></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'>While working previously in an emergency department, the RN observed suturing many times and on one occasion, she sutured a wound with the assistance of a physician. The RN feels she is competent to perform the procedure. Is she correct?</font></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'></textformat></p></html><html><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'><u>Knowledge, Skill and Judgement</u></font></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'>RNs have the authority to work below the dermis, which would include suturing a wound. Even though the RN believes she has the knowledge, skill and judgement to suture the wound safely, the College requires that RNs receive additional education that meets College approved criteria before performing the task. </font></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'><u>Client</u></font></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'>This client’s care needs are well established and the outcomes are predictable.</font></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'><u>Environment</u></font></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'>There are other health professionals competent in suturing available for consultation, and the required materials and supplies are available to perform suturing. However, there is a lack of organizational policy that supports RNs in performing this procedure. </font></textformat></p></html><html><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'>In this situation, the RN is not correct in thinking she can proceed. She should communicate that she is unable to perform suturing until she receives the required education and organizational policies are in place. </font></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'> </font></textformat></p></html><html><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'>An acute care psychiatric unit is implementing a new policy to perform electroconvulsive therapy on the unit, instead of sending patients to another facility for treatment. RPNs have the ability to perform this act and most of the psychiatric nurses on staff have experience with conducting electroconvulsive therapy. Since each RPN is required to determine his or her own personal competence and take the steps needed to obtain required knowledge, skill and judgement to ensure client safety, what should the unit leaders do before implementing the new policy?</font></textformat></p></html><html><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'>First, the organization’s policy should clearly outline the training and experience required by RPNs for performing this act. Leaders must also ensure that all involved staff have or receive the required training and experience and can competently perform the procedure before individual RPNs are permitted to proceed with the implementation.</font></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'>The organization policy would outline the specific client population to which this new policy would apply and any restrictions on treatments to be provided. </font></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'>In collaboration with other health professionals, the RPN would determine the appropriateness of performing the act on an individual patient basis.</font></textformat></p></html><html><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'>The RPNs would advocate for the required space, supplies, staffing and consultative resources to ensure the electroconvulsive therapy is performed safely and ethically for each patient. The RPN may refuse to perform the reserved act if the environment in which the patient is to receive the therapy is unsafe or unethical.</font></textformat></p></html><html><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'>A patient diagnosed with keratoconus (a disorder of the eye which results in progressive thinning of the cornea) has a valid prescription from an optometrist, and wants the optician to dispense contact lenses instead of glasses. The optician has limited experience with this type of condition, which impacts the lens type dispensed, but she has read a considerable amount of information and attended a webinar on the topic. </font></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'>Should this optician proceed with providing services to this client?</font></textformat></p></html><html><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'>Under the RPHA and the College’s regulations, opticians have the authority to dispense contact lenses. </font></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'>In this situation, the optician is licensed to dispense contact lenses with a prescription and has gained some knowledge on the topic of keratoconus, but the optician does not have experience with managing this type of client-care need.</font></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'>The client presents with more complex needs than the optician is experienced with managing, especially when dispensing contact lenses. </font></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'>The optician has a colleague whom she could consult or to whom she could refer the patient. The necessary equipment to perform an assessment for this patient is on site. </font></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'> </font></textformat></p></html><html><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'>Being competent means demonstrating you can apply the knowledge gained and that you are able to apply critical thinking and judgment in a given scenario. In this situation, the optician has the authority to dispense contact lenses; there are sufficient environmental supports in place, and the optician has some knowledge of the patients’ condition. However, this does not mean that the optician is competent to meet this client’s specific care needs, because she lacks the experience needed to manage a contact-lens client with this diagnosis. </font></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'>The optician may therefore choose (a) to transfer care to another optician, or (b) in collaboration with a colleague, to provide the needed patient services while acquiring additional skill and judgment. In the latter scenario, she would ask a colleague to be the patient’s primary optician and she would observe the assessment and dispensing process, then discuss the case with the other optician after the services have been provided. </font></textformat></p></html><html><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'>The introduction of the RHPA marked a significant, progressive change from the licensure of traditional health professionals (e.g. medicine and nursing) to a more collaborative approach that benefits all regulated health professionals under one act. </font></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'>The Reserved Act model is one example of how the RHPA embraces the concept that no one profession holds sole accountability for decisions related to client or patient care and services. </font></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'>There is also a new focus in the RHPA on client- or patient-centered care, which means the team must come together in the best interest of the client. All regulated health professionals are now being held to the same level of accountability for maintaining the requirements stipulated in the RHPA. </font></textformat></p></html><html><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'>The depth and breadth of the knowledge, skill, and judgment varies by profession.  Therefore, collaboration is highly important in this shared health care environment. We must rely on our own expertise as well as the expertise of others on the health care team to deliver safe, competent, and ethical care.</font></textformat></p></html><html><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'>Here are the Top 10 Takeaways from this Learning Module:</font></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 24px'><textformat leading='0' tabstops='[0, 24, 48, 96, 144]'><font face='Calibri' size='16.5pt' style="font-size:16.5pt;display: inline-block; text-align:left; min-width: 24px; margin-left: -24px;" color='#000000'>1.</font><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'>Self-regulation is an important model in health care because the inclusion of experts’ views in the governance of a profession is in the best interests of the public. Self-regulation is a privilege, however, and with privilege comes responsibility – neither of which should be taken for granted. </font></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 24px'><textformat leading='0' tabstops='[0, 24, 48, 96, 144]'><font face='Calibri' size='16.5pt' style="font-size:16.5pt;display: inline-block; text-align:left; min-width: 24px; margin-left: -24px;" color='#000000'>2.</font><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'>The RHPA will replace your profession-specific legislation.</font></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 24px'><textformat leading='0' tabstops='[0, 24, 48, 96, 144]'><font face='Calibri' size='16.5pt' style="font-size:16.5pt;display: inline-block; text-align:left; min-width: 24px; margin-left: -24px;" color='#000000'>3.</font><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'>All colleges have an obligation to act in the best interest of the public; therefore they take a common approach to regulating the professions, including shared basic requirements for registration and updating your contact information, to more complex obligations such as mandatory reporting and engaging in continuing competence activities.</font></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 24px'><textformat leading='0' tabstops='[0, 24, 48, 96, 144]'><font face='Calibri' size='16.5pt' style="font-size:16.5pt;display: inline-block; text-align:left; min-width: 24px; margin-left: -24px;" color='#000000'>4.</font><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'>There is a new model in place for authorizing the performance of health care activities: known as reserved acts, which are activities the government has deemed to be high risk. </font></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 24px'><textformat leading='0' tabstops='[0, 24, 48, 96, 144]'><font face='Calibri' size='16.5pt' style="font-size:16.5pt;display: inline-block; text-align:left; min-width: 24px; margin-left: -24px;" color='#000000'>5.</font><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'>The list of reserved acts in the RHPA is not assigned to a single profession; nor are individual acts explicitly associated with specific professions in the list. Instead, several professions share the authority to perform acts in the list, and regulations specify which of them fall into the scope of practice of each profession. </font></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 24px'><textformat leading='0' tabstops='[0, 24, 48, 96, 144]'><font face='Calibri' size='16.5pt' style="font-size:16.5pt;display: inline-block; text-align:left; min-width: 24px; margin-left: -24px;" color='#000000'>6.</font><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'>You must be aware of which reserved acts you are authorized to perform and if there are any conditions to meet before you perform them. </font></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 24px'><textformat leading='0' tabstops='[0, 24, 48, 96, 144]'><font face='Calibri' size='16.5pt' style="font-size:16.5pt;display: inline-block; text-align:left; min-width: 24px; margin-left: -24px;" color='#000000'>7.</font><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'>Health professionals are obligated to assess their own personal competence to perform authorized reserved acts. </font></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 24px'><textformat leading='0' tabstops='[0, 24, 48, 96, 144]'><font face='Calibri' size='16.5pt' style="font-size:16.5pt;display: inline-block; text-align:left; min-width: 24px; margin-left: -24px;" color='#000000'>8.</font><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'>Health professionals must always remain current in practice, and all colleges must have mandatory programs in place to ensure the continuing competence of registrants.</font></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 24px'><textformat leading='0' tabstops='[0, 24, 48, 96, 144]'><font face='Calibri' size='16.5pt' style="font-size:16.5pt;display: inline-block; text-align:left; min-width: 24px; margin-left: -24px;" color='#000000'>9.</font><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'>Colleges use three types of documents (codes of ethics, standards of practice, and practice directions) to guide and support registrants in competent practice; registrants are obligated to practice in accordance with these documents, even if they conflict with an employer’s policies. </font></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 24px'><textformat leading='0' tabstops='[0, 24, 48, 96, 144]'><font face='Calibri' size='16.5pt' style="font-size:16.5pt;display: inline-block; text-align:left; min-width: 24px; margin-left: -24px;" color='#000000'>10.</font><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'>The RHPA promotes collaborative interprofessional practice and client-centred care in the best interest of the public.</font></textformat></p></html><html><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'>This learning module focused on self-regulation and provided you with an overview of the RHPA. We shared with you the college's role and responsibilities and your own accountability to know and comply with the legislation, regulations, code of ethics, practice directions, and standards of practice for your health profession. We asked you to consider what you might offer to support your regulatory body, and how the college supports you in your efforts to practise safely and competently. For additional information on the college’s role, please visit your college’s website.</font></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'> </font></textformat></p></html><html><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'>We encourage you to review the practice scenarios that follow. These scenarios will provide you with an opportunity to reflect on the knowledge you’ve gained by completing this module, and to consider how the information it contains might apply to you and your practice. </font></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'></textformat></p><p align='left' style='text-align:left;direction: ltr; padding-left: 0px'><textformat leading='0' tabstops='[0, 48, 96, 144]'><font face='Calibri' size='16.5pt' style="font-size:16.5pt;" color='#000000'>The practice scenarios apply equally to all regulated health professionals. </font></textformat></p></html>