Professional Integrity · Rating sample

Dr. Hana Yildiz, a family medicine resident, is running 40 minutes behind schedule in a…

Read the scenario, answer it, then compare yourself to the answer key. Every option includes a rationale and a transferable principle.

b18Professional IntegrityRatinghardProfessional + Scholar

How desirable is each of the following responses by Dr. Yildiz in this situation? (1 = Very desirable; 2 = Somewhat desirable; 3 = Neither desirable nor undesirable; 4 = Somewhat undesirable; 5 = Very undesirable) Consider each option independently; several may share a rating.

Dr. Hana Yildiz, a family medicine resident, is running 40 minutes behind schedule in a busy ambulatory clinic. Her preceptor, Dr. Craig Campbell, observes the backlog and quietly suggests that everyone in the clinic saves an hour by copying the previous visit notes forward for routine follow-ups. Dr. Campbell demonstrates this on Dr. Yildiz's computer, pulling forward an unedited previous physical examination template into an unexamined patient's open encounter. Dr. Yildiz has not yet seen or examined the two remaining patients on her morning schedule. She understands that while note-forwarding is common practice, clinical records must accurately reflect services actually rendered during the specific visit. Dr. Yildiz must decide how to proceed.

Desirability scale: 1 very desirable, 2 somewhat desirable, 3 neither desirable nor undesirable, 4 somewhat undesirable, 5 very undesirable. Rate every option independently. Scores may repeat.

A. Adopt Dr. Campbell's shortcut for today to catch up, intending to amend erroneous text later if needed.

B. Thank Dr. Campbell for the tip while respectfully stating she prefers documenting findings after conducting her examinations.

C. Copy forward historical background data but delete all physical examination and assessment text until after evaluation.

D. Ask the clinic reception staff to rebook the two patients to avoid falling further behind schedule.

E. Evaluate the patients fully and document only history and examination findings that she directly verifies today.

F. Sign off the copied-forward clinical notes immediately to close the charts and keep clinic flow moving.

Rate each option independently

Samples are graded anonymously. Nothing is saved.

Show answer and rationale

A. Adopt Dr. Campbell's shortcut for today to catch up, intending to amend erroneous text later if needed.

Key: 4

This response is somewhat undesirable (Rating 4) because leaving unverified clinical findings in an active chart creates clinical confusion and risks false record certification if amendments are forgotten. Charting ahead of time violates documentation standards. It avoids a 5 only because there is an intent to correct inaccuracies.

Documenting prospective findings with intentions of later amendment compromises chart integrity.

B. Thank Dr. Campbell for the tip while respectfully stating she prefers documenting findings after conducting her examinations.

Key: 1

This response is very desirable (Rating 1) because it balances professional integrity with collegial diplomacy toward a supervisor. It clearly communicates her personal commitment to accurate charting while defusing hierarchy tension. It would shift downward only if the tone became argumentative.

Diplomatic boundary setting preserves documentation integrity within supervisory hierarchical relationships.

C. Copy forward historical background data but delete all physical examination and assessment text until after evaluation.

Key: 2

This response is somewhat desirable (Rating 2) because carrying forward stable past history or chronic medication lists is legitimate, provided unverified objective findings are excised. However, doing this while rushed risks accidental retention of outdated information. It would be a 1 if followed by rigorous post-visit verification.

Carrying forward baseline chart data requires rigorous deletion of unverified objective findings.

D. Ask the clinic reception staff to rebook the two patients to avoid falling further behind schedule.

Key: 3

This response is neither desirable nor undesirable (Rating 3) because while it prevents rushed or inaccurate charting, turning away scheduled patients inconveniences them and disrupts access. Rebooking should be reserved for true emergencies rather than routine delays. It would move down if the patients travelled far or had acute needs.

Cancelling appointments to manage documentation delays compromises access to patient care.

E. Evaluate the patients fully and document only history and examination findings that she directly verifies today.

Key: 1

This response is very desirable (Rating 1) because it ensures patient safety and uncompromised medical record accuracy despite schedule pressure. Truth in clinical documentation is non-negotiable. It upholds the Professional CanMEDS role under challenging practice constraints without unnecessary confrontation.

Clinical documentation must accurately reflect patient evaluations directly performed during that encounter.

F. Sign off the copied-forward clinical notes immediately to close the charts and keep clinic flow moving.

Key: 5

This response is very undesirable (Rating 5) because signing an unexamined patient's record containing fabricated examination data constitutes fraudulent documentation and compromises clinical safety. It exposes patients to diagnostic errors and the resident to disciplinary action. It represents a complete failure of integrity under time pressure.

Signing unverified clinical records constitutes fraudulent charting and threatens patient safety.

Exam context: FMProC assesses professional integrity alongside three other attributes. This is an unofficial worked example, not a live exam item.

Educational scenario only. Not clinical or professional advice.