Scope of Practice, Code of Conduct, Professional Concepts, Proper Record Keeping Flashcards

1
Q

What is CSEP?

A

Originally known as the Canadian Association of Sport Sciences (CASS) – officially announced at the Pan Am Games in Winnipeg in 1967
>55 years ago!

CSEP is a “national voluntary organization composed of professionals interested and involved in the scientific study of exercise physiology, exercise biochemistry, fitness, and health.”

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2
Q

What is CSEP’s Vision & Mission?

A

The recognized authority in exercise science and prescription,integrating research into best practice.

CSEP is the resource for translating advances in exercise science research into the promotion of fitness, performance, and health outcomes for Canadians. CSEP sets the highest standards for qualified exercise professionals through evidence-based practice and certification.

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3
Q

What are CSEP’s Goals?

A

1) To be the national and international voice for exercise science and prescription in Canada, and to represent and advance CSEP positions.

2) To pursue the vision and mission in an ethical, effective, and financially responsible manner.

3) To provide members working in exercise physiology and health and fitness with timely, relevant products and services.

4) To increase awareness of CSEP in Canada and internationally with funders, within the exercise physiology sector, and among the general public.

5) To promote evidence-based practice through the development of standards, policies, guidelines, and research related to exercise physiology and health and fitness.

6) To define, develop, and implement effective knowledge translation activities related to CSEP’s evidence-based body of knowledge and advancing certification in a timely manner.

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4
Q

What is a CSEP certification?

A

CSEP certified members are a community of qualified exercise professionals (QEP) who recognize the need to improve the health outcomes for all Canadians

CSEP is the Gold Standard in exercise science and personal training

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5
Q

What are the CSEP Certifications?

A

CSEP certified professionals provide clients with individualized exercise programming that supports lasting lifestyle changes

Basic Level:
CSEP-Certified Personal Trainer (CSEP-CPT)
Advanced Level:
CSEP-Clinical Exercise Physiologist (CSEP-CEP)

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6
Q

What is the CSEP-CPT?

A

Introductory health and fitness practitioner certification

Administer the CSEP-PATH to apparently healthy populations

Develops and implements tailored physical activity, fitness, and lifestyle plans

Represents the ‘minimum’ acceptable standard in the industry

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7
Q

What is the CSEP-CEP?

A

Advanced health and fitness practitioner certification

Works with asymptomatic and symptomatic populations

Advanced assessment and exercise therapy to those with MSK, CV, metabolic conditions, etc.

Accepts referrals from licensed health care professionals

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8
Q

What is the CSEP-PATH Foundation Knowledge?

A

Section 4 is the CSEP-PATH – it covers the 6 A’s (the first two [Ask, Assess] we will focus on for over half this course)
Section 4 [CSEP-PATH] builds on information covered in other chapters:
-Basic Anatomy & Physiology
-Lifestyle Behaviors and Health

Candidates are strongly encouraged to become familiar with the above chapters in addition to the behaviour change section and the sections on training with certain populations when moving through the 6 steps of the CSEP-PATH sequence

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9
Q

What are the Basic Anatomy & Physiology of the body? (Systems and what they do)?

A

These systems (nervous, cardiovascular, respiratory, energy, musculoskeletal) all work together to get the body moving, to provide the oxygen and nutrients required for such movement, and to remove metabolic waste that are produced as a result of the movement (i.e., carbon dioxide, heat, and waste products such as lactic acid)

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10
Q

What does CSEP-CPT Scope of Practice mean?

A

“Actions and activities that CSEP-CPTs are qualified and insured to perform under their defined certification”

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11
Q

What is involved in the CSEP-CPT Scope of Practice?

A

Conducts pre-participation health screening assessments on all clients using evidence-informed tools, and gathers information about PA and lifestyle behaviors (Lab 1)

Administers various fitness assessments on clients including submaximal aerobic fitness, MSK fitness (strength, endurance, power, flexibility, balance), and anthropometry (Labs 2-6)

Gathers and applies information about the PA, fitness, and lifestyle of a client or group of clients to design, implement, and monitor client-tailored submaximal exercise programs for healthier living (your term assignment)

Recognizes their own area of expertise and refers clients who fall outside that expertise to a CSEP-Clinical Exercise Physiologist (CSEP-CEP), physician, or other appropriate health care provider

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12
Q

A CSEP-CPT is NOT sanctioned by CSEP to?

A

*Utilize assessment protocols or design exercise programs requiring max aerobic or anaerobic effort

*Assess muscular strength using max 1RM or design programs based on resistance loads >90% predicted 1RM

Use ECG for any purpose

Administer fitness assessments, or design, implement and monitor client-tailored exercise prescription strategies for populations with unstable medical conditions or more than one medical condition, or that the CSEP-CPT feels ill- equipped to address.

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13
Q

What is the high performance specialization?

A

if the CSEP-CPT has successfully completed the CSEP High Performance Specialization™, they may use maximal assessment protocols (including maximal 1RM) and design programs that require maximal aerobic or anaerobic effort for apparently healthy clients.

Focuses on performance and occupational testing and training for QEPs working with elite athletes, emergency services personnel, armed forces, and high performance clients

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14
Q

Core Competencies of the high performance specialization?

A

Sport & occupational biomechanics, physiology, and performance psychology

Sport and occupational performance assessment

Sport and occupational exercise design & prescription

Energy intake for sport and occupational performance

Professional & ethical practice

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15
Q

Clientele for CSEP-CPT may include?

A

Apparently healthy individuals

Individuals of all ages

Individuals with a stable health condition who are able to exercise independently

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16
Q

What is the pre/post natal specialization?

A

Provides QEPs with the background knowledge to actively encourage a physically active lifestyle in their clients prior to conception, throughout pregnancy, and into the postpartum period

Both CPT and CEP certified CSEP members are eligible to pursue this credential

Once achieved it renews annually with your CPT/CEP without any additional fees

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17
Q

Core Competencies during pregnancy?

A

Physiological adaptations to pregnancy

Components of a healthy pregnancy

Common pregnancy complications

Myths & misconceptions about exercise

Trimester by trimester exercise prescription

Sleep during pregnancy

Labor and delivery

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18
Q

Core Competencies in the postpartum period?

A

Physiological changes

Future chronic disease risk and role of PA

Postpartum sleep

Breastfeeding

Considerations for beginning exercise

Promotion of active living

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19
Q

What is the CSEP Code of Conduct?

A

Applies to all individuals who hold any CSEP certifications or Specializations

Does not give guidance on how to act in every situation, rather it provides a standard on making ethically responsible decisions

Also keep in mind relevant provincial and federal regulations

If a situation presents and it is unclear how to proceed, reach out to colleagues or CEP for clarification

Founded on principles of integrity, competence, devotion to service and achievement of human welfare – this concept should guide conduct at all times

Your actions will enhance the dignity and status of the profession

Through your practice, enhance the public understanding of the exercise profession and offer knowledge, skills, and abilities when it may be of benefit to the public

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20
Q

CSEP Code of Conduct:Responsibilities to the Client

A

Act in a respectful manner and provide services without discrimination

Practice in a professional, competent, and responsible manner

Protect confidentiality, privacy, and security of client’s personal information

Apply only accepted evidence-informed principles and professional practices when providing services

Maintain professional boundaries

Avoid any real or perceived conflict of interest

Provide virtual services only when the same professional standards can be safely met as they do in-person

Continue professional development

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21
Q

CSEP Code of Conduct:Responsibilities to the Profession?

A

Share only evidence-informed best practices and scientific knowledge to clients, students/mentees, the public, and to other healthcare providers

When opinion is given which is contrary to the general scientific opinion, it must be indicated as such

Develop reputation on basis of merit of service performed or offered

Accurately represent qualifications and competence

Refrain from offering or accepting covert payment

Contribute to development of profession through volunteering, research, mentoring, student supervision

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22
Q

What are the CSEP Professional Concepts?

A

Understanding how adherence to CSEP-CPT Scope of Practice and Code of Conduct provisions will help mitigate risk of adverse events and liability exposure.

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23
Q

In the context of providing clients with professional physical activity and fitness assessments as well as training services, the QEP needs to understand the following legal concepts?

A

1) Nature of injury related to physical activity

2) Liability exposure, negligence, standard of care

3) Risk management

24
Q

What is Nature of Injury Associated with PA?

A

From a legal standpoint, there are four potential causes of injury of concern to the QEP:

Inherent risks

Ordinary negligence

Gross negligence

Product defects / product liability

25
What are Inherent risks?
risks inseparable from the activity
26
What is Ordinary negligence?
fault can be attributed to either facility or QEP (e.g., failure to meet ’standard of care’) or the participant (e.g., misuse of exercise equipment)
27
What is Gross negligence?
deliberate or reckless conduct (e.g., where QEP has prior knowledge of risks and does not take steps to correct it)
28
What is Product defects / product liability?
manufacturer of a product (e.g., fitness equipment used for training purposes) is at fault due to defect in product design or manufacture, or due to inadequate warnings about their use
29
What is Client Safety and Injury Prevention?
Consider benefits vs. risk Err on the side of caution Avoid high-risk / contraindicated exercises (E.g., sit-ups with hands behind neck, full squats, back hyperextension, full neck rolls, standing toe touch, etc.)
30
What is Considering benefits vs. risk?
Relative risk is low, especially when compared to the health benefits associated with physical inactivity Lowest among young adults
31
What is Erring on the side of caution?
Mild-to-moderate exercise intensity at the start of a program Excessive intensity, frequency, and duration offer very little additional benefic in terms of health status
32
What is Liability Exposure?
QEPs typically work in situations where there is a risk of injury. While some risk is inherent, liability exposure occurs in situations where an injury is attributable to the actions of the QEP; e.g.: -Injury as result of improper instruction and/or supervision of a client’s exercise -Severity of an injury is greater due to the QEPs failure to carry out proper emergency procedures in the face of an adverse incident
33
General categories for liability exposure?
Employment issues Pre-exercise health screening Exercise prescription Facility and equipment issues Emergency action plan (EAP)
34
What are Employment issues?
inadequate staff training or recruitment procedures by employer
35
What is Pre-exercise health screening?
failure to provide adequate client pre-exercise screening or assessment
36
What is Exercise prescription?
client sustains an injury or exacerbates an existing injury due to inappropriate exercise instruction by the CPT
37
What are Facility and equipment issues?
slip or trip hazards in a facility, or failure to properly maintain/service or secure equipment resulting in an injury
38
What is an Emergency action plan (EAP)?
failure to have a proper EAP in place, the failure to properly train staff in its execution or the failure of staff to follow procedures which are in place When proper pre-screening (discuss next class) and monitoring of client (discuss throughout course) is done – the risk of an adverse event or injury is unlikely HOWEVER – establishing an EAP and practicing it on a regular basis is very important Conduct emergency drills and practice CPR scenarios on a routine basis EAP should be clearly defined and posted in a visible location
39
What is Liability Exposure: Negligence?
Failure to do something that a reasonable/prudent professional would have done OR Doing something that a reasonable/prudent professional would not have done In other words - CPT did not meet ‘standard of care’
40
Typically, if a legal case is pursued against QEP, their conduct will be examined from these perspectives?
a. What was the standard of care owed to the claimant by the QEP? b. Did the QEP breach his/her standard of care? c. Did the breach cause the harm in question? d. What damages will the defendant owe to the claimant if negligence is proved?
41
What is the Standard of Care?
Generally speaking, the standard of care for any QEP in Canada is to provide ‘reasonably safe’ programs and services for their clients ‘Reasonably safe’ implies taking precautions such as following proper risk screening procedures and taking all recommended precautions to prevent ‘foreseeable’ health and injury risks ‘Foreseeable’ health risks include medical conditions and/or risk factors that can lead to problems such as cardiac arrest, stroke, or an insulin reaction Injury risks are conditions or situations that can lead to problems such as a back injury, bone fracture or joint sprain
42
What is Liability Exposure: Confidentiality & Record Keeping?
Clients may share sensitive personal or medical information with a QEP Clients trust that the QEP will use it only to inform their assessment and exercise prescription QEPs shall keep records and reports clearly and concisely for the information of clients, professional colleagues, legal purposes, and to record physical activity, fitness, and health services
43
What is Risk Management & Mitigation?
The best risk management strategy is to avoid risks! A QEP can manage and mitigate risks of personal injury to their clients (and potential risks of negligence claims associated with injuries) by ensuring their conduct is always consistent with CSEP’s ‘standard of care’ as documented in: -Scope of Practice -Code of Conduct -Certification procedures and requirements -Procedures outlined in CSEP-PATH
44
Take simple steps to avoid risks of personal injury to your clients such as?
Ensure clients are using proper technique and form Use proper spotting techniques Check facility's floor is free of slips and fall or tripping hazards (e.g., promptly clean up water spills, ensure equipment is not left on floor when not in use, make sure clients are wearing appropriate footwear) Mirrors, walls, exits, storage areas, lighting, etc. are maintained Environmental factors are regulated (stereo volume, air temperature, etc.) Safety & policy signs are in clear view Equipment is maintained (cleaned, functionating, intact, calibrated) – CHECKED DAILY! Keep proper records to monitor progress
45
What is Professional Liability Insurance?
While most common risks can be successfully avoided, not all risks are foreseeable or avoidable For risks that cannot be avoided (including inherent risks of PA) insurance is a common strategy to manage risk QEPs have Professional Liability Insurance that includes coverage for professional and commercial liability risks
46
How to do proper Client Record Keeping?
Be well-organized & keep records of your client’s history, assessment results, training programs and progress Records must be kept in a secure environment (e.g., password-protected files if on a computer or in locked cabinets if on hard copy) Clear and concise records helps to provide clients with client-centered service over time and in the case of any legal proceedings
47
What sort of records should you keep?
Keep records of: Cleaning & maintenance, Safety procedures, Manufacturer’s warranties and guidelines Personnel credentials *Signed informed consent, Get Active Questionnaire, etc. *Injury report forms *Client data *SOAP notes *must be kept in a secure environment
48
What are SOAP notes?
SOAP notes are a basic record keeping method employed by doctors and other health care providers Informed consent should state that personal health information will be collected as part of the assessment
49
What does SOAP Notes stand for?
S - Subjective Data O - Objective Data A - Assessment P - Plan of Action *Used in addition to the Client Information Sheet and other relevant paperwork Identify all problems and needs; then follow each problem in its own appropriate time frame
50
What is S: Subjective Data?
Subjective data obtained from the client Use client’s own words to capture subjective data & incorporate your own subjective observations of the client
51
What type of subjective data is important to collect?
Reason for visit Relevant past medical history including medications or history of surgery PA history: Did it work in the past? Why or why not? What are the limitations/barriers now? Psychosocial factors (time/facility availability, job demands, etc.)
52
What is O: Objective Data?
Objective data obtained by observations, pre-participation screening information, and the fitness assessment Include a synopsis of the data collected that is relevant to the specific session being charted Other paperwork like Get Active Questionnaire or client information sheet, etc. can be appended If able, also gather appropriate information from allied health care team (e.g., physio, family dr.)
53
What is A: Assessment?
Client’s status based on the interpretation of the subjective and objective information gathered What are the clients strengths and weaknesses? Did client have any adverse responses to exercise (physiologically or psychologically)?   Are further assessments needed? Use assessment to guide plan of action When doing the assessment, keep in mind your Scope of Practice as the SOAP note is a legal document.
54
What is P: Plan of Action?
Client’s physical activity, exercise or lifestyle intervention Goals? Design individualized, client-centered exercise program to meet goals E.g., Prescription Card Note date of next appointment and schedule re-assessment (used to see improvements/progress)
55
Where is SOAP Notes documented?
SOAP note information is documented in the CSEP-PATH Physical Activity and Exercise Prescription Card which is shared and discussed with the client in Step 4-AGREE
56
Why make SOAP Notes?
Clarify the thinking process and the rationale for a course of evaluation, action or both Unique needs and concerns are identified Intervention is documented Follow-up evaluations can be compared to earlier visits Success or failure can be fairly judged