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Being honest


Practising with integrity and trustworthiness

Honesty and integrity with supervisors


Male physician and female medical trainee looking at chartConsider the following case highlighting honesty and integrity with supervisors.

Case: Providing accurate information to others
Male medical student sitting at computer

Background

A first-year medical student is given an assignment to interview a patient and develop a case report for grading.

While writing the report the student realizes that he did not ask the patient about allergies. Knowing that the case report would not be used in the patient's care but would count toward the student's final grade, he writes a fictitious summary of the patient's supposed allergies and hands in the report.

The student achieves an exceptionally high mark and receives a comment from the tutor commending his thoroughness.

Background continued

Two years later, the former medical student, now a clinical clerk, is asked to see a patient and obtain a history.

Before reporting back to his supervisor, the clerk realizes that he did not ask the patient about her family history. Anxious to finish up the day and start the weekend, the clerk thinks back to the time in medical school when he did not get caught for falsifying data in the case report assignment.

The clerk records "no relevant family history" on the chart.

Think about it

  • Do you think the clerk would have considered falsifying patient information if he had been caught doing so on his past assignment?
  • What system and provider factors may drive individuals to compromise their integrity and potentially compromise patient safety?
  • A fast-paced environment such as healthcare might require that students and physicians complete tasks more quickly than would be ideal. What are some strategies that might help students to complete tasks thoroughly and accurately?

For more information see normalization of deviance in Adverse events domain.

Suggestions

Strategies that might help students to complete tasks thoroughly and accurately include:
  • time management
  • informing supervisors of obligations to be elsewhere at a certain time
  • allotting some leeway time at the end of the day to relieve pressure when running behind schedule
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  • The medical record is a legal document and is expected to be accurate.
  • Any statements made by a healthcare provider should be objective and factual.
  • You will be judged on the facts and your actions.
  • Patient care may suffer if you give false information.