Professionalism, Ethics, Communication and Patient Safety
Professionalism, ethics, communication and patient safety tests consent, confidentiality, capacity, boundaries, truth-telling, error disclosure, teamwork and culturally safe communication. The exam expects defensible reasoning, documentation and respect for patient autonomy.
Core rules
- Informed consent requires capacity, adequate information, understanding and voluntariness.
- Confidentiality can be breached only with consent or a lawful, proportionate justification such as serious risk to others.
- Assess capacity functionally: understand, retain, weigh and communicate a decision.
- Disclose harm openly, apologise, explain what happened and what will change; report incidents without blaming individuals.
- Use structured communication such as SBAR and closed-loop confirmation in urgent handovers.
- Respect cultural and religious values while maintaining clinical standards; check language and interpreter needs.
Worked example
A 16-year-old requests contraception confidentially. Assess capacity and safeguarding, explain confidentiality and its limits, and involve parents only with consent unless risk requires otherwise. Reasoning: confidentiality supports access, but safety overrides in defined circumstances.
Traps
Assuming a young person lacks capacity; breaching confidentiality unnecessarily; failing to document consent; and hiding errors to protect the team.