Practice Management, Ethics, and Patient Safety
What the exam tests
This domain tests consent, confidentiality, record-keeping and safety systems: the non-clinical marks that are easy to lose.
Core rules
- Informed consent requires capacity, information and voluntariness; minors need parent or guardian consent plus child assent where possible.
- Confidentiality: share only on a need-to-know basis; mandated reporting overrides it for suspected abuse.
- Records: contemporaneous, signed and dated; retain per local regulation. Radiographs must be justified (ALARA) with a lead apron and thyroid collar.
- Infection control: hand hygiene, autoclave at 134 degrees Celsius for 4 minutes or 121 degrees for 15 minutes, sharps disposal, surface disinfection and waterline flushing.
- Medical emergencies: syncope (supine, legs raised), anaphylaxis (adrenaline 0.01 mg/kg IM of 1:1000, max 0.5 mg), asthma (salbutamol), hypoglycaemia (glucose).
- Ethics: autonomy, beneficence, non-maleficence and justice; veracity; no misleading advertising.
Worked example
A parent refuses fluoride varnish for a high-risk child. Reasoning: respect autonomy, document the informed refusal, explain the risks in plain language, offer alternatives, and record the discussion. Do not forge consent or apply treatment against the parent's wishes.
Traps
Treating a child without documented consent; discussing a case in a public area; skipping thyroid shielding; running an autoclave without biological monitoring.