Professional Practice, Ethics, Patient Education, and Care Coordination
What the exam tests
Professional practice items center on communication, ethics, and systems. They typically present a disagreement, a confidentiality question, or a care transition, and ask what the clinician should do next.
Core concepts
- Ethical principles: autonomy, beneficence, nonmaleficence, and justice. For a competent adult, autonomy generally governs even when you disagree with the choice.
- Informed consent requires capacity, disclosure of risks, benefits, and alternatives, understanding, and voluntariness.
- Confidentiality for minors varies by state; many jurisdictions permit confidential STI and contraceptive care. Explain the limits (safety concerns, mandated reporting) up front rather than after the fact.
- Mandated reporting applies to suspected child abuse and, in many states, elder or intimate partner violence with injury. Tell the patient what you must report and why.
- Shared decision-making and teach-back improve adherence; health literacy is not the same as education level.
- Motivational interviewing supports behavior change without confrontation.
- Care coordination means closed-loop referrals, clear documentation, professional interpreters rather than family members, and warm handoffs.
- Implicit bias and reproductive justice shape who is offered LARC, whose pain is evaluated, and who is screened.
Traps
- Answering refuse care when the patient has capacity; the correct action is usually to document informed refusal and continue care.
- Using a family member as an interpreter.
- Disclosing information to a partner without consent.
Worked example
A 16-year-old requests contraception and asks that her parents not be told. Explain the state rules on confidentiality in reproductive care and its limits, provide care if legally permitted, and encourage, but do not require, family involvement.