Medical Record Keeping Post-Workshop Submission

 

This is the post-workshop component of the Medical Record Keeping course. Participants of this course are REQUIRED to complete this activity before the three-month post-workshop group learning webinar.


ABOUT THE COURSE

The medical record facilitates good care. With contemporaneous documentation of patient encounters, the reflection and review can reinforce the consistency, completeness and quality of your clinical activities. This course aims to address sufficient documentation, which is central to patient safety and continuity of quality care.

Participants will complete a series of learning activities:

1) Online self-learning (i.e. the pre-course activity)
2) Face-to-face group learning (i.e. the workshop)
3) Three-month post-workshop, online group learning (i.e. the webinar)

Three months after the workshop, participants will be reminded to submit sample clinical notes and referral notes. They will then attend a one-hour webinar.


TO NAVIGATE THROUGH THE ONLINE MODULES

It is not recommended to access the online modules on smartphones at this point as your learning experience might be compromised.

There are required learning activities in the modules, such as reviewing text and video materials, submitting your own (PDF or scanned image) files, responding to open-ended questions, responding to some short surveys.

‘TAKE NOTES’: To make notes for your own use, click on ‘TAKE NOTES’ at the upper right corner of your screen to open the notes field. All the course notes you have made can be found in a full list in the page of ‘My Courses’.

‘RESUME LEARNING”: Please be aware that it will take you several hours to complete the modules. For the convenience of self-paced learning, you may exit from the middle of the course and come back later. When you log into the e-learning portal again, click on ‘RESUME LEARNING’, and you will be redirected to where you left last time.


LEARNING OBJECTIVES

Upon completion of the course, participants will be equipped to:

  • Recognize the general principles and multiple purposes of medical record documentation
  • Identify the elements and characteristics of appropriate documentation of patient encounters
  • Use the SOAP-based tool to self-evaluate and improve the practice of documenting patient encounters
  • Practice effective written communication of referral or consult letters

COPYRIGHT

Material presented are in compliance with the University of Calgary Copyright Policy, Acceptable Use of Material Protected by Copyright.

Course materials are for individual use only and not to be distributed.


DISCLOSURE
  • This course has received no commercial sponsorship support.
  • This course is co-developed by the College of Physicians and Surgeons of Alberta and the University of Calgary CME&PD, and was planned to achieve scientific integrity, objectivity and balance.
  • Faculty disclosure
Faculty Credentials Disclosure Affiliation
Heather Armson MD MCE CCFP FCFP Nothing to disclose Professor, Department of Family Medicine;Assistant Dean, Personalized Learning, CME&PD, University of Calgary
Michael Caffaro MD CCFP Nothing to disclose Assistant Registrar and Complaints Director,
College of Physicians & Surgeons of Alberta
Nigel Flook MD CCFP FCFP Nothing to disclose Senior Medical Advisor,
College of Physicians & Surgeons of Alberta
Monica Sargious MD CCFP FCFP Nothing to disclose Clinical Assistant Professor,
Section Chief Community Primary Care,
Department of Family Medicine-Calgary Zone

 


PLANNING COMMITTEE

Heather Armson MD MCE CCFP FCFP (Chair)
Michael Caffaro MD CCFP
Sarah Weeks MD FRCPC
Nigel Flook MD CCFP FCFP
Wes Jackson MD CCFP FCFP
Monica Sargious MD CCFP
Monica Wickland-Weller MD
Chloe Burnett MSc MEd (CME Representative)


ACKNOWLEDGEMENT

This program has received educational grants from the College of Physicians and Surgeons of Alberta.

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