Understanding Consent and Professional Boundaries

Thank you for watching Module 5 – Boundaries and Consent in the Transitioning to Practice in Ontario learning series. Please take some time to reflect on what you learned by answering the questions below. You can check your answers at the end. We have also linked some helpful resources at the bottom to help support ongoing learning.

1.In patient care settings, “boundaries” are:	A. The physical and emotional limits of the therapeutic relationship between the patient and the physiotherapist	B. Partitions that provide patients with privacy during treatments	C. Legally defined remedies associated with breaches of confidentiality	D. None of the above	Correct Answer: A Boundaries describe the perimeter of professionally acceptable and appropriate behaviours, conversations, and interactions between physiotherapists and their patients.
2.“Consent” involves:	A. A clear explanation by the physiotherapist to the patient about treatment	B. Providing opportunities for the patient to ask questions	C. Options for the patient to decline some or all of the proposed activities or treatments	D. All of the above	Correct Answer: D Consent involves all of the aspects above that focus on providing patients with support for fully informed decision making.
3.Failure to establish appropriate boundaries and gain consent can result in:	A. Complaints to the College regarding the physiotherapist’s behaviour	B. An unsafe environment for care	C. Negative health outcomes	D. All of the above	Correct Answer: D Physiotherapists have responsibilities to ensure appropriate boundaries and consent are in place to prevent these and other negative outcomes for the patient.
4.“I’m going to perform a procedure on your left leg, okay?” is sufficient to confirm consent has been received.	True	False	Correct Answer: False Insufficient details were provided to the patient regarding the nature of the treatment, the benefits, risks, side effects, alternative course of actions and any consequences of not having the treatment. There was no opportunity for questions, and no confirmation from the patient regarding understanding or acceptance.
5.Before starting treatment, the PT explains the procedure then asks the patient if they agree to proceed. The patient responds with a sigh, then closes their eyes. Because the patient did not specifically say “no,” this is an example of non-verbal, implied consent.	True	False	Correct Answer: False Non-verbal implied consent does not exist. Consent must be clearly communicated by the patient to the PT in an affirmative manner.
6.“Consent is a conversation – not just a signed form.”	True	False	Correct Answer: True The essential element of consent is understanding and informed decision making, and this comes from having a conversation with the patient rather than simply having them sign a form.
7.When a breach of a professional boundary occurs during treatment:	A. It is essential to not discuss the breach or apologize to a patient without first getting legal advice	B. The PT should stop treatment and address the breach by identifying and correcting the inappropriate behaviour. The actions taken to address the breach should be documented.	C. The physiotherapist should finish treatment before responding to the breach	D. None of the above	Correct Answer: B Documentation is essential in situations where a breach of a professional boundary has occurred. Relying on memory or recollection is imperfect and often flawed, so immediate documentation provides important safeguards for both patients and physiotherapists.

Additional resources:

How to Develop a Sensitive Practice (video)

Earning and Keeping Your Patient’s Trust (video)

Boundaries and Sexual Abuse Standard

College of Physiotherapists of Ontario: Boundaries and Sexual Abuse Standard Elearning Module

Check Answers

Understanding Consent and Professional Boundaries

Correct Answer: A

Boundaries describe the perimeter of professionally acceptable and appropriate behaviours, conversations, and interactions between physiotherapists and their patients.

Correct Answer: D

Consent involves all of the aspects above that focus on providing patients with support for fully informed decision making.

Correct Answer: D

Physiotherapists have responsibilities to ensure appropriate boundaries and consent are in place to prevent these and other negative outcomes for the patient.

Correct Answer: False

Correct Answer: False

Non-verbal implied consent does not exist. Consent must be clearly communicated by the patient to the PT in an affirmative manner.

Correct Answer: True

The essential element of consent is understanding and informed decision making, and this comes from having a conversation with the patient rather than simply having them sign a form.

Correct Answer: B

Documentation is essential in situations where a breach of a professional boundary has occurred. Relying on memory or recollection is imperfect and often flawed, so immediate documentation provides important safeguards for both patients and physiotherapists.

Additional resources: