Self-Assessment Questionnaire

To assist you in identifying any potential areas of growth (i.e., where atrophy in knowledge or skill related to the College's standards of practice may have occurred since you last practised the profession) and developing your learning plan, please use the following self-assessment questionnaire.

Registrant Information

Please provide the following information as it appears on the public register (Naturopath Search) on the College's website. This will allow the College to match the questionnaire with your application for presentation to the Registration Committee.

Standard of Practice for Acupuncture

1. I am familiar with all of the requirements of the Standard of Practice for Acupuncture.*
2. I have the knowledge, skill and judgment necessary to perform acupuncture safely, ethically and competently.*
3. I am able to identify contraindications to acupuncture.*
4. I am able to identify when acupuncture is expected to be an effective treatment.*

Standard of Practice for Advertising

5. I am familiar with all of the requirements of the Standard of Practice for Advertising.*
6. I understand that my advertisements may not include:*

- any information that could be interpreted to be an endorsement; - a guarantee of the success of the service provided; - a comparative or superlative statement about service quality, products or people; - a misleading or inappropriate testimonial by any patient, former patient or other person with respect to my practice

Standard of Practice for Collecting Clinical Samples

7. I am familiar with all of the requirements of the Standard of Practice for Collecting Clinical Samples.*
8. I have the knowledge, skill and judgment to collect clinical samples safely, ethically and competently.*
9. I am familiar with Point of Care Tests authorized in the General Regulation for blood sample collection.*
10. I am familiar with non-blood sample collection requirements for laboratory tests authorized under the Laboratory Specimen Collection Centre Licensing Act.*
11. I have the knowledge, skill and judgment regarding appropriate infection control measures when collecting a sample for minimizing risk to patients, self and others.*
12. I have the knowledge, skill and judgment to ensure that any instrument or device used for collecting a sample is used solely for the purpose intended by the manufacturer.*
13. I have the knowledge, skill and judgement regarding obtaining informed consent for collecting clinical samples.*
14. I am familiar with sample transportation requirements.*
15. I am familiar with patient charting requirements related to collecting clinical samples.*

Standard of Practice for Communicating a Diagnosis

16. I am familiar with all of the requirements of the Standard of Practice for communicating a Diagnosis.*
17. I have the knowledge, skill and judgment necessary to communicate a diagnosis of a disease, disorder or dysfunction safely, ethically and competently.*
18. I am familiar with delegating restrictions around communicating a diagnosis.*

Standard of Practice for Conflict of Interest

19. I am familiar with all of the requirements of the Standard of Practice for Conflict of Interest.*
20. I understand which activities or arrangements where my participation provides the potential for my professional judgment to be compromised.*

Standard of Practice for Consent

21. I am familiar with all of the requirements of the Standard of Practice for Consent.*
22. I am familiar with personal health information collection requirements under the Personal Health Information Protection Act, 2004.*
23. I have the knowledge, skill and judgement to ensure that patient consent is obtained in accordance with the standard of practice.*
24. I am familiar with patient charting requirements around consent.
25. I have the knowledge, skill and judgement to ensure the patient is fully informed with respect to the proposed course of action.*
26. I have the knowledge, skill and judgement to determine a patient’s capacity to make his/her own decisions with respect to care.*

Standard of Practice for Delegation

27. I am familiar with all of the requirements of the Standard of Practice for Delegation.*
28. I am familiar with which controlled act authorized to the profession in the Naturopathy Act, 2007 may be delegated.*
29. I have the knowledge, skill and judgement to accept a delegation from another regulated health professional, in the context of a Naturopathic Doctor-patient relationship.*
30. I have the knowledge, skill and judgement to ensure that any delegation conforms to the delegatee’s College regulations, policies and guidelines.*
31. I am familiar with all pre-delegation requirements around patient assessment, risk assessment, and consent.*

Standard of Practice for Dual Registration

32. I am familiar with all of the requirements of the Standard of Practice for Dual Registration.*
33. I have the knowledge, skill and judgement to ensure my practise is managed in accordance with the standard of practice for dual registration.*
34. I am familiar with all billing and charting requirements around dual registration.*

Standard of Practice for Emergency Preparedness

35. I am familiar with all of the requirements of the Standard of Practice for Emergency Preparedness.*
36. I have the knowledge, skill and judgement to review my practice to assess the level of risk of adverse events.*
37. I have the knowledge, skill and judgement to stock the necessary supplies for emergency situations, based on the assessed level of risk in my practice.*
38. I am familiar with emergency procedures and staff emergency preparedness requirements for clinic practise.*

Standard of Practice for Fees & Billing

39. I am familiar with all of the requirements of the Standard of Practice for Fees and Billing.*

Standard of Practice for Infection Control

40. I am familiar with all of the requirements of the Standard of Practice for Infection Control.*
41. I am familiar with practices that minimize the chance, or spread of infection.*
42. I have the knowledge, skill and judgement to implement infection control protocols.*
43. I have the knowledge, skill and judgement to establish and maintain a clean field, as appropriate.*
44. I am familiar with reporting requirements for all required Reportable Communicable Diseases to the local Medical Officer of Health.*
45. I have the knowledge, skill and judgement to segregate all biomedical waste and handle it in accordance with the containment, labeling, storage and transportation requirements in Guideline C-4: The Management of Biomedical Waste in Ontario.*
46. I am familiar with reporting requirements for any incident involving exposure to biomedical material posing a risk of transmission.*

Standard of Practice for Internal Examinations

47. I am familiar with all of the requirements of the Standard of Practice for Internal Examinations.*
48. I have the knowledge, skill and judgment necessary to perform internal examinations safely, ethically and competently.*
49. I have the knowledge, skill and judgement to ensure that I am in compliance with the Standard of Practice for Performing Authorized Acts prior to performing an internal examination.*
50. I am familiar with the clinical indications and appropriate purposes for performing internal exams.*
51. I am familiar with all charting requirements around internal examinations.*

Standard of Practice for Naturopathic Manipulation

52. I am familiar with all of the requirements of the Standard of Practice for Naturopathic Manipulation.*
53. I have the knowledge, skill and judgment to perform manipulation safely, ethically, and competently.*
54. I am familiar with all assessment requirements prior to performing naturopathic manipulation.*
55. I have the knowledge, skill and judgement to perform cervical joint manipulation in accordance with the General Regulation.*
56. I am familiar with CONO’s Absolute & Relative Contraindications Guideline for screening patients.*
57. I have the knowledge, skill and judgment to know when naturopathic manipulation cannot be performed.*
58. I am familiar with all charting requirements around naturopathic manipulation.*

Standard of Practice for Point of Care Testing (POCT)

59. I am familiar with all of the requirements of the Standard of Practice for Point of Care Testing.*
60. I have the knowledge, skill and judgment to perform POCT safely, ethically and competently, to be able to interpret results and to identify when further testing or referrals may be necessary.*
61. I have the knowledge, skill and judgement to create a Standard Operating Procedure for the use of POCT equipment.*
62. I have the knowledge, skill and judgement to perform only those tests authorized in the General Regulation and Laboratory Specimen Collection Centre Licensing Act.*
63. I have the knowledge, skill and judgement to manage any adverse reactions or complications that may arise during or after the act.*
64. I am familiar with POCT equipment requirements approved for use in Canada.*
65. I am familiar with consent requirements around POCT.*
66. I have the knowledge, skill and judgement to ensure that proper infection control measures are in place when performing POCT to minimize the risk to patients, self and others.*
67. I have the knowledge, skill and judgement to appropriately interpret and explain POCT results to the patient*
68. I have the knowledge, skill and judgement to refer a patient when a critical value or clinically significant result is received*
69. I am familiar with all POCT charting requirements.*

Standard of Practice for Recommending Non-Scheduled Substances

70. I am familiar with all of the requirements of the Standard of Practice for Recommending Non-Scheduled Substances.*
71. I have the knowledge, skill and judgment to recommend non- scheduled substances safely, ethically and competently.*
72. I am familiar with all documentation requirements around recommending non-scheduled substances*

Standard of Practice for Record Keeping

73. I am familiar with all of the requirements of the Standard of Practice for Record Keeping.*
74. I am familiar with electronic record keeping requirements.*
75. I am familiar with and I have the knowledge, skill and judgement to meet the requirements of the Personal Health Information Protection Act, 2004 (PHIPA).*

Standard of Practice for Restricted Titles

76. I am familiar with all of the requirements of the Standard of Practice for Restricted Titles.*

Standard of Practice for Therapeutic Relationships

77. I am familiar with all of the requirements of the Standard of Practice for Therapeutic Relationships and Professional Boundaries.*
78. I have the knowledge, skill and judgement to avoid boundary violations.*

Declaration & Signature

Declaration I, the above-named individual, do hereby solemnly declare that: - I have completed this self-assessment on my own with no assistance or direction from others; - This self-assessment is a true assessment of my current knowledge of the Standards of Practice; and - I have been honest and truthful in completing this self-assessment.

Signature By checking the box below, you are affixing a signature to this form and indicating that this form and the information contained herein is bound directly to you.

Submission Copy

Below is a check box to receive a copy of your submission. It is highly recommended that you check this box and enter your e-mail address for a second time. This will enable the on-line system to send you a copy of the information that you have provided to the College.

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