Medical-Fitness Technician
Certification Course
Part C: Assessing Medical-Fitness
Learning Modules: 25-34
Certification Course
Part C: Assessing Medical-Fitness
Learning Modules: 25-34
Learning Module 26:
Informed Consent
Informed Consent
Study the Learning Module and take the Quiz.
Learning Objectives
- Understand the difference between a liability waiver and an informed consent.
- Become familiar with the basic areas of concern in obtaining an informed consent.
- Understand the concept of "inherent risk" and "probability."
Explanation
An informed consent is NOT a liability waiver. A liability waiver is a legal document releasing or relinquishing a known right, claim, or privilege. In the context of exercise testing, a liability waiver would be the relinquishment to pursue a claim (law suit) within a set of defined circumstances in case the participant suffers damages, injury, or death as a result.
Liability Waivers are sometimes used in an attempt to defer responsibility in case a service is provided or performed negligently. This is unethical and usually does not stand up in court. As a health and fitness professional, you should not use a liability waiver in an attempt to dodge your responsibility in providing competent care.
Instead, you should use an Informed Consent. An Informed Consent is a written acknowledgement that your client understands the inherent risks when participating in a medical-fitness test or training program.
Obtaining an Informed Consent from your client prior to their medical-fitness assessment clarifies their responsibility in choosing to perform the exercises, as well as their responsibilities while performing the exercises.
Medical-Fitness Technicians who provide their services competently are generally not held liable for an adverse event as long as the participant was aware of the inherent risks and their own responsibilities.
Liability Waivers are sometimes used in an attempt to defer responsibility in case a service is provided or performed negligently. This is unethical and usually does not stand up in court. As a health and fitness professional, you should not use a liability waiver in an attempt to dodge your responsibility in providing competent care.
Instead, you should use an Informed Consent. An Informed Consent is a written acknowledgement that your client understands the inherent risks when participating in a medical-fitness test or training program.
Obtaining an Informed Consent from your client prior to their medical-fitness assessment clarifies their responsibility in choosing to perform the exercises, as well as their responsibilities while performing the exercises.
Medical-Fitness Technicians who provide their services competently are generally not held liable for an adverse event as long as the participant was aware of the inherent risks and their own responsibilities.
Sample Informed Consent
Items 1-7 below explain the basic areas of concern in obtaining an informed consent from a participant prior to conducting a medical-fitness assessment. The statements are written in first-person for clarity from the participant's perspective.
1. Purpose and Explanation – Your Medical-Fitness Assessment includes standardized fitness tests that are conducted by a certified Medical-Fitness Technician to ensure safety and accuracy. You will be asked to perform a series of basic exercises with the objective to determine your physical functional capacity. Your results will help generate an appropriate exercise prescription. This will also give you the option to track your progress towards your personal fitness goals by periodically repeating the same exercise tests every few months depending on your fitness level and training program.
2. Instructions – You are allowed to modify each exercise to the best of your ability and to set your own pace to whatever intensity level is comfortable for you. You may stop any exercise test at any time for any reason. Your Medical-Fitness Technician may encourage you to slow-down, or may even insist that you stop, depending on the signs of exertion or discomfort that you exhibit during your exercise test.
3. Attendant Discomforts and Risks – There is the possibility of certain physiological changes occurring during your exercise tests. These include shortness of breath, pounding heart beats, palpitations, dizziness, fatigue, impaired coordination, and in extremely rare instances, heart attack, stroke, or death.
4. Your Responsibilities – It is important for you to have answered the screening questions accurately regarding any pre-existing heart-related symptoms, your medical history, and your current pattern of physical activity. You are fully responsible for disclosing all symptoms that you experience during your exercise tests, such as pain, shortness of breath, or pressure, tightness, and/or heaviness in your chest, neck, jaw, back, and/or arms.
5. Benefits to Be Expected – Upon completing your Medical-Fitness Assessment, you will obtain an accurate Fitness Score and an appropriate Exercise Rx. Your Fitness Score reflects: a) Your functional capacity, and during follow-up, b) The effectiveness of your exercise program, and c) Your progress towards your fitness goal. Aggregate data will be used for the advancement of exercise science and lifestyle therapies. If applicable, your doctor may use your Fitness Score to better manage any sedentary-related condition you may have in conjunction with your on-going medical treatment.
6. Inquiries – You are encouraged to get any desired clarifications regarding your Medical-Fitness Assessment and Therapeutic Fitness Training. If you or your doctor, physical therapist, coach, or personal trainer have any questions or concerns regarding the procedures, results, or potential health benefits of regular exercise, simply ask your certified Medical-Fitness Technician.
7. Use of Personal Information – The information that is obtained during your Medical-Fitness Assessment will be treated as privileged and confidential. It will not be released or revealed to any third party. Aggregate information will be used for statistical analysis and scientific research purposes while fully protecting your identity and right to privacy. Of course, you are always free to share your Medical-Fitness Score and Therapeutic Fitness Training experience with anyone you choose to do so.
8. Freedom of Consent – Your voluntary participation in a Medical-Fitness Assessment and/or Therapeutic Fitness Training acknowledges that you have read this Informed Consent and accept the attendant discomforts and risks. You understand: a) The nature of the procedures and exercises, b) That you are free to stop your exercise tests at any time, and c) That you had the opportunity to ask questions and get answers to your satisfaction. If you have any health or medical concerns that cannot be adequately addressed by your Med-Fit Tech, you should speak with your personal physician about sub-maximal fitness testing and light-moderate therapeutic fitness training.
2. Instructions – You are allowed to modify each exercise to the best of your ability and to set your own pace to whatever intensity level is comfortable for you. You may stop any exercise test at any time for any reason. Your Medical-Fitness Technician may encourage you to slow-down, or may even insist that you stop, depending on the signs of exertion or discomfort that you exhibit during your exercise test.
3. Attendant Discomforts and Risks – There is the possibility of certain physiological changes occurring during your exercise tests. These include shortness of breath, pounding heart beats, palpitations, dizziness, fatigue, impaired coordination, and in extremely rare instances, heart attack, stroke, or death.
4. Your Responsibilities – It is important for you to have answered the screening questions accurately regarding any pre-existing heart-related symptoms, your medical history, and your current pattern of physical activity. You are fully responsible for disclosing all symptoms that you experience during your exercise tests, such as pain, shortness of breath, or pressure, tightness, and/or heaviness in your chest, neck, jaw, back, and/or arms.
5. Benefits to Be Expected – Upon completing your Medical-Fitness Assessment, you will obtain an accurate Fitness Score and an appropriate Exercise Rx. Your Fitness Score reflects: a) Your functional capacity, and during follow-up, b) The effectiveness of your exercise program, and c) Your progress towards your fitness goal. Aggregate data will be used for the advancement of exercise science and lifestyle therapies. If applicable, your doctor may use your Fitness Score to better manage any sedentary-related condition you may have in conjunction with your on-going medical treatment.
6. Inquiries – You are encouraged to get any desired clarifications regarding your Medical-Fitness Assessment and Therapeutic Fitness Training. If you or your doctor, physical therapist, coach, or personal trainer have any questions or concerns regarding the procedures, results, or potential health benefits of regular exercise, simply ask your certified Medical-Fitness Technician.
7. Use of Personal Information – The information that is obtained during your Medical-Fitness Assessment will be treated as privileged and confidential. It will not be released or revealed to any third party. Aggregate information will be used for statistical analysis and scientific research purposes while fully protecting your identity and right to privacy. Of course, you are always free to share your Medical-Fitness Score and Therapeutic Fitness Training experience with anyone you choose to do so.
8. Freedom of Consent – Your voluntary participation in a Medical-Fitness Assessment and/or Therapeutic Fitness Training acknowledges that you have read this Informed Consent and accept the attendant discomforts and risks. You understand: a) The nature of the procedures and exercises, b) That you are free to stop your exercise tests at any time, and c) That you had the opportunity to ask questions and get answers to your satisfaction. If you have any health or medical concerns that cannot be adequately addressed by your Med-Fit Tech, you should speak with your personal physician about sub-maximal fitness testing and light-moderate therapeutic fitness training.
If your client has any questions about how medical-fitness services may effect their medical treatment, or if your client has ANY medical-specific question, defer your client to their personal physician for the answer to their medical questions. This is important even IF you believe you know the answer to their question..
Inherent Risk
"Inherent" risk means that there is a possibility that an adverse event may occur even though everything was done properly in order to minimize that risk. The incidence of a serious event, such as a heart attack, stroke, or death is extremely rare -- less than 1 in 100,000, when the participant is properly screened and the exercise tests are properly administered and supervised.
Even though something is "possible," it does not mean it is "probable" and certainly not necessarily causal. It is also possible that your client foregoes the fitness test and has a heart attack at home while watching television. Tap the link below to read the abstract of just one of hundreds of studies that demonstrate the safety -- and value -- of medical-fitness testing.
Even though something is "possible," it does not mean it is "probable" and certainly not necessarily causal. It is also possible that your client foregoes the fitness test and has a heart attack at home while watching television. Tap the link below to read the abstract of just one of hundreds of studies that demonstrate the safety -- and value -- of medical-fitness testing.
Despite the extremely low probability of an adverse event, the practical instruction for your client is: "Put in a good effort, but don't over-do it." If signs of over exertion become evident during an exercise test (heavy labored breathing, gestures or facial expressions of pain or severe discomfort), you should ask the participant how he/she is feeling and encourage him/her to slow down, rest, or even stop if signs of over exertion continue or worsen -- even if the participant denies feeling uncomfortable.
It is far better to error on the side of caution. Also, you want the participant to have a positive experience, so that he/she remains open to the idea of medical-fitness training with repeat fitness testing to track and maximize their results.
It is far better to error on the side of caution. Also, you want the participant to have a positive experience, so that he/she remains open to the idea of medical-fitness training with repeat fitness testing to track and maximize their results.