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Clinical documentation

Writing accurate, timely patient records that show what was found, done and planned.

Good work shows: Records date, time and author for each entry; writes findings and plans clearly; completes notes during or soon after care.

Clinical documentation is one of the healthcare skills on FinderK.

The job simulations and Skill Paths below include work that is checked for this skill. You do the work in an original fictional company and get feedback on it.

Job simulations

The trial review before the monitoring visit

Clinical research coordinator at Hallam Road Clinical Research Unit

About 80 minutes. Included in Plus.

Fourteen trial participants to check before the monitor arrives. Find the visit and eligibility deviations, report a major one honestly while the investigator and a nurse push for a softer version, then beat the 24 hour clock on a serious adverse event without making a medical call.

Skills: Check participants against a protocol; Report a deviation honestly and on time; Protect source records under pressure; Meet a safety reporting deadline; Stay inside delegated authority

Skill Paths

Related careers

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