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A1. You must listen to patients and respect their individuality, concerns and preferences. You must be polite and considerate with patients and treat them with dignity and courtesy.

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A1. You must listen to patients and respect their individuality, concerns and preferences. You must be polite and considerate with patients and treat them with dignity and courtesy.

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Using the Driscolls "What" model I reflect on the importance of that every patient should be treated individually.

Reference: Cambridge University Libraries, 2021. Models of reflection. Available at: https://libguides.cam.ac.uk/reflectivepracticetoolkit/models [Accessed January 24, 2022]

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B1: You must have and be able to apply sufficient and appropriate knowledge and skills to support your work as an osteopath.

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B1: You must have and be able to apply sufficient and appropriate knowledge and skills to support your work as an osteopath.

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My knowledge and skills are taught through my four years as an osteopath student at the European School of Osteopathy. The different seminars through the years covers the B1 standard of the OPS. All this to be able to apply sufficient knowledge and skills with my patients. I aim to keep my knowledge up to date.

One of the things that I must have and apply sufficient is my palpatory skills. I use and practice my palpation every day at work, and it is my key tool. I have practiced this since I started study physiotherapy. My palpatory skills have developed through the years. I have read this article and used it as a help to practice my palpatory skills. I can truly see a difference after I had the seminar with fascia in year 1, where it all was very difficult to imagine the layers and to feel them. Also, when working with other tissues as membranes, bones, muscle and viscera. Through the years it became easier, but it is still difficult now in year 4, but now it makes sense to me because I have studied the anatomy and practiced my palpatory skills with a lot of patients. One of the most important things I have learnt in year 4 is to take my time. Taking my time to feel the tissues and feel the changes. This made a huge difference for me and my skills because I now can feel much more and feel the changes.

Reference:

Aubin, A., Gagnon, K., & Morin, C., 2014. The seven-step palpation metod: A proposal to improve palpation skills. International Journal of Osteopathic Medicine. 17(1), pp. 66.72.

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D1. You must act with honesty and integrity in your professional practice.

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D1. You must act with honesty and integrity in your professional practice.

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It is important that patients is treated and handled with honesty and respect. I made a reflection on a case I had in year three.

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A2. You must work in partnership with patients, adapting your communication approach to take into account their particular needs and supporting patients in expressing to you what is important to them.

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A2. You must work in partnership with patients, adapting your communication approach to take into account their particular needs and supporting patients in expressing to you what is important to them.

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I had a patient where communication was difficult cause of we did not speak the same language. I used the ERA cycle to reflect on my experience.

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D2. You must establish and maintain clear professional boundaries with patients, and must not abuse your professional standing and the position of trust which you have as an osteopath.

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D2. You must establish and maintain clear professional boundaries with patients, and must not abuse your professional standing and the position of trust which you have as an osteopath.

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I haven’t had any situation where I have abused my position as a healthcare professional. I have my professional boundaries which I stand up for. I have had an experience the other way around, where I had a patient who was crossing my boundaries.

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A3. You must give patients the information they want or need to know in a way they can understand.

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A3. You must give patients the information they want or need to know in a way they can understand.

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The evidence is from my template I use with every patient when taking the case history. It can remind me to remember important information, their rights and options. This is a OPS criteria and therefore the lines are a permanent routine of my sessions with patients.

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D3. You must be open and honest with patients, fulfilling your duty of candour.

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D3. You must be open and honest with patients, fulfilling your duty of candour.

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My aim is to be honest and open with patients to secure patient care. I have made a reflection on a patient I had in year 1.

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A4. You must receive valid consent for all aspects of examination and treatment and record this as appropriate.

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A4. You must receive valid consent for all aspects of examination and treatment and record this as appropriate.

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I had a comment on my year 2 exam feedback: "Good but brief initial communication with patient informing of the steps to come, however this does not constitute informed consent."

This comment made me realise I had to improve on asking for consent because it is a part of the Osteopathic Practise Standard.

In my practise I wrote a small note to myself “Remember consent”. From that comment on the exam feedback, I practised on every patient I had for a session. I also put a line with “ask for consent” in my template I use for writing down my case history. At first I forgot it sometimes, but got better and better. It is important to me that this part of asking for consent don’t miss out in my sessions, therefore I do anything I can to remember and make it a routine. After a month, I deleted that line in my template. From now on I remember asking properly for consent.

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A5. You must support patients in caring for themselves to improve and maintain their own health and wellbeing.

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A5. You must support patients in caring for themselves to improve and maintain their own health and wellbeing.

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I had a patient with a long-term condition who I referred to the doctor. I did it to support my patient' health.

Reference: Cambridge University Libraries, 2021. Models of reflection. Available at: https://libguides.cam.ac.uk/reflectivepracticetoolkit/models [Accessed January 24, 2023]

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A6. You must respect your patients’ dignity and modesty.

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A6. You must respect your patients’ dignity and modesty.

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In my exam feedback from year 1 they wrote that I am "Polite with getting the patient to change position, taking of shorts". This shows that I already from the beginning of the education have an awareness of different modesty, culture and respect every patient.

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A7. You must make sure your beliefs and values do not prejudice your patients’ care.

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A7. You must make sure your beliefs and values do not prejudice your patients’ care.

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This OPS criteria is very important and made me reflect on the importance of treating individuals equally.

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D4. You must have a policy in place to manage patient complaints, and respond quickly and appropriately to any that arise.

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D4. You must have a policy in place to manage patient complaints, and respond quickly and appropriately to any that arise.

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I have not received any complaints from any patient during my work as a physiotherapist or osteopath student. I know the procedure and how to provide information to a patient if they want to make a complaint to the Danish Patient Complaints Agency.

If I got a personal complaint either face to face or written by e-mail, then I would talk or call the patient to hear about their situation and see if we can solve this by ourselves.

If a patient has a complaint, and they want to take it further then they must follow the instructions set up by the Danish Patient Complaints Agency. The patient contacts this agency for help and advice during the procedure. Then there is a procedure for me afterwards where the agency needs to get my opinion and documents sent for them to make an decision.

Reference:

The Danish Patient Complaints Agency. Complaint about health care. Available at: https://www.stpk.dk/en/ [Accessed January 25, 2025]

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The Danish Patient Complaints Agency handles complaints from patients. You can complain to us about:

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B2. You must recognise and work within the limits of your training and competence.

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B2. You must recognise and work within the limits of your training and competence.

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Recently I had a patient with endometriosis in year 4 where I had difficulties in what to do with examination, treatment and management plan. Recently we had a seminar on the subject but that was not enough for me to feel qualified and my knowledge was not sufficient for this case. The patient was diagnosed at her gynecologist and was in contact with her doctor. She did not have any surgery. She wanted to avoid operation if possible. This is here osteopathy is qualified for helping women with endometriosis because it is a long-term condition and it needs a holistic view. I referred the patient to one of my collages who is an educated osteopath which are seeing a lot of female patients. I was with my colleage and my patient to the session to see her way and to learn. Before the session I read this article “Osteopathic manual treatment in women with endometriosis: A scoping review on clinical symptoms, fertility and quality of life ”. That gave me some knowledge on endometriosis and prepared me for the session. My colleague saw my patients two times and then I took the rest of the sessions. My colleague gave me some education and discussion after the first session on what she did and why in examination, treatment and management plan. I continued by myself with treatment and management plan and felt more comfortable in giving the best patient care. My treatment was to increase the mobility of the tissue in the pelvis, and increase circulation to the area. We worked with her posture which was a posterior type, and talked diet at the first point.

It gives me a lot to follow a near-peer with a patient I have had my self. I watch and learn and can discuss the patient afterwards.

Reference:

Strooper M D, Nys L D, Theys L, Vermeersch A & Quaghebeur J, 2024. Osteopathic manual treatment in women with endometriosis: A scoping review on clinical symptoms, fertility and quality of life. International Journal of Osteopathic Medicine, 54, 100733.

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B3. You must keep your professional knowledge and skills up to date.

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B3. You must keep your professional knowledge and skills up to date.

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B3. To keep my knowledge up to date I continuously take new relevant courses. In end of year 2 I went to a course in treating babies with Miranda Clayton.

I learned about the importance of movements in babies and teenanger. It made me more ready to examine and treat babies. It was not easy theory cause of the big difference in treating adults. The course gave me a lot in understanding how we develope from baby to an adult and gave me and understanding on how to treat and advise parents. I want to improve and develope in this area in treating babies and children. I want to take more courses in the future, and already have registred a new cource in Denmark called "The big 5 - practical techniques for babies". Very excited for that.

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B4. You must be able to analyse and reflect upon information related to your practice in order to enhance patient care.

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B4. You must be able to analyse and reflect upon information related to your practice in order to enhance patient care.

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To enhance patient care I needed to do some research upon a sporting patient I had in year 2. It was a long-distance runner who came to me with an acute ankle sprain. His goal was to come back as fast as possible to run again. To achieve this, I needed to expand on my knowledge to ensure that the injury was treated correctly, and my management plan was up to date. I did some research and found this article I read before I had the next sessions with the patient. For me I get more secure and feel more confident in treating such a sporting patient when my knowledge is limited. When I have a patient and I know from the first session and case history that this is a case that is out of my limits, then I study and search for knowledge in that area to help my patient.

Reference:

Doherty C, Bleakley C, Delahunt E & Holden S, 2017. Treatment and prevention of acute and recurrent ankle sprain: an overview of systematic reviews with meta-analysis. British Journal of Sports Medicine. 51. pp. 113-125.

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C1. You must be able to conduct an osteopathic patient evaluation and deliver safe, competent and appropriate osteopathic care to your patients.

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C1. You must be able to conduct an osteopathic patient evaluation and deliver safe, competent and appropriate osteopathic care to your patients.

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My exam feedback in year 1 showed that my interaction and structure of the case history was good. “Good, professional interaction, and good structure of case history”. One of the things I could expand on was my ability to formulate working diagnoses: “Good list of hypotheses but beware of not only listing anatomical structures, do not forget to mention somatic dysfunction. Good clinical reasoning”. In year 2 I have developed my skills on that by listing orthopedic and osteopathic diagnosis. In the following year 3 and 4 I will study on different diagnoses to expand my knowledge on the many different working diagnosis there can be. This will help me to form a more specific working diagnosis.

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C2. You must ensure that your patient records are comprehensive, accurate, legible and completed promptly.

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C2. You must ensure that your patient records are comprehensive, accurate, legible and completed promptly.

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To ensure my records of the case history is of a good quality I have used this book. I got this book in my 1st year, and I am still using it on my 4th year as an osteopath student. It gives me advises on how to ask into all the different parts of the case history. It is important to have an accurate and relevant case history for me to get a working diagnosis with an accurate treatment and management plan. To help me practice and getting used to create appropriate working diagnosis then this book has helped me a lot. Every case history is written down in the patient’s journal which I am responsible for.

Reference:

Rulten, T., 2022. Case History Taking For Osteopaths With a touch of Differential Diagnosis. Independently published.

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C3. You must respond effectively and appropriately to requests for the production of written material and data.

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C3. You must respond effectively and appropriately to requests for the production of written material and data.

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In Denmark we have a Health Law including important parts of writing a journal as an authorized healthcare professional. For example, it says that: “§ 5. The duty to keep a patient record rests with every authorized healthcare professional who, as part of their business, treats a patient, section 1.”

The law includes information on what a journal needs to contain, how to store it, and how to refer information to other healthcare professionals. I follow this law in Denmark and by that fulfills the OPS C3 standard.

In my practice I have an electronic journal on my patients. It is important that these are saved and stored safely, and my patients’ journals are in an approved and safe system that we use at my clinic where I work. I produce a journal on every patient I have on the same day. They are written in a template so I make sure I remember every important detail.

Reference:

Retsinformation, 2018. Bekendtgørelse om autoriserede sundhedspersoners patientjournaler (journalføring, opbevaring, videregivelse og overdragelse m.v.)

Available at: https://www.retsinformation.dk/eli/lta/2018/530 [Accessed January 22, 2025]

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BEK nr 530 af 24/05/2018, Sundheds- og Ældreministeriet

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C4. You must take action to keep patients from harm.

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C4. You must take action to keep patients from harm.

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I have not had any experience myself where I had to interfere and protect a patient from harm from a college or other healthcare professionals. I once had an experience where I had to comply with the law and protect a vulnerable patient.

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C5. You must ensure that your practice is safe, clean and hygienic, and complies with health and safety legislation.

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C5. You must ensure that your practice is safe, clean and hygienic, and complies with health and safety legislation.

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In my first year as an osteopath student in 2021, I participated in an accreditation of the clinic I am working at. In Denmark it is the Danish Quality Model (DDKM) who sets the goals and standards to secure good quality.

We had a visit from a lady from the institute who went through a lot of questions with us and inspected the clinic in different aspects. Before the visit all on the clinic had to read and understand the goals and standards. We had each a little interview with the lady from the institute. That made me a little nervous, but it went well.

I think this is a very good way to learn and be aware of the hygiene, cleaning, safety and procedures for emergency on the clinic. For me it means that I am more comfortable in the clinic because I now know the important stuff. I know procedures of cleaning, doing my own hygiene of myself, the bench and other facilities I am using. I am also safer of having patients if anything should happen. It could be if a patient got a heart attack I know where the defibrillator is. Luckily, I haven’t experienced that.

Reference:

IKAS. Om DDKM - Hvad er DDKM og hvad er hensigten med DDKM. Available at: https://www.ikas.dk/omddkm [Accessed August 21, 2021].

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C6. You must be aware of your wider role as a healthcare professional to contribute to enhancing the health and wellbeing of your patients.

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C6. You must be aware of your wider role as a healthcare professional to contribute to enhancing the health and wellbeing of your patients.

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I used the ERA reflection model to reflect on a case I had in the end of my first year.

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D5. You must respect your patients’ rights to privacy and confidentiality, and maintain and protect patient information effectively.

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D5. You must respect your patients’ rights to privacy and confidentiality, and maintain and protect patient information effectively.

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D6. You must treat patients fairly and recognise diversity and individual values. You must comply with equality and anti-discrimination law.

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D6. You must treat patients fairly and recognise diversity and individual values. You must comply with equality and anti-discrimination law.

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D7. You must uphold the reputation of the profession at all times through your conduct, in and out of the workplace.

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D7. You must uphold the reputation of the profession at all times through your conduct, in and out of the workplace.

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I uphold the reputation of osteopathy as a profession by contribute with knowledge and honesty about what osteopathy can do. I have never been happier since I started studied osteopathy and started working as an osteopath student. Transitioning from physiotherapy to osteopathy has reshaped my clinical practice and identity. Osteopathy has challenged my understanding and I realised that I have improved a lot clinically and my passion for healthcare is bigger. The results with patients is much better and long lasting since I worked as a physiotherapist. I talk about osteopathy in my spare time, to family and friends and patients, and I cannot hide my enthusiasm. I make time to explain the hollistic approach and principles. I realised that people often get the feeling of empowering and there are something to do with a lot of issues which made me realise that osteopathy is really my way. In year 4 I wrote an article about sedentary work. It is online on the company’s website where I work. The article is about the effects of sedentary work, ergonomics, health effects on the systems, the osteopathic view, how to manage and to give advice. This article show that I uphold the reputation and confidence in the profession.

I cannot link to the article cause of my name is within the article.

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D8. You must be honest and trustworthy in your professional and personal financial dealings.

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D8. You must be honest and trustworthy in your professional and personal financial dealings.

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I wrote an reflection on how I am honest and trustworthy in financial dealings.

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D9. You must support colleagues and cooperate with them to enhance patient care.

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D9. You must support colleagues and cooperate with them to enhance patient care.

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D10. You must consider the contributions of other health and care professionals, to optimise patient care.

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D10. You must consider the contributions of other health and care professionals, to optimise patient care.

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I always consider other healthcare professionals when I struggle to do the best care for my patient. I give information or refer if there is no relieve of symptoms, any red flags, if my knowledge is not enough or if I want a second opinion.

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D11. You must ensure that any problems with your own health do not affect your patients. You must not rely on your own assessment of the risk to patients.

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D11. You must ensure that any problems with your own health do not affect your patients. You must not rely on your own assessment of the risk to patients.

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I have not had any trauma, physical or mental conditions who could have affected my job or care to my patients. If I got any condition, I would consider to get a sick leave to make sure anything related to me does not influence my care of patients.

The only thing I have had through my years as a practitioner, have been the flu, where I was of for a couple of days to make sure I did not have a fever and could infect patients.

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Influenza skyldes infektion i de øvre luftveje med influenzavirus A, B eller C. Alle kan blive ramt af influenza. Det er dog især ældre over 65 år og andre personer med sygdom, der påvirker immunforsvaret, som har øget risiko for et alvorligt forløb af influenza.

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D12. You must inform the GOsC as soon as is practicable of any significant information regarding your conduct and competence, cooperate with any requests for information or investigation and comply with all regulatory requirements.

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D12. You must inform the GOsC as soon as is practicable of any significant information regarding your conduct and competence, cooperate with any requests for information or investigation and comply with all regulatory requirements.

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This evidence shows my criminal record certificate which I submitted in my application to the European School of Osteopathy in 2021. It says that I was not registered with any convictions. I still do not have any convictions registered. This means I comply with regulatory requirements.

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A reflection on a sporting patient I had in year 4.

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A reflection on a pediatric patient I had in year 4.

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A reflection on a patient with a long-term condition I had in year 3.

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A reflection on a pregnant patient I had in year 4.