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Medical Record-Keeping (SGCR)

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The following are suggested resources to address learning opportunities identified when completing the self-guided chart review (SGCR).

*Please note this selection is not meant to be comprehensive or complete, and inclusion is not necessarily an endorsement by CPSO.

  • Medical Record-Keeping Program, University of Toronto
    Interactive online program that addresses CPSO’s medical record keeping policies. Uses case-based exercises, peer assessments and training on practice tools.
  • Documentation: Principles of Medical Record Keeping eLearning Module, Canadian Medical Protective Association
    Free eLearning module on medical record-keeping from a medico-legal perspective.
  • Good Practices: Physician-Patient: Documentation and record keeping, Canadian Medical Protective Association
    Topics include: what/when/how to document, clinical reasoning, operative reports, informed consent, discharge summaries, handovers, corrections to the medical record.