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Policy

Supervision of Medical Students on Clinical Rotations

Categories: rotations supervision UGME

Responsibility: Associate Dean, Undergraduate Medical Education
Approval: Undergraduate Education Committee / Faculty Council
Scope: All members of the patient care team
Date: 2014-05-14 / 2014-05-28

Preamble

This policy provides for the supervision of medical students on clinical rotations. Clinical supervision is fundamental to safeguarding standards, professional expertise and the delivery of quality care.

This policy addresses the Committee on the Accreditation of Canadian Medical Schools (CACMS) Standards ED-25 and ED-25-A.

  • ED-25. Supervision of medical student learning experiences at an institution that offers a medical education program must be provided throughout required clerkships (or, in Canada, clerkship rotations) by members of the institution’s faculty.
  • ED-25-A. At a medical education program, medical students in clinical learning situations involving patient care must be appropriately supervised at all times. While students learn through graded responsibility as their skills progress, supervision at all times must ensure patient and medical student safety.

The accountability of physicians and non-physicians who supervise medical students in clinical learning settings will be clearly described in the program’s policies and procedures. The level of responsibility delegated to the student by the supervisor will be appropriate for the student’s level of training, and the activities supervised will be within the scope of practice of the supervising health professional.

Purpose

Clinical supervision is a formal process of professional support and learning which enables medical students to develop knowledge and competence, assume supervised responsibility and enhance patient safety in complex clinical situations. To ensure patient safety and medical student safety, the three main functions of clinical supervision are to educate, support and evaluate the medical student.

The Faculty, the supervising physician and/or surgeon (hereinafter, “physician”), the medical student and the attending physician and/or resident all play important roles and share responsibility in this process. The College of Medicine is committed to these principles, and has developed this policy which outlines the standards for supervising medical students and the role of each member of the team.

Policy

Responsibilities

The responsibilities of the College of Medicine, the supervising physician, and the medical student are set out below.

  1. The College of Medicine shall:
    1. Support clinical supervision as an integral part of patient care;
    2. Ensure that appropriate, experienced practitioners are identified and trained.
  2. The supervising physician shall:
    1. Promote and model professional conduct at all times with medical students;
    2. Follow and support the Practice Standards of the College of Physicians & Surgeons of Saskatchewan.
    3. Identify issues relating to such matters as: conflict of interest, harassment, intimidation, and medical student safety; and be familiar with University, College and Program specific policies relating to these issues. When issues arise, provide support and direction in addressing these issues;
    4. Be aware of the medical student’s educational objectives and, in clerkship, the required clinical encounters for the period during which the medical student is working with them;
    5. Ensure that a supervising physician/resident is identified and available, when not immediately present to assist the medical student;
    6. Ensure on-call schedules for attending physicians and residents be structured to provide medical students with continuous supervision;
    7. Ensure that, when urgent judgments by responsible physicians are required, supervising physicians/residents are available. Under certain circumstance it may be necessary to be offsite; if so, the most responsible physician’s presence must be assured within a reasonable time in case of need.
    8. Respond in a timely fashion when paged by the medical student and be available to return to the hospital in an emergency;
    9. Ensure the medical student understands his or her role and responsibilities in the orientation process at the beginning of each clinical rotation. The supervising physician must ensure that the medical student is informed of what to do and who to call across the spectrum of clinical assignments and rotations;
    10. Take into consideration the medical student’s level of training and ensure the medical student is competent in a given clinical task before delegating that task;
    11. Ensure that any clinical activities supervised by a non-physician health professional are within the scope of practice of the supervising health professional, and that this supervisor has explicitly accepted delegated responsibility from the supervising physician for overseeing the medical student’s participation in those specific activities. (Note: This is not intended to imply that the many opportunities for informal interactions between medical students and other health professionals in the clinical setting necessarily comprise instances of clinical supervision by those professionals);
    12. Ensure that the patient is informed of the medical student’s status;
    13. Determine that the medical student is capable of caring for the number of delegated patients, and ensure the medical student is aware of all patients assigned to them;
    14. Recognize when a medical student is unable to provide safe patient care because of the number and/or complexity of patients assigned and/or because of stress and/or fatigue, and to intervene immediately to support both the medical student and the care of the patients that have been delegated to the medical student;
    15. Confirm the clinical findings of the medical student and review the management plan as well as patient progress with the medical student;
    16. Make necessary modifications to the patient care plan managed by the medical student;
    17. Provide ongoing feedback to medical students, and complete any required mid-point performance assessments and end-of-rotation performance assessments in a timely manner. When possible, feedback should be provided in person, along with the timely completion of the necessary documents.
  3. The medical students shall:
    1. Maintain a professional relationship with physician/resident supervisor, and display professional conduct at all times with peers, paramedical staff, co-workers, patients and/or members of the public;
    2. Exercise caution and consider their experience when providing clinical care;
    3. Strive to be cognizant of the limits of their knowledge and clinical skills;
    4. Inform their supervising physician if they are not able to care for the delegated patients because of the number and/or complexity of the patients assigned and/or because of stress and/or fatigue to ensure patient safety;
    5. When no resident is involved in the care of a patient, the medical student is responsible for notifying the supervising physician;
    6. Inform patients (or responsible family member) of their status as a medical student and provide the name of the responsible supervising physician (resident or staff);
    7. Inform their supervisor when a patient’s condition deteriorates, the diagnosis and/or management of the patient are in doubt;
    8. Complete an evaluation of their rotation at the end of a clinical rotation.

Approved by Faculty Council, May 28, 2014