Ethical participation of children and youth in medical education Flashcards
What are some challenges regarding paediatric patients and medical education
Truth telling - re trainee knowledge and skill informed consent Respect for persons Confidentiality Concerns re maleficence
Do you need consent to ask a patient to be involved in medical education, say on a CTU?
Yes. The child or parents should be fully informed of what is being proposed and give voluntary, non coerced consent.
- they should know their rights and expectations in a clinical setting where medical education is a component.
True/false: if a child is not yet competent, you have to obtain consent from parents to be involved in medical education and need nothing from the child
You should seek the child’s assent
If a child is not yet competent, but does not want to participate in medical education, but the parents do, what do you do?
you respect the patient’s dissent despite their lack of capacity
This is particularly important for encounters that have a purely educational goal
True/false: Patients do not need to be informed of trainees involvement in care because they are supervised by a staff physician
False: in both teaching and community hospital, patients and their families should be informed hat trainees are involved in their care under the supervision of a responsible staff physician. Trainees should clearly explain their role and supervisory context on the team to the child, parents or guardians
Should there be a chaperone present when medical students are involved in patient care?
Not necessary. The oxford guidelines regarding this subject do support the presence of a chaperone. However the CPS has said that there goes not need to be a chaperon. They do recommend that a parent be present for most encounters.
Do you need consent to discuss a case of a patient in an educational manner?
No. You should respect right for privacy - using only relevant de-identified information.
Although consent is not required, the CPS encourages residents/students to inform families when they are planning to use their cases for teaching.
You do need consent if you are using identifying information/data such as a photo. The consent needs to be written if the data is published. In these situations, you should explain how the photo/data is being used.
What are the positives and negatives of using kids as SPs in OSCES?
What can help curb the negatives?
Positives: job skill acquisition, satisfaction of making a contribution to medicine/society
Negatives: sick role, embarrassment, discomfort, emotional stress
Help: have opportunity to debrief and option to withdraw if there is any discomfort etc
Is it ok using children who are too young to assent in OSCEs?
There are ethical concerns regarding this.
The well-bring and comfort of the child must be paramount.
What do you do if a family does not want a trainee involved in their care?
Your staff explains that this is their right. The staff should also explore the feasibility and explain the limitations of this, for exampled trainees are often covering in house oncall
