Shadowing Obstacle for Pre-Professional Students

I'm wondering about contracts for students who have set up shadowing agreements in hospitals at home. This week I have received emails from two students saying that they have set up volunteer shadowing situations with their home hospital, but that the hospital needs a University contact person. When I agreed to be that person for the first student, I was sent a legal agreement from the hospital which I was told I must sign before the student can begin their position. The contract includes such things as the university being responsible fore seeing that student "comply with all applicable by-laws, rules, regulations, policies and procedures of the Clinical Agency" and "Be responsible for orientation, instruction, guidance, supervision...while ... in clinical learning experiences within the facility."

And, most importantly, it indicates that the university will "Maintain
liability insurance coverate for injuries or torts of students...." I have now heard from the second student that he, too, needs an agreement signed.

Are others having this experience? Those of you at the SAAHP meeting heard me speak to the difficulty of setting up shadowing experience. This makes it impossible!

Jean DeSaix, Ph.D.
Department of Biology Coker Hall CB#3280
University of North Carolina at Chapel Hill, NC 27599-3280
 

We had a nearly identical experience here in Illinois when one of my
students was shadowing a physician. All was well until the physician
wished to allow the student to accompany him in the local hospital. The
hospital would only allow the student to accompany the physician (a
surgeon) if the University assumed responsibility for the student
complying with various hospital regulations regarding confidentiality,
safety, behavior, etc., etc.

Because the statement quoted by Jean below is so similar to the
statement from the hospital in Illinois, I am led to believe that the
legal staffs of hospitals are feeling pressure to shift legal (tort)
responsibility to others such as Universities. We could not assign
anyone to follow the student around 24/7 and guarantee that she would
comply with hospital regulations (which we had no hand in drafting or
explaining to the student) so no one at our institution was willing to
sign the required permission form. The student lost, the profession
lost, the physician is mifted, the patients were spared having a student
observe certain procedures, the hospital is in no danger of being sued
on this issue.

I can certainly understand the hospitals' concerns, but this will make
shadowing and "internships" harder, if not impossible, to arrange. It
does not seem to have affected students' opportunities to engage in
volunteer activities that are entirely under the control of the
hospitals, but maybe we just have not heard yet of new problems in that
realm.

Norm Engstrom
Pre-Professional Advisor
Northern Illinois University
DeKalb, Illinois

 

Our students shadow physicians for academic credit under a
four-semester-hour course called Clinical Preceptorship. A faculty
member is assigned to be the contact person whom you describe. He
discusses legal matters with students before the course begins. Since
this is an academic activity, our students are covered by university's
insurance against injuries etc. No one has asked our students to carry
professional liability insurance.

The host physician signs an agreement with the university that includes
giving guidance to the student and providing written evaluation to the
faculty member.

Since a faculty member must be involved, clinical preceptorship is
usually during the regular school year and is hosted by physicians in
our county.

Joseph H. Lechner, Ph.D.
Professor of Chemistry
Mount Vernon Nazarene University
800 Martinsburg Road
Mount Vernon, OH 43050-9500
[740] 392-6868 extension 3211

 

Since I have so many opinions on almost everything else, why not one on "shadowing"? [Don't reply, please, the question is rhetorical!]

I always believed the main purpose of medically related experience is for prospective medical students to learn about themselves in the context of what they are planning to do in the future. It is not to learn medical techniques: that they learn in medical school and after. In the inward journey of learning about themselves they must also learn about patients as human beings, not cases, about physicians, nurses, and all others involved in health care. To do this the student partly should be like a fly on the wall, unnoticed but observing everything. At other times, when appropriate, students should speak with patients and the others to listen to their feelings, hear their experiences, attitudes, perceptions, opinions. All of this is then for each student to ponder, examine her/his own feelings and perceptions in the context of answering the questions: is this what I really want to do and am I suitable for it?

A fly on the wall is neither handling patients nor being charged for having this opportunity. The reward is an opportunity to confront reality, not dreams of glory. It is this inner journey that is important.

Daniel Marien

 

Dan has given us many pearl of wisdom over the years. But his
comments on the shadowing experience is perhaps the most
eloquent of them all. Dan, with your permission, I'm going to save
it to share with my students.

Happy Friday everyone!

Kay H. Singer, Ph. D.
Associate Dean
Trinity College of Arts and Sciences
Duke University

We have had to go through major hoops in order for our students to
shadow a physician. Our application is now 11 pages (it used to be 3).
We have our students sign up at the local community college for
liability insurance coverage- it is complicated and that was the
simplest way (long story). Many of the forms are from the hospital.
I've included our application checklist below:


Name __________________________
SSN ___________________________
Email __________________________


Oregon State University Medical Preceptorships Checklist
(You must have at least a 3.2 GPA, and at least junior standing, in
order to participate.)


A. _____ Obtain the application packet and read all pages!

_____ Complete application form (page 1). Include your area
of interest. If a particular physician has agreed to work with you,
you may write that information on the form. Otherwise, just rank your
choices and we will match you.

_____ Objectives / Statement of Understanding Form (page 2).
Read and sign this form.

_____ Health Form: (page 5). Complete enclosed health form
and arrange for TB and Hepatitis B immunizations from OSU Student Health
Services (cost is about $48 for initial shots, and $43 each for two
additional Hepatitis B shots). Fill out a Release of Records form at
Student Health services and get copies of ALL immunization records
(immunizations they do for you AND any immunizations from your family
physician)

_____ LBCC Registration for Liability Insurance: Enclose a
check for $43.00, payable to Linn Benton Community College (LBCC) and
fill out the attached LBCC registration form, which entitles you to
liability coverage.

_____ Health Insurance: You must be covered under a health
insurance policy, either through your parents or on you own. Space is
provided for required health insurance information.

_____ Confidentiality: Read and sign the enclosed forms (page
3).

_____ Bloodborne Pathogens and TB Prevention: We will be
scheduling a time for the representative from the hospital to come over
and show a film, after which you will be taking a test on Bloodborne
Pathogens and TB Prevention. We will let you know when the meeting is.
If you cannot make it you will need to make arrangements to go over to
the hospital to watch it and take the test.

B. _____ Meet with Dr. Barbara Taylor, preceptorship
administrator

C. _____ Sign up for 1 credit of Z410 (CRN is in the catalog and
on the web).


D. _____ Turn in the complete packet (9 pages plus your check for
$43.00 and copies of vaccinations) to Linda James in the College of
Science office (Kidder 128), at least four weeks before the end of the
previous term. Linda will review your areas of interest to match you
with a physician, and contact you when the match has been made.


Chere Pereira
Chief Premedical, Predental Advisor
Oregon State University
 

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