Clinical Supervision of Medical Students

Purpose

To ensure the safety of patients and students and foster an optimal environment for student learning.

When is this policy applicable?

This policy applies to medical students involved in patient care as part of the MD curriculum.

Who may supervise medical students?

• Faculty physicians or residents and fellows supervised by faculty physicians
• Licensed non-faculty physicians approved by the clerkship/course director
• Licensed healthcare providers supervising an activity within the scope of their practice

Levels of supervision

Students must be supervised at all times at one of the two following levels:

1. Direct supervision: supervisor is physically present with student and patient
2. Indirect supervision: supervisor is not physically present with student and patient but is present on the clinical site and immediately available to the student to provide direct supervision

Special Situations

1. Intimate exams: Students must be directly supervised by a clinician while performing an intimate exam. Intimate exams include genitourinary, rectal, and breast exams.
2. Procedures: The supervising physician is responsible for determining the level of supervision that is required based on the student's competency and the procedure being performed.

The level of supervision will be determined by the supervising clinician based on several factors:

1. Objectives and required clinical experiences for the course/clerkship
2. Level of training of the student and their experience with the clinical activity/setting
3. Supervising clinician's familiarity of the student's abilities
4. Acuity of the patient and complexity of the clinical activity

Regardless of the level of supervision, the supervising clinician must evaluate all patients primarily seen by students before they leave the healthcare setting.

Training of supervisors

Faculty physicians are responsible for all learning events in their environment, including events supervised and facilitated by non-physician healthcare providers and non-faculty physicians.

All supervising clinicians must be aware of and have access to this supervision policy and Emory's student mistreatment policy.

All faculty physicians responsible for supervising a student during a given clerkship/course must be aware of MD course objectives. Clerkship/course directors are responsible for disseminating this information.

Policy Implementation

Clerkship/course directors are responsible for ensuring access to aforementioned policies.

Students should immediately report concerns about inadequate supervision to the course/clerkship director, the Associate Dean of Student Affairs, Clinical Services, and should include it on the Learning Environment and Professionalism survey at the end of the course/clerkship.

Clerkship/course directors must ensure students are aware of how to report violations of this policy.