Students as Learner Models and Testing Subjects Policy

PURPOSE
Students are asked to be learner models or subjects of procedures and testing as part of their medical training. Examples include but are not limited to: Peer-to-peer physical examination during clinical skill sessions, peer-to-peer ultrasound scanning during point of care ultrasound (POCUS) sessions and performing basic laboratory tests such as blood typing on students. These experiences allow students to develop increased competency in clinical skills and gain insights into the perspective of patients.  

This policy outlines the conditions required for students to participate as the subjects of clinical skills and related learning activities and the expected behavior of peers, faculty, and staff during these activities. 

AUDIENCE
All medical students, faculty, and staff

LCME STANDARD
Not applicable

POLICY

  1. Students are afforded the rights to autonomy, privacy, and confidentiality.
  2. Being a learner model (LM) or testing subject (TS) is voluntary and requires verbal consent from the student and should only be considered when the learning objectives cannot be met with other available teaching methods.
  3. All students will be offered the same opportunities to volunteer as LM/TSs within the parameters stated in this policy.
  4. Students will not be penalized for opting out of participating as a LM/TS.
  5. Confidentiality expectations mirror professional obligations of confidentiality in patient care. All personal and health information revealed or discovered during participation in these sessions should remain confidential to the participants.
  6. Sessions that incorporate the use of students as LMs or TSs must meet the stipulations of this policy.
  7. Unprofessional behavior will not be tolerated.

PROCEDURE

  1. When faculty anticipate that student volunteers for these activities will be used during a session, they will notify students in advance of the session, share the risks of participation, and allow students to opt out of participating as an LM or TS prior to the session. Verbal consent must be obtained at the time of the learning session. Students can withdraw their consent at any time.
  2. Students opting not to participate as an LM/TS should discuss with faculty whether alternative opportunities to meet session objectives are needed.
  3. Students may be asked to examine/scan the head, neck, chest/thorax, abdomen, back, and limbs using peer practice. Evaluation of the chest/thorax typically requires exposure of the front and/or back of the thorax. Evaluation of the abdomen typically requires exposure from the lower costal margin to the umbilicus or pubic ramus, depending on the clinical situation. In some instances, students may elect to practice over clothing for privacy or comfort reasons. 
  4. Under no circumstances will a student with breasts be examined with exposed breasts. Examination of the breasts, inguinal, genital, and rectal areas may be undertaken only using simulation models and standardized patients.
  5. When possible, students can choose their own partner(s) for peer practice and separate clinical skills rooms or spaces will be available for peer practice.
  6. Simulation-based training using methods such as partial task trainers should be the primary method for procedural instruction. Students should not perform invasive procedures, such as phlebotomy or PIV placement, on their peers or instructor as part of the required School of Medicine curriculum. Selective courses are part of the required curriculum.
  7. In instances of unexpected health-related findings, the examining peer student will confidentially inform the examined student of the uncovered finding. If the examined student was not already aware of the finding, both students should confidentially inform the facilitating faculty member of the potentially new findings. If the examined student requests confirmation of the finding, faculty will repeat the same examination. Faculty will recommend that the student seek medical advice if appropriate for ongoing concerns of new findings.  
  8. Any breach of confidentiality or inappropriate behavior will be addressed according to the UC Davis Professionalism Policy. Examples of unprofessional behavior include but are not limited to inappropriate use of medical equipment, offensive language, or any form of abuse. Any student who witnesses or experiences inappropriate behavior by peers or faculty should report it to the faculty and coordinators overseeing the learning session, in addition to filling out a mistreatment report documenting the incident.
  9. Learning sessions that are unable to comply with this policy should not be held and alternative means for teaching the content and assessing the objectives must be developed.

RESPONSIBILITY
Clinical Skills Discipline Leaders
Course Directors
POCUS Discipline Leader

REFERENCES

UC Davis Policies and Procedures: Employee Requests Related to Cultural, Religious or Ethical Beliefs and abides by California Health & Safety Code 12342 and Church Amendments, 42 U.S.C. § 300a-7.

RELATED POLICY/POLICIES
Professionalism Policy
Student Code of Academic and Social Conduct

POLICY OWNER
Committee on Educational Policy

REVIEWED BY
Associate Dean for Students
Committee on Educational Policy*
Curriculum Steering Subcommittee
Director of Medical Student Professionalism
Executive Director of Clinical Education
Faculty Executive Committee

REVIEWED DATE and REVIEW CYCLE
November 2023; annual review cycle

* Indicates the policy owner