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4. Students

The Royal College of Radiologists gives the following advice:4

‘Teaching intimate imaging and treatment procedures is particularly challenging. Agreement that a student can be present should be obtained from the patient in advance of the examination and it should be made clear that there would be no disadvantage to the patient if they refused to have a student present. Patient consent for the student involvement should be recorded, usually in writing.  Patients may be reluctant to be examined by inexperienced individuals and the embarrassment and inexpertise of the student may convey itself to the patient; sensitive handling of the student as well as the patient is required. Students must participate not only in the procedure itself but also the process of pre-procedural discussion. Careful supervision of the performance of all aspects of the procedure performed by the student is necessary until the trainer is confident that the student is capable of achieving a diagnostic examination in a sympathetic fashion.’

4.1  Students may be either undergraduates or postgraduates and represent the future of the various branches of the profession. As such, it is important that students are able to participate in intimate examinations but this must clearly be balanced against the wishes of the patient.

4.2  If the examination is of an intimate nature, it is good practice to ensure that the patient is aware of the gender of the student when gaining their consent for a student to be present. The student should verbally confirm any consent given personally with the patient and this should be recorded in the notes or on the report.

4.3 Patients should be informed and give their verbal consent if the examination is likely to have to be performed again by a qualified practitioner in order to confirm a student’s findings; or if a qualified practitioner will need to undertake further examinations as part of the procedure.  Examples include internal examinations associated with cervical brachytherapy, or palpation of the testes for possible masses prior to ultrasound.

 4.4 A notice should be placed in the waiting area stating that students, who will become the next generation of practitioners, are undergoing training in the department and making it clear that the patient will not be at a disadvantage if they decline to have a student present.

4.5 Where possible, students should gain experience of how to conduct an intimate examination using simulators or anatomical models. An example would be the use of computerised endovaginal ultrasound simulators to learn the basic principles of this technique.

4.6 A student must not conduct an intimate examination on a patient without a qualified practitioner being present, even if the patient is happy to proceed with the examination. It therefore follows that a student cannot formally chaperone another student.

4.7 A student must not conduct an intimate examination on a child or an adult who lacks capacity to consent. If in any doubt, this specific capacity must be ascertained and recorded by a qualified practitioner before proceeding.

4.8 A student who is familiar with the normal examination procedure may act as a chaperone for a qualified practitioner with the agreement of the patient. In such situations, the student should have been trained to act as a chaperone and needs to agree to take on the responsibility and be authorised to do so. Higher Education Institutions who are responsible for the student’s training may also have policies that apply.

4.9 Students should consult written material produced for them by their parent Higher Education Institution on the subject of intimate examinations and chaperones.

4.10 In the case of patients undergoing a general anaesthetic, there must be written consent for a student to conduct an intimate examination on the patient.3 The patient must be treated with the same degree of sensitivity and respect as if they were awake.

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