Remote Consultation

Ensuring patient confidentiality in the virtual world.

Patients must consent to a student being present during a remote consultation in the same way they are asked if they are happy for a student to be involved in their care in a face to face setting.

With the increasing use of telephone consultation, it is important to facilitate the participation of students whilst upholding their responsibility to ensure patient safety and autonomy. Patent confidentiality must be respected, and explicit consent obtained for anyone, including students, to listen in.

The presence of an ‘invisible’ shadowing student during remote consultations can compromise confidentiality. Explicit patient consent is essential in these scenarios.

The MSC suggests that this should be done by the clinician leading the consultation at the start of the call and has provided further guidance in their publication Students attending remote consultations: Advice to medical schools and students 2020.

Specific guidance to WMS students is outlined below.

If you are undertaking a consultation with a patient requiring medical management independently (ie without direct observation by a clinician)

Step 1:

• Clinician verbally consents patient before consultation with student – as per MSC doc* p3
• Consent documented in patient records

Step 2:

• Student undertakes consultation – as per MSC doc* p6-8

Step 3:

• Student reports outcome of consultation to supervising clinician

Step 4:

• Clinician consults with patient to verify student outcomes and house-keep any required management
• Clinician completes patient record

If you are undertaking an extended patient encounter in GP or other independent non-acute consultation with a patient with a chronic condition recruited specifically for teaching.

Step 1:

• Clinician verbally consents patient before consultation with student – as per MSC doc* p3
• Consent documented in patient records

Step 2:

• Student undertakes consultation – as per MSC doc* p6-8

Step 3:

• Clinician de-briefs student (short discussion re learning outcomes achieved)

If you are undertaking a consultation or a patient requiring medical management under direct observation

Step 1:

• Clinician verbally consents patient before consultation with student – as per MSC doc* p3
• Consent documented in patient records

Step 2:

• Student undertakes supervised consultation – as per MSC doc* p6-8

Step 3:

• Clinician completes consultation with patient to house-keep any required management tasks
• Clinician completes patient record

Step 4:

• Clinician provides student with feedback re consultation skills