Medical students often learn basic clinical skills by practicing on classmates, patients, or trained instructors. Unlike patients in the clinical setting, students who volunteer to act as “patients” are not seeking to benefit medically from the procedures being performed on them. Their goal is to benefit from educational instruction, yet their right to make decisions about their own bodies remains.
To protect medical students’ privacy, autonomy, and sense of propriety in the context of practicing clinical skills on fellow students, instructors should:
- Explain to students how the clinical skills will be performed, making certain that students are not placed in situations that violate their privacy or sense of propriety.
- Discuss the confidentiality, consequences, and appropriate management of a diagnostic finding.
- Ask students to specifically consent to clinical skills being performed by fellow students. The stringency of standards for ensuring explicit, noncoerced informed consent increases as the invasiveness and intimacy of the procedure increase.
- Allow students the choice of whether to participate prior to entering the classroom.
- Never require that students provide a reason for their unwillingness to participate.
- Never penalize students for refusing to participate. Instructors must refrain from evaluating students’ overall performance based on their willingness to volunteer as “patients.”
AMA Principles of Medical Ethics: IV, V
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