Patient care activities may include a certain number of bedside procedures that the students will learn by observing, assisting, and performing under direct supervision until a required level of competence is achieved as required by New York State Hospital Code. Once competence is achieved, students may participate under indirect supervision. Students may not participate in patient care without either direct or indirect supervision. Supervising faculty physicians or their designees must be certified in the procedure being conducted.
The student is not directly engaged with the patient in the encounter, but acts as a bystander who:
The student acts as a secondary clinician who:
The student acts as an independent clinician with appropriate supervision as indicated
The supervisor is physically present, actively engaged in observing the student-patient encounter, and ready to answer questions, provide guidance, and intervene if necessary.
The supervisor is physically present at the clinical location, and immediately available to provide direct supervision if needed. The supervisor may not be engaged in activities which could delay direct supervision.
Any individual, properly credentialed, assigned by the supervising faculty member to provide direct or indirect supervision to the student. Designees may include resident physicians (interns, residents, fellows), and licensed independent practitioners (i.e. nurse, respiratory therapist, phlebotomist, etc). It is the responsibility of the clinical site to ensure healthcare providers employed at their site are appropriately trained, certified, and credentialed.
Examples of commonly performed procedures include but are not limited to physical examinations, venous puncture, arterial puncture, bladder catheterization, and nasogastric tube insertion.
Students will perform all patient care activities under direct supervision unless the supervising provider specifically approves indirect supervision. Students must clearly identify themselves to patients and members of the healthcare team as a medical student.
Students are always expected to take responsibility for their actions and are accountable for prioritizing the best interest of the patient. Students must be aware of their own limitations and request assistance or decline participation in any aspect of patient care that they do not feel comfortable or competent in, without fear of any consequences related to their evaluation, assessment, or advancement.
Students are expected to actively develop comfort and competency in participating in procedures through graduated levels of involvement during the four year curriculum. Upon graduation, students should be proficient in the AAMC’s Entrustable Professional Activities (EPAs) for entering residency.
Faculty physicians or their designees will determine the appropriate level of student participation (observe, assist, perform) and supervision (direct or indirect) based on factors include, but not limited to:
The supervising faculty physician will ensure their appointed designees are properly trained and credentialed to perform the activity at hand.
The supervising faculty physician or their designee will be available to review the procedure and provide formative feedback after care is delivered. Supervising faculty will encourage and support students’ progressive development of their competency and confidence in the EPAs.
Violations of the Student Supervision Policy can be reported to the course/clerkship director. If reporting to the course/clerkship director is not ideal, reports can be made directly to the Senior Associate Dean for Student and Academic Affairs.
A medical school ensures that medical students in clinical learning situations involving patient care are appropriately supervised at all times in order to ensure patient and student safety, that the level of responsibility delegated to the student is appropriate to his or her level of training, and that the activities supervised are within the scope of practice of the supervising health professional.
Reviewed by Phase 2: August 2018
Passed by Curriculum Committee: 12/14/18
Revisions Passed by Curriculum Committee: 6/15/21
Policy Implementation: Course/Clerkship Directors
Policy Contact: Senior Associate Dean for Student and Academic Affairs