Advice: work shadowing - the risks

GIVING older pupils the chance to experience what life is like in the world of work has become a core part of the school experience.

Participation can enhance a young person’s CV and help them choose the right career. And for those whose ambitions lie in the fields of medicine or dentistry, gaining a first-hand insight into these professions is even more significant. Evidence of such work placements can be an important part of any application to an undergraduate medical or dental programme, and some institutions, such as Glasgow Dental School, refuse to interview candidates who have not 'work-shadowed' in a practice.

This means it is highly likely that your practice will at some time be approached by pupils hoping to clock-up the requisite experience. Mindful of their own tribulations in gaining that much coveted university place, many practitioners will be eager to help. And laudable as this may be, MDDUS would advise managers to be aware of the various medico-legal implications that this entails.

HEALTH AND SAFETY

In the first instance, it must be noted that anyone who is participating in work experience is regarded as an employee for the purposes of health and safety legislation. This means the practice’s level of employers’ liability insurance will have to be checked and, if necessary, increased. It’s also worth remembering that certain health and safety requirements – such as the need to record risk assessments in writing or have a qualified first-aider – become active above a threshold number of employees, so the addition of students to the workforce could have quite onerous practical implications.

You should also be aware that the law defines those under 18 years of age as ‘young people’ and, as such, their employment must be preceded by a risk assessment which takes into account their lack of maturity, knowledge and ability to recognise danger. It is generally advisable to record the results of this assessment. Indeed, in circumstances where prospective work-shadow students are under the age of 16, the findings must be written down and passed on to their parents or legal guardians.

All hazards, even the apparently mundane ones such as those posed by surface cleaning products, should be assessed with a view to eliminating or at least minimising the risks they pose. Clearly dental and medical surgeries are fraught with potential dangers unique to the clinical setting and will therefore demand careful attention. The hazard presented by contaminated sharps, for example, is particularly relevant to dental surgeries where many of the instruments which have been in contact with the patient’s blood and saliva could cause a penetration injury. It is good practice for managers to ensure all practices have strict protocols in respect of this issue.

Students will probably not have started a hepatitis B vaccination programme, and safe systems of work must be in place that prevents contact with sharp instruments. The Health and Safety Executive also has an advice booklet called The Right Start. Work experience for young people: Health and safety basics for employers available at: www.tinyurl.com/pm-rightstart

CONFIDENTIALITY

Before beginning their placement, any student working in a clinical setting must be made aware of the fundamental importance of never divulging confidential patient information – including the mere fact of a patient’s attendance. This should be reinforced by a confidentiality agreement, to be signed by the student, which makes clear that the work placement will be terminated if the agreement is broken.

It is also strongly advised to get express consent from patients before they are treated or examined in the presence of a student, perhaps even in writing. Patients should be told they can change their minds at any time, in which case the student should leave immediately and without protest. Consider putting up an information poster in the waiting room to allow patients to consider this issue before being approached individually. Where possible, it is advisable not to take on work experience students who live in the local area to minimise the risk of them recognising a patient.

HANDS OFF

If a practice decides to accept a request for work shadowing, it should be made clear that there will be no opportunity for ‘hands-on’ experience. Students will be present in a purely observational capacity, and will be expected to conduct themselves in a proper manner. This means clean smart attire, a professional attitude and respect for the other staff members.

It is unfortunate that such acts of kindness towards the doctors and dentists of tomorrow carry with them so much statutory and medico-legal baggage. But for those who do decide to take the necessary measures, they can at least draw satisfaction from the fact that the young person involved should have a safe and enlightening experience, for which they will undoubtedly be grateful.

Doug Hamilton is a dento-legal adviser at MDDUS