Selective Suspension of clinical placements for a limited period
Last updated: 26 March 2020
Context for this decision
COVID-19 is an unprecedented health challenge of our times. We think that Australia has taken a number of preventative and precautionary measures which place us in a good position, however, we also think it will get worse before it gets better. We have been considering the benefits and risks, to individuals and to our community, of continuing all our student placements in clinical settings.
We have come to two conclusions:
- We would like to pause some clinical placements for a time-limited duration. The course will continue, only the placements will be paused.
- At the same time, we want to provide a framework whereby our students may assist in sustaining the healthcare system if it is needed.
We recognise the many benefits of placement
Student placements are an integral part of a clinical education and we are thankful that our strong relationship with our many healthcare partners, big and small, allow us to offer world-class education to 3,600 students via more than 261,000 placement days spread over more than 500 providers.
These placements are a tremendous benefit for the learning of our students and allow us to complete our accreditation requirements. There is evidence that the placement of students raises the quality of clinical provision in certain settings, thereby benefitting patients. These placements are only possible given the trusting relationship we have with our partners.
Thus, we take this difficult decision mindful of the tremendous value of clinical placements, but also mindful of our obligations to the patients who make this possible, to our students and to our placement providers.
A variety of risks are balanced in our decision
Our first concern has been that our presence in a clinical placement not pose a risk to patients. We assess that the direct risk to patients from the presence of our students is low, given the low known prevalence of community transmission in Victoria. However, an important consideration is that community prevalence of infection is predicted to increase, and most of our students are in the age-group where near-asymptomatic infection has been reported.
In addition to this:
- some are reluctant to have an extra individual in their clinic because it just increases the risk of someone who could turn positive in the next few days and then require the closure of the clinic.
- In some of our clinical settings students are using limited Personal Protective Equipment (PPE) supplies and this may impact on the future functioning in those settings.
- In some other settings, students use specialised equipment (e.g. aerosol producing drills in dentistry) the use of which has been stopped at a major placement provider as a precaution, which significantly impacts clinical teaching.
We have also observed sharply diminishing patient numbers in some of our outpatient clinics, and a higher than usual level of absence amongst staff due to safety considerations. These factors combined diminish the quality and integrity of the academic experience that our students have come to expect of us and our healthcare partners take pride in delivering.
From a student perspective we have received two kinds of responses.
- Some of our students are anxious about the extra risk posed to them. We judge this risk to be low. Nonetheless, we understand their concern and anxiety. Under usual circumstances we would work with such concerns because they can often be learning experiences. Under the currently stretched circumstances this is not always possible.
- Some others, judging that we are at the rising end of the epidemic, feel that their presence is not essential to the welfare of the patients and they should be practicing 'social distancing', especially with the elderly and those with multiple conditions. Some feel that supervising staff may be needed elsewhere in the hospital such as ICU.
Finally, we care deeply about the equivalence of the experience we offer to all our students under different settings. We feel that given the several issues above, we cannot assure this equity in many of our courses.
Planned stoppage and duration
We will start suspending these placements from the 21st of March, and the suspension will stay in effect till April 19th. We will review these circumstances regularly, weigh up the balance of risks and benefits, and make decisions for the period beyond April 19th with appropriate notice.
Students must follow the instructions about the process of stopping provided by their local School/Department/Unit.
Students assisting in sustaining healthcare
We fully appreciate the role of students to assist, as volunteers or as paid staff, in appropriate additional duties in a healthcare setting, especially in times of staff shortages and emergencies. COVID-19 could very likely be one such setting.
However, we differentiate a Clinical Placement, the primary purpose of which is student learning, from Students Volunteering and assisting in care for the purpose of maintaining the system.
Therefore, we will support our students in such an effort, so long as it is being done within an appropriate framework, with adequate supervision and governance, and in a fair and equitable fashion. We will soon issue a framework for our students’ involvement in this manner and how we will guide them in the process.
Course completion and continued engagement
Clinical placements are an integral part of a clinical education and we realise that stopping some of them has consequences for completion. Understandably, we are most concerned about this for those who are in the final year. We feel confident that if we can resume our regular instruction by April 20th, we should be able to make enough accommodations and substitutions that most would be able to graduate on time. If the suspension must be longer it will pose challenges.
The suspension is not a holiday. Individual courses will develop alternative activities, simulations and other experiences which will be available and required of our students. This will of course differ across the faculty.
As a health faculty, this is a difficult decision to take. We have not taken this lightly. We have heard the views of our students, their tutors, our placement coordinators, our placement providers and also those of colleagues across the country. On the balanced consideration of the factors as they apply to us now we feel this is the right way forward for some courses.
The impact of this announcement on individual placements will be detailed by each of your individual schools. The schools will also provide further detailed information.
Professor Shitij Kapur
Dean, Faculty of Medicine, Dentistry and Health Sciences
Professor Linda Denehy
Head, Melbourne School of Health Sciences
Professor John Prins
Head, Melbourne Medical School
Professor Alastair Sloan
Head, Melbourne Dental School
Professor Sarah Wilson
Head, Melbourne School of Psychological Sciences