Consent for participation in clinical teaching
Background: Possible stresses linked to clinical teaching
For the most part trainees tell us that their teaching programme is stimulating and interesting. However, because of its aims and its focus, training in Clinical Psychology as a whole can present personal challenges to trainees and it is widely recognised that clinical teaching itself can be, at times, personally demanding. At some point in their training it is quite likely that trainees will feel uncomfortable or upset by material to which they are exposed. While this is often a transient experience, some trainees may experience a more sustained impact. The "triggers" for this upset might occur when:
- trainees recognise some aspect of themselves in the clinical material
- teaching makes them more uncomfortably aware of long-standing personal issues which they had previously managed well
- some of the issues being discussed echo current dilemmas or life-events (such as bereavement, or relationship difficulties)
- some of the content of teaching is at variance with the trainee's personal, cultural or religious beliefs or values
Teaching on the Programme is not restricted to passive listening; it also involves active participation in exercises which trainees can find rather demanding. For example, most people find it somewhat exposing to role play in front of their peers, to disclose personal feelings, or to discuss their personal viewpoints; such things which can occur in experiential sessions, or in sessions where the focus is on feelings about professional work and career development.
Focusing on the ways in which teaching could be stressful is not intended to indicate that there is any intent to make it so. When planning training, the programme staff take into account the potential impact of the teaching content and the teaching method, especially when the topic is a sensitive one. We know that learning is inhibited by high levels of stress, which means that there are powerful educational reasons for keeping any stresses contained and manageable. We support our teachers in facilitating this within the sessions they provide.
Support for trainees
Although we expect trainees to be appropriately robust in relation to the issues which training throws their way, we also expect them to be able to reflect on and to talk about their feelings. On the other hand, for all of us there may be times - maybe when we can no longer be as robust as we would like - when seeking support from others is the most appropriate action. Although it can be very hard to draw the Programme's attention to difficulties, suffering in silence is not helpful, and not a good model for a professional career. There are, therefore, professional competencies that we expect you to develop during your training - resilience and reflective ability - that we would want to support you in developing, in the face of any of these challenges, stresses and demands that you experience within your participation in teaching (as well as in all other domains of your training).
Your consent to participation in clinical teaching
It is a requirement of the Health and Care Professions Council that when students participate as service users in clinical teaching they have given informed consent to this. Whilst you would rarely be "service users" within teaching, we want to expand this to include consent for all personally challenging activities within the taught curriculum. For this consent to be meaningful it is important to set out the Programme's expectations, and the rights of trainees.
Programme expectations in relation to clinical teaching
The Programme expects that trainees will actively participate in all aspects of the academic programme, including:
- Experiential exercises which take place as part of lectures
- Workshops on clinical topics
- Seminars (including clinical seminars, academic seminars, reflective practice seminars and modality specific clinical seminars)
- Role-play as part of the above activities (including taking the role of both therapist and client)
Where a trainee finds participation difficult they are entitled to withdraw, but the Programme expects them to do this in an appropriately professional manner. If their level of personal distress is very high and results (for example) in prolonged withdrawal from specific areas of teaching, it is expected that the trainee take appropriate action. Trainees will be required to discuss this with their Clinical Tutor at the earliest opportunity, who can then arrange for them to be exempted from teaching activities, and who will also discuss the most suitable strategies for managing the situation.
In practical terms, trainees who find themselves distressed during a lecture or a workshop are entitled to leave, but should do so as quietly as possible, returning if they feel able to, and if possible discussing their absence with the lecturer or workshop leader. Trainees who feel that a workshop task is too personally demanding are entitled not to participate, but should do so in an appropriately negotiated manner, discussing this with the workshop leader and notifying a member of the administrative staff (the withdrawal from teaching will be noted and may be discussed subsequently within the programme team in order to enhance support of trainees as well as review the teaching programme).
Disclosure of personal information
During academic teaching there should be no pressure on trainees to disclose personal information which they feel uncomfortable revealing and especially personal information which they do not see as relevant to the task of training. However, the nature of the programme means that discussion of personal feelings in relation to professional development is often appropriate and necessary, and there is an expectation that trainees will be open to discussion of these feelings if these are relevant to their clinical work and professional development.
Where there is a potential for, or an expectation of, discussion around personal feelings, responses or actions (for example, Personal Development and Reflection sessions, or Professional Issues Review and Reflection sessions), workshop leaders will ensure that appropriate 'ground rules' around the disclosure of personal information, and the confidentiality of this, are discussed and agreed with trainees.
Consenting to participate in clinical teaching
At the end of this document is a formal consent form. Signing it means that you acknowledge and accept the expectations set out above. Because these make it clear that there may be circumstances where you might wish to withdraw from clinical teaching, it should be clear that while you are consenting to participate in teaching this consent is not absolute, and includes the right to withdraw if there are good grounds for doing so.
You are not obliged to sign this form, but it may be a condition of your employment to do so, please check your contract with your employer. If you have any queries about it, you are free to discuss it and its implications with one of the Directors of the Programme.