Directive of the Faculty of Medicine, Masaryk University NO. 1/2016 RULES OF CONDUCT FOR STUDENTS PARTICIPATING IN CLINICAL EDUCATION AND TRAINING According to §28 par. 1 of Act no. 111/1998 Coll., on Higher Education Institutions and on Amendments and Supplements to some other Acts (The Higher Education Act) as amended (hereinafter referred to as “Higher Education Act”), I hereby issue this Directive. PART ONE Art. I Introductory Provisions 1. This Directive specifies duties and rules of conduct for students of the Faculty of Medicine, Masaryk University (hereinafter “FM MU”) when participating in clinical education and training in healthcare facilities. 2. Provisions of this Directive are consistent with the Study and Examination Regulations of Masaryk University, Act no. 111/1998 Coll. on the Higher Education Act, Act no 372/2011 Coll. on Healthcare Services and Act no. 258/2000 Coll. on Public Health Protection. 3. When applying this Directive, no discrimination or exclusion shall occur based on gender, age, race, language, origin, nationality, religion, or beliefs. 4. This Directive establishes: a. general rules of conduct of a student, b. basic rules for the relationship between a student and a teacher, c. basic rules for the relationship between a student and a patient, and d. penalties for not complying with these rules. Art. II GENERAL PROVISIONS 1. For the purpose of this Directive, a Student is defined as an active student of at least one specialisation at FM MU who participates in clinical training during his/her studies in the study programme taught at FM MU. 2. For the purpose of this Directive, a Teacher is defined as a person involved in teaching of students during their clinical training in a healthcare facility. 3. For the purpose of this Directive, Clinical Training is defined as any part of the study programme which takes place in any healthcare provider’s facility. Clinical training includes primarily clinical education, training, clinical placement over a university holiday and pre-graduation practice. 4. For the purpose of this Directive a Healthcare Facility is defined as a healthcare facility under Act no. 372/2011 Coll. on Healthcare Services in which the student carries out the clinical training. 5. For the purpose of this Directive a Patient is a natural person for whom healthcare services are provided in a healthcare facility where the student carries out clinical training. PART TWO Art. III GENERAL RULES OF CONDUCT FOR A STUDENT 1. The student is obliged to arrive for the clinical training on time according to the scheduled working time and to observe this working time. 2. The student is forbidden to leave the workplace during his/her participation in the clinical training. The student may only leave the workplace with the prior consent of the teacher. 3. The student is obliged to follow all hygiene rules and regulations which are required at the respective workplace where he/she carries out his/her clinical training, especially the Act no. 258/2000 Coll. on Protection of Public Health, to observe good hygiene practices for preventing the spread of infectious diseases, to attend clinical training when in a state of health and to undergo all vaccinations required for the respective workplace. 4. The student shall observe the general dress code typical of healthcare professionals and dress with respect to the dignity of the profession for which he/she is preparing to enter during his/her studies. The student is especially obliged not to wear any head covering, he/she shall wear a clean white laboratory coat and a readable name badge. The student shall groom, dress and act in a way so as to prevent the emergence and spread of infectious diseases and any damage to him/herself or his/her surroundings. 5. During the clinical training, the student shall wear clean personal protective equipment as required by the provider of healthcare services. The student shall not leave the premises of the provider of healthcare services wearing his/her personal protective equipment. 6. The name badge must be fastened onto the front of the clothing and must remain readable and clean. It must not hang loose. 7. Shoes must be specifically designed for working in hospitals and clean. 8. Hair and beard must be clean and trimmed. Longer hair (exceeding shoulder length) must be tied back. 9. The student shall not wear any jewellery items or watches on his/her hands and arms at workplaces where surgical or hygienic disinfection of hands is carried out. Nail treatment must not jeopardize the health of patients, especially with regard to possible spread of infections associated with healthcare, and must not impede the provision of healthcare in its entirety. Nails must be trimmed, short and clean. 10. Long earrings may pose a risk of injury to the patient and may also interfere with hygiene. They are inappropriate when providing care to a patient. Necklaces must not be long and must not enter the area designated for carrying out work. 11. Jewellery such as piercings in the nose, tongue, lip or eyebrow or any other areas should be removed at the workplace or secured in such a way that it will not be perceived negatively by the patients and personnel. 12. When entering and leaving the department, students shall wash and, if needed, disinfect their hands. Hygienic hand disinfection shall be carried out: a. prior to examining or treating of every patient, b. after every healthcare procedure carried out on a patient, c. prior to putting on gloves and after removing them. 13. Examination gloves shall be used by the student when: a. handling biological material, objects and tools contaminated with biological materials, including used clothes and linen and hazardous waste, b. using barrier nursing. 14. Further indications for use of gloves and washing and disinfecting hands will be determined by the teacher or healthcare professional. 15. Disposable protective personal equipment provided by the department (gloves, masks, disposable aprons, etc.) shall be put into the infectious waste right after the procedure. 16. The student shall disinfect the diaphragm of his/her stethoscope after examining every patient. 17. The student is forbidden from procuring prescriptions, medications and medical supplies without permission and from abusing such. Violation of this provision shall automatically be considered a particularly serious case of violation of this directive. Art. IV RELATIONSHIP OF A STUDENT AND A TEACHER 1. The student is obliged to educate him/herself in the individual branches of medicine and strive for deepening his/her professional knowledge and skills. 2. The student is obliged to follow all instructions regarding safety and health protection when working. He/she must be familiarized with all such instructions before starting the clinical training. 3. The student is obliged to respect and follow the teacher’s instructions and perform only such tasks that are part of the clinical training; these tasks should be carried out under the direct supervision of the teacher. The student may carry out tasks which are part of a healthcare procedure only upon a direct order from the teacher. 4. In the event that a student cannot perform a specific task for reasons of conscience, he/she is obliged to notify the teacher without delay. 5. In the event that a student learns of the occurrence of an event which has caused damage or may potentially cause damage to the student, another student, a patient, the healthcare facility, an employee of a healthcare facility and/or FM MU, he/she is obliged to notify the teacher or another responsible person of the occurrence of such event provided that it cannot be reasonably assumed that the teacher or another responsible person has already been made familiar with the case. 6. The teacher is obliged to maintain the confidentiality of information gained about students during the clinical training. 7. Teachers and students shall avoid any discriminating behaviour (especially based on race, gender, sexual orientation, religious belief and social status) towards all people with whom they come into contact during the clinical training. 8. The teacher is obliged to inform students about the potential risks of treating an infectious patient, necessary hygienic measures related to contact with such patients and other potential risks related to contact with infectious patients. Art. V RELATIONSHIP BETWEEN A STUDENT AND A TEACHER 1. The student is obliged to be considerate of the patient’s welfare and act on his/her behalf. 2. The student must not, intentionally or for its own sake, cause pain to the patient or any other damage to patient’s health or property. 3. The student is obliged to respect the autonomy of the patient’s will and his/her freedom of choice, especially to refuse that the student be present during a healthcare procedure, including consulting the patient’s medical records, to refuse to undergo a healthcare procedure and the right not to be informed about his/her state of health. 4. The student shall treat the patient correctly, with an understanding and patience appropriate to the patient’s age and intellectual maturity, and maintain his/her and the patient’s dignity and integrity. Students are prohibited from treating patients rudely, disrespectfully, or immorally. 5. The student must refrain, with regard to patients, from any demeaning activities which directly or indirectly consist of propagation or advertisement and the consequences of which are a campaign focused on broadening the customer base of any subject. It is also not allowed to initiate such activities via other people. 6. The student is obliged to maintain confidentiality about all facts he/she learns in relation to carrying out the clinical training, especially those about patients’ state of health. 7. The student is entitled to familiarise him/herself with the patient’s state of health and the consult patient’s medical records to the extent necessary for the purpose of the clinical training, unless the patient expresses his/her explicit disapproval. 8. The student must not carry patients’ medical records outside the area of the healthcare facility; the student is allowed to make copies and extracts from patients’ medical records but only with the patient’s consent and in an anonymous form. 9. The student is allowed to take any photographs of the patient and audio-visual recordings or photographs associated with the patient’s state of health only with the patient’s explicit consent. The student is allowed to make any audio-visual recordings or take photographs of healthcare professionals only with their explicit consent. The student must not publish such audio-visual recordings and photographs on social networks. Such photographs may continue to be used for the purpose of students’ work or publications in scientific literature with the patient’s consent. Unless the patient has specified otherwise, photographs shall be used only in an anonymous form in students’ works. PART THREE Art. VI PENALTIES 1. In the event that the student commits a serious breach of any of the provisions of this directive, the teacher is entitled to exclude that student for one day from the clinical training, during which for the purpose of fulfilling the study obligations the student shall be considered to be absent from the training for the whole day. 2. In the event that the student repeatedly commits a serious breach of any of the provisions of this directive, the teacher is entitled to exclude that student from the clinical training without providing an alternative date for the clinical training. A student excluded in this way shall receive a grade of F (Fail) for the subject under which the clinical training was carried out, in compliance with the Study and Examination Regulation of Masaryk University. 3. A severe breach of this Directive is considered to be a disciplinary offence according to the valid Disciplinary Code of the Faculty of Medicine, Masaryk University, and committing such a breach will be subject to the Disciplinary Commission of the Faculty of Medicine, Masaryk University. 4. A very serious breach of this Directive and related legislation shall be considered a criminal offence according to the Act no. 40/2009 Coll. of the Criminal Code and will be forwarded to the Police of the Czech Republic for investigation. PART FOUR Art. VII CONCLUDING PROVISIONS 1. The Study Department of the Faculty of Medicine, Masaryk University, is authorised to interpret the individual provisions of this Directive and update it. 2. Oversight of compliance with this Directive shall be carried out by the vice-dean for clinic study areas, vice-dean for preclinic study areas, vice-dean for stomatology, and the vice-dean for non-medical study areas. 3. This Directive enters into force on May 24, 2016. 4. This Directive takes effect on June 7, 2016. In Brno May 24, 2016 prof. MUDr. Jiří Mayer, CSc., m.p. dean of FM MU