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Navigating Confidentiality Dilemmas in Student Support: An Institutional Ethnography Informed Study
Emmanuel Tan1,2, Grainne P Kearney3, Jennifer Cleland4
1Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore.
Perspectives on Medical Education
|March 18, 2024
Summary
Personal tutors (PTs) balance student confidentiality with accountability, facing challenges in maintaining trust. A deeper understanding of confidentiality is needed to better support tutors and students in academic wellbeing programs.
Area of Science:
- Medical Education
- Student Wellbeing
- Pastoral Care
Background:
- School-level student support programs offer pastoral care and address academic and wellbeing concerns, often through personal tutors (PTs).
- PTs navigate a complex balance between student confidentiality and institutional accountability/duty of care.
- Understanding how PTs manage these tensions is crucial for improving student support.
Purpose of the Study:
- To explore the challenges faced by personal tutors in managing student confidentiality.
- To understand how PTs balance the tension between confidentiality and accountability.
- To advance the understanding of student support programs in medical education.
Main Methods:
- Qualitative study employing Institutional Ethnography.
- Conducted 11 semi-structured interviews with personal tutors (PTs) at a Singaporean medical school.
- Analyzed data iteratively in relation to national and institutional policies.
Main Results:
- Two composite accounts illustrated PTs' dilemmas, one prioritizing confidentiality like doctor-patient, the other a mentoring approach.
- Both PTs encountered confidentiality challenges, employing strategies to balance accountability and trust.
- PTs experienced conflict between school expectations and student needs.
Conclusions:
- Maintaining trust in the tutor-student relationship is vital.
- Tensions between confidentiality, accountability, and governance can impede tutors' ability to act in students' best interests.
- A refined understanding of confidentiality could enhance support for PTs and students.
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