Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore.
Maastricht University, Maastricht, The Netherlands.
Perspect Med Educ. 2024 Mar 12;13(1):182-191. doi: 10.5334/pme.1151. eCollection 2024.
School-level student support programmes provide students with pastoral care and support for academic, wellbeing and other issues often via a personal tutor (PT). PT work is a balancing act between respecting the confidential information divulged by students and doing what is expected in terms of accountability and duty of care. We aimed to explore how tutors manage this tension, with the aim of advancing understanding of student support programmes.
This qualitative study was informed by an Institutional Ethnography approach. We conducted 11 semi-structured interviews with PTs from one medical school in Singapore. We considered how they worked in relation to relevant national and institutional-level policy documents and reporting guidelines. Data collection and analysis were iterative.
We crafted two composite accounts to illustrate the dilemmas faced by PTs. The first depicts a PT who supports student confidentiality in the same way as doctor-patient confidentiality. The second account is a PT who adopted a more mentoring approach. Both tutors faced confidentiality challenges, using different strategies to "work around" and balance tensions between accountability and maintaining trust. PTs were torn between school and student expectations.
Fostering trust in the tutor-student relationship is a priority for tutors but tensions between confidentiality, accountability and governance sometimes make it difficult for tutors to reconcile with doing what they think is best for the student. A more nuanced understanding of the concept of confidentiality may help support PTs and ultimately students.
学校层面的学生支持计划通过个人导师（PT）为学生提供学业、身心健康和其他问题的关怀和支持。PT 的工作需要在尊重学生透露的机密信息和履行问责制和关怀义务方面取得平衡。我们旨在探讨导师如何应对这种紧张关系，以期深入了解学生支持计划。
本定性研究受机构民族志方法的启发。我们对新加坡一所医学院的 11 名 PT 进行了 11 次半结构化访谈。我们考虑了他们如何与相关的国家和机构层面的政策文件和报告准则相关联。数据收集和分析是迭代进行的。
我们精心制作了两个综合账户来说明 PT 面临的困境。第一个描述了一个以与医患保密相同的方式支持学生保密性的 PT。第二个账户是一位采用更指导方法的 PT。两位导师都面临着保密挑战，他们采用不同的策略来“解决”和平衡问责制与维护信任之间的紧张关系。PT 感到在学校和学生的期望之间左右为难。
在导师-学生关系中培养信任是 PT 的首要任务，但保密性、问责制和治理之间的紧张关系有时使 PT 难以协调他们认为对学生最有利的事情。更细致地理解保密性的概念可能有助于支持 PT，并最终支持学生。
