An update on the project run in the Dentistry School by Barry Gibson, Jan Owens, Michelle Winslow, and Adrian Jowett.
Since receiving funding for the oral histories in dentistry project we have approached students about to go on outreach this year. Our initial contact with the students introduced the project as a pilot project designed to prepare the way to embed oral histories into the undergraduate dental curriculum in order for them to gain deeper insight into the diversity in people’s lives. We explained how outreach enabled them to come into contact with patients from a wide variety of backgrounds from across South Yorkshire and beyond and that we wanted to use that experience to enhance their own learning and those of their peers in the future. As a result a total of nineteen students expressed an interest in taking part which was very encouraging.
The main challenge subsequent to that was securing NHS research ethics approval and NHS governance. This process took some time because we not only had to fill out the NRes forms but provide structured information sheets, consent forms for patients and release forms for the oral histories and a fully worked proposal. We also had to ensure that patients had support after the oral history interviews in case something was unearthed that caused distress for the participant. We finally secured permission on the 31 of March 2015 and final R&D Approval a couple of weeks later. These approvals were very important to secure because the project is really at the pilot stage and it was necessary to make sure students had the correct documentation and training before contacting participants.
The initial plan for this work will be to get students to interview one of their peer’s patients, rather than one of their own. We thought about this process in depth and the reason why we decided to proceed in this way was because of professional ethics. We felt that there may be an issue with a student treating someone and then gaining their life history in a separate session. This level of intimacy may have interfered with the patient professional partnership and created an even larger power imbalance. Proceeding with an oral history interview with their own patient meant that there would inevitably be the blurring of professional boundaries and make it difficult for students to identify where they were being a professional delivering care and where they were becoming overly caring and too involved in the patient’s life. There was the potential of jeopardising the professional relationship the student may have with the patient and the more boundaries become blurred the greater the workload for the student, especially if the patient had a particularly traumatic oral history to impart. The potential for creating stress through witnessing emotional suffering for some patients would be a risk for some students. It also meant that making objective decisions about care would become even more difficult for the student and patients may view their student as a shoulder to cry on rather than someone to provide care.
We are currently in the middle of arranging for students who are still interested in participating to receive the necessary training in Good Clinical Practice at the Sheffield Teaching Hospitals Trust and training in oral history. To the credit of students, they have a very full curriculum to address and much of the extra work will be done in their own time. As part of this process we have offered to meet the students for a coffee to discuss the project over the coming month.