A proposed observer in the room

Setting: An outpatient review

A medical student has been offered an observation opportunity. The patient may decline without changing the supplied care plan.

Task

Explore the concern behind this opening: If I say no to the student, will you think I am being difficult?
Clarify the patient perspective using an appropriate follow-up, such as: How would you like us to handle the student observation?
Explain the supplied information and its limits in manageable sections.
Explore practical barriers and agree a workable next step from the supplied options.
Check the patient understanding and identify any unresolved question.

A proposed observer in the room supplied information

A medical student has been offered an observation opportunity. The patient may decline without changing the supplied care plan.
We can have the whole consultation without the student. Your earlier agreement does not prevent you changing your mind, and we do not need an explanation in front of them.
Yes, we can continue the same planned consultation without the student. I cannot undo information already heard, but we can stop further observation now.
I can ask the student to leave on your behalf without discussing your symptoms. We can then check that you are comfortable before continuing.
The clinical review follows the same supplied plan whether or not the student observes. Raise any further privacy concern during the appointment.

Fictional scenario information supplied for exam communication practice only; not medical guidance for real patients.