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It started with a kiss
  1. Nicola Kerruish1,
  2. Lynley C Anderson2
  1. 1Department of Paediatrics and Child Health, University of Otago, Dunedin School of Medicine, Dunedin, New Zealand
  2. 2Bioethics Centre, University of Otago, Dunedin, New Zealand
  1. Correspondence to Dr Nicola Kerruish, Department of Paediatrics and Child Health, University of Otago, Dunedin School of Medicine, Dunedin 9013, New Zealand; nikki.kerruish{at}

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A medical student attempting to carry out a procedure such as inserting a cannula within a paediatric setting faces complex issues. First, because the student lacks experience, he/she will understandably be nervous about carrying out the procedure. This is true for medical students in every clinical setting, but these feelings may be heightened in the paediatric context because the procedure may be technically more difficult and the child patient possibly unaware of the need for learning or the inexperience of the operator. Second, the student will be conscious that they are being observed by the child's parents, who while probably aware of the student's inexperience and supportive of learning goals, will also be anxious to minimise their child's distress.

Reflection on ‘difficult cases’ is a key component of a medical student's life, and this ideally continues post graduation. In this case, the student rightly suggests that the incident described may seem trivial to many, but we applaud the decision to submit the paper, as it highlights some important issues.

The student has also correctly identified that the child's distress was felt by all in the room, not least by the student themselves. The student in such a situation might understandably and appropriately wish to take action to reduce this distress. As they point out, this is part of ‘human …

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