• University of Tennessee Medical Center Outside Learner/Observer Experience Registration

  • Thank you for your interest in participating as an Outside Learner/Observer at the University of Tennessee Medical Center. This is an observation only activity. Participants must review the Guidelines for Outside Learner/Observer prior to completing the below documentation. By completing the following information, outside learner/observer attests to being 18 years of age or older with high school diploma or successful GED requesting to participate at the University of Tennessee Medical Center in an educational experience or observership who is not enrolled in a health-related program through an "affiliated" educational institution.

    Note: This form should be completed before beginning the observational/educational experience and with each change of clinical area/sponsor.  If observation is extended or crosses calendar years, you will need to complete separate requests for each observation.  Requests for the upcoming year will be accepted beginning December 15th.

     

    If you have questions please contact:

    Donna Patty, MPS, BSN, RN-BC, Compliance Specialist 

    University of Tennessee Medical Center

    2121 Medical Center Way Suite 310

    Knoxville, TN 37920

    865-305-9116 (0ffice)

    865-305-6968 (Fax)

    dpatty@utmck.edu  

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  • Limit requested observation date to actual approved observance dates approved by the sponsoring care provided. Requests with exended dates may be delayed and require additional approval or require submission of additional Outside Learner/Observer Experience Registration form.  Research assistants and clinical liasions can request up to a maxium of six months.

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  • Vaccinations:

    If you are observing in a clinical area with patients you should receive the below vaccines to reduce the chance that you will get or spread vaccine-preventable diseases. We encourage you to be up-to-date with all recommended vaccines before you begin the observational experience. Documentation of the requested vaccines helps to ensure that observers understand our expectations to protect our patients, families and themselves. Failure to provide documentation may result in delay or unapproved experience. We reserve the right to request additional documentation regarding vaccination records as needed.

  • COVID-19 Vaccinations:

    COVID vaccine is encouraged for everyone, and we are happy to offer it to you free of charge through our vaccine clinic at the link below...

    https://vaccine1.utmedicalcenter.org/

     

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  • Declination of influenza vaccine will require outside learner/observer to wear a surgical mask during observational experience for the duration of flu season (typically October 1st-March 31st).

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  • Documentation of two MMR vaccines required OR positive titers for measles, mumps and rubella.

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  • Hepatitis B vaccination history is required for any observer in patient care areas.

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  • Documentation of three Hepatitis B vaccines required OR positive HbsAB titer.

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  • We cannot accept the history of the chicken pox as an indication of Varicella immunity.

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  • Documentation of two Varicella vaccines required OR positive Varicella titer. We cannot accept the history of the Chickenpox as an indication of immunity.

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  • All submissions must be reviewed for completeness and the requested experience/dates must be confirmed with sponsoring healthcare provider.  Please allow 5 days for review. An email request will be sent to the observer to address any incomplete information. Once all information is complete and confirmation of experience is approved, an email will be sent to observer/sponsoring healthcare provider regarding next steps.

  • Distribution of Form:

    Please print 3 copies of the completed form before clicking submit button.  

     

    • Copy to be maintained in departmental file
    • Copy to Human Resources if identification badge is required
    • Copy to outside learner/observer
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