American Journal of Obstetrics & Gynecology
Volume 188, Issue 2 , Pages 575-579, February 2003

Don't ask, don't tell: A change in medical student attitudes after obstetrics/gynecology clerkships toward seeking consent for pelvic examinations on an anesthetized patient☆☆

Ann Arbor, Mich, Philadelphia, Pa, and College Park, Md

From the Veterans Affairs Health Services Research and Development Center of Excellence, Veterans Affairs Ann Arbor Healthcare System,a the Division of General Internal Medicine, University of Michigan,b the Program for Improving Heath Care Decisions,c the Division of General Internal Medicine, University of Pennsylvania School of Medicine,d and the Department of Pediatrics, University of Maryland.e

Received 18 April 2002; received in revised form 3 July 2002; accepted 19 August 2002.

Abstract 

Objective: We explore whether the completion of an obstetrics/gynecology clerkship is associated with a decline in the importance that students place on seeking permission from the patient before conducting a pelvic examination while she is anesthetized. Study design: Students at five Philadelphia area medical schools (n = 401 students) were asked how important it would be for a patient to be told that a medical student will perform a pelvic examination while she is anesthetized. We examined associations between the completion of an obstetrics/gynecology clerkship and attitudes toward consent with the use of linear regression to adjust for gender and the total amount of clerkship experience. Results: After the data were controlled for gender and the total number of clerkships that had been completed, we found that students who had completed an obstetrics/gynecology clerkship thought that consent was significantly less important than did those students who had not completed a clerkship (P = .01). Conclusion: To avoid this decline in attitudes toward seeking consent, clerkship directors should ensure that students perform examinations only after patients have given consent explicitly. (Am J Obstet Gynecol 2003;188:575-9.)

Keywords:  Informed consent, medical student, ethics

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 Supported by a career development award in health services research from the Department of Veterans Affairs (P. A. U.) and by the Annenberg Public Policy Foundation.

☆☆ Reprint requests: Peter A. Ubel, MD, Program for Improving Health Care Decisions, 300 N Ingalls, Room 7B20, Ann Arbor, MI 48109-0429. E-mail: paubel@med.umich.edu

PII: S0002-9378(02)71415-4

doi:10.1067/mob.2003.85

American Journal of Obstetrics & Gynecology
Volume 188, Issue 2 , Pages 575-579, February 2003