Medical Student Attitudes on Explicit Informed Consent for Pelvic Exams Under Anesthesia

Medical Student Attitudes on Explicit Informed Consent for Pelvic Exams Under Anesthesia
Original Reports
Benjamin E Zuchelkowski, Soukaina Eljamri, Jill E McDonnell, Bhavya Varma, Natalie G Stern, Scott D Rothenberger, Kavita Shah Arora, Judy C Chang
Journal of Surgical Education, 17 January 2022
Abstract
Objective
To obtain an overview of medical student attitudes on the need for explicit consent for pelvic exams under anesthesia performed for educational purposes
Design
From February to October 2020, 201 medical students at a single medical school in the United States participated in a cross-sectional survey after completion of the obstetrics and gynecology clerkship. Outcome measures included endorsement of need for explicit informed consent for educational pelvic exams under anesthesia, and knowledge of informed consent processes for such exams.
Setting
University of Pittsburgh School of Medicine
Participants
Third- and fourth-year medical students
Results
Overall, 75% of medical students endorsed a need for explicit informed consent for educational pelvic exams under anesthesia, which extended to prostate, rectal, and breast exams under anesthesia. Additionally, 45% and 77% of these participants indicated that consent for educational pelvic exams under anesthesia should take the form of a separate signature line on the surgical consent form and/or a verbal form, respectively. Only 40% of students correctly identified institutional policy for obtaining informed consent for educational pelvic exams under anesthesia. Rotation with the oncologic surgical service (p = 0.02) and correct identification of institutional informed consent policies (p = 0.002) were associated with decreased perceptions of the importance of explicit informed consent for educational pelvic exams under anesthesia.
Conclusions
Medical students at the institution studied largely support explicit informed consent for educational pelvic and other sensitive exams under anesthesia, but a knowledge gap on institutional informed consent policy exists. Medical students support increased transparency and bodily autonomy. Due to the agreement of patients and medical students and the ethical rationale for this position, it may be appropriate for physicians and institutions to consider new processes of obtaining explicit informed consent for pelvic exams under anesthesia by medical students.