The Impact of Obtaining Explicit Informed Consent for Medical Student Participation in the Pelvic Exam Under Anesthesia: A Qualitative Interview Study

The Impact of Obtaining Explicit Informed Consent for Medical Student Participation in the Pelvic Exam Under Anesthesia: A Qualitative Interview Study
Research Article
Hannah C Milad, Katie Watson, Patrick F Eucalitto, Ricky Hill, Alithia Zamantakis, Marlise Jeanne Pierre Wright, Adaeze A Emeka, Susan Tsai, Susan Goldsmit, Magdy P Milad
International Journal on Obstetrics and Gynecology, 26 September 2024
Open Access
Abstract
The pelvic exam under anesthesia (EUA) is an essential step in gynecologic surgery. Attending, fellow, and/or resident physicians utilize exam findings for surgical planning. Afterwards, medical students often perform this exam for their own learning; the student exam provides no direct clinical benefit to patients. Historically, consent for trainee EUAs was embedded within the surgical consent form. At one urban academic medical center, a written consent form specifically for medical student participation in the pelvic EUA was introduced. Our study examines patient, physician, and operating room (OR) staff perceptions of this new, explicit consent process between May 2021 and May 2023. Thirty-one (31) subjects including patients, OR staff, and physicians were interviewed and Northwestern University IRB approval was obtained. Our data suggest patients appreciated being asked to explicitly consent to or refuse the student pelvic EUA and having a dedicated consent form left them with a positive feeling about the hospital and their healthcare providers. OR staff and physicians agreed that the student pelvic EUA is necessary and almost all supported an explicit consent form. Physicians did not find the additional consent form burdensome and noted only a modest decline in learning opportunities. Patients and healthcare providers agreed that requiring explicit written consent for the student pelvic EUA respected patient autonomy, improved healthcare quality, and caused minimal disruption to medical education. Our data support the use of an explicit written consent form for student participation in the pelvic exam under anesthesia as standard practice.