Aligning patient and physician views on educational pelvic examinations under anaesthesia: the medical student perspective

2020 ◽  
pp. medethics-2020-106473
Author(s):  
Sanjana Salwi ◽  
Alexandra Erath ◽  
Pious D Patel ◽  
Karampreet Kaur ◽  
Margaret B Mitchell
Keyword(s):  
Medical Student ◽  
Medical Students ◽  
Clinical Skill ◽  
Medical Community ◽  
Student Perspective ◽  
Physician Perspectives ◽  
Explicit Consent ◽  
Pelvic Examinations ◽  
Professional Guidelines

Recent media articles have stirred controversy over anecdotal reports of medical students practising educational pelvic examinations on women under anaesthesia without explicit consent. The understandable public outrage that followed merits a substantive response from the medical community. As medical students, we offer a unique perspective on consent for trainee involvement informed by the transitional stage we occupy between patient and physician. We start by contextualising the role of educational pelvic examinations under anaesthesia (EUAs) within general clinical skill development in medical education. Then we analyse two main barriers to achieving explicit consent for educational pelvic EUAs: ambiguity within professional guidelines on how to operationalize ‘explicit consent’ and divergent patient and physician perspectives on harm which prevent physicians from understanding what a reasonable patient would want to know before a procedure. To overcome these barriers, we advocate for more research on patient perspectives to empower the reasonable patient standard. Next, we call for minimum disclosure standards informed by this research and created in conjunction with students, physicians and patients to improve the informed consent process and relieve medical student moral injury caused by performing ‘unconsented’ educational pelvic exams.

Should medical students perform pelvic exams on anaesthetised patients without explicit consent?

2021 ◽  
pp. 147775092110704
Author(s):  
Chloe Bell ◽  
Nathan Emmerich
Keyword(s):  
Medical Student ◽  
Informed Consent ◽  
Medical Students ◽  
Medical School ◽  
Consent Process ◽  
Potential Harm ◽  
Explicit Consent ◽  
Subsequent Discussion ◽  
Pelvic Examinations

There have been many reports of medical students performing pelvic exams on anaesthetised patients without the necessary consent being provided or even sought. These cases have led to an ongoing discussion regarding the need to ensure informed consent has been secured and furthermore, how it might be best obtained. We consider the importance of informed consent, the potential harm to both the patient and medical student risked by the suboptimal consent process, as well as alternatives to teaching pelvic examinations within medical school. The subsequent discussion focuses on whether medical students should perform pelvic examinations on anaesthetised patients without personally ensuring that they have given their explicit consent. Whilst we question the need to conduct pelvic examinations on anaesthetised patients in any circumstance, we argue that medical students should not perform such exams without personally securing the patients informed consent.

scholarly journals Stigma towards psychiatry: correlating personal experience with existing literature

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S126-S127
Author(s):  
Jack Blake ◽  
George El-Nimr
Keyword(s):  
Medical Students ◽  
Medical School ◽  
Personal Experience ◽  
Clinical Placement ◽  
Medical Community ◽  
Prospective Students ◽  
Clinical Placements ◽  
Personal Experiences ◽  
University Life

AimsStigma towards psychiatry feels rife within medical school and this extends from university life into clinical placements. Mental health remains an unattractive area of medicine and is frequently regarded as subpar by other specialists. Against existing literature, this study compares the authors first hand experiences over the last five years within medical school to evaluate how representative their experiences of stigma in psychiatry are for the wider community and published literature. The study aims to inform the wider discussion on this topic and offer areas where intervention may yield a better perception and hence uptake of this specialism.MethodLiterature review relating to the topic was completed. Studies pertaining to medical students and/or educators views and experiences of psychiatric medical education and clinical placement were included for discussion. A reflection on the first author's specific experiences to date of psychiatry and his intent to pursue psychiatric career was conducted, with careful reference to existing literature. This allowed validating personal experiences in light of shared experience within the medical community in various national and international settings.ResultArguably, some non-psychiatric clinicians do inadvertently set the scene early in medical school for the stigma that is to be thrust upon students. This builds upon prospective students ranking psychiatry low for satisfaction, prestige and stating it to be a ‘pseudoscience’ or words to that effect. The lack of understanding from junior medical students of the role of the psychiatrist sees them associating psychosocial education as equivalent to psychiatry. This reinforces the idea of psychiatry being grounded in sciences other than anatomy, biochemistry, physiology and pharmacology. On clinical placement, there is little cross-speciality support for those students who want to be psychiatrists and sometimes even lost opportunities for those publically aspiring towards psychiatry. Placements in psychiatry give students a better understanding of psychiatry but this does not seem to significantly change their career aspirations and this is rather defined from the admission stages.ConclusionAfter comparing experience with literature, stigma towards psychiatry appears to be universal. It may be important to consider the types of students who are being attracted to medical school as currently students seem to have an intrinsic disinterest in psychiatry despite later becoming better informed through psychiatric placement. Culture is notoriously hard to change, particularly within medicine. This stigma exists both in the lay and medical communities with early potentially inaccurate lay views of psychiatry being validated and reinforced throughout medical school.

The role of ultrasound in modern medical curricula: A medical student perspective

2017 ◽  
Vol 31 (2) ◽  
pp. 200-201
Author(s):  
E. Neale ◽  
H. Spiers ◽  
H.N. Furness ◽  
T.L. Lewis
Keyword(s):  
Medical Student ◽  
Student Perspective ◽  
Medical Curricula

scholarly journals Teaching Pediatric Otoscopy Skills to the Medical Student in the Clinical Setting: Preceptor Perspectives and Practice

2020 ◽  
Author(s):  
Caroline Rose Paul ◽  
Alanna Higgins Joyce ◽  
Gary Beck Dallaghan ◽  
Meg Keeley ◽  
Corinne Lehmann ◽  
...  
Keyword(s):  
Medical Student ◽  
Medical Students ◽  
Online Survey ◽  
Clinical Teaching ◽  
Clinical Skills ◽  
Clinical Skill ◽  
Acute Otitis Media ◽  
The United States ◽  
Direct Patient Care ◽  
Barriers To Teaching

Abstract Background Acute otitis media (AOM) is the most frequent indication for antibiotic treatment of children in the United States. Its diagnosis relies on visualization of the tympanic membrane, a clinical skill acquired through a deliberate approach. Instruction in pediatric otoscopy begins in medical school. Medical students receive their primary experience with pediatric otoscopy during the required pediatric clerkship, traditionally relying on an immersion, apprentice-type learning model. A better understanding of their preceptors’ clinical and teaching practices could lead to improved skill acquisition. This study investigates how pediatric preceptors (PP) and members of the Council on Medical Student Education in Pediatrics (COMSEP) perceive teaching otoscopy. Methods A 30-item online survey was administered to a purposeful sample of PP at six institutions in 2017. A comparable 23-item survey was administered to members through the 2018 COMSEP Annual Survey. Only COMSEP members who identified themselves as teaching otoscopy to medical students were asked to complete the otoscopy-related questions on the survey. Results Survey respondents included 58% of PP (180/310) and 44% (152/348) of COMSEP members. Forty-one percent (62/152) of COMSEP member respondents identified themselves as teaching otoscopy and completed the otoscopy-related questions. The majority agreed that standardized curricula are needed (PP 78%, COMSEP members 97%) and that all graduating medical students should be able to perform pediatric otoscopy (PP 95%, COMSEP members 79%). Most respondents reported usefulness of the American Academy of Pediatrics (AAP) AOM guidelines (PP 95%, COMSEP members 100%). More COMSEP members than PP adhered to the AAP’s diagnostic criteria (pediatric preceptors 42%, COMSEP members 93%). The most common barriers to teaching otoscopy were a lack of assistive technology (PP 77%, COMSEP members 56%), presence of cerumen (PP 58%, COMSEP members 60%), time to teach in direct patient care (PP 46%, COMSEP members 48%), and parent anxiety (PP 62%, COMSEP members 54%). Conclusions Our study identified systemic and individual practice patterns and barriers to teaching pediatric otoscopy. These results can inform education leaders in supporting and enabling preceptors in their clinical teaching. This approach can be adapted to ensure graduating medical students obtain intended core clinical skills.

The Medical Student Experience in the Era of COVID-19: Reflections on the Transformation of Medical Education

2021 ◽  
Author(s):  
Aisha Terry ◽  
Janet Miller ◽  
Stephanie Rodriguez ◽  
Mairin Haley ◽  
Sivan Ben-Maimon ◽  
...  
Keyword(s):  
Medical Education ◽  
Medical Student ◽  
Medical Students ◽  
Focus Group ◽  
Education Reform ◽  
Personal Growth ◽  
Innovative Technology ◽  
Student Perspective ◽  
Student Wellness ◽  
Medical Education Reform

Abstract Phenomenon: The American medical student perspective on the coronavirus pandemic, particularly in terms of its effects on medical education and future curricular approach, is valuable. This study seeks to provide future physicians with a voice to share their personal experience with distance learning and suggestions for medical education reform in the era of COVID-19. Approach: A virtual focus group of medical students was conducted on April 30, 2020. Each student was asked to broadly and candidly reflect on their personal experiences relative to the COVID-19 pandemic, and to specifically expound upon how their personal growth and medical education has been impacted. Consent was obtained. Data was coded by key ideas and themes. The content of the discussion was analyzed. Findings: Seven third-year medical students attending a United States traditional school of medicine consented to participate. All participants provided extensive responses to the question. The focus group lasted for 2 hours. The group expounded upon five self-initiated themes: guilt, anxiety, self-awareness, volunteerism, and autonomy. Analysis of these themes from the context of medical student wellness and the future of medical curricula led to the conclusion that three general concepts should be emphasized in reforming medical education. Insights: The coronavirus pandemic has uniquely affected medical students. Their perspectives can inform medical education reform relative to curricular design and student wellness. Key concepts to consider include prioritizing routine virtual delivery of content through innovative technology, encouraging increased student autonomy and self-directed learning through less prescriptive schedules, and emphasizing reflection training and sharing.

Role of non-government organizations in engaging medical students in research

2017 ◽  
Vol 65 (3) ◽  
pp. 709-716 ◽  
Author(s):  
Branavan Manoranjan ◽  
Ayan K Dey ◽  
Xin Wang ◽  
Alexandra Kuzyk ◽  
Karen Petticrew ◽  
...  
Keyword(s):  
Medical Student ◽  
Medical Students ◽  
Research Training ◽  
Student Interest ◽  
Career Trajectory ◽  
Data Set ◽  
Government Organizations ◽  
Medical Student Research ◽  
The Impact

The continued decline in medical trainees entering the workforce as clinician-scientists has elevated the need to engage medical students in research. While past studies have shown early exposure to generate interest among medical students for research and academic careers, financial constraints have limited the number of such formal research training programs. In light of recent government budget cuts to support research training for medical students, non-government organizations (NGOs) may play a progressively larger role in supporting the development of clinician-scientists. Since 2005, the Mach-Gaensslen Foundation has sponsored 621 Canadian medical student research projects, which represents the largest longitudinal data set of Canadian medical students engaged in research. We present the results of the pre- and post-research studentship questionnaires, program evaluation survey and the 5-year and 10-year follow-up questionnaires of past recipients. This paper provides insight into the role of NGOs as stakeholders in the training of clinician-scientists and evaluates the impact of such programs on the attitudes and career trajectory of medical students. While the problem of too few physicians entering academic and research-oriented careers continues to grow, alternative-funding strategies from NGOs may prove to be an effective approach in developing and maintaining medical student interest in research.

Radiology Exposure in the Undergraduate Curriculum: A Medical Student Perspective on Quality and Opportunities for Positive Change

2017 ◽  
Vol 68 (3) ◽  
pp. 249-256 ◽  
Author(s):  
Kari L. Visscher ◽  
Lisa Faden ◽  
Georges Nassrallah ◽  
Stacey Speer ◽  
Daniele Wiseman
Keyword(s):  
Professional Development ◽  
Medical Student ◽  
Medical Students ◽  
Qualitative Study ◽  
Medical Curriculum ◽  
Student Evaluation ◽  
Positive Change ◽  
Student Perspective ◽  
Radiology Education

Purpose This article is a continuation of a qualitative study designed to explore how radiology exposures can impact medical student opinions and perceptions of radiology and radiologists. We focused on: 1) conducting a radiology exposure inventory from the perspective of the medical student; 2) student evaluation of the quality of the radiology exposures and suggestions for positive change; and 3) development of a framework to address the needs of medical students as it relates to radiology education in the undergraduate medical curriculum. Methods Research methodology and design for this qualitative study were described in detail in a previous article by Visscher et al [1] . Results Participants included 28 medical students; 18 were in medical school years 1 and 2 (preclerkship), and 10 were in years 3 and 4 (clerkship). Specific to the focus of this article, the data revealed 3 major findings: 1) multiple exposures to radiology exist, and they are received and valued differently depending on the medical student's stage of professional development; 2) medical students value radiology education and want their radiology exposure to be comprehensive and high quality; 3) Medical students have constructive suggestions for improving the quality of both formal and informal radiology exposures. Conclusions Performing a radiology exposure inventory from a medical student perspective is a useful way to explore how students receive and value radiology instruction. Medical students want a more comprehensive radiology education that can be summarized using the 5 C's of Radiology Education framework. The 5 C's (curriculum, coaching, collaborating, career and commitment) reflect medical students' desires to learn content that will support them in clinical practice, be supported in their professional development, and have the necessary information to make informed career decisions.

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