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.

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.

Meditation buffers medical student compassion from the deleterious effects of depression.

2017 ◽  
Author(s):  
Jennifer S Mascaro ◽  
Sean Kelley ◽  
Alana Darcher ◽  
Lobsang Negi ◽  
Carol Worthman ◽  
...  
Keyword(s):  
Medical Student ◽  
Medical Students ◽  
Medical School ◽  
Well Being ◽  
Daily Functioning ◽  
Wait List ◽  
School Students ◽  
Social Emotions ◽  
The Face ◽  
Second Year

Increasing data suggest that for medical school students the stress of academic and psychologicaldemands can impair social emotions that are a core aspect of compassion and ultimately physiciancompetence. Few interventions have proven successful for enhancing physician compassion inways that persist in the face of suffering and that enable sustained caretaker well-being. To addressthis issue, the current study was designed to (1) investigate the feasibility of cognitively-basedcompassion training (CBCT) for second-year medical students, and (2) test whether CBCT decreasesdepression, enhances compassion, and improves daily functioning in medical students. Comparedto the wait-list group, students randomized to CBCT reported increased compassion, and decreasedloneliness and depression. Changes in compassion were most robust in individuals reporting highlevels of depression at baseline, suggesting that CBCT may benefit those most in need by breakingthe link between personal suffering and a concomitant drop in compassion

Culinary Medicine Training in Core Medical School Curriculum Improved Medical Student Nutrition Knowledge and Confidence in Providing Nutrition Counseling

2021 ◽  
pp. 155982762110217
Author(s):  
Christopher R. D’Adamo ◽  
Kayli Workman ◽  
Christine Barnabic ◽  
Norman Retener ◽  
Bernadette Siaton ◽  
...  
Keyword(s):  
Medical Student ◽  
Medical Students ◽  
Medical School ◽  
Patient Care ◽  
School Curriculum ◽  
Nutrition Knowledge ◽  
Medical School Curriculum ◽  
Nutrition Counseling ◽  
Patient Counseling ◽  
Culinary Medicine

Background: Elective culinary medicine education has become popular to help fill important gaps in physician nutrition training. The implementation and outcomes among the inaugural cohort of medical students who received culinary medicine training as a required component of medical school curriculum at the University of Maryland School of Medicine are described. Methods: Following a series of elective pilot sessions, culinary medicine training was provided to all first-year medical students in the 2019-2020 academic year. The 3-hour training included evidence-based nutrition lecture, cooking simple recipes, and group discussion of the application to personal and patient care. Pre-/postsession questionnaires assessed nutrition knowledge, skills, and attitudes as well as nutritional counseling confidence. Paired t-tests estimated mean differences in outcomes pre- and posttraining. Qualitative data were subjected to thematic analysis. Results: Overall, 119 of 125 (95.2%) students provided pre- and posttraining outcomes data. All nutritional and patient counseling outcomes improved ( P < .05). Themes of being better prepared to address healthy eating barriers in patient care and personal ability to make healthy dietary changes were noted in qualitative analysis. Conclusion: One session of culinary medicine training in core medical student curriculum was feasible and improved medical student nutrition knowledge, skills, and attitudes and confidence in patient nutrition counseling.

scholarly journals Survey of Osteopathic Medical Students Regarding Physician Shadowing Experiences Before and During Medical School Training

2019 ◽  
Vol 6 ◽  
pp. 238212051985204
Author(s):  
Erik Langenau ◽  
Sarah B Frank ◽  
Sarah J Calardo ◽  
Michael B Roberts
Keyword(s):  
Medical Student ◽  
Medical Students ◽  
Medical School ◽  
Patient Care ◽  
Student Experiences ◽  
Cross Sectional ◽  
Convenience Sample ◽  
Care Experience ◽  
Ensure Patient Safety ◽  
College Of Osteopathic Medicine

Introduction: Shadowing a physician is an observational experience which includes a student observing a licensed healthcare provider caring for patients. Shadowing is commonly done by students before and during medical school, but little is known about the nature or extent of these extra-curricular observational experiences. Objective: We hypothesized that shadowing experiences were common yet variable. We investigated the prevalence, nature, and perceived value of medical student experiences with shadowing physicians (both before and during medical school). Methods: This survey-based study was non-experimental with a cross-sectional convenience sample of osteopathic medical students about their shadowing experiences before and during medical school. The survey was sent to all matriculated osteopathic medical students (OMS1-4) for the 2017 to 2018 academic year from two medical schools: Philadelphia College of Osteopathic Medicine (PCOM) (1084 total students) and PCOM-Georgia (554 total students). The final survey instrument included three sections: demographics (6 questions), pre-medical shadowing experiences (21 questions), and medical student shadowing experiences (24 questions). Results: Respondents (357) identified themselves as OMS1 (96), OMS2 (89), OMS3 (73), OMS4 (95) and other (2, OMS5) with enrollment at PCOM-Philadelphia (242) and PCOM-Georgia (115). Among survey respondents, 339 (95.5%) reported shadowing a physician as a pre-medical student, and 110 (30.8%) reported shadowing (outside of their required clinical rotations) a physician during medical school. Requirements to participate were inconsistent; fewer than 50% of shadowing experiences required Health Insurance Portability and Accountability Act of 1996 (HIPAA) training, proof of vaccination, or purified protein derivative (PPD) documentation. In addition to observation, pre-medical and medical students, respectively, participated in history taking (44 [13%], 47 [42.7%]), physical examinations (45 [13.3%], 44 [40%]) and procedures (13, [3.8%], 20 [18.2%]) during their shadowing experiences. Motivations to participate in shadowing varied between pre-medical and medical student experiences, but both groups mentioned their desire to learn more about a particular discipline, obtain letters of recommendation, and gain patient care experience. Students recommended both pre-medical (273 [80.5%]) and medical school (93 [84.5%]) shadowing to future students. Conclusion: Shadowing remains a common and important tool for students to learn about patient care, medicine and careers. The nature of each shadowing experience and participation requirements are quite variable. Measures to ensure patient safety, confidentiality, liability and supervision are inconsistently applied. Promoting guidelines, as well as codes of conduct, for shadowing could serve as a helpful resource for students, academic advisors and supervising clinicians.

Fourth-Year Podiatric Medical Student Perspectives on Clerkships and Residency Selection

2018 ◽  
Vol 108 (4) ◽  
pp. 311-319 ◽  
Author(s):  
David W. Shofler ◽  
Kathryn Bosia ◽  
Lawrence Harkless
Keyword(s):  
Medical Student ◽  
Medical Students ◽  
Medical School ◽  
Online Survey ◽  
Learning Experiences ◽  
Residency Programs ◽  
Forefoot Surgery ◽  
Quality Of Learning ◽  
Attending Physicians

Background: The fourth year of podiatric medical school is an important period in the education of the podiatric medical student, a period that consists largely of month-long clerkships. Nonetheless, there has been limited formal study of the quality of learning experiences during this period. Furthermore, there is limited knowledge of how podiatric medical students evaluate residency programs during clerkships. Methods: An online survey was developed and distributed electronically to fourth-year podiatric medical school students. The focus of the survey was the quality of learning experiences during externships, and decision making in ranking residency programs. Results: The most valuable learning experiences during clerkships were interactions with attending physicians, interactions with residents, and general feedback in surgery. Students self-identified that they most improved in the following areas during clerkships: forefoot surgery, clinical podiatry skills, and rearfoot surgery. The areas in which students improved the least were research, pediatrics, and practice management. The three most important factors students considered as they created their rank list were hands-on resident participation in surgical training, the attitude and personality of the residents, and the attitude and personality of the attending physicians. A range of surgical interest was identified among students, and students lacking in surgical interest self-reported less improvement in various surgical topics. Conclusions: The perspectives of fourth-year podiatric medical students are currently an underused resource. Improved understanding can help residency programs improve the quality of associated learning experiences and can make their programs more appealing to potential residency candidates.

Medical student and psychiatrist perceptions towards a psychiatric career

2017 ◽  
Vol 22 (4) ◽  
pp. 315-323
Author(s):  
Thomas Flamini ◽  
Natasha R. Matthews ◽  
George S. Castle ◽  
Elliot M. Jones-Williams
Keyword(s):  
Medical Student ◽  
Medical Students ◽  
Medical School ◽  
Family Life ◽  
Design Methodology ◽  
Online Survey ◽  
Structured Interview ◽  
Structured Interviews ◽  
Content Type ◽  
Practical Implications

Purpose The purpose of this paper is to investigate perceptions towards a career in psychiatry among medical students and psychiatrists and identify how recruitment into the specialty may be improved. Design/methodology/approach This study locally compares medical student and psychiatric doctor responses to a structured online survey and structured interviews with key managerial figures in the Humber NHS Foundation Trust. Findings Comparison across two main areas (pre-decision exposure to psychiatry and reasons for considering a psychiatric career) found that both students and doctors were influenced to make a choice about a career in psychiatry during medical school. Medical students found compatibility with family life to be more important when considering psychiatry, whereas doctors cited content-based reasons as significant pull factors. Stigma and fear of being harmed deterred some students from choosing a career in psychiatry. Structured interview responses reiterated the importance of pre-medical school and undergraduate mentorship in bolstering future recruitment to psychiatry. Practical implications Medical students perceive certain career issues differently to their postgraduate counterparts. Widening the content-based appeal of psychiatry and optimising the medical school experience of the specialty via varied and high-quality placements may be a key step towards tackling the national shortfall in qualified psychiatrists. Originality/value This is the first published study comparing medical student and psychiatric doctor perceptions of a career in psychiatry.

scholarly journals A survey of communication skills teaching at medical school

2006 ◽  
Vol 88 (3) ◽  
pp. 84-86 ◽  
Author(s):  
Andrew Raftery ◽  
Particia Scowen
Keyword(s):  
Informed Consent ◽  
Medical Students ◽  
Medical School ◽  
Communication Skills ◽  
Undergraduate Education ◽  
General Medical Council ◽  
Skills Assessment ◽  
Medical Council ◽  
Surgical Practice ◽  
Essential Component

Communication is an essential component of surgical practice. Awareness of its importance is increasing among surgeons due to both the association between litigation and poor communication and recent requirements for obtaining informed consent. The General Medical Council has stated that medical students should have acquired and demonstrated their proficiency in communication by the end of their undergraduate education. Furthermore, communication skills assessment is now a pass/fail component of the intercollegiate MRCS examination of the surgical royal colleges.

scholarly journals Medical student exposure to cardiothoracic surgery in the United Kingdom

2019 ◽  
Vol 29 (2) ◽  
pp. 173-178 ◽  
Author(s):  
Marisa Gasparini ◽  
Shruti Jayakumar ◽  
Sarah Ayton ◽  
Marco N Nardini ◽  
Joel D Dunning
Keyword(s):  
Medical Student ◽  
Medical Students ◽  
Medical School ◽  
Cardiothoracic Surgery ◽  
Clinical Exposure ◽  
Medical Graduates ◽  
The United Kingdom ◽  
Area Of Interest ◽  
Before And After ◽  
School Curricula

Abstract OBJECTIVES There has been declining interest in cardiothoracic surgery amongst medical graduates. This survey examines the exposure of British medical students to cardiothoracic surgery in various settings and its relationship with students’ interest in the speciality. METHODS A questionnaire composed of 14 quantitative and qualitative items was distributed amongst 162 medical students. The survey included questions on demographics, interest in cardiothoracic surgery, mechanisms of exposure to the speciality and desire to pursue a career in cardiothoracic surgery before and after exposure. RESULTS Amongst the surveyed students, 71.0% reported exposure to cardiothoracic surgery as part of their medical school curricula and 24.7% reported extracurricular exposure. Of the students, 46.7% reported clinical exposure. Overall, 27.1% of students reported interest in a career in cardiothoracic surgery, which was higher amongst students who had curricular (29.6%), clinical (35.5%) or extracurricular exposure (50.0%). Amongst interested students, 43.2% engaged in extracurricular cardiothoracic activities compared with 16.1% of students not interested in pursuing the speciality. Confidence in career choice after exposure increased more in interested students (20.4%) than not interested students (1.6%). Students rated exposure and mentorship as the most important factor in promoting a career in cardiothoracic surgery. CONCLUSIONS Medical students with an interest in cardiothoracic surgery are more likely to organize independent attachments in the speciality and attend extracurricular events; however, many students might fail to identify cardiothoracic surgery as an area of interest because of the lack of exposure at medical school.

scholarly journals Closing the gap: a transatlantic collaboration to foster quality improvement training in graduate entry medical students using applications of QI methodologies to medical education

2019 ◽  
Vol 8 (3) ◽  
pp. e000610 ◽  
Author(s):  
Allison Brown ◽  
Seamus Sreenan ◽  
Alice McGarvey
Keyword(s):  
Quality Improvement ◽  
Medical Student ◽  
Medical Students ◽  
Medical School ◽  
Educational Programme ◽  
Small Scale ◽  
Educational Approach ◽  
Clinical Exposure ◽  
Canadian Medical School ◽  
International Partnership

The alarming prevalence of medical error and adverse events in the health system raises a call to action to ensure that doctors in training receive adequate training in quality improvement (QI). Training medical students in QI remains a challenge given time constraints, lack of clinical exposure, and already saturated curricula. In some instances, QI training may be delivered during clerkship through didactic, and in some instances, and experiential learning. Preclinical years of medical school remain focused on introducing students to scientific and clinical concepts, rarely do they learn about QI. The Program for Innovation in Scholarship and Medicine (PRISM) is a programme that introduces first-year medical students to the fundamentals of QI using their experience as a medical student as the context. PRISM is a condensed QI curriculum that is delivered through an international partnership, based on a previously piloted programme at a Canadian medical school. Following an introductory workshop, medical students work in teams to develop QI proposals (project charters) which detail how QI principles and tools can generate small-scale improvements within their educational programme. Project charters are assessed by a team of faculty and upper year students, who have previously participated. On completion of the programme, students demonstrated increased knowledge, skills, and attitudes towards QI. Programme participants were satisfied with the structure and expectations of PRISM and expressed a newfound interest in QI. Nearly all participants would recommend PRISM to another medical student. In conclusion, PRISM serves as a resourceful, efficient educational approach for preclerkship students that provides an introduction to the concepts of QI in order for early trainees to build on baseline knowledge and skills throughout their training.

Psychometric properties of the Medical Student Well-Being Index among medical students in a Malaysian medical school

2013 ◽  
Vol 6 (1) ◽  
pp. 60-65 ◽  
Author(s):  
Muhamad Saiful Bahri Yusoff ◽  
Mohd Jamil Yaacob ◽  
Nyi Nyi Naing ◽  
Ab Rahman Esa
Keyword(s):  
Medical Student ◽  
Medical Students ◽  
Medical School ◽  
Psychometric Properties ◽  
Well Being
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