Purpose: The objective was to investigate the frequency and method by which patients consented to an exam under anesthesia (EUA) by medical students prior to gynecologic surgery at a major academic hospital.
Background: Pelvic exam under anesthesia is an essential component of gynecologic surgery. A consent process that addresses exams by medical students is ideal to protect patient autonomy and facilitate education.
Methods: After approval by Institutional Review Board, we conducted a retrospective review of all patients undergoing scheduled gynecological surgery at our institution pre-pandemic (July 1 to October 31, 2019). Data were abstracted using REDCap software. Descriptive statistics were used for data analysis.
Results: 606 patients (median age 47; 51% White, 40% Black, 9% other) underwent scheduled gynecologic surgeries, of which 128 were major abdominal surgeries, and 478 were minor or minimally invasive surgeries. 289 (48%) of patients were offered and signed an EUA consent form indicating that they would or would not permit medical student exam. 52% of patients were not offered this form preoperatively. Of oncologic surgeries, only 29% signed an EUA consent form, compared with 72% in the generalist division. For cases in which EUA consent was reviewed and signed with the patient, 87% of patients agreed to EUA by medical students.
Discussions: Not all patients are routinely consented for medical student pelvic EUA, but when consent is discussed, an overwhelming majority of patients do consent to EUA by medical students. All surgeons are encouraged to review and discuss this issue with their patients prior to surgery and to educate and recruit students into our specialty.
Topics: CREOG & APGO Annual Meeting, 2022, Resident, Faculty, Professionalism, Systems-Based Practice & Improvement, Interpersonal & Communication Skills, Practice-Based Learning & Improvement, GME, Quality & Safety, Advocacy,
Lakeisha Mulugeta-Gordon, MD, Hospital of the University of Pennsylvania; Catherine Salva, MD; Mary DeAgostino-Kelly, MD; Hannah Ryles, MD; Leigh Ann Humphries, MD
