Objective: Patients in outpatient Obstetrics and Gynecology (Ob/Gyn) practices have varying attitudes about interacting with medical students. At many of our ambulatory Ob/Gyn sites, provider team members (medical assistant, resident, attending) ask a patient at the beginning of a visit if they feel comfortable with a student being involved in their care. This practice can introduce bias and decrease patient autonomy. We sought to find a method for obtaining patient consent in the ambulatory OB/GYN setting for medical student involvement that allows for both patient autonomy and allows for learning opportunities for students.
Methods: We completed a literature review and found no clear examples of the best practices to ask patients their preferences for student engagement in their care. We subsequently held multiple focus groups with key stakeholders and brainstormed how best to elicit this information from patients.
Results: We created a short questionnaire administered via EMR prior to patient’s ambulatory Ob/Gyn visit. This allows patients to answer privately, without time pressure, and for all EMR users to see results. Patients are asked for consent to different aspects of the outpatient encounter, including history taking, general physical exam (eg, cardiac, abdominal), and intimate physical exam (eg, breast, pelvic).
Conclusion/ Discussion: It is important to balance patient autonomy and medical student education in every clinical setting, but especially in the ambulatory Ob/Gyn setting given the sensitive nature of exams. There is no clear best time or best way to approach patients about medical student involvement in their care. Further, there are often differences between the approach at resident vs. private clinics. Using a questionnaire administered via EMR prior to a patient’s visit is a potential way to provide patients more autonomy with making their decision about medical student involvement. Future directions will include assessing the results of the questionnaire and assessing the impact of the questionnaire on medical student education.
Topics: Faculty Development Seminar, 2023,
HannahConnor, MD; Taylor Streaty, BA; Holly Cummings, MD, MPH
