Conscientious refusal in reproductive medicine: an educational intervention.
OBJECTIVE
This study evaluates an educational intervention focusing on the ethical reasoning and communication skills necessary in counseling patients about morally objectionable medical interventions.


METHODS
All students on the core clerkship in obstetrics and gynecology at the University of Miami Miller School of Medicine participated in a structured workshop. Students completed anonymous surveys before and after the workshop. Associations between the participants' change in comfort level in providing nondirective counseling and measured demographic variables were analyzed.


RESULTS
Of 140 students, 37% (n = 52) positively changed their comfort level with nondirective options counseling; 10% (n = 14) negatively changed. Change in understanding of the physician's role was reported by 60% (n = 84). The exercise was rated as educationally valuable by 95% (n = 128), with 84% (n = 115) attesting that the workshop would help them "approach things differently."


CONCLUSIONS
Evaluation of multiple parameters demonstrated that this workshop heightened student awareness of the ethical and communications skills challenges posed by this clinical situation.
Lupi
Carla S
CS
Department of Obstetrics and Gynecology, Miller School of Medicine, University of Miami, Miami, FL, USA. clupi@med.miami.edu
Estes
Christopher M
CM
Broome
Monica A
MA
Schreiber
Nicolette M
NM
D003142:Communication; D004501:Education, Medical; D005260:Female; D006801:Humans; D008297:Male; D016079:Refusal to Treat / Q000941:ethics*; D018456:Reproductive Medicine / Q000941:ethics*; D011795:Surveys and Questionnaires