title: Medical students' awareness of traditional Southwest Native American values during pregnancy: a randomized, controlled trial.
abstract: OBJECTIVE
  To determine if medical students' attendance at specialized prenatal clinics for Southwest Native American women would impact their awareness of and comfort in discussing traditional and unique values during pregnancy.
  
  
  METHODS
  In this unblinded, randomized trial, all 154 third-year students rotating consecutively on our obstetrics-gynecology clerkship consented to enrolling in this study. Participants were randomly assigned either to attend a high-risk prenatal clinic (rural or urban locations) for Native American women or to not attend (control group). Each anonymously answered a 20-question survey at the beginning and end of the clerkship about their comfort level and their awareness of patients' beliefs. A mixed model ANOVA was used to compare differences in scores between the groups while accounting for cluster effects in the study design.
  
  
  RESULTS
  Regardless of whether the clinic was rural or urban, students became much more comfortable than controls in talking with Native American women about their pregnancy (p < 0.005). This applied especially to discussions about patients' spiritual beliefs, taboos that may affect pregnancy, participation in tribal ceremonies and belief in traditional medicine. As compared with the control group, students assigned to either clinic became more aware of how spirituality played an integral role in pregnancy (p < 0.05).
  
  
  CONCLUSIONS
  Attendance at these specialized prenatal clinics enhanced medical students' comfort in talking with pregnant Native American women about the integrative roles of spiritual beliefs, tribal ceremonies and complementary medicine in their pregnancy outcome.
authors.affiliation: Department of Obstetrics and Gynecology, School of Medicine, University of New Mexico, Albuquerque NM 87131, USA. jlvaldez@salud.unm.edu
authors.forename: Jeanine L
authors.initials: JL
authors.lastname: Valdez
authors.forename: Lawanda
authors.initials: L
authors.lastname: Jim
authors.forename: Anne M
authors.initials: AM
authors.lastname: Fullilove
authors.forename: Ronald M
authors.initials: RM
authors.lastname: Schrader
authors.forename: Brittany B
authors.initials: BB
authors.lastname: Albright
authors.forename: William F
authors.initials: WF
authors.lastname: Rayburn
mesh_terms: D000554:Ambulatory Care Facilities; D001291:Attitude of Health Personnel; D001364:Awareness; D002982:Clinical Clerkship; D003469:Culture; D005260:Female; D006801:Humans; D007198:Indians, North American; D008297:Male; D011247:Pregnancy; D011295:Prenatal Care; D019035:Rural Health Services; D029181:Spirituality; D013337:Students, Medical; D014481:United States; D016549:United States Indian Health Service; D019037:Urban Health Services