Donʹt ask, donʹt tell: A change in medical student attitudes after obstetrics/gynecology clerkships toward seeking consent for pelvic examinations on an anesthetized patient

Objective:We explore whether the completion of an obstetrics/gynecology clerkship is associated with a decline in the importance that students place on seeking permission from the patient before conducting a pelvic examination while she is anesthetized. Study design:Students at five Philadelphia area medical schools (n = 401 students) were asked how important it would be for a patient to be told that a medical student will perform a pelvic examination while she is anesthetized. We examined associations between the completion of an obstetrics/gynecology clerkship and attitudes toward consent with the use of linear regression to adjust for gender and the total amount of clerkship experience. Results:After the data were controlled for gender and the total number of clerkships that had been completed, we found that students who had completed an obstetrics/gynecology clerkship thought that consent was significantly less important than did those students who had not completed a clerkship (P= .01). Conclusion:To avoid this decline in attitudes toward seeking consent, clerkship directors should ensure that students perform examinations only after patients have given consent explicitly. (Am J Obstet Gynecol 2003;188:575-9.)